Acute Cholecystitis Dietary Guidelines and Management

When managing acute cholecystitis, it is strongly recommended that patients avoid consuming fatty foods, including fried and high-fat meals. Eating smaller portions, approximately 5-7 servings of full capacity per meal, is advised to reduce strain on the gallbladder. In more severe cases, such as when complications like abscess formation, septic shock, or cholangitis occur, oral intake of food and water should be temporarily stopped. During this time, patients often require aggressive pain management, antibiotic therapy, and in some cases, surgical intervention.

During an acute episode, Murphy's sign is typically positive during physical examination, which plays a crucial role in diagnosing acute cholecystitis. The test involves placing the examiner's right thumb under the right costal margin while the patient inhales. As the diaphragm and gallbladder descend during inhalation, contact with the thumb can trigger significant pain in the right upper quadrant. This pain is often accompanied by nausea, vomiting, and fever.

To confirm the diagnosis and assess for complications such as gallstones or obstructive pathology, imaging studies like abdominal ultrasound or CT scans are essential. These tests help determine the severity of the condition and guide further treatment decisions. Early diagnosis and appropriate dietary adjustments are key to managing acute cholecystitis effectively. Patients should always follow medical advice and avoid self-treatment.