Gallbladder disease can be difficult to diagnose

Many people experience “gallbladder attacks” and undergo treatment for gallbladder problems. But what exactly does the gallbladder do, and what are gallbladder attacks?

The gallbladder sits under the liver in your right upper abdomen. It stores bile that is made in your liver. After you eat, the gallbladder contracts and pushes bile into the intestine. Bile helps break down and digest food, especially fats.

Gallstones, the result of a gallbladder that does not function normally, can be a source of problems. Gallstones can form in the gallbladder when substances in the bile start to crystallize and pack together. Gallstones can range in size from tiny grains of sand to as large as a golf ball. About 20 percent of Americans have gallstones, but only about one-third of those will ever develop symptoms.

“Just because gallstones are found on a CT scan or an ultrasound, that does not mean you automatically need to have gallbladder surgery,” says Carol Sawmiller, MD, a general surgeon with Kettering Physician Network. “The goal of surgery is to relieve recurrent symptoms and prevent gallbladder infection. If you are feeling fine, surgery is not going to be helpful.”

Typical symptoms of gallbladder disease are pain in your right upper abdomen, nausea, bloating, and belching. Pain tends to occur after eating fatty foods and often radiates up to the shoulder blade or to the back. Diarrhea also can be a symptom. These symptoms overlap with symptoms of irritable bowel syndrome, gastritis, reflux, and food allergies or sensitivities like lactose intolerance. This sometimes makes the diagnosis of gallbladder disease more difficult.

Your doctor can order an ultrasound to diagnose stones if you are having these symptoms. If you have no stones but continue to have symptoms, a test called a HIDA scan can evaluate how well your gallbladder functions. Sometimes symptoms can be managed with dietary changes — avoiding high-fat foods or any specific foods that trigger attacks. Sometimes surgery is needed.

“If you have symptoms consistent with gallbladder disease and an abnormal test, you may benefit from gallbladder surgery,” Dr. Sawmiller says. “Almost all gallbladder surgery is performed laparoscopically, through several small incisions. People usually go home the same day.”

The gallbladder often gets blamed for symptoms it does not cause, like weight gain, crampy diarrhea, vague abdominal pain nausea, or vomiting unrelated to food. Gallbladder surgery is often not helpful if the testing is normal. “All surgeries have risks, so we need to be reasonably sure that the gallbladder is really the cause of the concerning symptoms,” advises Dr. Sawmiller. “If the symptoms don’t fit and the testing is normal, we need to look for other causes of pain, like ulcers, gastritis, or food allergies.”

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Kettering Health Network is a faith-based, not-for-profit healthcare system. The network has eight hospitals: Grandview, Kettering, Sycamore, Southview, Greene Memorial, Fort Hamilton, Kettering Behavioral Health and Soin.