Cholecystitis is a condition that causes inflammation of the gallbladder, a small organ that stores and releases bile, a digestive fluid that helps break down fats. It causes severe pain, fever, nausea, and vomiting in the upper right part of the abdomen. If left untreated, it can cause serious complications, such as infection, rupture, or gangrene of the gallbladder. Therefore, it is crucial to know the causes, symptoms, diagnosis, treatment, and prevention of cholecystitis.
Among the most common causes of cholecystitis are gallstones, which are hard deposits of cholesterol or bilirubin that can block the tube (cystic duct) connecting the gallbladder to the bile duct. Cholecystitis is caused by this accumulation of bile in the gallbladder wall, which irritates it. Other possible causes include:
Tumors that obstruct the bile duct or the cystic duct
Bile duct problems, such as narrowing or scarring
Infection of the gallbladder by bacteria or viruses
Severe illness or injury that reduces blood flow to the gallbladder
Immune deficiency or autoimmune disorders that affect the gallbladder
Some factors that increase the risk of developing cholecystitis are:
Being female or assigned female at birth (AFAB)
Being older than 40 years
Having a family history of gallstones
Being overweight or obese
Eating a high-fat or low-fiber diet
Losing weight rapidly or fasting for a long time
Having diabetes or liver disease
Taking certain medications, such as oral contraceptives or hormone replacement therapy
An intense and sudden pain can be a sign of cholecystitis in the upper right abdomen near the rib cage. In addition to radiating pain to the right shoulder and back, cholecystitis may be triggered by eating fatty food. The pain usually lasts several hours and may worsen with deep breathing, coughing, or movement.
Abdominal bloating or tenderness
Loss of appetite or nausea
Vomiting or diarrhea
Fever or chills
Jaundice (yellowing of the skin or eyes)
Dark urine or light-colored stools
There may be no symptoms of cholecystitis or mild symptoms that are mistaken for indigestion, gas, or heartburn. However, if untreated, cholecystitis can cause serious complications, including:
Infection of the gallbladder or the bile ducts
Perforation (tearing) or rupture of the gallbladder
Gangrene (tissue death) or abscess (pus-filled pocket) of the gallbladder
Empyema (collection of pus) in the chest cavity
Pancreatitis (inflammation of the pancreas)
Cholangitis (inflammation of the bile ducts)
Sepsis (a life-threatening infection that spreads throughout the body)
A doctor will perform a physical examination and ask about your medical history to diagnose cholecystitis. To determine if your gallbladder area is tender and swelling, he or she will press on your abdomen. Tests may be ordered by the doctor in order to confirm the diagnosis and to rule out other conditions that may cause similar symptoms.
Blood tests: To check for signs of infection, inflammation, liver function, and bilirubin levels.
Urine tests: To check for signs of infection or jaundice.
Ultrasound: To create images of your gallbladder and bile ducts and look for gallstones, blockages, fluid accumulation, wall thickening, or other abnormalities.
Computed tomography (CT) scan: To create detailed images of your abdomen and chest and look for complications such as perforation, rupture, gangrene, abscess, empyema, pancreatitis, or cholangitis.
Hepatobiliary iminodiacetic acid (HIDA) scan: To inject a radioactive dye into your bloodstream and track its flow through your liver, bile ducts, and gallbladder. This can show how well your gallbladder is functioning and whether there is any obstruction in the cystic duct.
Endoscopic retrograde cholangiopancreatography (ERCP): To insert a thin tube with a camera and light (endoscope) through your mouth into your small intestine and inject a dye into your bile ducts. This can show any blockages or narrowing in your bile ducts and allow the doctor to remove any gallstones or insert a stent (a small tube) to relieve the obstruction.
Treatment for cholecystitis depends on the severity and cause of your symptoms. The main goals of treatment are to relieve your symptoms, reduce inflammation, and prevent complications.
The pain may be controlled with analgesics, such as acetaminophen, ibuprofen, or oxycodone. Infections may be treated with antibiotics such as metronidazole and piperacillin. It is possible to dissolve the gallstones with gallstone dissolvers like ursodiol and chenodiol. However, these medications may not be effective for all types of gallstones and may take a long time to work.
For a period of time, you may be advised to avoid eating or drinking anything to rest your gallbladder. You may be given fluids and nutrients through an intravenous (IV) line to prevent dehydration and malnutrition.
The procedure of removing your gallbladder is called cholecystectomy. It can be performed either by making a large incision in the abdomen (open cholecystectomy) or by making several small incisions and using a camera and instruments (laparoscopic cholecystectomy). In most cases, surgery is recommended for people with recurrent or severe episodes of cholecystitis, perforation, gangrene, or other gallbladder conditions, such as tumors or polyps. Cholecystitis and gallstones can also be prevented by surgery.
To prevent cholecystitis, you should try to reduce your risk of developing gallstones and avoid factors that can trigger an attack. Some preventive measures are:
Eating a healthy and balanced diet that is low in fat and high in fiber
Maintaining a healthy weight and losing weight gradually if you are overweight or obese
Exercising regularly and staying physically active
Drinking plenty of water and avoiding alcohol
Avoiding foods that can cause gas or indigestion, such as spicy, fried, or greasy foods
Avoiding fasting or skipping meals
Taking medications as prescribed by your doctor and avoiding unnecessary use of oral contraceptives or hormone replacement therapy
Getting regular check-ups and screenings for gallstones and other conditions that can affect the gallbladder
If not treated properly, cholecystitis can cause severe pain and complications. By understanding the causes, symptoms, diagnosis, treatment, and prevention of cholecystitis, you can protect your gallbladder.
