The principles on which the complex treatment of stagnation of bile is based: if it is possible to eliminate the cause - the etiological treatment, including surgical treatment; when the cause can not be eliminated - symptomatic therapy with the maximum possible impact on individual pathogenetic components.
If stagnation of bile in the gallbladder or liver did not cause obstruction of the ducts, then drugs based on ursodeoxycholic acid, which is part of the bile, are used. These include the hepatoprotective drug with choleretic (increasing the synthesis of bile) and choleretic actions Ursofalk (Ursohol, Cholacid, Ursosan, Ursoliv, Ukrliv, Holudexan and other trade names) in the form of capsules and suspension for oral administration. This means also reduces the production of cholesterol and its absorption in the small intestine, which reduces the likelihood of the formation of cholesterol-containing stones. Capsules and suspension are prescribed for 10-15-20 mg per kilogram of body weight per day (a specific dose is determined by the doctor); long-term treatment.
Ursofalk can not be used for cirrhosis of the liver, acute cholecystitis or cholangitis, with calcified stones in the gall bladder and its dyskinesia, as well as in case of obvious functional deficiency of the liver, pancreas or kidneys. And among the side effects of ursodeoxycholic acid, the appearance of pain in the upper abdominal region, mild diarrhea, and the formation of bile calcitans.
Almost always prescribed cholagogue for bile stagnation, such as Allochol, Hofitol (Artichol, Tsinarix), Holiver, Odeston (Gimecromon, Holestil, Holstamin forte, etc.). The most effective hepatoprotector recognized drug Ademethionin (Heptor, Heptral).
Allochol (consisting of dry bile, extracts of nettle and garlic and activated carbon) promotes the production of bile, so when acute forms of hepatitis, liver dysfunction and obstructive jaundice do not apply it. Allochol tablets are taken after meals - 2 tablets three times a day. In some, the drug can cause skin allergies and diarrhea.
Tablets (and solutions for oral administration and for parenteral administration) Hofitol contain an extract of leaves of a seed artichoke, which promotes bile, diuresis and cholesterol metabolism. The drug in the form of tablets is taken three times a day for 1-2 tablets (before meals), a solution - 2.5 ml (for children - 0.6-1.25 ml). Hofitol can cause hives; it is contraindicated to use with stones in the gallbladder, obstruction of the biliary tract and liver failure.
A cholagogue Holiver, in addition to the extract of artichoke, contains extracts of bile and turmeric, stimulating the synthesis of bile acids and the output of hepatic bile. The drug is also effective for constipation associated with intestinal dysbiosis, and flatulence. Contraindications are similar to Hofitol; standard dosage - 2-3 tablets 3 times a day (before or after meals).
Cholagogonnye tablets Odeston (based on 7-hydroxy-4-methylcoumarin) not only accelerate the circulation of bile, but also relieve spasms. It is recommended to take for 10-14 days one tablet (0.2 g) three times a day, half an hour before meals. Odeston is contraindicated in cases of ulcerative colitis and any gastrointestinal diseases with ulceration, bile duct obstruction, hemophilia; not applicable in the treatment of children. Side effects of the drug are manifested in the form of diarrhea, epigastric pain, increased formation of intestinal gases.
The drug Ademetionine (S-adenosyl-methionine) contributes to the normalization of liver function and metabolism. It is prescribed for 2-3 tablets a day; Contra-indications of the drug concern individual intolerance, use in the treatment of children and pregnant women (in I-II trimesters). A possible side effect is discomfort in the hypochondrium.
In addition, in the treatment of stagnation of bile used drug cholagogue collections of medicinal plants. For example, cholagogue No. 2 (flowers of the immortelle sand, yarrow herb, peppermint leaves, coriander seeds) or collection number 3 (flowers of calendula, tansy and chamomile and mint leaves). From the dry raw materials prepare a decoction - a tablespoon to a glass of water (boil for no more than 10 minutes and insist half an hour in a sealed container, strain and add boiled water to the original volume). Cholagogue should be used after consultation with a doctor; drink decoctions before meals twice a day - 100 ml each.
Choleretic properties also have a dog rose: you can prepare infusion from dry berries or take the remedy Holosas (according to a dessert spoon per day, children - half a teaspoon). Also, you should take vitamins A, C, D, E, K.
Of homeopathic remedies for the treatment of bile stasis, Galsten (tablets for resorption under the tongue and droplets) and Gepar kompozitum (solution in ampoules for parenteral use) can be used.
Both preparations contain many components, but each contains a milk thistle (Silybum marianum) or a milk thistle (in the form of an extract of plant seeds). Among the active ingredients of milk thistle, the flavonolignan complex (silibinin, silibins, isosilbins, silicystrin, isosilicristin, silidianin and dihydroquercetin) has a particular benefit. Milk thistle also contains vitamin K and ω-6 fatty linoleic acid.
The preparation of Galsten stimulates the production of bile and activates its movement from the liver to the gallbladder and further, relieves spasms and inflammation. Doctors recommend taking this drug one tablet (under the tongue) twice a day; drops - 7-10 drops three times a day (in between meals). In the manual, adverse allergic reactions are noted, and in contraindications only increased sensitivity is indicated. However, Galstena contains Chelidonium majus, that is, celandine, and this plant is known to be poisonous (due to the presence of isoquinoline alkaloids) and can cause seizures, intestinal cramps, drooling and contractions of the uterine muscles.
Homeopathic preparation Gepar compositum consists of 24 active substances (one of them - rastoropsha). It is used by intramuscular or subcutaneous injection - one ampoule every 3-7 days for 3-6 weeks. Among the side effects marked hives and itching.
To date - depending on the etiology and localization of stagnation of bile - surgical treatment includes such types of surgical intervention as:
- laparoscopic removal of stones in cholelithiasis and concrements of bile ducts (endoscopic lithoextraction);
- removal of a cyst or tumor that prevents the outflow of bile;
- the installation of stents in the bile ducts;
- balloon dilatation (dilatation) of the lumen of the bile ducts with their obstruction;
- drainage of the common bile duct (choledochostomy);
- expansion of the gallbladder or its ducts with stenting and the formation of biligidestive anastomoses;
- operations on sphincters of the gallbladder;
- removal of the gallbladder (cholecystectomy).
With biliary atresia (see Bile stasis in a child), the ducts in the liver are created surgically: the children of the first two months undergo a reconstructive operation (portoenterostomy), but liver transplantation may be required.
Among the variety of recipes for alternative treatment of this pathology, it is possible to identify the most appropriate tips:
- To consume within 1-1,5 months a mix of juices prepared at home - carrot, apple and beetroot (in equal proportions); should drink 150 ml of this juice (an hour after eating).
- Drink natural apple cider vinegar, adding a tablespoon to a cup of apple juice or water with lemon juice; there you can put a teaspoon of honey.
- Take a mummy dissolved in water (tablet 0.2 g per 500 ml) for two weeks; to drink all the amount per day (in several receptions, half an hour before meals). Between courses of application it is advised to do 5-7-day breaks. A full cycle of such mummies can last 3-5 months. True, the alternative recipe does not mention that at such volumes of use of this biostimulator can be diarrhea, increased heart rate and increased blood pressure.
Also, alternative treatment suggests using oats and preparing a decoction of it: a tablespoon of whole grains are poured into two glasses of water and cooked for about half an hour; drink 15-20 minutes before meals 3-4 times during the day (drink all the amount per day). However, it should be borne in mind that oats act as a laxative and reduces blood pressure.
Churm with bile stagnation will help to cope with diarrhea (for this it is recommended to prepare a decoction). In a persimmon, there is a lot of beta-carotene and vitamin C, as well as manganese - a cofactor for the synthesis of the antioxidant enzyme superoxide dismutase, which increases the stability of the mucous membranes. Other powerful antioxidants found in persimmons include lycopene and cryptoxanthin. But the pomegranate not only promotes hemopoiesis, but also has cholagogue properties; but this fruit helps constipation.
So, it is safer to use cholagogue grasses in bile stasis: a medicine douche, an immortelle sandy, a birdwort (a knotweed), a three-leaved watch, a naked herring, corn stigmas, a sweet clover, a paint duck, a mountain arnica. Decoctions are prepared and taken, as well as pharmacy cholagogue (see earlier).
Diet in case of congestion of bile
The therapeutic diet for bile congestion is a diet number 5 and the introduction of certain restrictions and even prohibitions in the diet.
That is, fatty foods (animals and cooking fats, rich broths, fatty meat and fish, whole fat milk, cream, butter, sour cream, etc.) should be excluded; canned food and meat gastronomy with preservatives; semi-finished products and snacks; Refined sugar, fructose and sweets; bread and buns of white flour. See also - Diet for diseases of the gallbladder
Need to eat: fresh vegetables and fruits; Boiled, baked or stewed lean meat and poultry, seafood (source of protein); legumes (vegetable protein); healthy fats (walnuts, almonds, flaxseeds, pumpkin seeds).
Whole grains are required, such as brown rice, barley, oats, buckwheat; healthy oils with polyunsaturated fatty ω-3 and ω-6 acids: olive oil, sesame oil, linseed oil.
Exercises for bile congestion
Doctors warn: without movement, all processes in the body, including the secretion of bile, are violated. Therefore, gymnastics with bile stasis is needed, but it should not exacerbate pathology and intensify the symptoms.
It is recommended to walk (at least an hour a day), as well as such exercises with stagnation of bile, in which you do not need to do low inclines forward, sharp turns, strong flapping movements and jumps.
Remember the simple morning gymnastics: most of its elements are suitable for stagnation of bile. For example:
- Legs on the width of the shoulders, hands on the waist - alternately turn the body into the right and left sides.
- Legs on the width of the shoulders, hands behind the head - tilts to the right and left.
- In the same initial position - bend the right leg in the knee and reach for it with the elbow of the left hand, then bend the left leg and do the same with the elbow of the right hand.
- Lie on your back (legs straight, arms stretched along the body); on the inspiration, the right leg bends in the knee with the approach to the stomach, the exhalation assumes the initial position, the same is done by the other leg.
- Lying on the back, legs bend at the knees, put the palm of one hand on the stomach, take deep breaths with the diaphragm raised and protrude the abdominal wall; on an exhalation to involve a stomach or belly.
- Similar respiratory movements should be performed lying on the right and left sides.
By the way, the last exercise is a kind of internal self-massage of almost all organs located exactly where bile is stagnant. But a special therapeutic massage for bile congestion should be prescribed only by a doctor who has the results of examining the patient's gallbladder and liver.