Dr. Jeff Larsen

Greetings!

A few weeks ago, our topic was a review of some common causes of upper abdominal pain.  There are several things that can cause pain of the upper abdomen. One of those things is the gallbladder. The gallbladder is what I’d like to share information with you about today.

The gallbladder is an organ we usually don’t think about unless it’s causing problems. It lives in the upper right side of the abdomen, often almost under the ribs. Its job, in the body, is to help us digest fats in our diet by holding and intermittently releasing bile. Foods with fat in them cause the body to release chemicals that cause the gallbladder to release bile into the digestive tract. Bile mixes with fats in the bowel and allows them to be absorbed into our bodies.

The gallbladder can sometimes develop stones or stop working right. When it does, it can start causing pain, especially after eating greasy or spicy foods.

Most of the time, the gallbladder goes quietly about its job and we don’t think about its being there. When it becomes diseased, however, it is no longer an unnoticed part of your body. The symptoms of gallbladder disease are frequently classic and fairly easy to diagnose. Many people with gallbladder disease will have

• upper abdominal pain and sometimes pain under the right ribs (especially after eating),

• a feeling of needing to “burp” but not being able to,

• chest pain (your doctor has to make sure you don’t have a heart problem!),

• nausea and vomiting ranging from mild to severe.

• More serious gallbladder disease may show up as tea-colored urine, clay-colored stools, a yellowish hue of the skin, or fevers.

• Most people with gallbladder problems are not helped with antacid stomach pills.

If you have any of these symptoms, it is wise to go to your doctor. Because there are many things that can cause upper abdominal pain, a physician has to consider all of them. That being said, laboratory tests and an ultrasound are often used to diagnose gallbladder disease. Not all gallbladder disease is caused by gallstones. If your physician thinks your gallbladder is the issue and stones are not found with an ultrasound, the next step is a test called a HIDA scan. It is a test to see if the gallbladder is functioning too much or too little.

If you have upper abdominal pain and a test that shows an abnormal gallbladder, it is likely your doctor will send you to a surgeon to discuss removal of the gallbladder. Surgery sounds drastic, but review of the field of allopathic medicine shows that there have been no other good options in the past 100 years. When I discuss gallbladder disease with patients, I discuss all the treatment options one is likely to encounter so that it’s clear why surgery may be necessary.

Gallbladder surgery is usually very successful. If a person has symptoms caused by gallstones and the gallbladder is removed, over 95 percent of people improve after the gallbladder is removed.

Gallbladder surgery was very unpleasant in the past. It involved a large incision under the ribs on the right side of the upper abdomen. In the 1980s, doctors started removing gallbladders with small incisions and video cameras. Now, almost all gallbladder surgeries are done in this way with laparoscopic surgery. This is called “laparoscopic cholecystectomy.” Laparoscopic cholecystectomy is usually an outpatient surgery; most often, you can go home the same day as surgery.

Most people do not notice their gallbladder is gone except that they don’t hurt anymore.

If you have upper abdominal pain that goes on for any period of time, you should go to your physician to see what the cause is. The gallbladder is one of the most common causes of upper abdominal discomfort.

In an upcoming column, I’ll discuss another common cause of upper abdominal pain — ulcers, reflux gastritis and stomach infections. If you have upper abdominal pain that is helped by antacids, you may have one of these conditions; gallbladder disease is usually not helped with antacids.

Best wishes until next time!

Jeffrey A. Larsen MD is a board certified general surgeon who practices in The Specialty Clinic  at The Providence Medical Center  in Kodiak.

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