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Gall bladder

The gall bladder is a pouch like organ just below the liver. Its function is storage and concentration of the bile. The bile helps in digestion of the food, and it is released from the gall bladder into the intestines after we consume a meal.

Diseases of the gall bladder

Gallstones

The formation of stones within the gall bladder are called as gallstones. These are more common in middle aged women, obesity, with certain medications, high cholesterol, blood disorders, sedentary habits, pregnancy, diabetes, high fat and low fiber diet and it also has a genetic component.

Most stones are composed of cholesterol. This is in contrast to kidney stones which have more calcium. High cholesterol content in the bile can lead it to precipitate and form crystals. These crystals join together and from small stones and which gradually enlarge in size.

In India, upto 6% of adults have gallstones. In a majority of patients, these gallstones do not cause any symptoms and do not require surgery.

These stones, when causing symptoms may lead to pain in the abdomen. The pain is usually sudden and high intensity and may be associated with vomiting. Jaundice is seen in severe cases. These symptoms are due to inflammation of the gall bladder (called as cholecystitis) or from the stone causing obstruction in the bile duct or cystic duct. It can lead to pancreatitis (inflammation in the pancreas) if the stone causes obstruction of the pancreatic duct.

In patients with symptoms or complications, surgical removal of gall bladder is required. This can be done by laparoscopy (key-hole surgery) or open surgery. If the stone has come out of gall bladder and obstructed in bile duct, we need to remove the stone by ERCP.

The gall bladder is not compulsory for sustaining life. If removed, there are no major adverse effects on health. After removal of gall bladder, a minority of patients can have more dyspepsia (acidity), reflux or loose motions. This can be managed easily with medicines.

Cancer of gall bladder:

This is an uncommon type of cancer. It is most prevalent in North India, especially UP. It can lead to jaundice, abdominal pain and weight loss. Treatment is surgery and/or chemotherapy.

Gall bladder polyps:

The polyps are tumors in the inner lining of the gall bladder. They are picked up on sonography. Tiny polyps of <5mm size only need careful monitoring. If they are large, they need to be investigated further. 

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