The diagnosis of "chronic cholecystitis" often comes as a surprise: the abdomen does not hurt every day, yet the word is frightening. Let us explain what happens to the gallbladder, how the disease manifests, and what is known about the prognosis.
What chronic cholecystitis is
The gallbladder is a small organ under the liver. It stores bile produced by the liver and helps digest fats.
Chronic cholecystitis is inflammation that lasts a long time. It is triggered by repeated brief blockages of the duct: bile stagnates, presses on the wall, and the wall becomes irritated. Over time the gallbladder wall thickens and becomes denser, and the organ stores and releases bile less well.
The form may be calculous, with stones, or acalculous. The first is a common result of gallstone disease.
Why inflammation of the gallbladder develops
The leading cause is a stone that blocks the cystic duct. Bile cannot leave, accumulates, irritates the wall and presses on it, infection sets in — edema and inflammation appear. When the blockage recurs, the process becomes chronic.
Less often, inflammation is associated with severe diseases such as HIV or diabetes, and with gallbladder tumors — these are rare. Stones are more common in women, during pregnancy and hormone therapy, with obesity, rapid weight fluctuations, and diabetes; the risk increases after age 40, as well as with a diet high in fat and low in fiber, and with Crohn's disease.
Symptoms of chronic cholecystitis
In the chronic form there may be nausea, dull pain in the right upper abdomen, and other unpleasant sensations after eating. The pain radiates to the back or under the right shoulder blade, more often after fatty food.
An attack of biliary colic looks different: severe constant pain in the middle of the abdomen or on the right under the ribs, lasting longer than 30 minutes and up to several hours, with nausea and vomiting. It is these episodes that form chronic inflammation.
Sometimes there are no symptoms, and stones are found incidentally — on ultrasound or X-ray done for another reason.
How chronic cholecystitis is diagnosed
The doctor asks about the pain and examines the abdomen: pressure in the right upper abdomen is usually painful. Further tests are then ordered:
- ultrasound of the abdominal organs — stones and signs of inflammation
- blood tests: complete blood count, liver function tests, bilirubin, amylase and lipase
- CT or MRI of the abdomen
- plain abdominal X-ray
- radionuclide scanning of the gallbladder
The doctor selects the set of tests based on the clinical picture. With stones and recurrent attacks, removal of the gallbladder is discussed — the decision is made after a full evaluation.
Complications and prognosis: how long people live with chronic cholecystitis
The prognosis is conditionally favorable: with adequate treatment, working capacity is fully preserved. Most people recover completely after gallbladder removal.
The danger comes from complications. A stone in the bile ducts causes jaundice: the skin and sclera turn yellow, urine darkens, stool lightens — this is a reason for emergency hospitalization. There may be an abscess in the gallbladder, gangrene, perforation, pancreatitis, peritonitis. Gallbladder rupture and peritonitis are the most severe: even with correct treatment, a fatal outcome is possible. Stones complicate treatment and worsen the prognosis.
When to see a doctor
You should make an appointment with a doctor if abdominal pain lasts longer than 30 minutes, severe pain does not subside, or symptoms return after treatment.
Chronic cholecystitis by itself is not a reason to call an ambulance. Call 103 or 112 if the pain is sudden and very severe, radiates to the back and is accompanied by vomiting; if the temperature is very high or you have alternating chills and sweating; if the skin or whites of the eyes have turned yellow.
Come to the surgeon with prepared questions: do I have stones and where are they; what tests do I need; what will happen if surgery is delayed; what complications are likely in my case specifically.
This material is for reference and does not replace a doctor's consultation.
Sources
Update history
Reader reviews
No reviews yet — tell us whether this article was helpful.
Leave a review
This content is for reference and does not replace a doctor's consultation. Medical disclaimer