What is cholecystitis?
The gallbladder is a small, pear-shaped sac under the liver that stores bile. Bile is a greenish-brown liquid made in the liver and helps to digest food in the intestine. Cholecystitis is inflammation or swelling of the gallbladder. Cholecystitis can be acute or sudden in onset; or present for a long time or chronic.

In acute cholecystitis, there is extreme pain in the right upper part of abdomen, just beneath the ribs. The pain is constant and is usually made worse by moving.

How does it occur?
Acute cholecystitis is usually caused by a gallstone blocking the gallbladder outlet, preventing bile to get out. As a result, the bile becomes concentrated and sometimes stagnant and infected. This leads to irritation and swelling of the gallbladder, causing severe pain. Repeated attacks of acute cholecystitis cause permanent damage to gallbladder walls, leading to chronic cholecystitis.

What are the symptoms?
In acute cholecystitis, the main symptom is severe, constant pain under the right ribs that becomes worse on moving. Fever and sometimes jaundice may also be present. The gallbladder may burst if untreated, causing infection and inflammation of the abdominal cavity. In chronic cholecystitis, the symptoms include indigestion, pain in the right upper abdomen, nausea, and belching. Eating fatty foods often worsens the symptoms.

How is it diagnosed?
Acute cholecystitis is suspected from the characteristics of the pain and from the examination. A history of acute attacks, their symptoms, and the patient’s examination will suggest chronic cholecystitis.

Investigations like Ultrasound scanning and X-rays are used to confirm the diagnosis and for ruling out other possible causes. Blood tests may be used to look for signs of infection, obstruction, pancreatitis, or jaundice.

What is the treatment?
Usually hospital admission is required. Painkillers, antibiotics, and intravenous (IV) fluids are given until the diagnosis is confirmed.

The cholecystitis settles down in most cases without immediate surgery. Since it is likely that an attack of cholecystitis will happen again or the gall stone complication can occur, removal of the gallbladder (cholecystectomy) is recommended after the attack settles down. The surgical removal of the gall bladder is increasingly being done by laparoscopy. This involves a special tube with a light and camera being introduced into the abdomen to perform the surgery with minimal injury to the surrounding tissues.

How can cholecystitis be prevented?
Overweight individuals have a tendency to develop gallstones. Therefore, weight should be reduced if more than normal. Do not fast for weight reduction as it encourages gallstone development. Get plenty of exercise and enough rest.
 

  Global Health

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