What is cholecystitis, causes, types, treatments and prevention

What is

Cholecystitis is an inflammation of the gallbladder and develops, in most cases, when a person has gallstones – popularly known as gallstones.

The gallbladder is a small organ located just below the liver and its function is to temporarily store bile, a liquid produced by the liver that digests the fats ingested by us. When gallstones are present in the gallbladder, they can come off and block the cystic duct (channel where the bile leaves the gallbladder), causing the liquid to be “trapped” there.

The accumulation of bile in the gallbladder, together with a possible bacterial infection, can lead to inflammation of the organ, thus causing cholecystitis.

Causes

The disease can be caused by two factors: the accumulation of gallstones in the gallbladder and complications from any disease.

Calculous cholecystitis

Calculous cholecystitis is, in 90% of cases, the cause for the individual’s cholecystitis. As explained above, the inflammation happens, in this case, due to the accumulation of bile in the gallbladder.

In some cases, the infection can also be caused by the presence of some bacteria, in addition to the chemical substances that bile contains. When the trigger for the infection is this, you have to be very careful, as the disease can suffer serious complications – and you will know which ones are later.

Non-calculous cholecystitis

In cases of the disease that are not caused by the presence of gallstones, the inflammation comes from serious diseases or inflammation of the gallbladder, such as:

  • Accidental damage to the gallbladder through surgery;
  • Serious burns located in the region;
  • Blood poisoning;
  • Severe malnutrition;
  • Presence of the HIV or AIDS virus.

Groups of risk

Experts estimate that at least 20% of women and 8% of men over 40 have gallstones, so they are therefore at risk of developing cholecystitis.

The risks for the formation of these calculations are greater in the following groups:

  • Men and women who are between 40 and 60 years old;
  • Pregnant women or women who have had several pregnancies;
  • Women who are on hormone replacement or use birth control pills;
  • Obese people;
  • People who lost weight quickly;
  • People who have a high fat diet.

Types

Cholecystitis can be divided into two categories: acute and chronic. The two types are differentiated according to the intensity and frequency with which the pain is felt.

Acute cholecystitis

This type of cholecystitis occurs suddenly, accompanied by a very severe pain in the upper part of the abdomen, which usually lasts between 6 to 8 hours.

Chronic cholecystitis

Chronic cholecystitis is characterized by repeated attacks of pain that occur when gallstones periodically block the cystic duct. In such cases, an urgent visit to a hospital is of utmost importance.

Symptoms

Symptoms do not always happen in all patients diagnosed with the disease. An example is when the elderly or young children develop it, as it is, in most cases, asymptomatic.

However, when symptoms appear, they are similar in both types of cholecystitis and intensify with the intake of fatty foods.

Symptoms of acute cholecystitis

The most common and typical symptoms of acute cholecystitis are:

  • Severe pain in the right side of the abdomen;
  • Fever generally low (38 ° C);
  • Anorexia;
  • Sickness;
  • Vomiting;
  • Jaundice (yellowing of tissues).

Symptoms of chronic cholecystitis

The symptoms of this type of disease consist of those of acute cholecystitis, but with less intensity and greater persistence.

Diagnosis

When the patient has severe abdominal pain, he should immediately seek a gastric surgeon to check whether these symptoms are cholecystitis or not.

For the diagnosis, the doctor performs several types of exams, since only one of them is not enough to prove the disease.

Physical exam

First, the doctor will perform a simple test on you, called the Murphy sign. The test consists of breathing slowly while the doctor rests his hand firmly on your abdomen. If you have cholecystitis, you will feel pain when your gallbladder comes into contact with the doctor’s hand.

Blood test

Your doctor may order a blood test to find out if you have a greater amount of white blood cells in your body, as this indicates that there is some inflammation present in your body.

Ultrasound

If the first two tests are positive, you will most likely be referred for an ultrasound, so that cholecystitis is confirmed accurately by the exam.

Treatment

If, after the whole process of diagnosis, you really have cholecystitis, your doctor will most likely admit you to perform the appropriate treatment for the disease. The most appropriate is the removal of the gallbladder, but antibiotics are also administered, even before surgery.

Antibiotics

First, you will receive antibiotics, intravenously, so that your symptoms are stabilized. In such cases, broad-spectrum antibiotics are used . When the symptoms have stabilized, you can go home and return to the hospital just for surgery – if similar symptoms do not affect you again, of course.

Attention! 

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Surgery

Called a cholecystectomy, the surgery consists of removing the gallbladder from your body. For this, there are two forms of procedure, and you know which ones to follow.

Video-laparoscopic cholecystectomy

Under general anesthesia, video-laparoscopic surgery is performed through the following steps:

  1. A small incision is made in the navel and a needle is inserted into it to fill the abdominal cavity with carbon dioxide. This is done so that a space is created and the surgery can be performed.
  2. Then, a metal tube containing a video camera is introduced, so that the image of your organism is monitored through a monitor.
  3. After that, three more small incisions are made, so that the forceps to be used during the surgery are placed.
  4. Through an x-ray of the bile duct during surgery, gallstones can be detected inside. If so, they will be removed during or after surgery.
  5. If the radiograph does not show any calculations in the canal, the vesicle is detached from its location, the cystic artery and the vesicle canal are connected and, at the end, the vesicle is removed through one of the holes made at the beginning of the procedure.

Conventional cholecystectomy

This type of cholecystectomy is also performed under general anesthesia and consists of a large incision in the upper right wall of the abdomen and, through it, the infected organ is removed.

This type of surgery is indicated, mainly, for two groups:

  • Women in the last 3 months of pregnancy;
  • People who have cirrhosis.

Does my body function normally with the absence of a gallbladder?

Yea! When the gallbladder is surgically removed, the bile ducts inside and outside the liver dilate to contain more bile. Therefore, even without it, the amount of bile that flows into the intestine is sufficient to perform its digestive function.

Complications

If the disease is not treated as soon as possible and correctly, some complications may appear:

Gangrenous cholecystitis

This complication develops when severe inflammation interrupts blood flow to your gallbladder and, as a result, the gallbladder tissue begins to die. Tissue death leaves organs vulnerable to infection.

Suspicions of gangrenous cholecystitis arise when:

  • Your heart beats more than 90 times a minute;
  • You have a lot more white cells in your blood system;
  • The ultrasound shows that the wall of your gallbladder has a thickness greater than 4.5 mm.

Perforation of the gallbladder wall

When the gallbladder wall is punctured, due to necrosis caused by bacteria, the inflammation can turn into an infection of the abdominal tissues, also known as peritonitis .

Pancreatitis

If a gallstone is in the terminal part of the excretory ducts and the passage of bile is prevented, digestive pancreatic enzymes will be activated, causing pancreatitis through the degradation of the pancreas.

Mirizzi syndrome

As rare as this complication is, Mirizzi syndrome can also occur in a treatment of poorly done cholecystitis. This syndrome consists of the narrowing of the hepatic duct, due to compression or inflammation of the gallstones inside the gallbladder.

Prevention

The most effective way to prevent cholecystitis is to reduce the risk of gallstones. To do this, two points in your lifestyle need to be changed.

Physical exercise

If you are obese or slightly overweight, the amount of cholesterol present in bile will increase the risk of gallstones developing in your body. To control this condition, it is important that you follow a controlled diet, in addition to exercising.

But remember, sudden weight loss can disrupt the chemistry of bile and increase the risk of developing stones. In that case, then, it is recommended that your weight loss be gradual.

Controlled diet

This diet should be low in fats, such as fried foods, fatty meats and margarine, so that the patient’s recovery is complete. Some items are very important to include in the diet, such as:

  • Fresh fruits;
  • Vegetable;
  • Legumes;
  • Lean meats, such as chicken and turkey;
  • Lean fish, such as hake and swordfish;
  • Whole grains;
  • Water.

With these preventive measures, you decrease the chances of developing gallstones in your body, in addition to helping known people who are at risk groups for the disease. So share the article and help spread this precious information.

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