A blockage in the gallbladder can cause severe pain and illness. Gallstones are a common cause. Gallbladder problems often need urgent action.

The gallbladder is an internal organ similar to a pear in size and shape. It is found under the liver in the upper right region of the abdomen. It stores bile, a compound produced by the liver to digest fat. It helps the body absorb fat-soluble vitamins and nutrients.

Severe pain and discomfort can result if a blockage occurs or if it stops functioning correctly, pain and discomfort can occur.

In this article, we look at the function of the gallbladder, some common gallbladder problems and their symptoms, treatment options, and the long-term outlook.

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Some common gallbladder problems include:

Gallstones (cholelithiasis)

Gallstones are solid masses of cholesterol or pigment. They can range from the size of a grain of sand to that of a golf ball.

They occur when high levels of fat and bile cause crystals to form. These crystals may combine over time and expand into stones.

Gallstones may or may not cause symptoms.

If symptoms occur, they include:

Anyone with symptoms of gallstones should seek medical attention immediately.

Common bile duct stones (choledocholithiasis)

Small tubes transport bile from the gallbladder and deposit it in the common bile duct. From there, it moves to the small intestine. Sometimes, gallstones can lodge or form in the common bile duct.

These stones usually start in the gallbladder and migrate to the common bile duct. These are secondary common bile duct stones.

A primary common bile duct stone is one that forms in the bile duct itself. They are less common but more likely to cause an infection than secondary stones.

Symptoms of common bile duct stones include:

  • pain in the upper right abdomen
  • jaundice
  • itching
  • pale stools
  • dark urine

Gallbladder cancer

Gallbladder cancer is rare but can spread to other parts of the body before diagnosis, making it difficult to treat.

Symptoms include:

Risk factors include gallstones, porcelain gallbladder, being female, obesity, and older age.

Inflamed gallbladder (cholecystitis)

Acute or sudden cholecystitis occurs when bile cannot leave the gallbladder, for example, when a gallstone or biliary sludge causes a blockage. Chronic cholecystitis is when there are recurrent acute attacks.

A blockage in the bile duct can cause bile to build up. The excess bile irritates the gallbladder, leading to swelling and infection. Over time, the gallbladder becomes damaged and can no longer function fully.

Perforated gallbladder

Without treatment, gallstones can lead to a perforated gallbladder or fistula. A hole develops in the wall of the gallbladder and allows leakage of fluids into other parts of the body. A severe, widespread infection can result.

Perforation can also occur as a complication of acute cholecystitis.

What is a gastrointestinal fistula?

Bile duct stricture or blockage

Bile duct obstruction refers to a narrowing or obstruction of the bile ducts. The most common cause of a blockage is gallstones, but cholangitis, an infection, can also cause it. Strictures can result from cancer and injuries that happen during tests or surgery.

Symptoms include:

  • nausea
  • vomiting
  • abdominal pain
  • jaundice
  • pale stools
  • weight loss and loss of appetite

Without treatment, strictures can lead to a blockage, and blockages can result in complications such as:

Bile duct infection (cholangitis)

An infection can develop if gallstones, a tumor, parasites, sludge, or other features block the common bile duct.

Possible symptoms include:

  • fever and chills
  • malaise, or a general feeling of being unwell
  • abdominal pain
  • jaundice
  • itching
  • pale stools and dark urine

Early treatment is essential to prevent the infection from spreading. If it spreads, there is a risk of sepsis, a life threatening infection.

What is primary sclerosing cholangitis?

Dysfunctional gallbladder or chronic gallbladder disease

Repeated episodes of gallstone attacks or cholecystitis may result in permanent damage to the gallbladder, leaving it rigid and scarred.

Symptoms can be hard to pinpoint but may include:

Gallstone ileus

Gallstone ileus is rare but can be fatal. It occurs when a gallstone migrates to the intestine and blocks it.

Sometimes, a gallstone passes out through the rectum without a person noticing, but some people will need emergency surgery to clear the blockage.

Symptoms include:

  • crampy abdominal pain that comes and goes
  • abdominal distention and tightness
  • nausea and vomiting
  • constipation

The symptoms may change as the stone travels through the digestive system. The severity of the pain will not necessarily reflect the impact of gallstones inside the body.

Gallbladder abscess

Sometimes, a patient with gallstones will also develop pus in the gallbladder. This is called empyema, and it is a complication of cholecystitis. If it becomes infected and inflamed, an abscess can develop.

Symptoms include pain in the upper abdomen.

Without treatment, it can lead to gangrene or sepsis, and a fistula may develop.

Individuals with diabetes, a reduced immune system, and obesity have an increased risk of developing this complication.

Porcelain (calcified) gallbladder

Porcelain gallbladder is a condition where, over time, the muscular walls of the gallbladder develop a buildup of calcium. This makes them stiff, limiting the gallbladder’s function and increasing the risk of gallbladder cancer.

Symptoms include pain in the upper right abdomen that radiates toward the shoulder blade.

There may also be digestive problems, such as:

  • nausea
  • vomiting
  • gas and bloating

Symptoms may be worse in the evening.

Treatment usually involves surgery to remove the gallbladder.

Doctors use the word porcelain because the organ becomes bluish and brittle.

Gallbladder polyps

Gallbladder polyps is a name for several conditions that involve polyps or projections in the gallbladder.

Often, there are no symptoms, and doctors find them by chance during imaging tests for another condition.

Most are noncancerous, but a person with polyps measuring 1 centimeter or more may have a higher risk of gallbladder cancer. Removing polyps through surgery can drastically reduce this risk.

If a person has another gallbladder problem, such as cholecystitis, they may experience symptoms such as abdominal pain. If polyps become cancerous and affect the hepatic bile duct, jaundice may occur.

Symptoms of gallbladder problems can depend on the condition but include:

  • pain in the mid to upper right abdomen that can range from mild to severe
  • nausea or vomiting
  • fever and chills
  • changes in bowel movements, such as diarrhea and pale stools
  • dark urine
  • jaundice
  • reduced appetite and weight loss

Anyone with gallbladder symptoms should seek medical attention.

Severe symptoms that need urgent attention include the following:

  • abdominal pain lasting several hours
  • fever and chills
  • nausea, or vomiting
  • changes in bowel movement and urination
  • light stools and dark urine
  • jaundice, which causes a yellowing of the whites of the eyes

These symptoms may indicate an infection or inflammation that needs immediate treatment.

Obesity is a risk factor for gallstones and other gallbladder problems. However, people should discuss weight loss plans with a doctor first, as rapid weight loss can increase the risk of gallstones.

A balanced diet can help boost overall health and well-being.

Opt for:

  • whole rather than processed foods
  • healthy fats, such as olive oil
  • foods without added sugar
  • high fiber foods, such as fruits, vegetables, and whole grains

What should I eat and avoid for a healthy gallbladder?

A doctor will ask about:

  • symptoms
  • personal and family medical history
  • dietary habits

They will also carry out a physical examination.

If they suspect a gallbladder problem, they may order the following tests:

  • imaging tests, such as an ultrasound or CT scan
  • tests to examine bile ducts, such as MRI, hepatobiliary iminodiacetic acid (HIDA) scans, and an endoscopic retrograde cholangiopancreatography (ERCP)
  • blood tests to look for signs of infection, inflammation of the bile ducts, pancreatitis, and other complications

Gallbladder problems are usually treatable, but prompt treatment is often necessary.

Gallstones that do not cause symptoms do not usually need immediate treatment, but a doctor will monitor them.

If an infection is present, a person may need antibiotics.

Some gallstone problems will need surgery, for example:

  • gallstones with pain and other symptoms
  • a tumor
  • a blockage
  • a porcelain gallbladder

In some cases, an emergency gallbladder removal will be necessary.

If surgery is not possible, a person may need gallbladder drainage with a tube. The doctor inserts a tube through the skin directly into the gallbladder.

The gallbladder is not an essential organ, and gallbladder removal (cholecystectomy) is a common type of surgery.

In most cases, surgery will be laparoscopic or “keyhole” with general anesthesia.

The surgeon inserts a thin tube with a tiny video camera into a small incision in the abdomen. The camera transmits images from inside the body to a video monitor. Using the monitor for guidance, the surgeon removes the gallbladder through one of the small incisions.

In many cases, the person can go home the same day and return to their usual tasks after around a week.

Some people need open surgery, for instance, if there is widespread infection, inflammation, or scarring from other procedures. They may need to stay in the hospital for up to a week. They can usually return to normal physical activity around one month later.

What to know about laparoscopic gallbladder removal

Risk factors will vary according to the condition, but having gallstones can increase the risk of other conditions.

People may have a higher risk of gallstones and gallstone-related problems if they:

  • are female
  • have obesity
  • are older
  • lose weight rapidly
  • take some medications, including birth control pills
  • have a family history of gallstones or certain genetic factors
  • have diseases such as cirrhosis, sickle cell anemia, and cystic fibrosis
  • have problems with the ileus, or small intestine

Here are some tips that might help prevent gallbladder problems

Here are some answers to questions people often ask about gallbladder problems.

What are the signs of gallbladder problems?

The symptoms will depend on the cause. Not everyone has symptoms, but there may be upper abdominal pain, nausea, vomiting, and jaundice. Some people may lose weight due to a loss of appetite. Some problems can cause a fever.

What are the most common gallbladder problems?

Common problems include cholecystitis — an inflammation of the gallbladder — and gallstones (cholelithiasis). Other possible problems are gallbladder polyps, cancer, and strictures or obstructions of the bile ducts.

Gallbladder problems include gallstones, infections, and blockages. There are different types of problems, but common symptoms include pain in the upper abdomen, nausea, vomiting, and jaundice.

Gallstones and other issues can lead to severe illness, and it is essential to seek help if symptoms appear.

In many cases, treatment will involve surgery. Many people have their gallbladder removed as an outpatient and go home the same day. A person can live without a gallbladder and have a good quality of life after recovery.

Read this article in Spanish.