Gallbladder disease, also known as cholecystitis, is when the gallbladder becomes swollen and painful.
This condition is typically due to a blockage in the gallbladder, like gallstones. It can cause nausea, vomiting, and pain on the right side of the abdomen. It typically occurs in people who are middle-aged.
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What Is Gallbladder Disease?
The gallbladder is a small, pear-shaped organ that sits just below the liver. It’s responsible for storing bile, a liquid that helps to break down fat in digestion.
Gallbladder disease, or cholecystitis, occurs when the gallbladder becomes inflamed, resulting in pain and swelling. This condition is usually due to a blockage of the gallbladder’s opening. In 95% of cases, that blockage is a gallstone.
Gallstones are solid pieces of bile made up of cholesterol and sometimes liver waste and calcium salts. Many people have gallstones, but most gallstones don’t cause blockages.
In rare cases, gallbladder disease is not caused by gallstones and instead is the result of an infection, injury, cancer, or an underlying health issue, like an autoimmune disease.
Most people who develop gallbladder disease are middle-aged. It is more common in women than in men, and women are at higher risk when they are pregnant.
Though several treatments exist for gallbladder disease, the most common and effective is surgery to remove the gallbladder. The organ helps with digestion, but it isn’t necessary for digestion, so you can live without it.
What are the types of gallbladder disease?
Gallbladder disease is typically sorted into four categories:
- Acalculous — This type of gallbladder disease is rare and caused by something other than gallstones, typically infection, injury, tumor, or an underlying health issue.
- Acute — Acute gallbladder disease is when the gallbladder becomes inflamed, causing severe pain and swelling, and needs to be treated right away.
- Calculous — This type of gallbladder disease is the most common. It occurs when gallstones block the opening to the gallbladder, leading bile to back up. This causes pain and swelling.
- Chronic — Chronic gallbladder disease happens when a person has many episodes of mild gallbladder pain over time. While the symptoms come and go, they can eventually lead to long-term inflammation of the gallbladder.
How common is gallbladder disease?
Gallbladder disease is very common. About 500,000 people have surgery each year in the United States due to gallbladder disease.
What causes gallbladder disease?
In 95% of cases, gallbladder disease is caused by a blockage of the gallbladder’s opening.
This blockage can happen due to:
- Gallstones — Gallstones are solid pieces of bile made up of cholesterol and sometimes liver waste and calcium salts. Many people have gallstones, but not all gallstones cause blockages and lead to gallbladder disease.
- Biliary sludge — Biliary sludge is a mix of bile and crystals. It is usually smaller than a gallstone.
Although rare, gallbladder disease can also be caused by:
- Infection.
- Injury.
- Cancer or tumor.
- Underlying health issues, such as an autoimmune disease.
Gallbladder disease risk factors
You are at higher risk of gallbladder disease if you are:
- Female — Women make up 60% of people who have acute gallbladder disease. Pregnant women are more likely than non-pregnant women to develop gallbladder disease.
- Middle-aged — Although it can occur in children, younger adults, and older adults, middle-aged adults are most likely to develop gallbladder disease.
- Overweight — People who are overweight, obese, or eat a diet high in saturated fat are at higher risk of developing gallbladder disease.
- Using a feeding tube or fasting — Those who require prolonged use of a feeding tube or who fast are both at higher risk of developing gallbladder disease. This is likely because both IV feeding and fasting can lead to higher cholesterol levels.
Complications of gallbladder disease
If you experience sudden and severe abdominal pain on your right side, nausea, and vomiting, you should see your medical provider right away. Left undiagnosed or untreated, gallbladder disease can cause serious complications, such as:
- Blockage of the small intestine.
- Chronic gallbladder disease, where mild symptoms of gallbladder disease persist and cause inflammation over time.
- Dead tissue and pus-filled sores in the gallbladder.
- Gallbladder infection.
- Gallbladder tear.
How can I prevent gallbladder disease?
These measures will not completely prevent gallbladder disease, but they can reduce your risk or help with symptoms:
- Manage your weight carefully. Obesity, sudden weight loss, and fasting all increase your risk.
- Reduce saturated fats.
- Stay hydrated.
What Are the Signs and Symptoms of Gallbladder Disease?
- Fever.
- Loss of appetite.
- Pain on the right side of your abdomen that may reach as high as your shoulder blade.
- Nausea.
- Vomiting.
When should I see a doctor about my gallbladder disease symptoms?
If you have severe pain on your right side, fever, nausea, or vomiting, you should see your provider right away. Many people will find that their symptoms ease after a few days, but if left untreated, gallbladder disease can cause serious complications.
How Do You Diagnose Gallbladder Disease?
Your provider will likely start with reviewing your medical history and discussing your symptoms. They'll also conduct an exam, including pressing on the abdomen to see where the pain is located.
If your doctor suspects you have gallbladder disease, you will likely need one or more tests to confirm the diagnosis.
Tests to diagnose gallbladder disease
- Blood test — A blood test can reveal signs of an inflamed gallbladder, such as high levels of liver enzymes in the blood.
- Hepatobiliary (HIDA) scan — During this procedure, a doctor or nurse will inject a small amount of radioactive chemical into the body. The scan then shows how the chemical flows through your liver and gallbladder.
- Ultrasound — This noninvasive and painless imaging test uses sound waves to create a picture of the gallbladder.
- X-ray or CT scan — If an ultrasound is inconclusive, your doctor may order one of these imaging tests to get a better picture of the gallbladder.
How Do You Treat Gallbladder Disease?
In most cases, doctors will remove the gallbladder. The risk of complications from gallbladder disease is higher than the risks of complications from surgery. If you are too ill for surgery, your doctor may suggest a different treatment.
Lifestyle changes
Your doctor is likely to suggest eating a low-fat, low-spice diet. This can reduce your risk of gallbladder disease, prevent a recurrence, or reduce symptoms after surgery.
Surgery for gallbladder disease
Gallbladder removal surgery is considered the most effective way to treat gallbladder disease. Your body can function without a gallbladder, and the risk of gallbladder disease complications is higher than the risk of surgery complications.
Doctors typically perform one of the following surgeries to remove the gallbladder:
- Laparoscopic gallbladder removal surgery — During laparoscopic surgery, doctors make several small incisions and use tiny surgical tools to complete the removal of the gallbladder. The liver and small intestine are then sealed off where they once met the gallbladder.
- Open gallbladder removal surgery — Laparoscopic surgery is done most often. However, sometimes surgeons will need to make one large incision to remove the gallbladder. This option often is chosen when imaging tests show the gallbladder may be difficult to remove or when the doctor needs to clean the abdominal area to prevent infection.
What happens during gallbladder disease surgery?
Whether you are having laparoscopic surgery or open surgery, you will need to be in a hospital under general anesthesia. You may not be able to eat or drink for several hours before your surgery.
During surgery, you will have an IV and breathing tube. Your doctor will remove your gallbladder and seal off the small intestine and liver where they once met the gallbladder. Surgery takes one to two hours.
After surgery, you will need to spend time in a recovery room.
Percutaneous cholecystostomy for gallbladder disease
If you are too ill for gallbladder surgery, your doctor may perform a percutaneous cholecystostomy to drain the gallbladder of bile. During this procedure, your doctor will insert a tube directly into the gallbladder using imaging techniques. Once you are healthy enough, your doctor will likely suggest surgery.
How effective is treatment?
When gallbladder disease is treated right away with gallbladder removal surgery, the outcomes are very good. Gallbladder removal is one of the most common surgeries performed in the country. It has a high success rate, with most patients experiencing quick relief from symptoms.
How long does it take to recover after gallbladder removal surgery?
If you are having laparoscopic surgery, you may be able to go home the same day you have surgery. Open surgery usually requires a night or two in the hospital.
For the first several days, you will likely be tired and sore. You may experience some nausea or diarrhea. You can typically return to normal activities after two weeks.
After the gallbladder is removed, you may have trouble digesting fatty foods. For this reason, doctors recommend eating a low-fat diet.
Why Choose UPMC for Gallbladder Disease Care?
At UPMC, you can expect:
- Access to new and innovative treatments — Research programs at the University of Pittsburgh Division of Gastroenterology, Hepatology, and Nutrition keep our specialists armed with the latest tools to combat digestive disease. Our research discoveries help to conceive the next generation of diagnostic methods and treatments, which are then put to the test in clinical trials.
- Top doctors — Our digestive health specialists and surgeons work as a team to create individual treatment plans for diseases of the gallbladder, bile ducts, esophagus, stomach, intestine, liver, and pancreas.
- Care close to home — At UPMC, we provide care to patients at more than 40 hospitals and 800 outpatient care sites in Pennsylvania, New York, and Maryland. That means you never have to travel far to receive the world-class care you need.
