A guide to gallbladder disease

The gallbladder is a small, pear-shaped sac that is located under the liver that stores the bile produced by the liver. Sometimes it can get inflamed, infected, or form gallstones which can cause painful symptoms. In this article, consultant upper gastrointestinal surgeon Mr Tom Wiggins explains the characteristics of gallbladder diseases and how they can be treated.

What is the gallbladder?

The gallbladder’s purpose in the body is to store bile and release this to help break down fat and similar substances within the digestive system. When we start eating, the gallbladder contracts in order to release bile into the small intestine where it mixes with the food waiting to be digested.

What are the types of gallbladder diseases?

• Concentration of bile can cause crystals to form which can lead to gallstones. These are typically formed from bile salts or cholesterol and are small structures resembling gravel or small pebbles that form within the gallbladder. They are usually harmless and many patients with gallstones do not have symptoms. However, if symptomatic gallstones are left untreated they can cause significant pain or potential significant conditions.
• Biliary colic occurs when the gallbladder contracts around the stones which can cause debilitating pain which can occur repeatedly after eating and last for hours.
• Cholecystitis is where gallstones cause inflammation of the gallbladder and can lead pain, fever, and possibly sepsis. Typically, it is treated by surgery but may be treated with antibiotics in the first instance.
• Gallstone pancreatitis, which happens when a gallstone passes through the  pancreatic duct and can lead to significant inflammation. This usually requires in-hospital treatment and can be extremely serious.
• Obstructive jaundice, where a gallstone becomes lodged within the bile duct and can cause yellow discolouration of the skin. This would usually require removal from the bile duct prior to surgery.
• Biliary dyskinesia, where the gallbladder, does not contract in the usual manner and can lead to symptoms similar to gallstones even if they are not present.

What causes gallbladder disease?

Gallbladder diseases can affect adults of any age, and affects both female and male patients. They can form after periods of rapid weight loss due to bile salt crystallisation.  

How are gallbladder diseases treated?

When symptomatic gallstones go untreated patients can suffer severe pain which can significantly affect their ability to eat regular meals. Symptomatic gallstones typically require surgical removal of the gallbladder (laparoscopic cholecystectomy) but in the initial phases of acute cholecystitis doctors will prescribe antibiotics to treat the gallbladder infection. Unfortunately treatment of gallstones without removal of the gallbladder itself is not effective as there is a high risk of stones reforming or other complications. The gallbladder only stores bile which has been produced by the liver so removal of the gallbladder does not have a significant affect and bodily function should still be normal.

Laparoscopic cholecystectomy is typically recommended for patients with symptomatic gallstones. This procedure involves keyhole surgery to remove of the gallbladder under general anaesthetic using four small incisions within the abdomen. The vast majority of cases can be completed via this technique with only a small proportion of patients requiring open surgery (approximately 1%). A large proportion of patients can return home on the same day as surgery and expect full recovery within one to two weeks.

If you are having abdominal pain and believe you are suffering from gallstone issues, you can consult with Mr Wiggins via Top Doctors.