Definition
The term "cholecystitis" refers to an inflammatory process affecting the gallbladder: inflammation, whether acute or chronic, is closely related to the formation of stones in the biliary tract and gallbladder. Only rarely, cholecystitis occurs independently of the stones .
Causes
The vast majority of cases of cholecystitis are caused by the presence of stones in the gallbladder and / or biliary tract, a consequence, in turn, of accumulations of cholesterol and bile salts precipitated by the bile: the blockage of the bile duct causes inflammation of the gallbladder Other causes implicated in cholecystitis include: bacterial infections of the gallbladder, gallbladder surgery, exaggerated allergic reactions, narrowing of the bile duct, gallbladder cancer.
- Risk factors: AIDS, previous biliary colic, rapid weight loss, fertile / elderly age, recent pregnancy, obesity, female sex
Symptoms
Acute episodes of cholecystitis manifest with chills, abdominal pain confined to the right upper quadrant (which worsens on palpation) and fever, often associated with abdominal swelling, lack of appetite, nausea, sweating and vomiting. In the lithiasic form of cholecystitis ( independent of stones), the patient complains of jaundice, more or less marked.The chronic form of cholecystitis is characterized by repeated acute inflammatory processes and / or chronic irritation, sometimes asymptomatic.
- Complications: gangrene and perforation
The information on Cholecystitis - Cholecystitis Medicines is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Cholecystitis - Cholecystitis Medication.
Medicines
Treatment for cholecystitis almost always involves hospitalization of the patient, in order to block the progression of inflammation and reverse the pathology; in fact, cholecystitis is one of the pathologies that require immediate emergency treatment, precisely because a degeneration of the inflammatory process could cause even serious complications, such as perforation and gangrene.
The hospitalization of the patient aims to alleviate the symptoms and remove the inflammation, and consists of a series of measures:
- Fast
- Complete physical rest
- Replenishment of mineral salts (electrolyte therapy)
- Administration of antibiotics
- Administration of pain relievers for pain control: NSAIDs are usually taken
- Administration of antispasmodic drugs
In emergency situations - in which there is an accumulation of pus due to the presence of pyogenic bacteria, a peritonitis, a perforation or a collection of mucus with hypertension of the organ - immediate surgical intervention may be necessary, consisting in the removal of the gallbladder (cholecystectomy).
After the operation, it is recommended to respect a rest period and to follow a healthy and balanced diet, low in hyperlipidic and high-protein foods.
In general, the treatment for cholecystitis depends on the severity of the inflammation: mild forms can be treated with antibiotics or with a mini surgery; moderate and severe cholecystitis is generally treated with laparoscopic surgery (cholecystectomy: removal of the gallbladder )
The following are the classes of drugs most used in the therapy for cholecystitis, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
Antibiotics: indicated for the treatment of cholecystitis in case of bacterial superinfections; cephalosporins and penicillins are the most commonly used antibiotic drugs for this purpose:
- Cephalosporins
- Cefazolin (eg. Cefazolina GRP, Cefazil, Nefazol): belongs to the class of first generation cephalosporins. To remove the pathogen responsible for cholecystitis, it is recommended to take the drug at a dosage of 12 grams intravenously every 6-8 hours, for 2 weeks. Do not exceed 12 grams per day. The administration of antibiotics alone for the treatment of cholecystitis is questionable: only the surgical operation is able to completely cancel the inflammation.
- Cefoxitin (eg Mefoxin): second generation cephalosporin used in therapy for the treatment of cholecystitis. The indicative dose is to take 1-2 grams of the drug intravenously or intramuscularly every 12 hours, for 3-7 days (in case of no complications) or for 2-3 weeks (for severe cholecystitis). Consult your doctor.
- Cefotetan (eg Cepan, Darvilen): second generation cephalosporin. Depending on the severity of cholecystitis, take a dose ranging from 500 mg to 4 g of the drug per day intravenously or intramuscularly, possibly divided into two doses over 24 hours.
- Penicillins
- Piperacillin (eg. Limerik, Picillin, Ecosette): the drug is a semi-synthetic penicillin, with a broad spectrum of action, indicated for bacterial infections in the context of cholecystitis (especially those sustained by Pseudomonas aeruginosa, Klebsiella, Enterobacter, Escherichia coli, Neisseria gonorrhoeae etc.) As an indication, take a dose ranging from 125 to 200 mg / kg of the drug per day intravenously, in divided doses every 6-8 hours, for 7-10 days.
- Ampicillin (eg Ampilux, Amplital, Unasyn): indicatively, take 1-2 grams of the drug intravenously every 4-6 hours, in combination with other antibiotics. The choice of an antibiotic depends on the nature of the infection. Continue therapy for 10-14 days.
- Netilmicin (eg Zetamicin): available as a solution for injection intravenously or intramuscularly. Indicatively, for infections affecting the biliary tract in general and for cholecystitis in particular, the indicative dose of the drug is to take 2-3 mg / kg every 12 hours; alternatively, it is possible to take 1.3-2 mg / kg of active ingredient every 8 hours, for a maximum of 4-6 mg / kg per day. Consult your doctor.
Analgesics and antispasmodics for the control of pain associated with cholecystitis
- Meperidine or Pethidine (eg Demerol, Petid C): opioid analgesic drug to be taken orally at a dosage of 50-100 mg every 4 hours, as needed. Or, intramuscularly / intravenously or subcutaneously, at a dosage of 25-100 mg every 4 hours.
- Diclofenac (eg Fastum Painkiller, Flogofenac Retard, Momenlocaldol, Voltaren) preferable to pethidine. Take 50 mg of the drug orally 3 times a day (tablets); in some patients, a starting dose of 100 mg is required and then increased to 50 mg. After the first day, the total daily dose should not exceed 150 mg.
- Scopolamine butylbromide (eg Buscopan, Addofix, Erion): indicated to relax the smooth muscles of the genitourinary tract, also in the context of cholecystitis. It is recommended to administer 1-2 tablets of 10 mg 3 times a day for adults and children over 14 years of age. In case of children between the ages of 6 and 14, it is essential to consult your doctor before taking the drug.
- Paracetamol or acetaminophen (eg Tachipirina, Buscopam Compositum): fever is a very recurrent phenomenon in acute episodes of cholecystitis; for this reason, it is recommended to take paracetamol: indicatively, take the drug orally in the form of tablets, syrup, effervescent sachets or suppositories; it is recommended to take paracetamol at a dosage of 325-650 mg every 4-6 hours for 6-8 consecutive days.
