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Cholecystitis

What is cholecystitis?

Cholecystitis is inflammation of the gallbladder. The gallbladder is a small, pear-shaped sac under the liver that stores bile. Bile is a greenish-brown liquid made in the liver that helps digest food in the intestine.

Cholecystitis is very painful. The pain is felt in the right upper abdomen, just under the ribs. The pain is constant and is usually made worse by moving. Cholecystitis can be either acute (sudden) or chronic (long lasting).

How does it occur?

Acute cholecystitis is usually caused by a gallstone blocking the outlet from the gallbladder, so that bile cannot get out. The bile becomes concentrated and sometimes stagnant and infected. This irritates and inflames the inside of the gallbladder, causing severe pain.

Chronic cholecystitis occurs when the gallbladder walls have become permanently damaged by repeated attacks of acute cholecystitis.

What are the symptoms?

For acute cholecystitis, the main symptom is severe, constant pain under the right ribs that is worse on moving. There may also be fever and sometimes a yellowing of the skin (jaundice). If the gallbladder bursts, it can cause infection and inflammation of the abdominal cavity.

The symptoms of chronic cholecystitis are indigestion, pains in the upper abdomen, nausea, and belching. Eating fatty foods will often make the symptoms worse.

How is it diagnosed?

Your doctor will probably suspect acute cholecystitis from your description of the pain and from examining you. A history of acute attacks, symptoms, and a physical exam will suggest chronic cholecystitis. Scanning and x-rays may be used to confirm the diagnosis and rule out other possible causes.

How is it treated?

It is usually treated by admitting you to the hospital and giving you painkillers, antibiotics, and intravenous (IV) fluids until the diagnosis is confirmed. In most cases, the cholecystitis will subside without immediate surgery. But because it is likely that the attack will happen again, the doctor may recommend removal of your gallbladder once the attack subsides.

How can I take care of myself?

  • Follow the treatment prescribed by your doctor.
  • If you are overweight, talk with your doctor about how best to lose weight.
  • Don't try to lose weight by fasting. Fasting can encourage development of gallstones.
  • Keep healthy. Get plenty of exercise and enough rest.