What is the gallbladder?

Gallbladder

The gallbladder is a pear-shaped, hollow structure located under the liver and on the right side of the abdomen. Its primary function is to store and concentrate bile, a yellow-brown digestive enzyme produced by the liver. The gallbladder is part of the biliary tract.

The gallbladder serves as a reservoir for bile while it’s not being used for digestion. The gallbladder’s absorbent lining concentrates the stored bile. When food enters the small intestine, a hormone called cholecystokinin is released, signaling the gallbladder to contract and secrete bile into the small intestine through the common bile duct.

The bile helps the digestive process by breaking up fats. It also drains waste products from the liver into the duodenum, a part of the small intestine.

An excess of cholesterol, bilirubin, or bile salts can cause gallstones to form. Gallstones are generally small, hard deposits inside the gallbladder that are formed when stored bile crystallizes. A person with gallstones will rarely feel any symptoms until the gallstones reach a certain size, or if the gallstone obstructs the bile ducts. Surgical removal of the gallbladder (cholecystectomy) is the most common way to treat gallstones.

The gallbladder plays an important role in the digestive system, but many people don’t quite understand what this organ does or what causes gallstones. Here’s what you need to know about the gallbladder’s purpose, gallbladder disease, and gallstones.

The Purpose of the Gallbladder

Your gallbladder is located underneath your liver and connects to the common bile duct. When your liver produces bile, the liquid is stored in the gallbladder until it’s needed. After you eat, the gallbladder then releases its content into the bile duct, which transports the bile into the small intestine to help with digestion.

While the gallbladder plays a key role in proper digestion, you can live without this organ. If you have your gallbladder removed, bile will flow directly from your liver into your intestine. Side effects of this surgery include temporary diarrhea, but your body will adjust over time and resume digestion as usual.

What Are Gallstones?

The New York Times estimates 25 million Americans have gallstones each year, but only 1–3 percent of those people experience symptoms. Gallstones are just hardened digestive fluids—they can be tiny or grow to be more than an inch in diameter.

There’s a good chance you’ll never know that you have gallstones. The painful symptoms only come into play when one becomes lodged in the bile duct. This causes sudden, intense pain that may last for a few minutes or several hours.

Gallbladder Diseases

There are several conditions that are referred to “gallbladder disease,” including gallstones. It’s also possible to have an inflamed gallbladder or gallbladder cancer. These conditions commonly result in gallbladder removal, a surgery that’s called a cholecystectomy and often performed laparoscopically.

If you think you might have gallstones or have questions about your gallbladder, contact a gastroenterologist near you.

Gallbladder 101

What is your favorite greasy food? One that you know you shouldn’t eat, but indulge in anyway? Whether it’s beer-battered fish tacos or grandma’s signature meatloaf (with bacon), the foods that end up disagreeing with you are usually fat-filled—and can be a real pain in the gut.

However, it’s not just your stomach working overtime: Your gallbladder is part of your digestive system and is working harder than you may think. An expert from the Texas A&M College of Nursing talks about why it’s important to pay extra attention to what your gallbladder is trying to tell you.

What does a healthy gallbladder do?

The first question many people will ask about their gallbladder is, “What does my gallbladder do?” Similar to a car’s transmission fluid or a cat’s litter box, most people are only aware of their gallbladder when it starts to become a problem.

“A healthy gallbladder’s main function is to store bile,” said Matt Hoffman, FNP, clinical assistant professor at the Texas A&M College of Nursing. “It’s located right next to the liver, which creates bile, and the gallbladder sends the bile to the small intestine. Bile helps break down fat from food in your intestines and allows vitamins and nutrients to be more easily absorbed into the bloodstream.”

If things are running smoothly, you won’t notice your gallbladder at all, but when your gallbladder starts having complications, there are some tell-tale signs.

Gallbladder inflammation and gallstones

Your gallbladder, like any other organ, is susceptible to illness, and while it is located in the abdominal area, it won’t always seem that way from the pain it can cause in your body. The most common gallbladder ailment is called cholecystitis, or simply, gallbladder inflammation, and it can cause a worrisome pain.

“Sometimes with gallbladder inflammation, your pain can radiate in the shoulder,” Hoffman said. “People will have pain right above the stomach and may think they’re having a heart attack. The difference is that gallbladders don’t cause the pressure we typically associate with heart attack.”

Risk factors include an unbalanced, fat-rich diet and a history of gallbladder inflammation and ailments. The first sign of gallbladder inflammation is usually a sudden onset of pain in the upper right quadrant of the abdomen, but other symptoms can include nausea and vomiting, a mild fever and malaise.

“Patients will experience the pain after a high-fat meal,” Hoffman said. “Also, if you’ve ever had gallbladder ailments, you’re more likely to increase the chances of having similar or more severe ailments, like gallbladder cancer, in the future.”

Like a runny nose, gallbladder inflammation can be a day-to-day thing, but another more serious cause of inflammation is a condition called cholelithiasis, or gallstones—a condition where cholesterol deposits are left undissolved in the gallbladder.

Gallstones can happen to anybody, but people who are overweight, have high cholesterol or have experienced rapid weight loss have an increased risk of having gallstones. Also, women also at a higher risk because gallstones are linked to estrogen.

Gallstones are often benign and don’t cause any problems and are discovered when a health care provider is treating a different condition. However, if a provider suspects gallstones, they may test a patient’s cholesterol, run other blood tests or do an ultrasound scan to get a better picture of what is happening in the abdomen.

Treating your gallbladder ailments

Similar to having both kidneys or an appendix, your gallbladder isn’t a vital organ, and in some cases removing the gallbladder is the best course of treatment. Whether it’s because of gallstones or just chronic inflammation, a cholecystectomy—or gallbladder removal—may be the best course of action.

“The liver can compensate for the gallbladder and emulsify fat if the gallbladder needs to be removed,” Hoffman said. “Gallstones can get lodged in the pathway where the bile is trying to travel through, and that can led to more serious problems with other organs, such as the liver or intestines.”

Keeping a healthy gallbladder

When it comes to keeping your gallbladder in tip-top shape, it starts with your diet and becoming more mindful about the amount of fat is in your meals—especially if you have other risk factors, such as high cholesterol, or are overweight.

“It’s very important to know your food sources and your good fats from bad fats, because too much of a fatty food can cause irritation and a flare up of problems,” Hoffman said. “The best way to avoid gallbladder problems is to be self-aware of the foods that can be problematic.”

Hoffman also recommended talking about your family history of gallstones or high cholesterol with your health care provider, as they can help keep your gallbladder—and the rest of your digestive system—running smoothly.

— Dominic Hernandez

The gallbladder is an organ that is part of the human biliary system, which is involved with the production, storage and transportation of bile. Bile is a yellowish-brown fluid produced by the liver and used to break up and digest fatty foods in the small intestine.

The gallbladder is not absolutely necessary for human survival, as bile can reach the small intestine in other ways, according to Britain’s National Health Service. Some problems associated with the gallbladder are gallstones, gallbladder attack and gallbladder disease. Gallbladder pain is usually caused by biliary colic, gallstones, cholecystitis, pancreatitis and cholangitis, according to MedicineNet.

Gallstones

Gallstones are somewhat common. In fact, up to 20 million Americans have gallstones, according to National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD). Only around 20 percent of these stones cause problems, though, according to the World Gastroenterology Organization.

Gallstones are solidified particles of substances in the bile. They are made of a “combination of bile salts, cholesterol and bilirubin,” said Jordan Knowlton, an advanced registered nurse practitioner at the University of Florida Health Shands Hospital. Gallstones can be as small as a grain of sand or as large as a golf ball, according to The Oregon Clinic.

“Gallstones can be painful, and cause obstruction,” Knowlton said. “Depending on where the obstruction is, causes a variety of problems: gallbladder obstruction (cholecystitis), biliary tree obstruction (jaundice) and pancreatic duct obstruction (pancreatitis).” Gallstones can block the gallbladder ducts so that bile cannot reach the small intestine as effectively, which may prevent the gallbladder from doing its job and can lead to other gallbladder diseases.

Knowlton explained that while most gallstones pass on their own, some require a minor procedure or even surgery. “Diagnosis can be made by labs, ultrasound, or Hida scan,” she said.

According to the Mayo Clinic, factors that contribute to the risk of gallstones include obesity, high-fat or high-cholesterol diets, diabetes and taking medicines with estrogen. Women, people over 60, Native Americans and Mexican-Americans are also at a higher level of risk.

Gallstones can range in size from a grain of sand to a golf ball. (Image credit: Roblan )

Gallbladder attack

Gallstones can cause sudden pain that is called a gallbladder attack, according to the National Institutes of Health (NIH). Gallbladder attacks are usually the result of the gallstone blocking the bile ducts, thereby increasing pressure in the gallbladder. They usually occur soon after eating, especially heavy meals. According to the NIH, they can last from one to several hours or, according to the Mayo Clinic, as little as several minutes. The University of Maryland Medical Center lists the following as symptoms of a gallbladder attack: nausea, vomiting, loss of appetite and pain primarily in the upper right side of the abdomen. Pain may be acute or dull, and may be accompanied by jaundice. These symptoms can last from 15 minutes to a few hours.

The University of California San Francisco Department of Surgery pointed out that the symptoms of a gallbladder attack might be similar to those of a heart attack and other conditions, so it is important to consult a doctor for a correct diagnosis.

Gallbladder disease

There are several types of gallbladder disease:

Cholecystitis is the most common type of gallbladder disease, and often what medical professionals associate with the phrase. Knowlton described it as “inflammation of the gallbladder.” It is caused by gallstones obstructing the ducts to the small intestine. In addition to upper right abdominal pain, Knowlton said, cholecystitis carries with it a variety of symptoms, “including fever, positive Murphy’s sign , nausea and vomiting.” She said, “treatment depends on the severity of the symptoms … this can often be managed by rest and antibiotics, but for severe cases, surgery is the definitive treatment.”

Calculous cholecystitis is the most common type of cholecystitis and accounts for around 95 percent of all cases. This happens when the cystic duct specifically gets blocked by a gallstone or a type of bile called biliary sludge.

According to the NIH, after several attacks of pain, chronic cholecystitis may occur. This involves the gallbladder shrinking and losing its function.

“Those prone to gallbladder disease usually fall into the “5 F’s”: fair, fat, 40, female, and flatulent!” said Knowlton.

Choledocholithiasis is the “presence of at least one gallstone in the common bile duct,” according to Penn Medicine. It can block the flow of bile and cause the gallbladder to become inflamed or distended.

Acalculous gallbladder disease occurs without the presence of gallstones, according to the University of Maryland Medical Center. It happens when the gallbladder muscles or valve are not working correctly, and is often found in patients who are suffering from other serious disorders.

Cholangitis is inflammation in the common bile duct. According to the Medical University of South Carolina’s Digestive Disease Center, the most common cause is gallstones becoming lodged in the bile duct, though the condition can also be caused by bacterial infections, blockages caused by medical procedures, and tumors.

Gallbladder cancer is relatively rare, according to the Mayo Clinic. It can be difficult to diagnose because its symptoms are similar to other gallbladder ailments (nausea, vomiting, jaundice, fever).

Gallbladder polyps are lesions or growths in the gallbladder that are usually harmless and carry no symptoms, according to Healthline. The University of Southern California Center for Pancreatic and Biliary Diseases, however, warns that they can occasionally be a risk factor for gallbladder cancer.

Gangrene results from inadequate blood flow and can develop in the gallbladder if acute cholecystitis is left untreated. The NIH lists the following symptoms: confusion, fever, gas in tissues under the skin, feeling ill, low blood pressure and persistent pain.

Abscesses occur when the gallbladder becomes inflamed with pus. Like gangrene, it can occur as a complication of acute cholecystitis, according to The New York Times.

Gallbladder surgery and removal

According to the Mayo Clinic, when dealing with gallstones, doctors often recommend removing the gallbladder through surgery. If the problem does not involve gallstones, antibiotics are often the first treatment. But if the problem persists, the gallbladder will often be surgically removed. Around half a million people go through gallbladder removal each year, according to Brattleboro Memorial Hospital.

The most common and least invasive method of gallbladder removal is laparoscopic surgery. The NIH explained that in this procedure, the surgeon makes three or four small holes in the belly, inserts a laparoscope — a long tube with a camera — and then removes the gallbladder with tiny surgical tools.

If laparoscopic surgery cannot be performed, the doctor may remove the gallbladder through open abdominal surgery, according to the NIH.

Both forms of surgery are done under general anesthesia.

Diet for a healthy gallbladder

Maintaining a healthy diet and weight go a long way in keeping the gallbladder healthy. “You should eat a well-balanced diet with fruits, veggies, lean meats and fiber,” advised Knowlton. According to New Health Guide, foods that are particularly good for the gallbladder are:

Fresh, fiber-rich fruits and vegetables: Some great ones are avocados, cranberries, berries, grapes, cucumbers and beets. Broccoli, bell peppers and oranges are high in fiber and vitamin C, which if lacking can contribute to gallstones. Pectin-rich fruits — such as apples, strawberries and citrus — can also help, according to RawPeople.com. Radishes are a terrific option because they increase bile flow, but those already suffering from gallbladder problems shouldn’t eat too many of them.

Lean meat, fish and poultry: The least fatty cuts are loins or “rounds,” according to New Health Guide. Any type of fish, pork, lamb and skinless chicken are also good choices.

Whole grains: These include oats, bran cereal and brown rice. Try breads and cereals that contain whole, various grains and high amounts of fiber.

Low-fat dairy: Pay attention to the fat content in any type of dairy food.

Caffeinated coffee and alcohol: Studies have actually shown that moderate amounts (typically two drinks per day) of alcohol or caffeine from coffee may reduce the risk of gallstones. Caffeine from sources other than coffee, such as tea and soda, has not been shown to have a beneficial effect.

Plenty of water: RawPeople.com advises this one, pointing out that hydration is essential for maintaining the proper amount of water in the bile.

Nuts: The jury is still out on nuts. According to Everyday Health, some studies have shown that eating peanuts or tree nuts such as almonds and walnuts can help prevent gallstones, but it is important not to eat too many because nuts are high in fat.

Keeping away from certain foods can help, too. “Avoid fatty, fried foods, and limit alcohol!” cautioned Knowlton. According to New Health Guide, some other foods to steer clear of are:

Sweeteners, sugar, and refined carbohydrates: This includes high-fructose corn syrup and refined sugars, like those found in cookies, soda and snack foods.

Frozen or canned fruits and vegetables: They may have additives that make it harder for the gallbladder to do its work.

White flour foods: This includes white bread, pasta and many desserts.

Processed snacks: Potato chips, cookies, pies — almost any packaged snack are bad for your body.

High-fat foods: Fried food, fatty cuts of meat, whole-milk dairy products and foods that are highly processed should be avoided.

Very low-calorie diets: This generally means eating less than 1,000 calories a day. These diets can increase gallstone formation.

Additional reporting by Alina Bradford, Live Science contributor.

Editor’s Note: If you’d like more information on this topic, we recommend the following book:

Related pages about the human body

  • Human Body: Anatomy, Facts & Functions

Parts of the human body

Systems of the human body

  • Circulatory System: Facts, Function & Diseases
  • Digestive System: Facts, Function & Diseases
  • Endocrine System: Facts, Functions and Diseases
  • Immune System: Diseases, Disorders & Function
  • Lymphatic System: Facts, Functions & Diseases
  • Muscular System: Facts, Functions & Diseases
  • Nervous System: Facts, Function & Diseases
  • Reproductive System: Facts, Functions and Diseases
  • Respiratory System: Facts, Function & Diseases
  • Skeletal System: Facts, Function & Diseases
  • Skin: Facts, Diseases & Conditions
  • Urinary System: Facts, Functions & Diseases

Additional resources

  • New Health Guide: Gallbladder Diet
  • NIH: Fact Sheet About Gallstones
  • NIH: What Is Bile?

Gallbladder Tests

  • Abdominal ultrasound: a noninvasive test in which a probe on the skin bounces high-frequency sound waves off structures in the belly. Ultrasound is an excellent test for gallstones and to check the gallbladder wall.
  • HIDA scan (cholescintigraphy): In this nuclear medicine test, radioactive dye is injected intravenously and is secreted into the bile. Cholecystitis is likely if the scan shows bile doesn’t make it from the liver into the gallbladder.
  • Endoscopic retrograde cholangiopancreatography (ERCP): Using a flexible tube inserted through the mouth, through the stomach, and into the small intestine, a doctor can see through the tube and inject dye into the bile system ducts. Tiny surgical tools can be used to treat some gallstone conditions during ERCP.
  • Magnetic resonance cholangiopancreatography (MRCP): An MRI scanner provides high-resolution images of the bile ducts, pancreas, and gallbladder. MRCP images help guide further tests and treatments.
  • Endoscopic ultrasound: A tiny ultrasound probe on the end of a flexible tube is inserted through the mouth to the intestines. Endoscopic ultrasound can help detect choledocholithiasis and gallstone pancreatitis.
  • Abdominal X-ray: Although they may be used to look for other problems in the abdomen, X-rays generally cannot diagnose gallbladder disease. However, X-rays may be able to detect gallstones.

Bookshelf

Cholecystitis

Inflammation or infection of the gallbladder. This guideline only includes cholecystitis caused by gallstones.

Cholecystolithiasis

See gallbladder stones

Choledocholithiasis

See common bile duct stones

Cholelithiasis

May refer specifically to the presence of gallbladder stones or it may refer generally to the presence of gallstone disease.

Cholangitis

Inflammation or infection of the common bile duct. This guideline only includes cholangitis caused by gallstones

Common bile duct stones (CBDS)

Gallstones that have travelled from the gallbladder into the common bile duct, or stones that have formed in the bile duct. Stones in the bile duct may be found by gallbladder imaging or incidentally by unrelated imaging investigations.

Gallbladder stones

Gallstones in the gallbladder

Gallstones

Discreet, hard, fatty mineral deposits that develop in the gallbladder

Gallstone disease

The presence of gallstones in the gallbladder and/or common bile duct and/or the associated complications that gallstones cause

Gold standard

A term used in studies of diagnostic test accuracy to describe a method, procedure or measurement that is widely accepted as being the best available to test for or treat a disease. Also known as the reference standard

Index test

A term used in studies of diagnostic test accuracy to describe the test being evaluated

Mirrizi syndrome

Compression of the common bile duct caused by a gallstone becoming trapped in the neck of the gallbladder. A rare condition.

Obstructive jaundice

An obstruction in the common bile duct preventing the flow of bile from the gallbladder to the liver. This guideline only includes obstructive jaundice caused by gallstones

Pancreatitis

Inflammation or infection of the pancreas. This guideline only includes pancreatitis caused by gallstones.

Reference standard

A term used in studies of diagnostic test accuracy to describe a method, procedure or measurement that is widely accepted as being the best available to test for or treat a disease. Also known as the gold standard

Symptomatic

For the purposes of this guideline only, symptomatic refers to stones found on gallbladder imaging in people who have experienced symptoms at any time up to 12 months before diagnosis.

Suspected gallstone disease

Gallstone disease is the term used in this guideline to refer to the presence of stones in the gallbladder or common bile duct and the symptoms and complications they cause. Most people with gallstone disease have asymptomatic gallbladder stones, meaning the stones are confined to the gallbladder and they do not have any symptoms, and disease is often identified coincidentally as a result of investigations for other conditions. In suspected gallstone disease the symptoms may range from mild, non-specific symptoms that can be difficult to diagnose, to severe pain and/or complications which are often easily recognised as gallstone disease by healthcare professionals.

Xanthogranulomatous cholecystitis

A destructive inflammatory process that causes damage to the gallbladder. A rare condition caused by gallstone disease.

Acute cholecystitis

If your doctor suspects you have acute cholecystitis, you will probably be admitted to hospital for treatment.

Antibiotics

You will first be given an injection of antibiotics into a vein. Broad-spectrum antibiotics are used, which can kill a wide range of different bacteria.

Once your symptoms have stabilised, you may be sent home and given an appointment to return for surgical treatment (see below).

Alternatively, if your symptoms are particularly severe or you have a high risk of complications, you may be referred for surgery a few days after antibiotic treatment.

A cholecystectomy is the most widely used type of surgery for cases of acute cholecystitis.

Surgery

A cholecystectomy is the surgical removal of the gallbladder. There are two types of cholecystectomy:

  • laparoscopic cholecystectomy
  • open cholecystectomy

These are described below.

Laparoscopic cholecystectomy

Laparoscopic cholecystectomy is a type of ‘keyhole’ surgery. It is the most widely used type of cholecystectomy. A laparoscopic cholecystectomy is carried out under a general anaesthetic, which means you will be asleep during the operation and will not feel any pain.

During a laparoscopic cholecystectomy, the surgeon makes four small cuts, each about 1cm or smaller, in your abdomen (tummy) wall. One incision is made near your belly button and the other three made across your upper abdomen.

Your abdomen is inflated with carbon dioxide gas passed through the cuts. Inflating your abdomen gives the surgeon a better view of your organs and more room in which to work.

The surgeon passes an instrument called a laparoscope through one of the incisions. A laparoscope is a small, rigid tube that has a light source and a camera at one end. The camera transmits images of the inside of your abdomen to a television monitor.

The surgeon then passes small instruments down the other incisions to remove your gallbladder and any gallstones. After your gallbladder has been removed, the incisions are closed.

As this technique only involves making small cuts in your abdomen, you will not experience much pain afterwards. You should also recover quickly from the effects of the operation. Most people are able to return home either on the day of the surgery or the day after.

Read about laparoscopic cholecystectomy for more information about the procedure.

Open cholecystectomy

A laparoscopic cholecystectomy is not recommended if you:

  • are in the third trimester (the last three months) of pregnancy
  • for some people with cirrhosis (scarring of the liver)

In these circumstances, an open cholecystectomy may be recommended.

An open cholecystectomy may also be carried out if a planned laparoscopic cholecystectomy is not successful.

As with a laparoscopic cholecystectomy, an open cholecystectomy will be carried out under general anaesthetic so you will not feel any pain during the procedure. The surgeon will make a large cut in your abdomen to remove your gallbladder.

An open cholecystectomy is an effective method of treating acute cholecystitis, but has a longer recovery time than laparoscopic cholecystectomy. Most people take about six weeks to recover from an open cholecystectomy.

Percutaneous cholecystostomy

If your symptoms are severe or you are in poor health, your care team may decide immediate surgery is too dangerous.

In such circumstances, a temporary measure known as a percutaneous cholecystostomy may be carried out. A percutaneous cholecystostomy may be performed under a local anaesthetic, which numbs your abdomen. This means you will be awake during the procedure.

The surgeon will use an ultrasound scan to guide a needle to the site of your gallbladder. The needle is then used to drain bile out of the gallbladder, which should help relieve inflammation (swelling). Once your symptoms improve, your gallbladder can be surgically removed.

Living without a gallbladder

You can lead a perfectly normal life without a gallbladder. The organ can be useful but it’s not essential. Your liver will still produce bile to digest food.

However, some people who have had their gallbladder removed have reported symptoms of bloating and diarrhoea after eating fatty or spicy food. If certain foods do trigger symptoms, you may wish to avoid them in the future.

Sepsis Killed My Dad, but Knowing the Signs May Save a Life

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My dad was my biggest fan. He was always the first person I called when I had good news, and the first person I called when things were bad. He never missed a chance to tell me he was proud of me. Every year on my birthday, he would say, “I remember your birth like it was yesterday,” and tell me that seeing me being born was the happiest moment of his life.

In November 2009, my dad, the picture of health, walked me down the aisle on the happiest day of my life. By March 2010, he was dead.

It All Started With a Routine Colonscopy

That fall, my father had a colonoscopy. He had some polyps that were too large and tricky to remove during the procedure, and was told that there was a 40 percent chance that they were cancerous. He was given the option to have surgery, and at age 78, he decided to go for it. He always took good care of himself and went for regular checkups, and a 40 percent chance was just too high for him to comfortably live with.

He planned the surgery for February 2010, but then “Snowmageddon” hit the Washington, DC, area, and his surgery date was postponed until March. That same week, Congressman John Murtha, 77, died at the Virginia Hospital Center in Arlington — the same hospital where my dad was scheduled to have his surgery. Murtha reportedly died after developing an infection after his colon was damaged during gallbladder surgery days earlier. While this made my dad nervous, he figured the hospital staff would be extra vigilant after a high profile death, and that he would be safe.

A Seemingly Successful Surgery

My father had surgery on March 19. We were told the surgery went fine, and the good news was that the polyps were benign. He was kept in the hospital longer than expected because his heart rate was high and he had a mild fever. My brother and I, who both lived in New York City at the time, were in constant contact with him and his doctors.

After a week in the hospital, my dad was considered stable enough to be released to a rehab center. According to his doctors, he lost a lot of strength after being bedridden and in the hospital for so long, which is normal for someone his age. I flew home to Virginia to be there for his transfer, and to see for myself how he was doing.

I met him at the hospital on Saturday, March 27. He definitely seemed weak, and was on oxygen, but otherwise he appeared to be in good spirits. We had a lively discussion about the implications of the Affordable Care Act, which President Obama had just signed into law a few days earlier, and I filled him in on a recent trip and the current freelance project I was working on.

When it was time to move him, I followed his ambulance to the rehab center and got him settled in. Then he met with his doctors, had his first physical therapy session, and was ready for a nap. While he was sleeping, I went to the grocery store and back to his condo, where I made his favorite quiche to bring him for dinner. On my way back to see him, I stopped off at 7-Eleven for a Slurpee — a favorite treat of mine. When I got there, my dad asked for a taste, and wound up drinking the whole thing. He said the oxygen made his throat dry. We ate the quiche together and watched some TV before he went to sleep for the night, and I headed back to his place.

Suddenly, Something Went Wrong

When I returned the next morning, on Sunday, my dad was radically different. I brought him a fresh Slurpee, but he didn’t want it. He didn’t eat any quiche or any of the breakfast the hospital provided. When he asked me when we were going to the rehab center — the one we were currently sitting in — it was clear to me that something was very wrong. While he’d been weak the day before, he had his wits about him and had an appetite. But today he was drastically different.

I spoke to the nurses about my concerns, and brought them up with the doctor. I sat next to my dad as the doctor asked him basic questions. My dad wasn’t able to answer what day it was, or what year. The doctor attributed his confusion to his age and the fact that he’d recently had surgery.

I stayed with him all day and even moved my flight to the following morning so I could be with him longer. My dad was tired and listless the entire day, and it was clear that his condition wasn’t improving. I wanted to stay but was on the last week of a big project at work. My plan was to finish it and then return to stay with him longer the following weekend. That night, I kissed him goodbye and told him I loved him.

When I flew back to New York that morning, I was anxious and distraught over his condition. I was able to reach my dad on the phone, and he told me they were going to “take pictures of his tummy,” which was uncharacteristic and childlike language. I called my brother and asked him to please stay on top of my dad’s medical team to find out the results of the X-ray. My brother made plans to fly down to Virginia later that week.

The weather was terrible the day I flew home, and I was very late to the office because my flight was delayed; I needed to get busy working. I made it through the day, then went home that evening and showered. I broke down crying in the shower at how helpless I felt over the situation. Later, as I lay in bed reading a mindless book to distract myself, my brother called me and told me our father had died.

I was in shock. I couldn’t comprehend how my father could have gone from his mentally alert and normal, feisty self on Saturday, to not knowing what year it was on Sunday, to dying on Monday night. His cause of death was listed as “heart failure.”

I asked for an autopsy in an attempt to get answers. It turns out those pictures of his “tummy” he mentioned were never reviewed, but the results of both the autopsy and the X-rays were the same: his colon had been perforated during surgery. The cause of my father’s death was sepsis.

At first, I blamed myself. I knew something was wrong. I should have pushed his doctor harder and not accepted his answer that my dad’s confusion was because of his age. I also wondered what would have happened had I not returned to New York that Monday morning.

I’ve since learned that by the point he became confused, and even the day before, it likely would have been too late to reverse the course of the infection: Experts say there is a six-hour window.

Recognize the Warning Signs of Sepsis

With the news of Patty Duke’s death from sepsis on March 29 — six years to the day after my dad died from the same deadly infection — sepsis and its signs have been in the news. I urge you to familiarize yourself with the symptoms that the Centers for Disease Control and Prevention (CDC) have organized into an acrostic:

  • S: Shivering, fever, or feeling very cold
  • E: Extreme pain or general discomfort, as in “worst ever”
  • P: Pale or discolored skin
  • S: Sleepy, difficult to wake up or confused
  • I: “I feel like I might die”
  • S: Shortness of breath

According to the CDC, if you or a loved one experience these symptoms, particularly after a surgery or while you’re in the hospital, you should tell your doctor or healthcare professional this simple phrase: “I am concerned about sepsis.” It may save a life.

Anne L. Fritz is a freelance writer with more than 20 years of experience. She focuses on health, beauty, and parenting topics. She lives in Stamford, Connecticut, with her husband, son, daughter, and dog. You can find more of her musings on motherhood and more at Forever35.net.

Can You Live Without a Gallbladder?

Making a few basic dietary changes will help your body adjust to changes in the way bile is released.

Limit your fat intake

Try to avoid foods that contain more than 3 grams of fat in a single serving. Pay special attention to the labels on processed meats, dairy products, sauces, and toppings, which sometimes contain more fat than you’d think they would.

Other foods to approach with moderation include:

  • sausage
  • beef
  • fried foods
  • chips
  • chocolate
  • full-fat milk, yogurt, or cheese
  • cream
  • skin-on poultry
  • foods that contain a lot of vegetables, peanut, canola, or olive oil

If you already eat a lot of these foods, start out by trying to find low- or non-fat versions of these foods. As a rule of thumb, fat should only make up about 30 percent of your diet. If you consume roughly 2,000 calories per day, aim for under about 60–65 grams of fat.

Eat regular, small portions throughout the day

Try not to eat most your food over the course of three large meals. This can overwhelm your digestive tract because your liver doesn’t produce enough bile to effectively digest large amounts of food.

Instead, aim for about six meals containing 300–400 calories at a time. Try to include lean meats, such as fish or skinless chicken, or other non-processed protein sources. You can also load up on fruits and vegetables.

Limit your fiber intake

Eating high-fiber foods right after having your gallbladder removed can make any bloating, abdominal pain, and diarrhea you’re experiencing worse.

Following the procedure, try to limit your intake of the following high-fiber foods:

  • broccoli
  • cauliflower
  • cabbage
  • beans
  • nuts, such as peanuts and almonds
  • high-fiber breads, such as whole-grain or whole-wheat
  • high-fiber cereals, such as bran

You don’t need to completely cut these foods out of your diet. Just start with smaller amounts, and gradually increase your portions as you figure out what your body can handle.

Limit your caffeine

Caffeine from things like tea, coffee, or soft drinks can also increase gas, abdominal pain, and bloating after having your gallbladder removed. This is because caffeine increases stomach acid production, which can make your stomach empty out faster than usual. Without enough concentrated bile to help break down stomach contents headed into the intestine, the typical symptoms of gallbladder removal can be aggravated.

As with your fiber intake, you just need to limit your caffeine consumption while you recover from the procedure. You can gradually start adding more to your diet as your body adjusts.

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