It releases bile through ducts into the small intestine to help break down the foods you eat — particularly fatty foods. Typically the gallbladder doesn’t cause too many problems or much concern, but if something slows or blocks the flow of bile from the gallbladder, a number of problems can result. (1,2) Gallstones (Cholelithiasis) This is a condition in which small stones, or sometimes larger ones, develop inside the gallbladder. These stones form from substances found in bile, including cholesterol and a pigment called bilirubin. Gallstones may cause pain known as biliary colic (see below), but about 90 percent of people with gallstones will have no symptoms. Most symptomatic gallstones will have been present for a number of years. For unknown reasons, if you have gallstones for more than 10 years, they are less likely to cause symptoms. (3,4) Biliary Colic This term is often used to describe severe episodes of pain that can occur when gallstones block the flow of bile to the small intestine. The gallbladder contracts vigorously against the blockage, causing severe pain in spasms, or sometimes constant pain. Biliary colic episodes usually last one to five hours, with mild pain lingering for up to 24 hours. They’re especially common after large or fatty meals, particularly if you’ve been fasting beforehand. (5) Inflamed Gallbladder (Cholecystitis) Inflammation of the gallbladder can be caused by gallstones, excessive alcohol use, infections, or even tumors that cause bile buildup. But the most common cause of cholecystitis is gallstones. In this case, irritation by gallstones causes the gallbladder walls to become swollen and painful. An episode of inflammation can last for several hours, or even a few days. Fever is not unusual. Sometimes, the inflamed gallbladder is invaded by intestinal bacteria and becomes infected. Suspected episodes of cholecystitis always require medical attention, particularly if you have a fever. (6) Perforated Gallbladder An inflamed gallbladder can lead to a number of serious complications, including a torn, or perforated, gallbladder. This is a potentially life-threatening condition and requires emergency surgery to remove the gallbladder. (6) Acalculous Biliary Pain This refers to pain in the bile ducts that isn’t followed by any gallstones appearing in imaging tests. It may be due to improper emptying of the gallbladder, overly sensitive bile ducts or small intestine, or gallstones that are too small to be seen on imaging scans or that have passed through already. Surgery to remove the gallbladder is often successful at resolving biliary pain without gallstones. (7) Common Bile Duct Infection Most cases of inflammation in the bile duct system, called cholangitis, are caused by a combination of obstruction of a bile duct (by gallstone or biliary strictures) and a bacterial infection. If bacteria builds up above the blockage, it can back up into the liver and may cause severe infection. Antibiotics are needed to treat a bacterial infection. Doctors may also need to drain the fluid in the bile duct to determine the cause of blockage. (8,9) AIDS-Related Narrowing of Bile Ducts In people with AIDS, a weakened immune system can lead to frequent and widespread infections, some of which can result in the bile ducts narrowing. (7) Primary Sclerosing Cholangitis This refers to inflammation that causes scarring and narrowing of the bile ducts, and isn’t caused by any other known condition. While the causes of primary sclerosing cholangitis aren’t completely understood, doctors believe it’s most likely an autoimmune disorder, in which the immune system mistakenly attacks the body’s own tissues. (7) Gallbladder Abscess Sometimes a severe gallbladder infection can lead to an abscess on the organ, also called empyema of the gallbladder. Antibiotics alone may not be enough to treat abscesses and they may need to be drained. (10) Porcelain Gallbladder This occurs when the walls of the gallbladder become so calcified that they resemble porcelain on an X-ray. Porcelain bladders are thought to be associated with a very high risk of cancer and should be removed surgically. (4) Gallbladder Polyps These are growths that protrude from the surface of the inner gallbladder wall. Some polyps form as a result of inflammation or because of cholesterol deposits in the gallbladder wall. Others are tumors, which may be cancerous, though about 95 percent of gallbladder polyps are benign. According to the American Cancer Society, gallbladder polyps larger than 1 centimeter are more likely to be cancerous and therefore most doctors recommend they be removed. (11,12) Gallbladder Disease This is a blanket term that encompasses inflammation, infection, gallstones, or blockage of the gallbladder. Specific symptoms may vary according to what type of gallbladder condition you have, although many symptoms are common among the various types of gallbladder problems. Here are some common symptoms of gallbladder problems:
Severe pain in the upper right or center of your abdomenTenderness in the abdomen, particularly the right upper quadrantAbdominal pain lasting several hoursPain that may extend beneath the right shoulder blade or to the backPain that worsens after eating a heavy meal, particularly fatty or greasy foodsPain that feels dull, sharp, or crampyPain that increases when you breathe in deeplyHeartburn, indigestion, and excessive gasChest painA feeling of fullness in the abdomenNauseaVomitingFever, ranging from low-grade to severeShaking with chillsStools of an unusual color (often lighter, like clay)Dark urine (often described as tea-colored) (6,13,14)
Some gallbladder problems, like simple gallstones that are not blocking the bile ducts, often cause no symptoms at all. They’re most often discovered during an X-ray or CT scan that’s performed to diagnose a different condition, or even during abdominal surgery. If you spot any symptoms of gallbladder trouble, see your doctor for a diagnosis and prompt treatment to get your digestive tract running smoothly again. It’s essential to seek immediate treatment if you develop a severe gallstone complication that causes any of the following symptoms:
Abdominal pain so severe you can’t sit or lie still or keep food downJaundice (yellowing of the skin and eyes)Severe fever with chills (13)
