Sharp Side Pain? Why Cholecystitis Occurs & Medically Approved Next Steps

A sharp pain on the right side of your upper abdomen can be alarming. One possible cause is cholecystitis, a medical condition that requires prompt attention. Understanding what cholecystitis is, why it happens, and what to do next can help you respond calmly and appropriately.

This guide explains cholecystitis in clear, practical language using medically credible information from established clinical guidelines and research.

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What Is Cholecystitis?

Cholecystitis is inflammation of the gallbladder. The gallbladder is a small, pear-shaped organ located under your liver on the right side of your abdomen. Its job is to store bile, a digestive fluid that helps break down fats.

When the gallbladder becomes inflamed, it can cause significant pain and other symptoms. In many cases, cholecystitis happens suddenly (called acute cholecystitis). Less commonly, it can develop gradually over time (chronic cholecystitis).

Acute cholecystitis is considered a potentially serious condition and often requires medical treatment.

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What Causes Cholecystitis?

The most common cause of cholecystitis is gallstones.

1. Gallstones (Most Common Cause)

Gallstones are hardened deposits that form in the gallbladder. If a stone blocks the cystic duct (the tube that allows bile to flow out), bile builds up. This blockage causes:

• Increased pressure
• Irritation
• Inflammation
• Possible infection

This accounts for about 90–95% of acute cholecystitis cases.

2. Acalculous Cholecystitis (Without Gallstones)

In some cases, cholecystitis happens without gallstones. This is more common in people who:

• Are critically ill
• Have severe infections
• Have experienced major trauma
• Have recently had surgery
• Have prolonged fasting or IV nutrition

This type is less common but can be more serious.

3. Other Contributing Factors

Risk factors that increase the chance of developing cholecystitis include:

• Female sex
• Age over 40
• Obesity
• Rapid weight loss
• Pregnancy
• High-fat diet
• Diabetes
• Family history of gallstones

Having risk factors does not guarantee you'll develop cholecystitis, but it increases the likelihood.

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What Does Cholecystitis Feel Like?

The most common symptom is sharp or steady pain in the upper right abdomen.

Typical Symptoms of Acute Cholecystitis:

• Severe pain in the upper right abdomen
• Pain that may spread to the right shoulder or back
• Pain lasting longer than 30 minutes
• Fever
• Nausea or vomiting
• Tenderness when pressing the abdomen
• Pain that worsens with deep breathing

Unlike simple gallstone pain (biliary colic), which may come and go, pain from acute cholecystitis usually persists and worsens.

Warning Signs That Need Urgent Medical Care

Seek immediate medical attention if you have:

• High fever
• Yellowing of the skin or eyes (jaundice)
• Severe, worsening abdominal pain
• Confusion
• Low blood pressure
• Persistent vomiting

These may signal complications.

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How Serious Is Cholecystitis?

Cholecystitis can range from mild to life-threatening.

If untreated, complications may include:

• Gallbladder rupture
• Abscess (pus collection)
• Severe infection (sepsis)
• Gangrene (tissue death)
• Spread of infection to the bloodstream

The good news: with prompt diagnosis and treatment, most people recover well.

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How Is Cholecystitis Diagnosed?

Doctors use a combination of:

1. Medical History and Physical Exam

• Location and duration of pain
• Fever
• Abdominal tenderness

2. Blood Tests

• Elevated white blood cells (sign of infection)
• Liver function tests
• Inflammatory markers

3. Imaging Tests

• Ultrasound (first-line test)
• CT scan (if diagnosis unclear)
• HIDA scan (checks bile flow if needed)

Ultrasound is typically the primary imaging tool because it effectively detects gallstones and gallbladder inflammation.

If you're experiencing persistent upper right abdominal pain and want to understand whether your symptoms align with this condition, you can use a free Acute Cholecystitis symptom checker to help assess your situation before speaking with a healthcare provider.

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Medically Approved Treatment for Cholecystitis

Treatment depends on severity, but most cases of acute cholecystitis require hospital care.

1. Hospital Management

Initial treatment usually includes:

• IV fluids
• Pain management
• Antibiotics (if infection is suspected)
• Fasting (to rest the gallbladder)

2. Gallbladder Removal (Cholecystectomy)

The standard treatment for acute cholecystitis is surgical removal of the gallbladder.

• Usually done laparoscopically (minimally invasive)
• Often performed within 24–72 hours of diagnosis
• Most people go home within 1–2 days

You can live normally without a gallbladder. The liver continues to produce bile, but it flows directly into the intestine instead of being stored.

3. When Surgery Is Delayed

If someone is too ill for surgery:

• A drainage tube may be placed in the gallbladder
• Surgery may be delayed until the patient stabilizes

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Can Cholecystitis Go Away on Its Own?

Mild inflammation may temporarily improve, but true acute cholecystitis generally does not resolve permanently without treatment.

Delaying care increases the risk of:

• Recurrent attacks
• Infection
• Complications

It's important not to ignore persistent right-sided abdominal pain, especially with fever.

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How to Reduce Your Risk

While not all cases are preventable, you can lower your risk of gallstones and cholecystitis by:

• Maintaining a healthy weight
• Avoiding rapid crash dieting
• Eating a balanced diet rich in fiber
• Limiting high-fat, processed foods
• Managing diabetes if applicable
• Staying physically active

These steps support overall digestive and metabolic health.

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When to Speak to a Doctor

You should speak to a doctor promptly if you experience:

• Persistent right upper abdominal pain
• Fever with abdominal pain
• Pain lasting more than a few hours
• Repeated episodes of gallbladder-type pain
• Jaundice

Cholecystitis can become serious quickly. If symptoms are severe, go to the emergency department rather than waiting for a routine appointment.

Do not attempt to self-diagnose or treat suspected cholecystitis at home.

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The Bottom Line

Cholecystitis is inflammation of the gallbladder, most commonly caused by gallstones blocking bile flow. It often presents as sharp, steady pain in the upper right abdomen, sometimes accompanied by fever and nausea.

While it can sound intimidating, cholecystitis is treatable—especially when caught early. Most people recover fully after appropriate medical care, often including gallbladder removal.

If you're unsure whether your symptoms could be acute cholecystitis, consider using a trusted tool like a free, online symptom check for Acute Cholecystitis, and most importantly, speak to a qualified healthcare professional.

Any condition involving severe abdominal pain can be serious or even life-threatening. If symptoms are intense, worsening, or accompanied by fever or jaundice, seek immediate medical care.

Prompt evaluation and treatment make all the difference.