When we talk about chronic pain, some of the first conditions that come to mind are rheumatoid arthritis, osteoarthritis, or fibromyalgia. While these are all common culprits, often chronic pain can also result from an underlying disease. One such disease that can cause chronic pain is gallbladder disease. While gallbladder disease is quite common, it may not be a condition that you associate with chronic pain. So, let’s take a closer look at what gallbladder disease is, what causes it, and how it’s treated.
What Is Gallbladder Disease?
Gallbladder disease is an umbrella term used to describe several conditions affecting your gallbladder. The gallbladder is a small, pear-shaped organ located underneath your liver. Its primary function is to store the bile (a digestive fluid) produced by your liver and pass it along to the small intestine.
The main culprit of most types of gallbladder diseases is inflammation. This is because inflammation causes irritation of the gallbladder walls, which is known as cholecystitis. This inflammation is typically caused by gallstones blocking the ducts that lead to the small intestine causing a buildup of bile in the gallbladder. This can eventually lead to necrosis (tissue decay) or gangrene.
What Are the Different Types of Gallbladder Disease?
As previously mentioned, gallbladder disease is a term used to describe several different conditions that affect the gallbladder. These conditions can range from milder ailments like gallstones to more severe conditions such as cancer or gangrene. Let’s next take a look at some of the most common types of gallbladder disease.
Cholecystitis
Cholecystitis is the most common type of gallbladder disease. Typically, cholecystitis presents itself as either acute or chronic inflammation of the gallbladder. This condition is the result of a buildup of bile in the gallbladder, usually the result of lumps of solid material (gallstones). Unlike other types of gallbladder diseases, cholecystitis is not a permanent condition. Typically, an attack of cholecystitis lasts 2 to 3 days and will subside once the blockage has been removed.
Gallstones
Gallstones are the result of a buildup of certain substances in the bile (typically cholesterol, bile salts, and calcium) or substances within your blood (like bilirubin) that form hard particles which block the passageways to the gallbladder and bile ducts.
Oftentimes, gallstones can form as a result of your gallbladder not draining properly or as often as it should. They can range in size from as small as a grain of sand, to as large as a golf ball.
Chronic Acalculous Gallbladder Disease
Acalculous gallbladder disease, also known as acute acalculous cholecystitis, is a condition that causes inflammation of the gallbladder without the presence of gallstones. While there is not a lot known about how acalculous gallbladder disease develops, having a significant chronic illness or serious medical condition has been shown to cause an episode.
Gangrene
Gangrene can occur when your gallbladder receives insufficient blood flow. This condition is one of the most serious types of gallbladder diseases and is often one of the complications of cholecystitis.
Gallbladder Cancer
Gallbladder cancer is a relatively rare type of cancer. Like gallbladder disease, there are several types of gallbladder cancers, all of which can be difficult to treat as they are usually diagnosed in their later stages. While it is not a cause, gallstones are a common risk factor for gallbladder cancer.
Cancer of the gallbladder can spread from the gallbladder walls to the liver, lymph nodes, and other major organs. Oftentimes, gallbladder cancer will cause no symptoms until later stages, where it will then mirror many of the symptoms of cholecystitis.
Sclerosing Cholangitis
Sclerosing cholangitis is a rare disease that attacks the bile ducts. The ongoing inflammation caused by many gallbladder diseases can lead to scarring. This scarring is what is known as sclerosing, and has no known cause. What is known, however, is that nearly half of all people with sclerosing cholangitis have no symptoms whatsoever. Furthermore, it’s estimated that nearly 80 percent of people with this condition have ulcerative colitis.
Biliary Dyskinesia
Biliary dyskinesia is a condition that occurs when your gallbladder has lower-than-normal levels of function. It can be caused by inflammation of the gallbladder and may cause symptoms such as pain after eating, nausea, bloating, and indigestion. Biliary dyskinesia typically occurs without the presence of gallstones.
What Causes Gallbladder Disease?
Gallstones are by far the most common cause of gallbladder disease, although the presence of gallstones in and of themselves may not always cause complications. However, when gallstones do cause problems, it’s almost always because they block the flow of bile in your gallbladder, bile ducts, or both.
Less commonly, gallbladder disease can be caused by other complications such as the gallbladder not emptying properly. This can also cause a backup of bile, which is the most common cause of gallbladder inflammation. Inflammation makes your gallbladder swell and builds up pressure inside it. This can also cause bile to back up as a secondary effect.
While many gallbladder diseases cause little or no symptoms at all, it’s still very important to understand the signs should you begin to experience any abnormal symptoms.
Symptoms of Gallbladder Disease
Since there are several different types of gallbladder diseases, there are also several different symptoms, all with their own causes. The mildest and most common symptom of all gallbladder diseases is a type of intermittent pain known called biliary colic. Biliary colic causes a steady gripping or gnawing pain in the upper right abdomen near the rib cage, which can range from mild to severe, and may radiate to the upper back and shoulders. Some people with this condition report pain behind the breastbone, and others report mild nausea and vomiting.
Other common symptoms of most gallbladder diseases include:
- Gas
- Nausea
- Abdominal discomfort after meals
- Chronic diarrhea
- Jaundice
- Dark urine
- Lighter stools
If you notice any of the above-mentioned symptoms, it’s important that you speak with your doctor immediately.
Diagnosing Gallbladder Disease
If you believe that you may be living with gallbladder disease, it’s important to talk with your doctor right away. Since there are several different types of gallbladder disease, getting the right diagnosis is extremely important for successful treatment and recovery.
To properly diagnose gallbladder disease, your doctor will likely ask you for a full rundown of your medical history. After this, they will perform an abdominal exam that includes checking for pain or abnormalities in the abdomen. After this is done, and depending on your symptoms and the results of the abdominal exam, your doctor may want to move on to other tests or procedures. These include:
- Physical exam: A physical exam is a common first step in diagnosing gallbladder disease. During the exam, your doctor may perform a maneuver known as “Murphy’s sign,” to help determine the cause of your symptoms. The maneuver involves your doctor placing their hands on your abdomen and then asking you to breathe. If you feel pain during this maneuver, it may be due to gallbladder disease.
- Chest and abdominal X-ray: If Murphy’s sign points toward gallbladder disease, your doctor will likely order a chest and abdomen X-ray to help rule out or determine the cause of your abdominal pain. Cholecystitis will sometimes show stones on abdominal X-rays if the stones contain calcium. However, X-rays are not the best diagnostic tool for gallbladder disease and are often used to rule out other conditions.
- Ultrasound: If an X-ray doesn’t rule out or confirm gallbladder disease, your doctor may recommend an ultrasound. This test is one of the main methods your doctor uses to make a diagnosis of gallbladder disease. Ultrasounds can detect the presence of gallstones, thickened walls, polyps, or masses.
- HIDA scan: Lastly, your doctor may want you to undergo what is called a HIDA scan to help determine if you have gallbladder disease. A HIDA scan looks at the duct system within the gallbladder and liver. A HIDA scan evaluates the health and function of your gallbladder and can help accurately diagnose a number of different gallbladder diseases.
Once you’ve received a diagnosis, the next step is treatment. Depending on what type of gallbladder disease you have, treatment will vary.
How Is Gallbladder Disease Treated?
There are a number of different treatment options for gallbladder disease. These can range from simple lifestyle changes to surgery, and largely depends on what condition you have.
A typical first step for more minor cases of gallbladder disease, such as minor gallstones or cholecystitis, are lifestyle changes. Since certain health conditions, like obesity and diabetes, significantly increase your risk for gallstones, making changes to your lifestyle is an easy, non-invasive way to treat gallbladder disease. Losing weight and getting your diabetes under control both can help lower your risk. Increasing your level of physical activity also can help decrease your risk of gallbladder disease.
Should lifestyle changes not be enough, there are several medications that can help manage gallbladder disease. Gallbladder inflammation is usually treated first with pain medications such as codeine or hydrocodone. This is because the pain is oftentimes severe, and over-the-counter products like ibuprofen typically won’t be enough. In very severe cases of gallbladder disease, your doctor may prescribe stronger pain medications like morphine to help manage your pain.
Lastly, surgery may be recommended to remove your gallbladder if you have expierenced multiple episodes of inflammation or severe chronic pain. While it’s very common, gallbladder surgery is considered to be a major operation. To date, gallbladder surgery remains the most effective method for treating active gallbladder disease.
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