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Gallbladder Disease

What is Gallbladder Disease?

If you have been diagnosed with a low-functioning gallbladder, or with gallstones, this is technically a form of "gallbladder disease". There are specific diagnoses for various problems, but often the symptoms are common to them all. See each separate diagnosis or disease for more details. But whatever form of gallbladder disease you have, it is important to figure out the underlying cause or causes. A thorough understanding of this will help you to manage your gallbladder problem. You can do this by carefully studying our page Causes of Gallbladder Disease.


Bile Reflux

Bile Reflux, just as it sounds, is similar to acid reflux but in this case it is caused by the upward flow of bile from the duodenum of the small intestine into the stomach and the esophagus. The pyloric sphincter is a valve at the base of the stomach that opens to allow the passage of food into the small intestine. It is also supposed to keep food and bile acids from backflowing into the stomach. The symptoms of Bile Reflux are similar to the burning pain of heartburn but also may include nausea and vomiting of bile. Weight loss may also be an accompanying symptom. Treatment often includes antacids which are only partially helpful. The fact that antacids do not relieve symptoms is often diagnostic of bile reflux. Drugs that bind bile salts are generally more effective. Left untreated, bile reflux can cause gastritis, ulcers and possibly stomach cancer.
Causes of Bile Reflux
Bile reflux can be caused by gallbladder surgery, but is more often a result of gastric surgery. The pyloric valve can also be obstructed by scar tissue or by an ulcer.

Biliary Dyskinesia - also known as Low-Functioning Gallbladder
Acalculous cholecystopathy which means disease or condition of the gallbladder without the presence of gallstones. You might also call it functional gallbladder disorder or impaired gallbladder emptying. Some causes may be chronic inflammation, stress, a problem with the smooth muscles of the gallbladder or the muscle of the Sphincter of Oddi being too tight. Also, research shows that hypothyroidism contributes to biliary dyskinesia.
Symptoms of Biliary Dyskinesia - right upper quadrant pain in the absence of gallstones. Any gallbladder symptoms may accompany this problem as it results in lack of concentrated bile from the gallbladder to digest fats.

Inflammation of the bile duct itself. Chole = bile and angi = duct. Acute cholangitis is usually caused by a bacterial infection resulting from stagnation of the bile in the duct. Choledocholithiasis, a gallstone that gets stuck or lodged in the bile duct can create an obstruction that results in an infection. Less frequently, infections can evolve due to a stricture or narrowing of the duct itself such as in Primary Sclerosing Cholangitis (see below) or may accompany a cancer. Something blocks the free flow of the bile causing a stagnant condition which allows the bacteria to take hold.
Symptoms associated with cholangitis are pain, fever, chills, jaundice or yellowing of the skin and eyes, abdominal pain

Primary Sclerosing Cholangitis
PSC is a disease where the bile ducts of the liver harden, obstructing the flow of bile. It is characterized by inflammation, breaking down of and eventual hardening or fibrosis of the bile ducts within the liver and outside the liver both (intrahepatic and extrahepatic bile ducts.) It is most likely an autoimmune liver disease. Symptoms include itching (caused by bile backing up into the blood stream), jaundice (yellowing also caused by back of bile into bloodstream), tenderness in upper abdomen caused by inflammation to the ducts (cholangitis), possible fever and chills. This is a very serious disease. Medical intervention, among other things, often includes putting in a stent to help the bile to flow freely.

Inflammation of the gallbladder. Acute cholecystitis is nearly always due to gallstones but may be due to infection (bacterial). It can also be due to chemical irritation. Chronic cholecystitis occurs with or without stones (acalculous cholecystitis is without). If there are no stones present the medical treatment used is often antispasmodics and/or laxatives.

Choledocholithias - Gallstones in the Bile Ducts
This can be very painful and symptoms may differ depending upon where the stone is and if it is blocking bile flow. It can block the neck of the gallbladder causing distention and inflammation (cholecystitis). In the common bile duct it can cause a backing up of bile into the liver resulting in obstructive jaundice or into the pancreas causing acute pancreatitis.

Cholelithiasis - Gallstones
Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, and bilirubin.
The majority of symptoms relating to the gallbladder are caused by gallstones.

Impairment of bile flow due to obstruction in small bile ducts in the liver (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts outside of the liver (EXTRAHEPATIC CHOLESTASIS).
Symptoms of Cholestasis - blocking of the secretion of bile results in the bile backing up into the circulation. This may result in jaundice and excess bilirubin in the blood which would make the urine dark and the stools pale or chalk colored. The excess of bile salts in the systemic circulation may cause intense itching and skin irritation. There may be fat in the stools and clotting time of blood may be impaired due to malabsorption of fats and Vitamin K which is a fat soluble vitamin that various clotting factors are dependent upon.

Gallbladder Cancer
The American Cancer Society estimates that about 12,190 people will be diagnosed with gallbladder cancer in 2018 with 3,790 resulting in death. Statistics show that it occurs 5x as often in Native American people in New Mexico than in whites. Women are more susceptible than men.
There are rarely any symptoms with gallbladder cancer early on. In fact, it is often only discovered when the gallbladder is removed for other causes such as gallstones. Otherwise, gallbladder cancer is often quite advanced by the time it is diagnosed. If caught early, removing the gallbladder and affected tissues in bile ducts is the standard treatment.

Gallbladder Polyps
Gallbladder polyps are growths that protrude from the lining of the gallbladder. They're usually innocuous and rarely cancerous (malignant). 95% are non-cancerous. 10% are the result of inflammation.2. Most polyps are the result of cholesterol deposits.
Gallbladder polyps are usually asymptomatic and need no treatment. They may be found incidentally on an ultrasound of the gallbladder done for some other reason. There is rarely pain involved and any pain that is there is most likely due to something else such as gallstones.2. Occasionally, they may grow large enough to require surgical removal.

Porcelain Gallbladder
Porcelain Gallbladder is the calcification or encrustation of the gallbladder wall. It gets the name "porcelain" from it's blue color and brittle wall. A porcelain gallbladder is not a very frequent occurrence. However, gallbladder cancer is a risk for this condition. Removal is the treatment of choice.


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