Cholecystitis (Presumed)

Front view of liver, gallbladder, and stomach.

Your belly (abdominal) pain may be due to an inflammation and possible infection in the gallbladder. This is called cholecystitis. The gallbladder is a small sac under the liver. It stores and releases bile. Bile is a fluid made in the liver that helps with digesting fat. Eating fatty food stimulates the gallbladder to contract, and release the bile. Gallstones may form in this sac (called cholelithiasis). Most people don't have symptoms. But if the stone moves and blocks bile from leaving the bladder, it can cause pain and even an infection. The infection is called cholecystitis. Bile sludge without a stone can also cause cholecystitis.

To be more sure of the diagnosis, you may need to have an ultrasound, CT scan, or other special test.

Several things increase the risk of developing gallstones:

  • Being a woman

  • Being obese

  • Being older

  • Losing or gaining weight quickly

  • Having a high-calorie diet

  • Being pregnant

  • Using hormone therapy

  • Having diabetes

The most common symptoms are:

  • Belly pain, cramping, aching

  • Nausea, vomiting

  • Fever

Many illnesses can cause these symptoms. This pain often starts in the upper right side of your belly. The pain can also be in the top middle part of the belly. Sometimes it can spread to your right shoulder, back, and arm. It often starts suddenly, becomes more intense quickly, and then slowly decreases and goes away over a couple of hours. Older adults and people with diabetes may have trouble showing exactly where the pain is. The pain may occur after meals, particularly fatty meals.

Home care

  • You may have acute cholecystitis if you have ongoing symptoms that don't get better, or if you get a fever with your symptoms. You should go to the emergency room. This is not a condition that should be treated at home. Often surgery to remove the gallbladder (cholecystectomy) is needed.

  • If you have short periods of gallbladder pain that go away, this is called biliary colic. Rest in bed and follow a clear liquid diet until the pain, upset stomach, and vomiting go away. Call your healthcare provider for an appointment. Biliary colic can keep coming back and can cause acute cholecystitis.

  • Antibiotics and other medicine may be prescribed. Take these exactly as directed.

  • You can take acetaminophen or ibuprofen for pain, unless you were given a different pain medicine to use. Talk with your provider before using these medicines if you:

    • Have chronic liver or kidney disease

    • Ever had a stomach ulcer or GI (gastrointestinal) bleeding

    • Are taking blood-thinner medicines

  • Fat in your diet makes the gallbladder contract and may cause more pain. Don't have any fat in your diet over the next 2 days. Follow a low-fat diet after that. If you are overweight, a low-fat diet will help you lose weight.

Follow-up care

An infection in the gallbladder is a serious problem and must be watched carefully. Keep any appointments made to have further testing and to see a general surgeon. See your healthcare provider for another exam in the next 1 to 2 days, or as advised. Once cholecystitis has occurred, removing the gallbladder is often needed to prevent a recurrence. You can talk with your provider about this at your follow-up visit. If you were hospitalized for cholecystitis, your gallbladder may be taken out during that same hospital stay. Gallstones that are not causing infection or symptoms often don't need surgery.

When to get medical advice

Call your healthcare provider if you have any of the following:

  • Repeated vomiting

  • Belly swelling

  • Pain lasting more than 6 hours

  • Fever of 100.4°F (38ºC) or higher, or as directed by your healthcare provider

  • Shaking chills

  • Weakness, dizziness, or fainting

  • Dark yellow urine or stools that are light gray or clay-colored

  • Yellow color of the skin or eyes (jaundice)

  • Chest, arm, back, neck, or jaw pain

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