What causes a failing gallbladder?

Quick Overview

The gallbladder is a small, pear-shaped organ located just under the liver. Its main function is to store and concentrate bile, a digestive fluid produced by the liver. Gallbladder disease occurs when something blocks the flow of bile out of the gallbladder, causing it to swell and resulting in pain and possible infection. The most common causes of a failing gallbladder are gallstones, cholecystitis (inflammation), cancer, bile duct problems, and rapid weight loss. Symptoms of a failing gallbladder include pain in the upper right abdomen, nausea, vomiting, fever, clay-colored stools, and jaundice. Risk factors include obesity, female gender, family history, diabetes, and cirrhosis. Diagnosis often involves blood tests, ultrasound, CT scan, MRI, or ERCP. Treatment depends on the cause but may include rest, antibiotics, surgery to remove gallbladder, or drainage procedures. Preventive measures include maintaining healthy weight, eating a balanced diet, and getting treatment for related conditions.

What is the Gallbladder?

The gallbladder is a small, pear-shaped organ that sits just underneath the liver on the upper right side of the abdomen. It is connected to the liver and the small intestine via a series of ducts or tubes called the biliary tract.

The main function of the gallbladder is to store and concentrate bile, a yellow-brown or greenish liquid produced by the liver. Bile helps the body digest and absorb fats from food as it passes through the small intestine. The gallbladder acts as a reservoir, concentrating and storing bile between meals when it isn’t needed for digestion.

When food containing fat enters the small intestine, it stimulates the release of a hormone called cholecystokinin, which signals the gallbladder to contract. This contraction squeezes bile out of the gallbladder through the cystic duct and into the common bile duct. The common bile duct delivers bile to the small intestine, where it emulsifies fats to help digestion.

Anatomy of the Gallbladder

The gallbladder is a hollow, pear-shaped organ about 3-4 inches long in adults. It is divided into three sections:

  • Fundus – the widest portion located near the liver
  • Body – the main midsection
  • Neck – the narrow end connecting to the cystic and common bile ducts

The gallbladder wall has three layers:

  1. Mucosa – the innermost layer containing epithelial cells which secrete mucus to aid bile flow
  2. Muscularis – the middle layer of smooth muscle that contracts to squeeze bile out
  3. Serosa – the outer covering of connective tissue attached to the liver

Attached to the neck of the gallbladder are the cystic duct, which carries bile from the liver to the gallbladder, and the common bile duct, which carries bile from the gallbladder and liver to the small intestine. These ducts, along with the gallbladder itself, make up the biliary tract.

What Does the Gallbladder Do?

The main function of the gallbladder is to store and concentrate bile between meals. Bile is produced continuously by the liver and delivered to the gallbladder through the cystic duct.

Here the gallbladder performs two important jobs:

  • Concentration – the gallbladder absorbs water and electrolytes from the bile, increasing its concentration up to 5-10 times.
  • Storage – the concentrated bile is stored until needed for digestion.

When food containing fat enters the duodenum (first section of the small intestine), it stimulates the release of cholecystokinin from cells in the intestinal wall. Cholecystokinin signals the gallbladder to contract and release its stored bile into the common bile duct.

The common bile duct delivers the bile to the duodenum, where it emulsifies large fat droplets into smaller ones that can be broken down by lipase enzymes. Bile also helps the absorption of the fat-soluble vitamins A, D, E, and K. After delivering the bile, the common bile duct passes through the pancreatic duct to also receive pancreatic juices needed for digestion.

Once the food has been digested, the gallbladder relaxes again to continue concentrating and storing bile until the next meal.

What Causes the Gallbladder to Fail?

Gallbladder disease occurs when there is some obstruction or interference with the flow of bile out of the gallbladder. This typically leads to inflammation, pain, infection, and sometimes rupture of the gallbladder.

There are several common conditions that can cause the gallbladder to fail:


Gallstones are the most frequent cause of gallbladder problems. Gallstones form when bile contains too much cholesterol, bilirubin, or calcium. The stones can range from microscopic to larger than a golf ball.

Gallstones lodge in the neck of the gallbladder blocking bile flow. This causes bile and pressure to build up, resulting in inflammation and sometimes infection, a condition called cholecystitis.

If gallstones move out of the gallbladder and lodge in other ducts, they can obstruct the flow of bile and pancreatic enzymes needed for digestion. This can lead to inflammation of the pancreas known as gallstone pancreatitis.


Cholecystitis means inflammation of the gallbladder. It occurs most often when gallstones block the cystic duct. Besides gallstones, other less common causes include bile duct infections, tumors, certain medications, and serious illnesses.

Acute cholecystitis comes on suddenly and causes intense pain and fever. Without treatment, it can lead to serious complications like gallbladder rupture. Chronic cholecystitis is milder but can recur over time.

Gallbladder Cancer

Cancer in the gallbladder is rare overall but is one of the most common cancers of the digestive tract. Gallstones, chronic inflammation, and infections may increase risk.

Symptoms can include abdominal pain, nausea, vomiting, weight loss, and fever. Unfortunately gallbladder cancer is often detected late when it has spread to other organs.

Bile Duct Problems

Conditions that block or restrict bile ducts can lead to gallbladder problems. Causes include gallstones, narrowed or scarred ducts, tumors, infections, injury, and pancreatitis.

When bile flow is reduced, bile backs up in the gallbladder causing swelling and pain. Bile duct blockages can be serious since bile is needed for digestion.

Rapid Weight Loss

Losing weight very quickly can prevent the gallbladder from emptying properly. When the body metabolizes fat during rapid weight loss, extra cholesterol is sent to the gallbladder, which can cause gallstone formation.

Crash diets and bariatric weight loss surgery are linked to higher gallstone risk. Gallstones are common after gastric bypass surgery. Gradual weight loss is less likely to affect the gallbladder.

Symptoms of a Failing Gallbladder

Symptoms of gallbladder problems often depend on the specific condition causing the failure. However, some general symptoms include:

Pain in Upper Abdomen

Most conditions cause right upper abdominal pain, usually just below the ribs where the gallbladder is located. Gallbladder pain may radiate to the right shoulder or back. It is often triggered by eating a fatty meal.

Nausea and Vomiting

Nausea and vomiting can accompany gallbladder pain. Nausea after eating may occur as food passes through the swollen and inflamed gallbladder.


A failing gallbladder may become infected, leading to fever with chills. Acute cholecystitis frequently causes fever along with abdominal pain.

Clay-colored Stool

When gallstones block the bile ducts, bile cannot reach the intestines to color the stools brown. This results in light or clay-colored stools.


Bile duct blockages also cause bilirubin to build up in the blood and deposit in skin and eyes, leading to yellowing called jaundice. Dark urine and clay stools typically accompany jaundice.


Without sufficient bile, digestion of fats and absorption of nutrients is impaired. This can lead to symptoms like bloating, gas, and diarrhea.

Other non-specific symptoms like headache, dizziness, intolerance to fatty foods, and acid reflux can also occur with gallbladder disease. Anyone experiencing these symptoms should see a doctor.

Risk Factors

Certain factors are linked to increased risk of gallbladder problems:


Obesity is a major risk factor for gallstones since excess weight impacts how the gallbladder contracts and emptying of bile. Women with a BMI over 30 have double the risk. Rapid weight loss further increases risk.

Female Gender

Women have twice the risk of gallstones compared to men. Female hormones like estrogen increase cholesterol saturation of bile. Women also have a higher risk during pregnancy.

Family History

Many people with gallstones have a family history of gallstones. Inherited genes may cause bile abnormalities or release of cholesterol.

Age Over 40

Most people develop gallstones after age 40. Risk increases with age as bile becomes more saturated with cholesterol.


Hispanics, Native Americans, and those of northern European descent have higher prevalence of gallstones. African Americans may have lower risk.


People with diabetes, especially women, are at higher risk for gallstones since diabetes impacts insulin, obesity, and bile chemistry.


Cirrhosis reduces the liver’s ability to remove cholesterol from bile, increasing gallstone risk. Chronic liver disease causes bile abnormalities.

Other factors like high triglycerides, certain medications, Crohn’s disease, and rapid weight cycling can also increase susceptibility to gallstones and gallbladder disease.

Diagnosing Gallbladder Problems

If symptoms indicate a possible failing gallbladder, the following tests help confirm the diagnosis:

Blood Tests

Blood tests check for signs of infection, jaundice, or pancreatitis. Elevated white blood cells or pancreatic and liver enzymes may indicate these complications.


Abdominal ultrasound is usually the first imaging test done and can detect gallstones, thickening of the gallbladder wall, duct blockages and dilation, and tumors. Ultrasound is non-invasive and involves no radiation exposure.

CT Scan

A CT scan creates cross-sectional images that provide detailed views of the gallbladder and bile ducts. It may detect smaller stones not seen on ultrasound. CT scans involve radiation exposure.


Magnetic resonance cholangiopancreatography (MRCP) is an MRI technique to visualize the biliary system. It is used if ultrasound or CT are inconclusive but does not require contrast or radiation.


Endoscopic retrograde cholangiopancreatography (ERCP) involves passing a fiberoptic scope through the stomach into the bile ducts. Contrast dye is injected to highlight blockages and stones on x-rays.

For acute pain and suspected gallbladder inflammation, urgent imaging tests are done to assess complications and determine if emergency surgery is needed.

Treating a Failing Gallbladder

Treatment depends on the specific problem causing the gallbladder failure, but may include:

Rest and Pain Medication

Mild pain without complications may be managed by fasting, hydration, rest, and over-the-counter pain relievers. This allows acute inflammation to resolve on its own.


Antibiotics are used if infection is present along with fever, accelerated heart rate, nausea and vomiting. IV antibiotics are given before emergency gallbladder surgery.

Surgery to Remove Gallbladder (Cholecystectomy)

Removing the gallbladder, called cholecystectomy, is the definitive treatment for gallstones and damaged gallbladders not responsive to other treatments. It is one of the most common surgeries performed.

The two types of cholecystectomy are:

  • Laparoscopic – Minimally invasive surgery with small incisions and removal through tiny instruments. It has a short recovery time.
  • Open surgery – A larger abdominal incision to access and remove a severely inflamed or scarred gallbladder. It has a longer recovery time.

Removal stops gallstone attacks and prevents recurrence. Most people can digest food normally without a gallbladder since bile still flows from the liver. However, some still get indigestion after fatty meals without the gallbladder storing bile.

Surgery for Bile Duct Problems

Blocked or narrowed bile ducts may require additional endoscopic or surgical procedures to remove gallstones or insert stents to improve bile flow.

Conditions like gallstone pancreatitis or cholangitis require urgent procedures to relieve the bile duct obstruction before it damages other organs.

Chemotherapy and Radiation

Treatment for gallbladder cancer may involve removing the gallbladder along with radiation or anti-cancer medications to destroy remaining cancer cells. However, outcomes are often poor with advanced disease.

Preventing Gallbladder Disease

While not all gallbladder disease can be prevented, the following measures can lower your risk:

  • Maintain a healthy weight since obesity is a major risk factor.
  • Follow a balanced, low fat diet avoiding rapid weight loss.
  • Eat smaller meals with minimal fatty/greasy foods.
  • Limit cholesterol intake to less than 300 mg per day.
  • Increase fiber to help bind bile and lower cholesterol.
  • Avoid refined carbohydrates like white breads and sugars.
  • Engage in regular exercise to help manage weight.
  • Take medications as prescribed to manage related conditions like diabetes.
  • Talk to your doctor about any supplements or herbs as some impact the gallbladder.
  • Seek treatment early if experiencing any symptoms of gallbladder disease.

While many factors cannot be controlled, maintaining overall health and wellness can lower risk of gallbladder problems. Speak with your doctor if you have any concerns.


The gallbladder concentrates and stores bile produced by the liver to aid digestion. Gallbladder disease occurs when something obstructs the outflow of bile, leading to inflammation, pain, and possible infection.

Common causes of a failing gallbladder include gallstones, cholecystitis, cancer, bile duct problems, and rapid weight loss. Symptoms may include abdominal pain, nausea, fever, light stools, jaundice, and digestive issues.

Risk factors for gallbladder disease include obesity, female gender, family history, older age, diabetes, and cirrhosis. Diagnosis often utilizes blood tests, ultrasound, CT, MRI, or ERCP. Depending on the cause, treatment may involve rest, antibiotics, gallbladder removal, drainage procedures, or cancer treatments.

Preventive measures focus on maintaining a healthy weight through diet and exercise. Seeking treatment early for any gallbladder symptoms can help prevent complications. While many problems cannot be avoided, living an overall healthy lifestyle can help keep the digestive system functioning properly.

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