Thomas Bryant, MD, is a surgeon who practices at East Morgan County Hospital in Brush, Colo.
Question: How does a person know whether they are having problems with their gallbladder?
Answer: To know for sure, it is necessary to have some tests run. The symptoms of gallbladder disease are frequently confused with reflux, ulcers, “acid stomach”, or “irritable bowel syndrome”. Common complaints are indigestion, belching, gas, nausea and pain. The pain may be in the right or central upper abdomen, or in the back. Back pain is often perceived on the right under the lower tip of the scapula bone.
Eating greasy or spicy foods frequently provokes gallbladder attacks. A bad gallbladder may cause severe symptoms on one occasion and no symptoms on the next, even if the same types of food are eaten. Generally speaking, as time goes by, attacks are more easily provoked and more severe.
Since these symptoms can easily resemble symptoms from any of the other conditions mentioned, some tests are required to determine the cause.
Most but not all patients with gallbladder disease have gallstones. The best test for detecting gallstones is an ultrasound examination. This is a very easy test where the technician passes a sensor over the patient’s abdomen to make images of the internal organs. Gallstones are usually seen clearly.
Not everyone with a bad gallbladder has gallstones. This is because a gallbladder may malfunction for years before stones form. The best test for a malfunctioning gallbladder without stones is a HIDA scan. This test is done in the X-ray department. It requires that some medication be given through an intravenous line to make the gallbladder show up on a special scanner.
There are several different risk factors for gallbladder problems. Women have a much higher incidence of gallbladder disease than men. This may be related to levels of some female hormones. Women with many pregnancies or a long history of birth control pill use have an elevated risk. A diet high in fat results in increased gallbladder disease. Finally, genetics play a role. A strong family history of gallbladder disease increases the risk. Some ethnic groups, native Americans for example, have gallbladder problems much more frequently than the rest of the population.
Many people wonder if they need treatment for gallbladder problems; they wonder if eating more nutritiously would solve their stomach issues. That's a risky strategy. There is a risk that the next attack could come any time, even if you were very careful with your diet. Some attacks are so bad that they result in gangrene of the gallbladder. This would require an emergency operation, which can be harder and more dangerous than a planned operation. Also, gallstones can escape into the duct system below the gallbladder, which can result in obstruction to entire bile system. Stones in the ducts can also cause severe inflammation of the pancreas. Either of these complications can potentially be fatal.