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How to treat gallstones caused by cholecystitis

Nov 05, 2025 Source: Cainiu Health
Dr. Gao Jun
Introduction
Treatment for gallstones caused by cholecystitis includes antibiotic therapy, antispasmodic and analgesic treatment, litholytic medication, endoscopic stone removal, and surgical removal of the gallbladder. The treatment plan should be tailored based on the severity of inflammation and the size of the stones; timely intervention can relieve symptoms. If high fever, severe abdominal pain, or jaundice occurs, immediate medical attention is recommended.

　　Treatment options for gallstones caused by cholecystitis include antibiotic therapy, antispasmodic and analgesic treatment, litholytic medication, endoscopic stone removal, and surgical cholecystectomy. The treatment plan should be tailored based on the severity of inflammation and the size of the stones. Timely intervention can effectively relieve symptoms. If high fever, severe abdominal pain, or jaundice occurs, immediate medical attention is recommended.

　　1. Antibiotic therapy: Used to control gallbladder inflammation, antibiotics sensitive to intestinal bacteria—such as cephalosporins and quinolones—are prescribed to inhibit bacterial growth, reduce inflammatory response, and alleviate symptoms like abdominal pain and fever.

　　2. Antispasmodic and analgesic therapy: For pain caused by gallbladder spasms, antispasmodic drugs such as anisodamine are used, along with nonsteroidal analgesics, to relax the smooth muscles of the gallbladder, relieve pain, and improve patient discomfort.

　　3. Litholytic drug therapy: Applicable only to cholesterol stones smaller than 2 cm in diameter. Medications such as ursodeoxycholic acid promote dissolution of the stones. This requires long-term use and has a relatively high recurrence rate, necessitating regular monitoring of stone changes.

　　4. Endoscopic stone removal: Suitable for patients with small stones and preserved gallbladder function. Stones are removed via endoscopy using specialized instruments through the bile ducts or gallbladder, avoiding gallbladder removal and preserving its function.

　　5. Surgical cholecystectomy: A definitive treatment suitable for patients with recurrent episodes, large stones, or complications. The gallbladder is removed via laparoscopic or open surgery to completely eliminate the source of disease and reduce the risk of recurrence.

　　In daily life, maintain a low-fat diet, avoid fried foods and fatty meats, eat regularly to prevent prolonged fasting, engage in moderate exercise, manage body weight, reduce strain on the gallbladder, and support recovery.

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Why do gallstones cause pain?
Gallstone pain typically occurs due to obstruction of the cystic duct by stones, strong gallbladder contractions, irritation of the gallbladder mucosa by stones, secondary cholecystitis, or blockage of the common bile duct. When stones become lodged in the cystic duct as they move with bile flow, they prevent bile drainage, leading to increased pressure within the gallbladder. This causes stretching and stimulation of the gallbladder wall, resulting in intermittent or persistent pain, which is usually localized in the right upper abdomen.
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Dr. Huang Yuhong
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Is surgery required for cholecystitis complicated with gallstones?
In general, whether surgery is needed for cholecystitis accompanied by gallstones should be determined based on a comprehensive assessment of disease severity, symptom presentation, characteristics of the stones, and the patient's overall health condition. After detection of coexisting gallstones, regular medical follow-ups are necessary to closely monitor disease progression. It is advisable to maintain a low-fat diet daily, avoid alcohol consumption and excessive fatigue, to reduce discomfort caused by gallbladder contractions.
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Dr. Wang Lei
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Should you fast during a gallbladder attack?
In general, whether fasting is required during a gallbladder attack depends on the severity of the condition. When symptoms are mild, strict fasting is not necessary; patients may consume small amounts of light liquid foods. However, temporary fasting is needed when symptoms are severe. In daily care, patients with cholecystitis should maintain regular eating habits, avoid overeating, steer clear of high-fat and spicy foods, and minimize triggers that could provoke gallbladder attacks.
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Dr. Gao Jun
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Why does cholecystitis cause stomach pain?
In general, the main reasons why cholecystitis causes stomach pain include neural reflex effects, spread of inflammatory stimulation, abnormal bile secretion, gastrointestinal dysfunction, and confusion in pain localization. If discomfort symptoms occur, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. In daily life, one should maintain regular eating habits, avoid overeating or prolonged fasting, and reduce intake of high-fat and high-cholesterol foods.
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Dr. Wang Lei
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Which is more severe: acute cholecystitis or chronic cholecystitis?
In general, the severity of acute cholecystitis and chronic cholecystitis cannot be directly compared, as it depends on the specific progression of the disease and the individual's health condition. If discomfort symptoms occur, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. In daily life, overeating and binge eating should be avoided, and intake of high-fat, high-cholesterol foods should be reduced. Seek medical attention promptly if abdominal pain worsens or fever develops.
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Dr. Wang Lei
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Do all patients with gallstones have cholecystitis?
Not all patients with gallstones have cholecystitis. Gallstones are solid crystals formed due to abnormal components in bile, while cholecystitis is an inflammatory disease of the gallbladder. Some patients with gallstones may have no signs of gallbladder inflammation for a long time; however, gallstones are a major contributing factor in developing cholecystitis. If symptoms such as right upper abdominal pain or fever occur, prompt medical attention is recommended.
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Dr. Gao Jun
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What are the most severe consequences of gallstones?
There is no such thing as "how severe gallstones can possibly get." Gallstones may lead to asymptomatic carriage, trigger biliary colic, cause cholecystitis, result in bile duct obstruction, or increase the risk of gallbladder cancer. Timely intervention should be based on specific clinical manifestations. If sudden severe abdominal pain, fever, jaundice, or similar symptoms occur, immediate medical attention is recommended.
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Dr. Gao Jun
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Is an enlarged gallbladder a sign of cholecystitis?
In general, whether an enlarged gallbladder indicates cholecystitis must be determined based on specific symptoms and diagnostic tests. In some cases, an enlarged gallbladder is caused by cholecystitis and requires targeted treatment; in others, it results from other factors such as diet or gallstones, necessitating management according to the underlying cause. In daily care, regardless of whether the gallbladder enlargement is due to cholecystitis, maintaining a regular diet is essential.
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Dr. Gao Jun
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