Why ‘gallbladder’ health deserves attention after middle age, when metabolism slows

 Why ‘gallbladder’ health deserves attention after middle age, when metabolism slows
Sudden upper abdominal pain is a red flag for ‘cholecystitis’…see a hepatobiliary-pancreatic specialist for treatment
The gallbladder, widely known in Korean as ‘sseulgae’, is a major digestive organ in the upper abdomen. Though not large, it has an important influence on the digestive process. Because the risk of inflammation and gallstones tends to rise along with declining metabolism as we age, the gallbladder requires attention.

Inflammation of the gallbladder goes beyond simple pain and carries a growing risk of complications through tissue changes and reduced function. In particular, from the 40s onward it can easily worsen because of metabolic factors and unhealthy lifestyle habits, so it is important to look after gallbladder health.

In fact, the number of cholecystitis patients begins to rise in earnest from the 40s and 50s. According to Health Insurance Review and Assessment Service statistics, among all cholecystitis patients in 2024, those in their 40s were about 1.4 times as numerous as those in their 30s. Patients in their 60s were twice as numerous as those in their 30s, the largest of any age band.

Overeating and drinking form gallstones that block the bile duct and cause inflammation

Located near the liver, the gallbladder stores bile and sends it through the bile duct to the duodenum, playing an important part in digestion. In clinical practice, the liver, gallbladder, bile ducts and pancreas are often examined together. If the bile duct becomes blocked or disturbed and bacteria invade the bile, cholecystitis develops.

Gallstones are the leading cause of inflammation in the gallbladder. A gallstone is a kind of stone that hardens from an imbalance in the components of bile secreted by the liver. When a gallstone blocks the cystic duct, pressure inside the gallbladder rises and causes distension, and inflammation develops secondarily.


Most acute cholecystitis in particular is known to be caused by gallstones. In chronic cholecystitis as well, gallstones continuously irritate the gallbladder and cause histological changes in the organ, leading to inflammation.

Obesity, diabetes, lipid abnormalities and other conditions involving fat deposition, raised cholesterol and metabolic disease increase the risk of gallstones. When eating habits such as overeating and a high-calorie diet persist, gallstone formation and inflammation worsen the function of each organ.

In particular, continuing poor eating habits after middle age increases the risk of placing an excessive cumulative burden on the gallbladder. Sudden weight loss also affects gallstone formation. Research has reported that gallstones develop in about 25% of people who go on extreme diets.

Cholecystitis shows markedly different symptoms in its acute and chronic forms. Acute cholecystitis causes severe right upper abdominal pain along with abnormal symptoms such as nausea, vomiting and fever. On palpation, pressing the right upper abdomen produces severe pain. Chronic cholecystitis, by contrast, is quite often asymptomatic. It presents as bloating, discomfort and fullness centered on the upper abdomen, which is easily mistaken for a stomach problem.

Be prepared for complications and for chronic cases turning acute

Cholecystitis is diagnosed mainly by abdominal ultrasound. About 90-95% of gallstones can be visualized on ultrasound. In patients with cholecystitis, ultrasound can show gallstones inside the gallbladder and a thickened gallbladder wall caused by inflammation or fibrosis. In patients with acute cholecystitis, blood tests may show a rising white blood cell count, or fluid may be found collected around the gallbladder.

Treatment varies with the patient's condition. For acute cholecystitis, surgery to remove the organ is performed as the standard treatment. The gallbladder is an organ that stores and concentrates bile, and digestive function remains normal after its removal. If symptoms are mild, oral dissolution therapy using medication to dissolve gallstones may be used, but complete dissolution occurs in fewer than 30% of cases, and about half recur after five years or more.

For chronic cholecystitis, the principle is not to give specific treatment if there are no symptoms. However, since there is a long-term risk of progression to acute cholecystitis, if gallstones are found, changes are monitored through regular abdominal ultrasound screening. If symptoms resembling acute cholecystitis, such as sudden abdominal pain, appear thereafter, it is best to go to hospital for care immediately.

If cholecystitis is suspected, it is best to seek a hospital with a hepatobiliary-pancreatic specialist who can examine the gallbladder along with the pancreas and bile ducts comprehensively. Complications can occur in 10% of patients with acute cholecystitis, and even chronic cases can turn acute depending on how the disease develops. It is important to be examined from both internal medicine and surgical perspectives and to receive long-term care.

Park, Kwan Tae, Director and general surgery specialist at St. Peter's Hospital, said, “If you feel pain in the upper abdomen that you have not felt before, you should not ignore it even if the symptom disappears for a time,” adding, “It is important to obtain an early diagnosis from a specialist who can examine the gallbladder, pancreas and bile ducts comprehensively.”