Cholecystitis
Cholecystitis is the medical term for an inflamed gallbladder. The gallbladder is a pear-shaped organ which lies just below the liver. The gallbladder stores bile, a digestive fluid that is sent from the liver.
n the vast majority of people cholecystitis is caused by gallstones. Gallstones are crystal like structures that develop in the gallbladder or the bile ducts and can interfere with the normal flow of bile. Not everybody who has gallstones develops cholecystitis and many people have no symptoms of their gallstones, at all.
A small number of people will develop gallbladder inflammation without gallstones, this is called acalculous cholecystitis and usually occurs in people who are in hospital with another, often serious, condition.
Cholecystitis can be chronic (ongoing) or acute (sudden). People with gallstones may experience biliary pain (upper abdominal pain) or bloating after meals, but this doesn’t always mean the gallbladder is inflamed. Symptoms of cholecystitis vary but will often include:
- Abdominal pain in the upper abdomen that increases rapidly, may wax and wane but continues for up to several hours or is ongoing
- Abdominal bloating
- Nausea or vomiting
- Indigestion, flatulence and belching
- Pain in the back between the shoulder blades
- Low grade fever
- Inability to eat
Your risk of developing gallstones and subsequently cholecystitis increases if you are a woman, over the age of 60, obese, diabetic or have liver disease or if you are, or have been, pregnant.
To diagnose cholecystitis, your physician will review your history and perform a physical examination. People with cholecystitis usually have a tender gallbladder, located beneath the ribs on the right. Imaging tests such as an ultrasound or CT scan are performed. Blood tests may be performed to look for signs of infection, obstruction, pancreatitis, or jaundice.
People with cholecystitis will often present to their GP or to the emergency department. Initial treatment for cholecystitis includes bowel rest, medications to control pain and inflammation and antibiotics in case of infection.
Cholecystitis is usually treated by surgical removal of the gallbladder, unless there is a specific health reason not to undergo surgery. We know that of people who experience cholecystitis and present to hospital, 50% will be admitted again within one year, without surgery. Many people prefer not to have surgery during their initial illness, in which antibiotics are used to settle the gallbladder. However, a planned cholecystectomy is usually offered later.
Gallbladder removal is commonly performed using a minimally invasive technique called laparoscopic cholecystectomy. Gallbladder removal is one of the most commonly performed surgical procedures and does not cause any long term nutritional deficiencies.
There are risks associated with surgery and these must be balanced against the risks of symptoms returning and the complications of cholecystitis; These include;
- Multiple admissions to hospital with recurrent attacks of cholecystitis
- Non-functioning gallbladder (common after inflammation)
- Secondary infection in the gallbladder
- Perforation (bursting) of the gallbladder
- Erosion of large gallstones into adjacent organs