Cholecystitis

Definition of Cholecystitis

Cholecystitis is an inflammation of the gallbladder.

What is going on in the body?

The gallbladder stores bile. Bile is a yellowish-green liquid produced in the liver that aids in digestion. When a person eats, bile flows through a series of ducts into the intestines. It helps to break up food so that it can be used by the body.

When bile is supersaturated with cholesterol or bilirubin, it may form the crystals known as gallstones. These stones may block the flow of bile within the gallbladder, causing cholecystitis. Cholecystitis can also occur when the gallbladder is irritated by other diseases and conditions.

What are the signs and symptoms of the condition?

The inflammation of the gallbladder may cause the following symptoms:

• a feeling of abdominal bloating and excessive gas
• nausea and sometimes vomiting
• pain that is usually in the upper right or middle part of the abdomen
• radiation of the pain through to the back or into the shoulder
• worsening of the pain after a heavy or fatty meal

If complications occur, the individual may develop further symptoms:

• abnormally light colored stools
• blockage of the bowels
• dark-colored urine
• fever, chills, or even shock
• itching
• jaundice, or yellowing of the eyes and skin
• severe, constant abdominal pain

What are the causes and risks of the condition?

Cholecystitis may occur when the gallbladder is inflamed by one of the following:

• gallstones, the most common cause
• an autoimmune disorder, in which the person's immune system attacks the gallbladder for no known reason
• rapid weight loss
• pregnancy
• a malignant or benign tumor
• poor blood circulation to the gallbladder, such as from a clot that blocks blood flow
• infections or other diseases of the gallbladder
• serious or prolonged illness, such as recovery from a major operation or severe skin burns

What can be done to prevent the condition?

Cholecystitis can usually not be prevented.

How is the condition diagnosed?

Diagnosis of cholecystitis starts with a medical history and physical exam. The healthcare provider may order tests, including:

• abdominal CT scan
• abdominal X-ray
• blood tests to determine causes or complications
• special X-ray tests, using contrast agents
• ultrasound

What are the long-term effects of the condition?

Complications of cholecystitis may include:

• blockage of the ducts that carry bile to the intestines
• bowel obstruction
• gallbladder disease
• liver disease
• pancreatitis, or inflammation of the pancreas

What are the risks to others?

Cholecystitis is not contagious and poses no risk to others.

What are the treatments for the condition?

Removal of the gallbladder with surgery is the preferred treatment for cholecystitis. Surgery may be needed right away or delayed for several weeks in some cases.

Since the early 1990s, this surgery has usually been done with laparoscopy. This procedure is a type of less invasive surgery that leaves smaller scars than regular surgery. Laparoscopy involves inserting a small viewing tube through the skin of the abdomen into the abdominal cavity.

The viewing tube is equipped with tiny surgical tools that can be used to remove the gallbladder.

In severe cases, the procedure may need to be done with regular surgery, which leaves a larger scar.

As a fall-back option for those who cannot tolerate an operation, a special diet or medications are prescribed to help dissolve the gallstones. Medicines to reduce inflammation can be given as well.

What are the side effects of the treatments?

Surgery may cause bleeding, infection, and allergic reaction to anesthesia. Some people may notice more frequent bowel movements for a short time after surgery.

What happens after treatment for the condition?

Gallstones may recur after they are dissolved with medicines. Surgery is usually more successful.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

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