Treating acute cholecystitis
If you’re diagnosed with acute cholecystitis, you’ll probably need to be admitted to hospital for treatment.
Initial treatment will usually involve:
- not eating or drinking (fasting) to take the strain off your gallbladder
- receiving fluids through a drip directly into a vein (intravenously) to prevent dehydration
- taking medicine to relieve your pain
You’ll also be given antibiotics if it’s thought you have an infection.
These often need to be continued for up to a week, during which time you may need to stay in hospital, or you may be able to go home.
After initial treatment, any gallstones that may have caused acute cholecystitis usually fall back into the gallbladder and the inflammation will often settle down.
Removing your gallbladder may be recommended at some point after initial treatment to prevent acute cholecystitis coming back and reduce your risk of developing potentially serious complications.
This type of surgery is known as a cholecystectomy.
Although uncommon, an alternative procedure called a percutaneous cholecystostomy may be carried out if you’re too unwell to have surgery.
This is where a needle is inserted through your tummy to drain away the fluid that’s built up in the gallbladder.
If you’re fit enough to have surgery, your doctors will decide when the best time to remove your gallbladder is.
In some cases you may need to have surgery immediately or in the next day or 2, or it may be necessary to wait a few weeks until the inflammation has settled down.
Surgery can be carried out in 3 ways:
- laparoscopic cholecystectomy – a type of keyhole surgery where the gallbladder is removed using special surgical instruments inserted through a number of small cuts in your abdomen
- single-incision laparoscopic cholecystectomy – where the gallbladder is removed through a single cut, which is usually made near the bellybutton
- open cholecystectomy – where the gallbladder is removed through a single larger cut in the tummy
Although some people who have had their gallbladder removed have reported symptoms of bloating and diarrhoea after eating certain foods, it’s possible to lead a perfectly normal life without a gallbladder.
The organ can be useful, but it’s not essential as your liver will still produce bile to digest food.
Find out more about recovering from gallbladder removal
What is gallbladder disease?
Gallbladder disease includes inflammation, infection, stones or blockage of the gallbladder. The gallbladder is a sac located under the liver. It stores and concentrates bile produced in the liver. Bile aids in the digestion of fat and is released from the gallbladder into the upper small intestine in response to food (especially fats). Types of gallbladder disease include:
- Cholecystitis (inflammation of the gallbladder)
- Chronic acalculous gallbladder disease (in which the natural movements needed to empty the gallbladder do not work well)
- Gangrene or abscesses
- Growths of tissue in the gallbladder
- Congenital defects of the gallbladder
- Sclerosing cholangitis
- Tumors of the gallbladder and bile ducts
The mildest and most common symptom of gallbladder disease is intermittent pain called biliary colic. Typically, a patient experiences a steady gripping or gnawing pain in the upper right abdomen near the rib cage, which can be severe and can radiate to the upper back. Some patients with biliary colic experience the pain behind the breastbone. Nausea or vomiting may occur.
Between 1 percent and 3 percent of people with symptomatic gallstones develop inflammation in the gallbladder (acute cholecystitis), which occurs when stones or sludge block the duct. The symptoms are similar to those of biliary colic but are more persistent and severe. They include pain in the upper right abdomen that is severe and constant and may last for days. Pain frequently increases when drawing a breath. About a third of patients have fever and chills. Nausea and vomiting may occur.
Chronic gallbladder disease involves gallstones and mild inflammation. In such cases, the gallbladder may become scarred and stiff. Symptoms of chronic gallbladder disease include complaints of gas, nausea and abdominal discomfort after meals and chronic diarrhea.
Stones lodged in the common bile duct can cause symptoms that are similar to those produced by stones that lodge in the gallbladder, but they may also cause:
- Dark urine, lighter stools or both
- Rapid heartbeat and abrupt blood pressure drop
- Fever, chills, nausea and vomiting, with severe pain in the upper right abdomen
- Blood tests
- Ultrasound and other imaging techniques
Surgery may be warranted to remove the gallbladder if the patient has gallstones or the gallbladder is not functioning normally. Most of the time this can be performed laparoscopically (through small incisions) as an outpatient procedure.
The gallbladder is small sac that lies underneath the liver which is connected to the main bile duct through the cystic duct. Its main role is to act as sort of a reservoir for bile. Bile is produced by the liver where it then travels down through a series of tiny tubes known as bile ducts which eventually coalesce together to form the main bile duct. The bile is in a state of constant flow between the liver through the main bile duct and into the duodenum ( the lower gut) where it is used to help process fat. When we eat, the gallbladder contracts, and the bile within is then pumped into the bile duct systems and onto the duodenum where it helps with the digestion process.
Gallstones are pretty much what happen to bile when it transforms from its normally fluid state into a solid. These stones generally contain bits of hardened cholesterol like substance and the occasional bile pigment or calcium deposits. Gallstones can come in many different types, from multiple small stones to one large stone, or a mix of both.
Epidemiologists consider gallstones a pretty common occurrence whether they are symptomatic or asymptomatic. One out of three women and one out of seven men will form gallstones at some point in their lives with certain risk factors (age, pregnancy, obesity, and certain drugs) associated with their formation. A rare type of anemia called hemolytic anemia and certain blood borne infections can also cause gallstones to form. People who are vegetarians and moderate drinkers have a less likely to form gallstones than other groups.
Most people who have gallstones will not ever know that they have them unless they happened to go in for a scan or x-ray of their abdomen for another reason. Most gallstones will sit in the gallbladder and not cause any types of symptom and if you happen to have gallstones, chances are you will not need treatment for them. That being said, three out of ten people with gallstones do experience symptomatic gallstones.
Symptoms of gallstones
Biliary colic: Biliary colic is intermittent pain(colic) that originates in the gallbladder (biliary. This pain is usually felt where the gallbladder sits which on the right side of the upper abdomen right below the rib cage. It is usually a distressingly sharp pain that is caused by a gallstone getting stuck in the cystic duct which goes away when the stone falls back into the gallbladder. This pain generally comes after eating a hearty meal that is laden with fat. The fat from the meal enters the duodenum thus stimulating the gallbladder to contract hence causing the stone to become jammed in the cystic duct. The pain can last for several minutes to an hour.
Cholecystitis: Cholecyctitis mean inflammation of the gallbladder which can occur when the gallbladder is infected. Fevers, constant pain in the upper abdomen, nausea, vomiting, and just plain feeling unwell are the common symptoms of cholecyctitis. If this happens, it is usually necessary to remove the gallbladder.
Jaundice: Jaundice refers to the yellowing of the skin and the whites of the eyes due to bile build up in the blood stream. This occurs when the stones get out of the gallbladder and wind up getting stuck in the main bile duct forcing the bile to move in the opposite direction ultimately seeping into the bloodstream. If this happens, then a procedure called a ERCP is needed in order to get the stones out of the way.
Other symptoms that might occur include pancreatitis which is the inflammation of the pancreas and cholangitis which is the inflammation of the main bile duct.
While most cases of gallstones present little or no symptoms and can be left alone, some do require treatment in the form of surgery or medication.
Laparoscopic cholecystectomy, also known as a keyhole surgery, may be needed in order to remove the gallbladder from the patient. The surgeon will need to make several small cuts in the abdomen leaving a few scars for the patient to deal with. Like the appendix, the gallbladder is a organ that is not necessarily needed.
Medication: there are medications that can help control pain and fight of the infections that may occur with gallstone disease, but there are none that can actually cure gallstones, making surgery the preferred method of treatment.
GALLSTONE DIETS MAKE SENSE What you decide to put into your body helps determine your general health and well being. When you eat or drink too many things that are bad for you, oftentimes it will lead to sickness and disease which might end up cutting your life short.
For the last several decades, poor lifestyle and diet choices have caused more people to develop gallstones. This in turn, leads to more costly surgeries which are the only way to treat gallstones once they develop. However, it would make more sense (and cents) to merely prevent gallstones from developing in the first place with an effective gallstone diet regime.
Gallstones are formed when too many minerals start to accumulate inside the gallbladder. The gallbladder is an important part of the digestive system, storing up bile from the liver along with alkaline liquid which is used in digestion.
If you are diagnosed with a gallstone problem, here is some dietary advice that can help save from going under the knife to get your gallbladder worked on.
One of the best ways to keep gallstones from forming is to consume a lot of dietary fiber in order to help your digestive system function efficiently. Whole grain bread and cereals, bran flakes, muffins, bagels, corn bran muffins, whole grain pastas and brown rice are all loaded with dietary fiber.
Fruits and Veggies
Foods that are rich in water soluble fiber are also important to have and fruits and vegetables are the way to go for this dietary requirement. Grapes, fresh grape juice, apples, apricots, strawberries, raspberries, guavas, figs, oranges, lemons, currants, pears, avocados, raisins, dates and prunes are all great examples of fruits you should be eating.
Broccoli, green beans, kidney beans, lima beans, dried peas and artichokes are all examples of vegetables that happen to be rich in water soluble fiber. Fresh vegetable juices are also good for you especially cucumbers and beets, however, be sure to stay away from juicing cabbage.
Water is one of the most important substances that you can intake and the thing that you digestive system needs in order to run smoothly. Water will also helps your gallbladder and kidneys flush wastes on a more consistent basis.
Foods to avoid
If you are suffering from gallbladder problems, there are certain foods that you should keep your self away from. Pork, eggs, poultry, onions, beans that are not green, nuts and fried or fatty foods should be limited. You should also cut down on drinking milk, coffee, and alcohol. Salty foods, processed food, and sugary foods should also be cut out.
Gallstones with Biliary Colic
Your abdominal pain due to irritation and spasm of the gallbladder. This is called biliary colic. The gallbladder is a small sac under the liver, which stores and releases a bile. Bile is a fluid made in the liver that aids in the digestion of fat. A collection of crystals may form stones inside the gallbladder (gallstones). Gallstones can cause the gallbladder to spasm. If they block the duct out of the gallbladder, they can cause pain and even an infection.
A number of factors increase the risk for having gallstones:
- Being female
- Being severely overweight (obese)
- Older age
- Losing or gaining weight quickly
- Eating a high-calorie diet
- Being pregnant
- Taking hormone therapy
- Having diabetes
- Rest in bed.
- Drink only clear liquids until you feel better.
- You may have been prescribed medicine for pain or nausea. Take these as directed.
- Fat in your diet makes the gallbladder contract and may cause increased pain. Don’t eat foods that are high in fat (such as full-fat dairy, fried foods, and fatty meats) for at least 2 days.
- If you are overweight, talk to your healthcare provider about losing weight.
Follow up with your healthcare provider or as advised. There is a chance that you will have another episode of pain from your gallstones at some point. Removal of the gallbladder is an option to prevent this. Talk with your healthcare provider about your treatment options.
When to seek medical advice
Call your healthcare provider if any of the following occur:
- Worsening pain or pain lasting for longer than 6 hours
- Pain moving to the right lower belly
- Repeated vomiting
- Swollen belly
- Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider
- Very dark urine, light colored stools, or yellow color of the skin or eyes
- Chest, arm, back, neck or jaw pain
Date Last Reviewed: 3/1/2018