What is gallbladder disease?

The gallbladder's function is to store bile, which is produced by the liver and aids in the digestion of fats in the small intestine. The bile goes into the gallbladder through the cystic duct. The gallbladder acts as a reservoir until the small intestine needs the bile to digest fats. When bile in the gallbladder becomes concentrated and thickens, it can result in inflammation and/or the formation of gallstones. These stones may be present in the gallbladder and/or in the bile duct. Development of gallbladder disease is strongly linked to obesity, sedentary lifestyles and the Western diet, which is high in fat and sugar. An estimated 20 million Americans have gallbladder disease.

How would I know if I have gallstones?

About 90 percent of gallstones cause no symptoms. Unless you have symptoms, there is no reason to worry about gallstones.

What is a gallbladder attack?

People with gallbladder disease may periodically experience biliary colic, which is intermittent pain in the mid or right portion of the upper abdomen. When an individual has severe pain from one to several hours, it's termed a gallbladder attack. When gallstones or other matter block the duct, gallbladder inflammation (acute cholecystitis) can occur. Symptoms are similar but much more persistent and severe. Using pain relievers, changing positions and passing gas do not provide relief. Some people also develop fever and chills.

What is not symptomatic of a gallbladder attack?

Digestive issues like belching, feeling too full following a meal, bloating and heartburn are generally not caused by gallbladder disease. These symptoms are more likely caused by conditions such as peptic ulcer, gastroesophageal reflux disease, or general indigestion.

Should I see a doctor?

If you have symptoms of acute or chronic gallbladder disease, you should seek medical attention. Untreated, acute cholecystitis can progress to gangrene or perforation of the gallbladder. If you have diabetes, you are at higher risk for serious complications.

Is surgery the only treatment?

Surgical removal is the most effective treatment because it eliminates gallstones and reduces the risk of gallbladder cancer. Gallbladder removal has not been known to cause long-term adverse effects. Request a surgeon trained in laparoscopic cholecystectomy (lap chole). It is the preferred surgical method because the surgeon uses small instruments and makes tiny incisions so patients have less postoperative pain, fewer complications and resume normal activities faster. With open cholecystectomy, the surgeon makes a wide abdominal incision, resulting in longer recovery rates. In some cases, open cholecystectomy might be recommended. If that's the case, your surgeon would explain the reasoning for doing the more invasive surgical procedure.

(Bree Dewing is a surgeon at Sanford Clinic in Bismarck. She earned her undergraduate degree at the University of Minnesota in Minneapolis and completed a medical degree at Saba University School of Medicine in Saba, Netherlands Antilles. She did her residency in general surgery at the University of North Dakota School of Medicine and Health Sciences in Grand Forks.)