home Audience 8 Symptoms of gallstones, treatment and proper diet. How to dissolve gallstones using contact litholysis? Types of gallstones

Symptoms of gallstones, treatment and proper diet. How to dissolve gallstones using contact litholysis? Types of gallstones

The gallbladder is an organ that stores bile produced by the liver. The latter is necessary for digesting food. If necessary, it is thrown into duodenum. Bile is a complex substance containing a large number of bilirubin and cholesterol.

Stones in gallbladder are formed due to stagnation of bile, during which cholesterol is retained in the bladder and precipitates. This process is called the process of formation of “sand” - microscopic stones. If the “sand” is not eliminated, the stones adhere to each other, forming stones. Stones in the gall ducts and in the gallbladder itself take a long time to form. This takes 5-20 years.

Gallstones can for a long time not to manifest itself in any way, but it is still not recommended to start the disease: the stone can injure the wall of the gallbladder and inflammation will spread to neighboring organs(patients often also suffer from gastritis, ulcers, pancreatitis). We will look at what to do if gallstones occur and how to treat this problem without surgery in this article.

How are gallstones formed?

The gallbladder is a small sac that holds 50-80 ml of bile, a fluid that the body needs to digest fats and maintain normal microflora. If bile stagnates, its components begin to precipitate and crystallize. This is how stones are formed, which increase in size and quantity over the years.

Moreover, one of the most common causes of illness are considered:

Severe inflammation in the gallbladder.
The contractility of the gallbladder decreases, which causes stagnation of bile.
When bile contains large amounts of calcium, cholesterol, bile pigment, it is water-insoluble bilirubin.
Most often in women the disease is caused by obesity, big amount childbirth, taking hormones - estrogens.
Heredity. The formation of gallstones is caused by a genetic factor. If parents suffered from an illness, their child also has a risk of developing pathology.
Drug treatment – Cyclosporine, Clofibrate, Octreotide.
Diet. Fasting or long intervals between meals can cause gallstones. Limiting your fluid intake is not recommended.
Gallstones can occur due to, hemolytic anemia, due to Caroli syndrome, .
As a consequence of an operation during which they remove bottom part intestines.
Alcohol. Abuse of it provokes stagnation in the bladder. Bilirubin crystallizes and stones appear.

As you know, bile consists of various components, therefore stones may differ in composition. The following types of stones are distinguished:

Cholesterol - have a round shape and a small diameter (approximately 16-18 mm);
Calcareous – contain a lot of calcium and are quite rare;
Mixed - characterized by a layered structure, in some cases consisting of a pigmented center and a cholesterol shell.

In addition, bilirubin stones, which are small in size and localized both in the bag and in the ducts, can form in the gallbladder. However, most often the stones are mixed. On average, their sizes range from 0.1 mm to 5 cm.

Symptoms of gallstones

The clinical picture of symptoms when gallstones appear is quite varied. Symptoms depend on the composition, quantity and location of stones. Most patients with single large stones located directly in the gallbladder are often not even aware of their disease. This condition is called the hidden (latent) form of cholelithiasis.

As for specific signs, then gallstones make themselves felt with such symptoms:

(projection of the liver and biliary tract) – intensity from mild discomfort to hepatic colic;
dyspeptic syndrome - manifestations of digestive disorders - nausea, unstable stool;
an increase in body temperature is a consequence of the addition of a secondary bacterial infection.
if the stone descends along the bile duct, then the pain is localized in the groin and radiates to the femoral part.

In 70% of people this disease does not cause any discomfort, a person begins to feel discomfort only when the stones have already grown and blocked the bile duct and a typical manifestation is biliary colic, this is an attack of acute pain when the bile duct is periodically blocked by a stone. This attack of acute pain, that is, colic, can last from 10 minutes to 5 hours

Diagnostics

Diagnosis is carried out by a gastroenterologist. The diagnosis is established using the patient's complaints and some additional studies.

First, the patient undergoes an ultrasound of the abdominal organs. - the main and most effective method diagnosis of cholelithiasis. Detects the presence of stones in the gallbladder, thickening of the walls of the gallbladder, its deformation, expansion bile ducts. Its main advantages are non-invasiveness (non-traumatic), safety, accessibility and the possibility of repeated use.

If the situation is more serious, then doctors resort to cholecystocholangiography ( X-ray examination with the introduction of a contrast agent).

Consequences

The course of gallstone disease can be complicated by the following conditions:

phlegmon of the gallbladder wall;
biliary fistulas;
Mirizzi syndrome (compression of the common bile duct);
gallbladder perforation;
biliary pancreatitis;
spicy and ;
hydrocele of the gallbladder;
intestinal obstruction;
gallbladder cancer;
acute purulent inflammation(empyema) and gangrene of the gallbladder.

In general, the presence of a stone in the bladder is not dangerous as long as it does not block the bile duct. Small stones usually pass on their own, and if their size is comparable to the diameter of the duct (about 0.5 cm), then pain occurs with passage - colic. The grain of sand “slipped” further into small intestine- the pain disappears. If the pebble is so large that it gets stuck, then this situation requires immediate medical intervention.

Gallstones: treatment without surgery

Detection of gallstones does not always imply mandatory surgical intervention; in most cases, treatment without surgery is indicated. But uncontrolled self-medication at home is fraught with blockage of the bile ducts and an emergency end to the operating table of the surgeon on duty.

Therefore, it is better not to drink questionable cocktails from strictly prohibited choleretic herbs and vegetable oil, which some recommend traditional healers, and make an appointment with a gastroenterologist.

For conservative treatment cholelithiasis The following medications are prescribed:

Drugs that help normalize the composition of bile (ursofalk, lyobil);
Enzyme preparations that improve digestive processes, in particular the processes of lipid digestion (Creon).
For pain caused by contraction of the gallbladder, patients are recommended to use various muscle relaxants (plataphylline, drotaverine, no-spa, metacin, pirencipin).
Stimulators of bile acid secretion (phenobarbital, zixorine).

Modern conservative treatment, which allows preserving the organ and its ducts, includes three main methods: dissolving stones with drugs, crushing stones using ultrasound or laser, and percutaneous cholelitholysis (invasive method).

Dissolution of stones (litholytic therapy)

Dissolving gallstones with medicines helps cure gallstones without surgery. The main drugs used to dissolve gallstones are ursodeoxycholic acid (Ursosan) and chenodeoxycholic acid (Chenofalk).

Litholytic therapy indicated in the following cases:

The stones are small in size (from 5 to 15 mm) and fill no more than 1/2 of the gallbladder.
The contractile function of the gallbladder is normal, the patency of the bile ducts is good.
The stones are of cholesterol nature. Chemical composition stones can be identified using duodenal intubation(duodenum) or oral cholecystography.

Ursosan and Henofalk reduce the level of substances in bile that promote the formation of stones (cholesterol) and increase the level of substances that dissolve stones (bile acids). Litholytic therapy is effective only in the presence of small cholesterol stones, early stages diseases. The dose and duration of medication is determined by the doctor based on ultrasound data.

Stone crushing (extracorporeal lithotripsy)

extracorporeal shock wave lithotripsy(pulverization) is a technique based on the generation of a shock wave, leading to crushing the stone into many grains of sand. Currently this procedure used as preparatory stage before oral litholytic therapy.

Contraindications are:

Bleeding disorders;
Chronic inflammatory diseases Gastrointestinal tract (cholecystitis, pancreatitis, ulcer).

TO side effects Ultrasound lithotripsy includes:

Risk of bile duct blockage;
Damage to the walls of the gallbladder by stone fragments as a result of vibration.

The indication for ESWL is the absence of patency obstruction. biliary tract, single and multiple cholesterol stones with a diameter of no more than 3 cm.

Percutaneous transhepatic cholelitholysis

Rarely used because it refers to invasive methods. A catheter is inserted into the gallbladder through the skin and liver tissue, through which 5-10 ml of the mixture is injected dropwise special drugs. The procedure must be repeated; in 3-4 weeks, up to 90% of the stones can be dissolved.

You can dissolve not only cholesterol, but also other types gallstones. The number and size of stones do not matter. Unlike the previous two, this method can be used not only in individuals with asymptomatic cholelithiasis, but also in patients with severe clinical manifestations of the disease.

Surgery to remove gallstones

However, it is worth understanding that without surgical treatment can't be avoided with:

frequent biliary colic;
“disabled” (lost contractility) bladder;
large stones;
frequent exacerbations of cholecystitis;
complications.

In most cases, surgery to remove stones from the gallbladder is recommended for patients whose disease is accompanied by frequent relapses, attacks of severe pain, large stones, high temperature body, various complications.

Surgical treatment can be laparoscopic and open (cholecystolithotomy, cholecystectomy, papillosphincterotomy, cholecystostomy). Option surgical intervention determined for each patient individually.

Nutrition

Usually, a diet is prescribed as soon as the first signs of gallstones appear. It is specially designed for such patients, it is called - therapeutic diet No. 5, you must adhere to it constantly.

Food is prepared by boiling or baking, and you need to eat it often - 5-6 times a day. The diet for gallstones should contain a maximum of vegetables and vegetable oils. Vegetables at the expense vegetable protein stimulate the breakdown of excess cholesterol, and vegetable oils improve intestinal motility, promote contraction of the bladder, and thereby prevent the accumulation of bile in it.

If there are stones in the gall bladder, they speak of cholelithiasis. This disease is also called cholelithiasis. The gallbladder has a sac-like shape and is located in front of the liver. It is designed for liquid bile produced by the liver and performs very important function helping to process fats. But often from microscopic crystals of cholesterol, or from bile salts, stones form in the gall bladder. They can vary greatly in size. Some are very small, others reach the size walnut.

When such a stone blocks the bile duct, preventing the flow of bile to the small intestine, biliary colic (cholecystitis) occurs. As experts say, stones begin to form due to an imbalance of the substances that make up bile. In particular, this process provokes high cholesterol in bile. What are the signs of gallstones, how is treatment done, how does surgery help, what medications are used?

Symptoms of gallstone disease

When the stones are small, their number is small, and their location is favorable, the disease does not have significant symptoms. The absence of symptoms is typical for most cases. When will the stones big size, if the bile ducts are clogged during their movement, appears strong pain(colic). It often resolves on its own as the stone passes through the bile duct. But if it gets stuck there, emergency surgery may be required.

It is also necessary to visit a specialist if the area of the right hypochondrium often hurts. The doctor will diagnose, prescribe the method of treatment that is right for you.

Treatment of gallstones

Therapeutic methods:

Litholytic therapy. It is a technique for dissolving stones using certain medicines, without surgical intervention. It is carried out with small stones.

How are gallstones treated? Drugs

For dissolving stones, for conservative treatment cholelithiasis, the drugs are prescribed: Ursosan (ursodeoxycholic acid) and Henofalk (chenodeoxycholic acid). These medications lower cholesterol and bile acid levels. The dosage regimen and duration of taking the drugs are determined by the attending physician, based on the results of the ultrasound.

Stone crushing:

Extracorporeal lithotripsy. This technique assumes strong pressure on the stone, which is created by ultrasound. Under its influence, stones are destroyed and crushed into small particles. They are then dissolved using drugs. The technique is not a surgical operation, it is effective for small cholesterol stones.

How else to treat gallstones? Will the operation help?

Cholecystectomy (removal of the gallbladder). Surgery removal of the gallbladder is the most radical, but also the most effective method of treatment. Cholecystectomy is performed when the stones are large or in a dangerous location. The operation is indicated if there is inflammatory process, with frequent, painful attacks of hepatic colic, or with the development of complications of cholelithiasis.

Laparoscopic cholecystectomy:

This is the most common method of treating gallstone disease. The technique involves making small incisions through which a laparoscope is inserted. The gallbladder is removed using laparoscopy. This method has clear advantages over cholecystectomy, as it is performed in a gentle manner. In this case, the patient recovers quickly, and there are no scars left after the operation.

Traditional treatment

On early stages diseases, can be used traditional methods treatment. On the advice of a doctor, they can be used as an addition to drug treatment. Here are some recipes that may be useful to you:

Forest rowan (red)

Red rowan berries are very effective in treating gallstone disease. Pick fresh berries according to the season, eat two glasses a day. You can grind them and mix them with honey. Eat small meals throughout the day.

birch leaves

Dried leaves birch trees are also used as additional remedy at drug treatment(dissolving) stones. To prepare the medicine, pour 1 tbsp into a small saucepan. l. leaves. Pour a glass of boiling water over them. Boil again, reduce temperature to low. Simmer for 20 minutes. Then remove it from the stove and insulate it. Wait 1 hour. Drink a glass of the strained broth before meals.

Sauerkraut

Very good remedy. To dissolve small stones, drink a glass of brine every day from sauerkraut, before meals.

Preventive measures

Everyone understands that it is easier to prevent any illness than to treat it persistently and for a long time. Therefore, to prevent gallstones from appearing, you need to take some preventive measures. Then you won’t have to worry about treatment, surgery, or medications for gallstone disease.

Just limit your diet to fatty, fried foods rich in cholesterol. If you are overweight, take measures to reduce it - do what you can physical activity switch to a low-calorie diet.

If stones are found in the gallbladder, avoid taking medications containing estrogens. They contribute to the active formation of gallstones.
Take care of your health, visit your doctor regularly for preventive purposes and be healthy!

In this article we will try to understand the causes of gallstones, the first symptoms, risk factors and the possibility of treatment without surgery. We will also touch on the topic of nutrition and try to draw conclusions regarding the operation.

How do gallstones actually form?

First of all, you need to remember that cholelithiasis – this is a disease associated with metabolic disorders. This problem occurs in people with lipid metabolism disorders and cholesterol metabolism disorders. Bile takes part in the breakdown of fats and brings them to a very small state. If, for example, a person excludes fats from his diet, then the bile will concentrate, which will subsequently lead to the crystallization of stones. The thing is that cholesterol and bilirubin cannot be filtered by the kidneys, so they are excreted exclusively through bile. Under adverse conditions, they are able to settle and form crystals. After that, these crystals begin to turn into real stones, which are dangerous for blocking the ducts. If they are formed, then symptoms are obtained that are immediately very difficult to distinguish from other diseases. If the ducts are clogged, then bile ceases to be excreted, which will inevitably lead to inflammation of the gallbladder.

If you are not sure about the presence of gallstones, then you should go to ultrasound diagnostics, which will show the exact result.

Symptoms of gallstone disease:

Pain in the right hypochondrium radiating to the neck, arm or jaw
Nausea and bitterness in the mouth
constipation, flatulence, loose stool, heartburn
Yellowing of the skin and eye sclera

These stones can reach large sizes (with quail egg), when the size of the stone reaches 4-5 mm, it becomes larger size duct and the canal becomes clogged.
Dissolve large stones therapeutic ways impossible, so in such cases you need to undergo surgery. Most often, this results due to negligent treatment of one's health and untimely access to a doctor.

What causes stones to appear?

Cholesterol and fatty foods
Constant fasting or irregular eating
Passive lifestyle
Metabolic disorders
Diseases of the liver and digestive organs
Diseases of the gallbladder
Frequent drinking and nervous stress

The danger of stones in the body

The biggest danger is the development of all kinds of complications. If your stones continue to grow, they can form a bedsore on the surface of the bladder, a fistula, and even effusion into the intestines, which can lead to detrimental consequences, and even intestinal obstruction. The stones themselves pose a great threat not only to the gallstones, they can endanger other organs, including the pancreas.

Treatment without surgery

It all starts with nutrition, so try to take it extremely seriously from now on. You need to normalize lipid metabolism, lower cholesterol and cleanse the blood. To begin with, start following a low cholesterol diet/nutrition. Also, do not forget about the proper consumption of fats:

Eat mostly butter fats in the morning
At lunch fish fat(omega 3-6)
IN evening time use high quality vegetable fats

Adjust your weight and completely give up smoking and alcohol, exercise regularly and play sports or just walk.

Nutrition tips

Is it necessary to have surgery if there are stones in the gall bladder?

If you have 1-2 small stones, with bile problems is not observed (no blockages), there are no complications from the pancreas, there is no reflux of bile, bitterness or disruption of the stomach, then there is no need to rush into surgery. You can try to make yourself a proper diet or try to dissolve gallstones. But if you have pain and eating disorders, then you need to have surgery.

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Gallstone disease (cholelithiasis) is considered one of the most common diseases. It is characterized by formation in the gallbladder hard stones, different sizes and shapes. More often, women suffer from the disease, as well as people who abuse fatty and protein foods.

The gallbladder is important organ involved in the process of digestion. It accumulates bile produced by the liver, which is necessary for digesting food. It has narrow ducts that open into small intestine and deliver bile for digestion fatty foods, cholesterol, bilirubin. It is from bile that rocky formations are formed that block the bile ducts.

What is gallstone disease

The disease is characterized by the formation of hard stones in the gallbladder or ducts. Pathology appears as a result of a disorder in cholesterol metabolism. Bile consists of bilirubin and cholesterol, and stones in the bladder are formed due to its stagnation. In this case, cholesterol is retained in the body and forms a dense sediment in the gallbladder, from which sand is formed.

Over time, if treatment is not started, the grains of sand stick together, forming solid conglomerates. The formation of such stones takes from 5 to 25 years, and the patient does not experience discomfort for a long time.

The risk group for cholelithiasis includes older people, as well as patients taking medications that affect cholesterol metabolism. Provoke the development of the disease can hereditary disposition, poor nutrition(overeating and starvation), some gastrointestinal diseases, metabolic disorders.

Watch the video about the effects of fasting on the gallbladder:

Symptoms of gallstones

The severity and degree of manifestation of symptoms depends on the size of the stones and their location. The longer the disease lasts, the more painful the symptoms. One of the most pronounced signs cholelithiasis is severe and sharp pain, called hepatic or biliary colic.

It is localized in the right hypochondrium, and a few hours after the onset of the attack, it covers the entire area of the gallbladder. The pain can radiate to the neck, back, under the shoulder blade and to the heart.

Main symptoms:

heartburn;
bitterness in the mouth;
belching;
pain under the ribs on the right;
general weakness.

The cause of an attack is often the use of fatty, spicy and fried foods, alcohol. Pain can provoke stress, physical overload, gallbladder spasmcaused by the movement of stones. Blockage of the bile ducts is accompanied by constant nagging pain, feeling of heaviness in the right side.

Characteristic appearance severe nausea and vomiting, abnormal bowel movements, bloating. In some cases, there is an increase in temperature, fever, and with complete blockage of the main bile duct - jaundice and white feces.

Causes of stone formation

The gallbladder has a volume of no more than 70-80 ml, and the bile in it should not linger and accumulate. The process of its movement to the intestines must be continuous. With prolonged stagnation, cholesterol and bilirubin precipitate, where they crystallize. This process leads to the formation of stones of various sizes and shapes.

Causes of cholelithiasis (cholelithiasis):

obesity;
taking hormonal medications;
heredity;
alcohol abuse;
irregular meals, prolonged fasting;
taking medications that affect cholesterol metabolism (Octreotide, Cyclosporine);
inflammatory process in the gallbladder;
in women - numerous births;
diabetes;
intestinal surgery;
elevated level calcium in bile.

Often, gallstone disease is caused by the use of fatty and spicy food, endocrine pathologies, toxic liver damage.

Types of gallstones and how big they get

There are several types of stones that differ in composition. It depends on constituent components bile.

Types of stones:

cholesterol;
limestone;
mixed;
bilirubin.

Cholesterol stones are rounded smooth formations with a homogeneous structure. They can reach a size of about 15-20 mm in diameter, and the reason for their formation is a metabolic disorder in fat people. They are localized exclusively in the gallbladder and appear in the absence of an inflammatory process.

Calcareous, consist of calcium, and inflammation of the gallbladder is considered the cause of their formation. Around bacteria or small particles of cholesterol, calcium salts accumulate, which quickly harden and form stones. various forms and sizes.

Mixed stones occur as a result of increased inflammation in the liver and gallbladder. For cholesterol and pigment formations Calcium salts are layered, forming solid heterogeneous formations with a layered structure.

Bilirubin, are formed regardless of the presence of inflammation, and the reason for this is a violation protein composition blood or birth defects associated with increased breakdown of erythrocytes. These stones are small and are more often localized in the bile ducts.

The least common are calcareous stones, and more often mixed ones, the size of which ranges from 0.5 mm to 5-6 cm.

Diagnosis of cholelithiasis

GSD is asymptomatic for a long time, and patients go to the doctor only with severe pain. Hepatic colic requires examination by a gastroenterologist to confirm the diagnosis. The doctor must prescribe general analysis blood and biochemistry.

On biochemical research, an increased level of bilirubin is clearly visible, and in general there is an increase in leukocytes and a rapid ESR (erythrocyte sedimentation rate).

Further diagnosis requires ultrasound of the gallbladder, which shows the presence of stones in the gallbladder and ducts in 90-95% of cases, as well as choledochoscopy. Visible on x-ray calcareous formations, and ultrasonography using an endoscope allows you to see gallstones in very overweight, obese patients.

ERPG (endoscopic retrograde cholangiopancreatography) effectively identifies stone formations in the bile ducts.

When gallstones should not be touched

A surgeon will help get rid of large stones, but if the disease does not manifest itself in any way, then it is not necessary to treat it. The main thing that needs to be done is to follow a diet, maintain healthy image life, give up bad habits.

Small stones can be dissolved with the help of medicines, but it will take a very long time to be treated, and the effect is short-lived. In addition, the use of such drugs destroys liver cells and causes multiple complications.

If 1-2 small stones are found, they can be crushed using a shock wave. After which, the resulting fine sand leaves the body on its own. Under no circumstances should you use choleretic drugs (including during plant based). Uncontrolled movement of stones through the gallbladder threatens with dangerous complications.

Treatment methods

Drug treatment is used only for initial stage development of housing and communal services.

In this case, the doctor prescribes the following medications:

The addition of a secondary infection requires antibiotics, and Ziflan and bile acid preparations are used to dissolve cholesterol stones. The latter contain different active substances and are divided into two groups: ursodeoxycholic (Ursosan, Ursofalk) and chenodeoxycholic (Chenosan, Henohol).

Taking such drugs requires compliance with certain conditions:

small size of stones (5-15 mm in diameter);
the gallbladder contracts on its own;
There are no stones in the bile ducts.

You will have to drink these medicines for a long time, more than 2 years, and they can cause many complications.

There is a rather interesting technique called contact dissolution. Its essence is that a special substance that dissolves stones (Propionate) is injected into the gallbladder and ducts. After such a procedure, the patient requires long-term maintenance therapy.

No less popular is spraying (shock wave therapy), which turns stones into small grains of sand. But this method of treatment can only be used if there are no stones in the ducts.

Find out in the video about powerful tool which helps remove stones from the gallbladder:

When is gallbladder removal surgery necessary?

Complete removal of the gallbladder is carried out with the development of acute calculous or chronic cholecystitis. In this case, open abdominal surgery(classical cholecystectomy) or surgery using laparoscopy (laparoscopic cholecystectomy).

In some cases, it may be necessary surgical removal stones by laparoscopy, without removal of the gallbladder. It is carried out with frequent relapses, the presence of large stones.

Diet for gallstone disease

The first signs of the appearance of stones require a transition to strict dietary food. In this case, table number 5 is assigned, and you will have to adhere to it for life.

From the menu completely excluded:

You need to eat in small portions, at least 5-6 times a day, and food must be boiled or baked without butter and fat. The diet should contain a large number of vegetables and vegetable oils.

Prevention

As a prevention of cholelithiasis, it is necessary to eat right, normalize weight, engage in physical education, or simply ensure regular physical activity.

If cholelithiasis has already been diagnosed, in order to avoid repeated relapses, it is necessary to take litholytic drugs for six months, be wary of taking certain medications, reset excess weight. Prolonged fasting and irregular diet can also trigger the formation of stones.

Conclusion

GSD is more common in women, and malnutrition, physical inactivity and heredity, and bad habits can provoke its appearance.
The disease can be asymptomatic for a long time, without causing discomfort.
If hepatic colic occurs, you should immediately consult a doctor.
You can't take herbal choleretic drugs when diagnosing cholelithiasis.
You cannot choose medications to dissolve stones on your own. This should be done by a specialist.

Gastroenterologist, Hepatologist

Every tenth inhabitant of our planet is diagnosed with gallstones. They differ in size. Sometimes there is only one stone in the bubble, but most often there are several, and different shapes. This pathology, as a rule, are discovered during the next preventive examination. In this case, the question arises: “Gallstone in the gall bladder - should it be removed or not?” It is not possible to give a definite answer to this. The pathology may not manifest itself for a long time, but it is not recommended to start it. The stone can injure the walls of the organ, and inflammation can spread to other areas. In this article we will talk in more detail about the causes of this pathology and the treatment methods offered by modern medicine.

general information

The gallbladder is a small reservoir of liquid contents that is located next to the liver. The latter continuously produces bile. It constantly accumulates in the bladder, which, when emptied, throws it into the duodenum. Bile promotes active digestion of food. It consists of quite complex chemical substances, as well as from cholesterol and bilirubin. Over a long period of time, cholesterol gradually begins to precipitate and then be deposited on the so-called protein frameworks. This process entails the formation of microscopic stones, which over time can increase in size and merge with each other. In this case, we are usually talking about cholelithiasis.

The formation of a stone in the gallbladder is a fairly long process, taking from 5 to approximately 20 years. Experts distinguish the following types:

Cholesterol. They are distinguished by their round shape and small diameter of up to 18 mm.
Calcareous. They contain a lot of calcium and are extremely rare.
Mixed. Characterized by a layered structure.

The type of stones depends primarily on the person’s diet. For example, in Europe, 90% of all diagnosed gallstones are cholesterol in nature. In Japan, until 1945, calcareous forms predominated. However, over time and as the Japanese switched to a “Western” diet, the proportion of cholesterol stones began to increase.

It is noteworthy that on the African continent this kind of pathology is confirmed extremely rarely, which cannot be said about our country. On the territory of Russia, 12 out of 100 people are diagnosed with 600 thousand people annually; in the USA these figures are much higher. In America, about 1.2 million people undergo surgery every year.

Causes

IN normal conditions absolutely healthy people Bile in the bladder is in a liquid state and does not contribute to the formation of stones. However, experts name a number of factors that influence the change in its initial properties. As a result, stones are formed.

Inflammation of the wall of the pouch.
Metabolic disorders due to physical inactivity, stagnation of bile, ailments of an infectious nature.
Hereditary predisposition.
Liver diseases.
Food. Due to the consumption of cholesterol-containing foods, the concentration of this substance gradually increases and stones form.
Diet. Fasting often causes the development of gallstone disease.
Changes to hormonal level. An excess of female sex hormones is usually observed during pregnancy and the use of oral contraceptives.
Age. The body of older people quite often cannot cope with the load on the liver, which entails the formation of pathology.
Stress.
Drinking alcoholic beverages.

What symptoms indicate a gallstone?

How to relieve an attack of pain? What medications should I take for this? Before understanding these issues, it is necessary to tell what signs indicate the formation of stones.

Many people with this pathology often do not even suspect it. Symptoms most often appear several years after the onset of its formation.

Biliary colic appears suddenly. The pain is constant in nature and is localized mainly in the area of the right hypochondrium. The duration of the spasms can range from 15 minutes to approximately four hours. If after this time the pain discomfort does not go away, inflammation of the gallbladder can be suspected.

Also, patients note the presence of a pronounced dyspeptic syndrome (problems with stools, nausea, bloating). Some people have a fever. This symptom most often indicates the addition of a secondary bacterial infection.

Survey plan

If you have been diagnosed with a stone in the gallbladder, how to treat and what to do next can only tell qualified specialist. When primary symptoms It is recommended to consult a gastroenterologist. Diagnosis of this pathology involves a conversation with a doctor, the study of specific complaints of the patient, the collection of anamnesis.

If gallstones are suspected, it is mandatory to use instrumental methods diagnostics It is usually not possible to examine the pathology using the most ordinary radiograph. Patients are recommended cholecystography, which uses x-rays along with a contrast agent.

Even more accessible method diagnosis is considered ultrasonography. It allows you to identify stones, determine their size and shape, as well as mobility.

What to do if a pathology is detected?

If a gallstone has been diagnosed, treatment methods should be comprehensive. Modern medicine Depending on the nature of the pathology and the severity of the inflammatory process, it offers several approaches to therapy:

Diet (principles of proper nutrition).
Lifestyle correction (normalization of sleep and rest patterns, physical activity).
Conservative therapy.
Non-operative stone removal.
Surgical intervention (if, for example, the gallstone is 32 mm).

What to do first? All patients without exception with this diagnosis are recommended to review their familiar image life. It is necessary to give up everything bad habits(smoking, alcohol abuse) and try to adhere to a healthy lifestyle. Patients should increase motor activity to enhance the burning of fats in the body and the removal of cholesterol. For these purposes, it is not at all necessary to go to the gym and do serious exercises. It is quite enough to take a walk after work, attend yoga or exercise classes.

Let's talk about nutrition

Bile and cholesterol are intrinsically linked. This is because an excess of these substances can trigger the formation of gallstones. 80% of cholesterol is constantly produced by the liver. The remainder comes with food. Cholesterol is extremely important for the synthesis of sex hormones, normal digestion and absorption of vitamins. However, its excess leads to heart attacks. By controlling cholesterol levels with diet, you can avoid the occurrence of pathologies such as gallstones.

The diet in this disease is based on a decrease in the intake of animal fats and excessively high-calorie foods. As practice shows, vegetarians practically do not have to face such a problem. Patients with this diagnosis are advised to avoid high-fat animal foods (pork, saturated broths, fried meats, etc.). Smoked meats, canned foods, and lard are also prohibited. The diet should be diversified with vegetables and fruits, lean meat and fish are allowed in small quantities, as well as lactic acid products. The best breakfast counts oatmeal on the water with fresh berries or cottage cheese, you can bake it for lunch chicken fillet under vegetables, and for dinner make light vegetable salad with fish cutlets. Dishes are steamed or stewed.

It is recommended to take food in small portions, but often (4-5 times a day). All those who take a break between meals of more than 14 hours have increased likelihood development of this type of pathology. In addition, the risk group includes constantly losing weight ladies and lovers to refuse full breakfast. The lack of regular nutrition leads to the fact that a deficiency of certain acids appears in the gastrointestinal tract. Excess cholesterol is not broken down and falls out, that is, a stone is formed in the gall bladder.

Diet suggests complete failure from alcohol and coffee. Just half a cup of this stimulating drink a day provokes unnecessary and even useless contraction of the bladder.

As for the fair sex, those ladies who daily include citrus fruits, grains and legumes in their diet are less at risk of developing pathology.

Conservative treatment

Diet alone is usually not enough to resolve gallstones. How to dissolve it medicinally? Therapeutic treatment should primarily be aimed at reducing unpleasant symptoms. Here we're talking about about the so-called biliary colic. The severe pain that accompanies it is due to intense muscle spasm in the area of stone localization. At the same time, it is often observed vicious circle. The spasm provokes severe pain discomfort. Pain, through a neuro-reflex effect on all surrounding tissues, only intensifies the spasm. In this case, therapy should pursue two goals simultaneously: relieving spasms and eliminating pain.

Experts prescribe various antispasmodic drugs to reduce the pain discomfort that accompanies a gallstone. Only the doctor decides how to treat the pathology and what dosage of the drug to choose. As a rule, an attack is relieved by an injection of Papaverine or Dibazol. At acute attacks biliary colic recommended intramuscular injection"No-shpy" or "Eufillina". Of course, any of these medications has its contraindications, so the choice of one or another drug is made only after examining the patient.

Antispasmodics are often administered simultaneously with painkillers. “Baralgin” is particularly effective.

If it is not possible to reduce the symptoms with the help of the above medications, more strong remedies in combination (“Tramal” + “Atropine”).

Very often, due to nausea, the patient cannot take the medicine. In this type of situation, drugs are administered using an enema. As a rule, a combination of Eufillin, Analgin and belladonna is used.

Drug therapy is also actively used to dissolve gallstones. How to display it in this case? The calculus can be literally dissolved with the help of ursodeoxycholic acids (Ursosan, Ursohol, Ursofalk) and chenodeoxycholic acids (Chenohol, Henofalk, Henodiol).

Who is it suitable for? this method treatment? First of all, stones in the gallbladder should be of a cholesterol nature, their size should be no more than 15 mm, and the contractility of the bladder should be normal. The course of treatment usually lasts from 6 to approximately 24 months. During this time, patients are advised to avoid medications that promote stone formation and interfere with the normal absorption of drug components (for example, antacids).

Removing stones without surgery

For this, shock wave lithotripsy is used - a technique in which a specialist uses ultrasound or a laser to “break” a stone in the gall bladder. Surgery to remove a stone is not suitable for all patients. It is recommended only if the number of stones does not exceed three, they differ in cholesterol nature. Due to the fact that the procedure involves direct physical impact, it is not suitable for patients with bleeding disorders.

A total of no more than seven therapy sessions are required. The stones fragment to particles of about 3 mm, and then pass out on their own along with the bile. In practice, this treatment is usually combined with drug therapy. Common side effects include the following: development of the inflammatory process.

A laser can also be used to remove gallstones. Laser removal surgery is carried out on the same principle as ultrasound. However, with this procedure there is a fairly high probability of burning the mucous membrane. That is why its help is resorted to only in exceptional cases.

Surgical intervention

Surgery is different high efficiency with a problem such as a gallstone. The operation to remove an existing stone can be carried out in two ways:

Open cholecystectomy. This is a classic procedure recommended for large stones. During the operation, the doctor makes an incision in the abdominal cavity, then removes the gallbladder and, if necessary, drains it. Drainage involves the installation of special plastic tubes for the outflow of blood, biological fluids and wound exudate. A couple of days after surgery, the tubes are removed.
Laparoscopy is now actively used in many areas of medicine. One has to resort to its help in case of such pathology as a stone in the gall bladder. The operation to remove stones is characterized by its low-traumatic nature. Initially, the surgeon makes several punctures, through one of them the carbon dioxide directly to yourself abdominal cavity. This is necessary so that the abdomen increases in size, and in the resulting space it is easier to carry out manipulations. After this, the laparoscope itself is inserted directly through the trocar. It is a tube with a camera at the end. An optical cable with a light source can be connected to it. This device allows you to view organs from the inside, since the image from the laparoscope is displayed on a computer screen. Micromanipulators are inserted through the remaining trocars to perform the operation itself.

Today, when choosing from the options proposed above, experts most often give preference to the second. Laparoscopy is recommended if the stone in the gall bladder is 2 cm. An operation of this kind has many advantages. These include the following: fast recovery, absence postoperative scars, slight bleeding.