If you’re pain-free, embrace gallbladder
Although the gallbladder has a useful function, most people do fine without it, which may make you wonder what exactly the gallbladder does and why you can live without it.
Your liver produces bile (sometimes called gall) to mix with foods you eat and to break down fats during the digestive process. Bile is stored in your gallbladder. As partially digested food leaves your stomach and enters your small intestine, your gallbladder releases bile into your small intestine through a tube called a bile duct. Without your gallbladder, the bile your liver makes goes directly into your small intestine.
So why would your gallbladder be removed? It may be because you have gallstones that cause pain or that your gallbladder no longer functions very well and causes pain. Although 10 to 20 percent of adults have gallstones, most do not have pain or problems from them. Gallstones can be the size of sand particles or rather large, and they consist of cholesterol, bilirubin and/or calcium.
Pain from a gallbladder attack can be in the upper right area of the abdomen or back, the center of the abdomen just below the breastbone, between the shoulder blades or in the right shoulder. It may be sudden or gradual, last several minutes or hours, and come in waves or be slow and steady. Often there is nausea or vomiting. If you have had these symptoms and they’ve been caused by your gallbladder, you are likely to continue experiencing attacks unless you seek medical treatment.
Gallstones can cause serious complications with symptoms such as yellow skin and eyes, high fever with chills, pain that lasts more than five hours or clay colored stools. If this happens, see a doctor immediately.
Gallstones cannot usually be prevented, although avoiding rapid weight loss if you are obese may prevent them.
An abdominal ultrasound is usually the best way to diagnose gallstones. If no gallstones are apparent in an ultrasound, but your symptoms truly seem like a gallbladder problem, you could have a gallbladder that is not contracting and emptying normally, a blockage by a gallstone or tumor, gallbladder infection, inflammation of the pancreas or a liver problem. Other imaging scans can help your doctor pinpoint the problem.
Gallbladders are often removed through laparoscopic surgery using a miniature video camera and four tiny incisions.
Patients usually recover more rapidly and have less pain and fewer complications with laparoscopic surgery than from open surgery with a larger incision.
Immediately after surgery, you may experience diarrhea and bloating that usually goes away over time. About 99 percent of people with no gallbladder experience no long-term changes in digestion. People who have more chronic changes in digestion (i.e., diarrhea) may find diet changes or specific medications helpful.
Expect recovery to take about a week after laparoscopic surgery and up to six weeks after open surgery. Both types of surgery may cause abdominal pain that goes away gradually. Laparoscopic surgery can also cause temporary upper back pain. Ask your surgeon how soon after surgery you should get up and moving, and balance that with rest while you heal.
Gallbladders are useful and even if you have stones, you may be better off keeping yours as long as you do not have pain. If the gallbladder is not working well or stones are causing you pain, discuss with your health care provider whether surgery is a good choice for you.
Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section. Send your comments and column suggestions to firstname.lastname@example.org.