Inflammation of the gallbladder may be limited to the mucous lining or involve the entire wall of the gallbladder. Acute acalculous cholecystitis, or gallbladder inflammation not related to an obstruction, is more frequently seen in patients who are older, critically ill, diabetic, or experiencing prolonged immobility or fasting. Acute calculous cholecystitis is often caused by a gallstone obstructing the common bile duct and causes gallbladder distention filling it with bile or pus. After an acute attack, fibrosis of the gallbladder walls leads to decreased gallbladder function that may develop into chronic cholecystitis. Symptoms of chronic cholecystitis may include a history of fat intolerance, dyspepsia, heartburn, and flatulence.
The incidence of cholecystitis is higher in females. Since fat tissue promotes cholesterol secretion in the bile, and women tend to accumulate more fatty tissue than men, females have an increased risk of biliary obstruction leading to cholecystitis.
Those with fair complexion (Caucasians) are more likely to develop cholesterol gallstones, which can later develop into cholecystitis. Additionally, the incidence is particularly high in Native American populations, especially in the Navajo and Pima tribes.
Since excess fat tissue causes increased secretion of cholesterol in the bile, the obese patient has an increased risk of cholelithiasis and biliary obstruction leading to cholecystitis. Precipitation of cholesterol leading to biliary obstruction occurs when bile becomes supersaturated with cholesterol.
Fertile women have a higher risk of developing cholecystitis. Multiparous women with multiple pregnancies are more likely to have gallbladder inflammation. Pregnancy-related hormones delay the emptying of the gallbladder, which results in bile stasis. Biliary sludge may develop and cause obstruction. Since hormones may have an influence in cholecystitis, postmenopausal women receiving estrogen therapy have an increased risk of developing cholecystitis.
Advanced age is a risk factor for developing cholecystitis. Individuals over 40 years of age have an increased risk. After the age of 50, gender differences in incidence between males and females decrease.
A dysfunctional gallbladder prevents normal bile flow that is necessary for the digestion of fats. The patient with cholecystitis develops an intolerance to fatty foods and may experience flatulence.
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