Don’t dismiss symptoms of gallbladder disease, says Franklin surgeon

If you’re among the 20 million Americans living with gallstones, chances are you’re familiar with the abdominal pain and discomfort associated with gallbladder disease. As a surgeon who frequently performs gallbladder removal, or laparoscopic cholecystectomy, I am constantly talking to patients about symptoms and treatment of gallbladder disease.

What are gallstones?

Gallstones are hardened deposits of cholesterol and bile salts that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that’s released into your small intestine. Gallstones can be as tiny as a piece of sand, or as large as a golf ball. The incidence of gallstones often increases with age. According to the National Institutes of Health, approximately 20 percent of women and five percent of men ages 50 to 65 have gallstones, although it occurs in younger individuals as well. In fact, doctors often refer to the 5-F rule when considering a diagnosis of gallbladder disease, or cholelithiasis: Fair (more prevalent in the Caucasian population); Fat (BMI over 30); Female; Fertile (one or more children); and over Forty. Family history is another “F” that can be included, as I’ve often operated on multiple generations of the same family in my 40-plus year career.

Symptoms

Patients develop chronic inflammation in the wall of their gallbladder, which often results in the formation of stones. Symptoms typically include colicky, epigastric pain in the upper right portion of the abdomen that builds up, intensifies and relaxes over several minutes, often after a fatty meal. Sometimes I see patients who mistake gallbladder symptoms for indigestion. It is also often mistaken for heart disease. However, indigestion won’t manifest with colicky pain that clears on its own, particularly after a fatty meal. Some patients will experience chronic nausea or pain in their right shoulder. Advanced cases that warrant immediate medical attention involve fever with chills and pain so intense you can’t get comfortable. By the time patients see a surgeon, many have gone years with intermittent symptoms that have worsened over time, often landing them in the emergency department at night with uncontrollable pain. Those patients typically receive an ultrasound to rule out stones or an upper endoscopy to rule out ulcers or other diagnoses. While gallbladder disease symptoms are frequently the same for patients with or without stones, the presence of gallstones makes the disease much more critical. That’s because stones can block bile ducts and increase liver enzymes, posing an imminent health threat to the patient.

Surgery

While maintaining a healthy weight and eating low fat foods can help prevent or delay gallstones, lifestyle changes aren’t always effective, especially in those with a strong family history. Gallbladder surgery is the only one-time, fail-proof way to avoid future attacks, and usually requires zero maintenance medications afterward. Today’s gallbladder removal is much simpler and less painful than in years past thanks to advances in laparoscopic surgery. In fact, most surgeries take less than 40 minutes to complete. And while patients typically experience discomfort for two to three days after surgery, they’re usually smiling within the week, often free of pain for the first time in months. If you’re experiencing regular abdominal pain, talk to your doctor. An ultrasound only takes minutes and can confirm a diagnosis of gallbladder disease, which is very treatable when caught early.

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