Gallbladder disease is a condition that describes a set of symptoms related to the functioning of the gallbladder. This disease affects women more than men. The gallbladder is an organ that can be found under the liver, its function is to store bile. Bile is produced by the liver and stored in the gallbladder until it is used to help the intestines digest fat.
The primary symptom of gallbladder disease is pain that begins after eating. The pain in the upper abdomen may be severe or mild. A serious case of gallbladder disease can present symptoms of nausea, fever, and jaundice.
Gallbladder disease is most commonly caused by gall stones. Other conditions that result in gallbladder disease are Cholestasis, biliary colic, gallbladder cancer and polyps. Gallstones are stones that form in the gall bladder from cholesterol, calcium and bile salts. They can be small or large. Gallstones are created when cholesterol levels are too high in the bile. The extra cholesterol produces crystals which grow into stones. Gallstones affect people of all ages, but are not especially common in young children.
Cholestasis is a blockage of the bile ducts, which can occur in the liver or in the gallbladder. Cholestasis can cause jaundice. Biliary colic is a gallstone blocking a bile duct. Acute or prolonged inflammation of the gallbladder is called cholecystitis caused by gallstones. The inflammation of the gallbladder is not caused by the stones themselves, but by bacteria that builds up in the gallbladder. Choledocholithiasis is when gallstones obstruct a common duct. This gallbladder disease is a medical emergency that causes liver cell damage and jaundice, requiring immediate endoscopic or surgical treatment. Ileus is a bowel obstruction caused by a large gallstone. In this case, a patient with chronic gallstone disease has developed a fistula from the gallbladder to the digestive tract. Large stones can then pass into the intestines and cause a blockage. The treatment is always surgical. This is a rare condition. Cancer of the gallbladder is rare and the prognosis is extremely poor. Small polyps in the gallbladder are rarely of concern. Polyps over 15mm have a risk of becoming cancerous and the gallbladder should then be removed.
The risks of developing gallstones are hereditary factors, obesity, high cholesterol, women on oestrogen(contraceptive) pills, patients with Crohn’s disease and ulcerative colitis.
Diagnosis of gallbladder disease involves a complete physical exam as well as patient history of symptoms. If blood tests determine that the liver function is normal, an ultrasound scan can be used to detect gallstones. If the ultrasound results are questionable, more refined imaging can be performed, either an MRI or a CT scan.
An oral cholecystogram is an imaging test in which x-rays are taken over a few hours. The evening before the test the patient ingests a tracer which will show up on x-rays. The function of the gall bladder will be indicated by the path of the tracer.
ERCP (endoscopic retrograde cholangio-pancreatography) is a test used to determine if a patient has gallstones in the bile ducts. An endoscope is snaked down the throat to the duodenum. The location of the bile duct is determined and a dye is injected into the duct. An X-ray will determine if the duct is blocked. During this procedure gallstones may be removed eliminating the need for surgery.
Gallstone with mild or no symptoms generally are not treated.
Dissolution therapy is used to dissolve gallstones. Some gallstones respond well to ursodeoxycholic acid, dissolving over time, though in most cases the gallstones return. To be a candidate for dissolution therapy, the patient’s gallstones should be small to medium sized and not show up on a typical X-ray.
Lithotripsy is a process used to treat a single gallstone in the gallbladder or bile ducts. This therapy uses sound waves to shatter the gallstone. The shattered stone pieces will need to be removed or treated with dissolution therapy. This therapy is used with kidney stones, but the pieces are able to pass naturally through the body.
Surgery to remove gallstones usually involves removing the entire gallbladder. This surgery is referred to as cholecystectomy. If only the stones are removed, it is likely that more stones will grow in the gallbladder.
Gallbladder removal has no lasting effects on the health of the patient, other than completely relieving the pain.
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