Joseph has been a practicing Paramedic since 2010 and has worked in the prehospital and emergency room setting since 2005.
Acute abdominal pain sends thousands of people to the emergency room every year. Although there are many possible causes for that pain, Gallbladder pain due to gall stones can be quite common. Many people experience pain, usually from Gall Stones, and often they end up having their Gallbladder removed via surgery. In fact, more than half a million people have their Gallbladder removed each year, due to a Gallbladder stone problem or other problems involving the organ.
More often in recent years, the reason for the prevalence of gall stone issues originates in our obesity rates. Not unrelated, rapid weight loss diets can increase a persons risk for developing Gall Stones. For this and other reasons, females are at a higher risk of Gallbladder problems than are men. This is particularly worrisome since gallbladder symptoms in women can be masked or diminished like heart attack and other thoracic and abdominal issues, due to differences in nerve location and referred pain locations. In fact, the main risk factors for Gall Stone development are obesity, female, at or over 40 years of age, and menopause.
What Is The Gallbladder?
Studied since the Babylonian Empire, 2000 years BC, the Gallbladder is a small, hollow organ that lies just below your Liver, slightly to the right of your stomach. It is only about 3-3.5 inches in length. It holds bile that is produced in the Liver and releases it into the Duodenum, the beginning of the small intestine, upon the presence of partially digested fats that are released from the stomach. This bile then emulsifies the fats to prepare them for digestion and metabolism.
It is believed that the Gallbladder stores higher concentrations of bile when a person has a high fat diet. If that is true, it is easy to see why calcifications, or Gall Stones, form more often in those who eat fatty foods more often. It is also understandable that many people who experience Gallbladder stone pain feel it worse after a fatty or greasy meal, since that is when the Gallbladder is called on to release bile. It also, then, makes sense that when a person has their Gallbladder removed, they may have trouble digesting some fats for some time after their surgery.
When these Gall Stones form, a person is at risk of developing Cholecystitis, (inflamed Gallbladder), Pancreatitis (inflammation of the Pancreas) or other infections due to the inability to move bile from the organ and due to the stones irritating the organ. This can cause anywhere from achy pain to jaundiced appearance, or even worse.
Signs And Symptoms Of Gallbladder Stones
As discussed above, Gallbladder symptoms in women in particular can be masked or different from the presentation in men, similar to symptoms from other serious medical issues. Signs for all patients generally include severe upper abdominal pain, more specifically abdominal pain just below the rib cage, below the right breast. This pain is generally constant and in many cases can occur after eating a greasy meal or after eating in general.
Although it sits in proximity to the lower right lung, it generally does not present as lung or right chest pain, however, a Gallbladder symptom can also be mid-back pain or right shoulder pain due to the location of nerve endings and how the abdominal nerves are formed during gestational development. This is called referred pain.
The upper right abdominal pain can be accompanied by Nausea and/or Vomiting, along with sweating or diaphoresis (profuse sweating). Also, if the condition progresses without care, a person's skin and eyes can begin to yellow and a fever can occur. These tend to be late signs of the problem and could accompany diffuse abdominal pain (generalized pain) due to the infection and inflammation spreading throughout the abdomen.
Although possible to confuse with pain due to appendicitis, those questioning where there pain may be originating should remember that pain from appendicitis usually begins at the navel and travels to the right lower abdomen. Appendicitis pain usually begins with sharp pain and it does not generally have any relationship to when you last ate or what type of food you ate.
Reasons To Have Gallbladder Removal Surgery
The two main reasons for Gallbladder removal surgery are Cholecystitis (infection of the Gallbladder), generally caused by Gall Stones in the Gallbladder or one of the ducts to the small intestine, or the existence of Gallbladder Cancer. Although Gallbladder cancer is serious and should be taken as such, Cholecystitis is both more prevalent and can cause further damage to the body and even death much more quickly than Gallbladder Cancer.
Although many people have "silent stones" that do not cause pain and generally go unnoticed, once a person begins to experience Gallbladder pain the end result is usually Gallbladder removal. Although it generally may take multiple visits to the doctor before one is ready to take your Gallbladder out, if untreated, the infection will spread to nearby organs, including the small and large intestine. Therefore, after a confirmation of stones in the organ and continued pain or inflammation, the organ will need to come out. An untreated case will eventually lead to sepsis, shock, and then death. This pathway normally will not go unchanged due to the intense pain that is associated with the Cholecystitis.
Complications Of Gallbladder Removal Surgery
Here lies the definite reasons to not rush to Gallbladder Removal. Although in many cases people have true Cholecystitis and must have removal, others experience mild Gall Stone pain from "silent stones" or have digestive issues that may be related to their bile storage or production. Some of these people struggle with irritable bowels and just want some relief from never knowing when they may have to rush to the bathroom. Gallbladder removal should not be the first option for right upper quadrant abdominal pain. There needs to be confirmed stones and or confirmed inflammation in the organ itself or blockage of one of the billary ducts leaving the organ.
For those just looking for digestive relief, you may find quite the opposite from Gallbladder Removal. Especially in the short term after removal, most patients experience very irritable bowels due to unrestricted bile flow to the small intestine. Although this can be controlled somewhat by change in diet, finding the right combination of food can be difficult. Also, if this can be controlled by diet change, it is highly likely that the irritable bowels experienced before removal can be controlled by diet to the same extent.
There is also a small possibility that patients who have had Gallbladder stone issues and have their Gallbladder removed will have issues with scar tissue. When the Gallbladder is removed, the ducts to and from the Gallbladder are severed, stapled, and cauterized. In this process, scar tissue can form and can cause more digestive issues or sensitivity. For these an other reasons you should not push your doctor for Gallbladder removal, but rather allow them to assess the need for it and give you an educated decision.
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bearachute from Pittsburgh PA on June 15, 2011:
Nobody told me at all about the consequences of having mine removed 3 years ago, of course my operation was an emergency. It's nice to see some information on the possible outcomes.