The gallbladder is a fairly small organ, which is a pear-shaped reservoir with a capacity of 60-80 ml. The location of the gallbladder is on the lower surface of the right lobe of the liver, with which this organ is connected by bile ducts. The main function of the gallbladder is the accumulation of bile produced by the cells of the liver and its release into the intestines for processing incoming food. Through the membranes of the gallbladder, the absorption process of transporting salts, proteins, amino acids is carried out, the organ itself produces mucus and produces the hormone anticholecystokinin.

Various diseases and dysfunctions, pathological processes that develop in the gallbladder can negatively affect not only the process of digestion, but also the health of the whole organism as a whole. Certain diseases and pathologies of the gallbladder without timely therapy end in death.

What is a gallbladder?

In the structure of this organ, the fundus, body and neck are distinguished, passing into the cystic duct with a diameter of 1 to 3 mm and a length of 1 to 3 cm. In most people, the cystic duct flows into the common bile duct under a slight slope, contributing to the outflow of bile. But every fifth person has some deviations: from a change in the angle and place of confluence to spiral inversions around the common hepatic duct, which often contributes to the development of dyskinesia and functional stagnation of bile in the bladder. The length of the common bile duct can also vary and affect the efficiency of the organ.

Major diseases and pathologies of the gallbladder

Among the diseases of the biliary system, most are associated with dysfunctions of the organ due to improper composition of the diet or non-compliance with the time of eating.

Cholelithiasis

Symptoms of the main diseases of the gallbladder

The clinical picture and symptoms of diseases differ not only depending on the disease, but also on its stage and form. Acute attacks of most diseases of the gallbladder are characterized by pain in the right side and / or the area of ​​​​the right hypochondrium with irradiation (spread) on the back on the right up to the shoulder and collarbone. Dyspeptic symptoms are expressed in nausea, periodic or repeated vomiting. The abdominal muscles on the right are tense under the right ribs or in general on the right side of the peritoneum.
Differences in the symptoms of diseases:

Diagnostic methods and interpretation of laboratory parameters for diseases of the biliary tract and bladder

The main methods of primary diagnosis of diseases affecting the gallbladder and bile ducts are history taking, palpation of the peritoneum, laboratory blood tests and ultrasound examination of the organ. If necessary, a laparoscopic diagnostic method is used, as a rule, in the pathological form of cholecystitis and cancerous neoplasms.
What changes in the blood formula correspond to diseases of the gallbladder?

Diet as the basis of treatment and prevention

The basic principles of therapy for diseases of the hepatobiliary system are based on the principles of nutrition. Without strict adherence to the rules for compiling a diet, drug therapy will not contribute to a complete recovery. What can you eat in the presence of diseases and pathologies of the bladder and bile ducts?

• fatty, spicy foods, fried foods, alcoholic and carbonated drinks are excluded;
• food should be timely and fractional, at least 4-6 times a day, with the obligatory inclusion of warm food in the menu;
• porridges from oatmeal, rice, semolina, vegetable soups, low-fat varieties of meat, poultry, fish cooked in water, steamed, baked, dairy and sour-milk products with a low fat content are recommended;
• strong tea, coffee, cocoa should be avoided, giving preference to compotes, nectars, herbal teas;
• it is recommended to include vegetable oils of the first cold pressing in the diet: olive, linseed, etc.

Drug therapy is selected on the basis of general clinical and individual characteristics of the course of the disease. Enzyme-containing variants, pain relievers, antispasmodics, stone-dissolving drugs, or antibacterial agents may be prescribed. The choice of the drug is carried out by the attending physician.

Biliary dyskinesia is not an independent disease - it is a consequence of improper flow of bile into the duodenum for digestion. DZHVP is accompanied by aching, dull, sharp pains in the abdomen, an unpleasant odor from the oral cavity is considered an indirect sign. Treatment of pathology is aimed at correcting the underlying disease.

The main symptom of biliary dyskinesia is aching dull pain in the abdomen.

JVP - what is it?

Bile duct dyskinesia- this is a syndrome in which the normal motor activity of the biliary tract is disturbed, the tone of the gallbladder decreases. Allocate an organic and functional type of disorder.

The syndrome is observed in 70% of cases of diseases of the gastrointestinal tract. Of these, 10% of cases are primary dysfunctions that are not associated with other disorders of the digestive system.

With DZHVP, the motor activity of the biliary tract is disturbed

Pathology according to ICD-10 was assigned the code K82.8 - diseases of the bile ducts of unspecified origin.

Types of biliary dyskinesia

There are 3 types of JVP:

1. hypokinetic(hypomotor, hypotonic). In this case, there is a decrease in the tone of the gallbladder, a decrease in the motor activity of the ducts.
2. hyperkinetic(hypertonic, hypermotor). It is dominated by spastic phenomena, increased contractility of the organ.
3. mixed. With a mixed form, there is both a change in tone and colicky pains.

Hypomotor type dysfunction

It is characterized by a lack of bile for the process of digestion of food. The production of the substance does not suffer, but at the time of release there is not a sufficient contraction of the gallbladder. This leads to the fact that food is not digested and not absorbed in full.

Dysfunction of the hypomotor type in the vast majority of cases develops in elderly people.

A patient with hypotonic dyskinesia is a person over the age of 40 years. The main cause of dysfunction of this type of pathology is stress, psychological disorders.

A typical symptom is a dull arching pain that spreads to the back and right shoulder blade. The pain syndrome can last for several days.

DZHVP on hypertonic type

More often it develops in women from 30 to 35 years old, adolescents and children. The attack develops suddenly in the form of colic. At the same time, the pressure in the gallbladder increases sharply, a spasm of the sphincters of Lutkens or Oddi is observed. The pain syndrome lasts no more than 20 minutes. Develops after eating, at night.

The occurrence of JVP according to the hypertensive type is possible in children and adolescents

mixed form

It is characterized by the presence of signs of dysfunction in both hypokinetic and hypermotor types.

Causes of JVP

There are 2 types of biliary dyskinesia. The classification is based on the causes that caused a violation of the release of bile.

Causes of the primary syndrome:

1. stress factors- acute or chronic nervous strain both at work and in personal life. It provokes inconsistency in the work of the sphincters of the gallbladder.
2. Errors in the diet- neglect of the rules of healthy eating, rare meals. This leads to a violation of the production of digestive enzymes, hormones. Over time, dyskinesia develops.
3. Chronic allergic diseases. The presence of an allergen leads to irritation of the sphincters, which provokes inconsistency in their activity.

Causes of secondary dysfunction:

1. Gastrointestinal diseases - gastritis, enteritis, ulcers, cell death of the mucous membranes of the stomach and duodenum.
2. Chronic inflammation in the reproductive area, cystic changes in the ovaries, kidney disease.
3. Liver pathologies - hepatitis, cholangitis, the presence of stones in the gallbladder.
4. Salmonellosis in history.
5. Other bacterial and viral diseases of the gastrointestinal tract.
6. Worm infestations.
7. Congenital malformations of the structure of the gallbladder - bends, constrictions.
8. Endocrine pathologies, menopause in women.

Symptoms of gallbladder dysfunction

The symptomatology of the pathological process depends on the type of dysfunction.

Table: Signs of JVP depending on the type of disease

An increase in temperature with dysfunction of the bile ducts is not observed. Its presence indicates the beginning of the inflammatory process, bacterial damage.

Which doctor should I contact?

In case of violation of the digestive system, consult a gastroenterologist

The treatment of dysfunction of the digestive system is engaged in:

According to indications, consultations are possible.

Diagnostics

The task of the doctor at the stage of examining the patient is to determine the type of pathology, identify the causes of dyskinesia and exclude other diseases, including tumor genesis.

The survey includes:

1. Inspection and questioning patient, palpation of the abdomen.
2. ultrasound- to determine the size of the organ, exclude developmental anomalies, tumors, assess the contractile activity of the gallbladder.
3. General blood analysis- with an increase in ESR, one can judge the inflammatory process, an increase in eosinophils and leukocytes - possibly a helminthic invasion.
4. Biochemistry of blood- there may be an increase in bilirubin and cholesterol, the appearance of C-reactive protein.
5. Cholecystography- X-ray of the gastrointestinal tract using a contrast agent. As a contrast, iodine preparations are used orally or infusionally.
6. Cholangiography- according to indications - x-ray examination of the bile ducts after the introduction of a contrast agent. The drug is administered percutaneously by puncture method. At the same time, the doctor conducts drainage of the ducts. Manipulation is performed under local anesthesia.
7. Endoscopic cholangiography- according to indications - through the oral cavity with the help of an endoscope, a camera is passed into the gallbladder. Contrast is introduced, pictures are taken. At the same time, stones can be removed.
8. duodenal sounding- according to indications - a study of the composition of bile, an assessment of the motor activity of the bile ducts.

Cholecystography using a contrast agent allows you to get a complete picture of the state of the gastrointestinal tract

The method of examination of the patient is determined by the doctor. It may change depending on the symptoms and as the results of the study become available.

Treatment of biliary dyskinesia

Treatment of gallbladder motility disorders is carried out in a complex manner in both adults and children, and also depends on the type of dysfunction.

Patient management includes:

• mode;
• normalization of nutrition;
• drug therapy;
• physiotherapy;
• sanatorium treatment - if possible.

Physiotherapy is prescribed for gallbladder motility disorders

In addition, it is necessary to normalize the psycho-emotional state, sleep.

Medications

Drug treatment is long and depends on the type of bile duct motility disorder.

In the treatment of hypomotor dysfunction

Choleretics - Hofitol, Cholenzim, Allohol - they all contain either bile or bile acids, digestive enzymes, plant extracts.

The active components of the drugs enhance the contractile activity of the gallbladder, improve the digestion of food. Against the background of the reception increases the production of bile.

Taking Hofitol enhances the contractile activity of the gallbladder

Individual dosages are selected by the doctor. The duration of treatment is from 20 days to 2 months.

The drugs are well tolerated. Against the background of the reception, diarrhea, various allergic reactions may develop. In this case, drug tactics are reviewed.

This group of drugs is not prescribed in the presence of:

• nephritis, hepatitis in the acute period;
• obstruction of the bile ducts;
• the presence of stones;
• individual sensitivity.

Plant-based tonics that normalize the state of the nervous system:

• extract from ginseng root.

Take Eleutherococcus tincture to stabilize the nervous activity of the body

The drugs stimulate higher nervous activity, reduce fatigue, improve the body's adaptation to various stimuli.

Dosages depend on the age and condition of the patient and can range from 15 to 30 drops per 1 dose. The main side effect of tinctures is insomnia. Therefore, it is undesirable to take them in the evening.

Contraindications to the appointment:

• childhood;
• pregnancy, lactation;
• individual intolerance;
• insomnia in history;
• period of menstruation.

Tubazhi - with mineral water, sorbitol, magnesia - only during remission and in agreement with the doctor.

The procedure is aimed at improving the outflow of bile.

Tubazh help maintain the outflow of bile during the remission of the disease

You should take 100-200 ml of water or sugars dissolved in it, magnesium sulfate and lie on your right side on a heating pad for 40 minutes. It is forbidden for cholelithiasis, a history of ulcers, inflammation in the liver.

In the treatment of hypermotor dysfunction

Cholekinetics - relax the bile ducts, but increase the tone of the bladder itself, relieve spasms, reduce the level of lipids in the blood.

• Oxaphenamide;

Gepabene is prescribed to relax the bile ducts and relieve spasms

Both the one and the other drug are taken 1 capsule 3 times a day. Of the side effects, only episodic cases of diarrhea were observed. Medicines are not prescribed for inflammatory processes in the liver in the acute period.

Antispasmodics - No-shpa, Papaverine - to relax smooth muscles. This relieves pain during an attack.

No-shpa will help remove pain during an attack

Additionally, sedatives are indicated at the doctor's choice.

Folk remedies

Phytotherapy is referred to as folk methods of treatment. But at the same time, medicinal herbs used in official medicine are used. The duration of treatment with phytocollections is from 2 to 3 weeks.

Decoction of immortelle flowers

Use immortelle flowers to make a medicinal decoction

It will take 60 g of vegetable raw materials and 1 liter of boiling water. Fill and wrap. Let it brew until the broth has completely cooled. Take 100 ml half an hour before meals 3 times a day.

Corn silk

Brew corn silk to make a medicinal infusion

Requires 4 tbsp. l. pour 1 liter of boiling water. Wrap and leave to cool. Take 1 tablespoon 3 times a day.

Chamomile tea

Replace regular tea with chamomile tea to improve the digestive tract

Take 1 tbsp. l. chamomile flowers and pour 1 cup of boiling water. Insist 5 minutes. Take 1 glass of tea 3 times a day.

Liquorice root

Boil licorice root for an effective remedy for FAD

You will need 2 teaspoons of chopped vegetable raw materials. Pour a glass of boiling water and simmer over low heat for 15 minutes. Strain and top up with water to a full glass. Take 100 ml 3 times a day before meals.

Mint tea

Take mint tea 3 times a day before meals

Need 2 tbsp. l. pour 1 cup boiling water. Insist 30 minutes. Take 100 ml 3 times a day before meals. The course of treatment is 4 weeks.

Diet for JVP

Diet is an essential component of the treatment of bile duct dysfunction. In the first few days, pureed soups, cereals, vegetable purees are recommended. Starvation is not shown.

sample menu

Nutrition should be fractional: during the day, make 5-6 meals.

When following a diet, it is important to split the food - divide the daily norm of food into 5-6 meals

First day:

1. Breakfast - vegetable salad, rice milk porridge, tea, bread and butter.
2. The second breakfast is an apple, baked or 250 ml of fruit juice.
3. Lunch - vegetable soup, baked chicken breast, stewed cabbage, compote.
4. Snack - biscuit cookies, dried fruit compote.
5. Dinner - millet porridge, boiled beef, boiled beetroot salad with vegetable oil, tea.
6. At night - a glass of fermented milk product.

Second day menu:

1. Breakfast - oatmeal on the water, a glass of fermented baked milk.
2. The second breakfast is fruit puree.
3. Lunch - vegetable soup, pasta, steamed meat casserole, green tea, bread.
4. Snack - cottage cheese with raisins and dried apricots, sour cream.
5. Dinner - vegetable salad, steam omelette, tea.
6. At night - a glass of yogurt.

Features of treatment in children

According to medical statistics, 90% of children diagnosed with dyskinesia had episodes of inflammatory diseases of the gastrointestinal tract, helminthic invasions. At a more adult age, the development of this dysfunction is promoted by vegetovascular dystonia. Girls are diagnosed with this disorder more often than boys.

A feature of the treatment of this condition in children is that diet therapy comes first. A specialized diet is not provided, it is enough to follow the recommendations for proper nutrition.

They include minimizing fast food, nuts, snacks, mineral water. In addition, nutrition is shown at the request of the child, according to appetite. Do not strictly adhere to regime moments.

Snacking with various goodies - nuts, sweets, buns - is strictly prohibited. The best choice in this case are fruits.

Drug therapy is represented by drugs for the normalization of microflora, antispasmodics for pain, light sedatives on a plant basis, choleretics. Additionally, massages, electrophoresis with antispasmodics, a course of exercise therapy are shown.

Adequate motor activity should be present at all stages of treatment. Mandatory walks in the fresh air and positive emotions.

Features of treatment during pregnancy

In the early stages, a violation of the outflow of bile is the main cause of the development of severe forms of toxicosis. This manifests itself in the form of bouts of nausea, vomiting, lack of appetite, weight loss.

In this case, the best solution would be to hospitalize the woman in the gynecological department of the hospital.

With DZHVP in pregnant women, hospitalization and constant monitoring of doctors are necessary.

A feature of the treatment of pregnant women with a diagnosis of JVP is that many drugs are prohibited during the gestational period. The main tactic of managing the patient is to follow the principles of rational nutrition, eating according to appetite. It is forbidden to "eat for two" as grandmothers recommend.

Permissible medical treatment is the intake of herbal teas. For example, decoctions of corn stigmas, dill, mint. Antispasmodics are allowed.

Self-administration of herbal remedies during gestation is inappropriate. Treatment is carried out only under the supervision of a gynecologist.

DZHVP is not an indication for termination of pregnancy, for a caesarean section. Dysfunction does not affect the course of natural childbirth.

Possible Complications

JVP is not a normal state for the body. Treatment should be carried out in full. Otherwise the following complications may develop:

• cholecystitis - an inflammatory process involving the gallbladder;
• the appearance of stones in the gallbladder;
• acute and chronic pancreatitis;
• duodenitis is an inflammatory process in the duodenum.

Biliary dyskinesia (BBD) is a common disease of the gastrointestinal tract, which, according to some reports, affects almost one in three people. At the same time, not everyone knows exactly what kind of diagnosis it is. Biliary dyskinesia, as well as gallbladder dyskinesia, cause a lot of trouble, but do not threaten life. However, in some cases, the disease can lead to complications, so you should know what biliary dyskinesia is. Symptoms and treatment of this disease also belong to the category of information necessary for each person.

JVP - what is it?

To understand what lies behind the diagnosis of "dyskinesia of the gallbladder and biliary tract", you should know what functions the gallbladder and biliary tract have in the body.

Not everyone knows what it is - bile. Bile is a yellowish-brown liquid containing active biochemical substances that is involved in the process of digestion. For the most part, it is formed in the liver, and partly in the hepatic passages. Through special ducts, bile enters the gallbladder, where excess water is removed from it, and it acquires the desired concentration. The emptying of the bladder occurs reflexively in the event of food entering the gastrointestinal tract. From the gallbladder through another duct, bile enters the duodenum. Part of the bile also enters through special bile ducts directly from the liver into the duodenum, bypassing the gallbladder.

The function of bile is to break down and separate complex fats from food, as a result of which, with the help of the lipase enzyme produced in the pancreas, they are converted into fatty acids that can be directly absorbed by the body. Bile is also involved in the absorption of carbohydrates and fats.

The movement of bile through the biliary tract system occurs by contraction of the muscular walls of the ducts, as well as the walls of the bladder. At the same time, the rate of bile outflow should remain optimal. It is regulated by ring muscles - sphincters, which are located around the ducts and can open and close them. The sphincter of Oddi opens into the duodenum and regulates the flow of bile into it.

The work of sphincters and muscle walls, in turn, is regulated by hormones produced in the stomach and pancreas. In the case of too rapid contraction of the walls of the ducts, bile enters the intestine in a too dilute form. And in the case of slow movement of bile, it does not enter the intestines on time. Being too long in the bubble, it acquires excessive saturation. The ingestion of both too dilute and too concentrated bile from the biliary tract into the intestines adversely affects digestion.

It is according to this principle: too fast or too slow movement of bile that the disease is divided into two types. In the first case, there is hyperkinetic dyskinesia of the gallbladder and biliary tract, and in the second - hypokinetic.

These two types differ not only in their symptoms, causes and principles of treatment, but also in which categories of people are more susceptible to them. The hyperkinetic form of bile duct motility disorder is more typical for young people. Hypomotor dyskinesia of the gallbladder is more common in people over 40 years of age, as well as in people with an unstable psyche. In general, pathologies of the biliary system are more likely to affect women than men. Biliary dyskinesia can also occur in children, although not as frequently as in adults.

Specialists also use another classification based on how high the tone of the sphincters that control the movement of bile through the ducts is. A condition in which the tone of the sphincters is above normal is called hypermotor dyskinesia, and a condition in which it is lower is called hypomotor. These conditions are caused by the predominance of one or another type of autonomic nervous system - parasympathetic or sympathetic. The parasympathetic system is responsible for the increased muscle tone of the sphincters, and the sympathetic system is responsible for the reduced one. In most cases, the hypertensive type of dyskinesia corresponds to the hyperkinetic type of the disease, and the hypotonic type corresponds to the hypokinetic one, so we will not use such a classification in order to avoid confusion. Also, in rare cases, a person may experience a mixed type of biliary dysmotility - both hyperkinetic and hypokinetic disorders.

With JVP, we are not talking about organic changes in the biliary tract or gallbladder, but only about violations in the movement of bile. Bladder dyskinesia has an undulating course, including periods of remissions and exacerbations.

The disease should not be confused with pancreatic dyskinesia, as the dysfunction of the Vater nipple of the pancreas is sometimes called. This disease has several other symptoms and course.

Causes

For reasons of occurrence, biliary dyskinesia is divided into secondary and primary. Primary biliary tract dysfunctions are relatively rare. As a rule, primary JVP is caused by some defect in the development of the ducts or bladder:

• the presence of a septum inside the bladder,
• weakness of the bladder wall,
• double the number of channels
• kink of the gallbladder,
• intrahepatic, double, abnormally located or mobile bladder.

Secondary dysfunction of the biliary tract is a consequence of other diseases. These can be liver diseases - viral hepatitis, neurocirculatory dysfunction, diseases of the gastrointestinal tract - gastritis, ulcers, duodenitis, appendicitis, cholecystitis, cholelithiasis, food allergies, inflammation of the abdominal cavity, pathologies of the female genital organs, menopause. Also, biliary dyskinesia can be observed with infections and helminthic invasions, giardiasis, chronic infections (caries, tonsillitis, etc.).

Sometimes the main cause of impaired functioning of the biliary tract can be improper and irregular nutrition - prolonged fasting, drinking alcohol, spices, overly spicy fatty and overcooked foods, snacks, refusing to use vegetable oil.

But recently the point of view has become popular that dyskinesia often occurs against the background of neurotic conditions, stresses and experiences of the patient. This opinion is far from new, because it is not in vain that there is a stable stereotype that all diseases are caused by nerves. In fact, this is, of course, an exaggeration, but in the case of dyskinesia, such a connection looks logical. After all, the promotion of bile is controlled by the autonomic nervous system, which indirectly depends on the central nervous system, reacting to the hormones and neurotransmitters produced with its help. Therefore, any mental discomfort is reflected in the functioning of the muscles of the bile ducts, and, as a result, in the motility of the bile ducts. In addition, during stress and neuroses, people usually do not care much about the quality and proper nutrition, which also contributes to the development of the disease. The dependence of the disease on the state of the nervous system in the hypokinetic form is especially clearly manifested.

Peptic ulcer, appendicitis, and eating too spicy foods often provoke a hyperkinetic form of the disease.

Additional factors contributing to the onset of the disease include:

• sedentary lifestyle,
• hormonal disorders or changes in hormonal balance,
• asthenic body type,
• obesity,
• avitaminosis,
• inflammation of the liver.

Symptoms of biliary dyskinesia

Symptoms are somewhat different for the two main forms of the disease. However, one symptom is common to them. It is a pain. But the nature of the pain is also not the same. In the hyperkinetic form, the pain appears in attacks, usually after eating or at night. It has a sharp character and is felt in the region of the right hypochondrium. Sometimes the pain can radiate to the shoulder or shoulder blade, a bit like cardialgia or pain in osteochondrosis. The pain attack is usually short and lasts about half an hour.

In many cases, the attack takes on the character of biliary colic. With her, there is a strong pain under the rib, as well as numbness of the limbs, palpitations.
In the hypokinetic form, the pain is usually dull, aching. Sometimes pain may be absent altogether, and only heaviness and bursting in the hypochondrium can be felt. Also, with this form, there may be a feeling of bloating. Pain in the hypokinetic variant is usually longer than in the hyperkinetic variant and can last for hours. After eating or choleretic drugs, the intensity of pain decreases.

With the phenomenon of stagnation of bile (cholestasis), which is a possible development of a hypokinetic form, severe itching all over the skin, a change in the color of urine and feces (urine becomes dark, and feces, on the contrary, light) are characteristic. It can also cause yellowing of the skin and whites of the eyes.

In both cases, the pain is usually provoked by malnutrition, nervous stress. In the hyperkinetic form, physical activity can also be the cause of the attack.

Also, both options may be characterized by such indirect signs as loss of appetite, bitterness in the mouth, nausea, belching, diarrhea or constipation, profuse urination. The tongue usually has a white or yellow coating. Bad breath may be present. An increase in body temperature with dyskinesia is not observed.
In many cases, dyskinesia may be accompanied by autonomic and nervous symptoms - insomnia, fatigue, tachycardia, sweating, headaches. In women, there may be a violation of the menstrual cycle, in men - a decrease in potency.

Complications

Biliary dyskinesia is a disease that is very often ignored by patients outside the period of exacerbations. Meanwhile, with insufficient attention to oneself, dyskinesia can become one of the causes of diseases such as duodenal pathology, gastritis and cholecystitis (chronic inflammation of the gallbladder wall), liver pathology. The hypokinetic form is also dangerous in that it leads to stagnation of bile (cholestasis). In turn, this can lead to an acute form of pain syndrome - colic, as well as the formation of stones in the gallbladder - gallstone disease. Inflammation of the gallbladder can spread to the pancreas, leading to an even more serious disease - pancreatitis.

What to do if you suspect a disease?

You should consult a gastroenterologist. It can be difficult for the patient himself to diagnose dyskinesia, as well as to separate one type of disease from another and prescribe adequate treatment for himself. And this is necessary, because a treatment suitable for one type may be useless and even harmful for another. The specialist will prescribe the necessary tests, and tell you how to treat the disease.

Diagnostics

Only a qualified specialist has information about the defeat of the biliary tract, symptoms and treatment of the disease. Therefore, it is not worth diagnosing yourself, you need to see a doctor.

When diagnosing, bile duct motility disorders should be separated from other diseases of the gastrointestinal tract - gastritis, ulcers, pancreatitis, cholecystitis, duodenitis, hepatic colic or intestinal colic, angina pectoris, heart attack, neuralgia with osteochondrosis, etc.

During the initial examination, palpation of the painful area is performed. For dyskinesia is characterized by increased pain with pressure on the area of ​​the gallbladder and a deep breath. However, this method does not help to confidently diagnose dyskinesia, as well as correctly assess the severity and type of the disease. Therefore, it is also recommended to conduct a number of studies. First of all, it is necessary to take a blood test for lipids and bilirubin levels. It may also be necessary to analyze feces for dysbacteriosis and the presence of helminths. However, these tests may not reveal abnormalities.

Ultrasound is the most important diagnostic tool. It helps to assess the general condition of the bladder and ducts. The study can be carried out both on an empty stomach, after a three-day diet, and after a meal. In this case, the patient is advised to eat some foods that provoke bile secretion, for example, yogurt, cream, sour cream, chocolate, bananas. By the difference in the results, the functional ability of the biliary system will be visible. To determine the condition of the liver, an ultrasound of the liver can also be performed.

Also, duodenal sounding can often be performed. In this case, a probe is inserted through the esophagus to the duodenum, with the help of which samples of bile, pancreatic enzymes and duodenal juice are periodically taken. At the same time, magnesium sulfate, a substance that stimulates the release of bile, is also fed into the intestine through the probe. To establish the diagnosis of dyskinesia, the time of receipt of bile from various parts of the biliary system, as well as the chemical composition of bile and other digestive enzymes, are taken into account.

Among other types of studies, one can note the study of the state of the bile ducts using a contrast agent by radiography (contrast cholecystography and cholangiography), as well as a radioisotope method (cholesuintography).

With cholecystography, the extrahepatic bile ducts are examined, and with cholangiography, the bile ducts located in the liver are examined. In the first case, the patient is injected with a contrast agent through the esophagus, and in the second case, with an injection directly into the hepatic passages.

With the method of cholangiopancreatography, a contrast agent is injected through a probe directly into the duodenum. In all cases, the contrast agent helps to determine the dynamics of the movement of bile in the biliary tract on x-rays.

With cholescintigraphy, the radiation of isotopes passing through the biliary tract is captured by special equipment and gives a detailed picture of the pathology.

The most modern method is MRI, which gives the most complete and accurate picture of pathological processes. This procedure takes about 40 minutes.

An important role in the diagnosis is played by the analysis of the anamnesis - data relating to the patient's lifestyle and the diseases he has suffered.

Treatment of dyskinesia

With dyskinesia, treatment is prescribed by a doctor after a course of examination. If dyskinesia is secondary, then the main efforts should be aimed at eliminating the underlying disease. For example, with helminthic invasion, therapy is carried out with the help of anthelmintic drugs, in the case of hepatitis, antiviral agents are used. Also, if possible, symptomatic therapy of dyskinesia is also carried out, aimed at eliminating the discomfort caused by the disease.

There are two main types of treatment - dietary treatment and medication.

Diet

The therapeutic goal of the diet is that it should contribute to the complete emptying of the bladder and not cause pain attacks.

The diet involves changing the set of foods that a patient with dyskinesia should consume. In addition, it is necessary for successful treatment to change the eating habits themselves. It is recommended to eat as often as possible, at least 4 times a day, the optimal number of meals is 6. The intervals between meals should be at least 3 hours. You should not overeat, the food should not be too cold and not too hot. Also, you should not eat too late, the last meal should be 2-3 hours before bedtime. On the other hand, do not go to bed on an empty stomach.

There are foods that are generally not recommended for use with JVP and that should not be consumed during an exacerbation, as well as a set of recommended foods. The specific set depends on the characteristics of dyskinesia and concomitant diseases, if any. This set should be determined by a gastroenterologist or nutritionist. But in general, we can say that in case of illness it is not recommended to eat very fatty, spicy and fried foods. It is preferable to replace it with boiled or stewed dishes. When reheating food, avoid using margarines and animal fats. Low-fat dairy products are recommended in the morning and evening.

During periods of exacerbations, it is recommended to consume food in pureed or chopped form. You should also refuse meat with a high content of fats, smoked meats, offal, mushrooms, snacks, millet porridge, salted nuts, canned food, lard.

In the hyperkinetic form, one should limit the consumption of vegetable oils, rich broths, milk fats, fish, while in the hypokinetic form, on the contrary, they are recommended for use.

In the hypokinetic form, black bread, eggs, sour cream, cream are also shown - that is, products that stimulate the secretion of bile.

It is also worth limiting the amount of sour and sweet, white bread made from premium flour, ice cream, chocolate. However, it is recommended to consume more dairy products, fruits and vegetables.

Regular consumption of bran brings a very good effect. They should be taken every day in a tablespoon before meals.

The diet is permanent, and during the period of exacerbation of symptoms, it should be observed especially strictly.

From liquids, weak tea and mineral waters, especially those with low and medium mineralization, should be consumed. Mineral water should be drunk in a glass three times a day half an hour before meals. It is better to drink not cold water, but heated to room temperature. The exact type of water is best checked with a gastroenterologist, since all waters have a different composition of minerals, and the wrong choice can lead to the fact that they will not help, but even harm.

Medicines

The second main way to treat DVP is the use of drugs. Here it should be borne in mind that the means for the treatment of both main types of the disease differ markedly. In case of a hypokinetic type of disease, choleretic drugs are prescribed, for example, allochol. Drugs such as magnesium sulfate and xylitol improve gallbladder tone, while cholecystokinin and pancreozymin improve bile duct motility.

With hyperkinetic syndrome, especially with an attack of pain caused by muscle spasms, antispasmodics are indicated - noshpa, drotaverine, papaverine. Among the drugs that normalize the progress of bile through the ducts in the hyperkinetic form of the disease are ocafenamide, nicodine, flamid.

Traditional medicines are also widely used. Decoctions of mint, sage, St. John's wort, immortelle, coriander, corn stigmas, anise, help relieve many symptoms. It is also effective to drink grapefruit juice before meals. Tinctures of ginseng, eleutherococcus, lemongrass have a tonic effect and therefore can be useful in hypotonic dyskinesia.

Valerian and motherwort tinctures help to balance the effect on the bile ducts of the sympathetic and parasympathetic divisions of the autonomic nervous system.

Psychotherapy

Of course, if the disease is caused by disturbances in the functioning of the nervous system, anxiety and stress, then therapy should begin with putting the nerves and lifestyle in order, and adjusting the psyche. But, unfortunately, most patients are not ready to go to a psychotherapist instead of a gastroenterologist. Therefore, you can limit yourself to general recommendations - avoid stress, get enough sleep and take light sedatives. A psychotherapist can also prescribe stronger drugs - tranquilizers, antidepressants and antipsychotics.

In addition, dyskinesia can be caused by a sedentary lifestyle and congestion in the body. Therefore, very often a course of physiotherapy exercises can be useful in case of illness.

Physiotherapeutic procedures, massage are also applied. Among physiotherapy, electrophoresis with drugs in the right hypochondrium is most often used. Ultrasound, high and low frequency currents are also used. There are also special procedures to free the gallbladder from excess bile.

In general, treatment should be conservative. Surgical intervention is used extremely rarely, in cases where conservative therapy does not give any results.

Dyskinesia in children

In children in the first years of life, dyskinesia is usually caused by congenital defects in the structure of the bile ducts, for example, a kink of the bile duct. In older children, as in adults, dyskinesia is more often caused by an improper diet - inappropriate foods or long breaks between meals, or stressful, conflict situations at school or family. Sometimes such factors lay the foundation for the development of dyskinesia in adulthood.

Symptoms of the disease in children are usually similar to the symptoms of adults - pain or heaviness in the right hypochondrium, nausea, stool disorders. Therapy of pathologies of the biliary tract in school-age children should also follow the same pattern as treatment in adults - the main emphasis should be on diet and the elimination of the negative effects of anxiety and stress.

Prevention

Methods for the prevention of disorders of the biliary tract are generally similar to the methods of therapy for these pathologies. People who fall into the risk group - those who are stressed, lead a sedentary lifestyle, eat improperly and irregularly, should change their habits, diet, normalize their eating habits, regulate their daily routine, alternate work and rest, avoid stress.

Diseases of the gallbladder most often occur as a result of pathological processes in neighboring organs (liver, pancreas). Their symptoms have much in common - pain in the right hypochondrium, digestive disorders, discoloration and consistency of feces, changes in appetite, icteric syndrome. The gallbladder performs an important function - it is responsible for the accumulation and distribution of bile, and any disturbances in the functioning of the organ negatively affect the state of the digestive system as a whole.

Bile is constantly produced in the body, and just as constantly it is secreted through the hepatic bile duct. But in the process of digestion, it is required only when there is food in the intestines. If bile enters in the absence of intestinal contents, it can damage the intestinal mucosa.

The gallbladder is necessary so that the constantly secreted bile does not enter the intestines when there is no food in it. The regulation of the flow of bile into the intestines or gallbladder is quite simple - if the sphincter that ends the common bile duct is open, bile flows into the intestines. If it is closed, bile flows into the gallbladder. There it can accumulate for a long time. The water contained in the bile is partially absorbed, so the gallbladder bile is thicker and more viscous than the hepatic bile.

When the sphincter of the major duodenal papilla opens, the cystic bile enters the intestinal lumen first, then the hepatic bile. If for some reason the sphincter remains closed for a long time, bile stasis, the formation of stones and other violations of the outflow of bile are possible.

Gallbladder diseases - the main causes

Regardless of the causes and mechanism of development, gallbladder pathologies have similar symptoms. The main symptom is constant aching, arching pain in the right hypochondrium, which is not relieved by taking analgesics. With cholecystitis or cholelithiasis, the pain syndrome is the most intense. Usually, pain occurs after eating (especially fatty, spicy or fried). When the stones leave the gallbladder, sharp, cutting pains appear. In addition, other characteristic symptoms appear:

• febrile state (chills, temperature) in the acute course of the process;
• dyspeptic manifestations (nausea, vomiting, belching);
• stool disorders (diarrhea, constipation);
• bloating, flatulence;
• lack of appetite, weight loss;
• bitterness and dryness in the mouth;
• discoloration of urine (to intense yellow) and discoloration of feces;
• yellowness of the skin;
• skin itching, rashes on the body;
• insomnia, irritability.

The appearance of an icteric color of the skin and sclera indicates that the inflammatory process has spread to the liver. This threatens the development of severe complications and can lead to liver failure, cirrhosis or internal bleeding. Consider the main symptoms and treatments for the most common diseases of the gallbladder.

Dyskinesia of the gallbladder

This pathological condition is a prerequisite for the development of many diseases of the gallbladder and biliary tract. It can be asymptomatic for a long time. The essence of the disease is that the motor activity of the gallbladder is impaired. Most often, it is weakened, therefore, when the sphincter of the large duodenal papilla opens, the bladder contracts insufficiently, and when food enters, it does not expel the necessary amount of bile into the intestine. Part of it remains in the bladder, stagnates, and conditions arise for the development of the inflammatory process.

Symptoms of gallbladder dyskinesia - a violation of the digestion of fats, primarily animals. The patient may notice a slight deterioration in well-being after eating fatty foods or overeating, recurrent discomfort in the right hypochondrium, sometimes pain - pulling, blurred. Diarrhea can occur after a rich fatty meal.

This condition is treated with choleretic drugs, as well as drugs that increase the tone of smooth muscles - eleutherococcus, ginseng and others. Diet and physical activity are also recommended.

Cholelithiasis

The formation of stones in the gallbladder is a direct consequence of the stagnation of bile. Irregular diet, lack of physical activity and other factors can contribute to this. In addition, biliary dyskinesia in most cases precedes gallstone disease.

Gallstones are clumps of hardened bile that form due to excess water absorption. Among all diseases of the liver and gallbladder, gallstone disease is the most common. Its course is paroxysmal - during the period of remission, the symptoms are almost completely absent or insignificant (as with dyskinesia), but the attacks of the disease manifest themselves very clearly.

Exacerbation of gallstone disease (biliary colic) can provoke physical effort, overeating, shaking while driving, or even sudden movement. The most striking symptom is a sharp pain in the right hypochondrium. The attack may pass on its own, but this does not mean a cure for the disease. A few days after it, yellowing of the skin and sclera, skin itching, whitish feces are possible. These symptoms are a consequence of the entry of bile acids into the blood.

To relieve an attack, antispasmodic drugs are used that relieve spasm of the biliary tract and relieve pain. During an acute attack of gallstone disease, you can not move, eat food (especially fatty), use choleretic drugs. This condition requires medical intervention, so you need to call an ambulance.

Outside of exacerbation, therapeutic nutrition, moderate physical activity, cholagogues and antispasmodics are prescribed. The patient is advised to undergo regular examinations to prevent new exacerbations.

Cholecystitis is an inflammation of the gallbladder. Most often it is aseptic, that is, it occurs without the participation of infection, and has a chronic course. Its development is preceded by many reasons, including hereditary predisposition.

The most dangerous form is considered to be acute calculous cholecystitis, which occurs against the background of cholelithiasis. During an attack, the temperature rises, there is bitterness in the mouth, empty belching, severe weakness, pain in the right hypochondrium, vomiting of bile, which does not bring relief.

Stoneless chronic cholecystitis without exacerbation manifests itself as periodic pulling pains in the right hypochondrium, appetite disorders, discomfort and diarrhea after eating fatty foods. Symptoms of the disease during an exacerbation resemble biliary colic, but can last much longer.

First aid during an attack is the same as for biliary colic. During remission, anti-inflammatory drugs are used. With acalculous cholecystitis, less often than with cholelithiasis, one has to resort to surgical intervention; in treatment, more emphasis is placed on anti-inflammatory therapy.

Jaundice in diseases of the gallbladder

Icteric syndrome occurs with many liver diseases. Jaundice is subdivided into suprahepatic, hepatic and subhepatic jaundice by origin and laboratory features. For diseases of the gallbladder, it is precisely subhepatic (mechanical) jaundice caused by stagnation of bile that is characteristic. It occurs 2-3 days after an attack of gallstone disease, small manifestations of icteric syndrome can be observed without exacerbation with errors in the diet, improper medication.

Jaundice in this case is due to the entry into the blood of a large amount of bile acids and bilirubin. The skin, mucous membranes and sclera become yellowish. It is the yellow color of the sclera that is a reliable diagnostic criterion, since the skin can have a different natural tone. Another characteristic symptom is pruritus. It is due to the irritating effect that bile acids have on the nerve endings located in the upper layers of the epidermis. 1-2 days after yellowing of the skin, changes in the color of urine and feces appear. Urine becomes dark due to the appearance of bilirubin in it, and feces, on the contrary, become light due to its lack.

Laboratory tests reveal an increase in the level of bilirubin in the blood due to the bound fraction, the appearance of bile acids, an increase in the level of transaminases and alkaline phosphatase, which indicate liver damage. Bilirubin is found in the urine, and a sharp decrease in its level (acholia) is found in the feces.

Diagnostics

To make a correct diagnosis, describing the symptoms is often not enough - they are often blurred and often the patient may not attach importance to them until an attack occurs. General blood and urine tests, as well as a biochemical blood test, without exacerbation of diseases, can be completely normal. During an attack, the number of leukocytes in the general blood test increases. In the biochemical analysis, bile acids are detected 1-2 days after the attack, bilirubin rises. Its increase is also noted in the urine, and in the feces, on the contrary, it decreases.

Much more valuable information is provided by laboratory and instrumental methods for examining the function of the biliary tract. Ultrasound of the abdominal cavity allows you to see stones in the gallbladder, anatomical anomalies that predispose to them. For a more accurate diagnosis, angiographic methods are used, which allow you to track the dynamics of the outflow of bile. Duodenal sounding shows how bile enters the duodenum. In diseases of the gallbladder in children, this research method is rarely used.

Medical treatment of gallbladder diseases

Taking medications is a prerequisite for preventing attacks of the disease. Which drugs the doctor chooses depends on the characteristics of the course of the disease, the patient's ability to take medications regularly, and many other factors. Types of drugs used in diseases of the gallbladder:

• choleretic agents (cholesecretics);
• antispasmodics;
• hepatoprotectors;
• anti-inflammatory;
• tonic.

Painkillers for the treatment of gallbladder diseases are not recommended, since their effectiveness in this case is quite low, but there is a risk of provoking gastric ulcer and complicating diagnosis. To relieve pain, it is much more effective to use antispasmodics (No-shpu, Drotaverine, Mebeverine).

Cholagogue drugs are used only outside of an exacerbation, since their use during biliary colic can lead to a worsening of the patient's condition.

Hepatoprotectors (Gepabene, Karsil, Essentiale, Hofitol) are prescribed for all diseases of the gallbladder, as well as the liver to maintain its functions. They are taken in courses during the period of remission. Also, courses are taken tonic drugs that improve the function of the gallbladder.

Cholecystectomy

Surgical treatment of the disease is the removal of the gallbladder. Most often, they resort to it with cholelithiasis. The operation can be performed endoscopically (without incision) or laparotomically. The use of endoscopic methods today is considered more progressive, and in most cases the operation is performed in this way.

Indications for laparotomy (abdominal incision) - the impossibility of endoscopic surgery, suspicion of complications of cholecystitis. This operation is more traumatic, has been used recently quite rarely and strictly according to indications.

The operation to remove the gallbladder can be performed electively or urgently. The indication for emergency surgery is an attack of gallstone disease that is not relieved by medication (and if this is not the first attack, then in most cases surgery is required). Planned it can be carried out with cholecystitis, cholelithiasis or other lesions during remission, if therapeutic measures bring little effect, and exacerbations are common. In diseases of the gallbladder in women during pregnancy, elective cholecystectomy is not performed.

After the operation, you must follow a diet and take medicines. It is especially important to monitor the intervals between meals, as there is a risk of developing liver damage with the reverse outflow of bile, which normally enters the gallbladder.

Diet and proper nutrition

Diet in diseases of the gallbladder is crucial. It is the errors in it that provoke exacerbations. During the period of remission, it is necessary to limit the use of fatty, smoked, spicy foods - those for which bile is necessary. The liquid can be consumed without restrictions. It is very important to observe the intervals between meals - you should eat in small portions, but often. The time interval between meals should not exceed four hours. This is especially important for those who have undergone a cholecystectomy. The restriction on fatty foods applies not only to animals, but also to vegetable fats. Alcoholic drinks are completely prohibited.

During an exacerbation, food should not be taken until an attack of biliary colic is eliminated. You also shouldn't drink liquids. If you are very thirsty, you can moisten your lips with warm water or tea. After alleviating the condition and reducing the pain syndrome, you can eat a few tablespoons of pureed vegetable soup, drink some unsweetened tea or diluted juice. Semi-liquid viscous cereals can be entered into the menu only on the third day after the attack. And after about a week, switch to a special therapeutic diet 5A.

A proper diet should be based on the restriction of fats (animal and vegetable), junk food, spicy and spicy foods. You can not include pickles, canned food, smoked meats, fatty meats and fish in the menu. It is recommended to refuse pastries, muffins, fresh bread. Banned ice cream, sweets, sugary carbonated drinks, coffee, chocolate, cocoa. You will have to completely give up alcohol and smoking.

The diet includes pureed vegetable and cereal soups, cereals (rice, buckwheat, oatmeal), lean meat, seafood, boiled, baked or steamed vegetables. In cholelithiasis, a vegetarian, fruit diet, the use of dried fruits (dried apricots, raisins), berries, and vegetable salads are especially useful.

Prevention

Many factors play a role in the development of gallbladder diseases, and it is not possible to prevent all of them. Nevertheless, a healthy lifestyle, avoiding alcohol and smoking, moderate physical activity, limiting fatty and spicy foods (what nutritionists call heavy) will prevent the development of the disease, even if there are anatomical abnormalities (constrictions, adhesions, etc.)

Nutrition in diseases of the gallbladder is extremely important - it allows you to reduce the frequency of exacerbations, and allows the patient to feel good. It is necessary to strictly follow the recommendations of the doctor regarding diet and medication. In this case, the patient has the opportunity to lead a full life, despite the chronic disease.

It is important to remember that chronic diseases must be treated by a doctor, and the treatment of gallbladder diseases with folk remedies is permissible only after consulting a specialist so as not to harm your health.

Biliary dyskinesia - this is the presence in a person of a whole complex of certain disorders of the biliary system, which occur in connection with violations of the motor function of the gallbladder and bile ducts. At the same time, there are no organic changes in these organs. Patients very often have either too strong or insufficient contraction of the gallbladder.

Medical practice indicates that women are more susceptible to the occurrence of dyskinesias. There is evidence that biliary dyskinesia in women occurs 10 times more often than in men. With biliary dyskinesia, it does not enter the duodenum in sufficient quantities, as a result of which the patient experiences pain in the right hypochondrium. Dyskinesia is usually divided into hyperkinetic (if the condition provokes too high contractile activity of the biliary system) and hypokinetic (if the condition provokes too low contractile activity of the biliary system). It is noted that the incidence of hyperkinetic dyskinesia is more often observed in young people, and hypokinetic dyskinesia is typical for those who are already forty years old, and it also develops in people who suffer from mental instability.

Causes of biliary dyskinesia

Almost always, dyskinesia is diagnosed as a secondary disease. It manifests itself in humans as a consequence of some factors leading to disruption of the biliary tract.

So, the disease occurs in people who suffered at one time acute viral hepatitis , neurocirculatory dysfunction . In children, dyskinesia may develop due to some features of the constitution of the child, with vegetative , with a too sedentary lifestyle, due to, pathologies of the gastrointestinal tract , in the presence of foci of infection in the body. In addition, the development of biliary dyskinesia can be affected by malnutrition, a number of endocrine diseases. As a rule, with an immobile lifestyle, asthenia, and malnutrition, the patient develops hypokinetic dyskinesia.

Biliary dyskinesia in children and adults is considered as a psychosomatic disease that can be provoked by mental trauma, as well as strong ones. It has been proven that the motor activity of the gallbladder directly depends on stress and strong negative emotions: in this case, it slows down significantly, and stagnation of bile occurs in the gallbladder. Very often, when studying the case histories of such patients, it turns out that they had psychological problems of a diverse nature at one time.

In addition, the trigger for the development of dyskinesia of the gallbladder can be impaired nervous regulation of the gallbladder, period, insufficiency of the function of the endocrine glands.

There is also the possibility of attaching dyskinesia to,. In patients with peptic ulcer , there is a reflex occurrence of hyperkinetic dyskinesia. This form of the disease also threatens those who eat irregularly, too often eat very spicy foods that irritate the mucous membrane.

The main symptoms of biliary dyskinesia appear depending on which factor provoked the development of dyskinesia. As a rule, most people suffering from this disease complain of a complex of symptoms of nervosa. This is too high a level of fatigue, bouts of tearfulness and irritability, palpitations, sweating, recurrent headaches. In this case, patients feel pain in the right hypochondrium. If it's about hypertensive dyskinesia , then such pain is distinguished by paroxysmal character. In this case, the pain is quite acute, but lasts a short period of time. Pain may radiate to the right shoulder or shoulder blade. Especially often such attacks occur after eating fatty foods, strong stress, both physical and emotional. Very often, patients with hypertensive dyskinesia note a manifestation, which most often happens in the morning.

If the patient is suffering from symptoms hypotonic dyskinesia , then this condition is characterized by dull and aching pain, in which there is also a feeling of fullness in the region of the right hypochondrium. Such pain constantly worries the patient, while his appetite noticeably decreases, the person often feels sick, and belching appears. The rise in body temperature is not observed, a clinical blood test also does not indicate the presence of abnormalities.

In addition, symptoms of biliary dyskinesia in men may include decrease in sexual activity . At the same time, women may experience monthly cycle . Common signs of dyskinesia are depression, emotional as well as physical weakness. During an attack biliary colic the patient may have a feeling of a strong heartbeat or a feeling of cardiac arrest. He may be accompanied by a feeling of fear, numbness of the limbs.

The disease continues for a long period, with severe exacerbations periodically observed, which provoke stress and other elementary disorders. After the attacks, there is a periodic relief of the condition. Over time, dyskinesia can cause inflammation in the gallbladder and ducts, and cause gallstones to form.

Diagnosis of biliary dyskinesia

To accurately determine the form of dyskinesia, an ultrasound examination of the abdominal cavity is performed, as well as contrast cholecystography. A laboratory blood test is ordered. To determine what changes in the contractile activity of the biliary tract function take place (too high or too low), the patient is prescribed duodenal sounding or ultrasound, before which it is important to consume a choleretic breakfast.

Treatment of biliary dyskinesia

It should be borne in mind that the treatment of biliary dyskinesia directly depends on what causes provoked the manifestation of this disease. When prescribing therapy, it is necessary to take into account the fact that dyskinesias are classified as psychosomatic diseases. Therefore, psychotherapeutic measures are important in their treatment. However, such treatment can only be prescribed by a specialist psychotherapist. Patients, on the other hand, consider their problems to be exclusively somatic, therefore they rarely turn to a doctor of this profile. If the patient has symptoms of a depressive state, then the patient is often prescribed a course of treatment. tranquilizers , antidepressants , light preparations antipsychotics .

All further methods of treating dyskinesia directly depend on which form of the disease is diagnosed in the patient. If a patient has developed hypokinetic dyskinesia, he should observe a special one, including products with a choleretic effect and with a high content of certain minerals.

In the process of therapy, patients are prescribed regular use of mineral waters of a certain type. They need to drink one glass about three times a day, about half an hour before meals. In addition, with biliary dyskinesia, the use of massage and physiotherapy exercises is effective. Periodic spa treatment is also recommended. Sometimes it is advisable for the patient to prescribe duodenal sounding in order to free the gallbladder from bile. There is also the so-called "closed tubage" technique, which the patient can undertake independently, thus stimulating the contraction of the gallbladder.

If the patient suffers from the manifestation of hyperkinetic dyskinesia, then it is important for him to adhere to a diet that is characterized by restriction of irritant products, fats. To eliminate acute conditions, patients are shown the use of antispasmodic drugs, mineral waters. Surgical methods in this case are not effective.

In general, to improve the condition of patients, it is recommended to normalize the diet, rest and work, to exclude a number of products from the diet. You can also use some folk remedies, in particular herbal decoctions. For the treatment of dyskinesia, decoctions of coriander, anise, corn stigmas, St. John's wort, mint, sage, celandine, valerian root, immortelle grass are used. Traditional medicine also recommends drinking grapefruit juice some time before meals.

The doctors

Medications

Diet, nutrition for biliary dyskinesia

Despite the fact that biliary dyskinesia is an ailment that is not classified as a dangerous disease, dieting is extremely important to prevent further development. cholecystitis and other dangerous diseases. observed depending on which form of the disease occurs. However, in general, nutrition should contribute to the normalization of the motor functions of the biliary tract. If the patient suffers from manifestations of hypertensive dyskinesia, he needs to very sharply reduce the content in the diet of those products, the use of which helps to reduce the gallbladder. In this case, we are talking about too rich broths, animal fats, vegetable oils. But not very rich broths, fish soup, vegetable oils, dairy products make up the diet with the development of hypotonic dyskinesia.

The diet for biliary dyskinesia, which is hypertonic in nature, excludes the use of smoked, fried foods, alcohol, and spicy foods. Do not eat ice cream and drink carbonated drinks. Such food can provoke a severe spasm of the biliary tract. It is important to always eat only warm and fresh food. The diet should be a lot of vegetables, but it is desirable to limit the number of meat dishes. It is necessary to adhere to such dietary habits for a long time.

It is necessary to take food in small portions, doing this up to 6 times a day. It is advisable to eat a light meal right before bedtime. In general, the diet for this disease is similar to the principles of nutrition in the Mediterranean countries: it is dominated by vegetables, fruits, fish dishes. By the way, bran has a very good effect on the state of motility of the biliary tract: they should be taken by adding 1 tablespoon to everyday meals.

Prevention of biliary dyskinesia

In order to prevent the manifestation of this unpleasant ailment, one should, without delay, treat all disorders of a neurotic nature, avoid serious stressful situations, eat regularly, at the same time every day. More important is also a normal, full sleep and rest.

Intestinal dyskinesia

A variety of disorders of the large intestine of a functional nature are ailments that are very widespread today. (this disease is also called irritable bowel syndrome , spastic colitis ) is a condition in which the motor function of the intestine is impaired. To a greater extent, dyskinesia of the large intestine is manifested, to a lesser extent - dyskinesia of the small intestine. At the same time, organic lesions are not typical for this disease. In patients with intestinal dyskinesia, pain is manifested, their bowel function noticeably changes. In some cases, there is also too high a level of mucus secretion: a similar phenomenon is typical for about half of all patients.

Intestinal dyskinesia develops as a consequence of some neurotic disorders, serious stressful situations, conflicts, dystonia of the autonomic nervous system, and endocrine disorders. Also, a factor influencing the manifestation of intestinal dyskinesia is a hereditary predisposition to this disease. As in the case of biliary dyskinesia, this disease may manifest both hyperkinetic (spastic) and hypokinetic (atonic) changes. Quite often, both types of these disorders occur simultaneously.

A patient with progressing intestinal dyskinesia is very often concerned about pain in the abdomen, which is characterized by the absence of a clearly defined localization. There may also be disorders of the stool, too active production of mucus. The pain can have different intensity: sometimes there is a feeling of pressure in the lower abdomen, pressure in the lower abdomen, sometimes quite severe colic. They can last for several minutes or several days. Quite often, patients perceive such colic as the beginning of an attack of appendicitis. In some cases, it even comes to surgery for suspected appendicitis. Sometimes patients with intestinal dyskinesia note a periodic alternation of constipation and diarrhea. Especially often diarrhea overcomes a person in the morning, after he has taken food. In this case, feces with mucus impurities often come out.

Diagnosis of intestinal dyskinesia involves, first of all, the exclusion of possible organic ailments, the symptoms of which are similar to those of dyskinesia. The patient is scheduled for endoscopy, which reveals hyperemia of the mucous membrane of the colon. Microscopic examination of stool shows no changes.

It is important for all patients to maintain a healthy lifestyle, to avoid. If a person constantly manifests himself, he is recommended to introduce whole grain cereals, sour-milk products, and baked apples into the diet.

List of sources

• Sherlock S. Diseases of the liver and biliary tract / S. Sherlock - M .: GEOTAR-MED, 2002;
• Diseases of the liver and biliary tract: A guide for physicians / Ed. V.T. Ivashkin. - M., 2002;
• Ilchenko A.A. Cholelithiasis. Moscow: Anaharsis, 2004;
• Maev I.V., Samsonov A.A., Salova L.M. Diagnosis and treatment of diseases of the biliary tract: Textbook. - M .: GOU VUNMTs of the Ministry of Health of the Russian Federation, 2003;
• Ilchenko A.A. Diseases of the gallbladder and biliary tract: A guide for physicians. M.: Ana-harsis, 2006.