Cholecystitis is inflammation of the gallbladder. One of the most common causes of gallbladder inflammation is cholelithiasis, also known as gallstones.

The gallbladder is an organ in the digestive system that stores and secretes bile, a fluid that helps break down food during digestion. However, gallstones may form and block the ducts, leading to painful and sometimes life threatening complications due to gallbladder inflammation.

Gallstones are lumps of hardened materials that form in the gallbladder and range from tiny to golf-ball-sized. These may consist of cholesterol, a waxy substance that circulates in the blood, or bilirubin, a yellow pigment that results from red blood cell breakdown. Most are painless, but some cause complications, such as cholecystitis.

This article explores cholecystitis and cholelithiasis in more detail, including their causes, symptoms, diagnosis, and treatment.

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The following factors can contribute to gallstone development and gallbladder inflammation.

Cholecystitis

Two types of cholecystitis can develop, depending on the cause: calculous and acalculous.

The calculous type occurs when a gallstone or biliary sludge, a substance consisting of bile and small crystals of salt and cholesterol, blocks the cystic duct. According to the United Kingdom’s National Health Service (NHS), this accounts for about 95% of cholecystitis diagnoses.

Acalculous cholecystitis may occur due to the following, although the exact cause is not clear:

Cholelithiasis

Gallstones are common, occurring in 10% to 15% of all people in the United States. They may develop if bile’s cholesterol or bilirubin content is too high or its bile salts are too low, although more research is necessary to confirm why these changes occur.

Certain groups of people have a higher risk of gallstones, including:

Certain health conditions also increase the risk of gallstones, such as:

Additionally, rapid weight loss due to factors like weight loss surgery might increase the risk of gallstones. Those eating a high calorie diet with high levels of refined carbohydrates and low fiber intake also have a higher risk.

When gallstones cause symptoms, they usually present as cholecystitis.

Cholecystitis

Cholecystitis mainly leads to a sharp, sudden pain toward the upper-right side of the belly, according to the NHS. This pain may feel like it is moving toward the right shoulder. The painful part of the belly may feel tender to the touch, and the pain may worsen while breathing deeply. It often lasts for longer than a few hours.

Some people experience other symptoms, such as:

A less severe, ongoing version of these symptoms may occur due to faulty gallbladder emptying, known as chronic cholecystitis. This can lead to biliary colic — episodes of more noticeable symptoms.

However, severe presentations of these symptoms require urgent treatment.

Cholelithiasis

Gallstones do not usually cause symptoms. Doctors refer to these as silent gallstones, and they do not affect gallbladder, pancreas, or liver function or require treatment.

However, symptoms of cholecystitis may flare up due to an acute “gallbladder attack” caused by gallstones blocking the duct. These symptoms may occur in response to specific dietary triggers, such as greasy or spicy foods.

A cholecystitis diagnosis often leads to tests for cholelithiasis.

Cholecystitis

Doctors often test severe belly pain for cholecystitis using Murphy’s sign. An individual breathes in deeply while a physician presses their hand into the belly, right below the ribcage. The gallbladder moves downward while breathing in. People with cholecystitis usually experience sudden pain once the gallbladder reaches the physician’s hand.

The healthcare professional will then refer the individual for gallstone testing.

Cholelithiasis

Doctors base a gallstone diagnosis on:

Treating both conditions often involves removing the gallbladder.

Cholecystitis

According to the NHS, people with cholecystitis usually need to stay in the hospital for around a week. However, depending on the severity of their symptoms, some may be able to return home. Cholecystitis requires urgent treatment as it may lead to severe complications, such as a ruptured gallbladder or gallbladder tissue death.

The medical team may prevent an individual from eating or drinking anything to ease pressure on the gallbladder while providing fluids to help avoid dehydration. If the doctor suspects an infection, a person may also receive pain relief medication and antibiotics.

After initial treatment, doctors may recommend removing the gallbladder to prevent further episodes of cholecystitis and reduce the risk of complications in a procedure called cholecystectomy. It is one of the most common surgeries in the United States.

A person does not need a gallbladder to live, as bile can reach the gut through other channels.

Cholelithiasis

If gallstones do not cause symptoms, a person will not need treatment. However, if they cause a blockage contributing to cholecystitis, a person will need cholecystectomy. Nonsurgical measures may treat cholesterol stones, but bilirubin stones often require surgery.

Cholelithiasis (gallstones) is a common cause of cholecystitis, which is inflammation of the gallbladder.

Gallstones are hard lumps of cholesterol or bilirubin in the gallbladder. Many gallstones do not cause symptoms, but those that do can cause an inflamed gallbladder, which leads to cholecystitis symptoms such as sharp belly pain, fever, and nausea.

This requires urgent treatment and often leads to the removal of the gallbladder through a cholecystectomy. However, people can survive without a gallbladder, and cholecystectomies can help prevent severe complications.