How should gallstones with acute cholecystitis be treated?

If a patient with gallstones also has acute cholecystitis, he will definitely feel more severe pain. For the treatment of gallstones, if the symptoms are in the early stages, you can choose treatment with traditional Chinese medicine and let traditional Chinese medicine further regulate your body. If the symptoms are severe, the patient needs to eat and then undergo surgical treatment.

1. Gallstones, chronic cholecystitis:

Symptoms include: intermittent dull pain in the right upper abdomen or epigastric area, radiating to the right shoulder and back, often caused or aggravated by anger or greasy meals. Sometimes there may be sudden right upper abdominal colic (this is due to stone impaction), loss of appetite, uncomfortable bowel movements, red tongue with white coating, and wiry pulse. The syndrome differentiation is: stagnation of liver and gallbladder, and poor flow of visceral qi. The treatment is to soothe the liver and promote bile secretion, regulate qi and unblock the bowels.

Commonly used medicines: Bupleurum, Cyperus rotundus, Curcuma aromatica, Citrus aurantium, Magnolia officinalis, Costus root, Scutellaria baicalensis, White Peony Root, Lysimachia scabra, Rhubarb, Angelica sinensis, Licorice, etc. For those with severe pain, add Yuanhu and Chuanlianzi; for those with poor appetite, add tangerine peel and bamboo shavings; for dry stools, increase the amount of rhubarb or add Yuanming powder as appropriate. If biliary colic is suspected to be caused by a stone stuck in the neck of the gallbladder, the patient can be asked to lie on his right side and the right back can be patted to make the stone fall out of the stuck site and relieve the pain. During the illness, you should avoid eating greasy food and keep a calm mind.

2. Gallstones with acute cholecystitis and cholangitis:

Symptoms include: acute onset, pain in the right upper abdomen or stomach radiating to the right shoulder and back, loss of appetite, worsening abdominal pain after eating, or vomiting, fever, or chills, sometimes jaundice, less yellow urine, and a large lump in the urine.

The syndrome differentiation is: stagnation of liver and gallbladder, accumulation of dampness and heat. The treatment should be to clear the liver and gallbladder, regulate qi and promote bowel movements. Commonly used medicines: Centella asiatica, Polygonum cuspidatum, Taraxacum mongolicum, Scutellaria baicalensis, Curcuma aromatica, Toosendan fruit, Capillaris ternata, Bupleurum chinense, White Peony Root, Rhubarb, Yuanming powder, etc. For severe abdominal pain, add Yuanhu; for nausea and vomiting, add ginger and Pinellia; for persistent high fever, add gypsum.

The patient should fast, and if conditions permit, a gastric tube should be inserted for gastrointestinal decompression and infusion. An ointment that clears heat and detoxifies, promotes blood circulation and removes blood stasis can be applied to the right upper abdomen to promote the disappearance of inflammation. At the same time, antibiotics should be used and the changes in the condition should be closely observed.

3. Gangrenous cholecystitis, acute suppurative obstructive cholangitis bile duct:

At this stage of the disease, the most active measure should be surgical treatment, but some patients have contraindications to surgery or there are no local surgical conditions, so only conservative treatment can be adopted.

Traditional Chinese medicine calls this type of syndrome the fire poison type, and its main symptoms are: severe pain in the right upper abdomen and epigastric area, or even pain throughout the abdomen, persistent high fever, jaundice, and constipation. Physical examination: Blood pressure tends to decrease, and even abdominal muscles are tense and resistant to pressure. The tongue is red, with thick and greasy yellow coating, and the pulse is stringy or thin. White blood cell count is higher than 20,000/mm3.