What should I do if cholecystitis does not improve?

Written by Wu Hai Wu
Gastroenterology
Updated on January 28, 2025
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If cholecystitis does not improve over time, it is crucial to actively identify the reasons behind this persistent issue. For instance, it could be due to improper diet, such as frequently consuming greasy foods or overeating. It might also be due to an acute exacerbation of chronic cholecystitis, or possibly because of the presence of polyps or stones in the gallbladder, which can lead to persistent cholecystitis. In such cases, it is important to pay closer attention to the diet, opting for lighter meals, and to take oral anti-inflammatory and bile-promoting medications for treatment. If necessary, gallbladder removal surgery may be required.

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Does cholecystitis hurt?

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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Written by Huang Ya Juan
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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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How to diagnose cholecystitis?

Firstly, we can use physical examination to check. Acute cholecystitis will show tenderness in the upper right abdomen. If pressing below the right ribs causes significant pain, it is likely to be acute cholecystitis. Secondly, instrument examination can be utilized, with the most common and cost-effective being an ultrasound examination. When examining cholecystitis, fasting is required; no food should be consumed for at least eight hours. Additionally, modern CT scans or MRI can be used to help determine whether there is inflammation in the gallbladder. Blood tests can also be conducted; an increase in white blood cells in a routine blood test can indicate the presence of inflammation.

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Does a woman's back hurt after gallblitis?

Women with cholecystitis generally do not experience back pain. Pain associated with cholecystitis may cause pain in the right shoulder. In addition to shoulder pain, patients with cholecystitis may also experience pain under the right ribs. Severe cases may also be accompanied by chills, fever, jaundice, dark urine, etc. It is necessary to promptly complete abdominal imaging studies, such as ultrasound, CT, MRI, etc., to clarify the diagnosis. Active anti-infection treatment is required, which may include third-generation cephalosporin antibiotics or fluoroquinolone antibiotics. If necessary, surgical treatment may also be required. (The use of medications should be under the guidance of a physician)

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Does acute cholecystitis fear cold?

Patients with acute cholecystitis may exhibit chills. Due to the acute inflammation of the gallbladder in patients with acute cholecystitis, symptoms such as chills, high fever, fatigue, and loss of appetite which are characteristic of systemic infections may occur. Additionally, patients may experience significant pain in the upper right abdomen, which tends to worsen after eating. In cases of acute cholecystitis, it is crucial to use antibiotics for anti-infection treatment as soon as possible. Only when the inflammation is controlled can the condition be alleviated. In cases where gallstones cause cholecystitis, surgical treatment should be employed promptly. A complete cure can only be achieved by surgically removing the gallbladder. Therefore, it is essential to take acute cholecystitis seriously and seek medical attention promptly to actively manage the condition and significantly improve the patient's prognosis.