Psychoses in diseases of the biliary tract. Gallbladder and biliary tract. Cholecystitis is an inflammatory process

Biliary dyskinesia is a difficult flow of bile from the liver into the bladder and through the ducts. A distinctive feature of the disease is the absence of pathological changes in the structure of the liver and gallbladder with ducts. During examination, doctors identify two types of gallbladder dysfunction in patients - either its contraction is too slow or its contraction is too fast/frequent. According to statistics, men suffer from biliary dyskinesia more often than women (about 10 times).

Classification

The definition of the form of dyskinesia depends on how the gallbladder contracts:

hypermotor - in this case, the contraction of the organ is very frequent and rapid. This form of the disease in question is characteristic of young people;
hypomotor - contraction occurs slowly, the activity of this function of the gallbladder is significantly reduced. According to statistics, hypomotor biliary dyskinesia is often diagnosed in patients over 40 years of age and in patients with persistent neuroses/psychoses.

Depending on the cause of the development of the pathology in question, doctors can divide it into two types:

primary dyskinesia - it is usually associated with congenital anomalies in the structure of the biliary tract;
secondary - the disease is acquired during life and is a consequence of pathologies in other organs of the gastrointestinal tract (for example, secondary biliary dyskinesia often “accompanies” pancreatitis - an inflammatory process in the pancreas).

Causes of development of biliary dyskinesia

If we are talking about the primary type of the disease in question, then its causes are:

narrowing of the gallbladder;
doubling (bifurcation) of the bile ducts and bladder;
constrictions and septa located directly in the cavity of the gallbladder.

All these causes are congenital anomalies and are detected in early childhood during examination.

A secondary type of dyskinesia of the gallbladder and ducts can develop against the background of the presence of the following factors:

– inflammatory process on the mucous membrane of the inner walls of the stomach;
formation of ulcers on the gastric mucosa and/or;
– inflammation of the gallbladder;
pancreatitis - an inflammatory process in the pancreas;
duodenitis is a pathological inflammatory process in the duodenal mucosa;
hepatitis of viral etiology is a systemic disease in which the liver is affected by viruses;
hypothyroidism – decreased functionality of the thyroid gland.

In addition, the reasons that can lead to the development of dyskinesia of the gallbladder and ducts include neuroses - mental disorders that are not only well understood by the patient themselves, but are also subject to treatment, until complete recovery.

There are documented cases of diagnosing biliary dyskinesia against the background of a sedentary lifestyle, excess weight (stage 2-3 obesity), excessive physical activity (especially if heavy lifting is constantly occurring) and after psycho-emotional breakdowns.

Symptoms of biliary dyskinesia

The clinical picture of the described pathology is quite pronounced, so diagnosis does not present any difficulties for specialists. The main symptoms of biliary dyskinesia are:

, gallbladder and bile ducts - in the right hypochondrium. It can have a different character:

with increased contractile activity of the gallbladder - acute, paroxysmal, with irradiation to the scapula and right shoulder. Occurs either after intense physical activity or eating fatty foods in large quantities;
if the contractile activity of the bladder is reduced, then the pain will be of a completely different nature - dull, aching, constant (episodes of absence of pain are very rare), patients feel a feeling of fullness in the right hypochondrium;
– always occurs acutely, suddenly, differs in intensity, and is accompanied by increased heart rate. Increased blood pressure (not in all cases). Since the pain is too severe, the patient experiences a feeling of anxiety and fear of death.

Cholestatic syndrome (manifestations of pathology in the liver and biliary tract):

jaundice - the skin, sclera of the eyeballs, mucous membranes of the mouth and saliva turn yellow in different shades;
enlarged liver - in some cases the patient himself can feel it;
change in the color of stool - it becomes noticeably light;
change in urine color – it becomes distinctly dark;
itching of the skin without a specific localization.

Digestive system disorders:

bloating;
loss of appetite;
nausea and vomiting;
bad breath from the mouth;
dry mouth.

Neurosis is a mental disorder that can be cured (reversible):

irritability and insomnia;
increased sweating (hyperhidrosis);
chronic fatigue syndrome;
headaches - they are not constant, they are periodic.

The above symptoms cannot appear at the same time. For example, cholestatic syndrome is diagnosed in only half of patients with biliary dyskinesia, and bitterness and dryness in the oral cavity are more characteristic of hyperdyskinesia (contractile activity of the gallbladder is increased).

Diagnostic methods

Based solely on the pronounced symptoms of biliary dyskinesia, no specialist can make a diagnosis. To make a final verdict, doctors carry out the following activities:

Questioning the patient and analyzing the description of the disease - how long ago the first attacks of pain or other symptoms appeared, what they may be associated with (according to the patient).
Collecting an anamnesis of the patient’s life - have his relatives been diagnosed with the disease in question, are there any diagnosed chronic diseases of the gastrointestinal tract, have he taken any medications for a long time, have he been diagnosed with benign/malignant tumors, in what conditions does the patient work? (meaning the presence/absence of toxic substances at work).
Physical examination - the doctor determines what color the patient’s skin, sclera and mucous membranes are (whether there is jaundice or not), whether obesity is present, palpation (feeling) will help identify liver enlargement.
Laboratory tests - general and biochemical blood tests, general urine analysis, lipid profile (detects the level of fat in the blood), markers of hepatitis of viral etiology, examination of feces for worm eggs.

After this examination, the doctor can diagnose biliary dyskinesia, but to confirm it, the patient will also be prescribed an instrumental examination of the body:

ultrasound examination of all abdominal organs;
ultrasound examination of the gallbladder “with a test breakfast” - first an ultrasound scan is performed on an empty stomach, then the patient eats a fairly fatty breakfast and after 40 minutes a repeat ultrasound scan of the gallbladder is performed. This procedure makes it possible to find out in what form the disease in question occurs;
duodenal intubation - using a special intestinal probe, the duodenum is examined and bile samples are taken for laboratory testing;
FEGDS (fibroesogastroduodenoscopy) – examines the mucous membranes of the stomach, duodenum, and esophagus;
oral cholecystography - the patient drinks a contrast agent and after half an hour the gallbladder can be examined for the presence of developmental anomalies;
ERCP (endoscopic retrograde cholangiopancreatigraphy - one study combines both x-ray and endoscopic methods. This allows you to directly examine the bile ducts;
Hepatobiliary scintigraphy is a radioisotope method in which the patient is injected with a radioactive drug (intravenously), which accumulates in the liver and biliary tract, which makes it possible to study their complete and accurate image.

Treatment methods for biliary dyskinesia

The goal of treatment procedures is to ensure a complete outflow of bile from the liver. It will not be possible to do this solely with medications; an integrated approach is needed.

Therapy for biliary dyskinesia includes:

Creating and following a daily routine:

a competent combination of work and rest - for example, night sleep should not be less than 8 hours;
Take regular walks in the fresh air;
When doing sedentary work, do gymnastics every 2 hours - we are talking about the simplest bending, squats, and turning the body.

Strict diet:

Medicines:

choleretic drugs – choleretics;
enzyme preparations;
Cholespasmolytics.

Additional medical procedures:

tubing of the gallbladder (cleansing) - taking choleretic drugs in a lying position on the right side with a heating pad in the area of the anatomical location of the liver and biliary tract;
regular duodenal intubation - cleansing the duodenum after the release of bile;
electrophoresis;
acupuncture;
diadynamic therapy;
acupressure;
hirudotherapy (treatment with leeches).

Surgical intervention is absolutely impractical, therefore surgical treatment of biliary dyskinesia is never prescribed. On the recommendation of a gastroenterologist or therapist, the patient can be referred to a psychotherapist (if he has neuroses).

Treatment of biliary dyskinesia with folk remedies

Treatment of biliary dyskinesia with herbal preparations is also approved by official medicine - doctors recommend taking a course of using decoctions/tinctures of medicinal herbs twice a year. Here are two of the most effective and safe recipes:

Prepare the following herbs:

elecampane root – 10 g;
marshmallow root – 10 g;
calendula (flowers) – 15 g;
chamomile (flowers) – 10 g.

Mix the indicated plants and take only 2 tablespoons of the resulting mixture. They should be poured with half a liter of water, boiled and simmered over low heat for at least 7 minutes. Then the broth is infused (40-60 minutes), filtered and the resulting amount is drunk in small sips half an hour before meals three times a day. Duration of treatment – 3 weeks.

Mix plantain leaves (30 g), calendula flowers and sage leaves (10 g each), mint/rosehip/cumin (15 g each), cinquefoil (herb) and raspberry leaves (20 g each). And the preparation and administration scheme is the same as for the previous decoction.

Among the traditional methods, the following recipes can be distinguished:

There are also treatment methods with sand and clay, essential oils and vegetable juices, but there is no confirmation from official medicine regarding the advisability of such procedures. Any treatment with folk remedies should be carried out only after consultation with the attending physician and with regular monitoring of the dynamics of the disease.

Possible complications

As a rule, with biliary dyskinesia, patients seek help from doctors almost immediately after the first attack of pain. But many of them, having relieved the unpleasant symptoms, stop the prescribed treatment, thereby provoking the development of complications:

chronic cholecystitis - inflammation of the gallbladder that lasts more than 6 months in a row;
the formation of stones in the gallbladder and its ducts – cholelithiasis;
chronic pancreatitis – inflammation of the pancreas for 6 months;
– a skin disease that is a consequence of a decrease in the level of immunity;
duodenitis is an inflammatory process on the lining of the duodenum.

Biliary dyskinesia has a fairly favorable prognosis and does not shorten the patient’s life expectancy. But in the absence of proper treatment and non-compliance with the nutritionist’s recommendations, the development of the above complications is inevitable. And even these diseases are not life-threatening, but the patient’s condition will worsen significantly and eventually lead to disability.

The digestive system is a whole complex consisting of internal organs that perform important functions.

Failures in the functioning of individual organs often occur, which entails serious consequences.

Diseases of the gallbladder and biliary tract lead to deterioration of digestion, disruption of the production and passage of bile, blockage of the ducts, forming tissue tumors.

Women are more likely to suffer from such disorders than men. The reasons may include cholelithiasis, dyskinesia, cholecystitis, acute cholangitis, and cancer.

Each pathology is serious and must be treated immediately.

Functions of the organ

The gallbladder gradually stores bile produced by the liver. During eating, food enters the stomach cavity.

At this time, all accumulated bile is released from the gallbladder and enters the duodenum through the ducts.

Bile, entering the intestines, digests and assimilates incoming food. Any changes in this system can lead to global consequences.

What other functional properties does this organ have:

It effectively neutralizes gastric juice.
Activates the enzymatic ability of pancreatic and intestinal juices.
Destroys pathogenic microorganisms in the intestinal cavity.
Normalizes peristalsis and motor activity of the intestinal tube.
Removes toxins and metabolic products of drugs from the patient's body.

The main causes and mechanism of formation of pathologies

All diseases of the gallbladder and biliary tract have their own causes of formation and mechanisms of development. What they can be:

Infectious. Inflammatory processes can form in the cavity of the organ and on its mucous membranes due to the development of pathogenic microorganisms, viruses, fungi, and protozoa. Often the provoking factor is Escherichia coli, staphylococci, streptococci, Proteus.
Due to imbalances in bile components, its composition may change. This leads to the formation of stones and the development of gallstone disease. It provokes stagnation, leading to inflammation.
Diseases may develop that can have a direct effect on the impulses necessary for the gallbladder to carry out the motor activity of the organ. This leads to impaired bile patency and its stagnation.
Heredity, genetic predisposition, congenital pathology. Disorders can develop as a result of bending of the organ.
Tumor neoplasms. Often, the reasons that prevent the flow of bile through the ducts are polyps, cysts or malignant tumors.

Any of the listed disorders can lead to serious deviations in the functioning of the organ, so it is extremely important to detect pathology in a timely manner.

Symptoms of diseases

Common and characteristic symptoms will help identify the pathological condition. The appearance of the first signs should alert the patient and serve as a serious reason to consult a doctor.

Diseases of the gallbladder and biliary tract in the first stages are manifested by weakness, malaise, and fatigue. Performance decreases sharply, and general condition worsens.

The first sensations of pain may appear at a time when the disease has already reached a severe stage. Therefore, it is extremely important to undergo a medical examination on time.

What signs may appear:

Pain syndrome in the area of the right hypochondrium. Each disease is expressed by different phenomena of pain. Their nature and intensity may vary depending on the diagnosis. If the presence of polyps does not cause any pain, then pain due to cholelithiasis will be one of the main signs of the disease.
Often, pathological processes are accompanied by nausea, vomiting, vomiting may occur, diarrhea may be replaced by constipation, increased gas formation, bloating and flatulence appear.
In the oral cavity, patients feel a bitter taste and an unpleasant odor. You should be thoroughly examined by a doctor, since this phenomenon is typical for both gall and liver diseases.
The tongue may take on a red or crimson hue.
The patient's urine becomes dark in color. This is one of the clear signs of a disease called cholestasis. This phenomenon is explained by the accumulation and high concentration of urobilinogen in the urine.
The patient's feces become discolored. These changes occur due to stagnation of bile. Stercobilin, necessary for the natural coloring of feces, does not enter the intestinal cavity, which leads to corresponding consequences.
Manifestation of icteric phenomena. Cholestasis is characterized by the absorption of bile into the blood, which leads to deposits of substances in the skin epithelium and mucous membranes. The patient experiences yellowing of the eye sclera, oral mucosa and the skin itself.

These signs are the main ones accompanying pathological processes. But sometimes they may be accompanied by loss of appetite and increased body temperature.

Diseases

Each disease is presented in the form of pathological processes in which unpleasant symptoms appear, the causes of which are various changes in the functioning of the organ.

Any disease should be detected in time and excluded through the correct methods of therapy, therefore it is very important to consult a doctor in time when the first suspicious symptoms appear.

Cholecystitis

There are two forms of pathology: chronic and acute. Chronic is characterized by a violation of the flow of bile, in which the composition and density of this substance changes.

In the acute course of the disease, the walls of the organ become inflamed as a result of blockage of the bile ducts. The inflammatory process covers the entire bladder and develops as a result of cholelithiasis.

Reasons

The main cause of the development of the disease is stones. They disrupt the passage of bile and provoke infection with intestinal microflora.

Constant inflammation alters the walls of the gallbladder, leading to a chronic condition. There are other reasons:

Anatomical features of the organ.
Weakening of muscle tissue.
Stagnation phenomena.
Violation of the functional activity of the organ.
Weak secretion of secretions from the stomach.
Injury to the gallbladder or liver.
Long and grueling diets, fasting.

Manifestations

In the acute form, patients experience paroxysmal pain in the right side of the abdomen, which intensifies significantly when changing position.

There may be pain radiating to the neck and back. What other signs might there be:

Slight increase in body temperature.
Raising a high temperature during suppuration, intoxication.
Nausea, vomiting appears, the patient shudders, and his pulse quickens.
When the canal is blocked by a stone, acute pain and icteric symptoms occur.
Urine darkens, feces become discolored.

The chronic stage is manifested by the following symptoms:

Nausea.
Discomfortable phenomena.
Dull pain in the right side, especially after eating.
In the absence of a calculus, a deterioration in general condition, weakness, and malaise occurs.
Sleep disorders.

Postcholecystectomy syndrome

The disease is considered rare and is characterized by a complex of symptoms related to gallbladder diseases. They arise as a result of surgery after excision of an organ or its ducts.

Reasons

Main reasons:

There are remains of stones in the channels.
The opening connecting the ducts to the duodenum is narrowed.
Development of pancreatitis.
The appearance of gastritis.
Inflammatory process in the intestines.

Manifestations

The main symptoms are:

Bitterness, nausea, bloating and flatulence, and intestinal upset appear in the mouth.
Pain in the right side of the abdomen, radiating to the right shoulder and collarbone.
Pale skin, weakness.

With exacerbation of concomitant diseases, an increase in body temperature and the appearance of icteric phenomena are possible.

Dyskinesia

The disease is characterized by impaired functional abilities of the bile ducts as a result of unstable outflow of bile.

It can be intense or very weak. This process leads to serious digestive disorders.

Reasons

The main reasons are:

Low mobility, inactive lifestyle.
Hormonal imbalances, hormonal imbalances.
Disturbance of microflora in the intestines.
Excess body weight.
Lack of vitamins.
Stress, unstable psycho-emotional state.
Severe physical stress.
Eating disorder.

Manifestations

One of the common and main symptoms is pain. In the hyperkinetic form, its character may be different.

In many cases, the pain is paroxysmal in nature. More often appears after eating. The area of its localization is the right hypochondrium.

Other signs:

The occurrence of biliary colic.
Colic is accompanied by severe short-term pain and numbness of the limbs.
Pulse and heart rate increase.

Manifestation of the hypokinetic form:

The occurrence of dull and aching pain.
The appearance of heaviness and distension in the right side.
Bloating, flatulence.
The nature of the pain is long-lasting.
The pain decreases after eating and taking choleretic medications.

Itching, skin rashes, and loss of appetite may also appear.

Acute cholangitis

An inflammatory, often infectious disease of the bile ducts is considered a consequence of prolonged cholecystitis, surgery or cholelithiasis.

The occurrence can occur due to stagnation of bile, the development of tumor tumors.

Reasons

The main causes of the disease include stagnation of bile and infection.

In the first case, the process is formed as a result of blockage of the canals with stones, tumors, and helminthic infestations.

Long-term dyskinesia can also cause the formation of congestion. Under such conditions, the composition of bile changes, creating ideal conditions for the development of infection.

Surgical intervention can also cause the disease.

Manifestations

The main symptom of the pathology is pain, which can radiate to the right arm or bother the left side of the body.

Pain syndrome is accompanied by accompanying symptoms:

Blood pressure drops sharply.
Constant nausea with frequent vomiting, after which there is no relief.
Itching on the skin.
The muscle tissue on the right side of the abdomen is under tension.
Raising body temperature to 40 C.
The patient is chilly and has increased sweating.
Weak condition, poor health.

Neoplasm

Tumors can be benign or malignant. Both options occur without significant symptoms.

When the first signs appear, symptoms are noted that are often confused with cholecystitis.

Reasons

The causes of tumor neoplasms can be concomitant diseases of the biliary system, digestive organs, and hormonal disorders.

Tumors often arise due to poor nutrition, long-term use of medications with a wide range of side effects, chronic depressive and stressful conditions.

Particular attention is paid to bad habits and poor ecology.

Manifestations

Benign tumor neoplasms do not disturb their owner for a long time. They rapidly increase in size without causing significant problems.

Reaching large sizes, they can manifest themselves in the form of pain, skin rashes or itching. Jaundice often appears, covering not only the skin, but also the eye sclera.

Particular attention is paid to the general condition: the patient feels sick, he becomes ill, his sleep is disturbed, he becomes weak, and an apathetic state occurs.

Malignant, and therefore cancerous, formation is manifested by intense symptoms. The patient suffers from pain that does not respond to painkillers.

The patient constantly feels nauseous and vomits repeatedly. Due to loss of appetite or complete refusal to eat, he loses significant body weight.

When diagnosing a gallbladder using ultrasound (ultrasound), an increase in its size is noted.

Gallstone disease

High concentrations of cholesterol and low levels of bile acids provoke the formation of stones, which gradually increase in size as harmful substances accumulate.

Stones block the ducts, disrupting the flow of bile. The consequences are disturbances in the functioning of the gastrointestinal tract, pain syndromes, spasmodic conditions, and disturbances of the intestinal microflora.

Reasons

Obesity, overweight.
Diabetes mellitus.
Poor nutrition, drinking alcohol, fatty foods.

Manifestations

The patient feels severe pain, cramps and colic in the right side of the abdomen under the rib. He is constantly exhausted by nausea, which is very often accompanied by vomiting.

Blockage of the channels causes stagnation of bile. It gradually accumulates, penetrates the walls of the bladder, and then into the blood. This leads to yellowing of the skin on the body, mucous membranes in the mouth and eyes.

There are cases when the stone is independently released from the gallstone, after which it passes through the canals and enters the cavity of the duodenum.

If a calculus gets stuck in the ducts, an inflammatory process begins, leading to an acute form of cholecystitis.

This disease is dangerous due to its asymptomatic course, which may result in feelings of weakness, lethargy, and the development of complications.

The first signs of a pathological process should attract the patient's attention. He should definitely visit a doctor to find out the exact cause of pain in the right side of the abdomen and other unpleasant symptoms.

Some diseases can be asymptomatic and therefore can develop rapidly, disturbing their owner only during a severe stage.

Laboratory tests of blood, urine and feces will help identify the pathological condition. Instrumental diagnostic methods are also relevant.

Many diseases are easily amenable to traditional treatment using drugs. Sometimes only surgical intervention is required.

Any treatment method is accompanied by proper nutrition. Only a properly balanced diet will avoid many exacerbations and improve the functioning of the digestive system.

Refuse junk food. Instead, eat healthy foods. It is worth forgetting about bad habits forever, as they provoke painful conditions and aggravate their course.

Maintain a healthy lifestyle and follow all recommendations of the attending physician. Only a specialist can make a correct diagnosis and name the cause of unpleasant symptoms.

Don't delay your visit to the doctor. This is just as dangerous as self-medication.

Useful video

Most often, the disease comes unexpectedly, so it is recommended to know not only the symptoms of emerging biliary dyskinesia, but also treatment methods.

Dyskinesia and its types

Dyskinesia is a disease of the digestive organs, in the presence of which negative changes occur in the functioning of the motility of the biliary tract, as well as the appearance of the tone of the gallbladder. The condition provokes a disruption in the flow of bile into the duodenum, where the process of food digestion is inhibited.

But you shouldn’t refuse treatment. In the absence of treatment, the disease tends to develop into more serious diseases, for example, cholelithiasis or similar very unpleasant ailments of the body.

Bile is an essential component in the body that helps in the digestion process. It is the main substance that separates fats from the total mass of food, thereby making their area larger. As a result of excretion, they are absorbed into the blood.

In order for these actions to be carried out correctly, the bile consistency must have a suitable composition. This issue is dealt with by the gallbladder; if there is a large amount of water in the bile, it eliminates it, transferring it into the vessels.

If the motility of the gallbladder is impaired, and the internal fluid, without being filtered, enters the intestines, a disorder is observed and, as a result, diarrhea. In another variant, if bile, on the contrary, undergoes processing for a long time, then water is removed from it in increased quantities, which also negatively affects the functioning of internal organs.

The movement of internal fluid from the liver, where it is formed, to the duodenum is influenced by the work of the sphincters (circular muscles). The latter regulates the flow of bile: first into the gallbladder, and then into the duodenum.

Violation of a coherent system leads to the appearance of dyskinesia. The disease is distinguished based on the activity of muscle contractions (features of motor skills):

Hypokinetic - there is a decrease in contractions of the muscles of the biliary tract, the movement of internal fluid is difficult. It usually appears in people who have crossed the threshold of 40 years or in individuals with mental disorders.
Hyperkinetic - the activity of muscle contractions, on the contrary, is significantly increased. Caused by a sedentary lifestyle, it usually occurs either in school-age children or in the younger generation.

In addition, the disease is classified depending on the causes and time of manifestation into primary and secondary forms. Primary dyskinesia manifests itself during the formation of important internal organs, that is, in utero. While secondary is provoked based on the consequences of previous diseases.

Causes of the disease

It is impossible to determine the main cause for different cases. In each individual case, the disease develops individually. A person forms his own habits, eats unhealthy foods, which undoubtedly has an impact on the deterioration of general well-being, and can also cause an inflammatory process in the regulatory system.

One of the factors of occurrence is a stressful situation. It is frequent angry tension, nervousness, and bad mood that affect the motility of the biliary tract, narrowing the patency of the ducts.

The causes of improper functioning of the bladder and ducts in the primary form of the disease are congenital malformations of the fetus:

The bladder is located inside the liver
Bile ducts are doubled
The bubble has kinked
Formation of valves inside the ducts
An additional gallbladder has formed
A bubble has formed divided into two parts by a septum
Weak bladder walls
The bubble is quite mobile or incorrectly located

Factors that can influence the development of secondary forms of dyskinesia are identified:

Genetic predisposition
Diseases that the patient had previously (viral hepatitis, cholecystitis in various forms)
Dysbacteriosis of the large intestine
Mental disorders
Allergic reactions to foods
Respiratory tract infections
Inflammatory processes of the digestive tract
Kidney stones
Spasmodic condition of the passages through which internal fluid circulates
Helminths
Bad habits (excessive consumption of alcoholic beverages, smoking abuse)
Negative influence of external environmental factors (environmental pollution)

In addition, obesity or, conversely, prolonged unsuccessful diets contribute to the emergence of a painful problem.

If you experience pain, you should immediately seek advice from a qualified specialist. Treatment should begin by identifying the initial causes that led to this condition.

Symptoms of pathology

Signs of the disease do not immediately make themselves known. The disease develops for a long period without any symptoms. The first manifestation of discomfort is bad breath, pain in the right hypochondrium or biliary colic. Pain varies with different types of dyskinesia.

In the hyperkinetic form, pain occurs in short-term attacks, but quite intensely, with acute contractions. Unpleasant feelings appear in the area of the right shoulder or shoulder blade, especially during exercise, stressful situations or after eating fatty foods.

During the hypokinetic stage, sensations of aching, unpleasant pain appear that are constantly present. Periodically it disappears, but soon appears again. There is also a feeling of fullness in the right hypochondrium.

Colic attacks occur suddenly, with sharp pain. At the same time, the heartbeat increases sharply, the pulse goes off scale, a feeling of cardiac arrest and wild fear appear. Added to this is numbness in the arms and legs.

The main symptoms of the pathology are:

Severe itching all over the body
Stool becomes lighter in color
The skin and mucous membranes become yellow (jaundice)
Urine appears darker in color
When diagnosed, liver enlargement is observed
Appetite decreases
There is nausea, profuse vomiting
Presence of dryness and burning in the mouth in the morning
Irritability, nervous agitation
Fatigue, lack of performance
Increased sweating
Frequent headaches

Men experience a sharp decrease in sexual desire, and women suffer from menstrual irregularities. In any condition, depression, emotional weakness and physical disability are observed.

The disease can occur in a latent form, developing into a chronic condition, or it can flare up with an unexpected exacerbation. After the attack, there is a slight relief of symptoms.

An increase in body temperature at the time of acute progression is not detected; in addition, neither a general blood test nor a clinical one reveals any pathological changes. A long period of presence of the disease tends to provoke serious complications.

Diagnosis of the disease

If any symptoms appear that indicate the body is not working properly, it is recommended to seek advice from a qualified specialist. An experienced specialist can determine dyskinesia at the first examination by palpation and by the patient’s appearance.

The patient looks unhealthy, weakened, the skin is dry, and dermatitis is often present. The doctor asks a general question about the time of onset of abdominal discomfort and the duration of staining of the epidermis.

During the consultation, the causes of such symptoms are identified. What are the signs of illness associated with - bad habits, environmental conditions, difficult working conditions or previous illnesses, identified tumors.

Using palpation, the specialist determines the severity of pain during inspiration. By tapping, the size of the spleen and liver is measured.

If necessary, the patient is additionally examined by a therapist. Based on the tests performed and the results obtained, effective and prompt treatment is prescribed.

Treatment methods

Therapy is based not only on the results obtained from the study, but also on the identified cause that caused the disease. Primary treatment is based on removal of the underlying disease.

A fairly common cause of this problem is psychological stress and frustration. Therefore, the patient is recommended to visit a psychotherapist. If the leading symptoms are a depressive, depressed state, then the disease can only be eliminated with sedative medications.

If the symptoms do not relate to psychosomatic signs, then the form of dyskinesia (hypo- or hyperkinetic) is determined and, based on the results, treatment is recommended.

Healing requires an integrated approach, including several stages of therapy:

Treatment with medications
The use of traditional medicine using infusions, herbs and decoctions - recommended by a gastroenterologist
Diet therapy
Other cures

The main goal and main task of curing biliary dyskinesia is to normalize the functioning of the gallbladder, as well as to improve the motility of the excretory canals. In addition, treatment allows you to normalize the functioning of the outflow of bile.

Diet therapy

Diet for diseases of the biliary tract is the main component in normalizing the entire condition of the body. If you do not deviate from the established boundaries in nutrition and adhere to the work and rest regime prescribed by the doctor, you can avoid complications caused by the disease.

The diet for patients with this disease is No. 5. It has both general postulates for patients and differs depending on the form of the disease derived from the analysis (hypo- and hyperkinetic).

Food should be taken in small portions, 4-5 times a day. You need to eat food so that the introduced products are immediately broken down, and the gallbladder is quickly emptied. This is necessary to eliminate pain that occurs during prolonged digestion of food.

Eating should be done every 3-4 hours, this interval should not be increased or decreased. It is recommended to take the last meal before going to bed 2-3 hours in advance; however, you should not eat meat products, they are difficult for digestion.

Medical professionals recommend drinking one glass of low-fat kefir (1%) in the morning and after dinner to improve gastrointestinal motility. At any stage of the disease, you should not heat or cook food with lard, margarine or similar trans fats.

You need to completely avoid the following products:

spicy, fried, fatty, smoked
sausages and meat products, fish (fatty varieties), lard
fast food, chips, nuts, ice cream, chewing gum, chocolate
alcohol and cold carbonated drinks
canned food, baked goods, mushrooms

Select foods from the general diet that will need to be removed at the time of exacerbation of the disease:

mustard, pepper
salty ingredients and hot spices
onion, radish, horseradish, radish
rye bread

For consumption during any period of illness, it is advisable to eat the recommended set of nutritional ingredients:

low-fat soups and borscht
switch to a vegetarian diet
biscuits
poached eggs, boiled
porridge with water – buckwheat or rice
steamed fish or meat (low-fat)
vegetables in any form except raw
cooking with sunflower or olive oil; butter should only be consumed
in the morning as a sandwich
bread - only yesterday's
weak tea, preferably green, fresh juices, mostly freshly squeezed

If a hypokinetic form of the disease is detected, you should definitely include black bread, sour cream, cream, eggs (daily), vegetables and fruits in your diet. They are necessary to stimulate the motility of the ducts and pathways of the biliary system.

In a hyperkinetic state, it is necessary to strictly follow a diet and categorically refuse fermented milk products with high fat content; gray and black bread, fresh vegetables, sparkling water and animal fats. The use of mineral waters in any form is recommended.

Drug therapy

Due to the fact that most problems with the biliary tract occur against the background of mental disorders, treatment should begin with a psychotherapist. If the cause is confirmed and the basis for stagnation of bile and the lack of motility is the result of a depressive mood, antidepressants and sedatives are prescribed.

If the factors influencing the formation of the disease are provoked by neuroses, then antipsychotics and tranquilizers are recommended for use.

Do not forget about other reasons that led to the appearance of dyskinesia and carry out therapy to eliminate them: antihelminthic medications, removal of hypovitaminosis, combating allergic reactions, treatment of dysbacteriosis.

With the hypokinetic form of dyskinesia, choleretic medications are needed that can affect the growth of the tone of the gallbladder: xylitol, magnesium sulfate. The use of drugs that stimulate the motility of the bile ducts (Pankreosimin, Cholecystokinin) is also required.

If a hyperkinetic form is diagnosed, medications are required to increase the formation of internal fluid for the breakdown of products. These drugs include Oxafenamide, Nicodin, Flamin, Cyclalone.

If the sphincters are tense, then it is recommended to use antispasmodics (Buscopan, No-shpa). You definitely need to take medications that strive to normalize the balance of the sympathetic and parasympathetic systems. For these purposes, potassium bromide or tinctures of motherwort and valerian should be used.

Treatment with traditional methods

Traditional methods and medicinal herbs are an excellent addition to the main treatment. For therapy, decoctions are brewed and used separately for each form of the disease.

For the hypokinetic form of the disease, it is possible to use an infusion of chamomile flowers, corn silk, rose hips, nettle leaves, St. John's wort, oregano and immortelle flowers.

Separately, decoctions are prepared for the hyperkinetic stage - valerian or licorice root, dill, mint or motherwort.

You should not give up drinking mineral water. For active muscle contractions of the bile ducts, water is used:

While for decreased tone of the gallbladder, Essentuki No. 17 or Arzni is used to stimulate it.

Thus, treatment with herbs and mineral water leads to positive results. But therapy should be carried out in combination with medications and diet.

Additional measures

In addition to therapy with medications, diet and folk remedies, it is also effective to use additional methods of treatment:

Physiotherapy is the effect of medical devices, namely the use of electric current on an area in the area of the right forearm, as well as the effect of electrophoresis.
Acupuncture - when needles are inserted into specific points, the necessary internal organs are affected.
Exposure to leeches (hirudotherapy) - the latter are applied to nerve endings belonging to certain organs (pancreas, liver, gall bladder).
Balneology in sanatorium-resort recreation areas - treatment with mineral waters is advisable to carry out once every 12 months.
Acupressure – pressing and massaging non-specific points that affect the bile ducts are determined.

Thus, the methods of influencing the disease are so diverse that they can be selected individually for each patient. The main goal of therapy is to remove discomfort and completely eliminate the problem.

Complications of JVP

In the absence of therapy, the disease progresses and leads to a deterioration not only in a person’s general well-being, but also in the development of serious consequences. Complications are more difficult to treat than the original problem.

The following deteriorations may occur:

inflammatory process of the bile ducts (chronic cholecystitis)
gastritis
atopic dermatitis
cholelithiasis
pancreatitis – chronic stage of development
duodenitis
sharp decrease in weight category (dystrophy)
cholangitis

To protect yourself from emerging complications, you need to contact a medical specialist competent in this matter at the first symptoms.

You should also follow a number of rules to help prevent deterioration of the condition. You should not go to bed later than 11 pm, get enough sleep (8 hours a day), normalize the hours of intensive work and productive rest, and spend more time in the fresh air.

The main thing is to exclude a nervous condition or change your place of work if it involves constant stressful situations.

Dyskinesia in children

A similar disease occurs in children in the event of abnormal development in utero. Most often, a bend in the bladder or the presence of a septum in the central part is recorded, but there is also an incorrect location in the peritoneal cavity, and the formation of a secondary organ is also possible.

In children of preschool or primary school age, the causes are frequent stress, emotional stress, family quarrels, overexertion or frequent moving.

It is worth paying attention to the symptoms that appear in a child when an illness occurs:

After eating a fatty or acute meal, complaints of pain in the right hypochondrium
Frequent constipation or, conversely, intestinal upset
Sudden onset itching of the skin

Diagnosis is identical to that for adult patients. During diagnosis, the appropriate form of the disease is determined and appropriate treatment is prescribed.

For hyperkinetic dyskinesia, medications are used:

Medicinal herbs: decoction of dandelion, mint, rose hips, corn silk.
To stimulate the formation of internal fluid (Allohol, Holagol).
Increasing the tone of bile ducts (Sorbitol).
Mineralka Essentuki No. 17.

When fixing the hypokinetic form, the following medications are required:

Lightly carbonated mineral waters – Slavyanskaya or Smirnovskaya
Antispasmodics – Riabal, Eufillin
Traditional medicine - decoctions of chamomile, nettle, St. John's wort

It is mandatory to use a diet - the products are completely identical for both adult patients and small patients. If there are no painful attacks, a slight deviation from the strict limits of product introduction is possible.

Children susceptible to biliary tract diseases are subject to constant monitoring by doctors - gastroenterologist, psychotherapist, pediatrician. They are prescribed a scheduled ultrasound examination once every 6 months.

So, the ongoing disease in children is a more dangerous illness than in adult patients. The treatment of young patients is strictly controlled by medical professionals.

Thus, dyskinesia is a disease that has no boundaries in the age category. Anyone can purchase it; the main thing is that you should not neglect or refuse treatment.

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Biliary dyskinesia - causes, symptoms, forms and treatment methods

Classification

The definition of the form of dyskinesia depends on how the gallbladder contracts:

hypermotor - in this case, the contraction of the organ is very frequent and rapid. This form of the disease in question is characteristic of young people;
hypomotor - contraction occurs slowly, the activity of this function of the gallbladder is significantly reduced. According to statistics, hypomotor biliary dyskinesia is often diagnosed in patients over 40 years of age and in patients with persistent neuroses/psychoses.

Depending on the cause of the development of the pathology in question, doctors can divide it into two types:

primary dyskinesia - it is usually associated with congenital anomalies in the structure of the biliary tract;
secondary - the disease is acquired during life and is a consequence of pathologies in other organs of the gastrointestinal tract (for example, secondary biliary dyskinesia often “accompanies” pancreatitis - an inflammatory process in the pancreas).

Causes of development of biliary dyskinesia

If we are talking about the primary type of the disease in question, then its causes are:

narrowing of the gallbladder;
doubling (bifurcation) of the bile ducts and bladder;
constrictions and septa located directly in the cavity of the gallbladder.

All these causes are congenital anomalies and are detected in early childhood during examination.

A secondary type of dyskinesia of the gallbladder and ducts can develop against the background of the presence of the following factors:

gastritis - an inflammatory process on the mucous membrane of the inner walls of the stomach;
the formation of ulcers on the mucous membrane of the stomach and/or duodenum - peptic ulcer;
cholecystitis - inflammation of the gallbladder;
pancreatitis - an inflammatory process in the pancreas;
duodenitis is a pathological inflammatory process in the duodenal mucosa;
hepatitis of viral etiology is a systemic disease in which the liver is affected by viruses;
hypothyroidism – decreased functionality of the thyroid gland.

Symptoms of biliary dyskinesia

The clinical picture of the described pathology is quite pronounced, so diagnosis does not present any difficulties for specialists. The main symptoms of biliary dyskinesia are:

Pain in the right hypochondrium , gallbladder and bile ducts - in the right hypochondrium. It can have a different character:

with increased contractile activity of the gallbladder - acute, paroxysmal, with irradiation to the scapula and right shoulder. Occurs either after intense physical activity or eating fatty foods in large quantities;
if the contractile activity of the bladder is reduced, then the pain will be of a completely different nature - dull, aching, constant (episodes of absence of pain are very rare), patients feel a feeling of fullness in the right hypochondrium;
biliary colic - always occurs acutely, suddenly, differs in intensity, and is accompanied by increased heart rate. Increased blood pressure (not in all cases). Since the pain is too severe, the patient experiences a feeling of anxiety and fear of death.

Cholestatic syndrome (manifestations of pathology in the liver and biliary tract):

jaundice - the skin, sclera of the eyeballs, mucous membranes of the mouth and saliva turn yellow in different shades;
enlarged liver - in some cases the patient himself can feel it;
change in the color of stool - it becomes noticeably light;
change in urine color – it becomes distinctly dark;
itching of the skin without a specific localization.

Digestive system disorders:

bloating;
loss of appetite;
nausea and vomiting;
bad breath from the mouth;
bitter taste in the mouth;
dry mouth.

Neurosis is a mental disorder that can be cured (reversible):

irritability and insomnia;
increased sweating (hyperhidrosis);
chronic fatigue syndrome;
headaches - they are not constant, they are periodic.

The above symptoms cannot appear at the same time. For example, cholestatic syndrome is diagnosed in only half of patients with biliary dyskinesia, and bitterness and dryness in the oral cavity are more characteristic of hyperdyskinesia (contractile activity of the gallbladder is increased).

Diagnostic methods

Based solely on the pronounced symptoms of biliary dyskinesia, no specialist can make a diagnosis. To make a final verdict, doctors carry out the following activities:

Questioning the patient and analyzing the description of the disease - how long ago the first attacks of pain or other symptoms appeared, what they may be associated with (according to the patient).
Collecting an anamnesis of the patient’s life - have his relatives been diagnosed with the disease in question, are there any diagnosed chronic diseases of the gastrointestinal tract, have he taken any medications for a long time, have he been diagnosed with benign/malignant tumors, in what conditions does the patient work? (meaning the presence/absence of toxic substances at work).
Physical examination - the doctor determines what color the patient’s skin, sclera and mucous membranes are (whether there is jaundice or not), whether obesity is present, palpation (feeling) will help identify liver enlargement.
Laboratory tests - general and biochemical blood tests, general urine analysis, lipid profile (detects the level of fat in the blood), markers of hepatitis of viral etiology, examination of feces for worm eggs.

After this examination, the doctor can diagnose biliary dyskinesia, but to confirm it, the patient will also be prescribed an instrumental examination of the body:

ultrasound examination of all abdominal organs;
ultrasound examination of the gallbladder “with a test breakfast” - first an ultrasound scan is performed on an empty stomach, then the patient eats a fairly fatty breakfast and after 40 minutes a repeat ultrasound scan of the gallbladder is performed. This procedure makes it possible to find out in what form the disease in question occurs;
duodenal intubation - using a special intestinal probe, the duodenum is examined and bile samples are taken for laboratory testing;
FEGDS (fibroesogastroduodenoscopy) – examines the mucous membranes of the stomach, duodenum, and esophagus;
oral cholecystography - the patient drinks a contrast agent and after half an hour the gallbladder can be examined for the presence of developmental anomalies;
ERCP (endoscopic retrograde cholangiopancreatigraphy - one study combines both x-ray and endoscopic methods. This allows you to directly examine the bile ducts;
Hepatobiliary scintigraphy is a radioisotope method in which the patient is injected with a radioactive drug (intravenously), which accumulates in the liver and biliary tract, which makes it possible to study their complete and accurate image.

Treatment methods for biliary dyskinesia

The goal of treatment procedures is to ensure a complete outflow of bile from the liver. It will not be possible to do this solely with medications; an integrated approach is needed.

Therapy for biliary dyskinesia includes:

Creating and following a daily routine:

a competent combination of work and rest - for example, night sleep should not be less than 8 hours;
Take regular walks in the fresh air;
When doing sedentary work, do gymnastics every 2 hours - we are talking about the simplest bending, squats, and turning the body.

Strict diet:

Spicy/fatty/smoked foods and canned food (homemade and industrial) are excluded from the menu;
salt intake is reduced - it is permissible to take no more than 3 grams of salt per day;
regularly drink mineral water - it can be different, which is suitable for a particular patient is determined by the attending physician or nutritionist;
Food should be taken in small portions, but the frequency of meals should be large - up to 6-7 per day.

Medicines:

choleretic drugs – choleretics;
enzyme preparations;
Cholespasmolytics.

Additional medical procedures:

tubing of the gallbladder (cleansing) - taking choleretic drugs in a lying position on the right side with a heating pad in the area of the anatomical location of the liver and biliary tract;
regular duodenal intubation - cleansing the duodenum after the release of bile;
electrophoresis;
acupuncture;
diadynamic therapy;
acupressure;
hirudotherapy (treatment with leeches).

Treatment of biliary dyskinesia with folk remedies

Treatment of biliary dyskinesia with herbal preparations is also approved by official medicine - doctors recommend taking a course of using decoctions/tinctures of medicinal herbs twice a year. Here are two of the most effective and safe recipes:

Prepare the following herbs:

elecampane root – 10 g;
marshmallow root – 10 g;
calendula (flowers) – 15 g;
chamomile (flowers) – 10 g.

Mix plantain leaves (30 g), calendula flowers and sage leaves (10 g each), mint/rosehip/cumin (15 g each), cinquefoil (herb) and raspberry leaves (20 g each). And the preparation and administration scheme is the same as for the previous decoction.

Among the traditional methods, the following recipes can be distinguished:

if the contraction of the gallbladder is reduced, a cold compress should be applied under the right hypochondrium at the time of an attack of pain, and in case of increased contractile activity, a hot compress should be applied.
for a month, in the morning on an empty stomach, drink a glass of milk mixed with carrot juice in a 1:1 ratio;
in case of pain syndrome against the background of diagnosed hypertensive dyskinesia, you should do an enema with corn oil - one tablespoon of oil per liter of warm water.

There are also treatment methods with sand and clay, essential oils and vegetable juices, but there is no confirmation from official medicine regarding the advisability of such procedures. Any treatment with folk remedies should be carried out only after consultation with the attending physician and with regular monitoring of the dynamics of the disease.

Possible complications

chronic cholecystitis - inflammation of the gallbladder that lasts more than 6 months in a row;
the formation of stones in the gallbladder and its ducts – cholelithiasis;
chronic pancreatitis – inflammation of the pancreas for 6 months;
atopic dermatitis is a skin disease that is a consequence of a decrease in the level of immunity;
duodenitis is an inflammatory process on the lining of the duodenum.

You will receive useful advice for patients diagnosed with VSD by watching this video:

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category.

Erosive gastritis: symptoms and treatment, diet for erosive gastritis

Belching: causes and treatment

The information is provided for informational purposes only. Do not self-medicate. At the first signs of illness, consult a doctor. There are contraindications, a doctor's consultation is required. The site may contain content prohibited for viewing by persons under 18 years of age.

Biliary dyskinesia: symptoms, treatment

Dyskinesia is not at all an inflection, not a curvature of the pathways or the bile bladder itself, as most people believe. This term, translated from Greek, stands for “movement” and “violation”. Thus, we can conclude that biliary dyskinesia is a pathological condition of the body in which the motility or tone of the system that carries bile to the duodenum from the liver is impaired. This condition leads to pain in the right iliac region, problems with stool appear, and in some cases bitterness in the mouth, but during the examination no damage to these organs is detected.

In most cases, dyskinesia develops in people who have abnormalities in the development of the biliary organs, and are also adherents of an unbalanced diet. Dyskinesia can also appear in people who are exposed to severe stressful and traumatic situations. In addition, there are other reasons for the development of this condition. Women are particularly susceptible to this disease. Treatment of dyskinesia consists of eliminating the manifestations, and also, if the biliary tract has poor contractility and slow speed of movement, ensuring the prevention of stone formation.

A little about physiology and anatomy

Bile is a brownish-yellow liquid that is needed by the body during digestion. The main function of bile is to separate dietary fats into small fractions, thereby increasing their surface area. In this state, fats are better processed by the lipase enzyme and, after decomposition, the components of fats - fatty acids - are absorbed into the blood. In addition, bile is involved in the absorption of carbohydrates and proteins. Three-quarters of bile is produced by the liver and one-quarter by the hepatic ducts, and thanks to it, the small intestine can function normally: it carries out the processes of absorption of nutrients, division and death of its own cells.

To ensure the normal functioning of all the described processes, bile must be in normal concentration. The normalization process is carried out by the gallbladder, which releases excess water to the vessels. If bile enters the intestines in a diluted form (is not retained in the bladder), then irritation of the intestinal walls occurs, which leads to diarrhea. Also, when bile remains in the gallbladder for a long time, its concentration increases; this state of affairs also has its consequences.

Bile is formed in the liver, after which it reaches the gallbladder through special ducts, and from there it enters the duodenum. The movement of secretions is ensured by pressure changes in the biliary tract, which is pumped using sphincters - special circular muscles.

Thus, when the sphincter that allows bile into the gallbladder is closed, it drains from the liver. After its opening, the secretion penetrates into the bladder, which was in an almost empty state, and accordingly, the pressure in it was significantly lower than in the duct itself. When fatty foods enter the duodenum from the stomach, the gallbladder contracts due to muscles and the sphincter opens, bile passes through the duct to the orbicularis muscle, which closes the entrance to the duodenum. After the first sphincter closes, the second one (leading to the intestine) opens, and bile enters the intestine. The sympathetic nervous system, as well as some substances produced by the pancreas and stomach, are responsible for the reduction of the biliary tract.

Dyskinesia and its types

Having an idea of the anatomy of the biliary system, the basic principles of pathology can be explained in detail. Thus, dyskinesia is a condition in which:

one or more sphincters located in the bile ducts do not relax in a timely manner;

or, conversely, regardless of food intake, they refuse to relax;

a very strong contraction of the gallbladder may occur;

the rate of bile outflow decreases due to sluggish contractions of the bile duct and bladder.

Depending on the nature of the tone disturbance and motor function, dyskinesia can be:

hyperkinetic: active outflow of bile, accompanied by sudden releases of bile;

hypokinetic: bile is released slowly, and movement in the biliary tract slows down;

hypotonic: sphincter tone is significantly reduced;

hypertensive: the tone of the circular muscles, on the contrary, is increased.

In most cases, the hypertensive state is combined with increased motor skills, and a spastic, or hypertonic-hyperkinetic type of dyskinesia is formed. In the case of the opposite situation, almost the same thing happens: the tone of the pathways is weakened and an atonic or hypotonic-hypokinetic type appears. A mixed type may also be present.

Spastic dyskinesia is most typical in the case of increased tone of the parasympathetic department. The atonic type of pathology develops in the case of predominance of the sympathetic department of the autonomic part of the central nervous system.

Causes of the disease

The following reasons lead to disruption of the movement or tone of the biliary tract:

Congenital malformations of the gallbladder and biliary tract:

abnormally located gallbladder;

accessory gallbladder;

valves in the gastric duct;

the presence of a dividing septum in the gallbladder;

inflection of the gallbladder;

intrahepatic gallbladder;

congenital weakness of the gallbladder wall;

duplication of the bile ducts.

Such pathologies lead to the development of so-called primary dyskinesia.

past intestinal infections;

the period of menopause, in which dysregulation of bile duct contractility occurs;

giardiasis, in which the gallbladder is colonized by protozoan flagellated organisms;

previous viral hepatitis;

diseases of the endocrine system: thyrotoxicosis, diabetes, obesity;

foci of infection that are constantly present in the body (chronic tonsillitis, caries);

neurocircular dystonia, in which there is a violation of the normal sequence during contraction of the muscles of the biliary tract;

traumatic situations or constant stress;

eating habits: eating a significant amount of spicy, smoked, fatty foods, avoiding or focusing on vegetable fats, long periods of fasting.

Signs of the disease

Symptoms of biliary dyskinesia may differ depending on the type of pathology, that is, it is hypokinetic or hyperkinetic.

The main difference for the main types of dyskinesia is the nature of the pain.

In the iliac region on the right.

In the right hypochondrium.

Aching, dull, low-intensity pain. May be described as a feeling of pulling under the rib or heaviness.

It is felt only under the rib.

It radiates to the right shoulder and shoulder blade.

Errors in diet, strong emotions.

After fatty foods, stress, physical activity.

Symptoms associated with pain

Feeling of bloating, diarrhea, constipation, belching of air, loss of appetite, nausea, bitterness in the mouth.

Diarrhea, constipation, increased urine output, vomiting, nausea.

During an attack, the following may appear: headache, drop in blood pressure, sweating, irritability.

It goes away on its own.

Taking the drugs "Buscopan", "No-spa".

During the period between attacks

The disease gradually changes a person’s personality (reversibly): mood swings, fatigue, irritability, and tearfulness appear. Outside of an attack, there is nothing to worry about.

There is nothing to worry about; short-term pain may periodically appear in the right side of the abdomen near the navel, in the pit of the stomach, in the hypochondrium.

With both types of dyskinesia, the following symptoms may appear:

menstrual irregularities – in some women;

decreased libido levels in men;

the appearance of a yellow coating on the tongue;

bad breath;

recurrent headaches;

An extreme manifestation of the hyperkinetic variant of the disease is the formation of biliary colic. Its manifestation occurs suddenly, in the form of severe pain in the right region of the body, under the rib, which is accompanied by numbness of the limbs, panic attacks, and rapid heartbeat.

The maximum degree of manifestation of hypokinetic dyskinesia is a pathological condition called choleostasis - that is, stagnation of bile in the bile ducts. The following symptoms indicate it:

the stool becomes grayish or most often light yellow in color;

yellowing of the whites of the eyes and skin;

severe itching all over the skin.

Diagnosis of the disease

Symptoms alone are not enough to make a diagnosis, since similar signs can also appear with more severe liver pathologies. In addition, it is necessary to establish the exact cause (for example, a malformation of the biliary tract) that led to the disease in order to subsequently eliminate it.

Biliary dyskinesia is a condition in which the structure of these organs is not disturbed. Therefore, the diagnosis is made in the presence of contractility disorders or imbalances in tone along the path of bile from the liver to the duodenum. How can this be diagnosed?

Performing an ultrasound examination of the gallbladder after a choleretic breakfast. Initially, a three-day diet is followed, which ends with a “clean” ultrasound of the abdominal cavity. With the help of the study, the size of the volume of deformation is assessed, and an examination is carried out for the presence of gallstones and biliary tract abnormalities. After this, the person begins to take foods that promote the release of bile into the duodenum (the menu could be: a couple of bananas, chocolate, full-fat yogurt, 10 grams of fat sour cream or cream), after which the doctor can observe in what sequence and how the promotion of bile works along the paths.

By assessing portions of duodenal contents. To do this, a study is performed called duodenal intubation: a person swallows a thin probe, which, upon reaching the duodenum, collects its contents.

The study should be carried out on an empty stomach. First, through a probe, a portion of the intestinal contents is obtained, which is the standard intestinal environment, consisting of the juice of the duodenum itself, pancreatic juice and bile. After this, magnesium sulfate is injected into the intestine, which causes the gallbladder to contract, and bile enters the intestine from the bladder itself. It is taken for research, after which the bile, which has drained during this time, and the intrahepatic bile ducts are taken for analysis. To establish a diagnosis of dyskinesia, the time it takes to obtain the second analysis, after the administration of the drug, and after the third analysis, is important. An important informative component is also the content of lipids, which are presented in the last two portions.

Cholangiography (examination of intrahepatic ducts) and cholecystography (examination of intrahepatic bile ducts) are contrast radiography methods. In cholecystography, the patient must take a contrast agent orally, after which the path of the contrast agent is traced using an x-ray before it reaches the gallbladder and after it is removed. The work and sequence of contraction of the gallbladder sphincters and ducts are analyzed. When performing the second method, a radiopaque substance is injected directly into the duct itself, after which the doctor uses an X-ray machine to observe the progress of the substance along the biliary tract.

Endoscopic retrograde cholangiopancreatography, or ERCP, is an instrumental method in which a probe equipped with an optical fiber is inserted into the duodenum. Through it, a contrast agent is injected into the bile ducts, the opposite of the normal flow (retrograde), the progress of which is observed on an x-ray.

Cholescintigraphy is a radiological study during which a radioisotope drug is injected into the body. Thanks to special radiation, it becomes possible to visualize the process of its passage into the liver, secretion into the bile ducts, the path to the gallbladder and reaching the duodenum.

In complex cases of the disease, it is necessary to perform magnetic resonance cholangiography, which is a non-invasive study in which a contrast agent is injected into the body, and the path of its progress is visible on a magnetic resonance imaging scanner. To undergo such a diagnosis, the patient must remain in the tomograph chamber for about minutes, keeping still.

A blood test for bilirubin with fractions and lipids, a coprogram and a stool test for helminth eggs and dysbiosis are methods that allow you to determine the degree of preservation of the functions of the biliary tract, as well as studies that allow you to determine the presence in the body of the cause of the possible occurrence of the disease - worms. It is impossible to make a final diagnosis based on these tests alone.

Treatment of biliary dyskinesia consists of:

drug therapy: prescribed in courses to ensure relief of the attack and prevent its further occurrences, as well as to prevent complications;

taking infusions and decoctions of various herbs: prescribed by a gastroenterologist depending on the type of disease and is an integral part of treatment;

diet therapy: is different for hyperkinetic and hypokinetic forms of pathology.

The basis of treatment for dyskinesia is nutrition. Only through strict adherence to the rules can the occurrence of attacks be avoided and surgical complications such as cholelithiasis and acute cholecystitis can be prevented.

A diet for dyskinesia involves following general nutritional rules, however, there are points that differ significantly depending on the type of disease (hyperkinetic and hypokinetic).

It is necessary to eat in such a way that the gallbladder is completely emptied, so as not to cause a painful attack. To do this:

do not heat food in trans or animal fats: lamb, goose, pork, margarine;

avoid eating too hot or cold foods;

Eat low-fat fermented milk products in the morning and evening;

have dinner 2-3 hours before bedtime, but do not overeat meat;

maintain intervals of 3-4 hours between meals;

eat food in small portions;

eat little by little, 4-5 times a day.

Avoid during periods of exacerbation

cold carbonated drinks;

lard from any bird or animal;

fatty fish and meats;

freshly squeezed juices and diluted with water;

sweets: jam, pastille, caramel, marshmallows, marmalade, honey;

ripe and sweet berries and fruits;

a small amount of butter, while a certain part of it should be taken on an empty stomach as a sandwich;

olive and sunflower oil;

steamed omelettes and boiled eggs;

low-fat fermented milk products;

boiled, stewed and baked vegetables;

porridge with milk or water, rice and buckwheat;

boiled, steamed and baked low-fat fish, poultry and meat;

milk soups with cereals;

Features of nutrition for hypomotor dyskinesia

The diet should consist of foods that stimulate biliary motility:

vegetable and butter;

vegetables (boiled, stewed, baked);

Features of nutrition for hypermotor dyskinesia

In the presence of this form of pathology, it is imperative to exclude from the daily diet foods that stimulate bile secretion and bile formation: soda, broths, fresh vegetables, fatty fermented milk and dairy products, black bread, animal fats.

It has a general purpose and is based on the type of dyskinesia present.

Since dyskinesia is a disease caused by a violation of nervous regulation and directly depends on the state of the psyche, before starting treatment for disorders of motor activity in the biliary tract using choleretic drugs, it is necessary to restore the patient’s mental background. If the pathology appears against the background of a depressive state, it is necessary to prescribe a course of mild antidepressants. If the disruption of the bile secretion process was caused by severe anxiety, neuroses, then it is advisable to start with antipsychotics and tranquilizers.

Such drugs can be prescribed by a psychiatrist or psychotherapist.

In addition, the cause of dyskinesia is treated: correction of dysbiosis, elimination of hypovitaminosis, treatment of allergies, anthelmintic therapy.

In this case, choleretic drugs are needed, which:

improve motility of the biliary tract: for example, pancreozymin, cholecystokinin;

increase the tone of the gallbladder: xylitol, magnesium sulfate.

In addition to choleretic drugs, tonics are also required: lemongrass tincture, Eleutherococcus extract, ginseng adjustment.

In this case, drugs are needed that stimulate an increase in the formation of bile: with a larger volume of bile, the ducts work longer and do not contract quickly, causing a painful attack. These are medications: “Nicodin”, “Flamin”, “Okafenamide”.

Also, if the sphincters are overstrained, it is necessary to relax them. This effect is achieved by taking antispasmodics: Buscopan, No-shpy.

In addition, drugs are needed that normalize the balance of the sympathetic and parasympathetic systems: motherwort tincture, potassium bromide, valerian tincture.

Treatment with traditional methods

Biliary dyskinesia is one of those pathologies for which treatment with folk remedies is an excellent addition to the main treatment with medications, and in some cases is the only method (in the treatment of dyskinesia in children).

High degree of mineralization:

Low degree of mineralization, which must be consumed warm:

Herbs used to make a decoction

chamomile flowers

If the test results confirm the presence of bile stagnation, but there is no damage to the liver tissue (AST and ALT levels are not elevated in the liver test analysis), then blind zoning is necessary. To do this, on an empty stomach you should drink a solution of magnesium sulfate, highly mineralized mineral water or a sorbitol solution. After this, you should lie on your right side, before placing a warm heating pad under it. You should lie in this position for about minutes.

Additional therapies

For the treatment of biliary dyskinesia the following is used:

treatment in gastroenterological sanatoriums, which provide therapy with mineral waters;

treatment with leeches (hirudotherapy);

physiotherapy: microwave, electrophoresis, diadynamic currents.

Complications of biliary dyskinesia

Such a functional disorder can cause the following consequences:

metabolic disorders and weight loss, which occurs as a result of impaired absorption of necessary substances without their proper bile treatment;

allergization of the body, which manifests itself in the form of a skin rash;

gastritis and gastroduodenitis - inflammation of the stomach or duodenum. This is due to the fact that in the presence of this disease, unconcentrated bile is often thrown into the duodenum and stomach, which leads to subsequent inflammation;

inflammation of the pancreas;

cholangitis - inflammation of the intrahepatic bile ducts;

the formation of chronic cholecystitis (inflammation of the gallbladder wall).

Disease prevention and prognosis

To prevent the development of pathology, certain rules must be followed:

exclude traumatic situations;

eat well: eat more plant fiber, boiled animal products, cereal products, less fried fish or meat;

walk in the fresh air;

alternate physical and mental work;

go to bed no later than 11 pm;

sleep at least 8 hours a night.

If pathology already exists, then you should follow all the recommendations of the gastroenterologist, and also pay attention to the psycho-emotional background.

Biliary dyskinesia cannot reduce life expectancy, but can affect its quality.

The cause of biliary dyskinesia, which develops in young children, is the abnormal structure of these same ducts. In most cases, this is a bend in the gallbladder or the presence of additional partitions in it; an abnormal location or duplication of the biliary tract may also be present.

In older children, the cause of the development of pathology is emotional stress. This is a large workload, a team at school or kindergarten, family relocation, parental quarrels and other factors.

Other causes of biliary dyskinesia are:

helminthic infestations: roundworms, giardiasis;

past salmonellosis, dysentery, hepatitis A;

chronic tonsillitis, frequent sinusitis;

asphyxia or hypoxia during childbirth;

Childhood dyskinesia is a more dangerous disease: without normal emulsification of fats, sufficient amounts of substances and fatty acids necessary for the body, as well as fat-soluble vitamins - K, E, D, A, are not absorbed, each of which is very important for a growing body.

If parents begin to notice that the child begins to cry at the slightest provocation, gets tired quickly, becomes irritable, withdrawn, then it is necessary to contact a gastroenterologist to rule out the presence of biliary dyskinesia. If at the moment it is not identified, then this is not a reason to think that the danger has passed. This result indicates that there is a predisposition to the disease, but the pathology has not yet appeared. In this case, it is necessary to pay attention to the child’s daily routine and diet in order to prevent the formation of the disease.

The following symptoms may indicate the development of pathology:

itching of the skin, the cause of which is unknown, not as a result of taking a new medication or food, not after a bite, not after an injection;

periodic - especially if fried or fatty foods were consumed, manifestations of pain in the right hypochondrium;

alternating diarrhea and constipation.

Diagnosis of the disease is carried out through ultrasound examination with a choleretic breakfast. X-ray contrast, and even more so, radioisotope techniques can be performed in children only if there are strict indications, and since the advent of magnetic resonance cholangiography, they have practically ceased to be performed.

Treatment of pathology in children

For the treatment of diseases in children, special preference is given to herbal preparations. Their selection is carried out depending on the type of pathology.

Thus, in the presence of hypomotor dyskinesia, the following is prescribed:

mineral waters "Essentuki 17";

blind probing with xylitol or sorbitol;

herbal therapy: decoctions of mint, corn silk, rose hips, dandelion;

medications that increase the tone of the biliary tract: xylitol, sorbitol or magnesium sulfate;

drugs that stimulate the process of bile formation: “Liobil”, “Allohol”, “Holosas”, “Holagol”.

For hypermotor dyskinesia, therapy is as follows:

electrophoresis with novocaine in the area of the gallbladder;

mineral waters: “Smirnovskaya”, “Slavyanovskaya”;

herbal therapy: decoctions of stinging nettle, chamomile, St. John's wort;

antispasmodic drugs: “Riabal”, “Eufillin”.

After stopping the attack, the child should be rehabilitated in a sanatorium that offers mineral water therapy and other physiotherapy:

to improve the motor activity of the biliary tract: electrophoresis of magnesium sulfate, SMT therapy;

for sedative purposes: bromelectroson, pine baths;

to eliminate spasm of the biliary tract: electrophoresis of antispasmodics (papaverine, no-spa) in the area of the biliary tract, magnetic therapy;

galvanic collar according to Shcherbak;

The diet described above can be fully applied to children. A strict diet must be followed for a year, after which an examination is carried out for the presence of attacks of biliary colic; if the symptom is not confirmed, the diet can be gradually expanded.

Children with biliary dyskinesia are registered with a pediatrician, neurologist, and gastroenterologist. They must undergo routine ultrasound scans twice a year. Also, courses of choleretic therapy should be carried out every 6 months. Once or twice a year, the child should receive a referral for therapy in sanitary resort complexes.

We invite you to read the article on the topic: “Diseases of the liver and biliary tract: their symptoms and diet” on our website dedicated to the treatment of the liver.

Biliary tract diseases
- Cholecystitis is an inflammatory process
Common Liver Diseases
- Diagnosis: liver cirrhosis
Diet for liver diseases
- Nutrition according to diet No. 5

Diseases of the liver and biliary tract have characteristic symptoms, which can be used to make a preliminary diagnosis of the patient. Modern medicine identifies several main diseases of these organs.

Dyskinesia is a disease that is characterized by impaired contractile function of the gallbladder and ducts of the organ, dysfunction of the sphincter of Oddi. As a result, the process of bile excretion is disrupted. There are 2 forms of dyskinesia:

1. Hyperkinetic. characterized by increased tone of the gallbladder, strong and rapid contractions of the organ, and insufficient opening of the sphincters. Young people are more often affected. Symptoms:

paroxysmal pain that is sharp in nature;
painful sensations in the hypochondrium on the right.

These signs intensify after emotional experiences, during menstruation.

2. Hypokinetic. This form is characterized by insufficient contraction of the gallbladder. Elderly people are more often affected. Symptoms:

pain in the right hypochondrium is dull and mildly expressed;
bursting pain.

There are also general symptoms of the disease:

a feeling of bitter taste in the mouth in the morning;
general weakness;
decrease in emotional background;
pain in the right hypochondrium after eating a spicy dish or excitement;
insomnia;
decreased libido;
menstrual irregularities;
diarrhea or constipation that is regular.

With dyskinesia, the stage of exacerbation is replaced by remission - and so on in a circle.

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Cholecystitis is an inflammatory process

With this disease, the wall of the gallbladder becomes inflamed. There are acute and chronic forms. Symptoms of the acute form:

acute, sharp pain in the abdomen, which is constant;
feeling of nausea;
repeated vomiting;
elevated temperature;
intense signs of jaundice;
rapid pulse.

Chronic cholecystitis often occurs without symptoms and manifests itself only during an exacerbation.

Gallstone disease is another pathology. It is characterized by the formation of stones in the bile ducts. In most cases, the disease occurs without symptoms. The most common signs include:

biliary colic, that is, acute paroxysmal pain;
painful sensations in the hypochondrium on the right side, which “radiate” to the shoulder;
vomit.

At the first symptoms, you should consult a doctor.

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Diseases of the liver and biliary tract: diet

Diet is important for both chronic and acute forms of diseases. The diet promotes long-term remission, and during exacerbation it alleviates the condition. The rules for compiling the diet are as follows:

Excluded: fatty, spicy foods, alcohol, cold dishes, carbonated drinks.
Protein. Low-fat meat and fish, milk, cheese, cottage cheese are very healthy. Moderate consumption of raw eggs or omelets is allowed.
Cereals. Oatmeal and buckwheat are especially valuable.
Butter and vegetable oil. It is an excellent source of fat. But lard, meat and fatty fish, canned food, margarine, etc. are strictly prohibited.
Carbohydrates. Fresh vegetables and fruits. But radishes, garlic, onions, radishes, etc. should be discarded. Greens are also useful, especially for stones. It is better not to include sorrel and spinach in the diet.
Juices. If the patient suffers from diarrhea, it is better to consume vegetables and fruits in the form of juices or pureed. Blueberries, pomegranates, and quince are especially good.

It is very important to follow a diet. You need to eat often and in small portions, especially with cholecystitis.

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Common Liver Diseases

The main diseases include: hepatitis, cirrhosis, fatty degeneration and liver cancer.

Hepatitis is damage to the liver by a virus. There are acute and chronic forms of hepatitis. The acute form is characterized by the following symptoms:

signs of intoxication;
signs of jaundice: the skin and sclera have a yellow tint;
the feces acquire a whitish-clayey tint;
urine darkens to a rich dark color;
hemorrhagic signs:
nosebleeds;
skin itching;
bradycardia;
depressed psycho-emotional state;
irritability;
damage to the central nervous system;
enlarged liver and spleen.

In a milder form of exacerbation of hepatitis, symptoms may not be expressed. In severe cases of exacerbation, necrotic changes in the liver and a decrease in its size are observed.

With chronic hepatitis, the following symptoms are observed:

the liver and spleen increase in size;
dull pain in the area of the organ;
skin itching;
feeling of heaviness;
loss of appetite;
belching;
flatulence;
hyperhidrosis.

Patients find it difficult to tolerate fatty foods and alcohol.

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Diagnosis: liver cirrhosis

With this liver disease, the normal structure of the organ is replaced by scar tissue and takes on a nodular shape. This interferes with the full functioning of the organ. In most cases, the disease occurs without symptoms. The following symptoms are characteristic of cirrhosis:

general weakness;
decreased performance;
painful sensations in the hypochondrium on the right side;
bloating;
urine becomes darker;
weight loss;
palms turn red.

If the disease is not treated, complications begin:

accumulation of fluid in the abdomen;
impaired state of consciousness and memory;
stomach bleeding;
jaundice.

Cirrhosis is the cause of liver cancer in most cases. Oncology manifests itself as progressive cirrhosis and is accompanied by pain in the abdominal area.

Another disease is fatty degeneration, or steatosis. In this case, the tissue of the organ is rebuilt, and there is an excessive accumulation of fat in the cells of the organ. The disease may occur without symptoms, or may be accompanied by the following signs:

increase in liver size;
pain in the organ area;
feeling of nausea;
painful sensations in the hypochondrium on the right side.

Steatosis varies in duration. In this case, phases of exacerbation are replaced by remissions.

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Diet for liver diseases

For pathologies of this organ, it is very important to follow a therapeutic diet. It includes the following products:

Lipotropic products. This is cottage cheese, soy, cod. They are necessary to prevent fatty degeneration of the organ.
Fats. It is very important to maintain a balance of fats of animal (70%) and vegetable (30%) origin. Ideal sources of fat: fish, meat, cottage cheese.
Vegetable oils. Olive, sunflower, corn - you can choose any.
Carbohydrates. The daily norm is 400 - 450 g. However, carbohydrates obtained from honey, sugar and other sweets should not exceed 100 g.

For diseases of the liver and gall bladder, another diet is also indicated.

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Nutrition according to diet No. 5

Meals with this diet are frequent (up to 6 times a day) and fractional. Food does not need to be chopped, food processing is important: boiling, steaming, baking are ideal options. Meat and fish are first boiled and then baked. The temperature of the food should be from 45 to 60 °C. Products that are recommended:

yesterday's bread (rye, wheat), crackers;
milk soups;
vegetable soups with added cereals;
fruit soups;
lean meat (beef);
lean poultry (chicken, turkey);
low-fat fish (bream, pike perch, hake, perch);
vegetables - raw, boiled, baked;
vegetable and fruit salads;
crumbled porridge (cook in water, then add milk);
egg (no more than 1 piece per day), egg white omelettes;
fermented milk products (raw and in the form of casseroles, cheesecakes, soufflés, etc.);
berries and fruits of sweet varieties.

Allowed in moderation:

spices (cinnamon, vanilla, bay leaf, cloves);
greens (parsley, dill);
the tea is not strong;
coffee with milk or weak.

The following products should be excluded:

freshly baked bread, muffins, confectionery, etc.;
fatty meats (pork, lamb, goose);
fatty fish (chum salmon, stellate sturgeon, beluga, sturgeon) and salted;
sausages;
viscera (liver, lungs, brains, kidneys);
sharp and salty cheeses;
hard-boiled eggs;
fat (pork, beef, lamb, margarine, cooking);
mushrooms;
legumes (peas, chickpeas, mung beans, beans);
greens (spinach, sorrel);
vegetables (radish, turnip, radish, garlic, onion);
marinades (including vegetable ones);
broths (meat, mushroom, fish);
okroshka, cabbage soup;
seasonings and spices (pepper, mustard, horseradish);
alcohol;
sweets (chocolate, ice cream, cocoa).

This diet is indicated for all diseases of the liver and gall bladder. It must be observed especially strictly during periods of exacerbation of the disease.

Weakness, increased fatigue

Many human diseases have their own manifestations - symptoms. Several combined symptoms are called a syndrome. Symptoms can be the same for different organs, or specific - characteristic only of the pathology of a particular organ or for a specific disease.

Symptoms make it possible to recognize the disease when diagnosing it. They can be bright and permanent. This is typical for acute diseases. More mild symptoms are a sign of a chronic disease. The ability to distinguish and notice the manifestations of the disease is very important for the doctor and the patient himself. A person may not pay attention to some symptoms and not suspect that he is developing an illness until he consults a doctor, perhaps for a completely different reason. Therefore, knowledge of the elementary manifestations of diseases is the necessary basics for people who care about their health. However, having discovered a symptom of a particular disease, you should not immediately diagnose yourself, become discouraged, and even less start self-medicating. You need to clearly understand that if you suspect a dysfunction of any organ, you should immediately go to the doctor. Only he can objectively identify the symptoms, analyze them and begin adequate treatment or prescribe additional studies.

Indeed, there is a considerable amount of truth in this. People often do not pay attention to other symptoms of serious diseases. The neglect of the disease is not only serious suffering for the patient, but also a difficult path to recovery. Sometimes this inevitably leads to disability or even death.

Symptoms are divided into objective and subjective. Subjective ones are associated with a person’s feelings and do not have manifestations that others can see. For example, complaints of pain. Objective symptoms have real manifestations that another person can see. For example, yellowing of the skin or enlargement of the liver, felt upon palpation. Objective signs of diseases are more accurate and therefore more informative.

Naturally, liver diseases, like diseases of many other organs, have their own specific and nonspecific, objective and biased manifestations.

With liver diseases, weakness and increased fatigue are common. This is a fairly common symptom for the pathology of many organs and diseases, and it is subjective. Sometimes this may not be associated with liver disease or another organ at all. Man is a living being, and he is characterized by fluctuations in his physical and spiritual state. Therefore, if you experience weakness or increased fatigue, do not immediately blame your liver. This may be due to unusually high physical or emotional stress. In such cases, recovery occurs with proper rest and taking vitamins. If you feel increased fatigue for no reason or it is unusually strong, then you may suspect something is wrong.

In liver diseases, weakness and increased fatigue are associated with intoxication. However, if in infectious diseases intoxication is caused by the pathogen itself or its toxins, then in liver pathology this occurs due to a violation of its detoxification function. The body accumulates toxins produced as a result of its vital activity, since they are not destroyed in the liver. If the patency of the biliary tract is impaired, reverse absorption of its components from bile occurs, which also leads to intoxication. Weakness and increased fatigue in liver disease also occur due to disturbances in protein, carbohydrate, and vitamin metabolism.

Digestive disorders

The liver plays a huge role in digestion, therefore, with its diseases, digestive function will certainly suffer. In case of chronic hepatitis, cirrhosis, chronic cholecystitis, this will be less noticeable than in acute diseases of the liver and biliary tract. In chronic liver diseases, digestive manifestations are nonspecific. They are characteristic of chronic pancreatitis, chronic enterocolitis, etc. One of the manifestations is dyspepsia, which can manifest itself as unformed stool, constipation, flatulence (bloating), belching, heaviness in the epigastrium (upper abdomen between the costal angles). The quality of the stool changes. It becomes a greasy consistency - steatorrhea, which is associated with impaired absorption and breakdown of fats. Bile performs a regulatory function for the intestines, improves the absorption of fats and proteins by the cells of the intestinal walls. Therefore, with diseases of the liver and biliary tract, peristalsis and intestinal secretory function are disrupted, and nutrient absorption deteriorates - all this leads to weight loss. This minimizes the bacteriostatic effect of bile, which promotes the colonization of the small intestine with excess flora. This leads to the occurrence of enterocolitis with its characteristic symptoms. A long-term pathological process in the gallbladder steadily leads to a disorder of pancreatic function. As a result, a picture of chronic pancreatitis appears. Based on the above, it becomes clear that in chronic liver diseases, the symptoms are varied, other organs are involved in the pathological process, and therefore it is difficult to recognize manifestations characteristic exclusively of the liver.

Acute diseases, such as acute hepatitis, acute cholecystitis, choledocholithiasis (blockage of the common bile duct with a stone), have more pronounced manifestations in the digestive tract. Severe nausea and vomiting, including bile, may occur. A special sign specific to hepatitis and bile duct blockage is complete or partial discoloration of stool. With hepatitis, the passage of bile is impaired due to dead cells that block the bile canaliculi inside the liver. This condition is temporary and characterizes a certain stage of hepatitis. With cholelithiasis, a block occurs due to a stone that has entered the bile duct. In this case, stool discoloration may occur suddenly or worsen. There are valve stones that, rotating, either block the duct completely or release it. Then the discoloration may periodically change to the normal color of the stool. Impaired bile outflow is a common companion to tumors of the biliary tract; then stool discoloration occurs gradually and irreversibly.

Pain

Most diseases of the liver and biliary tract are accompanied by pain. In this case, pain is felt in the right hypochondrium. There are no pain receptors in the liver tissue, so pain in liver diseases occurs due to stretching of the fibrous capsule that covers the liver. With the inflammatory process in it, blood stagnation, and tumor growth, the volume of the liver increases accordingly. This leads to slow expansion of the capsule.

Pain is a special reaction of the body to an irritant that threatens the normal functioning of the body. The sensation of pain is a signal to eliminate the irritant that causes it. Pain is a necessary component that allows a living organism to adapt in nature. It, or rather its character and location, helps the doctor make the correct diagnosis.

The fibrous capsule of the liver is dense, and therefore responds to stretching slowly. This explains the nature of the pain. When the pathological focus is localized directly in the liver, it has a dull, aching character, that is, it is not intense and continues for a long time; There may be a feeling of heaviness. This type of pain accompanies hepatitis, the initial stages of cirrhosis, and tumor diseases of the liver. If the pathological process occurs in the biliary tract, then the pain is intense, acute, and cramping. This is due to the occurrence of spasms caused by smooth muscles, or, conversely, stretching of the bile ducts and bladder. Very intense acute pain occurs with inflammatory diseases of the biliary tract, such as acute purulent cholecystitis or cholangitis. When tapping along the costal arch, the pain increases sharply. This type of pain is a sure sign to go to the doctor or call emergency medical help.

Must remember! Taking painkillers if you experience severe abdominal pain before being examined by a doctor is strictly prohibited! This is especially true for strong or narcotic drugs. Analgesics eliminate pain and smooth out the clinical picture of what may be a very serious disease, in which the only way to escape is immediate surgery. Taking antispasmodics is allowed, but if you are not strong in pharmacology, leave this idea and call “03”.

Temperature rise

Often liver diseases are accompanied by a rise in body temperature - fever. It is the body’s protective reaction to a pathogenic factor. At elevated temperatures, immune reactions aimed at destroying the infectious agent proceed better. When a disease occurs, a fever of up to 38 °C is considered normal for the body, provided that it is well tolerated and lasts up to five days. In this case, taking antipyretics is not justified.

With hepatitis and cirrhosis, body temperature usually does not rise above 38 °C and remains at 37-37.5 °C. It can be at normal levels of 36.6 °C during the day, and only rise in the evening. Acute diseases, especially purulent ones - cholecystitis and cholangitis, are characterized by a rise in temperature to 39 ° C and above. Such conditions may be accompanied by twitching of skeletal muscles, including facial muscles. The popular name for this condition is “shaking.” This is another good reason to immediately consult a doctor.

Changes in the skin

Liver diseases, especially chronic, long-term cirrhosis and hepatitis, are accompanied by pale skin, which is a component of an “unhealthy appearance.” The reasons for this are disorders of metabolic (metabolic) processes in the body, disturbances of normal hematopoiesis, and conditions after bleeding.

Pigmentation disorders occur in liver diseases. New age spots appear or the skin takes on a bronze or smoky gray tint in the armpits and palms.

Spider veins - small areas of skin with dilated capillaries - are also characteristic of chronic liver diseases. They arise due to depletion of the capillary wall against the background of metabolic disorders. Most often localized on the back and cheeks.

Chronic cirrhosis is accompanied by impaired blood clotting, capillary fragility, and the occurrence of hemorrhagic diathesis. If touched lightly, bruises may remain.

« Liver palms“- symmetrical spotty redness of the palms and soles, especially pronounced in the area along the edges of the palms on the hills, sometimes on the palmar surfaces of the fingers. The spots become paler when pressure is applied and quickly turn red when pressure is removed. The mechanism of their occurrence is not well understood. Characteristic of cirrhosis and chronic hepatitis.

Xanthomas– yellow intradermal plaques located on the eyelids (xanthelasmas), elbows, hands, feet, buttocks, knees and armpits.

Occurs when there is a violation of the outflow of bile, an increased content of fats in the blood.

Sometimes the only symptom of a violation of the outflow of bile from the liver is persistent itching of the skin. It can persist for years, accompanied by abrasions and scratching. It was assumed that the cause of its occurrence was the skin’s reaction to an increase in the level of bile acids in the blood, but there are refutations of this hypothesis.

Jaundice

Jaundice (icterus)- one of the specific signs of liver disease. Jaundice is a yellowing of the skin, sclera, and mucous membranes due to the accumulation of excess bilirubin in the blood. There are three types of jaundice depending on the origin: suprahepatic, hepatic and subhepatic. Suprahepatic is associated with increased breakdown of red blood cells and, as a result, with an increase in the level of bilirubin in the blood. Occurs in case of poisoning with hemolytic poisons, Rh conflicts, etc. Hepatic jaundice is caused by impaired liver function in the binding of bilirubin and its release into bile. Characteristic of hepatitis and cirrhosis. Subhepatic jaundice occurs when the bile ducts are blocked and bilirubin flows from the bile back into the blood. Occurs in gallstone disease, tumors of the bile ducts and the head of the pancreas. Depending on the type of jaundice, the corresponding fraction of bilirubin predominates in the body, which determines the shade of jaundice. With suprahepatic it is lemon yellow, with hepatic it is saffron yellow, with subhepatic it is green or dark olive. Jaundice is often accompanied by changes in the color of stool and urine.

Hair loss

Due to hormonal imbalance that accompanies chronic liver diseases, hair loss in the armpits and pubic areas is possible. In men, against this background, enlargement of the mammary glands may appear - gynecomastia.

Dilation of veins in the abdomen

An unfavorable prognostic sign of chronic hepatitis and, as a consequence, cirrhosis or self-occurring cirrhosis is an increase in the skin veins in the abdomen. This is due to a violation of the venous outflow through the portal vein through the liver. Therefore, blood from the abdominal organs flows through the veins of the anterior abdominal wall, which, as a result, increase in size. This is often accompanied by dilation of the esophageal veins, which leads to fatal bleeding. The venous network, which appears on the abdomen, was called the “head of a jellyfish” for its similarity to the original. Dilation of the abdominal veins is rarely observed without an increase in its volume - ascites - due to the accumulation of free fluid in the abdominal cavity.

Liver odor from the mouth

Sometimes you can hear the expression “liver smell”. It has a sweetish aroma, similar to the smell of fresh liver or overripe fruit. It is felt when the patient breathes, from his vomit and sweat. This smell is caused by a violation of the metabolism of amino acids and aromatic compounds.

Summarizing all of the above, it can be noted that the symptoms give a clear but incomplete picture of the disease. We must not forget that we live in an age of technological progress. This allows the use of a huge range of laboratory and instrumental examinations in diagnosis. One of the informative modern methods for examining the liver and biliary tract is ultrasound. Among laboratory methods, a biochemical blood test is indicative. If you suspect liver disease, consult your doctor. He will prescribe the necessary studies, indicate the necessary treatment and tell you which folk recipes can be used for this pathology.

Diseases of the liver and biliary tract constitute a large group of abdominal diseases.

They occur over a long period of time, chronically, causing patients a lot of trouble, the need to be treated on an outpatient basis, in a hospital, and sometimes undergo surgery.

Biliary dyskinesia.

Biliary dyskinesia This is a disorder of the tone of the bile ducts, manifested by a violation of the outflow of bile from the liver, gallbladder into the duodenum, which is accompanied by the appearance of pain in the right hypochondrium.

This disease often occurs in people suffering from neurasthenia, after various diseases of internal organs, after suffering viral hepatitis, allergies, etc., writes digest.subscribe.ru

Dyskinesia is characterized by acute colicky pain in the right hypochondrium, radiating to the right scapula and right shoulder. The pain is short-lived and recurs several times a day. The patient's body temperature is normal, the liver is not enlarged, sweating, rapid pulse, weakness, decreased blood pressure, and irritability often appear.

Dyskinesia can also occur in a different, seemingly delayed type. This is characterized by constant, dull, aching pain in the right hypochondrium, nausea, belching, bitterness in the mouth, slight bloating, constipation, slight pain in the right hypochondrium upon examination, the liver is not enlarged. Typical for dyskinesia is the connection between pain and anxiety, neuro-emotional tension, and stress. Laboratory data for this pathology are not typical.

In terms of examination, patients undergo duodenal intubation (passing a soft-elastic probe with a metal olive at the end into the duodenum) to monitor the release of bile into the intestine; as a rule, no pathology is observed here. When cholecystography (X-ray examination of the gallbladder) and ultrasound examination, the gallbladder is determined to be sluggish, stretched, and stagnant. With a sharply painful form, the bubble quickly contracts, is small in size, and round. In terms of treatment of the disease, injections of non-narcotic painkillers and antispasmodics are given.

Cholangitis

Cholangitis is an inflammatory process in the bile ducts with damage to small ducts (cholangiolitis) and larger extra- and intrahepatic ducts. Choledochitis is inflammation of the common bile duct. Papillitis, inflammation of the outlet of the common bile duct into the duodenum, where there is a muscular sphincter of smooth muscles that regulates the release of bile. Cholangitis can be caused by bacteria, viruses, and helminths. In its course it also differs into acute and chronic. Cholangitis can be caused by tumor processes in the area of the duodenum and extrahepatic bile ducts, the presence of stones in the biliary system, inflammation of the pancreas, and postoperative complications.

Acute cholangitis at the beginning of its development in the 1st stage, it is characterized by a rise in body temperature with severe repeated chills. The onset of the disease is sudden. Body temperature rises daily or once every 2-3 days. Characterized by pain in the right hypochondrium, vomiting, and decreased blood pressure. In the next 2nd stage of the disease, the above-described symptoms are accompanied by an enlargement of the liver, it becomes painful on palpation, and slight jaundice of the eyes and skin occurs. In the next 3rd stage, if there is no improvement, a picture of liver failure develops with severe jaundice, cardiac dysfunction, collapse is possible, pancreatitis (inflammation of the pancreas) often occurs, and finally, in the 4th stage, severe liver failure and coma develops. Acute catarrhal cholangitis is manifested by increased body temperature, chills, enlargement and tenderness of the liver, but the severity of intoxication does not reach a severe degree. Purulent cholangitis is very severe, characterized by severe intoxication, up to the development of bacterial shock. It is not uncommon for damage to the central nervous system in the form of prostration, confusion, purulent cholangitis is often complicated by local abscesses, exudative pleurisy and inflammation of the pleura, lung abscess, peritonitis (inflammation of the peritoneum), pancreatitis (inflammation of the pancreas).

Chronic cholangitis– chronic inflammation of all bile ducts, extrahepatic and intrahepatic. It can occur in the form of a latent (hidden) form. Pain and tenderness in the right hypochondrium are weak or absent, there are chills, a slight increase in temperature, occasional skin itching, mild jaundice of the skin, and a gradual enlargement of the liver. Recurrent form: pain and tenderness in the right hypochondrium, nausea, bitterness in the mouth, itchy skin, in the period of exacerbation, jaundice, fever, possibly a prolonged increase in temperature, liver, spleen are enlarged, dense to the touch. Protracted septic form - severe course with fever, chills, pain in the right hypochondrium, enlarged liver, spleen, severe intoxication, kidney damage, jaundice. Stenotic form - general weakness, malaise, fever, chills, itching, jaundice, enlarged liver, spleen, often combined with ulcerative colitis. In the later stages of chronic cholangitis, severe liver cirrhosis may develop.

Chronic calculous cholecystitis.

Chronic calculous cholecystitis– a chronic inflammatory disease of the gallbladder accompanied by the formation of stones in it. Gallstone disease is caused by the same factors as noncalculous cholecystitis. In addition, cholesterol metabolism disorders leading to stone formation, primarily diabetes mellitus, obesity, gout, and atherosclerosis, play an important role. Congenital factors contribute to the formation of pigment stones. A violation of rational nutrition is of great importance - excessive consumption of foods rich in fat, containing cholesterol ( fatty meat, fish, eggs, oil), cereals and flour dishes that promote a shift in the bile reaction to the acidic side, which reduces the solubility of cholesterol. The development of gallstone disease is promoted by hypovitaminosis A, plus hereditary factors. Predisposition to the development of gallstone disease is pregnancy, irregular diet, sedentary lifestyle, hereditary factors, intestinal diseases in the past, viral hepatitis in the past, rich in fat and excess nutrition, chronic obstruction of the duodenum, which disrupts the outflow of bile from the gallbladder and promotes the formation stones.

Gallstones are formed due to precipitation and crystallization of the main components of bile. This process is facilitated by dyskinesia, changes in the composition of bile, inflammation, and stagnation of bile. Most often, stones form in the gallbladder, less often in the bile and hepatic ducts.

In case of exacerbation of liver and gall bladder disease, it is recommended to switch to gentle diet number 5, after consulting with your doctor.

The following types of gallstones are distinguished:

1. Homogeneous homogeneous stones, 1. Cholesterol stones, are formed due to metabolic disorders, most often in obese patients, without inflammation in the gallbladder, and are X-ray negative. 2. Pigment, bilirubin stones, are also formed in an aseptic environment. 3 Limestones, are rare.

2. Mixed stones, the absolute majority of all gallstones. The core consists of organic matter, around which layers of three main elements are deposited - cholesterol, bile pigments, and calcium salts.

3. Complex stones– are a combination of both forms. The core of the stone contains cholesterol, and the shell is mixed (calcium, bilirubin, cholesterol). These stones occur during inflammatory processes in the gallbladder and bile ducts.

The mechanism of gallstone formation may be as follows:

1. Supersaturation of bile with cholesterol and activation of lipid (fat) oxidation in it.

2. Decrease in the content of protein substances in bile.

3. A sharp decrease or complete absence of the fatty complex in bile; this complex prevents the crystallization of cholesterol and the formation of stones.

4. Under the influence of food imbalance, allergies, microflora, inflammation develops in the wall of the gallbladder with the release of mucus.

5. Cholesterol deposits occur in lumps of mucus.

6. The fusion and growth of lumps leads to the formation of cholesterol gallstones; pigments penetrate into the stone, forming its core.

The symptoms of chronic calculous cholecystitis are very characteristic, they begin:

1. Intense paroxysmal pain in the right hypochondrium, radiating to the right shoulder, right shoulder blade, right collarbone, right neck, accompanied by bitter vomiting, dry mouth, itchy skin, increased body temperature, chills.

2. Jaundice then appears in some patients.

3. This is followed by tension and sharp pain in the right hypochondrium, in the projection of the gallbladder during examination.

4. After the attack of pain subsides, the enlarged gall bladder and the edge of the liver are palpated. Cholecystography and ultrasound examination of the gallbladder reveal stones against the background of the above-described changes in the gallbladder.

Chronic noncalculous cholecystitis

Chronic cholecystitis non-calculous (calculous) - a chronic, multi-cause inflammatory disease of the gallbladder, usually combined with dysfunction of the biliary system.

1. Stagnation of bile (biliary dyskinesia, pregnancy, obesity, negative emotions).

2. Violation of diet.

3. Influences from the abdominal organs during the development of inflammatory processes in them..

4. Previous acute cholecystitis.

5. Intestinal dysbiosis.

The main mechanisms of development of chronic non-calculous cholecystitis:

1. Biliary dyskinesia accompanies any case of chronic cholecystitis.

2. Spasms of the gallbladder and ducts.

3. Penetration of infections into the gallbladder, causing an inflammatory process.

Clinical symptoms of chronic cholecystitis:

1. Pain in the right hypochondrium, radiating to the neck, right collarbone, right shoulder and scapula, back, heart area, usually occurring after eating fatty foods, alcohol, fried foods, accompanied by nausea, vomiting, bitterness and dry mouth, pain intense, paroxysmal or otherwise monotonous, constant, not very strong.

2. There is a slight yellowness of the whites of the eyes, pain in the projection of the gallbladder and liver upon palpation. Pain when lightly tapping on the right costal arch. Pain when pressing above the right collarbone.

The diagnosis is confirmed by radiography of the gallbladder - cholecystography, while the shadow of the gallbladder is absent, the motor function of the bladder and its emptying are sharply slowed down, there is deformation of the gallbladder and uneven contours. During an ultrasound examination, the size of the gallbladder is reduced, sometimes, on the contrary, enlarged, the walls of the bladder are thickened (more than 3 mm), the walls are deformed, the contraction of the gallbladder is impaired.

Cirrhosis.

Cirrhosis– progressive or, less commonly, non-progressive, diffuse, chronic, multi-cause liver disease, which is the final stage of development of unfavorable forms of chronic hepatitis, a consequence of difficulty in the outflow of bile or blood from the liver or genetic defects and is characterized by a significant decrease in the mass of functioning liver cells, restructuring of structure and tissue liver.

Liver cirrhosis in its variants can be: viral, alcoholic, immune, toxic genetic, etc. According to the stage of liver failure: compensated, subcompensated and decompensated. By activity: exacerbation, active phase, moderate activity, remission (inactive phase). The course of cirrhosis can be stable, slowly progressing and rapidly progressing. The causes of cirrhosis can be: chronic alcohol abuse, active viral hepatitis, exposure to toxic substances, a sharp narrowing of the liver ducts (cholelithiasis), etc. The most common types of liver cirrhosis are alcoholic and viral.

Initial stage of cirrhosis– stage of compensation. The patient has: moderate pain in the liver and stomach, intensifying after eating, physical activity, bitterness in the mouth, bloating; the general condition is satisfactory, initially there is a uniform increase in both lobes of the liver, later the left lobe mainly increases, with normal or reduced sizes of the right lobe, the liver is dense, its surface is uneven, lumpy on palpation, it is possible to detect an enlargement of the spleen. An ultrasound scan of the liver reveals its enlargement, diffuse changes in the liver tissue, and an enlarged spleen. With radioisotope scanning of the liver, the data are the same.

Advanced stage of cirrhosis, the patient develops signs of decompensation: general weakness, fatigue, pain in the right hypochondrium, stomach area, nausea, vomiting, severe bloating, bitterness and dry mouth, loss of appetite, weight loss, bleeding from the gums, nose, itching, headaches , impotence in men, menstrual cycle disorders in women, ; severe jaundice, atrophy of skeletal muscles, increased body temperature, atrophy of the genital organs in men, a smooth, varnished tongue, pronounced red lips, red stars on the body, the liver is enlarged, dense, often uneven, the edge is rounded, the spleen is enlarged. X-ray of the esophagus reveals varicose veins in the upper third of the stomach. Ultrasound scan of the liver - liver enlargement, diffuse nature of the lesions, expansion of the portal vein.

Stage of severe decompensation.

Clinical symptoms are the same as in the previous stage, but more pronounced and characteristic. Severe jaundice, nosebleeds, hematomas on the body after injections, headaches, memory loss, sleep disturbances, visual and auditory hallucinations are also noted. Swelling is pronounced, ascites appears (fluid in the abdominal cavity), dilatation of the subcutaneous veins of the anterior abdominal wall, often accumulation of fluid in the pleural cavity on the right, umbilical hernia, bleeding hemorrhoids, often bleeding from varicose veins of the esophagus and stomach.

A progressive decrease in liver size begins. An ultrasound scan of the liver shows that it is still enlarged, the lesion is diffuse, and the portal vein is dilated. Fibrogastroduodenoscopy and fluoroscopy of the stomach - pronounced varicose veins of the esophagus and stomach. Many of these signs of the disease are fatal and often the patient simply does not live to see all the listed symptoms of the disease.

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Nutrition for diseases of the biliary tract

Nutrition for acute and chronic forms of cholecystitis is somewhat different. During an exacerbation, food should be as light and gentle as possible, not placing a large burden on the functioning of the digestive system. The first day you should exclude food, completely switching to herbal teas: chamomile, rose hips, currants, linden. The next day, you can eat slimy soups and pureed porridges, weak broths with the addition of rice, rolled oats, barley or wheat.

Chronic cholecystitis outside the acute stage involves eating food that helps improve bile secretion and reduce cholesterol levels. Sugar is completely excluded from the diet and a sufficient amount of fiber is introduced. During acute periods, they switch to a diet that resembles a fasting day: it can be a kefir, rice, or watermelon day.

To improve the discharge of bile, meals should become frequent, but not plentiful, so-called fractional ones - up to 8 times a day. This will significantly reduce the load on the gallbladder.

The drinking regime involves drinking a sufficient amount of liquid in the form of clean water, tea, and compotes. You should avoid highly carbonated mineral water, fizzy drinks, and especially alcohol.

What diet for diseases of the biliary tract?

Poor and unbalanced nutrition plays a decisive role in the etiology of the development of inflammation in the biliary tract. Fried, pickled, fatty and spicy foods rich in cholesterol and lipids, overeating and irregular food intake greatly affect the quality of biochemical processes in the body. This promotes the formation of sand and stones from inorganic and organic substances that accumulate in the gallbladder and ducts. If the diet is balanced, then metabolic processes proceed normally and deposits do not form.

A diet for gallbladder pathologies involves reducing the amount of foods with cholesterol and increasing the amount of plant components in food. You should remove fatty foods (meaning animal fats), alcohol, limit the amount of salt, pepper, spices, and avoid drinking strong coffee and carbonated drinks. It is not recommended to either starve or overeat - the liver is very sensitive to imbalances in food intake. Breakfast, snack, lunch break, afternoon snack and dinner - the minimum number of meals. You need to eat in small portions, getting up from the table, without waiting to feel full. Snacks should consist of some kind of fruit or low-calorie vegetable salad.

You should drink about 2 liters of water per day between meals, and not during it. You can drink carbonated water after you have separated it from carbon dioxide. Preference should be given to alkaline mineral waters: Truskavetskaya, Morshinskaya, Borjomi, Nabeglavi, etc.

Diet menu for diseases of the biliary tract

An approximate menu option for pathology of the gallbladder and ducts is as follows:

Breakfast - cottage cheese casserole made from low-fat cottage cheese, egg whites and honey, rosehip tea.
Snack – fruit salad with honey or yogurt.
Lunch – rice soup with grated tomatoes, baked chicken breast with vegetables, green tea.
Afternoon snack – fruit and berry compote with crackers.
Dinner – potato and carrot casserole with sour cream, herbal tea.
At night - a glass of kefir.

Second option:

Breakfast - steamed protein omelette, a piece of yesterday's bread, fruit juice.
Snack – apple or pear.
Lunch – pureed zucchini soup, buckwheat with steamed fish cutlets, tomato juice.
Afternoon snack – oatmeal cookies, yogurt.
Dinner – fish baked in foil with vegetables, tea.
At night - a glass of yogurt.

Third option:

Breakfast – rice pudding with strawberry jam, herbal tea.
Snack – apple baked with cottage cheese.
Lunch – vegetable soup, pilaf with chicken, berry compote.
Afternoon snack – fruit salad with Greek yogurt.
Dinner – fish casserole with vegetable salad, rosehip tea.
At night - tea with milk.

Diet foods are mainly prepared in a steamer, boiled or baked in the oven or microwave. Fried foods irritate the digestive tract, so their use is excluded.

Dishes should be under-salted, consuming no more than 8-10 g of salt per day.

Despite the rich menu, portions of dishes should be small; you should not eat until you feel full. Overeating increases the load on the gallbladder and increases pain.

The diet for diseases of the biliary tract consists of nutritious foods that serve as the basis for a rational, balanced diet. Such nutrition is indicated not only in the presence of illness, but also as a prevention of pathologies and exacerbations of diseases of the gastrointestinal tract.

Diseases of the biliary tract– this is a group of diseases of various nature, in which the pathological process is localized in the bile ducts.

Biliary (hepatic) colic.
Gallstone disease.
Cholangitis is inflammation of the bile ducts.
Cholecystitis is acute and chronic.

Biliary (hepatic) colic. Paroxysmal, usually severe pain in the right hypochondrium is a manifestation of various diseases of the biliary tract as a result of a violation of the outflow of bile from the gallbladder or through the common bile duct. Hepatic colic is caused by the movement of bile “sand”, a stone wedged in the bile ducts or its movement, plugs from mucous masses with cholecystitis, stenosis of the large duodenal papilla with inflammation or tumor growth, persistent impairment of the motor function of the bile ducts - dyskinesia.

Symptoms and course. If the gallstone moves back into the gallbladder cavity or is pushed into the common bile duct and then into the intestine, the obstruction to the bile disappears and the pain subsides even without medical help. Attacks are provoked by errors in eating: rich, fatty and fried foods, alcohol, cold carbonated drinks, as well as physical overload, bumpy driving. Pain occurs in the right hypochondrium or under the pit of the stomach, and can radiate to the back, right half of the chest, right supraclavicular region, right shoulder blade and right arm. Nausea and vomiting that do not bring relief, flatulence and stool retention are common. Some patients may develop a fever and short-term jaundice.

Recognition. The causes of an attack of biliary colic are identified by ultrasound of the abdominal cavity, cholecystography or intravenous cholangiography; with the latter two studies, biliary dyskinesia is also diagnosed. A gastroduodenoscopy is required to examine the area of the nipple of Vater.

Gallstone disease. The main manifestation of the disease is the presence of stones in the gall bladder and ducts. The main cause of stone formation is a violation of the metabolism of cholesterol, bile acids and bilirubin, inflammation in the gallbladder and stagnation of bile in it. Women are more often affected. Lifestyle influences the occurrence of gallstone disease: overeating, low mobility, especially during sedentary work, irregular nutrition, obesity.

Symptoms and course. The main clinical manifestations of the disease are attacks of biliary colic (see above). If they are accompanied by inflammation of the gallbladder, then the disease is regarded as acute calculous cholecystitis. Outside of attacks, patients experience heaviness in the right hypochondrium, bitterness in the mouth, nausea, belching, sometimes for a long time patients do not notice any signs of the presence of stones, they are accidentally detected during examination for other diseases.

Recognition. Recognition of stones is facilitated by ultrasound examination of the abdominal cavity.

Treatment. Currently, cholecystectomy predominates - removal of the gallbladder with stones. For stones that are freely “lying” in the cavity of the gallbladder and consisting only of cholesterol, no more than 2 cm in size, they can be dissolved with chenodeoxycholic and ursodeoxycholic acid. The course of treatment lasts a year or longer; after a few years, stones form again in more than half of the patients.

Postcholecystectomy syndrome. Various painful manifestations that are observed after removal of the gallbladder.

Symptoms and course. Complaints: heaviness and dull pain in the right hypochondrium, intolerance to fatty foods, bitter belching. Sometimes the pain intensifies in attacks and is accompanied by general weakness, palpitations, and sweating. A more serious consequence is the presence of stones in the ducts, inflammation or narrowing of the major duodenal papilla, inflammatory or post-traumatic stricture (narrowing) of the common or hepatic ducts. This syndrome is manifested by biliary colic, jaundice, and fever. Signs of postcholecystectomy syndrome appear at different times after surgery, are inconsistent, periods of deterioration alternate with remission.

Recognition. Examination to clarify the nature of postcholecystectomy syndrome in a hospital setting. Research methods: ultrasound examination of the abdominal cavity, intravenous cholangiography, gastroduodenoscopy to examine the area of the papilla of Vater, retrograde cholangiopancreatography.

Cholangitis. Inflammation of the bile ducts. According to the course and morphological changes in the ducts, it can be acute, subacute and purulent. It often occurs as a concomitant lesion in acute cholecystitis, postcholecystectomy syndrome, and can also be an independent disease.

Symptoms and course. The main manifestations are pain in the right hypochondrium, fever with chills, sweats, nausea, and vomiting. The liver is enlarged and painful. As the disease progresses, the spleen may become enlarged. A common symptom is jaundice, which is accompanied by itchy skin. With purulent cholangitis, all clinical signs of inflammation are more pronounced, the temperature rises to 40°C, and the development of subphrenic abscess and sepsis is possible.

Hepatitis may be complicated, in severe cases with hepatic coma.

Recognition. The diagnosis is made based on characteristic symptoms. Laboratory data play a supporting role: increased number of leukocytes, accelerated ESR, changes in biochemical tests. Cholangiography, gastroduodenoscopy, retrograde cholangiography, and less commonly laparoscopy (examination of the abdominal organs through a laparoscope) are used.

Treatment. Broad-spectrum antibiotics, nitrofuran medications, choleretic, antispasmodics, diet. In some cases, surgical intervention is indicated: removal of stones from the bile ducts, dissection of the narrowing of the papilla of Vater. Sanatorium-resort treatment in remission.

Acute cholecystitis. Inflammation of the gallbladder wall when microbes penetrate into it. Possible both against the background of cholelithiasis and in the absence of stones. Women are more often affected.

Symptoms and course. Typically an acute onset after an error in diet: rich, fatty, fried or spicy foods, drinking alcohol, confectionery with cream, mushrooms, etc. Pain in the right hypochondrium is usually severe (as in biliary colic), radiating to the back, right shoulder blade, right supraclavicular region. If pancreatitis occurs, then they spread to the left hypochondrium. Elderly people suffering from coronary heart disease may simultaneously experience pain to the left of the sternum or behind the sternum - reflex angina. Many patients experience nausea and vomiting, first from food eaten, and later from bile or bile. The temperature rises from low subfebrile numbers to high ones. When palpating the abdomen, pain is detected in the right hypochondrium and in the pit of the stomach, the abdominal muscles are tense, after 2-4 days a painfully tense gallbladder begins to be felt in the form of a round formation, as well as an enlarged, painful liver. The pulse is increased, blood pressure tends to decrease. In most patients, yellowness of the skin, sclera and mucous membranes appears within 2-3 days. The following forms of acute cholecystitis are distinguished.

Catarrhal form occurs with low fever, moderate pain lasting from 2 to 7 days, and minor changes in blood tests. Timely and correct drug therapy leads to recovery, otherwise it can develop into a phlegmonous form.

Phlegmonous cholecystitis more severely expressed: severe pain, often vomiting, which does not bring relief, high temperature (38-39 ° C), chills, severe general weakness, loss of appetite, pronounced leukocytosis in blood tests.

Gangrenous cholecystitis is more severe than phlegmonous, the temperature is above 39 ° C, peritonitis is often associated - inflammation of the peritoneum. Without timely surgery, it can be fatal.

In older people, even phlegmonous and gangrenous cholecystitis are not always clearly defined: the increase in temperature may be insignificant, pain and symptoms of peritoneal irritation are mild or completely absent.

Complications of acute cholecystitis include: perforation (violation of the integrity of the wall) of the gallbladder with the subsequent development of purulent or bile peritonitis, the formation of fistulas or abscesses, acute cholangitis. Blockage of the bladder neck or its duct due to the wedging of a large stone leads to distension of the gallbladder, if with mucus, then this is called “mucocele”, with transparent transudate - “dropsy”, with pus - “empyema”. Concomitant inflammation of the pancreas - reactive pancreatitis is a fairly common complication.

Recognition of acute cholecystitis is difficult, since its manifestations resemble other diseases of the abdominal organs: acute appendicitis, pancreatitis, perforated gastric and duodenal ulcers, right-sided renal colic and acute pyelonephritis. The diagnosis is made on the basis of the clinic, from laboratory data the number of leukocytes is important. Ultrasound can detect stones in the bile ducts, swelling of the gallbladder wall, its size, and the condition of the main bile ducts. Of the radiological methods, a survey image of the abdominal cavity is important.

Treatment. Patients with acute cholecystitis, regardless of their condition, should be hospitalized in the surgical department of the hospital. Bed rest, fasting, and a heating pad with ice are prescribed on the right hypochondrium. Detoxification therapy is carried out. Broad-spectrum antibiotics are prescribed. If the inflammatory process does not subside within 24 hours of intensive treatment, patients are advised to undergo surgery - removal of the gallbladder (cholecystectomy).

Chronic cholecystitis. Inflammation of the gallbladder develops gradually, rarely after acute cholecystitis. In the presence of stones they speak of chronic calculous cholecystitis, in their absence - chronic acalculous cholecystitis.

It often occurs against the background of other chronic diseases of the gastrointestinal tract: gastritis, pancreatitis, hepatitis. Women are more often affected.

Symptoms and course. Complaints of dull aching pain or discomfort in the right hypochondrium, epigastric region, sometimes under the right shoulder blade, nausea, bitterness in the mouth, bloating. The appearance of these sensations is usually associated with the consumption of fatty, fried foods, smoked foods, and sometimes diarrhea begins after it. Palpation of the abdomen reveals pain in the right hypochondrium, and less often, an enlarged liver, also painful. During an exacerbation, the clinical picture of acute cholecystitis is much similar: the pain is of the nature of hepatic colic, the temperature can rise to low-grade levels. Jaundice appears only in complicated cases: blockage of the common bile duct with stones, mucus, cholangitis, hepatitis, and less commonly pancreatitis. Chronic cholecystitis is often accompanied by dyskinesia - a violation of the motor function of the bladder itself and the biliary tract. With dyskinesia of the hypomotor type, the volume of the contracted bladder decreases, slowing down its emptying with subsequent stagnation of bile; with the hypermotor type, on the contrary, the contractile function is accelerated, which is manifested by paroxysmal pain of aching or cramping nature. Biliary dyskinesia, even in the absence of chronic cholecystitis, affects the patient’s well-being.

Recognition. The diagnosis is made based on the clinic, abdominal ultrasound, cholecystography, and analysis of duodenal contents.

Treatment. A diet completely excluding fatty and fried foods, preferably a predominance of plant foods. Mineral waters from the following sources are recommended: Essentuki, Jermuk, Zheleznovodsk, Borjomi, Izhevsk. Bottles of mineral water are opened in advance to allow gases to escape and heated in a water bath-pan with water. During the period of exacerbation - broad-spectrum antibiotics in medium therapeutic doses as prescribed by a doctor.

Risk factors and causes of biliary tract diseases

Hereditary features of the structure of the gallbladder,
Eating disorders
Excess body weight,
Pathology of the pancreas,
Taking certain medications.

General manifestations of biliary tract diseases

Pain in the right hypochondrium, sometimes radiating to the right scapula, shoulder, and collarbone. Often, attacks of pain imitate hepatic colic due to cholelithiasis or cholecystitis; in this case, the pain is acute, cramping, often accompanied by an increase in body temperature. Common symptoms may include vomiting, nausea, belching, and diarrhea.

Diagnosis of biliary tract diseases

Diagnosis of biliary tract diseases is based on examination by a gastroenterologist, ultrasound of the abdominal organs, data from a biochemical blood test, and stool analysis. If necessary, radiography of the biliary tract is performed using contrast, a study of the composition of bile obtained during endoscopy (gastroscopy)

Treatment of patients with diseases of the biliary system depends on the form and stage of the disease. In practice, a large number of choleretic agents are used, including those of plant origin, which enhance the secretion of bile and facilitate its entry into the intestines. Another equally important means of treating and preventing biliary tract diseases is diet. In order to promptly identify the pathological process and carry out a course of therapy, you need to consult a gastroenterologist at the Alternative Medical Center.