An inflamed gallbladder, known medically as cholecystitis, refers to inflammation of the gallbladder. The gallbladder is a small, pear-shaped organ located just under the liver. Its main function is to store and concentrate bile, a digestive fluid produced by the liver. An inflamed gallbladder can cause severe pain and other troublesome symptoms. But will it go away on its own without treatment? Let’s take a closer look.
What Causes Gallbladder Inflammation?
There are two main types of cholecystitis:
- Acute cholecystitis occurs suddenly and causes severe pain and infection. It is often triggered by gallstones blocking the cystic duct, the tube that carries bile from the gallbladder.
- Chronic cholecystitis involves long-term inflammation that causes gradual damage to the gallbladder walls. It is usually due to repeated episodes of acute cholecystitis.
Gallstones are the most common cause of both acute and chronic cholecystitis. Gallstones form when substances in bile, such as cholesterol or bilirubin, crystallize and stick together. Risk factors for developing gallstones include:
- Obesity
- Rapid weight loss
- Pregnancy
- Family history
- Age over 40
- Female gender
- Certain medical conditions, like diabetes
When gallstones move into the cystic duct and block bile flow, it causes a buildup of pressure in the gallbladder. This leads to swelling and irritation of the gallbladder walls. If gallstones block the duct completely, bile can become trapped in the gallbladder, enabling infectious bacteria to multiply and cause an infection.
Besides gallstones, other less common causes of cholecystitis include:
- Tumors blocking the cystic duct
- Parasites infecting the gallbladder
- Trauma or injury to the gallbladder
- Abnormal anatomy of the cystic duct
Signs and Symptoms
Some of the most common signs and symptoms of an inflamed gallbladder include:
- Sudden, severe pain in the upper right abdomen – This is usually the first and most obvious symptom. The pain may radiate to other areas like the back or right shoulder.
- Fever – A fever over 100.4°F (38°C) may indicate an infection in the gallbladder.
- Nausea and vomiting – The pain can cause nausea and vomiting.
- Bloating – Bloating or gas pains may occur.
- Clay-colored stool – Blocked bile flow can lead to pale, clay-colored poop.
- Yellowish skin or eyes – Jaundice results from a buildup of bilirubin, causing yellow discoloration.
The pain of cholecystitis usually comes on quickly and lasts at least 30 minutes or longer. It may happen after eating a fatty meal. Other symptoms can include abdominal tenderness, sweating, and chills or shakes. Symptoms tend to be more severe with acute cholecystitis compared to chronic.
Will It Go Away Without Treatment?
In most cases, an inflamed gallbladder will not simply go away on its own without proper treatment. There are a few reasons why:
- The underlying cause, like gallstones blocking the bile duct, will still be present. This will continue to irritate the gallbladder.
- There is a high risk of dangerous complications developing, like a gallbladder rupture.
- If infected, the bacteria can spread quickly to other organs and lead to serious, even life-threatening illness.
- The pain and digestive symptoms make it very difficult to go about normal daily activities.
Leaving acute cholecystitis untreated is not recommended, as complications can develop rapidly. Chronic cholecystitis also requires treatment because it can lead to gallbladder damage over time.
Can Gallstones Resolve on Their Own?
While small gallstones may pass through the bile ducts and be eliminated on their own in some cases, most will not. Larger stones can easily get stuck. Waiting to see if symptoms resolve without intervention is not wise if gallstones are known to be present, as complications can arise any time a stone moves and blocks a duct. Prompt treatment is advised.
Diagnosis
If cholecystitis is suspected, the doctor will start by reviewing symptoms and performing a physical exam, palpating the abdomen to check for tenderness. They may order one or more of the following diagnostic tests:
- Ultrasound – This is the first-line imaging test to visualize the gallbladder and look for gallstones.
- HIDA scan – Also called a cholescintigraphy scan, this detects blockages in bile flow from the gallbladder.
- CT scan – A CT scan provides more detailed images if complications like perforation are suspected.
- Blood tests – Blood work helps check for signs of infection and liver problems.
Once cholecystitis is confirmed, treatment can begin right away. Letting the condition continue without treatment is likely to result in a worsening of symptoms and increased complications.
Treatment Options
Treatment for an inflamed gallbladder aims to resolve the current symptoms while preventing repeat attacks of inflammation. Options may include:
Pain Medication
Medications like anti-inflammatories, Tylenol, or prescription narcotics can help relieve the severe abdominal pain in the short-term. IV fluids may be given to prevent dehydration from vomiting.
Antibiotics
If there is an infection present, antibiotics administered through an IV can treat the bacteria and prevent it spreading. Common antibiotics used include ciprofloxacin, ampicillin, and metronidazole.
Gallbladder Removal Surgery
Cholecystectomy, surgery to remove the gallbladder, is the definitive treatment for cholecystitis. It is very effective at resolving inflammation and preventing future attacks. Gallbladder removal can often be done laparoscopically through small incisions using a camera, with a short hospital stay and recovery time.
Removal is usually recommended after a first bout of acute cholecystitis, and is the standard treatment for chronic cholecystitis. Oral dissolution medications are sometimes used first to try to dissolve smaller gallstones, but surgery may still be required if stones remain.
Alternative Treatments
Some alternative approaches like herbal remedies, acupuncture, or dietary changes may help relieve discomfort and potentially dissolve small stones. However, there is little quality evidence on their effectiveness. They should not be relied upon as a substitute for medical treatment.
Complications
Potential complications that can result from leaving cholecystitis untreated include:
- Gangrene – Loss of blood supply can cause gallbladder tissue to die.
- Gallbladder rupture – Pressure buildup can cause the gallbladder to burst, spilling bile into the abdomen.
- Abscess – A pocket of pus can form in or around the gallbladder.
- Peritonitis – Rupture or abscess can cause infection of the abdominal lining.
- Sepsis – Bacteria from the infected bile can spread to the bloodstream.
- Pancreatitis – Inflammation of the pancreas from gallstones passing through.
- Jaundice – Bilirubin buildup causes yellowing of the skin and eyes.
- Liver dysfunction – Impaired bile flow can impact liver function.
These complications can become very dangerous, even fatal, if cholecystitis is left untreated. Quick medical intervention is key.
When to Seek Emergency Care
You should seek emergency medical care for cholecystitis or suspected gallbladder problems if you experience:
- Sudden, severe abdominal pain spreading to the back or chest
- Fever over 100.4°F (38°C)
- Confusion or dizziness
- Persistent vomiting
- Yellowish color to the skin or whites of the eyes
- Signs of shock, like excessive sweating, rapid heart rate, or lightheadedness
Going to the ER promptly if any concerning symptoms develop allows doctors to provide fast treatment to help prevent the condition from becoming life-threatening.
Recovery and Outlook After Treatment
With prompt medical treatment, most cases of acute cholecystitis can recover fully without complications. If gallstones were present, the chances of recurrence are high if the gallbladder remains in place. Chronic gallbladder inflammation is also likely to return if the underlying cause is not addressed.
Gallbladder removal surgery provides a permanent cure in the majority of people. Recovery typically involves:
- 1-2 days hospital stay for laparoscopic procedure
- Gradual return to normal activities over 1-2 weeks
- Following a low-fat diet until digestion adjusts
- Some degree of diarrhea for 2-4 weeks as bile flow changes
- Avoiding strenuous activity for 4-6 weeks
After recovery, most people can enjoy a normal diet and lifestyle without their gallbladder. Long term antibiotics may be prescribed if there was a gallbladder infection. Follow up imaging tests are sometimes needed to confirm all gallstones were eliminated.
Prevention
Preventing gallstones can help reduce your risk of developing cholecystitis. Recommendations include:
- Maintaining a healthy weight
- Limiting fatty, greasy, and sugary foods
- Eating more fiber
- Exercising regularly
- Avoiding rapid weight loss
- Controlling other medical conditions, like diabetes
There is some evidence that vitamin C and coffee consumption may help prevent gallstones. If stones are present, prompt treatment can lower the odds of them causing cholecystitis.
Conclusion
An inflamed gallbladder usually will not resolve without medical intervention. Allowing cholecystitis to go untreated risks serious complications. Typical treatment involves pain relief, antibiotics for infection, and gallbladder removal surgery to prevent recurrence. Seeking prompt medical care provides the best outlook for a quick recovery.