Chronic Acalculous Gallbladder

Chronic Acalculous Gallbladder Disease

The gallbladder is a small, pear-shaped organ located just beneath the liver in the upper right abdomen. Its main function is to store bile, a digestive fluid produced by the liver that helps break down fats in the small intestine. The bile is released from the gallbladder into the small intestine through a tube called the common bile duct.


Gallbladder disease is a common condition that affects millions of people worldwide. Chronic acalculous gallbladder disease (CAGD) or chronic acalculous cholecystitis is a type of gallbladder disease that occurs when the gallbladder does not function properly, but there are no gallstones present. This blog will explore the different types of CAGD, symptoms, causes, risk factors, prevention, diagnosis, stages, treatment and management, road to recovery, and frequently asked questions.

Types of Chronic Acalculous Gallbladder Disease

There are several types of acalculous cholecystitis, including biliary dyskinesia, chronic cholecystitis, and gallbladder motility disorder. However, these are the primary types of cholecystitis:

Biliary dyskinesia occurs when the gallbladder does not contract normally, and there is a delay in the emptying of bile into the small intestine. This can cause pain, nausea, vomiting, and other digestive symptoms.

Chronic acalculous cholecystitis is a chronic inflammation of the gallbladder that can occur without the presence of gallstones. Acalculous cholecystitis causes abdominal pain, fever, nausea, and vomiting.

Gallbladder motility disorder occurs when the muscles of the gallbladder do not contract and relax properly, causing the bile to accumulate in the gallbladder. This can lead to pain, nausea, vomiting, and other digestive symptoms.

Symptoms of Chronic Acalculous Gallbladder Disease

Unlike acute gallbladder disease, which is typically caused by gallstones, CAGD is not associated with the presence of gallstones. CAGD symptoms can be similar to those of acute gallbladder disease, but they tend to be less severe and can develop over a longer period of time. Here are some of the most common CAGD symptoms:

  1. Abdominal pain: The most common symptom of CAGD is pain in the upper right or centre of the abdomen. The pain may be dull or sharp and can be intermittent or constant. It may also radiate to the back or shoulder blades.
  2. Nausea and vomiting: Some people with CAGD may experience nausea and vomiting, particularly after eating fatty or greasy foods. This is also one of the most common signs of inflammation.
  3. Bloating and gas: CAGD can cause bloating and gas, which can lead to discomfort and a feeling of fullness in the abdomen.
  4. Indigestion and heartburn: CAGD can cause indigestion and heartburn, which may be triggered by eating certain foods or lying down after a meal.
  5. Diarrhoea or constipation: CAGD can cause changes in bowel habits, including diarrhoea or constipation.
  6. Fatigue: Fatigue is one of the most common signs of inflammation. Some people with CAGD may experience fatigue or weakness, which can be caused by inflammation or other changes in the body.
  7. Fever and chills: In rare cases, CAGD can cause fever and chills, which may be signs of inflammation.

What Causes Chronic Acalculous Gallbladder Disease?

The exact cause of CAGD is not fully understood. However, several factors have been identified as potential contributors to the development of the condition.

One of the main factors that can lead to CAGD is a dysfunction of the gallbladder's muscular contractions. The gallbladder stores and releases bile into the small intestine to help digest fats. When the muscular contractions of the gallbladder become impaired, bile can build up in the gallbladder, leading to inflammation and other changes that can cause symptoms of CAGD.

Another factor that can contribute to the development of CAGD is gallbladder motility disorders. These disorders are characterized by abnormalities in the way the gallbladder contracts and relaxes, leading to changes in the way bile is stored and released. This can cause inflammation and other changes in the gallbladder that can lead to CAGD.

In addition to gallbladder dysfunction, several other causes have been associated with an increased risk of developing CAGD. These acalculous cholecystitis causes include:

  1. Age: CAGD is more common in people over the age of 50.
  2. Gender: Women are more likely than men to develop CAGD.
  3. Obesity: Obesity is a known risk factor for the development of CAGD.
  4. Rapid weight loss: Rapid weight loss can lead to changes in the way bile is stored and released, which can increase the risk of developing CAGD.
  5. Pregnancy: Changes in hormone levels during pregnancy can increase the risk of developing CAGD.
  6. Diabetes: People with diabetes are more likely to develop CAGD.
  7. Genetic factors: There may be genetic factors that increase the risk of developing CAGD.

It is important to note that while these factors have been associated with an increased risk of developing CAGD, they do not necessarily cause the condition. Additionally, not all people with these risk factors will develop CAGD. Further research is needed to fully understand the causes of CAGD and how to prevent and treat the condition.

Risk Factors for Chronic Acalculous Gallbladder Disease

Unlike acute gallbladder disease, which is typically caused by gallstones, CAGD is not associated with the presence of gallstones. The exact cause of CAGD is not well-understood, but certain risk factors may increase the likelihood of developing the condition.

Here are some of the most common risk factors for CAGD:

  1. Gender: Women are more likely than men to develop CAGD. The reason for this is not clear, but it may be related to hormonal changes that occur during pregnancy or menopause.
  2. Age: CAGD is more common in older adults, particularly those over the age of 50. This may be because the muscles in the gallbladder weaken with age, making it more difficult for the organ to contract and release bile.
  3. Obesity: Being overweight or obese can increase the risk of developing CAGD. This may be because excess body weight can put pressure on the gallbladder, causing it to function poorly.
  4. Rapid weight loss: Losing weight too quickly, such as through crash dieting or bariatric surgery, can also increase the risk of developing CAGD. This may be because rapid weight loss can cause the gallbladder to contract and release bile more frequently, leading to inflammation and other symptoms of gallbladder disease.
  5. Chronic conditions: Certain chronic conditions, such as diabetes, liver disease, or inflammatory bowel disease, may increase the risk of developing CAGD. This may be because these conditions can affect the way the gallbladder functions.
  6. Previous gallbladder disease: People who have had gallbladder disease in the past, such as gallstones or acute cholecystitis, may be at a higher risk of developing CAGD. This may be because previous damage to the gallbladder can affect its ability to function properly.
  7. Family history: Having a family history of gallbladder disease or other digestive conditions may also increase the risk of developing CAGD. This may be due to a genetic predisposition to the condition.

While these risk factors may increase the likelihood of developing CAGD, it is important to note that not everyone with these risk factors will develop the condition. Additionally, some people may develop CAGD without any known risk factors. If you are experiencing symptoms of CAGD or are concerned about your risk of developing the condition, it is important to talk to your healthcare provider to determine the best course of action.

How to Prevent Chronic Acalculous Gallbladder Disease

While there is no sure-fire way to prevent CAGD, some lifestyle changes and healthy habits may reduce the risk of developing the condition. These include:

  1. Maintaining a healthy weight: Being overweight or obese increases the risk of developing CAGD. Eating a balanced diet and engaging in regular physical activity can help maintain a healthy weight and reduce the risk of CAGD.
  2. Eating a healthy diet: Eating a diet low in fat and high in fibre may help prevent CAGD. Avoiding fatty, fried, and processed foods may help reduce the risk of developing the condition.
  3. Staying hydrated: Drinking enough water and staying hydrated may help prevent CAGD by keeping the bile thin and flowing smoothly.
  4. Avoiding rapid weight loss: Losing weight too quickly can cause an imbalance in the bile flow and increase the risk of developing CAGD. Gradual weight loss through healthy eating and exercise is recommended.
  5. Managing chronic conditions: Managing conditions such as diabetes and high blood pressure may help reduce the risk of developing CAGD.

Diagnosis of Chronic Acalculous Gallbladder Disease

To diagnose CAGD, your healthcare provider may perform a physical exam and review your medical history and symptoms of gallbladder disease. They may also order imaging tests such as an ultrasound, a CT scan, or an MRI to examine the gallbladder and rule out other conditions such as gallstones.

In some cases, a special test called a hepatobiliary iminodiacetic acid (HIDA) scan may be performed to measure the gallbladder's ability to contract and release bile.

Chronic Acalculous Gallbladder Disease Stages

CAGD is typically divided into three stages based on the severity of symptoms:

  • Stage I: Mild symptoms, occasional pain, and discomfort after eating fatty foods.
  • Stage II: Moderate symptoms, frequent pain, and discomfort after eating fatty foods.
  • Stage III: Severe symptoms, constant pain, and discomfort, and impaired quality of life.

Chronic Acalculous Gallbladder Disease Treatment and Management

CAGD treatment typically involves managing symptoms and preventing complications. In some cases, surgery may be necessary to remove the gallbladder.


Medications such as antispasmodics and pain relievers may be prescr..

Chronic Acalculous Gallbladder Disease Road to Recovery and Aftercare

Recovery after surgery typically involves a short hospital stay, a few weeks of rest, and recovery at home. During this time, following your healthcare provider's instructions for wound care, pain management, and physical activity is important.

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