Respond to the following 2 discussion posts separately with separate reference lists.
1. Role of the gallbladder
The gallbladder is a small sac like organ located on the under surface of the liver that serves as a reservoir for bile. In addition to storing bile, the gall bladder concentrates it by removing water and electrolytes, leaving bile salts, bile pigments, and cholesterol. The presence of chyme in the small intestine triggers the gallbladder to contract, releasing bile into another duct system where it goes to the small intestine. The small intestine also produces a hormone called cholecystokinin that controls gallbladder contraction when fat is present (Dlugasch & Story, 2021).
Nausea and Vomiting?
Cholecystitis is an inflammation of the gallbladder because of cystic duct obstruction (blocked bile duct). The gallbladder temporarily stores bile, which is a liquid that contains a fat digesting substance produced in the liver. The cystic duct obstruction leads to a buildup of bile in the gallbladder that causes inflammation. After eating foods high in fat or cholesterol, the body attempts to release bile from the gallbladder but cannot because of the blockage. Since the body cannot break down the fats, there is a feeling of fullness, loss of appetite, nausea and vomiting
(Dlugasch & Story, 2021).
Cholecystitis begins with a typical manifestation of biliary colic. Biliary colic is a pain located in the right upper quadrant or epigastric area that can radiate to the back or right shoulder. This happens when the gallbladder contracts and causes a gallstone to temporarily block the duct that drains the gallbladder. In cholecystitis, the pain is severe, steady, and prolonged and is accompanied by fever. The Murphy sign is positive which is pain elicited when the patient takes a deep breathe upon palpation of the right upper quadrant (Dlugasch & Story, 2021).
Gallstones are thought to develop because of an imbalance in the chemical make-up of bile inside the gallbladder. The level of cholesterol in bile becomes too high and the excess cholesterol forms stones. Patients are at risk of developing gallstones if they are over forty years of age, female, and obese (Dlugasch & Story, 2021).
Dlugasch, L. Story, L. (2021). Applied Pathophysiology for the Advanced Practice Nurse.Jones &Bartlett, MA. ISBN 9781284150452
2. As part of the digestive system the gallbladder is responsible for storing the bile that aids in the digestion of fats. Before consumption the gallbladder is full of bile. When you start eating, your gallbladder receives signals to contract and squeeze the stored bile through the biliary tract (Cleveland Clinic, 2021). As described in the Cleveland Clinic article, bile travels to the common bile duct and into the duodenum combining with the food waiting for digestion (2021).
When the gallbladder is compromised this interferes with the physiology of the gallbladder. Food left sitting in the intestine, undigested, is likely to cause discomfort, thereby causing nausea and then vomiting. For example, with cholecystitis the transference of bile to the small intestine to break down fats and assist with digestion is inhibited from occurring which may induce nausea and vomiting.
Between 1 percent and 3 percent of people with symptomatic gallstones develop inflammation in the gallbladder (acute cholecystitis), which occurs when stones or sludge block the duct (Johns Hopkins Medicine, 2021). Pain in the upper right quadrant (URQ) is experienced in this location as this is where the gallbladder is positioned, and it is inflamed. Additionally, pain frequently increases when drawing a breath (Johns Hopkins Medicine, 2021)
There are a couple gallstone formations which are thought to develop in several ways depending on what is happening with the body. Cholesterol stones form when there is too much cholesterol, too much bilirubin and insufficient bile salts or when the gallbladder is incapable of emptying (Johns Hopkins Medicine, 2021). Pigment stones are believed to occur with cirrhosis, biliary tract infections, and hereditary blood disorders such as sickle cell anemia (Johns Hopkins Medicine, 2021).
Cleveland Clinic. (2021, July 28). Gallbladder. Retrieved from Cleveland Clinic: https://my.clevelandclinic.org/health/body/21690-gallbladder
Johns Hopkins Medicine. (2021). Gallbladder disease. Retrieved from Johns Hopkins Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/gallbladder-disease
Johns Hopkins Medicine. (2021). Gallstones. Retrieved from Johns Hopkins Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/gallstones
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