The gallbladder is a small sac located under the liver. It stores bile that the liver makes and squirts bile into the bowel (intestine) when a meal is eaten. Bile helps digest fats in the food. Cholecystitis is inflammation of the gallbladder. It’s often called a gallbladder attack. Cholecystitis is usually caused by gallstones that get stuck in the duct (tube) that takes bile from the gallbladder to the bowel.
Cholecystitis is usually caused by gallstones (called cholelithiasis) but it can also be related to problems with bile being made or stored in the gallbladder. This other type is called acalculous, meaning without calculi (stones). Other causes are sickle cell disease, infections, and diabetes. The acalculous type is found more often in older men, very sick people, or bedridden elderly people. Other risk factors for cholecystitis are like those for gallstones. They include age, female sex, certain ethnic groups (such as Native Americans), obesity, fasting, high-fat diet, losing and gaining weight excessively, drugs, and pregnancy.
The most common symptoms are pain and cramping in the upper right side of the abdomen (belly). Pain in the chest, upper back, or right shoulder may also occur. Pain is worse with breathing in or moving or when pressure is on the area. Belching, nausea, and vomiting can occur, usually after eating high-fat foods. Low temperature, yellow skin and whites of the eyes, pale stools (bowel movements), and itchy skin may occur if the main duct bringing bile to the intestines is blocked by a stone. An infected gallbladder may cause high temperature and chills.
The health care provider makes a diagnosis from a medical history and physical examination. X-rays, blood tests, and ultrasonography will confirm it. When ultrasonography shows unclear results, the health care provider uses a special x-ray test (HIDA scan).
For treatment, the gallbladder and gallstones are removed by surgery (cholecystectomy). Laparoscopic removal is the usual method. It allows shorter recovery and can be an outpatient surgery. For laparoscopic removal, the surgeon makes four tiny cuts in the abdomen. The surgeon uses instruments through these cuts to remove the gallbladder. If laparoscopic surgery cannot be used, standard surgery is done, which will require a prolonged hospital stay.
Removing the gallbladder doesn’t affect normal living, except for occasional indigestion when eating fatty foods for 6 to 12 months after gallbladder removal. This problem usually goes away.
Drugs can also be used to dissolve stones, but medicines can take months or years to work and are only rarely used.
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