The gallbladder is a small pear-shaped organ located just below the liver. It plays an important role in food digestion by storing bile produced by the liver and providing it to the small intestine where it breaks down fat. The gallbladder generally goes unnoticed unless a patient experiences symptoms of a disorder, such as gallstones. Gallstones are like grains of sand or small rocks that develop in the gallbladder as a result of bile becoming chemically unbalanced. Only about 60 percent of people with gallstones experience symptoms, as the stones can develop and pass through the gallbladder and intestines without causing symptoms. However, when a gallstone is large it may become caught in the passageways, or ducts, of the gallbladder, pancreas or liver, resulting in extreme pain and serious illness.
Gallstones generally fall into one of two categories, depending on the cause. Pigment gallstones develop when bile contains too much bilirubin, a naturally occurring chemical normally removed by the liver. Pigment gallstones generally develop in individuals with liver conditions such as cirrhosis or sickle cell anemia. Another type, cholesterol gallstones, comprises 80 percent of all gallstones and consists mostly of undissolved cholesterol. Because most gallstones result from high levels of cholesterol, diet plays a very important role in the prevention of gallstone development.
Diets high in fats and cholesterol are a main contributor to gallstone development. However, cholesterol levels in your bile do not always correspond to cholesterol levels in your blood, especially since cholesterol-lowering drugs do not prevent gallstones, even though they lower blood cholesterol levels. Crash diets that include too little fat, skipping meals, too few calories, rapid weight loss or going long periods without eating prohibit the gallbladder from emptying often enough or completely, increasing the risk of gallstone development.
In addition to diet, other risk factors for developing gallstones include gender, body weight, age and ethnicity. Women are more likely to develop gallstones because estrogen causes more cholesterol to be excreted in bile. Women who have high levels of estrogen in their bodies, such as those who are pregnant, taking birth control pills or on hormone therapy, are especially at risk. Overweight individuals may also have higher levels of cholesterol excreted into their bile. Individuals older than 60 years of age and those of Native-American and Mexican-American descent are also high-risk groups.
If gallstones develop and cause symptoms, medical intervention is necessary in order to avoid permanent organ damage. Symptoms of gallstones often include:
• Severe abdominal pain
• Pain that may extend beneath the right shoulder blade or to the back
• Pain that worsens after eating a meal, particularly fatty or greasy foods
• Pain that increases when you breathe in deeply
• Chest pain
• Heartburn, indigestion and excessive gas
• A feeling of fullness in the abdomen
• Vomiting, nausea, fever
• Shaking with chills
• Tenderness in the abdomen, particularly the right upper quadrant
• Jaundice (yellowing of the skin and eyes)
• Stools of an unusual color (often lighter, like clay)
Seek medical treatment immediately if you experience these symptoms, especially if accompanied by dark urine, fever, chills and/or yellowing of the skin and whites of the eyes, as this may indicate an obstructed bile duct. This can result in severe gallbladder infection or, rarely, gallbladder rupture, which is a potentially fatal condition. Gallstones are also a common cause of pancreatitis.
The most common treatment for gallstones is surgical removal of the gallbladder. This procedure is usually performed on an outpatient basis using the laparoscopic method, allowing most patients to return to normal activities within days. A person with a healthy liver can function normally without a gallbladder. However, lifestyle modifications such as limiting fat intake and increasing dietary fiber may be necessary for normal digestive function.
If you experience signs or symptoms associated with gallstones or fall into a high-risk group, contact your physician to discuss treatment options and ways to minimize your risk. It is important to seek medical care at the first sign of gallbladder attack or pain to avoid additional complications such as infections, duct obstructions, gallbladder rupture or pancreatitis.
This information is not intended to replace the advice of your doctor, but rather to increase awareness and help equip patients with information to facilitate conversations with their physician.
The top priority of most people who’ve passed a gallstone is to keep it from happening again. You can reduce the number of repeat episodes (and maybe even prevent them) by doing the following:
Have your gallbladder removed surgically before additional complications occur.
Watch your weight. An ideal body weight can help keep gallstones from forming. If you need to shed pounds, don’t lose too much too fast. Rapid weight loss increases gallstone production.
Reduce dietary fat and sugar. Both have been linked to an increased risk for gallstones. Instead, eat a diet rich in fruits and vegetables; vegetarians infrequently get gallstones.
Drink plenty of fluids. At least six to eight glasses of water a day will help you maintain the right water content for bile.
Stay regular. Eating fiber-rich foods is always helpful. For occasional constipation, use a bulk-forming laxative.
Exercise. Try to get 30 minutes of aerobic exercise—jogging, swimming, biking, brisk walking—at least three to five times a week.
Article courtesy of Affinity Medical Center. For more information, see their website at www.AffinityMedicalCenter.com.
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