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What on Earth is a gallbladder?
The gallbladder is an interesting little organ located right beneath your liver. It looks kind of like the picture you see in this article but hopefully yours doesn't have all those stones. The gallbladder has one discernible function; it stores, concentrates, and releases bile into your small intestine when you eat food and need to digest fat.
Bile you say?
Yes, bile. Notice I didn't say that the gallbladder makes bile? It doesn't. Bile is made by the liver and it's used by the body to break down fat in the small intestine.
What are gallstones and how do I know if I have them?
Sometimes, the concentration process of bile creates stones. Up to 10% of people in the United States may have gallstones. Bile is composed of cholesterol and something called bilirubin (and other things), so when there is a strange balance in these substrates, stones can form. Most people that have gallstones do not know that they have gallstones!
Many times they are found incidentally by your doctor who was looking for something else. Especially if your doctor is doing an ultrasound of your abdomen for any reason. If your doctor finds gallstones in your gallbladder incidentally they may ask you the following questions: "Do you have pain in your right upper quadrant by your ribs? Does it hurt after you eat? Do you have any nausea or vomiting? Diarrhea?"
If you say no to all of those questions, you just have gallstones and it's probably not a big deal but you will want to follow up with your doctor at your regular intervals. Also, your doctor may call your gallstones cholelithiasis because that's the fancy doctor way of saying it.
So what if you don't say no to all those questions? Or you went to the doctor because you had pain in your right upper quadrant (RUQ) by your liver and under your lowest ribs?
Well, you might have something called biliary colic or cholecystitis (inflammation of the gallbladder, usually caused by gallstones causing obstruction to the flow of bile).
Dull pain in your RUQ after eating a meal (especially a fat-laden, decadent, delicious meal) that lasts for about 30 minutes (or sometimes much longer) and then goes away. Some people feel this pain at night or just randomly. Should you go see your doctor? Yes. Yes, you should.
Kind of like biliary colic but now it's not going away at all and you're getting super nauseous and you're vomiting. The pain is just there and it's worse than usual, maybe it's radiating to your right shoulder, and you kind of feel like you have a fever. This kind of pain usually warrants an ER visit and during your hospital stay, your doctors are going to advise you that you need your gallbladder out.
If I have gallstones, what should I do?
This is a conversation you will have with your doctor. General recommendations are as follows.
If you have incidental gallstones that do not cause any symptoms, there is no reason for surgery. Keep a healthy diet, be aware of your body, and follow-up with your doctor if you develop some of the symptoms described above. Most people that have gallstones DO NOT DEVELOP symptoms throughout their lives, so do not feel like gallbladder problems are imminent.
If you have biliary colic, it's important to go discuss this with your doctor and they will probably help you schedule an elective gallbladder removal (cholecystectomy) to prevent some more dramatic complications in the future. Again, if you have gallstones without symptoms, elective removal of the gallbladder has not shown any benefit.
If you're in the ER with cholecystitis, you shouldn't leave the hospital with your gallbladder (unless there's some other reason not to perform surgery which you'll discuss with your doctors).
How do they take my gallbladder?
Nowadays, gallbladder surgeries are done mostly laparoscopic (a minimally invasive option). Doctors make four small holes in your belly, put in a camera and a couple of graspers and they cut out the gallbladder. Surgery takes about an hour.
They took my gallbladder from me, what's going to happen? CAN I STILL EAT THE FOOD I LIKE?!
Yes. Yes, you can. At first, you will probably have some diarrhea regardless of what you eat for the first week or so. After that your tummy will normalize. As I mentioned above, your liver is actually the organ that makes bile, so your body will learn to compensate and your liver will be able to provide enough bile for you to enjoy the foods you love. However, it's probably not a bad idea to practice moderation just for your own health!
If you liked this article, look out for more of my stuff. My goal is to make some common medical occurrences understandable to the average person. I'm currently a 3rd year medical student and have been a part of the health care system for the last 4 years. I've found that sometimes in health care we don't do a great job of explaining what's going on in our patients' bodies and I'm here trying to bridge that gap.
Former Exercise Physiologist