The Curbsiders Internal Medicine Podcast

#340 Gallbladder Disease

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Jun 13, 2022
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INSIGHT

Gallbladder Function And Stone Pathophysiology

  • The gallbladder stores and concentrates bile and delivers it in a regulated way to the duodenum.
  • Gallstones most commonly form from bile stasis and risk factors include age, obesity, medications, and certain populations.
ADVICE

History To Diagnose Biliary Colic

  • Ask about crescendo severe postprandial pain lasting 30 minutes to a few hours, often at night, to identify biliary colic.
  • Probe for absence of bloating/gas to distinguish biliary colic from dyspepsia.
ADVICE

Initial Workup For Suspected Gallstones

  • Order a hepatic function panel and a right upper quadrant ultrasound as initial tests for suspected symptomatic gallstones.
  • Use ultrasound first because it best detects gallbladder stones and sludge.
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