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Gallbladder Information

The gallbladder is a pear-shaped organ that arises from the liver. It stores and concentrates bile which is produced by the liver. After a meal, the gallbladder contracts to release bile which helps in digestion of fats and other products. Bile is a yellow-green liquid, composed of water, lecithin, cholesterol, bile salts, and bilirubin.

Occasionally stones may develop in the gallbladder or bile ducts resulting in blockage of the normal flow of the bile. This presents as severe pain in the upper abdomen. Furthermore, stone formation may produce gallbladder inflammation, a condition known as cholecystitis. Inflammation of the gallbladder without the presence of stone formation is called acalculous cholecystitis, and is often caused from prolonged fasting, severe illness, and several other reasons. In rare cases, gallbladder disease may result in cancer development in the gallbladder and biliary ducts.



Usually gallstones do not cause symptoms and therefore do not need treatment. However if gallstones become symptomatic and cause pain, discomfort or other complications such as pancreatitis, then we need to remove the gallbladder. In most cases, treatment of gallstones involves surgical removal of the gallbladder which does not affect the normal physiological functioning of the body.

Based on their composition, gallstones can be categorized as, cholesterol stones and pigment stones. Cholesterol stones comprise of more cholesterol and bilirubin, but less bile salts, whereas pigment stones have more bile salts, along with calcium.

Risk factors

There are various risk factors that may result in the development of gallstones, including:

  • Obesity
  • Rapid weight loss: increases fat metabolism of the body that causes excess cholesterol secretion by the liver
  • Prolonged fasting: may produce over concentration of the bile with cholesterol to produce gallstones
  • Elevated oestrogen production: this occurs during pregnancy or while taking hormone replacement therapy or birth control pills and increases cholesterol levels
  • Gender: women are more prone to gallstone formation as compared to men
  • Ethnicity: Native Americans have genetically influenced higher levels of cholesterol in bile that increases risk of gallstones
  • Intake of cholesterol-lowering drugs and low caffeine, increases risk of gallstones
  • Sedentary lifestyle with less physical activity

In addition, people with high triglyceride levels and conditions such as anemia, sickle-cell disease, thalassemia, hereditary spherocytosis, elliptocytosis, or jaundice, are at high risk of developing gallstones.


Gallstones may not cause any symptoms but when symptoms appear, they usually are sudden and often referred to as a "gallbladder attack". Typical symptoms include:

  • Severe abdominal pain
  • Back pain near shoulder blades
  • Nausea and vomiting
  • Abdominal bloating and belching
  • Intestinal colic
  • Stomach upset


Gallstones and cholecystitis (inflammation of the gallbladder) can be easily diagnosed through ultrasound.


Other advanced techniques or tests include endoscopic ultrasonography, cholescintigraphy (HIDA) scan, CT scan, Endoscopic retrograde cholangiopancreatography (ERCP) as well as laparoscopic common bile duct exploration.


Gallbladder surgery is considered the best option for gallstone treatment. Most people can live a normal life without their gallbladder, as gallbladder removal results in direct passing of the bile from the liver into the small intestines through ducts.

The surgery to remove the gallbladder is called a cholecystectomy and is, usually performed through laparoscopic techniques which are minimally invasive as compared to open abdominal surgery which requires a long incision. In laparoscopic gallbladder surgery, small incisions are made to insert surgical instruments, along with a laparoscope that has a light source with a camera on the end. The laparoscope helps to locate the gallbladder and tiny instruments are used to surgically remove it.

Gallbladder surgery may require an overnight stay in the hospital. The major complication of gallbladder surgery is injury to the bile ducts that can result in leakage of the bile inside the body and may cause pain and infection.

In cases where gallstones are present inside the bile ducts, endoscopic retrograde cholangiopancreatography (ERCP) technique can be used during gallbladder surgery. ERCP technique involves swallowing a long, flexible tube, with a light source, called an endoscope that is connected with a viewing monitor. The endoscope reaches the small intestine through the stomach and the bile duct is located by releasing a special dye. The affected duct can be cut with tiny instruments located on the endoscope, followed by capturing of the gallstones which have migrated into the bile duct with a mesh basket that is then removed along with the endoscope.

In cases of small and uncalcified gallstones, certain medications can medically dissolve the gallstones. In addition, Lithotripsy (use of shock waves) can be used to crush gallstones; this procedure is frequently used for kidney stones.

Preventive measures (Diet)

Eating a proper diet may reduce the frequency and severity of gallstone symptoms and includes:

  • Low-fat diet
  • Increased dietary fibre

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