Symptoms and Treatment of Cholecystitis

Written by Huang Ya Juan
Gastroenterology
Updated on September 25, 2024
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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.

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Written by Li Ying
Gastroenterology
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Is surgery necessary for cholecystitis with gallstones?

Gallstone cholecystitis primarily has several treatment methods, targeted towards symptomatic and asymptomatic treatments. These include medical treatment and surgical treatment. Not all cases of cholecystitis require surgery. For some asymptomatic gallbladder stones, treatments can be managed through dietary therapy, symptomatic treatment, and preventive treatment for those at high risk, including dietary adjustments or treatments that promote bile flow. Preventive gallbladder removal may be considered for those at high risk of gallbladder cancer. For symptomatic cases, the main goal is to control symptoms and primarily reduce inflammation. For chronic cholecystitis and gallstones, if there is no significant improvement with medical treatment, then surgical treatment may be considered.

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Written by Wu Hai Wu
Gastroenterology
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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.

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Written by Zhang Tao
Hepatobiliary Surgery
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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.

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Written by Zhang Tao
Hepatobiliary Surgery
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The difference between acute cholecystitis and chronic cholecystitis

Chronic cholecystitis clinically manifests as recurrent dull pain in the upper abdomen and biliary colic, which the patient can quickly relieve on their own; acute cholecystitis involves more severe pain that cannot be relieved without intervention, and is usually accompanied by fever, nausea, and vomiting. In chronic cholecystitis, pressing on the right upper abdomen elicits no special reaction; in acute cholecystitis, pressing on the right upper abdomen causes obvious pain, known as a positive Murphy's sign. Acute cholecystitis is accompanied by a significant increase in white blood cells, and an ultrasound can reveal a marked enlargement and thickening of the gallbladder wall; chronic cholecystitis does not show these specific characteristics.

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Written by Huang Gang
Gastroenterology
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How to treat gallbladder inflammation pain in women?

Women with cholecystitis causing pain, when the condition is more severe, can appropriately consume some antispasmodic and analgesic medications, and simultaneously use antibiotics for treatment, to alleviate these symptoms of pain. Normally, a light diet should be maintained, avoiding overly greasy foods. Smoking and alcohol should be quit, spicy peppers should not be consumed, and it is best to avoid fried foods or barbecued items. Regular attention to developing good dietary and lifestyle habits is necessary to manage the condition and reduce the likelihood of recurrent cholecystitis.