Is It Your Gallbladder?

Gallbladder pain, typically caused by gallstones, is commonly misdiagnosed and can go untreated in many patients. More than 25 million Americans have gallstones, but only a fraction of those people complain of symptoms and receive appropriate treatment. Receiving a comprehensive assessment from Dr. Andrew Rochman will ensure an accurate diagnosis and the best available treatment approaches. If you suspect you may have gallbladder problems, contact Dr. Rochman’s office immediately to set up an appointment. Some of the symptoms include:

  • Sudden, rapidly intensifying pain in the center or upper right portion of the abdomen
  • Upper back pain, particularly between the shoulder blades
  • Right shoulder pain
  • Vomiting
  • Nausea
  • Bloating
  • Indigestion
  • Heartburn
  • Yellowing of the skin and whites of the eyes
  • High fever and chills
  • Clay colored stool

Common Causes of Gallbladder Problems

Symptoms of gallbladder problems arise from a variety of reasons, and distinguishing between them is important for making accurate treatment decisions.

  • Gallstones in the gallbladder (cholelithiasis) – Gallstones develop when the bile contains too much cholesterol or a chemical called bilirubin. When present in high amounts, excess cholesterol crystallizes, forming small stones in the gallbladder.
  • Gallstones in the bile duct (choledocholithiasis) – Approximately 1 in 7 people who have gallstones will develop stones in the bile duct. The bile duct transports bile from the gallbladder to the intestine, aiding digestion.
  • Gallbladder inflammation (cholecystitis) – In some cases, the gallbladder becomes inflamed, which may lead to serious complications. Inflammation typically occurs when gallstones block the bile duct, resulting in a buildup of bile within the gallbladder.
  • Pancreas inflammation (pancreatitis) – When gallstones block the bile duct, special enzymes from the pancreas can no longer travel to the small intestine. These enzymes are forced back into the pancreas, leading to pancreatic inflammation.

Risk Factors for Gallbladder Problems

Certain individuals are at greater risk of developing gallstones and other gallbladder problems, including:

  • Women
  • People age 60 or older
  • Mexican-Americans or American Indians
  • Individuals who are overweight or obese
  • People who eat high-fat, high-cholesterol, or low-fiber diets
  • Those who have recently lost a lot of weight
  • Women on hormone replacement therapy drugs
  • People with a family history of gallstones

Tests Used to Diagnose Gallbladder Problems

  • Ultrasound – Ultrasound is perhaps the best diagnostic tool for identifying gallstones. Ultrasound uses sound waves to penetrate tissue and create an accurate image of the gallbladder and surrounding areas, allowing Dr. Rochman to identify the location of gallstones or inflammation.
  • HIDA scan – Hydroxy iminodiacetic acid (HIDA) is a special radioactive chemical that is injected into the arm and taken up by the gallbladder. Using a special camera, the doctor can trace the flow of HIDA into the gallbladder and small intestine. This procedure helps to diagnose gallbladder inflammation, obstruction of the bile duct, and other gallbladder problems.
  • Abdominal X-ray – During an abdominal X-ray, you will be asked to lie on your back and hold your breath while the images are taken. Abdominal X-rays provide a picture of the abdominal organs, allowing Dr. Rochman to diagnose gallbladder disease.
  • Liver function tests – Liver function tests (LFTs) measure levels of special enzymes and chemicals produced by the liver. This can be assessed following a simple blood draw. By identifying levels of liver substances, the physician can determine whether the liver and gallbladder are functioning properly.
  • Amylase and lipase test – The pancreas produces the enzymes amylase and lipase, which aid in digestion. A blood test can measure levels of these chemicals, which provides information about potential inflammation of the pancreas.

Gallbladder Disease

The gallbladder is located just below your liver and stores bile to aid in digestion. Although the gallbladder typically doesn’t cause much concern, if it becomes slows or blocks the flow of bile to the liver, many problems can occur.

Gallbladder disease, gallbladder Inflammation, and gallstones are a common result of gallbladder problems. These issues are commonly misdiagnosed resulting in extended pain for patients. Dr. Rochman has 25 years of experience diagnosing and treating gallbladder conditions. If you think you are suffering from any gallbladder issue, contact Dr. Rochman’s office immediately to set up an appointment.

Gallbladder Removal (Cholecystectomy)

There are two ways to surgically remove the gallbladder: an “open” or laparoscopic procedure. In the traditional “open” surgical procedure, the surgeon makes a 5 to 7 inch incision in the patient’s abdomen so the gallbladder can be removed. This approach causes more post-operative pain and patients will require a longer period to heal and return to normal daily activities. For patients who are obese or who have extensive scar tissue from other surgeries, the “open” procedure is the only surgical option.

Most patients have their gallbladders removed through a laparoscopic procedure. After the patient is asleep under general anesthesia, Dr. Rochman uses thin tubes, a tiny telescope and a tiny camera to remove the gallbladder. The procedure requires only four small incisions which are closed with stitches or surgical tape after the gallbladder has been removed.

During the surgical procedure, Dr. Rochman may conduct a cholangiogram to determine if gallstones are located in the bile ducts. If more stones are found, he may be able to use a scope to remove them during the laparoscopic procedure. If that isn’t an option, Dr. Rochman may choose to open the patient’s abdominal cavity so the remaining gallstones can be removed. Since he has significant experience with both laparoscopic and open gallbladder removal surgeries, Dr. Rochman is uniquely qualified to handle even the most complex cases.

What Happens After Surgery?

Patients usually go home the same day as a laparoscopic gallbladder removal. They will be able to return to normal activities within a week. Even though the procedure is classified as a “minimally invasive procedure,” patients may experience abdominal pain, nausea and possibly vomiting. As long as the patient feels capable, he or she should start walking soon after the procedure.

There are no complications with the vast majority of laparoscopic gallbladder surgeries. However, patients can experience complications such as infection, bleeding, and blood clots. These complications are rare, and Dr. Rochman discusses them in more depth prior to surgery.

If you suspect that you may have a gallbladder problem, contact Dr. Rochman’s office to set up an appointment.

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