What to do if you have cholecystitis?

Written by Zhang Tao
Hepatobiliary Surgery
Updated on September 02, 2024
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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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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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Can you drink water with acute cholecystitis?

Whether patients with acute cholecystitis can drink water mainly depends on the course of the disease. In the early stages of acute cholecystitis, patients may experience digestive symptoms such as nausea, vomiting, and abdominal distension. At this time, they should not drink water; instead, they require fasting and gastrointestinal decompression to better control the condition, especially to prevent the occurrence of intestinal obstruction. After antibiotic treatment and control of the inflammation, once the gastrointestinal function is fully restored, patients can then drink water, but only in small amounts. For patients with acute cholecystitis, if symptoms do not improve after conservative treatment, it may even be necessary to surgically remove the gallbladder to achieve a definitive cure. The primary method is laparoscopic cholecystectomy, which can effectively treat the condition.

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How to diagnose cholecystitis?

Firstly, we can use physical examination to check. Acute cholecystitis will show tenderness in the upper right abdomen. If pressing below the right ribs causes significant pain, it is likely to be acute cholecystitis. Secondly, instrument examination can be utilized, with the most common and cost-effective being an ultrasound examination. When examining cholecystitis, fasting is required; no food should be consumed for at least eight hours. Additionally, modern CT scans or MRI can be used to help determine whether there is inflammation in the gallbladder. Blood tests can also be conducted; an increase in white blood cells in a routine blood test can indicate the presence of inflammation.

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Symptoms and Treatment of Cholecystitis

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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Gallblitis Symptoms

The symptoms of cholecystitis are divided into chronic cholecystitis and acute cholecystitis, and they present differently clinically. During acute cholecystitis, there is pain in the right upper abdomen in the gallbladder area, accompanied by fever, fatigue, decreased appetite, and even jaundice. Physical examination can reveal obvious tenderness and rebound pain in the right upper abdomen at the gallbladder. In contrast, chronic cholecystitis may not have obvious symptoms. Occasional pain may occur in the gallbladder area, but it is bearable. Typically, there is no obvious tenderness in the area, and the condition usually requires diagnosis through examinations such as an ultrasound.