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.

IMAGES PROVIDED BY:

1) PIXOLOGICSTUDIO/SCIENCE PHOTO LIBRARY / Getty Images

2) Scott Bodell / Medfical Images

3) George Chernilevsky / Wikipedia  (left), moonisblack / Thinkstock  (right)

4) BSIP / UIG / Getty Images

5) YakobchukOlena / Thinkstock

6) Dr P. Marazzi / Science Source

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12) crankyT / Thinkstock

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14) moodboard / Thinkstock

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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cost, life after cholecystitis, complications, diet

Medicine and health

04/18/22

And why was it removed for me

Ekaterina Bakushina

lives without a gallbladder

You wake up in the morning not from an alarm clock, but from a sharp burning sensation in the solar plexus: this happens when you have neither a gallbladder nor discipline.

It was 2008: tomorrow I have my final exam at school, and today I am rolling on the floor with severe pain in my stomach. No pills help. They don’t even have time to digest – I feel sick and vomit acid.

It’s good that there are doctors in the family: they gave me an injection with painkillers, the next day I was like a cucumber. The exam went well, but the pain returned again a day later.

With a new attack, I went to the hospital. The doctor on duty, seeing how I doubled over with a gray face, sent me for an ultrasound. There it turned out: I have acute cholecystitis, or inflammation of the gallbladder.

I’ll tell you how he was first treated with conservative methods, how then my gallbladder was removed and how I now live without it.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we give recommendations. Relying on our point of view or not is up to you.

What is acute cholecystitis and why does it occur?

Acute cholecystitis is an inflammation of the gallbladder that5% of cases develop due to the fact that the organ duct is clogged with a stone. Such cholecystitis is called calculous.

Acute Cholecystitis – MSD Manual

The gallbladder is the reservoir for bile secreted by the liver. There it acquires the necessary concentration, and at each meal it is released into the duodenum, where it breaks down the fats that come with food.

Acute cholecystitis – NHS

If the gallbladder duct is blocked by a stone, bile cannot be expelled. Because of this, there is an acute pain in the right hypochondrium, which is called hepatic colic, nausea, vomiting, and sometimes the temperature rises. An ultrasound in the gallbladder will show stones, as well as signs of an inflammatory process.

Cholecystitis – Mayo Clinic

In such cases, cholecystectomy, that is, removal of the gallbladder, is often prescribed. Without treatment, its wall may rupture over time, leading to a life-threatening condition – peritonitis, when inflammation spreads to the entire abdominal cavity.

Acalculous cholecystitis is rare, its causes are, for example, damage to the gallbladder during trauma or surgery, sepsis, that is, blood poisoning. Usually people with this disease are already in the intensive care unit. 9GMS Clinic

Choice of treatment – conservative or surgical , determination of indications and contraindications for surgery for cholelithiasis is the prerogative of the surgeon.

As a rule, acute calculous cholecystitis is an unconditional indication for surgical intervention. Then the surgeon decides on the timing of the operation.

There are situations when active anti-inflammatory therapy is first carried out to stop acute inflammation in the gallbladder, and after a certain time, surgical intervention is performed.

If the inflammation in the gallbladder is insignificant, and the pain syndrome is pronounced, then the operation is most often performed immediately.

Why stones appear in the gallbladder

I had an ultrasound in the hospital and they found a stone that caused the seizures. It is believed that this happens when the composition of bile changes – for example, it becomes more concentrated.

Gallbladder stones – NHS

Main risk factors: female gender, age over 40 years, overweight, sedentary lifestyle, dietary problems such as excess fatty foods and lack of fiber, rapid weight loss, intake of certain drugs, liver disease.

Gallstones – Mayo Clinic

There is also evidence that there is a genetic predisposition to the formation of gallstones.

Gallbladder Stones: Risk Factors – Uptodate

The doctor at the hospital listed the reasons why young people can form stones, in particular, unhealthy diet and sudden weight loss.

It was about me. For example, during the last years at school, preparing for exams and running from one tutor to another, I constantly ate on the go, often only sandwiches and chocolates. Also, my grandmother had stones in the gallbladder, perhaps the hereditary factor also played a role.

The appointment was based on compulsory health insurance, so all the procedures turned out to be free.

How to deal with asymptomatic gallbladder stones

Andrey Farber

gastroenterologist, MD, GMS Clinic

Asymptomatic stone carriers usually use observational tactics with diet. This approach is explained by the minimum probability – 1-2% of cases per year – that an acute surgical situation will arise, that is, there will be indications for surgery.

Patients with asymptomatic stone carriers are under the supervision of a surgeon or gastroenterologist. They periodically undergo a scheduled examination, which includes:

1. Ultrasound examination of the abdominal organs. With its help, the dynamics of the state of the gallbladder itself and the stones located in its lumen are assessed – their size and quantity, as well as the state of the liver, biliary tract and pancreas.
2. Blood tests – they make a conclusion about the functional state of the liver and pancreas.

Based on the results of the examination, the issue of further tactics and the effectiveness of conservative treatment is decided.

How I treated calculous cholecystitis without surgery

Since I had one and rather small stone, up to a centimeter in size, my parents and I, on the advice of doctors, decided to do with conservative treatment.

Approaches to the treatment of gallstones – Uptodate

International guidelines for the management of hepatic colic advise the use of non-steroidal anti-inflammatory drugs such as ibuprofen. If there is severe inflammation of the gallbladder, antibiotics are used.

Non-surgical treatment of gallstones – Uptodate

Ursodeoxycholic acid may be prescribed to dissolve gallstones: it changes the viscosity of bile and helps to get rid of gallstones. True, in order for the stones to disappear, a long-term medication is usually required – up to two years.

Treatment of acute cholecystitis with stones – Uptodate

I was prescribed Ursosan to dissolve the stone – it just contains ursodeoxycholic acid. In addition, they prescribed No-shpu to relieve pain attacks: it is a drug that relieves spasms of the muscles of the gastrointestinal tract and the genitourinary system. Due to the lack of research, it is used only in Russia, a number of countries in Eastern Europe and Asia.

I was also prescribed “Festal” and “Mezim” – these enzyme preparations are used for violations of the pancreas. Such conditions can be combined with cholecystitis.

I was treated not in the hospital, but at home. For two months, while she was taking Ursosan, she also experimented with folk cholagogues, the recipes of which she found on the Internet. I insisted juices from carrots and celery, made decoctions from beets and chamomile.

I also tried to eat right. After a while, all symptoms disappeared. For almost ten years I didn’t think about my gallbladder, until I again had a similar attack of pain and vomiting. Most likely, he was provoked by a stormy feast.

How much does a healthy meal cost for a family of four

And it all happened again: the same symptoms, an ambulance call, an examination at a public hospital, an ultrasound scan and a recommendation for an operation. At my stories about attempts to dissolve the stone with a decoction of herbs, the gastroenterologist smiled indulgently. He said: “It is impossible to cure gallstone disease with traditional medicine. There is only one correct solution: surgery.”

How effective is conservative therapy for dissolving gallstones

Andrey Farber

gastroenterologist, MD, GMS Clinic

Unfortunately, conservative therapy to dissolve gallstones is not suitable for all patients with gallstone disease.

Very careful selection of patients for this treatment must be made. The size and number of stones, their density characteristics, the preservation of the contractile function of the gallbladder, the functional state of the liver and pancreas are taken into account.

In addition, the age and weight of patients, as well as the presence of concomitant diseases, are taken into account. Treatment in this case is handled by a gastroenterologist, therapist or general practitioner.

How I had an operation to remove my gallbladder

I really did not want to have an attack somewhere on a trip abroad or at an important event. And there were all the prerequisites for this: my stone not only did not dissolve, but also increased by another six millimeters.

Laparoscopic Cholecystectomy – Uptodate

Open cholecystectomy – Uptodate

Another argument in favor of the operation was the desire to give birth in the future. Doctors convinced: during pregnancy, everything changes a lot in a woman’s body, and no one knows how the gallbladder will behave. I didn’t need extra problems, and I decided.

It is not possible to remove only stones from the gallbladder: the entire organ is removed. This can be done through open surgery or through laparoscopy – when the gallbladder is removed through small punctures.

Four punctures are made in total, through which the camera and instruments are then inserted. This is exactly the kind of surgery I was given.

How to perform an expensive operation under CHI

Despite the fact that I lived in Moscow, I decided to perform the operation in my homeland, in Lipetsk. I chose a local surgeon on the advice of relatives. She signed up for the operation about a month after hospitalization. All procedures before, after and during the intervention were free of charge, according to compulsory health insurance.

Before hospitalization, I passed the necessary tests, underwent fluorography and ECG. A few days later, already in the hospital, the anesthesiologist talked to me. It was the first operation in my life, and it was scary: how the anesthesia would work, whether I would feel anything, whether I would wake up at all. The anesthesiologist explained everything in an accessible way, reassured me and clarified whether I was allergic to drugs. Then he warned that from six o’clock in the evening nothing could be eaten.

Early the next morning, I was taken to the operating room. It was cold and scary. I was told to undress completely and lie down on the operating table. The nurse began to administer drugs, the anesthesiologist put a mask on me, and after a few seconds I felt a pleasant weakness in my whole body and suddenly fell into a dream.

I began to come to my senses from a strange feeling in my throat: there, as I understood later, there was a tube from a ventilator. Patients are connected to it during long-term operations. As soon as the doctor realized that I was regaining consciousness, the tube was removed and I was asked to lie down on a gurney on my own. I vaguely remember how I ended up in the ward, but two hours later I woke up completely.

It’s good that I managed to take a picture of it, because after a few minutes I squeezed it with such force that it could not stand it and crumbled. It was insulting to tears: I thought that it could still be dissolved without removing the entire organ.

In the evening, a surgeon visited me and answered my worries like this: crushing gallbladder stones with a laser or ultrasound is a dangerous way that can clog the bile ducts or damage the gallbladder itself. The safest option is laparoscopic cholecystectomy, and rehabilitation after it is quite easy and fast.

I spent about three days in the hospital, and on the fourth day I was discharged. In the hospital, they gave injections of painkillers and antibiotics, bandaged the puncture sites. The sutures were removed a week later at the polyclinic at the place of residence.

The next day after the operation, I was bandaged, and I saw the work of the surgeon: the sutures were neat and miniature. Five years later, they are almost invisible. Such a pebble was taken out of my gallbladder. The extract from the hospital describes in detail the history of my illness, the treatment that I was given there, as well as recommendations for the postoperative period. Among them is a special diet

How was the recovery after removal of the gallbladder

The first month after the operation, intense physical activity, weight lifting are contraindicated. Also, the first week at home, I sat on baby food: liquid cereals, kissels, yogurts. The second time I made friends with a double boiler.

Diet after gallbladder removal – Mayo Clinic

My entire diet for the next two months became boiled and steamed. Nothing greasy: I even drained the first water when I cooked chicken broth. Apples – only in steam processing and without peel. Nothing spicy, smoked, rich, soda, alcohol, coffee and chocolate are prohibited. I was so afraid of going to the hospital again that I adhered to the diet strictly. It was very sad, but when I saw minus three kilograms on the scales, I perked up. It was nice to lose weight.

The first time after the operation, on the advice of my parents, also doctors, I took Trimedat and Creon. The antispasmodic and enzyme eliminated abdominal discomfort and helped digestion. I spent about 1,000 rubles on medicines.

12 important questions to nutritionist Elena Motova

Now I don’t go on a special diet: in general, I try to eat right, but I can afford both fast food and alcohol.

Do I need a special diet after gallbladder removal

Andrey Farber

Gastroenterologist, Candidate of Medical Sciences, GMS Clinic

After laparoscopic removal of the gallbladder, if there are no complications and the postoperative period is typical, it is necessary to strictly follow the diet for a week after the operation. Then the diet is gradually expanded over the next month.

In the future, in most cases, diet is not required, the person lives a normal life and eats as usual.

In some patients, after removal of the gallbladder, pain or discomfort in the abdominal cavity, flatulence, and various stool disorders persist. Then it is better to switch to frequent fractional meals in small portions at regular intervals with the restriction of products that provoke such situations.

These patients are recommended lean meats and fish, steamed, boiled or in a culinary sleeve with a minimum amount of fat, fermented milk products, and some fruits and vegetables, depending on their tolerance.

As a rule, gradually, patients themselves form an individual list of products and methods of their preparation, which allows them not to experience discomfort when eating.

How do I live after gallbladder removal and what complications did I face

Five years have passed since the operation, and things are far from going smoothly for me. In the morning I often wake up not from an alarm clock, but from a sharp burning sensation in the solar plexus. This condition happens for several days every three to four months.

Bile reflux – Mayo Clinic

One day I decided to find out what it was. To make it faster, I turned to a private clinic. There I underwent fibroesophagogastroduodenoscopy, that is, they examined the stomach and duodenum using a special apparatus, and diagnosed me with duodeno-gastric reflux.

In this condition, bile from the duodenum is thrown into the stomach. The doctor explained that after the removal of the gallbladder, this happens. I paid 4,000 rubles for the procedure and consultation.

The doctor recommended taking No-Shpa in case of discomfort, drinking enzymes, eating more often, without taking long breaks between meals, and not going to bed for the first 20 minutes after eating.

How much does it cost to cure pancreatitis

Burning does not happen every day, but from time to time. In addition to medicines, an infusion of flax seeds, drunk on an empty stomach, helps me from it. It pleasantly envelops the stomach. One bag of ground plant, which is enough for me for a very long time, costs about 200 R. My grandmother advised me this recipe.

At the same time I cook breakfast. When I have time, I cook porridge. In a hurry, I manage with ready-made cereals with milk. In general, I try to have a hearty breakfast and not take long breaks in eating. Otherwise hello, burning.

An infusion of flax seeds is easy to prepare: pour a teaspoon of ground seeds into a glass of warm water and stir thoroughly for 5-7 minutes My breakfast, when there is time for it EGD results

I have no regrets about the fact that I had a cholecystectomy according to OMS.

There is no guarantee that the operation will be better and without consequences in a private clinic. The human factor is always there. For a fee, such an operation in Moscow will cost an average of 60,000 R, in Lipetsk – 30,000 R.

My expenses started after the operation. First of all, I spend on enzymes, anti-nausea and antispasmodics. I want to live and eat fully, so this first aid kit is always with me – in case of emergency.

Also, as a routine diagnostic, on my own initiative, I do an ultrasound of the abdominal cavity once a year to understand what is happening there. This year I did it for a fee, gave 1800 R.

1800 R

I paid for abdominal ultrasound

Life without a gallbladder costs me about R 3300 per year

Abdominal ultrasound

1800 R

Enzymes and other medications

1500 R

Remember

1. Inflammation of the gallbladder most often develops due to blockage of the bile ducts by stones. This is due to changes in the composition of bile, the main risk factors are: female gender, age over 40, overweight, sedentary lifestyle, excess fatty foods in the diet, rapid weight loss, taking certain medications, liver disease.
2. Surgery is the most effective treatment for cholelithiasis, it is not always possible to dissolve stones with the help of drugs. During the operation, the entire gallbladder is removed. Getting stones out of it or crushing them is too dangerous – you can damage the organ or cause blockage of the bile ducts.
3. The modern method of treatment is laparoscopic removal of the gallbladder through small punctures in the abdominal cavity.
4. After the operation, you need to follow a diet and not lift weights for about a month, then you can live a normal life. However, if there is pain or discomfort in the stomach, it is better to monitor nutrition and eat often, but in small portions.

Did you also have an illness that affected your lifestyle or attitude? Share your story.

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