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Gallbladder Inflammation: Causes, Symptoms & Treatment
Gallbladder inflammation (cholecystitis) is an inflammation of the gallbladder, most often caused by gallstones. It causes severe abdominal pain and requires prompt medical treatment.
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Gallbladder inflammation (cholecystitis) is an inflammation of the gallbladder, most often caused by gallstones. It causes severe abdominal pain and requires prompt medical treatment.
What is Gallbladder Inflammation?
Gallbladder inflammation, medically known as cholecystitis, is an inflammation of the gallbladder – a small, pear-shaped organ located beneath the liver that stores bile fluid. This fluid plays a key role in the digestion of fats. The condition can be acute (sudden onset) or chronic (recurring over a longer period of time).
Causes
In most cases, gallbladder inflammation is triggered by gallstones that block the bile duct and cause a buildup of bile. Less commonly, other factors may be involved:
- Bile stasis without gallstones (acalculous cholecystitis), for example after major surgery or in critically ill patients
- Bacterial infections of the gallbladder
- Reduced blood flow to the gallbladder
- Tumors or polyps obstructing bile drainage
Symptoms
The typical symptoms of acute gallbladder inflammation include:
- Severe, cramping pain in the upper right abdomen (biliary colic), which may radiate to the right shoulder or back
- Nausea and vomiting
- Fever and chills
- Tenderness when pressing on the upper right abdomen
- Yellowing of the skin and eyes (jaundice) if the bile duct is also affected
In chronic cholecystitis, symptoms may be milder, presenting as recurring digestive discomfort, bloating, or general unease after fatty meals.
Diagnosis
Doctors use several methods to diagnose gallbladder inflammation:
- Ultrasound (sonography): The primary imaging method; can reveal gallstones, thickening of the gallbladder wall, and fluid accumulation
- Blood tests: Elevated inflammatory markers (e.g., CRP, white blood cell count) and liver enzymes indicate inflammation
- CT scan or MRI: Used for unclear findings or suspected complications
- MRCP (Magnetic Resonance Cholangiopancreatography): Imaging of the bile ducts without radiation exposure
Treatment
Treatment depends on the severity and underlying cause of the inflammation:
Conservative Treatment
In mild cases, initial management includes inpatient care with:
- Fasting to reduce stress on the gallbladder
- Intravenous fluids
- Pain relief medications and antispasmodics (spasmolytic agents)
- Antibiotics in cases of bacterial infection
Surgical Treatment
For recurrent symptoms, gallstone disease, or complications, cholecystectomy – the surgical removal of the gallbladder – is the treatment of choice. It is most commonly performed as a minimally invasive procedure (laparoscopy) and is a routine operation with excellent outcomes. Life without a gallbladder is entirely possible, as the liver continues to produce bile directly into the digestive tract.
Complications
If acute gallbladder inflammation is not treated in time, serious complications can develop:
- Gallbladder perforation (rupture of the gallbladder wall)
- Empyema of the gallbladder (pus accumulation)
- Gangrenous cholecystitis (tissue death)
- Peritonitis (inflammation of the abdominal lining)
- Sepsis (life-threatening bloodstream infection)
When to See a Doctor?
Severe pain in the upper right abdomen, fever, vomiting, or yellowing of the skin require immediate medical attention. Acute gallbladder inflammation is a medical emergency and must be treated promptly.
References
- Lammert F. et al. - Gallstones. Nature Reviews Disease Primers, 2016. DOI: 10.1038/nrdp.2016.24
- Yokoe M. et al. - Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 2018. DOI: 10.1002/jhbp.515
- Strasberg S.M. - Acute Calculous Cholecystitis. New England Journal of Medicine, 2008. DOI: 10.1056/NEJMcp0800893
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