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Gallbladder Overview

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Gallbladder disease is one of the most common digestive diseases. It results in over 800,000 hospitalizations in the United States each year as well as 500,000 surgeries. American women are twice as likely to suffer with gallbladder problems as men. The exact reasons aren’t clear but there is a definite pattern related to obesity, pregnancy, age, low fiber diet, inadequate hydration and rapid weight loss. A few other conditions may also affect stone formation in the gallbladder such as Crohn’s disease, oral hormonal therapy or elevated triglycerides.

The gallbladder is located under the liver in the right upper quadrant of the abdomen. It stores and concentrates bile produced by the liver and releases it into the duodenum or first portion of the small intestine when a fatty meal is consumed. The bile along with other enzymes plays a key role in digestion. Malfunctioning of the gallbladder can be caused by inflammation, infection or stones that irritate or actually block all or part of the bile duct. Symptoms can include abdominal pain, bloating, fever, nausea, vomiting. It is difficult to manage the acute symptoms with anything other than pain medicines for symptomatic relief of pain and possibly antibiotics. Severe cases too often lead to surgery to remove stones or the entire gallbladder sac. Tests to measure blood chemistries and an imaging study such as ultrasound or CT scan may be necessary to determine the urgency in the acute phase.

Gallstones compose a solid formation of cholesterol and bile salts. Research tells us that approximately 80 percent of all gallstones are cholesterol gallstones which form when the liver begins secreting bile that is abnormally saturated with cholesterol. This may be due to a genetic predisposition to form stones. Prevention is centered on good hydration and a diet high in soluble fiber (oats, bran, fruit, vegetables, and soy fiber), guar gum and pectin. High fat foods will aggravate symptoms of gallbladder disease. Research also suggests that moderate coffee drinkers and people who exercise regularly are much less prone to gallstones.

Although surgical techniques for gallbladder removal have vastly improved we still have few therapeutic options available to manage or prevent this condition. Certain genetic and medical conditions are associated with greater risk of having a problem gallbladder. Healthy lifestyle focusing on high fiber-low fat diet, good hydration and regular exercise seem to correlate with better outcomes.

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About Bruce Kaler M.D.