The gallbladder is a small organ just beneath the liver that’s shaped like a pear and is located on the right side of your abdomen. It has the purpose of holding the digestive fluid or bile that the liver produces to be released into the small intestine. The gallbladder often does this purpose very well, often times without any complications.
But in the rare cases when you feel pain where your gallbladder is located, this can be an indication that your gallbladder is inflamed. This painful inflammation of the gallbladder is referred to as Cholecystitis. Cholecystitis causes is generally divided into two types based on the frequency it occurs:
Acute Cholecystitis is an inflammation that occurs only once. But when the condition persists for a long time and induces repeated painful attacks, then it is known as Chronic Cholecystitis.
Chronic Cholecystitis can induce pain in an episodic manner, or it can be felt as a constant pain. Rarely is it reported that there are patients suffering from chronic Cholecystitis who never experience pain.
Cholecystitis causes #1: Gallstones
Most cases of Cholecystitis causes (about 95% of them) are due to gallstones. Due to the gallbladder’s primary function of storing bile and being in close proximity to the liver and small intestine, certain substances such as cholesterol, bile pigments, and calcium tend to accumulate. When this happens, gallstones are formed and block the gallbladder that causes bile to accumulate, this, in turn, becomes one of the cholecystitis causes.
Having gallstones is not a sure way that you will go on to have Cholecystitis, as most people who have gallstones are not even aware they have one. But almost all people diagnosed with Cholecystitis causes will be found out to have gallstones.
Cholecystitis causes #2: Gender
Believe it or not, gender can also play a major role in having Cholecystitis. This is because women are twice more likely to experience gallstone formation that almost often leads to Cholecystitis and is one of the cholecystitis causes.
Cholecystitis causes #3: Age
Following up on that, women whose ages are from 20-60 years old are much more likely to have Cholecystitis.
Cholecystitis causes #4: Birth Control Pills
Pregnant women, especially those who are taking birth control pills are also much more likely to experience Cholecystitis due to complications involving gallstones.
Cholecystitis causes #5: Tumors
Tumors in your liver, pancreas, and gallbladder will more than likely block your gallbladder’s bile flow, and thus will prevent bile to drain out into the small intestine properly. This build-up of bile will, if left unchecked, lead to Cholecystitis.
Cholecystitis can also be caused by a bunch of different factors such as:
- Food Habits or diet
- Excess cholesterol which happens during rapid weight loss and pregnancy
- Diabetes (which causes blood flow in the gallbladder to decrease)
- Massive system infection
- Bacterial infection of the gallbladder
- Severe illness
- Severe burns and injury (rare)
7 Risk Factors Most Commonly Associated with Cholecystitis
There are certain factors in line with above causes that can cause your chances to develop Cholecystitis to increase, such as:
- Having Gallstones – as said before, having gallstones is a major risk for developing cholecystitis.
- Genetic predisposition – gallstones are much more likely to occur in women than in men, putting women at a higher risk of developing the condition. Genetic predisposition may also include your race: such as being a native American, and a Mexican American.
- Age – Age is one of the main cholecystitis causes.
- Family History - Cholecystitis can sometimes be hereditary.
- Rapid weight loss
- Having Diabetes
Cholecystitis causes, if left unchecked and untreated, can seriously lead to the following complications:
- Bile build-up - Bile will build up in your gallbladder as there will be an inflammation preventing it from flowing.
- Infection in the gallbladder - Once bile builds up in your gallbladder due to blockage of flow, the bile may stagnate if left untreated. The bile will then become infected and will infect the surrounding tissue.
- Necrosis of the gallbladder - Cholecystitis can cause the tissue in your gallbladder to die if it is left untreated for a long time. This necrosis or death of tissue can cause a tear in your gallbladder, and in worst cases, cause a rupture in the organ.
- Enlarged gallbladder - With time, your gallbladder will enlarge due to infection or the death of its tissue.
- Pancreatitis – Cholecystitis is often accompanied by this condition, which is an inflammation of the pancreas.
- Empyema – An infected and inflamed gallbladder can lead to a collection of pus surrounding the organ. This condition is known as Empyema and can induce fever, severe abdominal pain, and increased white blood count.
- Cancer of the Gallbladder – Although this rarely happens, it is a result of a long-term cholecystitis left untreated.
Symptoms of Cholecystitis and Diagnostic Procedures
9 Common Symptoms of Cholecystitis
Symptoms of cholecystitis can have varying degrees as to how they appear. Cholecystitis symptoms may appear suddenly without warning and sometimes develops slowly for years. You may start to notice that the symptoms associated with cholecystitis start to appear after eating as this is where bile comes into play. This becomes especially apparent if the meal you have just eaten is high in fat.
Symptoms of cholecystitis may include:
- Biliary colic - which is an abdominal pain, that may range from sharp to dull, but is most often severe. It is experienced in the right upper quadrant of your abdomen. Biliary colic is a good indicator that you have a chance to develop cholecystitis, as this symptom sometimes appear even before most symptoms of cholecystitis can come into play.
- Bloated Feeling - A common cholecystitis symptom is the feeling of being bloated, which can especially occur right after eating. Abdominal cramps may also be present due to improper digestion caused by the lack of bile.
- Right shoulder pain - Depending on the condition, right shoulder or back pain can also accompany abdominal pain, as the abdominal pain radiates to these parts.
- Nausea - Nausea is always associated with symptoms of cholecystitis, and will also include vomiting. These symptoms of cholecystitis appear in 75% of people who develop the condition.
- Fever - Fever is one of the common symptoms of cholecystitis especially when physical examination occurs, as in most cases the gallbladder at this point is already swollen and perhaps infected.
- Inflammation - When your gallbladder has cholecystitis it is most likely inflamed, and the increase in size can often be felt outside the body of the person. The gallbladder in your upper right abdomen during cholecystitis will be tender to touch, and when actually touched will be painful.
- Jaundice - Jaundice is a symptom not only common to cholecystitis but in other conditions as well, and is characterized by a yellowish color in the skin and eyes. In cholecystitis, however, jaundice is caused by the build-up of bilirubin (a liver byproduct) that is absorbed into the bloodstream and in time will be deposited in your skin and the whites of your eyes.
- Irregular stools - Another cholecystitis symptom is that your stools become loose and light-colored, this is caused by improper digestion as the bile, which is an important factor in the digestive process becomes irregularly delivered to the small intestine, sometimes not even having the chance to flow at all.
- Itching - A feeling of itchiness is also a cholecystitis symptom, especially when it occurs in the area directly above your gallbladder, which is located in the upper right portion of your abdomen. The itchiness is described as “like wearing a rough fabric”, and can be felt even in the shoulder or in your back. Itching in these areas is a sign that your gallbladder is inflamed.
Note that experiencing any one of these symptoms of cholecystitis may not directly indicate that you have cholecystitis. However, when there is a noticeable presence of 3 or more of these cholecystitis symptoms, then you may need to get yourself checked.
Cholecystitis Diagnostic Procedure
If you have felt the symptoms of cholecystitis mentioned above, then perhaps you ought to get yourself checked and be officially diagnosed with the condition for you to get treated. Symptoms of cholecystitis are diagnosed through a number of clinical procedures, but perhaps the most common of these procedures is through careful abdominal examination. This is because when the gallbladder gets inflamed, it can be directly felt through the abdominal wall, in which case that part of your body becomes tender to touch. A cholecystitis symptom that becomes apparent upon touching the upper right corner of your abdomen, is the difficulty of breathing because of the pain. This cholecystitis symptom is also known as Murphy’s sign.
There are other ways that your physician can use to diagnose if you have cholecystitis or not:
- Blood Tests – Your physician may choose to subject you to blood tests. When the results show an increase in white blood count, as well as mildly elevated bilirubin count, then that is a clear indicator that you have cholecystitis.
- Ultrasound – Ultrasound can also be used to detect the severity of the cholecystitis’ inflammation. This is because ultrasound can indicate how thick the gallbladder wall is already, as well as to indicate the presence of gallstones.
- CT Scan – in addition to the ultrasound as an imaging test, computerized thermography or CT scan can also be used to create pictures of your gallbladder to find out if you have cholecystitis.
- HIDA Scan – HIDA, which stands for hepatobiliary iminodiacetic acid scan involves injecting a small amount of radioactive dye into your body so that the dye can track the bile in your body as it travels through bile ducts. This type of test takes anywhere from an hour to four hours to get your results.
If you have been diagnosed with cholecystitis, then the next procedure would be to get yourself treated.
Cholecystitis Treatment and Care
Treatment for Cholecystitis
The first step you have to take to get treatment for cholecystitis is immediate hospitalization. At the hospital, after you have been diagnosed with the condition, you will be given preliminary treatment for cholecystitis through the intravenous supply of fluids, salts, and sugars. Note that you will not be allowed to consume any food or drink orally, and what fluid remains in your stomach will need to be drained out through the insertion of an NG tube, or nasogastric tube. This tube will be inserted into the stomach through the nasal passage. This fasting process is done so that there is no additional stress imposed on your already inflamed gallbladder.
After the initial treatment for cholecystitis, a number of other options are made available to you, depending on the severity of the condition, and the specific cause of the attack. One or more of the treatment for cholecystitis listed below can be given to the patient:
- Prescription of Antibiotics – When the gallbladder is infected, as, with most cases of cholecystitis, one or more broad-spectrum antibiotics can be prescribed to fight off the infection.
- Pain relievers – You can almost always expect pain once your treatment for cholecystitis has begun, as the gallbladder will be noticeably inflamed at this point. Pain relievers help you control pain for as long as the treatment for cholecystitis needs, or until the inflammation in your gallbladder is relieved.
- Oral dissolution- This is often chosen by doctors as a last resort among most used treatment for cholecystitis, and is reserved for patients who can’t undergo surgery. This involves therapy that uses oral medications to help dissolve gallstones.
In 95% of cases, cholecystectomy or surgery to remove the gallbladder is the most often prescribed treatment for cholecystitis for patients. This is because most patients suffering from the condition will eventually require this type of treatment for cholecystitis, as cholecystitis is a frequently recurring condition.
The scheduling of your cholecystectomy will largely depend on the severity of your symptoms and the doctor’s assessment of your surgical risk. Most often, the surgical removal of your gallbladder will be done after you have been stabilized and have a low enough surgical risk. The shortest time a cholecystectomy can be done is within 48 hours of your stay at the hospital, most gallbladder removal surgeries are done within a period of five or six days after your diagnosis.
Cholecystectomy is commonly done by using a tiny video camera attached to the end of a flexible tube. The surgeon then proceeds to use special surgical tools to remove the gallbladder, making use of the tiny video camera to see inside your abdomen. Four small incisions are made in your abdomen and the surgeon watches a monitor while performing the surgery. This process is called laparoscopic cholecystectomy and is highly preferred than open cholecystectomy, which involves cutting a long incision across your abdomen.
Cholecystitis Recovery and Care
After you have undergone treatment for cholecystitis and your gallbladder is removed, bile will now flow directly from your liver to the small intestine because there is no gallbladder present to store it anymore. Most people after they have undergone treatment for cholecystitis can resume their daily activities within a period of 7-10 days after surgery. Minor discomfort will persist for about 2-3 weeks, but other than that you’re all set for work.
After having treatment for cholecystitis, you should impose it upon yourself to make important changes to your diet:
- Meal Portion Control - Try to eat much smaller portioned meals, and eating more often rather than eating a few big portioned meals daily right after having your cholecystitis treatment. Eating five to six smaller meals daily will allow the bile in your small intestine to normalize. This is much more ideal in comparison to eating a few big meals daily, which can trigger a spasm in the gallbladder and bile ducts and may throw off your digestive system completely.
- Eat a Low-fat diet – this diet is only temporary, as it is often recommended by your doctor after the first few weeks of your cholecystitis treatment. This is to allow your body and digestive system to adjust to living without a gallbladder. Some people actually go back to their normal diet after those first few weeks. However, there are cases where continually eating fatty foods will result in stomach aches
- Return to back to your regular diet gradually
- Avoid eating a large meal when you have fasted for a whole day.
- Avoid spicy foods
You will feel a few significant changes after having cholecystitis treatment such as stomach ache when eating spicy and fatty foods, and more frequent bowel movements. Although most of these won't persist after the first few weeks of surgery, some will go on to be permanent changes. In this case, many people need to take medication aside from adopting lifestyle changes to help them manage their symptoms.