Symptoms and Treatment of Cholecystitis

Written by Huang Ya Juan
Gastroenterology
Updated on September 25, 2024
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Cholecystitis is divided into acute cholecystitis and chronic cholecystitis. Acute cholecystitis typically presents very typical and obvious clinical symptoms, primarily manifesting as acute abdominal pain. Acute cholecystitis often occurs after eating greasy food, mainly presenting as severe colicky pain in the upper right abdomen, which is episodic and worsens. The pain may radiate to the right shoulder or back, followed by nausea, vomiting, and in severe cases, fever. Some severe cases may also present with jaundice and symptoms of systemic infection and toxicity. Acute simple cholecystitis is often treated non-surgically, and most cases can be cured. If the patient has a history of multiple attacks or the presence of stones, elective cholecystectomy is usually performed later. For suppurative or gangrenous cholecystitis, surgery should be performed promptly after appropriate preparation to remove the diseased gallbladder, typically within three days of onset. If the patient's condition is critical at the time of surgery, or if there is severe local infection and the anatomy is unclear, the doctor will not forcibly remove the gallbladder to avoid major bleeding and damage. Instead, a cholecystostomy may be performed first, followed by cholecystectomy after three months. Chronic cholecystitis, besides occasional upper abdominal discomfort and indigestion, usually shows no prominent symptoms, and most patients only learn about their condition through ultrasound examination. However, for recurrent acute attacks or symptomatic chronic cholecystitis, especially those with stones larger than 1 cm or multiple stones, cholecystectomy should be performed. Elderly or frail individuals with other serious illnesses, such as cardiovascular disease, diabetes, kidney disease, or liver disease, may receive medical treatment, including general digestive aids and antispasmodic medications. Bile preparations have choleretic effects, can increase the secretion of bile, promote the digestion and absorption of fats, and facilitate the excretion from the gallbladder, which can alleviate symptoms and stabilize the condition. Considering that acute attacks of chronic cholecystitis in elderly people progress rapidly and that emergency surgery has a much higher mortality rate than elective surgery, it is advisable to perform surgery during a remission period. Whether treated with medication or surgery, it is important to follow medical advice.

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Written by Luo Han Ying
Endocrinology
1min 15sec home-news-image

Is cholecystitis hereditary?

Cholecystitis is an inflammation of the gallbladder, which is related to dietary habits in our daily lives. For example, people who particularly enjoy oily foods, or generally eat in large quantities, or have irregular eating habits, such as those who often skip breakfast and eat meals inconsistently, are prone to developing cholecystitis. If we consider cholecystitis on its own, it actually does not have a genetic predisposition. However, cholecystitis is often seen in individuals who are obese and have irregular lifestyles, and such traits can typically be related to family habits. For instance, if parents and grandparents are overweight, their children are also likely to be overweight. Similarly, if one's lifestyle is irregular, characterized by inconsistent meals, it might be a reflection of the family's general irregular lifestyle. Therefore, children of parents who suffer from cholecystitis are also more likely to suffer from the condition, not due to genetics, but due to their body type, dietary habits, and family lifestyle practices.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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What are the serious consequences of cholecystitis?

The severe consequences of cholecystitis include gangrene and perforation of the gallbladder, leading to obvious signs of peritonitis throughout the abdomen, with noticeable tenderness and rebound pain. For patients with recurrent cholecystitis, it is advisable to use antibiotics for anti-infection treatment as soon as possible, as the condition can only be alleviated after the inflammation is under control. During recurrent episodes, surgical treatment should also be considered promptly. Removal of the gallbladder through surgery is the only way to achieve a radical cure. In most cases, laparoscopic cholecystectomy is chosen because it has the advantages of smaller incisions, less damage, and faster recovery, and is therefore often the preferred option in clinical settings. Patients who have undergone surgery should also avoid spicy and irritating foods to reduce inflammation and better facilitate recovery.

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Written by Zhu Dan Hua
Gastroenterology
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What are the symptoms of cholelithiasis cholecystitis?

Cholecystitis due to gallstones is relatively common in clinical practice, with abdominal pain being a frequent reason for seeking medical attention. The pain usually manifests in the upper abdomen or right side, occurring in intermittent or continuous episodes. Typically, the nature of the pain is described as distension, colic, or dull pain. Patients may also experience radiating pain in the lower back, typically extending to the right side of the abdomen. Additionally, a small number of patients may experience nausea, vomiting, and even fever alongside abdominal pain. Fevers are usually mild to moderate, with body temperatures around 38°C (100.4°F). Nausea and vomiting occur as a digestive response following gallbladder contraction and subsequent inflammatory stimulation, with vomitus generally consisting of gastric contents and bile, but not blood. Therefore, if gallstone-induced cholecystitis is suspected, it is recommended for patients to undergo active endoscopic removal, typically via laparoscopic surgery. Of course, older patients might be treated conservatively with medications.

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Written by Zhang Tao
Hepatobiliary Surgery
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What to do if you have cholecystitis?

Cholecystitis usually occurs in people with gallstones or gallbladder polyps. Patients with cholecystitis generally experience discomfort and bloating pain in the upper right abdomen. Cholecystitis is an inflammation of the inner wall of the gallbladder, which can cause abdominal pain in mild cases and lead to bile stasis and suppurative cholecystitis in severe cases. The first step in treating cholecystitis is to actively use antibiotics. Those with cholecystitis should actively use antimicrobial and anti-inflammatory drugs. It is also important to maintain a light diet and avoid consuming too many greasy foods. To prevent recurrence, it is generally recommended that patients take oral anti-inflammatory and bile-promoting tablets after cholecystitis symptoms are controlled. These medications can play a preventive role in patients with acute and chronic cholecystitis.

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Written by Si Li Li
Gastroenterology
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Location of pain in female cholecystitis

The main symptoms of cholecystitis include upper abdominal pain. Mild cases generally are limited to the upper abdomen, while severe cases may affect the entire body, and 70% of patients with cholecystitis do not show any symptoms. The early symptoms of cholecystitis can suddenly manifest as severe colicky pain in the upper right abdomen, which can also radiate to the right shoulder and back. These symptoms are generally triggered by consuming a large amount of fatty foods and are more likely to occur at night. If the condition progresses, the pain becomes persistent and progressively worsens, and may also be accompanied by mild to moderate fever. Some patients may experience chills and high fever, indicating that the condition is very severe.