Ayurveda

Gallbladder

Gallbladder

is a pear shaped organ, almost like a small sac, placed under the liver. The main function of this organ is to store bile secreted from the liver. In an adult, when fully utilized it measures about 8 centimeters in length and about 4 centimeters in diameter. The discussed organ is situated as an intermediary between the liver and the duodenum (beginning of the small intestine). It is also known as cholecyst. An acute infection of the organ is likewise termed as Cholecystitis.

Gallbladder Structure and the Biliary Tree

Structural Components of the Gallbladder

The organ is made up of three parts: fundus, body and neck. The neck narrows down to become the cystic duct and joins the path through which bile is transported from the liver to the small intestine, namely, the biliary tree. The cystic duct then merges onto the common hepatic duct. The pancreatic duct too joins in to form together what is known as the common bile duct. So it can be said that the pancreatic duct and the common hepatic duct are the merging branches of the common bile duct. The neck has a few mucosal folds at the angle of curvature and it is here, that gallstones are found to nest. This area is known as Hartmann’s pouch.

Function

It is a store house of bile secreted from the liver. Bile is a pale yellowish green liquid which acts on fat contained in food and helps to break them down. When fatty food enters the digestive tract, it stimulates the secretion of a gastrointestinal hormone, namely, cholecystokinin (CCK). This sends a signal to the brain which instructs the bile storage house to start releasing the bile in to the duodenum. In its full capacity, this sac can store about 50 milliliters of bile.

The bile has an emulsifying effect on fat. When it enters the discussed organ, it becomes more concentrated and dense in its consistency. This particular event has an important role in the formation of gallstones.

Gallbladder Diseases

In the United States of America, about 20 million people suffer from gallstones. It is the most common ailment of the said organ. In fact, other so called ailments of the said organ are complications arising from gallstones. The other diseases related to it are also listed below:

<img src="http://digestion.ygoy.com/wp-content/uploads/2010/01/Opened-Gallbladder-showing-numerous-stones1.jpg" alt="Opened Gallbladder showing numerous stones" title="Opened Gallbladder showing numerous stones" style="float:right;margin-left:5px" /

  • Gallstones

    : Gallstones are formed by the crystallization of the concentrated bile components like bile salts, emulsified fat and cholesterol deposits, mineral salts etc. They are formed in the gallbladder, but can move with the bile flow and get lodged in the cystic duct, or the common bile duct or in the Ampulla of Vater ( it is the meeting point of the pancreatic duct and the common bile duct). This may cause obstruction and an impending infection.

  • Acute Cholecystitis

    : This infection is present in 20% of the cases of the discussed organ related infection. When an obstruction is caused, the reflux and retention of bile into the organ can cause an acute infection aided by the presence of gut bacteria. Some of these bacteria belong to the Escherichia Coli and the Bacteroides species. It also causes inflammation of the walls of the organ. A cholecystectomy or a complete removal of the organ is the most opted choice of treatment in this case.

  • Ascending Cholangitis

    : When the gallstones obstruct parts of the biliary tract or the bile ducts , it causes an acute infection and this condition is termed as cholangitis. It is mostly treated with strong antibiotics or a surgery may be required to drain the ducts.

  • Gallstone Ileus

    : This is a complication which arises when the gallstone reaches the intestine. This has the potential of becoming fatal and needs immediate surgery to treat it.

  • Pancreatitis

    : Pancreatitis is caused when the gallstone gets lodged in the Ampulla of Vater and causes an obstruction for the pancreatic enzymes to drain into the common bile duct. The retention of these enzymes has a self destructing effect on the cells of the pancreas. This is known as autolysis or self–digestion.

  • Perforated Cholecyst

    : It happens in 10% of patients with an acute infection. The retention of the bile along with the infection has a corrosive effect on the walls of the organ causing them to become thin and perforated eventually. This is a serious condition and can prove fatal. The contents of the organ spill outside , on to the other abdominal organs and causes infection. This is known as peritonitis.

Treatment

Cholecystectomy

Cholecystectomy

:

  • Often the treatment for almost all the ailments mentioned above is a cholecystectomy or a complete removal of the organ. This can be done in a traditional open surgery or in a minimally invasive laparoscopic procedure. About 750,000 patients in the United States undergo this procedure in America each year.
  • Removal of the said organ does not affect the quality of life. This is because there are ways to make the bile reach the intestine. The prognosis of the procedure is very good.
  • The infection is dealt with a wide variety of antibiotics.

Side Effects of Cholecystectomy

However, bile in the absence of the said organ is directly dumped into the liver. This may affect the speed of transit of the food through the intestine. The bile is not sent to the duodenum in regulated amounts. The speed with which food goes down the tract is also increased and this causes malabsorption. The water cannot be absorbed by the intestines leading to watery diarrhea. The situation may be such, that the individual would need to go to the bathroom after every meal. This is the most prevalent side effect of the procedure.

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