home Preparations Symptoms of a disease of bile. The main and first symptoms of inflammation of the gallbladder in women. General information and norms of the size of the gallbladder

Symptoms of a disease of bile. The main and first symptoms of inflammation of the gallbladder in women. General information and norms of the size of the gallbladder

At the initial stage of the development of pathology, the symptoms of gallbladder disease do not appear for a long period. This is the main danger. Let's look at what happens in this organ under the influence of a long-term sluggish inflammatory process. To begin with, it is worth understanding that the bubble consists of three layers. These are serous, muscular and mucous walls. Each of them is responsible for a specific function. The mucous membrane provides filtration and concentration of incoming bile. The muscle layer is responsible for the timely contraction of the cavity for the release of bile into the duodenum after receiving a signal from the food chain.

Any pathological process involving an inflammatory agent leads to gradual deformation and damage to normal physiology. cell structure. At the site of inflammation in the absence timely treatment starts to form connective tissue. In the future, this becomes the basis for colloidal scars. gallbladder loses its elasticity and ability to filter and concentrate bile. Multiple "constrictions" of cicatricial etiology make it difficult to discharge this physiological fluid. A stagnant environment creates prerequisites for the development of pathogenic microflora. It is at this stage that the first signs of gallbladder disease may appear.

The first obvious symptoms of gallbladder disease

The most common disease of the gallbladder is cholecystitis. It is a kind of starting point for the formation of cholelithiasis, pancreatic necrosis, structural changes in the hepatic parenchyma. The first obvious symptoms of this gallbladder disease may include:

frequent belching of an egg;
heaviness in the right hypochondrium;
massive discharge of bile, accompanied by pain in the intestines and liquid stool with a characteristic brown tint;
coated tongue (mainly in the root part) with a dense yellow or brown coating.

Less obvious symptoms of gallbladder disease are frequent feeling unwell human, headaches on an empty stomach, frequent disorders acts of defecation (stool is not regular, constipation is replaced by functional diarrhea, fatty stools may appear). An increase in body temperature is not characteristic of chronic cholecystitis in the acute stage in pure form. However, a pathogenic process in the pancreas often joins it. Against the background of necrosis of pancreatic cells, an increase in body temperature occurs.

Phases of exacerbation of this disease may be accompanied by frequent vomiting, bitterness in the mouth, loss of appetite. Often there is a reflux of bile into the cavity of the stomach and into the esophagus. This is accompanied by intense burning and belching bitterness.

And what happens in the future?

If at this stage the disease is not treated intensively, then in the future the symptoms of gallbladder disease will increase. Pathologies of other organs of the digestive system will begin to join them. After 2 years, hepatosis and cirrhosis of the liver may develop. The constant stagnation of bile will lead to the precipitation of the initial excrement in the form of bilirubin. In the future, against this background, will begin to develop gallstones, which can lead to cholecysectomy or bladder rupture.

Quite often, the symptoms of gallbladder disease occur already in conjunction with manifestations of signs of other pathologies. We are used to not paying attention to mild weakness, nausea and yellow coating on the tongue. But it is precisely these indirect signs that can promptly signal us that it is necessary to undergo an examination and conduct a course of restorative therapy. If you have signs of pancreatitis, gastritis and colitis, then more serious treatment will be required.

We recommend that you, in the presence of even temporary discomfort in the right hypochondrium, not be limited to ultrasound examination of the liver and gallbladder. Also perform bile tests using duodenal sounding, check the condition of the pancreas, small and large intestines. Believe, reveal on early stage pathology in the gastrointestinal tract - this means maintaining your health for many years.

The minimum set of examinations for the diagnosis of gallbladder diseases should include:

general and biochemical analysis blood with the obligatory determination of the level of sugar, amylase, liver tests and bilirubin;
ultrasound examination of the liver, pancreas and gallbladder;
fibrogastroscopy with bile sampling for biological and chemical analysis;
x-ray of the intestine or colonoscopy (if possible, can be replaced by magnetic resonance computed tomography).

Treatment should be carried out by a gastroenterologist. Exclude presence viral hepatitis And diabetes. Follow a strict diet with no spicy, salty and fatty foods. It is also worth paying attention to the functioning of the intestines. Avoid prolonged constipation. They can provoke the growth of oncological neoplasms in the colon.

A full life of any person implies the normal functioning of all internal organs and systems. One of the most important difficult functional features organism is the optimal functioning of the digestive tract system. Violation of the capacity of at least one section of the vital chain entails a series of pathological changes in specific organs, provoking the development of an inflammatory process in other structures of the body.

Not all people imagine the exact location of the internal organs. Understanding usually comes with a problem. Production disruption essential substances, including bile, which promotes the breakdown of fats, leads to pathological changes affecting all internal systems. Therefore, with problems with the gastrointestinal tract, it is important to know where is the gallbladder located and how does it hurt.

IN human body one of the most important organs is the liver. Its functionality includes several important actions, one of which is the formation of bile. The biological fluid synthesized by the body is directly involved in the digestive process. After its formation, the liver pushes bile through a special duct into the gallbladder, where it accumulates and concentrates.

Being preserved as a single clot, a certain amount of biological substance can be released from the pear-shaped bladder into the intestinal region to participate in the processing of food entering the esophagus. This is especially true for overly fatty, fried foods. At normal functioning organ ejection process occurs approximately 2 hours after the ingestion of food.

The main function of bile is the breakdown of fat components absorbed by the body. It contributes quality assimilation nutrients, screening out harmful components, the synthesis of protein cells. The secretion of bile stimulates normal work cavity of the stomach, intestines, contributes to the optimal production of enzymes by the pancreas.

One more important feature bile is to protect the intestinal microflora from the penetration, reproduction of pathogenic microorganisms in it.

Location of the gallbladder

Before making assumptions about why pain in the gallbladder may occur, you need to familiarize yourself with its location in the body. Some don't even think about possible reasons soreness, taking painkillers in the hope of eliminating discomfort. This is the wrong decision, because before stopping the pain syndrome, you need to have an idea about the structure of the organ and its location.

The gallbladder is a small pear-shaped hollow organ, located 3 cm below the costal arch, in close contact with the wall of the peritoneum and the right bottom liver. The intersecting part of the rectus abdominis with right side costal arch and is the site of localization of the gallbladder.

On a note! At physiological changes anatomical structure some people have a lower liver standard level. In this case, the gallbladder is located in the intestinal loops.

Standard organ sizes:

pear-shaped, without partitions, kinks;
gallbladder length from 7 to 12 cm;
volume 40-60 ml.

The main task of the gallbladder is the accumulation of bile, its release into the intestinal region if necessary. For two days in a normal, healthy body, up to 2 liters of bile are produced and excreted.

Anatomical structure of the gallbladder

The body can be conditionally divided into three components:

bottom;
the neck of the organ;
main body.

The bottom is clearly visible with the help of ultrasound, as it stands out noticeably from the main body of the gallbladder. The body is located between the hepatic duct and the bottom, is the most wide part organ. The neck is the narrowest structure that is involved in the connecting process of the liver duct with the gallbladder.

The hepatic duct plays the role of a transporter of biological exudate (bile), it can be up to 4 cm long. Up to 50 ml of bile substance can be contained inside the bladder at the same time. When the need arises, bile is released through the small duct. Stimulates the release of fluid signal transmitted through the nerve fibers of the digestive system at the time of entry into the esophagus of food. The excretory duct is called the pancreatic ampulla.

The main components of the gallbladder are:

internal epithelial tissue;
mucous membrane;
outer serous wall.

On the outer serous side of the organ there are a large number of folds in which the mucous glands are located. Its feature is the increased absorbability of the liquid. Therefore, the incoming bile, which is contained for some time in the gallbladder, has an increased concentration. Since the folds of the mucous membrane have a spiral arrangement, the incoming fluid has the ability to move in two directions.

If the digestive process does not occur, the pancreatic sphincters are in a protective position, which prevents the flow of bile. As soon as an impulse about the beginning of digestion arrives, the sphincters weaken their protective ability, bile enters the duodenum.

Features of the manifestation of pain, location

Pathological changes occurring in the gallbladder are almost asymptomatic at the initial stages. A person does not feel any discomfort or periodically experiences discomfort in the right hypochondrium.

Violation of the work of the body contributes to the temporary accumulation of a certain amount of bile in it. It goes through the stages of concentration and crystallization. Accumulating mainly in the area of cholesterol, the formation of stones occurs. It can be either a single stone clot or a multiple accumulation of neoplasms. When stones pass through the bile ducts, a person may experience pain of increased intensity.

The initial diagnosis is to determine the presence of pathological changes by palpation of the organ. At the same time, there is an increase in the size of the gallbladder, a change in consistency to an increased degree of hardness, there is tension in the muscle tissue.

At the existing stages of the disease, pain manifests itself in different ways:

The initial stage is characterized by the presence of discomfort, the periodic presence of colic. Colic can be short-term, lasting up to 5 minutes, long-lasting, not letting go for several hours.
Later stages of the disease are characterized by the constant presence of pain, while the patient experiences a feeling of nausea.

Additional symptoms of pathology are:

dryness of the mucous membrane oral cavity;
nausea, accompanied by vomiting;
the presence of a frequently repeated eructation;
a significant increase in body temperature (up to 40 degrees);
dizziness, disorientation in space;
general weakness, overwork of the body;
tachycardia, rapid pulse, unstable heartbeat;
increased sweating;
feeling metallic taste in the mouth;
itching skin;
feeling of a stone intestine, bloating;
increased gas formation;
violation of the act of defecation (diarrhea, constipation).

If a person experiences these symptoms, you should immediately seek medical advice.

The nature of pain depending on the pathology

The main symptom of any disease is characterized by the difference in the manifestation of the patient's conditions. The main provocateurs pain syndrome are the following anomalies:

metabolic disorders in the body;
the presence of chronic, newly acquired diseases;
inflammatory processes localized in the bladder and ducts;
getting injured;
the presence of congenital pathologies.

Learn more about pain syndromes:

Disease	Image	Symptoms
		Inflammatory process that forms in the mucous membrane of the organ. The main causes of pathology are malnutrition, diseases of the biliary tract (the presence of stones in the bladder), inflammatory processes that develop in adjacent organs. At acute development the following states are present: cutting sensations in the liver; hyperthermia (up to 39-40 degrees); Pathological changes in the digestive system (nausea, vomiting, belching, stool disorders); drying of the oral mucosa; febrile conditions; increased fatigue. In the chronic stage of the disease there are remissions, relapses. In the initial stage of the disease, there is practically no discomfort, periodic attacks of nausea, weakness, Blunt pain in the right hypochondrium
		The development of the disease is facilitated by a metabolic disorder in the body, a modification of the consistency of bile, an unbalanced diet, insufficient physical activity, increased body weight, and hormonal imbalance. The intensity of the pain syndrome directly depends on the number, scale of stones in the bladder, and the location. The initial stages of the disease are characterized by sluggish current symptoms, which subsequently increase significantly. In this case, the following signs of pathology appear: Minor cutting sensations in the right side of the hypochondrium, radiating to the scapular region, shoulder joint, hand; The urge to vomit a feeling of fullness in the abdomen, increased gas formation; bitter taste in the mouth. During the blocking of the biliary tract by stony substances, a sharp, unbearable pain sensation occurs, which intensifies during a sigh, a change in body position. Quite often, this condition is accompanied by nausea, the release of vomit. provoke unpleasant symptoms capable of excessive exercise, shaking while riding in public transport, sharp body turns
		Pathology is a violation of the discharge of secretory fluid due to a malfunction of the biliary tract, the organ itself. The disease is provoked by frequent stressful situations in which the patient is, hard physical labor, lack of diet. The initial stage of the disease is not characterized by particularly pronounced symptoms. Further development is manifested by the following states: Pain of a pulling, aching nature, localized in the right hypochondrium; Persistent loss of appetite The presence of belching, accompanied by a taste of bitterness; nauseous conditions; flatulence of the intestines
		This pathology indicates a decrease in the functional abilities of the organ. The following pathologies contribute to bending: Congenital deviations of the anatomical structure; Deformation, displacement of neighboring organs as a result of excessive physical activity; Pathological enlargement of the liver. Pathology is accompanied by such conditions as: cramps in the lower abdomen; The urge to vomit General intoxication of the body, accompanied by nausea, weakness; Increased sweating accumulation of gases in the intestines. The occurrence of pathology provokes the development of pancreatitis, gastric ulcer, the formation of erosions on the mucous membranes of the stomach, cholelithiasis. The disease is dangerous with the risk of cracks that can release secretory fluid into the abdominal cavity
		The symptomatology characteristic of cancerous neoplasms manifests itself depending on the severity of the pathology. At the first stages of the development of oncological diseases, pain is absent. Subsequent stages are characterized by the presence of the following symptoms: Pronounced pain, not amenable to relief by taking antispasmodics medicines; disruption of work gastrointestinal tract accompanied by an intestinal disorder; yellowing of the skin; drastic weight loss Accumulation of free fluid in the abdominal cavity, accompanied by a sharp deterioration in the general condition of the patient

Diagnostic methods

Availability pathological processes in the gallbladder should not be ignored. It is necessary to undergo a consultation, a diagnostic examination by an oncologist. Based on the patient's complaints at the time of contacting the clinic, his general inspection the following diagnostic measures are assigned:

general and chemical analysis of blood;
fibrogastroduodenoscopy to determine the type of infection that provoked the pathology;
cholecystography (X-ray examination using contrast agent);
Ultrasound of the gallbladder, which determines the degree of deformation of the organ, its thickening;
cholegraphy with a contrast component to assess the functional ability of the biliary tract;
radiography, which determines the size, functional abilities of the organ;
MRI, CT, contributing to the recognition of changes in tumor formations.

Ultrasound of the gallbladder - the norm

Based on the results of the examination, doctors prescribe the appropriate treatment.

Treatment options

Based on the diagnosis, appropriate treatment of pathologies is carried out. General therapeutic measures include taking medications aimed at:

Drugs that reduce spastic conditions:

Drotaverine (take up to 3 times a day no more than 240 mg);
No-Shpa (1-2 tablets 3 times a day);
Spasmalgon (dosage is 2-3 doses per day, 1-2 tablets).

Cholagogue preparations:

Ursosan (1 capsule per day);
Holosas (1 teaspoon of syrup 3 times a day);
Heptor (800-1600 mg per day).

Antibiotics:

Ampicillin ( intramuscular injections 0.5-1 g every 6 hours);
Oksamp (500-1000 mg 4 times a day);
Cefazolin (500-1000 mg twice a day).

Physiotherapeutic procedures are also carried out:

taking baths with the addition of coniferous extract;
conducting UHF-therapy on the hypochondrium;
the use of electrophoresis with Papaverine, Platifillin.

Video - The first symptoms of gallbladder problems that should not be ignored

Traditional medicine

An effective treatment is the use of traditional medicine.

Recipes of folk remedies:

A good way to dissolve liver secretions is to take 30 ml of olive oil 3 times a day for 3 days. Oil intake should be carried out half an hour before a meal, after which it should be washed down with 30 ml of grapefruit or lemon juice.
The cleansing of the gallbladder is facilitated by eating raw yolks. To do this, in the morning it is recommended to separate the yolks of two chicken eggs from the proteins, drink on an empty stomach, drinking juice squeezed from 2 lemons. The duration of therapy is 2 weeks. At high cholesterol method is contraindicated.
Cleansing the gallbladder with wild rose. To prepare the medicinal composition, it is necessary to clean, cut the root of the plant, into 2 tbsp. tablespoons of the product add 220 ml of boiling water, after which the contents are boiled over low heat for half an hour. Strain, divide into 3 doses, consume in small sips during the day. The course of treatment is 2 weeks.

Sometimes a course of hirudotherapy is equated to traditional medicine. The leech is placed on the area of the right hypochondrium, the duration of one procedure is 15-20 minutes.

Regardless of what causes painful conditions in the gallbladder, it is necessary to diagnose the cause that led to the development of the pathology in a timely manner. A competent specialist is able to quickly recognize the disease, prescribe adequate treatment. Therefore, if alarming symptoms of abnormal functioning of the organ occur, it is recommended not to delay the solution of the problem, but to immediately seek medical help.

The gallbladder is a digestive organ resembling a hollow pear of small size. It is located under the liver, with which it is connected by the system bile ducts. The photo below shows its location. The main function of the bile ducts and gallbladder is associated with the accumulation and excretion of bile. Gallbladder disease disrupts its normal functioning.

Bile is a fluid produced in the liver. Its function in the body is the ability to activate the movement of food through the intestines and improve the absorption of fats. During the day, about two liters of bile are produced in the human liver.

Various disorders in the functioning of the digestive system cause diseases of the gallbladder:

Dyskinesia. Dyskinesia is one of the most common diseases of the gallbladder. Its occurrence is associated with a violation of the contractions of the bile ducts and the walls of the gallbladder. Dyskinesia appears as periodic pain in the right upper abdomen. The nature of the pain may vary.Dyskinesia is a benign disease. However, you should not leave it unattended, as it can cause the development of cholelithiasis (GSD).
Cholelithiasis occurs due to a violation of the metabolism of bilirubin (a pigment that gives bile a greenish-yellow color), bile acids, cholesterol and inflammation in the gallbladder, slowing down the separation of bile or stagnation of bile in it.
Cholecystitis. This is called inflammation of the gallbladder. In some cases, there is a blockage of the bile ducts, which interferes with the outflow of bile and causes inflammation. This condition requires hospitalization and surgery.
cholesterosis- deposition of cholesterol in the walls of the bladder.
polyps– benign formations. The disease is asymptomatic. Symptoms appear when the gallbladder outlet is blocked.
Cancer Diseases of the gallbladder can provoke the occurrence of biliary pancreatitis, inflammation of the pancreas.

Causes of gallbladder disease

infections - coli, streptococcus, staphylococcus, Pseudomonas aeruginosa, cause inflammation of the mucous membrane of the gallbladder and complications in the form of cholecystitis;
imbalance chemical composition bile (increase in cholesterol, bile acids and minerals) contributes to the formation of stones and the development of cholelithiasis;
violation of the innervation of the gallbladder leads to the development of its dyskinesia;
giardiasis;
the role of hepatitis viruses is not excluded;
hereditary changes in the shape, size of the body.

Symptoms

Similar diseases, regardless of the causes and mechanism of their development, are manifested by similar main symptoms:

patients are concerned about pain in the right side of the abdominal cavity, which is not relieved by taking medications. Pain may have varying degrees intensity (insignificant in the inflection of the gallbladder, expressed in cholecystitis, stones). Increased pain occurs during the day following a meal, especially fried, fatty, smoked. In the event of the release of stones from the gallbladder, a sharp pain occurs, called hepatic colic.
dyspeptic symptoms - nausea, vomiting;
fever;
crimson tongue;
loss of appetite;
weight loss;
bitter taste in the mouth;
flatulence, bloating;
belching with air;
dry mouth;
stool disorder, constipation;
intense color of urine from rich yellow to brown. Such staining is associated with the absorption of bile acids into the blood and their subsequent excretion in the urine;
. A decrease in the amount of bile acids entering the intestine does not stain the feces in the normal brown color;
insomnia;
skin itching;
fever and jaundice may develop.

The appearance of jaundice indicates hepatic-renal failure. It can cause the development of cirrhosis of the liver, bleeding, internal fistulas.

The listed basic symptoms may vary in each case of manifestation of the disease. Some of them may not show up.

Diagnostics

For diagnostics similar diseases the following types of research are used:

Blood analysis.
Inspection of the skin, oral cavity.
Ultrasound of the gallbladder helps to diagnose gallstone disease, cholecystitis, neoplasms. The procedure can be difficult in case of bloating.
Cholecystography is used in cases where it is impossible to conduct an ultrasound examination. Detects the presence of gallstones.
Chole scintigraphy is used for suspected chronic or acute cholecystitis.
Computed, magnetic resonance imaging is a study that detects the smallest inclusions (stones, formations).
A fine needle biopsy is used to detect tumor cells.
Duodenal sounding is a test in which a thin tube is inserted into the duodenum and bile is collected through it for research, which determines the composition of bile, reveals inflammatory elements and atypical cells.

Gallbladder disease: treatment

For the treatment of diseases of this type you need to see a gastroenterologist. If necessary, in the absence positive result from therapeutic treatment a consultation with a surgeon is scheduled.

After carrying out the appropriate diagnosis, experts decide on surgical intervention. An effective supplement drug treatment is the use of folk remedies.

Folk remedies

Widely used in the treatment of gallbladder disease herbal preparations. The composition of the fees includes herbs with anti-inflammatory and choleretic effects:

wormwood
yarrow
immortelle flowers
fennel fruit
birch leaves

The collection of the herbs listed above has proven itself well. To do this, each type of herb is taken in the volume of one dessert spoon, the entire volume of the mixture is placed in a container and poured with 400 ml of cold boiled water. The container is covered and left for ten hours to infuse. After the specified time, the infusion is filtered. Take it before meals, three times a day, 0.33 cups.

Effective use of the following recipe. It will require dandelion roots and leaves. Squeeze the juice out of them and dilute it boiled water. The resulting drug, take one tablespoon three times a day.

A quick result that brings almost instantaneous results is achieved through the use of a potion that anyone can prepare with their own hands. For him, you need knotweed grass, bear ears, corn stigmas, smooth hernia, bean pods. All ingredients are taken in equal parts.

The resulting raw material is mixed. For infusion, take one tablespoon of the resulting collection, pour 250 ml of boiling water. To get the best result, the infusion is prepared in a thermos, steaming it for an hour. After the specified time, the solution is filtered and the medicine is taken during the day, one-third of a glass 30 minutes after eating. To improve the separation of bile, the infusion is drunk on an empty stomach before meals.

If it is impossible to take the infusion during the day, herbalists advise taking the potion prepared according to the following recipe. It will require yarrow grass, rhubarb, sandy immortelle flowers, which are taken in proportions 5:2:3. One tablespoon of mixed raw materials is brewed in boiling water. Hour insist in a thermos. Drink infusion before going to bed for 2/3 cup. The course of treatment is 24 days.

In the treatment of the gallbladder folk remedies use a set of special exercises:

Exercise 1

Lie on your back. bend left leg, on the count of times, raise your right hand up and inhale. Exhale for a count of two. The exercise is repeated with the other leg.

Exercise 2

The exercise is performed lying on your back, on the floor. Hands are placed on the belt. Exhaling, raise your head and shoulders up, looking at your socks. When exhaling, they return to their original position.

Exercise 3

The exercise is performed lying on the left side. The straight left arm is raised up, the left leg is bent at the knee. While inhaling, raise your right hand up. Right leg bent at the knee and strongly pressed to the chest with right hand. Repeat several times.

Exercise 4

Get on all fours. As you inhale, raise your arm up and to the side. As you exhale, return to the starting position. The exercise is repeated several times, alternately changing hands.

Treatment should be carried out under medical supervision. Folk methods may act as additional therapy that reduces the progression of the disease. The main treatment is prescribed by a doctor and is carried out using prescribed medications.

Medical treatment

Drug treatment includes the appointment of complex therapy, taking into account the causes of the disease and existing pathological changes. However, in any course, there are basic principles used in the treatment of all diseases of this organ:

Diet. The purpose of the diet is to reduce harmful influence consumed food for the work of the gallbladder. For such diseases, table No. 5 according to Pevzner is recommended, which excludes fatty varieties meat, poultry, fish and rich broths.

It is desirable to use lean meats (beef, rabbit), poultry (chicken), fish (preferably river fish), dairy products, vegetables and fruits. Food with such a diet is steamed or stewed. It is forbidden to eat fried, smoked dishes. Milk is not recommended.

Nutrition. In diseases of the gallbladder, the process of eating and its quantity are of particular importance. Optimal six meals a day with small portions, dinner at least two hours before bedtime. Snacks and dry meals are not allowed.
Etiotropic therapy used to stop the cause of the disease. It includes taking antibiotics (ampicillin, gentamicin) in the treatment of cholecystitis, surgical treatment for gallstone disease (cholecystectomy), gallbladder tumors and polyps.
Pathogenetic therapy shown to restore the functions of the gallbladder. Antispasmodics are prescribed in the treatment of hyperkinetic type of dyskinesia, they reduce the overall intoxication of the body with cholecystitis and tumors. In order to improve digestion, preparations containing enzymes with bile acids (mezim, pancreatin, festal) are used.
Symptomatic therapy provides for treatment aimed at reducing discomfort, pain relief (ketones), antispasmodics (drotaverine, no-shpa), their combinations () lowering fever (paracetamol).

To dissolve stones, drugs are used: henofalk, henochol, henodol, henosan. Their appointment is associated with the general course of the disease and the health of the patient.

Prevention

Prevention of such diseases includes:

rational nutrition, excluding dry food, eating fried, smoked foods, overeating, eating at night;

In the treatment of diseases of the gallbladder in combination with drug exposure recommended diet. The diet depends on the complexity of the disease and its severity.

With an exacerbation of cholecystitis, the menu contains liquid products: unsweetened tea, juices diluted with water, light vegetable grated soups. The use of cereals is allowed, but after the removal of the attack, for about 3-4 days.

Food should not be hot or cold.

Sauces, marinades, smoked meats, pickles, baking, spicy and fatty dishes, garlic, rhubarb, radish, radish, onion are excluded from the diet.

Permitted to use lean varieties poultry, rabbit meat, beef, fish, mostly river fish, boiled.

Sample menu:

From drinks, weak tea with milk, kissels, compotes, decoctions of dried fruits, natural juices diluted with water.
Dried, "yesterday's" wheat, Rye bread.
After the attack is weakened, dairy products are included in the diet: homemade yogurt, milk, kefir, sour cream, but in moderation.
Sunflower, butter and olive oil are eaten as a dressing for food.
Soft-boiled eggs are allowed, without yolks, omelets baked in the oven or steamed.
Light pureed soups without the use of onions and carrots for sautéing.
Low-fat meat of fish, beef, poultry, rabbit in baked or boiled form.
Crumbly, semi-viscous porridge made from oatmeal, buckwheat, pearl barley.
Baked or raw vegetables and fruits.

Gallbladder disease in children

In childhood, there is inflammation of the gallbladder and bile ducts, dyskinesia, less often - cholelithiasis, tumors.

Diseases of the biliary tract are typical for children of all ages, but they are more common in 6-10 years. The disease is more prevalent in girls. Inflammation of the biliary tract at the age of 4-5 years occurs with symptoms of prolonged subfebrile temperature body and moderate general intoxication. The inflammatory process usually affects the entire biliary tract system.

For any nature and type of disease, long-term treatment is required. If there is no recurrence within two years, the child is removed from the register of the pediatrician.

Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on individual characteristics specific patient.

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Inna Lavrenko

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Gallbladder diseases are conditions associated with a violation of the natural functioning of the organ and the pathways that remove bile. They are accompanied by a difficult separation of bile and some other manifestations.

It resembles a pear in shape and is located near the lower lobe of the liver. Despite its small size, this organ plays an extremely important role - it is in it that bile accumulates, which the liver produces and, thanks to muscle contraction, at some point it enters the duodenum, where it fulfills its purpose.

Bile accumulates in the bladder until digestive tract there will be no need for its use, namely, in the process of eating by a person. The intestine, thanks to this substance, copes with the active digestion of incoming food.

Problems and pathological conditions of the organ and pathways lead to a significant deterioration in the quality human life– in addition to pain, pathology makes you abandon the usual products, in some cases, such a measure is adhered to until the end of life. A long stagnation of bile in the bladder can eventually lead to significant changes - given fluid in large volumes has a destructive effect on all organs into which it enters and in which it stagnates.

It is customary to distinguish several main diseases of the biliary tract and gallbladder, and each of these conditions requires a professional approach to the treatment process:

colic;
dyskinesia;
the appearance of a tumor and so on.

Causes leading to the development of the disease

The first "bells" that speak of a growing problem with the gallbladder are:

feeling of bitterness in the mouth;
loss of appetite;
sleep disturbance and constant malaise.

Actions that affect the development of gallbladder disease:

wrong diet. The constant use of unhealthy food causes too active secretion, and some of its components can lead to the accumulation of stones and sand;
high concentration or lack of cholesterol;
got infection. Some types of bacteria can lead to progressive inflammation of the mucous membranes;
the cause of the disease may be a disturbed work of the muscles of the organ - insufficient or, conversely, too frequent contraction;
the so-called innate moment also plays a primary role. If the patient has a hereditary change in the anatomical shape of the organ, then this greatly increases the chances of bending. Genomic changes in the cellular structure create ideal conditions for the development of a malignant or benign tumor.

What is gallbladder dyskinesia?

In the vast majority of cases, an unbalanced diet, or rather, its detrimental effect, causes the appearance of dyskinesia of the gallbladder and tracts that remove the secret. This condition manifests itself in the form of impaired work of the musculature of the organ.

A large amount of spicy and fried foods, irregular meals are moments that can cause a hyperkinetic (contractions are too strong and frequent) and hypokinetic (contractions are not intense enough for the secret to leave) form of the disease.

The accumulation of bile that occurs with this, without taking adequate treatment, will only lead to a deterioration in the condition and the development of other diseases that pose ever greater threats. Dyskinesia affects not only the gallbladder, but also the sphincters that connect the ducts to other organs of the digestive tract:

Sphincter of Oddi (located near the entrance of the duct into the duodenum);
Myricia (located at the confluence of the ducts from the gallbladder and liver);
Lutkens-martynov (neck of the gallbladder).

In patients with the development of such a pathological condition, severe pain is noted in the hypochondrium. Sensations are specific in nature - the attacks are repeated and are of a aching type. Apart from pain There may be other symptoms as well:

increased heart rate;
nausea;
headache;
increased sweating.

In medical practice, painful conditions affecting the gallbladder are not uncommon. The most common condition among them is considered to be. In this case, a violation of metabolic processes is noted, as a result of which stones begin to form in the elements of the biliary system.

According to statistics, the beautiful half of humanity is more susceptible to this condition, women over forty who have given birth to several children and are overweight are at risk. The incidence rate after fifty years in women and men is about the same level.

The likelihood of solid formations in the gallbladder is higher in those people whose work usually takes place in a sitting position and is associated with psycho-emotional overload. Appeared stones may have different formulations, size, and location. The main point leading to the active formation of such formations is a high percentage of cholesterol in the body.

The course of the disease is long - the formation of stones in the gallbladder can last more than one year and not bring discomfort at all. In eight out of ten cases, gallstone disease occurs without any symptoms.

In other patients, the following signs may indicate an impending problem:

pain attacks in the side in the right hypochondrium
sensations of pain;
belching and nausea;
feeling of bitterness.

The presence of stones is most often characterized by biliary colic. And you can read about the methods by clicking on the link.

Colic as an indicator of gallbladder problems

Such colic in itself is not a disease, it is only main symptom, indicating problems with the pathways that excrete bile and the organ itself. Most often, it appears due to blockage of the duct by a solid formation, which makes it difficult for the secretion to flow out and leads to a spasm of pain, and dyskinesia. biliary colic, that's enough characteristic manifestation, it can be completely distinguished from other painful conditions by the following symptoms:

the unpleasant sensations that appear are closely related to the food taken, or rather, with the use of heavy food (smoked, fried, alcoholic drinks and spicy);
in some cases, physical exertion, a long stay in a tilt position, severe stress can become an impetus;
pain attacks are intense and pronounced, on average, the pain does not end for three to five hours;
the syndrome reaches its maximum mark after sixty minutes;
during such a phenomenon, a person may have a fever and vomiting;
pain intensifies even with a slight movement, a deep breath, spreads, giving to other organs.

The main task of doctors during the diagnosis of this condition is to stop the attack. As soon as the pain is removed, proceed to further research, which helps to understand the causes.

This painful condition can be divided into two groups:

Acute cholecystitis is characterized by sudden and severe pain. Feelings can be located with right side, but in some cases they give to the spine. Other signs may appear - vomitus interspersed with bile, increasing temperature, increasing muscle tension, jaundice.

The chronic variant may not manifest itself in any way for a long time. Symptoms are not pronounced, but may appear after eating a heavy meal in significant quantities. Patients sometimes report general weakness, excessive irritability sleep becomes short. Increasing manifestations most often indicate an incipient exacerbation.

Tumor

Obstructive formations in the bile excretion system can be benign in nature, as well as malignant, that is, dangerous. Usually the first ones do not manifest themselves in any way and are discovered by chance during a diagnostic examination. Such formations often appear with the development of cholecystitis.

Polyps, this is a pathological proliferation of the upper layer of the mucous membrane of the gallbladder and clinical manifestations are not observed. Polyps, by the way, are observed in five percent of patients, most of whom are women over thirty. Cancer malignant tumors in almost one hundred percent of cases, they are supplemented by cholelithiasis.

The process of the appearance of a tumor is similar to polyps, the condition quickly spreads to other organs of the gastrointestinal tract.
The most common diagnosis is adenocarcinoma. Usually the initial stage of cancer proceeds without obvious manifestations, only at a later stage do general indicators begin to appear:

loss of appetite;
high fatigue;
anemia;
weight is reduced.

When conducting an examination during palpation, a specialist can detect a dense formation that looks like a tubercle - the most characteristic symptom tumors that are malignant.

Changing anatomical shape

The gallbladder consists of several sections: neck, body and fundus. The impact of a mechanical nature and congenital moments can lead to a change in the natural arrangement of these parts, form a constriction, and other unpleasant moments.

Deformation of this kind causes difficulty in the work of the biliary tract, which ultimately leads to serious stagnation. Symptomatic manifestations largely depend on the degree of change, but also note the general points that speak about this problem. Almost always, the inflection is accompanied severe pain, which mark in the right side under the ribs.

There are also various difficulties that are associated with the digestive process, since the deformation causes a violation of the normal separation of the secret. If, due to the changed shape of the organ, blood circulation is disturbed, unpleasant changes appear in general well-being, including frequently changing mood, sweating, unwillingness to do anything.

If the neck of the gallbladder is twisted, this causes tissue necrosis. In this situation, it appears sharp pain in the whole abdomen, nausea and a strong fever.

The ongoing decomposition causes the rapid spread of the inflammation process, and without the intervention of qualified specialists, this can lead to the death of the patient, and in a fairly short time (about twelve hours).

In order to reduce the possibility of developing gallbladder disease, you need to adjust your own life. It is important to remove all points that can create a suitable environment for the development of diseases. Prevention pathological conditions JP means:

balanced and ;
severe restriction in the use of alcohol;
you can not take too much food. It is best to eat about four times a day, but in small portions;
the diet should include foods that include protein;
avoid starvation, excessive stress and stress - all this can become a provoking factor;
but sports should not be completely abandoned, training should be moderate.

Pain under the ribs on the right side should make a person think - very often they can be the first signal, then do not hesitate to go to the hospital for help. A diagnostic study allows you to determine a specific disease, and if this is done on time, then the ongoing treatment will certainly bring a positive result.

Remember - you can’t self-medicate or completely ignore the pain, since all this can lead to sad consequences. But a responsible approach to one's own health gives a favorable prognosis for a full recovery.

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Dyskinesia of the gallbladder and biliary tract is a disease in which there is a violation of motility (movement) and tone of the gallbladder, as well as its ducts.

Some statistics

Among all diseases of the gallbladder and bile ducts, dyskinesia is 12.5%.

Women are 10 times more likely to suffer from this disease than men. What is associated with the peculiarities of hormonal and metabolic processes female body(for example, changes during pregnancy, taking oral contraceptives). Women are especially vulnerable young age asthenic physique.

Among children, adolescents are most often affected.

In 2/3 of all cases, this is a secondary disease that develops against the background of damage to the gastrointestinal tract (colitis, peptic ulcer of the duodenum and / or stomach, pancreatitis, gastritis).

The most common (about 60-70% of all cases) is the hypotonic form. IN modern medicine the disease was first described by surgeons in 1903-1909, who operated on a patient with severe pain in the right hypochondrium. However, when they opened the abdominal cavity, they did not find any stones or inflammation in the gallbladder. After that, the disease began to be carefully studied by general practitioners.

However, even in antiquity it was noticed that there is a connection between the negative emotions of a person and the disease of the gallbladder, as well as its ducts. Therefore, such people were called "bilious".

In addition, everyone knows about the four types of temperament, which are described in the treatises of medicine by doctors of antiquity.

For example, anger and irritability indicate an excess of energy at the point of the gallbladder - a hypertonic variant of dyskinesia (choleric type of temperament). That is, the wall of the gallbladder is tense and greatly reduced.

While bitterness, lethargy and a tendency to depression indicate a lack of energy at the point of the gallbladder - a hypotonic variant of dyskinesia (a melancholic type of temperament). That is, the wall of the gallbladder is sluggish and poorly reduced.

Anatomy and physiology of the gallbladder

gallbladder- a hollow organ. It is usually located on the right in the upper abdomen, approximately at the level of the middle of the lower hypochondrium (below the last rib).

The length of the gallbladder ranges from 5 to 14 cm, and the width is from 3 to 5 cm. Its capacity on an empty stomach is from 30 to 80 ml. However, with stagnation of bile, its volume increases.

Normally, the gallbladder has an elongated pear-shaped shape (with wide and narrow ends). However, sometimes its shape is rather bizarre: spindle-shaped, elongated, doubled, with an inflection or internal bridges, and so on.

The gallbladder has three parts - the bottom, body and neck (narrow part). The cystic duct leaves the neck, which later joins with the hepatic duct to form the common bile duct. In turn, the common bile duct opens into the cavity of the duodenum (12 PC) in the region of Vater's nipple, which is surrounded by the sphincter (muscular ring) of Oddi.

The structure of the gallbladder wall

The mucous membrane consists of epithelial and various glandular cells that produce mucus. It forms multiple folds that form the sphincter of Lutkens-Martynov at the neck of the gallbladder, which prevents the release of bile before certain stages of digestion.

The muscular layer, which is mainly composed of smooth muscle fibers arranged circularly (circular)

The connective tissue membrane covers the outside of the gallbladder. It contains blood vessels.

Tasks of the gallbladder

Accumulation, concentration and storage of bile produced in the liver

Secretion of bile into the lumen of the duodenum as needed

Bile is produced by liver cells continuously (from 0.6 to 1.5 liters per day). Then it enters the intrahepatic ducts, and from them - into the gallbladder. In the gallbladder, bile is concentrated due to the absorption of excess water, sodium and chlorine from it by the epithelial cells of the mucous membrane.

Mechanism of excretion of bile from the gallbladder

The most important neurohumoral factors regulating this complex process are:

The autonomic nervous system (sympathetic and parasympathetic divisions), which regulates the work of almost all internal organs
Normal when activated vagus nerve(vagus), which provides sensory and motor innervation to most internal organs, the gallbladder contracts, and the sphincter of Oddi relaxes. If there is a violation of coordination in the work of the sympathetic and parasympathetic divisions of the autonomic nervous system, this mechanism is violated.
Intestinal hormones (motilin, cholecystokinin-pancreozymin, gastrin, secretin, glucagon) that are produced in the gastrointestinal tract during meals
When exposed to cholecystokinin in normal doses, the gallbladder contracts, and the sphincter of Oddi relaxes (in large breaths, gallbladder motility is inhibited). Gastrin, secretin, glucagon have the same effect as cholecystokinin, but less pronounced.
Neuropeptides (neurotensin, vasointestinal polypeptide, and others) are a type of protein molecule that has the properties of hormones.
They prevent the contraction of the gallbladder.
As a result of the close interaction of these factors during a meal, the muscular layer of the gallbladder contracts 1-2 times, increasing the pressure in it to 200-300 mm of water column. Therefore, the sphincter of Lutkens-Martynov relaxes, and bile enters the cystic duct. Next, bile enters the common bile duct, and then through the sphincter of Oddi - into 12 PCs. When diseases occur, this mechanism is disrupted.

The main functions of bile in digestion

Creates the necessary conditions in 12 PCs for the loss of pepsin (the main enzyme of gastric juice) of its properties
Participates in the breakdown of fats, contributing to their absorption, as well as absorption fat soluble vitamins(A, E, D)
Improves motor function (motility) of the small intestine and increases appetite
Stimulates the secretion of mucus and the production of intestinal hormones: motilin, cholecystokinin-pancreosemin and others
Activates the enzymes necessary for protein digestion (trypsin and lipase - pancreatic juice enzymes)
Promotes the proliferation of epithelial cells of the intestinal mucosa
Possesses antibacterial property, which is weakened by stagnation of bile

Causes of dyskinesia of the gallbladder

Distinguish between primary and secondary dyskinesia of the gallbladder and biliary tract (JVP), depending on the causes that led to the disease.

Also, a theory is currently being considered about a violation in the functioning of liver cells, so they initially produce bile, the composition of which has already been changed.

Primary dyskinesia of the gallbladder and biliary tract

At the onset of the disease, there are only functional disorders that are not detected by research methods (ultrasound, x-ray). However, as the disease progresses, structural changes in the gallbladder and its ducts.

Most common causes primary JVP

Secondary dyskinesia of the gallbladder and biliary tract

Occurs against the background of already developed diseases or conditions. Changes are clearly visible with the input methods of research.

The most common causes of secondary JVP

Symptoms of dyskinesia of the gallbladder

Depend on the type of violation of the motor activity of the gallbladder and its ducts.

Types of JVP

Hypotonic (hypomotor) dyskinesia develops with insufficient contractility of the gallbladder and its ducts. It occurs in patients with a predominance of the tone of the sympathetic nervous system (normally dominates during the day), which lowers the tone and motor activity Gastrointestinal tract, as well as the gallbladder and its ducts. Most often, this form of the disease affects people over 40 years old.
Hypertensive (hypermotor) dyskinesia develops with increased contractility of the gallbladder and biliary tract. It occurs in people with a predominance of the parasympathetic nervous system (normally dominates at night), which enhances the motor function and tone of the gastrointestinal tract, as well as the gallbladder and its ducts. Most often this form of the disease affects adolescents and young people.
Hypotonic-hyperkinetic dyskinesia is a mixed variant of the course of the disease. The patient has symptoms of both hypotonic and hypertonic forms of dyskinesia in varying degrees expressiveness.

Signs of dyskinesia of the gallbladder

Symptom	Manifestations	Development mechanism
Hypotonic dyskinesia
Pain	Constant, long, dull, bursting, aching. It is located in the right hypochondrium, but does not have a clear localization. As a rule, it increases during a meal or immediately after it.	The bottom of the gallbladder is stretched, which is caused by stagnation of bile due to insufficient production of cholecystokinin in the gastrointestinal tract.
Belching - involuntary release of gas from the stomach into the mouth with a characteristic sound, and sometimes smell	It usually occurs after meals, but sometimes between meals.	The regulation of the gallbladder by the nervous system is disrupted, so the patient makes more swallowing movements, swallowing air while eating. As a result, the pressure in the stomach increases. Therefore, the muscular wall of the stomach contracts, and the tone of the output sphincter decreases - and the air is expelled.
Nausea and / or vomiting (sometimes with an admixture of bile, if there is a reflux of bile from 12 PCs into the stomach)	More often occurs after eating and nutritional errors: eating fatty foods, fast food, overeating and others	Due to impaired motor skills, the nerve receptors of the gastrointestinal tract are irritated, which send an impulse to the vomiting center (located in the brain). From it, impulses are sent back to the gastrointestinal tract and diaphragm, leading to contraction of their muscles and the occurrence of reverse movements. Also for bacterial and viral infections, helminthiases, the vomiting center is irritated by the products of their vital activity (toxins).
Bitterness in the mouth (most characteristic of the hypotonic variant of dyskinesia)	Mostly in the morning, after eating or exercising.	Motility is disturbed, and the sphincters of the gastrointestinal tract also relax. As a result, anti-peristaltic movements appear (food moves in the opposite direction). Therefore, bile from 12 PCs enters the stomach, then into the esophagus, then into the oral cavity.
Bloating (flatulence)	There is a feeling of fullness of the abdomen at the height of digestion, which is often accompanied by pain. After the passage of gases, the pain subsides.	Digestion is disturbed due to insufficiency of bile. As a result, the processes of putrefaction and fermentation in the lumen of the small intestine are intensified. Therefore, gases are released in large quantities.
Decreased appetite		Bile stagnates due to poor contractility of the gallbladder. Therefore, it is not sufficiently allocated to the lumen of 12 PCs.
Diarrhea (rare)	It usually occurs shortly after eating.	With bile deficiency, digestion is disturbed: proteins, fats and carbohydrates are poorly broken down. As a result, the cells of the mucous membrane of the small intestine are irritated, which increase the excretion of water, sodium and chlorine. At the same time, their absorption decreases. Therefore, the volume of the food bolus increases, and its progress through the intestines is accelerated.
Constipation (common)	There is no stool for more than 48 hours or there is a systematic insufficient bowel movement.	It occurs due to a slowdown in the movement of the food bolus through the intestines due to spasm or relaxation of the tone of the intestinal wall. Therefore rises reverse suction water. At the same time, fecal masses decrease in volume, and their density increases. In addition, there is a lack of bile acids (found in bile), which normally have a stimulating effect on the intestinal muscles.
Obesity	Develops with a long course of the disease or is the cause of its occurrence	Due to the insufficiency of bile, the process of digestion and the breakdown of fats is disrupted. Therefore, the production of insulin by the pancreas increases. As a result, the synthesis of fats and their accumulation in the fat cells of the subcutaneous fat, as well as on the internal organs, are enhanced.
	Decrease in heart rate, lowering blood pressure, redness of the skin of the face, sweating, increased salivation.	The mechanism of development is complex and not fully understood. However, it is believed that there is a low resistance of the heart and blood vessels to stress. Therefore, during it, less oxygen enters the brain, organs and tissues. As a result, the balance between the sympathetic and parasympathetic nervous systems is disturbed, and the internal organs receive the wrong commands to work.
Hypertensive dyskinesia
Pain	The pain is intense, colicky, occurring acutely in the right hypochondrium after stress or emotional stress (most often), dietary errors, physical activity. The pain lasts from 20 to 30 minutes, repeats several times during the day. Often she gives the right side to the back, shoulder blade or arm. However, sometimes the pain radiates to the left (to the region of the heart), simulating an attack of angina pectoris. In the period between attacks, as a rule, there is a feeling of heaviness in the right hypochondrium.	The pain is associated with a sharp contraction of the gallbladder during increased tone sphincters of Oddi and Lyutkens-Martynov, so bile does not go away.
Decreased appetite	Bile is a stimulant of appetite, intestinal motility and the production of intestinal hormones.	The gallbladder is in a spasmodic state and is excessively reduced. However, at the same time, the sphincters responsible for the timely flow of bile in 12 PCs do not work or relax between meals. Therefore, bile in insufficient or large quantities enters 12 PCs.
Weight loss (common)	The subcutaneous fat layer becomes thinner, muscle mass decreases.	Due to the release of bile between meals, food is poorly broken down. Therefore, proteins, carbohydrates, fats, vitamins and minerals are absorbed in insufficient quantities. In addition, due to reduced appetite, patients do not eat enough.
Nausea and vomiting	Often accompanied by an attack biliary colic, and outside the attack they are usually absent.	Gastrointestinal receptors are irritated due to impaired motility, so nerve impulses are sent from them to the vomiting center (located in the brain). Back from it, impulses are sent to the receptors of the gastrointestinal tract and diaphragm, intercostal muscles, so they contract, spewing gastric contents.
Diarrhea (common)	As a rule, it occurs shortly after a meal or during an attack.	Bile enters the lumen of the small intestine in large quantities between meals (asynchronously). As a result, bile acids found in bile inhibit absorption, and also increase the secretion of water and salts (sodium, chlorine), causing an increase in the volume of feces and accelerating their movement through the intestines.
Symptoms of a violation in the work of the autonomic nervous system (the center is located in the brain)	During an attack, sweating, palpitations, general weakness, headache, and increased blood pressure appear. Outside the attack, irritability, fatigue, sleep disturbances, increased blood pressure, the occurrence of aching pain in the heart, palpitations and other symptoms are noted.	The development mechanisms have not been fully established. It is assumed that the disease is based on the lability of the nervous system due to the weakness of the heart and blood vessels, which at the time of stress poorly supply organs, tissues and the brain with blood. Therefore, the autonomic nervous system gives the wrong commands to the vessels, the gastrointestinal tract, internal organs as well as the gallbladder and its ducts.
Signs that can develop in both forms of JVP with the same manifestations
Jaundice of the skin and visible mucous membranes (rarely develops)	Appears with a pronounced violation of the outflow of bile (stone, narrowing of the common bile duct). In this case, the feces are colorless, and the urine is colored dark.	With stagnation of bile, bilirubin (a pigment contained in bile) is absorbed into the blood and spreads throughout the body, settling in the skin and mucous membranes, giving them an icteric tint. Since bile does not enter the digestive tract, the feces become colorless.
Plaque on the tongue (may develop with other diseases: colitis, gastritis and others)	May be white or with a yellowish tinge in the case of reverse reflux of bile (most often occurs with hypotonic variant of dyskinesia). If the plaque is pronounced, then patients may experience a feeling of discomfort on the tongue and a dulling of taste sensations.	It appears as a result of a violation of the processes of keratinization (the transformation of mucosal cells into scales) and desquamation of the epithelium from the surface of the tongue. It occurs due to a violation of the transfer of nutrients to the tongue.

Diagnosis of dyskinesia of the gallbladder and biliary tract

Tasks - to determine the type of biliary dyskinesia and identify concomitant diseases that can support their dysfunction.

Ultrasound examination (ultrasound)

Allows you to determine the shape and presence of congenital anomalies in the development of the gallbladder, as well as the degree of its emptying.

Basic X-ray examinations

They are the leading methods in the diagnosis of diseases of the gallbladder, as well as the biliary tract.

Cholecystography
It is based on the ingestion of preparations containing iodine (Biliselectan, Cholevid, Yodobil and others).
Indications
- The study of the structure and detection of the presence of stones in the gallbladder
- Study of the excretory and storage (concentration) function of the gallbladder, as well as its extensibility.
Flaw
The impossibility of determining the state of the biliary tract, since they are not visible on the pictures.
Methodology
The patient on the eve of the study at 19.00 takes two raw eggs. Starting from 21.00, he takes a contrast agent with an interval of 30 minutes, drinking water. The contrast agent is absorbed in the intestines into the blood, and then excreted by the liver cells.
In the morning on an empty stomach, several overview shots of the right side of the abdomen are taken. Then the patient is offered a choleretic breakfast (as a rule, it is the yolk of an egg) and a series of shots is taken again.
Interpretation of results
In the hypertonic form, the gallbladder sharply and rapidly decreases from its original volume: by 75% in the first 5-15 minutes, by 90% in the next 1.5-2 hours. Then for a long time it is in this state, not being emptied due to the fact that there is a spasm of the sphincter of Oddi.
In the hypotonic form, the gallbladder is enlarged, and its contraction after a choleretic breakfast is very slow from the initial volume: by 20-30% within 15 minutes and remains so for three to four hours.

Infusion cholecystography
The method is based on the intravenous administration of a contrast agent containing iodine, which accumulates in the gallbladder and its ducts.
Indications
Determination of the tone of the sphincter of Oddi.
Methodology
The patient in the morning on an empty stomach in the X-ray room on the table is intravenously injected with Bilignost solution for 15-20 minutes. And at the same time, a morphine solution is injected to artificially contract the sphincter of Oddi. After 15-20 minutes, a picture is taken, which shows the gallbladder and its extrahepatic ducts. The normal width of the common bile duct is 3-7 mm.
Interpretation of results
In case of insufficiency of the sphincter of Oddi, the contrast agent enters 12 PCs at 15-20 minutes after administration with a width of the common bile duct of 9 mm or more.

Cholangiography
It is carried out to study the bile ducts after the introduction of a contrast agent into them.
Indications
- Suspicion of pronounced narrowing of the bile duct
- Jaundice of the skin and mucous membranes caused by blockage of the bile duct by a stone or compression by a tumor
- Severe and prolonged pain syndrome
Basic methods for diagnosing dyskinesia

If necessary, during the procedure, small stones are removed from the lumen of the common bile duct, and a tube is inserted into it to facilitate the outflow of bile.

duodenal sounding

The goal is to study bile, as well as the function of the gallbladder and its ducts,

On an empty stomach to the patient, through the mouth and stomach, a probe is inserted into 12 PCs. Then it is laid on the right side and bile is received in portions:

The first phase (“A” portion) is a mixture of pancreatic juice and 12 PCs. It is collected from the moment the probe is inserted until the stimulant is introduced (magnesium sulfate solution). Normally, 15-20 ml of golden yellow secretion is obtained in 10-20 minutes.
The second phase is the period of time from the moment the stimulant (choleretic) is introduced until the next portion of bile appears (the phase of the closed sphincter of Oddi). Normally, the duration is from 3 to 6 minutes.
The third phase is obtaining the contents of the cystic duct. Normally, about 3-5 ml of secretion is obtained in 3-5 minutes.
The fourth phase (portion "B") - obtaining the contents of the gallbladder. Bile is thick dark brown. Normally, 30 to 50 ml of bile is secreted in 15-25 minutes.
The fifth phase (portion "C") is hepatic, during which light yellow liquid bile is obtained from the intrahepatic bile ducts.

Interpretation of results

Treatment of diseases that led to the development of dyskinesia is carried out:

Worm infestation (for example, giardiasis or opisthorchiasis)
peptic ulcer(using two or three component circuits)
Fighting infection (prescribing antibiotics)
Removal of stones from the gallbladder and treatment of other ailments

Outside the period of exacerbations:

Mineral waters are used: in the hypertonic version - waters of low mineralization (Slavyanovskaya, Narzan, Essentuki 2 or 4), in the hypotonic version - waters of high mineralization (Arzani, Essentuki 17).

It is recommended to stay in a sanatorium with a slope for the treatment of diseases of the digestive system.

Diet for dyskinesia of the gallbladder

Compliance with the diet is the basis for success in the treatment of the disease; it is prescribed for a long time (from 3-4 months to a year).

Target- sparing the liver, biliary tract and gastrointestinal tract, as well as the normalization of their function.

During an exacerbation of the disease with any type of dyskinesia, the following are excluded:

Fatty meats (goose, duck) and fish (sardine, sturgeon, halibut)
Smoked, fried, fatty, salty, sour and spicy foods
Alcohol, rich broths, seasonings, onion, garlic, radish, sorrel
Confectionery with cream, muffin, chocolate, carbonated drinks, cocoa, black coffee
Foods that increase gas formation: peas, beans, rye bread
Cream, whole milk
Canned foods and marinades

It is recommended to eat fractionally (5-6 times a day) and in small portions.

Culinary processing:

Products are boiled, baked or steamed: meatballs, steam cutlets and so on.

In the first days of an exacerbation, it is recommended to consume foods in liquid mashed or minced form. As acute symptoms disappear, this is not required.

Features of the diet for hypomotor dyskinesia

Allowed for consumption

Yesterday's rye bread or wheat flour second class
Lactic acid products not more than 6% fat: sour cream, cottage cheese, kefir
Low-fat meats (beef) and fish (hake, pollock, pike perch), Domestic bird(chicken)
Vegetables in any form
No more than one yolk per day
Boiled low-fat varieties of sausages and sausages
Vegetable fats And butter
Honey, sugar, caramel, marmalade, marshmallow
fruit and vegetable juices, as well as fruits and berries of non-acidic varieties (apples, apricots and others)
Tea, coffee with milk
Any cereals and pasta
Soups with vegetable broth

Features of the diet for hypermotor dyskinesia

It is allowed to use the same products as for hypomotor dyskinesia, but the following are excluded:

Sausages and sausages (even boiled)
Sugar, caramel
Pork, veal
Egg yolk
fresh berries, vegetables and fruits

Alternative methods of treatment of dyskinesia

A good addition to the main treatment with medicines, especially after reducing the acute symptoms of the disease.

Infusions and decoctions	How to prepare and take	What effect to expect
Hypotonic dyskinesia
Decoction of immortelle flowers	3 tbsp pour flowers into an enamel bowl, pour a glass of boiling water. Then heat in a water bath for 30 minutes, stirring constantly. Remove from heat, let cool, and then strain. Take half a glass 20-30 minutes before meals. Course - 2-3 weeks.	Strengthens the contraction of the gallbladder and improves the outflow of bile Normalizes the composition of bile Improves the work of the digestive tract Locally disinfects
Infusion of corn stigmas	1 tsp crushed raw materials, pour a glass of boiling water and let it brew for 30 minutes. Then express and take 3 tbsp. l. three times a day for half an hour before meals. Course - 2-3 weeks.	Liquefies bile and eliminates its stagnation Lower blood bilirubin and cholesterol levels
Oregano herb infusion	Pour 2 tbsp. crushed raw materials 200 ml of boiling water. Express after 20-30 minutes. Take the entire infusion throughout the day in three doses 30 minutes before meals. Course - 1 month or more.	Enhances the motor activity of the intestines and biliary tract Provides local anti-inflammatory and choleretic action Normalizes the functioning of the nervous system
Hypertensive dyskinesia
Peppermint infusion	2 tsp peppermint and pour 200 ml of boiling water. Let it steep for 30 minutes, then strain. Take 1/3 cup 20 minutes before meals twice a day. Course - 3-4 weeks.	Reduces pain and nausea Relaxes the muscles of the bile ducts and sphincters, promoting the outflow of bile Improves digestion and appetite Has a local anti-inflammatory effect
Decoction of licorice root	2 tsp crushed raw materials, pour 200 ml of boiling water, place in a water bath for 20 minutes. Let cool, then strain and bring to the original volume with boiled water. Take 1/3 cup 30 minutes before meals three times a day. Course - 2-3 weeks.	Relaxes the smooth muscles of the gallbladder and its ducts
For both types of dyskinesia
Decoction or tea from chamomile flowers	1 tsp dry chamomile flowers pour 200 ml of boiling water. Express after 3-5 minutes. Consume for a long time three times a day, like tea.	Reduces bloating Improves the work of the digestive tract Helps reduce or eliminate belching Normalizes the functioning of the nervous system, helps fight insomnia Accelerates the healing of wounds on the mucous membranes (ulcers, erosions) Fights locally with pathogenic microbes Increases appetite