You’ve got gall

by Karen Bowen

After eating a burger, or other greasy foods do you ever feel pain in the center or upper right part of your abdomen? Does pain sometimes spread to your right shoulder or back? If so, you may have gallbladder issues.

Your gallbladder is a small, hollow, pear-shaped organ that helps digest foods. Sitting on the right side of your abdomen, resting in a depression beneath the right lobe of your liver, it collects, stores and concentrates bile secreted by the liver.

To emulsify fats in partially digested foods during digestion, the gallbladder excretes concentrated bile into the common bile duct, which eventually drains into the duodenum (the first section of the small intestine).

It also carries waste products from the liver to the duodenum for eventual expulsion. An adult’s gallbladder holds and stores about 50 ml of bile.

When your gallbladder is working well, it remains unnoticed, but when irritated, its painful inflammation (cholecystitis) cannot be ignored. Irritation can be caused by infection, contributing circulatory illnesses, tumours, kinking or scarring of the bile duct and most commonly – gallstones, which form when bile becomes saturated with cholesterol or bilirubin.

Many people have gallstones without knowing it. Often, gallstones rest quietly in the gallbladder or get passed through the digestive system without any issues.

However, when a gallstone blocks the tube leading out of the gallbladder, it can cause a buildup of bile, which painfully distends the gallbladder. In addition to abdominal pain, other symptoms of cholecystitis include: tenderness in the abdomen when touched, nausea, vomiting and fever.

These signs and symptoms, which can last for hours, frequently appear quickly after a meal, especially a large meal that includes fatty foods.

Perhaps you may be naturally prone to developing gallstones for reasons out of your control, such as: genetics (Native Americans and Mexican Americans are more susceptible); age (over 40); gender (women have a higher risk); or Crohn’s disease in the terminal ileum.

However, the following factors can be monitored, controlled and treated: high triglyceride levels; low HDL (high-density level) cholesterol; taking prescribed cholesterol-lowering medications; high estrogen levels due to pregnancy, hormone replacement therapy, or birth control pills; bile duct infection; cirrhosis of the liver or other liver disease; and anemia.

Even with a predisposition for developing gallstones, you can still significantly reduce your risk by becoming more active, staying hydrated, maintaining an appropriate weight and eating a healthy diet – reducing your intake of fats and increasing your fiber by eating more fruits, vegetables and whole grains.

If you decide to lose weight, lose it slowly, since losing more than one or two pounds per week increases your risk.

If you have high risk factors, monitor any unusual abdominal pain since untreated cholecystitis could lead to serious, even life-threatening complications, including infected bile, jaundice, gangrene, and a ruptured gallbladder.

So, have your doctor to check it out. If you experience pain so severe that it prevents you from sitting still or getting comfortable, have someone take you to the emergency room immediately.

Many times, hospital treatment to control the inflammation is all that’s needed, which may include fasting to rest your gallbladder; IV fluids for rehydration; antibiotics to fight infection; or pain medication.

However, when surgery is required to remove stones blocking the bile or cystic duct, your doctor may perform an ERCP (endoscopic retrograde cholangiopancreatography), which is minimally invasive and usually resolves the symptoms within three days.

Unfortunately, ERCP is not usually a permanent solution, since more stones will probably develop over time.

Eventually, most people with a history of gallstones have their gallbladder surgically removed, usually laparoscopically – another minimally invasive procedure consisting of a few small abdominal incisions.

After the gallbladder is removed, bile flows directly from the liver into the small intestine, instead of being stored in the gallbladder, which shouldn’t impact normal trucking activities, once recovered from surgery.

But, maintaining your gallbladder health instead of having surgery is easier to digest.

Karen Bowen is a professional health and nutrition consultant, and she can be reached at

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