Chronic cholecystitis (patient information)

Cholecystitis
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Cholecystitis?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
Cholecystitis On the Web
Ongoing Trials at Clinical Trials.gov
Images of Cholecystitis
Videos on Cholecystitis
FDA on Cholecystitis
CDC on Cholecystitis
Cholecystitisin the news
Blogs on Cholecystitis
Directions to Hospitals Treating Cholecystitis
Risk calculators and risk factors for Cholecystitis

For the WikiDoc page for this topic, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Meagan E. Doherty, Furqan M M. M.B.B.S[2]

Overview

Chronic cholecystitis is the chronic inflammation of the gallbladder. Chronic cholecystitis is causes abdominal pain, nausea, and vomiting. The abdominal pain is usually worsened after eating fatty or greasy food. Chronic cholecystitis is long-standing swelling and irritation of the gallbladder. The diagnosis is established by the combination of physical examination, laboratory, and imaging findings. The treatment of cholecystitis is mainly surgical removal of gallbladder. Possible complications of chronic cholecystitis are the gangrene, perforation, and malignancy of the gallbladder.

What are the symptoms of Chronic Cholecystitis?

Chronic Cholecystitis

• Attacks of upper abdominal pain, often with nausea or vomiting
• Abdominal pain that is located on the upper right side or upper middle of the abdomen
  • The pain may:
    • Spread to the back or below the right shoulder blade
    • Worsened by eating fatty or greasy foods

Other symptoms that may occur include:

• Abdominal fullness
• Clay-colored stools
• Excess gas
• Fever
• Heartburn
• Indigestion
• Nausea and vomiting
• Yellowing of skin and whites of the eyes (jaundice)

What causes Cholecystitis?

Chronic Cholecystitis

• Chronic cholecystitis is usually caused by gallstones in the gallbladder.
• It is usually preceded by repeated attacks of acute cholecystitis.
• This leads to thickening of the gallbladder walls.
• The gallbladder begins to shrink and eventually loses the ability to perform its function, which is concentrating, storing, and releasing bile.

Who is at highest risk?

Risk factors for chronic cholecystitis include:

• Gender: The disease occurs more often in women than in men
• Age: The incidence increases after age 40
• The presence or development of gallstones
• Race: Native Americans have a higher rate of gallstones

Diagnosis

Chronic Cholecystitis

Your doctor may order the following blood tests:

• Amylase and lipase
• Bilirubin
• Complete blood count (CBC):
  • May show a higher than normal white blood cell count
• Liver function tests

Imaging tests that can show gallstones or inflammation include:

• Abdominal ultrasound
• Abdominal CT scan
• Abdominal x-ray
• Oral cholecystogram
• Gallbladder radionuclide scan

Diseases with similar symptoms

Acute Cholecystitis

• Perforated peptic ulcer
• Acute peptic ulcer exacerbation
• Amoebic liver abscess
• Acute amoebic liver colitis
• Acute pancreatitis
• Acute intestinal obstruction
• Renal colic
• Acute retrocolic appendicitis

Chronic Cholecystitis

• Billiary colic
• Peptic ulcer
• Hiatus hernia
• Colitis
• Functional bowel syndrome

When to seek urgent medical care?

Chronic Cholecystitis

Call for an appointment with your healthcare provider if you develop any symptoms of cholecystitis.

Treatment options

Chronic Cholecystitis

Surgery is the usual treatment. Surgery to remove the gallbladder (cholecystectomy) can be performed as an open or laparoscopic procedure. The open procedure requires a large cut in the upper-right part of the abdomen. Laparoscopic surgery uses instruments and a small camera inserted through a cluster of a few small cuts.

In patients who are poor candidates for surgery because of other diseases or conditions, the gallstones may be dissolved with medication taken by mouth.

Medications to avoid

Patients diagnosed with Cholecystitis should avoid using the following medications:

• Fenofibrate
• Gemfibrozil
  If you have been diagnosed with Cholecystitis, consult your physician before starting or stopping any of these medications.

Where to find medical care for Cholecystitis?

Directions to Hospitals Treating Cholecystitis

Prevention of Cholecystitis

Chronic Cholecystitis

The condition is not always preventable. Eating less fatty foods may relieve symptoms in people with acute cholecystitis who have not had their gallbladder removed. However, the benefit of a low-fat diet has not been proven.

What to expect (Outlook/Prognosis)?

Possible complications of cholecystitis

• Gangrene (tissue death) of the gallbladder
• Cancer of the gallbladder (rarely)
• Jaundice
• Pancreatitis
• Worsening of the condition

Sources

• http://www.nlm.nih.gov/medlineplus/ency/article/000264.htm
• http://www.nlm.nih.gov/medlineplus/ency/article/000217.htm