The gallbladder is at sac-like organ located under the liver in the right upper quadrant of the abdomen. The gallbladder is connected to both the liver and the first part of the small bowel via the bile ducts. The bile that is secreted by the liver is stored in the gallbladder. Bile is necessary to digest fatty foods and to absorb fat and fat soluble vitamins. With meals, fatty foods stimulate the gallbladder to contact and release the bile into the small bowel.
Gallstones are pebble-like collections of solid material that can form in the gallbladder.
Most people with gallstones do not have any symptoms and do not require any treatment.
When gallstones are symptomatic they cause what is called biliary colic:
- Abdominal pain located in the right upper quadrant of the abdomen. The pain usually happens after eating and it can radiate to the right shoulder.
- Nausea and vomiting
- Cholecystitis. The gallstones can obstruct the outlet of the gallbladder causing it to become inflamed. This causes persistent pain and requires immediate medical attention. Surgery to remove the gallbladder is usually necessary.
- Choledocholithiasis. One or more gallstones can get out of the gallbladder and cause an obstruction in the bile duct. This can cause jaundice (yellowish discoloration of the eyes and the skin) or cholangitis (infection in the bile duct).
- Pancreatitis. Gallstones passing through the bile duct can cause a transient obstruction of the pancreatic duct leading to inflammation of the pancreas which causes severe abdominal pain.
- Gender. Gallstones are more common in women.
- Age. The risk of gallstones increases with age.
- Use of medications containing estrogen (such as birth control pills)
- Rapid weight loss
- Sickle cell disease
Imaging tests to look for gallstones are usually ordered:
- CT scan
If treatment is indicated you may need:
- Surgery to remove the gallbladder.
- ERCP which is an endoscopic procedure that allows removal of gallstones from the bile duct.