What is chronic cholecystitis?
Chronic cholecystitis is a disease characterized by persistent inflammation of the gallbladder, an organ located below the liver. Although it is less severe than acute cholecystitis, which causes more intense pain, it can cause significant discomfort and requires proper medical attention.
Age is directly linked to the development of the disease. According to research, chronic cholecystitis can affect about 9.3% of the Brazilian population. In the United States, the estimated incidence of gallstones ranges from 10% to 15%.
Symptoms of chronic cholecystitis
Generally, affected individuals experience recurrent abdominal pain in the upper right region, which can be described as a sensation of heaviness, stabbing pain, or colic. It can radiate to the back and right shoulder. Additionally, the patient may present:D
- nausea
- vomiting
- feeling of fullness after meals
- flatulence (gas)
- stools lighter in color than usual
The presence of these symptoms, especially after meals rich in fats, may suggest a crisis associated with chronic cholecystitis.
Diagnosis
The diagnosis of chronic cholecystitis involves an analysis of the clinical and family history, physical and complementary exams. The doctor asks questions about the symptoms and requests laboratory tests, such as a complete blood count and liver function tests.
Imaging evaluations, such as abdominal ultrasound, are options to identify the presence of gallstones, thickening of the gallbladder wall, and signs of inflammation.
In some cases, endoscopic retrograde cholangiopancreatography (ERCP), an internal examination of the patient, may be necessary to visualize the bile ducts in more detail.
Treatment of chronic cholecystitis
In mild cases, the treatment of chronic cholecystitis involves lifestyle changes. This may include a low-fat diet, regular physical activity, and medications to control pain and inflammation, such as anti-inflammatories.
However, in more severe or recurrent cases, removal of the gallbladder may be necessary. Laparoscopic cholecystectomy surgery is the most common procedure for treatment. The technique involves removing the organ through small incisions in the abdomen, using specific instruments such as laparoscopic forceps and scissors.
Recovery after laparoscopic cholecystectomy is usually faster than after traditional surgery, and patients generally experience less pain. Additionally, the technique is associated with a lower risk of infections and results in smaller scars. However, in more complex cases, open surgery may be necessary.
After the removal of the gallbladder, the body can still digest food normally, even without it. Bile (fluid produced by the liver, essential for the digestion of fats in the small intestine) flows directly from the liver to the small intestine, instead of being stored and released by the gallbladder.
Prevention
Although the formation of gallstones and chronic cholecystitis cannot be completely avoided, some measures can help reduce the risk of developing this disease:
- healthy eating: maintain a balanced diet, rich in fiber, fruits, vegetables, and whole grains, and low in processed foods and saturated fats
- regular exercise: for proper functioning of the digestive system
- adequate hydration: drink the recommended amount of water advised by health professionals to prevent the formation of gallstones
- moderation in alcohol consumption
- avoid smoking
References
CASTRO, P.M.V. et al. Laparoscopic cholecystectomy versus minilaparotomy in cholelithiasis: systematic review and meta-analysis. Brazilian Archives of Digestive Surgery, v.27, n.2, p. 148-153, 2014.
DAMASCENO, Sarah Santos et al. Videolaparoscopic cholecystectomy: technical approach, indications for the treatment of calculous cholecystitis and possible complications. Brazilian Journal of Development, v. 8, n. 7, p. 52464-52483, 2022.
LAURA, M.; SHAFFER, S.; SHAFFER, E.A. Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer. Gut and Liver, v6, n.2, p172-187, 2012.
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Cholelithiasis: presence of stones (calculi) inside the gallbladder, a small organ located near the liver. It can cause intolerance to fatty foods, abdominal pain, and nausea
Gallstones: occurs when small stones form in the organ responsible for storing bile produced by the liver. Symptoms include abdominal pain and nausea
Pancreatitis: inflammation of the organ located behind the lower part of the stomach (pancreas). The most common symptoms are abdominal pain, nausea, and vomiting