Cholecystitis is inflammation of the gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that’s released into your small intestine.
In most cases, cholecystitis is caused by gallstones that block the tube leading out of your gallbladder. This results in a buildup of bile that can cause inflammation. Other causes of cholecystitis include bile duct problems and tumors.
If left untreated, cholecystitis can lead to serious complications, such as a gallbladder that becomes enlarged or that ruptures. Once diagnosed, cholecystitis requires a hospital stay. Treatment for cholecystitis often eventually includes gallbladder removal.
Signs and symptoms of cholecystitis may include:
- Severe, steady pain in the upper right part of your abdomen
- Pain that radiates from your abdomen to your right shoulder or back
- Tenderness over your abdomen when it’s touched
- Sweating
- Nausea
- Vomiting
- Fever
- Chills
- Abdominal bloating
Cholecystitis signs and symptoms usually occur after a meal, particularly a large meal or a meal high in fat.
Cholecystitis occurs when your gallbladder becomes inflamed. Gallbladder inflammation can be caused by:
- The vast majority of cholecystitis cases are the result of gallstones that block the cystic duct — the tube through which bile flows when it leaves the gallbladder — causing bile to build up and resulting in gallbladder inflammation.
- A tumor may prevent bile from draining out of your gallbladder properly, causing bile buildup that can lead to cholecystitis.
- Bile duct blockage. Kinking or scarring of the bile ducts can cause blockages that lead to cholecystitis.
The following factors may increase your risk of cholecystitis:
- Most cases of cholecystitis are linked to gallstones. If you have gallstones, you’re at high risk of developing cholecystitis.
- Being female. Women have a greater risk of gallstones than men do. This makes women more likely to develop cholecystitis.
- Increasing age. As you get older, your risk of gallstones increases, as does your risk of cholecystitis.
Cholecystitis can lead to a number of serious complications, including:
- Enlarged gallbladder. If your gallbladder becomes inflamed due to bile buildup, it may stretch and swell beyond its normal size, which can cause pain and increase the risk of a tear (perforation) in your gallbladder, as well as infection and tissue death.
- Infection within the gallbladder. If bile builds up within your gallbladder, causing cholecystitis, the bile may become infected.
- Death of gallbladder tissue. Untreated cholecystitis can cause tissue in the gallbladder to die (gangrene), which in turn can lead to a tear in the gallbladder, or it may cause your gallbladder to burst.
- Torn gallbladder. A tear (perforation) in your gallbladder may be caused by an enlarged or infected gallbladder that occurs as a result of cholecystitis.
Tests and procedures used to diagnose cholecystitis include:
- Blood tests.Your doctor may order blood tests to look for signs of an infection or signs of gallbladder problems.
- Imaging tests that show your gallbladder. Imaging tests, such as abdominal ultrasound or a computerized tomography (CT) scan, can be used to create pictures of your gallbladder that may reveal signs of cholecystitis.
Treatment for cholecystitis usually involves a stay in the hospital to stabilize the inflammation in your gallbladder. Once your cholecystitis is under control, your doctor may recommend surgery to remove your gallbladder, since cholecystitis frequently recurs. In emergency situations, such as a ruptured gallbladder, surgery may be required right away.
Because cholecystitis frequently recurs, most people diagnosed with cholecystitis eventually require gallbladder removal surgery (cholecystectomy). When you’re feeling better, your doctor may recommend cholecystectomy. When you’ll undergo surgery depends on your situation. If you have complications of cholecystitis, such as gangrene or perforation of your gallbladder, you may need to have surgery immediately.
Cholecystectomy is most commonly performed using a tiny video camera mounted at the end of a flexible tube. This allows your surgeon to see inside your abdomen and to use special surgical tools to remove the gallbladder (laparoscopic cholecystectomy). The tools and camera are inserted through four incisions in your abdomen, and the surgeon watches a monitor while guiding the tools during surgery.
Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder. You don’t need your gallbladder to live, and gallbladder removal doesn’t affect your ability to digest food, although it can cause diarrhea that is usually temporary.
Because most cases of cholecystitis are caused by gallstones, you can reduce your risk of cholecystitis by taking the following steps to prevent gallstones:
- Lose weight slowly. If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose 1 or 2 pounds (0.5 to about 1 kilogram) a week.
- Maintain a healthy weight. Obesity and being overweight increase the risk of gallstones. Work to achieve a healthy weight by reducing the number of calories you eat and increasing the amount of physical activity you get. Once you achieve a healthy weight, work to maintain that weight by continuing your healthy diet and continuing to exercise.
- Choose a healthy diet. Diets high in fat and low in fiber may increase the risk of gallstones. To reduce your risk of gallstones, choose a diet that’s full of fruits, vegetables and whole grains.