Table of ContentsView AllTable of ContentsCommon CausesUncommon CausesGallbladder CancerFrequently Asked QuestionsNext in Gallbladder Disease GuideHow Gallbladder Disease Is Diagnosed
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Table of Contents
Common Causes
Uncommon Causes
Gallbladder Cancer
Frequently Asked Questions
Next in Gallbladder Disease Guide
The term “gallbladder disease” describes any health problem that affects the gallbladder.
While the most common cause ofgallbladder diseaseis gallstones (calledcholelithiasis),there are a number of other causes, including gallbladder inflammation (calledcholecystitis), biliary dyskinesia, functional gallbladder disease, primary biliary cholangitis, primary sclerosing cholangitis, and gallbladder cancer.
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Gallstones are the most common manifestation of gallbladder disease andform as a result oftoo much cholesterol or bilirubin (a pigment that is made in the liver when red blood cells are broken down).
Gallstones are crystals that form inside the gallbladder, which is a pear-shaped organ located in the upper right side of your abdomen under your liver. They can lodge in the biliary ducts.
What Does the Gallbladder Do?
Withcholesterol gallstones, your bile is “overwhelmed” with cholesterol and not able to dissolve it like it normally does, so stones form. The vast majority of people with gallstones in the United States have cholesterol stones.
Lastly, gallstones may form if the gallbladder does not empty bile properly (this is called bile stasis).
Some of therisk factors for developing gallstonesinclude:
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There are a number of other less frequent causes of gallbladder disease.
Cholecystitis
Cholecystitis is the inflammation of the gallbladder. It is typically the result of gallstones that block bile (called acute cholecystitis) or less commonly, without gallstones (called acalculous cholecystitis).
Acute cholecystitisoccurs when a gallstone becomes lodged within the cystic duct, leading to gallbladder inflammation. In addition to the typical pain (biliary colic) of having a gallstone, a person may have a fever, nausea, vomiting, malaise, and/or a loss of appetite. An elevated white blood cell count is also usually present.
Acalculous cholecystitiscauses the same symptoms and signs as acute cholecystitis, however, there is no gallstone present. Instead, experts believe this condition results from gallbladder stasis and ischemia (poor blood flow).
Acalculous cholecystitis typically occurs in people who are severely ill.
Some factors that increase a person’s chance of developing acalculous gallbladder disease include:
Biliary Dyskinesia
Biliary dyskinesia describes a syndrome of biliary duct system obstruction related to a functional abnormality of the sphincter of Oddi.
The muscular structure surrounds the area where the common bile duct joins up with the pancreatic duct as they enter the small intestine. Since the sphincter of Oddi does not function properly in this disease, a biliary obstruction may occur.
Intermittent episodes of biliary obstruction cause dull pain in the upper right or upper center part of the abdomen.
While an abdominal ultrasound may reveal a widened common bile duct, a test called the sphincter of Oddi manometry can be used to definitively diagnose biliary dyskinesia. If the sphincter of Oddi pressure is elevated (the test is positive), a person may undergo removal of the sphincter (called an endoscopic sphincterotomy).
Amagnetic resonance cholangiopancreatography (MRCP)orendoscopic ultrasound (EUS)can further detect the cause of biliary dyskinesia.
It’s unclear what causes biliary dyskinesia. It’s seen most often in people who have had their gallbladders removed; although the vast majority of people who have had their gallbladders removed do not experience biliary dyskinesia.
Other experts have suggested that this disorder results from spasm or nerve loss to the sphincter muscle.
Functional Gallbladder Disorder
Functional gallbladder disorder refers to people who experience biliary pain (discomfort in the upper right or center part of the abdomen) in the absence of gallstones or a sphincter of Oddi dysfunction.
People with functional gallbladder disorder have normal blood tests, without evidence of inflammation or liver problems. They also have a normal ultrasound of the gallbladder with no evidence of gallstones.
After ruling out other conditions that may mimic biliary pain (for example, ischemic heart disease or peptic ulcer disease), a person may undergo a test called cholecystokinin (CCK)-stimulated cholescintigraphy—also called a hepatobiliary iminodiacetic acid (HIDA) scan—to confirm the diagnosis of a functional gallbladder disorder.
This test calculates the ejection fraction of the gallbladder (how much tracer leaves the gallbladder). If the ejection fraction is low, like less than 40 percent, the test supports a diagnosis of a functional gallbladder disorder.Treatmentof this disorder entails removal of the gallbladder (called a cholecystectomy).
While still unclear, it’s possible that people with an underlying gastrointestinal motility issue (for example, abnormal gastric emptying) may be at risk for developing functional gallbladder disorder.
How Gallbladder Sludge Forms
Gallbladder cancer is rare and occurs when cells in the gallbladder grow rapidly and uncontrollably.
Both gallstones and primary sclerosis cholangitis increase a person’s chance of developing gallbladder cancer, although gallstones are far more common.
According to theAmerican Cancer Society,at least four out of five people with gallbladder cancer have gallstones when they are diagnosed. However, the vast majority of people with gallstones do not have and will never develop gallbladder cancer.
Other risk factors for developing gallbladder disease include:
Gallstones are the major cause of gallbladder disease. These hardened stones most often result when the gallbladder doesn’t empty properly and the cholesterol in bile form crystals. Gallstones cause symptoms when they block a bile duct, triggeringbiliary colic(a “gallbladder attack”).
Although gallstones are the major cause of bile duct obstruction, the ducts may be blocked without a gallstone. The condition, referred to asacalculous cholecystitis, is typically seen in critically ill people in whom gallbladder function is greatly diminished. The reduced bile flow causes thickening of bile and increased pressure that leads to damage to the gallbladder due torestricted blood flow.
Some people are predisposed to gallstones due to certain risk factors, such as:A family history of gallbladder diseaseObesityDiabetesLiver diseasePregnancyBirth control pillsRapid weight loss
Some people are predisposed to gallstones due to certain risk factors, such as:
Elevatedestrogenlevels during pregnancy are associated with an increase in cholesterol levels, particularly “bad”low-density lipoprotein (LDL) cholesterol. Increased LDL concentrations in bile can, in turn, promote gallstone formation.The same can occur in people taking estrogen-containingbirth control pillsor who are onestrogen replacement therapy.
How Gallbladder Disease Is Diagnosed
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stinton LM, Shaffer EA.Epidemiology of gallbladder disease: cholelithiasis and cancer.Gut Liver. 2012;6(2):172-87. doi:10.5009/gnl.2012.6.2.172U.S. National Library of Medicine.Gallstones. Medline Plus.Jones MW, Ferguson T.Acalculous cholecystitis. In:StatPearls [Internet].Goldman L, Schafer AI.Goldman’s Cecil Medicine. Philadelphia, PA: Saunders Publishing; 2011.Dibaise JK, Richmond BK, Ziessman HH, et al.Cholecystokinin-cholescintigraphy in adults: consensus recommendations of an interdisciplinary panel.Clin Gastroenterol Hepatol. 2011;9(5):376-84. doi:10.1016/j.cgh.2011.02.013American Cancer Society.Risk factors for gallbladder cancer.Li X, Guo X, Ji H, Yu G, Gao P.Gallstones in patients with chronic liver diseases.BioMed Res Int. 2017;2017:1-8. doi:10.1155/2017/9749802De Bari O, Wang TY, Liu M, Paik C-N, Portincasa P, Wang DQ-H.Cholesterol cholelithiasis in pregnant women: pathogenesis, prevention and treatment.Ann Hepatol. 2014;13(6):728-45.Wang S, Wang Y, Xu J, Chen Y.Is the oral contraceptive or hormone replacement therapy a risk factor for cholelithiasis: a systematic review and meta-analysis.Medicine. 2017;96(14):e6556. doi:10.1097/MD.0000000000006556American Cancer Society.Key statistics for gallbladder cancer.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stinton LM, Shaffer EA.Epidemiology of gallbladder disease: cholelithiasis and cancer.Gut Liver. 2012;6(2):172-87. doi:10.5009/gnl.2012.6.2.172U.S. National Library of Medicine.Gallstones. Medline Plus.Jones MW, Ferguson T.Acalculous cholecystitis. In:StatPearls [Internet].Goldman L, Schafer AI.Goldman’s Cecil Medicine. Philadelphia, PA: Saunders Publishing; 2011.Dibaise JK, Richmond BK, Ziessman HH, et al.Cholecystokinin-cholescintigraphy in adults: consensus recommendations of an interdisciplinary panel.Clin Gastroenterol Hepatol. 2011;9(5):376-84. doi:10.1016/j.cgh.2011.02.013American Cancer Society.Risk factors for gallbladder cancer.Li X, Guo X, Ji H, Yu G, Gao P.Gallstones in patients with chronic liver diseases.BioMed Res Int. 2017;2017:1-8. doi:10.1155/2017/9749802De Bari O, Wang TY, Liu M, Paik C-N, Portincasa P, Wang DQ-H.Cholesterol cholelithiasis in pregnant women: pathogenesis, prevention and treatment.Ann Hepatol. 2014;13(6):728-45.Wang S, Wang Y, Xu J, Chen Y.Is the oral contraceptive or hormone replacement therapy a risk factor for cholelithiasis: a systematic review and meta-analysis.Medicine. 2017;96(14):e6556. doi:10.1097/MD.0000000000006556American Cancer Society.Key statistics for gallbladder cancer.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Stinton LM, Shaffer EA.Epidemiology of gallbladder disease: cholelithiasis and cancer.Gut Liver. 2012;6(2):172-87. doi:10.5009/gnl.2012.6.2.172U.S. National Library of Medicine.Gallstones. Medline Plus.Jones MW, Ferguson T.Acalculous cholecystitis. In:StatPearls [Internet].Goldman L, Schafer AI.Goldman’s Cecil Medicine. Philadelphia, PA: Saunders Publishing; 2011.Dibaise JK, Richmond BK, Ziessman HH, et al.Cholecystokinin-cholescintigraphy in adults: consensus recommendations of an interdisciplinary panel.Clin Gastroenterol Hepatol. 2011;9(5):376-84. doi:10.1016/j.cgh.2011.02.013American Cancer Society.Risk factors for gallbladder cancer.Li X, Guo X, Ji H, Yu G, Gao P.Gallstones in patients with chronic liver diseases.BioMed Res Int. 2017;2017:1-8. doi:10.1155/2017/9749802De Bari O, Wang TY, Liu M, Paik C-N, Portincasa P, Wang DQ-H.Cholesterol cholelithiasis in pregnant women: pathogenesis, prevention and treatment.Ann Hepatol. 2014;13(6):728-45.Wang S, Wang Y, Xu J, Chen Y.Is the oral contraceptive or hormone replacement therapy a risk factor for cholelithiasis: a systematic review and meta-analysis.Medicine. 2017;96(14):e6556. doi:10.1097/MD.0000000000006556American Cancer Society.Key statistics for gallbladder cancer.
Stinton LM, Shaffer EA.Epidemiology of gallbladder disease: cholelithiasis and cancer.Gut Liver. 2012;6(2):172-87. doi:10.5009/gnl.2012.6.2.172
U.S. National Library of Medicine.Gallstones. Medline Plus.
Jones MW, Ferguson T.Acalculous cholecystitis. In:StatPearls [Internet].
Goldman L, Schafer AI.Goldman’s Cecil Medicine. Philadelphia, PA: Saunders Publishing; 2011.
Dibaise JK, Richmond BK, Ziessman HH, et al.Cholecystokinin-cholescintigraphy in adults: consensus recommendations of an interdisciplinary panel.Clin Gastroenterol Hepatol. 2011;9(5):376-84. doi:10.1016/j.cgh.2011.02.013
American Cancer Society.Risk factors for gallbladder cancer.
Li X, Guo X, Ji H, Yu G, Gao P.Gallstones in patients with chronic liver diseases.BioMed Res Int. 2017;2017:1-8. doi:10.1155/2017/9749802
De Bari O, Wang TY, Liu M, Paik C-N, Portincasa P, Wang DQ-H.Cholesterol cholelithiasis in pregnant women: pathogenesis, prevention and treatment.Ann Hepatol. 2014;13(6):728-45.
Wang S, Wang Y, Xu J, Chen Y.Is the oral contraceptive or hormone replacement therapy a risk factor for cholelithiasis: a systematic review and meta-analysis.Medicine. 2017;96(14):e6556. doi:10.1097/MD.0000000000006556
American Cancer Society.Key statistics for gallbladder cancer.
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