A gallbladder inflammation, also known as cholecystitis, can cause significant discomfort and pain. The gallbladder is a small, pear-shaped organ located just below the liver on the upper right side of the abdomen. Its main function is to store and concentrate bile, a digestive fluid produced by the liver. When the gallbladder becomes inflamed, it can cause severe abdominal pain that requires prompt medical attention.
Symptoms of an Inflamed Gallbladder
Some of the most common symptoms of an inflamed gallbladder include:
- Severe pain in the upper right abdomen that can radiate to the right shoulder or back
- Pain that worsens after eating a meal, especially one high in fat
- Nausea and vomiting
- Fever
- Chills
- Bloating
- Gas
- Burping
- Jaundice (yellowing of the skin and eyes)
The pain from an inflamed gallbladder can be constant or come and go in episodes, but it is often severe and unrelenting. It usually starts suddenly, rapidly intensifies, and can last for several hours. The abdominal pain may be accompanied by pain between the shoulder blades or under the right shoulder.
What Causes Gallbladder Inflammation?
There are several possible causes of gallbladder inflammation, including:
- Gallstones blocking the cystic duct, which is the tube that carries bile from the gallbladder. This is the most common cause of cholecystitis.
- Thick bile that gets trapped in the gallbladder due to insufficient emptying.
- Tumors blocking the gallbladder ducts.
- Bacterial infections of the gallbladder, such as salmonella or E. coli.
- Parasites such as liver flukes getting into the gallbladder.
- Other medical conditions like diabetes, Crohn’s disease, and cirrhosis affecting gallbladder function.
Gallstones are the culprit behind inflammation in over 90% of cholecystitis cases. When a stone gets stuck in the cystic duct, it causes a buildup of bile in the gallbladder, which then becomes swollen and inflamed. This can impair blood flow to the gallbladder and cause tissue damage or infection.
Risk Factors
Certain factors can increase your risk of developing gallbladder inflammation, including:
- Being female – women are twice as likely to get cholecystitis.
- Being overweight or obese.
- Pregnancy – pregnant women have a higher risk due to elevated estrogen and progesterone.
- Family history of gallstones.
- Age over 40 years old.
- Rapid weight loss.
- Certain ethnic backgrounds such as Native American, Hispanic, and Northern European.
- Having an underlying health condition like diabetes or cirrhosis.
Types of Cholecystitis
There are two main types of gallbladder inflammation:
Acute Cholecystitis
This occurs suddenly and causes severe gallbladder inflammation. Without treatment, it can lead to serious complications like gallbladder rupture. Symptoms come on quickly and intensify rapidly. It is usually caused by a gallstone blocking the cystic duct.
Chronic Cholecystitis
This involves milder but persistent gallbladder inflammation that keeps recurring over time. It may be caused by repeated episodes of acute cholecystitis or constant gallstone irritation. Symptoms tend to be less severe but recur often.
Diagnosing an Inflamed Gallbladder
If gallbladder inflammation is suspected, the doctor will start by reviewing your symptoms and medical history. Diagnostic tests may include:
- Physical exam – Pressing on the abdomen to check for tenderness or masses.
- Blood tests – To look for signs of infection or inflammation.
- Ultrasound – This is usually the first imaging test done. It can detect gallstones, gallbladder thickening, and blockages.
- CT scan – Provides more detailed gallbladder images than ultrasound.
- Hepatobiliary iminodiacetic acid (HIDA) scan – Checks gallbladder emptying function.
- Endoscopic ultrasound (EUS) – Uses sound waves to create detailed gallbladder images.
Once cholecystitis is diagnosed, treatment is usually needed right away.
Treatment for an Inflamed Gallbladder
Treatment options may include:
- Antibiotics – Used to treat any infection.
- Pain relievers – To help relieve abdominal pain and discomfort.
- Gallbladder removal surgery (cholecystectomy) – This is the definitive treatment in most cases of cholecystitis. The gallbladder is removed through small incisions using laparoscopic surgery. Recovery time is faster than open surgery.
- Drainage procedure – A tube is inserted to drain excess bile and pus from the gallbladder and provide temporary relief in severe cases before surgery.
- Gallstone removal – Gallstones may sometimes be removed without taking out the entire gallbladder.
Let’s take a more in-depth look at some of these treatment options:
Antibiotics
Antibiotics are used to treat any bacterial infection that may be contributing to the gallbladder inflammation. They can provide rapid relief of symptoms and may be given intravenously in acute cholecystitis. Common antibiotics used include ciprofloxacin, ampicillin, and metronidazole. In chronic cholecystitis, oral antibiotics may be prescribed to prevent recurrent attacks of inflammation.
Pain Medications
Medications are used to relieve the severe abdominal pain of cholecystitis. This can help make the patient more comfortable while awaiting definitive treatment. Common medications given include:
- NSAIDs like ibuprofen or naproxen to decrease inflammation.
- Narcotics such as morphine or hydromorphone for severe pain.
- Antispasmodics like dicyclomine help relieve muscle spasms in the gallbladder.
Gallbladder Removal Surgery
Removing the gallbladder is the most common and effective treatment for cholecystitis. This is a curative treatment that prevents recurrence. Laparoscopic cholecystectomy is usually done as soon as the patient is stable and involves:
- General anesthesia.
- Small incisions in the abdomen.
- Inserting a laparoscope with a camera to visualize the gallbladder.
- Surgically removing the gallbladder.
- Placement of a drain to remove fluids.
- Closing the incisions with stitches or surgical glue.
This minimally invasive surgery results in less pain, faster recovery, and lower risk of complications compared to open cholecystectomy. Most people can go home the same day and resume normal activities within a week or two.
Drainage and Stenting Procedures
In severe cases where the patient is too unstable for immediate gallbladder removal, drainage procedures may be done to temporarily relieve the inflammation. This can help stabilize them before definitive surgery. Drainage techniques include:
- Inserting a needle through the skin to draw out bile and pus from the gallbladder.
- Placement of a drainage catheter through the gallbladder wall to evacuate it.
- Endoscopic stent placement within the cystic duct to open the blockage and improve bile flow.
Once the patient is better, gallbladder removal surgery is recommended to prevent recurrence of cholecystitis.
Gallstone Removal without Cholecystectomy
In certain situations, the gallstones causing cholecystitis may be removed without taking out the entire gallbladder. Techniques include:
- Lithotripsy – Breaking up stones into smaller pieces so they can pass through the bile ducts.
- Endoscopic retrograde cholangiopancreatography (ERCP) – Removing stones in the common bile duct with an endoscope.
- Cholecystostomy – Establishing a permanent opening in the gallbladder to allow stone passage.
However, gallstone recurrence rates are high after such procedures so cholecystectomy is often still required eventually.
Recovering from Gallbladder Inflammation
If you’ve had your gallbladder removed, pay close attention to your diet during recovery. Since the gallbladder stores and concentrates bile, its removal means bile will now continuously drip into your small intestine. Eating smaller, low-fat meals can help prevent diarrhea from the excess bile release. Other tips include:
- Avoid greasy, fatty foods which are harder to digest.
- Eat more frequent small meals rather than 1-2 large meals.
- Limit dairy products if you have diarrhea after eating them.
- Gradually reintroduce fats back into your diet.
- Consider digestive enzymes or bile salts supplements.
- Stay well hydrated and take over-the-counter anti-diarrheals if needed.
Following gallbladder surgery, call your surgeon if you have:
- A fever over 101°F (38°C).
- Moderate to severe abdominal pain.
- Persistent nausea and vomiting.
- Yellowing of your skin or eyes (jaundice).
- Bleeding, pus, increased swelling or redness at the incision sites.
These could indicate potential complications that need medical attention. Otherwise, your symptoms should gradually improve as you recover.
Preventing Gallbladder Inflammation
Some key tips for helping prevent gallbladder inflammation include:
- Maintaining a healthy weight.
- Exercising regularly.
- Eating a balanced, low-fat diet.
- Avoiding rapid weight loss.
- Limiting alcohol intake.
- Managing medical conditions like diabetes.
- Taking supplemental bile salts to improve gallbladder emptying.
If you have had gallstones in the past, these preventive strategies are especially important.
When to See a Doctor
You should seek prompt medical attention if you experience:
- Severe or worsening pain in your upper right abdomen.
- Fever, chills, or vomiting.
- Persistent pain lasting more than 5 hours.
- Pain with yellowing of your skin and eyes.
- Dark urine or light stools.
These can be signs of acute cholecystitis or gallbladder complications, which require urgent treatment. Reporting your symptoms early leads to better outcomes.
Conclusion
An inflamed gallbladder can cause considerable pain and discomfort. Symptoms may include severe abdominal pain, fever, nausea, and jaundice. Gallstones blocking the cystic duct are the most common cause of cholecystitis. Treatment typically involves antibiotics and gallbladder removal surgery. Recovery focuses on following a low-fat diet to limit diarrhea and digestive upset. Pay attention to any concerning symptoms and contact your doctor promptly for evaluation. With appropriate treatment, most people recover well from gallbladder inflammation and its removal.