Gallbladder conditions

Q: What is the gallbladder

A: The gallbladder is an organ under the liver in the right upper abdominal area. IT is right under the right ribcage 

 Q: What is the function of the gallbladder

 A: The gallbladder concentrates and stores bile and it empties all during the day. The bile is made by the liver and exits the liver through a system of ducts that converge into one doctor to which the gallbladder duct attaches.  The bile enters the gallbladder to be concentrated and then exits during the day periodically. When we eat this emptying is more abrupt significant. A fatty meal tends to stimulate the gallbladder strongly to contract and empty. For that reason, we tell people before the gallbladder is removed to avoid fatty meals. That way we prevent gallbladder attacks or the exiting of a stone to the ain bile ducts. 

 Q: What are signs that the gallbladder is sick?

 A: The most usual presentation is upper abdominal pain or discomfort especially after a meal. It tends to be stronger after a fatty meal, but it can happen after any food. The pain or discomfort tends to be sporadic and comes in waves. At times it can be severe and move to the left chest and or back around the right side of the abdomen and flank. 

 Q: What are the conditions that cause the gallbladder to be sick?

 A: Two main reasons the gallbladder gets sick and needs to be removed are:

  1. Gallstones - these are small clusters of bile acids and salts that precipitate and get too big to come out of the gallbladder and block the ability of the gallbladder to empty. This causes pain and at times can cause infection of the gallbladder or even block the main bile ducts of the liver causing jaundice(yellow discoloration of the white of the eyes) and more serious conditions like pancreatitis. The gallbladder is removed to prevent these situations. Gallstones are usually diagnosed by ultrasound or CT scan.

  2. biliary dyskinesia- This is a big name for a condition that causes the gallbladder to contract abnormally and cause pain. There are no stones but through a test called a HIDA scan, we can determine if the gallbladder is abnormally contracting. This is a diagnosis by exclusion, meaning that we exclude other causes. Then the HIDA is done and if abnormal, we have 95% certainty that it is the cause of the pain and the gallbladder is removed.

Q: Is surgery the only way to treat a sick gallbladder?

 A: At this time it is the only way. Breaking the stones does not work as it does in the kidneys. Taking the stones out and keeping the gallbladder assures more stone formation and the gallbladder stops working well when cut open. since the gallbladder does not perform an important function, we remove it and this leaves no repercussions long term. 

 Q: What happens to the bile that was going into the gallbladder?

 A: The bile, which is made in the liver and transported by ducts arising in the liver, flows into the duodenum which is the part of the intestines that connects the stomach to the small bowel. The duodenum then will capture the extra water and perform the function of the gallbladder to preserve water and electrolytes.

Q: Are there any side effects associated with the removal of the gallbladder?

A: there is a small percentage of people that can experience an augmented urge to go to the bathroom after the gallbladder is removed and on occasions have diarrhea. this is likely due to the more watery bile reaching the intestines. IT is usually treated by taking Imodium before a heavy and fatty meal. These symptoms usually go away after a few months. 

Q: Will I gain or lose weight after gallbladder surgery?

A: There is no association with weight loss or gain after gallbladder removal.