What Your Gallbladder May Be Trying to Tell You
Gallstones, symptoms, surgery, and more—Munson Healthcare General Surgeon Caleb Alley, DO, answers common questions about gallbladder disease.
The gallbladder is a small organ that sits just underneath your liver and stores bile—a digestive fluid that helps break down fats. Though it’s one of the smallest organs involved in digestion, gallbladder problems are surprisingly common. They’re also often accompanied by confusing, sporadic, and seemingly disconnected symptoms that many people dismiss until they become more serious.
Munson Healthcare general surgeon Caleb Alley, DO, answers your most common questions about gallbladder disease, including symptoms, diet considerations, when to seek care, common misconceptions, and more.
What are the telltale signs that it's time to see a specialist?
Alley: Gallbladder symptoms typically include recurrent pain in the right upper side of the abdomen (sometimes towards the middle) that usually occurs about 30 minutes after eating and lasts a few hours. Sometimes these pains are accompanied by bloating, indigestion, nausea and vomiting. You may have heard that symptoms can surface with fatty or greasy meals. While that’s certainly true, symptoms can follow meals with many types of foods.
It’s time to see a specialist when these symptoms become recurrent. Your primary doctor can start your evaluation with imaging, such as an ultrasound or CT scan, to evaluate for gallstones or thickening of the gallbladder wall.
Also important: Never assume that chest symptoms are gallbladder related! Chest pain, shortness of breath, sweating, faintness, or pain spreading to the arm, jaw, or back can indicate a heart attack and should be treated as an emergency.
How much of a role does nutrition play in gallbladder disease?
Dr Alley: This is a big misconception that can prevent people from seeking the treatment they may need. Many patients assume that gallstones are related to fatty foods or a poor diet, but you can absolutely develop gallstones or have a gallbladder attack despite eating a generally healthy diet. That’s because gallstones form from a chemical imbalance in your bile, which is influenced by several factors:
- Family history and genetics
- Older age
- Gender (women are more prone)
- Being overweight or obese
- Rapid weight loss
- Pregnancy
- Certain medical conditions (such as diabetes or liver disease)
- Certain medications (including those that affect cholesterol or hormone levels)
With that being said, eating healthy can reduce some risk factors—particularly maintaining a healthy weight and avoiding rapid weight loss.
What's the biggest misconception about gallbladder disease that you hear from patients?
Alley: A lot of patients assume that if their pain resolves, the problem is resolved. A hallmark sign of gallbladder problems is on-again-off-again pain. If you have gallstones, you are potentially at risk for complications. Don’t prolong sharing your symptoms, however intermittent they are, with your primary care provider.
Is surgery the only effective treatment for gallstones? When are non-surgical treatments appropriate, what are they, and when is surgery the best option?
Alley: About 10-15% of the population has gallstones, including here in Northern Michigan, and of those people, only about 25% go on to develop symptoms or complications. In other words, just because gallstones are identified on imaging doesn’t necessarily mean you need treatment.
When gallstones do cause symptoms or complications, gallbladder removal (called a cholecystectomy) is the most effective treatment. At Munson, this is most often performed using a minimally invasive laparoscopic or robotic approach through four or five small incisions. The procedure typically takes 30 to 90 minutes, and most patients can return home the same day.
Sometimes we prescribe a medication called ursodeoxycholic acid that can dissolve certain cholesterol stones; however, it can take months or years to work, and gallstones often recur after stopping the medication. For these reasons, we tend to reserve medication for patients who aren’t good candidates for surgery.
How is it possible to live without a gallbladder? What should patients know about life after gallbladder removal?
Alley: The gallbladder is simply a storage tank for bile until it is needed for digestion. Even without the gallbladder, your body still produces bile and often even learns to compensate for the lack of the storage tank. We see this in patients who have imaging performed years after a cholecystectomy.
After gallbladder surgery, I typically recommend that patients stick to a bland diet for a few weeks and then gradually increase the fats in their diet.
What are the risks of delaying treatment? Why is it beneficial to address gallbladder symptoms before they become an emergency?
Alley: Not every episode of gallbladder pain requires immediate surgery, but recurring symptoms are often a sign that the underlying problem isn't going away. Over time, attacks may become more frequent and interfere with eating and daily activities.
Addressing gallbladder disease before it becomes an emergency can help prevent complications such as gallbladder inflammation (cholecystitis) or bile duct blockage (choledocholithiasis), which can require more urgent treatment.
What do patients in Northern Michigan often get wrong about gallbladder disease or wish they had known sooner?
Alley: Northern Michigan is a vast area filled with strong people. We have to be in order to survive the long hard winters. It is easy to shrug off the sporadic symptoms, since they tend to completely resolve between episodes.
In addition, many towns do not have a hospital with surgical capabilities, so patients must travel to other towns that do. Fortunately, that is not the case here. Once your primary care doctor has ordered an evaluation, we can typically see you within just a few weeks.
There is a lot of online discussion about gallbladder health. One growing claim is that gallbladder disease is tied to low-fat diets. Another is that fasting helps lower risk. What does the evidence actually tell us?
Alley: Dietary fat stimulates the gallbladder to contract and empty. In fact, including healthy fats such as olive oil and fish oil can help the gallbladder contract and empty regularly1. But people don't develop gallstones from simply not eating enough fat. Remember that gallstones form for a variety of reasons, and diet is just one of many factors.
On the other hand, rapid weight loss and prolonged fasting can increase gallstone risk. When someone eats very little or loses weight quickly, the liver releases more cholesterol into the bile, and the gallbladder may not empty as effectively.
Instead, I recommend eating a balanced diet with adequate healthy fats, plenty of fiber, and limited refined carbohydrates and unhealthy fats.
Quick Facts About the Gallbladder & Gallbladder Disease
What are gallstones?
Gallstones are hardened deposits that form inside the gallbladder. They can range in size from tiny grains to larger stones and may or may not cause symptoms.
Can gallstones go away on their own?
In most cases, gallstones do not go away on their own. While symptoms may come and go, the stones themselves typically remain present unless they are removed or treated.
When should I call a doctor about gallbladder symptoms?
Schedule an appointment if you experience recurring pain in the upper abdomen, nausea after meals, discomfort that repeatedly follows eating, or symptoms that are becoming more frequent or affecting your quality of life.
When should I go to the emergency room for gallbladder symptoms?
Seek emergency care if you have severe abdominal pain that doesn't improve, fever, chills, yellowing of the skin or eyes (jaundice), dark urine, or persistent vomiting. Chest pain, shortness of breath, sweating, faintness, or pain radiating to the arm or jaw should also be treated as a medical emergency.
Looking for More Answers?
Explore additional gallbladder facts, treatment information and surgical services available through Munson Healthcare. Our surgical teams throughout Northern Michigan offer advanced minimally invasive techniques, including laparoscopic and robotic-assisted procedures as well as indocyanine green dye, which helps us identify the bile ducts and prevent injury.
As Dr. Alley explains:
"These techniques rival surgical care in any system I have participated and trained in to date and allow us to bring up-to-date care to patients throughout Northern Michigan."