Gallbladder: A Tiny Organ with a Big Impact

It may not grab the spotlight the way the heart and lungs do, but your gallbladder plays a key role in your health. Understanding how this tiny but mighty organ works — and what can happen when it doesn’t — can you help identify potential problems.

What is the Gallbladder?

The gallbladder is a hollow, baglike organ about the size and shape of a pear. It’s located in the upper right quadrant of your abdomen, underneath your liver. The gallbladder is part of the biliary system, a series of ducts in the liver, pancreas and gallbladder that empty into the small intestine.

The gallbladder’s main job is to store a substance called bile that helps the body break down fat. Bile is produced in the liver and drains into the gallbladder, where it is stored until it is needed for digestion.

Why Is Bile Important?

Your digestive system relies on bile to break down the fat you eat into fatty acids, which are then absorbed and used by the body. In addition to providing you with energy, fat is important because it allows your body to absorb vitamins A, D, E and K. These nutrients are fat-soluble, meaning the only way your body can use them is if they are absorbed along with fat.

After bile passes through the small intestine, about 90% of bile salts — a component of bile that makes cholesterol, fat and fat-soluble vitamins easier to absorb — is reabsorbed into the bloodstream through the wall of the lower small intestine. These bile salts are then extracted from your blood by the liver and re-secreted back into bile. This cycle is repeated 10 or 12 times a day.

When Does Gallbladder Malfunction?

One common condition affecting the gallbladder is gallstones, which are deposits of hardened digestive fluid that form in the gallbladder. These stones can be as small as a grain of sand or as large as a golf ball, and people may have one or many of them.

Gallstones often cause no symptoms and don’t need treatment. For those who do experience symptoms, they include:

• Severe abdominal pain, especially in the upper right part of the abdomen, just below the rib cage

• Right shoulder pain

• Nausea and/or vomiting

• Back pressure

• Fever

• Jaundice

Although uncommon, cancer can also cause the gallbladder to malfunction. Gallbladder cancer can be serious if it’s not caught early, as it can easily spread to the liver. Some symptoms of gallbladder cancer are:

• Abdominal pain

• Jaundice

• Bloating

• Unexpected weight loss

Other possible gallbladder problems include bacterial infections, which may be acute or chronic and occur with or without gallstones; and gallbladder dysfunction, which can happen when the pumping action of bile into the small intestine triggered by hormones is too weak, meaning the digestive system doesn’t get enough bile.

Should Gallbladder Be Removed?

In some cases, such as when a patient is diagnosed with gallbladder cancer or if gallstones are causing severe symptoms such as acute pancreatitis, the gallbladder may need to be surgically removed. After surgery, bile flows from the liver into the small intestine through the common bile duct, a tube that carries bile from the liver and the gallbladder through the pancreas.

Although the body can no longer store bile between meals after the gallbladder has been removed, most people don’t experience much of a long-term change in their digestion. Potential side effects of gallbladder removal include indigestion and diarrhea (especially after consuming high-fat foods), which may happen because bile is released into the digestive system in a slow drip rather than a flood once the gallbladder is gone. These side effects tend to resolve as the body adjusts to its “new normal” of slower bile release.

When To See a Doctor

If you are experiencing symptoms such as severe abdominal pain or digestive problems like excessive belching, talk to your healthcare provider. Many providers have an in-office ultrasound machine to check your gallbladder in a noninvasive way. From there, your provider can determine if you need further treatment.