“How do I know if I need my gallbladder removed?”
I've been feeling quite a bit of pain in my abdominal area. I was already tested for appendicitis, and it came back as nothing. But my doctor mentioned that this could have something to do with my gallbladder and wants to look into it more. How do I know if this issue is my gallbladder? If it is, would it have to be removed?
5 Answers
You need a RUQ US.
The work-up of abdominal pain can be challenging. If the primary care doctor has been unable to make a diagnosis after taking a good history and performing a good physical exam, they add labs and/or imaging to help make the diagnosis. For gallbladder, this includes labs (CBC, CMP) and an abdominal ultrasound. If the symptoms (history) fits and the ultrasound shows gallstones, then it is oftentimes the culprit. If unsure (or no gallstones), then an additional test (called HIDA scan) can be performed. If your doctor ends up deciding the gallbladder is the source of your discomfort/pain, then surgery is only known intervention. Modifying your diet and herbal remedies can temporarily relieve symptoms or make the symptoms less frequent/severe - but are not a good long-term strategy.
Kendrix Evans
Surgeon
The easiest way to narrow it down is to notice when you gave abdominal pain. If the pain is in the right upper quadrant or epigastrium and radiates to the back after fried, spicy, or fatty foods, then it's likely gallbladder related. An ultrasound of the gallbladder is the best test.
Kendrix (Ken) J. Evans, MD, MS
Kendrix (Ken) J. Evans, MD, MS
Gallbladder pain is often located on the right side of the abdomen, but it can also be near the heart and in the back as well. It may be associated with nausea, vomiting, fevers that are worse after eating food, especially foods that are high in fat. The best test to rule out this disease is a right upper quadrant ultrasound to examen the gallbladder with images. Some may require further studies like a CT scan or a HIDA scan. If the results show gallbladder disease, then you may need to proceed with surgery.
The best test for gallbladder disease is an ultrasound. This will evaluate for the presence of gallstones. Right upper quadrant pain and gallstones is enough for me to recommend to most patients that a cholecystectomy (removal of the gallbladder) is warranted. An ultrasound may also examine for thickening of the wall of the gallbladder that indicates inflammation.
If the ultrasound is normal, the next test to get is a HIDA scan. A HIDA scan tests the function of the gallbladder. Dye will be injected into your veins and will then be taken up inside your gallbladder. The HIDA scan tests for how rapidly the dye empties from the gallbladder. If it empties too slow, this is called biliary dyskinesia, and is a pathologic problem of the gallbladder that warrants surgery.
If you have gallbladder disease, whether it is from stones or a functional problem, surgery is the treatment. There is no medicine and no diet changes that will ward off symptoms for the long run. I almost always recommend surgery to patients who are medically fit for surgery.
If the ultrasound is normal, the next test to get is a HIDA scan. A HIDA scan tests the function of the gallbladder. Dye will be injected into your veins and will then be taken up inside your gallbladder. The HIDA scan tests for how rapidly the dye empties from the gallbladder. If it empties too slow, this is called biliary dyskinesia, and is a pathologic problem of the gallbladder that warrants surgery.
If you have gallbladder disease, whether it is from stones or a functional problem, surgery is the treatment. There is no medicine and no diet changes that will ward off symptoms for the long run. I almost always recommend surgery to patients who are medically fit for surgery.
