Cholecystitis

The abdominal area is a miracle pack in our body. It consists of intestines, gallbladder, pancreas and other crucial parts of the body. The gallbladder is an organ in the shape of a pear. It is in the right part of the abdomen. The function of the gallbladder is to secrete bile to the small intestine. Inflammation of the gallbladder is called cholecystitis. Cholecystitis can also result from the gallstones blocking the gallbladder. The buildup of bile causes inflammation and tumours and bile duct problems too can be the reason behind the inflammation at times.

Types of cholecystitis:

Cholecystitis is categorized into acute and chronic cholecystitis.

-  Acute cholecystitis: An abrupt inflammation of the gallbladder leads to agonizing pain in the upper right abdomen. The pain caused due to this type of cholecystitis can also be felt in the shoulder blades. Perforation of the gallbladder tends to happen in advanced cases where the strong bile fluid flows to the abdominal cavity as a puncture is formed in the wall of the gallbladder. Emergency medical attention is required in this case, as this can be life-threatening.

-  Chronic cholecystitis: Recurring attacks of acute cholecystitis can lead to inflammation and irritation in the gallbladder. This develops over time, leading to a chronic condition. The gallbladder thickens and shrinks because of the damage caused to the walls of the organ. The functioning of the organ can also be brought down to a great extent in this condition.

Cholecystitis Symptoms:

Multiple symptoms are associated with cholecystitis. A few of them are listed here.

- Intense pain in the upper right abdomen: The gallbladder is situated in the upper part of the right abdomen. The pain shoots from this region. The pain can be also felt in the centre of the abdomen. The pain grows in intensity when a deep breath is taken.

- Severe pain in the shoulder: The pain can be moving from the right shoulder to back. This can be a dull pain or intense pain. This symptom varies from individual to individual.

- Tenderness in the abdomen: The buildup of bile in the gallbladder leads to tenderness in the abdominal area. This can be felt when touched.

- Nausea and vomiting: Bile is the digestive fluid, which is secreted by the gallbladder. When the condition of cholecystitis builds up, the affected can experience nauseating feel, due to indigestion, or the improper functioning of the digestive system without the digestive fluid. In a few people affected by this condition, vomiting is also present.

- Fever: Excruciating pain is often accompanied with fever when the condition is acute.

- Indigestion: Lack of the digestion fluid and indigestion are dots that can be connected easily. This can be seen often after a fatty food intake. Indigestion does not stop with discomfort, and causes abdominal pain, and cramping, especially after a fatty meal.

Cholecystitis Causes:

- Gallstones: Bile is the digestive fluid that plays a vital role in aiding the process of digestion. The gallbladder holds the fluid and releases it slowly to the small intestine. The fluid has to pass through the cystic duct, which is a small tube-like structure. Then it moves to the common bile duct, from where it is sent to the small intestine. When the fluid gets stuck in the opening of the gallbladder the gallstones or the biliary sludge is formed. This is the major reason for cholecystitis. This biliary sludge is also called as pseudolith, meaning, fake stone. In short, gallstones are chief causes of this condition.

- Severe Illness: Severe illness too can cause cholecystitis. However, this is a very rare cause.

- Tumour: Tumors develop around the gallbladder, or in any of the upper abdominal area, can lead to this condition. This is because the bile fluid cannot be drained out completely from the gallbladder. Tumour can block the fluid from passing out to the small intestine, which eventually leads to the formation of gallstones, and leads to cholecystitis.

- Blockage of bile duct: Scarring or kinking of the bile ducts can lead to the blockage in the gallbladder. Any blocks in the gallbladder obviously lead to the formation of the gallstones and cholecystitis.

- Viral Infection: A few viral infections can lead to inflammation of the gallbladder. Patients with AIDS are often seen with the gallbladder problem of cholecystitis.

- Problems of the blood vessels: When the flow of the blood is restricted or inadequate to any organ, health issues related to the organ crop up. The same is the case with the gallbladder. Any problems with the blood vessels that restrict the flow of blood to the gallbladder can lead to cholecystitis. Certain illnesses can cause the blood vessel problems.

-  Shock, lack of immunity and extended fasting can disturb the bile chemistry and lead to cholecystitis.

How to Cholecystitis is diagnosed?

Healthcare professionals recommend multiple methods to diagnose the condition of cholecystitis.

- Blood tests: Blood tests are often the initial step to find the existence of gallbladder problems. Signs of infections can be found with the results.

A range of imaging tests is also suggested by the doctors to diagnose cholecystitis and other gallbladder problems.

- Abdominal ultrasound: The pictures of the gallbladder and to some extent the bile duct can be seen using this imaging test. This ultrasound makes use of sound waves to create pictures of the inner organs.

- Abdominal CT: The detailed pictures of the abdomen, liver, gallbladder and bile ducts are produced by the CT. Any inflammation or infection can be clearly diagnosed with the Computed Tomography.

- MRCP: Magnetic Resonance Cholangiopancreatography is called MRCP in short. This MRI examination offers clear images of the gallbladder, bile duct, pancreas, pancreatic duct and the liver. For any bile related abnormalities,   this imaging examination is considered to be accurate and powerful. Inflammation or blockage in the bile system can be identified with this diagnosis.

- Hepatobiliary nuclear imaging: A radioactive tracer is used to find the abnormalities that affect the liver, gallbladder and the ducts of the biliary system.

Cholecystitis Prevention:

The most operative method to keep off cholecystitis is to avoid the formation of gallstones. However, a few risk factors are inevitable. When dietary changes and lifestyle modifications are made, the effective prevention is on the cards.

Dietary habits:

-  Fatty foods are often linked with the formation of gallstones. Restricting such foods, and foods that are rich in cholesterol content is mandatory. Sausages, meat pies, cakes, confectionaries and biscuits should be restricted or consumed rarely.

-  Foods that are rich in fibre are recommended to keep the gallbladder healthy. Fresh fruits, vegetables and whole grains should be a part of everyday diet.

-  Consuming nuts in small quantities each day, say 2 to 3 units, can help in keeping off cholecystitis.

Lifestyle modification:

-  Excessive weight or obesity means the cholesterol level in the bile too is high. This eventually means, the chances of formation of gallstones are also higher. Controlling weight with the right diet and right exercise schedule helps in keeping the formation of gallstones far.

-  Rapid weight loss never helps, when it comes to keeping the gallbladder healthy. The bile chemistry is disturbed largely when the crash diets are practised. Again, the formation of gallstones is on the cards.

-  Gallstones are inevitable when alcohol consumption is high.

Cholecystitis Treatment:

Hospital stay is mandatory for treating cholecystitis. This is to ensure the inflammation is controlled. While medication is the first option, a surgery is not often ruled out.

- Fasting: The gallbladder that has gone through excessive stress requires rest. The same can be offered only through fasting. The inflamed gallbladder can be controlled through fasting. However, IV fluids are given to ensure the patient is not dehydrated. The patient gets the energy through the IV fluids, and the gallbladders and intestines get enough rest to control the inflammation.

- Antibiotics: Antibiotic dosages are recommended by the doctors if the condition is caused by an infection.

- Medications: The inflammation of the gallbladder often leads to pain, and pain medications are recommended to manage it.

- ERCP: This procedure is done to remove the gallstones. A small incision is involved, and a camera with a flexible tube is inserted to let the gastroenterologist and the surgeon get a view of the biliary system. The passage of the bile duct system is cleared off the blockage, and a laser fibre is used to destroy the gallstones. The stones are also received as fragments by using balloons or baskets.  Though a minimally invasive procedure, a risk of injury to the pancreas exists in a small percentage.

- Percutaneous cholecystostomy: This procedure is performed in patients who are about to undergo cholecystectomy.  This is done to reduce the inflammation of the gallbladder, by letting the congested bile to flow out.

- Percutaneous transhepatic cholangiography (PTC): This procedure is again done to reduce the inflammation of the gallbladder. A few stones are removed during the PTC, while few others bypassed.

When cholecystitis is a recurring condition, and signs of future complications arise, removal of the gallbladder is suggested by the physician.

Cholecystectomy can be of 2 types- open cholecystectomy or laser cholecystectomy.

- Open cholecystectomy: A surgical cut is used to remove the gallbladder when the patient is given general anaesthesia. The recovery time is longer in this scenario.

- Laser cholecystectomy: This procedure is again done under general anaesthesia. The surgeon sends a small camera through a small incision in the belly button, and the gallbladder is removed. The scars are minimal, and the recovery time is faster.

Complications:

Multiple serious complications are associated with cholecystitis.

- Infections: When the digestive fluid bile is clogged in the gallbladder for long, it becomes infectious. Infected bile, when passed to the small intestine, can lead to several health risks.

- Gallbladder tissue death: The tissue in the gallbladder can die, which is called gangrene. This happens when cholecystitis is not treated for long. In elderly people, people who take a long time to meet the doctor and in people with diabetes, this is a common complication. The gallbladder is torn eventually or it can even burst, which is a distractors scenario.

- Perforation: A tear in the gallbladder wall can cause the bile entering into the abdominal cavity, a life-threatening condition.

- Gallbladder distention: Bile accumulated in the organ can lead to swelling and stretching of it, and the risk of perforation is high.

- Pancreatitis: The pancreatic duct experiences an obstruction when the gallbladder allows the stones to pass to the biliary duct. Though rare, pancreatitis is a complication that is severe and cannot be ruled out.

Myths of  Cholecystitis

Several myths are associated with the gallbladder problems that include cholecystitis. From the disease to the treatment methods, these myths can hinder proper treatment.

Myth #1: Gallstones only can lead to cholecystitis:

There are multiple risk factors that include being a female, pregnancy and old age. But gallstones are the chief reasons for cholecystitis.

Myth #2: Removal of the gallbladder can lead to severe complications:

To live a normal and healthy life, a gallbladder isn’t required. The function of secreting the bile to the small intestine does not stop with the removal of this organ. The liver sends the bile, the digestive fluid, directly to the small intestine.

Myth #3: Fat has to be eliminated completely when cholecystitis affects:

Good fats or the unsaturated fats do not harm the body when taken in the right quantities. Taking fish, sardines, milk and tofu are in fact good for the health of the gallbladder. Even after the surgery to remove the gallbladder, 3 grams of fat is recommended per day.

Myth #4: Hormonal medications have nothing to do with the condition:

Cholecystitis can occur due to the medications that can control the hormonal balance. Estrogen content medications are one of the causes of the condition. Consuming them with the approval of the doctor is a must. When affected by this condition, again, stopping them without the consent of the doctor is a big red flag.

Myth #5: The gallbladder cannot be removed during pregnancy:

While the surgery is not preferred during the pregnancy, medical science ensures safer removal of the organ is not impossible when the pregnant women experience pain and unbearable discomfort.

Conclusion

If you or anyone you know to experience any of the symptoms of Cholecystitis, you must not ignore them. The disease could lead to further complications if left untreated. You must contact your doctor in case you experience any of the symptoms given above. In addition to this, you must avoid food items that have high cholesterol content, confectioneries and fatty foods in order to avoid the formation of gallstones.

Last updated on : 21-09-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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