Gallbladder Disease Is Common and Treatable
When Maggie became ill after a special dinner at a favorite restaurant, she chalked her stomach pain and vomiting up to food poisoning and called the restaurant to alert them to her illness.
Several months later she chose a different restaurant to celebrate her birthday with friends. When she suffered similar symptoms after returning home, she thought a second case of food poisoning rather unlikely and made an appointment with her doctor.
After hearing Maggie's symptoms and performing a physical exam, her doctor said he suspected her painful after-dinner attacks were caused by gallbladder disease that flared up when she indulged in a rich, fat-laden meal. Results from an ultrasound scan, the standard diagnostic test for gallstones, proved positive, and he recommended surgery to remove the gallbladder. 
Suhail Sami Daye, M.D., Massena Memorial Hospital General Surgeon, said, “Symptoms such as frequent indigestion can often be due to gall stones. Early evaluation and treatment is recommended to avoid infection and jaundice. A laparoscopic gall bladder surgery is very well tolerated, due to the small incisions used. Patients feel very well by the day after surgery, and are able to eat any foods they wish.”
Symptoms like those Maggie experienced are not uncommon. Gallbladder disease, almost always caused by the formation of gallstones, is a common condition present in up to 20 million Americans. The majority of those with gallstones is never bothered by them, however, and may find out about them incidentally, if they have a scan for another problem.
But about 10 percent of those with gallstones suffer very painful attacks which are finally relieved by surgery to remove the gallbladder. In the past, gallbladder surgery required a large incision, and patients took up to six weeks to recover.
“Today, gallbladder surgery is usually performed using laparoscopy with minimal cutting and patients can often return home the next day and be back to their normal routines in a week or so,” Dr. Daye added.
Gallbladder disease is common in the Western world and has increased in the past five decades, partly because of an aging population and partly because of increasing levels of obesity.
Risk factors include age, being female, multiple pregnancies, having diabetes and being overweight. Certain ethnic and racial groups also face higher risks. In the United States gallbladder disease is highest among Native Americans and persons of Mexican descent. Whites face a medium and African-Americans, a lower risk.
When Gallstones Form
The gallbladder is a small, pear-shaped organ that functions as a reservoir for bile that is secreted by the liver. Gallstones develop when substances in the bile (usually cholesterol, also secreted by the liver) form hard, crystallized particles.
The size of stones can vary from as small as a pebble to the size of a walnut. As long as the stones stay in the gallbladder they don't do any harm. The pain of a gallbladder attack occurs when a stone temporarily blocks or becomes lodged in the cystic duct, and the gallbladder contracts to try to dispel the stone. The pain subsides when the stone is either passed or falls back into the gallbladder.
The pain is often severe and can last from one to several hours. Gallbladder pain typically occurs in the upper right abdomen but can radiate to the back, the shoulder and between the shoulder blades. It is often accompanied by nausea, vomiting, fever and jaundice.
A gallbladder attack can usually be managed by pain medication followed by watchful waiting. About one third of people may never have a recurrence, but, more commonly, other attacks will follow perhaps separated by weeks, months or even years. A voiding a high fat diet decreases the risk of another attack.
A preliminary diagnosis, based on a patient's symptoms, can be confirmed with ultrasound, a reliable, non-invasive diagnostic tool. The only problem is that, because 10 to 12 percent of the population has "silent" stones, the presence of stones on an ultrasound scan doesn't guarantee that stones are the cause of the pain. Physicians have to consider other possible causes such as irritable bowel disease and stomach ulcers.
Once a diagnosis has been confirmed, surgery to remove the gallbladder is the most common option. Today most surgeries performed are laparoscopic procedures known as laparoscopic cholecystectomy (lapcholy for short). An estimated 600,000 surgeries are performed to remove gallbladders in the United States each year.
This minimally invasive surgery involves making several tiny incisions in the abdomen through which a scope and operating instruments are inserted. The scope projects the images to a TV monitor the surgeon uses to guide the instruments. The gallbladder is cut away and removed through a hole in the belly button.
The patient returns home after a day or so with incisions so small they often don't require a stitch, merely a piece of surgical tape. Recovery is rapid and patients can return to their normal routines in a week or so.
For more information about Massena Memorial Hospital Surgical Services, call 315-769-4345.
