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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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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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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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.

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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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Is hot compress effective for cholecystitis?

The main symptoms of cholecystitis include pain in the upper right abdomen and fever. If this occurs, applying heat to the painful area may temporarily relieve the pain, but it is merely a symptomatic treatment and not a cure, as cholecystitis is caused by an infection and requires antibiotic treatment. Therefore, the fundamental treatment is to reduce inflammation. Merely using heat for relief does not address the root of the disease. Thus, it is essential to receive treatment in a hospital, where a doctor can prescribe medication, which is the most effective and fundamental method.