Gallstone disease symptoms, treatment without surgery and diet. Cholelithiasis

Cholelithiasis attack what to do? This problem is usually faced by people aged 40 and over. However, the pathology begins to develop 10-15 years before the onset of symptoms. Doctors call this the latent stage. Concrements have already formed in the gallbladder, but have not yet overflowed it, have not begun to clog the ducts. When the process starts, patients suffer from pain. How to deal with the situation at home and under what circumstances should an ambulance be called?

What are the reasons for the attack? You may not feel the gallbladder before it. At the time of the attack, pain begins in the area of \u200b\u200bthe organ (in the right hypochondrium).

Doctors say they are called by:

1. Physical exercise. Lifting weights or changing body positions is the most common cause of an attack. A long stay of the body in a tilted position also leads to a shift in the conglomerate.
2. Finding the patient in a stressful state. It provokes spasms of the muscles of the gallbladder. Compressing, the walls of the organ push out the accumulated stones.
3. Drinking a lot of fluids. Its excess leads to the dilution of bile. Having become more fluid, the secret picks up calculi, carrying them to the ducts, like grains of sand.
4. The presence of a viral infection in the body. In this case, an attack of gallstone disease is caused by a general weakening of the immune system, inflammatory processes.
5. Violation of the recommended diet. The patient's condition worsens when eating fatty or fried foods. Also, the cause of seizures is drunk alcoholic drinks.

An attack of gallstone disease is a condition when a stone begins to move in the patient's ducts. This is due to increased bile flow or spasms. In order not to provoke them, patients should not eat foods that activate the work of the gastrointestinal tract and liver. Any pressure on the organ also leads to colic.

An attack in the diagnosis of gallstone disease is observed in pregnant women in the third trimester. During this period, the fetus presses on internal organsinterfering with the normal movement of bile.

Typical and atypical seizure patterns

Pain in cholelithiasis manifests itself in the area of \u200b\u200bthe right hypochondrium. However, there are also atypical symptoms.

An attack of gallstone disease can take several forms:

1. Dyspeptic. There are practically no painful sensations. The patient periodically feels nausea and a bitter taste in the mouth. The patient has a disruption of the digestive system, profuse gas formation, heartburn and belching.
2. Pain torpid form. Dyspeptic symptoms are also present here. Added to them are pain in the stomach and right hypochondrium. In some cases, it is given to the right shoulder and under the scapula. The sensation is aching in nature with periodic intensification.
3. Painful paroxysmal form of the disease. The sensations are acute. Pain during an attack is localized in the right hypochondrium, giving in to the entire right half of the body, up to the jaws. The attack begins suddenly and also ends. The pains last from several hours to 2-3 days.

How to relieve gallbladder pain, every patient with a diagnosis of gallstone disease should know. But in order to fulfill the doctor's recommendations, it is necessary to accurately recognize the pathology. There are also atypical signs of an attack of gallstone disease.

With atypical symptoms, pain radiates to the left side of the body. In this case, the signs are easily confused with the manifestations of angina pectoris. An increase in temperature is also referred to atypical manifestations. The latter testifies to the concomitant movement of stones with inflammation.

The initial diagnosis of gallstone disease largely depends on the patient's own feeling. Without fail, along with pain, manifestations of the disease are associated with disruption of the gastrointestinal tract.

Stool disorders, flatulence, nausea, and other signs clearly indicate the presence of problems with conglomerates in gallbladder... Sometimes the patient develops skin problems. How does an attack of gallstone disease manifest itself on the integument of the body? Jaundice and itching. This is a reaction to the intoxication of the body with bile.

Emergency help

What to do with an attack of gallstone disease? The first step is to relieve symptoms. For this, there are both medicinal and traditional methods. Further, it is advisable to visit a doctor.

Relief of colic drugs

To relieve an attack of gallstone disease, use the following methods:

• observe complete rest;
• take pain relievers and medicines to relieve spasms;
• promote vasodilation;
• they drink a lot of warm, boiled water.

Taking pills alone often cannot relieve pain in the gallbladder. How can this be explained? Medicines are not able to make a person stop moving sharply, lift weights, or play sports. Meanwhile, the movement of stones is often provoked by physical activity. Medication will relax the muscles. But the patient needs to "help" the drugs, keeping calm. You need to lie down with your legs extended.

It is advisable that a relative or close person is nearby during colic. In an emergency, he can call an ambulance medical assistance

Preparations for relieving an attack of gallstone disease are used only as prescribed by the attending physician. Doctors recommend using proven remedies. Various antispasmodics are used. Often prescribed No-shpu, Drotaverin, Platifilin, Papaverin. It can be not only tablets, but also solutions for injections. Injections are more effective because they deliver faster active ingredients into the blood.

They are taken for gallstones and pain relievers, anti-inflammatory drugs. They also come in tablets and liquid.

After an attack, health will support curative fasting. You must refuse food for at least 12 hours. After that, the diet for 2-3 days consists of fresh vegetable-based soups. Instead of tea, a rosehip decoction is used. After 3 days, the diet is expanded. Low-fat dairy products are added, rye bread, cereals and non-sour vegetables.

If the attack does not recur, then the variety of dishes increases, but in strict accordance with the diet. It is better to add foods gradually, observing the reaction of the body. If it is negative, the added product is eliminated from the diet.

Seeing a doctor

An attack of gallstone disease is stopped at home. But it is still desirable to be examined by a doctor. First aid for an attack of gallstone disease ─ its profile.

The disease gives serious complications:

1. Inflammation of the gallbladder. The complication requires medical intervention that uses antibiotics.
2. Peritonitis. This inflammation abdominal cavity, can be fatal.
3. Pancreatitis A disease in which bile is not released into the duodenum.
4. Renal or hepatic impairment.

The described complications affect the general condition of a person and lead to serious health consequences. For this reason, visiting a doctor for attacks of gallstone disease is mandatory. This is especially true in cases in which pain does not go away for a long time, even after using the recommended medications and observing rest.

Prevention of exacerbation of gallstone disease

The disease has periods of exacerbation and remission. How to relieve an attack with gallstone disease is described above. How to prevent aggravation? How to make sure that there are no seizures and complications of cholelithiasis? The most reliable way is surgical intervention. Removal of stones from the gallbladder is one hundred percent guarantee of the absence of pain and other symptoms. But surgery is risky and contraindicated.

It is easier to control your health with a diet for gallstone disease.

The patient adheres to certain rules:

• food should not be fatty;
• excluded spicy foods - turnips, onions, garlic, horseradish and dishes with the addition of a large amount of seasonings;
• any smoked meats are excluded;
• instead of coffee and strong tea, herbal decoctions or juices are included in the diet for gallstone disease;
• eggs are allowed to be consumed, but not more than one per day;
• to provide the body with proteins, low-fat dairy products are introduced into the diet;
• there should be a lot of vegetables on the table, primarily zucchini, carrots, cauliflower and pumpkin;
• should limit the use of white flour baked goods.

Avoiding weight gain is also important to prevent seizures. Overweight people suffer from gallstone disease more often than slender people. However, doctors associate this with addictions in food.

Not only diet, but also moderate exercise helps to keep weight under control. In addition to them, it is necessary to give up bad habits. This is especially true for the use of alcoholic beverages. Alcohol has a detrimental effect on the functioning of the liver and gallbladder.

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

Not all people imagine the exact location of internal organs. Usually, understanding comes with a problem. Violation of the production of necessary substances, including bile, which promotes the breakdown of fats, leads to pathological changes affecting all internal systems. Therefore, in case of problems with the gastrointestinal tract, it is important to know where is the gallbladder and how it hurts.

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

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

The main function of bile is to break down fat components that are absorbed by the body. This promotes quality assimilation nutrients, screening out harmful components, synthesis of protein cells. The secretion of bile stimulates the normal functioning of the stomach cavity, intestines, and promotes optimal production of enzymes by the pancreas.

Another important feature of bile is the protection of the intestinal microflora from penetration, reproduction of pathogenic microorganisms in it.

Location of the gallbladder

Before making assumptions about why pain in the gallbladder may occur, it is necessary to become familiar with its location in the body. Some do not even think about the possible causes of pain, taking pain relievers in the hope of relieving the discomfort. This is a wrong decision, because, before stopping the pain syndrome, you need to have an idea of \u200b\u200bthe structure of the organ and its location.

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

On a note! With physiological changes anatomical structure in some people, the liver is just below the standard level. In this case, the gallbladder is located in the area of \u200b\u200bthe intestinal loops.

Standard organ sizes:

• pear-shaped, without partitions, bends;
• the length of the gallbladder is from 7 to 12 cm;
• volume 40-60 ml.

The main task of the gallbladder is to accumulate bile, excreting it into the intestinal area if necessary. For two days in a normal, healthy body, up to 2 liters of bile are produced and secreted.

Anatomical structure of the gallbladder

The body can be conditionally divided into three component parts:

• bottom;
• organ neck;
• main body.

The bottom is clearly visible with ultrasound examination, since it is noticeably allocated from the main body of the gallbladder. The body is located between the hepatic duct and the bottom, it is the widest part of the organ. The cervix is \u200b\u200bthe narrowest structure that participates in the connecting process of the liver duct with the gallbladder.

The hepatic duct plays the role of a transporter of biological exudate (bile), in length it can reach 4 cm. Inside the bladder, up to 50 ml of bile substance can be simultaneously contained. When the need arises, bile is released through the small duct. Stimulates the release of fluid by a signal transmitted along the nerve fibers by the digestive system at the moment food enters the esophagus. The excretory duct is called the flow-pancreatic ampulla.

The main components of the gallbladder are:

• internal epithelial tissue;
• mucous membrane;
• external serous wall.

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

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

Video: Anatomy of the gallbladder, bile ducts and Kalo triangle

Features of the manifestation of pain, place of localization

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

Violation of the organ contributes to the temporary accumulation of a certain amount of bile in it. It goes through the stages of concentration and crystallization. Accumulating mainly in the area of \u200b\u200bcholesterol, stones are formed. It can be either a single stone clot or multiple accumulations of neoplasms. When stones pass through the ducts of the biliary tract, a person may experience pain of increased intensity.

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

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

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

Additional symptoms of pathology are:

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

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

The nature of pain depending on the pathology

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

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

For more information on pain syndromes:

Disease	Picture	Symptoms
		An inflammatory process that forms in the mucous membrane of an organ. The main causes of pathology are not proper nutrition, diseases of the biliary tract (the presence of stones in the bladder), inflammatory processes that develop in adjacent organs. In acute development, the following conditions are present: · Cutting sensations in the liver; Hyperthermia (up to 39-40 degrees); · Pathological changes in the digestive system (nausea, vomiting, belching, stool disorder); Drying of the mucous membrane of the oral cavity; • febrile conditions; · Increased fatigue. In the chronic stage of the disease there are remissions, relapses. At the initial stage of the disease, there is practically no discomfort, periodic attacks of nausea, weakness, dull pain in the right hypochondrium are possible
		The development of the disease is facilitated by metabolic disorders in the body, a modification of the consistency of bile, unbalanced nutrition, insufficient physical activity, increased body weight, hormonal imbalance. The intensity of the pain syndrome directly depends on the number, scale of stones in the bladder, and the place of localization. The initial stages of the disease are characterized by a sluggish current symptomatology, which subsequently increases significantly. In this case, the following signs of pathology appear: · Slight cutting sensations in the right side of the hypochondrium, radiating to the scapular region, shoulder joint, arm; • urge to vomit; • feeling of fullness in the abdomen, increased gas production; · Bitter taste in the mouth. During the overlap of the biliary tract by stony substances, a sharp, unbearable painful sensation arises, which intensifies during a sigh, a change in body position. Quite often, this condition is accompanied by nausea, the release of vomit. Excessive physical exertion, shaking while riding in public transport, sharp turns of the body can provoke unpleasant symptoms
		Pathology is a violation of the discharge of secretory fluid due to a malfunction of the biliary tract, the organ itself. The disease is provoked by frequent stressful situations in which the patient is, hard physical labor, lack of diet. The initial stage of the disease is not characterized by particularly pronounced symptoms. Further development manifests itself in the following conditions: · Pain of a pulling, aching character, localized in the right hypochondrium; · Persistent loss of appetite; • the presence of belching, accompanied by a bitter taste; · Nauseous conditions; Bloating
		This pathology indicates a decrease in the functional abilities of the organ. The following pathologies contribute to bending: · Congenital abnormalities of the anatomical structure; Deformation, displacement of adjacent organs as a result of excessive physical exertion; · Pathological enlargement of the liver. Pathology is accompanied by conditions such as: · Cuts in the lower abdomen; • urge to vomit; General intoxication of the body, accompanied by nausea, weakness; · Increased sweating; · The accumulation of gases in the intestines. The onset of pathology provokes the development of pancreatitis, gastric ulcer, the formation of erosions on the mucous membranes of the stomach, cholelithiasis. The disease is dangerous with the risk of cracks that can release secretory fluid into the abdominal cavity
		Symptoms characteristic of cancerous growths are manifested depending on the severity of the pathology. At the first stages of the development of oncological diseases, pain is absent. Subsequent stages are characterized by the following symptoms: Pronounced pain sensations that cannot be stopped by taking antispasmodic drugs; • disruption of the gastrointestinal tract, accompanied by intestinal upset; Yellowing of the skin; · Sharp weight loss; Accumulation of free fluid in the abdominal cavity, accompanied by a sharp deterioration in the general condition of the patient

Diagnostic methods

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

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

Ultrasound of the gallbladder - the norm

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

Video: Gallbladder, how to determine if there is a pathology

Treatment options

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

Drugs that reduce spastic conditions:

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

Choleretic drugs:

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

Antibiotics:

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

Physiotherapy procedures are also carried out:

• taking baths with the addition of pine extract;
• conducting UHF therapy in the hypochondrium;
• the use of electrophoresis with Papaverine, Platyphyllin.

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

Traditional medicine

An effective treatment is the use of funds traditional medicine.

Folk remedies recipes:

1. A good way to dissolve hepatic secretions is to take 30 ml of olive oil 3 times a day for 3 days. The oil should be taken half an hour before a meal, after which it should be washed down with 30 ml of grapefruit or lemon juice.
2. Eating raw yolks helps cleanse the gallbladder. To do this, in the morning it is recommended to separate the yolks of two chicken eggs from the whites, drink it on an empty stomach, washed down with juice squeezed from 2 lemons. The duration of therapy is 2 weeks. With high cholesterol, the method is contraindicated.
3. Cleansing the gallbladder with rose hips. For cooking medicinal composition it is necessary to clean, cut the root of the plant, into 2 tbsp. spoons of the product, add 220 ml of boiling water, then boil the contents over low heat for half an hour. Strain, divide into 3 doses, use in small sips throughout the day. The course of treatment is 2 weeks.

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

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

Is a disease accompanied by the formation of stones in the gallbladder (cholecystolithiasis) or in the bile ducts (choledocholithiasis). Stones are formed as a result of the deposition of bile pigments, cholesterol, certain types of proteins, calcium salts, infection of bile, its stagnation, and lipid metabolism disorders. The disease may be accompanied by pain in the right hypochondrium, biliary colic, jaundice. Surgery is required. Pathology can be complicated by cholecystitis, fistula formation, peritonitis.

General information

- a disease characterized by a disorder in the synthesis and circulation of bile in the hepatobiliary system as a result of impaired cholesterol or bilirubin metabolism, as a result of which stones (calculi) are formed in the bile ducts and gallbladder. Pathology is dangerous by the development of severe complications with a high probability of death. The disease develops much more often in women. The treatment is carried out by specialists in the field of clinical gastroenterology and abdominal surgery.

Causes

In case of violation of the quantitative ratio of bile components in the body, solid formations (flakes) are formed, which, with the course of the disease, grow and merge into stones. The most common cholelithiasis occurs with impaired cholesterol metabolism (excess cholesterol content in bile). Bile oversaturated with cholesterol is called lithogenic. Excess cholesterol is formed due to the following factors:

• With obesity and the use of a large amount of cholesterol-containing foods.
• With a decrease in the amount of bile acids entering the bile (decreased secretion during estrogenism, deposition in the gallbladder, functional insufficiency of hepatocytes).
• With a decrease in the amount of phospholipids, which, like bile acids, prevent cholesterol and bilirubin from solidifying and settling.
• With congestion in the bile circulation system (thickening of bile due to the absorption of water and bile acids in the gallbladder).

Stagnation of bile, in turn, can be mechanical and functional. With mechanical stagnation, there is an obstacle to the outflow of bile from the bladder (tumors, adhesions, kinks, enlargement of nearby organs and lymph nodes, scars, inflammation with wall edema, strictures). Functional disorders are associated with a disorder of the motility of the gallbladder and biliary tract (hypokinetic biliary dyskinesia). Also, infections, inflammation of the organs of the biliary system, allergic reactions, and autoimmune conditions can lead to the development of gallstone disease.

Risk factors for the development of gallstone disease are elderly and senile age, taking medications that interfere with the exchange of cholesterol and bilirubin (fibrates, estrogens during menopause, ceftriaxone, ocreotide), genetic factors (gallstone disease in the mother), nutritional disorders (obesity, sudden weight loss, starvation , increased cholesterol and high-density blood lipoprotein levels, hypertriglycerinemia).

The likelihood of developing pathology is increased by multiple pregnancies, metabolic diseases ( diabetes, fermentopathy, metabolic syndrome), diseases of the gastrointestinal tract (Crohn's disease, diverticula of the duodenum and bile duct, infection of the biliary tract), postoperative conditions (after resection of the stomach, stem vagoectomy).

Pathology

Gallstones are diverse in size, shape, there can be a different number (from one calculus to hundreds), but they are all subdivided according to their predominant component into cholesterol and pigment (bilirubin) ones.

Cholesterol stones yellow color, consist of undissolved cholesterol with various impurities (minerals, bilirubin). Almost the vast majority of stones are of cholesterol origin (80%). Pigmented stones of dark brown to black color are formed with an excess of bilirubin in bile, which happens with functional disorders of the liver, frequent hemolysis, infectious diseases of the biliary tract.

Classification

According to the modern classification, gallstone disease is divided into three stages:

• Initial (pre-stone)... It is characterized by changes in the composition of bile) does not manifest itself clinically, it can be detected when biochemical analysis composition of bile.
• Forming stones... Latent stone carriage is also asymptomatic, but with instrumental diagnostic methods, it is possible to detect calculi in the gallbladder.
• Clinical manifestations... It is characterized by the development of acute or chronic calculous cholecystitis.

Sometimes a fourth stage is distinguished - the development of complications.

Symptoms of gallstone disease

The symptomatology is manifested depending on the location of stones and their size, the severity of inflammatory processes and the presence of functional disorders. A characteristic pain symptom in cholelithiasis is biliary or hepatic colic - pronounced acute, sudden pain under the right edge of a cutting, stabbing nature. After a couple of hours, the pain finally concentrates in the projection area of \u200b\u200bthe gallbladder. It can radiate to the back, under the right shoulder blade, to the neck, to the right shoulder. Sometimes radiation to the heart area can cause angina pectoris.

Pain often occurs after eating spicy, spicy, fried, fatty foods, alcohol, stress, heavy physical exertion, prolonged work in an inclined position. The causes of pain syndrome are spasm of the muscles of the gallbladder and ducts as a reflex response to irritation of the wall by calculi and as a result of hyperextension of the bladder with excess bile in the presence of obstruction in the biliary tract. Global cholestasis with blockage of the bile duct: the bile ducts of the liver expand, increasing the organ in volume, which responds with a painful reaction of the overstretched capsule. Such pain has a constant dull character, often accompanied by a feeling of heaviness in the right hypochondrium.

The accompanying symptoms are nausea (up to vomiting, which does not bring relief). Vomiting occurs as a reflex response to irritation of the peri-papillary region of the duodenum. If the inflammatory process has captured the tissue of the pancreas, vomiting may be frequent, with bile, indomitable. Depending on the severity of intoxication, there is an increase in temperature from subfebrile numbers to severe fever. When the common bile duct is blocked by calculus and the sphincter of Oddi is obstructed, obstructive jaundice and discoloration of feces are observed.

Complications

Most frequent complication Gallstones are inflammation of the gallbladder (acute and chronic) and obstruction of the biliary tract with calculus. Blockage of the bile duct in the pancreas can cause acute biliary pancreatitis. Also, a frequent complication of gallstone disease is inflammation of the bile ducts - cholangitis.

Diagnostics

If symptoms of hepatic colic are detected, the patient is referred for consultation with a gastroenterologist. Physical examination of the patient reveals symptoms characteristic of the presence of calculi in the gallbladder: Zakharyin, Ortner, Murphy. Skin soreness and muscle tension are also determined. abdominal wall in the projection area of \u200b\u200bthe gallbladder. Xanthems are noted on the skin, with obstructive jaundice, a characteristic yellow-brownish color of the skin and sclera.

A general blood test during the period of clinical exacerbation shows signs of nonspecific inflammation - leukocytosis and a moderate increase in ESR. Biochemical blood test reveals hypercholesterolemia and hyperbilirubinemia, increased activity alkaline phosphatase... With cholecystography, the gallbladder is enlarged, has calcareous inclusions in the walls, the stones with lime inside are clearly visible.

The most informative and most widely used method of examining the gallbladder is abdominal ultrasound. It accurately shows the presence of echo-tight formations - stones, pathological deformations of the walls of the bladder, changes in its motility. On ultrasound, the presence of signs of cholecystitis is clearly visible. Also, MRI and CT of the biliary tract allows visualization of the gallbladder and ducts. They are informative in terms of detecting violations of the circulation of bile, they can always be transferred to an open abdominal operation in case of technical need.

There are methods for dissolving calculi using ursodeoxycholic and chenodeoxycholic acid preparations, but this kind of therapy does not lead to a cure for gallstone disease and, over time, the formation of new stones is possible. Another method of destruction of stones is shock wave lithotripsy - it is used only in the presence of a single calculus and in patients who do not suffer from acute inflammation of the gallbladder or ducts.

Forecast and prevention

The prognosis directly depends on the rate of formation of stones, their size and mobility. In the overwhelming majority of cases, the presence of stones in the gallbladder leads to the development of complications. If successful surgical removal gallbladder - a cure without pronounced consequences for the quality of life of patients. Prevention consists in avoiding factors contributing to increased cholesterolemia and bilirubinemia, bile stasis.

Balanced nutrition, normalization of body weight, an active lifestyle with regular physical activity allow to avoid metabolic disorders, and timely detection and treatment of pathologies of the biliary system (dyskinesias, obturations, inflammatory diseases) reduces the likelihood of bile stasis and sedimentation in the gallbladder. Particular attention should be paid to the metabolism of cholesterol and the state of the biliary system to persons with a genetic predisposition to stone formation.

In the presence of stones in the gallbladder, the prevention of attacks of biliary colic will be following a strict diet (excluding fatty, fried foods, muffins, pastry creams, sweets, alcohol, carbonated drinks, etc. from the diet), normalizing body weight, consuming a sufficient amount of liquid. To reduce the likelihood of movement of calculi from the gallbladder along the ducts, work associated with a prolonged stay in an inclined position is not recommended.

Today, almost everyone can find symptoms of gallstone disease, regardless of age and lifestyle. Moreover, this pathology has become "younger" and manifested itself much more often than before. If earlier it was found most often in people over 40, now it can be found even in young guys and girls. There may be many reasons for this.

What is the disease?

Before considering the symptoms of gallstone disease, it is imperative to find out the mechanism of its development. Pathology can be chronic or acute. It develops gradually. It is characterized by the appearance of small or large stones in the bile ducts and bladder. This process is quite long.

The formation of stones begins with the fact that bile thickens. Granules appear in it, on which molecules of undigested calcium and cholesterol are deposited. It should be noted that stones can be multiple or single. They also come in different sizes. When they begin to move, an acute attack occurs, which is accompanied by a very severe pain syndrome.

Signs of gallstone disease may not appear immediately, that is, the pathology develops for a certain time. In addition, large elements can “sit” in the ducts for a long time and not move anywhere. Although this also causes a lot of problems. It should be noted that this disease is very common, and the number of cases is constantly growing.

It must be said that there are several types of stones:

• pigmented;
• cholesterol;
• calcareous;
• pigment cholesterol;
• complex stones, consisting of the above three components.

The causes of the appearance of pathology

Before considering the symptoms of gallstone disease, you need to understand why it happens at all. So, among the reasons contributing to the development of pathology, the following can be distinguished:

• age (after 40 years, the nervous and humoral systems of the body begin to act differently on the internal organs, less effectively);
• high weight (especially if a person eats too fatty, spicy foods rich in cholesterol);
• metabolic disorders in the body;
• improper nutrition;
• unsuitable climate and bad ecology;
• infection of the biliary tract (in them cholesterol precipitates, which then accumulates, ramps and turns into stones);
• insufficient amount of acids that are capable of dissolving lipids;
• any other pathologies of internal organs (physiological, infectious or inflammatory).

Signs of pathology

The symptoms of gallstone disease are not specific, so it is difficult to recognize it at first. An accurate diagnosis can only be made by a doctor. However, the disease manifests itself as follows:

There are other signs of cholelithiasis: allergic reactions, increased fatigue, sleep disturbance and lack of appetite, lethargy. I must say that they can appear singly or simultaneously.

Diagnosis of the disease

Symptoms of gallstone disease in adults cannot give a complete picture, which is necessary for the appointment of adequate treatment. Naturally, you will have to visit an experienced doctor who will carry out the entire range of diagnostic measures. They help to establish the size of stones, the degree of development of pathology, its type.

Various instruments are used for diagnosis, both technical and clinical. In the second case, the doctor palpates the gallbladder and ducts, in which the patient may feel discomfort and pain. In addition, colic may be accompanied by the discharge of very small stones, which also indicates the presence of the disease.

During the diagnosis, the symptoms of gallstone disease in adults and children (if any) are taken into account. In addition, the patient will need to undergo the following procedures:

• ultrasound examination of internal organs;
• analysis of blood and urine (for the content of duodenal elements, cholesterol, bilirubin, fat metabolism and alpha-amylase activity);
• a thorough analysis of the patient's medical history and the history of his family;
• analysis of feces (in it you can often see which elements of food are not digested);
• examination of the inner surface of the stomach, duodenum and esophagus (esophagogastroduodenoscopy);
• cholangiopancreatography (examination of the bile ducts from the inside using a duodenofibroscope);
• computed tomography of internal organs;

It is necessary to take into account the non-specificity of the symptoms, therefore the diagnosis should be made as accurately as possible. Otherwise, the doctor may simply treat the wrong disease, which will lead to unpredictable consequences.

Features of the course of an acute attack and first aid

This pathology can develop gradually, but the time will come when it will make itself felt. Therefore, you must know how to relieve an attack of gallstone disease. I must say that a person feels worst of all at the moment when solid particles begin to move along the ducts and clog them. In this case, severe pain and other symptoms appear. Moreover, most often the attack occurs at night. It usually lasts up to 6 hours. If you have an attack of gallstone disease, you must know what to do. So, you will have to take the following measures:

1. A heating pad or warm compress should be applied to the gallbladder. As a last resort, it is necessary to organize a warm bath to reduce pain and relieve the condition.
2. Now you need to take any pain reliever that can relieve spasms (Atropine, Papaverine, No-shpu).
3. It is imperative to call an ambulance and hospitalize the victim. Moreover, you need to go to the hospital if an exacerbation of pathology occurs. It is in the hospital that you can spend all necessary diagnostics and carry out surgery (if absolutely necessary).
4. Along with pain relievers, you must take anti-inflammatory and antibacterial drugs.

I must say that timely measures taken can significantly alleviate the patient's condition. Now you know how to relieve an attack of gallstone disease. However, this does not mean that the pathology does not need to be treated.

Features of the treatment of pathology

Now you can figure out how to deal with this problem using traditional, unconventional and radical methods. Let's start with the first ones. Treatment of gallstone disease should be comprehensive. That is, it is not enough to simply remove stones from the ducts and bladder. It is necessary long time carry out drug therapy, observe a certain diet, follow the instructions of doctors.

Specialists use various drugs for cholelithiasis:

1. To eliminate pain, intramuscular and intravenous analgesics are used (Talamonal, analgin solution). In extreme cases, narcotic substances: morphine, "Promedol".
2. To eliminate spasms in the ducts, it is necessary to use drugs "Papaverine" or "No-shpa", and under the skin. To improve the circulation of bile, you can use special drugs ("Cholenzym"). However, try not to use stronger medications, as this can lead to an acute attack that will result in surgery.
3. Treatment of gallstone disease is accompanied by the discharge of solid elements. For this, warm teas and heating pads are usually used.
4. If the pathology has already passed into the chronic stage, try to periodically undergo treatment courses prescribed by your doctor. For example, drugs such as "Liobil" and others are taken.

In any case, you cannot choose medicines yourself, since you can only harm yourself. It is better to consult with a specialist and undergo a thorough examination.

Features of treatment with folk remedies

Naturally, drug therapy is not a panacea and does not always help. Self-prepared substances can also enhance the effect. For example, treatment of gallstone disease folk remedies will significantly increase your chances of getting rid of the pathology, but you should not use them without the agreement of the doctor. So, the following recipes can be useful:

1. Red beet juice... Long-term use of this drink will help you quickly deal with stones. Moreover, they will dissolve completely painlessly. You can use not only juice, but also beetroot broth. To do this, the vegetable needs to be cooked for a long time. Please note that not all people like this drink.
2. Treatment of gallstone disease, folk remedies, in particular, can be done with mixture of different plants, each of which has its own specific action. For example, such a remedy can remove pain syndrome, cleanse internal organs, improve their blood supply: the roots of calamus, valerian and buckthorn, wild rosemary, mint, hawthorn, chamomile, lily of the valley and rose hips mixed in equal quantities. Before this, all plants should be crushed. The maximum amount of each herb is 5 grams. Next, pour the mixture with 1.5 liters of water and put on fire. The liquid should boil no more than five minutes. Also, let the product sit (about 6 hours). You need to take it several times a day, 100 ml. It is necessary to drink the remedy until complete recovery.
3. In order to eliminate stagnation of bile in the ducts, use a decoction of berries and leaves of wild strawberries. Take it three times a day in a glass.
4. Ordinary dill is also considered useful. To prepare the broth, you need two large spoons of seeds and 2 cups of boiling water. Next, the mixture must be put on fire. It should boil for no more than 12 minutes. Try to drink half a glass every day. Moreover, the liquid should be warm. It will take you several weeks to heal.
5. An infusion of chicory root will help you effectively dissolve stones and remove them from the body. To prepare a drink, take 60 grams of crushed raw materials and pour 200 ml of boiling water over it. The broth should be infused for at least 20 minutes. Then take the drink in small portions throughout the day. It is best if the broth is fresh every time.
6. Black radish juice and honey will help you clear your gallbladder and dissolve stones. Try to drink 1 tablespoon of the mixture on an empty stomach in the morning. After that, you can eat only after a quarter of an hour. Please note that this procedure is lengthy and takes at least six months.

Also, try to improve your bile secretion. To do this, take carrot and cabbage juice every day.

Indications for surgical intervention and types of operations

There are cases that it is impossible to use medications with gallstone disease or folk recipes they just don't help. In addition, acute attacks require the intervention of a surgeon. In this case, the stones are removed promptly. There are certain indications for intervention:

There are also contraindications to the operation: the patient's serious condition, any oncological diseases other organs, strong inflammatory processes in the body, as well as individual characteristics.

Removal of gallstones is done in several ways:

1. Traditional (laparotomy). To do this, the doctor must open the anterior abdominal wall and remove the bladder along with all its contents. Such an operation is performed in the event that the stones are too large or the organ will no longer perform the function assigned to it.
2. Laparoscopic. You do not need to cut the peritoneum for this. They simply make small holes in the bladder area and remove stones through them. At the same time, recovery after such an operation is much faster; there are practically no scars on the skin. That is, this type of intervention is used most often.

If you have gallstone disease, the operation can be performed without a scalpel. For example, now in medicine, specialized technical means are used that are capable of crushing the formed elements. This technique is called shock wave lithotripsy. This procedure is not possible everywhere. After the procedure, small stones are simply dissolved with the help of drugs and removed from the body.

Power features

For more effective treatment, the patient is prescribed diet No. 5. With gallstone disease, it is considered optimal. So, the calorie content of such a diet is about 2800 kcal daily. If the patient is obese, then these indicators can be reduced to 2300 kcal. You need to eat at least 5 times a day in small portions.

You need to drink clean water, and as much as possible (from two liters per day). Try not to drink carbonated water, alcohol is prohibited. Tea, juices, and herbal teas are best. Products for gallstone disease should be fresh and safe. It is forbidden to eat fatty, fried, smoked, spicy food, chocolate, canned food, sausages and semi-finished products, fish and meat broths. Also, try not to use garlic, peppers, fat, onions, sorrel, and excessive amounts of salt when cooking.

Allowed foods include bran bread, vegetables and fruits, low-fat dairy products, lean meats and fish. Moreover, the latter should be baked in the oven or steamed. Eat porridge and boiled eggs (no more than 1 per day). Use olive oil instead of sunflower oil. If you have a period of exacerbation, then the products should be grated.

You cannot prescribe a diet on your own. Try to consult with an experienced professional in the field, as well as your doctor. If you do not know what you can cook for gallstone disease, the recipes presented in this article will be very useful to you.

So, take 300 g of potatoes, 25 g of carrots, 19 g of butter, 350 g of water, 7 g of parsley and 25 g of onions. All vegetables must be boiled. Gradually add butter and parsley to the "soup". Chop carrots and potatoes.

Carrot and potato puree is useful and very tasty during illness. All vegetables must be boiled and poured (grind). Next, add a little milk and a little salt to the mixture. Now the puree can be brought to a boil and served.

Eggplant is a very useful vegetable in such a situation. It can be stewed in sour cream sauce. To prepare such a dish, take 230 g of eggplant, herbs, a little butter and salt. For the sauce, you will need 50 g of water, 50 g of sour cream, a little butter and flour. Cook the eggplant last. The sauce is made like this: fry flour in a preheated pan, add oil and water to it. The mixture should be boiled for about 20 minutes. Sour cream is added last. Now peel and chop the eggplant, salt it and let it sit for a few minutes to remove the bitterness. Next, put the pieces in a skillet and simmer a little over low heat. Finally, add the sauce to the eggplant and leave the dish to simmer for another 5 minutes. Enjoy your meal!

Disease prevention

It is imperative to treat the presented pathology, but it is best to prevent it. That is, you must follow all the necessary preventive measures to help you avoid the disease. Otherwise, it will take a long and painful treatment.

For example, try to maintain optimal body weight. Obesity only contributes to the appearance of this pathology and other health problems. Therefore, force yourself to move, do morning exercises, do gymnastics or any other active sport. Walk more, go hiking, run, ride a bike, swim.

Highly effective way prevention is balanced and proper nutrition. You should not overload your digestive tract, so do not overeat, try to give up unhealthy foods, meals and habits. For example, stop smoking, drinking alcohol, and eating in fast food establishments. Exclude spicy, fatty, smoked foods and canned food from the menu. Limit your intake of sweets, muffins, lard, oily fish, and other heavy foods. After all, what is not digested in the stomach turns into a harmful sediment, from which stones are subsequently formed. If you are unsure of how to properly calculate your diet, consult your dietitian. He will build you a nutritional system that will get rid of the threat of the appearance of the disease and bring your body into shape.

If you want to lose weight, then you need to do it very carefully so that the activity of body systems is not disturbed. You don't need to lose weight abruptly and quickly. It can only hurt.

However, if the disease does appear, it is necessary to urgently stop its development. That is, try not to delay treatment after the first symptoms are discovered and the correct diagnosis is made.

As for questions about removing stones, then you need to consult with your doctor. If necessary, you can get advice from other specialists in this area. Self-medication is not worth it, as the consequences can be very serious. It is better to combine all traditional and non-traditional ways to eliminate the disease under the supervision of a doctor. Be healthy!

Gallstone disease (GSD) is a pathological process accompanied by the formation of stones in the gallbladder.

The second name of the disease is calculous cholecystitis. Since gallstone disease affects an organ of the digestive tract (gallbladder), it is usually treated.

Features of gallstones

Concrements are the main manifestation of gallstone disease. They are composed of calcium, cholesterol, and bilirubin and come in a variety of sizes. With a small value, we are talking about the so-called "sand" in the gallbladder, but if the formations are large, they are considered full-fledged stones (calculi).

Such formations can grow in size over time. So, from a small grain of sand, a stone of 1 cm or more can appear. The calculus can have a different shape - from round or oval to polyhedron outlines. The same goes for the density of the stones. There are quite strong calculi, but there are also very fragile ones, capable of crumbling from one touch.

The surface of the stone can be flat, spike-like or porous (in cracks). These features are typical for all stones, regardless of their location. However, stones are often found in the gallbladder. Such an anomaly is called gallstone disease, or gallbladder calculus. Less commonly, stones are found in the bile ducts. This disease is called choledocholithiasis.

Concrements in the gallbladder can be either single or multiple. There can be dozens or even hundreds of them. However, it should be remembered that the presence of even one calculus can cause serious harm to health. Moreover, dangerous complications are often the result of small, rather than large, gallstones.

Reasons for the formation of stones

If, for some reason, the quantitative balance of the components that make up bile is disturbed, the formation of solid structures - flakes occurs. As they grow, they merge to form stones. Often the disease develops under the influence of the accumulation of excessive amounts of cholesterol in the bile. In this case, bile is called lithogenic.

Hypercholesterolemia can result from:

• obesity;
• abuse of fatty foods containing large amounts;
• reducing the amount of specific acids entering bile;
• reducing the amount of phospholipids that prevent hardening and sedimentation and cholesterol;
• stagnation of bile.

Bile stasis can be mechanical or functional. If we are talking about the mechanical nature of this deviation, then factors such as:

• tumors;
• adhesions;
• kinks of the gallbladder;
• enlargement of adjacent organs or lymph nodes;
• scarring;
• inflammatory processes accompanied by edema of the organ wall;
• strictures.

Functional failures are associated with impaired motility of the gallbladder itself. In particular, they occur in hypokinetic patients. In addition, the development of cholelithiasis can be the result of disorders in the work of the biliary system, infectious and allergic diseases, pathologies of an autoimmune nature, etc.

Classification

Gallstone disease is divided into several stages:

1. Physicochemical or pre-stone... This is the initial stage of the development of cholelithiasis. During its course, gradual changes in the composition of bile occur. No special clinical manifestations does not arise at this stage. Discover initial stage LCB is possible when conducting a biochemical study of the composition of bile.
2. The phase of latent (hidden) stone-carrying... At this stage, calculi in the gallbladder or its ducts are just beginning to form. The clinical picture is also not typical for this phase of the pathological process. It is possible to identify gallstone neoplasms only during instrumental diagnostic procedures.
3. The stage when the symptoms of the disease begin to appear brighter and more severe... In this case, we can talk about the development of acute calculous cholecystitis, or ascertain the fact of its transition into a chronic form.

In some sources, you can see a four-stage gradation of gallstone disease. The last, fourth, phase of the disease is characterized as such, in which concomitant complications of the pathological process develop.

Types of gallstones

Stones localized in the gallbladder can have different chemical composition... According to this criterion, they are usually divided into:

1. Cholesterol... Cholesterol is one of the components of bile, however, with an excess of it, calculi can form. This substance enters the human body along with food, and is evenly distributed throughout its cells, contributing to its full functioning. If there is a violation of the process of assimilation of cholesterol, it begins to accumulate in the bile, forming stones. Cholesterol stones are round or oval in shape, and can reach from 1 to 1.5 centimeters in diameter. Their location is often the bottom of the gallbladder.
2. Bilirubin... Bilirubin is a breakdown product of hemoglobin. Stones that form when it is in excess in the body are also called pigment stones. Bilirubin stones are inferior in size to cholesterol ones, but there may be more of them. At the same time, they affect not only the bottom of the gallbladder, but are also able to localize in the biliary tract.

Gallstones can have varying degrees of calcium saturation. It depends on how clearly the neoplasm can be seen on the screen of the ultrasound machine or on the X-ray. In addition, the choice of a therapeutic technique also depends on the degree of saturation of calculi with calcium. If the stone is calcified, it means that it will be much more difficult to deal with it with medication.

Depending on the size, gallstones are:

1. Small... The size of such neoplasms does not exceed 3 cm in diameter. With single stones, localized in the area of \u200b\u200bthe bottom of the gallbladder, the patient does not show any specific clinical symptoms.
2. Large... These are called stones, the diameter of which exceeds 3 cm. They interfere with the normal outflow of bile, and can cause attacks of biliary colic, or other unpleasant symptoms.

Not only the types, but also the size of calculi can affect the choice of therapeutic tactics for gallstone disease. Large stones, as a rule, are not subject to drug dissolution. They are also not crushed with ultrasound, since such a therapeutic approach is unlikely to give the expected results.

In this case, cholecystectomy is performed - an operation to remove the gallbladder along with the stones in it. If the calculi are small, more gentle treatment methods are considered.

In some cases, the attention of doctors can also be focused on the location of the neoplasms. Stones in the area of \u200b\u200bthe gallbladder floor rarely disturb the patient, since they are not characterized by any clinical picture.

If calculi are localized in the immediate vicinity of the neck of the diseased organ, this can cause obstruction of the bile duct. In this case, the patient will be disturbed by unpleasant symptoms, manifested by pain in the right hypochondrium and a violation of the digestive process.

Symptoms and signs of gallstone disease

Gallstone disease is a pathological process that can be absolutely asymptomatic for a long time. This is especially true of the initial stages of the disease, when the calculi are still too small, and therefore do not clog the bile ducts, and do not injure the bladder wall.

The patient may not be aware of the presence of the disease for a long time, that is, be a latent stone carrier. When the neoplasms reach a fairly large size, the first alarming signs of a pathological process in the gallbladder appear. They can manifest themselves in different ways.

The first symptoms of gallstone disease, which occur even before the onset of pain in the right hypochondrium, include:

• feeling of heaviness in the abdomen after eating;
• bouts of nausea;
• slight yellowing of the skin (obstructive jaundice).

Such a clinical picture occurs due to a violation of the process of bile outflow. Under the influence of such a failure, deviations in the work of the organs of the digestive tract occur.

The most common symptoms and signs of gallstone disease include:

1. , which signal the development of biliary colic. The duration of an attack can last from 10 minutes to several hours, while the pain can be acute, unbearable, and radiate to the right shoulder, other areas of the abdomen or back. If the attack does not go away within 5-6 hours, the patient may develop serious complications.
2. An increase in body temperature, indicating the development of an acute disease, which is a frequent companion of gallstone disease. Intense inflammation of the gallbladder leads to the active release of toxic substances into the blood. If there are frequent attacks of pain after biliary colic, and they are accompanied by fever, this indicates the development acute cholecystitis... If the temperature rises are temporary, and the thermometer reaches 38 ° C, this may indicate the occurrence of cholangitis. But, nevertheless, the temperature is not a mandatory sign of LCD.
3. The development of jaundice. This anomaly occurs due to prolonged stagnant processes due to a violation of the outflow of bile. First of all, the eye sclera turn yellow, and only then the skin. In people with fair skin, this symptom is more noticeable than in dark-skinned patients. Often, along with yellowing of the skin and whites of the eyes, patients change color and urine. It acquires a dark hue, which is associated with the release of large amounts of bilirubin by the kidneys. With calculous cholecystitis, jaundice is only an indirect, but not mandatory symptom. In addition, it can become a consequence of other diseases - cirrhosis, hepatitis, etc.
4. Acute body response to fat intake. Under the influence of bile, lipids are split and absorbed into the blood. If, with gallstones, stones are near the neck or bile duct, they simply block the path of bile. As a result, it cannot circulate normally in the intestines. A similar anomaly causes diarrhea, nausea, flatulence, dull pain in the abdomen. But these symptoms are not specific manifestations of cholelithiasis, since they are found in most gastrointestinal diseases. Intolerance to fatty foods can occur at different stages of the development of gallstone disease. However, even a large calculus, if it is at the bottom of the diseased organ, is not an obstacle to the outflow of bile. Therefore, fatty foods will be digested and absorbed quite normally.

If we talk about the general symptoms of cholelithiasis, then it can be quite varied. Possible different in intensity and nature of abdominal pain, indigestion, nausea, sometimes with bouts of vomiting. But since the clinic of the disease is typical for many pathologies of the gastrointestinal tract, experienced doctors always prescribe an ultrasound of the gallbladder in order to understand the cause of the patient's discomfort.

Diagnostics

If there are symptoms characteristic of biliary colic, you should immediately consult a specialist. First of all, a physical examination and collection of anamnesis is carried out, based on finding out exactly what symptoms the patient suffers from.

On palpation of the abdomen, there is tension and soreness of the skin in the muscles of the abdominal wall in the immediate vicinity of the diseased gallbladder. In addition, the doctor notes that the patient has yellowish spots on the skin, which arise as a result of lipid metabolism disorders, yellowing of the eye sclera and skin.

But the physical examination is not the main diagnostic procedure. This is a preliminary examination that gives the physician a basis for referring the patient to specific examinations. In particular:

1. ... In the presence of an inflammatory process in the gallbladder, a moderate increase in ESR and pronounced leukocytosis will be noticed in the test results.
2. ... When the doctor deciphers the data, an increased level of cholesterol and bilirubin is noted against the background of abnormal alkaline phosphatase activity.
3. Cholecystography. This diagnostic technique helps to accurately study the state of the gallbladder. During the procedure, an increase in the organ and the appearance of lime inclusions on its walls are revealed. With the help of cholecystography, lime stones located inside the diseased organ are found.
4. Ultrasound of the abdominal cavity is the most informative diagnostic technique for suspected development of gallstone disease. In addition to detecting neoplasms, specialists note the deformation of the gallbladder wall. Also, negative changes in the motility of the diseased organ are recorded. It is clearly visible on ultrasound and signs characteristic of cholecystitis.

A thorough study of the state of the gallbladder is also possible with an MRI or CT scan. No less informative diagnostic technique, during which violations in the circulation of bile are detected, is scintigraphy. The method of retrograde endoscopic cholangiopancreatography is also widely used.

Complications

The formation of calculi in the gallbladder is fraught not only with impaired motility of the diseased organ. ZhKD can have an extremely negative impact on the functioning of other organs, especially those that are in the immediate vicinity of the GB.

So, the edges of the stones are able to injure the walls of the bladder, causing the development of inflammatory processes in them. In severe cases, neoplasms block the entrance and exit of the bile, thereby making it difficult for the outflow of bile. With such deviations, stagnant processes begin to occur, entailing the development of inflammation. This process can take from several hours to several days, but sooner or later it will definitely make itself felt. The extent of the lesion and the intensity of the pathological phenomenon may be different.

So, it is possible the formation of a slight edema of the wall of the gallbladder, or its destruction. The consequence of this dangerous process is the rupture of the diseased organ. A similar complication of gallstone disease directly threatens the patient's life.

The spread of the inflammatory process to the abdominal organs is fraught with the development of peritonitis. A complication of this condition can be infectious toxic shock or multiple organ failure. With its development, there are serious disruptions in the functioning of the heart, kidneys, blood vessels and even the brain.

If the inflammation is too intense, and pathogens release excessive amounts of toxins into the bloodstream, ITS may appear immediately. Under such circumstances, even immediate resuscitation measures are not a guarantee of the patient's recovery from a dangerous state and the prevention of death.

Treatment of gallstone disease

Treatment of pathology can be conservative and surgical. As a rule, therapeutic techniques are used to begin with. These include:

1. Dissolving gallstones with special medications. In particular, chenodeoxycholic and ursodeoxycholic acids. This technique is effective only for single cholesterol stones. If the patient has no contraindications, such therapy is prescribed for a year and a half.
2. Extracorporeal shock wave lithotripsy - conservative method treatment of gallstones, involving the use of a shock wave, which leads to the destruction of gallstones. Such a wave is created using special medical devices. Such treatment of gallstones is carried out only with cholesterol stones of small size (up to 3 cm). The procedure practically does not cause pain and is quite easily tolerated by patients. Pieces of stones are removed from the body during bowel movements.
3. Diet. This is one of the foundations for successful recovery and removal of unpleasant symptoms. Throughout the course of diet therapy, you must follow the rules fractional nutrition... Food should be taken 4-6 times a day in small portions. Fatty, spicy, fried, spicy foods, smoked meats, pickles, carbonated and alcoholic drinks, chocolate are necessarily excluded from the diet. The patient should refuse fatty meats and hot spices. A healthy diet for cholesterol is based on the use of dairy products and plant products. It is imperative to add wheat bran to the menu.

The most popular today is the surgical treatment of gallstone disease - cholecystectomy. It is carried out in 2 ways:

• classic;
• laparoscopic.

Only a surgeon can determine which type of operation is appropriate for each individual case. Cholecystectomy is mandatory for:

1. Numerous neoplasms in the gallbladder. In this case, the exact number and size of calculi do not play any role. If they occupy at least 33% of the diseased organ area, cholecystectomy is mandatory. It is not possible to crush or dissolve such an amount of calculi.
2. Frequent attacks of biliary colic. Pain with this deviation can be quite intense and frequent. They are removed with the help of antispasmodic drugs, but sometimes such treatment does not bring relief. In this case, doctors resort to surgical intervention regardless of the number of calculi and their diameter.
3. Presence of stones in the bile ducts. Obturation of the biliary tract conceals in itself a serious threat for the patient's health, and significantly worsens his well-being. The outflow of bile is impaired, the pain syndrome becomes more intense and obstructive jaundice develops. In such a situation, an operation is indispensable.
4. Biliary pancreatitis. - an inflammatory process that develops and proceeds in the tissues of the pancreas. The pancreas and the gallbladder are connected by one bile duct, therefore, a disruption in the work of one organ entails negative changes in the work of another. In some cases, calculous cholecystitis leads to a violation of the outflow of pancreatic juice. The destruction of organ tissue can lead to serious complications, and directly threatens the patient's life. The problem must be solved exclusively by surgery.

Mandatory operation is also required for:

1. Peritonitis. Inflammation of the abdominal organs and tissues of the peritoneum itself is a dangerous condition that can lead to death. The pathological process can develop when the gallbladder ruptures and bile infected with pathogenic microorganisms enters the abdominal cavity. In this case, the operation is aimed not only at removing the affected organ, but also at thorough disinfection of adjacent organs. Delaying the operation can be fatal.
2. Stricture of the bile ducts. The narrowing of the canal is called stricture. An intense inflammatory process can lead to such violations. They lead to stagnation of bile and its accumulation in the liver tissue, although the gallbladder can be removed. During surgical intervention, the surgeon's efforts are aimed at eliminating strictures. The narrowed area can be widened, or the doctor creates a bypass path for bile, through which it is excreted directly into the rectum. It is impossible to normalize the situation without surgical intervention.
3. Accumulation of purulent contents. When joining bacterial infection pus accumulates in the tissues of the gallbladder. The accumulation of pus within the gallbladder itself is called empyema. If the pathological contents are collected outside of it, without affecting the abdominal organs, then we are talking about the development of a paravesical abscess. Such anomalies lead to a sharp deterioration in the patient's condition. During the operation, the gallbladder is removed and the abscess is emptied, followed by careful treatment with antiseptics to prevent peritonitis.
4. Biliary fistulas are pathological openings located between the gallbladder (less often its ducts) and adjacent hollow organs. For such a deviation, any specific clinical picture is uncharacteristic, but it can significantly disrupt the outflow of bile, leading to its stagnation. In addition, they can cause the development of other diseases and digestive disorders. During the operation, pathological holes are closed, which helps to prevent unwanted complications.

In addition to the stage of pathology, size and composition of stones, big role the age of the patient and the presence of concomitant diseases play a role in the choice of a therapeutic technique. With intolerance to pharmacological agents drug treatment CLD is contraindicated for the patient. In this case, the only correct way out of this situation will be an operation.

But for elderly people with diseases of the cardiovascular system, kidneys or other organs, surgery can only harm. In this case, doctors try to avoid such treatment tactics.

As you can see, the choice of a therapeutic technique for gallstone disease depends on many factors. It is only the attending physician who can say for sure whether there is a need for an operation after all the necessary diagnostic measures have been taken.

Diet for gallstone disease

Power supply for LCD should be fractional. Food should be taken in small portions 4-6 times a day. Food temperature should not be less than 15 or more than 62 degrees Celsius. Prohibited products for ZhKB include:

• alcohol;
• legumes in any form;
• fatty dairy and fermented milk products;
• roast;
• spicy;
• salty;
• smoked;
• fatty fish and meat;
• caviar;
• sweets;
• canned food;
• mushrooms in any form;
• hot fresh bread, toast, croutons;
• spices, seasonings;
• marinade;
• coffee;
• chocolate products;
• cocoa;
• strong black tea;
• hard or salted cheese.

• dried bread made from 2 grade flour;
• low-fat cheeses;
• boiled, steamed or baked vegetables;
• finely chopped white cabbage (in limited quantities);
• baked or boiled lean meat;
• different types of cereals;
• vermicelli and pasta (within reasonable limits);
• jams and preserves;
• sweet fruits and berries;
• weak tea;
• sweet homemade juices;
• mousse;
• dried fruit compote;
• butter, which must be added to various dishes in an amount of no more than 30 g per day;
• low-fat varieties of fish (pike perch, pike, hake, etc.);
• whole milk. It can be consumed both in pure form and used for making cereals.

Low-fat cottage cheese and natural low-fat yoghurts are also allowed (preferably homemade).

Forecast and prevention of gallstone disease

To prevent the development of gallstone disease, it is necessary, if possible, to avoid factors that can cause the development of hypercholesterolemia and bilirubinemia. It is also important to exclude stagnant processes in the gallbladder and its ducts. This is facilitated by:

• balanced and nutritious food;
• physical activity;
• careful tracking of body weight, and, if necessary, its correction;
• timely detection and complete cure of diseases of the biliary system.

Particular attention should be paid to the circulation of bile and cholesterol levels in people with a genetic predisposition to gallstone disease.

If we talk about the prevention of biliary colic when a disease is detected, then patients need to follow a strict diet. They should carefully monitor their weight and consume enough liquid (1.5 - 2 liters per day). To avoid the risk of calculus moving along the bile ducts, patients must avoid performing work that requires a long stay in an inclined position.

Predictions regarding the development of gallstone disease for all patients are different, since they directly depend on the rate of formation of stones, their size and mobility. In most cases, the presence of stones in the gallbladder leads to a number of adverse and severe complications. But if the surgical intervention is carried out in a timely manner, dangerous consequences diseases are completely preventable!