Gall Bladder - The Storehouse of Bile
Know your Body

Gall Bladder - The Storehouse of Bile

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 26 Feb 2014 - 12:44.

The gall bladder is a small pear-shaped organ situated in the right upper quadrant of the abdominal cavity under the base of the liver and connected to it by the hepatic duct. It is approximately 3 to 4 inches long and about 1 inch wide.
Function of gall bladder: The main function of the gall bladder is to store and concentrate digestive liquid called bile, which is manufactured by the liver. The liver continually secretes bile, which passes to the gall bladder via the hepatic duct. The gall bladder is nicknamed as the storehouse of bile.
Bile is a digestive fluid necessary to emulsify fats and neutralize acids in the food, which is partly digested. A muscular valve in the common bile duct opens to allow the flow of bile from the gall bladder to the cystic duct along the common bile duct and into the duodenum.
Fats are one of the three proximate principles of the food we take. Without bile fats, food cannot be digested. Any problem in the gall bladder reflects bile which leads to several problems.
Common condition of gall bladder: Most important and common conditions affecting the gall bladder are acute and chronic cholecystitis and gallstones called cholelythiasis.
Acute cholecystitis:
Inflammation of the gall bladder termed cholecystitis mostly affects women aged forty who are heavy and in their reproductive age.
Acute Cholecystitisas a condition where there is sudden inflammation of the gall bladder causing severe abdominal pain. In 90 percent of the cases, gallstones in the gallbladder cause acute cholecystitis, which obstruct the duct leading from the gallbladder to the common bile duct. Severe illness and rarely, tumors of the gallbladder can also cause cholecystitis.
The bile, which gets trapped, becomes concentrated causing irritation and pressure build-up in the gallbladder. This invariably leads to bacterial infection. Sometimes the gallbladder may perforate warranting urgent surgical attention. The attack may follow ingestion of a large or fatty meal.
If there are gallstones in the gallbladder surgical removal of the stones would prevent the incidence of cholecystitis. Reduced intake of fats prevents recurrent attacks of cholecystitis. Examination of the abdomen by touch (palpation) reveals tenderness. Tests that detect the presence of gallstones or inflammation include: abdominal ultrasound abdominal / CT scan / abdominal X-ray / oral cholecystogram gall bladder / radionuclide scan / A CBC shows infection by an elevated white blood cell count.
Although cholecystitis may resolve spontaneously, surgery to remove the gallbladder (cholecystectomy) is indicated because inflammation frequently persists or recurs. This operation is performed as soon as possible after the onset of cholecystitis, unless the patient is very ill, or if the inflammation is thought to have been present for many days.
Emergency surgery is done when gangrene (tissue death), perforation, pancreatitis, or inflammation of the common bile duct occurs. Non-surgical treatment consists of pain control, antibiotics to eliminate the infection, and a low fat diet when food is tolerated after the acute attack. With cholecystectomy; the outcome for cholecystitis is very good. In critically ill patients who are not in a position to undertake surgery the infected bile is drained through a tube and operation performed after sufficient antibiotic coverage.
Gall Stones:
Sometimes the substances contained in bile get crystallized in the gall bladder, forming gallstones. These small, hard concretions are more common in persons over 40, especially in women and the obese. They can cause inflammation of the gall bladder, called cholecystitis a disorder that produces symptoms similar to those of indigestion, especially after a fatty meal is consumed. If a stone becomes lodged in the bile duct, it produces severe pain. Gallstones may pass out of the body spontaneously; however, removing the gall bladder surgically treats serious blockage
The mechanism of formation of gallstones involves precipitation of the cholesterol and bile salts from the bile. Most of the bile is formed in the liver from cholesterol, which gets concentrated in the gall bladder. Excess concentration leads to formation of a rock-like material in the gall bladder. These are termed gallstones.
A person can have several gallstones. These gallstones range usually from the size of a sand grain to a maximum size of 1 or 2 inches. Smallest sized stones may pass through the biliary tree. However, big-sized stones lead to obstruction and inflammation. A chance of formation of gall stones increases with age especially amongst women.
Gallstones often are asymptotic and usually found by chance when taking an X-ray of the abdomen for some other purpose. Any obstruction by a gallstone gives rise to severe pain in the upper right side of the abdomen. Strong muscular contractions increase onset and extent of pain, which comes and goes in waves. Strong muscular contractions occur in an attempt to push the gallstone and relieve obstruction. There may be mild pain under the right ribs especially after a fatty meal because the fat in the diet provokes a reflex contraction of the gall bladder.
If the size of the gallstone is large enough to cause complete obstruction of the gall bladder, it results in the infection of the gall bladder. This leads to fever and Jaundice (Obstructive jaundice).
Diagnosis of gallstones is always through an ultrasound of the abdomen.
Established cases of gallstones need surgical remedy. If the size of the stone is too small it may not cause any symptoms. It may even pass out of the body spontaneously. Bigger stones lead to obstruction, hence the gall stones should be removed surgically and the procedure is called cholelythostomy. If there is infection one needs to take absolute rest, fat free diet and antibiotic coverage. If there are recurrent attacks of cholesystitis one may need removal of the gallbladder called Cholecystectomy.
Whenever there is slightest suspicion of cholecystitis one must consult a physician and get thoroughly investigated.
*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.