General Surgery, HVMG
Problems related to the gallbladder are one of the most common causes of abdominal pain. Stones in the gallbladder are usually the culprit, but polyps in the gallbladder, stones in the main bile duct or sometimes just poor function of the gallbladder can also cause symptoms.
The gallbladder is a pear shaped organ which sits tucked up under the liver in the right upper abdomen. It functions as a reservoir for bile made by the liver. After eating, the gallbladder contracts to push the bile down into the intestine where it helps to digest fat. If there are stones present, one of them may get stuck in the narrow outlet of the gallbladder when it squeezes down. This usually results in pain in the right upper abdomen, which may radiate thru to the back and is often accompanied by nausea. Episodes may last from a few minutes to several hours depending on how stuck the stone is. Most of the time the symptoms will resolve on their own, but occasionally the stone remains stuck and the patient develops what is known as acute cholecystitis. With increasing pain, vomiting, and sometimes fever these patients usually end up at the hospital.
While anyone may develop gallstones, the phrase “fair, female and forty” describes those at highest risk. Obesity and family history are also risk factors. The best way to diagnose gallstones is with a simple ultrasound test. This will identify the stones and any other possible signs of inflammation.
In addition to stones in the gallbladder, stones which make their way into the main bile duct can also cause problems. If they cause a blockage here, bile backs up and the patient becomes jaundiced and may also develop pancreatitis. This often requires a specialized procedure, known as an ERCP, to remove the stone from the bile duct. Polyps in the gallbladder are also a fairly frequent finding on ultrasound. Most polyps are benign and don’t cause problems, but if they get larger than about 1 cm they can cause symptoms. Some patients have symptoms suggestive of gallbladder disease but no stones or polyps on ultrasound. In this situation a poorly functioning gallbladder, referred to as biliary dyskinesia, may result in right upper quadrant pain and nausea. A test called a HIDA scan can evaluate how well the gallbladder is working.
The treatment for gallbladder disease is usually cholecystectomy – surgery to remove the gallbladder. Lifestyle changes and medication may help somewhat but surgery is curative. Most of the time the surgery can be done laparoscopically. This requires only four small incisions and is usually an outpatient procedure. Most people return to work in 1-2 weeks and resume a normal diet.
If you’ve been experiencing pain in the right upper abdomen, particularly after eating foods high in fat, you may need an evaluation for gallbladder disease. We are here for you! Please call our office at 740-380-1300 to schedule an appointment today.