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Cholecystitis (Gallbladder Disease) Causes, Symptoms, and Treatments

Cholecystitis is when the gallbladder becomes swollen and painful. Other names are gallbladder disease or an inflamed gallbladder.

It can cause digestive problems like vomiting and most often affects people in middle age.

In most cases, doctors suggest surgery to remove the gallbladder when it's inflamed or infected. Without treatment, gallbladder disease can lead to serious health issues.

Search our provider directory and schedule an appointment with a UPMC Digestive Health Care expert close to you or call 1-866-442-7876.

What Is Cholecystitis?

Doctors define cholecystitis as an inflamed gallbladder.

The gallbladder is a small organ below the liver. It stores bile, a liquid that helps to break down fat.

When the gallbladder opening gets blocked, bile can back up in the gallbladder, leading to swelling and pain.

About 500,000 people have gallbladder removal surgery in the U.S. each year due to this disease.

What causes cholecystitis?

In 95% of cases, one of the following blocks the opening of the gallbladder:

  • Gallstones. These are solid pieces in bile, mostly made up of a waxy substance called cholesterol. They can also contain waste from the liver and calcium salts. Many people have gallstones, but the stones don't often block the gallbladder's opening.
  • Biliary sludge. This is a mix of bile and crystals like gallstones but smaller.

More rarely, gallbladder disease happens for other reasons, such as:

  • Underlying health issues, including some autoimmune diseases. The immune system may attack healthy cells in the gallbladder, creating scar tissue.
  • The growth of tumors or cancer in the gallbladder.
  • An infection that causes an abscess or scarring at the gallbladder's opening.
  • Injury from surgery.

What are the risk factors and complications of cholecystitis?

Inflamed gallbladder risks

Gallbladder disease risks include:

  • Age. It's most likely to occur in middle age, especially in one's 40s. But it can occur in children, younger adults, and older adults.
  • Weight. People who are obese and those who eat a diet high in saturated fats are more at risk.
  • SexWomen make up 60% of people with acute gallbladder disease. Pregnant women have a higher risk of getting the disease than non-pregnant women.
  • Feeding tubes and fasting. Prolonged feeding through a tube into the veins (IV feedings) or fasting can also lead to gallstones. Both of these issues can cause increases in cholesterol levels.

Cholecystitis complications

In many cases, the signs of gallbladder disease will go away on their own after two or three days. But, people with cholecystitis risk having more problems if it doesn't resolve.

An untreated, inflamed gallbladder can also lead to:

  • Chronic gallbladder disease, where a lower degree of swelling and pain persists.
  • A tear in the wall of the gallbladder.
  • A gallbladder infection. Infections can spread to the abdominal wall and other parts of the body.
  • A blockage in the small intestine.
  • Gangrene (dead tissue) and pus-filled sores in the gallbladder.

Search our provider directory and schedule an appointment with a UPMC Digestive Health Care expert close to you or call 1-866-442-7876.

Cholecystitis Symptoms and Diagnosis

What are the signs and symptoms of cholecystitis?

Signs of an inflamed gallbladder can include:

  • Pain in the right side of the belly, which may spread to just below the right shoulder blade.
  • Nausea and vomiting.
  • Fever.
  • Loss of appetite.

In many cases, the symptoms will get better on their own in two to three days.

If pain and fever get worse, that's likely a sign of a severe issue. Doctors may suggest removing the gallbladder soon after diagnosis to avoid more problems.

How do you diagnose cholecystitis?

Doctors will ask you about your symptoms.

If your doctor thinks you might have gallbladder disease, they'll also:

  • Do a physical exam. They'll gently press on your belly to find out where the pain is.
  • Draw blood. Blood tests can reveal signs of an inflamed, infected, or diseased gallbladder. For instance, gallbladder disease can cause high levels of liver enzymes in the blood.
  • Order an ultrasound. This painless test uses sound waves to show organs in the abdomen. If it's inconclusive, they'll use other imaging tests, such as a CT scan or X-ray. These tests use small amounts of radiation to see organs in the body.

Doctors also may suggest a hepatobiliary scan (called a HIDA scan).

In this test, a nurse or technician inserts a small amount of a radioactive chemical into the body. A scan shows how the chemical flows through the liver and gallbladder before the body expels it.

Search our provider directory and schedule an appointment with a UPMC Digestive Health Care expert close to you or call 1-866-442-7876.

How Do You Treat Cholecystitis?

In most cases, doctors suggest surgery to remove the gallbladder. The risk of problems from gallbladder disease is higher than the risk of surgery.

While the gallbladder helps with digestion, you can live without it.

Some people must reduce high-fat and spicy foods after gallbladder surgery to avoid cramping or other symptoms.

Laparoscopic gallbladder surgery

Most often, gallbladder removal surgery is laparoscopic or minimally invasive.

During laparoscopic gallbladder surgery, your surgeon will:

  • Make small, minor cuts in the stomach rather than one large cut.
  • Insert tiny surgical tools through a small flexible tube with a camera.
  • Control the tools to cut the gallbladder away and seal the openings in the liver and small intestine.

Open gallbladder removal surgery

Sometimes people require open surgery to remove their gallbladder through one large cut.

Imaging tests may reveal that the surgeon will have trouble accessing the gallbladder using the minimally invasive technique.

Or, doctors may suggest open surgery if they need to clean the abdominal area to avoid infection.

Percutaneous cholecystostomy

Rarely the surgeon needs to drain the gallbladder by inserting a tube directly into it.

Imaging techniques allow the doctor to guide the tube in place.

Doctors may suggest this if you're temporarily too ill for gallbladder removal surgery.

Diet changes

Doctors suggest diet changes for people with a high risk of bleeding or other issues stemming from the surgery. A low-fat and low-spice diet can reduce the risk of repeated incidences of gallbladder disease.

Lifestyle changes often don't work, and people often require surgery later anyway.

Contact Us

Search our provider directory and schedule an appointment with a UPMC Digestive Health Care expert close to you or call 1-866-442-7876.