Does your stomach hurt after you eat? Are you avoiding your favorite food, like pizza, hamburgers and fries? It could be your gallbladder.
Your gallbladder
Your gallbladder stores and concentrates bile made by your liver. Bile is the bitter yellow stuff that is generated when you throw up. It is basically a “detergent” that your intestines use to break down fatty or rich foods. When you eat, your stomach sends out hormone messages telling your body and your intestines to anticipate food. One of those messages goes to the gallbladder, especially after a fatty meal.
If everything is working properly, your gallbladder gets this message, squeezes and squirts bile into the small intestines to help with digestion.
Problems arise when this process works too well. In some people, as the bile concentrates, it thickens into sludge. The sludge grows crystals that can form gallstones, which may block the gallbladder’s outlet, trapping the bile. The squeezing gallbladder causes a cramping sensation, usually under the right ribs or in the middle, upper abdomen.
Rarely, the stone will leave the gallbladder and block the system downstream. This can cause problems with your pancreas and block the bile out of the liver, causing yellow skin or eyes, which is the condition known as “jaundice.” There is another variety of gallbladder problems that doesn’t feature gallstones, but causes pain when the gallbladder squeezes.
The attack
The classic “gallbladder attack” symptoms are cramp-like pains occurring in the right- or middle-upper abdomen, often described as “waves of pain.” Women often say the pain reminds them of childbirth pain. Other symptoms may also be present, llike band-like pain radiating around the upper abdomen to the back, a bloating sensation after meals, right shoulder pain, shortness of breath or pain in the chest. Gallbladder attacks are often initially thought to be heart attacks.
People with gallbladder symptoms often say their stomach hasn’t felt right for years, especially after rich meals. Eventually, the problem can escalate, causing a gallbladder attack, for which a doctor orders an ultrasound to look for gallstones. If no stones are found, another study can evaluate how well the gallbladder squeezes and if the pain radiates from there.
What you can do
The first step to address gallbladder issues is to avoid fatty or rich food. It’s an easy, but temporary solution. By avoiding fatty food, your stomach doesn’t tell the gallbladder to squeeze as often, or as much.
There have been efforts to find medicines or diets to melt the gallstones or to break stones and flush them out. These haven’t proven successful.
The best option is gallbladder removal surgery. This is usually done through three or four small holes (quarter-inch to half-inch incisions) using a “laparoscope.” The laparoscope is a fiberoptic tube that shines light in the abdomen and allows the surgeon to look inside. It is connected to a camera and TV that the surgeon watches as he or she does your surgery. The surgery takes about an hour and an half. Most people return home the same day.
People with severe gallbladder attacks or other medical problems may require the older-style incision under the right rib cage. This is how all gallbladder surgeries used to be done. It is very safe, it just hurts more and takes more recovery time.
Normal recovery is about three days of soreness.
Two weeks after surgery, most patients have essentially no pain; but they often report feeling tired for as long as a month after surgery. There are no changes in your diet after the surgery and most people report no side effects at all – other than their gallbladder pain is gone.
Dr. Samuel Cargill is a board certified general surgeon and fellow of the American College of Surgeons. He practices at Enumclaw Medical Center-Cole Street, part of Franciscan Medical Group.
