Why the need for gall bladder
Many of us know what cholecystitis, dyskinesia of the bile ducts, stone formation and the like is. A large number of people experienced these pathologies first-hand. But not everyone has a clear idea of how this or that organ works in norm and in pathology, what functions it performs and where it is located. In fact, it’s quite easy to understand.
The gallbladder is an organ in the form of a pear-shaped sac. Basically, this organ is a reservoir for accumulating the necessary amount of bile, which is produced by the liver. .
The liver produces bile constantly but throws it out in small portions, as it has many other functions. The size of the gallbladder (or rather, the capacity of an average of 50 ml) allows it to accumulate a sufficient amount of liver secretion.
The production of bile is not a constant necessity of the body. If food is received, then bile is needed in large quantities. If food is not received, then it is not necessary. Thus, the outflow of the secretion of the liver is of periodic nature. Through the duct, the bile enters the duodenum, premixed with the enzymes of the pancreas. Thus, the digestive system works as a well-established mechanism under the supervision of both endocrine and nervous systems. But even in such a precise mechanism there are malfunctions.
In the course of evolution, the gall bladder was formed as a reservoir for digestion due to the fact that the ancestors of modern humans occasionally had a chance to get enough food to eat, so that a “spare” bile was required for complete digestion of absorbed food. Modern man loads his digestive tract several times a day. And not only by lots of food, but also difficult to digest (fatty, spicy, fried). From what has been said, we can draw a conclusion that bile is involved in the breakdown of fats. However, this function is not the main one, but an auxiliary one. The fact is that in the stomach and in the intestine there is a sufficient amount of substances for dissolving fats — enzymes, acids, and some salts. Their number is enough to split much more than one serving.
The fact is that any fat has one ability. For example, an eaten piece of bacon, herring or butter covers the stomach and intestines with a solid fatty film which is not easy to digest by the means of digestive reagents, because the decay goes very slowly. But if this solid film is digested to a number of droplets of fat, then the contact surface with enzymes and acids becomes larger, hence digestion is accelerated. When exposed to bile, the fatty film breaks into droplets. This process is called fat emulsification. It should be noted that in modern products, such as fatty sauce or mayonnaise, artificial emulsifiers that perform the function of bile have already been added.
A fasting gallbladder suffers heavily, as well as an overeating one. If a person does not eat, bile stagnates, accumulates, thickens, forming stones. The general duct can be overlapped with a stone, then bile and pancreatic juice do not enter the duodenum, and enzymes begin to digest the pancreas itself. Therefore, it is not healthy to arrange “hunger strikes”. Meals should be taken several times a day in small portions. If you consume food up to 5 times a day, it is most likely to provide a healthy digestive system.
Fats are necessary to the body, but not in a very large amount. It is necessary to give preference to vegetable fats, and not to those of animal origin. Food in general should be varied and balanced.
If you regularly feel heaviness and pain in the right hypochondrium, if the skin turns yellow, you should consult a doctor, as this may be a sign of various diseases – from dyskinesia of bile ducts and cholecystitis to malignant neoplasms.
How it works
The gallbladder is located in a fossa on the lower surface of the liver. In accordance with human anatomy one end of a gallbladder is wider and faces towards the anterior abdominal wall, and the other end is narrower. The narrow part faces the gates of the liver (this is the place where the hepatic vessels pass). The narrow end is called
the cervix. The cervix passes into the bile duct which then merges with the hepatic duct, and then connects to the pancreas. Thus, a hepatopancreatic ampulla is formed opening into the lumen of the duodenal bowel.
The ducts have sphincters which prevent the outflow of liver secretion in the opposite direction and promote the normal progression of bile into the lumen of the intestine. Between the bottom and cervix there is the body of the organ. The upper part of the body touches the liver, and the lower one faces the abdominal cavity adjacent to the duodenum, colon and stomach. In rare cases there may be an adherence to the small intestine. The structure of a gallbladder somehow resembles the structure of the intestine. From inside, it is lined with a mucous membrane, on the outside – with a serous one, and between them there is a muscle layer consisting of smooth muscles. The wall is thin, the color of the organ is dark green.
How do you know where the gallbladder is located? In fact, it’s quite simple. First, you need to connect the upper edge of the right armpit and the navel with an imaginary line. Then find the point of intersection of this line with the costal arch. In this way, physicians determine the point where the organ is located. When a patient is examined, palpation of the gallbladder in the right hypochondrium, that is, palpation, is performed during examination. If the size is normal, the doctor will not be able to feel it in the right hypochondrium, since the organ has a soft consistency and protrudes from under the liver at a maximum of 1 cm.
However, in some cases it is possible to probe the gallbladder. These are the conditions in which the size increases or the consistency varies, for example:
- stone formation;
- purulent inflammation (empyema);
- benign tumors;
- malignant neoplasms.
With various diseases, a doctor can palpate specific changes.
For example, if the cervix is clogged with a stone, then a tuberosity is felt.
If there is, for example, dropsy, then a smooth formation of an elastic consistency is felt. You can find a hard formation in case of cancer.
However, under these conditions, it is also possible not to palpate the organ, but it is possible to identify a number of symptoms. For example, the pathology may be indicated by the pain in the process of palpation. There are many symptoms and techniques for detecting a pathology of the gallbladder which the doctor uses during a physical examination. First, the doctor asks about the complaints, then he examines the patient and then prescribes some treatment.
The laboratory and instrumental examinations of the anatomical and functional state of an organ are the most informative. The most common and available nowadays is ultrasound (ultrasound examination) which can show the norm or pathology. The examination allows seeing the size of the gallbladder, its shape, the presence of any formations in the body itself or in the cervix. The length of the gallbladder in an adult is 7 to 14 cm, the width is 3 to 5 cm, and the capacity is 40 to 70 ml, the length of the cystic duct is 3-4 cm. It should be noted that the normal size of the gallbladder changes from birth to adulthood. Age features are taken into account when the doctor does ultrasound examination, but pediatricians are more closely involved in this.
In any case, if you notice discomfort, pain, heaviness in the right hypochondrium, icterus of the skin and mucous membranes, or if your relative or friend complains about it, you should suspect a problem with the gallbladder and seek medical help.