Although irritable bowel syndrome (IBS) is a disorder of the large intestine, having IBS is no guarantee that the rest of your digestive system works perfectly. One very important organ in the process of digestion is the gallbladder. Problems with the gallbladder can result in a variety of symptoms. The following discussion will provide you with an overview of your gallbladder, educate you as to the more common gallbladder diseases, and discuss any possible overlap with IBS.
What Does the Gallbladder Do?
Your gallbladder is a small, sac-like organ, located on the right side of your upper abdomen, tucked in under your liver. The gallbladder's main job has to do with a substance called bile, which is important in our ability to digest the foods we eat. Bile is first produced by the liver and then stored in the gallbladder. When we eat foods that have fat in them, the gallbladder secretes bile into the small intestine. There, the bile breaks down fat, allowing it to be absorbed into our bloodstream.
Symptoms of Gallbladder Problems
Although some gallbladder problems, including gallstones, may exist without any noticeable signs, the following symptoms may be indicative of gallbladder disease:
- Bloating after meals, particularly meals with a high fat content
- Chronic diarrhea
- Nausea after meals
- Pain in the middle or right side of your abdomen
Some gallbladder conditions announce their presence through what is commonly referred to as a "gallbladder attack," and officially known as "biliary colic." Such an attack may occur within a few hours of eating a large or fatty meal and may wake you up from sleep. You may experience pain in your upper right abdomen and this pain may also radiate to the upper back, between your shoulder blades, under your right shoulder, or behind your breastbone. Some gallbladder attacks result in nausea and vomiting. Usually these attacks only last for an hour or so. Such an attack should be reported to your doctor, even if symptoms subside.
If you are experiencing the following symptoms, you need to seek immediate medical attention:
- Clay-colored stools
- Fever and chills alongside nausea and vomiting
- Signs of jaundice
- Severe and persistent pain in your upper right abdomen
The following are some of the more common gallbladder diseases:
Diagnostic Tests for Gallbladder Disease
Once you have told your doctor that you are experiencing unusual digestive symptoms, your doctor will perform a physical examination and recommend bloodwork. Further testing may include:
- An ultrasound can identify the location and size of gallstones.
- The x-ray pictures from a computerized tomography (CT) scan may indicate the presence of gallstones, as well as show any inflammation or injury to the gallbladder and the bile ducts.
- A cholescintigraphy (HIDA scan) involves the injection of a radioactive substance that allows for information to be gathered as to how the gallbladder is functioning and to assess for the presence of gallbladder infection and blockage in the bile ducts.
- A more invasive procedure is the endoscopic retrograde cholangiopancreatography (ERCP). Using an endoscope, any stones in the bile dict can be identified and removed.
Treatment of Gallbladder Problems
As stated above, some small gallstones can be removed non-surgically through the use of ERCP, but only if they have left the gallbladder and made their way into one of the large ducts (i.e. the common bile duct). There are other ways of non-surgically dissolving gallstones, but these approaches are only used in rare circumstances.
The most common way to treat gallbladder problems is to remove the gallbladder, a procedure known as a cholecystectomy. The procedure is most often performed laparoscopically, which means that the gallbladder is removed through the use of only very small incisions.
IBS and Gallbladder Problems
Unlike some other health problems, there does not seem to be any evidence that IBS patients are more likely to suffer from gallbladder disease than other people.
One interesting avenue of research is ongoing regarding whether or not gallbladder motility may contribute to IBS symptoms. Studies on the subject are few and far between and have yielded very mixed results. For example, one study found no difference in rates of gallbladder contractions between IBS patients and healthy control subjects. Another study found faster rates than would be expected in patients who suffer from constipation-predominant IBS (IBS-C) and slower rates than would be expected in those who suffer from diarrhea-predominant IBS (IBS-D). An additional study found no difference between IBS patients and healthy controls in terms of gallbladder contraction rates two hours after eating, but found a significant difference three hours after eating. Clearly, more research is needed before any conclusions can be drawn about the role of the gallbladder in IBS.
Is It IBS or Gallbladder?
Because IBS is a functional disorder, many IBS patients lack full confidence in their diagnosis. It is common to wonder if other digestive disorders are present. Since some IBS patients experience nausea and because abdominal pain can radiate, it is understandable to wonder whether gallbladder disease has been overlooked. The best way to address such a concern is through a conversation with your doctor. With your new-found knowledge as to the gallbladder and common gallbladder problems, a discussion with your doctor will either calm your worries, or if your doctor also suspects an accompanying gallbladder condition, lead to further diagnostic tests and a more clear-cut diagnostic picture.
Related Reading from Dr. Bolen, Your IBS Guide:
"Gallstones" National Digestive Diseases Information Clearinghouse (NDDIC) Accessed February 24, 2012.
"Gallstones and gallbladder disease - Symptoms" University of Maryland Medical Center Accessed February 24, 2012.
"Gallstones and gallbladder disease - Treatment" University of Maryland Medical Center Accessed February 24, 2012.
Guclu, M., et.al. "Ultrasonographic evaluation of gallbladder functions in patients with irritable bowel syndrome" Journal of Gastroenterology and Hepatology 2006 21:1309-1312.
Lee, O. "Asian Motility Studies in Irritable Bowel Syndrome" Journal of Neurogastroenterology and Motility 210 16:120-130.
Misra, S., et.al. "Gallbladder Dynamics in Patients with Irritable Bowel Syndrome and Essential Dyspepsia" Journal of Clinical Gastroenterology 1991 13:65-68.
Sood, G., et.al. "Abnormal Gallbladder Function in Patients with Irritable Bowel Syndrome." American Journal of Gastroenterology 1993 88:1387-1390..
DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.