Gallbladder complaints – such as cramp-like pain beneath the right ribcage, bloating or feeling unwell after eating fatty foods – significantly impair quality of life. Although gallstones have long been recognised, medical science in 2026 has a much deeper understanding of the underlying causes of gallbladder dysfunction, whether these involve genetic predisposition or functional motility disorders.
From Endomedix Gastroenterology Centre Based on the latest research findings, this summary sets out what may lie behind these problems.
Gallstones: The classic underlying cause
The most common form of gallbladder disease is gallstones (cholelithiasis). Stones form when the chemical balance of the bile is disrupted.
Types of rock and their origins:
- Cholesterol stones (75%): They form when the liver secretes too much cholesterol, or when the gallbladder does not contract vigorously enough (hypomotility), causing the bile to thicken.
- Pigment stones: They develop when bilirubin levels are high (e.g. due to cirrhosis of the liver or certain diseases of the blood-forming organs).
The „5F rule” – Who is most at risk?
According to research, the following groups are at the greatest risk:
- Female: It is more common due to hormonal effects (oestrogen).
- Forty (aged 40 and over): The risk increases with age.
- Fertile: Pregnancy hormone levels increase the risk of kidney stones.
- Fat (Overweight): Obesity increases the excretion of cholesterol.
- Fair (Light-skinned): The role of certain ethnic and genetic factors.
Functional disorders: When there’s no stone, but it still hurts
Cases in which an ultrasound scan fails to reveal any stones, yet the patient is still suffering from biliary colic, present a modern diagnostic challenge. These functional gallbladder disorders.
- Gallbladder dyskinesia: The gallbladder is unable to contract properly. This can be detected using a special isotope scan (HIDA scan) can be verified.
- Oddi’s sphincter dysfunction: The sphincter at the end of the bile duct contracts spasmodically, obstructing the flow of bile. This is often caused by disturbances in the nervous system or abnormalities in the gut-brain axis.
Inflammation and tumours
- Acute inflammation: It is usually caused by a stone becoming lodged and requires urgent treatment.
- Inflammation without stones: A rare, serious condition that develops in critically ill patients as a result of impaired blood supply.
- Polyps and tumours: Polyps larger than 10 mm carry a risk of becoming malignant; they should therefore be kept under close monitoring or removed surgically.
Diagnostics at Endomedix
To identify the exact cause, Endomedix uses state-of-the-art equipment:
- Abdominal ultrasound: The basic filtering method.
- Endoscopic ultrasound (EUS): The most accurate method for identifying small stones and polyps.
- MRCP: A non-invasive MRI scan to map the bile ducts in detail.
- Laboratory tests: Measurement of inflammatory markers and biliary enzymes (GGT, ALP).
What can you do to keep your gallbladder healthy?
- Regular meals: It prevents bile from becoming too thick.
- A high-fibre diet: Eating vegetables, fruit and healthy fats (e.g. olive oil).
- Gradual weight loss: Paradoxically, a drastic diet may increase the risk of gallstones!
