Answers
What is cholecystitis (gallbladder inflammation)?
Short answer
Cholecystitis is inflammation of the gallbladder, usually because a gallstone blocks its outlet. It causes constant pain in the upper right belly lasting many hours, often with fever and vomiting. It needs hospital treatment with antibiotics and, in most people, removal of the gallbladder.
Symptoms
Short attacks of pain after meals that settle within a few hours are usually biliary colic. Pain that does not settle, especially with fever, suggests cholecystitis.
- Constant pain under the right ribs or in the upper belly, lasting more than 4 to 6 hours
- Pain that may spread to the right shoulder or back
- Fever, nausea and vomiting
- Tenderness when the right upper belly is pressed
Tests
Blood tests show signs of infection and check the liver. An ultrasound shows stones, a thick gallbladder wall and fluid around it. Sometimes a CT, MRCP or EUS is done to look for a stone in the bile duct.
Treatment
- Admission to hospital, fluids through a drip, pain relief and antibiotics
- Removal of the gallbladder by keyhole surgery, ideally during the same admission or soon after
- For people too unwell for surgery, the gallbladder can be drained through the skin or, at specialised centres, through an endoscope (EUS-guided drainage)
- If a stone has also slipped into the bile duct, it is removed by ERCP
When it is urgent
Go to the emergency department straight away, or call 112, for severe belly pain that does not settle, high fever with shivering, yellow eyes, confusion or repeated vomiting. Delayed treatment can lead to gangrene or a burst gallbladder.
Diet before and after gallbladder surgery
Eat more
- After the attack settles: small, light meals such as khichdi, dal, curd, idli, steamed vegetables and fruit
- Plenty of fluids
- After surgery: return to normal food over one to two weeks
Cut down
- Large, heavy or fried meals while waiting for surgery
- Rich gravies, cream and full-fat sweets
- Long gaps without eating followed by a big meal
Good to know
- No diet dissolves gallstones or prevents another attack; surgery does.
- During the attack, the stomach is often rested in hospital, with fluids through a drip.
Common questions
Can medicines dissolve the stones and avoid surgery?
Rarely. Medicines work only for a few small cholesterol stones, take months, and stones often come back. They are not a treatment for cholecystitis.
Can I live normally without a gallbladder?
Yes. Bile flows straight from the liver into the intestine. Most people eat normally within a few weeks.
What if I delay surgery?
Repeat attacks are common, and the next attack may be worse, with complications such as pancreatitis or a stone in the bile duct.