Overview
Cholecystitis is a sudden or recurring inflammation of the gallbladder - the small pouch beneath your liver that stores digestive fluid (bile). When a gallstone blocks the exit, bile gets trapped. As pressure builds, the gallbladder swells and becomes painful.
When the inflammation develops suddenly, it is called acute cholecystitis. Some people have repeated episodes of inflammation over time. Cholecystitis treatment depends on how severe the condition is, whether the patient is facing complications and if they are well enough for surgery. Acute cholecystitis requires prompt hospital assessment and inpatient care.
Sarvodaya Hospital, one of the best hospitals for cholecystitis treatment, provides advanced diagnostic care and comprehensive treatment for gallbladder conditions through its gastroenterology department. Treatment may include surgery to remove the gallbladder when needed.
Symptoms of Cholecystitis
- Persistent pain in the upper right or centre of the abdomen.
- Pain spreading towards the right shoulder or back.
- Tenderness below the right ribs, sometimes worse with deep breathing.
- Nausea, vomiting or loss of appetite.
- Fever, sometimes sweating.
- Yellowing of the skin or the whites of the eyes (jaundice).
Causes of Cholecystitis
The main causes include:
- Gallstones: Hardened deposits in bile can block the tube through which the gallbladder empties.
- Biliary Sludge: Thickened bile can obstruct the gallbladder’s outlet.
- Severe Illness: Critical health conditions can reduce blood flow to the gallbladder or prevent it from emptying properly. This condition can cause inflammation without gallstones, called acalculous cholecystitis.
- Less Common Causes: Certain infections, scarring or tumours may interfere with bile drainage.
Risk Factors for Cholecystitis
Some factors increase the chance of gallstones, while others make gallbladder inflammation more likely or more serious:
- Existing Gallstones: In most cases, gallbladder inflammation starts with gallstones.
- Increasing Age and Family History: Gallstones become more common as age increases and may run in families.
- Pregnancy or Oestrogen Exposure: Hormonal changes can increase the likelihood of gallstone formation.
- Excess Weight or Rapid Weight Loss: Both can lead to stone formation.
- Diabetes: This may increase the risk of severe gallbladder complications.
- Critical Illness, Major Surgery or Serious Injury: These increase the risk of inflammation even without gallstones.
Diagnosis of Cholecystitis
The doctor asks when your symptoms began, checks for fever and jaundice, and examines your abdomen for tenderness when pressed.
Tests help confirm inflammation and identify any blockage or complications:
- Blood Tests: These help check for signs of inflammation or infection. Liver function tests help show whether bile is draining properly.
- Abdominal Ultrasound: Sound waves create pictures that show gallstones, thickening of the gallbladder wall or fluid around it. This is usually the first scan.
- Hepatobiliary Scan: A small amount of radioactive tracer is injected into a vein to follow bile flow. This can reveal a blocked gallbladder outlet when ultrasound findings are unclear.
- Magnetic Resonance Imaging: Detailed pictures of the bile ducts help identify stones outside the gallbladder when a duct blockage is suspected.
- Computed Tomography Scan: Detailed X-ray images may help detect complications or another cause of abdominal pain.
Cholecystitis Treatment Options and Supportive Care
Treatment depends on the cause, how severe the condition is and the person’s overall health:
- Fluids and Temporary Fasting: The doctor may ask the person to avoid eating and drinking for a short time. Intravenous (IV) fluids prevent dehydration while treatment is arranged.
- Pain Relief and Antibiotics: Medicines help control the pain. Antibiotics may be prescribed if a secondary bacterial infection is suspected or present, though they do not remove the underlying blockage.
- Laparoscopic Cholecystectomy: The surgeon removes the inflamed gallbladder through small cuts in the abdomen using a camera and surgical instruments.
- Open Surgery: A larger abdominal cut may be needed when severe inflammation, scarring or other difficulties make keyhole surgery unsafe.
- Gallbladder Drainage: If immediate surgery is too risky, a tube may drain trapped fluid from the gallbladder. Surgery can be reconsidered after the person’s condition improves.
- Bile Duct Stone Removal: Endoscopic retrograde cholangiopancreatography (ERCP) uses a flexible tube passed through the mouth into the small intestine to remove stones lodged in the main bile duct. This clears the blockage, though gallbladder removal is usually still required.
- Robotic-Assisted Cholecystectomy: In suitable cases, the surgeon may recommend removing the gallbladder using robotic instruments through small cuts in the abdomen. A magnified, three-dimensional view helps the surgeon see clearly and guide the instruments precisely. Compared with open surgery, the smaller cuts may help reduce pain and scarring and support a quicker recovery.
Because surgery removes the whole gallbladder (not just the stones), bile will simply flow directly from your liver into your small intestine. Your body continues to digest food normally.
Benefits of Early Cholecystitis Treatment
Timely assessment and treatment can:
- Relieve pain and control infection when present.
- Identify blocked bile ducts or other complications promptly.
- Reduce the risk of gallbladder damage or rupture.
- Reduce repeated attacks when gallbladder removal is appropriate.
Complications if Left Untreated
Ongoing inflammation can damage the gallbladder. If an infection develops, it may also spread to nearby tissues or the bloodstream.
Possible complications include:
- Pus Collection: Infection may cause pus to collect inside or around the gallbladder.
- Gangrene: Reduced blood supply can cause part of the gallbladder wall to die.
- Perforation: A tear in the wall can allow bile and infected fluid to leak into the abdomen.
- Peritonitis: Leakage can inflame or infect the lining inside the abdomen.
- Sepsis: A severe response to infection can damage organs and become life-threatening.
Complications can occasionally develop despite treatment, particularly when illness is already advanced. Continued monitoring is therefore important.
When Should You See a Doctor?
Book an appointment promptly for recurring pain or discomfort in the upper abdomen, even if it goes away between episodes. An experienced general surgeon can assess whether gallstones are causing the symptoms.
Seek emergency care for:
- Sudden, severe abdominal pain or pain persisting for several hours.
- Abdominal pain with fever, shivering or jaundice.
- Repeated vomiting or being unable to keep liquids down.
- Confusion, fainting or rapidly worsening weakness.
Do not wait for a routine appointment with a cholecystitis doctor if any of these warning signs occur.
Prevention & Lifestyle Modifications
Not every case can be prevented, but the following steps may help reduce the risk of gallstones:
- Avoid Crash Diets: If weight loss is needed, lose weight gradually and sustainably.
- Choose Fibre-Rich Foods: Include vegetables, fruit, pulses and whole grains in your diet.
- Eat Healthy Fats in Moderation: Cut back on greasy, deep-fried foods and excessive saturated fats, while keeping healthy fats in your diet.
- Stay Physically Active: Regular activity supports weight management.
While awaiting planned treatment, eating smaller meals and avoiding foods that trigger symptoms may help. Dietary changes cannot clear a blockage or treat an acute attack.
Pre-Post Treatment Care
Pre-Treatment
- Bring previous scan reports and share your medical history, including earlier bouts of pain or jaundice.
- Inform your doctor about all current medications, supplements, allergies, and existing health conditions.
- Complete all advised blood tests and pre-surgery evaluations on time.
- Follow instructions about fasting and medication changes.
- Discuss the planned surgery, its risks and expected recovery.
Post-Treatment
- Take prescribed medicines and follow wound or drainage-tube care instructions.
- Restart meals as advised; smaller portions may feel more comfortable initially.
- Begin gentle walking and increase activity gradually.
- Ask when to resume work, driving, exercise and heavy lifting.
- Attend all follow-up visits and inform your doctor if you experience persistent diarrhoea.
- Seek urgent medical care for fever, worsening pain, jaundice, repeated vomiting or fluid coming from the wound.
