Cholecystitis is inflammation of the gallbladder. The gallbladder is an organ where bile is stored berimportant role in the digestion of fat in the body.
Cholecystitis can occur suddenly (acute) or long-term (chronic). Most cases of acute cholecystitis are caused by a blockage in the bile duct, while chronic cholecystitis is an inflammation that occurs after a person experiences acute cholecystitis repeatedly.
Causes of Cholecystitis
Most cholecystitis is caused by a blockage in the bile duct, so that bile becomes trapped in the gallbladder. Bile duct blockage can be caused by:
- Gallstones, which are hard particles in the gallbladder that are usually a collection of cholesterol
- Biliary sludge, which is bile that has been mixed with cholesterol and salt crystals
- Infectious diseases, such as HIV/AIDS that trigger inflammation of the bile ducts
- Disorders of blood vessels, usually due to diabetes
- Scar tissue in the bile ducts
- Tumors of the bile ducts
The blockage triggers irritation of the gallbladder, which then causes swelling and inflammation. In some cases, the swollen gallbladder can also become infected by bacteria.
There are several factors that can increase the risk of cholecystitis, including:
- Female gender
- Pregnancy
- Undergoing hormone therapy
- old age
- Experiencing obesity
- Weight gain or loss too fast
Symptoms of Cholecystitis
The main symptom of cholecystitis is the appearance of severe pain in the right upper abdomen that lasts for several hours. This pain tends to appear after eating fatty foods. Abdominal pain that appears can radiate to the back or right shoulder blade or right shoulder.
In addition, cholecystitis can also be accompanied by the following symptoms:
- Stomach pain that feels sharp and gets worse when you take a deep breath
- Nausea, vomiting, bloating, and loss of appetite
- Fever
- The skin and whites of the eyes turn yellow
- Lump in stomach
- Stool is clay-colored or pale
When to go to the doctor
Check with your doctor if you experience the above symptoms. Management of cholecystitis needs to be done as early as possible to prevent complications.
See a doctor immediately if you experience severe stomach pain, nausea, vomiting, and fever, especially if accompanied by changes in skin color and yellowing of the whites of the eyes.
Cholecystitis Diagnosis
To diagnose cholecystitis, the doctor will ask the patient's complaints or symptoms, as well as the patient's medical history.
The doctor will also perform a physical examination. One of the signs that can indicate the presence of acute cholecystitis is: Murphy's sign positive. This characteristic sign is found by pressing the abdomen under the patient's right rib while asking the patient to breathe deeply. Murphy's sign is said to be positive if the patient feels pain in the place that is pressed when he takes a deep breath.
To confirm the diagnosis, the doctor will perform the following investigations:
- Blood tests, to detect bile infections and determine liver function
- Ultrasound scan, X-ray, MRI, or CT scan, to check for obstruction of the gallbladder or obstruction of the bile ducts
Cholecystitis Treatment
Treatment for cholecystitis will be carried out in the hospital so that the patient's condition can be better monitored. Treatment steps that will be carried out by the doctor include:
- Suggestions for fasting for a while and adopting a low-fat diet so that the workload of the gallbladder is reduced
- Giving fluids through an IV to avoid dehydration
- Use of drugs, such as painkillers to relieve pain or antibiotics to treat infections
In addition to the above treatment, the doctor may recommend the patient to undergo surgery to remove the gallbladder (cholecystectomy) to reduce the risk of complications and prevent the recurrence of cholecystitis.
There are 2 methods of cholecystectomy that can be done, namely:
- Laparoscopic cholecystectomy, using a special surgical instrument equipped with a video camera that is inserted through a small incision in the abdomen
- Open incision cholecystectomy, by making a larger incision in the abdomen
Generally, after a cholecystectomy, the digestive process will continue normally.
Cholecystitis Complications
Untreated cholecystitis has the potential to lead to serious complications, namely:
- Gallbladder tissue dies and rots
- Gallbladder rupture
- Infection of the abdominal cavity due to rupture of the gallbladder (peritonitis)
- Accumulation of pus (abscess) in the gallbladder
Prevention of Cholecystitis
Cholecystitis is difficult to prevent, especially acute cholecystitis. However, the risk of developing cholecystitis can be reduced in the following ways:
- Eat foods that are low in fat, such as fruits or vegetables
- Maintain an ideal body weight by exercising discipline and adopting a healthy diet
- Lose weight gradually