Cholelithiasis. Causes, Symptoms, Classification and Complications

21.06.2020

Sometimes a person susceptible to diseases of the gallbladder, without challenging provoking the attack of a gall-eyed disease, is a long time in an uncomfortable position for the gallbladder, revealing a harmful product by drinking the dish of alcohol. The reasons for exacerbation are many, the question remains: what to do with the attack of gallpathy disease, how to stop pain and prevent recurrence.

The disease develops slowly and unnoticed: Initially, several stones are formed in bile ducts, which makes the conclusion of bile, and there are no inflammations, the formations of uluses and other complications. Already on initial stage The first obvious feature is manifested: colic in the liver. Paints are associated with the passage of stones on biliary ducts - the concrections are trying to get into the intestines to then go out with the rest of the organism. However, the size of the stones sometimes do not allow passing through narrow ducts, the bile flow is stuck halfway, causing pain.

The symptoms of the attack of gallstone disease in the later stages include:

intense and long-lasting pain;
the patient has rapid breathing with small breaths and small exhalations;
there is a general change in the skin, the color becomes pale;
due to reinforced metabolism, sweating is developing;
peak shock may occur.

If a person directly faces the symptoms listed, tightening with a further visit to the doctor is not worth it.

A little about liver colic

The liver colic is the first and faithful symptom of gall-eyed illness. The liver colic possess the specified properties:

pain is localized in the right side, is acute;
at times, pain irradiates in the back - a shovel, neck, in rare cases buttock and hand;
the main sign may be the external bloating of the abdomen;
in some cases, the patient jumps the temperature - beats the chills or throws in the heat;
often, the exacerbation corresponds to the disorder of the functions of the gastrointestinal tract, the difficulty in digestion;
arrhythmia is observed (violation of heartbeat).

Acute pain throws the patient half an hour, then smoothly goes into a larger character. If it is impossible to anesthety of the stomach, after a couple of hours, the pain feeds finally, sometimes lasts at all 10-15 minutes.

Of course, the presence of one of the list of symptoms does not indicate the mandatory formation of stones in the bustling bubble, but a similar attack will serve as a good call to change habits and treating the hospital.

How to help yourself yourself

If the attack found surprise, it will be necessary to remove the attack of bile-named disease independently.

The first help is as follows: you need to lie on the sofa, the bed is either chair - a place where you can stretch your legs, feel peace. If the sick house is alone, it does not prevent from calling friends, relatives with a request for help. Ask friends to come, it is possible to occur vomiting or gaining an attack (not always anesthetic medicine) so much that you have to cause an ambulance carriage.

Painty drugs often become:

but-shp;
dROTAVERIN;
papaverine;
antispasmodics of any order.

The attending doctors warn the task in advance - they offer a patient painful in the event of an attack. If the proposal from the doctor has not arrived, discuss the names of drugs at the reception.

Separate doctors recommend take a bath. Water is gaining a pleasant, warm temperature (from 37 to 39C), should not burn human body. You don't need to lie in the bath for a long time: it is enough to relax for 10-15 minutes. Then it is recommended to quickly lie down in bed so that the warmed organism is not cooled again, and the body temperature has not changed. An alternative version that allows you to "warm" the body, improve the operation of the vessels - to make the heap to the legs. The patient is recommended to be as much as much as possible in blankets and warm things, with a bricken disease, warmly will serve a good service. If the patient jumps the temperature, the sick feels chills, strongerly bite the man in the blanket.

In order to avoid dehydration, drink more water. Mineral, filtered water is recommended, water from under the tap, carbonated drinks is strictly prohibited.

As a rule, serious attacks last 20 - 30 minutes, after the specified time expired, it is allowed to leave the bed or a bath and continue to do business. If the attack did not end, it means that the doctor's consultation is urgently needed. We have to call the hospital and call an ambulance.

Remember: The earlier it will be detected (or several) and the patient will consult a complaint with a doctor, the higher the probability of avoiding the operation.

Complications of gallstone disease and parallel diseases

If, with the stones in the bustling bubble, you can not consult a doctor on time, you can face a number of quite serious complications that strongly reflect on the state of your body. At first, the stones are small, painkillers cope with the task to muffle pain, but gradually the formation becomes massive, the passage for the biliary ways is complicated. When stones get stuck, blocking bile ducts, unpleasant phenomena occur:

biliary cirrhosis of the liver;
jaundice;
cholecystitis ();
cholangitis.

Cholecystitis is accompanied by recognizable symptoms:

pain is localized on two sides of the body, acquiring a sinking character;
yellowed skin;
changing body temperature;
pain sensations are irradiating in the back, create a feeling of pulsation;
problems with food processing - vomit urge, nausea.

With increasing stones and the clogging of the ducts, the pain does not stop, is very intense. In order not to delay the treatment, bringing to the operation, it is better to worry about preventing the consequences in advance.

Listed diseases will serve as a prerequisite for the appearance of gallstones:

crohn's disease;
gout;
diabetes.

The total reason for the transition of diseases to each other is the deterioration of the body's condition. As a rule, in clinics about such interrelations, preventive measures are observed, allowing to reduce the likelihood of gallstones.

Because of complications and parallel diseases, unhappy on time, a person suffers repeatedly: the first time trying to cope with the diagnosed disease, the second - when an additional disease appears, and the patient has to deal with several fronts at the same time. The metabolism and life of a person, symptoms indicating the emergence of complications, depend on the occurrence of complications during the bark sickness, require an urgent need to cause ambulance. The attending physician will be able to make a decision - whether to hospitalize the patient or it turns out to be a complex of elementary measures.

In hospitalization, the further medical course is prescribed individually depending on the cause of the attack in addition to the running gallbladder.

Prevention

A bile-shaped attack of a single character is a warning and reminder of the need for health care. To protect against repetition, it is enough to observe a number preventive Mer. The emergency value is obtained after an attack. For instance:

The diet developed by nutritionists is solely to prevent new attacks of gallstone disease, is accompanied by a list of prohibited products:

pasta (even the highest grade);
sausage;
spinach;
dairy products S. increased content fat;
dishes susceptible to heat treatment, in addition to cooking and cooking for a couple;
forget about seasonings, pickled and stronger products;
coffee;
alcohol.

Staiting a diet is required during an attack and after it. The power mode helps to reduce the load on the gallbladder, on the processing system as a whole. Take care of the diet, it is easy and will not require great effort.

If the diagnosis of "gall-eyed disease" is diagnosed, it will have to temporarily forget about the intensive weight loss techniques. Quite often, women mistakenly believe that fitness is able to strengthen health, bile stones become an exception. Such diets violate metabolism, the processing of food and the selection of bile from bile ducts is distinguished. The need to lose weight is better to discuss with the doctor, finding out the way out of the situation.

The diet has a list of allowed and prohibited products, recommendations for the dosage and frequency of daily nutrition. The daily rate of beneficial substances in humans differs, give a clear individual council exclusively the doctor. However, the rules are known common to each case.

For example, it will be necessary to plan the menu and the quantitative attitude of the dishes in the list. A large portion of food should be divided into 5-6 food receptions. The size of the dish should not be molded with massive, so as not to slow down the inflamed organs.

By fulfilling simple preventive rules, it will be for a long time to forget about. It is important to remember - you should not provoke the attacks so that then the task of removing unwanted pain will not be taken.

From ancient times, humanity is known about the huge number of books and articles is devoted to this fear. Despite this, many people do not know which help should be painful during the attack of the Board. What symptoms are characteristic of it, what can be done for a person, what drugs can help? These are questions in which it is worth understanding.

What is the HCB?

The attack first aid is considered in the article) - a fairly relevant theme, because the HCB is a common ailment. With a named disease in bile ducts and stones accumulate. They are cholesterol and pigment. The first of them are most common. The composition of cholesterol stones includes cholesterol, mucin, biliar tube, phosphate, carbonate and palmitate calcium, as well as other substances.

Pigment stones are divided into black and brown. Black structures are mainly found in the bustling bubble. They are formed from calcium billarinate and other bilirubin compounds, carbonate and phosphate calcium salts, mucin, other substances. Brown stones are most often detected in bile ducts. These structures consist of non-conjugated bilirubin calcium salts with inclusion of cholesterol, protein.

Risk factors

Deals in which symptoms of the attack of gallpathy disease may appear, arises by various reasons. One of the risk factors is a female floor. Statistics show that representatives of the beautiful half of humanity called the disease developing much more often than in men. Another equally important risk factor is age. Gallstones are found in many people after 60 years.

Obesity plays a prominent role in increasing the frequency of gall-eyed illness. In too complete people produced bile, oversaturated by cholesterol. Another very significant factor is pregnancy. In women in position, the level of estrogen increases. Because of this, the secretion of cholesterol in bile increases.

Other risk factors, due to which a gall-eyed disease occurs (attack), are:

a rapid and significant reduction in body weight;
diabetes;
diseases of the small intestine;
acceptance of oral contraceptives.

Asymptomatic and dyspeptic forms of the disease

Some people have stones in the bustling bubble, but the patients do not make any complaints. This form of the disease is called asymptomatic (latent). Its specialists are considered as a period of the RCB flow, because, according to statistics, about 10 or 15 years old, 30-50% of people have symptoms of illness and complications.

Another shape of the gallway disease is dyspeptic. Sick people complain about the functional disorders of the GTS. The following symptoms are observed (they occur, as a rule, after meals, especially if fried, oily, sharp dishes, alcoholic beverages were used):

the feeling of gravity in the epigastria and the right hypochondrium;
gorky taste B. oral cavity;
heartburn;
excess accumulation of gases in the intestines;
unstable stools.

Hepatic (bile) colic

The asymptomatic and desputic forms of bile-named disease are not the only one. Specialists also highlight the liver it is the most common clinical form Diseases. It is detected in 75% of sick people suffering from the board.

For the hepatic (bile) colic characteristic of the suddenly manifest and periodically repeated symptoms of the attack of gallway disease. Part of the patients they arise due to improper nutrition and physical exertion. The rest of people cannot identify provoking factors. Attacks begin at night, during sleep.

Symptoms of the attack of the LCB

The attack of the disease is manifested. In most cases, it is localized in the epigastrium, sometimes felt in the area mesia-shaped process. Possible irradiation of pain in right shoulder or to the area of \u200b\u200bthe right blade. The uncomfortable sensations in intensity and nature can be different: stitching, grains, grabs.

In addition to pain, such suspicious signs may also be observed as nausea, vomiting with an admixture of bile, which does not bring relief. However, it is worth noting that these symptoms of the attack of bile-named disease are quite rare. They arise from a small number of people sick people.

In case of inspection, experts notice the following objective signs from their patients:

anxiety, nonsense (sick people are moving and trying to take such a position in which the pain would have retreated);
employment of the pulse up to 100 shots per minute;
the language is wet, covered with a whitewasted shade;
the belly will be taken, his right half lags behind in the act of breathing;
with percussion and palpation of the belly, people complain about sharp pain in the field of right hypochondrium.

Duration and frequency of attacks

Pain in people suffering from HCRs, arises suddenly. The duration of the attack can be from 15 minutes to 8 hours. Sometimes pain torments and for 12 hours. This happens when developing acute cholecystitis. When the attack of the disease passes, pain disappears. There is only an unpleasant feeling in the abdomen.

The frequency of attacks with the disease is individual. In some sick people, the symptoms of bile colic can occur every day, secondly - once a week, thirdly - once a month. It is extremely rarely only one pain attack.

First aid

If the symptoms of the attack of gall-eyed illness occurred, then it is necessary to urgently call a doctor. Before the arrival of a specialist, the patient should be given first aid:

provide peace (recommended bed mode);
give the heating (it must be put on the region of the right hypochondrium);
suggest take a warm bath.

At the time of the attack of the gallway disease, drugs are allowed to give drugs: antispasmodics ("drootaverin", "but-shpa") in combination with analgesics ("Spasmalgon", "Baratgin"). You can wait for a doctor's arrival. The specialist will tell how to remove the attack, and will introduce the necessary drugs in a certain dose:

"No-Shpu" (intramuscularly 2 ml);
"Papaverin", 2% (intramuscularly 2 ml);
BARALGIN (intravenously 5 ml);
"Atropine", 0.1% (subcutaneously 1 ml).

Other dangerous states may be hidden for the symptoms of the attack of bile-free disease. To confirm the diagnosis, you will need to make a detailed analysis of blood, ultrasound or x-ray. In the presence of indications, the following activities will be performed:

cleaning bile ducts;
operational removal of existing stones, gallbladder.

Features of nutrition

The attack of gallpoint disease, the symptoms, the treatment of which is known to each gastroenterologist, is not familiar to many people. However, not everyone is thinking about prevention. In preventing the occurrence of attacks of biliary disease, significant help will have a change in its daily menu.

First, it should be abandoned by refractory fats. Due to the lack of bile, the activity of a special enzyme - lipase is reduced. This, in turn, leads to a deterioration of splitting and assimilating fats. People feel pain, spasms, bloating. Only butter and vegetable oil is allowed.

Secondly, from your menu should be excluded rye bread, mushrooms, peas, beans, nuts, millet, chocolate candies, coffee, cocoa, dough. These products cause exacerbation, because their digestion requires the voltage of the enzyme systems of the human body.

The sand and stones formed in the bustling bubble interfere with the normal renewal of bile, change the mechanism of its action. For the treatment and preventing these processes, folk healers advise what to do. The attack can be warned if:

Torn olive oil. This product contributes to the acceleration of crushing stones in the domestic organ. Folk Lekari recommend daily before bedtime, take 1 tbsp. l. Oil and then drinking juice squeezed from lemon halves. The duration of the use of a folk agent can be 1 week. At this time, you need to stick to the plant diet, do not smoke, do not drink alcoholic beverages, coffee, do not eat products that provoke the intestinal swolish.
Drinking herbal decoction. First, the collection of mint, chamomile and immortelle in the 2: 1: 1 ratio. Then brew 1 tbsp. l. Mixtures of 0.5 liters of hot water. The resulting medicine is kept on low heat for 30 minutes. The finished decoction is filtering and drinking 0.5 cups four times day, half an hour before meals.
Eat an empty stomach lemon for 3 days. This fruit is cleaned of the peel and passed through the meat grinder. In the resulting mixture is added 0.5 h. soda.

So, it became known to you that such an attack of a gall-name disease. Symptoms, first aid - this is what all people should be aware, because no one is insured against the disease. Also, do not forget that the emergence of boobs can be warned. Prevention should include compliance with the rational nutritional mode, a decrease or elimination of the bustling bubble (the fight against adamasses, frequent meals), timely treatment of existing chronic diseases.

Among the pathologies of internal organs, biliary disease in terms of its prevalence occupies one of the leading positions, but not everyone knows the symptoms of pathology. The difficulty lies in the fact that for a long time The disease occurs in a hidden form, no way let him know.

According to statistics, 15% of the population suffers in the developed countries of this pathology. If you analyze the age groups of the diseased, then you can find a direct connection between age, the floors of the disease and their number. In particular, it is noted that women sick more often than men twice.

If we consider women whose age exceeded a mark of 40 years, then each fifth will turn out to be ill. Men of the same age have one ill clearance for 10 people. The distribution of the number of cases in the age groups is as follows:

40 - 50 years - 11%;
50 - 69 years - 23%;
70 years and older - 50%.

Features of the course of the disease

The following organs are responsible for the function of the movement of the bile: gallbladder, liver, bile duodenum, duodenum ,. Each organ from the list has its own "duties." Together they organize transportation of bile in the body.

Part of the bile must flow into the intestine to ensure normal digestion. Part is glowing in the bubble itself. If it is struck, stones begin to form. Motor-tonic disorders of bereal evasion, aggravated by inflammatory processes, exacerbate the situation. They lead to acceleration of the rock formation process. All stones capable of forming in bile are divided into the following varieties:

cholesterol (90% of the total);
pigment;
mixed.

Cholesterol stones are formed if the bile is too much cholesterol. At the same time, stones are formed in bile, then they fall on the bottom, they are precipitated. The process is accompanied by the formation of crystals. Since the motoric is impaired, these crystals can not get into the intestines, and free the bubble cavity. Therefore, the stones over time are only increasing. This process becomes irreversible.

Pigment stones have another name - bilirubinov. The cause of their appearance is a high rate of decay of red blood cells. Such a phenomenon is characteristic of hemolytic anemia.

The mixed look of stones carries the features of both described species. They in their composition have bilirubin, cholesterol, calcium, which, after falling into the sediment, are combined and gradually finish an increasingly significant number of deposits. The formation of stones in this case provokes an inflammatory process affecting the bile ductures. The development of breastholder disorders (discsenia) becomes an additional factor contributing to the development of pathology.

The main reasons for the formation of bile stones

Set the cause of the formation of bile stones is quite difficult. As a rule, this is not one factor, but a whole range of problems that influence the development of pathology. There are several main reasons that provoke stones formation:

incorrect meals, in which vegetable fats are consumed by little, and animals are too much;
hormonal dysfunction (violations in work thyroid gland);
low-wear standard of living;
violations of the lipid balance (as a rule, accompanied by excess body weight);
inflammatory phenomena;
spinal injuries;
starvation;
pregnancy;
diabetes;
hereditary predisposition;
problems of the small intestine.

There is another group of factors that sometimes contribute to the formation of stones:

The last factor is considered demographic. It has no specific explanation, revealed on the basis of perennial observations.

Stages

The disease has several stages. The division of the disease development process at the stage is based on a typical manifestation of this pathology in our time. Traditionally, the following stages are distinguished:

the initial stage, it is customary to be called physico-chemical or proven (it is accompanied by a change in the gall composition, it does not show itself clinically, therefore it can be detected only with the help of laboratory data, namely with the help of biochemical analysis of bile);
stage of formation of stones is considered latent stone, clinical signs No, specific symptoms are absent, but the formation in the bile can already be determined by the instrumental method;
stage clinical manifestationsFor this period, calculous cholecystitis is forming both acute and chronic form;
the fourth stage consists in the emergence of complications that develop due to the devastating impact of the main disease

Signs

A typical disease will manifest themselves depending on what sizes have stones where they are. Give yourself to know the disease can in different ways. This is due to the type of accompanying inflammatory processas well as with functional disorders.

Almost always present (bile colic, liver colic). They are determined in the field of the opposition to the right. They occur most often unexpectedly, the sick complain that they have "knees side" or "cuts". Subsequently, pain is localized specifically at the location of the bubble. The pain can be given in the shoulder, neck, back, shovel, painful sensations are always felt exclusively on the right. When pain irrades to the heart, angina develops, which greatly impairs the general condition.

The appearance of pain is associated with the use of severe and harmful food. This includes spices, fatty dishes, alcohol, sharp. Especially seriously perceived fried dishes. Wrong exacerbation of the disease and pain can severe physical exertion, exhausting sports, hard work. Stress is also one of the reasons for the appearance of pain syndrome. If the work is associated with a long finding in an oblique position, then you can also face pain during the disease.

After all, such a position contributes to the appearance of obstacles to bile outflow. The source of pain - the spasm of muscles, located in the zone zone, as well as the spasm of its ducts. Spasms in this case are reflexive in nature, they arise due to the fact that the concreters are annoyed by their impact of the wall of the bile.

Also, spasm appears in the event that the walls of the bubble are stretched above the norms due to the accumulation of unnecessary bile volumes in it.

This happens when the bile ducts are clocked, that is, obturation arises. Global cholestasis can be diagnosed by expanded bulldocks In the liver. All this is accompanied by blockage of gall duct. The liver may also increase. Therefore, in the area of \u200b\u200bthe right hypochondrium, in addition to permanent pains, heaviness appears.

The pains often join. Nauseous strongly and almost constantly. This state may include vomiting. But relief that should arise, such vomiting does not give. Vomiting also arises due to irritation, in fact, this is a reflex response of the body. If vomiting has become an indomitable, most likely, inflammation spreads and has already affected the pancreas. In this case, in the vomit masses can be seen bile.

Inxication is gradually developing, which can be expressed in ailment, weakness, in temperature on the subfebrile level. Sometimes the temperature rises much higher, real fever can begin. If the stone bobs the bile duct and the sphincter will lose the passability, the feces will become light, the jaundice will develop.

Methods of diagnosis

Stones in bile

If you have a liver colic, you must be consulted with your doctor. It should not be ignored. This is fraught with complications. You must send to the surveys that will show whether there is a bubble of various types in a bubble. There is also an external inspection.

On the abdominal wall in the area of \u200b\u200bthe bubble, you can see tensions, skin soreness. Spots appear on the skin yellow colorThey are called xanthomas. They are perfectly visible during an external inspection. The reason for these stains lies in the violation of lipid metabolism. Yellow skin as a whole, also become yellow sclera.

By general analyzes blood can be determined by signs of inflammation of a non-specific nature in acute stage. Such signs include a moderate increase in ESP, increased leukocytes. If there is a biochemical analysis, then the increase in cholesterol (hypercholesterolemia) will be revealed, (hyperbilirubinemia), an increased activity will be observed, which happens with alkaline phosphatase.

Also conduct cholecystography. Its goal is to identify an increase in the gallbladder and the presence of lime inclusions in the walls of this organ. This method makes it possible to see stones with lime inside the bubble. This method is considered very effective in diagnosis.

Ultrasound is a very informative method of diagnosis. This study reveals echonights (stones), as well as pathological deformations. The accuracy of the diagnosis in this case is very high. The size and localization of the concrections are detected, their approximate quantity. You can track the changes associated with the motorcycle of this organ. Signs of cholecystitis are also found on the ultrasound.

MRI and CT perfectly show the state of bile and ducts, so their application for the examination for the disease under consideration is very effective. Scintigraphy (Introduction to the body of isotopes with radioactivity in order to obtain an image on gamma tomograph) shows violations in bile circulation. For surveys in the same direction, endoscopic retrograde cholangiopankatography is used.

Treatment

Disease treatment - complex

People suffering from gallpinder disease, limit the load, the menus them form in accordance with the principles of rationality. The hygienic mode corresponds to the total type. Diet No. 5 is appointed, it is complemented by the exception of fats. The main tactic in treatment is the wait. Specific treatment is rarely appointed. Often, a certain mineral water is recommended.

If calculous cholecystitis begins, then the operational removal is carried out. The tactics of the operation depends on the state of the patient, as well as on the state of the tissues adjacent to the busty bubble. The size of the accretions also need to be considered.

With operational intervention in this case it is impossible to delay, because this condition can lead to peritonitis, caming, acute pancreatitis and mechanical jaundice.

If there are suspicion of gallstone disease, you need to go on consultation to and surgeon. Correct the status easier at the initial stages than in running cases. After all, comply with the diet, to conduct a measured lifestyle easier than to make the operation.

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Fat food - the main "provocateur" of the exacerbation of cholecystitis

That is why it is important to know the symptoms of exacerbation of chronic cholecystitis - to quickly take measures and seek medical attention.

What provokes exacerbation

Chronic cholecystitis can be (with stones) and beless. Provoke the exacerbation of the latter can:

consumption of large quantities of oily, oily, smoked or pickled food, as well as combinations of these harmful products;
overeating;
alcohol intake;
pronounced stress;
allergy - especially food;
the diet in which there was no fiber and vegetable fibers for a long time.

In the case of calculous cholecystitis, the exacerbation may be caused additionally:

shaking ride;
physical exertion (especially after a long period of hypodynamine);
a sharp change in the position of the body, especially if the pre-man was tight.

The aggravation of chronic cholecystitis is greater likely to have a person with such states:

anomalies for the development of biliary tract;
obesity;
discinesia (violation of the coordination of muscle movements) of the biliary tract;
during pregnancy;
during supercooling, cold illness or exacerbation of chronic pathologies of internal organs.

A warning! Chronic cholecystitis can be in the stages of exacerbation from 1 time per month to 3-4 recurrences per year. Depending on this, doctors talk about a lightweight, median or severe course of the disease, which determines the overall tactics of its treatment.

Signs of exacerbation

The main following is pain in the abdomen, disorders called "dyspepsia", weakness, temperature increase. Consider each of them in more detail.

Pain syndrome

The first thing that indicates the aggravation of chronic cholecystitis is pain in the stomach. Its location, intensity and duration depend on such individual characteristics:

what kind of presence is accompanied by cholecystitis;
are there any complications of the inflammation of the gallbladder;
are there any (and what) related diseases of the digestive tract organs.

The last factor will influence the appointed treatment, but in particular - on the diet with the exacerbation of chronic cholecystitis.

The main symptom of exacerbation - pain in the right hypochondrium

Pain with exacerbation of pathology is usually located in the right hypochondrium, but can be felt in the area "under the spoon". It can be a permanent, not very strong, more than character, can even be felt like pain, but as heaviness under the right edge.

The above pain characteristics are more characteristic of a reduced tone of the gallbladder. If the tone of the organ is increased, or the aggravation was provoked by the movement of the stone, signs of aggravation of chronic cholecystitis will be called bile colic. It is a pain:

strong;
right under the edge;
attacking nature;
giving into the right blade, shoulder or under the worship;
facilitating warm heating on this area;
after vomiting, the pain is enhanced.

If the cholecystitis was complicated by the spread of inflammation and on the peritoneum, which "envelops" the gallbladder, then other pain characteristics appear:

constant;
increased with the movement of the right hand or tilt of the body, turns.

If the exacerbation of cholecystitis led to the development of inflammation and in the pancreas, pain may acquire a slope, give the "under the spoon", the left hypochondrium, the area around the navel.

When the inflammation of the gallbladder led to the irritation of solar nervous plexus, pain is described as:

having a burning character;
intense;
backing in the back;
intensifying when pressed to the lower region of the sternum.

Dyspepsia

This term denote such symptoms that spelling that chronic cholecystitis aggravated:

bitterness in the mouth;
vomiting - with an admixture of bile;
nausea;
bitter belch;
bloating;
diarrhea.

Itching skin

A person is worried about itching when bile is stirred in his ways, its pressure is increased in them, and some of the bile acids falls into the blood. It can be all the body, but itching can be felt anywhere.

A warning! The symptom is more characteristic of the gallway disease, but it can also appear when a candy-free chronic cholecystitis. This feature suggests that the treatment of the disease should be carried out in the hospital, and not at home.

Other symptoms

In a quarter of people, the aggravation of the inflammatory process of the gallbladder will be accompanied by pain in the heart, which is associated with community nerve fibers These two organs.

Skin itchine and the level of bilirubin levels lead to psycho-emotional disorders:

weakness;
irritability;
increased fatigue;
quick mood change.

In 30-40% of people, the exacerbation of cholecystitis will be accompanied by an increase in temperature within up to 38 degrees.

In addition, pain in joints, headaches, weakness in the limbs may also be marked, increased sweating, arrhythmia and greeting heartbeat.

Help with exacerbation

The main thing is what to do with the exacerbation of cholecystitis is to seek medical attention. A person can call " Ambulance"If the pain is very strong or accompanied by a deterioration in the overall state, and go to the gastroenterologist on the same day as the first signs of the exacerbation of the disease.

First aid for cholecystitis should be provided by the "ambulance" or surgical hospital doctors. Medical workers will determine the diagnosis and measure such parameters of the general state of a person as arterial pressure and pulse. Depending on this, they will be solved than it is possible to carry out anesthesia: drugs that reduce muscle tone (they also reduce the pressure in the vessels), or directly with painkillers. Before the arrival of specialists, no tablets do not need to drink - so you can harm yourself.

Roshovnik's decoction is an excellent bile agent, but it is impossible to apply it during exacerbation

All you can do before the arrival of physicians is:

do not eat (especially if there is nausea or vomiting);
drink liquid in small volumes;
lie down into bed by taking a convenient position (usually on the right side);
put under the side a little warm height, strictly following your sensations. If it causes an increase in pain, the heating floor must be removed.

A warning! You can not take any herbs (especially choleretic), drink preparations, warm the belly in a warm bath. Even if the "blind tubing" was prescribed before the exacerbation, then in the period of exacerbation, it was contraindicated in the period of exacerbation - intensifying the work of the sick bubble, you can provoke the development of surgical complications.

Treatment of exacerbation of chronic cholecystitis is performed first in surgical, and then therapeutic complication. Man prescribe injection forms Antibiotics, drugs that take off the spasm of the muscles of the gallbladder, painkillers, medicines necessary for the treatment of concomitant diseases of the pancreas, stomach, intestines. If necessary, perform an operation to remove the gallbladder.

If a decision is made about conservative treatment Pathology, be sure to exacerbate cholecystitis needed, which will provide the body with everything necessary, with "turning off" reductions (but providing a bile outflow) of the sick bubble, giving him the opportunity to recover.

Meets the following requirements:

In the first two days, it is necessary to spill, drink only fastening and unsweetened tea, rice decoction in a total volume - at least 2 liters per day. In this case, it is necessary to eat liquid to small portions so that it is absorbed.
On the third day, if the pain pokes, the diet is expanding. Enter: Vegetable soups, liquid non-flush porridges (semolina, oatmeal, rice), eggs from nonclass berries.
By 5 days boiled meat and fish of low-fat varieties, dairy products.
After another 2 days, food can be filled with a small amount of vegetable or butter. You can add dairy products, sweet fruits, potatoes, stewed cauliflower, baked apples without peel, white bread crackers, boiled egg.
It is impossible in any case: pickles, marinades, onions, sorrel, spinach, white cabbage, taking alcohol.
Simple carbohydrates are limited.

Physiotherapy and taking herbs is very useful outside the exacerbation of the disease. When you can enter them into treatment, you must tell the attending therapist, in whose "Office" a person is translated when the cholecystitis exacerbation phenomena is stopped.

Good day, dear readers!

In today's article, we will consider with you such a disease, like a gall-eyed disease, as well as its signs, causes, diagnosis, treatment, diet and prevention. So…

What is a gallstone disease?

Gallgames (HCB) - a disease, which is characterized by the formation of stones in the gallbladder or bile ducts (concrections).

Another name of the disease is choletiasis.

The main symptoms of gallstone disease are colic in the right hypochondrium, gravity in the abdomen and yellowing skin Pokrov.

The main cause of the gallway disease is a violation of cholesterol, bilirubin and some other exchange processesIn which bile pigments, "bad" cholesterol, salt, some types of protein and other substances settle in the bustling bubble and its ducts. Over time, these substances begin to stick to each other and harden, forming the so-called stones.

One of the most popular consequences of finding stones in biliary organs is development.

Development of gallstone disease

Before you understand the process of formation of stones in the bustling bubble and its ducts, we will try to describe it in a simple language, what kind of organs they perform the function in the livelihoods of the body.

The gallbladder is an organ, a kind of bile reservoir, connected to the liver, pancreas and a duodenum. In the bustling bubble there is a separation of bile particles from the water, i.e. In this organ, the concentration of bile occurs, which when feeding food, especially heavy food, the gallbladder occurs in the initial dental department (12 pans), where this secret contributes to the digestion of food.

The gallways are the ducts through which the liver, the bubble, the pancreas and the duodenum are connected.

The bile - liquid secret generated by the liver, which across the liver duct falls into the gallbladder, where, as we have already spoken, its concentration (separation from water) occurs. Bile is needed for normal digestion.

Now we will proceed to consider the development of gallstone disease.

Some factors, such as pregnancy, the reception of some drugs (especially influencing cholesterol and bilirubin), obesity, starvation, use of harmful food, metabolic proceedings, diabetes mellitus and other pathologies lead to the fact that in the bustling bubble there is a stagnant bile. The particles from which are actually bile and consists of "bonding", forging small seals, which over the years are increasing in size. The biliary ducts in size are much less than the bubble, and therefore, at a certain time, for example, when typing the body, the stone falls into the duct and gets stuck in it, forming a blockage (obturation). Sometimes a stone with difficulty passes through the clearance of the bile duct, "scratching" its walls. But the case and other case cause strong acute pain In the area where the stone is moving or stuck. In rare cases, the stones are formed in the bile ducts themselves.

The bile stones are seals, the size of several millimeters to several centimeters, formed mainly from cholesterol sediments, calcium salts, various pigments (bilirubin - bile pigment), proteins and other substances. Stones, or as they are also called in the Scientific World - Conditioners may be various shapes, sizes, as well as based from various particles, with a predominance of a substance. According to the structure, the councils can be crystalline, layered, fibrous or amorphous.

The next stage of development of the HCB depends on the localization of the blockage of the duct. If this happens to the main biliary duct, i.e. immediately behind the gall bubble, bile from the liver falls immediately in small intestineHowever, the lack of its concentration leads to poor food digestion. In addition, bile acids begin to circulate in the body without a controller (bubble), which leads to the fact that an aggressive secret begins to harm the body, because It is a bubble that regulates when the bile is needed in the intestine, but when not.

If the stone clogs the clearance of a common bile duct, then bile, only concentrated, from the oversupply returns back to the liver, and starts to hit it. This leads to toxic hepatitis.

If the stone clogs the lumen of the total duct at the duodenum itself, then the pancreas and pancreas fall into the lesion zone.

With all these blockages, it is necessary to understand that the bile cannot be in sufficient quantity, or in general to get into the small intestine, the food at it cannot normally digest. Bile, with the impossibility of removing from the body, begins to poison the body, sometimes infectious microorganisms appear in it, which contributes to the development of human life-threatening.

Of course, the above-described process is very superficial, but the general picture of the state of affairs I think is now understandable.

Treatment of bile-named disease is aimed at eliminating stones from the body without damage to the gallbladder and biliary tract. Usually the treatment is conservative, but some situations can be solved only by surgical path.

Statistics Board

Bile disease from year to year is becoming more and more common diseases of many people around the world. Thus, some authors indicate an increase in the number of cases of the CIS disease in residents of the CIS countries, every 10 years, almost twice.

The number of women who meet the HCB, compared to men, is usually from 2: 1 to 8: 1. Another factor in which the number of patients with this pathology increases - age than a person older than, the higher the risk of manifestation of the disease.

If we talk about the total number of patients with HCB - 10% of the population of the Earth, aged after 70 years, the number of patients is up to 30%.

If we talk about the geography of the dissemination of the disease, the number of cases occurs most of all in developed countries - the United States, Europe, the CIS countries, while in food is mainly used vegetable origin - Southeast Asia, India, Japan, cases of bile-named disease Minimum quantity. Of course, in addition to food, big role Plays and movement, because In the low-developed countries, people in most part are constantly in motion.

ICD

ICD-10: K80.

Symptoms

The process of developing gallstone disease occurs long time - from the beginning of the formation of stones to the first signs of the disease can pass from 5 to 10 years. This is due to the fact that the presence of stones in the bustling bubble does not disturb the person, and the pain appear only when they fall into the gallways and begin to injure

The first signs of gallway disease

Yellowing of the skin, the scool of the eyes, mucous membranes of the oral cavity;
Sharp colic in the right hypochondrium (raging colic), which manifest themselves when the stone moves on the biverways;
Feeling of gravity in the stomach, frequent belching;
Feeling bitterness in the oral cavity.

The main symptoms of gallstone disease

Bile or hepatic colic (sharp sharp pains in the right hypochondrium with returns to the right blade, forearm, hand, lower back, sternum, and even neck), appearing mainly after drinking, spicy, fried and oily food, use alcoholic beverages, stress, heavy exercise or body shake;
Nausea, (sometimes with bile), after which the sense of relief usually does not occur;
Yellowness of the skin, the scool of the eyes, mucous membranes of the oral cavity ();

Additional symptoms:

Increased body temperature - up;
Increased sweating;
Discoloration of carts;
Stupid in the field of liver, developing in the consequence of the expansion of bile ducts of this organ, which leads to an increase in liver in the amount;
Cramps.

Symptoms may vary depending on the localization of the blockage of bile ducts by stones, as well as related diseases.

Complications of gallstone disease

Among the complications of gallpoint disease can be allocated:

(inflammation of the gallbladder);
Cholangitis (inflammation of biliary ducts);
Acute biliary pancreatitis;
Formation of fistula;
Toxic hepatitis;
Pancreatic cancer, liver and other gastrointestinal bodies.

Causes of gallstone disease

Among the main reasons for the formation of stones in the bustling bubble and bile ducts are:

Stast of bile in the bustling bubble;
Ultra-high concentration of bile;
Violation of exchange processes in the body, in particular bilirubin, cholesterol, lipids (fats, phospholipids, etc.) and other substances that often provoke such diseases as - enzympathy, metabolic syndrome. other;
Dyskinesia biliary tract;
passing into;
Hypofunction of liver cells;
Diseases of the pancreas and other gastrointestinal bodies;
Hemolytic anemia;
Congenital anomalies in the structure of the gastrointestinal tract;
The presence in bile ducts of scars, tumors, adhesions, inflammatory and other pathological changes, and processes;
The presence in the body of infection, especially intestinal sticks.

Factors that increase the risk of developing HCBS (cholelyatiasis)

Incorrect meals - starvation, overeating or large intervals between meals;
Use of harmful, sharp, oily, fried and spicy food;
Sedentary lifestyle;
Excess weight, ;
Reception of some drugs: hormonal contraceptives, estrogen, fibrats, "okreotic", "" and others.
Pregnancy, especially multiple;
Floor - in women, the number of cases with HCB is several times higher than in men;
Age (especially after 70 years) - than a person older, the greater the likelihood of stones;
Heredity.

Types of gallway disease

The LCD is classified as follows:

On Localization of the LCB

Cholecystolithiasis - Stones are formed in the bustling bubble;
Khdocholithiasis - Stones are formed in bile ducts.

According to the composition of the stones:

Cholesterol stones - Consist mainly of cholesterol sediments, and partly from salts, bilirubin (bile pigment), various minerals, protein and other substances. Painted in yellow shades. Cholesterol councils are found in 80% of all the case of choletiasis.

Pigmented (bilirubin) stones - Consist mainly of bilirubin, calcium salts and partially cholesterol sediments. Painted in dark brown or black colors. The formation of pigment concrections usually contributes to disruption of the functioning of the liver, infectious diseases of bile ducts and frequent hemolysis.

Limestone stones. The main part of the councils consists of impurities of lime salts.

Mixed stones. The most popular type of stones, which consist of all the above substances.

Stages of gallway disease:

1 Stage (initial, physico-chemical or prove stage, primary stones). It is characterized by structural changes in the composition of bile, as well as the absence of clinical manifestations (symptoms) of the disease. It is possible to identify violations with the help of biochemical analysis of bile.

2 stage (stones formation, latent stone). It is characterized by the absence of clinical manifestations, only occasionally can be felt some discomfort in the abdomen. Remove the presence of stones using instrumental diagnostics (Ultrasound, x-ray).

3 Stage (secondary stones). It is characterized by the presence of SPM symptoms, may be accompanied by the development of cholecystitis.

4 stage. It is characterized by a number of complications caused by choletiasis.

Diagnosis of gallway disease

The diagnosis of gallpoint disease includes the following examination methods:

Anamnesis;
abdominal cavity;
Oral cholecystography;
Retrograde cholangiopancratography;
Biochemical analysis of bile;
Scintiography of the biliary system.

Treatment of bile-named disease is aimed at eliminating stones from the body, as well as the normalization of the functioning of all organs and their appendages involved in the development, passage and removal of bile.

Treatment of biliary disease typically includes the following methods:

1. Removing bile stones and eliminating them from the body:
1.1. Medicinal method of removal of stones;
1.2. Ultrasonic method;
1.3. Laser method;
1.4. Remote shock-wave lithotripsy (DUVLT);
1.5. Surgical method (operation);
1.6. Why can not remove a gallbladder
2. Diet.

1. Remove bile stones and eliminating them from the body

1.1 Drug removal method of stones

Removal right stones Using drugs, it implies the use of drugs that normalize the composition of the bile and metabolism, which leads to the gradual splitting of the concreters. It is assigned mainly in the presence of small concrections, or after the ultrasonic method of their removal.

The disadvantage of this method of removal of stones is long use Drugs, which, firstly, are relatively not cheap tools, and their use should usually produce at least 6 months. Secondly, through long-term use of drugs, the development of additional unpleasant symptoms in patients is not uncommon, which may worsen and without the hard limit of the HCR.

Medicinal preparations designed to split the concrections and their excretion from the body are based in most cases on bile acids.

Among the drugs for the treatment of HCB can be allocated: Ursodoxiholic acid (Ursonan, Ursodex, "Exthol"), Henodoxocycolic acid ("Henosan", "Henofalc", "Henohol"), vegetable agents (sandmaker extract).

Additionally, drugs are prescribed, stimulating the reduction of the gallbladder, which contributes to the pushing of the accretions from themselves and their further excretion from the body.

Among the stimulating operation of the gallbladder of drugs can be allocated: "Zixorin", "Lobil", "Holosas".

1.2 Ultrasonic Stone Removal Method

The ultrasound method for removing horizontal stones is made with the help of special ultrasound medical equipment, which, with the help of a wave effect on the gall, throws it into smaller particles.

The disadvantage of this method is the possibility of the formation of pointed fragments, which can damage their mucous membranes when exiting the gallbladder and biliary ducts. To prevent such a result, after ultrasound treatment prescribed medicationswhich we talked a little higher about. The medicine splits sharp corners together with small stones and remove their remnants from the body without possible complications.

1.3 Laser Stone Removal Method

The laser method of removal of gall stones is made with the help of special laser medical equipment. The essence of the method lies in the implementation of a small puncture in the human body, through which, directly on the stone itself, a special laser is directed, destroying the accreter into smaller particles.

The disadvantage of this method of removal of stones is the possible risk of burns on the mucous membranes of the gastrointestinal bodies, which can further provoke ulcers. In addition, as in the case of an ultrasound method, particles of destroyed stones can have sharp edges capable of damaging bile ducts when leaving the body. Therefore, after removing the accretions with a laser, drugs are also prescribed.

1.4. Remote shock-wave lithotripsy (DUVLT)

The removal of stones using a remote shock-wave lithotripsey (DUVLC) is carried out with the help of powerful electrical discharges caused by an electromagnetic generator. The equipment produces pulse discharges high and low density alternating each other, which, when exposed to the concrete destroys its structure, after which the stone breaks down.

The disadvantage of this method is a large number of possible complications, the main of which are bile colic, the development of acute cholecystitis, pancreatitis, mechanical jaundice, the hematoma of the liver and gallbladder.

1.5. Surgical method removal of stones (surgery)

Open cholecystectomy. It is the most popular and cheap removal of gallstones. Testimony to conduct open operation is the presence in the bustling bubble and its drives of stones big sizeFrequently strong pain and the development of complications of gallstone disease.

The disadvantage of surgical direct removal of stones is the injury (section) of tissues on a large area - a section of about 15-30 cm, the removal of the gallbladder, the risk of developing complications - from internal bleeding and infection to infection to death (from 1% to 30%, especially the percentage is growing with septic shock and other serious complications of the HCR).

Laparoscopic cholecystectomy. Laparoscopic cholecistectomy, unlike open cholectectomy, implies a gentle method of removal of stones, which is carried out with a laparoscope. To do this, there are several small (up to 1 cm) of cuts through which, with a laparoscope (thin tube with a video camera for observation and accuracy operational intervention) From the body gets a bubble with stones. The main advantage is the minimum injury to the body tissues. However, the risk of serious complications still remains.

And in the first and second case for surgical method The removal of the councils is contraindicated, so it is necessary to carry out an operation or not solves only the attending physician, and only on the basis of a thorough diagnosis of the body.

1.6. Why can not remove a gallbladder

As we spoke at the beginning of the article, the gallbladder plays one of the important roles in the processes of digestion. This organ accumulates bile, where it concentrates, after which, when eating food into the body, the gallbladder occurs bile in the initial dental department ( duodenal gut), where food passes the digestion process.

If the gallbladder is not, the bile will be a more liquid, less concentrated, circulating over all organs entering the so-called "choleretic system" without a controlling body. These processes in the end lead to poor digestion of food, the development of a number (, esophagitis, and others). At the same time, patients who have removed the gallbladder often feel gravity in the abdomen, pain in the right hypochondrium, feeling of bitterness in the oral cavity and metal Tribus Food.

But the saddest thing in this picture is that in non-compliance with preventive measures, the stones can appear again, but already in the biliary ways themselves (choledocholiticiasis), because The composition of the bile, if not changed lifestyle, will not change.

In this way, it can be noted that the treatment of a biliary disease by removing the gallbladder along with the stones is carried out only at least when conservative treatment methods have not led to the desired result.

Diet with gallway disease is usually assigned after removal of raging stones. This is due to the fact that even without the presence of a gallbladder, the concrections can re-form, but already in the biliary ways. The diet is aimed at preventing the re-development of the HCB.

After removal of stones, diet No. 5, developed by M.I. Pevzner. Its foundation is eating food with a minimum amount of fats and powered by small portions (4-5 times a day).

What can be eaten with boards: Non-fat varieties of meat and fish, porridge (rice, oatmeal, buckwheat low-fat dairy products (milk, sour cream, kefir, cottage cheese), eggs (1 per day), bread (better yesterday or handwritten), olive oil, any vegetables and fruits (all In addition to acidic), tea, fastening coffee with milk, compotes, juices.

What you can not eat at the boarding school: fat, sharp, spicy, fried and smoked food, sausages, canned food, fatty varieties of meat and fish (pork, home duck, catfish, crucian, carp, bream), fat, fats animal origin, pickled vegetables, spinach, legumes, alcohol, Strong coffee, gas composition, grape juice, sdobu, chocolate.

Important! Before use folk remedies Treating gallstone disease, be sure to consult with your attending physician!

It is also necessary to understand that the funds below are directed to the removal of stones, so their movement on bile ducts to exit the body can be accompanied by colic, bits of nausea and pain.

Birch. 2 tbsp. Spoons of birch, assembled and dried in spring birch leaves pour boiling water with a glass and put on a slow fire. Doing the remedy must be needed until its volume decreases twice. After that, the remedy needs to be cooled, strain and take over the day for 3 approaches, half an hour before meals. Course treatment - 3 months.

Radish with honey. Out of the radish juice, mix it with, in proportion 1: 1 and take 1 time per day, starting with 1/3 cup, and over time, the dose you need to increase to 1 cup of money per day.

Rowan red. To remove stones from the gallbladder and its duks, you can eat daily 2 cups of fresh fruits of wild rowan red. To improve taste properties, berries can be used in a mix with honey, sugar sand or bread. The course of treatment is 6 weeks.

Olive oil. Daily, 30 minutes before meals need to take olive oil. In the first days - by ½ h. A spoon, after 2 days - 1 tsp, then 2 teaspoons, etc., increasing the dosage to ½ cup. Course treatment - 1 month.