Most of us probably don’t think about our gallbladder very often. It is there, and it quietly does its job, and doesn’t usually get much attention unless it stops working right. When that occurs, it can get your attention very quickly, as gallbladder disease can be quite acute and painful in some cases. Let’s discover together what we can do to help keep this “cousin” of the liver in top operating condition.
What is Gallbladder Disease?
Gallbladder disease is a family of disorders that affect the gallbladder, an organ located near the liver. The main purpose of the gallbladder is to store and concentrate a substance produced by the liver called bile. Bile is held in the gallbladder until it is needed by the intestinal tract to help digest fats. Anything that interferes with the operation of the gallbladder or interrupts the transport of bile from the gall bladder can come under the heading of gallbladder disease. The majority of gallbladder disease is one of two types: Cholecystitis (inflammation of the gallbladder) or cholelithiasis (gallstones). These are two distinct disorders, and they can exist independent of one another, but about 95% of the time, a person with an inflamed gallbladder has gallstones, and a person with gallstones will have an inflamed gallbladder. Gallbladder disease is quite common, and in the early stages most folks don’t even know they have gallstones. They are twice as common in women as they are in men, and most cases of gallstones are found in people between the ages of twenty to sixty. There is also a higher incidence of gallbladder disease in Mexican Americans and Native Americans than in the Caucasian American population.
If you did a survey of the average man or woman on the street, I doubt if many could give a good explanation of what the gallbladder does. Despite that fact, it plays a very important role in the mechanics of this amazing organism we call the human body. The gallbladder is small, especially when compared to its neighbor and business partner known as the liver, which happens to be the second largest organ in the body. It is shaped somewhat like a pear, and is linked to the liver, pancreas, and duodenum (first part of the small intestine) by a series of ducts. The liver manufactures bile, which is a greenish-brown fluid that is a conglomeration of bile salts, cholesterol, fatty compounds, and other chemical substances. From the liver, it travels through the bile ducts to be stored in the gallbladder until needed. While in the gallbladder, some of the fluid is removed, and the bile becomes thicker, and more concentrated.
When the intestinal tract senses the presence of food, it puts in a call to the gallbladder for some bile to help digest it. The higher the fat content of the food, the more bile that is needed. The gallbladder answers the call and squeezes out bile via muscular contractions, but before the bile reaches the duodenum, the pancreas gets in on the act as well. It sends secretions that combine with the bile to make it more effective as a digestive agent. This chemical stew helps to create the perfect pH environment within the duodenum for optimal digestion, and the bile also assists with the absorption of needed fats by the small intestine.
What Causes Gallbladder Disease?
The process described in the above paragraph sounds like a great system, doesn’t it? Well, like most or the functions of our bodies, it really is a fantastic arrangement. When it’s working right, it runs like a well-oiled machine. But gallbladder disease occurs when a problem(s) comes up that causes the system to fail to one degree or another. Most of the time that problem is called a gallstone.
Gallstones are solidified accumulations of bile pigments, cholesterol, and calcium. They form when any of the components of bile are not present in the correct proportion. They can also form if the gallbladder makes the bile too concentrated. These stones may then block the bile ducts that normally allow the bile to flow from the gallbladder towards the duodenum. When this happens, the bile begins to back up into the gallbladder and create pressure and inflammation. The muscles of the gallbladder still contract when signaled by the intestines in an attempt to send bile, but the “plumbing” is clogged, and the bile cannot exit the gallbladder. All of these factors lead to cholecystitis (inflammation of the gallbladder). In addition, the gallbladder can begin to swell, and bacterial infections may occur as well. This causes more inflammation, especially on the walls of the gallbladder. Due to this swelling and infection, parts of the gallbladder wall can be cut off from their blood supply, and the cells begin to die from lack of oxygen. This necrosis can further intensify the gallbladder disease.
Another possible result of gallstones is that they can block the ducts that carry the bile from the liver into the gallbladder. When this happens, a substance called bilirubin can begin to build up. Bilirubin, a waste product formed when the liver processes red blood cells (RBCs), is yellowish in color, and excess bilirubin in the blood will eventually cause the skin and whites of the eyes to turn yellow. This condition is known as jaundice, and is sometimes one of the symptoms of gallbladder disease.
Gallstones often grow slowly, and it may take years for them to start causing problems. A person can have one or hundreds of them, and they can vary in size from a grain of sand up to the size of a golf ball. Ouch! They also can take on different shapes, from smooth and round like a marble, to odd-shaped structures with multiple edges. Most gallstones are one of three varieties:
- Cholesterol gallstones: These are the most common, with about 80% being of this type. They are typically yellow, and mainly composed of undisolved cholesterol.
- Pigment gallstones: This type of gallstone is generally smaller, and dark brown or black in color. They often form in patients who have high amounts of bilirubin in their system.
- Primary bile duct stones: While most gallstones are formed in the gallbladder, and end up in the bile ducts, this type originates in the bile ducts themselves. These are the rarest type of gallstones.
One of the main reasons that gallstones form is because there is too much cholesterol present in the bile that the liver produces. This type of cholesterol, which the body produces, is different than dietary cholesterol which is known as blood or serum cholesterol. Taking dietary steps or medications to lower your blood cholesterol will have no effect on the amount of cholesterol your liver produces.
Other factors that can increase your risk for gallbladder disease include:
- Incomplete emptying of the gallbladder: This can occur when a person does not eat often enough or does not take in enough fat (typically not a problem in this country). Sometimes this will happen during pregnancy as well. When the gallbladder does not contract often enough, it will often fail to fully empty itself of bile, and this can be a factor in the formation of gallstones.
- Gender: Women have twice the rate of gallbladder disease, and the most likely reason for this is that one of the side effects of the hormone estrogen is increased amounts of cholesterol in the bile. Pregnancy, Hormone Replacement Therapy (HRT), and the use of birth control pills can all increase a woman’s chance of developing gallstones.
- Diet: Crash diets that are excessively low in calories and fat and encourage rapid weight loss will slow down the contractions of the gallbladder, and thus may contribute to the formation of gallstones. Dieting like this also can change the bile chemistry and create problems as well.
- Weight-loss surgeries: Persons who undergo gastrointestinal or bariatric surgery (sometimes called “gastric bypass” surgery) greatly increase their risk for gallstones. As many as one third of folks who have these surgeries will develop gallstones within three months.
- Obesity: Being even slightly overweight will tend to increase the amount of cholesterol in your bile, as well as decrease the percentage of bile salts and disrupt bile chemistry. Both of these factors increase risk for gallstones.
- Food Allergies: Certain food allergies are also known to encourage gallbladder disease. Common culprits include pork, onions, chicken, turkey, eggs, corn, beans, citrus fruit, nuts, and coffee.
What Are the Symptoms of Gallbladder Disease?
- Severe pain in the region of the liver/gallbladder is the most common symptom. It may be intermittent or constant.
- Worse pain with deep breathing
- Shallow breathing (due to pain), called “Murphy’s sign.”
- Increased respirations
- Increased heartrate
- Fever
- Nausea
- Vomiting
- Jaundice
Some rare, but serious, complications that can occur from gallbladder disease include:
- Massive infection of the gallbladder, causing it to fill with pus (empyema).
- Burst gallbladder, resulting in peritonitis,
- Blockage of the intestine by an abnormally large gallstone (gallstone ileus).
What is the Best Way to Prevent or Treat Gallbladder Disease?
Removal of the gallbladder is one of conventional medicine’s most favorite answers to gallbladder disease. In fact this procedure (cholecystectomy) is one of the most common surgeries in America. This can be a risky operation, especially if it is an advanced case of gallbladder disease. Sometimes infected gallbladders can be treated with antibiotics, but once the disease has progressed so far, recovery simply from antibiotic treatment is unlikely. The liver will compensate to a great degree by supplying needed bile, but many people have unpleasant side effects after surgery such as chronic diarrhea.
Obviously, the best cure is prevention of gallbladder disease in the first place. In addition to stabilizing your weight without using crash diets and avoiding foolish choices such as gastric bypass surgery, here are a few other preventative tips regarding gallbladder disease:
- Cut down or eliminate high fat foods, animal fats, and all fried foods.
- Eat a high-fiber diet. The best way to do this is eat lots of fresh and raw fruits and vegetables.
- Drink plenty of purified water
These are all things you should be doing anyway, so get on the wellness bandwagon, and you will avoid most of the diseases, such as gallbladder disease and many others, that plague us in this modern age.
