Early symptoms of cholecystitis

Due to various reasons such as work pressure, diet, living environment, etc., people in our modern society are very prone to illness. It is not because of the comfortable living conditions that our bodies have become "pretentious". In fact, we modern people pay great attention to health preservation. But it doesn't mean that if you pay attention to your health, diseases won't come to you. Disease is pervasive and can penetrate into the human body as long as there is even a tiny gap. Common diseases in our body include: colds, fever, pneumonia, bronchitis, cholecystitis, etc. Now let’s talk about cholecystitis in detail.

Cholecystitis can be said to be a relatively common disease among humans. The reason why it is common is that its incidence rate is relatively high. Cholecystitis is actually divided into two types: acute cholecystitis and chronic cholecystitis. So, what are the early symptoms of these two types of cholecystitis? They are introduced one by one below.

Cholecystitis often coexists with cholelithiasis. Severe pain or colic in the right upper abdomen is mostly acute cholecystitis caused by stones or parasites blocking the neck of the gallbladder. The pain often occurs suddenly, is very severe, or presents like colic. In acute cholecystitis without obstruction of the cystic duct, the pain in the right upper abdomen is generally not severe, and is mostly persistent bloating. As the gallbladder inflammation progresses, the pain may also worsen, and the pain is radiating. The most common radiating sites are the right shoulder and the lower angle of the right scapula.

1. The early symptoms of acute cholecystitis are basically the same as those of acute acalculous cholecystitis.

(1)① Pain: Severe pain or colic in the right upper abdomen is usually caused by acute cholecystitis due to stones or parasites blocking the neck of the gallbladder. The pain often occurs suddenly and is very severe, or presents a colic-like state. It often occurs after eating high-fat foods and often occurs at night. General pain in the right upper abdomen is seen in acute cholecystitis without obstruction of the cystic duct. The pain in the right upper abdomen is usually not severe and is usually continuous and bloating. As the gallbladder inflammation progresses, the pain may also worsen. The pain is radiating, and the most common radiating sites are the right shoulder and the lower angle of the right scapula. This is caused by the inflammation of the gallbladder stimulating the right phrenic nerve endings and the peripheral nerves of the abdominal wall. ② Nausea and vomiting are the most common symptoms. If nausea and vomiting are persistent or frequent, it may cause dehydration, collapse and electrolyte imbalance, which is more common when stones or ascaris block the gallbladder duct. ③ Chills, chills, and fever. Mild cases often have chills and low fever; severe cases may have chills and high fever, the temperature may reach above 39°C, and mental symptoms such as delirium and delirium may occur. ④ Jaundice is less common. If jaundice occurs, it is generally mild, indicating that the infection has spread to the liver through the lymphatic vessels, causing liver damage, or the inflammation has invaded the common bile duct.

(2) Abdominal examination may reveal tension, tenderness, rebound pain in the right upper abdomen and mid-upper abdomen, and a positive Murphy sign. In patients with cholecystectomy or pericholecystic abscess, a tender mass or a significantly enlarged gallbladder may be felt in the right upper abdomen. When abdominal tenderness and abdominal muscle tension extend to other areas of the abdomen or the entire abdomen, it indicates gallbladder perforation. Or there is acute peritonitis. 15% to 20% of patients suffer from liver damage due to edema around the cystic duct, gallstone compression and pericholecystitis, or inflammation involving the common bile duct, causing spasm and edema of the sphincter of Oddi, leading to bile excretion obstruction and mild jaundice. If the jaundice becomes significantly worse, it may indicate common bile duct obstruction with stones or concurrent common bile duct inflammation. In severe cases, signs of peripheral circulatory failure may occur. Blood pressure is often low and even infectious shock may occur, which is particularly common in severe cases of purulent gangrene.

2. Early symptoms of chronic cholecystitis

(1) Persistent dull pain or discomfort in the right upper abdomen; symptoms of indigestion such as nausea, belching, acid reflux, abdominal distension and heartburn; pain in the right lower shoulder blade area; symptoms aggravated after eating high-fat or greasy foods; long course of disease, with alternating acute attacks and remissions. Acute attacks are similar to those of acute cholecystitis, and remissions may sometimes be free of any symptoms.

(2) There may be mild tenderness and percussion pain in the gallbladder area, but no rebound tenderness. In cases of cholestasis, an enlarged gallbladder may be felt. In acute attacks, there may be muscle tension in the right upper abdomen, normal body temperature or low fever, and occasionally jaundice. The tenderness point of the gallbladder is at the intersection of the outer edge of the right rectus abdominis and the costal arch, the tenderness point of the thoracic spine is beside the 8th to 10th thoracic vertebrae, and the tenderness point of the right phrenic nerve is between the two lower corners of the sternocleidomastoid muscle on the right side of the neck.

By understanding the early symptoms of both acute and chronic cholecystitis, it will be easier for us to check ourselves in the future. If you find yourself having similar symptoms as above but are undecided, you must go to the hospital for examination in time, because any disease cannot be delayed and must be treated in time to be cured as soon as possible. If we are diagnosed with cholecystitis, we must control our diet appropriately while taking medication, have three meals on time, and strictly avoid greasy, fried, and high-cholesterol foods.