Most patients have had prior attacks of biliary colic or acute cholecystitis. The pain of cholecystitis is similar in quality and location to biliary colic but lasts longer (ie, > 6 h) and is more severe. Vomiting is common, as is right subcostal tenderness. Within a few hours, the Murphy sign (deep inspiration exacerbates the pain during palpation of the right upper quadrant and halts inspiration) develops along with involuntary guarding of upper abdominal muscles on the right side. Fever, usually low grade, is common.
In the elderly, the first or only symptoms may be systemic and nonspecific (eg, anorexia, vomiting, malaise, weakness, fever). Sometimes fever does not develop.
Acute cholecystitis begins to subside in 2 to 3 days and resolves within 1 wk in 85% of patients even without treatment.
Without treatment, 10% of patients develop localized perforation, and 1% develop free perforation and peritonitis. Increasing abdominal pain, high fever, and rigors with rebound tenderness or ileus suggest empyema (pus) in the gallbladder, gangrene, or perforation. When acute cholecystitis is accompanied by jaundice or cholestasis, partial common duct obstruction is likely, usually due to stones or inflammation.
Other complications include the following:
Mirizzi syndrome: Rarely, a gallstone becomes impacted in the cystic duct and compresses and obstructs the common bile duct, causing cholestasis.
Gallstone pancreatitis: Gallstones pass from the gallbladder into the biliary tract and block the pancreatic duct.
Cholecystoenteric fistula: Infrequently, a large stone erodes the gallbladder wall, creating a fistula into the small bowel (or elsewhere in the abdominal cavity); the stone may pass freely or obstruct the small bowel (gallstone ileus).
These days, the manual acceleration of lymph drainage is mainly used by practitioners to reduce the size of lymphedemas, even though the main function of the lymphatic system is detoxification and disposal of metabolic waste. The compromised quality of the air, water, food, etc., causes significant accumulations of metabolic waste products in our body, some of which are toxic. In many cases, this accumulation of toxins causes us to feel low energy levels, fatigue, mood swings (the clinical symptoms of which are often confused with depression by physicians) fatigue, etc. There is no doubt that lymph drainage is a powerful method for lymphedema reduction, but I also believe we should offer lymph drainage to our clients as a detoxification program. Clients who receive full-body medical massage regularly (for example, on a weekly basis) should be getting a lymph drainage session every fifth treatment. I do not advise therapists to incorporate techniques of full-body massage with lymph drainage techniques, as this can cause severe reactions such as headache, dizziness, nausea, etc. Detoxification causes a significant improvement in the power and function of the immune system. I personally see regular lymph drainage sessions incorporated with full-body stress management massage as no less important than immunization against the flu virus and other infections. Immunizations sometimes do not protect people from contracting the flu, for example. A consistent detoxification program has proven very effective in protecting humans from infections.
The main function of the lymphatic system is detoxification, but it also plays an important role in immunity. Lymph is an extracellular fluid that enters the lymphatic vessels and is mixed with cellular elements. The lymphatic system starts at the lymphatic sacs in the extracellular spaces.
Siberian Ginseng – Soviet researchers have reported that eleuthero extract has radioprotective abilities, and can be used therapeutically in conditions of acute and chronic radiation and sicknesses such as hemorrhaging, severe anemia, dizziness, nausea, vomiting , and headaches due to x-rays.
Panax Ginseng – Hemorrhage was a symptom of humans exposed to atomic radiations in Hiroshima and Nagasaki. Japanese research doctors found that “Panax ginseng prevented hemorrhaging tendency after x-irradiation.” Bone marrow death is one result of radiation damage to blood-forming tissues. It occurs ten to twenty days after exposure to high doses of radiation. Panax ginseng extract prevents bone marrow death and accelerates normalization of red and white blood cell counts in animal studies.
Gingko Biloba – According to Science News Daily, extracts of its leaves contain antioxidant compounds including glycosides and terpenoids known as ginkgolides and bilobalides. These compounds are thought to protect cells from damage by free radicals and other reactive oxidizing species found in the body. These are generated continuously by the body’s normal metabolism, and in excess in some diseases or after exposure to pollution or radiation. They damage proteins, DNA and other biomolecules and left unchecked can kill cells. Results suggest that ginko biloba extracts can neutralize the free-radicals and oxidizing agents produced in the cells by the radiation and so prevent them from undergoing apoptosis.
(*) Black & Green Tea – The polyphenol epigallocatechin gallate (EGCG) derived from green tea protects animals from whole-body radiation, blocking lipid oxidation and prolonging life span. Several sources indicate that there were hundreds who survived Hiroshima at ground zero and the one thing they all had in common was drinking 20 cups of green tea per day.
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