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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Does cholecystitis hurt?

Whether cholecystitis is painful depends on the nature of the inflammation. If it is acute cholecystitis, it often causes severe pain in the gallbladder area, which is persistent and accompanied by chills, fever, poor spirit, loss of appetite, and even jaundice. If it is chronic cholecystitis, there may not be obvious symptoms of gallbladder pain. However, it can lead to an acute attack of chronic cholecystitis under the conditions of chills, high-fat diet, or other causes, which then causes pain in the gallbladder area.

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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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Can you drink alcohol with acute cholecystitis?

Acute cholecystitis, clinically divided into calculous cholecystitis and acalculous cholecystitis, is closely related to diet regardless of the type. Therefore, patients with acute cholecystitis should not consume alcohol, as drinking can lead to another attack of acute cholecystitis. Most episodes of acute cholecystitis are directly related to diet and excessive drinking, so not only during an acute attack but also in everyday life, it is important to avoid greasy, fried foods, spicy and irritating foods, and excessive alcohol consumption, in order to prevent stimulating the swelling of the gallbladder mucosa and triggering an attack of acute cholecystitis.

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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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What should I do if cholecystitis does not improve?

If cholecystitis does not improve over time, it is crucial to actively identify the reasons behind this persistent issue. For instance, it could be due to improper diet, such as frequently consuming greasy foods or overeating. It might also be due to an acute exacerbation of chronic cholecystitis, or possibly because of the presence of polyps or stones in the gallbladder, which can lead to persistent cholecystitis. In such cases, it is important to pay closer attention to the diet, opting for lighter meals, and to take oral anti-inflammatory and bile-promoting medications for treatment. If necessary, gallbladder removal surgery may be required.