Medicines for Acute cholecystitis

What it is

Acute cholecystitis is sudden inflammation of the gallbladder — a small pouch under the liver that stores bile. It is most often caused by a gallstone blocking the tube that drains bile from the gallbladder (the cystic duct), so that bile builds up and the gallbladder becomes inflamed and, sometimes, infected. It is a common complication of gallstones and usually needs hospital treatment. The main symptom is severe pain in the upper right part of the tummy (or the centre), which is often constant (unlike the shorter-lived pain of simple gallstone "attacks"), may spread to the right shoulder or back, and is typically worse with movement, breathing in, or when the area is pressed. Other symptoms can include feeling or being sick, a high temperature and feeling generally unwell, and, in some cases, yellowing of the eyes and skin (jaundice) if the bile flow is more blocked. Acute cholecystitis is more than a simple gallstone attack because the gallbladder is inflamed and can become infected, and, if untreated, it can lead to complications (such as the gallbladder becoming severely inflamed, infected, or, rarely, perforating). It therefore usually needs hospital assessment and treatment. Treatment typically includes rest, fluids, pain relief, and antibiotics to treat any infection, and — because gallstones are usually the cause and the problem tends to recur — removal of the gallbladder (an operation called a cholecystectomy, usually done by keyhole surgery), which may be done during the same hospital stay or a little later. Most people recover well after treatment, and removing the gallbladder cures the problem and prevents it happening again. The key messages are that severe, constant upper right tummy pain with feeling unwell needs assessment, that acute cholecystitis usually needs hospital treatment, and that removing the gallbladder is the usual definitive treatment.

How it is treated

Acute cholecystitis usually needs hospital assessment and treatment, and removing the gallbladder is the usual definitive treatment. If acute cholecystitis is suspected — severe, constant upper right (or central) tummy pain, often with feeling or being sick, a temperature, or feeling unwell — medical assessment is needed, and severe or worsening symptoms need urgent attention. In hospital, the diagnosis is confirmed with examination, blood tests, and scans (such as an ultrasound), which show the inflamed gallbladder and any gallstones. Initial treatment usually involves: resting the gut (not eating for a period), fluids given into a vein, pain relief, anti-sickness treatment, and antibiotics to treat any infection; with this, the inflammation often settles over a few days. Because the problem is usually caused by gallstones and tends to recur (and can cause further complications), the definitive treatment is removal of the gallbladder (cholecystectomy), usually performed by keyhole (laparoscopic) surgery — this may be done during the same hospital admission (often preferred, and frequently done within the first days) or arranged a little later, depending on the situation. Removing the gallbladder cures the problem and prevents recurrence, and people can live normally without a gallbladder. In some cases — for example if a person is not well enough for surgery, or the gallbladder is very inflamed — other measures (such as draining the gallbladder temporarily) may be used, with surgery later. Most people recover well after treatment. It is important to seek urgent attention for warning signs of a more serious problem — such as high fever and feeling very unwell (possible spreading infection), jaundice, or severe, worsening pain — which may indicate complications. The reassuring message is that acute cholecystitis, though it needs hospital treatment, is usually treated effectively — with the inflammation settled by rest, fluids, pain relief, and antibiotics, and the problem cured by removing the gallbladder — and most people recover well.