Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.
Let’s talk about the importance of the gallbladder.
Sommer explained, “The gallbladder is in the digestive system. Its main function is to store bile, and bile is what helps your digestive system break down the fats. Bile is a mixture of mainly cholesterol, bilirubin and bile salts. What it does is, basically, when you eat a fatty meal, your gallbladder is stimulated to contract and release that bile, and it helps to break down the food.”
It’s a pretty complex process.
Sommer said, “It’s a little sack and if you eat, it’s contracted because it’s doing its job. It’s squeezing to help digest the food that you have just eaten. It resembles a deflated balloon, and that’s what it looks like. It looks like a little water balloon.”
What is gallbladder disease?
Sommer said, “It’s when your gallbladder gets either tired or sluggish or sometimes you can get stones in your gallbladder. So a lot of times if you have stones in your gallbladder, and when you eat a food and it contracts, the stones rub against the walls of the gallbladder, and they cause inflammation, which then causes pain. So a lot of times, people with signs and symptoms of gallbladder disease will have pain after they eat in the epigastric area, or the upper right quadrant of their stomach, and that’s because the gallbladder is doing its job, but there’s stones in there, and it’s rubbing and irritating the lining of the gallbladder. It becomes inflamed. Sometimes you can just have the walls of the gallbladder become inflamed, and that causes the pain. It’s a pretty active little organ. Every time you put food in your mouth, usually there’s some amount of fat, so it’s going to stimulate it to contract, and the gallstones, like we talked about, they also will rub and cause pain, and sometimes the bile shoots out of what’s called the common bile duct, a stone can get stuck in there, and that could be painful as well.”
Is it like kidney stones?
Sommer said, “A little bit. But they’re usually, it’s not like kidney stone. You might have one, two or three, sometimes in the gallbladder, you can have several or many. I’ve seen pictures where a gallbladder is, like, packed with stones.”
Chronic acalculous gallbladder means you gallbladder doesn’t work well.
Sommer said, “Sometimes it’s sluggish. You may not have stones. It just there’s a dysfunction in the gallbladder, and it doesn’t do what it’s supposed to do, and it tries, and that causes pain. It’s almost like it’s quivering, trying to contract, but it can’t do its job. So that will cause you pain as well.”
Gangrene can result.
Sommer said, “A lot of times with chronic inflammation, if you have chronic inflammation of stones and it goes untreated, it’s kind of like the tissue dies off, or you can actually form an abscess or an infection. You can also have like, polyps in the gallbladder, and you can also have tumors in the gallbladder. There is a cancer that is associated with gallbladder.”
What are the symptoms?
Sommer said, “It’s intermittent pain. A lot of times it’s associated with eating, and it could be like a gripping, a gnawing pain in the right upper abdomen near the rib cage. Sometimes it can radiate to the upper back. You can have pain behind your breastbone, a lot of times in severe gallbladder flare. Some people know that they have disease. They opt not to take the gallbladder out. They go on vacation, they appear in an urgent care or in the ER because they have nausea, vomiting and terrible pain. It’s pretty common, and a lot of times, when we talk about acid reflux, the two symptoms are very similar, so you usually end up ruling both out if you have any of that pain. It usually revolves around eating, especially when you eat a fatty meal. If you have gallbladder disease and you have the fatty meal, it’s going to set it off. Guaranteed.”
Jaundice can also occur.
Sommer said, “Sometimes the stones block the common bile duct, and then your body can’t get rid of the bile, and you end up accumulating bilirubin, which causes jaundice, which is a yellowing of the eyes or the skin. You might have dark urine, light stools, you might have a change in heartbeat. It might go up. You might have a drop in your blood pressure, fever, chills, nausea, vomiting, severe abdominal pain. So if you have stones, your gallbladder just needs to come out. It doesn’t go away, it doesn’t get better.”
How can you diagnose gallbladder disease?
Sommer said, “There are blood test, yes, that’ll check bilirubin. If your bilirubin is elevated, or sometimes liver enzymes are elevated, and there’s really is no other reason you’re experiencing the right upper quadrant pain, it could be a sign that it’s your gallbladder. Ultrasound is usually the best test to figure out whether you have the disease or not. You just need to make sure you don’t eat before the ultrasound so the gallbladder isn’t contracted and gallbladder gallstones will pick up on a CAT scan as well.”
Removal of the gallbladder can certainly help.
Sommer said, “It is done laparoscopically. So you have three little incisions, and they usually pull your gallbladder out through your belly button. It is done under anesthesia. I don’t think you want to be awake for it. Nine times out of 10, it will be done by laparoscopy, where you have several small incisions. They pull it out through the belly button. There’s less scarring, less pain. It’s a shorter hospital stay. It’s a same day surgery. Unless it’s done emergently, in the hospital, and there’s some other reason, like it was really big or sign of infection, you usually go home that day. A lot of the discomfort afterwards, is you have that air, that gas, and sometimes you might have pain again, in your shoulder, in the back. So post-op wise, you just need to move around, walk around, and get that gas to go away.”
Full recovery takes about four to six weeks.
Sommer said, “We’ve talked about surgery before, because everything is mostly same day, people think that they’re going to be moving and doing jumping jacks in three to five days. You’re not. You still need to recover four to six weeks.”
For more information, click here: https://www.keywestsurgicalgroup.com/