Gallbladder Disease

Pathophysiology, Diagnosis, and Treatment

Simore Afamefuna, PharmD Candidate; Shari N. Allen, PharmD, BCPP


US Pharmacist. 2013;38(3):33-41. 

In This Article

Abstract and Introduction


Gallbladder disease, particularly cholelithiasis (gallstones), affects more than 20 million Americans each year. Patients often go undiagnosed because cholelithiasis often does not present with symptoms. Symptoms range from nausea or abdominal discomfort to biliary colic and jaundice. Gallbladder diseases are diagnosed most accurately via imaging techniques. However, laboratory values such as CBC, liver-function testing, and serum amylase and lipase should be included to help distinguish the type of gallbladder disease and/or identify associated complications. The most effective treatment for patients with gallbladder disease is surgery. Gallbladder disease is influenced by diet, exercise, and nutrition, and patients should be encouraged to incorporate these healthy habits into their lifestyle in order to reduce their risk of gallbladder disorders.


The most common form of gallbladder disease is cholelithiasis (gallstones).[1] Cholelithiasis affects more than 20 million Americans annually, resulting in a direct cost of more than $6.3 billion.[2] Gallstones generally are asymptomatic and typically are discovered during a surgical procedure for an unrelated condition or during autopsy.[1,2] In the United States, cholelithiasis is the most common inpatient diagnosis among gastrointestinal and liver diseases.[3,4] Although gallstones are usually asymptomatic, some patients progress to symptomatic disease. The primary clinical manifestation and complication of cholelithiasis is cholecystitis (inflammation of the gallbladder).[1,2] Less commonly, patients with severe cases may develop gallstone pancreatitis, gallbladder perforation, or other gallbladder diseases (Table 1).[1,5–8]