Cholecystitis

What Is It?

Cholecystitis is an inflammation of the gallbladder. The gallbladder is a small saclike organ located in the upper right side of the abdomen, just below the liver. The gallbladder temporarily stores bile, which is a liquid that contains a fat-digesting substance produced in the liver. During a meal, bile moves from the gallbladder through small tube-like passages (called the cystic duct and the common bile duct) into the small intestine. Here, bile mixes with food to help break down fats.

Cholecystitis usually develops when a person has gallstones, which are rock-like chemical deposits that form inside the gallbladder. If a gallstone blocks the cystic duct, bile becomes trapped in the gallbladder. Chemicals in the trapped bile or a bacterial infection can then lead to inflammation of the gallbladder itself.

There are two types of cholecystitis:

• Acute cholecystitis is the sudden inflammation of the gallbladder that causes abdominal pain.

• Chronic cholecystitis is inflammation of the gallbladder that lasts a long time. It is caused by repeat attacks of acute cholecystitis. Damage to the walls of the gallbladder leads to a thickened, scarred gallbladder. Ultimately, the gallbladder can shrink and lose its ability to store and release bile.

Gallstones alone can cause episodes of pain without any infection. This typically is called biliary colic.

Women are more likely than men to get gallstones. The risk of gallstones also is higher in:

• Anyone older than age 60

• Women who are pregnant or have had several pregnancies

• Women who take estrogen replacement therapy or birth control pills

• Obese people

• People who have lost weight rapidly

• People who eat a high-fat diet

Symptoms

Symptoms of acute cholecystitis may include:

• Pain. You may feel this discomfort in the center of the upper abdomen, just below the breastbone, or in the upper right part of the abdomen, near the gallbladder and liver. In some people, the pain spreads to between the shoulder blades, to the right shoulder blade, or to the right shoulder. Symptoms typically start after eating.

• Fever

• Shaking chills

• Nausea and/or vomiting

• Loss of appetite

• Jaundice (yellowing of the skin or eyes), dark urine, pale, grayish bowel movements -- These symptoms appear when gallstones pass out of the gallbladder and into the common bile duct, blocking the flow of bile out of the liver.