Acute Cholecystitis Quiz
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Stomachache
Localized abdominal pain
Loss of appetite
Cannot take a deep breath because of stomach pain
Yellow eyes
Pain in the middle of the upper stomach
Stomach tenses when pressed lightly
Not seeing your symptoms? No worries!
What is Acute Cholecystitis?
A condition in which the gallbladder (organ that stores bile from the liver) becomes infected or blocked by a stone, causing bile to build up and the gallbladder to swell.
Typical Symptoms of Acute Cholecystitis
- Stomach or abdominal pain that prevents deep breathing
- Stomach or abdominal pain with the abdomen becoming hard when gently pressed
- Stomach or abdominal pain
- High white blood cell counts on blood test within last 1 week
- Stomach or abdominal pain after eating oily foods
- History of gallstones or gallbladder inflamamtion
- Pain in the upper right abdomen
- Pain in the upper abdomen
Diagnostic Questions for Acute Cholecystitis
Your doctor may ask these questions to check for this disease:
- Are you experiencing stomach or abdominal pain that prevents you from taking deep breaths?
- Do you have stomach or abdominal pain with your abdomen becoming hard when gently pressed?
- Do you have any stomach or abdominal pain?
- Were you diagnosed with high white blood cell count recently?
- Do you experience stomach or abdominal pain after eating oily foods?
Treatment of Acute Cholecystitis
Treatment includes antibiotics and pain medications. Patients may be asked to fast and receive fluids through a needle in the vein to help rest the gallbladder. Some patients may need a procedure to remove a stone or surgery to remove the gallbladder.
Reviewed By:
Maxwell J. Nanes, DO (Emergency Medicine)
Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Dec 5, 2025
Following the Medical Content Editorial Policy
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Symptoms Related to Acute Cholecystitis
Diseases Related to Acute Cholecystitis
FAQs
Q.
Severe Pain? Why Your Gallbladder Is Failing & Cholecystectomy Next Steps
A.
Severe upper right abdominal pain that is intense, persistent, or recurs after meals is often due to gallstones and may mean your gallbladder is failing; cholecystectomy is the routine, very safe fix with typically quick recovery, and you should seek urgent care for fever, jaundice, vomiting, or pain lasting hours. Delaying evaluation can lead to complications such as acute cholecystitis, pancreatitis, or infection. There are several factors to consider about diagnosis, imaging, timing and type of surgery, recovery, diet changes, and risks that could affect your next steps; see the complete guidance below.
References:
* pubmed.ncbi.nlm.nih.gov/32677894/
* pubmed.ncbi.nlm.nih.gov/30588448/
* pubmed.ncbi.nlm.nih.gov/32266004/
* pubmed.ncbi.nlm.nih.gov/34109156/
* pubmed.ncbi.nlm.nih.gov/36965682/
Q.
Sharp Side Pain? Why Cholecystitis Occurs & Medically Approved Next Steps
A.
Sharp right upper abdominal pain can be cholecystitis, most often caused by gallstones blocking bile flow; it brings persistent pain that may spread to the shoulder, often with fever or nausea, and needs prompt medical attention but is highly treatable. Next steps typically include urgent evaluation with ultrasound and blood tests, hospital care with IV fluids, pain control, and antibiotics, and early laparoscopic gallbladder removal when appropriate; there are several factors to consider, including red flags like jaundice or worsening pain and when surgery might be delayed, so see the complete guidance below.
References:
* Müller SO, Kern S, Reitz C, Wirth S, Müller M. Acute Cholecystitis: Current Concepts in Pathophysiology, Diagnosis, and Treatment. Diagnostics (Basel). 2023 Feb 15;13(4):755. doi: 10.3390/diagnostics13040755. PMID: 36832264.
* Brouwers RGWL, Deerenberg EB, Van Deelen R, IJzerman MJ, Reijke M, Groenewegen N, van der Laan L, Stoot JH. Pathogenesis and pathophysiology of acute cholecystitis. Best Pract Res Clin Gastroenterol. 2020 Jun-Aug;46-47:101704. doi: 10.1016/j.bpg.2020.101704. PMID: 32800539.
* Takada T, Miura F, Mayumi T, Yoshida M, Wada K, Asbun HJ, Pitt HA, Strasberg SM, Kuvshinoff BW, Hirata K, Hwang TL, Chen MF, Han HS, Kim MH, Deziel DJ, Su CH, Su CC, Shimada M, Yamamoto M, Gouma DJ, Bassi V, Singh H, Garden OJ, Kiriyama S, Yokoe M, Endos M, Gomi H, Tokumura H, Kitano S, Inomata M, Shinya H, Hibi T, Gabata T, Tsuyuguchi T, Itoi T, Ishikawa K, Arata S, Takeda K, Surgical Infectious Diseases Society; Japanese Society of Abdominal Emergency Medicine. Tokyo Guidelines 2018: updated guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):1-76. doi: 10.1002/jhbp.495. PMID: 29043447.
* Darden MN, Acker WW, Serebryanik K, Kim S, Kharlamov K, Patel ND. Acute Cholecystitis: Diagnosis and Management. J Investig Med. 2021 Jul;69(5):1001-1008. doi: 10.1136/jim-2021-001799. PMID: 33903173.
* O'Connor JD, Lim DK, Youssef F, Pardi DS. Right Upper Quadrant Pain: Differential Diagnosis and Management. Curr Gastroenterol Rep. 2018 Mar 15;20(3):14. doi: 10.1007/s11894-018-0622-y. PMID: 29546410.
Q.
Gallbladder Pain? Why It’s Failing & Medically Approved Next Steps
A.
Gallbladder pain often strikes after fatty meals and is most commonly caused by gallstones, but it can progress to inflammation, infection, or bile duct blockage with jaundice. Seek urgent care for severe or persistent right upper abdominal pain, fever, or yellowing, as doctors confirm the cause with ultrasound, blood tests, sometimes a HIDA scan, and treat with pain control, antibiotics, and often minimally invasive surgery. There are several factors to consider for prevention, timing, and whether to monitor or remove the gallbladder. See the complete details below to understand these choices and other warning signs that can change your next steps.
References:
* Portincasa P, Wang DQ, Moschetta A, et al. Gallstone disease: Clinical updates and future perspectives. J Hepatol. 2024 Feb;80(2):373-391. doi: 10.1016/j.jhep.2023.09.020. Epub 2023 Sep 26. PMID: 37765660.
* Gunjur A, Gunning A, Moshkelgosha S, et al. Gallstone disease: current treatment and future trends. Ann Transl Med. 2023 Jul 11;11(13):504. doi: 10.21037/atm-23-410. PMID: 37528343; PMCID: PMC10398064.
* Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study. Gastroenterology. 2021 Jan;160(1):99-114.e3. doi: 10.1053/j.gastro.2020.04.014. Epub 2020 Apr 20. PMID: 32325287.
* Yokoe M, Takada T, Hwang TL, et al. Global clinical practice guidelines for acute cholecystitis 2018. J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):1-58. doi: 10.1002/jhbp.515. Epub 2017 Dec 23. PMID: 29090886.
* Mahid SS, Park KT, Brinton DL, et al. Biliary dyskinesia: an analysis of the national trends in diagnosis and management. JAMA Surg. 2015 Feb;150(2):160-5. doi: 10.1001/jamasurg.2014.1501. PMID: 25427103.
Q.
Sharp Side Pain? Why Your Gallbladder Hurts & Medical Next Steps
A.
Sharp right upper abdominal pain that worsens after meals often points to gallbladder issues like gallstones or acute cholecystitis, and red flags such as fever, jaundice, persistent vomiting, or pain lasting hours mean you should seek urgent care. Evaluation usually involves a medical exam, blood tests, and an ultrasound, with treatment ranging from watchful waiting and medications to surgery if attacks recur; there are several factors to consider. See below for details on bile duct blockage warning signs, who is at higher risk, exact symptoms, and prevention steps that can guide your next medical decisions.
References:
* Indar A, Mohammad S, Riaz S, Riaz S, Riaz A. Acute Cholecystitis. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644406.
* Portincasa P, Di Ciaula A, Palmieri VO, Svelto M, De Angelis M, Scaccianoce S, La Notte V. Cholestasis, Gallstone Disease, and Gallbladder Sludge: Pathogenesis, Diagnosis and Treatment. J Clin Med. 2023 Jan 24;12(3):928. doi: 10.3390/jcm12030928. PMID: 36769493; PMCID: PMC9917544.
* Gholson CF, Loria A, Brar N. Gallstone Disease. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32491500.
* European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol. 2016 Jun;64(6):1393-417. doi: 10.1016/j.jhep.2016.03.005. Epub 2016 Mar 23. PMID: 27018042.
* Loria A, Brar N, Gholson CF. Cholecystectomy. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32491501.
Q.
Sharp Rip Under Your Ribs? Why It’s Your Gallbladder & Medical Next Steps
A.
Sharp pain under the right ribs that worsens after eating is often from the gallbladder, usually gallstones causing biliary colic; if pain is constant or comes with fever, chills, vomiting, or yellowing of the skin or eyes, it may be acute cholecystitis that needs urgent care. Doctors confirm with an exam, blood tests, and ultrasound, and treatment ranges from pain control and a low-fat diet to antibiotics and gallbladder removal; there are several factors to consider for your next steps, so see the complete details below.
References:
* Pavan, S., Piana, D., Di Leo, M., & Vescovi, P. (2018). Cholelithiasis: Clinical Presentation and Pathogenesis. *Digestive Diseases, 36*(2), 99–112. (PMID: 29424888)
* Kim, H. J., Kim, J. S., & Lee, M. S. (2020). Acute cholecystitis: current concepts in diagnosis, treatment, and long-term prognosis. *Annals of Translational Medicine, 8*(13), 856. (PMID: 32662282)
* Wang, H., & Tan, Y. M. (2020). Management of acute cholecystitis: From diagnosis to treatment. *World Journal of Gastrointestinal Surgery, 12*(9), 241–251. (PMID: 32906806)
* Zakko, L. A., & Sandlin, A. (2021). Biliary Colic: A Review of Diagnosis and Management. *Gastroenterology & Hepatology, 17*(3), 119–125. (PMID: 33719003)
* Guerra, A., Shrestha, R., & Lopez, R. (2022). Gallbladder disease: A review. *Journal of Digestive Diseases, 23*(2), 101–108. (PMID: 35147551)
Q.
Can eating fatty or heavy foods trigger right-sided pain under the ribs?
A.
Eating fatty or heavy foods may cause right-sided pain under the ribs, especially if there are gallstones involved.
References:
Berhane T, Vetrhus M, Hausken T, Olafsson S, & Søndenaa K. (2006). Pain attacks in non-complicated and complicated gallstone .... Scandinavian journal of gastroenterology, 16373282.
Q.
Could right rib pain be caused by gallbladder problems like gallstones?
A.
Yes, right rib pain can be due to gallbladder issues like gallstones, which often cause pain in the upper right part of the belly.
References:
Berhane T, Vetrhus M, Hausken T, Olafsson S, & Søndenaa K. (2006). Pain attacks in non-complicated and complicated gallstone .... Scandinavian journal of gastroenterology, 16373282.
https://pubmed.ncbi.nlm.nih.gov/16373282/
Khan U, Aarebrot A, Mo S, Landa S, Rösler C, Sodha OK, et al. (2024). Epstein-Barr in a Patient Presenting with Right Upper .... The Journal of emergency medicine, 38423863.
https://pubmed.ncbi.nlm.nih.gov/38423863/
Revzin MV, Scoutt LM, Garner JG, & Moore CL. (2017). Right Upper Quadrant Pain: Ultrasound First!. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 28586152.
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Halpin V. Acute cholecystitis. BMJ Clin Evid. 2014 Aug 20;2014:0411. PMID: 25144428; PMCID: PMC4140413.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140413/Bagla P, Sarria JC, Riall TS. Management of acute cholecystitis. Curr Opin Infect Dis. 2016 Oct;29(5):508-13. doi: 10.1097/QCO.0000000000000297. PMID: 27429137.
https://journals.lww.com/co-infectiousdiseases/Abstract/2016/10000/Management_of_acute_cholecystitis.13.aspxGallaher JR, Charles A. Acute Cholecystitis: A Review. JAMA. 2022 Mar 8;327(10):965-975. doi: 10.1001/jama.2022.2350. PMID: 35258527.
https://jamanetwork.com/journals/jama/article-abstract/2789654