What Is Cholecystitis?

Cholecystitis is a swelling and irritation of your gallbladder, a small organ in the right side of your belly near your liver.

The gallbladder’s job is to hold a digestive juice called bile. It releases bile into your small intestine when your body needs it to break down fats. But if the path to your small intestine is blocked, bile gets trapped. That backup can irritate your gallbladder. That’s how cholecystitis happens.

Nausea and vomiting are common symptoms. They often show up after you’ve eaten a big or especially fatty meal.

It’s easy to mistake it for other health problems, but another telltale sign is intense pain – in your belly, in your back or under your right shoulder blade.

If you don’t see a doctor and get treatment, it can lead to dangerous infections or become a long-term condition. The most common solution is surgery to remove your gallbladder.

What Causes It?

The usual reason bile backs up is that gallstones -- lumps of bile turned solid -- block the way to the small intestine. Gallstones are common. About 10% to 20% of Americans have them. About half of people with gallstones will get cholecystitis.

But gallstones aren’t the only problem that can cause this condition. Others include:

  • Gallbladder sludge, a thick liquid, builds up in the organ. This can happen if you’re pregnant or if you’ve lost a lot of weight quickly.
  • Tumors block bile’s path. A growth in your pancreas or liver can stop it from draining.
  • Your gallbladder doesn’t have a good blood supply. People with diabetes can have this problem.
  • An infection affects your gallbladder. Bacteria can damage the system that drains bile, causing it to back up.

Cholecystitis can come on suddenly. You may hear a doctor or nurse call it an “acute” case. Or it can be a long-term problem. Those cases are called “chronic.”

Who Is More Likely To Get It?

You have a higher chance of getting cholecystitis if you’re:

  • A woman older than 50
  • A man older than 60
  • Overweight
  • Diabetic

You also run a bigger chance of getting it if your diet is high in fat and cholesterol or your ancestry is Native American, Hispanic or Scandinavian.

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What Are the Symptoms?

Cholecystitis can mimic other health problems, so you’ll need to see a doctor for a diagnosis.

You might feel a sharp, sudden pain in the upper right of your belly. You may also feel pain in your back or below your right shoulder blade. Deep breaths may make it worse. Some other symptoms to watch out for include:

If you can’t get comfortable or sit still because your pain is so strong, head to an emergency room.

What to Expect at the Doctor’s Office

The doctor will examine you, ask a few questions about your symptoms and probably order some tests. You should be ready to:

  • Detail when your symptoms started. Have you felt this way before?
  • Describe how severe your pain is.
  • Talk about whether anything makes your pain better or worse.

Your doctor can tell from blood tests whether you have an infection and whether your liver is working the way it should. She may also want you to have some imaging tests. These may include:

 

  • X-ray of your belly, which will show your internal organs, bones and tissues.
  • Ultrasound , which will show your gallbladder and liver and let doctors check blood flow.
  • CT scan , which gives doctors a more detailed look at organs, muscles and bones than an X-ray can.
  • HIDA scan , which checks how your gallbladder moves and shows if bile is blocked. You get a shot of a chemical, and then a scanner traces it as it moves through your body.
  • PTC, which uses a dye injected into your liver to show how bile is moving through your body.
  • ERCP, which uses a long, flexible tube threaded down your throat, through your stomach and into your small intestine. It has a light and camera at the end. This test also uses a dye to check how bile is flowing through your system.

What Problems Can It Cause?

If you don’t get treatment, your gallbladder can become infected and some of the tissue may die. Infection can also spread to other parts of your body, including your pancreas (pancreatitis) and the lining of your belly (peritonitis).

If the tubes that carry bile suffer too much damage, cholecystitis can harm your liver, too. You could have repeated bouts of painful symptoms. Eventually, your gallbladder will shrink and not work as well. The condition would become a long-term, or “chronic” problem.

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Treatments

If you have cholecystitis, especially an acute case, you may have to spend some time in the hospital.

You will have to keep your stomach empty so that your gallbladder can rest. You’ll probably get fluids through a tube inserted in a vein. You may get pain medicine, and, if doctors are concerned about infection, an antibiotic, too. Once treatment begins, you should start to feel better.

If gallstones caused your problem, doctors may try medications to dissolve them and give you a prescription drug to keep them from forming again. A very low-fat diet may also keep them from coming back.

What if I Need Surgery?

By far the most common treatment is to take out the gallbladder.

Your doctor may decide to do the surgery right away, unless you are too sick. If you need to wait, doctors can ease symptoms by inserting a tube through your skin straight into the gallbladder and draining some bile.

Surgery to remove your gallbladder, called a “cholecystectomy,” usually takes about an hour and is considered low-risk.

You’ll get general anesthesia, so you won’t be awake or feel any pain during the procedure. The doctor will make a small cut in your belly button to take a look inside with a special instrument. He’ll then take out the gallbladder through another small cut.

You can live a healthy life without your gallbladder.

Prevention

You can take steps to reduce your chances of getting gallstone and cholecystitis. They include:

  • Lower your cholesterol and watch your weight
  • Exercise regularly
  • Eat a diet rich in fruits, vegetables and healthy fats. Eggs, soybeans and peanuts are great choices.
WebMD Medical Reference Reviewed by William Blahd, MD on September 27, 2016

Sources

SOURCES:

Mayo Clinic: “Diseases and Conditions – Cholecystitis.”

Cleveland Clinic: “Diseases and Conditions – Cholecystitis,” “Laparoscopic Cholecystectomy (Gallbladder Removal).”

Johns Hopkins Medicine Health Library: “Cholecystitis.”

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