You may know the gallbladder is part of your digestive system, but what exactly does it do? And how do you know if you have gallbladder problems, such as gallstones or inflammation?
In this video, San Diego Health host Susan Taylor talks with Dan Giurgiu, MD, a surgeon at Scripps who specializes in minimally invasive laparoscopic and robotic surgery, about gallbladder conditions, symptoms and treatments.
The gallbladder is a pear-shaped organ about three to six inches long. It is located just below the liver and stores bile, a fluid produced by the liver that helps your body digest fat. When you eat, the gallbladder squeezes bile through a duct into your small intestine to help you digest your food.
Gallstones develop when bile hardens into solid formations that can range in size from a grain of sand to a golf ball.
What causes gallstones to form? In many cases, high-fat foods are to blame.
“I tell my patients that it’s often foods that they don't even suspect — good homemade chicken soup is very fatty. Certain vegetable oils are very high in fat content,” Dr. Giurgiu says. “You could be having a salad thinking that you’re eating healthy, but the dressing is very high fat content.”
Other gallstone risk factors include ethnicity, especially Mexican or Native American, gender, (women are at higher risk) and being overweight. High estrogen levels raise the risk, which is why gallstones are more common during pregnancy and in people who take medications that contain estrogen.
You may develop one gallstone or several. Small gallstones usually do not cause any symptoms or problems.
“Most people who have gallstones are what we call asymptomatic, meaning they have no pain whatsoever, and they never even know they have gallstones,” says Dr. Giurgiu. “But if the gallbladder starts to get filled with stones or a stone travels to the neck of the gallbladder, the duct can easily get clogged, leading to pressure building up inside the gallbladder.”
The rising pressure causes what is known as a gallbladder attack. Symptoms usually come on quickly and last for a few minutes to several hours.
Gallbladder attack symptoms include:
- Sudden, intense pain in the upper right or middle of your abdomen
- Sudden, intense pain between your shoulder blades or in your right shoulder
- Pain that increases very rapidly
- Yellowing of your skin or the whites of your eyes (jaundice)
- Nausea or vomiting
- Fever and chills
Because gallstone symptoms can be similar to heart attack symptoms, people sometimes think they’re having a heart attack when gallstones are the real problem. If you have these symptoms, especially severe pain, Dr. Giurgiu recommends going to the emergency room.
However, not all people with gallstone problems experience intense pain. You may feel abdominal discomfort after eating or wake up in the middle of the night with stomach pain that goes away after a short time. It’s important to tell your primary care doctor about these types of symptoms so they can test for gallstones, usually with ultrasound or other imaging methods, as well as identify other possible causes.
Without treatment, problematic gallstones can create more severe complications. Repeated gallbladder attacks can cause a condition called cholecystitis, which is inflammation of the gallbladder that can lead to infection. Another possible complication is gallstone pancreatitis or inflammation of the pancreas, which is very serious.
Surgery to remove the gallbladder, called cholecystectomy, is the usual treatment for gallstones and other gallbladder conditions. Medications may help dissolve the stones, but since they tend to recur, surgery is generally the preferred treatment. You can live without your gallbladder; the most common side effects are temporary changes in bowel function, such as diarrhea. Most changes can be managed with dietary changes.
In most cases, robotic cholecystectomy is often an option. Robotic technology can improve dexterity and precision, often allowing the surgeon to use minimally invasive surgical techniques even in more difficult cases. Typically, patients who have no infections or other complications can go home the same day.
“Early treatment of gallbladder problems with surgery can help prevent the ugly complications of infections and pancreatitis,” says Dr. Giurgiu. “If you have any chronic pain or symptoms, make an appointment with your doctor to get it checked out.”