Cholecystitis is inflammation of the wall of gallbladder that results in pain in right upper quadrant of abdomen along with tenderness. Chronic cholecystitis is inflammation of gallbladder that persists for long period of time. Person suffering from chronic cholecystitis has recurring attack of pain. At least 90 percent cases of chronic cholecystitis are due to gallstones.
Gallbladder is a small sac located below the liver. Its main function is to store bile produced by liver. Bile is an enzyme used for digestion of fat. It moves from the gallbladder to the intestine through a tube called common bile duct.
Chronic cholecystitis also occurs because of repeated attacks of acute cholecystitis. This condition is more common in women as compared to men. Treatment consists of painkiller medicine and antibiotics. Surgery removal of gall bladder is often necessary to cure the condition.
Most Common Cause Of Chronic Cholecystitis
Chronic cholecystitis almost always occurs due to repeated attacks of acute cholecystitis. The main underlying cause for this condition is presence of gall stones in the gallbladder. Gall stones blocks the flow of bile which leads to inflammation, irritation and infection in the bladder wall.
Repeated attack will end up in thickening of the gallbladder wall.Later on the gall bladder may shrink in size. The predisposing factors known to form gallstones are hereditary, obesity, improper dietary habits.
Besides gall stones, cholecystitis can also develop due to other reasons such as:
- Infection in the bile duct.
- Too much collection of cholesterol in gallbladder. This can occur during pregnancy or in people who lose their weight rapidly.
- Diabetics are prone to develop cholecystitis. It occurs due to reduced blood supply to the gallbladder.
- Any abnormal growth or a tumor in liver or pancreas can cause inflammatory changes in the gallbladder.
Risk factors for developing chronic cholecystitis:
- Gallstones are more common in women. Thus women are at greater risk of developing cholecystitis.
- Pregnant women or women taking hormone replacement therapy.
- Obese individuals
- Rapid loss of weight
Sign And Symptoms Of Chronic Cholecystitis
The clinical picture produced by chronic cholecystitis is often ill defined. This may include nausea, vomiting, vague pain and tenderness in the gallbladder region, too much of belching and passage of flatus and diarrhea. There may be periodic attacks of acute colicky pain in upper right side of abdomen which may last for few hours or one or two days. The pain often radiates from right upper quadrant to right side of back and shoulder.
Sometimes there is associated low grade fever. Blood examination indicates high rise in white blood cell count. There is high risk of perforation or rupture of gallbladder in chronic cholecystitis. In presence of rupture or an abscess patient may develop serious symptoms such as high grade fever, severe pain in abdomen, jaundice, rapid pulse rate, toxic look of face, low blood pressure and shock.
In chronic cholecystitis belching, distension, mild pain in right abdomen and right lower side of shoulder blade is often observed after eating fried and fatty food. Particularly after pastries, fatty food, fruits, cabbage, etc.
Treatment Of Chronic Cholecystitis
The treatment of choice for any chronic cholecystitis case is laparoscopic surgical removal of gallbladder. The operation is called cholecystectomy. Some patients who are not fit for surgery, the symptoms can be alleviated with the help of medicines. Often pain killers and antibiotics are necessary to relieve pain and infection.
Besides medicine dietary modifications and avoidance of constipation are also important measures that need to be taken. Patient should eat bland diet during the acute episode; avoid eating pastry, spicy food. They should also avoid fruits and vegetables that produce discomfort in the abdomen. Patient must eat small meals at frequent intervals instead of large 3 meals to avoid distension and irritation in the gall bladder.