Acute cholecystitis – symptoms, treatment, diet

Inflammation of the gallbladder in approx. 90% of cases is conditioned by the presence of gallstones in it, so it occurs in people who have been suffering from gallstones for years. There is a close relationship between the symptoms of inflammation and urolithiasis, so in the first hours of an acute attack, it is usually extremely difficult to distinguish acute cholecystitis from an attack of biliary colic.

Acute cholecystitis

Acute cholecystitis is one of the complications of gallstone disease. As a reminder, cholelithiasis is a condition characterized by the formation of deposits in the gallbladder or in the bile ducts. The symptoms of cholecystitis and cholelithiasis are very similar, so it is usually difficult to distinguish inflammation from biliary colic in the first hours of an attack.

Causes of acute cholecystitis

Acute cholecystitis occurs when inflammation of the gallbladder walls and insufficient blood supply occur due to obstruction of bile circulation. Moreover, billowing bile and other products derived from its chemical modifications cause irritation of the gallbladder walls, leading to the secretion of inflammatory factors. High pressure in the gallbladder can even lead to necrosis as the blood flow in the gallbladder mucosa is impaired.

It happens that severe cholecystitis coexists with other diseases, e.g. in conditions after surgery, as a result of severe body injuries or burns. The ailment may also accompany diabetics. Then the disease is influenced by the following factors:

  1. bacterial infections,
  2. stagnation of bile in the gallbladder,
  3. dehydration,
  4. impaired blood flow.

Check: What does the diet look like after gallbladder surgery?

Acute cholecystitis – symptoms

Acute cholecystitis is very common after a hard-to-digest meal and begins with pain in the right hypochondrium, usually radiating to the right subscapular region. The pains are very strong, stabbing and exhausting, accompanied by vomiting. There is also a moderate increase in body temperature up to 38 ° C. Rapid inflammation can lead to gangrene of the gallbladder, its rupture and peritonitis.

What to do when the first symptoms appear?

The symptoms associated with biliary colic can be relieved with painkillers, e.g. metamizole, paracetamol or diastolic agents such as papaverine, hyoscine, and drotaverine. If the pain persists, see your doctor immediately as acute cholecystitis requires surgery.

Note: Proper diagnosis of biliary colic is important, as it can make it difficult to diagnose other diseases, including acute cholecystitis.

Acute cholecystitis – diagnosis

In acute cholecystitis, medical history and palpation are the most important factors, which allow for a fairly quick diagnosis. When examining the patient, the doctor may notice tenderness of the abdominal integuments in the right subcostal area. Sometimes a sore gallbladder and peritoneal symptoms are felt. Some patients may experience increased heart rate and rapid breathing.

Among the tests performed in the diagnosis of acute cholecystitis, we can distinguish:

  1. blood tests – indicate a large number of white blood cells, with leukocytes shifted to the right, i.e. the presence of young forms. In addition, tests can reveal high activity of liver markers as well as high bilirubin and amylase activity;
  2. imaging tests – the basic examination is an ultrasound of the abdominal cavity, which may reveal the deposits in the bladder, thickening of its walls and the presence of fluid around the bladder. In addition, endoscopic ultrasound is performed as an auxiliary, especially when the deposits in the ultrasound image are visible as the gallbladder. In some cases, X-ray examination (abdominal cavity examination) is useful – it enables the visualization of calcified deposits and gas bubbles located in the walls of the gallbladder and porcelain bladder.

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Treatment of acute cholecystitis

Although, in most cases, acute cholecystitis resolves with medical treatment, sometimes surgery is required. The procedure should be performed within a few days of the first symptoms.

In recent years, advances in minimally invasive surgery have made it possible to treat gallbladder stones laparoscopic method. The use of access to the abdominal cavity through a few small punctures in the integuments (usually 3) enables the procedure of excision of the gallbladder under videoscopic control, without the need to cut the abdomen as in the classical technique.

The main advantages of laparoscopy are:

  1. reduction of surgical trauma,
  2. less postoperative pain,
  3. shorter stay in hospital,
  4. early return to full life activity,
  5. better cosmetic results, without large scars.

It is difficult to predict the development and course of acute cholecystitis, therefore the patient should be examined by a surgeon. The final diagnosis of acute cholecystitis is based on the clinical picture confirmed by ultrasound examination of the abdominal cavity. As in all acute diseases of the abdominal cavity, warm compresses or a hot water bottle must not be placed on the abdomen as well. However, you can put a drying compress or an ice bag.

Is it possible to cure inflammation completely?

We speak of a complete cure of acute cholecystitis when it is removed along with the remaining stones. However, it is worth noting that even the surgery will not eliminate the genetic predisposition to the formation of plaques. After the removal of the gallbladder, they can develop, for example, in the biliary tract. Then, the stones are removed using an endoscope (ERCP procedure). Patients who have had their gallbladder removed should avoid physical activity and heavy lifting or shopping for about two or three months. Ignoring these recommendations may result in an umbilical hernia at the cut site.

If you have impaired intestinal motor function, visceral hypersensitivity or have a genetic predisposition, you can undergo tests to diagnose digestive disorders.

Acute cholecystitis – how to prevent it?

The best way to prevent acute cholecystitis is by early surgical treatment of gallstone disease. However, it is impossible to eliminate a genetic predisposition. The risk of stone formation and therefore chronic cholecystitis can be reduced by changing lifestyle and diet. Implementing a low-fat diet helps prevent bouts of biliary colic.

Diet after surgery

Following are some dietary advice after gallbladder surgery.

  1. After gallbladder surgery, a proper diet is very important. It should be based on foods rich in carbohydrates and low in fats.
  2. Patients should not eat too heavy meals, but at the same time should not starve themselves – preferably meals should be taken in smaller amounts, but more often (about 5-6 meals a day).
  3. Regularity is also important, patients should eat at fixed times and remember to chew carefully.
  4. Unfortunately, the beloved baked and fried dishes should be replaced with stewed or boiled ones.
  5. Fatty meats, fish, margarine and mayonnaise – these are products not recommended in the patient’s diet. Better health effects will be achieved by eating skimmed and dairy-based foods, groats, graham / wheat bread or pasta.

To support gallbladder function, drink dandelion root tea.

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