Gallbladder Disease

The gallbladder is a sac found beneath the liver. It stores the bile produced by the liver, which helps the body digest fatty foods. Bile is expelled from the gallbladder into the upper small intestine. While the gallbladder’s purpose is rather specialized, several varieties of disease can affect it. These diseases can lead to inflammation or infection of the organ, form stones, or even block the path of the gallbladder.

Cholecystitis
This condition arises when the gallbladder becomes inflamed. Should a gallstone become stuck in the bile duct, it can block the bile flow and contribute to a back-up. That back-up can cause swelling, pain, and other unpleasantness in the patient.

Gallstones
Gallstones are rock-hard bile deposits that can arise within the gallbladder. They can vary in size; some are no bigger than a grain of rice, while others can grow as large as a golf ball. Some patients may only develop a single gallstone, while others may harbor many. The most common approach to this condition, which has no signs or symptoms, is gallbladder removal surgery.

Chronic Acalculous Cholecystitis
This form of cholecystitis develops without gallstones, causing the gallbladder to function suboptimally. This variety of cholecystitis is far more common among critically ill patients or those recovering from a significant trauma or surgical procedure. These patients often complain of recurring sepsis and have likely had one or more instances of swift, harsh cholecystitis.

Gangrene and Abscesses Around the Gallbladder
Gangrene is tissue death as a consequence of insufficient blood flow. Abscesses are pockets of pus that can cause significant distress while they are active and risk even greater issues if they are pierced.

Polyps or Tumors
These may develop within the gallbladder itself or its connecting bile duct. The most immediate concern with such literal developments is that they can interfere with bile flow through your body.

Primary Sclerosing Cholangitis
This is a condition in which the bile ducts connected to the liver become inflamed and scarred, causing narrowing or blockage within those ducts. With a reduced or obstructed pathway, the bile within the body backs up and exacerbates liver damage.

How To Know If You Have a Gallbladder Disease

The most frequent symptom of gallbladder disease is intermittent pain, known as “biliary colic.” Usually, a patient will describe a steady sensation or gripping or gnawing pain isolated to the upper portion of the right abdomen, close to the rib cage. This pain can be severe and radiate to the upper back. Some patients may instead experience their biliary colic behind the breastbone. Nausea and vomiting are a frequent consequence.

Just 1-3% of patients with symptomatic gallstones will develop acute cholecystitis. Its symptoms are similar to biliary colic, but the pain from acute cholecystitis flares up more often and is more severe; pain within the upper right abdomen tends to be severe, constant, and linger for days. This pain frequently worsens when drawing in breath, and around a third of patients also express sensations of fever or chills. Much like with biliary colic, nausea and vomiting are also quite frequent with acute cholecystitis. Stones that become stuck in the common bile duct can cause many of the same issues as stones that hang around the gallbladder, including:

• Jaundice
• Darkened urine, lighter stools, or both
• Rapid heartbeat and sudden drops in blood pressure
• Fever, chills, nausea, vomiting, and severe pain in the upper right abdomen.

Diagnosing Gallbladder Disease

There are two main methods of discerning whether or not a patient has any gallbladder disease.

Blood Tests
These tests focus on the blood around the liver rather than the entire body. They may analyze the level of digestive amylase and lipase enzymes for inflammation. Alternately, they may take a holistic approach, observing the levels of different blood cells; a high white blood cell count is often a sign of infection.

Imaging Techniques Like Ultrasound
The earliest imaging techniques for gallbladder issues involved looking for gallstones with an X-ray; however, this has since fallen out of use due to limited viability. Ultrasound is a popular imaging method as the sound waves can help visualize where any obstruction or problem may be around the gallbladder. Magnetic resonance cholangiopancreatography is a form of MRI that focuses on analyzing the gallbladder for the issues. Lastly, endoscopic retrograde cholangiopancreatography (ERCP) involves running a tube down the throat, through the stomach and small intestine, then injecting dye; this dye then allows the gallbladder, liver, and pancreas to be visualized in an X-ray.

Treatment

If gallstones are discovered within your body or your gallbladder is not operating as it should, surgery is often the solution. Dr. Luciano Fiszer, MD, and the rest of the staff at Elite Surgical Miami can surgically remove these problems with either a laparoscopic procedure involving several small incisions or robotic assistance. Regardless of the approach taken, the good news for our patients is that both routes are low-intensity outpatient procedures. If you suspect that your gallbladder has been giving you problems and have undergone testing to confirm the issue, we would be thrilled to make your gallbladder issues go away. Contact us to book an appointment today.