What is Cholecystitis and How to Deal with it?

Medically reviewed by Aaron L Weigmann MD., MS Plastic Surgeon October 31, 2024| Written by Shahid Bashir

What is Cholecystitis and How to Deal with it?

Cholecystitis is the inflammation of the gallbladder - a pear-shaped organ in the right upper region of your belly. The liver produces a digestive fluid called bile. The gallbladder stores bile and releases it in the small intestine through bile ducts, which help digest fats. 

Gallstones can develop in the bile ducts and block the release of bile into the small intestine. This results in the buildup of bile in the gallbladder which can cause gallbladderinflammation or cholecystitis. 

Cholecystitis can be acute or chronic, and gallstones are the common cause of both types.

The common symptoms of cholecystitis include pain in the abdomen, nausea, and vomiting. Medical management of cholecystitis often involves the removal of the gallbladder.Untreated cholecystitis can cause rupture of the gallbladder, sepsis, and even death. 

Reports show that about 200,000 in the USA develop cholecystitis every year. Gallstones are the cause of 95% of cholecystitis cases. 

What Does Cholecystitis Pain Feel Like?

Abdominal pain of cholecystitis can be mistaken for other health concerns. But cholecystitis pain shows specific characteristics that help differentiate it. 

Along with the pain in the abdomen, you can also feel shoulder and back pain in cholecystitis. The pain worsens after eating especially fatty foods.Bloating is also common in cholecystitis. 

The other common signs and symptoms of cholecystitis include:

  • Tenderness in the abdominal area
  • Nausea
  • Vomiting
  • Fever
  • Yellowing of skin and eyes — jaundice

What is the Main Cause of Cholecystitis?

Cholecystitis, or the inflammation of the gallbladder, can be caused by:

1.Gallstones

Gallstones are stones that are usually made of cholesterol or bilirubin. These stones develop within the gallbladder and often get trapped in the bile ducts, stopping the bile from flowing to the small intestine. 

Bile starts to build up in the gallbladder and causes inflammation. 

Gallstones are a common condition worldwide, affecting over6% of the total population. The ratio is even higher in the USA, where15% of the population has gallstones. Studies show that about95% of people with cholecystitis have gallstones. 

2. Bacterial Infection 

The biliary duct system consists of ducts that transport bile from the liver to the gallbladder. Bacteria can infect the biliary duct system when the passage of bile towards the small intestine is disrupted. 

Bacteria can also directly affect the gallbladder and cause infection. 

Bacterial infection is a fairly common cause of cholecystitis. However, if a person is immunocompromised, the risk of bacterial infection and cholecystitis increases significantly. 

3. Tumor

A tumor can grow in the gallbladder or the bile ducts. If this blocks the transfer of bile into the small intestine, then the bile starts to build up in the gallbladder. 

Thus, tumors work similarly to gallstones in causing cholecystitis.

4.  Gallbladder Sludge

It is a thick material that develops in the gallbladder when bile stays in the gallbladder for a long time. This sludge can block the normal flow of bile into the bile ducts and cause inflammation.

Gallbladder sludge commonly develops in pregnant women and those who lose weight rapidly.

What is the Best Treatment for Cholecystitis?

The best treatment for cholecystitis is the surgical removal of the gallbladder or cholecystectomy. But when the surgery isn’t possible, symptoms are managed through other treatment options and dietary & lifestyle changes.

Medical management of cholecystitis includes:

1. Medications

When a patient arrives at the hospital with cholecystitis, the initial management includes not eating or drinking anything. Keeping the stomach empty helps the gallbladder rest and relieves the symptoms. This is followed by IV administration of antibiotics and painkillers. 

Antibiotics prevent infection from spreading while painkillers help relieve pain. Initial management also includes injecting fluids through veins to prevent dehydration. 

2. Gallbladder Removal Surgery

Cholecystectomy or removal of the gallbladder is the most common and effective treatment option for cholecystitis. The two options for cholecystectomy are laparoscopic surgery and open surgery.

Laparoscopic cholecystectomy is a minimally invasive surgery that involves tiny incisions in the abdominal area. So, there’s a lower risk of complications, making it the gold standard surgical option for gallbladder removal.Reports show that 92% of cholecystectomy surgeries are done laparoscopically.

Open cholecystectomy is reserved only for complicated cases or when laparoscopic equipment isn’t available. It has a higher risk of post-surgery complications and pain compared to laparoscopic cholecystectomy. 

You can live a healthy life even after the removal of the gallbladder. The bile produced in the liver flows directly to the stomach after the gallbladder removal. 

3. Other Treatment Options

If gallbladder removal isn’t possible, then we may use the following options for managing cholecystitis: 

  • Gallstones Removal: When cholecystectomy is not an option, doctors remove gallstones in the bile duct to improve the condition. This treatment option is calledEndoscopic Retrograde Cholangiopancreatography (ERC).
  • Gallbladder Drainage: This procedure involves inserting a tube from your abdomen into the gallbladder. The infectious fluids and waste from the gallbladder are removed from the body through that tube. This procedure of gallbladder drainage is calledcholecystostomy

4. Dietary and Lifestyle Changes

Diet and lifestyle changes can improve the symptoms and condition of cholecystitis. Dietary changes include eating a low-fat and high-fiber diet. A fatty diet requires bile for its digestion. However, in cholecystitis, the bile can’t pass through the blocked bile ducts and enter the digestive system. This results in poor fat digestion and symptoms such as bloating anddiarrhea

Studies show that cholesterol from a fatty diet can also lead to the development of gallstones. On the other hand, a diet high in fiber prevents the risk of developing gallstones. 

Plant-based diets reduce the risk of gallstones bylowering cholesterol levels. They are also easy for the digestive system to process even when the gallbladder is not functioning. 

Lifestyle changes such as physical activity can also improve the symptoms of cholecystitis. A2019 study shows that physical activity reduces the risk of developing gallstones and symptoms related to gallbladder problems. 

What Foods Are Good for Cholecystitis?

Here are some foods that you can eat for cholecystitis:

1. Green Vegetables

Studies show that consuming a vegetable diet reduces the risk of gallstones. This is because cholesterol is a major cause of gallstones, and vegetables are low in cholesterol. The other benefit of consuming vegetables is the dietary fiber you get from them.

Some fiber-rich greenvegetables for cholecystitis include:

  • Cucumbers
  • Cabbage
  • Green peas
  • Lettuce
  • Cauliflower
  • Green Peppers
  • Carrots

2. Fresh Fruits

Like green vegetables, consuming fruits alsoreduces the risk of gallstones. They are high in fiber and don’t increase the body's cholesterol levels. Certain fruits, such as oranges, guava, and strawberries, are rich in vitamin C.Studies show that vitamin C has a protective role against gallstones. Vitamin C also hasantioxidant properties and can reduce gallbladder inflammation. 

Some healthyfruits for cholecystitis are:

  • Oranges
  • Cherries
  • Apples
  • Lemons
  • Pears
  • Grapefruits
  • Kiwi

3. Legumes

Legumes are another excellent food choice for people with cholecystitis. They are high in fiber and cholesterol-free foods that you eat to meet your nutritional demands.Studies show that legumes lower the risk of developing gallstones.

Some legumes that you can include in your diet are:

  • Beans
  • Lentils
  • Peas
  • Chickpeas

4. Lean Proteins

Lean proteins should be your preferred choice to meet your daily protein requirements. The food sources of lean proteins are low in fats, which helps prevent gallstones and other digestive problems in cholecystitis. 

Proteins also haveanti-inflammatory properties and can improve the inflammation in the gallbladder. 

Some lean protein food options to include in your diet are:

  • Egg whites
  • Chicken breast
  • Cowpeas
  • Low-fat cottage cheese
  • Black beans

5. Coffee

Multiple studies show that coffee is effective in gallbladder problems. For example, a 2019 study showed that people who consumed more than 6 cups of coffee per day had a23% lower risk of developing gallstones.

How Does Fiber Affect the Gallbladder Issues?

Fiber can affect the gallbladder issues in the following ways:

  1. Gallstones are the major problem that affects the functioning of the gallbladder. Cholesterol is the main culprit in developing gallstones.Studies show that fiber-rich foods lower the cholesterol levels in the body and prevent gallstones. 
  2. High blood glucose is another contributing factor in the development of gallstones. A fiber diet helpsregulate blood sugar levels and lower the risk of gallstones.
  3. Studies show that obesity is a major risk factor for gallbladder issues. Fiber foods are low in calories and can help you manage weight andprevent obesity-related problems.
  4. Fiber hasanti-inflammatory properties that can help your body against gallbladder inflammation. 
  5. Gallbladder sludge, which develops due to pregnancy and rapid weight loss, can block the bile ducts and cause cholecystitis.Research shows that consuming a fiber diet lowers the accumulation of gallbladder sludge. 

This reflects the fact that fiber is extremely beneficial for gallbladder-related issues. So, if you have cholecystitis or want a healthy gallbladder, add more fiber-rich foods to your diet. One convenient way to increase your fiber intake and achieve yourdaily fiber goal is toget powdered fiber.

What Foods Are Bad for Cholecystitis?

Fatty foods, especially saturated fats, are worse for cholecystitis. 

Firstly, saturated foodsincrease cholesterol levels in the body, increasing the risk of developing gallstones. Secondly, the efficient digestion of fats is also not possible with cholecystitis. 

It’s because your digestive system requires bile for the proper digestion of fats. Since the bile can’t reach the digestive system in cholecystitis due to blocked bile ducts; so you are bound to experience digestive problems. 

Here are some fatty foods that you should avoid with cholecystitis:

  • Processed meat
  • Fatty cuts of meat
  • Fried foods
  • Full-fat dairy products
  • Bakery items
  • Whipping Cream

FAQs

1. Can a person have cholelithiasis and cholecystitis at the same time?

Cholelithiasis, or gallstone formation, is the primary cause of cholecystitis. According to the reports,95% of people with cholecystitis have gallstones. So, there is a greater chance that a person can have cholelithiasis and cholecystitis at the same time. 

2. Can I exercise with Cholecystitis?

Studies show that exercise and physical activities reduce the risk of gallbladder problems. However, if the inflammation is severe and you experience pain with movements, try avoiding exercise and intense physical activities.

3. Is egg okay for cholecystitis?

You can eat egg whites with cholecystitis because they are a good source of proteins.Studies show that proteins can reduce inflammation and improve recovery. However, avoid eating egg yolks as they are high in fats and can cause digestive problems with cholecystitis. 

Conclusion

Cholecystitis is the inflammation of the gallbladder that affects over 200,000 people in the USA every year. The primary cause of cholecystitis is gallstones that block the bile ducts - causing the bile to be trapped in the gallbladder and leading to inflammation.

Cholecystitis can be cured by removing the gallbladder as there are limited complications associated with gallbladder removal. 

Dietary changes play an important role in cholecystitis before and after the surgery. Avoid fatty diets with cholecystitis as they can worsen the symptoms. Replacing fatty diets with plant-based foods high in fiber can significantly improve the symptoms and overall condition.