About Gall Bladder Disease
Gall bladder disease is an often painful condition that can result in inflammation and serious infection if untreated. Gallstones are the culprit in gall bladder disease and although they can cause significant pain, it is not unusual for doctors to discover them when patients are being tested for other conditions. Gall bladder removal is the preferred method of treatment, although the type of surgery recommended will depend on the size and location of your gallstones.
-
Identification
-
The gall bladder looks a little like a pear and is located in the right section of the abdomen, below the liver. The gall bladder stores bile produced by the liver. During digestion, the gall bladder contracts and releases bile in the intestine to aid in the digestive process. Gall stones usually form from cholesterol found in the bile. Cholesterol crystals lump together to make up the masses that become gall stones. Gall stones can also be composed of calcium or bilirubin, or may be a mixture of cholesterol, calcium and bilirubin. When stones grow large enough, inflammation, infection and obstruction of the gall bladder ducts can occur.
Symptoms
-
Pain is the primary symptom of gall bladder disease. Pain is usually severe and can be felt on the right side of the abdomen or in the upper middle section of the abdomen. The pain may be recurring and you may notice it after eating. It may extend to your back and may feel worse after you take a deep breath. The pain may be particularly noticeable after you eat fatty foods. Other symptoms include fever, chest pain, heartburn, and nausea and vomiting.
-
Risk Factors
-
If you are a woman between 20 and 40 years of age, your chances of developing gall bladder disease are twice as high as the risk for men. Women produce increased amounts of estrogen during their fertile years, which increases cholesterol in the bile. Although young women are at a higher risk of developing gall bladder disease, most cases are diagnosed in people over age 40. Other risk factors include taking birth control bills and obesity and rapid weight loss. People with a high level of blood triglycerides are more likely to develop gall stones, as are people taking drugs to lower cholesterol. Cholesterol-lowering drugs result in more cholesterol being passed into the bile.
Diagnosis
-
Several diagnostic tools are used to diagnose the presence of gallstones. An abdominal ultrasound can be used to identify larger gall stones, thickened gall bladder walls and problems with ducts. An oral cholecystogram (OCG) is a special kind of X-ray used to determine if the gall bladder is contracting as it should and if there are stones present. While an ultrasound provides immediate results, OCG is helpful in diagnosing smaller stones that ultrasonography misses.
Computerized tomography (CAT) and MRI scans can also detect gallstones. If stones are confined to the ducts, endoscopic retrograde cholangiopancreatography (ERCP) may be necessary to confirm the diagnosis. During ERCP, the patient swallows a thin, flexible tube that is passed through the stomach until it reaches the bile ducts and pancreas. At this point, dye is injected throught the tube to make the stones visible when an X-ray is taken.
Treatment
-
In many cases of gall bladder disease, the preferred method of treatment is to remove the gall bladder. Removing the gall bladder does not have a significant impact on your life in most cases, as the body adjusts and places bile directly in the small intestine after the gall bladder is removed. Surgery can be done laparoscopically, through a small incision in the abdomen, or through an open surgical procedure.
Extracorporeal shock-wave lithotripsy (ESWL) can be effective in some cases, particularly if gall stones are stuck in the bile ducts. In this procedure, shock waves are aimed at the gallstones, breaking them into pieces. The pieces then drain into the intestine or are removed with an endoscope. In some cases, it is possible to dissolve small stones with medication. Medication is only effective in dissolving cholesterol stones and may be recommended for patients who are not in good enough health to undergo surgery.
-
