Visual Guide To Your Gallbladder

Medically Reviewed by Minesh Khatri, MD on August 22, 2021

Your gallbladder sits on the right side of your belly, below your liver. It’s a small organ, shaped like a pear, that holds a fluid called bile. This liquid, made in your liver, helps you digest fats and certain vitamins. When you eat, your body gets the signal to release it — through channels called ducts — into your small intestine.

The most common reason people have trouble with their gallbladder is gallstones. You get them when bile clumps together and forms solid masses. They can be as big as a golf ball, and you can have just one or several.

Most stones are made of hardened cholesterol. But people with certain conditions like cirrhosis and sickle cell disease are more likely to have another kind called pigment stones. These are made of bilirubin — a brownish yellow compound your liver makes when it breaks down old red blood cells.

If a gallstone gets into a duct and keeps bile from flowing out, your gallbladder can get inflamed. That’s called cholecystitis, and it can lead to nausea, vomiting, and belly pain. Bacteria also can cause it. You can tell you’re having gallbladder trouble by where it hurts: the upper right part of your belly. It might get worse when you take deep breaths, and you may also feel an ache in your back or right shoulder blade.

Your doctor will examine you and might want to take a sample of your blood to look for signs your body is fighting an infection. You probably will have an imaging test, like an ultrasound. It uses sound waves to make detailed images of your gallbladder. Your doctor also might want an X-ray of your belly or other blood tests to see how well your liver is working.

Some gallstones never cause problems and can be left alone — they’re called “silent.” But if you have symptoms, your doctor may recommend surgery, called cholecystectomy, to take out your gallbladder. You’ll be fine without it — the bile your liver makes will flow straight into your intestine.

Researchers believe estrogen plays a role in gallstones. The female sex hormone can boost the amount of cholesterol in your bile. And pregnancy can cause a buildup of something called gallbladder sludge, a thick liquid your body can’t absorb easily.

If someone in your family has had gallstones, your chances of getting them are higher. Mexican-Americans and Native Americans are more likely to have them than other people — the Pima tribe of Arizona has the highest rate of gallbladder disease in the world. Researchers think certain genes can raise the amount of cholesterol in bile.

If you’re overweight, your body may make more cholesterol, which means you’re more likely to have gallstones. You also may have a larger gallbladder that doesn’t work as well as it should. If you carry most of your weight around your waist rather than in your hips and thighs, that may also raise your chance of getting gallstones.

If you drop weight too quickly, you can be more likely to have gallstones, because weight loss surgeries and very low-calorie diets can be hard on your gallbladder. Cycling — losing and regaining weight over and over — also can cause trouble. The safest course is a slow one: Aim to shed fewer than 3 pounds a week.

Foods high in cholesterol and fat can raise your chances of gallstones. And you’re more likely to have gallbladder issues if you don’t have much fiber in your diet or you eat a lot of refined carbohydrates like white bread and white rice.

Birth control pills and hormone replacement therapy can raise your chances of gallstones because they have estrogen in them. Medicines called fibrates, which help lower your cholesterol, have been linked to gallbladder disease because they can raise the amount of cholesterol in your bile. 

If you have this condition that affects your kidneys, you may have more of a kind of fat called triglyceride in your blood, and that can boost your chances of gallstones. Researchers also think your gallbladder may not react to your body’s signals the way it should and that can let bile build up.

The risk of gallstones is higher once you’re past 40, but you can do a few things to help avoid them. Stay at a healthy weight, but don’t fast or go on crash diets. Eat plenty of fiber and good fats like olive and fish oil, and don’t eat much refined grain. Choose whole wheat instead of white bread, for example, and brown rice instead of white.

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Mayo Clinic: “Diseases and Conditions — Gallstones.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Gallstones. “

Massachusetts General Hospital: “Conditions and Treatments — Cholecystitis. “

American College of Gastroenterology: “Gallstones in Women.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Dieting and Gallstones.”

American Heart Association: “Cholesterol Medications.”

Arteriosclerosis, Thrombosis, and Vascular Biology, November 2001.

Drug Safety, January-February, 1992.

Nigerian Journal of Surgery, July-December, 2013.

Neuroendocrinology Letters, February-April, 2003.

National Institute of Diabetes and Digestive and Kidney Diseases: “Smoking and the Digestive System.”

Smokefree.gov by the National Cancer Institute: “Benefits of Quitting.”

United Kingdom National Health Service: “Gallbladder Removal.”

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Where is the Gallbladder Located

Gallbladder Location

Learning About the Gallbladder

Many people don’t usually bother to educate themselves about the gallbladder until it starts causing trouble. However, learning as much as possible about this important organ can be helpful, especially if you are experiencing an issue and are trying to get a better picture of what may be going wrong.

What is the Gallbladder?

The gallbladder is a small organ, which is attached to the liver. Its job is to store the bile. When a person eats, the gallbladder releases bile into the small intestine where it helps break up fats.  

The Most Common Gallbladder Problems

Gallstones

Gallstones are solid particles formed from bile cholesterol and bilirubin.

Cholecystitis

Gallbladder inflammation. It can be acute or chronic. The condition occurs when the gallstones are stuck at the gallbladder’s opening.

Gallstone Pancreatitis

Gallstones block the pancreatic duct, resulting in pancreas’ inflammation.

Gallbladder Problems

Gallbladder Cancer

Gallbladder cancer is a rare condition. It’s difficult to diagnose and usually discovered at the late stages of the disease.

Can you Live Without a Gallbladder

While the gallbladder is a useful organ, a human body can function without it. After a gallbladder removal surgery, the bile proceeds directly into the small intestine, which warrants some changes to the patient’s lifestyle.

What Does a Gallbladder Look Like?

The gallbladder is a pear-shaped organ. It’s usually 3 to 4 inches long and about 2 inches in diameter. Much like the urinary bladder, when the organ is empty, it’s flat. As it fills with bile, the gallbladder balloons to start taking the shape of a pear. The gallbladder’s storage capacity is about 50 ml (1.7 fl. oz.).

The organ’s anatomical structure includes:

Fundus

The top rounded part of the gallbladder (the bottom of the pear). It’s located near the inferior surface of the liver.

Body

The middle part of the gallbladder.

Neck

The bottom part of the gallbladder (top part of the pear). It’s connected to the cystic duct that turns into a common duct. The latter connects the gallbladder to the liver and the pancreas.

Where Is the Gallbladder Located?

The gallbladder is located on the right side of your body, directly under the liver. It’s attached to the liver and the pancreas with a series of ducts. The gallbladder generally sits at the midline of the right (larger) lobe of the liver.

Medical professionals can palpate the gallbladder when the patient is lying on the back or side. Without special knowledge, it’s hard for the patient to locate the gallbladder even if it’s enlarged.

When to See a Doctor for Gallbladder Issues

If you feel that you may be experiencing gallbladder symptoms you may need a laparoscopic cholecystectomy procedure. It is imperative that you seek medical advice from an experienced medical physician like Dr. Steven Williams. He is known as the surgeon of choice for Hiatal Hernia / GERD, Gallbladder, Hernia, Varicose Veins and Spleen Surgery in the Boise area.

Contact us today for more information about gallbladder conditions, diagnosis, and treatment options or to set an appointment.

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where it is located, how it hurts, functions, structure

The role of the gallbladder in the body

Together with the ducts, the gallbladder forms the biliary system, which ensures the accumulation, storage and excretion of bile¹.

Bile is a digestive fluid that performs several functions:

• promotes the breakdown and absorption of fats;
• regulates the activity of intestinal and pancreatic enzymes;
• has bactericidal properties;
• activates small intestine motility;
• is involved in excretory processes.

Bile is secreted by the liver, but the gallbladder only stores it. During the day, the human liver can produce from 500 to 1000 ml of bile. It enters the gallbladder through the duct system. It holds about 50 ml of bile. Every time a person eats and food enters the duodenum, the walls of the gallbladder contract and bile is released into the lumen of the intestine.

Where is the gallbladder located?

The gallbladder is located in the right hypochondrium under the liver (Fig. 1.). It fits snugly to it from the bottom side and comes into contact with the stomach, small intestine, and the membrane of the abdominal cavity. The gallbladder is connected to the liver by a duct that carries bile. This is a small organ, normally it is not palpable².

Figure 1. Location of the gallbladder. Source: Cancer Research UK / Wikimedia Commons (CC BY-SA 4.0)

Structure of the gallbladder

The gallbladder is a relatively small, pear-shaped, sac-like organ. The volume of the organ is 40-60 cm3, its length is from 8 to 12 cm, width is from 3 to 5 cm. The length of the cystic duct is about 3.5 cm. The body, neck and fundus are distinguished in the structure of the gallbladder. The bottom forms the lower part of the bladder and protrudes slightly from under the liver. It passes into the middle part of the body – its body. The body tapers upward, forming a neck, the narrowest part. It joins with the cystic duct, which in turn opens into the common bile duct. The edge of the organ in the neck area is angled to facilitate the outflow of the secret. There are sphincters on the ducts – muscle valves that open when the outflow of bile begins, prevent its reverse flow (reflux of the contents of the duodenum into the gallbladder), and also block the secretion flow when the digestion process is completed (Fig. 2).

Figure 2. The structure of the gallbladder and biliary tract. Source: OpenStax (CC BY 4.0)

The wall of the gallbladder has three layers or sheaths. The outer connective tissue sheath performs protective functions. The muscular layer forms the main layer of the walls. It is needed to contract the organ during the release of bile. The mucous membrane forms folds that straighten out when the bladder fills. In the region of the neck and cystic duct, these folds are arranged in a spiral. This is necessary to improve the excretion of bile.

Functions of the gallbladder

Bile is constantly produced by the liver, but it is only needed during digestion, when food is in the stomach. The rest of the time, it accumulates and is stored in the gallbladder². In this case, the body performs several functions:

• Reservoir. During periods when digestion does not occur, bile gradually accumulates inside the gallbladder.
• Evacuator. During digestion, bile is released, its movement through the ducts into the lumen of the duodenum.
• Concentration. With the accumulation of bile, it gradually thickens, and the concentration of acids changes so that the secret does not damage the mucous membrane of the digestive tract and ensures the breakdown of lipids. This is necessary, for example, if a person does not eat for a long time and there is no outflow of bile.
• Absorption. The walls of the organ absorb excess fluid, due to which the concentration of the secret increases. It is possible to absorb not only liquid, but also other components contained in bile in excess.
• Secretory. Glands in the neck of the gallbladder secrete mucus necessary to move bile.

When the process of digestion begins, the gallbladder contracts, the sphincters on the ducts open, bile enters the duodenum. When the bile has fulfilled its functions, the walls of the gallbladder begin to produce the hormone anticholecystokinin. Under its action, the organ relaxes, the sphincter closes, bile stops flowing into the duodenum.

How the gallbladder performs its functions affects the properties of bile, its movement, and the digestive process.

Is it true that the gallbladder is an “unnecessary” organ?

The gallbladder is really not a vital organ. With gallstone disease, the doctor may recommend its removal. For this, a cholecystectomy is performed. After such an operation, bile will have nowhere to accumulate. Because of this, the work of the liver is gradually rebuilt. She will secrete bile not continuously, but in portions. And during the period while this “perestroika” is going on, and after it, you will need to follow a special diet.

Removal of the gallbladder is performed only if indicated, if there is a risk of blockage of the ducts, large stones are formed or there are other factors that threaten the development of complications. A person can live without this organ, but its removal almost always affects the quality of life: there are dietary restrictions, you need to carefully monitor your health. Cholecystectomy affects the functioning of the pancreas and liver. Sometimes after surgery, there are disorders of the stool and digestion¹.

Symptoms of diseased gallbladder

Disorders of the gallbladder develop gradually. Often this is due to malnutrition and an unbalanced diet, which also affects other digestive organs. Because of this, digestion gradually worsens, the first general symptoms appear. Often they are associated with the state of not only the gallbladder, but the entire digestive system. The first signs of disease may be:

• pain, colic in the right hypochondrium;
• metallic taste, bitterness in the mouth;
• belching, nausea, vomiting;
• redness of the tongue or the formation of a light coating on it.

If these symptoms appear, you should be examined by a gastroenterologist.

If the condition of the gallbladder worsens, the symptoms become more specific. Appear:

• Pain in the hypochondrium intensifies, can be very intense after eating fatty, smoked, fried foods. If a stone comes out of the gallbladder and clogs the duct, the pain is acute, sharp, paroxysmal. With the formation of polyps inside the organ, there may be no pain.
• Jaundice of the skin and whites of the eyes, which appears due to problems with the evacuation of bile. The acids contained in it enter the bloodstream, and this provokes the development of jaundice.
• Cal becomes light. Normally, bile enters the duodenum, and the acids contained in it color the feces brown. If there is little bile, this does not happen and the stool brightens.
• Intense yellow or dark color of urine. Partially, bile acids are excreted in the urine, and because of this, its shade changes.
• Problems with digestion and stool. After a fatty, heavy meal, nausea appears, vomiting is possible. Stool disorders gradually increase – flatulence, prolonged constipation or diarrhea appear. This is due to violations of the digestion of fatty foods, due to insufficient flow of bile into the duodenum³.

In diseases of the gallbladder, there are also signs of liver problems: a constant bitter taste in the mouth, redness of the tongue.

Sometimes there are symptoms that are not related to digestion or liver function: sleep disturbances, irritability, skin itching. Appetite almost always gradually worsens.

What are gallbladder diseases?

If the biliary system is disturbed, the outflow of bile does not occur correctly. Because of this, its composition changes, inflammation may begin. As a result, one of the characteristic diseases develops⁴.

Biliary dyskinesia

In this disease, the functioning of the biliary system is disturbed. Both the bladder itself or the ducts and the sphincters of the ducts may be involved in the process. Because of this, bile secretion occurs incorrectly:

• too little or too much of it;
• outpouring occurs too early;
• there is an outflow delay.

Dyskinesia may be primary (congenital, associated with disorders of the structure of the organs of the biliary system) or secondary. Secondary dyskinesia develops against the background of inflammation of the gallbladder or ducts, cholelithiasis, some viral diseases, as well as peptic ulcer of the stomach and duodenum, pancreatitis, gastritis and other diseases. Often dyskinesia occurs due to dysfunction of the sphincter of Oddi. This is a muscular valve that opens the cystic duct for the outflow of bile into the duodenum. Dyskinesia is manifested by pain in the right side, digestive disorders, deterioration in general well-being.

Gallstone disease

A common disease in which bile stagnation is formed, its composition changes, and calculi are formed – gallstones. Stones can consist of cholesterol, bilirubin, have a mixed composition. The formation of stones is dangerous due to blockage of the ducts, the appearance of colic, the development of severe complications (Fig. 3).

Figure 3. Formation of gallstones. Source: BruceBlaus / Wikipedia (CC BY-SA 4.0)

Gallstone disease is more common in women. It causes a violation of the metabolism of cholesterol and bilirubin, inflammation of the biliary tract, deterioration of the outflow of bile. This occurs under the influence of various factors, including advanced age, hereditary predisposition, malnutrition, sedentary lifestyle, fasting, strict diets, hormonal disorders, or conditions that increase estrogen levels.

In the early stages of cholelithiasis treatment, the gastroenterologist will prescribe a therapeutic diet and give recommendations on lifestyle changes. If the stones are large or acute inflammation develops against the background of cholelithiasis, an operation will be needed. Stones are often removed along with the gallbladder itself. After such an operation, rehabilitation and adherence to a special diet will be required.

Cholecystitis

Cholecystitis is an inflammation of the lining of the gallbladder. It often develops as a complication of cholelithiasis due to a violation of the outflow of bile. It can be acute or chronic, it occurs in different forms. Cholecystitis is accompanied by acute pain, general malaise. In an acute course, it is life-threatening. The state of health can quickly deteriorate – so much so that the patient will need urgent medical attention.

Cholecystitis is treated by restoring and stimulating the flow of bile, and using antibiotics and antimicrobials to fight the infection. If the patient goes to the doctor in time, the prognosis is favorable. Without treatment, severe complications leading to death can develop.

Other diseases

The following diseases are less common:

• Polyp formation. Occurs if the upper layer of the inner shell of the organ grows and forms benign tumors. These can be adenomas, papillomas, inflammatory or cholesterol polyps.
• Cancer of the gallbladder. It can develop as a complication of cholelithiasis as a result of the degeneration of polyps and for other reasons. It can be adenocarcinoma, less common is squamous and papillary cancer, in which the tumor forms inside the wall of the organ.
• Fistula. An opening in the wall of the gallbladder through which bile flows. Appears as a complication of cholelithiasis or chronic cholecystitis. May be life threatening. The fistula can be removed only during the operation.
• Empyema. Appears after blockage of the cystic duct when a bacterial infection is attached. With empyema, pus accumulates inside the organ, and this is accompanied by pain, high fever, and intoxication. The condition can be life-threatening.

Prophylaxis for the proper functioning of the gallbladder

The gallbladder is not a vital organ, but its diseases disrupt the digestive system, and after its removal, the load on the liver, pancreas and other organs increases. In order for the gallbladder to remain healthy and work normally, it is enough to follow the following recommendations:

• Eat right. It is important to observe the diet, eat regularly and not starve for a long time. The diet should contain as little as possible fatty, fried, smoked foods.
• Observe the regime of the day. You need regular physical activity, proper sleep and rest.
• Limit alcohol consumption, stop smoking.
• Try to reduce stress levels.

If one of the relatives had cholelithiasis or other diseases of the gallbladder, it is necessary to undergo a preventive examination by a gastroenterologist every year. It is also necessary to see a doctor if there are factors that provoke disorders in the digestive system: overweight, a sedentary lifestyle, diseases of the pancreas or other digestive organs, irregular meals.

For women during pregnancy, menopause, taking oral contraceptives, the risk of developing gallbladder disease increases. To control it, you need to consult a gastroenterologist.

If a person has gallbladder disease or is at increased risk of developing one, it is especially important for them to control their diet.

1. Meals should be fractional: you need to eat often and in small portions.
2. The diet should be as low as possible fatty foods, muffins, sweets, coffee, alcoholic and carbonated drinks.
3. Products are best boiled, stewed, baked or steamed.
4. It is undesirable to eat fried, smoked, salty, canned foods.
5. Drinking more fluids is important⁵.

Conclusion

The gallbladder is an important organ for the proper functioning of the digestive system. With a balanced diet and normal physical activity, the risk of disruption to its work is minimal. Excess weight, a sedentary lifestyle, irregular meals and a poor diet can provoke his diseases. Some gallbladder diseases can be life-threatening. Therefore, it is important to consult a doctor if their symptoms appear: digestive problems, acute pain in the right hypochondrium, stool disorders.

Resources

1. Quinn Phillips. What Are Common Gallbladder Problems? Symptoms, Causes, Diagnosis, Treatment, and Prevention. Everydayhealth. 2020.
2. Gallbladder. Cleveland Clinic. 2021.
3. Noreen Iftikhar. What to Do If You’re Having a Gallbladder Attack. health line. 2018.
4. Kimberly Holland. Identifying Gallbladder Problems and Their Symptoms. health line. 2019.
5. Jenna Fletcher. What are the most common gallbladder problems? medical news today. 2018.

Deformation of the gallbladder / Diseases / Clinic EXPERT