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

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

JVP - what is it?

Bile duct dyskinesia is a syndrome in which the normal motor activity of the biliary tract is disrupted and the tone of the gallbladder is reduced. There are organic and functional types of the disorder.

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

With GIB, the motor activity of the biliary tract is disrupted

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

Types of biliary dyskinesia

There are 3 types of JVP:

1. Hypokinetic(hypomotor, hypotonic). In this case, there is a decrease in the tone of the gallbladder and a decrease in the motor activity of the ducts.
2. Hyperkinetic(hypertonic, hypermotor). Spastic phenomena and increased contractility of the organ predominate here.
3. Mixed. In the mixed form, there is a change in tone and colicky pain.

Hypomotor type dysfunction

Characterized by a lack of bile for the process of digesting food. The production of the substance is not affected, but at the time of release, the gallbladder does not contract sufficiently. This leads to the fact that food is not digested and not absorbed in full.

Hypomotor type dysfunction in the vast majority of cases develops in older people

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

A typical symptom is a dull, arching pain spreading to the back and right shoulder blade. The pain syndrome may last for several days.

JVP of hypertensive type

It most often develops in women aged 30 to 35 years, adolescents and children. The attack develops suddenly in the form of colic. In this case, the pressure in the gallbladder increases sharply, and a spasm of the Lutkens or Oddi sphincters is observed. The pain syndrome lasts no more than 20 minutes. Develops after eating, at night.

The occurrence of hypertensive type DVT is possible in children and adolescents

Mixed form

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

Causes of JVP

There are 2 types of bile duct dyskinesia. The classification is based on the reasons that caused the disruption of bile release.

Causes of the primary syndrome:

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

Causes of secondary dysfunction:

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

Symptoms of gallbladder dysfunction

The symptoms of the pathological process depend on the type of dysfunction.

Table: Signs of ADHD depending on the type of disease

Types of dysfunction	Hypomotor dyskinesia	Hypermotor dyskinesia
Symptoms	Dull pain in the right hypochondrium. Belching - after eating, between meals. Nausea. Vomiting with bile. Bitterness in the mouth - in the morning, after eating. Flatulence. Decreased appetite. Impaired defecation – often constipation. Obesity. Bradycardia. Hypersalivation. Hyperhidrosis.	During an exacerbation, the pain is intense, reminiscent of colic. Lack of appetite. Thin. Nausea and vomiting - against the background of an attack of colic. Rarely occur on their own. Diarrhea. Attacks of tachycardia. Increased blood pressure. Irritability. Fatigue. Sleep disturbance.
	Yellowness of the skin and sclera due to impaired bile outflow. The coating on the tongue is white or yellowish.

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

Which doctor should I contact?

If your digestive system is disturbed, consult a gastroenterologist

Treatment of dysfunction of the digestive system involves:

Consultations are possible according to indications.

Diagnostics

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

The examination includes:

1. Inspection and survey patient, palpation of the abdomen.
2. Ultrasound– to determine the size of the organ, exclude developmental anomalies, tumors, and assess the contractile activity of the gallbladder.
3. General blood test– with an increase in ROE, one can judge the inflammatory process; an increase in eosinophils and leukocytes is possibly a helminthic invasion.
4. Blood biochemistry– an increase in bilirubin and cholesterol, and the appearance of C-reactive protein may be observed.
5. Cholecystography– X-ray of the gastrointestinal tract using a contrast agent. As a contrast, iodine preparations are used orally or by infusion.
6. Cholangiography– according to indications – x-ray examination of the bile ducts after administration of a contrast agent. The drug is administered percutaneously using the puncture method. At the same time, the doctor drains the ducts. The manipulation is performed under local anesthesia.
7. Endoscopic cholangiography– according to indications – a camera is passed through the oral cavity using an endoscope into the gallbladder. Contrast is introduced and photographs are taken. At the same time, it is possible to remove stones.
8. Duodenal sounding– according to indications – study of the composition of bile, assessment of the motor activity of the bile ducts.

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

The doctor determines the method of examining the patient. It may change depending on symptoms and as research results become available.

Treatment of biliary dyskinesia

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

Patient management tactics include:

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

Physiotherapy is prescribed for gallbladder motility disorders

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

Medicines

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

In the treatment of hypomotor dysfunction

Choleretics - Chophytol, Cholenzym, Allochol - they all contain either bile or bile acids, digestive enzymes, plant extracts.

The active components of the drugs enhance the contractile activity of the gallbladder and improve the digestion of food. When taken, bile production increases.

Taking Hofitol enhances the contractile activity of the gallbladder

The doctor selects individual dosages. The duration of treatment is from 20 days to 2 months.

The drugs are well tolerated. While taking it, diarrhea and various allergic reactions may develop. In this case, drug tactics are reconsidered.

This group of drugs is not prescribed if:

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

Herbal tonics that normalize the nervous system:

• extract from ginseng root.

Take eleutherococcus tincture to stabilize the body’s nervous activity

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

Dosages depend on the age and condition of the patient and can range from 15 to 30 drops per dose. The main side effect of tinctures is insomnia. Therefore, it is not advisable to take them in the evening.

Contraindications for use:

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

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

The procedure is aimed at improving the flow of bile.

Tubages help maintain the flow of bile during the period of remission of the disease

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

In the treatment of hypermotor dysfunction

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

Typical representatives:

• Oxafenamide;

Gepabene is prescribed to relax the bile ducts and relieve spasms.

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

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

No-spa will help relieve pain during an attack

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

Folk remedies

Herbal medicine is considered a traditional method of treatment. But at the same time they use medicinal herbs used in official medicine. The duration of treatment with herbal mixtures is from 2 to 3 weeks.

Decoction of immortelle flowers

Use immortelle flowers to prepare a medicinal decoction

You will need 60 g of plant material and 1 liter of boiling water. Pour and wrap. Let it brew until the broth cools completely. Take 100 ml half an hour before meals 3 times a day.

Corn silk

Brew corn silk to make a medicinal infusion

You need 4 tbsp. l. pour 1 liter of boiling water. Wrap up and leave until cool. Take 1 tablespoon 3 times a day.

Chamomile tea

Replace regular tea with chamomile to improve gastrointestinal function

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

Licorice root

Boil licorice root to obtain an effective remedy in the fight against ADHD.

You will need 2 teaspoons of crushed plant material. Pour a glass of boiling water and simmer over low heat for 15 minutes. Strain and add water to a full glass. Take 100 ml 3 times a day before meals.

Peppermint tea

Take mint tea 3 times a day before meals

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

Diet for ADHD

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

Sample menu

Meals should be divided: during the day, take 5-6 meals.

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

First day:

1. Breakfast - vegetable salad, rice milk porridge, tea, bread and butter.
2. Second breakfast – baked apple or 250 ml of fruit juice.
3. Lunch – vegetable soup, baked chicken breast, stewed cabbage, compote.
4. Afternoon snack – biscuits, dried fruit compote.
5. Dinner – millet porridge, boiled beef, boiled beet salad with vegetable oil, tea.
6. At night – a glass of fermented milk product.

Second day menu:

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

Features of treatment in children

According to medical statistics, 90% of children diagnosed with dyskinesia had episodes of inflammatory diseases of the gastrointestinal tract and helminthic infestations. In adulthood, the development of this dysfunction is facilitated by vegetative-vascular dystonia. Girls are diagnosed with this disorder more often than boys.

A feature of the treatment of this condition in children is that diet therapy comes first. There is no special diet provided; it is enough to follow the recommendations for proper nutrition.

They include minimizing fast food, nuts, snacks, and mineral water. In addition, nutrition is indicated according to the child’s demand and appetite. You should not strictly adhere to the regime moments.

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

Drug therapy is represented by drugs to normalize microflora, antispasmodics for pain, mild plant-based sedatives, and choleretics. Additionally, massages, electrophoresis with antispasmodics, and a course of exercise therapy are indicated.

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

Features of treatment during pregnancy

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

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

In case of DVT in pregnant women, hospitalization and constant monitoring by doctors are required.

A peculiarity of the treatment of pregnant women diagnosed with VDP is that many medications are prohibited during the gestational period. The main tactics for managing the patient is to follow the principles of rational nutrition, eating according to appetite. It is forbidden to “eat for two” as grandmothers recommend.

Acceptable drug treatment is taking herbal teas. For example, decoctions of corn silk, dill, mint. Taking antispasmodics is allowed.

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

JVP is not an indication for termination of pregnancy or for cesarean section. Dysfunction does not affect the course of natural childbirth.

Possible complications

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

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

This is a group of diseases of various natures, in which the pathological process is localized in the bile ducts.

Types of biliary tract diseases

• biliary (hepatic) colic;
• cholelithiasis;
• postcholecystectomy syndrome;
• cholangitis– inflammation of the bile ducts;
• acute cholecystitis And chronic.

Biliary (liver) 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 cause the movement of bile “sand”, a stone wedged in the bile ducts or its movement, plugs from mucous masses during cholecystitis, stenosis of the major duodenal papilla due to inflammation or tumor growth, persistent impairment of the motor function of the biliary tract - dyskinesia.

Symptoms and course. If gallstone moves back into the cavity of the gallbladder or is pushed into the common bile duct, and then into the intestine, the obstacle 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. Causes of an attack biliary colic detected by abdominal ultrasound, cholecystography or intravenous cholangiography; with the latter two studies it is also diagnosed biliary dyskinesia. 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 gallbladder 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 cholelithiasis: overeating, low mobility, especially during sedentary work, irregular nutrition, obesity.

Symptoms and course. The main clinical manifestations of the disease are seizures 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, more than half of the patients develop stones again.

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 appear at different times after surgery, are inconsistent, periods of deterioration alternate with remission.

Recognition. Examination to clarify the character 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 flow and morphological changes in the ducts there may be acute, subacute And purulent. 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, 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. At purulent cholangitis all clinical signs of inflammation are more pronounced, the temperature rises to 40°C, and the development of subdiaphragmatic abscess and sepsis is possible.

May be complicated by hepatitis, 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 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 joins pancreatitis, 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 have nausea and vomiting, first of food eaten, then of 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 on days 2–3. 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 may develop into 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 flows more severely than phlegmonous, temperature above 39 °C, often associated peritonitis- inflammation of the peritoneum. Without timely surgery, it can be fatal.

Even in older people 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.

To complications 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 acute cholecystitis difficult, since its manifestations resemble other diseases of the abdominal organs: acute appendicitis, pancreatitis, perforated gastric ulcer And duodenum,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, they must 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.

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, as a rule, is 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, which is also painful. During an exacerbation there are many similarities with the clinic acute cholecystitis: the pain is of a nature hepatic colic, the temperature may rise to subfebrile levels. Jaundice appears only in complicated cases: blockage of the common bile duct with stones, mucus, cholangitis, hepatitis, and less commonly pancreatitis.

Chronic cholecystitis 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; in 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 chronic cholecystitis affect 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 - a pan of water. During an exacerbation, use broad-spectrum antibiotics in medium therapeutic doses as prescribed by a doctor.

Causes of biliary tract diseases

Risk factors and causes of biliary tract diseases:

• hereditary features of the structure of the gallbladder;
• eating disorders;
• excess body weight;
• pancreas pathology;
• taking certain medications.

Symptoms 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 biliary tract diseases

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, it is necessary to consult a gastroenterologist.

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. A similar 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:

1. , 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.

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

• jaundice - the skin, sclera of the eyeballs, oral mucosa and saliva are colored 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.

1. Digestive system disorders:

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

1. 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:

1. 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).
2. 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).
3. Physical examination - the doctor determines what color the patient’s skin, sclera and mucous membranes are (there is jaundice or not), whether obesity is present, palpation (feeling) will help to identify an enlarged liver.
4. 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:

1. 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 twisting the body.

1. Strict diet:

1. Medicines:

• choleretic drugs - choleretics;
• enzyme preparations;
• Cholespasmolytics.

1. 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:

1. 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.

1. 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.

Biliary dyskinesia – this is the presence in a person of a whole complex of certain disorders of the biliary system, which arise in connection with disturbances in the motor function of the gallbladder and bile ducts. However, there are no organic changes in these organs. Patients very often experience either too much or insufficient contraction of the gallbladder.

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

Causes of biliary dyskinesia

Dyskinesia is almost always diagnosed as a secondary disease. It manifests itself in humans as a consequence of certain factors leading to disruption of the biliary tract.

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

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

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

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

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

If the patient suffers from symptoms hypotonic dyskinesia , then this condition is characterized by a dull and aching pain, which also manifests itself as a feeling of fullness in the area of ​​the right hypochondrium. Such pain constantly worries the patient, while his appetite noticeably decreases, the person often feels nauseous, and belching appears. There is no rise in body temperature, and a clinical blood test also does not indicate the presence of abnormalities.

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

The disease continues for a long period, with periodic severe exacerbations that provoke stress and other basic disorders. After attacks, periodic relief occurs. Over time, dyskinesia can cause inflammation in the gallbladder and ducts, and also cause the formation of gallstones.

Diagnosis of biliary dyskinesia

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

Treatment of biliary dyskinesia

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

All further methods of treating dyskinesia directly depend on what form of the disease is diagnosed in the patient. If a patient has developed hypokinetic dyskinesia, he should follow a special diet that includes foods with a choleretic effect and a high content of certain minerals.

During therapy, patients are prescribed regular consumption of a certain type of mineral water. They should be drunk one glass about three times a day, about half an hour before meals. In addition, for biliary dyskinesia, the use of massage and physical therapy is effective. Periodic spa treatment is also recommended. Sometimes it is advisable for the patient to be prescribed duodenal intubation in order to empty the gallbladder of bile. There is also a so-called “closed tubage” technique, which the patient can do independently, thus stimulating contractions of the gallbladder.

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

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

Doctors

Medicines

Diet, nutrition for biliary dyskinesia

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

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

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

Prevention of biliary dyskinesia

To prevent the manifestation of this unpleasant illness, you should immediately treat all neurotic disorders, avoid serious stressful situations, and eat regularly at the same time every day. Normal, complete sleep and rest are also more important.

Intestinal dyskinesia

A variety of functional disorders of the large intestine are ailments that are very widespread today. (this disease is also called irritable bowel syndrome , spastic colitis ) is a condition in which intestinal motor function is impaired. Dyskinesia of the large intestine manifests itself to a greater extent, and dyskinesia of the small intestine to a lesser extent. However, organic lesions are not typical for this disease. Patients with intestinal dyskinesia experience pain, and their bowel function changes noticeably. In some cases, there is also an excessively high level of mucus secretion: this phenomenon is typical for about half of all patients.

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

A patient whose intestinal dyskinesia progresses is very often bothered by pain in the abdomen, which is characterized by the absence of a clearly defined localization. Stool disorders and excessive mucus production are also possible. The pain can have different intensity: sometimes there is a feeling of pressure in the lower abdomen, pressure in the lower abdomen, sometimes quite severe colic. They can last a few minutes or several days. Quite often, patients perceive such colic as the beginning of an attack of appendicitis. In some cases, it even comes to surgical intervention on suspicion of appendicitis. Sometimes patients with intestinal dyskinesia note periodic alternation of constipation and diarrhea. Especially often, diarrhea overcomes a person in the morning, after he has eaten. In this case, feces with mucus impurities are often released.

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

It is important for all patients to maintain a healthy lifestyle and avoid. If a person constantly develops symptoms, it is recommended that he introduce whole grain porridge, fermented milk products, and baked apples into his diet.

List of sources

• Sherlock Sh. Diseases of the liver and biliary tract / Sh. Sherlock - M.: GEOTAR-MED, 2002;
• Diseases of the liver and biliary tract: A guide for doctors / Ed. V.T. Ivashkina. - M., 2002;
• Ilchenko A.A. Gallstone disease. M.: Anacharsis, 2004;
• Maev I.V., Samsonov A.A., Salova L.M. and others. Diagnosis and treatment of biliary tract diseases: Textbook. - M.: GOU VUNMC Ministry of Health of the Russian Federation, 2003;
• Ilchenko A.A. Diseases of the gallbladder and biliary tract: A guide for doctors. M.: Anaharsis, 2006.

Biliary dyskinesia is a disease in which the motility of the gallbladder is impaired and the functioning of the bile ducts malfunctions, which causes stagnation of bile or its excessive secretion.

This disorder occurs mainly in women. As a rule, patients of young age (20-40 years) and thin build suffer from biliary dyskinesia. In some women, there is a strong relationship between the exacerbation of complaints and the period of the menstrual cycle (exacerbation occurs 1-4 days before the onset of menstruation), and the disease can also worsen during menopause.

Since this disease causes changes in the properties of bile, the absorption of some important substances and fat-soluble vitamins is impaired. At risk are women with diseases related to the genital area, as well as people often exposed to stress.

There are two main forms of gallbladder dyskinesia:

• Hypertonic (hyperkinetic)– the tone of the gallbladder is increased;
• Hypotonic – the tone of the gallbladder is reduced.

Causes

Why does biliary dyskinesia occur, and what is it? Primary causes

1. Long-term, systematic violation of the diet (irregular meals, overeating, the habit of eating heavily before bed, abuse of spicy and fatty foods).
2. Disorders of neurohumoral regulatory mechanisms of the biliary tract.
3. Sedentary lifestyle, congenital underdeveloped muscle mass.
4. Neurocirculatory dystonia, neuroses, stress.

Secondary causes biliary dyskinesia:

1. Previously suffered acute.
2. , infections ().
3. When the neck or body of the gallbladder is bent (organic causes).
4. For enteritis.
5. Chronic inflammatory processes of the abdominal cavity (chronic inflammation of the ovaries, etc.).
6. Hormonal disorders (menopause, menstrual irregularities, insufficiency of the endocrine glands: hypothyroidism, lack of estrogen, etc.).

Most often, biliary dyskinesia is a background symptom and not a separate one. It indicates the presence of stones in the gall bladder, the occurrence of pancreatitis, or other abnormalities in the function of the gall bladder. The disease can also develop as a result of eating certain foods: sweets, alcohol, fatty and fried foods. Severe psychological or emotional stress can cause the onset of dyskinesia.

Classification

There are 2 types of dyskinesia:

1. Dyskinesia of hypokinetic type: the gallbladder is otanic (relaxed), it contracts poorly, stretches, and has a much larger volume, which is why bile stagnation occurs and its chemical composition is disrupted, which can lead to the formation of gallstones. This type of dyskinesia is much more common.
2. Hyperkinetic type dyskinesia: the gallbladder is in constant tone and reacts sharply to the entry of food into the lumen of the duodenum with sharp contractions, releasing a portion of bile under great pressure.

Accordingly, depending on what type of biliary dyskinesia you have, the symptoms of the disease and treatment methods will vary.

Symptoms of biliary dyskinesia

Considering the symptoms of dyskinesia, it is worth noting that they depend on the form of the disease.

Mixed variants of JVP usually appear:

• constipation or their alternation with diarrhea,
• loss of appetite,
• pain when palpating the abdomen and right side,
• fluctuations in body weight,
• belching, bitterness in the mouth,
• general disorder.

For hypotonic dyskinesia The following symptoms are typical:

• aching pain arising in the right hypochondrium;
• constant feeling of nausea;
• vomiting.

For the hypotonic form of the disease The following set of signs is typical:

• acute pain, periodically occurring in the right hypochondrium, with pain radiating to the back, neck and jaw. As a rule, such pain lasts about half an hour, mainly after eating;
• constant feeling of nausea;
• decreased appetite;
• general weakness of the body, headaches.

It is important to know that the disease not only manifests itself in a gastroenterological clinical picture, but also affects the general condition of patients. Approximately every second large patient diagnosed with biliary dyskinesia initially consults a dermatologist because of. These skin symptoms indicate problems with the gastrointestinal tract. At the same time, patients are concerned about regular skin itching, accompanied by dryness and flaking of the skin. Blisters with watery contents may occur.

Diagnosis of biliary dyskinesia

The following laboratory and instrumental examination methods are prescribed:

• and urine,
• stool analysis for lamblia and coprogram,
• liver tests, blood biochemistry,
• conducting an ultrasound examination of the liver and gall bladder with a choleretic breakfast,
• performing fibrogastroduodenoscopy (swallow the “sweetheart”),
• if necessary, gastric and intestinal intubation is performed with bile samples taken by stage.

However, the main method for diagnosing VVP is ultrasound. Using ultrasound, you can evaluate the anatomical features of the gallbladder and its tracts, check for the presence of stones and see inflammation. Sometimes a stress test is performed to determine the type of dyskinesia.

Treatment of biliary dyskinesia

• Treatment of hyperkinetic form of dyskinesia. Hyperkinetic forms of dyskinesia require dietary restrictions on mechanical and chemical food irritants and fats. Table No. 5 is used, enriched with products containing magnesium salts. To relieve spasms of smooth muscles, nitrates, myotropic antispasmodics (no-spa, papaverine, mebeverine, hymecromone), anticholinergics (gastrocepin), as well as nifedipine (Corinfar), which reduces the tone of the sphincter of Oddi at a dose of 10-20 mg 3 times a day, are used.
• Treatment of hypokinetic form of dyskinesia. You should apply a diet within the framework of table No. 5; for hypokinetic dyskinesias, food should be enriched with fruits, vegetables, products containing plant fiber and magnesium salts (edible bran, buckwheat porridge, cottage cheese, cabbage, apples, carrots, meat, rosehip decoction). Vegetable oil, sour cream, cream, and eggs also contribute to emptying the gallbladder. It is necessary to establish normal functioning of the intestines, which reflexively stimulates contraction of the gallbladder. Cholekinetics (xylitol, magnesium sulfate, sorbitol) are also prescribed.

Patients with biliary dyskinesia are advised to undergo observation by a gastroenterologist and neurologist, and annual health courses in balneological sanatoriums.

Physiotherapy

In the hypotonic-hypokinetic variant, diadynamic currents, faradization, sinusoidal modulated currents, low-pulse currents, low-intensity ultrasound, pearl and carbon dioxide baths are more effective.

In the case of hypertonic-hyperkinetic form of dyskinesia, patients are recommended inductothermy (disk electrode is placed above the right hypochondrium), UHF, microwave therapy (MW), high-intensity ultrasound, novocaine electrophoresis, ozokerite or paraffin applications, galvanic mud, pine, radon and hydrogen sulfide baths.

Diet for dyskinesia

Any advice on how to treat biliary dyskinesia will be useless if you do not adhere to certain dietary rules that help normalize the condition of the biliary tract.

Proper nutrition will help create favorable conditions for the normal functioning of the gastrointestinal tract and normalize the functioning of the biliary tract:

• everything highly salty, sour, bitter and spicy is prohibited;
• seasonings and spices are limited, fried foods are prohibited;
• fat in the diet is sharply limited, replacing it as much as possible with vegetable oils;
• a strict ban is imposed on potentially harmful and irritating products (chips, nuts, soda, fast food, salted fish);
• All food is initially given in a warm and semi-liquid form, especially during painful attacks;
• All food is boiled, steamed or stewed, baked in foil.

Sample menu for the day:

1. Breakfast: soft-boiled egg, milk porridge, tea with sugar, sandwich with butter and cheese.
2. Second breakfast: any fruit.
3. Lunch: any vegetarian soup, baked fish with mashed potatoes, vegetable salad (for example, cabbage), compote.
4. Afternoon snack: a glass of milk, yogurt, fermented baked milk or kefir, a couple of marshmallows or marmalades.
5. Dinner: steamed meatballs with vermicelli, sweet tea.
6. Before bed: a glass of kefir or drinking yogurt.

Treatment of children with biliary dyskinesia

In children with biliary dyskinesia, treatment is carried out until bile stagnation and signs of bile outflow disturbance are completely eliminated. In case of severe pain, it is advisable to treat the child in a hospital for 10-14 days, and then in a local sanatorium.

Timely diagnosis of biliary tract dysfunctions and proper treatment of children, depending on the type of disorders detected, can prevent the formation of further inflammatory diseases of the gallbladder, liver, pancreas and prevent early stone formation in the gallbladder and kidneys.

Prevention

To prevent pathology from developing, follow these rules:

• a full night's sleep of at least 8 hours;
• go to bed no later than 11 pm;
• alternate mental and physical work;
• walks in the fresh air;
• eat well: eat more plant foods, cereals, boiled animal products, less -
• fried meat or fish;
• exclude traumatic situations.

Secondary prevention (that is, after the occurrence of biliary dyskinesia) consists of its earliest detection, for example, with regular preventive examinations. Biliary dyskinesia does not reduce life expectancy, but affects its quality.