What is the cause of gallstones and shortness of breath? How can food allergies lead to chest and shoulder pain? What are the symptoms of a heart attack and how can it be prevented?

Gallbladder Disease and Shortness of Breath

Shortness of breath and shoulder pain that develops after eating can be a sign of gallbladder disease. Your gallbladder is a sac that stores bile to help your body digest high-fat content foods. The gallbladder can develop cholesterol deposits that can form into clusters called stones. A gallstone that becomes lodged in the gallbladder duct can lead to inflammation and severe pain in your chest, abdomen and right shoulder, according to MayoClinic.com. Foods that are high in fat, such as cream, cheese and fried foods are most likely to trigger a gallbladder attack.

Allergic Reactions and Chest Pain

You can have an allergic reaction to any food. A food allergy occurs when you eat a food that your immune system does not identify as safe. The immune system attempts to rid the body of the proteins in the food by creating immunoglobulin E antibodies. These antibodies trigger your white blood cells to produce histamine, a chemical that protects against infection but causes inflammation in soft tissues. Your lungs are made of soft tissues that can become constricted and swollen from a food allergy. Chest pressure commonly causes referred pain in your back and shoulders. Referred pain is pain that originates in one area of your body and is felt in another.

Allergy-Induced Asthma and Breathing Difficulties

After consuming an allergic food, your lungs can swell, restricting your breathing ability. This can lead to shortness of breath, chest pain, tightness, coughing and wheezing. Shoulder pain is possible with this condition, again due to reflected pain. Chest pain commonly can cause reflected pain in your upper back and shoulders. The only way to prevent these symptoms is to identify and avoid all foods that cause an allergic reaction.

Heart Attacks and Eating

A heart attack can happen at any time, but eating does not increase your risk of having one. Shortness of breath and shoulder pain are classic symptoms of a heart attack. A heart attack occurs when a blood vessel that goes to your heart is clogged, cutting off the blood supply. This is a serious medical condition that could lead to death.

Postoperative Care After Gallbladder Removal

Surgical removal of the gallbladder, known as a cholecystectomy, is considered an extremely effective form of treatment for gallstones. Postoperative care plays an essential role in a fast recovery and quick return to daily life while preserving the patient’s quality of life in the long run. After the surgery, the patient will be closely monitored, and the surgeon will keep the patient informed about the surgical outcomes and overall conditions. To minimize the risk of pneumonia and promote early mobility, the patient is advised to breathe deeply, sit up straight, and slowly walk around the bed. Daily activities must be resumed as soon as possible to improve blood circulation and prevent complications.

Can Food Sensitivities and Allergies Cause Gallbladder Problems?

While food allergies and sensitivities can cause a range of digestive issues, including chest and shoulder pain, they do not directly cause gallbladder problems. Gallbladder issues are typically caused by the formation of gallstones, which are hardened deposits of cholesterol and other substances that can block the bile ducts and lead to inflammation and pain. However, certain foods that are high in fat and cholesterol, such as fried foods, can trigger gallbladder attacks in people with existing gallbladder issues. The best way to prevent these symptoms is to identify and avoid the specific foods that cause an allergic reaction or trigger gallbladder pain.

Preventing Complications After Gallbladder Removal

After gallbladder removal surgery, it is crucial to follow the surgeon’s recommendations for postoperative care to prevent complications and ensure a smooth recovery. This includes: monitoring vital signs and oxygen levels, performing deep breathing exercises, engaging in early mobility, and resuming daily activities as soon as possible. By taking these steps, the patient can minimize the risk of pneumonia, improve blood circulation, and return to their normal routine more quickly while maintaining a good quality of life.

Shortness of Breath & Shoulder Pain After Eating

It’s alarming when you become short of breath but it can be especially frightening if it’s accompanied by shoulder pain. The most common condition thought of with these symptoms is a heart attack, but if the symptoms only develop after eating it can be a sign of a digestive-related condition. Anytime you experience adverse reactions from eating, avoid the foods that trigger your symptoms and call your doctor.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Gallbladder Disease

Shortness of breath and shoulder pain that develops after you eat can be a sign of gallbladder disease. Your gallbladder is a sac that stores bile to help your body digest high-fat content foods. The gallbladder can develop cholesterol deposits that can form into clusters called stones. A gallstone that becomes lodged in the gallbladder duct can lead to inflammation and severe pain in your chest, abdomen and right shoulder, according to MayoClinic. com. Foods that are high in fat, such as cream, cheese and fried foods are most likely to trigger a gallbladder attack.

• Shortness of breath and shoulder pain that develops after you eat can be a sign of gallbladder disease.

Allergic Reaction

Chest Pain After Eating Ice Cream

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You can have an allergic reaction to any food. A food allergy occurs when you eat a food that your immune system does not identify as safe 1. The immune system attempts to rid the body of the proteins in the food by creating immunoglobulin E antibodies. These antibodies trigger your white blood cells to produce histamine, a chemical that protects against infection but causes inflammation in soft tissues. Your lungs are made of soft tissues that can become constricted and swollen from a food allergy 1. Chest pressure commonly causes referred pain in your back and shoulders. Referred pain is pain that originates in one area of your body and is felt in another.

• You can have an allergic reaction to any food.
• Referred pain is pain that originates in one area of your body and is felt in another.

Allergy-Induced Asthma

After consuming an allergic food, your lungs can swell, restricting your breathing ability. This can lead to shortness of breath, chest pain, tightness, coughing and wheezing. Shoulder pain is possible with this condition, again due to reflected pain. Chest pain commonly can cause reflected pain in your upper back and shoulders. The only way to prevent these symptoms is to identify and avoid all foods that cause an allergic reaction.

• After consuming an allergic food, your lungs can swell, restricting your breathing ability.
• Chest pain commonly can cause reflected pain in your upper back and shoulders.

Heart Attack

Can Food Sensitivities and Allergies Cause Gallbladder Problems?

Learn More

A heart attack can happen at any time 3. Eating does not increase your risk of having a heart attack, but shortness of breath and shoulder pain are classic symptoms of a heart attack. A heart attack occurs when a blood vessel that goes to your heart is clogged, cutting off the blood supply. This is a serious medical condition that could lead to death.

• A heart attack can happen at any time 3.
• A heart attack occurs when a blood vessel that goes to your heart is clogged, cutting off the blood supply.

Health tips after gallbladder removal surgery (cholecystectomy) to treat gallstones

Surgical removal of the gallbladder is considered an extremely effective form of treatment for gallstones. In addition to an appropriate surgical procedure conducted by expert surgeon, postoperative care plays an essential role in a fast recovery and quick return to daily life while preserving patient’s quality of life in the long run.

Postoperative care after gallbladder removal surgery (cholecystectomy)

After gallbladder removal surgery, it is highly recommended to follow these advices:

1. After the surgery is performed, the patient will be transferred to a recovery room while all vital signs, e. g. heart rates, respiratory rates and blood pressure as well as other relevant parameters, e.g. oxygen saturation level are measured and closely monitored. During a postoperative visit, the surgeon will keep the patient informed about the surgical outcomes and overall conditions. In case any question or concern is raised, the patient shall not hesitate to discuss with the surgeon.
2. To minimize the risk of pneumonia that might develop after surgery, the patient is advised to breathe deeply 5-10 times in each hour. 
3. To promote early mobility, the patient should refrain from lying in bed. Without provoking pain or discomfort, the patient can sit up straight and slowly walk around the bed. Daily activities must be resumed as soon as possible to improve blood circulation and prevent blood clot formation. Under close supervision of rehabilitation specialists, the patient should start walking 5-6 times/day as walking helps to enhance blood flow throughout the body while maintaining normal breathing, gastrointestinal and urinary tract functions which often slow down after surgery.          
4. If pain develops at the surgical site during changing the position, use hand or pillow to alleviate pain. 
5. It is important to regularly observe any abnormal signs and symptoms that might potentially indicate postoperative complications, e.g. pain, swelling and redness. If any of these abnormalities arises, keep the surgeon informed immediately.   
6. If pain develops, do not wait until pain gets worse or becomes unbearable. Pain management can be effectively applied once pain starts.
7. For patients who underwent laparoscopic cholecystectomy, it involves insufflation of gas (usually carbon dioxide) into the peritoneal cavity. Therefore, the patients often experience pain or discomfort caused by excess gas, e.g. shoulder pain which normally subsides within 1-2 days. Continuous mobilization and walking can help to mitigate pain.
8. Generally, a surgery to remove gallbladder does not bring about any postoperative complications. However, 1-2 follow-up appointments will be scheduled by the surgeon within 2-3 weeks after surgery in order to monitor treatment outcomes and watch out for possible complications. 

Recovery at home after surgery

• While resting at home, the patient needs to avoid constipation. To do so, it is suggested to consume high-fiber foods, such as fruits and vegetables to makes stool bulkier and softer, stay adequately hydrated by drinking enough water 8-10 glasses/ day and refrain from straining during bowel movement.
• To continuously promote mobilization and prevent blood clot formation, especially in the legs, the patient should gradually resume daily tasks and activities, starting from getting up and walking. 
• Lifting heavy objects (heavier than 6 kg.) and strenuous exercise are not suggested for at least 4-6 weeks after surgery. 
• Keep the surgical wound (incision) clean and follow surgeon’s instructions on how and when to replace the bandage.  
• It seems common to have some minor bleeding from the incision. However, if it bleeds too much and the incision becomes moist, immediate medical assistance must be sought. 
• To prevent wound irritation that largely interrupts wound healing process, avoid wearing tight or coarse clothes. 

Diet modification 

The gallbladder is a small pouch located under the liver. Its main function is storing bile produced by the liver. Some people might be concerned about foods after having their gallbladders surgically removed. In fact, most patients who underwent cholecystectomy can live worry-free regarding their daily diet as the liver still produces adequate amount of bile which is necessary for the digestive process. Instead of having bile stored in the gallbladder, once your gallbladder is removed after cholecystectomy, the bile produced by the liver flows directly into the small intestine, allowing continued digestion of fats. Nevertheless, the amount of fat intake each meal profoundly affects the digestion process. Despite there is no standard diet that people should follow after gallbladder removal surgery, it is best to limit fatty and greasy foods. An excess fat can potentially cause fat indigestion manifested by dyspepsia, bloating and diarrhea, especially a few months after surgery. To maintain a good health after gallbladder surgery, it is vital to strictly follow these eating tips:

1. Gradually get back to healthy eating habit: A day after surgery, the patient is recommended to start eating a clear fluid diet and soup. During the first week after surgery, easy-to-digest food should be taken. Hereafter, regular diet can be gradually resumed while watching for bloating and abdominal discomfort.
2. Consume smaller portions of healthy food but more often: Rather than having 3 big meals a day, it is necessary to manage to split into 4-6 mini-meals each day in order to enhance a proper digestion. As the limited amount of bile, late meal at night that likely causes bloating and stomach discomfort must be avoided. Protein-enriched diets, e.g. fish, white egg, tofu and low or non-fat dairy products should be regularly taken along with vegetable, fruits and whole grains. Caffeine-containing beverages, such as coffee and tea as well as spicy food should also be avoided.          
3. Limit fatty and greasy food to minimize bloating and diarrhea: As the body still requires essential fatty acids derived from food, the patient can gradually start eating high-fat food in limited amount. Consuming excessive fat might lead to fat indigestion which often causes stomachache, bloating or flatulence and diarrhea. Healthy fat can be obtained from fish and vegetable oil with unsaturated fatty acids. Excess consumption of greasy food fried or cooked with excess oils, cheese, pizza and other food containing trans fat must be strictly avoided. The average amount of dietary fat that the patient should consume should not exceed 30% of the recommended amount each day (60 grams of total fat). It remains important to read the nutrition facts label before consuming any food. A low fat diet must contain no more than 3 grams of fat per each serving of food.   
4. Eat more of high-fiber diet: To improve gastrointestinal motility, high-fiber diet can be gradually consumed over weeks. Nonetheless, eating too much of fiber rich diet that produces gas as a byproduct can also cause diarrhea, abdominal pain and bloating due to an excess gas. 
5. Write a food diary to keep tracking of your food intake: Keeping a diary of what you eat and how you feel while eating can help the tracking of healthy eating habit. By doing so, the patients learn about what and how much they can eat without triggering any abdominal symptoms. Some patients can resume their regular diet a month after surgery.      

Being physically active 

After surgery it is important to take an active role in the recovery phase. Preoperative and postoperative rehabilitation care will be conducted by rehabilitation specialists and multidisciplinary team aiming at improving patient’s quality of life while accelerating recovery to achieve a quick return to daily life and activities.

• Leg exercise: After being discharged from the hospital, early mobilization is the key to attain a faster recovery. These include walking around the house and climbing stairs while holding onto the handrail. Prolonged immobilization or bed rest without movement poses a significant risk of blood clot formation due to an impaired circulation. In unfortunate cases, blood clots formed inside the blood vessels might travel across the body and block the blood supply to a particular organ, such as the arteries in the lungs (pulmonary embolism). To improve blood circulation and prevent clot formation in the calf, regular movements of the feet and legs, e.g. ankle rotation, ankle stretching and knee lifts are highly advised.    

• Deep breathing: Assisted breathing device (an incentive spirometer) should be continuously used for 3-5 days as advised. To restore lung function and prevent lung infections, deep breathing, 4-5 times in each hour, is extremely important. If experiencing cough or sneeze, the patient may gently hold the pillow against the abdomen to counteract any jolting from cough, sneeze or movement. It helps mitigate pain since it holds the incision and sensitive skin surrounding the incision firmly in place.  
• Getting in and out of bed: Getting out of bed too quick after surgery might lead to insufficient blood supply to the brain, causing a sudden dizziness and fall. To get out of bed, roll onto your side, bend the knees until the legs are hanging over the side of the bed, then use the arms to lift the upper body up and push off with the arms to stand up.  
• Doing appropriate activities: In the first 2 weeks after surgery, the patients is not suggested to do strenuous activities or physical exertion. Short-distance walking might be advised. Driving is not recommended for at least 5-7 days after surgery. Before driving off, assessing the pain while fastening the seat belt, pushing hard on a brake and controlling the steering wheel. After 2 weeks, physical activities, e.g. riding a bicycle and jogging can be resumed as usual. Lifting heavy objects (heavier than 6 kilograms) must be avoided as it substantially aggravates pain. After 1 month, other physical exertion and workout, e.g. lifting objects, moving furniture and mowing the lawn can be gradually resumed.        
• Holistic rehabilitation care: For patients who have underlying conditions or who are physically active, e.g. athletes, a holistic rehabilitation program performed by the rehabilitation specialists and a multidisciplinary team to achieve a full recovery within the shortest period of time might be further required.    

Practicing good sleep hygiene

To maintain a regular sleep routine after surgery, following these tips seems beneficial:

• Getting enough sleep: After surgery 1-2 weeks, it is crucial to maintain adequate sleep up to 8-10 hours/day for enhancing healing process and recovery. Poor sleep habits, such as having an irregular sleep schedule or consuming too much caffeine or alcohol can interfere with sleep quality. These also include having a late sleep pattern or drinking too much of water before going to sleep. If pain develops, painkiller medications can be taken as prescribed. In most cases, it takes 5-7 days until a full recovery. 
• Shifting the focus: Instead of paying attention only to discomfort feeling after surgery, changing interests to pleasant hobbies or leisure activities, e.g. reading books, listening to music, playing games and social media engagement can largely relieve stress and anxiety.
• Guided imagery for relaxation: Guided imagery is a simple relaxation technique that help to quickly and easily manage stress, reduce tension and alleviate pain. It is an intentionally thought of a peaceful place or scenario along with closing eyes, deep breathing and muscle relaxation, allowing the body to react to your own thoughts.  

Staying away from aggravating factors

To remain as healthy as possible after surgery, it is highly recommended to:  

• Stop smoking: Smoking increases the risk of problems during and after surgery. Quitting smoking at least 3-6 weeks before surgery can significantly decrease the rates of complications related to the surgery. Without smoke cessation prior to surgery, the anesthesiologists face additional challenges to control respiratory function while under the anesthesia, fighting against lungs compromised by smoking. This might lead to an increased risk of anesthesia complications. More importantly, besides poor wound healing process, smoking impairs heart function and disturbs normal heart rhythms, therefore it substantially increases risk of cardiac arrest or heart attack while operating.    
• Avoid unhealthy diets: To prevent blood sugar fluctuations before and after surgery, the patients need to refrain from consuming high sugar diet.   Electrolyte drinks containing sodium should be limited as it results in a fluid buildup and swelling. Unhealthy diet, e.g. raw, uncooked and fermented food as well as alcoholic beverages must be avoided.      
• Relieve stress and anxiety: Not only physical health, but mental health also plays an important role in a successful surgery. If there is any concern related to surgery including pain management, discuss thoroughly with the surgeon. It remains crucial to stay worry-free and manage stress efficiently while following all instructions suggested by the surgeon.    

Abnormal signs and symptoms that need medical attention after surgery

If any of these warning signs arise after surgery, immediate medical assistance must be sought: 

• Persistent and severe abdominal pain
• Severe nausea or vomiting
• Yellowing of skin and eyes
• Absence of bowel movement longer than 3 days after surgery
• Unresolved diarrhea longer than 3 days after surgery
• Fever (body temperature > 38’c)  

The ERAS Program – An accelerator of rapid recovery after surgery

Enhanced Recovery after Surgery Program or ERAS refers to patient-centered, multidisciplinary team developed pathways for surgeries to reduce the patient’s surgical stress, promote early mobilization, re-establish oral feeding, optimize physiologic function and alleviate pain or discomfort. Conducted prior to, during and after surgery, the ultimate goal of ERAS is to achieve a fast recovery while minimizing pre- and postoperative complications. This significantly leads to a shorter hospital stay and a quick return to daily life and activities with a full range of motion.  

Supported by cutting-edge technology and appropriate surgical approaches, the ERAS Program is conducted by a multidisciplinary team, consisting of surgeons, rehabilitation and nutrition specialists, physiotherapists, nurses and pharmacists highly specialized in surgical care. 

As patient-centered approach, the ERAS Program has been designed to improve the recovery process throughout patient’s journey. The program starts from a full medical examination and assessment of medical conditions. In high-risk patients, e.g. elderly patients or patients with multiple underlying diseases that could affect the surgical outcome, surgical planning will be further discussed among different specialists in order to design the best possible procedure suitable for each individual. Pre-operative assessment will be conducted and relevant care, e.g. treatment of hematological problems such as anemia, nutrition support, quitting smoke, blood sugar control will apply, ensuring a physical fitness prior to surgery. Different exercises and pre-rehabilitation programs to strengthen the muscles will be introduced to each individual under close supervision of internal medicine and rehabilitation specialists. In addition, the pharmacist needs to review all current medications and supplements that might affect patient’s safety during surgery. To maintain a normal physiological function, fasting will be required as minimal as possible.

Due to advanced technology in minimally invasive surgery, laparoscopic cholecystectomy (LC) has become a gold standard among eligible cases. Cutting-edge technology used in LC involves the use of three-dimensional (3D) HD vision system and 4K ultra-high definition which provides detailed images of gallbladder and surrounding organs in all dimensions. Furthermore, indocyanine green (ICG) fluorescence imaging technology can clearly view the boundary of lesion and adjacent organs during the operation, leading to less damages to the surrounding tissue. With smaller incisions, in comparison to conventional approach, LC results in less pain, fewer risks and postoperative complications, faster recovery time and shorter hospital stay.

Concerning pain control and prevention of undesired effects after surgery, the anesthesiologist manages pain that widely varies from person to person by using multimodal analgesia while reducing side effects of anesthesia and morphine drugs. Moreover, other related issues, including nausea and vomiting induced by anesthesia, optimal body temperature and fluid administration will be efficiently managed by a multidisciplinary team. ERAS program also recommends early removal of urinary drainage to reduce the risk of catheter-associated urinary tract infections. Monitored and advised by nutrition specialists, early oral feeding should be applied as soon as possible, enabling an improved bowel movement.  

Postoperative immobility can potentially induce local venous stasis caused by accumulation of clotting factors, resulting in blood clot formation which is firmly associated with an increased risk of venous thrombosis – blockage of a vein caused by blood clot (thrombus). Delayed mobilization has been also linked with impaired lung function and respiratory complications. 

ERAS program advocates early mobilization starting on the first day after surgery to counteract catabolic changes and maintain muscle strength. Prior to hospital discharge, postoperative instructions, including wound care and home medications will be given. It is important that the patients need to follow post-operative appointments as scheduled, enable the surgeon to monitor surgical outcome and check on recovery. For emergencies, patients can reach the hospital around-the-clock via given contact.

ERAS program is considered a multimodal perioperative care pathway designed to achieve early recovery after surgical procedures. The key elements of ERAS are comprised of patient and family education, general health optimization prior to operation, pre-rehabilitation, minimal fasting, multimodal analgesia with appropriate use of opioids, early mobilization, early removal of urinary drainage, quick initiation of oral feeding and fast recovery. Apart from excellent surgical outcome with less postoperative complications, patient’s quality of life and a quick return to normal activities are taken into the consideration.

Chronic cholecystitis, treatment of chronic cholecystitis in the network of NEARMEDIC clinics

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• Published: February 2, 2016

• Article updated: January 29, 2023

Indigestion may be due to chronic or acute pathologies. Most often, dyspeptic symptoms occur against the background of dysfunction of the gastrointestinal tract, but the work of the auxiliary digestive organs should also be taken into account. Thus, a lack of bile does not allow the body to fully absorb fats, resulting in nutritional deficiencies. Diseases of the gallbladder and biliary tract are also manifested by diarrhea, nausea, vomiting and other unpleasant symptoms.

Chronic cholecystitis is a common disease among middle-aged men and women. This pathology is more often diagnosed in women. The long course of cholecystitis can be complicated by an infectious process and even the death of organ tissues, so it is important to be examined in a timely manner when the first symptoms of the disease appear. As a treatment for the disease, gastroenterologists prescribe diet, drugs, and surgery. With timely therapy, the prognosis is favorable, but some forms of cholecystitis are characterized by a high mortality rate.

More about the disease

Chronic cholecystitis is an inflammatory disease of the gallbladder that develops over a long period of time. Most often, this form of inflammation is formed after the manifestation of acute cholecystitis. A common cause of the pathology is blockage of the excretory ducts of the gallbladder with calculi, but other etiologies are also possible. Patients suffering from such a disease complain of pain in the right hypochondrium, diarrhea, nausea, vomiting and other symptoms. Unpleasant sensations may periodically disappear, but during exacerbations, pain intensifies.

In most cases, chronic cholecystitis is complicated by an infectious process of a bacterial or fungal nature. Pathogenic microflora can penetrate into the organ from the cavity of the gastrointestinal tract or from distant anatomical regions. The development of infection contributes to prolonged stagnation of bile. In addition, already existing diseases, such as diabetes mellitus and HIV infection, negatively affect the course of cholecystitis. Delaying treatment increases the risk of developing dangerous complications, so it is recommended to be examined by a gastroenterologist in the early stages of inflammation, when abdominal pain and symptoms of indigestion appear.

Organ function

The gallbladder is the anatomical part of the liver. This sac-like organ is essential for storing bile synthesized by the liver cells and removing fluid into the small intestine during digestion. The release of bile into the cavity of the duodenum promotes the absorption of fatty foods and improved absorption of nutrients. In the organ there is a constant accumulation of secretion, leading to an increase in the viscosity of the fluid. After food enters the intestines, hormones stimulate the relaxation of special valves and the release of bile into the digestive tract through special ducts.

Other organ functions:

• Maintenance of metabolism.
• Improvement of small intestine motility.
• Excretion of excess cholesterol and bilirubin from the body.
• Activation of enzymes necessary for the digestion of protein foods.

The gallbladder is often exposed to pathological influences. Violation of the muscular membrane of the organ can make it difficult to release bile – this process not only harms digestion, but also contributes to the formation of stones that can further completely clog the bile ducts and damage the internal membranes of the gallbladder. Normally, the organ does not contain microflora, however, with diseases and anatomical defects, pathogenic and conditionally pathogenic microorganisms from the intestine can penetrate into the gallbladder.

Causes

Inflammation in the gallbladder can be triggered by various factors. First of all, this is stagnation of bile, which disrupts the functions of the organ and contributes to the occurrence of infection. E. coli, streptococci, Giardia and other pathogens can penetrate from the intestine into the body. In this case, the occurrence of infection can be a direct cause of inflammation or a consequence of such a pathological process.

Possible causes:

• Blockage of the biliary tract due to an anatomical defect, stones or valve malfunction.
• Gallstone disease is a common pathology of the gallbladder. Calculi can form in the organ due to a violation of the chemical composition of bile and stagnation of the secret.
• Malignant or benign tumor. A growing neoplasm may impede the evacuation of bile from the organ.
• Primary infections. In patients with HIV infection, the gallbladder can be affected by a variety of viruses.
• Violation of motility of the gallbladder and its ducts. With insufficient or chaotic contractility of the smooth muscles of the organ, the outflow of bile into the intestine is difficult.

A chronic form of inflammation may occur if the patient has not been treated for acute cholecystitis. This pathology persists for many years and significantly impairs the quality of human life.

Risk factors

There are various forms of predisposition to the disease associated with individual characteristics of a person, primary pathologies, nutrition and heredity. Doctors must take into account the presence of risk factors for cholecystitis during examinations.

Key risk factors:

• Female sex and age between 25 and 45 years.
• Obesity and significant weight loss over several months.
• Taking certain medications. In particular, the risk of developing inflammation in the gallbladder increases with the use of hormonal drugs.
• Pregnancy.
• Chronic diseases of the intestines, liver and pancreas.
• Surgical treatment of abdominal organs, injuries.
• Chronic foci of inflammation in different parts of the body.
• Prolonged parenteral nutrition.
• Improper diet or prolonged fasting.
• Abuse of alcoholic beverages.
• Myocardial infarction and other heart diseases.
• Vascular disorders in diabetes mellitus.
• Abnormal reflux of pancreatic secretions into the gallbladder (pancreatobiliary reflux).
• Insufficient physical activity.

Effective pathology prevention measures are based on the elimination of risk factors, associated with lifestyle and individual patient history.

Forms of the disease

Doctors classify chronic cholecystitis based on the cause of the inflammation and the course of the disease. There is also a classification based on the severity of symptoms.

Basic forms:

• Chronic calculous cholecystitis is the most common variant of the disease that occurs due to blockage of the excretory ducts of an organ with stones. It is characterized by severe symptoms during exacerbations. The inflammatory process can spread to neighboring anatomical structures, including the diaphragm and pleura.
• Chronic non-calculous cholecystitis is a rarer form of the disorder, often diagnosed in patients with severe disease. In this case, the inflammatory process occurs due to trauma, surgery, severe infection, and other causes not related to the formation of stones. With untimely treatment, non-calculous cholecystitis can cause the patient’s death.

The danger of chronic inflammation is due to obliterated symptoms. Patients pay attention to discomfort only during exacerbations, as a result of which the disease gradually progresses and causes complications.

Symptoms and signs

The symptomatic picture of the disease depends on the severity of the inflammatory process, the age of the patient and the frequency of exacerbations. The predominant symptom is usually pain in the right hypochondrium, extending to the back and central abdomen. If the inflammation affects the diaphragm, there may be pain in the right arm and shoulder blade.

Additional signs:

• Tension of the abdominal muscles.
• Great weakness, fatigue.
• Appearance of cold sweat.
• Nausea and vomiting.
• Lack of appetite.
• Loose stool.
• Bloating.
• Rapid heartbeat.
• Shortness of breath.
• Low blood pressure.
• Yellowing of the skin and mucous membranes.
• Retrosternal pain.

Due to insufficient intake of vitamins and minerals in the body, symptoms such as pallor of the skin and constant fatigue occur. Against the background of the development of complications, more severe pathological signs appear. With prolonged sharp pain in the abdomen and persistent fever, you should seek medical help as soon as possible.

Diagnostics

Necessary examinations can be ordered by a gastroenterologist. During the appointment, the doctor will ask the patient about the complaints and study the anamnestic information. A physical examination can detect jaundice, bloating, and tenderness in certain areas of the body. Based on the data received, the doctor will prescribe the necessary instrumental and laboratory tests.

Necessary diagnostic manipulations:

• Ultrasound examination of the gallbladder and bile ducts. The advantages of the method are safety and real-time imaging of organs. The doctor can immediately detect gallstones, changes in the walls of the organ and other pathological signs that indicate cholecystitis.
• Blood test to detect inflammatory and infectious process. With severe inflammation in the blood, the number of leukocytes increases. Also, a diagnostic criterion is the concentration of liver enzymes.
• Collection of bile from an organ using duodenal sounding. The specialist sends the resulting material to the laboratory for the detection of pathogenic microflora.
• X-ray contrast study of the gallbladder (cholecystography). The doctor receives information about the size, shape and functional activity of the organ. With the help of this study, anatomical abnormalities, cholelithiasis or other ailments can be detected.

If the physician is unable to make a diagnosis after requesting the results of the listed tests, a gastroscopy, computed tomography or laparoscopy may also be ordered. It is necessary to determine the cause of inflammation as accurately as possible.

Treatment

In chronic cholecystitis, the main method of treatment is a special diet that reduces the negative impact on the organ. Medications may be prescribed to treat infection and inflammation. If the disease has caused dangerous complications, such as gangrene of the gallbladder or peritonitis, surgery is necessary.

Main indications:

• Diet therapy. The patient needs frequent fractional meals. It is necessary to exclude the constant consumption of fatty foods, alcohol, beans and fried meat. The diet should be followed for a long time to prevent the recurrence of the disease. When the gallbladder is removed, patients are prescribed a lifelong diet.
• Antibiotics and anti-inflammatory drugs. In chronic infections, it is recommended to obtain a sample of the microflora by probing and select an effective antimicrobial agent using a laboratory test.
• Antispasmodics and pain relievers to relieve symptoms.
• Cholagogue medicines. Medicines of this group are used to improve the excretion of bile into the duodenum.

The main methods of surgical treatment of cholecystitis doctors include the removal of the gallbladder or the removal of stones that clog the ducts of the organ. In severe complications of the disease, a complex open intervention in the abdominal cavity may be required.

Complications

Chronic cholecystitis can provoke the development of severe complications even when symptoms are erased. The main danger is the focus of infection, which can spread to other organs.

Main complications:

• Gangrene of the gallbladder – destruction of the tissues of the organ, leading to a purulent process in the abdominal cavity.
• Peritonitis – extensive inflammation of the peritoneum, causing severe symptoms and intoxication of the whole organism. This pathology can occur against the background of perforation of the inflamed gallbladder.
• Inflammation of the pancreas due to penetration of the contents of the gallbladder into the organ.
• A severe infectious process in which pathogens are spread through the bloodstream (sepsis).

Timely surgical treatment can prevent the development of such complications.

Thus, chronic cholecystitis is a frequent consequence of acute inflammation of the gallbladder. Symptoms of the disease persist for many years and negatively affect the quality of human life. Consultation with a gastroenterologist will help the patient choose an effective treatment for the disease.

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Causes of shortness of breath – Omega-Kyiv reference book

Shortness of breath – a feeling of lack of air. Most often, shortness of breath can occur during physical exertion, when running or climbing a high floor. But, in some cases, shortness of breath occurs even at rest. In this case, you must contact the medical center to conduct a thorough examination of the body. On examination, the patient must indicate how long ago the shortness of breath occurred, how often and with what concomitant symptoms it occurs.

Possible causes of shortness of breath:

• Diseases of the respiratory system. This series of pathologies includes chronic obstructive pulmonary disease, emphysema, lung cancer, as well as the consequences of tuberculosis. In diseases of the lung tissues, the patient feels an acute lack of air, which in the early stages occurs during physical exertion, and later becomes a painful problem even while at rest;
• Diseases of the cardiovascular system. Pathologies of the heart, without timely treatment, can lead to acute heart failure. Shortness of breath occurs immediately after a myocardial infarction, when necrosis of the heart tissue occurs and blood supply is disturbed. Also, shortness of breath is a symptom of coronary heart disease, high blood pressure and congenital heart disease. With heart failure, shortness of breath occurs with strong physical exertion, and with the development of the disease, it can occur even in a supine position;
• Obesity. If there is excess weight, shortness of breath occurs due to the load on the heart, which is caused by body weight. In the first stage of obesity, shortness of breath appears when walking or running, interferes with eating. If the body weight is too large, it is difficult for the patient to inhale and exhale even at rest;
• During pregnancy. During the period of gestation, shortness of breath is not considered a pathology, but is a normal phenomenon. Difficulty breathing is caused by an increase in the size of the uterus, which affects the increase in intraperitoneal pressure, which in turn reduces lung capacity.

Despite the variety of reasons, it is still necessary to make an appointment with a general practitioner and undergo an examination. Diseases in the advanced stage can significantly aggravate the patient’s condition and worsen the quality of life.

Types of dyspnea:

• Expiratory. This type of shortness of breath is characterized by difficulty exhaling. The cause of problematic exhalation is the narrowing of the lumen of the bronchi. Most often, expiratory dyspnea occurs with chronic obstructive pulmonary disease, emphysema, and the consequences of tuberculosis;
• Inspiratory. With this shortness of breath, it is difficult to inhale. Pathology develops against the background of a significant narrowing of the lumen of the trachea or bronchi. Inspiratory dyspnea is characteristic of asthma, and inflammatory processes in the bronchi;
• Mixed. In this form, the patient has difficulty in both inhalation and exhalation. The cause may be an advanced stage of chronic obstructive pulmonary disease or pathologies of the cardiovascular system.

How to treat shortness of breath?

Shortness of breath is only a symptom of diseases that develop in the human body. Therefore, it will be necessary to determine the cause of the disease and influence its destruction.

If shortness of breath occurs due to coronary heart disease or myocardial infarction, the patient needs hospitalization, diagnosis and complex treatment with medications.