When you experience a burning sensation at the top of your chest, don’t immediately assume it’s just ordinary acid reflux, because this… is another symptom caused by “gallstone disease,” a common condition that can be treated with “surgery.”
Gallbladder is an organ in the abdominal cavity that functions to store bile to aid in digestion. Bile is produced by the liver and transported through branches of the bile ducts within the liver tissue into the common hepatic duct, then back up to the cystic duct to be stored in the gallbladder first, because the sphincter at the beginning of the small intestine is closed, preventing bile from flowing down.
When we eat fatty foods, the autonomic nervous system signals the sphincter in the small intestine to open. The gallbladder contracts to release bile through the cystic duct into the common bile duct, entering the small intestine. Bile’s role is to break down fat into small droplets, which are then further digested by pancreatic lipase into fatty acids and glycerol.
Gallbladder VS Gallstone Disease: How Are They Related??
The most common disease related to the gallbladder is gallstone disease. The gallbladder is an organ located beneath the liver, functioning like a reservoir to store and release bile, helping improve digestion and nutrient absorption.
“Gallstones” form when components of bile, especially cholesterol and bilirubin (the pigment in bile), crystallize into stones similar to sugar crystals settling at the bottom of a syrup bottle. This condition can be treated surgically, and with current advancements, a new treatment method is gallbladder surgery through the vagina.
Types of Gallstones: Divided into 2 Types
- Cholesterol stones are the most common type, accounting for about 80% of all gallstones. They appear as white, yellow, or green stones and form due to increased cholesterol in bile or insufficient contraction of the gallbladder muscles, which prevents complete expulsion of bile.
- Pigment stones are smaller and darker than cholesterol stones. They are often found in patients with liver cirrhosis or blood disorders such as thalassemia or G6PD deficiency anemia.
Risk Factors for Developing Gallstones
- Genetics: Individuals with family members who have gallstones are at higher risk.
- Obesity: A significant risk factor because obesity increases cholesterol levels in bile.
- Estrogen and pregnancy: These increase cholesterol levels and reduce gallbladder motility. Women taking contraceptives or hormone replacement therapy are at higher risk.
- Gender and age: Gallstones are more common in women and the elderly.
- Diabetes: Diabetic patients tend to have higher triglyceride levels and reduced gallbladder contraction, increasing the risk of gallstones.
- Rapid weight loss: Causes the liver to secrete more cholesterol and reduces gallbladder contraction, leading to bile stasis and increased risk of stone formation.
- Diet: Especially high-fat, low-fiber diets increase the risk of gallstones.
Symptoms Indicating You (May) Have Gallstones
- Severe abdominal pain, especially in the upper or right upper abdomen, lasting from 15 minutes to several hours, possibly radiating to the shoulder blade or right shoulder area.
- Nausea and vomiting.
- Other gastrointestinal symptoms such as bloating, indigestion, heartburn, and gas, especially a burning sensation behind the breastbone after eating fatty foods.
- If acute cholecystitis occurs, symptoms include fever, pain under the right rib cage, and possibly jaundice with dark urine.
Diagnosis of Gallstones
- Medical history and physical examination.
- Blood tests to assess liver function.
- Ultrasound of the upper abdomen.
- Endoscopic retrograde cholangiopancreatography (ERCP) for suspected bile duct stones.
- Percutaneous transhepatic cholangiography (PTC) for bile duct obstruction cases.
Treatment Approaches for Gallstones
- Gallbladder surgery.
- Open abdominal gallbladder surgery.
- Laparoscopic cholecystectomy (gallbladder removal via laparoscopy).
Endoscopic retrograde cholangiopancreatography (ERCP) in cases with bile duct stones.
Transvaginal cholecystectomy for gallstone removal
Possible Side Effects After Surgery!
Since the gallbladder only stores bile, after its removal, bile continues to be produced by the liver and flows through the bile ducts into the small intestine to digest fats normally, although it may be less concentrated. About 10% of people without a gallbladder may experience diarrhea due to excessive bile flow.
Transvaginal cholecystectomy should be performed by experienced surgeons; otherwise, complications such as bile duct injury, bile duct leakage, or bile duct obstruction may occur.
