Cholecystitis - chronic

Alternative names
Chronic cholecystitis

Definition
Chronic cholecystitis is long-standing inflammation of the gallbladder.

Causes, incidence, and risk factors

Chronic cholecystitis is caused by repeated mild attacks of acute cholecystitis. This leads to thickening of the walls of the gallbladder. The gallbladder begins to shrink and eventually loses the ability to perform its function: concentrating and storing bile. Eating fatty foods may aggravate the symptoms of cholecystitis, because bile is needed to digest such foods.

The disease occurs more often in women than in men, and the incidence increases after the age of 40. Risk factors include the presence of gallstones and a history of acute cholecystitis.

Symptoms

     
  • Chronicindigestion  
  • Vague abdominal pain  
  • Nausea  
  • Belching

Signs and tests

Tests that reveal inflammation or gallstones in the gallbladder:

     
  • Abdominal CT scan  
  • Oral cholecystogram  
  • Abdominal ultrasound

Treatment

Surgery is the usual treatment. Cholecystectomy (surgical removal of the gallbladder) can be performed as an open or laparoscopic procedure. The open procedure requires a large incision, while laparoscopic surgery requires a cluster of small incisions for the insertion of instruments including a small camera.

For patients who are poor candidates for surgery because of other diseases or conditions, methods to dissolve gallstones may be of use. The symptoms of chronic indigestion can be managed by low-fat diets and weight reduction. Acid-suppressing and anticholinergic medications may also be helpful, as may antacids.

Expectations (prognosis)

Cholecystectomy is a common procedure with low risk. Patients who do not undergo surgery may be bothered by indigestion, but symptoms can be managed with a low-fat diet, weight loss, and medications.

Some patients continue to experience chronic indigestion after cholecystectomy, but this is likely caused by another condition.

Complications

Gallstones with chronic inflammation of the gallbladder can result in a worsening of the condition, pancreatitis, or (rarely) cancer of the gallbladder.

Calling your health care provider

Call for an appointment with your health care provider if you develop any symptoms of cholecystitis.

Call for an appointment with your health care provider if you have been diagnosed with chronic cholecystitis and your symptoms worsen or do not improve with treatment, or if new symptoms develop.

Prevention

The condition is not always preventable. People who have had an attack of acute cholecystitis but have not had their gallbladder removed may feel better with a reduced intake of fatty food.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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