Gallbladder Diseases and Acute Cholecystitis

Gallbladder Diseases

• The gallbladder is a small, muscular sac located beneath the liver, in the upper right abdomen.
• It connects to the liver via a short tube, which branches from a larger duct leading to the duodenum (the first part of the small intestine).
• The liver produces bile, a greenish-golden, bitter liquid crucial for digesting fats, cholesterol, and fat-soluble vitamins.
• The gallbladder stores bile, concentrating it from approximately 600-800ml to 40-70ml per day.
• Bile is composed of bile acids, pigments, water, cholesterol, and lecithin (including bilirubin, a breakdown product of red blood cells).
• When a person eats, the lining of the intestine releases the hormone cholecystokinin, signaling the gallbladder to release bile into the duodenum to aid digestion.

Acute Cholecystitis

• Acute cholecystitis is an inflammation of the gallbladder.
• Causes include gallstones blocking the cystic duct (the duct connecting the gallbladder to the common bile duct), or bacterial infection (like Salmonella).
• Symptoms include severe, sharp pain in the upper right abdomen that may radiate to the right shoulder, fever, nausea, vomiting, and indigestion.
• Jaundice (yellowing of the skin and eyes) can be observed in 15% of patients.
• Difficulty taking a deep breath on the right side, while the doctor exerts pressure on the area, without also feeling pain on the left side above the abdomen.
• Other conditions (like peptic ulcers, hepatitis, pancreatitis, kidney stones, and renal colic) can cause similar symptoms, differentiating them can be crucial for diagnosis.

Factors causing acute Cholecystitis

• Diabetes
• Pregnancy
• Rapid weight gain or loss
• Undergoing surgery
• Heart disease
• AIDS

Chronic Cholecystitis

• Chronic cholecystitis is a long-lasting inflammation of the gallbladder.
• Symptoms often include a feeling of fullness and bloating, especially after eating fatty foods, as well as digestive discomfort, and stomach acidity.

Gallstones (Cholelithiasis)

• Gallstones are solid deposits formed within the gallbladder from components of bile.
• They can be cholesterol-based or bile-salt based.
• Cholesterol stones are more common among women due to the impact of estrogen on blood cholesterol levels.
• The conditions contributing to the formation of gallstones include lack of water consumption, rapid changes in weight, and contractive drugs, diabetes, or fasting for prolonged periods.
• There can be an infection related to bacteria such as E. coli.

Gallstones Symptoms

• Some symptoms are similar to acute cholecystitis (for example, pain in the upper right abdomen, nausea, and vomiting).
• In some cases, there are no noticeable symptoms.
• Jaundice and steatorrhea (fatty stools) can sometimes arise.

Treatment

• Dietary modification is often a primary part of managing gallbladder problems.
• A diet low in fat is often prescribed, with recommended fat intake typically reduced to about 15% of total daily calories.
• Avoid sulfur-containing foods (e.g., cabbage, cauliflower, onions, and green peppers), spices, pickles, beans, and fried foods.
• Regular, smaller meals, rather than larger ones, are suggested, to reduce gallbladder load.
• If there's a need for surgery, careful consideration of appropriate fat intake prior to the intervention may be required..
• Medical intervention may be necessary for certain gallbladder problems, especially chronic ones or gallstones causing obstructive symptoms. It may include surgery.