The main problems which afflict the gall-bladder are an inflammatory condition known as cholecystitis and gallstones. The inflammatory condition often leads to cholelithiasis or gall-stones which are usually caused by disturbances in the combination of the bile. A change in the ratio of cholesterol and bile salts may result in the formation of deposits.
The gall-bladder is a pear-shaped organ, ten cm. long and three to five cm. wide. It lies on the under-surface of the liver on the right side just under the lower margin of the ribs. The function of the gall-bladder is to store and concentrate the bile secreted by the liver and to deliver it into the duodenum at appropriate times to assist in the process of digestion.
Bile is an excretion composed mainly of bile salts and acids, colour pigments and cholesterol. Bile assists in the digestion and absorption of fats and the absorption of fat-soluble vitamins A, D, E and K, minerals and calcium.
The gall-bladder is usually full and relaxed between meals. During the process of digestion, when food reaches the duodenum, a hormone called cholecystokinin begins to be produced in the internal mucosa. When this hormone reaches the gall-bladder through the blood stream, it causes the gall-bladder to contract, thereby releasing the bile concentrate into the duodenum via a common duct.
At the start, gall-stones may be in the form of fine gravel. But these fine particles constitute the nucleus for further deposits, ultimately leading to the formation of larger stones. The incidence of gall-stones is five times higher in females than in males, particularly in the obese and over 40 years of age.
Symptoms
The major symptom of gall-bladder disease is acute or intermittent epigastric pain. Indigestion , gas, a feeling of fullness after meals, constipation, nausea and disturbed vision are the other usual symptoms. Intolerance to fats, dizziness, jaundice, anaemia, acne and other lesions may also occur. Varicose veins, haemorrhoids and break-down of capillaries are also disorders associated with gall-bladder troubles.
Causes
The association of gall-bladder disease with obesity together with their reported rarity in primitive people, living on simple diets, suggest that dietary factors play a major role in the development of this disease. The main causes of gall-bladder disorders is overnutrition caused by refined carbohydrates, especially sugar as the loss of fibre removes a natural barrier to energy intake. Over- nutrition also leads to increased cholesterol secretion.
Meals rich in fats may cause an attack of gall-bladder pain or gall-stone colic. Chronic constipation is a most important predisposing factor. Poor health, hereditary factors, stress, spinal displacements, bad posture and muscular tension may also cause gall-bladder disorders. The Chinese link the gall-bladder disorders with the emotion of anger.
Types of gall-stones
There are three types of gall-stones, depending on the cause of their formation. These are: cholesterol stones, caused by the change in the ratio of cholesterol to bile salts; pigment stones, composed of bile pigment and caused by the destruction of red blood cells due to certain blood disease, and mixed stones consisting of layers of cholesterol, calcium and bile pigment resulting from stagnation of the bile flow. The third type is by far the most common.