Description

Cholecystitis (ko-luh-sis-TIE-tis) is swelling and irritation, call of inflammation of the gallbladder. The gallbladder is a small pear-shaped organ on the right side of the abdomen below the liver. The gallbladder contains the fluid that digests food. This fluid is called bile. The gallbladder releases bile into the small intestine.

More often, gallstones blocking the tube leading from the gallbladder cause cholecystitis. This results in the accumulation of bile, which can cause inflammation. Other causes of cholecystitis include bile duct changes, tumors, serious illness and certain infections.

If left untreated, cholecystitis can lead to serious complications, such as rupture of the gallbladder. These can be life-threatening. The treatment of cholecystitis often involves surgery to remove the gallbladder.

Symptoms

Symptoms of cholecystitis may include:

  • Severe pain in the upper right or in the center of the belly of the area.
  • The pain radiating to the right shoulder or on the back.
  • Sensitivity in the belly area, when it's touched.
  • Nausea.
  • Vomiting.
  • Fever.

Cholecystitis symptoms can occur after a meal. A big or high fat meal is more likely that the cause of the symptoms.

When to see a doctor

Make an appointment with your health care professional if you have symptoms that concern you. If your abdominal pain is so bad that it can't sit still or get comfortable, have someone drive you to the emergency room.

Causes

Cholecystitis is when the gallbladder is inflamed. Inflammation of the gall bladder can be caused by:

  • Gallstones. Most often, the cholecystitis is the result of hard particles of the bile that can form in the gallbladder called gallstones. Gallstones can block the duct that carries bile when it comes out of the gallbladder. The tube is called the cystic duct. The bile accumulates in the gallbladder, causing swelling and irritation.
  • The Tumor. A tumor can keep the bile from the drainage of the gallbladder as it should. This causes the accumulation of the bile that can lead to cholecystitis.
  • Obstruction of bile ducts. Stones or thickening of the bile and tiny particles called sludge can block the bile duct and lead to cholecystitis. Kinks or fibrosis of the bile ducts can also cause obstruction.
  • Infection. AIDS and other infections caused by viruses, can cause inflammation of the gallbladder and irritation.
  • Serious illness. Very serious disease that can damage the blood vessels and decrease blood flow to the gallbladder. This can lead to cholecystitis.

Risk factors

Gallstones is the main risk factor for contracting the cholecystitis.

Complications

If left untreated, cholecystitis can lead to serious complications, including:

  • The infection in the gallbladder. If the bile accumulates in the gallbladder, the bile may become infected.
  • Death of gallbladder tissue. Cholecystitis that is not treated can cause tissue in the gallbladder to die. This is called gangrene. This complication is more common, mainly affecting older people, those who wait to get treatment, and people with diabetes. Gangrene can lead to a tear in the gallbladder. Or it may cause your gallbladder to burst.
  • Tearing of the gallbladder. A tear, a so-called drill, on the gall bladder may be the result of inflammation or infection of the gallbladder or the death of gallbladder tissue.

Prevention

You can reduce your risk of cholecystitis, taking the following measures to prevent gallstones:

  • Lose weight slowly. The rapid weight loss can increase the risk of gallstones.
  • Be at a healthy weight. Being overweight makes you more likely to have gallstones. To reach a healthy weight, reduce calories and increase physical activity. Stay at a healthy weight through a healthy diet and exercise.
  • Choose a healthy eating plan. Eating foods that are high in fat and low in fiber may increase the risk of gallstones. To reduce your risk, eating lots of fruits, vegetables and whole grains.

Diagnosis

To diagnose cholecystitis, your healthcare provider will perform a physical examination and ask about your symptoms and medical history. Tests and procedures used to diagnose cholecystitis include:

  • Blood tests. Blood tests to look for signs of infection or other problems of the gallbladder.
  • The imaging tests that show your gallbladder. Abdominal ultrasound, endoscopic ultrasound, computed tomography, or magnetic resonance cholangiopancreatography can make the images of the gallbladder and the bile ducts. These images may show signs of cholecystitis or stones in the bile ducts and the gallbladder.
  • An analysis that shows the movement of bile through the body. A hepatobiliary iminodiacetic acid (HIDA) scan of the slopes of the decision making and the flow of bile from the liver to the small intestine. A scan involves the placement of a radioactive tracer in the body. The dye binds to the cells that produce the bile. During the scan, the dye can be seen as it travels with the bile through the bile ducts. This can show any obstruction.

Treatment

The treatment of cholecystitis most often involves a stay in the hospital to control the swelling and irritation, called inflammation of the gallbladder. Sometimes, surgery is needed.

In the hospital, treatments to control the symptoms may include:

  • The fasting. You may not be able to eat or drink in a first time to take the stress out of your inflamed gallbladder.
  • Fluids through a vein in your arm. This treatment helps to prevent the loss of body fluids, called dehydration.
  • Antibiotics to fight the infection. You may need these if the gallbladder is infected.
  • Medications for pain. These can help control the pain until the inflammation in the gallbladder is relieved.
  • Procedure to remove the stones. You can have a procedure called an endoscopic retrograde cholangiopancreatography (ERCP). This procedure uses a dye to make the bile ducts are displayed during the making of images. Then, a health professional can use instruments to remove the stones blocking the bile ducts or in the cystic duct.
  • The drainage of the gallbladder. Sometimes, the gallbladder drainage, called cholecystectomy, it can remove the infection. You can have this procedure if you are unable to have the surgery to remove the gallbladder. To drain the gallbladder, a health professional can go through the skin in the belly. This method is called percutaneous drainage. Or the health professional could spend a scope through the mouth, called endoscopic drainage.

The symptoms usually improve within 2 to 3 days. But the inflammation of the gallbladder often returns. At the time, the majority of people with cholecystitis need surgery to remove the gallbladder.

Surgery for removal of the gallbladder

The procedure to remove the gallbladder is called a cholecystectomy. Most of the times, this is a minimally invasive procedure called laparoscopic cholecystectomy. This type of surgery is used a couple of tiny cuts, called incisions in the abdomen. An open procedure, in which a long incision in the abdomen, is rarely needed.

The time of the surgery depends on the severity of your symptoms and your overall risk of complications during and after surgery. If the surgical risk is low, you can have the surgery during your stay in the hospital.

Once your gallbladder is removed, bile flows from the liver to the small intestine, instead of being stored in the gallbladder. You can still digest food without a gallbladder.

Preparing for your appointment

Make an appointment with your health care professional if you have symptoms that concern you. For cholecystitis, you may be sent to a specialist in the digestive system, called a gastroenterologist. Or you may be sent to a hospital.

What you can do

Before your appointment:

  • Be aware of pre-appointment restrictions. When you make the appointment, ask if there is something that you need to do in advance, such as restrict your diet.
  • Make a list of your symptoms, including those that do not seem to be related to the reason for your appointment.
  • Make a list of the personal information, including major stresses or recent life changes.
  • Make a list of all the medications, vitamins, herbs and other supplements that you take, including over-dose.
  • Have a friend or family member, if possible. Someone who goes with you can help you gather the information that it receives.
  • Make a list of questions to ask your health care professional.

For cholecystitis, some basic questions to ask include:

  • Is cholecystitis probably the cause of my belly ache?
  • What are other possible causes of the symptoms?
  • What tests do I need?
  • Do I need to have my gallbladder removed?
  • How much time will I need surgery?
  • What are the risks of the surgery?
  • How much time does it take to recover from gallbladder surgery?
  • There are other treatments for cholecystitis?
  • You should see a specialist?
  • Are there brochures or other printed material that I can take with me? What websites do you suggest?

Be sure to ask all the questions that you have.

What to expect from your doctor

Your healthcare provider is likely to ask questions such as:

  • When did your symptoms begin?
  • Has had pain like this before?
  • Are your symptoms constant or come and go?
  • How bad are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Cholecystitis