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Gallbladder and shortness of breath: Back pain and shortness of breath: 10 causes

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Back pain and shortness of breath: 10 causes

The back is prone to injury because it works hard to keep the body in an upright position and support the basic daily movements. When back pain occurs alongside shortness of breath, causing difficult or painful breathing, some people may worry that the cause is more serious.

In most cases, back pain and shortness of breath are merely due to a muscle strain or are the result of carrying extra weight. However, sometimes back pain with shortness of breath is due to a serious medical condition that requires prompt attention.

Someone experiencing these symptoms in addition to chest pain, sweating, nausea, dizziness or loss of consciousness should see their doctor or seek emergency care.

Read on for information about 10 potential causes for back pain and shortness of breath.

There are a lot of small and large muscles in the back and between the ribs, which means a strain is a common possible cause of a person’s back pain.

Straining and injuring these muscles can cause pain, which can make it more difficult to take a deep breath.

Muscle strains respond well to rest, ice or heat, and over-the-counter pain relievers, such as ibuprofen or acetaminophen.

A muscle strain typically goes away after a few days, but if it lasts longer, the doctor can prescribe stronger medications, such as a muscle relaxant, to help relieve the discomfort.

Pneumonia is an infection of the lungs that can develop after a cold or the flu. In most cases, someone who is healthy will recover without any complications. However, pneumonia can be severe in older adults or people who have other medical conditions.

Either a virus or bacteria can cause pneumonia. If the pneumonia is bacterial, a person may need antibiotics to clear up the infection completely. Some people may require hospitalization and supportive care to prevent further complications.

Being overweight means the muscles of the back have to work harder to support the basic activities of daily life. Having extra fat around the chest or back can also make it harder to breathe or take a deep breath.

Losing weight can help reduce this stress on the back. In addition, regularly exercising to work the muscles of the back can help to strengthen them and reduce pain over time.

Share on PinterestA person with high blood pressure has an increased risk of heart disease.

Blockages to the heart can cause discomfort elsewhere in the body, such as the back, jaw, arms or shoulders.

Coronary artery disease can also cause shortness of breath as it becomes more difficult for the arteries to carry oxygen throughout the body.

Anyone who suspects heart disease should mention these symptoms to their doctor for further evaluation and treatment, if necessary.

People at high risk for heart disease include those with high blood pressure, high cholesterol levels, or have a family history of heart disease.

Also, someone who smokes, is overweight, or has diabetes is also at higher risk for coronary artery disease.

Gastroesophageal reflux disease (GERD) occurs when stomach acid backs up into the esophagus and causes chest pain, heartburn, or a sour taste in the mouth.

However, the pain can radiate to the back, often between the shoulder blades and usually after eating. In addition, if the stomach acid leaks into the airways, it can cause shortness of breath, pneumonia, or chronic coughing.

Someone who suspects that they have GERD can usually treat it relatively easily at home with the use of antacids.

Simple home remedies, such as not eating before lying down and avoiding common triggers can also help prevent GERD. Potential triggers include acidic foods, citrus, chocolate, coffee, and alcohol.

The gallbladder is a small organ that sits in the abdomen and stores bile, which is a substance that the liver produces to help digest fats. Sometimes, small stones can form in the gallbladder that block the flow of bile.

Without treatment, gallbladder disease can cause extreme pain in the abdomen that radiates to the back. Shortness of breath, as well as confusion and rapid heart rate, can occur if the gallbladder has an infection that spreads to the bloodstream.

If a person has gallbladder stones, they may need surgery to remove the stones or the entire gallbladder. Someone who is susceptible to developing stones should avoid eating fatty foods, which can worsen bile production and increase the likelihood of developing stones.

A heart attack requires immediate treatment. It signals a blockage in the heart vessels that is compromising the tissue in the heart. Though some people have crushing chest pain, others have vague symptoms, such as back pain and or shortness of breath.

Anyone who suspects they may be having a heart attack should proceed to the nearest emergency room or call emergency services immediately.

The primary symptom of a pulmonary embolism, which is a blood clot in the lung, is often shortness of breath and chest pain. Some people may experience back pain as well.

Pulmonary embolism is a condition that requires medical treatment.

It is essential to report any cases of sudden shortness of breath to the doctor immediately, or seek emergency care if it occurs after hours.

The aorta is a large blood vessel that exits the heart and helps to distribute blood throughout the body.

An aortic dissection occurs when there is a tear in the aorta, causing blood to leak into the vessel walls. This is a very rare condition but causes severe back pain, shortness of breath, chest pain, weakness, and sweating.

An aortic dissection is a life-threatening event that requires immediate treatment. Depending on where the dissection is, emergency surgery may be necessary.

Shortness of breath and back pain are not typical signs of lung cancer. However, lung cancer can cause shortness of breath or chest pain. However, if the cancer spreads to the bones, it can cause pain in other parts of the body, such as the back or hips.

Anyone diagnosed with cancer will require treatment by a cancer specialist, or oncologist. A person may need surgery to remove the tumor, chemotherapy, or radiation therapy.

There are many potential causes of shortness of breath and back pain. In many cases, treatment is possible at home with rest. However, it is important to check in with the doctor, especially with severe shortness of breath, chest pain, or if the symptoms do not go away after a few days.

Can gallstones cause shortness of breath?

Whilst gallstones are a common cause of upper abdominal pain – it is not the only cause of upper abdominal pain or right upper abdominal pain. Furthermore, just because you have gallstones does not necessarily mean that they are the cause of your symptoms.  One should never assume things as this is the worst mistake in medicine.

The description of your symptoms do not sound like any one thing in particular and sound more like a collection of symptoms:

1. “Cannot digest properly and burping after meals” – many reasons that this sensation may occur and would need to clarify what is meant by not digesting properly. Eating too fast, aerophagia, anxiety, stress are some non-pathological reasons for these symptoms. They are not typical symptoms of gallstones.

2. Tense muscles are not a typical symptom of gallstones – certainly sounds more musculoskeletal.

3. Unable to breathe properly – not a typical symptom of gallstones and only a problem related to gallstones when have cholecystitis and peritonism.

I would recommend visiting your usual GP to get some investigations performed and if stress is a particular issue at the moment which certainly can lead to some of the symptoms you are experiencing, counselling and stress management techniques may be helpful.

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Recognizing Symptoms of a Gallbladder Attack

A gallbladder attack can be a very painful, potentially dangerous medical condition. This article will help you understand the signs and symptoms of gallbladder attack and how it can be treated.

What is the gallbladder?

The gallbladder (gall bladder) is a sac that sits in the right upper abdomen, just below the liver, and stores bile (gall) produced by the liver. Bile is made up of water, cholesterol, bile salts, fats, proteins and bilirubin (a yellowish-brown pigment). If the liquid bile contains too much cholesterol or bilirubin, it can harden into gallstones.

Most people with gallstones don’t even know that they have them. In some cases, a gallstone may cause the gallbladder to become inflamed, causing pain, infection, or other serious complications.

Gallbladder Issues–What exactly are they?

When abdominal pain occurs, gallbladder problems are at the top of the list of possible causes for the pain.

Gallbladder Attack

A gallbladder attack is a term commonly used to describe a gallstone blockage event.

In a normal person, bile acids and proteins prevent the formation of gallstones. But when there’s an imbalance in the bile components, pebble-like deposits known as gallstones are formed in the gallbladder. As gallstones block the bile ducts, pressure increases in the gallbladder. This can cause an “attack” of sporadic pain in the center of the upper abdomen called biliary colic. This belly pain will radiate outwards, moving gradually to the center of the belly or upper back.

A gallbladder attack or gallstone blockage can last anywhere from 15 minutes to a few hours. Gallstones are often managed by waiting for them to be naturally passed.

Common signs and symptoms of a gallbladder attack

  • Gallbladder pain. Pain in the upper right side or middle of the abdomen. The pain can be dull, sharp, or cramping. The pain usually starts suddenly. Feeling of pain is steady and may spread to the back or the area below the right shoulder blade. Having steady pain particularly after meals is a common symptom of gallbladder stones
  • Nausea. Nausea or vomiting are common symptoms of all types of gallbladder problems
  • Jaundice. Yellow-tinted skin may be a sign of a common bile duct block from a gallstone

Risk Factors for Gallstones

Numerous factors contribute to your risk of gallstones. Risk factors can include:

  • being overweight or obese
  • eating a high-fat or high-cholesterol diet
  • having diabetes
  • having a family history of gallstones
  • being age 60 or older
  • taking medications that contain estrogen
  • being a woman

Gallbladder Infection

A gallbladder infection most commonly occurs due to gallstone obstruction of one of the ducts that moves bile from the gallbladder to the intestine. Bacteria in the bile may lead to gallbladder gangrene, rupture, abscess, or a bloodstream infection.

Signs and Symptoms of Gallbladder Infection

Recognizing symptoms that may indicate a gallbladder infection is important, as this condition requires urgent medical treatment.

  • Fever. Fever is a characteristic symptom of gallbladder infection. Fever generally does not occur with a typical gallbladder attack, the presence of fever is an important distinguishing characteristic that points to an infection. A sudden temperature spike in someone with gallbladder-related symptoms could indicate the development of gallbladder gangrene or rupture, or the development of a bloodstream infection.
  • Gallbladder Pain. Gallbladder infection almost always causes severe pain, which usually begins in the right or middle upper abdomen. Over time, the pain increases in intensity and becomes more generalized, a characteristic that helps distinguish a gallbladder infection from a gallbladder attack. Gallbladder pain that lasts more than 6 hours points to the possibility of a gallbladder infection.
  • Gastrointestinal Disturbances. Abdominal distension due to decreased intestinal activity in response to a gallbladder infection or inflammation may also occur.
  • Heart Palpitations, Rapid Breathing and Confusion. A racing heartbeat, rapid breathing and confusion are typical symptoms of shock, which may develop if a gallbladder infection spreads to the bloodstream.

Gallbladder Disease

Cholecystitis is the most common type of gallbladder disease. A common sign of Cholecystitis may be either an acute or chronic inflammation.

Acute cholecystitis is generally caused by gallstones, but may also be the result of tumors or various other illnesses. Acute cholecystitis will present with pain in the upper right side or upper middle part of the abdomen. The pain can come right after a meal and range from sharp pangs to dull aches that may often radiate to the right shoulder. Additional symptoms of acute cholecystitis include: fever nausea, vomiting, jaundice, and different colored stools.

Cholecystitis is considered chronic after several attacks of acute cholecystitis, the gallbladder will begin to shrink and lose its function of storing and releasing bile. Abdominal pain, nausea, and vomiting may follow.

Test Used To Evaluate for Gallbladder Disease

  1. Blood Tests – A blood test may also be performed to help diagnose gallbladder disease. A complete blood count, or CBC, can help confirm an infection if there is a high white blood cell count. Other specific blood tests can also reveal high bilirubin levels (the cause of jaundice, a complication of gallbladder problems) or elevated enzymes suggesting an obstruction in the gallbladder.
  2. Urine Tests – Urine tests may also be performed to help diagnose problems with the gallbladder by looking for abnormal levels of chemicals like amylase, which is an enzyme that aids in the digestion of carbohydrates, and lipase, another enzyme that helps break down fats.
  3. Ultrasound – This test uses sound waves to examine the bile ducts, liver and pancreas. It is not invasive and is very safe. Stones may be seen in the gallbladder or bile ducts. Imaging may be impaired in patients who are obese or have recently eaten food.
  4. Endoscopic Ultrasound – This device uses a special scope with an ultrasound probe on the end. The scope is passed down into the small intestines where internal ultrasound images of the bile ducts, gallbladder and pancreas can be obtained.
  5. CT Scan – It is helpful in diagnosing cancers within the pancreas. It may identify gallstones but is not as effective in finding them as an ultrasound.
  6. ERCP – ERCP (Endoscopic Retrograde Cholangiopancreatography). This is a special type of endoscope, which allows access to the bile ducts and pancreas ducts. It also allows therapy to be performed such as removing stones from the bile ducts or pancreas ducts.
  7. MRCP – MRCP (Magnetic Resonance Cholangiopancreatography). This test uses a machine called MRI (Magnetic Resonance Imaging). It is a noninvasive test that employs special computer software to create images of the bile and pancreatic ducts similar to the images obtained by ERCP and does not require an endoscopy.

Gallbladder Removal

If you have gallbladder disease, your gastroenterologist may recommend removing your gallbladder. Humans can live without a gallbladder. The surgical removal of the gallbladder is called a cholecystectomy.

What is Gastroenterology?

Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. It involves a detailed understanding of the normal action (physiology) of the gastrointestinal organs including the movement of material through the stomach and intestine, the digestion and absorption of nutrients into the body, removal of waste from the system, and the function of the liver as a digestive organ.

What is a Gastroenterologist?

A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver.


While the stomach does a wonderful job of starting the digestion process, it doesn’t work alone. The small intestine, colon, and many other organs participate in turning food into nutrients the body can use. The gallbladder is one of the many organs that plays a part in the digestion process, but what exactly is the purpose of the gallbladder?

What is the Purpose of the Gallbladder?

The liver produces a fluid called bile which helps the small intestine break down fats from food, as well as fat-soluble vitamins such as A, D, E, and K. Bile also carries waste out of the body. Bile is mostly made up of cholesterol, bilirubin, and bile salts. The gallbladder, a small pear-shaped organ, releases bile during mealtimes to help the body digest fats. When the body is not actively digesting, such as overnight or between meals, the gallbladder stores bile.

Where is the Gallbladder Located?

The gallbladder is located in a small indention underneath the liver.

Common Gallbladder Problems

The gallbladder can be affected by several potential health conditions. Anything which blocks the normal flow of bile into and out of the gallbladder can lead to health issues.

  • Polyps
  • Infection
  • Tumors
  • Cholecystitis (inflammation of the gallbladder)
  • Gallbladder cancer
  • Gallbladder is not working properly
  • Gallbladder has stopped working
  • Gallstones which cause symptoms

Not all gallstones cause symptoms. You could have gallstone and not even know it! ‘Silent’ gallstones, meaning that the stones do not cause symptoms, may be present for years and discovered during an imaging test for another condition. As long as silent gallstones do not cause symptoms, the gallbladder does not need to be removed. Most of the time, the gallbladder is removed when a problem occurs – especially in the case of gallstones. Once you have gallstones, they are likely to recur if the gallbladder is not removed. You can live a normal lifestyle without a gallbladder, since bile has other paths to reach the small intestine.

Can You Avoid Gallstone With Diet?

Gallstones usually occur when the substances which make up bile are out of balance. Too much bilirubin or cholesterol can cause gallstones to form. Insufficient bile salts can also lead to gallstone formation. There is no surefire way to avoid gallstones. However, you can help reduce your risk with your diet.

  • Choose low fat or nonfat foods
  • Choose diets high in fiber and whole grains
  • Be sure to include plenty of fruits and vegetables in your diet
  • Avoid foods high in cholesterol
  • Avoid fatty meats, and opt for lean cuts and fish
  • Don’t skip meals, if possible

Keeping active and maintaining a healthy weight are other ways to reduce your risk of developing gallstones. Exercise is a natural way to reduce cholesterol. Even better, exercise is great for your overall well-being!

Who is at Risk for Gallstones?

Some people are at a higher risk of gallstones than others. It’s especially important for people who have inherent risk factors to practice healthy eating and lifestyle habits. People at risk for gallstones include:

  • Women
  • Pregnant women
  • Being Native American
  • Having a family history of gallstones
  • Having diabetes
  • People over age 60
  • Being obese or overweight
  • Eating a high fat and/or high cholesterol diet
  • Eating a low-fiber diet
  • Losing weight at a rapid rate
  • People on certain medications, including some cholesterol-lowering medications and some hormone therapy drugs

Having any one of these risk factors increases your chance of developing gallstones. Being proactive about the risk factors which you can control will help reduce your chance.


When your gallbladder is causing uncomfortable symptoms and side effects, there’s a good chance that you will need to have your gallbladder removed.

Gallbladder removal surgery, also known as a cholecystectomy, is a fairly common procedure. There are several potential reasons why your gallbladder may need to be removed.

Why Does My Gallbladder Need to be Removed?

When functioning normally, the gallbladder controls the distribution of bile, a fluid which helps the digestive system process fats. Bile is stored in the gallbladder when the body is not actively digesting, such as between meals or overnight, and released into the small intestine during mealtimes.

There are several conditions which can interrupt the normal flow of bile. When bile can’t flow normally, a person may feel symptoms such as pain, discomfort, nausea, and more.

Common reasons to have your gallbladder removed:

  • Extreme inflammation (cholecystitis)
  • Infection
  • Tumors
  • Gallbladder cancer
  • Gallbladder is not working properly
  • Gallbladder has stopped working
  • Gallstones which cause symptoms

Some people may have gallstones that do not cause symptoms. These gallstones are often found during other medical tests and procedures. Since ‘silent’ gallstones are asymptomatic, they do not generally need to be removed unless they start causing symptoms.

Common Types of Gallbladder Removal Surgery

The type of gallbladder removal surgery you receive will depend on the source of the problem, the size of any gallstones, and how the gallbladder can safely be removed.

Open cholecystectomy: Also known as ‘traditional’ or ‘conventional’ gallbladder removal surgery.

  • A long incision is made in the patient’s abdomen. The gallbladder is separated, sutures applied to cystic ducts and arteries, and the gallbladder removed.
  • Patients can expect to stay in the hospital for up to a week after the operation.
  • The average recovery time to return to normal work and activities is usually four to six weeks.

Laparoscopic cholecystectomy: Sometimes called ‘keyhole’ surgery due to the small incisions and use of a tiny video camera during the procedure.

  • Several small incisions are made in the patient’s abdomen. As with open cholecystectomy, the gallbladder is separated, sutures applied, and the gallbladder removed.
  • If for any reason the gallbladder is determined unsafe to remove by way of laparoscopic cholecystectomy, your surgeon will switch to open cholecystectomy.
  • Since this procedure is less invasive, patients can usually leave the hospital within 24 hours of surgery.
  • The average recovery time to return to normal work and activities is usually two weeks.

For both open and laparoscopic cholecystectomy, your surgeon will want to verify that there are no gallstones in the bile duct by taking an X-ray of the area. If any gallstones are found, they will be removed during surgery.

Non-surgical treatment: Some people are unable to have surgery due to pre-existing medical conditions or prior surgery in the upper abdomen. In these cases, non-surgical treatments may be an option.

  • Medication may be prescribed to dissolve cholesterol-based gallstones. However, it may take months or years for the gallstones to completely dissolve, and the stones may return at a later date.
  • Shock wave dissolution, also known as lithotripsy, is a procedure which uses a focused sound wave to break cholesterol gallstones into small pieces. The pieces are then carried naturally out of the gallbladder and into the digestive system.

What Happens if My Gallbladder is Not Removed?

Anesthesia is a frightening concept for many people, leading some to postpone or avoid gallbladder removal surgery. Untreated, your gallbladder can result in several complications.

  • Cholecystitis (gallbladder inflammation) can lead to a ruptured gallbladder.
  • Cholangitis (bile duct infection) can be harmful in itself, but can spread to other organs such as the liver.
  • Loose gallstones in your system can lead to pancreatitis if they block the bile duct.
  • Any of these complications can quickly become dangerous for your health.

Recovery Tips After Gallbladder Removal Surgery

It’s normal for you to feel sick, bloated, or tired immediately after your surgery. Caring for your wounds and taking care of your health will speed along your recovery.

  • Dress your stitches properly, cleaning the area, replacing dressings regularly, and applying any medication your doctor prescribes.
  • Get plenty of sleep!
  • Eat small, light meals immediately after the surgery, and build up to normal intake over the next few days.
  • Exercise – but choose gentle activities such as walking.
  • Do not drink alcohol for at least 24 hours after surgery.

If you experience fever, jaundice, pain, persistent nausea, or a return of your original symptoms, contact your doctor immediately as these could be signs of complications.


Surgery and lifestyle changes are two things which often go hand in hand. Surgeries take place for a wide variety of reasons. Beyond the recovery process, the body usually has to adapt to a new equilibrium.

The gallbladder is one organ which is usually removed when something goes awry with how it functions. Is it possible to live without a gallbladder?

Is it Possible to Live Without a Gallbladder?

It is absolutely possible to live a long and healthy life without a gallbladder. To understand why, you’ll need to know a little background about what the gallbladder does.

The gallbladder stores a fluid called bile, which is produced by the liver to help break down fats during digestion. When bile cannot be delivered to the small intestine as normal, the gallbladder is most often removed.

Gallstones, which are usually made up of cholesterol or bilirubin, can clog gallbladder ducts and cause pain, nausea, and many other symptoms. Since gallstones often recur after removal, the gallbladder is generally removed. Swollen or infected gallbladders happen for a variety of reasons and are also candidates for removal.

Even though the gallbladder helps digestion, the body has other ways of transporting bile to the small intestine. The main difference is that without a gallbladder, bile is continuously delivered into the small intestine instead of being stored and distributed at intervals.

Types of Gallbladder Removal Surgery

There are several types of gallbladder removal surgery, which is also known as a cholecystectomy.

  • Open cholecystectomy: A procedure where an incision is made in the patient’s abdomen and the gallbladder is removed. Hospital stays usually average around a week, while recovery is estimated between four to six weeks.
  • Laparoscopic cholecystectomy: Multiple incisions are made in the patient’s abdomen and a specialized camera is used during the procedure. Hospital stays are usually less than 24 hours, and most patients can return to normal activities within two weeks.
  • Non-surgical treatments: Usually used when surgery is not an option for a patient. These patients may have had prior abdominal surgery or other health conditions. Medication can be prescribed to dissolve cholesterol-based gallstones. Lithotripsy, or shock wave dissolution, is another way to dissolve cholesterol-based gallstones.

Open cholecystectomies used to be the most common type of gallbladder removal surgery, but laparoscopic cholecystectomy surgery has now become the standard for most cases.

Activity and Diet Without a Gallbladder

After recovering from surgery, you can return to your normal activities without needing to alter or reduce the intensity of your work, workouts, or hobbies.

The main lifestyle changes you’ll expect following gallbladder removal surgery center around your diet. Your gallbladder was in charge delivering bile to your small intestine during mealtimes and storing bile when not needed, such as overnight.

Without a gallbladder, bile is constantly delivered to your small intestine. This means that you may experience some changes in your digestion. For most people, these side effects go away over time.

You may experience:

  • Flatulence
  • Diarrhea
  • Indigestion

Your body will also digest food differently now that the flow of bile has changed. Fatty foods, full fat milk and dairy, and spicy foods may cause indigestion in some people. A balanced diet which is high and fiber and low in fat is a good place to start as you determine the right diet for you.

Dietary recommendations to help manage your digestion:

  • Avoid fatty or fried foods
  • Reduce or cut out spicy foods
  • Choose high fiber foods and whole grains
  • Choose plenty of vegetables
  • Opt for low fat or non-fat dairy
  • Reduce your caffeine intake if it causes indigestion
  • Avoid eating a large meal after fasting
  • Eat smaller meals throughout the day

You can live a healthy lifestyle without your gallbladder. Finding the right diet for your digestive system may take some time. Stay positive, experiment with different combinations of food and drink, and always consult your doctor with any questions or concerns you may have.

If you experience persistent symptoms, develop jaundice, become weak, or notice significant weight loss after surgery, you will want to speak to your doctor.


The gallbladder is a small, pear-shaped organ which stores and releases bile, which is helpful in digesting fats. Sometimes, whether as a result of infection, gallstones, or other issues, the gallbladder needs to be removed. One type of gallbladder removal surgery – laparoscopic cholecystectomy (LC) – is one option to remove a problematic gallbladder.

What is Laparoscopic Gallbladder Removal Surgery?

There are two main types of gallbladder removal surgery, open and laparoscopic cholecystectomy.

  • Open cholecystectomy: Also known as ‘traditional’ cholecystectomy. A single abdominal incision is made to allow the surgeon to remove the gallbladder.
  • Laparoscopic cholecystectomy: Several small incisions and a specialized scope called a laparoscope (a tiny video camera) are used to remove the gallbladder.

Laparoscopic gallbladder removal surgery is far less invasive than open cholecystectomy.

What is the Procedure for Laparoscopic Cholecystectomy?

Prior to the surgery, the patient is put under general anesthesia and remains asleep throughout the procedure.

  1. Surgeons make several small incisions in the abdomen and pass surgical instruments and the laparoscope (a video camera with a light attached) through the incisions.
  2. The surgeon locates the gallbladder. If the gallbladder is too complicated to remove with LC, they will switch to an open cholecystectomy and a larger incision will be made to allow access to the gallbladder.
  3. If the gallbladder is safe to remove with LC, the surgeon closes off the attached vessels and tubes and removes the gallbladder from the body.
  4. The incisions are then closed.

Your surgeon may perform a cholangiogram during LC to see if there are any gallstones in the bile duct. A cholangiogram is a test which identifies any gallstones which are located in the tubes and ducts outside of the gallbladder. A dye is injected into the bile duct to illuminate any stones. Then, an X-ray is taken. If any gallstones are located, they will be removed.

Can All Patients Receive a Laparoscopic Cholecystectomy?

Laparoscopic cholecystectomy is not an option for everyone. People who have previous upper abdominal surgery or certain pre-existing health conditions may need an alternate treatment method.

LC is also not viable if the gallbladder is infected, extremely inflamed, or if the gallstones are very large.

Benefits of Laparoscopic Gallbladder Removal

LC surgery is a safe and effective way to remove a problematic  gallbladder. After LC surgery, you can usually resume your normal activities after one or two weeks, depending on how quickly you recover.

Benefits of LC Surgery Include:

  • Shorter recovery time
  • Shorter hospital stay (usually less than 24 hours)
  • Less postoperative pain
  • Less scarring
  • Fewer complications

Open cholecystectomy is a more invasive procedure than LC, and requires more recovery time and a longer hospital stay.

Living Without a Gallbladder

Living without a gallbladder is rarely different than your normal lifestyle. After recovery, you can still be as active as you were prior to your surgery.

Most of your lifestyle changes will be diet-related. Since the gallbladder stores bile and helps digest fats, you may need to cut down on fatty food. You may also need to choose low-fat dairy, high fiber options, and limit foods which trigger side effects. Eating smaller meals throughout the day can also be beneficial to limiting or avoiding side effects.

Side Effects Include:

  • Flatulence
  • Indigestion
  • Diarrhea

You generally want to aim for a balanced, healthy diet following any type of gallbladder removal surgery.

Symptoms of Gallstones

You may have gallstones and not even know it! These ‘silent’ gallstones may be with you for years, yet never cause symptoms.

People generally have their gallbladders removed when their gallstones cause symptoms. While it’s possible to remove just the gallstone, gallstones are likely to recur and cause further symptoms. Gallbladders which are not working properly may also need to be removed.

Symptoms of Gallstones:

  • Pain in the right shoulder
  • Pain in the central abdomen or upper right portion of the abdomen lasting at least 30 minutes
  • Pain between the shoulder blades
  • Jaundice
  • Fever
  • Clay-colored stools

Everyone’s pain tolerance is different, and some people prefer to wait and see if the gallstones go away on their own. However, keep an eye out for the development of emergency symptoms. These symptoms require immediate medical attention.

Emergency Symptoms of Gallstones:

  • Pain which prevents you from finding a comfortable resting position
  • High fever and chills
  • Jaundice

If you experience any of these emergency symptoms, it’s important to seek medical attention as soon as you can.


Gallbladder removal usually occurs when a patient has gallstones that cause pain, jaundice, and nausea among other symptoms.

The gallbladder is not an essential organ, and people who have their gallbladders removed can live happy, normal lives. Lifestyle changes after gallbladder removal are mostly diet-centric and should not affect any exercise routines you may have.

Lifestyle Changes After Gallbladder Removal

The gallbladder’s purpose is to store and release a fluid called bile. The body produces bile naturally to help digest fatty foods. Bile is released during mealtimes and stored when the body is not actively digesting food, such as while you are asleep.

People can live without the gallbladder because this organ is not essential to digestion. The body has other ways of delivering bile to the small intestine.

Most people will experience some digestive side effects after surgery, but these symptoms usually go away on their own within a few weeks.

Digestion changes you may experience:

  • Flatulence
  • Diarrhea
  • Indigestion

Everyone’s system processes food in a slightly different way, so there is not a set diet. However, there are some recommended guidelines to help you adjust your eating habits.

Diet changes to help you manage living without a gallbladder:

  • Eat smaller meals spread throughout the day.
  • Avoid eating a large meal after fasting.
  • Reduce or cut out foods which make side effects worse, especially fatty and fried foods, as well as gravies.
  • Choose a diet high in fiber and low in fat.
  • When eating meat, choose leaner cuts and fish.
  • Choose non-fat or low-fat dairy.
  • Caffeinated beverages such as soda and tea can be difficult for some people to digest. Cut back your normal amount and slowly reintroduce caffeine to your system.

When choosing your new diet, aim to find a balanced diet which fits your needs and does not cause you discomfort. Finding the right changes for your lifestyle may take some experimentation. Consult your doctor with any questions or concerns.

If you start to lose weight, become weak, or if symptoms persist or worsen, speak to your doctor.


The gallbladder produces a substance called bile which helps our small intestine break down fats in the foods we eat. Sometimes, gallstones develop in the gallbladder and prevent the normal flow of bile. Gallstones can cause blockages in the gallbladder, causing pain, discomfort, and complications such as cholecystitis. But can gallstones lead to gallbladder cancer?

Can Gallstones lead to Gallbladder Cancer?

According to the American Cancer Society, gallbladder cancer is estimated to affect approximately 11,000 people in the United States this year. Gallbladder cancer is a rare condition which can either start in the gallbladder or start in another area of the body and spread to the organ.

It is uncommon for people who develop gallbladder cancer to have gallstones. Gallbladder cancer occurs when malignant cells develop in the tissue or membrane of the gallbladder, while gallstones affect the normal flow of bile into and out of the gallbladder.

Gallbladder cancer can be hard to detect, as there are generally no signs or symptoms in the early stages. Symptoms can also mimic other diseases, leading to a delayed diagnosis. The gallbladder is located behind the liver, which can further make detection difficult.

When gallbladder cancer is detected, it is often in a later stage of progression. The early stages are limited to the gallbladder itself, and are easier to treat. Later stages can spread to surrounding muscles, organs, and tissue, and are more difficult to treat.

Gallstone vs Gallbladder Cancer Symptoms

The symptoms of gallstones and gallbladder symptoms are similar in some respects, but should not be confused for one another.

Gallbladder cancer can be hard to detect, and is often caught in later stages or while seeking treatment for another health issue.

Symptoms of gallbladder cancer include:

  • Fever
  • Nausea and vomiting
  • Bloating
  • Lumps in the abdomen
  • Pain above the stomach
  • Jaundice

Some people may have gallstones and not even know it! Asymptomatic gallstones are often called ‘silent’ gallstones.

For other people, symptoms of gallstones – also known as ‘gallbladder attacks’ – occur during or after mealtimes. The gallbladder tries to release bile into the digestive tract to help break down fats, but the bile is blocked by a gallstone. Gallbladder attacks may last for one or several hours, and stop when the gallstone moves.

Symptoms of gallstones include:

  • Pain in the right shoulder
  • Pain in the central abdomen or upper right portion of the abdomen lasting at least 30 minutes
  • Pain between the shoulder blades
  • Jaundice
  • Fever
  • Clay-colored stools

Speak to your healthcare provider if you experience the symptoms of gallstones or gallbladder cancer. The sooner you seek treatment, the more likely you are to catch a problem before it gets worse!

Treatment for Gallbladder Cancer

The type of treatment for gallbladder cancer will depend on the patient’s age and health, symptoms, and progression of the cancer.

The most common types of treatment are:

  • Surgery: The gallbladder, tumor, and surrounding tissue may be removed to stop the spread of cancerous cells.
  • Chemotherapy: Medication is administered by IV or capsule in a set regimen to destroy the cancerous cells, stop their growth and division, and prevent further spread.
  • Radiation Therapy: X-rays are used over a series of sessions to destroy cancerous cells. This method is often used to shrink tumors prior to surgery, or afterwards to get rid of any remaining cancerous cells.

What is Gallbladder Disease?

The term gallbladder disease refers to conditions which affect the gallbladder. The two most common conditions are:

  • Gallstones
  • Cholecystitis (inflammation of the gallbladder)
  • Infection

What are Gallbladder Polyps?

Polyps are growths or lesions which protrude from the wall of an organ. They can occur in many areas within the body, including the gallbladder. When a person has gallbladder polyps, the polyp grows from the gallbladder wall into the interior of the gallbladder.

Most of the time, polyps are benign, meaning they are non-cancerous. Malignant polyps are cancerous and require treatment so they do not spread to other organs.

The type of treatment for malignant gallbladder polyps will depend on the size and location of the polyp. Your doctor will be able to make the best assessment of your specific case.


Our Gastroenterology Department

Florida Medical Clinic

In addition to providing general consultation, the Florida Medical Clinic Gastroenterology Department may schedule appointments for patients with diseases or disorders of the pancreas, liver, gallbladder, esophagus, stomach, small intestine and colon. Learn more about our Gastroenterology physicians and providers.

At Florida Medical Clinic, we have a team of nearly 300 providers with extensive training in fields such as anesthesiology, cardiology, endocrinology, plastic surgery, gastroenterology, hematology/medical oncology, hospital medicine, pain management, nephrology, obstetrics and gynecology, ophthalmology, orthopaedic surgery, pathology, podiatry, radiology, and urology. From common ailments like allergies and asthma to more complex conditions such as heart failure and cancer, there are no issues that Florida Medical Clinic can’t handle with compassion and expertise.

Our incredible physicians and advanced medical providers impact the lives of patients like you each and every day, going above and beyond to address virtually any need that might arise. To request an appointment at Florida Medical Clinic, please complete our online form and our office will contact you within one business day to schedule your appointment.

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Acute cholecystitis – NHS

Acute cholecystitis is inflammation of the gallbladder. It usually happens when a gallstone blocks the cystic duct.

Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. The cystic duct is the main opening of the gallbladder.

Gallstones are very common, affecting about 1 in 10 adults in the UK.

They do not usually cause symptoms, but can occasionally cause episodes of pain (biliary colic) or acute cholecystitis.

Acute cholecystitis is potentially serious because of the risk of complications.

It usually needs to be treated in hospital with rest, intravenous fluids and antibiotics.

Symptoms of cholecystitis

The main symptom of acute cholecystitis is a sudden, sharp pain in the upper right-hand side of your tummy (abdomen). This pain spreads towards your right shoulder.

The affected part of the tummy is usually very tender, and breathing deeply can make the pain worse.

Unlike other types of abdominal pain, the pain of acute cholecystitis is usually persistent and does not go away within a few hours.

Some people may have additional symptoms, such as:

  • a high temperature (fever)
  • feeling sick
  • being sick
  • sweating
  • loss of appetite
  • yellowing of the skin and the whites of the eyes (jaundice)
  • a bulge in the tummy

When to seek medical advice

See a GP as soon as possible if you develop sudden and severe abdominal pain, particularly if it lasts longer than a few hours or is accompanied by other symptoms, such as jaundice and a high temperature.

If you’re unable to contact a GP immediately, phone your local out-of-hours service or call NHS 111 for advice.

It’s important for acute cholecystitis to be diagnosed as soon as possible, as there’s a risk serious complications could develop if it’s not treated promptly.

What causes acute cholecystitis?

The causes of acute cholecystitis can be grouped into 2 main categories: calculous cholecystitis and acalculous cholecystitis.

Calculous cholecystitis

Calculous cholecystitis is the most common, and usually less serious, type of acute cholecystitis. It accounts for around 95% of all cases.

Calculous cholecystitis develops when the main opening to the gallbladder, the cystic duct, gets blocked by a gallstone or a substance known as biliary sludge.

Biliary sludge is a mixture of bile, a liquid produced by the liver that helps digest fats, and small cholesterol and salt crystals.

The blockage in the cystic duct causes bile to build up in the gallbladder, increasing the pressure inside it and causing it to become inflamed.

In around 1 in every 5 cases, the inflamed gallbladder also becomes infected by bacteria.

Acalculous cholecystitis

Acalculous cholecystitis is a less common, but usually more serious, type of acute cholecystitis.

It usually develops as a complication of a serious illness, infection or injury that damages the gallbladder.

Acalculous cholecystitis can be caused by accidental damage to the gallbladder during major surgery, serious injuries or burns, sepsis, severe malnutrition or HIV/AIDS.

Diagnosing acute cholecystitis

If you have severe tummy pain, a GP will probably carry out a simple test called Murphy’s sign.

You’ll be asked to breathe in deeply with the GP’s hand pressed on your tummy, just below your rib cage.

Your gallbladder will move downwards as you breathe in. If you have cholecystitis, you’ll experience sudden pain as your gallbladder reaches your doctor’s hand.

If your symptoms suggest you have acute cholecystitis, your GP will refer you to hospital immediately for further tests and treatment.

Tests you may have in hospital include:

  • blood tests – to check for signs of inflammation in your body
  • an ultrasound scan of your tummy – to check for gallstones or other signs of a problem with your gallbladder

Other scans, such as an X-ray, CT scan or MRI scan, may also be carried out to examine your gallbladder in more detail if there’s any uncertainty about your diagnosis.

Treating acute cholecystitis

If you’re diagnosed with acute cholecystitis, you’ll probably need to be admitted to hospital for treatment.

Initial treatment

Initial treatment will usually involve:

  • not eating or drinking (fasting) to take the strain off your gallbladder
  • receiving fluids through a drip directly into a vein (intravenously) to prevent dehydration
  • taking medicine to relieve your pain

You’ll also be given antibiotics if it’s thought you have an infection.

These often need to be continued for up to a week, during which time you may need to stay in hospital, or you may be able to go home.

After initial treatment, any gallstones that may have caused acute cholecystitis usually fall back into the gallbladder and the inflammation will often settle down.

Surgery

Removing your gallbladder may be recommended at some point after initial treatment to prevent acute cholecystitis coming back and reduce your risk of developing potentially serious complications. 

This type of surgery is known as a cholecystectomy.

Although uncommon, an alternative procedure called a percutaneous cholecystostomy may be carried out if you’re too unwell to have surgery.

This is where a needle is inserted through your tummy to drain away the fluid that’s built up in the gallbladder.

If you’re fit enough to have surgery, your doctors will decide when the best time to remove your gallbladder is.

In some cases you may need to have surgery immediately or in the next day or 2, or it may be necessary to wait a few weeks until the inflammation has settled down.

Surgery can be carried out in 3 ways:

  • laparoscopic cholecystectomy – a type of keyhole surgery where the gallbladder is removed using special surgical instruments inserted through a number of small cuts in your abdomen
  • single-incision laparoscopic cholecystectomy – where the gallbladder is removed through a single cut, which is usually made near the bellybutton
  • open cholecystectomy – where the gallbladder is removed through a single larger cut in the tummy

Although some people who have had their gallbladder removed have reported symptoms of bloating and diarrhoea after eating certain foods, it’s possible to lead a perfectly normal life without a gallbladder.

The organ can be useful, but it’s not essential as your liver will still produce bile to digest food.

Find out more about recovering from gallbladder removal

Possible complications

Without appropriate treatment, acute cholecystitis can sometimes lead to potentially life-threatening complications.

The main complications of acute cholecystitis are:

  • the death of gallbladder tissue (gangrenous cholecystitis) – which can cause a serious infection that could spread throughout the body
  • the gallbladder splitting open (perforated gallbladder) – which can spread the infection within your tummy (peritonitis) or lead to a build-up of pus (abscess)

Emergency surgery to remove the gallbladder is needed to treat these complications in about 1 in every 5 cases of acute cholecystitis.

Preventing acute cholecystitis

It’s not always possible to prevent acute cholecystitis, but you can lower your risk of developing it by reducing your risk of getting gallstones.

One of the main things you can do to lower your chances of getting gallstones is to adopt a healthy, balanced diet and reduce the number of high-cholesterol foods you eat, as cholesterol is thought to contribute to the formation of gallstones.

Being overweight, particularly being obese, also increases your risk of developing gallstones.

You should therefore control your weight by eating a healthy diet and exercising regularly.

But low-calorie rapid weight loss diets should be avoided because there’s evidence they can disrupt your bile chemistry and actually increase your risk of developing gallstones.

A more gradual weight loss plan is best. 

Find out more about preventing gallstones

The gallbladder

The gallbladder is a small pear-shaped organ located beneath the liver. It’s main purpose is to store and concentrate bile.

The liver produces bile, a liquid that helps digest fats and carries toxins excreted by the liver.

Bile is passed from the liver through a series of channels called bile ducts into the gallbladder, where it’s stored.

Over time bile becomes more concentrated, which makes it more effective at digesting fats.

The gallbladder releases bile into the digestive system when it’s needed.

The gallbladder is an organ that’s useful, but not essential. It can safely be removed without interfering with your ability to digest food.

Page last reviewed: 07 August 2019
Next review due: 07 August 2022

Acute Cholecystitis – NORD (National Organization for Rare Disorders)

Acute cholecystitis has no single clinical or laboratory finding with the level of diagnostic accuracy needed for diagnosis. Instead, the recommended diagnostic technique combines clinical observations with an abdominal ultrasound. The Tokyo Guidelines require one local sign or symptom, one systemic sign, and a confirmatory image test to form a diagnosis. However, these requirements may lead to under-diagnosis in patients presenting fewer symptoms. The Murphy’s sign test is a commonly used diagnostic tool. The physician applies pressure just below the ribs on the right side and asks the patient to inhale. Inhalation will bring the gallbladder into contact with the physician’s fingers, causing pain and an arrest in inspiration if the gallbladder is inflamed. Blood tests showing elevated levels of white blood cells (leukocytosis), elevated C-reactive protein, may be signs of infection and inflammation.

Imaging techniques are used to directly observe gallstones, gallbladder wall thickness, or cystic duct obstruction. The gallbladder wall is pathologically thickened if it is >3mm or wider. The two main imaging techniques used for cholecystitis are abdominal ultrasound and hepatobiliary scintigraphy (HIDA scan). Abdominal ultrasound is often the first test due to its widespread availability, lack of invasiveness, lack of ionizing radiation, and high accuracy in detecting gallbladder stones. Ultrasound can show the presence of stones, wall thickening and pericholecystic fluid.

A hepatobiliary iminodiacetic acid (HIDA) scan tracks the production and flow of bile from the liver to the small intestine and shows blockage. This test involves the intravenous injection of HIDA, a radioactively labelled compound, secreted into bile. A specialized camera can detect the radioactivity, allowing it to trace the movement of this bile. If the gallbladder does not fill within an hour, the cystic duct is likely obstructed. Although it is the most sensitive and specific diagnostic tool, it is limited in its use because of limited availability, long testing time, and ionizing radiation exposure. It can also be inaccurate if bilirubin is elevated which is indicative of decreased ability of the liver to secrete compounds such as HIDA into bile.

Cholangiography and computed tomography (CT) may also be used to identify cholecystitis, although their diagnostic accuracy is unknown. During CT scanning, a computer and x-rays are used to create a film showing cross-sectional images of certain tissue structures. During cholangiography, a contrast dye is injected into the bloodstream, which enables x-rays to create an image of the bile ducts. Additional imaging techniques include MRI.

Diagnosis is often delayed in elderly patients, as the only symptoms may be an alteration of mental state or decreased food intake.
The 2007 Tokyo Guidelines grade the severity of the disease to help guide its treatment. Cases are graded as mild, moderate, and severe as follows:

Mild (grade 1):
• Having none of the features of moderate or severe cholecystitis

Moderate (grade 2):
● Elevated white cell count
● Palpable, tender mass in upper right quadrant
● Duration longer than 72 hours
● Local inflammation (could be biliary peritonitis, pericholecystic abscess, hepatic abscess, gangrenous cholecystitis, or emphysematous cholecystitis)

Severe (Grade 3):
● Cardiovascular dysfunction
● Neurological dysfunction
● Respiratory dysfunction
● Renal dysfunction
● Hepatic dysfunction
● Hematologic dysfunction

Acute Acalculous Cholecystitis (AAC)

Diagnosis of AAC is often much more difficult than that of typical cholecystitis because it is much less common and patients often have severe concomitant medical problems that are the reason for hospital admission. The disease is generally suspected in any critically or chronically ill patient presenting with abdominal pain, fever and unexplained leukocytosis and sepsis. Blood tests may show increases in white blood cells (leukocytosis), transaminases, alkaline phosphatase, bilirubin, and amylase. As in calculous cholecystitis, ultrasound is the primary diagnostic imaging technique for AAC. Ultrasound may show gallbladder wall thickening greater than 5 mm, pericholecystic fluid, biliary sludge, gallbladder distention, gallbladder striation, mucosal peeling, air bubbles (emphysematous cholecystitis), and gallbladder perforation. Presence of at least two of the following is generally used to diagnose AAC: positive ultrasound Murphy’s sign, gallbladder wall thickening, gallbladder distension and pericholecystic fluid, in the absence of gallstones.

CT and MRI are used when ultrasounds are inconclusive. An MRI can show gallbladder wall thickening, increased bile density, air bubbles, fluid buildup, and bleeding inside the gallbladder.

Hepatobiliary scintigraphy is the best diagnostic tool for AAC because it can detect those without the disease 100% of the time. This test shows improper gallbladder filling in both AAC and calculous cholecystitis.

Could Your Abdominal Pain Actually Be Gallstones? – Health Essentials from Cleveland Clinic

There’s a lot going on in your body between your chest and your pelvis. So when abdominal pain strikes, it can be nearly impossible to tell where it’s coming from.

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If the pain is in the upper part of the abdomen, some people
wonder if they should blame their gallbladder – the tiny, pear-shaped organ
that sits under the liver on the right side of your abdomen. It’s a fairly
common cause of upper abdominal pain, but it’s not the only potential cause.

Are there certain clues that suggest a gallbladder problem? Gastroenterologist Michael Kirsch, MD, explains how this organ works and some of the classic gallbladder symptoms.

What exactly is the gallbladder, anyway?

Most of the time, the gallbladder just stores bile produced by the liver. Bile helps to break down fats, so when you eat a meal, the gallbladder gets to work squeezing some of that bile into the intestine to help with digestion.

If bile contains too much of one or more of its components, it can harden into pebble-like gallstones, which can block the flow of bile.

“In most people, stones never cause any symptoms,” Dr.
Kirsch says. (You could have one right now and not even realize it!) If these
“silent” stones are discovered accidentally during other medical tests or
procedures, there’s no need to do anything about them.

But sometimes, the blockage creates a buildup of pressure in the gallbladder and causes pain. That’s a gallbladder attack.

Where do you feel gallbladder pain?

Even for a skilled physician, it can be difficult to tell whether someone’s gallbladder is the source of their abdominal pain. That’s because a number of things can cause localized pain in the abdomen, including a peptic ulcer or a heart attack.

In typical cases, gallbladder pain:

  • Is an achy pain felt in the mid-upper abdomen.
  • Can radiate to the right shoulder or back.
  • Lasts for 20 minutes to an hour.
  • Recurs in an identical fashion.
  • May be accompanied by other digestive symptoms, such as nausea or vomiting.

“The pain can be spontaneous and not necessarily restricted
to meal time — it can awaken someone at night,” Dr. Kirsch says.

Certain people are more likely to have gallbladder problems,
including anyone who is:

  • Female.
  • Pregnant.
  • Diabetic.
  • Obese.
  • Over the age of 40.
  • Losing weight quickly.
  • Eating a high-fat diet.
  • Taking birth control pills or hormone replacement therapy.

If the gallbladder might be the culprit…

Sometimes, gallstones resolve themselves. Other times, they
get stuck in the gallbladder or in the bile ducts and cause recurring pain.

If you have pain that you suspect is related to your
gallbladder, see a gastroenterologist to help you get to the bottom of it.

It might be helpful to keep a record of when and where you
experience symptoms.

“The most important tool for a physician is listening very carefully to the patient’s medical history,” Dr. Kirsch says. “That is by far the most valuable piece of data that the physician will have available – even more valuable than an ultrasound or CAT scan or laboratory blood tests.”

If your doctor suspects gallstones as the culprit, they may
order one of those tests for confirmation.

If the gallbladder is deemed to be the source of the problem, your doctor might recommend gallbladder removal surgery.

This probably sounds like a dramatic step, but the reality
is that you don’t actually need your gallbladder to live a happy, healthy life.
Your liver can release bile directly into the intestines to help with
digestion. And, the gallbladder can be removed with a laparoscope.

“The vast majority of everyone who has their gallbladder removed lives perfectly well,” Dr. Kirsch says.

If you’re unsure, find your way to a doctor ASAP

Because of all of the possible causes, it’s important to
tread carefully when it comes to abdominal pain.

If the pain is severe, gets worse or is accompanied by sweating, shortness of breath, or bloody vomit or stool, it’s worth a trip to the ER.

“It can be a difficult call with all the abdominal pain that
we see as to whether the gallbladder is responsible or there’s some other
cause,” Dr. Kirsch says. “It takes experience and judgment.”

Acute Cholecystitis – Symptoms, Diagnosis & Treatment from Healthily

If your doctor suspects you have acute cholecystitis, you will probably be admitted to hospital for treatment.

Antibiotics

You will first be given an injection of antibiotics into a vein. Broad-spectrum antibiotics are used, which can kill a wide range of different bacteria.

Once your symptoms have stabilised, you may be sent home and given an appointment to return for surgical treatment (see below).

Alternatively, if your symptoms are particularly severe or you have a high risk of complications, you may be referred for surgery a few days after antibiotic treatment.

A cholecystectomy is the most widely used type of surgery for cases of acute cholecystitis.

Surgery

A cholecystectomy is the surgical removal of the gallbladder. There are two types of cholecystectomy:

  • laparoscopic cholecystectomy
  • open cholecystectomy

These are described below.

Laparoscopic cholecystectomy

Laparoscopic cholecystectomy is a type of ‘keyhole’ surgery. It is the most widely used type of cholecystectomy. A laparoscopic cholecystectomy is carried out under a general anaesthetic, which means you will be asleep during the operation and will not feel any pain.

During a laparoscopic cholecystectomy, the surgeon makes four small cuts, each about 1cm or smaller, in your abdomen (tummy) wall. One incision is made near your belly button and the other three made across your upper abdomen.

Your abdomen is inflated with carbon dioxide gas passed through the cuts. Inflating your abdomen gives the surgeon a better view of your organs and more room in which to work.

The surgeon passes an instrument called a laparoscope through one of the incisions. A laparoscope is a small, rigid tube that has a light source and a camera at one end. The camera transmits images of the inside of your abdomen to a television monitor.

The surgeon then passes small instruments down the other incisions to remove your gallbladder and any gallstones. After your gallbladder has been removed, the incisions are closed.

As this technique only involves making small cuts in your abdomen, you will not experience much pain afterwards. You should also recover quickly from the effects of the operation. Most people are able to return home either on the day of the surgery or the day after.

Read about laparoscopic cholecystectomy for more information about the procedure.

Open cholecystectomy

A laparoscopic cholecystectomy is not recommended if you:

  • are in the third trimester (the last three months) of pregnancy
  • for some people with cirrhosis (scarring of the liver)

In these circumstances, an open cholecystectomy may be recommended.

An open cholecystectomy may also be carried out if a planned laparoscopic cholecystectomy is not successful.

As with a laparoscopic cholecystectomy, an open cholecystectomy will be carried out under general anaesthetic so you will not feel any pain during the procedure. The surgeon will make a large cut in your abdomen to remove your gallbladder.

An open cholecystectomy is an effective method of treating acute cholecystitis, but has a longer recovery time than laparoscopic cholecystectomy. Most people take about six weeks to recover from an open cholecystectomy.

Percutaneous cholecystostomy

If your symptoms are severe or you are in poor health, your care team may decide immediate surgery is too dangerous.

In such circumstances, a temporary measure known as a percutaneous cholecystostomy may be carried out. A percutaneous cholecystostomy may be performed under a local anaesthetic, which numbs your abdomen. This means you will be awake during the procedure.

The surgeon will use an ultrasound scan to guide a needle to the site of your gallbladder. The needle is then used to drain bile out of the gallbladder, which should help relieve inflammation (swelling). Once your symptoms improve, your gallbladder can be surgically removed.

Living without a gallbladder

You can lead a perfectly normal life without a gallbladder. The organ can be useful but it’s not essential. Your liver will still produce bile to digest food.

However, some people who have had their gallbladder removed have reported symptoms of bloating and diarrhoea after eating fatty or spicy food. If certain foods do trigger symptoms, you may wish to avoid them in the future.

90,000 Cholecystitis symptoms and treatment in adults

Cholecystitis is the general name for a group of diseases that lead to the development of inflammatory processes in the gallbladder. The main sign of pathological changes in the tissues of the organ is systematic pain in the right hypochondrium. Cholecystitis occurs in men and women of all age groups.Risk factors are alcohol abuse, an unbalanced diet, and stressful situations. Children and adults with signs of cholecystitis will need advice from a gastroenterologist, nutritionist and therapist.

The reasons for the development of pathology

The foci of inflammation in the gallbladder are formed under the influence of pathogenic microflora or stagnation of bile.In the first case, viruses or bacteria enter the organ through sources of chronic infection (oral cavity, nasopharynx) or directly from the intestine. The causative agents of the disease are staphylococci, streptococci or hepatitis C and B viruses.

The reasons for the stagnation of bile remain:

  • gallstone disease;
  • violation of the patency of the biliary tract;
  • congenital malformations or malformations;
  • chronic gastrointestinal pathologies.

The risk of developing cholecystitis increases against the background of a hereditary predisposition of a person to inflammation of the gallbladder. In a similar way, the organ is affected by the systematic use of alcohol and smoking tobacco. Hormonal changes in a woman’s body during pregnancy or menopause remain a significant risk factor for disrupting the normal functioning of the gallbladder.

Types of inflammatory processes in the gallbladder

Gastroenterologists use several reasons to classify cholecystitis.Among them:

  • the presence or absence of calculi (stones) in the lumen of the gallbladder;
  • the severity of destructive changes in the tissues of the organ;
  • the severity of the patient’s symptoms of cholecystitis.

In the first case, doctors distinguish calculous (with the deposition of stones) and non-calculous cholecystitis. Concrements are detected in 90% of patients who are faced with an inflammatory process in the gallbladder. Non-calculous cholecystitis, characterized by the absence of stones, is characterized by rare exacerbations and a favorable prognosis when choosing conservative treatment methods.

The severity of symptoms and destructive changes allows doctors to identify acute and chronic types of the disease. In the first case, the patient is faced with a sharp manifestation of symptoms, acute pain syndrome, intoxication of the body. The chronic form of cholecystitis can be almost asymptomatic. Pain is rare and of low intensity.

According to the severity of the clinical picture of the disease, mild, moderate and severe forms of cholecystitis are distinguished.The main difference between the two is the duration and frequency of pain in patients.

Symptoms of pathology

Chronic cholecystitis is characterized by an undulating course. Attacks of pain of varying intensity occur in the right hypochondrium.The pain syndrome is of an irradiating nature – the shoulder, scapula or collarbone become secondary foci. An increase in unpleasant sensations occurs after a meal by the patient or against the background of moderate physical exertion.

Other symptoms of cholecystitis include:

  • general weakness;
  • 90,011 increase in body temperature;

  • systematic bouts of nausea;
  • Regular vomiting with impurities of bile.

Against the background of intoxication of the body, tachycardia, shortness of breath, hypotension are manifested.The presence of stones in the lumen of the gallbladder leads to yellowness of the skin of patients and intense itching.

Do you have symptoms of cholecystitis?

Only a doctor can accurately diagnose the disease.
Do not delay the consultation – call

+7 (495) 775-73-60

Diagnostic measures

The main difficulty for the gastroenterologist is determining the type and nature of the patient’s cholecystitis.The patient needs to visit a gastroenterologist. During the history and physical examination, the doctor will make a preliminary diagnosis. The strategy for the treatment of cholecystitis is developed after the gastroenterologist receives the results of the following studies:

As an additional test, the doctor may refer you to a computed tomography scan of the abdomen.

Cholecystitis treatment

Onconservative treatment of acute and chronic cholecystitis, not complicated by stones, is based on the patient’s diet and medication.Diet with cholecystitis involves switching to boiled or stewed dishes. The break between meals should not exceed 4 hours.

Medication therapy includes pain relievers and antispasmodics. If pathogenic microflora is found in the patient’s biomaterials, the doctor may insist on the use of antibiotics.

Physiotherapy is designed to restore the tone of the gallbladder. Patients receive referrals for electrophoresis, inductometry and UHF.

Surgical intervention is performed against the background of advanced cholecystitis.Removal of the gallbladder is performed during abdominal or laparoscopic surgery. In the first case, the surgeon is able to assess the condition of the adjacent organs and tissues. In the second, doctors use endoscopes that minimize the time needed to fully restore the patient’s working capacity.

Statistics

Cholecystitis is the most common abdominal pathology.It accounts for up to 12% of clinically reported cases. Concrements are found in 60-95% of people suffering from inflammation of the gallbladder.

Cholecystitis develops more often in women: signs of the disease are found in girls 4-6 times more often than in men. Up to 75% of those with a chronic or acute type of disease belong to the 45-60 age group.

Questions and answers

Answers to frequently asked questions:

Vinogradov

Dmitry Alekseevich

Work experience 5 years

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The greatest danger to human life is not the disease itself, but its possible complications.So, intoxication of the body can lead to multiple organ failure. In the absence of medical care, the patient may not survive the onset of an exacerbation

Dmitry Vinogradov

Gastroenterologist

Is cholecystitis dangerous for the life of patients?

Patients at risk should follow the recommendations of the gastroenterologist regarding the daily diet.Refusal from alcoholic beverages and tobacco products will positively affect the time intervals between attacks of chronic cholecystitis.

Dmitry Vinogradov

Gastroenterologist

Are there effective remedies for disease prevention?

Patients who have had their gallbladder removed retain their original quality of life.A timely operation eliminates the likelihood of complications that can threaten the life of a child or adult.

Dmitry Vinogradov

Gastroenterologist

Is surgery on the background of cholecystitis dangerous?

90,000 Gallbladder diseases – symptoms and treatment

The first visit of a patient to a doctor about biliary colic does not mean that he has an acute process.Almost always, a careful examination reveals the presence of signs of chronic suffering of this organ. In other words, cholecystitis develops gradually and therefore an acute attack of cholecystitis is an exacerbation of a chronic, latent gallbladder disease.

In chronic cholecystitis, the most common symptoms are indications of pain in the right hypochondrium, bitterness in the mouth, poor appetite, nausea, and sometimes vomiting of bile in the morning.

An exacerbation of the disease is accompanied by attacks of unbearable cutting pain in the right hypochondrium or in the epigastric region. The pain has a typical irradiation (direction) – up, to the right and from behind – to the region of the right shoulder blade, to the right shoulder, to the right half of the neck, sometimes spreads over the entire abdomen, intensifies with a deep breath, in the position on the left side. Pain syndrome may be accompanied by nausea and repeated vomiting with an admixture of bile, which does not bring relief.Pallor and yellowness of the skin is noted. The tongue is coated with a yellow-brown bloom, dryish. The mobility of the abdominal wall in the upper right part is limited. Here, a zone of increased skin sensitivity, pain on palpation (pressure), and sometimes a symptom of muscle protection are determined.

It should be emphasized that the localization of pain in the right half of the chest, right scapula is as characteristic of diseases of the gallbladder as ischemic heart disease is characterized by pain in the chest and in the left arm.It is important to find out the immediate, provoking cause of the pain syndrome. An attack of cholecystitis is most often associated with the abuse of fatty foods and other errors in food. Relapse of an attack is most often caused by a stressful situation, nervous tension, mental trauma. In persons suffering from cholelithiasis, pericholecystitis, an attack often occurs in connection with physical exertion, horseback riding, cycling, or driving on bumpy roads.

Transient jaundice that develops after an attack is characteristic of cholelithiasis, but it can also be with hypermotor dyskinesia.In some cases, in violation of the outflow of bile, patients note the appearance of discolored feces (white-gray) within 1-2 days.

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In uncomplicated cholelithiasis, an attack of pain begins suddenly and just as suddenly stops, the patient already the next day feels quite satisfactory.

More often, chronic diseases of the biliary tract occur with so-called minor symptoms – general malaise, subfebrile condition, unexpressed dyspeptic symptoms, pain or discomfort from the heart. Such patients for a long time but unsuccessfully visit doctors of various specialties, who sometimes mistakenly diagnose rheumatism, thyrotoxicosis, neurocirculatory dystonia, peptic ulcer, gastritis, neuralgia, etc., while the cause of all these symptoms lies in latent cholecystitis, dyskinesia or cholelithiasis.It may be the other way around, the patient is being treated for various diseases of the gallbladder, in fact, the true cause is duodenal ulcer.

In elderly and senile people, there is a painless course of cholecystitis, which is associated with a change in the threshold of pain sensitivity, the body’s inactivity in old age.

In patients with chronic diseases of the biliary tract, the stomach may be involved in the process, while belching, bitter taste in the mouth, heartburn, nausea, and anacid are often noted.Stool disorders (diarrhea, constipation) are possible. All these disorders affect the state of the central nervous system, patients become nervous, irritable, and suffer from insomnia. Conversely, individuals suffering from chronic diseases of internal organs may develop gallbladder dyskinesia.

Hypotonic (atonic) dyskinesia

usually characterized by mild, dull pain (feeling of heaviness) in the right hypochondrium. Pain, as a rule, is accompanied by nausea when eating, an unpleasant taste in the mouth, poor tolerance of food odors.

Cholecystitis: signs of how to treat | MRI Expert

Modern medicine has to deal with the pathology of the biliary tract quite often. And the number of such diseases continues to grow. Today we will talk about cholecystitis: what kind of disease it is, what are its symptoms, causes, how it is detected and treated.

Nikolai Borisovich Patrushev, a gastroenterologist, Clinic Expert, Perm, answers our questions.

– Nikolai Borisovich, there is evidence that today 10-20% of the adult population suffers from cholecystitis, and there is a tendency for further growth of this pathology.Please tell us what it is?

– In one phrase, cholecystitis is an inflammation of the gallbladder. The pathology of the biliary tract remains an urgent problem for today’s medicine. Yes, there is a trend towards an increase in the incidence. Moreover: according to forecasts of scientists, the number of diseases of the digestive system (which includes the pathology of the biliary tract) in the next 15-20 years in the world will grow by 30-50%.

– What types of cholecystitis are known to modern medicine?

– There are two of them: acute and chronic cholecystitis.The first is developing rapidly, against the background of complete well-being. A pain syndrome appears in the abdomen, the pain is localized in the right hypochondrium. Nausea, vomiting may appear, and the temperature may rise. As a rule, acute cholecystitis is the most common manifestation of cholelithiasis. Such patients are hospitalized through the ambulance line in a surgical hospital.

Read more about gallstone disease here: Remove or leave? What to do if gallstones are found?

Chronic cholecystitis initially develops as an independent process, gradually, imperceptibly.Often the diagnosis of “cholecystitis” is made to the patient during examination for completely different diseases.
It should be borne in mind that diseases of the gallbladder and biliary tract are characterized by a variety of clinical manifestations, the duration of the course, protracted exacerbations – this determines the frequent appeal for medical help, makes these ailments a social problem.

– What are the causes of cholecystitis? What causes it?

– Various factors are involved in the development of this pathology.In the first place, I would put the violation of the contractile function of the gallbladder. This leads to stagnation of bile, slowing down its evacuation from the gallbladder. Most often, the contractile function of the gallbladder is affected by psychoemotional overload, neurotic reactions and prolonged stressful situations, physical inactivity.

The infectious factor is also important. Infectious agents enter the gallbladder from chronic foci of inflammation in the body – for example, in diseases of the ENT organs, stomach, duodenum, from other parts of the intestinal tube.

Contribute to the development of cholecystitis and helminthic invasions – say, opisthorchiasis. Previous hepatitis A (Botkin’s disease) can also lead to inflammation of the gallbladder.

Also, this disease can be provoked by the reflux of pancreatic juice into the cavity of the gallbladder – a so-called chemical burn of the mucous membrane of the gallbladder occurs, which can lead to its inflammation.

Read the materials on the topic:

How to protect yourself from Botkin’s disease?
Is there a stress vaccine?
Childhood – for movement! What does hypodynamia lead to?

– Please tell us about the signs of cholecystitis.How does it manifest itself?

– Cholecystitis can occur with varying degrees of severity. The symptoms will depend on this, as well as on the stage of the disease. First of all, the pathology is manifested by pain syndrome. These pains arise due to spasm of the gallbladder or due to its stretching.

Pain appears in the right hypochondrium, as a rule, 40 minutes – 1.5 hours after an error in the diet (for example, when eating spicy, fatty foods, fried foods, overeating). The pain is felt for about half an hour and, with a mild form, goes away on its own.In severe forms, the pain is more intense and prolonged.

Another pain can be provoked by a long stay of a person in a sitting position – driving a car, at a computer. From the right hypochondrium, such pains can be given upward – to the right shoulder, neck, right shoulder blade.

In addition to pain, the patient may be disturbed by the so-called dyspeptic disorders: belching, nausea, metallic taste in the mouth, sometimes vomiting (if it occurs repeatedly, bile may appear in it).Bloating, alternating constipation and diarrhea may occur.

Also, cholecystitis can be accompanied by irritability, insomnia, decreased performance.

The more severe the form of cholecystitis, the brighter and longer the listed symptoms will be expressed.

– Is there asymptomatic cholecystitis? That is, the person is not worried about anything, and the disease is detected only when carrying out any diagnostic tests – for example, as part of a preventive examination

– Yes, it happens.In 50% of cases, cholecystitis is latent, asymptomatic. Signs of pathology of the gallbladder before clinical manifestations of the disease can only be indicated by ultrasound data. Therefore, this study must be included in the examination program for diseases of the digestive system.

In addition, there are atypical clinical forms that can mislead the doctor, simulating various diseases of other organs and systems, for example, cardiovascular, endocrine and others (the so-called “masks”).And when we begin to understand, it turns out that we are talking about the pathology of the gallbladder. The most famous and studied is the so-called cardiac mask of cholecystitis (or cholecystocardial syndrome): every third or second patient with cholecystitis may complain of heart problems. This is a rapid heartbeat, shortness of breath, pain in the heart. An electrocardiogram in such patients without any abnormalities.

Cholecystitis can also proceed under the guise of thyroid pathology – here the patient’s complaints will be similar to thyrotoxicosis (irritability, excessive sweating, the same palpitations, trembling of the fingers, an increase in body temperature to 37-37.5 degrees).In this case, the thyroid gland may turn out to be somewhat enlarged, and here it is necessary to understand whether the symptoms are caused precisely by its pathology, or the problem is still in the gallbladder.

Cholecystitis may also have an allergic mask, and a number of others. To understand this, the doctor must have considerable practical experience, correctly build a diagnostic search.

– Let’s talk about the diagnosis of cholecystitis. What does it include? How can a doctor detect this pathology?

– Today, the most accessible and common method for diagnosing cholecystitis is an abdominal ultrasound.Ultrasound diagnostics allows you to assess the condition of the walls of the gallbladder: if they are thickened by more than 4 mm, this is already a clear sign of cholecystitis, if less, it is possible that the pathology is only at the beginning of development. The doctor also evaluates the contractility of the gallbladder.

Ultrasound will help to identify stones in the gallbladder. If they are found and there is also cholecystitis, then they speak of stone (calculous) cholecystitis.

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There are other research methods.For example, probing of the duodenum (duodenal intubation). It allows you to assess the biochemical composition of bile, sow it for infection and identify microbes that cause inflammation in the gallbladder.

– How can doctors help a patient with this ailment? How is cholecystitis treated?

– We can only help after when, in the course of a full examination, we will as much as possible find out all the reasons that led to the appearance of cholecystitis in the patient.The treatment program is structured as follows. In the first place is medical nutrition. First of all, this is a fractional meal, five to six times a day. The gallbladder “loves” that we eat at the same hours: this is how we train it and prevent stagnation of bile in it. It is important that the food is not hot or cold, but warm.

The selection of drugs is carried out taking into account the function of the gallbladder, in particular, its contractility. If the function is increased, if there are sharp spastic pains, antispasmodic drugs are recommended.When, with the normal contractile function of the organ, we find signs of viscous, stagnant bile, drugs with a choleretic effect are used.

If studies show poor bladder contractility, then drugs that stimulate its function are included in the treatment program to help it work properly.

In certain cases, antiparasitic, antibacterial, anti-inflammatory drugs are used. All this is decided by the doctor, depending on the results of the study.

Let’s not forget about other methods of treating cholecystitis – the same health resort. Chronic patients need at least three or four years in a row to go to resorts – as they used to say, “to the waters.” It is very useful. But it is necessary to go there with all the medical documents, then the patient will be properly selected there the diet, the mode of water intake (its type, quantity and temperature).

– What can you eat with cholecystitis, and what can you not?

– Proteins, fats and carbohydrates should be exactly as much as necessary for the normal functioning of the body.The diet should include lean meats (beef, rabbit meat), fish (preferably boiled or steamed), low-fat cottage cheese, wheat bran. Among cereals, preference is given to oatmeal and buckwheat.

Let’s not forget about fresh vegetables and fruits (better let it be melon, pumpkin, watermelon, carrots, apples).

Fatty, fried foods, smoked meats, marinades, pickles, alcoholic beverages, including beer are excluded. In the same list we include carbonated drinks, hot seasonings and egg yolks (the latter – for the period of exacerbation).

Fasting days (1-3 per week) will not interfere: these can be rice-compote, curd, watermelon days. In addition, drink plenty of fluids.

– How to prevent the development of cholecystitis? Please tell us about prevention

– Probably, a lot is clear already from the above. Basic prevention differs little from the prevention of many other diseases. This is a healthy lifestyle, rational nutrition – we eat often, not on the run, we chew food thoroughly, slowly.

Agree, it would seem, simple, common truth. But, believe me, first of all, they are important in terms of preventing cholecystitis.

Interviewed by Igor Chichinov

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For information:

Patrushev Nikolay Borisovich

Gastroenterologist, Candidate of Medical Sciences
Graduated from the Perm State Institute in 1988.
Primary Specialization in Gastroenterology – 1995
2005 to 2014 worked at the Central Research Institute of Gastroenterology (Moscow). First – the doctor of the department of chronic liver diseases, then the head of the consultative and diagnostic department of the institute.
Since 2020 – a gastroenterologist at the “Expert Clinic” Perm.
Receives at the address: Perm, st. Monastyrskaya, 42a.

Influence of pathology of the biliary tract on the risk of coronary heart disease | Shilov A.M., Loranskaya I.D., Mikhailova A.Kh., Tarasenko O.F.


For citation: Shilov A.M., Loranskaya I.D., Mikhailova A.Kh., Tarasenko O.F. The influence of pathology of the biliary tract on the risk of coronary heart disease. Breast cancer. 2008; 25: 1695.

Modern practical medicine is characterized by polymorbidity – a combination of various pathologies of internal organs that have a significant impact on the development and clinical manifestations of the underlying disease.For many years, the connection between diseases of the biliary tract and the cardiovascular system has been of constant scientific and practical interest. Back in the middle of the first half of the twentieth century, the founder of clinical thinking S.P. Botkin pointed out the relationship between diseases of the biliary tract and the heart.

A feature of the pathology of the biliary tract, at present, is the increasing frequency of its combinations with diseases of the cardiovascular system, in particular with ischemic heart disease (IHD).Many researchers have tried to answer questions about the relationship and interaction of clinical manifestations and the course of these pathologies [1-6,12,13,14]. The presence of a common clinical and laboratory parameters of the lipid spectrum of blood in biliary pathology and ischemic heart disease suggest a common risk factors for their development. It has now been established that diseases of the biliary tract and ischemic heart disease have many common risk factors: excessive consumption of fatty and high-calorie foods, a sedentary lifestyle, obesity, hypercholesterolemia, and others [7,8,11].According to Trijs et al. (1990), serum lipids measured at different periods of the development of biliary pathology may be a weak reflection of true dyslipidemia at the critical time of the formation of gallstones [13]. This statement is confirmed by the following facts: after cholecystectomy, a decrease in blood serum lipids is recorded, and during exacerbations of calculous cholecystitis, in particular with the formation and increase in the size of calculi, the level of lipids in the blood significantly increases [6,8].According to I.N. Grigorieva. the increased content of apoB-lipoproteins (VLDL and LDL) in the blood of patients with cholelithiasis, which are an independent genetic marker of coronary artery disease, may indicate the possible commonality of some aspects of the pathogenesis of cholelithiasis and coronary artery disease. A number of studies have shown the presence of a high correlation between the levels of lipids in the blood serum, the presence of atherosclerosis of the great vessels (carotid arteries) of the ascending and abdominal aorta in patients with cholelithiasis [6]. This fact is confirmed by the data of an epidemiological study of an unorganized population of women in the city of Novosibirsk: in general, in the group among women aged 25–64 years, IHD was detected in 13%, among women with IHD, gallstones occurs in 17.7% of cases (in the population as a whole – this figure is 10.5%) and vice versa, 22% of women with cholelithiasis suffer from coronary artery disease, while in the absence of cholelithiasis, the prevalence of ischemic heart disease is 11.9%.The statement that biliary pathology occurs more often among the urban population than in rural areas is controversial, since at present the line separating urban and rural residents is becoming more and more blurred. The statistics show that the villagers began to get sick with gallstone disease as often as the residents of the city [2].
In connection with the above, the purpose of this work was to study the prevalence of risk factors for coronary artery disease, the interaction of pathology of the biliary and cardiovascular systems, their relationship with the dietary habits and lifestyle of the population in the Buryat Okrug.In our study, we tried to determine the role of various pathologies of the biliary system in the risk of developing coronary artery disease.
Materials and research methods. The study included 120 patients with gallbladder diseases aged 16 to 60 years, which, depending on the type of pathology, were divided into four subgroups: 1st subgroup – 57 patients with cholelithiasis (GSD), 2nd – 31 patients with chronic acalculous cholecystitis (CBC), 3rd – 14 patients with hypomotor gallbladder dysfunction (HMDZHP), group 4 – 18 patients with hypermotor gallbladder dysfunction (HrMDZHP).As a comparison group, 18 patients with coronary artery disease without pathology of the biliary system were examined. All patients underwent a comprehensive examination, including: collection of complaints and anamnesis of the disease, clinical and biochemical blood tests. To identify and confirm ischemic heart disease, pathology of the biliary tract, all patients included in the study program were recorded ECG in 12 standard leads, echocardiography with Doppler examination of intracardiac hemodynamics, ultrasound examination of the liver, gallbladder, pancreas, esophagogastroduodenoscopy with stage chromatological examination of bile, microscopic (to assess the degree of pathology from the biliary tract).
Among the examined patients there were 44 (36.7%) men and 76 (63.3%) women. The average age of patients with cholelithiasis was 44.3 ± 1.3 years, patients with CCB – the average age was 47.9 ± 1.7 years, with GMVD – 40.4 ± 2.8 years, with HrMVD – 35.9 ± 7.2 years old.
In the comparison group of patients with stable exertional angina of I – II functional class without circulatory disorders, there were 9 men and 9 women, the average age in the group was 52.5 ± 7.1 years (from 41 to 67 years).
The Quetelet body mass index (BMI) was calculated for all patients: BMI norm

Symptoms of biliary dyskinesia and cholecystitis in children

Dyskinesia is a violation of the outflow of bile through the biliary tract.

There are two types of disorders of the motility of the biliary tract:

  • Hyperkinetic (when contractions of the gallbladder are intensified).
  • Hypokinetic (when the walls of the bladder and ducts are relaxed, and the outflow of bile is slowed down).

Causes of the disease

  • Previous hepatitis
  • Intestinal infections
  • Giardiasis
  • Helminthiasis
  • Anomalies in the development of the gallbladder and bile ducts, etc.

Symptoms

Symptoms of hyperkinetic dyskinesia:

  • Intense paroxysmal pain in the right hypochondrium, sometimes radiating to the right shoulder and scapula. The pain appears due to an error in diet, physical activity, stressful situation.
  • Nausea, less often vomiting. A painful attack is more pronounced when this form is combined with sphincter hypertension.

Symptoms of hypokinetic dyskinesia:

  • Constant, non-intense pain in the right hypochondrium, accompanied by a feeling of fullness, heaviness in the abdomen, nausea, a bitter taste in the mouth, decreased appetite.
  • Stool disorders (constipation or diarrhea).
  • Sometimes the color of the stool changes: it becomes light.
  • The danger of hypokinesia of the gallbladder is that with stagnation of bile, the absorption of fluid and water-soluble substances increases, the concentration of cholesterol and bilirubin in bile increases, which contributes to the formation of clots, and later stones in the gallbladder.

Diagnostic methods for dyskinesia

With the help of ultrasound of the gallbladder, the shape, size, deformation of the gallbladder, the condition of the ducts, and the presence of stones are assessed.

Duodenal intubation in children with biliary dyskinesia makes it possible to assess the volume of portions of bile, its microscopic and biochemical composition. When examining the duodenal contents, signs of inflammation, a tendency to form stones, lamblia, etc. can be detected.

Timely diagnosis and adequate treatment of dyskinesia, taking into account its type, allows to normalize the processes of bile excretion and digestion, to prevent inflammation and early stone formation in the biliary tract in children.Long-term disturbance in the work of the biliary system can lead to the development of cholecystitis, cholangitis, cholelithiasis, intestinal dysbiosis.

The results of the blood test also indicate the presence of an inflammatory process in the body. In such cases, the child often needs to be hospitalized in order to conduct an examination and prescribe the correct treatment.

Prevention

Children with biliary dyskinesia need dispensary observation by a pediatrician, pediatric neurologist and gastroenterologist, ultrasound control, choleretic therapy courses twice a year, and recreational recreation in specialized sanatoriums.It is necessary to monitor the nutrition and regimen of the child, his emotional state.

More about pediatric gastroenterology at the YugMed clinic

90,000 Cholecystitis: prevention, diagnosis and treatment

Zulfiya Ravilievna Galimova – general practitioner, doctor of the highest category

We present to your attention an interview with a therapist, doctor of the highest category Zulfiya Ravilievna Galimova on the topic: “Cholecystitis: prevention, diagnosis and treatment”

What is cholecystitis? How common is this disease in Russia and in the world?

– Cholecystitis is an inflammation of the gallbladder.The basic principles of the development of the inflammatory process in the wall of the gallbladder are as follows: the presence of microflora in the lumen of the bladder and impaired outflow of bile. Cholecystitis is acute and chronic, calculous (with stones) and non-calculous (without stones).

In terms of prevalence, cholecystitis, along with peptic ulcer disease, is one of the leading diseases of the digestive system. Among the acute diseases of the abdominal organs, acute cholecystitis takes the 2nd place.

In Europe, women suffer from cholecystitis more often (about 4 times), in Asian countries, the incidence of cholecystitis in males and females is approximately equal.According to various researchers, stones with cholecystitis are detected in 60-96% of cases.

What processes trigger the mechanism of this disease? What are the risk factors?

The gallbladder is one of the organs of the digestive system. It is small in size and communicates through the bile ducts with the liver, from where bile enters it. The gallbladder itself performs a reservoir function and retains bile in itself exactly until the moment food masses enter the duodenum.After that, this organ contracts and through the bile ducts removes bile into the intestines, which helps to neutralize gastric juice and activate intestinal and pancreatic enzymes.

Bile stagnation and infection in the gallbladder are of major importance in the development of pathology. Pathogenic microorganisms can enter the organ hematogenously (with blood flow) and / or lymphogenically (through the lymphatic pathways) from other foci of chronic infection (periodontal disease, otitis media, etc.) or by contact from the intestine.Pathogenic microflora is more often represented by bacteria (staphylococci, Escherichia coli, streptococci), less often by viruses (hepatotropic viruses C, B), protozoa (lamblia), parasites (ascaris).

Impaired utilization of bile from the gallbladder occurs under the following conditions:

Gallstone disease. Cholecystitis with gallstones occurs in 85-90% of cases. Concretions in the gallbladder cause bile stasis. They clog the lumen of the outlet, injure the mucous membrane, cause ulceration and adhesions, supporting the process of inflammation.

Biliary dyskinesia. The development of pathology is facilitated by functional impairment of the motility and tone of the biliary system. Motor-tonic dysfunction leads to insufficient emptying of the organ, stone formation, inflammation in the gallbladder and ducts.

Congenital anomalies. The risk of cholecystitis increases with congenital curvatures, scars and constrictions of the organ, doubling or narrowing of the bladder and ducts. The above conditions provoke a violation of the drainage function of the gallbladder and leads to stagnation of bile.

Other diseases of the biliary system. The occurrence of cholecystitis is influenced by tumors, cysts of the gallbladder and bile ducts, dysfunction of the valve system of the biliary tract (sphincters of Oddi, Lutkens), Mirizzi syndrome. These conditions can cause deformation of the bladder, compression of the ducts and the formation of bile stasis.

In addition to the main etiological factors, there are a number of conditions, the presence of which increases the likelihood of symptoms of cholecystitis, affecting both the utilization of bile and a change in its qualitative composition.These include dyscholia (violation of the normal composition and consistency of gallbladder bile), hormonal changes during pregnancy, menopause.

The development of enzymatic cholecystitis is facilitated by the regular reflux of pancreatic enzymes into the bladder cavity (pancreatobiliary reflux).

Cholecystitis often occurs against the background of malnutrition, alcohol abuse, tobacco smoking, adynamia, sedentary work, hereditary dyslipidemia.

Thus, the most important risk factors are:

  • diseases of the gastrointestinal tract
  • the presence of parasites (lamblia, ascaris)
  • Injury to the gallbladder and liver
  • Presence of foci of chronic infection
  • disorders of the immune status
  • Frequent constipation
  • irregular meals
  • Frequent overeating
  • sedentary
  • pregnancy
  • alcohol, smoking.

What symptoms might indicate cholecystitis?

– Clinical manifestations depend on the nature of the inflammation, the presence or absence of calculi (stones). Chronic cholecystitis is more common than acute and usually has an undulating course. During the period of exacerbation with stoneless and calculous form, paroxysmal pain of varying intensity appears in the right side of the abdomen, radiating to the right shoulder, scapula, collarbone. Painful sensations arise as a result of improper diet, heavy physical exertion, severe stress.Pain syndrome is often accompanied by vegetative-vascular disorders: weakness, sweating, insomnia, neuroses. In addition to pain, nausea, vomiting with an admixture of bile, stool disturbances, and bloating are observed. Patients note an increase in body temperature to febrile values, chills, a feeling of bitterness in the mouth or belching bitter. In severe cases, symptoms of intoxication are found: tachycardia, shortness of breath, hypotension.

In calculous form against the background of persistent cholestasis, there is yellowness of the skin and sclera, itching.In the remission phase, there are no symptoms, sometimes there is discomfort and heaviness in the right hypochondrium, stool disorders and nausea. Periodically, cholecystocardial syndrome may occur, characterized by chest pain, tachycardia, and rhythm disturbances.

Acute acalculous cholecystitis is diagnosed quite rarely, manifested by episodic pulling pains in the hypochondrium on the right after overeating, drinking alcohol. This form of the disease often proceeds without indigestion and complications.In the acute calculous form, the symptoms of cholestasis predominate (pain, itching, yellowness, bitter taste in the mouth).

Which diagnostic methods are effective?

– Diagnosis of cholecystitis begins with a survey and examination of the patient. Thanks to this, the doctor can understand what symptoms the patient is suffering from, how long ago they appeared, and suggest what pathologies may be associated with. To confirm or deny his assumptions, he orders a series of tests and examinations.

To determine the type and severity of the disease, the following examinations are carried out:

Ultrasound of the gallbladder. In patients with chronic cholecystitis, thickened sclerotic walls of the deformed gallbladder are visualized.

Fractional duodenal intubation. During the procedure, take three portions of bile (A, B, C). This makes it possible to assess the motor skills, color and consistency of bile. In order to detect the pathogen that caused the bacterial inflammation, the sensitivity of the flora to antibiotics is determined.

Cholecystocholangiography. Provides information about the work of the gallbladder, biliary tract in dynamics. Using the X-ray contrast method, a violation of the motor function of the biliary system, calculi and organ deformation are detected.

Laboratory blood test. In the acute period, neutrophilic leukocytosis and ESR acceleration are detected in the KLA. In the biochemical analysis of blood, an increase in the level of ALT, AST, cholesterolemia, bilirubinemia, etc. is noted.

In doubtful cases, to study the work of the biliary tract, hepatobiliscintigraphy, EGD, MSCT of the gallbladder, diagnostic laparoscopy are additionally performed. Differential diagnosis of cholecystitis is carried out with acute diseases accompanied by pain syndrome (acute pancreatitis, appendicitis, perforated stomach and duodenal ulcer). The clinic of cholecystitis should be distinguished from an attack of renal colic, acute pyelonephritis, right-sided pneumonia.

What is the standard of care? Is surgery required?

– The basis for the treatment of acute and chronic non-calculous cholecystitis is complex drug and diet therapy.With often recurrent calculous form of the disease or with the threat of complications, they resort to surgical intervention on the gallbladder. The main directions in the treatment of cholecystitis are recognized:

Diet therapy . The diet is indicated for all stages of the disease. Fractional meals are recommended 5-6 times a day in boiled, stewed and baked form. Long breaks between meals (more than 4-6 hours) should be avoided. Patients are advised to exclude alcohol, legumes, mushrooms, fatty meats, mayonnaise, cakes.

Drug therapy . For acute cholecystitis, pain relievers and antispasmodics are prescribed. When pathogenic bacteria are detected in bile, antibacterial agents are used, based on the type of pathogen. During remission, choleretic drugs are used that stimulate bile formation (choleretics) and improve the outflow of bile from the organ (cholekinetics).

Physiotherapy. Recommended at all stages of the disease in order to relieve pain, reduce signs of inflammation, and restore the tone of the gallbladder.With cholecystitis, inductothermia, UHF, electrophoresis are prescribed.

Removal of the gallbladder – with advanced cholecystitis, ineffectiveness of conservative treatment methods, calculous form of the disease. Two techniques of organ removal are widely used: open and laparoscopic cholecystectomy. Open surgery is performed for complicated forms, obstructive jaundice and obesity. Video-laparoscopic cholecystectomy is a modern, low-traumatic technique, the use of which can reduce the risk of postoperative complications and shorten the rehabilitation period.In the presence of calculi, non-surgical stone crushing is possible using extracorporeal shock wave lithotripsy.

What measures are there to prevent the occurrence of this disease? What rules should be followed by those who have had cholecystitis?

– For the prevention of exacerbations, one should adhere to the basics of a balanced diet, exclude alcoholic beverages, lead an active lifestyle, and rehabilitate foci of inflammation (sinusitis, tonsillitis).Patients with chronic cholecystitis are recommended to undergo an ultrasound scan of the hepatobiliary system annually.

It is recommended to take food at least 4-5 times a day in small portions. It is strictly forbidden to eat a lot at night, especially for fatty foods and alcoholic beverages. Meals are best taken at the same time.

Drinking a sufficient amount of water is of great importance – at least 1.5-2 liters per day. Also, prevention consists in adhering to diets for weight loss.To do this, doctors advise choosing low-calorie diets or fasting days based on fermented milk products, fruits, vegetables, and meat.

Reception by the therapist Zulfiya Ravilievna Galimova is carried out in the clinic “Miracle Doctor” – Moscow, st. School, 49.

Prepared interviews:
Maria Zelenskaya,
Head of Public Relations, Association of Medical Journalists,
Editor-in-Chief of the Digest of the Academy of Obstetrics and Gynecology

90,000 Diseases of the gallbladder: symptoms, signs, treatment

When a patient first turns to a specialist for biliary colic, this does not mean that an acute pathological process is already underway in the body.Most often, the examination results determine chronic cholecystitis, the treatment of which takes quite a long time.

Symptoms of cholecystitis develop gradually, so often an attack of biliary colic is an exacerbation of a chronic form of latent gallbladder disease.

In most cases, chronic cholecystitis manifests itself:

  • pain in the right hypochondrium;

  • decreased appetite;

  • bitterness in the mouth;

  • nausea, less often – morning vomiting of bile.

With exacerbations of the disease, there are attacks of cutting pain in the epigastric region or in the right hypochondrium.

The pain can radiate up and to the right – in the area of ​​the right scapula, right shoulder, right half of the neck. In some cases, painful sensations spread throughout the abdomen, intensifying when lying on the left side and taking deep breaths.

Additional signs of the disease

In addition to pain, a feeling of nausea arises, vomiting with an admixture of bile may appear, which does not bring relief to the patient.The skin becomes jaundiced or pale. A brownish-yellow coating appears on the tongue, the patient complains of dry mouth.

Restriction of mobility is observed in the upper right part of the abdominal wall, it is painful on palpation, skin sensitivity is increased.

It is important to understand that the localization of pain in the right shoulder blade and the right half of the chest is characteristic not only of diseases of the gallbladder, but also of a number of other pathological conditions of the body. That is why it is extremely important to find out the cause of the pain attack.With cholecystitis, pain most often appears after eating fatty foods and other foods that are difficult for digestion. Relapse of an attack is most often associated with mental trauma, nervous strain or stress.

In patients with gallstone disease, an attack often occurs due to physical strain and overwork, for example, after riding a bicycle or the gym.

If transient jaundice develops after an attack, this may be a symptom of both hypermotor dyskinesia and gallstone disease.In some cases, in violation of the outflow of bile, in patients for several days, discolored gray-white feces are observed.

A painful attack with uncomplicated gallstone disease begins suddenly and also ends suddenly. The very next day, the patient feels satisfactory.

Nonspecific symptoms

Often manifested in chronic diseases of the biliary tract in the form of:

As a result, the patient may visit different doctors for a long time, who may misdiagnose the disease and determine rheumatism, neuralgia, thyrotoxicosis, gastritis or peptic ulcer disease.However, the reason for this clinical picture is latent cholecystitis, cholelithiasis or biliary dyskinesia.