Cholecystitis

Cholecystitis is inflammation of the gallbladder usually caused by gallstones that obstruct the flow of bile.

It may also be caused by bile duct obstructions due to scarring and tumors.

In serious cases, cholecystitis can lead to life-threatening complications, such as a gallbladder rupture. In such case, surgery is required to remove the gallbladder.

Some common signs and symptoms of cholecystitis are:

• Severe pain in your upper right abdomen that may radiate to your right shoulder or back
• Pain over your abdomen which is aggravated by touch
• Nausea
• Vomiting
• Fever

The signs and symptoms appear more commonly after a large or fatty meal.

When to see a doctor

Consult your doctor if you experience any of these signs or symptoms. If your pain is severe, ask someone to take you to emergency room.

The causes of Cholecystitis are:

• Gallstones: Gallstones are small, hard crystalline solids that obstruct the flow of bile out from the gallbladder through the cystic duct. When the bile cannot leave the gallbladder, it accumulates there and causes its inflammation.
• Tumor: A tumor can obstruct flow of bile out from the gallbladder causing accumulation of bile that can lead to cholecystitis.
• Bile duct blockage: Sometimes, the bile ducts may be blocked due to sharp bends of the duct or scarring that can block bile flow and cause cholecystitis.

Making a diagnosis of Cholecystitis is done by performing several tests and procedures.

Consult your doctor if you have any of these signs or symptoms. You may be refereed to a doctor who specializes in the digestive system (gastroenterologist) for further investigations.

How to prepare yourself for the visit

Getting prepared for the visit can optimize the therapy and help make the visit more fruitful.

• List out all the symptoms
• Write down your key medical information.
• Write down the names of all your medications, vitamins or supplements.

Make a list of the questions to ask your doctor. Some typical question can be:

• What could be the possible cause of my abdominal pain?
• Do I need a surgery to remove my gallbladder? If yes, how soon? What are the associated risks?
• When can I get back to normal life after a surgery?
• Are there other treatment options for cholecystitis?

What your doctor wants to know

A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your doctor.

Your doctor might ask you typical questions like:

• When did you start noticing your symptoms?
• What the symptoms that you experience? How severe are they?
• Have you experienced similar pain before?
• How severe are your symptoms?
• Does anything improve or worsen your symptoms?

Your doctor can recommend following tests and procedures for further diagnosis:

• Blood tests: Your blood may be withdrawn and sent to the lab for testing the signs of an infection or signs of gallbladder problems.
• To further the diagnosis, your doctor can recommend imaging tests like:
• Abdominal ultrasound or a computerized tomography (CT) scan: These tests can provide detailed images of your gallbladder so that your doctor can determine if cholecystitis is present.
• Hepatobiliary iminodiacetic acid (HIDA) scan: This imaging test tracks the movement of bile from the site of its production to the small intestine. Any blockage during the movement can be tracked by using a radioactive dye.

Several treatment methods exist for Cholecystitis.

You may need hospitalization and possibly a surgery to remove the inflamed gallbladder.

• Hospitalization: Hospitalization is necessary to prepare you for the surgery and involves treatments to control inflammation. Treatments may include:
• Fasting: Foods can stress your already inflamed gallbladder. So, fasting is recommended to take the load off your gallbladder. To prevent dehydration, an injection can be given through your veins.
• Antibiotics: Antibiotics are used if your gallbladder is infected by microorganisms.
• Pain medications: Pain relievers help reduce the pain associated with inflamed gallbladder.
• Gallbladder Removal Surgery: Also called cholecystectomy, this is an invasive procedure to remove the gallbladder in patients who have recurrent cholecystitis. Your doctor will decide when to have your surgery after analyzing the severity of symptoms and risks associated with surgery. You may have to be ready for the surgery within 48 hours or during your hospital stay if you don’t have significant surgery associated risks.
• Natural Orifice Transluminal Endoscopic Surgery (NOTES): Researchers are studying a new less invasive technique called NOTES which may offer the benefits of reduced scarring and discomfort. As of now, laparoscopic cholecystectomy is the standard of care for gallbladder surgery.

Preventing gallstones is the major approach to cholecystitis prevention.

Here are some tips on how to prevent gallstones:

• Lose weight gradually: If you are thinking of losing some pounds, don’t rush. Weight loss of 1 or 2 pounds a week is considered healthy.
• Maintain a healthy weight: Having an extra sheet of fat can increase the risk of gallstones. Focus on a healthy weight through calorie restriction supplemented by appropriate physical activity.
• Watch your diet: Opt for a diet high in fruits, vegetables and whole grains. Limit fat intake.

There are several risks and complications associated with Cholecystitis.

Risk

Gallstones are the major risk factor for developing cholecystitis.

Complications

• Infected gallbladder: Inflamed gallbladder is more likely to be infected by microorganisms.
• Gallbladder tissue necrosis: When cholecystitis is left untreated for a long time, the gallbladder tissues may die causing a tear in the gallbladder.
• Torn gallbladder: Persistent inflammation or infection of gallbladder can result in a tear which is a serious complication of cholecystitis.