Cholecystitis – Symptoms, Causes and Prevention

Inflammation in the gall bladder is referred to as cholecystitis. The gallbladder is a small, pocket-shaped organ located in the upper right part of the abdomen below the liver. It stores a digestive liquid called bile that is released into your small bowel.

In the majority of cases, the obstruction caused by gallstones is the reason for cholecystitis. This causes excessive build-up of bile which can cause inflammation. Other causes of cholecystitis include complications of the bile duct, tumours, severe diseases and some infections.

Cholecystitis can lead to serious, sometimes fatal complications, such as a breakdown of the gall bladder if not treated quickly. Cholecystitis is often treated by removing the gall bladder.

Symptoms

Symptoms of cholecystitis may include the following:

  • Severe pain at upper right or mid-abdomen.
  • Pain extending into right shoulder or back.
  • Tenderness above the abdomen as it is touched.
  • Nausea
  • Vomiting
  • Fever

Signs and symptoms of cholecystitis frequently occur after eating, especially bulky or fatty foods.

Causes

Cholecystitis arises in case of inflammation of the gallbladder that is. caused by:

  • Gallstones. The most common reason for cholecystitis is hard particles (gallstones) that form in your gallbladder. These gallstones can block the tube (cyst canal) through which bile moves as it leaves the gallbladder. The bile is stored in great quantities, leading to inflammation.
  • Tumor. A tumor can prevent bile from emptying your gallbladder properly, resulting in bile deposits that can lead to cholecystitis.
  • Bile duct blockage. Blockage or scarring of the bile ducts may result in blockages that cause cholecystitis.
  • Infection. AIDS as well as some viral infections can cause inflammation of the gallbladder.
  • Blood vessel problems. A very serious illness can damage blood vessels and reduce blood flow to the gallbladder, resulting in cholecystitis.

Risk factors

Bile stones are the most important risk factor for cholecystitis.

Complications

Cholecystitis may result in a number of severe complications, which include:

  • Infection within the gallbladder. If bile accumulates inside your gallbladder, causing cholecystitis, bile can get infected.
  • Death of gallbladder tissue. Because of cholecystitis, gallbladder tissues may die known as gangrene. This is the most common complication, especially among seniors, those who have been treated late, and those with diabetes. This can lead to gallbladder rupture, or it can cause your gallbladder to explode.
  • Ruptured gallbladder. A tear or puncture of the gall bladder can result from swelling, infection or death of the gall bladder tissue.

Prevention

You can decrease your risk of cholecystitis by taking these steps to avoid gallstones:

  1. Lose weight slowly. Rapid weight loss may lead to an increased risk of gall stones. If you want to lose weight, try to lose about 1 or 2 pounds (about 0.5 1 kg) in one week.
  2. Maintain a healthy weight. Excess weight increases your chances of developing gallstones. To reach a healthy weight, lower your calorie intake and increase your physical activity. Maintain a healthy weight thanks to healthy eating and good exercise.
  3. Choose a healthy diet. Diets that are higher in fat and low in fibre can increase the risk of gallstones. To reduce the risk, choose healthy food with more fruits, vegetables and whole grains.

Diagnosis

A wide range of tests and diagnostic procedures are used for diagnose cholecystitis that includes:

  • Blood tests. Your doctor may check your blood for any visible signs of infection or gallbladder complications.
  • Imaging tests that show your gallbladder. Abdominal ultrasound, endoscopy or computerized tomography (CT) may be used to produce pictures of your gallbladder which may indicate signs of cholecystitis or gall ducts and gallstones.
  • A scan that shows the movement of bile through your body. Hepatobiliary iminodiacetic acid (HIDA) analysis makes it possible to follow the formation and flow of bile from the liver to the small intestine and to detect obstructions. A HIDA the examination involves the injection of a radioactive dye into your body, which binds to the cells that form bile so that we can see them moving with bile through the bile ducts.

Treatment

Cholecystitis is usually treated by a hospital stay to treat inflammation of the gall bladder. In some cases, surgery is necessary.

In the hospital, your doctor will carry out certain interventions to monitor your signs and symptoms. Treatment options can include:

  • Fasting. Your doctor may not let you eat or drink at the beginning to eliminate stress from your inflamed gallbladder.
  • Fluids through a vein in your arm. This treatment assists in the prevention of dehydration.
  • Antibiotics to fight infection. If you have a gallbladder infection, your doctor will likely prescribe antibiotics.
  • Pain medications. They may help in controlling the pain until the inflammation in your gallbladder is healed.
  • Procedure to remove stones. Your doctor can carry out a called procedure endoscopic retrograde cholangiopancreatography (ERCP) to remove blockages of the bile ducts or cystic canal.

The symptoms may decrease in 2-3 days. However, inflammation in the gall bladder often recurs. Most individuals suffering from this condition eventually require surgical removal of the gallbladder.

Surgery for removing the gallbladder is known as cholecystectomy. Typically, it is a mini-invasive process, involving a few tiny incisions in your abdomen (laparoscopic cholecystectomy). Open surgery, involving a long incision of the abdomen, is rarely needed.

The length of the intervention depends on the seriousness of the symptoms and the overall risk of complications during and after the intervention. If the surgical risk is low, surgery may be performed within 48 hours or during your time in hospital.

In the case of cholecystectomy, bile flows directly from the liver into your small intestine and is not stored in your gallbladder. You may live a normal life without your gallbladder.

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