Function of the gall bladder
The function of the gallbladder is to store and process the bile produced in the liver. The gallbladder forms the end point of the gallbladder duct (Ductus cysticus), through which the gallbladder is connected to the liver bile duct (Ductus hepaticus). The point at which the two ducts join is called the choledochal duct, the common bile duct.This bile duct finally unites with the excretory duct of the pancreas shortly before it opens.
The opening into the small intestine is a constriction with a sphincter muscle (papilla Vateri, papilla duodeni major). This sphincter is always tense and closes the exit of the bile duct. As a result, the bile (“bile”) cannot flow out, which in turn leads to an intentional congestion of the bile into the gall bladder.
The bile is now temporarily stored in the gallbladder until we consume food. The digestive process causes, among other things, the sphincter muscle to relax and release the opening into the duodenum. This leads to rhythmic tension of the muscles (contractions) in the gallbladder and the gall bladder duct (triggered by the hormone cholecystokinin).
These contractions cause the bile temporarily stored in the gallbladder to be actively transported out into the small intestine. In the small intestine, the bile is needed for fat digestion and is used to excrete sparingly soluble substances from the body. To prevent the gallbladder from bursting due to too much fluid, pure water and common salt (NaCl) are removed from the stored bile. As a result, the volume is reduced to as little as a tenth of the original amount of fluid and the concentration of the individual substances in the bile increases significantly. This increases the probability of gallstones forming.
Gall bladder pain
Pain in the area of the gallbladder can be attributed to various causes. Frequently there is an inflammation of the gallbladder, an acute cholecystitis. This can be triggered by gallstones, for example.
Other causes of an inflammation of the gallbladder include infections with bacteria, injuries to the abdominal organs, tumors or malformations of the gallbladder/bile duct. In acute inflammation of the gallbladder, the area under the right costal arch is very painful under pressure. Coughing can also cause severe pain.
Sometimes additional symptoms such as fever, chills, nausea and vomiting occur. If the cause of the gall bladder inflammation is a stone disease, a characteristic colicky pain can occur, which is acute and severe and manifests itself by cramp-like waves. These are caused by muscle contractions of the gallbladder and bile duct, which are intended to expel the stone.
Gallstones, which are responsible for pain in the gallbladder area, are often accompanied by nausea and a feeling of fullness, especially after very high-fat meals. If an acute inflammation of the gallbladder becomes chronic, the pain also changes. They are usually weaker, but usually exist throughout.
Due to the chronic inflammation, the gall bladder can develop into a so-called porcelain gall bladder. This is characterized by a thickened wall with calcium deposits. It can degenerate malignantly and must be removed surgically.
Gall bladder cancer can also cause pain in the area of the gall bladder, but this only occurs in an advanced stage of the disease. Initially, the disease presents very few symptoms. It is not uncommon for pain that actually originates in the stomach to be confused with gallbladder pain.
A slight inflammation of the gastric mucosa can be perceived as pain in the right upper abdomen and can be mistakenly projected onto the gallbladder. Last but not least, muscular or nervous causes can also cause pain in the gallbladder area. The gallbladder itself is not always the source of the pain. Because of the many different causes of pain, a doctor should be consulted if there is no improvement.
