Cholecystitis is an inflammation of the gallbladder, an organ which is responsible for concentrating the bile used in digestion. Individuals with cholecystitis experience pain in their upper right abdomens, and they can also develop symptoms such as nausea. Treatment for this condition varies, depending on the cause, but most classically the gallbladder is removed from the patient.
The most common type of cholecystitis is caused by choleliths, also known as gallstones. These small pieces of material can block the ducts which drain the gallbladder, allowing a buildup of bile and causing the walls of the gallbladder to become inflamed. Bacteria from the gut can also enter the gallbladder, causing infection, and if the condition is allowed to persist, inflammation can spread to the surrounding abdominal organs.
In acalculous cholecystitis, no choleliths are present, and the inflammation is caused by something else. Decreased blood supply to the gallbladder, as sometimes happens in diabetics, can cause inflammation, as can a buildup of gallbladder sludge. Trauma patients or severely ill patients can also develop inflamed gallbladders.
The condition is classified as either acute, meaning that it has only happened once, or chronic, meaning that the inflammation has been sustained and persistent. In both cases, gallbladder inflammation is diagnosed after a physical exam reveals abdominal tenderness, and medical imaging shows that the organ is inflamed. Once the cause has been determined, the doctor can discuss treatment options.
People with this condition usually need to be hospitalized. They are typically given antibiotics and drugs to manage the inflammation. In some cases, drugs can be used to break up the gallstones and resolve the condition. In other instances, it may be necessary to perform a cholecystectomy, in which the gallbladder is removed. If the patient is not stable enough for surgery, tubes may be inserted to drain the gallbladder and the patient will be given supportive care until he or she stabilizes and more long term cholecystitis treatment can be offered.
After a gallbladder removal, a patient will be given care instructions so that he or she understands how to live without the gallbladder. Patients usually need to make dietary modifications, and they may need to take certain medications to manage without their gallbladders. Bile is still accessible to the digestive tract, because it is produced by the liver, but certain digestive activities can be hampered by the lack of a reservoir of bile which is normally held in the gallbladder.
