Does cholecystitis hurt?

Written by Zhao Xin Lan

Endocrinology

Updated on September 12, 2024

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Whether cholecystitis is painful depends on the nature of the inflammation. If it is acute cholecystitis, it often causes severe pain in the gallbladder area, which is persistent and accompanied by chills, fever, poor spirit, loss of appetite, and even jaundice. If it is chronic cholecystitis, there may not be obvious symptoms of gallbladder pain. However, it can lead to an acute attack of chronic cholecystitis under the conditions of chills, high-fat diet, or other causes, which then causes pain in the gallbladder area.

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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.

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How is cholelithiasis cholecystitis treated?

The treatment of cholecystitis with gallstones is divided into two main categories. The first category refers to the treatment of asymptomatic gallstone cholecystitis, as well as symptomatic treatment. For asymptomatic cases, treatment can include dietary management for chronic, symptom-free cholecystitis, including those with gallstones. In symptomatic cases, the treatment focuses on improving gallbladder function and symptomatic relief. Dietary treatment mainly suggests regular meals without overeating, promoting a regular eating pattern. The second method is to use medication to improve gallbladder function, and preventive gallbladder removal can also be considered. For symptomatic cases, the primary goal is to control symptoms and reduce inflammation, mainly through medication. If medical treatment is not effective, surgical options may be considered.

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Location of pain in female cholecystitis

The main symptoms of cholecystitis include upper abdominal pain. Mild cases generally are limited to the upper abdomen, while severe cases may affect the entire body, and 70% of patients with cholecystitis do not show any symptoms. The early symptoms of cholecystitis can suddenly manifest as severe colicky pain in the upper right abdomen, which can also radiate to the right shoulder and back. These symptoms are generally triggered by consuming a large amount of fatty foods and are more likely to occur at night. If the condition progresses, the pain becomes persistent and progressively worsens, and may also be accompanied by mild to moderate fever. Some patients may experience chills and high fever, indicating that the condition is very severe.

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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.

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Symptoms of acute cholecystitis

Acute cholecystitis is a relatively common digestive system disease in clinical practice, often triggered by the presence of gallstones, leading to acute inflammation of the gallbladder. When an acute cholecystitis attack occurs, it typically presents as pain in the upper right abdomen, accompanied by fever, and sometimes nausea and vomiting, similar to symptoms of gastric discomfort. Additionally, if a gallstone falls and lodges in the cystic duct, or even in the common bile duct, it can cause jaundice, as indicated by the yellowing of the skin and sclera. During a physical examination, it might be possible to detect tenderness in the upper right abdomen, or even rebound tenderness. Another possible positive sign could be Murphy's sign, which are all common manifestations of acute cholecystitis.