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Cholecystitis
Does acute cholecystitis require hospitalization?
Patients with acute cholecystitis often have a history of gallstones or gallbladder polyps. An acute attack of cholecystitis can be triggered by inattention to diet or other reasons, such as unclean food. If the patient's abdominal pain is not severe, they can be advised to rest in bed and take oral anti-inflammatory and bile-promoting medications. If the patient experiences significant upper abdominal pain, accompanied by fever and other discomforts, and the abdominal pain persists and radiates to the back, it is recommended that the patient be hospitalized. During the hospital stay, it is essential to ensure the patient eats and receives clinical infusions, as well as complete relevant examinations.
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.
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.
Is rib pain gallblitis?
The gallbladder is located in the upper right abdomen, at the intersection of the midpoint of the right costal margin and the costal arch, near the midclavicular line. If there is tenderness in this area, it indicates a positive Murphy's sign. Usually, an ultrasound can reveal whether there is gallbladder wall thickening or a rough surface. Additionally, the ultrasound can detect gallstones or bile duct stones. Furthermore, a complete blood count should be performed to check for elevated white blood cells, which could indicate acute suppurative cholangitis. This condition may present with fever, positive Murphy's sign, Charcot's triad or pentad, and all require ultrasound for differentiation. Rib pain is mostly related to trauma, strain, or localized pressure during sleep, such as from a pillow corner, ashtray, or remote control. It can also be associated with costochondritis or intercostal neuralgia, and breathing heavily or coughing may cause pain. To confirm a diagnosis of cholecystitis, an ultrasound and a complete blood count should be performed.
Is cholecystitis hereditary?
Cholecystitis is an inflammation of the gallbladder, which is related to dietary habits in our daily lives. For example, people who particularly enjoy oily foods, or generally eat in large quantities, or have irregular eating habits, such as those who often skip breakfast and eat meals inconsistently, are prone to developing cholecystitis. If we consider cholecystitis on its own, it actually does not have a genetic predisposition. However, cholecystitis is often seen in individuals who are obese and have irregular lifestyles, and such traits can typically be related to family habits. For instance, if parents and grandparents are overweight, their children are also likely to be overweight. Similarly, if one's lifestyle is irregular, characterized by inconsistent meals, it might be a reflection of the family's general irregular lifestyle. Therefore, children of parents who suffer from cholecystitis are also more likely to suffer from the condition, not due to genetics, but due to their body type, dietary habits, and family lifestyle practices.
How to Diagnose Cholecystitis
The definitive diagnosis of cholecystitis mainly involves the following aspects: First, clinical manifestations are crucial. The most common symptoms include nausea, vomiting, abdominal distension, and loss of appetite. Regarding physical examination, there is typically pain in the lower right abdomen and mid-lower right abdomen, with tenderness upon palpation. Furthermore, the onset of cholecystitis is characterized by postprandial pain, particularly after consuming fatty foods or feeling overly full. If these symptoms are present, further examination such as gallbladder ultrasound can be conducted to check for thickening of the gallbladder wall. Additionally, blood tests for inflammatory markers like complete blood count and CRP (C-reactive protein) can be performed. The diagnosis of cholecystitis can be confirmed by combining these symptoms and test results.
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.
What are the symptoms when there are problems with the gallbladder?
Gallbladder issues, specifically symptoms of cholecystitis, mainly include chills, fever, persistent dull pain in the upper right quadrant of the abdomen, episodic colic pain that radiates to the right shoulder and back, and may also be accompanied by jaundice, dark urine, nausea, vomiting, and constipation. Patients with cholecystitis often experience sudden pain at night, typically due to overeating or consuming greasy foods. Once cholecystitis occurs, it is advised to seek medical attention at a regular hospital as soon as possible, complete the relevant diagnostic tests, such as imaging studies of the abdomen, consider surgical treatment, and engage in active anti-infection treatment.
Where to massage for symptoms of gallblitis pain?
Gallbladder inflammation pain requires massaging the upper right abdomen, also known as the Murphy's point. The symptoms of gallbladder inflammation primarily include chills, fever, jaundice, pain, etc. Once a gallbladder inflammation attack occurs, it is necessary to promptly complete the relevant auxiliary examinations to determine the cause of the disease. Treatment should be based on the cause, and surgical treatment may be necessary when needed. The main causes of gallbladder inflammation include biliary infection, bile stasis, and biliary stones, etc. Patients with gallbladder inflammation should have a light diet and avoid greasy food.
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.