Gallbladder problems usually arise from blockages in the tubes that allow the passage of bile between your liver, gallbladder, and small intestine. The gallbladder is a pear-shaped organ located below the liver. It stores bile, a fluid produced by the liver to digest fats. While the stomach and intestines digest food, the gallbladder releases bile through a tube called the bile duct. The duct connects the gallbladder and liver to the small intestine.

If something is obstructing the flow of bile through the bile ducts, your gallbladder is likely to cause problems. This is often a gallstone. Gallstones form when substances in the bile harden. Many gallbladder problems improve with the removal of the gallbladder.

What is Bile?

Bile is a greenish-brown alkaline fluid composed of waste products, cholesterol, and bile salts. While bile is not a digestive enzyme, bile salts function similarly by emulsifying large fat droplets. The primary function of bile in the digestive system is to break down fats. It is secreted from the gallbladder (where it is stored) and enters the small intestine in response to a hormone called cholecystokinin (released when food enters the small intestine from the stomach). When bile enters the duodenum (the first part of the small intestine), it improves the solubility and absorption of digested fat and also breaks down fat-soluble vitamins for absorption.

What is the Gallbladder? Where is the Gallbladder located?

The gallbladder is a small, pear-shaped hollow organ located just below the liver on the right side of the body. The gallbladder forms a reservoir to store the fluid known as bile, which is also referred to by its origin name “gall.” It is a muscular organ that contracts and forces bile through the cystic duct when needed. The main functions of the gallbladder are to store (produced in the liver), concentrate, and release bile into the digestive system.

What Does the Gallbladder Do?

The gallbladder serves the following purposes:

• To store and concentrate bile
• To respond to intestinal hormones (such as cholecystokinin) to empty and refill the bile reservoir
• To contribute to the regulation of bile composition (water content, bile salts, and more)
• To control the flow of bile into the small intestine
• To contract (gallbladder contraction to release bile into the bile ducts)

Gallbladder Diseases

Gallbladder problems are usually caused by blockages in the tubes that allow the passage of bile between your liver, gallbladder, and small intestine. The most common source of blockage is the formation of gallstones (cholelithiasis) when substances in the bile harden.

Common types of gallbladder diseases include:

Gallstones (Cholelithiasis): Gallstones form when substances in the bile, such as cholesterol, bile pigments, and calcium salts, create hardened particles that block the passage to the gallbladder and bile ducts. Gallstones can vary in size from as small as a grain of sand to as large as a golf ball.

Most of the time, gallstones do not cause symptoms. However, when gallstones block the cystic duct, which leads to the common bile duct or the bile ducts themselves, bile accumulates in the gallbladder, causing pressure, swelling, and pain. The pain caused by gallstones is known as biliary colic and typically occurs in the upper abdomen or sometimes under the right shoulder blade and increases.
Gallbladder Inflammation (Cholecystitis): When the gallbladder becomes blocked due to gallstones or other obstruction, it can lead to inflammation of the gallbladder, known as cholecystitis.

Cholecystitis can develop rapidly (acute) within a few hours or reoccur over a long period (chronic). Acute cholecystitis starts suddenly and typically causes severe pain in the upper abdomen that lasts for more than 6 hours. If left untreated, gallbladder inflammation can become severe.

Gallbladder Sludge: When bile remains in the gallbladder for an extended period, microscopic particles of bile can accumulate without forming stones, leading to the formation of gallbladder sludge. This sludge can eventually lead to the formation of gallstones or blockage of the bile ducts.

Gallbladder Cancer: Gallbladder cancer is a relatively rare disease. There are different types of gallbladder cancer. Gallstones are a common risk factor for gallbladder cancer.

Gallbladder cancer can spread from the inner walls of the gallbladder to the outer layers, then to the liver, lymph nodes, and other organs. The symptoms of gallbladder cancer may resemble those of gallstones.

Gallbladder Pain without Gallstones: Sometimes, people experience gallbladder pain even without a noticeable blockage in the bile duct. This pain can be caused by:

Sensitive bile duct or small intestine
Failure of the muscle between the bile duct and small intestine to work properly
Small, undetected gallstones passing through the ducts

Risk Factors for Gallbladder Problems:

• Being female
• Being 40 years of age or older
• Being overweight or obese
• High blood cholesterol levels
• Family history of gallstones
• Rapid weight loss
• Diabetes
• Consuming a high-fat or high-cholesterol, low-fiber diet
• Being pregnant
• Taking medications with high estrogen content
• Inactivity

Symptoms of Gallbladder Disorders

Gallbladder disorders share similar symptoms, including:

Pain: The most common symptom of gallbladder problems is pain. This pain typically occurs in the middle and upper right portion of your abdomen. It can be mild and intermittent or severe and frequent. In some cases, the pain can radiate to other areas of the body, including the back and chest.
Nausea or vomiting: Nausea and vomiting are common symptoms of all gallbladder problems. However, they can also cause digestive issues like acid reflux and gas.
Fever or chills: Chills or unexplained fever can indicate an infection. If you have an infection, you need treatment before it worsens and becomes life-threatening. If the infection spreads to other parts of your body, it can be life-threatening.
Chronic diarrhea: Having more than four bowel movements a day for at least three months can be a sign of chronic gallbladder disease.
Jaundice: Yellowing of the skin or jaundice can be a sign of a blockage or stone in the common bile duct. The common bile duct is the duct that goes from the gallbladder to the small intestine.
Unusual stools or urine: Light-colored stools and dark-colored urine are possible signs of a blockage in the common bile duct.

Prevention of Gallbladder Problems

What helps with gallbladder pain? The following tips can help reduce your risk of gallbladder problems, such as gallstones:

• Focus on fiber: Eat foods high in fiber, such as whole grains, vegetables, and fruits.
• Choose healthy fats: Opt for healthy fats like olive oil and fish oils.
• Limit sugary and fatty foods: Try to limit foods that are high in sugar, refined carbohydrates, or unhealthy fats.
• Maintain a healthy weight: Excess weight or obesity is a risk factor for gallstones. If you need to lose weight, plan for gradual weight loss.
• Lose weight gradually: If you need to lose weight, plan for gradual weight loss. Rapid weight loss can increase the risk of gallstones. Aim to lose 1 or 2 pounds per week.
• Stick to a regular eating schedule: Skipping meals or fasting can increase your risk of gallstones.
• Exercise: Research suggests that regular physical activity can reduce the risk of gallstones.

Gallbladder Diet

A balanced diet that includes various foods does not cure gallbladder stones, but it can help maintain overall health and control the pain caused by gallstones.
If you are experiencing gallbladder problems, adjusting your diet can be beneficial. Foods that can worsen gallbladder disease include:

• Foods rich in trans fats and other unhealthy fats
• Processed foods
• Refined carbohydrates like white bread and sugar

Instead, try to structure your diet according to the following:

• Consume high-fiber foods such as beans, peas, fruits, whole grains, and vegetables.
• Reduce carbohydrate and sugar intake.
• Consume fats that are good for you, such as those found in fish oil and olive oil.

Diagnosis of Gallbladder Disorders

Laboratory and imaging tests are used to determine the type of gallbladder disease and identify any complications.

• Imaging tests of the gallbladder: Ultrasound and CT scans are commonly used to visualize the gallbladder.
• Tests to examine the bile ducts: These tests are used to determine if a gallstone is causing blockage in the bile ducts. Tests that check the bile ducts for stones include MRI and endoscopic
• procedures such as ERCP.
• Blood tests: Doctors may use blood tests to detect signs of infection, inflammation of the bile ducts, or other complications caused by gallstones.

Treatment of Gallbladder Disorders

Gallbladder stones that do not cause symptoms serve as a warning for potential future gallbladder problems and do not require urgent treatment.
Gallbladder disorders that cause symptoms or infections require treatment.

Treatment options include surgical removal of the gallbladder (cholecystectomy), medications to dissolve gallstones, and antibiotics to treat infections. Laparoscopy, known as cholecystectomy, is the preferred method for surgical removal of the gallbladder, involving the placement of surgical instruments and a small video camera through several small incisions.

When to See a Doctor?

Symptoms that should prompt you to seek medical attention include:

• Right upper quadrant pain that does not subside within 5 hours
• Fever, nausea, or vomiting
• Changes in bowel movements and urination

This combination of symptoms may indicate a serious infection or inflammation that requires urgent treatment.