Cholecystitis
Disease Details
Family Health Simplified
- Description
- Cholecystitis is the inflammation of the gallbladder, often caused by gallstones blocking the cystic duct.
- Type
- Cholecystitis is typically an acute or chronic inflammation of the gallbladder. It is not generally considered to be a genetic condition, and there is no specific type of genetic transmission associated with it. The condition is most often caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation. Other causes include infections, tumors, and bile duct problems.
- Signs And Symptoms
- Most people with gallstones do not have symptoms. However, when a gallstone temporarily lodges in the cystic duct, they experience biliary colic. Biliary colic is abdominal pain in the right upper quadrant or epigastric region. It is episodic, occurring after eating greasy or fatty foods, and leads to nausea and/or vomiting. People with cholecystitis most commonly have symptoms of biliary colic before developing cholecystitis. The pain becomes severe and constant in cholecystitis. Nausea is common and vomiting occurs in 75% of people with cholecystitis. In addition to abdominal pain, right shoulder pain can be present.On physical examination, an inflamed gallbladder is almost always tender to the touch and palpable (~25-50% of cases) in the midclavicular right lower rib margin. Additionally, a fever is common. A gallbladder with cholecystitis is almost always tender to touch. Because of the inflammation, its size can be felt from the outside of the body in 25–50% of people with cholecystitis. Pain with deep inspiration leading to termination of the breath while pressing on the right upper quadrant of the abdomen usually causes severe pain (Murphy's sign). Yellowing of the skin (jaundice) may occur but is often mild. Severe jaundice suggests another cause of symptoms such as choledocholithiasis. People who are old, have diabetes, chronic illness, or who are immunocompromised may have vague symptoms that may not include fever or localized tenderness.
- Prognosis
-
The prognosis for cholecystitis varies depending on whether it is acute or chronic and how promptly it is treated.
- **Acute cholecystitis**: With timely medical intervention, most patients recover fully. Treatment typically involves antibiotics and sometimes surgery (cholecystectomy) to remove the gallbladder. Delayed treatment can lead to complications such as gallbladder gangrene or perforation, which can worsen the prognosis.
- **Chronic cholecystitis**: This condition results from repeated episodes of inflammation. The prognosis is generally good with appropriate management, often involving elective cholecystectomy to prevent recurrence and complications.
Overall, with proper and timely treatment, the long-term outlook for most individuals with cholecystitis is favorable. - Onset
- Cholecystitis typically has a sudden onset, with symptoms developing over a few hours. It often presents with severe pain in the upper right abdomen, which can radiate to the shoulder or back.
- Prevalence
- Cholecystitis, which is the inflammation of the gallbladder, occurs in approximately 10-20% of the population in the United States over their lifetime. The condition is most commonly caused by gallstones blocking the cystic duct, leading to inflammation. Cholecystitis is more prevalent in women than in men and tends to increase with age.
- Epidemiology
- Cholecystitis accounts for 3–10% of cases of abdominal pain worldwide. Cholecystitis caused an estimated 651,829 emergency department visits and 389,180 hospital admissions in the US in 2012. The 2012 US mortality rate was 0.7 per 100,000 people. The frequency of cholecystitis is highest in people age 50–69 years old.
- Intractability
- Cholecystitis, which is inflammation of the gallbladder, is typically not considered intractable. It can often be managed effectively with appropriate medical intervention, such as antibiotics, pain management, and sometimes surgical removal of the gallbladder (cholecystectomy). However, complications or recurrent episodes may complicate treatment in some cases.
- Disease Severity
-
Cholecystitis is the inflammation of the gallbladder.
- Severity: The severity of cholecystitis can range from mild to severe. Mild cases may resolve with medical treatment and lifestyle changes, while severe cases can lead to complications such as gallbladder rupture or infection, requiring surgical intervention.
- NAN: This term is not directly related to the context of cholecystitis. If you are referring to a specific measurement or ranking system involving NAN, please provide more details. - Healthcare Professionals
- Disease Ontology ID - DOID:1949
- Pathophysiology
-
Cholecystitis is the inflammation of the gallbladder, typically occurring due to obstruction of the cystic duct by gallstones (cholelithiasis). The pathophysiology involves the following steps:
1. **Obstruction:** Gallstones block the cystic duct, leading to an accumulation of bile in the gallbladder.
2. **Inflammation:** The trapped bile causes increased pressure and inflammation of the gallbladder wall.
3. **Infection:** Secondary bacterial infection may develop, most commonly involving organisms like E. coli, Klebsiella, and Enterococcus.
4. **Ischemia:** The increasing pressure can compromise blood flow to the gallbladder, resulting in localized ischemia.
5. **Necrosis and Perforation:** If left untreated, severe inflammation can lead to gallbladder wall necrosis and potential perforation, which can cause peritonitis.
This process manifests clinically with acute right upper abdominal pain, fever, and leukocytosis. - Carrier Status
- Cholecystitis is an inflammation of the gallbladder, often caused by gallstones blocking the cystic duct. Carrier status is not applicable to cholecystitis as it is not a genetic or infectious disease that can be "carried" and transmitted to others.
- Mechanism
- Blockage of the cystic duct by a gallstone causes a buildup of bile in the gallbladder and increased pressure within the gallbladder. Concentrated bile, pressure, and sometimes bacterial infection irritate and damage the gallbladder wall, causing inflammation and swelling of the gallbladder. Inflammation and swelling of the gallbladder can reduce normal blood flow to areas of the gallbladder, which can lead to cell death due to inadequate oxygen.
- Treatment
-
Treatment for cholecystitis typically includes the following:
1. **Hospitalization:** Most patients are admitted to the hospital for monitoring and management.
2. **Fasting:** Patients are usually advised to refrain from eating and drinking to rest the gallbladder.
3. **Intravenous fluids:** To maintain hydration and electrolyte balance.
4. **Antibiotics:** If an infection is suspected or confirmed, antibiotics are administered to treat the bacterial infection.
5. **Pain management:** Medications are given to manage pain and discomfort.
6. **Surgery:** The most common treatment is cholecystectomy, which is the surgical removal of the gallbladder. This can be done laparoscopically or via open surgery, depending on the severity of the condition and patient factors.
Management of any underlying conditions and supportive care are also important aspects of treatment. - Compassionate Use Treatment
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For cholecystitis, compassionate use and off-label or experimental treatments could be considered in specific scenarios, particularly when standard treatments are ineffective or contraindicated. Here are a few possibilities:
1. **Antibiotics**: While antibiotics are a standard treatment, certain newer or broader-spectrum antibiotics might be used off-label if the infection is caused by resistant bacteria.
2. **Endoscopic Techniques**: Procedures like Endoscopic Retrograde Cholangiopancreatography (ERCP), though standard for certain conditions, might be used off-label for acute cholecystitis complicated by bile duct stones or other obstructions when surgery is not an option.
3. **Experimental Drugs**: Some anti-inflammatory or immunomodulatory drugs that are currently being tested in clinical trials might be considered under compassionate use programs if the inflammation is severe and unresponsive to conventional treatments.
4. **Cholecystostomy**: While percutaneous cholecystostomy is a recognized intervention, it might be considered an off-label or compassionate option for critically ill patients who cannot undergo surgery.
Before considering any of these options, it is essential to consult with a healthcare professional to understand the potential risks and benefits based on individual patient circumstances. - Lifestyle Recommendations
-
For cholecystitis, lifestyle recommendations include:
1. **Dietary Adjustments**:
- **Low-Fat Diet**: Reduce intake of high-fat and greasy foods which can trigger gallbladder attacks.
- **Frequent Small Meals**: Eating smaller, more frequent meals can help manage symptoms better.
- **Increase Fiber**: Incorporate more whole grains, fruits, and vegetables into your diet.
2. **Hydration**: Drink plenty of water to help with digestion and overall health.
3. **Maintain Healthy Weight**: Gradual weight loss if overweight, as rapid weight loss can increase the risk of gallstones.
4. **Regular Physical Activity**: Engage in regular exercise to maintain a healthy weight and improve digestion.
5. **Avoid Rapid Weight Loss**: Quick loss of weight can lead to the formation of gallstones, potentially worsening or triggering cholecystitis.
6. **Limit Alcohol Consumption**: Excessive alcohol can exacerbate symptoms and complicate the condition.
7. **Monitor Symptoms**: Keep track of any foods or activities that seem to trigger symptoms and avoid them.
Making these lifestyle changes can help manage and potentially alleviate symptoms of cholecystitis. - Medication
-
For cholecystitis, common medications include:
1. **Antibiotics**: For treating bacterial infection. Examples include:
- Ciprofloxacin
- Metronidazole
- Ceftriaxone
2. **Pain Medication**: For managing pain. Examples include:
- Acetaminophen
- NSAIDs (e.g., ibuprofen)
3. **Antispasmodics**: To reduce gallbladder spasms. Examples include:
- Hyoscine butylbromide
However, these are typically used in conjunction with other treatments, and surgical intervention (such as cholecystectomy) may be required in many cases. Always consult a healthcare professional for appropriate diagnosis and treatment. - Repurposable Drugs
- Cholecystitis is the inflammation of the gallbladder. For repurposable drugs, certain antibiotics such as ciprofloxacin, metronidazole, or levofloxacin can be considered to treat infections causing or resulting from cholecystitis. Anti-inflammatory medications, such as NSAIDs, can be used to manage pain and inflammation. However, specific drug repurposing should always be guided by a healthcare provider.
- Metabolites
-
Cholecystitis is inflammation of the gallbladder. It is generally not associated with specific metabolic byproducts or metabolites in the bloodstream or urine that are so distinctive they define the condition. The main diagnostic markers include:
1. **Bilirubin**: Increased levels may indicate a blockage or inflammation in the biliary system.
2. **Alkaline Phosphatase (ALP)**: Elevated levels can suggest bile duct obstruction.
3. **Gamma-Glutamyl Transferase (GGT)**: Often elevated in bile duct disease.
4. **Liver Enzymes (AST and ALT)**: May be mildly elevated if the liver is affected by the inflammation.
"Nan" does not apply to cholecystitis as it is not a relevant term within the context of this condition. - Nutraceuticals
-
Nutraceuticals, encompassing a range of food-derived products that provide health benefits, have not been widely studied specifically for cholecystitis. Cholecystitis is the inflammation of the gallbladder, typically due to gallstones blocking the cystic duct. While diet and lifestyle play roles in managing gallbladder health, specific nutraceuticals for cholecystitis are not well-established. However, general dietary recommendations to support gallbladder health include:
1. **High-Fiber Foods:** Whole grains, fruits, and vegetables may improve digestion and reduce the risk of gallstone formation.
2. **Healthy Fats:** Consuming moderate amounts of healthy fats, such as those from fish, nuts, and olive oil, may support gallbladder function.
It’s essential for individuals with cholecystitis to consult healthcare providers for personalized dietary advice and treatment options. - Peptides
- Cholecystitis is the inflammation of the gallbladder, often caused by a blockage of the cystic duct by gallstones. Peptides are not typically used directly in the treatment of cholecystitis. The primary approach often involves antibiotics, pain management, and possibly surgery to remove the gallbladder (cholecystectomy).