What is Gallbladder Disease?

Most people are familiar with gallstones. After all, roughly 10 to 15 percent of the population will develop gallstones at some point. But not all types of gallbladder disease involve stones. Learn more about these conditions and what to do if you think you might have one of them.

Types of gallbladder diseases

The gallbladder is a small sac located under the liver. It stores bile, which releases into the upper small intestine to aid with fat digestion. Gallbladder disease includes any condition that causes inflammation, infection, blockages or gallstones. Here’s a look at each one.

Gallstones (cholelithiasis)

Gallstones are small, hard deposits that form in the gallbladder. The process of gallstones forming is called cholelithiasis. Possible causes include too much cholesterol or bilirubin in your bile, or the inability of your gallbladder to empty properly.

About 90 percent of gallstones are asymptomatic. The remaining cases may cause the following symptoms.

• Sudden and rapidly intensifying pain in the upper right abdomen (biliary colic)
• Nausea or vomiting
• Pain lasting from several minutes to a few hours
• Episodes less frequently than once a week but at the same time of day each time they occur
• Episodes several hours after eating large or fatty meals

Common bile duct stones (choledocholithiasis)

Gallstones can pass from the gallbladder into the common bile duct, a condition known as choledocholithiasis. Symptoms of stones in the common bile duct are similar to gallbladder stones. Additional symptoms may also occur.

• Yellowish skin or eyes (jaundice)
• Dark-colored urine and light-colored stools
• Rapid heart rate and abrupt blood pressure drop

Common bile duct stones are responsible for most cases of pancreatitis, or inflammation of the pancreas, a potentially life-threatening condition.

Acalculous gallbladder disease

This condition is described as gallbladder disease without stones. The symptoms are the same as gallstones, yet doctors find no evidence of them. This problem often develops when the natural movements needed to empty the gallbladder don’t work well.

Gallbladder inflammation (acute cholecystitis)

A handful of people with symptomatic gallstones develop inflammation in the gallbladder, or acute cholecystitis. This occurs when stones or sludge block the bile duct. Symptoms are similar to the biliary colic common with gallstones, but the pain may be more persistent and severe. Fever and chills are also more likely in people with gallbladder inflammation.

Dysfunctional gallbladder (chronic cholecystitis)

A combination of gallstones and mild inflammation may lead to chronic gallbladder disease. In such cases, the gallbladder becomes stiff with scar tissue. Symptoms of a dysfunctional gallbladder include the following.

• Gas, nausea and abdominal discomfort after meals
• Chronic diarrhea (four or more times per day for at least three months)

Perforated gallbladder

Waiting too long to seek help for gallbladder disease can lead to a perforated or ruptured gallbladder. The pain may decrease temporarily once this occurs, but this is a misleading side effect because widespread abdominal infection occurs shortly afterward. Perforation of the gallbladder is most common in people with diabetes.

Fistulas

If an inflamed gallbladder adheres to and perforates nearby organs, a fistula may develop between them. This channel allows gallstones to pass into the small intestine, which may require immediate surgery.

Pus in the gallbladder (empyema)

A small percentage of people with gallbladder inflammation develop this condition. Empyema causes severe abdominal pain that may last for more than a week straight. Pus in the gallbladder can become life-threatening if the infection spreads.

Gangrene or abscesses

If gallbladder inflammation goes untreated, it may develop into an abscess or necrosis with possible gangrene. Men over age 50 with a history of heart disease are most at risk.

Blockages (gallstone ileus)

A gallstone blocking the intestinal tract is known as gallstone ileus. Patients over age 65 are most at risk. Depending on the stone’s location, surgery may be required to remove it.

Infection in the common bile duct (cholangitis)

A blockage in the common bile duct can lead to an infection. Antibiotics are highly effective, but only if administered immediately after the infection develops. If the cholangitis does not improve with antibiotics, surgery may be required to open and drain the duct.

Gallbladder cancer

A majority of patients with gallbladder cancer have gallstones. However, this cancer is quite rare, even among people with gallstones. Symptoms often don’t appear until gallbladder cancer is quite advanced. When they do, they may include the following.

• Weight loss
• Anemia
• Recurrent vomiting
• A lump in the abdomen

If gallbladder cancer is caught early, removing the gallbladder may be the cure. However, if the cancer spreads, other treatments may be required.

Benign growths (polyps)

Doctors may detect polyps during diagnostic testing for gallbladder disease. Small growths pose little to no risk, but larger ones should be removed to prevent cancer.
Inflammation and scarring in the bile duct (sclerosing cholangitis)

The cause of this rare disease is unknown, though younger men with ulcerative colitis are most at risk. Any polyps detected alongside this condition have a high likelihood of being cancerous.

Porcelain gallbladder

This term comes from the fact that calcified gallbladders look like porcelain on an X-ray. The condition is also associated with high cancer risk.

What to do if you think you have gallbladder disease

Asymptomatic gallbladder disease may not require treatment, and even symptomatic cases are rarely life-threatening. However, complications can occur if gallbladder disease is left unaddressed. That’s why you should visit a doctor right away if you experience any of these concerning symptoms.

• Abdominal pain lasting several hours
• Nausea and vomiting
• Fever or chills
• Jaundice
• Dark-colored urine and light-colored stools

These symptoms may occur if you have a gallbladder infection, inflammation or disease. Other digestive conditions share many of these symptoms, including pancreatitis, ulcers and appendicitis. Therefore, it’s important to seek an official diagnosis so you can pursue the proper treatment.

If you have a history of gallstones or other gallbladder problems, a primary care physician or urologist at INTEGRIS Health can help.