You thought it was indigestion, but it was cholecystitis…more dangerous after middle age [e-Health Quick Take]

 The gallbladder, commonly known in Korean as 'sseulgae', is a digestive organ in the upper abdomen. It stores and concentrates bile to aid digestion. Small but important, it faces a rising risk of inflammation and gallstones after middle age because of declining metabolism and changes in lifestyle.


According to the Health Insurance Review and Assessment Service on the 17th, among patients with cholecystitis in 2024 those in their 40s were about 1.4 times as numerous as those in their 30s, while patients in their 60s numbered twice as many as those in their 30s, the highest level of any age band.

The gallbladder stores bile produced in the liver and sends it through the bile duct to the duodenum to aid digestion. If the bile duct becomes blocked in this process or the flow of bile is disturbed, bacterial infection can occur and lead to cholecystitis. The most common cause is gallstones. Gallstones are stones formed by hardening due to an imbalance in the components of bile; when they block the cystic duct, pressure inside the gallbladder rises and inflammation results.

Metabolic conditions such as obesity, diabetes and hyperlipidemia are major factors that raise the risk of gallstones. When overeating or a high-calorie diet continues, the composition of the bile changes and stones can form easily. Conversely, rapid weight loss also promotes gallstone formation. Indeed, there are reports that gallstones were found in about 25% of people who had dieted excessively. Anyone who continues poor eating habits after middle age in particular runs a high risk of placing an excessive cumulative burden on the gallbladder.

Cholecystitis shows markedly different symptom patterns depending on whether it is acute or chronic. Acute cholecystitis is often accompanied by severe right upper abdominal pain, nausea, vomiting and fever, and the pain worsens when the right upper abdomen is pressed. Chronic cholecystitis, by contrast, often has no clear symptoms or presents only as bloating, discomfort and fullness in the upper abdomen, making it easy to mistake for simple indigestion or a gastrointestinal disorder.

Treatment varies according to the patient’s condition. For acute cholecystitis, cholecystectomy is performed as the standard treatment, and even after the gallbladder is removed there is no great impact on everyday digestive function. When symptoms are mild, drug therapy to dissolve the stones may be attempted, but it has the limitations of a low rate of complete dissolution and a high likelihood of recurrence. For chronic cholecystitis, the principle is to monitor the condition if there are no symptoms. If gallstones are found, however, changes are checked with regular ultrasound examinations. If acute symptoms such as sudden upper abdominal pain or fever appear thereafter, the patient should go to a hospital immediately.

Park, Kwan Tae, Director of General Surgery at St. Peter's Hospital, stressed, "If you feel pain in the upper abdomen that you have not felt before, you should not ignore it even if the symptom disappears for a time. Inflammation of the gallbladder is also quite likely to cause complications." He added, "From the 40s onward in particular, metabolic factors and unhealthy lifestyle habits tend to worsen, so it is good to keep a close watch on gallbladder health. It is important to obtain an early diagnosis from a specialist who can examine the gallbladder, pancreas and bile ducts together."