Gallbladder Problems: Everything You Need to Know

Most of us don't give much thought to our gallbladders—until they become painfully plugged up.

Your gallbladder is like a little storage sac: It sits under your liver, collecting bile until the liquid is needed to help break down fats. After you eat fatty foods, your gallbladder contracts to pump bile into your small intestine for digestion, according to Medline Plus.

William Silverman, MD, Professor Emeritus of Internal Medicine - Gastroenterology and Hepatology at University of Iowa Health Care, told Health that when people develop a problem in this pear-shaped organ, it's typically one of two things: "Gallstones, which are incredibly common, or gallbladder cancer, which is exceedingly rare."

Read on to learn more about both.

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What Exactly Are Gallstones?

Gallstones form when substances in bile harden, per Medline Plus. The pebble-like lumps can form when there's an imbalance of substances in the bile. Gallstone attacks usually happen after you eat.

More than 25 million Americans have them—but most never even know it, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

When gallstones block the bile ducts of your biliary tract (which is made up of your gallbladder and bile ducts), the gallstones can cause sudden pain in your upper right abdomen. This pain is called a gallbladder attack, or biliary colic. If left untreated, gallstones can cause serious complications, per NIDDK.

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The Role of Female Hormones

According to NIDDK, women are more likely to develop gallstones than men.

Specifically people who have extra estrogen in their body due to pregnancy, hormone replacement therapy or birth control pills may be more likely to produce gallstones.

"During pregnancy you secrete the hormone progesterone in an increased amount and that decreases the gallbladder contraction," said Dr. Silverman. Bile lingering in the organ may become stagnant and stones may precipitate out.

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Who Else Is at Risk?

Certain populations are predisposed to gallstones, said Dr. Silverman, including the Pima Indians in Arizona. But most cases aren't related to genetics, added Dr. Silverman.

According to NIDDK, you are more likely to develop gallstones if you have obesity, especially if you are a woman, have had fast weight loss, such as from weight-loss surgery, or have been on a diet high in calories and refined carbohydrates and low in fiber

As per the NIDDK, you are more likely to develop gallstones if you have one of the following health conditions:

  • Cirrhosis, a condition in which your liver slowly breaks down and stops working due to chronic, or long-lasting, injury
  • Hemolytic anemias, conditions in which red blood cells are continuously broken down, such as sickle cell anemia
  • Some intestinal diseases that affect normal absorption of nutrients, such as Crohn's disease
  • High triglyceride levels
  • Low HDL cholesterol
  • Metabolic syndrome, which can also raise the risk of gallstone complications
  • Diabetes and insulin resistance

The majority of people who get gallstones don't have any of the major known risk factors, said Dr. Silverman. "That would suggest that there are many things that we still really don't understand."

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How Are Gallstones Treated?

Sometimes healthcare providers discover gallstones by accident while looking for something else. In that case it's generally best to leave them alone.

But if you're experiencing symptoms, your provider will likely suggest cholescystectomy—an operation to remove the gallbladder (which may be done laparoscopically), per NIDDK.

Fortunately, the organ isn't essential; once it's gone, bile will flow directly from your liver to your small intestine.

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Non Surgical Options

A healthcare provider may use the following types of nonsurgical treatments to remove or break up cholesterol gallstones, according to NIDDK.

Endoscopic retrograde cholangiopancreatography (ERCP) can be used to remove a gallstone that is stuck in the common bile duct.

In Oral dissolution therapy, ursodiol and chenodiol are medicines containing bile acids that can be used to break up gallstones. These medicines work best to break up small cholesterol stones and may require months or years of treatment to break up all stones.

Shock wave lithotripsy can be used to blast gallstones into small pieces. This procedure is ued rarely, and sometimes along with ursodiol.

In the slides ahead you'll find the most common signs of a gallbladder problem.

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Symptom: Pain in the Upper Right Abdomen

This is where your gallbladder is located, just beneath your liver. Sudden, extreme pain could mean that stones are causing a blockage: Your gallbladder may be contracting but unable to drain, "so pressure builds up and it hurts," said Dr. Silverman.

But there are many other reasons you might experience pain in this area, said Dr. Silverman, including muscle spasms. Call your healthcare provider for emergency advice.

Sudden, intensifying pain in your intestines—located in the center of your abdomen—could also be a sign of gallstones, per NIDDK.

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Symptoms: Fever and Chills With Abdominal Pain

A blockage by gallstones can cause a buildup of bile in the gallbladder, which may lead to an infection called cholecystitis. Cholecystitis happens when a digestive juice called bile gets trapped in your gallbladder, per Johns Hopkins Medicine.

Pain, chills, and a fever of 100.4 degrees or higher are classic symptoms, and may come on after a big meal.

There are a variety of ways to detect the problem, according to Johns Hopkins Medicine, including blood tests and a scan that tracks the flow of bile. If you're diagnosed, your provider will likely want to check you into the hospital.

The treatment might involve fasting, antibiotics, and pain meds until the inflammation subsides.

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Symptoms: A Change in the Color of Your Urine and Stools

Bile salts are what make stools brown. If you noticed that your number-twos are pale or clay-colored, that might indicate that a gallstone is blocking the bile duct.

Your urine can also provide a clue. When there is excess bile building up in the body, it can turn your pee a tea-colored, per NIDDK.

Yellowing of your skin and eyes may occur as well.

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Symptom: Yellowing of the Skin and Eyes

Jaundice can by a sign of gallstones, but when it's accompanied by abdominal pain and weight loss, it may be a symptom of gallbladder cancer, according to the American Cancer Society.

If a tumor is blocking the flow of bile, the yellow-brown fluid may build up in the body and give the skin and the whites of the eyes a yellow tint.

Keep in mind, though, that jaundice is caused more often by hepatitis than cancer. In any case, it's a good idea to see your healthcare provider right away.

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A Sign You May Need Your Gallbladder Removed

Gallbladder polyps are growths on the inside of the gallbladder wall show up on ultrasounds, often when providers are investigating unrelated problems, per UpToDate.

Most of the time, they're nothing to worry about. But people with big polyps have a higher risk of developing gallbladder cancer, said Dr. Silverman.

"I would emphasize that these are very large polyps, not tiny ones," said Dr. Silverman.

As a preventative measure, your healthcare provider may recommend gallbladder removal.

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What About Gallbladder Cancer?

People who have a history of gallstones or large polyps are more likely to develop gallbladder cancer—but even among this group, the risk is very small, per the American Cancer Society.

The American Cancer Society estimates there about 12,000 cases diagnosed per year.

Still, if you've dealt with gallbladder problems in the past and begin experiencing abdominal pain, bloating, itchiness, loss of fever, nausea, or unexplained weight loss, then make an appointment with your healthcare provider.

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