What are the symptoms of cholelithiasis cholecystitis?

Written by Zhu Dan Hua
Gastroenterology
Updated on September 04, 2024
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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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How to deal with nausea and the urge to vomit from cholecystitis?

Nausea and vomiting caused by cholecystitis should be treated with medications according to individual clinical symptoms. At the same time, it is important to make a correct judgment based on the cause of the disease. If cholecystitis is caused by overeating, medications that aid digestion should be used first to alleviate symptoms. If a bacterial infection is confirmed, antibiotics should also be used to reduce inflammation and treat the condition symptomatically. Patients with cholecystitis should maintain a light diet, avoid overeating and greasy food, and should quit smoking and drinking alcohol, maintaining a structured lifestyle.

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Do you need to fast and hold your urine for a gallbladder inflammation B-ultrasound?

When undergoing an ultrasound for cholecystitis, fasting is required, but there is no need to hold urine. However, if the examination involves the adnexa of the uterus, bladder, prostate, and other areas, it requires holding urine to perform the test, allowing the prostate, adnexa, etc., to sufficiently distend. This helps in more clearly observing pathological changes. Patients with cholecystitis need to fast before an ultrasound. If food is consumed before the scan, the gallbladder contracts more quickly, making it difficult to accurately identify lesions. Patients with cholecystitis may experience chills, fever, right upper abdominal pain, jaundice, yellowing skin, dark urine, etc. In severe cases, patients may develop septic shock and require active treatment measures.

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Why is there nothing wrong with the B-ultrasound for cholecystitis?

As for why cholecystitis appears normal in an ultrasound, there are two possible reasons. One possibility is that the medical practitioner conducting the ultrasound may lack sufficient clinical experience to identify an inflamed gallbladder. Another reason could be limitations in the ultrasound equipment itself, which might fail to detect an inflamed gallbladder. There are very few cases where cholecystitis appears normal under ultrasound. The main ultrasound features of cholecystitis include gallbladder wall edema, roughness, and an enlarged gallbladder among other radiological changes. Once cholecystitis is diagnosed, it is crucial to undertake active treatment measures, such as aggressive anti-infection treatment, spasmodic pain relief, etc.

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Where to massage for symptoms of gallblitis pain?

Gallbladder inflammation pain requires massaging the upper right abdomen, also known as the Murphy's point. The symptoms of gallbladder inflammation primarily include chills, fever, jaundice, pain, etc. Once a gallbladder inflammation attack occurs, it is necessary to promptly complete the relevant auxiliary examinations to determine the cause of the disease. Treatment should be based on the cause, and surgical treatment may be necessary when needed. The main causes of gallbladder inflammation include biliary infection, bile stasis, and biliary stones, etc. Patients with gallbladder inflammation should have a light diet and avoid greasy food.

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How to Diagnose Cholecystitis

The definitive diagnosis of cholecystitis mainly involves the following aspects: First, clinical manifestations are crucial. The most common symptoms include nausea, vomiting, abdominal distension, and loss of appetite. Regarding physical examination, there is typically pain in the lower right abdomen and mid-lower right abdomen, with tenderness upon palpation. Furthermore, the onset of cholecystitis is characterized by postprandial pain, particularly after consuming fatty foods or feeling overly full. If these symptoms are present, further examination such as gallbladder ultrasound can be conducted to check for thickening of the gallbladder wall. Additionally, blood tests for inflammatory markers like complete blood count and CRP (C-reactive protein) can be performed. The diagnosis of cholecystitis can be confirmed by combining these symptoms and test results.