Chronic cholecystitis history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
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Overview
Cholecystitis usually presents as a pain in the right upper quadrant. This is usually a constant, severe pain. The pain may be felt to 'refer' to the right flank or right scapular region at first. This is usually accompanied by a low grade fever, vomiting and nausea. More severe symptoms such as high fever, shock and jaundice indicate the development of complications such as abscess formation, perforation or ascending cholangitis. Another complication, gallstone ileus, occurs if the gallbladder perforates and forms a fistula with the nearby small bowel, leading to symptoms of intestinal obstruction.
Chronic cholecystitis manifests with non-specific symptoms such as nausea, vague abdominal pain, belching, and diarrhea.
History
- A clear history about the previous episodes is important in chronic cholecystitis and in gall stone disease.
- A directed history should be taken to ascertain the onset, duration and progression of disease.
- Drug history has to be obtained. (opioids, estrogen pills)
- History co morbid conditions like diabetes, hypertension.
- History of any infections like salmonella, candida, cholera, and tuberculosis has to be obtained.
- History of any recent rapid weight loss, hospitalization is important.
- History suggestive of any immunocompromised state is important to rule out AIDS.
Symptoms
Acute Cholecystitis
The main symptom is abdominal pain that is located on the upper right side or upper middle of the abdomen. The pain may:
- Be sharp, cramping, or dull
- Come and go
- Spread to the back or below the right shoulder blade
- Be worse after eating fatty or greasy foods
- Occur within minutes of a meal
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)
Chronic Cholecystitis
- Attacks of upper abdominal pain
- Belching
- Diarrhea
- Nausea or vomiting