Definition of acute cholecystitis

Acute cholecystitis is inflammation of the gallbladder usually caused by the presence of a gallstone in the cystic duct. The latter carries bile, stored in the gallbladder, to the intestine. When the cystic duct is blocked by a gallstone, the bile stays in the gallbladder and causes inflammation.

Symptoms of acute cholecystitis

Symptoms of acute cholecystitis may include pain in the upper right part of the abdomen, vomiting, nausea, fever and chills. In the elderly, symptoms may be nonspecific such as loss of appetite, feeling tired or weak, and vomiting.

Diagnosis of acute cholecystitis

The diagnosis of acute cholecystitis is usually made with an abdominal ultrasound, which can help detect the presence of gallstones. Walls, other imaging tests can also be used (eg: cholescintigraphy).

Treatment of acute cholecystitis

Treatment for acute cholecystitis is usually cholecystectomy, the removal of the gallbladder. Treatment requires hospitalization during which individuals are fasted and receive supportive care including intravenous hydration, pain relievers and antibiotics. Usually, cholecystectomy is done within 24 to 48 hours of the onset of symptoms. However, it can be delayed or avoided if patients are unstable and / or at increased risk for surgery.

Nutritional approach for acute cholecystitis

In the context of acute cholecystitis, the goal of the nutritional approach is to promote the well-being of individuals by offering them a diet that takes into account their clinical condition and their tolerance.

• Initially, individuals are kept on an empty stomach. This helps limit stimulation of the gallbladder and prevent increased inflammation.
• Then, individuals are also given fluids and electrolytes intravenously. This helps restore the fluid and electrolyte balance promoting optimal clinical condition before surgery.
• Finally, oral food is gradually reintroduced, starting with fluids and then a low fat diet (low in lipids).

References

• https://www.merckmanuals.com/fr-ca/accueil/troubles-du-foie-et-de-la-v%C3%A9sicule-biliaire/maladies-de-la-v%C3%A9sicule-biliaire- and-biliary-tract / chol% C3% A9cystitis
• https://www.merckmanuals.com/fr-ca/professional/troubles-h%C3%A9patiques-et-biliaires/pathologies-de-la-v%C3%A9sicule-et-des-canaux-biliaires/chol% C3% A9cystitis-acute% C3% ABquery = Chol% C3% A9cystitise
• https://www.merckmanuals.com/fr-ca/accueil/les-faits-en-bref-troubles-du-foie-et-de-la-v%C3%A9sicule-biliaire/maladies-de-la- v% C3% A9biliary-and-biliary-tract / chol% C3% A9cystitis
• St-Denis, Louise. November 2018. Nutrition, pancreas and bile ducts. NUT 3047 Clinical nutrition and chronic diseases 1. Montreal: University of Montreal.al.

Article written by:

Marie-Noël Marsan, Nutritionist