What is a gallbladder?

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Gallbladder is a pouch like organ which is pear in shape tucked under your liver. It functions to temporarily store bile juices which will be used later in the digestion process of food high in fat content. Bile juices contain several chemical compounds mainly water, ions, cholesterol and fatty acids, and bile pigments. 

Several diseases of the liver, gallbladder and the biliary duct such as gallstone may lead to gallbladder attacks which can be pretty severe and annoying to some.

What does a gallbladder attack feels like?

You may experience gallbladder attacks when the gallbladder or the biliary duct is trying to overcome an obstruction that has been preventing the release of bile from gallbladder to the intestine for the digestion process. The muscular layer of the gallbladder and the biliary duct alternatively contracts and relaxes to overcome an obstruction leading to a sensation of pain. The pain can also be caused by the inflammation and infection of the gallbladder by gallstones.

Usually this pain will be felt over your right upper quadrant of the abdomen radiating to the central chest region. At times, you may also experience pain at your right back or tip of the shoulders. Gallbladder attacks are commonly felt after consuming food rich in fats and it is in an episodic pattern with pain free episodes. The abdominal pain is often associated with nausea and vomiting. Common painkillers like paracetamol can be non functioning for this type of pain.

Common causes of gallbladder attacks

  • Gallstones

Gallstones are formed when there is an imbalance between the composition of cholesterol and bile pigments. Risk factors include, being aged more than 40 years old, women at reproductive age and previous history of having gallstones. These gallstones can be either cholesterol, pigment or mixed stones. 

Gallstones in the gallbladder may cause inflammation of the gallbladder and this condition is called cholecystitis. At times, these gallstones can be passed to the biliary duct and cause obstruction to the biliary system leading to obstructive jaundice. Patients with obstructive jaundice commonly present with yellow discoloration of the skin, itchiness, tea coloured urine and pale stools.

  • Tumor

Tumor of the distal biliary duct, pancreas, ampulla of vater and the duodenum are collectively named as periampullary tumors. These tumors are responsible for a quarter of obstructive jaundice and gallbladder attacks. Tumors obstructing the biliary system eventually prevents the passing of bile away from it causing frequent episodic gallbladder attacks.

You may experience other constitutional symptoms such as loss of weight, loss of appetite, intermittent fever and early satiety for months or years. 

  • Sclerosing cholangitis

Sclerosing cholangitis is often associated with an autoimmune disease of the biliary duct causing the narrowing of the duct lumen. Thus, the muscular layer of the duct will try harder to release bile causing abdominal pains. 

It is usually accompanied with other autoimmune diseases such as inflammatory bowel disease, and autoimmune hepatitis.

  • Abscess

Abscess originating from the liver or biliary duct can also obstruct the biliary system from releasing bile juices, causing severe abdominal pain. Abscess are often caused by polymicrobial organisms or fungus and protozoa depending on risk factors.

Patients with abscess often have their fever first before experiencing abdominal pain and jaundice. These abscesses are usually treated with a long course of appropriate antibiotics and fluid for hydration.

Summary

Gallbladder attacks can be very worrying and severe. If you experience typical gallbladder attacks, do visit a doctor immediately and get your body screened. Your doctor will take a thorough history and assessments with a series of imaging and blood investigation to come up with a working diagnosis. The possible causes of the attack is then treated accordingly to relieve your pain and other associated symptoms.