Cholecystitis

Cholecystitis

1. Definition Cholecystitis is an inflammation of the gallbladder, either acute or chronic, which can be caused by various factors including gallstones, infections, or other medical conditions.

2. Causes / Etiology The main causes of cholecystitis include:

• Gallstones (Cholesterol stones or Pigment stones)
• Bacterial infections (e.g., E. coli, Klebsiella)
• Viral infections (e.g., Hepatitis A)
• Trauma to the gallbladder
• Inflammation of the pancreas (pancreatitis)
• Certain medical conditions (e.g., Crohn's disease, Ulcerative colitis)

3. Types or Classification There are two main types of cholecystitis:

• Acute Cholecystitis: Inflammation of the gallbladder that occurs suddenly, usually due to gallstones or infections.
• Chronic Cholecystitis: Inflammation of the gallbladder that develops gradually over time, often due to recurring gallstone attacks or other chronic conditions.

4. Pathology Step 1 → Gallstones or infections cause inflammation of the gallbladder, leading to: Step 2 → Increased mucus production and thickening of the gallbladder wall Step 3 → Reduced blood flow to the gallbladder, causing tissue damage and scarring Step 4 → Inflammation and infection of the surrounding tissues, including the bile ducts

5. Clinical Features General features:

• Severe abdominal pain, often in the right upper quadrant
• Fever and chills
• Nausea and vomiting
• Loss of appetite
• Abdominal tenderness and guarding

Specific features:

• Jaundice (yellowing of the skin and eyes) in cases of bile duct obstruction
• Gallstone ileus (intestinal obstruction caused by a large gallstone)
• Pancreatitis or other complications of gallstone disease

6. Complications Acute complications:

• Gallbladder rupture
• Perforation of the gallbladder
• Abscess formation
• Infection of the bile ducts (cholangitis)

Chronic complications:

• Gallstone disease (recurrent attacks)
• Bile duct obstruction
• Pancreatitis
• Chronic liver disease

7. Diagnosis / Investigations Routine tests:

• Complete Blood Count (CBC)
• Blood chemistry tests (e.g., liver function tests)
• Ultrasound of the abdomen
• X-ray of the abdomen

Special tests:

• Endoscopic retrograde cholangiopancreatography (ERCP)
• Magnetic Resonance Cholangiopancreatography (MRCP)
• Cholecystography (HIDA scan)

8. Management General management:

• Rest and hydration
• Pain relief medication
• Antibiotics for infection
• Dietary changes (e.g., low-fat diet)

Modern treatment:

• Laparoscopic cholecystectomy (surgical removal of the gallbladder)
• Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction
• Percutaneous transhepatic cholangiography (PTC) for bile duct drainage

Dietary advice:

• Avoid fatty or greasy foods
• Eat smaller, more frequent meals
• Avoid foods that trigger gallstone attacks (e.g., citrus fruits, spicy foods)

9. Homeopathic Therapeutics

• Calcarea carbonica: for gallstones, inflammation, and digestive issues
• Natrum muriaticum: for gallstone disease, jaundice, and liver problems
• Carbo vegetabilis: for digestive issues, bloating, and gas
• Bryonia: for gallstone pain, inflammation, and fever
• Lycopodium: for liver problems, digestive issues, and allergies

• Calcarea carbonica: useful for gallstone attacks, inflammation, and digestive issues. • Natrum muriaticum: indicated for gallstone disease, jaundice, and liver problems. • Carbo vegetabilis: useful for digestive issues, bloating, and gas. • Bryonia: indicated for gallstone pain, inflammation, and fever. • Lycopodium: useful for liver problems, digestive issues, and allergies.