GALLBLADDER INFLAMMATION

Cholecystitis is inflammation of the gallbladder, a small organ near the liver that plays a part in digesting.  This is most often caused by an obstruction within the gallbladder.  If left untreated, this may lead to infection.

The main risk factor for cholecystitis is having a gallbladder stone or cholelithiasis.  The factors that increases the chance of having gallbladder stones include, increasing age (over 40 years), female sex, obesity or rapid weight loss, drugs and pregnancy.

What causes cholecystitis?

  • Gallstones. Most cholecystitis is the result of hard particles that develop in your gallbladder  (gallstones) from imbalances in the substances in bile, such as cholesterol and bile salts.
  • Tumor. A tumor may prevent bile from draining out of your gallbladder properly, causing bile buildup that can lead to cholecystitis.
  • Bile duct blockage. Kinking or scarring of the bile ducts can cause blockages that lead to cholecystitis.

Signs and symptoms of cholecystitis may include:

  • Severe pain in your upper right abdomen
  • Pain that radiates from to your right shoulder or back
  • Clay-colored stools
  • Loss of appetite
  • Tenderness over your abdomen when it’s touched
  • Nausea
  • Vomiting
  • Fever and chills

Cholecystitis signs and symptoms often occur after a meal, particularly a large or fatty meal.  Older people may not have fever or pain. Their only symptom may be a tender area in the abdomen.

Diagnosing cholecystitis starts when you describe your symptoms to your doctor. Next is a physical exam. Your doctor will carefully feel your right upper abdomen to look for tenderness. Then the doctor may request for tests to confirm diagnosis.

Tests and procedures used to diagnose cholecystitis include:

  • Blood tests. Your doctor may order blood tests to look for signs of an infection or signs of gallbladder problems.
  • Imaging tests that show your gallbladder. Imaging tests, such as abdominal ultrasound or a computerized tomography (CT) scan, can be used to create pictures of your gallbladder that may reveal signs of cholecystitis.
  • A scan that shows the movement of bile through your body. A hepatobiliary iminodiacetic acid (HIDA) scan tracks the production and flow of bile from your liver to your small intestine and shows blockage. A HIDA scan involves injecting a radioactive dye into your body, which binds to the bile-producing cells so that it can be seen as it travels with the bile through the bile ducts.

 

RECOMMENDED MEDICATIONS

Treatment for cholecystitis will depend on your symptoms and your general health. People who have gallstones but don’t have any symptoms may need no treatment. For mild cases, treatment includes bowel rest, fluids and antibiotics given through a vein, and pain medicine.

The main treatment for acute cholecystitis is surgery to remove the gallbladder (cholecystectomy). Often this surgery can be done through small incisions in the abdomen (laparoscopic cholecystectomy), but sometimes it requires a more extensive operation. Your doctor may try to reduce swelling and irritation in the gallbladder before removing it. Sometimes acute cholecystitis is caused by one or more gallstones getting stuck in the main tube leading to the intestine, called the common bile duct. Treatment may involve an endoscopic procedure (endoscopic retrograde cholangiopancreatography, or ERCP) to remove the stones in the common bile duct before the gallbladder is removed.

In rare cases of chronic cholecystitis, you may also receive medicine that dissolves gallstones over a period of time.

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