SALT LAKE CITY — You feel pain in your upper right abdomen and reach for the antacids, thinking it's probably heartburn. Or you worry it's a heart attack. Or maybe you sit there, clueless, and wish it would please just go away. Fortunately, most of the time it does.
What a lot of people never consider is that the pain is coming from their gallbladder. At least some of the time, that's the culprit.
The gallbladder and its woes, including gallstones and inflammation, how to tell what's going on and treatment options, will be discussed in Saturday's Deseret News/Intermountain Healthcare Hotline. From 10 a.m. to noon, Dr. Heidi Jackson, a general surgeon, and Dr. Celia Garner, an internist, both at LDS Hospital, will take phoned-in questions. The number is 1-800-925-8177. And for the first time, questions can also be submitted and will be answered during the same two-hour period on the Deseret News Facebook page, www.facebook.com/desnews.
Most people with gallstones will never experience a symptom or have a problem, Garner said. Still, "gallbladdder disease will often cause pain in the abdominal area, particularly to the upper right. The common thing you feel in association with it is vomiting, nauseous, decreased appetite. But that can go with acid reflux, which is another thing that can present in a similar fashion."
The list of act-alikes can also include hepatitis, pancreatitis and a variety of other conditions.
If there's pain from gallstones, it typically "comes on a bit slowly, gets worse over time and resolves when the gallbladder relaxes enough to let the stone pass," Garner said. "If it lasts longer, it suggests the stone is not passing and that can cause issues.... I encourage my patients, if there's something going on and you're worried about it, get it checked out so if it is something it can be treated."
Gallbladder-related pain can show up in a variety of locations, including radiating toward the back or around the lower area where the shoulder blade is. So, though, can other conditions.
Gas, nausea and abdominal discomfort after meals can be a symptom of chronic cholecystitis, a combination of gallstones and mild inflammation. It can also lead to chronic diarrhea, Jackson said.
Diagnosing is partly a process of elimination, but it helps to know what triggers the pain and how long it lasts.
Ultrasound is a valuable diagnostic tool for gallbladder issues. The other gold-standard test is called a Hida scan, where dye is injected selectively into the liver, which makes bile that goes into the gallbladder. With the dye, healthcare providers can see if the gallbladder fills and how much it ejects, which shows how well it functions or if there's a problem. Most of the bile should be ejected, Garner said. A CT scan is not as valuable with the gallbladder. Basic blood tests are also used to check for infection or inflammation. Even the electrolytes and bilirubin level tell some of the story.
Sometimes an ultrasound looks normal but there are symptoms, so they do the Hida scan.
If there are persistent problems, surgery may be the best option, she said. With lesser symptoms, some patients get considerable relief by avoiding fatty foods.
The hotline looks at a different health topic the second Saturday of every month.
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General surgeon Dr. Heidi Jackson and internist Dr. Celia Garner, both at LDS Hospital, will answer questions about gallbladder problems, including diagnosis and treatment, Saturday from 10 a.m. to noon for the Deseret News/Intermountain Healthcare Hotline. The number is 1-800-925-8177 or 801-236-6061 on the Wasatch Front. You can also post questions during that time on the Deseret News Facebook page, www.facebook.com/desnews, and the doctors will answer them during the hotline.