Cholecystitis

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 cholecystitis 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.

Cholecystitis 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 side 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:

Symptoms may get worse after a high-fat meal. If you can’t get comfortable or sit still because your pain is so strong, head to an emergency room.

Cholecystitis Causes

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.”

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Cholecystitis Risk Factors

You have a higher chance of getting cholecystitis if you:

  • Are a woman older than 50
  • Are a man older than 60
  • Are overweight
  • Have diabetes
  • Are pregnant

Or if you have:

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.

Cholecystitis Diagnosis

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. They 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.

Cholecystitis Treatment

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 your gallbladder can rest. You’ll probably get fluids through a tube put into a vein. You may get pain medicine and, if doctors are concerned about infection, an antibiotic. 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.

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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’re too sick. If you need to wait, doctors can ease symptoms by putting 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 bellybutton to take a look inside with a special instrument. They’ll then take out the gallbladder through another small cut.

You can live a healthy life without your gallbladder.

Cholecystitis Prevention

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

  • Lower your cholesterol.
  • Exercise regularly.
  • Eat a diet rich in fruits, vegetables, and healthy fats. Eggs, soybeans, and peanuts are great choices.

Obesity is a major risk factor for getting gallstones. Losing weight can reduce your chances, but be sure you do it in a healthy way. If you’re planning a rapid weight loss program, such as weight loss surgery, your doctor or nurse should monitor you. They may recommend bile acid pills to prevent gallstones as you lose weight.

Cholecystitis Complications

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 are damaged too much, 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.

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on July 24, 2020

Sources

SOURCES:

Mayo Clinic: “Diseases and Conditions – Cholecystitis.”

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

Johns Hopkins Medicine Health Library: “Cholecystitis.”

Medscape: “Gallstones (Cholelithiasis).”

Scientific Reports: “The relation between gallstone disease and cardiovascular disease.”

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