ALL ABOUT GALLBLADDER DISEASE
Now that I have Gallbladder Disease, how did
I get it in the first place? A thorough understanding of this is what will help you
to manage your gallbladder problem.
CAUSES or Risk Factors for Gallbladder
Disease
Symptoms
Specific
Gallbladder Diseases
CAUSES OF GALLBLADDER
DISEASE
- Hypothyroidism
- Hashimoto's
Thyroid Disease
- Low stomach acid
- Food Sensitivities or Allergies
- Overweight
- Rapid weight loss
- Lack of exercise
- Estrogen intake and birth control pills(estrogen increases
the concentration of cholesterol in the bile)
- Chronic Heartburn
- Frequent use of Antacids
- Atkin's Diet
- Over age 40 and increase in risk as one ages
- Female especially those who have had children
- Ethnicity (Pima Indians and Mexican-Americans)
- High triglycerides, high LDL cholesterol, decreased HDL
cholesterol,
- Alcohol intake
- Family history of gallbladder disease (Heredity)
- Cholesterol-lowering drugs, immunosuppressive drugs
- Antidepressants which slow down gallbladder contractions
- Very Low Calorie Diets
- Diet high in saturated fats
- Diet high in refined foods and sugars
- Diet low in fiber (which is what the refined diets are)
and not enough vegetables
- Non-fat diets
- Low-fat diets
- Constipation
- Diabetes
- Insulin Resistance
- Diseases such as chronic inflammatory bowel disease, Chron's
disease (ulcerative colitis is contraversial) Hemolytic anemias
The combination of a "civilized" diet, of saturated
fats, fried foods, hydrogenated (or fake) fats and white sugar, white flour, highly-processed, nutrient-stripped
food, along with a sedentary lifestyle tends to create an environment ripe for the formation of gallstones or other
gallbladder problems.
Eating too many of the wrong fats puts you at risk, but people
who eat no fat at all are also at risk. No fat in the diet means that the gallbladder works less frequently, which
could cause stasis and bile thickening. Moderate amounts of the right fats, such as olive oil, are much better.
Although being female is an increased risk
for gallbladder disease, according to a study published in BMC Gastroenterology 2002,(1) gallstones
in children is on the rise. And men are not excepted either, although the ratio still tends to
be 80% women to 20% men.
WHAT
ARE SYMPTOMS OF GALLBLADDER DISEASE
Regardless of the diagnosis of your gallbladder disease,
most of the symptoms will be similar. This is one of the reasons it is hard to know exactly what is going on without
several tests. The most common symptoms are indigestion, gas, bloating, burping, belching, especially (but not
necessarily) following a meal. It usually is a meal containing fat but after some time it seems to be unrelated
not only to fat intake but even food intake. It may progress to constant tenderness or discomfort (unrelated to
food intake) under the rib cage on the right side. The symptoms are similar to those of a gallbladder attack but with less severity. For a complete list of symptoms relating to gallbladder problems go to general
gallbladder symptoms.
Even if it does not seem to be connected to food now, if
you can remember back, some symptoms of indigestion usually followed a meal. What caused or is causing the lack
of fat digestion could be of various origin.
A stone could be blocking the bile flow. The
gallbladder could be distended due to stones or inflammation. There could be infection in the gallbladder causing
tenderness or the tenderness could simply be due to stasis of bile causing distention. The gallbladder could
be not emptying fully (biliary dyskinesia) and lack
of bile causes improper fat digestion.
Or the problem could start in the liver with stasis of bile there and the formation of sludge or tiny calculi slowing
bile flow and causing it to thicken. Constipation and weight gain can also be symptoms of gallbladder problems.
SPECIFIC
GALLBLADDER DISEASES
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 sphinter 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.
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
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 - 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.
If this is your diagnosis follow the thread to read about
the connection between hypothyroid and gallbladder disease.
Cholangitis
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, 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.
Cholecystitis
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. I use the products in the gallbladder attack
kit for the pain in this case.
Cholecystitis
Inflammation of the Gallbladder
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, or bilirubin.
Since the majority of symptoms relating to the gallbladder
are caused by gallstones, there is a page dedicated that alone. If cholelithiasis or gallstones is your diagnosis,
follow the thread from here to Gallstones. Otherwise, read
on.
Cholelithiasis and Choledocholithias
Gallstones and Stones in the Bile Ducts
Cholestasis
Impairment of bile flow due to obstruction in small bile
ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS)
Symptoms - 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 8,750 people
will be diagnosed with gallbladder cancer in 2006. Statistics show that it occurs 5x as often in Native American
people in New Mexico than in whites. Women are more suseptible 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.
(1)O Kleiner, J Ramesh, M Huleihel,
B Cohen, K, BMC Gastroenterology 2002
Drawings copywrited @2006 by Darcy Cantrell
(2)Persley, Kimberly M., Current Treatment Options
in Gastroenterology, 2005
Acalculous biliary pain: new concepts for an old entity.,Shaffer E.
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