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

7) monkeybusinessimages / Thinkstock

8) Hero Images / Getty Images

9) ratikova / Thinkstock

10) wcphoto12 / Thinkstock

11) Wavebreakmedia Ltd / Thinkstock

12) crankyT / Thinkstock

13) AndreyPopov / Thinkstock

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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Cancer treatment

Gallbladder cancer

Gallbladder cancer (GBC) is a rare disease that develops with cholelithiasis, chronic cholecystitis. Among malignant tumors of the gastrointestinal tract, gallbladder cancer is in fifth place. The tumor process is detected in most cases in women after 50 years. In 70% of cases, gallbladder cancer is represented by adenocarcinoma, in other cases – by papillary or squamous cell carcinoma.

The tumor is located on the neck and bottom of the bladder. The disease must be diagnosed and treated as early as possible, because the tumor can quickly progress and affect other organs. The peculiarity of RZHP is precisely in its pronounced malignancy and local spread to the liver. Metastasis occurs along the paths of lymphatic drainage to the nearest tissues, the parietal peritoneum, pancreas, and para-aortic tissue. The prognosis in such cases is usually unfavorable. In order not to start the disease, you need to contact an oncologist at the first alarming signs. LISOD specialists know the latest methods of gallbladder cancer treatment.

Diagnosis

LISOD uses world medical standards to diagnose gallbladder cancer.

• Laboratory research is carried out in a clinical laboratory equipped with modern equipment. For diagnostics, a special spectral system is used, which allows obtaining results with high accuracy. An increase in bilirubin levels indicates the presence of liver or gallbladder disease, including gallbladder cancer. Also, the study of the levels of alkaline phosphatase and aspartate aminotransferase helps to identify gallbladder disease.
• Ultrasound allows not only to detect a tumor, but also its spread to the walls of the gallbladder and liver. This method is especially effective when used during endoscopy or laparoscopy. This technique makes it possible to examine the gallbladder at close range.
• Computed tomography (CT) is used for both initial diagnosis and tumor staging. In addition, the state of the pancreas and liver is specified. This allows LISOD specialists to properly plan surgical treatment.
• Cholangiography (contrast examination of the bile ducts) also helps in the diagnosis of gallbladder tumors.
• Laparoscopy. Through a small incision in the anterior abdominal wall, a laparoscope is inserted into the abdominal cavity to examine the internal organs, including the gallbladder. During this study, a biopsy is taken (taking a suspicious piece of tissue for microscopic examination) and the stage (prevalence) of the tumor is specified.
  In LISOD, when performing such operations, modern endoscopic and laparoscopic equipment is used, which employs leading specialists – endoscopic surgeons who are proficient in these techniques (both diagnostics and performing surgical interventions in full). The laparoscopic method allows you to make an accurate and correct diagnosis, determine the volume and stage of the process, and also choose the tactics of treatment.

The Comprehensive Examination allows LISOD specialists to confirm or refute the diagnosis of gallbladder cancer.

Treatment

Surgery is the main method in the treatment of gallbladder cancer.

Cholecystectomy is the surgical removal of the gallbladder and its surrounding tissues for cancer of the gallbladder. It is also possible to remove regional (neighboring) lymph nodes. For gallbladder surgery, LISOD uses the laparoscopic method. Laparoscopy of the gallbladder consists in the fact that through small incisions (0.5 – 1.5 cm) with a special optical device, a laparoscope (a telescopic tube containing a lens system and attached to a video camera) penetrates into the abdominal cavity. Thus, the surgeon sees the surgical field on the monitor screen and has the opportunity to excise the neoplasm with very thin special instruments. Then the excised tissues are placed in special bags-containers and removed. Laparoscopy of the gallbladder is a low-traumatic method, easier tolerated by patients, and there are fewer adverse reactions.

For inoperable cases, chemotherapeutic treatment is carried out, and sometimes, if indicated, radiotherapy is prescribed.

Symptoms

Common signs of gallbladder cancer are pain , liver enlargement , palpable tumor-like mass in the abdomen . Sometimes there is gastric dyspepsia , pain in the gallbladder . The pain is localized in the right hypochondrium and epigastric region, gives to the right shoulder. Similar pains occur with stone and tubeless cholecystitis. In most cases, gallbladder cancer is combined with cholelithiasis and cholecystitis.

Due to obstruction of the common bile duct, jaundice appears , which, unlike blockage of the duct by a stone, develops without previous hepatic colic and fever. Anemia is rare, there is no noticeable weight loss.

Risk factors

Several risk factors are now known to increase the risk of gallbladder cancer. However, the presence of one or even several of these factors does not necessarily mean the development of cancer.

• Gallbladder stones and inflammation. 75-90% of patients with gallbladder tumors had stones or signs of chronic inflammation of this organ. People with large gallbladder stones were more likely to develop a tumor than those with multiple small gallstones. However, keep in mind that most people with gallstones will never develop cancer.
• “Porcelain” gallbladder. In patients with severe inflammation of the gallbladder, the walls of the gallbladder may be covered with calcium overlays, which significantly increases the risk of developing cancer. Therefore, we recommend the removal of such a gallbladder.
• Typhoid fever. People infected with the bacterium Salmonella, which causes typhoid fever, have a 6-fold increased risk of developing gallbladder cancer. However, typhoid fever is a rare disease.
• Common bile duct cysts contain bile, may increase in size and contain areas of precancerous changes, which increases the risk of developing gallbladder cancer.
• Cigarette smoking also increases the risk of gallbladder cancer.
• Professional hazards. Workers in the rubber and steel industries have an increased risk of developing gallbladder cancer as a result of exposure to a number of chemicals, such as nitrosamines.
• Malformations of the pancreatobiliary zone at the confluence of the ducts of the liver, gallbladder, and pancreas increase the risk of developing gallbladder cancer.
• Age. Most patients with gallbladder cancer are over 70 years of age.
• Gallbladder polyps of 1 cm or more often turn into a malignant tumor. Therefore, we recommend removal of the gallbladder in this category of people.
• Obesity is also a risk factor for gallbladder cancer.
• Diet. The high carbohydrate and low fiber content increases the likelihood of gallbladder tumors.
• Helicobacter pylori. The presence of such an infection increases the risk of developing both stomach and duodenal ulcers, as well as the occurrence of stones and gallbladder cancer.

Prevention

In most cases, gallbladder cancer cannot be prevented. However, some risk factors can be avoided.

• Maintaining a normal weight is one of the ways to reduce the risk of both cancer of this localization and other tumors (colon, prostate, uterus, kidney, breast).
• Adequate consumption of fruits and vegetables and limiting animal fat intake may reduce the risk of developing gallbladder cancer.
• Daily physical activity is another way to reduce the risk of gallbladder cancer.
• Smoking cessation also reduces the risk of developing gallbladder cancer.
• Treatment of gallbladder stones reduces the likelihood of chronic inflammation and the risk of cancer.

Questions and Answers

Questions from patients and answers from our specialists are published in this section. Each person’s question concerns a specific problem related to their disease. Israeli clinical oncologists and the head doctor of LISOD, MD, Professor Alla Vinnitskaya answer the patients.

The answers of specialists are based on knowledge of the principles of evidence-based medicine and professional experience. The answers correspond solely to the information provided, are for informational purposes only and do not constitute medical advice.

The main purpose of section is to provide information to the patient and family so that they can decide with their doctor about the type of treatment. The tactics of treatment offered to you may differ from the principles set forth in the answers of our specialists. Feel free to ask your doctor about the reasons for the differences. You must be sure that you are receiving the correct treatment.

Ask your doctor

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what is possible with breastfeeding

After giving birth, a woman continues to influence the internal processes in the child’s body through the milk she feeds him. Nutrition affects the quality of milk, because with it the baby receives vitamins and nutrients. They ensure its proper development and strengthen the immune system. Therefore, the menu of a nursing mother in the first days and months should be as nutritious, balanced and varied as possible.

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Lactation

Baby

menu

diet

In the menu of a nursing mother, it is important to take into account the balance of calories, proteins, fats, carbohydrates, the benefits for the woman herself and the growing body of the child. We will tell you how her diet changes after childbirth.

Contents of the article

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

Starting from the maternity hospital, a woman has to think about what to eat and what not, because some foods can cause colic or allergies in the baby. Out of fear of harming the child, some women begin to eat only buckwheat and deny themselves everything. Others are sure that the child needs to be accustomed to different foods from the cradle, and they do not make any restrictions.

Already on the first day, the menu of a nursing mother should be carefully thought out. It is desirable that it be correct and safe, because the child is just adapting to an independent life outside the mother’s womb. We talked about what should be the diet in these important first weeks with a certified dietitian Alexandra Paetou, mother of two children.

Nursing mother’s menu: main misconceptions

As a rule, new mothers are intimidated even in the maternity hospital, handing them a standard memo. Looking at the list of foods that are allowed on the menu of a nursing mother, it is easier to say what is allowed than to list prohibitions. From this moment, the eternal fear begins to eat “something is not right” and thereby bring all possible troubles to your baby. Here lies the first misconception: if you do not want your child to grow up with an allergy, you need to eat varied.

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Another common misconception: a diet for a nursing mother, the menu of which will include a minimum of calories, will help you quickly return to your previous weight. The only thing it will help is to lose breast milk and “put” the baby on artificial mixtures.

It should be remembered that the daily caloric intake of a woman’s diet during lactation should not be lower than 2000 kcal. Otherwise, at first you will lose most of your hair and the normal condition of your teeth and nails. And then such food with a meager menu will deprive you of the status of a nursing mother.

General dietary guidelines for breastfeeding mothers

Almost everything a woman eats passes into her breast milk in one form or another. Of great importance is the preparation of a menu for a nursing mother immediately after childbirth. Just think: in the womb, a baby swallowed sterile amniotic fluid, and then an incredible amount of intestinal bacteria and nutrients fell on him, which his enzymatic system does not yet know. To facilitate this acquaintance with the world of other food, you need to choose products wisely.

Eating lettuce leaves, fresh vegetables and eating them with multivitamins, a woman still does not supply her body with everything it needs. This chain lacks an important link – the balance of proteins, fats and carbohydrates, which come only with food. For a nursing mother of a newborn, the menu should be designed in such a way that this ratio is taken into account. Protein sources are meat, fish, eggs, chicken, turkey, cottage cheese, dairy products. They also contain fats. Complex carbohydrates – pasta, cereals, bread, green and leafy vegetables, legumes, and it is better to refuse simple ones, with the exception of some fruits. We are talking about sweets and pastries.

Calculate the ratio of calories, proteins, fats and carbohydrates (CBFA) that enter the body with food. About 30 kcal is needed per kilogram of weight. With a weight of 60 kg, the need is 1800 kcal per day. But so much is needed in the normal state. Breastfeeding puts extra calories on the menu of a nursing mother. To this figure, you need to add about 500 more kcal if the baby was just born. As for BJU, per kilogram of weight you need 1.5 – 2 grams of protein, 1 gram of fat and 4-5 grams of carbohydrates.

Thus, with a weight of 60 kg, you should consume daily from 90 to 120 g of protein, no more than 60 g of fat and 240-300 g of carbohydrates, preferably complex. The nutrition of a nursing woman should take into account these parameters, then the body’s resources will be enough for two. In order not to make mistakes in the calculations, you need to use a kitchen scale and free services on the Web.

Let’s list the basic rules that the breastfeeding diet implies:

• The entire diet for the day should be divided into 5-6 meals.
• Small portions should be consumed before feeding the baby.
• Avoid citrus fruits, strawberries, raspberries, red caviar, fish, seafood, and smoked meats for rashes in crumbs. And it is better to refrain from exotic fruits for up to 6 months.
• It is better to cook dishes by steaming, stewing, boiling, baking without a fried crust.
• In case of colic, the menu of a nursing mother needs to be adjusted, excluding sour cream, mayonnaise, pickled and fatty foods, grapes, sweet soda.
• It is better not to try a new product or a dish from it, or introduce them with caution, observing the reaction and well-being of the baby.
• Increase fluid intake, because milk is 90% water. Enough 10 glasses of clean water of 250 ml every day.
• To enhance lactation, it is good to drink warm, freshly brewed green tea or any fermented milk drink before feeding.
• It is worth forgetting about chips, fast food and other “harmful things”, including alcohol, even in small quantities. Forget the myths about beer making you milk.
• In the body of a nursing mother, the content of vitamins and minerals is 30%, and sometimes 50% below the norm. It is better to discuss with the doctor the introduction of a vitamin and mineral supplement.
• Eating for two, as our great-grandmothers said, is not worth it. In general, it is enough to add 20% to your diet.

Sample menu for a nursing mother

When compiling a menu for a nursing mother for the first months, it is necessary to take into account a list of products that will help regulate the functioning of the digestive tract. The fact is that during lactation, many women suffer from constipation, and in order to avoid this, you need to eat foods high in coarse fiber. These are whole grain cereals, bran bread, whole grain toast, apples with skin, and so on.

Daily menu option for a breastfeeding mother could be:

Breakfast:

1st option: omelet with cheese, tea with milk, a slice of grain bread.

2nd option: oatmeal/buckwheat/millet porridge in water with fruit and a spoonful of honey, cocoa, half an apple or other fruit.

3rd option: cottage cheese casserole with jam, black tea with milk, toast.

Lunch:

1st option: vinaigrette, chicken broth with croutons, steamed vegetables, meatballs, apple juice.

2nd option: vitamin salad, plain cabbage soup, casserole with potatoes and minced meat, dried fruit compote, a couple of slices of bread.

3rd option: mashed cheese soup with oven croutons, boiled potatoes with herring, green tea.

Snack:

1st option: a couple of cheesecakes with honey.

2nd variant: fruit salad of apples, pears and peaches with oatmeal dressed with natural yoghurt.

3rd option: bran bread toast with tuna and herbs.

Dinner:

1st option: lazy dumplings with sour cream sauce, black tea with milk.

2nd option: baked cod in foil with vegetables, buckwheat porridge, compote.

3rd option: steam meatballs baked with broccoli cheese, green tea with lemon.

Nursing mother’s nutrition by months

A varied and proper diet of a woman during this period is the key to the health and successful development of the baby. In order not to have to study books on the menu of a nursing mother and the Internet immediately after giving birth, think over the recipes for the first week in advance, preferably by the day. When you leave the hospital, this concern will fall on your shoulders, so it will be good to prepare.

First week

The adaptation of the child is just beginning, so this is the most important time. The first week should be planned so that there is no milk on the menu of a nursing mother. There is a stereotype that it is it that contributes to an increase in lactation. But it does not help in this. It has been proven that milk provokes gastrointestinal dysfunction in the mother and child, and can also provoke allergies in the baby. But fermented milk products are more acceptable for his digestion. It is not advised to drink juices and fruit drinks, strong tea and coffee, eat nuts in the first week.

During the first three days, you can drink herbal tea (nettle, chaga), special lactagon drinks with cumin, fennel, and others. Compote from dried fruits is also allowed, preferably from apples, which are simply poured with hot water and left in a thermos. Black and green tea should not be abused so as not to cause overexcitation of the baby’s nervous system due to the presence of caffeine. What you can eat to make the menu of a nursing mother balanced:

• Boiled or steamed vegetables (cauliflower, broccoli, zucchini, turnips).
• Kashi (buckwheat, millet) is best made from whole grain flakes, a little bran can be added to stimulate bowel function.
• Vegetarian soups with a minimum of potatoes.
• Oven baked apples.
• Bread.
• Parsley, dill, spinach, arugula are allowed, they help relieve gas.
• Kefir, natural yogurt, cottage cheese (only a spoon at first), a piece of cheese is possible from the fourth day after childbirth.

By the way, the menu of a nursing mother after a caesarean section differs from the nutrition of a woman after natural childbirth only in these first days. The abdominal operation forces the intestines to adjust to normal work. Of course, ideally, you should do without the help of cleansing enemas and laxative suppositories. Usually, after a caesarean section, mothers consume low-fat chicken or veal broth (secondary), boiled fish, cereals on the water (but not rice). By the fourth day, you can switch to the usual diet provided for during lactation.

First month

In the second week, the number of dishes increases slightly, but without fanaticism. It is still important to ensure that foods with a high allergenic potential do not enter the menu of a nursing mother from the first weeks. You can start cooking a weak beef broth, eat 100 g of beef, the same amount of low-fat steamed fish.

It is important to follow a simple rule: meat, eggs, fish and other products must be well cooked. Recipes when you need to eat raw eggs, sushi, and so on, are not allowed on the menu for a nursing mother either in the first month or in the next 5-6 (minimum). You also need to limit your intake of sugar, salt, spices, onions, and garlic, which can detract from the taste of milk.

On the fourth week, the intestinal microflora is formed in the child, enzymatic systems are launched. Therefore, when 1 month is running out, the following products can be added to the menu of a nursing mother:

• potatoes in uniform
• oatmeal
• beets
• boiled eggs
• dry cookies 9 0010
• cowberry or cranberry fruit drinks

Second month

Let’s start with what food should be avoided for now and in the menu of the second month of a nursing mother. It causes increased flatulence white cabbage, cucumbers, tomatoes; sodas, black bread, legumes and grapes. Other foods are strong allergens. Among them are chocolate, pumpkin, citrus fruits, berries, honey, nuts, crayfish, crabs, caviar, red fish.

The menu for breastfeeding mothers becomes even more varied in the second month. The main thing is that a woman receives the substances necessary for life: vitamins, trace elements, fiber, proteins, unsaturated fatty acids. To do this, it is important to consume:

• dairy and sour-milk products
• lean meat of beef, rabbit, chicken, turkey without skin
• lean river and sea fish
• butter and vegetable oil
• cereals, bread (preferably yeast-free with bran)
• vegetables and fruits (green and yellow apples, banana, pear, kiwi, plum)

It often happens that when a baby is a month old, the menu of a nursing mother becomes too relaxed. But the time for variety, cakes, fast food and a glass of wine has not yet come. An illiterate diet during this period can not help, but harm the baby: provoke constipation, colic, allergic reactions and poisoning.

Third month

After 2 months, the menu of a nursing mother is still aimed at developing and strengthening the child’s immunity. By the way, at this time, the figure of a woman is actively returning to normal. The fact is that lactation is an energy-consuming process. Every day, at least 700 kcal burns due to it. And if you reduce the consumption of fat, then this will not affect milk in any way. The body maintains its constant fat content, regardless of how much fat came with food.

At 3 months, the menu of a nursing mother is supplemented with interesting dishes. Just do not chase after too difficult ones so as not to take up precious time that can be spent on relaxation. The desire to do everything sometimes causes stress in the mother, and it certainly does not contribute to the production of milk.

We offer a look at the menu for a week for a nursing mother, recipes and photos of which you can easily find on the Web.