What should I do if I have cholecystitis?

Written by Si Li Li
Gastroenterology
Updated on April 21, 2025
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The main symptoms of cholecystitis include sudden onset of pain in the upper right abdomen, which can radiate to the back or right shoulder. It commonly occurs after consuming a large amount of fatty foods or during the night. Symptoms also include fever, chills, nausea, vomiting, poor appetite, and less desire to eat. A routine blood test will show increased white blood cells and neutrophils. An upper abdominal CT or abdominal ultrasound can detect cholecystitis. In terms of treatment, the first approach is symptomatic treatment, which can involve using antispasmodic and analgesic medications. The second approach is anti-inflammatory treatment. Furthermore, the diet should be light and easy to digest, and fatty, rich, and greasy foods should be avoided.

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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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Written by Si Li Li
Gastroenterology
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What is good to drink for cholecystitis?

Cholecystitis is a common and frequently occurring disease in surgery, mainly caused by various reasons, resulting in an inflammatory reaction in the gallbladder. Normally, traditional Chinese herbs like dandelion or lysimachia can be used for making tea. These herbs are known for their heat-clearing, detoxifying, and anti-inflammatory properties, and they have very minimal side effects, providing certain therapeutic effects on the disease. In addition to drinking herb-infused water, dietary adjustments are also necessary. For instance, it is advisable to eat less fatty, rich, and greasy foods, as well as to avoid spicy, fried, and irritating foods. Drinking more water and eating more vegetables is also recommended.

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Written by Zhang Jun Jun
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Which department should I go to for cholecystitis?

Firstly, it is necessary to determine the cause of the cholecystitis. The most common type of cholecystitis is caused by gallstones. If the cholecystitis is an acute episode caused by gallstones, leading to pain, nausea, vomiting, or even high fever, surgical intervention is usually indicated. It is generally recommended to consult with departments such as general surgery or hepatobiliary surgery, as emergency surgery may be needed. The second scenario involves cases where cholecystitis is detected during routine physical examinations without symptoms. Ultrasound may show gallstones or gallbladder polyps. In symptom-free situations, it is possible to consult general departments like gastroenterology, and regular follow-ups and checks of inflammation indicators, as well as abdominal ultrasonography, can be performed to monitor the dynamic changes of the cholecystitis. The third scenario pertains to cholecystitis where new techniques such as MRCP are available. With this technology, gallstones can be removed under endoscopic guidance. Generally, these procedures are performed in the gastroenterology department. Thus, for acute cholecystitis with choledocholithiasis and concurrent biliary pancreatitis, it may be treated with endoscopic techniques under gastroenterology, avoiding the need for traditional or minimally invasive surgery. Therefore, patients with cholecystitis may visit either the hepatobiliary surgery or gastroenterology departments.

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Does cholecystitis require surgery?

Whether cholecystitis requires surgery depends on the acute or chronic status of the inflammation and its severity. If it is acute suppurative cholecystitis, emergency surgery is needed to avoid gallbladder perforation and resultant peritonitis, which could lead to serious septic shock, thus emergency surgical treatment is necessary. If it is mild chronic cholecystitis, elective surgery can be considered, and there is no need for emergency treatment. If it is asymptomatic chronic cholecystitis, it can also be managed with dietary adjustments and symptomatic medical treatment, and surgery may not be strictly necessary.

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Written by Liu Wu Cai
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Can acute cholecystitis recur?

Acute cholecystitis can recur. This condition often results from a bacterial infection leading to an inflammatory response. At this stage, it can be treated with antibiotics to control the inflammation and alleviate the condition. However, if the gallbladder is not surgically removed, the inflammation can repeatedly flare up, potentially leading to chronic cholecystitis. This results in recurrent discomfort and pain in the upper right abdomen, affecting the quality of life. Therefore, for patients with acute cholecystitis, especially those caused by gallstones, it is advisable to undergo surgery as soon as possible. Only through surgical removal of the gallbladder can a complete cure be achieved, preventing recurrence.