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Signs that you need your gallbladder out: The request could not be satisfied


5 Signs That You Might Need Gallbladder Surgery

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Unless you’ve felt the stabbing pain of gallstones, most likely you’ve never given your gallbladder a second thought. But this small organ can trigger big problems. Learn the signs and symptoms of gallbladder trouble, and when it’s time to seek a surgeon’s advice.               

What Is the Gallbladder And What Does It Do?

The gallbladder is a small, pouchlike organ in the upper right part of your abdomen (belly). The gallbladder collects and stores bile, a fluid produced by the liver that helps break down fatty foods.

Why Does Your Gallbladder Need To Be Removed?

You may need gallbladder surgery if you have pain or other symptoms caused by gallstones — small stones that can form in the gallbladder. They can block the flow of bile and irritate the gallbladder. Common symptoms of gallbladder problems include:

  • Indigestion, with bloating, heartburn, and gas
  • Sharp pain in your belly
  • Nausea and vomiting
  • Fever
  • Yellowing of the skin and the whites of the eyes (jaundice)

The good news? You don’t need a gallbladder to live, so if it’s causing severe problems, your doctor will likely recommend surgery to remove it.

You may need gallbladder surgery if you have pain or other symptoms caused by gallstones.

How Is the Gallbladder Removed?

There are two ways of removing the gallbladder. Both are performed under general anesthesia, which means you’ll be asleep and pain-free during the operation. Talk with your health care provider about which one is right for you:

  • Laparoscopic (keyhole) cholecystectomy (gallbladder removal): This is the most common way to remove the gallbladder.
    • The surgeon makes several small incisions, or cuts, in your abdomen. She then inserts a laparoscope — a thin, lighted tube that lets her see inside your belly — through one of the cuts.
    • Other medical instruments, including a tiny camera, are inserted through the other cuts. Gas is pumped into your belly to expand the space, so your surgeon has more room to see and work.
    • The gallbladder is removed using the laparoscope and other instruments. The surgeon closes the incisions with small stiches, staples, surgical tape, or glue. These will disappear as you heal, so your doctor won’t have to remove them later. With this method, you can leave the hospital sooner and recover faster.
  • Open cholecystectomy: In some cases, laparoscopic gallbladder removal may not be possible. Reasons include severe gallbladder problems or scar tissue in the abdomen from earlier surgery. With open surgery, your surgeon will make a single, larger incision in your belly to access and remove your gallbladder. She will then close the incision with stitches and cover it with a dressing.

Sometimes a laparoscopic procedure turns into an open one during the operation if your surgeon can’t see your gallbladder clearly or remove it safely. If you’re scheduled for a laparoscopy, talk with your doctor ahead of time about the risk of it becoming an open procedure.

What Are the Risks of Gallbladder Removal?

Gallbladder removal surgery is considered a standard, safe procedure. Complications of laparoscopic surgery are rare. But, like any type of surgery, there’s a risk of complications, which can include:

  • Bleeding
  • Infection in the surgery area
  • Blood clots
  • Bile leakage
  • Heart problems
  • Hernias (when a small amount of your gut, or intestine, or other tissue bulges through the muscles that cover it)

Ask your doctor about the benefits and risks of surgery before your operation.

How Long Does It Take To Recover From Gallbladder Surgery?

Your recovery time will depend on which procedure you had.

  • Laparoscopic: Most people can leave the hospital on the same day or the day after the operation. If you leave that day, have someone stay with you for at least 24 hours as you may still be feeling the effects of the anesthesia. You’ll likely be able to return to your normal activities in about two weeks.
  • Open: Usually you’ll have to stay in the hospital for three to five days afterwards. Recovery takes about six to eight weeks.

It’s easy to get the care you need.

See a Premier Physician Network provider near you.

Sources: National Health Service; Society of American Gastrointestinal and Endoscopic Surgery; Medline Plus

Signs You Might Need Gallbladder Surgery: Surgical Associates of North Texas: Advanced Laparoscopic Surgeons

Gallbladder symptoms can range from minor and annoying to excruciating and unbearable. In some cases, the symptoms are temporary, and an episode passes quickly. However, it is a frequent problem that the symptoms persist or recur, which indicates that the underlying problem needs to be treated.

When gallbladder pain occurs, it’s usually in the upper right quadrant of your abdomen, just below the rib cage. While common, this is not the only location, as the pain can occur anywhere in the abdominal region and often will feel like it is radiating around the back towards the right shoulder blade. Severe pain may be accompanied by nausea and vomiting.

When a gallbladder issue is both painful and persistent, removing the gallbladder through surgery called a cholecystectomy is the recommended treatment. Your gallbladder is an organ that you can very easily live without. Its function is to store bile that is used to aid in the digestion of certain foods.  If the gallbladder is removed, then the liver and the biliary system will take over such that it’s not likely that a cholecystectomy will cause you any digestive issues.

Still, surgical decisions aren’t made lightly.  Even though a cholecystectomy is one of the safest and most common outpatient surgeries performed in this country, the decision for surgery is one that should only be made by someone who is qualified to actually perform the surgery.  While a specialist like Dr. deVilleneuve can help you decide if gallbladder surgery is the best option for you, there are signs you can watch for that may indicate the need for a cholecystectomy is imminent.

Disorders of the gallbladder

Though there are several problems that can affect the gallbladder, the most common by far is the formation of gallstones. These are hard particles that are made of bile, cholesterol, calcium, and several other components which have a tendency to get lodged in the bile ducts, effectively blocking the passage of bile out of the gallbladder.

When this occurs it can cause severe pain.  The “classic” presentation is a sharp, stabbing pain in the right upper part of the abdomen that starts about 30 minutes after eating a meal with a high-fat content.  In reality, however, gallstones can cause symptoms anytime regardless of what your diet consists of.

Gallstones, in addition to causing pain, can also cause other problems as a result of their obstructing the bile ducts.  Depending on where the obstruction occurs, gallstones can cause pancreatitis as well as making you jaundiced. When gallstones get lodged in what is called the neck of the gallbladder, it can lead to the gallbladder becoming infected and eventually turning gangrenous.   When any of these conditions occur, admission to the hospital for urgent surgery is indicated.

Signs you need gallbladder surgery

Since gallstones are the most common issue affecting the gallbladder, signs of these generally indicate you’ll be a candidate for surgery. As many as 80% of those with gallstones eventually require surgery, even though they may have had gallstones for years before their first attack. Some of the common signs of gallstones include:

Abdominal pain

This is far and away the most common complaint among gallstone sufferers.  The onset is usually after eating and can be described as anything from sharp, stabbing in nature to dull, cramping type discomfort.  Often people will assume that they are having gas pain or reflux, until eventually deciding to get the pain checked out. These pains may be intermittent, or it could occur after every meal. Attacks that last longer may be indicating a more serious gallbladder problem.


Gallstones may mimic other digestive issues, so you may not connect nausea and vomiting with your gallbladder, but if these coincide with abdominal pain, there’s a pretty decent chance that gallstones are the root cause.


An inflammation of the pancreas could be a sign of gallstones, which can migrate and block the duct from the pancreas as well as from the gallbladder. Gallstones are one of the two most common causes of acute pancreatitis in adults.

Weight changes

Any condition that brings on rapid weight gain and/or weight loss can lead to gallstone formation.  Two of the most common populations that experience this are bariatric surgery patients who have lost a lot of weight after their procedure and women both during and immediately after pregnancy.

When it’s time

If you require gallbladder surgery, then you will definitely want to find someone who specializes in this type of surgery.  Dr. Scott deVilleneuve of Surgical Associates of North Texas is such a surgeon. He specializes in minimally invasive surgery, including cholecystectomies.  He has completed over 2,500 laparoscopic cholecystectomies since starting his practice in McKinney over 14 years ago and can help you determine the best option for you.

Warning Signs You Might Need Your Gallbladder Removed

Symptoms of gallbladder disease can range from minor and unnoticeable to unbearable and debilitating, and if left untreated, can lead to gallbladder rupture, inflammation of the pancreas, or inflammation of the bile ducts. In this article, we review a few of the major warning signs that you might need your gallbladder removed. If you are exhibiting any of the symptoms discussed in this article or have any further questions, schedule a consultation with Whalen Clark, M.D., a board-certified general surgeon specializing in abdominal procedures, including colorectal surgery in Tampa. 

Related: 9 Types of Gallbladder Diseases and Complications

Abdominal Pain

By far, the most common complaint among individuals suffering from gallstones is abdominal pain, which typically comes on after eating. The pain can be described as anything from sharp and stabbing to dull and cramping. You may assume that you’re experiencing gas pain or acid reflux due to the intermittent nature of these pains; however, it’s important to be wary of any abdominal pain that lasts several hours. 

Gallbladder pain is typically centered in the upper right or direct center of your abdomen, but it may also extend beneath the right shoulder blade and on to the back. It may increase either when you breathe in deeply or after eating a heavy meal, particularly greasy or fatty foods. You should seek immediate attention by a medical professional if you develop abdominal pain so intense that you cannot sit still or find a comfortable position. 

Related: Could My Gallbladder Be Causing Abdominal Pain?

Weight Changes

Obesity can lead to gallstones because it alters the balance of cholesterol and bile acids in the gallbladder and makes it more difficult for the gallbladder to empty as cholesterol-rich bile accumulates and hardens into stones. Losing excess weight, if done gradually, is a surefire way to reduce your risk of gallstones; however, rapid weight loss (three pounds or more per week) can trigger gallstones. Just like obesity, rapid weight loss has the potential to trigger an imbalance in the levels of bile acids, cholesterol, and lecithin. 

Two of the most common groups of people that experience this are bariatric surgery patients because they tend to lose a significant amount of weight in the first three to six months and women both during and immediately after pregnancy. If you wish to lose weight, weight loss of one half to two pounds per week is a good goal for most people. We recommend increased physical activity and a sustainable diet, as extremely low-fat diets can inhibit gallbladder contractions as well. 

Related: What Are Gallstones?

Digestive Issues

Gallstones have the potential to mimic other digestive issues, leading to symptoms like nausea, vomiting, stools of an unusual color, and dark urine. If you’re experiencing chronic gallbladder disease, you may also experience unwanted symptoms of acid reflux, excessive gas, indigestion, and heartburn. It may be difficult to distinguish a problem with your gallbladder from other digestion issues, but more than four bowel movements per day for at least three months or an unexplained fever may signal you have an infection in need of treatment. 

If you’re experiencing any of the symptoms outlined in this article, you’re probably wondering what the procedure looks like for gallbladder removal. Whalen Clark, M.D., a premier colorectal surgeon in Tampa who handles everything from colorectal cancer and gallbladder disease to hernias and pancreatic cancer, utilizes the cutting-edge technology of the da Vinci® surgical system to perform gallbladder removal through a single incision that leaves virtually no scar. You can leave the hospital in as little as one day and recover in as little as one week.

To learn more about gallbladder removal or colorectal surgery in Tampa, or to schedule a consultation with Whalen Clark, M.D., please request an appointment today.

Disclaimer:The contents of this website are for general educational purposes only. All content and media on the Whalen Clark, M.D. website does not constitute professional medical advice nor is the information intended to replace the services of Whalen Clark, M.D. or other qualified medical professionals. If you believe you are having a medical emergency, call 911 immediately. 

The content, views, and opinions communicated on this website do not represent the views of Whalen Clark, M.D. Reliance on any information provided by this website is solely at your own risk. Although this website contains links to other medical websites, this is strictly for informational purposes. Whalen Clark, M.D. is not responsible nor do they approve of the content featured on any third party linked websites referenced on this website.

5 Signs You Might Need Gallbladder Surgery: Sreelatha Reddy, MD: Gastroenterologist

You may not think much about your gallbladder until it starts causing problems. The organ located on the right side of your abdomen stores small amounts of bile that are released into your small intestine after you eat to help you break down fats.

This is important, but you can live a healthy life without your gallbladder. This is a positive thing if you’re struggling with gallbladder disease, which can lead to a need for gallbladder removal.

At Houston Gastrointestinal & Liver Clinic, P.A. in Sugar Land, Texas, Dr. Sreelatha Reddy diagnoses and treats gallbladder disease with an understanding of how painful it can be. If you’re wondering if your own symptoms may be gallbladder-related, read on.

Gallbladder disease 101

Problems with your gallbladder almost always derive from gallstones. Made up of hard deposits, gallstones can be as small as a grain of sand or as large as a pingpong ball. And once you have gallstones, blockages and infection can occur. These symptoms indicate gallbladder disease

While no one knows the exact cause of gallstones, they seem to be linked with excess amounts of cholesterol or the natural chemical bilirubin in your bile, or having a gallbladder that doesn’t empty properly. 

Having diabetes, carrying excess weight, or leading a sedentary lifestyle may also increase your risk. These risks also increase with age, especially after age 40.

Signs you may need gallbladder surgery

Sometimes gallstones can be dissolved with medications. If not, you may benefit from endoscopic retrograde cholangiopancreatography, or ERCP. During this procedure, a thin tube and instruments are inserted through your mouth to remove gallstones. 

In severe cases, meaning bile can’t circulate normally, Dr. Reddy may recommend surgery to remove your gallbladder. 

Common signs that you may need gallbladder surgery include:

  • Fever and sweating
  • Nausea and vomiting
  • Pain between your shoulder blades or in your right shoulder
  • Pain that comes and goes
  • Sudden or intensifying pain in your right, upper abdomen 

Your abdomen may also feel tender or painful, especially after eating. 

Signs of a gallbladder emergency include pain so intense that you can’t get comfortable or sit still, yellowing of your skin and eyes, or a high fever accompanied by chills. If you experience these symptoms, seek immediate medical care.

If you’re at risk for gallbladder disease, we may recommend lifestyle changes, such as slowly losing excess weight, eating more high-fiber foods, and not skipping meals. While these steps can’t replace surgery, they may help prevent the need for surgery if you start early on. 

To learn more about gallbladder problems or find out if surgery may be ideal for you, call Houston Gastrointestinal & Liver Clinic, P.A. or request an appointment through our website.

5 Signs that you should need Gallbladder Surgery

Gallbladder is a little pear-shaped like organ, underneath your liver. Gallbladder’s core function is to store the bile produced by the liver and pass it along through a conduit that purges into the small intestine tract. Bile helps digest fats in your small intestine.

The term gallbladder diseases is used for a several kinds of conditions that can influence the gallbladder. Inflammation causes most of gallbladder diseases because of disturbance of the gallbladder walls, which is known as Cholecystitis. This inflammation is often, because of gallstones obstructing the ducts leading to the small intestine tract and making bile develop. It might in the end lead to necrosis (tissue obliteration) or gangrene.

Unless an individual felt the stabbing or sharp pain in abdomen of gallstones and you have never thought about your gallbladder. Yet, this small pear shaped organ can trigger huge problems. Understand more on the signs and symptoms of gallbladder disease and when it’s an ideal opportunity to consult the surgeon.

For what reason Does Your Gallbladder Need To Be Removed?

You may require gallbladder removal surgery if you notice
sharp pain in abdomen or some other symptoms brought about by gallstones — small
stones that can develop in the gallbladder. They can obstruct the flow of bile
and disturb the gallbladder. General symptoms of gallbladder issues include:

  • Indigestion or acid reflux, with swelling, heartburn, and gas
  • Sharp pain in abdomen
  • Nausea and vomiting
  • Fever
  • Change in color of the skin and the whites of the eyes to yellow (jaundice)

There is good news? You don’t have to live with a gallstone
or gallbladder disease anymore, so if it’s causing serious health issues, your
doctor will probably prescribe surgery to remove it.

You may require gallbladder surgery if you feel pain
or any other symptoms occurred by gallstones.

What Is the Procedure to remove Gallbladder?

There are two different methods of removing the gallbladder. Both surgical treatments are performed with general anesthesia, which implies you’ll be at sleep and there will be no sense of pain during the surgery. Consult with your doctor about which procedure is recommended for you:

Laparoscopic (keyhole) Cholecystectomy

This is the most widely recognized approach used for Gallbladder removal surgery.

  • Surgeon makes a few small entry points
    (incisions), or cuts, in abdomen to insert a laparoscope — a small tube with
    micro camera and light on it to look inside abdomen— through one of the incision.
  • Other clinical instruments, including a small
    camera, are embedded through different cuts. Gas is siphoned into abdomen to increase
    the space, so that surgeon has more space to see and perform the surgery.
  • The gallbladder is removed with the help of
    laparoscope and other clinical instruments. The surgeon closes the incision with
    small stiches, staples, surgical tape, or glue. These will vanish as patient
    heal, so surgeon won’t need to evacuate them later. With this technique, you
    can leave the hospital early and recovery will be much faster.

Open Cholecystectomy

In few cases, laparoscopic gallbladder removal surgery may not be an option for treatment. Reasons incorporate extreme gallbladder issues or scar tissue in the abdomen from prior surgery. With open medical procedure, your specialist will make a one single, bigger entry point on abdomen to access and remove the gallbladder. Once the gallbladder removed, surgeon will closed the incision with sutures and cover it with a dressing.

In some cases a laparoscopic surgery transforms into an open
one during the operation if surgeon can’t see the gallbladder properly or remove
it securely. In case you’re booked for a laparoscopy, consult with your PCP
early about its risk factor turning into an open surgery.

What Are the Risk Factors involved in removal of Gallbladder?

Gallbladder removal surgery is considered a standard, safe
procedure. Complications of laparoscopic surgery are rare. But, like any type
of surgery, there’s a risk of complications, which can include:

Laparoscopic Gallbladder removal surgery is most recognized
and safe method. Risk factors involved in laparoscopic surgery are uncommon.
However, similar to a surgery, there’s a risk factors, which may include:

  • Bleeding
  • Blood clots
  • Infection in the surgical area
  • Leakage of bile
  • Heart problems
  • Hernias (when a limited quantity of gut, or intestine, or other tissue swells through the muscles that cover it)

Consult your PCP about the advantages of Laparoscopic
surgery and risks of surgery before you schedule the surgery.

How much time will it take to recover from Gallbladder

Your recovery time will rely
upon the procedure your surgeon has recommended:

  • Laparoscopic: Many
    individuals get discharge from the hospital on the same day after the surgery.
    However, if you’re discharged from the hospital same day, it is highly
    recommended to take proper rest for at least for a two week or recommended by
    surgeon. You can resume your routine activities in about two weeks
  • Open: It
    takes slightly longer time to get recover from surgery and you’ll have to stay
    in the hospital for at least three to five days post-surgery. Recovery takes around
    six to eight weeks.

For more information on Diagnosis & Treatment of Gallstones or Gallbladder removal surgery, please feel free to contact our healthcare expert today for free online consultation at +1 (817) 748-0200

Gallbladder Removal (Cholecystectomy): Gallbladder Surgery


What is gallbladder removal?

Gallbladder removal is a surgery to take out a small organ called the gallbladder. Another name for gallbladder removal is cholecystectomy (KOL-i-si-STEK-tuh-mee).

If your gallbladder causes problems, you may have surgery to remove it. You may need to make some minor changes to your diet after a cholecystectomy. But you can live well without your gallbladder.

What is the gallbladder?

Your gallbladder is a small organ in the upper right part of your abdomen (belly). It looks like a small pouch and stores bile. Bile is the liquid your liver produces that helps to break down fats.

Who needs to have their gallbladder removed?

People who have gallstones may need gallbladder removal. Gallstones are small, pebble-like deposits that build up in your gallbladder. Gallstones are typically made of bile byproducts called cholesterol or bilirubin. The stones usually form because of an imbalance in the substances that create bile.

Some people don’t feel gallstones or know they have them. Sometimes, gallstones block the flow of bile and affect your pancreas (pancreatitis) or gallbladder (cholecystitis). You may have:

Is gallbladder surgery the only treatment for gallstones?

Although there may be a chance that medications could be helpful, they haven’t been scientifically proven effective. Your provider may recommend surgery if your gallbladder causes you problems from gallstones. Depending on your general health, you may not need treatment if your gallstones don’t cause any symptoms.

Procedure Details

What happens before gallbladder removal?

A few weeks before surgery, you meet with your healthcare provider. At this appointment, you may:

  • Get a blood test to make sure you’re healthy enough for surgery.
  • Discuss what technique your surgeon will use and ask any questions.
  • Receive instructions about when to stop eating and drinking before your operation.
  • Talk about ways you can reduce your risk of postoperative complications, such as quitting smoking.

What are the types of gallbladder removal?

Your surgeon may use open surgery or laparoscopic surgery to remove your gallbladder. With open surgery, your surgeon operates through one large incision. During laparoscopic surgery, your surgeon operates through a few small incisions. Laparoscopic surgery can lead to faster recovery, less pain and small scars.

Your surgeon may recommend open surgery if you can’t have laparoscopic surgery. For example, if you have a lot of scar tissue on your abdomen, your surgeon may need to use an open technique. Sometimes, your surgeon may need to turn a laparoscopic surgery into an open one to see more clearly and remove your gallbladder safely.

What happens during open cholecystectomy?

During an open cholecystectomy, your surgeon:

  • Makes one incision underneath your ribs.
  • Uses surgical tools to remove your gallbladder.
  • Closes the incision with stitches.

What happens during laparoscopic cholecystectomy?

During a laparoscopic cholecystectomy, your surgeon:

  • Makes a small incision near your belly button and two to three incisions in the top right part of your abdomen.
  • Inserts a small tube with carbon dioxide to inflate your abdomen. This inflation offers easier access to your gallbladder.
  • Uses a laparoscope (a small tool with a camera and light) to project an image of the inside of your abdomen onto a large screen.
  • Removes your gallbladder by inserting small surgical tools through the incisions.
  • Releases the gas from your abdomen and closes the incisions with stitches.

What happens after gallbladder removal?

After laparoscopic gallbladder removal, you usually return home the same day. You may have to stay in the hospital for a day or two after open surgery.

Someone needs to drive you home after gallbladder removal surgery. If you return home the same day as the operation, you should have someone stay with you for 24 hours.

Do I need to change my diet after gallbladder removal?

Although your gallbladder is not essential, it helps you digest fatty foods. Immediately after gallbladder removal, you’ll need to avoid fatty and fried foods.

To avoid discomfort, fat calories after surgery should make up no more than 30% of your diet. In the weeks after surgery, reintroduce high-fiber foods slowly. Whole grains, nuts, seeds and vegetables may cause severe bloating or gas if you eat too much too quickly.

Risks / Benefits

What are the risks or complications of cholecystectomy?

You can live a healthy life without your gallbladder. Most people don’t have long-term side effects of cholecystectomy. Like any other surgery, gallbladder removal carries some risks of bleeding or infection.

What are the gallbladder removal side effects?

After gallbladder removal, you may have temporary side effects. For a few days, you might notice:

  • Bloating, diarrhea or gas.
  • Bruising or swelling near the incision site.
  • Fatigue.
  • Mood swings or irritability.
  • Nausea or upset stomach.
  • Pain in your shoulders or abdomen from the gas used to inflate your abdomen.

Does my digestive system still work after cholecystectomy?

Yes. After the operation, your digestive system can still function. Your liver still makes bile so you can digest food. Instead of staying in your gallbladder, the bile drips directly into your digestive system. Most people can resume their usual diet once they recover from gallbladder surgery.

Recovery and Outlook

What is the recovery time after gallbladder removal?

After open gallbladder removal, recovery typically takes around six to eight weeks. Recovery from laparoscopic gallbladder removal typically takes around two weeks.

When can I return to work after gallbladder removal?

Most people can drive and return to desk jobs within a week or two. If your job involves physical work or hours on your feet, speak with your healthcare provider. You may need to stay home from work or modify your routine for up to eight weeks.

When to Call the Doctor

When should I see my healthcare provider?

See your healthcare provider right away if you experience:

  • Discharge or redness at your incision site.
  • Fever above 100.4 degrees Fahrenheit.
  • Pale stools or dark urine.
  • Persistent nausea or vomiting.
  • Severe or increasing pain.
  • Swelling that doesn’t go away.

A note from Cleveland Clinic

Gallbladder removal or cholecystectomy is surgery to take out an organ called the gallbladder. You may need this surgery if you have gallstones. Gallstones are small pebble-like deposits that build up in your gallbladder. Your surgeon may use an open or laparoscopic cholecystectomy. Both procedures are safe, effective options, and most people recover within two to eight weeks. Cholecystectomy is a common treatment for gallstones. You can live well without your gallbladder.

8 Common Signs and Symptoms of Gallbladder Problems

8 Common Signs and Symptoms of Gallbladder Problems

Tuesday, February 2nd, 2016 | Written by Premier Surgical Staff

The gallbladder is often taken for granted. Unlike the heart or the liver, we don’t often see headlines on “How to have a healthy gallbladder.” Patients at Premier Surgical sometimes confess they didn’t even know what the gallbladder did exactly—until there were problems. Learn more in our Gallbladder 101 eBook.  

Your gallbladder is a pear-shaped organ just under your liver. It stores bile, which is a fluid made by your liver to digest fat. As your stomach and intestines digest food, the gallbladder releases bile through a tube called the common bile duct to your small intestine. Most gallbladder problems occur when substances in the bile harden, creating gallstones which can block the duct.

The American Gastroenterological Association suggests more than 25 million Americans have gallstones with 1 million new cases diagnosed annually. Less commonly, cancer can form in the gallbladder.

Most gallbladder issues are initially indicated by pain in the upper right or middle abdomen. The most common symptoms of gallbladder problems are:

  • Abdominal pain, which may range from dull to sharp, and which may worsen after eating a fatty meal
  • Heartburn, indigestion, and excessive gas
  • Sensation of fullness in the abdomen
  • Vomiting or nausea
  • Fever, shaking, and chills
  • Tenderness in the upper right abdomen
  • Jaundice or yellowing of the skin and eyes
  • Light or clay unusually colored stool

According to the National Institute of Health, gallstones cause the majority of gallbladder problems. Eating fatty or greasy food can irritate a gallbladder condition, since there’s not as much bile to manage the digestion process. Certain risk factors may also increase your chance of developing gallstones, such as genetics, and obesity. Talk with your physician about your family history and your lifestyle.

Many people have little to no awareness of their gallbladder until it begins to cause pain. If you experience gallbladder symptoms you should seek the consult of a physician to receive prompt treatment. Gallbladder problems left untreated can turn into serious medical emergencies. Gallbladder attacks can be extremely painful and frightening. If you cannot find relief from symptoms or you experience a sudden intensifying of pain or present fever, you should seek medical attention immediately.  

Premier Surgical Associates is the largest surgical group in the Knoxville region, providing comprehensive surgical care, with referrals from across the entire East Tennessee Region. To learn more about Premier Surgical Associates visit our website at www.premiersurgical.com.


90,000 Anemia: when treatment is ineffective

Photo from the archive of the center and webmd.com

Ble bottom skin of a child, blue under the eyes , cracks in the corners of the lips, fatigue, lack of appetite . Mothers fasting would have diagnosed quickly – anemia, there is not enough iron. “Only a doctor can diagnose a disease. And not necessarily anemia occurs due to a lack of iron in the body, as many believe, ”says Valentina Daugyalavichene – pediatric hematologist of the Medical Diagnostic and Treatment Center, located on V.Gribo in Vilnius.

Anemia is a condition in which the body’s hemoglobin content decreases. Hemoglobin, which contains iron, carries oxygen to the tissues. When its content decreases, the process slows down. As a result, a person becomes less hardy, gets tired faster, experiences weakness, the cells of the body are renewed more slowly – the skin becomes thin and dry, hair begins to thin, nails become brittle, disturbances in the functioning of the nervous and immune systems occur.

“Childhood anemia due to iron deficiency is a fairly common disease,” says Valentina Daugyalavicienė, a doctor with twenty years of practice in hematology oncology, and draws the attention of parents. “Usually iron preparations are prescribed for the treatment of the disease, but it happens that their intake does not lead to an improvement in the general condition of the patient, or to an improvement in the results of the examination.”

What is the reason for the ineffective treatment? The doctor has no doubt that the first step is to find out whether the malaise is really iron deficiency anemia.There are times when this disease is caused not only by a lack of iron. “The mother of a 12-year-old boy suspected anemia in her son, noticing that he looks exhausted, complains of abdominal pain, sometimes his eyeballs turn yellow. On palpation of the boy’s abdomen, we found an enlarged spleen. During echoscopy, stones in the gallbladder were also seen. Additional blood tests showed elevated serum iron and elevated bilirubin levels. We diagnosed hereditary microspherocytosis.This disease is inherited – from birth, a person has both small red blood cells, called microspherocytes, and red blood cells of normal size. Small erythrocytes are inflexible, getting into the spleen, they die. Only normal size erythrocytes slip through the spleen ducts. When erythrocytes break down in the spleen (which is why it increases), too much iron is formed. Do I need to take iron supplements in this case? Of course no!” – says the children’s hematologist V.Daugyalavicienė.

If hemoglobin drops to life-threatening levels, these patients need red blood cell transfusion. If the crisis of the disease repeats, and doctors constantly state a low hemoglobin content, the spleen has to be removed. “Such patients are under our supervision because of the formation of stones in the gallbladder, – says the doctor. – Stones can get stuck in the bile ducts. In this case, the operation is inevitable, you have to remove the gallbladder. ”

Sometimes the doctor has to remove iron from the body, rather than prescribe its preparations.“My parents brought two sisters, 7 and 9 years old, to my office, diagnosed with anemia, but both were treated for a long time and ineffectively,” recalls the children’s hematologist. – When we conducted additional examinations, it turned out that the girls are sick with thalassemia, which is characterized by hereditary disorders in the structure of the hemoglobin molecule. With this disease it is impossible to prescribe iron preparations, on the contrary, there is an excess of iron in the body. ”

Anemia is usually diagnosed based on blood tests.When iron stores are depleted, signs of anemia do not appear immediately, but their appearance often indicates other diseases. “The cause of anemia, the treatment of which does not give results, can be diseases of the kidneys, liver and malignant processes that have begun in the body,” emphasizes the children’s hematologist V. Daugalavicienė. “Therefore, it is necessary to purposefully conduct additional examinations – blood tests, biochemical blood tests.”

If examinations show that iron deficiency anemia was diagnosed correctly, and the treatment still does not give the results that patients expect, it is necessary to establish – why? “Perhaps the doctors prescribed too little iron, or perhaps the iron was not taken long enough.Or the prescribed iron supplement is not suitable for the patient and needs to be replaced. Other diseases cannot be ruled out, for example, disturbances in the work of the digestive tract – gastritis, peptic ulcer, inflammatory bowel diseases, ”the doctor notes.

She herself had a similar case: “A teenage girl came to the consultation who complained of weakness and fatigue. In physical education lessons, she quickly got tired, felt an increased heartbeat, and sweated a lot. She had no appetite, although she did not complain of stomach pains.The girl was diagnosed with iron deficiency anemia. After taking iron supplements, her condition did not improve at all. During gastrofibroscopy – an endoscopic examination of the stomach, we found signs of gastritis, and the test for the bacterium H. pylori was also positive. The patient was prescribed a combined treatment by a gastroenterologist and a hematologist. Ten days later, her condition and test results improved, but the girl had to undergo long-term treatment under the supervision of a hematologist and gastroenterologist. “

Children’s hematologist V. Daugalavičienė says that one cannot give up on anemia and save oneself with iron preparations alone. If the child’s condition causes concern, the family doctor cannot answer the questions that arise, the test results are not entirely clear or the prescribed treatment is ineffective, a consultation with a pediatric hematologist is simply mandatory. The doctor diagnoses and treats not only iron deficiency anemia, but also all diseases of the blood and the hematopoietic system – changes in the number and function of blood cells, blood clotting disorders, lymphoma.

Ursodeoxycholic acid in liver diseases associated with cystic fibrosis

Review Question

Does ursodeoxycholic acid improve liver function, reduce the risk of chronic liver disease, and improve overall outcomes in people with cystic fibrosis?


Problems with the consistency of bile (thickening) and bile outflow lead to liver disease in 20% of young people with cystic fibrosis.The bile ducts can become blocked, which can cause cirrhosis of one or more parts of the liver. Ursodeoxycholic acid is a naturally occurring bile acid that people with cystic fibrosis take in tablet or liquid form to try to prevent liver disease. The best result is achieved when taking the drug in a total dose of 20 mg / kg / day in 2 or 3 doses, initially prescribed for several months, but possibly for an indefinite period. The drug was originally used to treat gallstones, but over the past few years it has also been used to treat and prevent the progression of liver disease associated with cystic fibrosis.This is an updated version of the review.

Search date

We conducted our last evidence search on April 9, 2017.

Characteristics of research

We searched for clinical trials using ursodeoxycholic acid that were at least three months in duration and were able to include four trials, but only three of them had suitable data for analysis.This review includes studies involving 118 people aged four to 32 years. The drug doses used in these three clinical trials ranged from 10 to 20 mg / kg / day. Two studies compared ursodeoxycholic acid tablets to non-drug tablets (placebo), and a third trial compared ursodeoxycholic acid treatment with “conventional” treatments. Due to the complex design of the two trials, it was not possible to analyze the data for all participants.The tests lasted up to 12 months, but no more. However, one trial reported some data after nine years of follow-up.

Key Outcomes

Not all of the outcomes listed in our review were evaluated, only weight gain, skinfold thickness, and bile excretion. There were no real differences between the various treatment regimens for any of these outcomes. Long-term outcomes that we consider important, such as death or the need for liver transplantation, were reported only in follow-up in one clinical trial.At the same time, there was no information about what people who died or needed a liver transplant received – ursodeoxycholic acid or placebo.

Existing research indicates that side effects of this treatment are rare, but there is insufficient information on long-term use to justify its routine use in people with cystic fibrosis. Since there is no other treatment to prevent liver disease, further research is needed on the use of ursodeoxycholic acid.

Quality of evidence

Clinical trials were well designed and conducted, but did not always provide enough information to properly evaluate them. While we generally do not believe that any factors related to the trial would have significantly influenced the results, we had some concerns that in one trial at the start of the trial, participants receiving ursodeoxycholic acid had different health conditions than the health status of the participants in the placebo group.In addition, in another trial, there were several people who dropped out of the study and were not included in the final analysis, and the reasons were not given. Overall, we rated the quality of the evidence we found as low or very low.

Gamma-glutamyl transpeptidase (gamma-HT)

General information about the study

Bile is produced in liver cells and is secreted through a system of microtubules called bile ducts. They then combine into the hepatic ducts that extend outside the liver to form a common bile duct that drains into the small intestine.Bile is essential for the absorption of dietary fats. Also, some medicinal substances are excreted through the bile. It is formed constantly, but enters the intestines only during and after a meal. When it is not needed, it accumulates in the gallbladder.

Gamma-glutamyl transpeptidase is an enzyme that is found in the cells of the liver and biliary tract and is a catalyst for certain biochemical reactions. It is not contained in the bloodstream, only in cells, when destroyed, their contents enter the blood.Normally, some of the cells are renewed, so a certain GGT activity is found in the blood. If many cells die, its activity can increase significantly.

The GGT test is the most sensitive test for bile stagnation – cholestasis. The activity of GGT when obstructing the outflow of bile, for example, with stones in the bile ducts, increases earlier than the activity of alkaline phosphatase. However, this increase is nonspecific, since it occurs in most acute diseases of the liver and bile ducts, for example, in acute viral hepatitis or cancer, and usually such a result is not very informative in establishing a specific disease or condition that caused liver damage.

Unlike other liver enzymes, the production of GGT is “triggered” by alcohol, so in those who abuse it, its activity can be increased even in the absence of liver disease. In addition, the production of GGT is stimulated by some drugs, including phenobarbital and paracetamol, so while taking them, you can expect an increase in GGT without damaging the liver.

GGT is also found in the kidneys, spleen, pancreas, brain, prostate, and an increase in its activity is nonspecific only for liver disorders.

What is the research used for?

  • To confirm the disease of the liver and biliary tract, especially if there is a suspicion of blockage of the biliary tract with stones in the bile duct or with a tumor of the pancreas.
  • To monitor the effectiveness of treatment for alcoholism or alcoholic hepatitis.
  • For the diagnosis of diseases affecting the biliary tract – primary biliary cirrhosis and primary sclerosing cholangitis.
  • To determine whether an increase in alkaline phosphatase activity is caused by liver disease or bone disease.
  • To monitor the condition of patients with diseases in which GGT is increased, or to assess the effectiveness of their treatment.

When is the study scheduled?

  • When performing standard diagnostic panels that can be used for routine medical examinations, in preparation for surgery.
  • When performing “liver function tests” used to assess liver function.
  • For complaints of weakness, fatigue, loss of appetite, nausea, vomiting, abdominal pain (especially in the right hypochondrium), jaundice, darkening of urine or lightening of feces, skin itching.
  • If alcohol abuse is suspected or when monitoring patients undergoing treatment for alcoholism or alcoholic hepatitis.