What is gallbladder inflammation (cholecystitis)?

Gallbladder inflammation is inflammation of the gallbladder, a small organ in the biliary system. It most commonly follows mechanical blockage by a gallstone but can have other causes.

• Usually begins with pain in the upper right abdomen
• Can be acute or chronic
• The underlying cause is determined during medical evaluation

Common complaints are pain in the upper right abdomen, nausea, vomiting and fever. Some people may develop jaundice (yellowing of the skin or eyes). The following findings require urgent assessment:

• Pain in the upper right abdomen lasting more than 6 hours
• Fever or shaking chills
• Jaundice (yellowing of the skin or eyes)
• Persistent vomiting, inability to take fluids, fainting sensation or shortness of breath

If any of these are present, go to the emergency department immediately.

Evaluation usually starts with a physical exam and history. Doctors often order blood tests to check for inflammation and liver function, and imaging—usually an ultrasound—to look for gallstones and signs of inflammation. Additional tests may be used if the diagnosis is unclear.

• Physical exam and medical history
• Blood tests: inflammation markers and liver function tests
• Imaging: ultrasound is typically the first choice; additional imaging or functional tests if needed

A clinician determines the diagnosis and urgency.

Different services may be the first point of contact depending on symptom severity. For severe or acute symptoms, the Emergency Department is appropriate. Primary care or Internal Medicine can perform initial assessment; General Surgery evaluates surgical needs; Gastroenterology is consulted if there is suspicion of main bile duct involvement.

• Emergency Medicine: severe or sudden symptoms
• Internal Medicine / Primary Care: initial assessment
• General Surgery: surgical evaluation and management
• Gastroenterology: suspected main bile duct (cholangitis) or specialized biliary work-up

Reducing factors that may worsen symptoms can be helpful. These are general suggestions and do not replace individualized medical advice.

• Limit very fatty or fried foods
• Maintain balanced eating and avoid rapid, extreme weight loss
• Stay hydrated and rest
• If you have known gallstones, follow regular medical follow-up