home Auditorium 8 Irradiation of pain in gallstone disease. Gallstone disease - symptoms and treatment. Causes of an attack of cholelithiasis

Irradiation of pain in gallstone disease. Gallstone disease - symptoms and treatment. Causes of an attack of cholelithiasis

There are many reasons for exacerbation, the question remains: what to do during an attack of gallstone disease, how to relieve pain and prevent relapse.

Symptoms and development of the disease

The disease develops slowly and imperceptibly: initially, several stones form in the bile ducts, making it difficult to remove bile, and no inflammation, formation of ulcers or other complications are observed. Already at the initial stage, the first obvious sign appears: colic in the liver. Painful sensations are associated with the passage of stones through the bile ducts - the stones try to get into the intestines and then be released with the rest of the waste from the body. However, the size of the stones sometimes does not allow passage through narrow ducts; the flow of bile gets stuck halfway, causing pain.

Symptoms of a late-stage gallstone attack include:

intense and prolonged pain;
the patient experiences rapid breathing with small inhalations and small exhalations;
there is a general change in the skin, the color becomes pale;
sweating develops due to increased metabolism;
Painful shock may occur.

If a person directly experiences the listed symptoms, there is no point in delaying further visits to the doctor.

A little about hepatic colic

Hepatic colic is the first and surest symptom of gallstone disease. Hepatic colic has the following properties:

the pain is localized in the right side and is acute;
at times the pain radiates to the back - shoulder blade, neck, in rare cases, buttock and arm;
the main symptom may be external bloating;
in some cases, the patient’s temperature fluctuates – chills or fever;
often an exacerbation corresponds to a disorder of the gastrointestinal tract functions, difficulties in digestion;
arrhythmia (heartbeat disturbance) is observed.

Acute pain annoys the patient for half an hour, then smoothly turns into an aching character. If it is impossible to numb the stomach, after a couple of hours the pain subsides completely, sometimes lasting for even minutes.

Of course, the presence of one of the list of symptoms does not necessarily indicate the formation of gallstones, but such an attack will serve as a good call to change habits and go to the hospital.

How to help yourself

If the attack takes you by surprise, you will need to relieve the attack of cholelithiasis yourself.

First aid is as follows: you need to lie down on a sofa, bed or chair - a place where you can stretch your legs and feel peace. If the patient is alone at home, it doesn’t hurt to call friends and relatives asking for help. Ask your friends to come, there may be a case of vomiting or an intensification of the attack (painkillers do not always help) so much that you will have to call an ambulance.

Painkillers are often:

The attending physicians prevent the problem in advance - offer the patient a painkiller in case of an attack. If you have not received a proposal from your doctor, discuss the names of the medications at your appointment.

Some doctors recommend taking a bath. The water is at a pleasant, warm temperature (from 37 to 39C), and should not burn the human body. There is no need to lie in the bath for a long time: just relax for a few minutes. Then it is recommended to quickly go to bed so that the warmed body does not cool down again and the body temperature does not change. An alternative option that allows you to “warm” the body and improve the functioning of blood vessels is to apply a heating pad to your legs. It is recommended to wrap the patient as much as possible in blankets and warm clothes; in case of cholelithiasis, warmth will serve a good purpose. If the patient's temperature fluctuates, the patient feels chills, wrap the person in a blanket more tightly.

To avoid dehydration, drink plenty of water. Mineral, filtered water is recommended; tap water and carbonated drinks are strictly prohibited.

As a rule, serious attacks last 20–30 minutes; after the specified time has elapsed, you are allowed to leave the bed or bath and continue doing business. If the attack does not end, then the matter is serious and a doctor’s consultation is urgently needed. You'll have to call the hospital and call an ambulance.

Remember: the sooner a stone (or several) is detected in the gall bladder and the patient complains to the doctor, the higher the likelihood of avoiding surgery.

Complications of cholelithiasis and concurrent diseases

If you do not see a doctor in time for gallstones, you may encounter a number of quite serious complications that greatly affect the condition of your body. At first, the stones are small, painkillers cope with the task of dulling the pain, but gradually the formations become more massive, and passage through the biliary tract becomes more difficult. When stones get stuck, blocking the bile ducts, unpleasant phenomena occur:

biliary cirrhosis of the liver;
jaundice;
cholecystitis (inflammation of the gallbladder);
cholangitis.

Cholecystitis is accompanied by recognizable symptoms:

the pain is localized on both sides of the body, acquiring a girdling character;
yellowed skin;
change in body temperature;
pain radiates to the back, creating a sensation of pulsation;
problems with processing food - vomiting, nausea.

When the stones enlarge and the ducts are blocked, the scary thing is that the pain does not stop and is very intense. In order not to delay treatment until surgery, it is better to worry about preventing consequences in advance.

The following diseases will serve as a prerequisite for the appearance of gallstones:

The common reason for the transition of diseases into each other is the deterioration of the body’s condition. As a rule, clinics remember this relationship and take preventive measures to reduce the likelihood of gallstones.

Due to complications and parallel diseases that are not treated in time, a person suffers many times: the first time when he tries to cope with a diagnosed disease, the second time when an additional disease appears, and the patient has to fight on several fronts at the same time. The metabolism and life of a person depend on complications of gallstone disease; symptoms indicating the occurrence of complications require an urgent need to call an ambulance. The attending physician will be able to decide whether it is worth hospitalizing the patient or whether it will be possible to get by with a set of basic measures.

During hospitalization, further treatment course is prescribed individually depending on the cause of the attack in addition to the neglected gallbladder.

Prevention

A single gallstone attack is a warning and reminder of the need to take care of your health. To protect yourself from recurrence, it is enough to follow a number of preventive measures. The demands become extremely important after an attack. Eg:

You should fast for 12 hours after the onset of pain;
then they move on to drinking rosehip decoction, eating soups prepared with fresh vegetables;
on the third day after inflammation, cereals boiled in water, cottage cheese (necessarily low-fat), milk (low-fat), broths with lean meat, bread (rye), fresh vegetables and fruits are returned to the diet - eliminating the sour taste;
With great caution, after an attack occurs, river fish, turkey meat, and chicken (without skin) should be added to food. Discuss with your doctor the possibility of a therapeutic course of taking mineral water.

The diet, developed by nutritionists solely to prevent new attacks of gallstone disease, is accompanied by a list of prohibited foods:

pasta (even the highest grade);
sausage;
spinach;
dairy products with high fat content;
dishes subject to heat treatment, in addition to boiling and steaming;
forget about seasonings, pickled and highly salted foods;
coffee;
alcohol.

It is required to adhere to a diet during an attack and after it. The diet helps reduce the load on the gallbladder and the processing system as a whole. Take care of your diet, it is not difficult and does not require much effort.

If you are diagnosed with gallstone disease, you will have to temporarily forget about intensive weight loss methods. Quite often, women mistakenly believe that fitness can improve health; gallstones become an exception. Such diets disrupt metabolism, food processing and the secretion of bile from the bile ducts are impaired. It is better to discuss the need to lose weight with your doctor, finding a way out that suits both parties.

The diet has a list of permitted and prohibited foods, recommendations regarding dosage and frequency of daily meals. The daily intake of nutrients varies from person to person; only a doctor can give clear, individual advice. However, there are known rules that are common to each case.

For example, you will need to plan the menu and the quantitative ratio of dishes on the list in the morning. A large portion of food should be divided into 5-6 meals. The size of the dish should not be massive, so as not to overload the inflamed organs.

By following simple preventive rules, you will be able to forget about stones in the bile ducts for a long time. It is important to remember that you should not provoke attacks, so that later you do not have to deal with unwanted pain.

How does a person’s gallbladder hurt?

Pain in the projection of the gallbladder occurs more often in the case of dyskinesia (motor dysfunction) of the bile ducts or canals, inflammation, and the movement of gallstones. The insidiousness of these pathological conditions lies in the fact that the gallbladder hurts even with an old disorder. Early stages are usually asymptomatic. The root causes of pain in the gallbladder are congenital defects in the structure of the organ, its channels (narrowing, tortuosity), tumor formations, and helminthic infestation. Early stages are treated with medication, advanced stages are treated surgically, often by laparoscopy (cholecystectomy).

Pain in the right hypochondrium may indicate ailments in the gallbladder.

How does it hurt and where is the gallbladder located?

Only a doctor can know how the gallbladder hurts in various diseases. To eliminate discomfort, people usually take painkillers or antispasmodics, but not every drug is approved for different types of pain in the gallbladder area. Only a specialist can tell you what medications to take. But before you understand why pain occurs in the gallbladder, you need to know its structure and location. This will allow you to more accurately determine the location of painful sensations.

The organ is located directly above the liver. They are inextricably linked by bile ducts. The bubble is small and pear-shaped. The task of the organ is the accumulation and timely removal of bile produced in the liver. This liquid is necessary for normal digestion, in particular for the absorption of fats. Bile facilitates the flow of food bolus through the intestines. In 48 hours, the human liver can produce up to 2 liters of bile.

Symptoms

The main sign of pathology is detected by palpation, when a greatly enlarged bubble is felt. A person experiences pain in the area on the right in the hypochondrium with the scapula. The sensations are constant and radiate to the right side, lower back, and shoulder. Additionally, there is a strong tension in the muscle tissue of the peritoneum from the side of the painful organ.

The gallbladder hurts differently at different stages:

At the beginning of the development of pathology, unpleasant sensations are similar to colic, as during an attack. Pain in the gallbladder increases with coughing, rapid and deep breathing, and during body movement. Possible manifestation at night.
In the later stages of the disease, the pain becomes constant, sharp, and intense. The patient is constantly nauseous.
In especially severe cases, pain shock develops.

A diseased gallbladder weakens a person, causing fever, vertigo, vomiting, dry mouth, in addition to pain in the right side.

Signs of abnormalities can be long-lasting or short-term (from 5 minutes to several hours). Additionally appear:

If severe pain occurs in the gallbladder, you should immediately contact a specialist who will diagnose the root cause of the discomfort, prescribe an examination and adequate treatment.

Causes

Various factors can provoke hydatidiform colic. Main provocateurs:

Below are the most basic factors that explain why pain occurs in the gallbladder area.

Cholecystitis

The disease involves inflammation of the organ in acute and chronic form. The condition is accompanied by a general disorder of biliary function with such manifestations as:

aching pain with constant discomfort in the right hypochondrium;
deterioration of the patient's condition;
increased pain and discomfort after nutritious, fatty, peppery foods, eggs, soda, coffee, alcohol.

nausea;
drying of the mucous membrane in the mouth.

poor nutrition;
abuse of junk food, alcohol-containing drinks;
constant overeating;
other inflammations of nearby organs, in particular the pancreas with pancreatitis.

Acute pathology usually develops against the background of cholelithiasis due to blockage of the main duct that removes fluid from the organ. Symptoms:

The patient requires ambulance.

Bad habits and poor diet can cause inflammation in the gallbladder.

With chronic cholecystitis, the clinical picture gradually develops. The initial stages are asymptomatic. Discomfort usually appears 2 hours after eating or exercising.

The patient complains that it hurts and pulls in the area of the inflamed organ with impact in the shoulder blade, lower back, neck, back of the head, he regularly vomits. Additionally appears:

metallic aftertaste in the mouth;
air belching;
digestive upset (constipation, diarrhea);
headache;
insomnia with irritability (less often).

Gallstone disease is provoked by stagnation of bile and a malfunction in the metabolic processes occurring in the organ. More often, the disease affects women over 40 years old. Usually the disease is asymptomatic. It becomes very painful if the stone gets into the bile duct. Small stones can pass out of the body naturally with feces. If the stone is large, surgical removal is required.

The nature of the pain in cholelithiasis is diffuse, that is, spreading to the entire abdomen with a gradual concentration in the area on the right side and hypochondrium. Additionally, patients experience:

severe nausea leading to vomiting;
chronic constipation.

With cholelithiasis, gallstones are formed, which, depending on the composition, can be:

Different methods are used to remove each type of stone, so it is important to undergo an ultrasound of the gallbladder. Provocateurs of the appearance of cholelithiasis:

improper diet and regimen;
sedentary lifestyle;
overweight;
long-term use of hormonal drugs;
pathology of the pancreas (pancreatitis).

Dyskinesia

Motor dysfunction of the gallbladder and biliary tract causes disturbances in the flow of bile from the liver to the organ and duodenum for digestion. There are two types of dyskinesia:

hypotonic with decreased motor skills;
hypertensive with motor activity exceeding the norm.

Symptoms of the disease:

For hypotension:

pain - nagging, aching, localized in the right hypochondrium, often at night;
feeling of fullness and bloating;
refusal to eat;
airy belching with a bitter aftertaste;
nausea.

If the disease is not treated, it can lead to the appearance of stones in the bile.

For hypertension:

pain - short-term acute, paroxysmal, localized in the right hypochondrium;
The sensations are provoked by intense physical activity and abuse of high-calorie foods.

Kink

Such organ defects are accompanied by:

constant nausea;
gagging;
headache;
severe intoxication with sensations similar to poisoning.

Less commonly, the pathological condition is characterized by:

diffuse abdominal pain due to gastrointestinal obstruction;
sensations, as with gastric reflux, when gastric contents are thrown into the throat, oral cavity, and less often - into the nose.

Against the background of pathology, gastric ulcers, pancreatitis, erosive damage to the mucous membranes, and cholelithiasis often develop due to changes in the composition and density of bile. Root causes of excesses:

congenital anomalies;
displacement of internal organs due to excessive physical activity, heavy lifting, pregnancy;
liver enlargement due to cirrhosis, hepatitis.

Multiple bends are additionally accompanied by:

impaired blood supply to internal organs;
sweating;
flatulence;
Gradually intensifying severe, diffuse pain in the side from the gall side.

Such manifestations may indicate the risk of developing a crack in the bladder and leakage of bile into the peritoneum. Diagnosis is carried out using ultrasound.

The result of prolonged cholelithiasis is cancer. Tumors in the gallbladder can appear in late stages:

chronic pain in the right hypochondrium, which is not relieved by conventional antispasmodics;
nausea, vomiting and other dyspeptic disorders;
rapid weight loss.

The insidiousness of the disease is the asymptomatic nature of the early stages, even without the occurrence of jaundice. In 30% of people, the tumor is palpable in the form of a dense, lumpy, practically painless formation, which is located below the rib. The outcome of treatment depends on the timeliness of diagnosis of the pathology. Early detection gives a 100% chance of cure.

How to treat?

Pain in the area of the gallbladder projection and other manifestations can be deciphered by an experienced gastroenterologist. You can learn from him how and for how long to treat the disease, what medications to use, after a full examination and identification of the root causes of discomfort.

Diagnosis is often carried out using ultrasound, which allows you to obtain data on the condition of the organ:

presence of stones, sand;
inflammation;
increase in size;
consistency of bile.

The general course for all types of gallbladder pathologies includes:

The last two points are applied after the exacerbation of the disease has ceased.

Operation

Surgery is a necessary method of improving the condition in such cases:

lack of results from drug treatment and diet therapy;
blockage of the bile duct with a large stone;
detection of a tumor of any nature;
calculous inflammation of the organ, that is, with stones in the bile.

The following techniques are usually used to remove the gallbladder:

classic cavity method;
minimally invasive resection during laparoscopy (cholecystectomy).

What to do with first aid?

If the cause of the pain syndrome is known to the patient, and it is not an ulcer, diverticulitis, or chronic organ pathologies, the pain can be relieved independently, at home. First aid rules:

During an attack of pain in the gallbladder, you need to ensure rest and minimize stress, as well as drink pain relievers prepared in advance.

Ensuring complete rest, that is, nothing can be done, especially lifting weights.
Take medications prescribed by your doctor for such cases.
Drink suitable folk remedies prepared at home. For example, honey syrup with horseradish or birch tincture, which guarantee pain relief within a week.
It is forbidden to take any anti-inflammatory drug on your own, especially with acetylsalicylic acid.
Do not drink coffee, caffeinated drinks, or alcohol.
It is forbidden to do enemas, even with constipation.

If the cause of pain is gallstones, you need to urgently call an ambulance.

Manifestations without knowledge of the root causes, requiring urgent medical intervention:

stabbing pain in the navel with a sharp jump in body temperature, dark urine, yellowness of the mucous membranes, nausea, ending in vomiting;
stabbing pain in the stomach with simultaneous pulling pain in the forearm;
nagging intestinal pain;
a sharp attack of pain spread along the abdominal wall, with intestinal bleeding and vomiting;
severe pain in the liver area, dizziness, increased heart rate, and the appearance of sticky, profuse, cold sweat.

Painkillers are not suitable for such pain. If you take an antispasmodic, the symptoms will blur and it will be more difficult to diagnose the problem.

Important information

If assistance is not provided in a timely manner, pathologies of the bile-forming system can lead to serious consequences, such as:

stagnation due to weak outflow of bile;
infection of bladder contents;
purulent-inflammatory process on the bladder walls;
formation of biliary fistulas;
formation of subhepatic abscesses.

Doctors

If you have pain in the bladder, you should seek advice from the following specialists:

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Gallstones: symptoms and treatment

Gallstones - main symptoms:

Gallstones are formed due to metabolic problems in the body. They are the cause of cholelithiasis. Stones formed in the organ can be located anywhere - both in the bladder itself and in its ducts, and even in the liver, while their shape and size vary from very small (sand) to very large.

The appearance of stones often causes irritation of the organ mucosa, resulting in the development of a disease such as cholecystitis.

Gallstones are formed in the gall bladder mainly from cholesterol crystals, but for the time being they do not bother a person - biliary colic is a consequence of blockage of one of the stones in the ducts.

Most often, women aged forty and older suffer from this pathology. Men, on the other hand, experience the disease 6–8 times less often, but why this happens is not fully understood.

Symptoms

For a long time, gallstones do not make themselves felt and people find out about their presence randomly during an examination or when they begin to move through the ducts and even block them.

The main signs of gallstones depend on the location of the stone - the manifestation of gallstones will be associated with the size and shape of the latter. The symptoms that all patients with gallstones experience are as follows:

pain under the rib on the right side (paroxysmal, stabbing);
nausea;
bitter taste in the mouth;
flatulence and other intestinal problems;
belching air;
development of jaundice.

Sometimes symptoms such as fever and chills are also noted - this can occur when the stone begins to move through the ducts. However, most often, an increase in temperature indicates the addition of an infection and the development of cholecystitis, the symptoms of which are characteristic of the inflammatory process.

Predisposing factors that cause hepatic colic are stress and physical overexertion, eating spicy, fatty and fried foods, and excessive alcohol consumption.

The first symptoms of the disease are a deterioration in general well-being and pain, which, although localized under the ribs on the right side, radiates to other parts of the body. The pain develops due to the fact that the stone in the gallbladder, starting to come out, irritates and stretches the walls of the ducts. Or the pain syndrome may be caused by overstretching of the bladder due to the accumulation of bile in it.

Note that the symptoms in case of blockage of the ducts are as follows: the sclera and skin of a person become yellow, the person feels heaviness on the right side under the ribs, vomiting appears mixed with bile, which does not bring relief. This condition is extremely dangerous, as it can lead to seizures and a critical increase in temperature.

Usually the attack ends after the stone enters the small intestine. To improve the patient's condition, lay him on his right side and apply a heating pad. But sometimes the size of the stone is such that it cannot pass through the ducts and gets stuck in them - in this case, removal of stones from the gallbladder is carried out by surgical extraction.

Causes

Normally, stones should not form in a healthy body. However, there are predisposing factors that influence the disruption of metabolic processes and become the causes of the formation of stones in the gall bladder.

Excessive consumption of foods rich in cholesterol is the main cause of the development of cholelithiasis. From here comes the second predisposing factor - obesity, due to a disturbance in the nutritional process. Also, a disturbance in the composition of bile with the formation of sediment in the form of solid particles, which subsequently form stones, can be caused by such reasons as disturbances in the liver, long-term use of oral contraceptives, and some pathologies of internal organs.

The formation of stones occurs against the background of a decrease in the ability of the gallbladder walls to contract, which, in turn, also depends on completely objective reasons. For example, the reasons for a decrease in contractile function are the presence of pathologies such as dyskinesia, flatulence and others. If operations were performed on the organ, this can also cause a disruption in its performance.

Other reasons are physical inactivity and poor nutrition. And during pregnancy, there may be an additional load on the gallbladder, as a result of which its transport function is disrupted.

Mechanical obstacles to the outflow of bile also cause the appearance of stones. In particular, this can occur with various tumors, in the presence of adhesions and cysts, with severe swelling of the walls of the bladder, and even due to a congenital defect - a bend in the duct.

Gallstone disease can also be caused by reasons such as infections that enter the organ through the bloodstream or lymph flow from other systems of the body. Any infection that penetrates the gallbladder causes its inflammation, after which inflammation of its ducts develops. This leads to the development of cholecystitis and cholangitis, against which cholelithiasis often develops.

Today, doctors distinguish two types of stone formation in this organ:

primary, in which gallstones form over a long period of time and do not make themselves felt for a long time;
secondary, when the formation of stones occurs due to the development of congestion in the gallbladder.

Features of treatment

The diagnosis of cholelithiasis is made based on examination data. Patients are recommended to have an ultrasound of the gallbladder, but if it is difficult to determine the presence and location of stones on ultrasound, cholecystography or retrograde cholangiopancreatography is performed.

Treatment of pathology directly depends on the size and number of stones in the organ and their location. It can be either conservative or surgical. Timely conservative treatment makes it possible to preserve the integrity of the organ and ducts and consists of such procedures as:

dissolution of stones by taking certain medications;
crushing using ultrasound.

Also in some cases, percutaneous cholelitholysis and laparoscopy are indicated - minimally invasive methods for removing stones. Sometimes treatment involves surgery - cholecystectomy. Diet for gallstones also plays an important role. Treatment with traditional methods has also proven itself well.

Drug treatment consists of treatment with drugs such as Henofalk and Ursosan - they allow you to dissolve stones and painlessly remove them from the body.

Drug treatment is indicated only in cases where the stones are small in size and when the functioning of the organ itself is not impaired. A method such as crushing gallstones using ultrasound or laser can be used when large stones need to be broken into small pieces that can independently move through the bile ducts into the intestines. It usually takes several sessions to destroy the stones, but this method is used in cases where a person has several large stones in the gallbladder that cannot be dissolved by taking medications.

Percutaneous cholelitholysis is rarely used and the procedure involves administering a substance that dissolves stones through a special catheter. Much more often, stones are removed from the gallbladder through small incisions (laparoscopy).

The most common operation for patients with cholelithiasis is cholecystectomy, which involves a large-scale operation to remove the organ. This procedure should be used in cases where other methods are unable to solve the problem, or when the entire organ is filled with large stones.

Treatment of this pathology is also associated with the need to adhere to a certain diet. The diet for gallstones includes the following recommendations:

eat food up to six times a day in small portions;
increase consumption of foods rich in magnesium;
increase the amount of animal protein in your diet.

In addition, the diet for gallstones recommends completely avoiding foods such as sausages and smoked meats, pickles and preserves, legumes and butter, and also eliminating some vegetables (cucumbers, eggplants, radishes). It is not recommended to consume coffee, alcohol and organ meats.

The diet for gallstones allows you to eat fish and white meat, cereals (oatmeal and buckwheat are especially useful), cottage cheese and low-fat milk, fruits and vegetables that do not irritate the gastrointestinal mucosa, as well as drink mineral water and natural juices.

Traditional medicine methods

This disease is also treated with folk remedies. In particular, the dissolution of stones is carried out by drinking a glass of hot water with the juice of one lemon squeezed into it. In this case, slow dissolution occurs, so you need to use this recipe for a long time.

Other juice mixtures are also used for a long time:

carrots, cucumbers and beets;
carrots, celery and parsley juice.

There are other folk remedies to get rid of the disease. For example, you can treat an illness with raisins, which are mixed with holosas and Borjomi mineral water. Or tincture of pine nuts.

Note that using folk remedies you can remove stones from the gallbladder that are small in size, provided that there are only a few of them. It is dangerous to “expel” large stones, as this can lead not only to blockage of the ducts, but also to their rupture.

If you think that you have gallstones and symptoms characteristic of this disease, then doctors can help you: a therapist, a gastroenterologist.

We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.

Jaundice is a pathological process, the formation of which is influenced by a high concentration of bilirubin in the blood. The disease can be diagnosed in both adults and children. Any disease can cause such a pathological condition, and they are all completely different.

Reactive hepatitis is a pathological process that leads to dystrophic-inflammatory processes in the liver. Most often, this disease develops against the background of gastroenterological ailments of a chronic nature, systemic and other diseases. It should be noted that nonspecific reactive hepatitis, unlike viral, toxic and other forms of this disease, is highly treatable.

Drug-induced hepatitis is an inflammatory process in the liver provoked by certain medications. If treatment of the disease is not started in a timely manner, then the onset of necrotic processes in the affected organ and cirrhosis is quite possible. In advanced stages, death is no exception. According to statistics, drug-induced hepatitis is diagnosed three times more often in women than in men. This circumstance has no scientific explanation yet.

Cholecystitis is an inflammatory disease that occurs in the gallbladder and is accompanied by severe symptoms. Cholecystitis, the symptoms of which occur, as well as the disease itself, occurs in about 20% of adults, can occur in acute or chronic form.

Ischemic colitis is a disease characterized by ischemia (blood circulation disorders) of the vessels of the large intestine. As a result of the development of pathology, the affected segment of the intestine does not receive the required amount of blood, so its functions are gradually impaired.

With the help of exercise and abstinence, most people can do without medicine.

Symptoms and treatment of human diseases

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Questions and suggestions:

Chronic calculous cholecystitis is a disease in which stones form in the cavity of the gallbladder, which subsequently cause inflammation of the walls of the bladder.

Cholelithiasis It is a common disease and occurs in 10-15% of the adult population. In women, this disease occurs 2-3 times more often than in men. Cholecystitis is an ancient human disease. The first gallstones were discovered during the study of Egyptian mummies.

Anatomy and physiology of the gallbladder

The gallbladder is a hollow, pear-shaped organ. The gallbladder is projected approximately in the middle of the right hypochondrium.

The length of the gallbladder is from 5 to 14 centimeters, and the capacity is 30-70 milliliters. The bladder has a bottom, body and neck.

The wall of the gallbladder consists of mucous, muscular, and connective tissue membranes. The mucosa consists of epithelium and various glandular cells. The muscular layer consists of smooth muscle fibers. At the cervix, the mucous and muscular membranes form a sphincter, which prevents the release of bile at inappropriate times.

The bladder neck continues into the cystic duct, which then merges with the common hepatic duct to form the common bile duct.
The gallbladder is located on the lower surface of the liver so that the wide end of the bladder (bottom) extends somewhat beyond the lower edge of the liver.

The function of the gallbladder is the accumulation, concentration of bile and release of bile as needed.
The liver produces bile and when it is not needed, the bile accumulates in the gallbladder.
Once bile enters the bladder, it is concentrated by absorption of excess water and microelements by the epithelium of the bladder.

Bile secretion occurs after eating. The muscle layer of the bladder contracts, increasing the pressure in the gallbladder to 200-300 mm. water column. Under the influence of pressure, the sphincter relaxes, and bile enters the cystic duct. The bile then enters the common bile duct, which opens into the duodenum.

The role of bile in digestion

Bile in the duodenum creates the necessary conditions for the activity of enzymes found in pancreatic juice. Bile dissolves fats, which promotes further absorption of these fats. Bile is involved in the absorption of vitamins D, E, K, A in the small intestine. Bile also stimulates the secretion of pancreatic juice.

Causes of development of chronic calculous cholecystitis

The main reason for the appearance of calculous cholecystitis is the formation of stones.
There are many factors that lead to the formation of gallstones. These factors are divided into: unchangeable (those that cannot be influenced) and those that can be changed.

Constant factors:

Floor. Most often, women get sick due to taking contraceptives, childbirth (estrogens, which are increased during pregnancy, increase the absorption of cholesterol from the intestines and its abundant excretion in the bile).
Age. People aged 50 to 60 years are more likely to suffer from cholecystitis.
Genetic factors. These include family predisposition and various congenital anomalies of the gallbladder.
Ethnic factor. The largest number of cases of cholecystitis is observed among Indians living in the southwestern United States and among the Japanese.

Factors that can be influenced.

Nutrition . Increased consumption of animal fats and sweets, as well as hunger and rapid weight loss can cause cholecystitis.
Obesity. The amount of cholesterol in the blood and bile increases, which leads to the formation of stones
Diseases of the gastrointestinal tract. Crohn's disease, resection (removal) of part of the small intestine
Medications. Estrogens, contraceptives, diuretics (diuretics) - increase the risk of cholecystitis.
Physical inactivity (immobile, sedentary lifestyle)
Decreased muscle tone of the gallbladder

How are stones formed?

Stones can be made from cholesterol, from bile pigments, or mixed.
The process of formation of cholesterol stones can be divided into 2 phases:

First phase– violation of the ratio of cholesterol and solvents (bile acids, phospholipids) in bile.
In this phase, the amount of cholesterol increases and the amount of bile acids decreases.

Increased cholesterol occurs due to disruption of various enzymes.
- decreased hydroxylase activity (affects cholesterol reduction)
- decreased acetyl transferase activity (converts cholesterol into other substances)
- increased breakdown of fats from the fat layer of the body (increases the amount of cholesterol in the blood).

The decrease in fatty acids occurs for the following reasons.
- Disorders of fatty acid synthesis in the liver
- Increased secretion of bile acids from the body (impaired absorption of fatty acids in the intestine)
- Impaired intrahepatic circulation

Second phase – bile saturated with cholesterol forms bile stasis (stagnation of bile in the bladder), then the process of crystallization occurs - forming crystals of cholesterol monohydrate. These crystals stick together and form stones of varying sizes and composition.
Stones consisting of cholesterol can be single or multiple, usually round or oval in shape. The color of these stones is yellow-green. The sizes of the stones vary from 1 millimeter to 3-4 centimeters.

Bile stones are formed due to an increase in the amount of unbound, water-insoluble bilirubin. These stones are composed of various polymers of bilirubin and calcium salts.
Pigment stones are usually small in size, up to 10 millimeters. Usually there are several pieces in a bubble. These stones are black or gray.

Most often (80-82% of cases) mixed stones are found. They consist of cholesterol, bilirubin and calcium salts. The stones are always multiple in number and yellow-brown in color.

Symptoms of gallstone disease

In 70-80% of cases, chronic calculous cholecystitis develops asymptomatically over several years. The discovery of stones in the gall bladder in these cases occurs by accident - during an ultrasound performed for other diseases.

Symptoms appear only if the stone moves along the cystic canal, which leads to its blockage and inflammation.

Depending on the stage of cholelithiasis, the symptoms presented in the next section of the article are also highlighted.

Clinical stages of cholelithiasis

1. Stage of violation of the physicochemical properties of bile.
At this stage there are no clinical symptoms. The diagnosis can only be made by examining bile. Cholesterol “snowflakes” (crystals) are found in bile. Biochemical analysis of bile shows an increase in cholesterol concentration and a decrease in the amount of bile acids.

2. Latent stage.
At this stage, the patient does not have any complaints. There are already stones in the gallbladder. The diagnosis can be made using ultrasound.

3. Stage of onset of symptoms of the disease.
- Biliary colic is a very severe, paroxysmal and acute pain that lasts from 2 to 6 hours, sometimes more. Attacks of pain usually appear in the evening or at night.

The pain is in the right hypochondrium and spreads to the right shoulder blade and right cervical region. Pain most often appears after a rich, fatty meal or after heavy physical activity.

Products that may cause pain after consumption:

Cream
Alcohol
Cakes
Carbonated drinks

Other symptoms of the disease:

Increased sweating
Chills
Increase in body temperature to 38 degrees Celsius
Vomiting of bile that does not bring relief

4. Stage of development of complications

At this stage, complications develop such as:
Acute cholecystitis– this disease requires immediate surgical intervention.

Hydrocele of the gallbladder. The cystic duct is blocked by a stone or narrowed to the point of complete blockage of the duct. The release of bile from the bladder stops. Bile from the bladder is absorbed through the walls, and a serous-mucosal secretion is released into its lumen.
Gradually accumulating, the secretion stretches the walls of the gallbladder, sometimes to enormous sizes.

Perforation or rupture of the gallbladder leads to the development of biliary peritonitis (inflammation of the peritoneum).

Liver abscess. Limited accumulation of pus in the liver. An abscess forms after a section of the liver is destroyed. Symptoms: high temperature up to 40 degrees, intoxication, enlarged liver.
This disease can only be treated surgically.

Gallbladder cancer. Chronic calculous cholecystitis greatly increases the risk of cancer.

Diagnosis of cholelithiasis

In case of the above mentioned symptoms, you should consult a gastroenterologist or therapist.

Conversation with a doctor
The doctor will ask you about your complaints. Reveals the causes of the disease. He will dwell in particular detail on nutrition (after taking what foods do you feel unwell?). Next, he will enter all the data into the medical record and then begin the examination.

Inspection
The examination always begins with a visual examination of the patient. If the patient complains of severe pain at the time of examination, then his face will express suffering.

The patient will be in a supine position with legs bent and brought to the stomach. This is a forced position (reduces pain). I would also like to note a very important sign: when the patient turns onto his left side, the pain intensifies.

Palpation (palpation of the abdomen)
On superficial palpation, flatulence (bloating) of the abdomen is determined. Increased sensitivity in the right hypochondrium is also determined. Possible muscle tension in the abdominal area.

With deep palpation, an enlarged gallbladder can be determined (normally, the gallbladder cannot be palpated). Also, with deep palpation, specific symptoms are determined.
1. Murphy's symptom - the appearance of pain during inspiration at the moment of palpating the right hypochondrium.

2. Ortner’s symptom – the appearance of pain in the right hypochondrium when tapping (percussion) on the right costal arch.

Ultrasound of the liver and gallbladder
Ultrasonography clearly identifies the presence of stones in the gall bladder.

Signs of the presence of stones on ultrasound:
1. Presence of hard structures in the gallbladder
2. Mobility (movement) of stones
3. Ultrasonographic hypoechoic (visible in the picture as a white space) trace below the stone
4. Thickening of the gallbladder walls more than 4 millimeters

Abdominal x-ray
Stones containing calcium salts are clearly visible

Cholecystography– a study using contrast to better visualize the gallbladder.

CT scan– carried out in the diagnosis of cholecystitis and other diseases

Endoscopic cholangiopancreatography- used to determine the location of the stone in the common bile duct.

The course of chronic calculous cholecystitis
The asymptomatic form of cholecystitis lasts a long time. From the moment gallstones are identified, within 5-6 years, only 10-20% of patients begin to develop symptoms (complaints).
The appearance of any complications indicates an unfavorable course of the disease. In addition, many complications can only be treated surgically.

Treatment of cholelithiasis

Stages of treatment:
1. Prevent stone movement and related complications
2. Litholytic (crushing stones) therapy
3. Treatment of metabolic (metabolic) disorders

In the asymptomatic stage of chronic cholecystitis, the main treatment method is diet.

Diet for gallstone disease

Meals should be divided, in small portions 5-6 times a day. The food temperature should be - if cold dishes are not lower than 15 degrees, and if hot dishes are not higher than 62 degrees Celsius.

Prohibited products:

Alcoholic drinks
- legumes, in any form of preparation
- dairy products with high fat content (cream, full-fat milk)
- any fried foods
- meat from fatty varieties (goose, duck, pork, lamb), lard
- fatty fish, salted, smoked fish, caviar
- any types of canned food
- mushrooms
- fresh bread (especially hot bread), croutons
- spices, herbs, salinities, pickled foods
- coffee, chocolate, cocoa, strong tea
- salty, hard and fatty types of cheese

Cheeses can be consumed, but low-fat

Vegetables should be consumed boiled or baked (potatoes, carrots). You can eat finely chopped cabbage, ripe cucumbers, and tomatoes. Use green onions, parsley as an addition to dishes

Meat from low-fat varieties (beef, veal, rabbit), as well as (chicken and turkey without skin). Meat should be consumed boiled or baked. It is also recommended to use chopped meat (cutlets)

Vermicelli and pasta are allowed

Sweet ripe fruits and berries, as well as various jams and preserves

Drinks: not strong tea, not sour juices, various mousses, compotes

Butter (30 grams) for dishes

Low-fat types of fish are allowed (pike perch, cod, pike, bream, perch, hake). It is recommended to use fish boiled, in the form of cutlets, aspic

You can use whole milk. You can also add milk to various cereals.
Non-sour cottage cheese and non-sour low-fat yoghurts are allowed

Effective treatment of cholecystitis when symptoms are present is possible only in a hospital setting!

Drug treatment of biliary colic (pain symptom)

Typically, treatment begins with M-anticholinergics (to reduce spasms) - atropine (0.1% -1 milliliter intramuscularly) or Platifilin - 2% -1 milliliter intramuscularly

If anticholinergics do not help, antispasmodics are used:
Papaverine 2% - 2 milliliters intramuscularly or Drotaverine (Noshpa) 2% -2 milliliters.

Baralgin 5 milliliters intramuscularly or Pentalgin also 5 milliliters are used as painkillers.
In case of very severe pain, use Promedol 2% - 1 ml.

Conditions under which the effect of treatment will be maximum:
1. stones containing cholesterol
2. smaller in size than 5 millimeters
3. the age of the stones is no more than 3 years
4. no obesity
They use drugs such as Ursofalk or Ursosan - 8-13 mg per kilogram of body weight per day.
The course of treatment should be continued for 6 months to 2 years.

Direct stone breaking method
The method is based on direct injection of a strong stone dissolver into the gallbladder.

Extracorporeal shock wave lithotripsy- crushing stones using the energy of shock waves created outside the human body.

This method is carried out using various devices that produce different types of waves. For example, waves created by a laser, an electromagnetic device, or a device that produces ultrasound.

Any of the devices is installed in the projection of the gallbladder, then waves from various sources affect the stones and they are crushed into small crystals.

These crystals are then freely released along with bile into the duodenum.
This method is used when the stones are no larger than 1 centimeter and when the gallbladder is still functioning.
In other cases, if symptoms of cholecystitis are present, surgery to remove the gallbladder is recommended.

Surgical removal of the gallbladder

There are two main types of cholecystectomy (removal of the gallbladder):
1. Standard cholecystectomy
2. Laparoscopic cholecystectomy

The first type has been used for a long time. The standard method is based on abdominal surgery (with an open abdominal cavity). Recently, it has been used less and less due to frequent postoperative complications.

The laparoscopic method is based on the use of a laparoscope apparatus. This device consists of several parts:
- video cameras with high magnification ability
- different types of tools
Advantages of method 2 over the first:
1. Laparoscopic surgery does not require large incisions. The incisions are made in several places and are very small.
2. The seams are cosmetic, so they are practically invisible
3. Performance is restored 3 times faster
4. The number of complications is ten times less

Prevention of gallstone disease

Primary prevention is to prevent the formation of stones. The main method of prevention is exercise, diet, avoiding alcohol consumption, avoiding smoking, and losing weight if you are overweight.

Secondary prevention consists of preventing complications. The main method of prevention is the effective treatment of chronic cholecystitis described above.

Why is gallstone disease dangerous?

Gallstone disease or calculous cholecystitis is the formation of stones in the gall bladder. This often causes severe inflammation and leads to serious symptoms. First of all, the disease manifests itself in severe pain, impaired flow of bile from the gallbladder, and digestive disorders. Treatment of cholelithiasis is usually classified as surgical. This is explained by the fact that the inflammatory process caused by the movement of stones poses a serious threat to the health and life of patients. That is why the problem is usually solved in the fastest way - removing the gallbladder along with the stones.

Gallstone disease is dangerous primarily due to the following complications:

Thus, cholelithiasis requires a very serious attitude. In the absence of timely diagnosis and treatment, it can significantly harm the patient’s health, and sometimes even threaten his life. To increase the chances of a successful recovery, the first symptoms of calculous cholecystitis should not be ignored. Early consultation with a doctor often helps to detect stones when they have not yet reached significant size. In this case, the likelihood of complications is lower and you may not have to resort to surgical treatment to remove the gallbladder. However, if necessary, you still need to agree to the operation. Only the attending physician can adequately assess the situation and choose the most effective and safe method of treatment.

Is it possible to cure calculous cholecystitis without surgery?

Currently, surgery remains the most effective and justified method of treating calculous cholecystitis. When stones form in the gall bladder, as a rule, an inflammatory process develops, which not only disrupts the functioning of the organ, but also poses a threat to the body as a whole. Surgery to remove the gallbladder along with stones is the most appropriate treatment option. In the absence of complications, the risk to the patient remains minimal. The organ itself is usually removed endoscopically ( without incision of the anterior abdominal wall, through small holes).

The main advantages of surgical treatment of calculous cholecystitis are:

Radical solution to the problem. Removing the gallbladder guarantees the cessation of pain ( biliary colic), since colic appears due to contractions of the muscles of this organ. In addition, there is no threat of relapse ( repeated exacerbations) cholelithiasis. Bile will no longer be able to accumulate in the bladder, stagnate and form stones. It will flow directly from the liver to the duodenum.
Patient safety. Nowadays, endoscopic removal of the gallbladder ( cholecystectomy) is a routine operation. The risk of complications during surgery is minimal. If all rules of asepsis and antisepsis are observed, postoperative complications are also unlikely. The patient recovers quickly and can be discharged ( in consultation with the attending physician) just a few days after the operation. After a few months, he can lead a very normal lifestyle, apart from a special diet.
Possibility of treating complications. Many patients turn to the doctor too late, when complications of calculous cholecystitis begin to appear. Then surgical treatment is simply necessary to remove pus, examine neighboring organs, and adequately assess the risk to life.

However, the operation also has its disadvantages. Many patients are simply afraid of anesthesia and surgery. In addition, any operation is stressful. There is a risk ( albeit minimal) postoperative complications, due to which the patient has to stay in the hospital for several weeks. The main disadvantage of cholecystectomy is the removal of the organ itself. After this operation, bile no longer accumulates in the liver. It continuously enters the duodenum in small quantities. The body loses the ability to regulate the flow of bile in certain portions. Because of this, you have to follow a diet without fatty foods for the rest of your life ( There is not enough bile to emulsify fats).

Nowadays, there are several methods of non-surgical treatment of calculous cholecystitis. This is not about symptomatic treatment ( relieving muscle spasms, eliminating pain syndrome), namely about getting rid of stones inside the gallbladder. The main advantage of these methods is the preservation of the organ itself. If the result is successful, the gallbladder is freed from stones and continues to perform its functions of accumulating and dispensing bile.

There are three main methods of non-surgical treatment of calculous cholecystitis:

Drug dissolution of stones. This method is perhaps the safest for the patient. The patient must take drugs based on ursodeoxycholic acid for a long time. It helps dissolve stones containing bile acids. The problem is that even to dissolve small stones, you need to take the medicine regularly for several months. If we are talking about larger stones, the course may take 1–2 years. However, there is no guarantee that the stones will dissolve completely. Depending on individual metabolic characteristics, they may contain impurities that will not dissolve. As a result, the stones will decrease in size and the symptoms of the disease will disappear. However, this effect will be temporary.
Ultrasonic stone crushing. These days, crushing stones using ultrasonic waves is a fairly common practice. The procedure is safe for the patient and easy to perform. The problem is that the stones are crushed into sharp fragments, which still cannot leave the gallbladder without injuring it. In addition, the problem of bile stagnation is not solved radically, and after a while ( usually several years) stones may form again.
Laser stone removal. It is used quite rarely due to its high cost and relatively low efficiency. The stones also undergo a kind of crushing and fall apart. However, even these parts can injure the mucous membrane of the organ. In addition, the risk of relapse is high ( re-formation of stones). Then the procedure will have to be repeated.

Thus, non-surgical treatment of calculous cholecystitis exists. However, it is used mainly for small stones, as well as for the treatment of patients for whom it is dangerous to operate ( due to concomitant diseases). In addition, none of the non-surgical methods of stone removal are recommended for acute cases. Concomitant inflammation requires surgical treatment of the area with examination of neighboring organs. This will avoid complications. If intense inflammation has already begun, crushing the stones alone will not solve the problem. Therefore, all non-surgical methods are used mainly for the treatment of patients with stones ( chronic course of the disease).

When is surgery needed for gallstone disease?

Gallstone disease or calculous cholecystitis in the vast majority of cases at a certain stage of the disease requires surgical treatment. This is explained by the fact that stones that form in the gallbladder are usually detected only during severe inflammation. This process is called acute cholecystitis. The patient experiences severe pain in the right hypochondrium ( colic), which worsen after eating. Your temperature may also rise. In the acute stage, there is a possibility of serious complications, so they try to solve the problem radically and quickly. This solution is cholecystectomy - surgery to remove the gallbladder.

Cholecystectomy involves complete removal of the bladder along with the stones it contains. In an uncomplicated course of the disease, it guarantees a solution to the problem, since the bile formed in the liver will no longer accumulate and stagnate. The pigments simply will not be able to form stones again.

There are quite a few indications for cholecystectomy. They are divided into absolute and relative. Absolute indications are those without which serious complications can develop. Thus, if surgery is not performed when there is an absolute indication, the patient's life will be at risk. In this regard, doctors in such situations always try to convince the patient of the need for surgical intervention. There are no other treatments or they will take too long, increasing the risk of complications.

The absolute indications for cholecystectomy for cholelithiasis are:

A large number of stones. If there are stones in the gall bladder ( regardless of their number and size) occupy more than 33% of the organ volume, cholecystectomy should be performed. It is almost impossible to crush or dissolve such a large number of stones. At the same time, the organ does not work, since the walls are greatly stretched, do not contract well, stones periodically clog the cervical area and interfere with the outflow of bile.
Frequent colic. Attacks of pain due to gallstone disease can be very intense. They are relieved with antispasmodic drugs. However, frequent colic indicates that drug treatment is not successful. In this case, it is better to resort to removing the gallbladder, regardless of how many stones there are and what size they are.
Stones in the bile duct. When the bile ducts are blocked by a stone from the gallbladder, the patient's condition greatly worsens. The outflow of bile stops completely, the pain intensifies, obstructive jaundice develops ( due to the free fraction of bilirubin).
Biliary pancreatitis. Pancreatitis is inflammation of the pancreas. This organ shares an excretory duct with the gallbladder. In some cases, with calculous cholecystitis, the outflow of pancreatic juice is disrupted. Tissue destruction during pancreatitis threatens the patient's life, so the problem must be urgently solved through surgery.

Unlike absolute indications, relative indications suggest that there are other treatment methods in addition to surgery. For example, in the chronic course of cholelithiasis, stones may not bother the patient for a long time. He does not have colic or jaundice, as happens in acute cases of the disease. However, doctors believe that the disease may worsen in the future. The patient will be offered to undergo surgery as planned, but this will be a relative indication, since at the time of the operation he has practically no complaints and no inflammatory process.

Special mention should be made of surgical treatment of complications of acute cholecystitis. In this case we are talking about the spread of the inflammatory process. Problems with the gallbladder also affect the functioning of neighboring organs. In such situations, the operation will include not only the removal of the gallbladder with stones, but also the solution of the problems resulting from this.

Surgical treatment may also be required for the following complications of gallstone disease:

In addition to the stage of the disease, its form and the presence of complications, concomitant diseases and age play an important role in the choice of treatment. In some cases, patients are contraindicated for drug treatment ( intolerance to pharmacological drugs). Then surgical treatment will be a reasonable solution to the problem. Elderly patients with chronic diseases ( heart failure, kidney failure, etc.) may simply not be able to endure the operation, so in such cases, surgical treatment, on the contrary, is tried to be avoided. Thus, the treatment strategy for gallstone disease may vary in different situations. Only the attending physician can clearly determine whether a patient needs surgery after a full examination.

How to treat cholelithiasis with folk remedies?

In the treatment of cholelithiasis, folk remedies are ineffective. The fact is that with this disease, stones begin to form in the gallbladder ( usually crystals containing bilirubin). It is almost impossible to dissolve these stones using traditional methods. To split or crush them, powerful pharmacological drugs or ultrasonic waves are used, respectively. However, folk remedies play a role in the treatment of patients with gallstone disease.

Possible effects of medicinal plants for gallstone disease are:

Smooth muscle relaxation. Some medicinal plants relax the muscular sphincter of the gallbladder and the smooth muscles of its walls. Thanks to this, attacks of pain are relieved ( usually caused by spasm).
Decreased bilirubin levels. Increased levels of bilirubin in bile ( especially with prolonged stagnation) may promote stone formation.
Outflow of bile. Due to the relaxation of the sphincter of the gallbladder, bile flows out. It does not stagnate, and crystals and stones do not have time to form in the bubble.

Thus, the effect of using folk remedies will be predominantly preventive. Patients with liver problems or other factors predisposing to gallstone disease will benefit from periodic treatment. This will slow down the formation of stones and prevent the problem before it occurs.

To prevent gallstone disease, you can use the following folk remedies:

Radish juice. Black radish juice is diluted with honey in equal proportions. You can also cut a cavity in the radish and pour honey into it for 10–15 hours. After this, the mixture of juice and honey is consumed 1 tablespoon 1 - 2 times a day.
Barberry leaves. Green barberry leaves are thoroughly washed with running water and filled with alcohol. For 20 g of crushed leaves, 100 ml of alcohol is needed. Infusion lasts 5 – 7 hours. After this, drink 1 teaspoon of the tincture 3-4 times a day. The course lasts 1 – 2 months. After six months it can be repeated.
Rowan infusion. 30 g of rowan berries are poured into 500 ml of boiling water. Leave for 1 – 2 hours ( until the temperature drops to room temperature). Then the infusion is taken half a glass 2 - 3 times a day.
Mumiyo. Shilajit can be taken both to prevent the formation of stones and for cholelithiasis ( if the diameter of the stones does not exceed 5 - 7 mm). It is diluted in a ratio of 1 to 1000 ( 1 g mummy per 1 liter of warm water). Before meals, drink 1 glass of solution, three times a day. This product can be used for no more than 8 - 10 days in a row, after which you need to take a break of 5 - 7 days.
Mint with celandine. Equal proportions of dry leaves of these herbs are consumed as an infusion. For 2 tablespoons of the mixture you need 1 liter of boiling water. Infusion lasts 4 – 5 hours. After this, the infusion is consumed 1 glass per day. Sediment ( grass) filtered before use. It is not recommended to store the infusion for more than 3 - 4 days.
Snake knotweed. To prepare the decoction, you need to pour 2 tablespoons of dry crushed rhizomes into 1 liter of boiling water and cook for 10 - 15 minutes over low heat. 10 minutes after turning off the heat, strain the broth and allow it to cool ( usually 3 – 4 hours). The decoction is taken 2 tablespoons half an hour before meals, twice a day.

A common method of preventing gallstone disease is blind probing, which can be performed at home. This procedure is also used in medical institutions. Its purpose is to empty the gallbladder and prevent bile stagnation. People with gallstones ( detected by ultrasound examination) blind probing is contraindicated, as this will lead to stone entry into the bile duct and can seriously worsen the general condition.

To prevent bile stagnation using blind probing, you can use pharmacological drugs or some natural mineral waters. Water or medicine should be drunk on an empty stomach, after which the patient lies on the right side, placing it under the right hypochondrium ( to the area of the liver and gallbladder) warm heating pad. You need to lie down for 1 – 2 hours. During this time, the sphincter will relax, the bile duct will expand, and bile will gradually flow into the intestines. The success of the procedure is indicated by dark stool with an unpleasant odor after a few hours. It is advisable to consult with your doctor about the methodology for conducting blind probing and its advisability in each specific case. After the procedure, you need to follow a low-fat diet for several days.

Thus, folk remedies can successfully prevent the formation of gallstones. In this case, regularity of treatment courses is important. It is also advisable to undergo preventive examinations with a doctor. This will help detect small stones ( using ultrasound) in case traditional methods do not help. After the formation of stones, the effectiveness of traditional medicine is greatly reduced.

What are the first signs of gallstone disease?

Gallstone disease can proceed secretly for a long time, without manifesting itself in any way. During this period, the patient’s body experiences stagnation of bile in the gallbladder and gradual formation of stones. Stones are formed from pigments contained in bile ( bilirubin and others), and resemble crystals. The longer the bile stagnates, the faster such crystals grow. At a certain stage, they begin to injure the inner lining of the organ, interfere with the normal contraction of its walls and interfere with the normal outflow of bile. From this moment on, the patient begins to experience certain problems.

Typically, gallstone disease first manifests itself as follows:

From the moment stones begin to form until the first signs of illness, quite a long time usually passes. According to some studies, the asymptomatic period lasts on average 10–12 years. If there is a predisposition to the formation of stones, it can be reduced to several years. In some patients, stones form slowly and grow throughout life, but do not reach the stage of clinical manifestations. Such stones are sometimes discovered at autopsy after the death of a patient for other reasons.

It is usually difficult to make a correct diagnosis based on the first symptoms and manifestations of gallstone disease. Nausea, vomiting and digestive disorders can also occur with disorders in other organs of the digestive system. To clarify the diagnosis, an ultrasound is prescribed ( ultrasonography) abdominal cavity. It allows you to detect a characteristic enlargement of the gallbladder, as well as the presence of stones in its cavity.

Is it possible to treat calculous cholecystitis at home?

Where calculous cholecystitis will be treated depends entirely on the patient’s condition. Patients with acute forms of the disease are usually subject to hospitalization, but there may be other indications. At home, cholelithiasis can be treated with medication if it is chronic. In other words, a patient with gallstones does not need urgent hospitalization unless he has severe pain, fever, or other signs of inflammation. However, sooner or later the question arises of surgically eliminating the problem. Then, of course, you need to go to the hospital.

In general, it is recommended to hospitalize a patient in the following cases:

Thus, hospitalization at a certain stage of the disease is necessary for almost all patients with cholelithiasis. Not everyone has it associated with surgery. Sometimes this is a preventative course of treatment or diagnostic procedures performed to monitor the progress of the disease. The duration of hospitalization depends on its goals. Examination of a patient with gallstones discovered for the first time usually takes 1–2 days. Prophylactic drug treatment or surgery depends on the presence of complications. Hospitalization can last from several days to several weeks.

At home, the disease can be treated under the following conditions:

chronic course of cholelithiasis ( no acute symptoms);
finally formulated diagnosis;
strict adherence to the instructions of the specialist ( regarding prevention and treatment);
the need for long-term drug treatment ( for example, non-surgical stone dissolution can last 6 – 18 months);
possibility of caring for the patient at home.

Thus, the possibility of treatment at home depends on many different factors. The advisability of hospitalization in each specific case is determined by the attending physician.

Is it possible to exercise if you have gallstone disease?

Gallstone disease or calculous cholecystitis is a fairly serious disease, the treatment of which must be taken very seriously. The formation of gallstones may not cause noticeable symptoms at first. Therefore, some patients, even after accidentally discovering a problem ( during a preventive ultrasound examination) continue to lead their usual lives, neglecting the regime prescribed by the doctor. In some cases, this can lead to accelerated progression of the disease and deterioration of the patient's condition.

One of the important conditions of the preventive regimen is limiting physical activity. This is necessary after the discovery of stones, during the acute stage of the disease, as well as during treatment. At the same time, we are talking not only about professional athletes, whose training requires every effort, but also about everyday physical activity. At each stage of the disease, they can affect the development of events differently.

The main reasons for limiting physical activity are:

Thus, sports are most often contraindicated in patients with cholecystitis. However, moderate physical activity is necessary in certain cases. For example, to prevent the formation of stones, you should do gymnastics and take short walks at a moderate pace. This promotes normal contractions of the gallbladder and prevents bile from stagnating. As a result, even if the patient has a predisposition to form stones, this process slows down.

daily walks of 30–60 minutes at an average pace;
gymnastic exercises without sudden movements and limiting the load on the abdominal muscles;
swimming ( not for speed) without diving to great depths.

These types of loads are used to prevent the formation of stones, as well as restore muscle tone after surgery ( then they start after 1 – 2 months). If we are talking about professional sports with heavy loads ( weightlifting, sprinting, jumping, etc.), then they are contraindicated in all patients with cholelithiasis. After surgery, full-fledged training should begin no earlier than 4 to 6 months, when the incision sites have healed well and strong connective tissue has formed.

Is pregnancy dangerous if you have gallstone disease?

Gallstone disease in pregnant women is a fairly common occurrence in medical practice. On the one hand, this disease is typical for older women. However, it is during pregnancy that quite a few prerequisites arise for the appearance of gallstones. Most often it occurs in patients with a hereditary predisposition or chronic liver diseases. According to statistics, exacerbation of gallstone disease usually occurs in the third trimester of pregnancy.

The prevalence of this problem during pregnancy is explained as follows:

Metabolic changes. As a result of hormonal changes, the metabolism in the body also changes. This can lead to accelerated stone formation.
Motor changes. Normally, the gallbladder stores bile and contracts, releasing it in small portions. During pregnancy, the rhythm and strength of its contractions are disrupted ( dyskinesia). As a result, bile stagnation may develop, which contributes to the formation of stones.
Increased intra-abdominal pressure. If a woman already had small gallstones, the growth of the fetus may cause them to move. This is especially true in the third trimester, when the growing fetus pushes the stomach, colon and gall bladder upward. These organs are compressed. As a result, the stones located near the bottom of the bubble ( at the top of it), can get into the bile duct and block it. This will lead to the development of acute cholecystitis.
Sedentary lifestyle. Pregnant women often neglect walks or basic physical exercises, which also contribute to the normal functioning of the gallbladder. This leads to stagnation of bile and accelerated formation of stones.
Changing your diet. Changing food preferences can affect the composition of the microflora in the intestines and worsen the motility of the bile ducts. If the woman had latent ( asymptomatic) form of cholelithiasis, the risk of exacerbation increases greatly.

Unlike other patients with this disease, pregnant women are at much greater risk. Any complication of the disease is fraught with problems not only for the mother’s body, but also for the developing fetus. Therefore, all cases of exacerbation of cholecystitis during pregnancy are regarded as urgent. Patients are hospitalized to confirm the diagnosis and thoroughly assess their general condition.

Exacerbation of gallstone disease during pregnancy is especially dangerous for the following reasons:

high risk of rupture due to increased intra-abdominal pressure;
high risk of infectious complications ( including purulent processes) due to weakened immunity;
fetal intoxication due to an inflammatory process;
Fetal nutritional disorders due to poor digestion ( food is digested worse, since bile does not enter the duodenum);
limited treatment options ( not all drugs and treatment methods that are usually used for gallstone disease are suitable for pregnant women).

If you consult a doctor in a timely manner, serious complications can usually be avoided. The functioning of the gallbladder and its diseases do not directly affect the reproductive system. Patients are usually hospitalized and, if necessary, undergo cholecystectomy - removal of the gallbladder. In this case, preference is given to minimally invasive ( endoscopic) methods. There are peculiarities in the surgical technique and methods of pain relief.

In the absence of complications of cholelithiasis, the prognosis for mother and child remains favorable. If the patient turned to a specialist too late, and the inflammatory process began to spread in the abdominal cavity, the question of removing the fetus by cesarean section may be raised. The prognosis is somewhat worse, since we are talking about a technically complex surgical intervention. It is necessary to remove the gallbladder, extract the fetus, and carefully examine the abdominal cavity to prevent the development of peritonitis.

What are the types of calculous cholecystitis?

Calculous cholecystitis does not occur in the same way in all patients. This disease is caused by the formation of stones in the gall bladder, which causes an inflammatory process. Depending on exactly how this process will proceed, as well as on the stage of the disease, several types of calculous cholecystitis are distinguished. Each of them not only has its own characteristics of course and manifestations, but also requires a special approach to treatment.

From the point of view of the main manifestations of the disease(clinical form)The following types of calculous cholecystitis are distinguished:

The form and stage of calculous cholecystitis are one of the most important criteria when prescribing treatment. At first, doctors usually try drug treatment. Most often, it turns out to be effective and allows you to fight symptoms and manifestations for a long time. Sometimes latent or mild forms are observed throughout the patient’s life. However, the very presence of stones always poses a threat of exacerbation. Then the optimal treatment will be cholecystectomy - complete surgical removal of the inflamed gallbladder along with stones.

If a person has an attack of gallstones, the symptoms will be quite specific. They are represented mainly by pain. Gallstone disease is a very common disease. With it, stones form in the cavity of the gallbladder and excretory ducts. The causes of the disease are cholesterol metabolism disorders, poor nutrition, obesity, and diseases of the digestive system.

Development of the disease

The development of gallstone disease occurs in 3 stages. In the first two stages there are no symptoms. They appear only when calculous cholecystitis develops. The attack is quite difficult. Lack of proper care can lead to complications and even death of the sick person. The main manifestation of the attack is hepatic (biliary) colic.

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This is a pain syndrome. It occurs suddenly against the background of a normal state. The pain is acute, felt in the area of the right hypochondrium or epigastric zone. The nature of the pain and its intensity vary. It can be piercing or cutting. The symptom can last for several hours, which causes great discomfort to the patient.

After 1-2 hours, pain is felt in the projection of the gallbladder onto the abdominal wall. Irradiation most often occurs in the back, right shoulder blade or shoulder. The pain can also radiate to the neck. In some patients, pain is felt in the heart area. It can easily be confused with an attack of angina. If the attack lasts more than 6 hours, acute cholecystitis can be suspected.

Colic is a symptom of both acute and chronic inflammation of the gallbladder in the acute stage. In 70% of patients, after the first attack, a second attack develops. During the period between the onset of symptoms, the person feels well. A peculiarity of pain in biliary colic is its increase in the first hour. Then the pain becomes constant.

In most cases, signs of illness during an attack appear at night. Increased pain is observed when lying on the left side and when inhaling air. Such patients often take a forced position (lying on the right side with the lower limbs pulled up).

The mechanism of colic

The appearance of pain during an attack of gallstone disease is due to the following factors:

irritation of an organ or its bile ducts with a stone;
stretching the bladder wall;
increased pressure in the organ cavity;
muscle spasm.

Endocrine factors also play an important role. Against the background of cholelithiasis, the production of norepinephrine and serotonin is disrupted. The latter is responsible for the pain threshold. Its deficiency reduces the pain threshold, which negatively affects the condition of the sick person. Norepinephrine has the opposite effect. It activates the body's antinociceptive (pain-relieving) system.

The presence of stones in the gallbladder leads to stretching of the membrane. This organ consists of several membranes, one of which is muscular. Stimulation of specific receptors leads to muscle spasm. The contraction is due to the active entry of calcium ions into muscle cells. This process occurs with the participation of various neurotransmitters (acetylcholine, norepinephrine, serotonin, cholecystokinin).

The attack itself occurs in the presence of provoking factors. Very often, colic appears due to errors in nutrition. An attack can be triggered by eating fatty foods (meat, mayonnaise, butter, lard, fried potatoes), spices, and smoked foods. It is possible to develop biliary colic due to stress, various infections, drinking alcohol and when working with the body tilted.

Other signs of illness

An attack of gallstone disease can manifest itself with the following symptoms:

During an attack, pain is almost always combined with nausea.

In severe cases, vomiting develops, which does not improve the person’s condition. There may be a bitter taste in the mouth. A constant sign of cholelithiasis is jaundice. It is caused by stagnation of bile and increased levels of bilirubin in the blood. In such people, the skin acquires a yellowish tint.

Yellowing of the sclera is possible. In case of blockage of the common bile duct by a stone, jaundice is very pronounced. Discoloration of stool and darkening of urine are often observed. Other symptoms of gallstone disease include stool instability. The temperature rarely exceeds 38ºC.

Severe fever and chills during an attack indicate the addition of a secondary infection and the development of purulent processes. In this situation, urgent hospitalization is required. Objective signs of an attack of cholelithiasis include abdominal pain, liver enlargement, and the presence of positive Ortner's, Ker, Murphy and Mussy symptoms. Ortner's sign is positive on the right.

To determine it, use the edge of your palm to tap on the lower costal arches on the right and left. If pain appears, then the symptom is positive. Gallstone disease can lead to the following complications:

inflammation of the bile ducts (cholangitis);
empyema (accumulation of pus) of the gallbladder;
dropsy;
perforation of the organ wall with a stone;
peritonitis;
secondary pancreatitis;
liver cirrhosis.

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An acute attack of gallstone disease requires hospitalization. The patient is placed on the right side and sedated. Antispasmodics and NSAIDs are used. An examination is carried out in a hospital setting.

If necessary, antibiotics are prescribed and detoxification therapy is organized. An operation is performed according to indications. Thus, the main symptom of cholelithiasis during an exacerbation is intense paroxysmal pain.

Cholelithiasis is a disease of the gallbladder and bile ducts with the formation of stones. Although, the correct name of the medical term is “cholelithiasis” - ICD-10 code: K80. The disease is complicated by poor liver function, hepatic colic, cholecystitis (inflammation of the gallbladder) and may result in obstructive jaundice with the need for surgery to remove the gallbladder.

Today we will look at the causes, symptoms, signs, exacerbation, treatment of cholelithiasis without surgery using medical and folk remedies, what to do in case of an attack of pain, when surgery is needed. We’ll especially talk about the patients’ nutrition (diet), menus, what foods can and cannot be eaten during treatment without surgery and after it.

What it is?

Gallstone disease is a pathological process in which stones (calculi) form in the gallbladder and ducts. Due to the formation of stones in the gall bladder, the patient develops cholecystitis.

How gallstones form

The gallbladder is a reservoir for bile produced by the liver. The movement of bile along the biliary tract is ensured by the coordinated activity of the liver, gallbladder, common bile duct, pancreas, and duodenum. This ensures the timely entry of bile into the intestines during digestion and its accumulation in the gallbladder on an empty stomach.

The formation of stones in it occurs due to changes in the composition and stagnation of bile (dyscholia), inflammatory processes, motor-tonic disorders of bile secretion (dyskinesia).

There are cholesterol (up to 80-90% of all gallstones), pigment and mixed stones.

The formation of cholesterol stones is facilitated by the oversaturation of bile with cholesterol, its precipitation, and the formation of cholesterol crystals. If the motility of the gallbladder is impaired, the crystals are not excreted into the intestines, but remain and begin to grow.
Pigment (bilirubin) stones appear as a result of increased breakdown of red blood cells during hemolytic anemia.
Mixed stones are a combination of both forms. Contains calcium, bilirubin, cholesterol.

They occur mainly in inflammatory diseases of the gallbladder and bile ducts.

Risk factors

There are several reasons for the occurrence of cholelithiasis:

excess secretion of cholesterol into bile
decreased secretion of phospholipids and bile acids into bile
bile stagnation
biliary tract infection
hemolytic diseases.

Most gallstones are mixed. They include cholesterol, bilirubin, bile acids, proteins, glycoproteins, various salts, and trace elements. Cholesterol stones contain mainly cholesterol, have a round or oval shape, a layered structure, a diameter of 4–5 to 12–15 mm, and are localized in the gallbladder.

Cholesterol-pigment-calcareous stones are multiple, have edges, and have different shapes. They vary significantly in quantity - tens, hundreds and even thousands.
Pigment stones are small in size, multiple, hard, fragile, completely homogeneous, black in color with a metallic tint, located both in the gallbladder and in the bile ducts.
Calcium stones consist of various calcium salts, have a bizarre shape, have spiky processes, and are light or dark brown in color.

Epidemiology

According to numerous publications throughout the 20th century, especially its second half, there was a rapid increase in the prevalence of cholelithiasis, mainly in industrialized countries, including Russia.

Thus, according to a number of authors, the incidence of cholelithiasis in the former USSR almost doubled every 10 years, and stones in the bile ducts were detected at autopsies in every tenth person who died, regardless of the cause of death. At the end of the 20th century, more than 5 million and in the USA more than 15 million patients with cholelithiasis were registered in Germany, and about 10% of the adult population suffered from this disease. According to medical statistics, cholelithiasis occurs in women much more often than in men (ratio from 3:1 to 8:1), and with age the number of patients increases significantly and after 70 years reaches 30% or more in the population.

The increasing surgical activity for cholelithiasis observed throughout the second half of the 20th century has led to the fact that in many countries the frequency of biliary tract operations has surpassed the number of other abdominal operations (including appendectomy). Thus, in the USA in the 70s, more than 250 thousand cholecystectomies were performed annually, in the 80s - more than 400 thousand, and in the 90s - up to 500 thousand.

Classification

Based on the characteristics of the disease accepted today, the following classification is distinguished in accordance with the stages relevant to it:

Stone formation is a stage that is also defined as latent stone formation. In this case, there are no symptoms of gallstone disease, but the use of instrumental diagnostic methods makes it possible to determine the presence of stones in the gallbladder;
Physico-chemical (initial) stage - or, as it is also called, the pre-stone stage. It is characterized by changes occurring in the composition of bile. There are no special clinical manifestations at this stage; detection of the disease at the initial stage is possible, for which a biochemical analysis of bile is used to determine the characteristics of its composition;
Clinical manifestations are a stage whose symptoms indicate the development of an acute or chronic form of calculous cholecystitis.

In some cases, a fourth stage is also distinguished, which consists of the development of complications associated with the disease.

Symptoms of gallstone disease

In principle, cholelithiasis can occur for a very long time without any symptoms or manifestations. This is explained by the fact that the stones in the early stages are small, do not clog the bile duct and do not injure the walls. The patient may not even suspect that he has this problem for a long time. In these cases, they usually talk about stone-carrying. When gallstone disease itself makes itself felt, it can manifest itself in different ways.

Among the first symptoms of the disease, heaviness in the abdomen after eating, stool disturbances (especially after eating fatty foods), nausea and moderate jaundice should be noted. These symptoms may appear even before severe pain in the right hypochondrium - the main symptom of cholelithiasis. They are explained by unexpressed disturbances in the outflow of bile, which makes the digestion process worse.

The most typical symptoms and signs of cholelithiasis are:

In general, the symptoms of cholelithiasis can be quite varied. There are various stool disorders, atypical pain, nausea, and periodic bouts of vomiting. Most doctors are aware of this variety of symptoms, and just in case, they prescribe an ultrasound of the gallbladder to exclude cholelithiasis.

Attack of cholelithiasis

An attack of cholelithiasis usually means biliary colic, which is the most acute and typical manifestation of the disease. Stone carriage does not cause any symptoms or disorders, and patients usually do not attach importance to mild digestive disorders. Thus, the disease proceeds latently (hidden).

Biliary colic usually appears suddenly. Its cause is a spasm of smooth muscles located in the walls of the gallbladder. Sometimes the mucous membrane is also damaged. Most often this happens if the stone moves and gets stuck in the neck of the bladder. Here it blocks the outflow of bile, and bile from the liver does not accumulate in the bladder, but flows directly into the intestines.

Thus, an attack of cholelithiasis usually manifests itself as characteristic pain in the right hypochondrium. At the same time, the patient may experience nausea and vomiting. Often an attack occurs after sudden movements or exertion, or after eating a large amount of fatty food. Once during an exacerbation, stool discoloration may be observed. This is explained by the fact that pigmented (colored) bile from the gallbladder does not enter the intestine. Bile from the liver flows only in small quantities and does not give intense color. This symptom is called acholia. In general, the most typical manifestation of an attack of cholelithiasis is characteristic pain, which will be described below.

Diagnostics

Identification of symptoms characteristic of hepatic colic requires consultation with a specialist. The physical examination carried out by him means identifying symptoms characteristic of the presence of stones in the gallbladder (Murphy, Ortner, Zakharyin). In addition, a certain tension and soreness of the skin is detected in the area of the abdominal wall muscles within the projection of the gallbladder. The presence of xanthomas (yellow spots on the skin formed against the background of a disorder in the body's lipid metabolism) is also noted, and yellowness of the skin and sclera is noted.

The results of a general blood test determine the presence of signs indicating nonspecific inflammation at the stage of clinical exacerbation, which include, in particular, a moderate increase in ESR and leukocytosis. A biochemical blood test reveals hypercholesterolemia, as well as hyperbilirubinemia and increased activity characteristic of alkaline phosphatase.

Cholecystography, used as a method for diagnosing cholelithiasis, determines the enlargement of the gallbladder, as well as the presence of calcareous inclusions in the walls. In addition, in this case, the stones with lime inside are clearly visible.

The most informative method, which is also the most common in the study of the area of interest to us and for the disease in particular, is ultrasound of the abdominal cavity. When examining the abdominal cavity in this case, accuracy is ensured regarding the identification of the presence of certain echo-proof formations in the form of stones in combination with pathological deformations to which the walls of the bladder are exposed during the disease, as well as with changes that are relevant in its motility. Signs indicating cholecystitis are also clearly visible on ultrasound.

Visualization of the gallbladder and ducts can also be performed using MRI and CT techniques for this purpose in specifically indicated areas. Scintigraphy, as well as endoscopic retrograde cholangiopancreatography, can be used as an informative method indicating disturbances in the processes of bile circulation.

Drug treatment of gallstone disease

Treatment of cholelithiasis without surgery is used in the presence of cholesterol gallstones (X-ray negative) up to 15 mm in size with preserved contractility of the gallbladder and patency of the cystic duct.

Contraindications for drug dissolution of gallstones:

inflammatory diseases of the small and large intestines;
obesity;
pregnancy;
“disabled” - non-functioning gallbladder;
acute inflammatory diseases of the gallbladder and biliary tract;
stones with a diameter of more than 2 cm;
liver disease, diabetes mellitus, peptic ulcer of the stomach and duodenum, chronic pancreatitis;
pigment or carbonate stones;
gallbladder cancer;
multiple stones that occupy more than 50% of the volume of the gallbladder.

Ursodeoxycholic acid preparations are used, the action of which is aimed at dissolving only cholesterol stones, the drug is taken for 6 to 24 months. But the probability of relapse after the stones dissolve is 50%. The dosage of the drug and duration of administration are determined only by a general practitioner or gastroenterologist. Conservative treatment is possible only under the supervision of a doctor.

Shock wave cholelithotrepsia is treatment by crushing large stones into small fragments using shock waves, followed by taking bile acid preparations (ursodeoxycholic acid). The chance of relapse is 30%.

Gallstone disease can be asymptomatic or minimally symptomatic for a long time, which creates certain difficulties in identifying it in the early stages. This is the reason for late diagnosis, at the stage of already formed gallstones, when the use of conservative treatment methods is limited, and the only treatment method remains surgical.

Treatment with folk remedies for cholelithiasis

I will give an example of several recipes for dissolving stones. There are a large number of them.

Green tea. Drink as a preventive measure against cholelithiasis, since green tea prevents stone formation.
Lingonberry leaves. The leaves of this plant help dissolve gallstones. Pour a glass of boiling water over 1 tablespoon of dried lingonberry leaves and leave for 20-30 minutes. Take 2 tablespoons 4-5 times a day.
Ivan-tea or narrow-leaved willowherb. Brew 2 tablespoons of dry fireweed leaves in a thermos, pour boiling water (0.5 l). Leave for 30 minutes. Drink 100 ml of tea an hour before meals three times a day for six months. You can infuse the same brew as long as the tea has color. Consult a doctor before use, as stones may be dislodged.

The main thing in treating cholelithiasis with folk remedies is to make sure that you have cholesterol stones that can be dissolved. To do this, you need to undergo an ultrasound (the stones are visible) and an x-ray (cholesterol stones are not visible).

After this, visit a herbalist and choose the most effective combination of herbs for your case. In parallel with the use of folk remedies, it is necessary to adhere to the principles of rational nutrition - sometimes only a change in diet allows you to get rid of small cholesterol stones. It is also necessary to devote time to physical activity - walking, a little exercise in the morning - that is, move more.

Diet for gallstone disease

It is necessary to limit or exclude from the diet fatty, high-calorie, cholesterol-rich foods, especially if there is a hereditary predisposition to gallstone disease. Meals should be frequent (4-6 times a day), in small portions, which helps reduce stagnation of bile in the gallbladder. Food should contain a sufficient amount of dietary fiber from vegetables and fruits. You can add food bran (15g 2-3 times a day). This reduces the lithogenicity (propensity to form stones) of bile.

The therapeutic diet for cholelithiasis lasts from 1 to 2 years. Following a diet is the best prevention of exacerbations of cholelithiasis, and if you do not adhere to it, severe complications may develop.

The consequences of non-compliance include: the occurrence of atherosclerosis, the appearance of constipation, which is dangerous due to stones in the bladder, increased load on the gastrointestinal tract and increased bile density. A therapeutic diet will help cope with excess weight, improve intestinal microflora and protect the immune system. As a result, a person’s mood improves and sleep normalizes.

In severe cases, non-compliance with the diet leads to ulcers, gastritis, and colitis. If you want to recover from pathology without surgery, then diet is a primary requirement.

Operation

Patients should undergo elective surgery before or immediately after the first attack of biliary colic. This is due to the high risk of complications.

After surgical treatment, it is necessary to follow an individual dietary regimen (frequent, small meals with the limitation or exclusion of individually intolerable foods, fatty, fried foods), adherence to a work and rest regime, and physical exercise. Avoid drinking alcohol. Spa treatment after surgery is possible, subject to stable remission.

Complications

The appearance of stones is fraught not only with disruption of organ functions, but also with the occurrence of inflammatory changes in the gallbladder and nearby organs. So, because of the stones, the walls of the bladder can be injured, which, in turn, provokes inflammation. If the stones pass through the cystic duct with bile from the gallbladder, the flow of bile may be obstructed. In the most severe cases, stones can block the entrance and exit of the gallbladder, becoming lodged in it. With such phenomena, stagnation of bile occurs, and this is a prerequisite for the development of inflammation. The inflammatory process can develop over several hours and over several days.

Under such conditions, the patient may develop an acute inflammatory process of the gallbladder. In this case, both the degree of damage and the rate of development of inflammation can be different. Thus, both slight swelling of the wall and its destruction and, as a consequence, rupture of the gallbladder are possible. Such complications of cholelithiasis are life-threatening. If the inflammation spreads to the abdominal organs and peritoneum, the patient develops peritonitis. As a result, infectious-toxic shock and multiple organ failure can become a complication of these phenomena. In this case, disruption of the functioning of blood vessels, kidneys, heart, and brain occurs. With severe inflammation and high toxicity of microbes multiplying in the affected wall of the gallbladder, infectious-toxic shock can appear immediately.

In this case, even resuscitation measures do not guarantee that the patient will be able to be brought out of this state and death will be avoided.

Prevention

To prevent the disease, it is useful to carry out the following activities:

do not practice long-term fasting;
To prevent cholelithiasis, it is useful to drink enough fluid, at least 1.5 liters per day;
in order not to provoke the movement of stones, avoid work associated with prolonged stay in an inclined position;
follow a diet, normalize body weight;
increase physical activity, give the body more movement;
eat more often, every 3-4 hours, to cause regular emptying of the bladder from accumulated bile;
Women should limit their intake of estrogen; this hormone promotes the formation of stones or their enlargement.

For the prevention and treatment of cholelithiasis, it is useful to include in the daily diet a small amount (1-2 tsp) of vegetable oil, preferably olive oil. Sunflower is only 80% digestible, while olive oil is completely digestible. It is also more suitable for frying as it produces fewer phenolic compounds.

The intake of vegetable fat stimulates the activity of the bile bladder, as a result of which it is able to empty itself at least once a day, preventing congestion and the formation of stones.

To normalize metabolism and prevent cholelithiasis, it is worth including magnesium in your diet. The microelement stimulates intestinal motility and bile production, removes cholesterol. In addition, sufficient zinc intake is necessary for the production of bile enzymes.

If you have gallstone disease, it is better to stop drinking coffee. The drink stimulates the contraction of the bladder, which can cause blockage of the duct and a subsequent attack.

Fatty foods are the main “provocateur” of exacerbation of cholecystitis

That is why it is important to know the symptoms of exacerbation of chronic cholecystitis - in order to quickly take action and seek medical help.

What provokes an exacerbation

Chronic cholecystitis can be (with stones) or without stones. Exacerbation of the latter can be provoked by:

consuming large amounts of fatty, fatty, smoked or pickled foods, as well as combinations of these unhealthy foods;
binge eating;
drinking alcohol;
severe stress;
allergies - especially food allergies;
a diet that lacked fiber and plant fiber for a long time.

In the case of calculous cholecystitis, exacerbation can be additionally caused by:

bumpy ride;
physical activity (especially after a long period of physical inactivity);
a sudden change in body position, especially if the person has eaten a heavy meal beforehand.

Exacerbation of chronic cholecystitis is more likely to occur in a person with the following conditions:

abnormalities in the development of the biliary tract;
obesity;
dyskinesia (impaired coordination of muscle movements) of the biliary tract;
during pregnancy;
during hypothermia, colds or exacerbation of chronic pathologies of internal organs.

Warning! Chronic cholecystitis can be in the acute stage from 1 time per month to 3-4 relapses per year. Depending on this, doctors talk about mild, moderate or severe course of the disease, which determines the general tactics of its treatment.

Signs of exacerbation

The main ones are abdominal pain, disorders called “dyspepsia,” weakness, and fever. Let's look at each of them in more detail.

Pain syndrome

The first thing that indicates an exacerbation of chronic cholecystitis is abdominal pain. Its location, intensity and duration depend on the following individual characteristics:

what type of cholecystitis is accompanied by;
are there any complications of gallbladder inflammation;
whether there are (and what exactly) concomitant diseases of the digestive tract.

The last factor will influence the prescribed treatment, but especially the diet during exacerbation of chronic cholecystitis.

The main symptom of exacerbation is pain in the right hypochondrium

Pain during exacerbation of pathology is usually located in the right hypochondrium, but can also be felt in the area “under the stomach”. It may be constant, not very strong, aching in nature, and may even be felt not as pain, but as a heaviness under the right rib.

The above characteristics of pain are more typical for decreased tone of the gallbladder. If the tone of the organ is increased, or the exacerbation was provoked by the movement of a stone, signs of exacerbation of chronic cholecystitis will be called biliary colic. It is a pain:

strong;
on the right under the rib;
paroxysmal in nature;
radiating to the right shoulder blade, shoulder or under the collarbone;
relieved by applying a warm heating pad to the area;
after vomiting the pain intensifies.

If cholecystitis is complicated by the spread of inflammation to the peritoneum, which “envelops” the gallbladder, then other characteristics of pain appear:

constant;
worsens when moving the right hand or bending the body, turning.

If an exacerbation of cholecystitis has led to the development of inflammation in the pancreas, the pain may become girdling in nature, radiating to the pit of the stomach, the left hypochondrium, and the area around the navel.

When inflammation of the gallbladder has led to irritation of the solar plexus, the pain is described as:

having a burning character;
intense;
radiating to the back;
aggravated by pressing on the lower area of the sternum.

Dyspepsia

This term refers to the following symptoms indicating that chronic cholecystitis has worsened:

Itchy skin

A person is bothered by itching when bile stagnates in its ducts, its pressure in them increases, and some of the bile acids enter the blood. The whole body may itch, but the itch can be felt anywhere.

Warning! The symptom is more typical for cholelithiasis, but can also appear in the acalculous version of chronic cholecystitis. This sign indicates that treatment of the disease should be carried out in a hospital and not at home.

Other symptoms

In a quarter of people, exacerbation of the inflammatory process of the gallbladder will be accompanied by pain in the heart, which is associated with the commonality of the nerve fibers of these two organs.

Skin itching and increased bilirubin levels in the blood lead to psycho-emotional disorders:

weaknesses;
irritability;
increased fatigue;
rapid mood changes.

In 30-40% of people, exacerbation of cholecystitis will be accompanied by an increase in temperature up to 38 degrees.

Additionally, joint pain, headaches, weakness in the limbs, increased sweating, arrhythmia and increased heart rate may also occur.

Help with exacerbations

The main thing to do in case of exacerbation of cholecystitis is to seek medical help. A person can either call an ambulance if the pain is very severe or is accompanied by a deterioration in the general condition, or go to an appointment with a gastroenterologist on the same day as the first signs of exacerbation of the disease appear.

First aid for cholecystitis should be provided by an ambulance team or doctors at a surgical hospital. Medical professionals will make a diagnosis and measure the person’s overall condition, such as blood pressure and pulse. Depending on this, they will decide what to use for pain relief: drugs that reduce muscle tone (they also reduce pressure in blood vessels), or direct painkillers. You don’t need to take any pills until the specialists arrive - you could harm yourself.

Rosehip decoction is an excellent choleretic agent, but it should not be used during an exacerbation.

All you can do before paramedics arrive is:

do not eat food (especially if there is nausea or vomiting);
drink liquid in small amounts;
lie down in bed, taking a comfortable position (usually on your right side);
put a slightly warm heating pad under your side, while strictly monitoring your sensations. If this causes increased pain, the heating pad should be removed.

Warning! You should not take any herbs (especially choleretic), drink medications, or warm your stomach in a warm bath. Even if before an exacerbation a “blind tubage” was prescribed, then during an exacerbation it is contraindicated - by strengthening the work of the diseased gallbladder, you can provoke the development of surgical complications in yourself.

Treatment of exacerbation of chronic cholecystitis is carried out first in surgical and then therapeutic complications. A person is prescribed injectable forms of antibiotics, drugs that relieve spasms of the gallbladder muscles, painkillers, medications necessary for the treatment of concomitant diseases of the pancreas, stomach, and intestines. If necessary, surgery is performed to remove the gallbladder.

If a decision is made on conservative treatment of the pathology, it is imperative that in case of exacerbation of cholecystitis, it is necessary to provide the body with everything necessary, while “switching off” the contractions (but ensuring the outflow of bile) of the diseased gallbladder, giving it the opportunity to recover.

Meets the following requirements:

In the first two days, you need to fast, drink only weak and unsweetened tea, rice water in a total volume of at least 2 liters per day. At the same time, you need to drink liquid in small portions so that it is absorbed.
On the third day, if the pain subsides, the diet is expanded. Introduced: vegetable soups, liquid non-dairy porridges (semolina, oatmeal, rice), jelly from non-acidic berries.
By day 5, boiled meat and low-fat fish and dairy products are added.
After another 2 days, food can be seasoned with a small amount of vegetable oil or butter. You can already add dairy products, sweet fruits, potatoes, stewed cauliflower, baked apples without peel, white bread crackers, and a boiled egg to your diet.
Under no circumstances should you eat: pickles, marinades, onions, sorrel, spinach, white cabbage, or drink alcohol.
Simple carbohydrates are limited.

Physiotherapy and herbal intake are very useful outside of exacerbation of the disease. The attending physician-therapist, to whose “department” the person is transferred to relieve the symptoms of exacerbation of cholecystitis, should tell you when they can be introduced into treatment.