Chronic cholecystitis and acalculous cholecystitis are common diseases involving the gallbladder.
Chronic Cholecystitis is characterized by swelling and irritation of the gallbladder that progresses over time.
Acalculous cholecystitis is diagnosed when there is an inflammatory disease of the gallbladder without clear pathology involving gallstones or a duct obstruction.
Both are severe illnesses that can lead to serious complications.
What Causes Chronic Cholecystitis?
Chronic cholecystitis is caused by repeated attacks of acute cholecystitis, which are in turn caused by gallstones.
What that means is that the gallbladder is producing gallstones, which are tiny rocks consisting of cholesterol. These rocks thicken and attack the walls of the gallbladder, leading to inflammation (acute cholecystitis). The gallbladder begins to shrink because of these attacks. Over time, the gallbladder loses its ability to focus on its job, which is to store and release bile upon command.
This condition tends to occur more often in women as opposed to men. Most patients are over forty with birth control pills and pregnancy being common culprits.
Prevalence and Demographics in Los Angeles
Studies estimate roughly 10% of adults in the United States show signs of chronic cholecystitis based on diagnostic imaging. Applying that rate to Los Angeles County’s 10 million residents, over 1 million may be affected.
Middle-aged adults between 30-60 years old represent the most diagnosed cases. The condition shows only a slight skew towards women at 55% compared to men at 45%. Contrary to some assumptions, Hispanics in LA exhibit lower rates than other ethnicities. Yet obesity still stands out as a major risk factor.
Like most health issues, access to quality care also plays a large role. Lower income neighborhoods in LA could have many undiagnosed or untreated cases due to lack of coverage, transportation issues, or inability to take time off work for medical care.
Common Causes and Risk Factors
Gallbladder inflammation usually develops when bile builds up and causes irritation over time. But what leads to bile issues in the first place? Several key factors contribute to chronic cholecystitis risk:
- Gallstones - The main predictor, 80-95% of chronic cholecystitis patients have gallstones stuck in their bile ducts. Other less common obstructions like tumors also impede bile flow.
- Metabolic issues - Dysfunctions that affect how the body processes nutrients, like diabetes, metabolic syndrome, and other endocrine disorders. Being overweight can exacerbate these problems.
- Infections - Parasitic, bacterial, or viral pathogens entering the digestive tract can spread to the gallbladder. Intestinal infections like giardiasis may play a role.
- Trauma or Toxins - Physical damage to the abdomen or exposure to certain chemicals/toxins have also shown links. Anatomical defects allow leakage of bile where it doesn’t belong.
- Ethnicity & Family History - Hispanic and Northern European descent individuals have slightly higher predispositions. So do those with relatives having gallbladder problems.
- Diet - Frequent fatty, sugary, or processed meals make gallbladder expel more bile after eating which takes a toll long-term. Rapid weight loss and crash dieting can also tax the gallbladder.
- Age & Gender - Middle age and female gender confer higher risk, but the exact reasons are still uncertain. Changes in estrogen levels may contribute for women.
What Chronic Cholecystitis Symptoms Should You Watch For?
Symptoms of chronic cholecystitis include sharp cramps on the right or upper side of your tummy, and steady pain lasting for at least a half-hour. Pain that spreads to your lower back or lower right shoulder blade can also occur in some people.
Another way you can determine if you have chronic cholecystitis is to watch your stool for clay coloring. You may also experience fever, nausea, vomiting, and jaundice (yellowing of the skin and whites of the eyes).
Dr. Moein can perform tests to diagnose your gallstone condition before recommending surgical intervention.
Symptoms and Complications
The tricky thing about chronic cholecystitis is it often starts silently without symptoms for years. Eventually, though, the inflammation can flare into pain episodes. Biliary colic gallbladder attacks may come and go at first. Without treatment, the condition advances leading to long-term effects:
- Gallbladder Attacks - Violent abdominal pain on the upper right side that can last hours to days. Often starts suddenly, especially after eating a meal high in fat.
- Fever, Chills, Jaundice - If gallstones completely block ducts or an infection arises, more severe symptoms emerge.
- Nausea & Vomiting
- Chronic Digestive Issues - Fats may not get absorbed properly or bowel movements become unpredictable long-term.
- Pancreatitis - The swollen gallbladder may press on or block the drainage of the pancreas also resulting in pancreatic inflammation and damage.
- Gallbladder Rupture - Left untreated, resurfacing attacks can permanently impair the gallbladder's functioning and anatomy. Bile leakage into other areas can become life-threatening.
- Higher Cholesterol, Heart Disease - Chronic inflammation cascades into blood vessel and metabolic changes that accelerate cardiovascular disease.
- Cancer Risk - Very rarely (in less than 1 percent of cases), abnormal cell growth can lead to gallbladder cancer, usually when long-standing gallstones are present.
Catching chronic cholecystitis early is key before additional complications set in or connective tissue hardening makes surgery more difficult.
Surgery for Chronic Cholecystectomy
Surgery is the most common treatment for long-term inflammation of the gallbladder. The surgery is low-risk and involves the removal of the gallbladder to prevent future diseases or conditions.
If you are too sick to have surgery, the gallstones can be dissolved with medicine taken orally. This method can take two years or longer to work, and the gallstones can return. Ideally, and if you can, you will take steps to restore your health to make surgery possible, which can offer permanent relief.
Exploring Treatment Options in Los Angeles
Medical Management:
In the initial stages, medical management is often the preferred approach in Los Angeles. This involves the use of medications to control symptoms, dietary adjustments, and lifestyle modifications to minimize inflammation. Anti-inflammatory drugs and medications to promote gallbladder emptying may be prescribed(1).
Laparoscopic Cholecystectomy:
For cases where medical management proves insufficient or when chronic cholecystitis leads to complications, surgical intervention may be recommended. A laparoscopic cholecystectomy, involving the removal of the gallbladder through small incisions, is a common and effective procedure in Los Angeles(2).
Endoscopic Retrograde Cholangiopancreatography (ERCP):
In situations where gallstones are contributing to chronic inflammation, ERCP may be employed. This procedure allows for the removal or dissolution of gallstones, addressing the underlying cause(3).
Advancements in Treating Chronic Cholecystitis
Cholecystostomy Tube Placement:
For individuals who are not suitable candidates for surgery, the placement of a cholecystostomy tube may be considered. This tube allows for the drainage of bile, alleviating symptoms and reducing inflammation(4).
Focused Shock Wave Therapy:
Recent advancements include focused shock wave therapy, a non-invasive method to address chronic cholecystitis. This innovative approach may offer an alternative, particularly for those seeking non-surgical options(5).
Postoperative Care and Recovery in Los Angeles
Pain Management and Medications:
For those undergoing surgical interventions, effective pain management is crucial for a smooth recovery. Los Angeles healthcare providers may prescribe medications and recommend strategies to alleviate discomfort during the healing process(6).
Dietary Guidelines After Chronic Cholecystitis Treatment:
Adjusting one's diet is a key component of recovery post-treatment. Individuals in Los Angeles recovering from chronic cholecystitis are often advised to follow a low-fat diet initially and gradually reintroduce normal foods to avoid digestive issues(7).
Follow-up Appointments and Monitoring:
Regular follow-up appointments with healthcare providers in Los Angeles are essential for monitoring recovery progress, addressing any concerns, and ensuring a smooth transition back to normal activities.
What is Acalculous Gallbladder Disease?
Otherwise referred to as acute acalculous cholecystitis, this condition causes inflammation of the gallbladder without evidence of gallstones. Severe illness can arise from other medical conditions, long-term illnesses, and trauma.
What are the Symptoms of Acalculous Gallbladder Disease?
Some of the main symptoms of acalculous cholecystitis include shortness of breath, abdominal pain, fever, chills, and fatigue.
What Causes Acalculous Gallbladder Disease?
This condition is common in patients with significant illnesses. Risk factors include trauma, such as severe burns or tissue injury, heart surgery, bacterial illness, and diabetes mellitus.
Surgery for Acalculous Gallbladder Disease
Surgery is often necessary when the condition has become chronic. Laparoscopic gallbladder surgery will remove the ill organ, absolving you of pain while eliminating the chances of the problem recurring.
Ready to Discuss Surgery for Chronic Cholecystitis or Acalculous Cholecystitis?
When your gallbladder is bothering you, you may not know where to turn. When you develop pain and other symptoms, a diagnosis can bring you relief through recommended surgery. Schedule a consultation with world-class general surgeon Dr. Babak Moeinolmolki by calling Healthy Life Bariatrics throughout Los Angeles, Encino, and Glendale, California – (310)807-2378.
