Cholecystitis, or gallbladder disease, is the inflammation of the gallbladder. This condition can make the gallbladder become swollen and painful; it may also result in vomiting or digestive problems. Cholecystitis most often affects people of middle age. Without proper treatment, cholecystitis can lead to serious health issues.
On this page:
What Is Cholecystitis?
Doctors define cholecystitis as an inflamed gallbladder. The gallbladder is a small organ located below the liver. Its primary function is to produce bile, a liquid that helps break down fat. If the gallbladder’s opening is blocked, it can lead to a backup of bile in the gallbladder and create swelling and pain.
Cholecystitis is also referred to as gallbladder disease or an inflamed gallbladder.
How common is cholecystitis?
Gallbladder disease is very common. It is estimated that 10% to 20% of the world population will develop a gallstone at some point in their lifetimes, with about 80% of cases being asymptomatic. About 500,000 people undergo gallbladder removal surgery every year in the U.S. alone.
What causes cholecystitis?
Cholecystitis is caused by an obstruction or blockage at the gallbladder's opening. This blockage is typically caused by a gallstone — a mixture of cholesterol, calcium salts, and waste from the liver. Biliary sludge may also block the gallbladder. Sludge is a mixture of bile and small crystals like gallstones, but smaller. Many people have gallstones in their gallbladders, but they may not be large enough to cause blockage.
In more rare cases, gallbladder disease can be caused by:
- Infection that causes an abscess or scarring at the gallbladder’s opening.
- Injury from surgery.
- Growth of tumors or cancer in the gallbladder.
- Underlying health issues, including some autoimmune diseases where the immune system may attack the healthy cells of the gallbladder, creating scar tissue.
Cholecystitis risk factors
Because gallbladder disease results from a buildup of gallstones, any behavior that can lead to more gallstone production is a risk factor for cholecystitis.
Gallbladder disease risk factors include:
- Age – Cholecystitis is most common in middle-aged adults, especially those in their 40s. But it can occur in children, younger adults, and older adults.
- Feeding tubes and fasting – Prolonged feeding through a tube into the veins (IV feedings) or fasting can lead to gallstones and increased cholesterol levels. This combination can lead to gallstones that might block the gallbladder.
- Sex – Women make up 60% of people with acute gallbladder disease. Pregnant women are at higher risk of cholecystitis than non-pregnant women.
- Weight – People with obesity and those who eat a diet high in saturated fats are at increased risk of cholecystitis.
Complications of cholecystitis
In many cases, the signs and symptoms of gallbladder disease will go away on their own after only two or three days. But if they do not resolve, the risk of worsening complications increases.
If left undiagnosed, an inflamed gallbladder can lead to:
- A blockage in the small intestine.
- A gall bladder infection that could spread to the abdominal wall and other parts of the body.
- A tear in the wall of the gallbladder.
- Chronic gallbladder disease, where a lower degree of swelling and pain persists.
- Gangrene (dead tissue) and pus-filled sores in the gall bladder.
How can I reduce my risks of cholecystitis?
Much of gallbladder disease prevention can be attributed to eating a healthy diet. Gallbladder disease can stem from high levels of cholesterol, rapid weight loss, prolonged fasting, or cycling between losing and gaining weight. That’s why a healthy and consistent diet is key for prevention.
Some tips for a healthy diet include:
- Eating plenty of fruits, vegetables, beans, or other foods high in fiber, like whole grains, including brown rice, wheat bread, and oats.
- Consuming healthy fats like those found in fish or olive oil, which help the gallbladder contract and empty on a regular basis.
- Limiting refined carbohydrates and sugar.
- Staying away from unhealthy, saturated fats like those found in fried foods and desserts.
Be sure to talk with your doctor before making drastic changes to your diet, as rapid weight loss can lead to the production of gallstones, which may lead to gallbladder disease.
What Are the Signs and Symptoms of Cholecystitis?
Gallbladder disease symptoms include:
- Fever.
- Loss of appetite.
- Nausea and vomiting.
- Pain in the right side of the belly, which may spread to just below the right shoulder blade.
Most cases of gall bladder disease will improve on their own after just two to three days of symptoms. If symptoms of gallbladder disease persist for more than three days, be sure to contact your doctor immediately. Worsening pain and fever might be a sign of a severe issue, and your doctor may recommend removing your gallbladder.
When should I see a doctor about my Cholecystitis symptoms?
If your symptoms of gallbladder disease persist for more than three days, you should contact your primary care provider or go to the emergency room. In severe cases of cholecystitis, the gallbladder may need to be removed to avoid future complications.
How Do You Diagnose Cholecystitis?
Your doctor will begin by asking you about your symptoms.
If they believe you might have gallbladder disease, they might:
- Perform a physical exam -- Your doctor will gently press on your belly to find the origin of the pain.
- Take blood -- A blood test can reveal signs of an inflamed, infected, or diseased gallbladder. For instance, gallbladder disease will cause high levels of liver enzymes in the blood.
Tests to diagnose cholecystitis
If your doctor believes you have gallbladder disease, they might order some tests to confirm the diagnosis, including:
- Ultrasound — This painless test uses sound waves to show organs in the abdomen.
- CT or x-ray — Other types of imaging that use small amounts of radiation to show the body's organs.
- Hepatobiliary scan (HIDA scan) — This test requires a nurse or technician to insert a small amount of a radioactive chemical into the body. The scan will show how the chemical makes its way through the body, flowing through the liver and gallbladder before the body expels it.
How Do You Treat Cholecystitis?
The goal of treatment for cholecystitis is to prevent further damage to the gallbladder or the recurrence of inflammation or infection. Most treatments involve surgery for more serious cases, but minor cholecystitis can be managed with concerted changes in diet.
Nonsurgical treatment
- Dietary changes — A low-fat, low-spice diet can reduce the risk of repeated incidences of gallbladder disease. However, lifestyle changes often do not work well enough, and people often require surgery later. Doctors also recommend diet changes for people with a high risk of bleeding or other issues after gallbladder surgery.
Surgical treatment
- Laparoscopic gallbladder surgery – The surgeon makes small cuts in the abdomen rather than one large cut. Then they insert surgical tools through a small, flexible tube with a camera. The surgeon controls the tools to cut away the gallbladder and seal the opening in the liver and small intestine.
- Open gallbladder removal surgery – This technique is used when imaging shows that it might be difficult to reach the gallbladder through a more minimally invasive option or the abdomen requires cleaning to prevent infection. The surgeon will make one large cut and remove the gallbladder through traditional surgical techniques.
- Percutaneous cholecystectomy – If a patient is too ill for a gallbladder removal surgery, the doctor might suggest draining the gallbladder by using imaging techniques to insert a tube directly into the gallbladder.
How effective is treatment?
Removing the gallbladder will alleviate all symptoms of gallbladder disease and prevent the possibility of future complications of the gallbladder.
How long does it take to recover from cholecystitis surgery?
People who have had their gallbladder removed might experience softer and more frequent stools as bile can flow more freely into the intestine to break down food. This issue may only be temporary, and you should discuss such changes with your doctor. Recovery from gallbladder removal surgery may require a brief hospital stay for surgery, recovery, and monitoring
Having your gallbladder removed does not prevent the creation of gallstones. In fact, they may become more frequent and require medical attention to remove them. After-surgery therapy may include medication containing bile acids that can break down gallstones or shock therapy to break up the stones.
