Gallbladder symptoms and treatment
Symptoms and signs of gallbladder disease happen when gallstones disturb the gallbladder. The general symptoms and signs associated with gallstone disease contain:
• intermittent and severe pain in the right side of upper abdomen. This pain can also spread to the chest, shoulders or back. Sometimes this pain may be mistaken for a heart attack.
• Chronic indigestion and nausea In addition to these symptoms, gallstones can also cause
more serious complications. These happen when bilestones are removed from the gallbladder and kept within bile ducts. This can drive to infection and obstruction of these ducts. When this occurs it is called acute cholecystitis (if the infection is within the gallbladder) or cholangitis (if the infection is within the bile ducts). Occasionally gallstones may block the bile duct at the entrance to the pancreas and intestine causing pancreatitis (inflammation of the pancreas). Gallstones arc the most common cause of
acute pancreatitis. If gallstones block the bile ducts for many years then liver damage occurs, leading to liver failure. In rare cases large gallstones may move into the small intestine and
cause obstruction near the junction of the small and large intestine. The most common symptoms associated with these complications include the following:
• Severe and steady pain in the right upper abdomen that docs not resolve on its own
• Fever and chills
• Severe nausea with vomiting
• Severe pain in the middle of the abdomen and back
• Jaundice, a yellow discoloration of the skin and eyes
Nearly all gallstones can be easily identified by an ultrasound examination. This is a simple and painless procedure in which sound waves are utilized to create pictures of the gallbladder, bile ducts and its contents. This test is highly sensitive for identifying cither gallstones or sludge within the gallbladder. Cholecystogephy is a test in which pills containing dyes arc taken. These dyes arc absorbed and excreted by the liver into the bile. Dye accumulates within the gallbladder and an X-ray is taken.If gallstones are suspected within the bile ducts, then more specific and complicated testing may need to be performed. The most common test to evaluate bile ducts is called ERCP (endoscopic retrograde cholangio-pancrcatography).
This involves swallowing a small flexible tube through which a physician looks. The tube is then passed through the stomach and into the small intestine where the bile duct enters. Dye
is then injected into the bile ducts and X-rays arc taken. If it is impossible to perform the ERCP, then a PTC (percutaneous transhepatic cholangiogram) can be done. In this lest, a very thin needle is passed through the abdomen into the bile ducts, dye is injected and an X-ray is taken.
The gallbladder is an important organ, but is not essential for life. Many patients with gallstones or its complications have their gallbladders surgically removed safely. Until recently this was performed by “open” surgery, where the surgeon makes a large abdominal incision. Now the preferred surgical technique is to remove the gallbladder through a half-inch incision using a pencil-thin scope, a tiny video camera and long, thin instruments that arc inserted through other tiny incisions.
This procedure is called laparoscopic cholecystctomy. It is used in 80 percent of the gallbladder removals because it is relatively safe, reduces the hospital stay to a day or two. Is less painful and allows the patient to return to work or normal activity in a short time.
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