Gallbladder disease/gallstones

The gallbladder is a small sac that lies under the liver. It is in the right upper part of the abdomen. The gallbladder stores bile, which is made by the liver. The bile helps to digest fats and helps the liver to get rid of certain waste products. The gallbladder is connected to the liver and intestine by tubes called ducts. After a meal, the gallbladder releases the bile into the intestine. Bile is made up of cholesterol, salts, and bilirubin. The bilirubin and cholesterol can form crystals that may become a stone. Stones may be as small as a grain of sand, or as large as a golf ball.

Inflammation of the gallbladder is called cholecystitis or gallbladder disease. About 90 to 95 percent of the time it is from gallstones. People who are most likely to have gallstones are:

• women over the age of 20
• men over the age of 60
• Native Americans
• Mexican-Americans
• overweight men and women
• people who fast or lose a lot of weight quickly
• pregnant women, and
• women on birth control pills or hormone replacement therapy

Sometimes people have gallstones and do not have any symptoms. They do not usually need treatment.

Pain is the common symptom of gallbladder disease. The pain is a severe pain in the right upper abdomen. It may also be felt between shoulder blades or under the right shoulder blade. It is usually sudden and severe. The pain can last from 15 minutes to several hours. There may also be vomiting or sweating. After the attack is over, there may not be one for a few weeks, months, or even years. The pain often starts after a meal that is high in fat.

It is thought that a stone blocking the duct causes the pain. If the pain lasts for several hours, the gallbladder may become inflamed. The pain will continue, and there may be a fever. A healthcare provider needs to be contacted. Usually the person with this kind of pain will be admitted to the hospital. No eating will be allowed and pain medicine, antibiotics, and intravenous (IV) fluids will be given.

More serious complications can occur if a stone passes out of the gallbladder duct into the main bile duct. The stone may block the duct, or move into the pancreas. Either of these may cause a more serious infection. The symptoms may include pain, fever and jaundice. Jaundice is a yellow color to the skin and eyes.

The main treatment of gallbladder disease is to remove the gallbladder. This can be done with a cut in the abdomen, or by using a lighted scope and making several small cuts in the abdomen. When a scope is used it is called a laparoscopy cholecystectomy. This is the most popular way to remove the gallbladder. There is less pain, and a shorter hospital stay.

If the person cannot have surgery there are some other ways to treat the gallstones. If there are just a few small stones, pills may be taken to dissolve the stones. Sound waves have also been used. With either of these methods, the stones will usually return.

It is not known for sure what causes stones to form. A diet that is high in fat and cholesterol, and low in fiber may increase the change of having gallstones.

A provider should be seen for any of these symptoms including pain in the right upper abdomen. It is important to remember that these symptoms are similar to the symptoms of a heart attack, so do not delay in seeking care.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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