Last updated: January 12, 2012

Gall Bladder Symptoms

Gall Bladder Symptoms: An overview

Gall bladder symptoms include several different types of symptoms of different gall bladder diseases. Gall bladder symptoms in any individual patient not only depend the particular type of gall bladder disease but also depends upon the patient’s age and other medical problems. Gall bladder symptoms from acute cholecystitis are different from the gall bladder symptoms from biliary colic. Similarly gall bladder symptoms from acute cholangitis are different from gall bladder symptoms from chronic cholecystitis. Gall bladder symptoms from gall stone pancreatitis are different from gall bladder symptoms from acalculous cholecystitis.

The several different types of diseases that can cause gall bladder symptoms have various degrees of seriousness and need different treatment. As a physician working in ICU, I mostly take care of patients that have serious forms of gall bladder disease requiring close monitoring. I will briefly describe the different types of diseases causing gall bladder symptoms on this page. I will give you examples from real patients with gall bladder symptoms that took care of. The real life examples will help you understand gall bladder symptoms better than just describing the list of possible symptoms.

Mechanisms of development of gall bladder symptoms

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Image courtesy of: National Kidney & Urologic Diseases Information Clearinghouse (NKUDIC)

The gall bladder is a small pouch lives collects bile juice from the liver. Bile is made by liver and is collected by small tubules that eventually come together and for the common bile duct. As the common bile duct travels towards the upper part of the intestine where it releases the juice, it gives off a small branch called the cystic duct which connects to the gall bladder. Gall bladder serves to collect and hold the excess juice until it is needed in the intestine for help in digestion of the food. When it is needed, gall bladder contracts and empties its contents. Gall bladder symptoms develop when there is some defect in this mechanism. Anything that obstruct the path of bile flow, anything that causes over distension or anything that causes turbulence and infection in the sac can produce pain and other gall bladder symptoms.

Gall bladder symptoms from biliary colic

Gall bladder symptoms from biliary colic is usually self limited and is the most mild form of gall bladder symptoms. It occurs when there is some kind of object stopping the outflow of bile from the gall bladder. A small stone or some turbulent sludge may obstruct the neck of the pouch and prevent bile from coming out. When the patient eats fatty food, it creates an stimulus for the gall bladder to contract to try to empty its contents. It then gets distended and patient gets gall bladder symptoms. The pain is usually located in the right upper part of the stomach and may last for a few hours. It is an intense pressure like discomfort and may go into the right shoulder. Patients may have some nausea and vomiting with gall bladder symptoms from biliary colic.

Gall bladder symptoms from acute cholecystitis

Gall bladder symptoms from acute cholecystitis tend to be more severe than the gall bladder symptoms from biliary colic. The mechanism of development of gall bladder symptoms in acute cholecystitis is initially similar to biliary colic but it gets more complicated later. In addition to the obstruction and distension that happens just like I described for the patients with gall bladder symptoms from biliary colic, patients with acute cholecystitis develop inflammation or infection of the gall bladder wall. When that happens, the gall bladder becomes tender and inflamed. Patient develop a worse pain and have a fever. The blood tests show signs of inflammation and patients are usually sick enough to end up in the hospital. Many patients with gall bladder symptoms from acute cholecystitis require hospitalization and treatment with antibiotics and possible surgery.

Gall bladder symptoms of acute cholangitis

Gall bladder symptoms from from acute cholangitis can be life threatening and need emergent treatment. The obstruction in acute cholangitis is at the common bile duct, not at the neck of the gall bladder. In patients with gall bladder symptoms from acute cholangitis, the bile can not flow downstream to the intestine at all. It then causes back flow of the bile into the liver and ultimately into the blood causing yellowing of the skin and the eyes. This yellow discoloration is called Jaundice and is one of the symptoms that separates gall bladder symptoms of cholangitis from gall bladder symptoms of biliary colic and gall bladder symptoms of acute cholecystitis. In cholangitis, the complete obstruction of bile causes severe infection and damage of liver tissue. Patients develop severe infection and inflammation. They may have severe pain and can result in death of the patient if not treated urgently.

Gall bladder symptoms from gall stone pancreatitis

Gall bladder symptoms from gall stone pancreatitis have inflammation in the pancreas. In addition to causing obstruction in the flow of bile, small stones from gall gladder can lodge off and cause inflammation of the pancreas. The exact mechanism is somewhat complex but the inflammation of pancreas can be very severe and dangerous. Patients will gall bladder symptoms from gall stone pancreatitis have very severe pain right in the middle of the stomach. The pain may go all the way to the back and patients need hospital admission. Most patients with gall bladder symptoms from gall stone pancreatitis need treatment.

Gall bladder symptoms from acalculous cholecystitis

Patients with gall bladder symptoms from acalculous cholecystitis may not have the typical symptoms that patient with other gall bladder symptoms get. Patients with acalculous cystitis have inflammation of the gall bladder but do not have any visible stones. They have very unusual symptoms and depend on the unique circumstances of the patient. Most of these patients are already in the hospital and develop gall bladder symptoms from acalculous cystitis while they are being treated for other conditions. Diagnosis of symptoms from acalculous cystitis can be difficult and needs careful monitoring.

Like many other diseases discussed here, gall bladder symptoms depend upon how other organs and overall health of the patient contribute in the development of gall bladder symptoms in that particular patient. That is why you have to really understand the circumstances under which the patient developed the gall bladder symptoms to clearly understand how gall bladder symptoms develop in any particular patient. I have composed a series of articles based on my real patients who had gall bladder symptoms. When you read these stories and understand how gall bladder symptoms is diagnosed and treated in real life, you will have a clear idea about multiple types of gall bladder disease and how they present. Just reading a list of gall bladder symptoms in a textbook or a health website will not give you the whole picture that you get from reading real patient stories.

Real cases of gall bladder symptoms in adults based on actual patients of Dr. Sapkota: