Support Groups

People who have support tend to cope and manage oneself better when they have that extra support and hear from others who may have experienced the same as they did. I myself have had cholecystitis and had a cholecystectomy and wish I had the support from others who were experienced what I had. I think I would have been less scared going into surgery and it could of benefited me by learning from other people with the same disease. You can find local support groups in your area by searching on the internet. Here is a link to a website that helps find support groups for your diagnosis and that is in your area. patient.info/directory.

Here are some support groups online I found that answer questions you may have...

Support groups:
www.dailystrength.org
lifewithnogallbladder.com 
http://www.experienceproject.com/groups/Had-My-Gallbladder-Removed/23921

I would also encourage those with cholecystitis to talk to other people. It is interesting what you find out about other peoples stories and how the compare and differ from your unique story.


www.amritaclinics.com

Recommended Apps for Patients with Cholecystisis

Most of us nowadays are always on the go and don't have time to stop and research resources. These days our world is fast paced and uses a quicker way especially with technology, and what better way than to use your smart phone! Here are some free apps you can download and use for resources on the go! 

• WebMD- Offers symptom checker, conditions, medicine, first aid information, local health listings (clinics), medical terms etc.
• iTriage- Offers symptoms, doctors, facilities, conditions, medications, procedures, news, and your own triage.
• Medical Dictionary- Offers definition of disease, description, symptoms and pictures.
• MyPlate Calorie Tracker- Offers tracking calories- consumed, burned and net calorie amount. And also offer workouts for only 10 minutes!
• Nutrition Lookup by SparkPeople- Offers healthy choices for every meal and information such as calories that particular food has.
• Yummly Recipes- Offers healthy recipes that are easy and includes information of the nutrition of that food. 
• 
• androinica.com

Care for Patients with Cholecystitis

Due to patients having cholecystitis the common treatment is a cholecystectomy, the removal of the gallbladder. This most often is a day procedure and the patient would be back home in a few hours, depending on how the surgery goes and coming off anesthesia. Nursing education for the patient to promote the best care for the patient is to educate them and their family about taking deep breaths and coughing every hour to expand the lungs full to prevent atelectasis. Incisions on this type of patient are located on the abdomen and can present pretty tender. To relieve pain is to take the prescribed medication for pain relief like for example oxycodone, hydrocodone etc. and take only as prescribed. Another intervention is to use a pillow over the incision while maneuvering or coughing which may help reduce pain. Make sure the incision sites and dressings are clean, dry and intact. Notify health care professional if signs or symptoms of infection or bleeding occur. The diet to encourage this patient is a diet low in fats and high in carbohydrates and proteins, to promote healing and a diet that is not hard on the digestive tract, something soft. Avoid excessive fats in meals such as fried food etc. Have the patient follow up to make sure promotion of health and healing is adequate. Resources are posted at the bottom for a patient if they are interested in more information on this disease.

 Informational Websites:

• http://www.surgery.ucsf.edu/conditions--procedures/gallstones-%28cholelithiasis%29.aspx
• http://www.healthline.com/health/chronic-cholecystitis#Overview1
•  http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis

My resources:

Hinkle, Janice L., Kerry Cheever. Hinkle & Cheever: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th Edition. CoursePoint, 11/2013. VitalBook file.
downloads.lww.com

Diet Considerations

What should I eat? Most contributing factors that cause people with cholecystitis to have an episode is due to their diet and what they choose to put in their mouths. The gallbladder is used to store bile made from the liver which helps digest fats. Due to the inflammation of the organ, fatty foods can cause the gallbladder to become even more irritated or even continue to form gallstones. Avoid eating foods high in fat or fried foods to decrease the risk of another attack or the formation of gallstones. These foods include: red meat, nuts, eggs, dairy products, ice cream, chocolate, spicy foods, carbonated drinks, black tea, coffee, alcohol, fried foods like fries and vegetables such as cauliflower and cabbage The most helpful foods to eat that will most likely not irritate the gallbladder would be avocados, blackberries, vinegar, potatoes, pasta, rice, yogurt, lean meat, low fat milk and whole grain foods.



Retrieved from:

• Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.

• http://www.diethealthclub.com
• pyyhcff.weebly.com 

Medical Treatment Options

What are my options? Medical options for cholecystitis are dependent on the severity of symptoms the patient may be having. For acute cholecystitis, commonly broad spectrum antibiotics are administered in case of infection present; the benefit is unclear as to why it is beneficial. Another option is for a percutaneous catheter drainage or endoscopic catheter with a stent to relieve the obstruction is also another option. If the cholecystitis has progressed it can cause more complicated injuries to the body. Other options for complicated progressive cholecystitis are, Open cholecystectomy or Laparoscopic cholecystectomy. 

Laparoscopic cholecystectomy is the removal of the gallbladder through one of the four small incisions either by electrosurgical or laser excision. Benefit of this procedure is minimal scarring, less postop pain and a shortened hospital stay. This is the major invention for medical treatment nowadays for cholecystitis. 
www.drjongani.com

Open cholecystectomy is defined as the removal of the gallbladder through one incision (bigger). Patients may have an open surgery instead of laparoscopic due to not being able to remove gallbladder through the small incisions or if needed, more room to perform the procedure. More scarring occurs, bigger incision site, longer hospital stay etc. There are still more methods used especially seen in elderly patients who have high risks during surgery and cannot undergo surgery. Chemodissolution is the use of chemicals to dissolve gallstones, like bile acids. Ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) are the common agents used. Lithotripsy is used as well, defined as the breaking up of gallstones using shock waves.This allows the stones to break up and allow for the stones to be small enough to pass through the cystic duct and let the gallbladder function in a normal state.

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.

Signs and Symptoms of Cholecystitis

How do we know when we have Cholecystitis? What are the signs? Are their any symptoms? The most common complaint is upper right abdominal pain, due to the complications of the intermittent biliary colic duct. It is also common for With pain, it is usually accompanied by nausea, vomiting, diarrhea, sweating and gas. The occurrence of symptoms is mostly commonly seen in episodes. Episodes can occur often after a meal, due to an obstruction by a gallstone in the cystic duct, but they can occur spontaneously as well, mostly at night. The pain usually lasts 15 minutes to an hour or even longer. The trigger that most patients report that creates episodes with symptoms is food. Specific food reported to trigger episodes are fatty foods, especially. Additional symptoms that patients report having include: flatus, bloating, belching and epigastric burning.

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.

www.psychologytoday.com 
www.enkivillage.com

Diagnosis of Disease

So what is the diagnosis? Diagnosing Cholecystitis is determined by appropriate evaluation of lab values, family history, diet history, physical examination and imaging (ultrasound). One of the most common ways to diagnose the presents of Cholecystitis is using an ultrasound of the abdomen to view whether there is a blockage or the presence of gallstones in the gallbladder. This can also show the thickening of the gallbladder wall indicating inflammation. However, on occasion, the presence of gallstones and the thickened wall of the gallbladder may not be diagnosed. Other tests used for the diagnosis of cholelithiasis and cholecystitis are: Hepatobiliary scintigraphy or cholescintigraphy by hydroxyiminodiacetic acid (HIDA). This scans and determines the functional assessment of gallbladder excretion,  determining if cholecystitis is present. Another test used is a CT scan, magnetic resonance cholangiography (MRCA), and endoscopic retrograde cholangiopancreatography (ERCP) are useful for specific cases.

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.





www.ultrasoundcases.info

Etiology/ pathophysiology of Cholecystitis

So what's really wrong when you have Cholecystitis? As I mentioned in an earlier post it is the inflammation of the gallbladder which is usually caused by obstruction (usually gallstones) or otherwise known as Cholelithiasis and causes the wall of the gallbladder to thicken as a result. Any one can get gallstones, it depends mostly on your diet but also could be indicated if you have family history or if your an older women (more prone). Gallstones are composed of crystallized pigment and cholesterol. To get more on a cellular level of the pathophysiology; its the obstruction of the cystic duct where the bile flows through to the duodenum to help digest fats. With the obstruction, this escalates the bile in the gallbladder to stasis leading to a bacterial infection causing the gallbladder to be inflamed. If left untreated, this can quickly escalate to gangrene of the gallbladder and could lead to the rupture of the gallbladder leading to more serious complications as a result: peritonitis, septic shock, empyema or cholecystoenteric fistula.

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.

www.yorksurgeon.com

Epidemiology of Disease- Cholecystitis

Epidemiology or in other words is the contributing factors and this diseases specific commonalities. With this disease specifically, Cholecystitis is estimated to nearly have 10-20% of Americans in the U.S. to have gallstones causing the inflammation. The surgery of removal, Cholecystectomy, is one of the most common surgeries performed annually. About 500,000 operations take place each year. The incidences of Cholecystitis due to gallstones increases more with age and is more common in woman. Race and ethnicity showed a few similarities. There is an increased prevalence among communities of Scandinavian, Pima Indians, and Hispanic heritages. Caucasian's are more prone to cholecystitis than African Americans in the United States.

http://emedicine.medscape.com/article/171886-overview#a6
www.wisegeek.org

What is Cholecystitis?

www.ahealthgroup.com

 

Cholecystitis is defined as an acute inflammation of the gallbladder wall (the green sac). This can be caused by a number of things contributing to it. This usually occurs when obstruction of the cystic duct occurs, causing the bile stored in the gallbladder to become stasis. Most occurrences of cholecystitis is from a blockage of some sort, acalculous cholecystitis (gallstones), or a bacterial infection. 

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.