How Things Work
The gallbladder is a collection pouch that accumulates green bile fluid as it drains from the liver. The purpose of bile is to help with digestion, particularly of fats. Cholesterol and bilirubin (a byproduct from the breakdown of red blood cells) are also found in bile.

When cholesterol or bilirubin particles begin to cluster, gallstones start to form. In most cases, they do not cause problems. However, when they become caught in the gallbladder outlet, symptoms including pain, belching, gas, nausea, and decreased appetite can occur. While not a pretty image, think of your gallbladder as a pond, say Larrian Gillespie, M.D., author of The Menopause Diet, and the forthcoming You're Not Crazy, It's Your Hormones." When the ratio of progesterone to estradiol changes in women, the gallbladder becomes sluggish and doesn't drain bile as well," she says. "The bile stagnates and looks like green algae."

Diagnosis
An x-ray will usually not detect gallstones, but they can be seen on ultrasound or CT scan. If gallstones e found and your symptoms correspond to this condition,you may also have blood tests to rule out liver or pancreas involvement.

Complications
Pain from gallstones occurs when the muscle walls of the gallbladder contract to help empty bile into the intestines. When the muscle contracts against a gallstone, or if a gallstone blocks the bile from draining, a strong, deep ache can occur. If the bile duct is blocked, bile can build up and serious infection in the gallbladder, liver, or pancreas can occur.

Gallbladder Surgery
When gallstones form to the point where pain is persistent, surgical removal is the best treatment option, says William S. Richardson, M.D., chief of laparoscopic surgery at Ochsner Clinic in New Orleans. "Unlike heartburn or gastric reflux where weight loss, over-the-counter preparations, or a change of diet may help, with gallstones pain continues in at least 30 percent of cases. Other therapies are not nearly as effective as removal of the gallbladder."

The surgery is done through a laparoscopic incision in the navel, where the fluid and stones are removed, followed by the gallbladder itself. Patients rarely spend even one night in the hospital, says Dr. Richardson. The recovery period lasts from one to two weeks.

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