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Pain in the right upper quadrant, nausea, and discomfort after eating may be associated with inflammation of the gallbladder. Cholecystitis may have an acute course with pronounced symptoms or a chronic course — with alternating periods of remission and exacerbation. Depending on the cause and severity of the disease, treatment may include medication therapy or surgical intervention.
At the «Oxford Medical» medical center in Kyiv, you can undergo the necessary examinations and treatment for cholecystitis. Make an appointment for a consultation to determine the cause of the symptoms and receive individual recommendations regarding treatment.
Cholecystitis — is inflammation of the gallbladder, a small organ that stores bile and releases it into the intestine. When inflamed, the walls of the gallbladder swell and its normal function is disrupted, which may be accompanied by pain and other unpleasant sensations.
The gallbladder plays an important role in digestion, in particular helping the body absorb fats. That is why disruption of its function may affect well-being and tolerance of certain foods.
Most often, inflammation of the gallbladder occurs due to blockage of its duct by a stone. As a result, the outflow of bile is disrupted, pressure inside the organ increases, and an inflammatory process develops. According to MSD Manual, more than 90% of patients with acute cholecystitis have gallstone disease.
The main causes and risk factors of cholecystitis are:
Gallstones remain the most common cause of the disease, but inflammation is also possible without them. Determining the cause helps the doctor choose the appropriate treatment approach and assess the risk of recurrent exacerbation of cholecystitis.
Depending on the course of the disease, acute and chronic cholecystitis are distinguished. Inflammation may also be calculous, when stones are present in the gallbladder, or acalculous — when they are absent. These features are important for assessing the patient's condition and choosing treatment.
Acute cholecystitis — is inflammation that develops rapidly and requires urgent medical care. Most often, it occurs due to blockage of the cystic duct by a stone. In such cases, the outflow of bile is disrupted, the walls of the organ swell, and the inflammatory process may gradually intensify.
Depending on the severity of the inflammation, catarrhal, phlegmonous, and gangrenous forms are distinguished. In severe cases, tissue death or damage to the wall of the gallbladder may occur. Therefore, acute cholecystitis usually requires inpatient treatment, often with surgery.
Chronic cholecystitis — is long-term inflammation of the gallbladder that is often associated with the presence of stones and repeated episodes of irritation of its walls. Over time, they may thicken, lose elasticity, and the gallbladder's ability to contract normally gradually worsens.
The disease may be accompanied by periodic exacerbations. At the same time, the nature of the inflammatory changes and the condition of the gallbladder may differ, so further management is determined based on the examination results.
The symptoms of cholecystitis depend on the form of the disease and the severity of the
inflammation. Most often, patients are troubled by pain in the right upper quadrant, nausea,
and discomfort after eating. In acute inflammation, the symptoms are usually more intense,
while a chronic course may be accompanied by less pronounced complaints.
The main symptoms of acute cholecystitis:
severe and prolonged pain in the right upper abdomen, which may radiate to the back or right shoulder blade;
increased body temperature, sometimes chills;
nausea and repeated vomiting;
abdominal tenderness when pressing in the area of the gallbladder.
Bitterness in the mouth after eating may also occur. However, this symptom is not characteristic only of cholecystitis and may occur for other reasons.
With chronic cholecystitis, the following manifestations are possible:
The doctors of «Oxford Medical» emphasize: severe pain in the right upper quadrant, especially together with fever, chills, or repeated vomiting, requires urgent medical attention. If yellowing of the skin or the whites of the eyes appears, this may indicate impaired bile outflow and the development of complications.
The examination begins with a doctor's consultation, during which the doctor clarifies the complaints, the circumstances of their onset, and performs an examination. To confirm the diagnosis and assess the condition of the gallbladder, instrumental and laboratory tests are prescribed.
Diagnosis of cholecystitis may include:
Not all tests are necessary for every patient. Their scope depends on the symptoms and the results of the initial examination. The obtained data help determine the cause of the inflammation, assess its severity, and choose the further treatment approach.
The treatment method depends on the form of the disease, its severity, and the patient's general condition. In a chronic course, medication therapy is used in some cases, while acute cholecystitis often requires hospitalization and surgical intervention.
Conservative therapy may be used for chronic cholecystitis, as well as to stabilize the patient's condition before surgery or if there are contraindications to it.
Depending on the patient's condition, the following may be prescribed:
Additionally, the doctor may recommend temporary dietary changes and restriction of physical activity. In a chronic course outside an exacerbation, UHF therapy is sometimes used as an auxiliary physiotherapeutic method, although there is insufficient convincing evidence of its effectiveness.
The doctors of «Oxford Medical» warn against taking choleretic medications independently. In the presence of stones or impaired bile outflow, such agents may worsen the condition. Therefore, treatment for cholecystitis should be selected after examination, taking into account the cause of the inflammation and concomitant diseases.
According to the recommendations of the World Society of Emergency Surgery, in acute calculous cholecystitis, surgical treatment is usually preferred. It may also be recommended for patients with chronic inflammation if the disease is accompanied by recurrent painful attacks or significant changes in the gallbladder.
Indications for surgery may include:
Most often, laparoscopic cholecystectomy is performed. The surgeon makes several small punctures in the abdomen and inserts a miniature video camera and surgical instruments through them. Guided by the image from the camera, the surgeon carefully separates the gallbladder from the surrounding tissues and removes it. The operation is performed under general anesthesia.
The laparoscopic approach makes it possible to reduce trauma to the abdominal wall. Patients usually regain mobility faster and require a shorter hospital stay than after open surgery. However, in complex anatomical conditions or with significant spread of inflammation, the surgeon may switch to open surgery.
The doctors of «Oxford Medical» note: if the patient's general condition does not allow the operation to be performed safely, temporary drainage of the gallbladder is possible. Its contents are drained through an inserted catheter, which helps control the inflammatory process. After the condition improves, the doctors reassess the possibility of surgical intervention.
Possible complications of cholecystitis include:
Such complications require urgent care. Timely treatment makes it possible to reduce the risk of the spread of inflammation, damage to the gallbladder, and the development of life-threatening conditions.
Nutrition for cholecystitis should be balanced, with a moderate fat content. Fatty and fried foods may worsen pain and nausea, so such foods should be limited. During an exacerbation, additional dietary restrictions may be needed. After well-being improves, the diet is gradually expanded.
Main dietary recommendations:
The doctors of «Oxford Medical» recommend not excluding fats from the diet completely and not following strict diets without medical indications. The body needs a certain amount of healthy fats, while excessive restrictions may lead to nutrient deficiencies. The diet for cholecystitis should be agreed upon with a gastroenterologist or dietitian, taking into account the course of the disease and individual tolerance of foods.
The basis of cholecystitis prevention is reducing the risk of gallstone formation, which most often causes inflammation.
To reduce the risk of cholecystitis, it is recommended to:
These measures help reduce the risk of stone formation but do not eliminate the possibility of gallbladder inflammation.
The cost of cholecystitis treatment depends on the severity of the inflammation and the amount of medical care required. If surgery is indicated, the cost is calculated taking into account the method of intervention, anesthesia, and the need for postoperative monitoring in the inpatient facility.
Current prices for medical services at «Oxford Medical» can be viewed here. During the consultation, the doctor will familiarize you with the possible treatment options and explain which procedures and examinations may be needed. To make an appointment with a doctor, submit a request through the online appointment form on the website or call the contact center.
The information is for informational purposes and does not replace a doctor's consultation.
Sources:
With cholecystitis, pain is most often felt in the right upper abdomen and may spread to the back, right shoulder blade, or shoulder. In acute inflammation, it is usually severe and prolonged, sometimes worsening during a deep breath. In chronic cholecystitis, the pain may be less intense and occur periodically.
With cholecystitis, the pain is usually concentrated under the right ribs, while with pancreatitis it more often occurs in the upper abdomen and radiates to the back. Both diseases may be accompanied by nausea and vomiting, so it is difficult to distinguish them based on symptoms alone. Instrumental examinations are needed to establish the diagnosis.
With chronic cholecystitis outside of an exacerbation, moderate physical activity is usually allowed, including walking, swimming, and light gymnastics. The intensity of exercise should be increased gradually. During acute inflammation or the onset of pain, training should be stopped and medical help should be sought. After surgery, the timing of returning to sports depends on the course of recovery.
The possibility of complete recovery depends on the cause and form of the disease. In acute calculous cholecystitis, removal of the gallbladder is most often recommended, which makes it possible to eliminate the source of inflammation and prevent recurrent attacks. Medication therapy can reduce inflammation, but if its cause remains, the disease may occur again.
In some cases, cholecystitis can be treated without surgery. This depends on the cause of the inflammation, the condition of the gallbladder, and the risk of complications. Conservative therapy may include pain relief, antibiotics when indicated, and other supportive measures. However, in acute calculous cholecystitis, medications are often insufficient for complete recovery.
Not in all cases. In acute calculous cholecystitis, surgery is usually recommended. In chronic disease, the need to remove the organ depends on the frequency of recurrent attacks and the presence of stones. If the surgical risk is high, the doctor may suggest other ways to control the inflammation or drain the bile.
The latest diagnostic technologies that allow you to obtain the most accurate results;
Appointment of a course of modern drug therapy using high-quality drugs;
Performing minimally invasive or endoscopic surgery using advanced technology (if necessary);
Individual selection of a comprehensive treatment course for each patient.
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