What is a contracted gallbladder?

Your gallbladder is a small, oval-shaped organ that sits behind your liver. It acts as a storage facility for bile. Bile is a fluid made by your liver to help with digestion and remove waste materials from your body.

When food leaves your stomach for your small intestine, your gallbladder releases bile to help break down fat and nutrients. It also uses a substance called bilirubin to flush out cholesterol and old red blood cells.

A contracted gallbladder means that your gallbladder has shrunk in size and may not be visible on an imaging test. This can prevent your gallbladder from properly functioning.

Read on to learn more about the symptoms of a contracted gallbladder and what causes it to happen.

A contracted gallbladder doesn’t always cause symptoms.

But in some cases, you might notice:

  • sharp pain in your upper right abdomen or right below your chest
  • pain in your upper middle back or right shoulder
  • loss of appetite
  • nausea and vomiting
  • diarrhea
  • jaundice

The symptoms of a contracted gallbladder depend on the underlying cause.

Your gallbladder naturally shrinks when it releases bile to help with digestion. This is part of the normal digestion process and usually doesn’t cause any symptoms.

In other cases, a contracted gallbladder is caused by:

  • Gallstones. These are hardened collections of substances like cholesterol or bilirubin. Gallstones can block bile ducts and keep your gallbladder from releasing bile.
  • Inflammation. Chronic inflammation can cause scarring of gallbladder tissue. This can make it harder for your gallbladder to store and release bile, which can affect your digestion of certain nutrients.
  • Cystic duck blockage. The cystic duct is the pathway bile travels between your liver, gallbladder, and bile ducts that connect your gallbladder to your small intestine. If gallstones or other substances block the cystic duct between the liver and gallbladder, bile can’t be delivered into your gallbladder, causing it to shrink.
  • Hardened gallbladder. Also known as a porcelain gallbladder, this condition may be the result of too many gallstones, but experts aren’t sure of the exact cause. This condition is associated with a higher risk for gallbladder cancer.

If you’re having symptoms of a gallbladder issue, your doctor will start by asking some questions about:

  • symptoms you’ve noticed
  • when your symptoms started
  • how often you notice symptoms
  • whether your symptoms are constant or come and go
  • anything, such as certain foods or activities, that makes your symptoms go away or become more severe

Based on these details, your doctor may use a few methods to diagnose a contracted gallbladder and its cause.

Ultrasound or CT scan

An ultrasound gives an image of your gallbladder and nearby structures. You may need to avoid eating before an ultrasound to make sure any contraction isn’t due to normal digestion. A contracted gallbladder will be very hard or impossible to see on ultrasound images.

Ultrasound imaging can also highlight inflammation or gallstones that might be causing your symptoms.

Your doctor may also use CT scans to get a cross-sectional view of your gallbladder, especially if they can’t see it on an ultrasound image.

Blood test

A complete blood count can help your doctor diagnose underlying conditions that may affect your gallbladder functions. This can include jaundice, pancreatitis, and complications caused by gallstones or bile duct blockage.

HIDA test

Your doctor may want to give you an injection of a substance that makes your gallbladder easier to see on an imaging test. A common method for this is a hepatobiliary iminodiacetic acid (HIDA) test. This involves injecting a radioactive tracer into your arm. This tracer can be tracked as it goes to your liver and into your gallbladder along with your bile. Your doctor may be able to see abnormal gallbladder function as the tracer moves through your biliary system.

A contracted gallbladder doesn’t always require treatment, especially if it’s not causing any symptoms.

But if you have a contracted gallbladder due to an underlying condition, your doctor might recommend:

  • Endoscopic retrograde cholangiopancreatography (ERCP). A surgeon uses an endoscope equipped with tools to remove gallstones blocking bile ducts. ERCP is usually done if there are only a few gallstones that need to be removed.
  • Oral dissolution. Your doctor will prescribe an oral medication that helps to dissolve gallstones as it passes through your gallbladder. This is done if your gallstones are caused by cholesterol substances.
  • Cholecystectomy. This refers to surgery to remove your gallbladder. It can be done through an opening just above your gallbladder. It can also be done laparoscopically with a series of small holes that can fit tools and lights to remove the gallbladder without needing to create a large incision.
  • Shockwave lithotripsy. Your doctor will use shock waves to shatter gallstones so they’re small enough to pass out of your gallbladder. This is usually done if gallstones are small.

A contracted gallbladder isn’t always something to be concerned about. If you’re not experiencing any pain or discomfort, it’s probably just part of your usual digestive process. But if you experience any symptoms, including pain or nausea, check in with a doctor to determine the underlying case. Most underlying causes respond well to a variety of nonsurgical treatments.