Chronic Cholecystitis (Gallbladder Disease)
Overview
Chronic cholecystitis is long-standing inflammation of the gallbladder, most often associated with gallstones, causing recurrent right-upper abdominal or right-hypochondriac fullness and pain after fatty or large meals, belching, nausea, and intolerance of greasy food; pain may radiate to the right shoulder or back. Chinese medicine treats it under 'hypochondriac pain' (xie tong), with patterns of liver-gallbladder damp-heat, liver qi stagnation, and static blood obstructing the collaterals. Chinese care is adjunctive; gallstones, biliary obstruction, and acute attacks require medical evaluation.
TCM disease & pathogenesis
In TCM this is 'hypochondriac pain' (xie tong) or gallbladder distension. The hypochondria are the domain of liver and gallbladder; the liver meridian spreads over the ribs and the gallbladder meridian runs within them, so the site is the gallbladder but the liver is central, with spleen-stomach involvement. Emotional constraint or a rich fatty-sweet diet impairs liver dispersion and blocks gallbladder qi, or damp-heat accumulates in liver-gallbladder and brews bile until stones form over time and obstruct the biliary tract—pain results from blockage. Prolonged pain may enter the collaterals as qi stagnation with blood stasis. Excess patterns are liver-gallbladder damp-heat and liver qi stagnation with acute, tender pain and bitter mouth; deficiency or mixed patterns show dull lingering pain. Treatment soothes liver and benefits the gallbladder, clears heat and drains dampness, moves qi to stop pain, aiding stone expulsion or quickening blood as appropriate. Biliary obstruction or acute suppuration needs surgical/biomedical assessment.
Pattern differentiation (clinical patterns)
Liver-Gallbladder Damp-Heat
Right-hypochondriac distending or colicky pain radiating to shoulder and back, bitter mouth and dry throat, nausea and fat intolerance, constipation and dark urine, possible jaundice, red tongue with yellow greasy coating, wiry rapid pulse.
Clear heat and drain dampness; soothe the liver and benefit the gallbladder.
Liver Qi Stagnation
Intermittent dull or distending right-hypochondriac pain that fluctuates and is triggered by emotional upset or overeating, chest oppression, belching, poor appetite, pale-red tongue with thin white coating, wiry pulse.
Soothe the liver and regulate qi; harmonize the stomach and stop pain.
Static Blood Obstructing Collaterals
Long-standing fixed stabbing hypochondriac pain worse at night or after prolonged standing, sometimes a palpable mass, dark tongue with stasis spots, rough pulse.
Quicken blood and transform stasis; free collaterals and stop pain.
Connections
Daily care & prevention
Eat regular meals (do not skip breakfast) with a low-fat diet, avoid greasy or fried food and large meals, keep a healthy weight, and avoid rapid weight-loss diets; record food triggers and pain location. Press Yanglingquan (GB34), Taichong (LR3), Qimen (LR14), Danshu (BL19), Riyue (GB24), and Zusanli (ST36). Severe or persistent attacks with fever or jaundice need urgent care.
When to seek medical care
Seek urgent care for severe persistent right-upper abdominal pain lasting hours, fever and chills, yellow skin or eyes and dark urine (jaundice/obstruction), vomiting and inability to eat or drink, or shoulder-tip pain with collapse (possible acute cholecystitis, cholangitis, or pancreatitis).