Cholecystitis: Treatment, symptoms, advice & help
Cholecystitis is the term used for the inflammation of the gall bladder. The gall bladder is a small abdominal organ located just below the liver, in the right abdominal region and is responsible for storage of digestive juices which are produced by the liver. Cholecystitis may be acute, characterised by sudden onset or it may be longstanding. Most commonly, it occurs as a result of gallstones, which are solid deposits that may form inside the gallbladder.
Cholecystitis: Incidence, age and sex
Cholecystitis is quite a commonly encountered problem in recent times. Although it may occur in any age but individuals above the age of 40 years are most susceptible to this disorder. Its incidence is more in females as compared with males.
Signs and symptoms of cholecystitis: Diagnosis
The predominant feature of cholecystitis includes intense pain in the upper right region of the abdomen, which may radiate to the upper back. The pain may be severe and constant in nature and is termed as ‘biliary colic’. It may be associated with high-temperature, nausea and vomiting. Sometimes the individual may also experience belching, bloating, abdominal fullness or even jaundice.
The investigation of choice for detecting cholecystitis is ultrasonography. However other imaging tests like CT scan or Endoscopic retrograde cholangio-pancreatography (ERCP) may also be done if diagnosis is in doubt. Certain blood tests like serum bilirubin and liver function tests are also recommended to aid the diagnosis.
Causes and prevention of cholecystitis
The most common and predominant cause of cholecystitis is gallstones; predisposing and causative factors for gallstones include obesity, diabetes, genetic susceptibility and haemolytic anaemia. Women and especially those who are pregnant or more than forty years of age are more susceptible to the formation of gallstones. Gall stones can be of two types namely cholesterol stones which are most common and pigment stones which are formed due to excessive production of bilirubin pigment by liver. It is very rare to find cholecystitis without the occurrence of gallstones; however such cases may be encountered wherein individuals with HIV, prolonged fasting or prolonged ICU admission are at high risk of developing cholecystitis.
Complications arising from cholecystitis are rarely seen nowadays. However in rare cases, infection of gall bladder may occur which may in turn lead to septicaemia. Pancreatitis or perforation of gall bladder may also occur but is a very seldom occurrence.
The first and foremost treatment of gall bladder includes symptomatic relief and management of inflammation of the gall bladder by adequate fluids (intravenous fluids, if needed) and analgesics. Once the inflammation has subsided, then the treatment should proceed further which includes surgical removal of the gall bladder. Nowadays, this is generally done laparoscopically and this procedure is called laparoscopic cholecystectomy wherein the surgery involves small incisions which leads to a speedy recovery. Other methods like ‘lithotripsy’ can also be used to manage the underlying gall stones. But it is not very effective and recurrences are usually observed in such individuals. It is always better to get the gall bladder surgically removed, unless it is contraindicated.