Cholecystitis: 3 Signs of a Gallbladder Infection
What is cholecystitis?
Cholecystitis is an inflammation of the gallbladder. It is sometimes called a gallbladder infection. Your gallbladder is located just below the liver, and is the storage house for a fluid called bile.
When you eat a fatty meal, the gallbladder releases bile to help you digest the food. Sometimes, little clumps of bile can harden, creating gallstones.
Usually, these stones (also known as cholelithiasis) never cause any problems. But in some people, they can get stuck in the narrow passageway as they exit the gallbladder and block the flow of bile. This creates pain and inflammation. The pain is called biliary colic.
More commonly, the stones only block the gallbladder exit (called the cystic duct) temporarily. But when it remains blocked and gets inflamed or infected, it is called cholecystitis.
If you have cholecystitis, you will need surgery to remove the gallbladder.
Gallbladder infection symptoms
Describing intermittent, right upper quadrant pain that is worse after eating for the last few months makes me think someone has gallstones. If you then tell me that over the last day you had this pain more intensely, along with fevers, chills, and nausea, I am likely to send you to the emergency room. —Dr. Shria Kumar
Biliary colic is an intense pain that comes and goes in your middle to upper right part of your belly. The pain can come on fast, usually after eating a big, high-fat meal.
It peaks within 30 minutes. You will also feel nauseous and may vomit. Then it goes away within an hour or so (as the stone stops blocking the cystic duct).
When the cystic duct remains blocked and gets inflamed, it is called cholecystitis. At this point, you might develop fever and chills, constant nausea, lack of appetite, and throwing up. You may look pale and sick.
- Intense pain in the right upper or upper-mid belly. You may feel the pain around your side and back. It comes on quickly, usually after eating.
- Loss of appetite.
- Fever, chills, and sweating.
- Elevated heart rate.
Other symptoms you may have
- Pain and symptoms that happen at night.
- Chest pain.
- Right shoulder pain.
Gallstones occur because of an imbalance in the bile, which is made up of cholesterol (a fat) and salts. About 10% to 15% of people will have gallstones at some point in their life. Yet the majority of people—80%—will never even know it.
Gallstones can block the tube (cystic duct), stopping the flow of bile out of the gallbladder. Then bile builds up. And the gallbladder becomes swollen and extremely painful.
In some cases, the stones get unstuck, which is why symptoms might go away. But if they’re really stuck, the pain will continue and lead to cholecystitis. This can increase the chances for an infection or for the gallbladder to burst.
How do you treat a gallbladder infection?
Your gallbladder stores bile that your liver makes. Removing it does no harm to your overall body functions. Day to day, you are unlikely to notice it. But just because you remove the gallbladder doesn’t mean you can’t form gallstones. Though it’s less likely. —Dr. Kumar
With cholecystitis, you will likely be admitted to the hospital. The first step is always fluids and antibiotics through an intravenous (IV) line. This will help calm the inflammation down. The gallbladder almost always needs to be surgically removed, but will not be done if you have an active infection. Normally antibiotics calm the infection in about 72 hours, then the gallbladder is removed.
Removing your entire gallbladder will stop your symptoms and decrease the risk of future infections associated with gallstones. Your gallbladder is not an essential organ, and your body will adjust to not having it.
If you have a severe disease or poor health, surgery might be too risky. So the doctor will instead give you antibiotics and insert a tube to drain the gallbladder.
Gallbladder surgery: cholecystectomy
Most people with an inflamed gallbladder will need a laparoscopic cholecystectomy. It involves several small incisions in your abdomen rather than one large one. The surgery is done under general anesthesia.
You may go home that day or the next day. You will likely feel some pain and nausea after the surgery, due to the anesthesia, surgery, and recent infection. It can take a week or more to begin to feel better.
Contact your surgeon immediately if you get any fevers, chills, intense abdominal pain, constant nausea and vomiting, yellowing of the eyes or skin, or redness or drainage from your incisions.
Is cholecystitis an emergency?
It’s common to have gallstones that occasionally get stuck and then unstuck, causing temporary (though still painful) symptoms. You should call your doctor to see if they want to see you or think you need to go to the hospital.
But If your pain is unbearable or if your symptoms do not improve within a few hours or you develop fevers, chills, a fast heart rate, repeated bouts of vomiting, or worsening symptoms, you should go to the emergency room. There is a risk of infection and your gallbladder rupturing. It can cause a body-wide infection and is life threatening.
Who is most likely to have gallbladder problems?
Ask your doctor: What risk factors likely caused me to have this condition? Is there anything I can do to decrease future gallstone formation? —Dr. Kumar
You are more likely to get a gallbladder infection if you:
- Have had gallstones
- Have a family history of gallstones
- Older age
- Are a woman in your child-bearing years
- Liver disease
- Inflammatory bowel disease
- Sickle cell anemia
- Certain medications, like oral contraceptive pills
- Need IV nutrition
- Lost a lot of weight recently (like after bariatric surgery)
How to prevent a gallbladder infection
Gallstones and gallbladder infections are caused by many things you can’t control. Like aging and genetics.
But you can lower your chances of getting one by exercising and keeping your weight in a healthy range. Eat foods that are low in saturated fats and high in fiber.
Jesse Passman is a PGY-1 surgery resident. He graduated from Rice University with a BS in Ecology and Evolutionary Biology and received his MD from the University of Pennsylvania Perelman School of Medicine. During medical school, Jesse performed work in public health and surgery, taking a year-out to pursue an MPH at the University of Pennsylvania and do research in global surgery and the public health implications and clinical outcomes of trauma. In his free time, Jesse likes to travel, hike, backpack, and cycle.