Biliary dyskinesia

Biliary dyskinesia (BD) is a functional disorder of the body's biliary system that is associated with impaired movement of bile from the gallbladder into the duodenum. Normally, bile is secreted by the gallbladder and released into the duodenum when meals are eaten to aid in the digestive process.

Biliary dyskinesia can manifest itself in two forms:

1. Hypokinetic dyskinesia: In this case, the gallbladder contractions become weak and insufficient for normal bile production. This can lead to bile retention and cause abdominal pain and discomfort after meals.
2. Hyperkinetic dyskinesia: In this form, gallbladder contractions become too active and frequent, which can also cause abdominal pain and discomfort. Patients may experience frequent contraction-like pains.

Symptoms of GI symptoms may include:

• Pain in the right upper quadrant of the abdomen.
• Feeling of heaviness or discomfort after eating.
• Possible heartburn and nausea.
• Flatulence and vomiting.

Diagnosis of GERD includes clinical examination, biliary ultrasound, magnetic resonance cholangiopancreatography (MRCP), and other tests. Treatment depends on the form of GERD and may include dietary recommendations, medications to improve gallbladder contractions, and other methods.

Causes of the biliary dyskinesia

The causes of biliary dyskinesia can be varied, including:

1. Hepatobiliary diseases: Diseases of the liver, gallbladder, or bile ducts can cause biliary dyskinesia. Examples of such diseases include inflammation (e.g., cholecystitis), gallbladder or bile duct stones, cirrhosis, and others.
2. Psychosomatic factors: Stress, anxiety and psycho-emotional disorders can cause functional biliary dyskinesia. In this case, problems can occur without obvious structural changes in the organs.
3. Food factors: Certain foods can trigger contractions of the gallbladder and bile ducts, which can cause symptoms of dyskinesia. These can include fatty, fried or spicy foods, as well as alcohol.
4. Hormonal factors: Changes in hormonal levels, such as pregnancy or taking oral contraceptives, can affect gallbladder contraction and cause symptoms of dyskinesia.
5. Neurologic factors: Some neurologic diseases, such as parkinsonism or diabetes, may affect normal biliary motility.

Pathogenesis

The pathogenesis or mechanism for the development of LDD may vary depending on its type. Here are the general aspects of the pathogenesis of LDD:

1. Gallbladder musculature: In hyperkinetic form of GIR, the gallbladder musculature may contract too vigorously and frequently, resulting in pain and an inappropriate release of bile into the intestine. In the hypokinetic form, the bladder muscles do not contract sufficiently, which can cause slow movement of bile and stone formation.
2. Sphincter dysfunction: Dyskinesia may be associated with a disruption of the sphincters that control the flow of bile out of the gallbladder or liver. This can lead to bile retention and pain.
3. Psychosomatic and emotional factors: Emotional stress, anxiety and depression can affect biliary function. For example, stress can provoke gallbladder contractions and increase the symptoms of BPS.
4. Food factors: Foods rich in fat can stimulate gallbladder contractions and cause symptoms of GI in some people. This is due to the need for bile to digest fat.
5. Hormonal changes: Hormonal changes, such as pregnancy or use of hormonal medications, can affect biliary function.
6. Genetic factors: Some people may be more predisposed to developing LDD due to genetic factors.
7. Inflammation: Inf lammation of the biliary tract or gallbladder can provoke or exacerbate symptoms of GI symptoms.

Symptoms of the biliary dyskinesia

Symptoms of GIJD can vary depending on the type and degree of the disorder, but typically include the following manifestations:

1. Pain or discomfort in the right upper quadrant of the abdomen: This is one of the most common symptoms of GERD. The pain can be moderate to intense and usually gets worse after eating fatty or fried foods.
2. Dyspepsia: Patients with GERD may experience digestive disorders such as heartburn, nausea, vomiting, and feeling full.
3. Stool disorders: Other symptoms may include diarrhea or constipation, which may be due to impaired fat digestion.
4. Unpleasant sensations in the stomach area after eating: A feeling of heaviness, abdominal bloating and discomfort may occur after eating.
5. Pain that may irradiate to the shoulder or back: In some cases, pain from GI pain may spread to the shoulder or back area.
6. Recurrent abdominal pain: Symptoms of GERD can be recurrent, meaning they appear periodically.
7. Worsening after eating fatty or spicy foods: Symptoms of GERD may worsen after eating foods rich in fats, spices or alcohol.
8. Bile duct sphincter dysfunction: In some cases, GERD can cause bile duct sphincter dysfunction, which can lead to reflux of bile into the stomach.

The pain of biliary dyskinesia can vary in intensity and localization, and it can occur at different times. Here are some of the typical characteristics of pain in this condition:

1. Pain in the right upper quadrant of the abdomen: This is the most typical location of pain in biliary dyskinesia. Pain is often felt under the ribs on the right side, in the area of the liver.
2. Pain after eating: Symptoms usually increase after eating fatty, fried or spicy foods, as these foods can provoke contractions of the gallbladder and bile ducts.
3. Colic: Pain can be spasmodic, meaning it can come and go in waves, which is often called colic.
4. Pain accompanied by other symptoms: Abdominal pain may be accompanied by other symptoms such as nausea, vomiting, white bile (mustard colored bile), stool disorders, abdominal bloating, etc.
5. Pain can be triggered by physical activity, stress, or ingestion of certain foods.

Forms

Biliary dyskinesia (BD) can manifest itself in different forms, and doctors usually distinguish between two main types of this disorder:

1. Hyperkinetic (hyperfunctional) GI: In this case, contractions of the gallbladder and bile ducts are too frequent or too intense. This can lead to abdominal pain, discomfort and other symptoms associated with overactivity of the bile ducts.
2. Hypokinetic (hypofunctional) GI: In this case, gallbladder and bile duct contractions are too slow or weak. Such abnormalities can lead to slow or incomplete emptying of the gallbladder, which can cause stone formation and associated symptoms.

Hyperkinetic LDL is often associated with pain, cramping and diarrhea, whereas hypokinetic LDL can lead to pain, constipation and gallstones. It is important to emphasize that symptoms may vary from patient to patient, and the exact type of GI can only be determined after diagnosis by a physician using clinical findings and instrumental testing such as biliary ultrasound.

Complications and consequences

Here are some of the possible complications and consequences of FGID:

1. Gallstonedisease: Biliary dyskinesia can contribute to the formation of gallstones (cholelithiasis) due to insufficient emptying of the gallbladder. Stones can cause pain, inflammation, and even blockage of the bile ducts.
2. Cholecystitis (inflammation of the gallbladder): Jvp may increase the risk of cholecystitis, which is accompanied by right upper quadrant abdominal pain, vomiting, and fever.
3. Pancreatitis (inflammation of the pancreas): Disrupted bile output from the gallbladder can cause pancreatitis, which can lead to upper abdominal pain, elevated pancreatic enzyme levels, and other symptoms.
4. Jaundice: Long-term impairment of bile excretion from the liver may cause jaundice of the skin and sclera of the eyes, indicating impaired bilirubin metabolism in the body.
5. Persistent pain and discomfort: GIHD can lead to chronic pain and discomfort in the upper abdomen, which reduces the patient's quality of life.
6. Reflux esophagitis: Uncontrolled throwing of bile into the stomach (bile acid reflux) can cause inflammation of the esophageal mucosa (esophagitis) and associated symptoms such as heartburn.
7. Degeneration of the gallbladder mucosa: Long-term effects of dyskinesia on the gallbladder can lead to changes in its structure and function.
8. Irritable bowel syndrome: IBS can be accompanied by symptoms of irritable bowel syndrome (IBS), such as abdominal pain, diarrhea, and constipation.

An exacerbation of biliary dyskinesia can manifest as both an increase in symptoms and a worsening of the patient's overall condition. These exacerbations can be caused by a variety of factors and conditions, including the following:

1. Improper diet: Eating fatty, fried, spicy or too much food can put more strain on the gallbladder, which can exacerbate the symptoms of GI symptoms.
2. Stress and emotional stress: Stress can cause worsening of symptoms of BPS as it can affect the motility of the biliary tract.
3. Overeating: Eating too much food or overeating can cause symptoms to worsen and exacerbate DLD.
4. Alcohol use: Alcohol use can increase symptoms of LDD and cause an exacerbation.
5. Continuous use of uncontrolled medications: Some medications can affect biliary tract function, so using them without consulting a doctor can cause an exacerbation.
6. Diseases such as cholecystitis: Inflammation of the gallbladder (cholecystitis) or the formation of stones in the bile ducts can cause acute symptoms and exacerbation of DLD.

An exacerbation of LDD may be manifested by increased pain in the right upper quadrant of the abdomen, nausea, vomiting, stool disturbance, and other symptoms.

Diagnostics of the biliary dyskinesia

You should see a gastroenterologist for diagnosis and treatment of biliary dyskinesia. A gastroenterologist is a specialist in diseases of the digestive organs, including the biliary tract and biliary system.

At your first consultation, your gastroenterologist will conduct a detailed interview to find out your symptoms and medical history. He or she may ask you questions about the nature of your pain, eating habits, physical activity, and other factors that could be related to GERD.

Further, the doctor may prescribe various laboratory and instrumental studies, such as ultrasound examination of the gallbladder and bile ducts, functional tests of the biliary system, gastroenteroscopy and other methods to establish an accurate diagnosis and assess the degree of violation.

After receiving your results and diagnosis, your doctor will develop a personalized treatment plan that may include diet, drug therapy, exercise, and other activities to improve your condition.

It is important to see a gastroenterologist to get a professional medical evaluation and treatment, as GIJP can have different forms and degrees of severity, and treatment should be appropriate and individualized for each patient.

Diagnosis of biliary dyskinesia (BD) requires a comprehensive approach and may include the following methods and procedures:

1. Medical History and Physical Exam: The physician will take a history and perform a physical exam to look for symptoms characteristic of GI, such as right upper quadrant abdominal pain, nausea, and vomiting.
2. Laboratory tests: Blood tests can help rule out other diseases and evaluate liver function. A blood test for bile acids may also be performed.
3. Ultrasound (biliary ultrasound): This method allows you to visualize the gallbladder and biliary tract and determine the presence of stones, inflammation, or other structural changes.
4. Cholangiography: This is a special X-ray examination with the injection of a contrast agent into the bile ducts for more detailed visualization.
5. Biliary test (hepatobiliary scintigraphy): This test evaluates the contractile function of the gallbladder and detects abnormalities in its function.
6. Gastroenteroscopy: Sometimes an endoscopic examination of the upper digestive tract may be necessary to identify other possible causes of symptoms.
7. Manometry: This test measures the pressure and contractility of the bile ducts to determine if dyskinesia is present.

Differential diagnosis

Differential diagnosis of biliary dyskinesia (BD) involves identifying and distinguishing this condition from other diseases or disorders that may have similar symptoms. It is important to diagnose the condition correctly in order to prescribe the most appropriate treatment. The following are some conditions to consider in the differential diagnosis of GI tract disease:

1. Gallstonedisease: Similar to GI, gallstone disease can cause pain and discomfort in the abdominal area. However, in cholelithiasis, symptoms may be related to the presence of gallstones in the gallbladder or bile ducts.
2. Gastritis and peptic ulcer disease: Thesegastrointestinal disorders can also have similar symptoms to GI, including upper abdominal pain and nausea.
3. Irritable bowel syndrome (IBS): Symptoms of IBS, such as abdominal pain, constipation, or diarrhea, may resemble those of IBS. However, they are usually not related to biliary tract function.
4. Pancreatitis: Inflammation of the pancreas (pancreatitis) can be manifested by upper abdominal pain, which can be similar to the symptoms of PJD.
5. Gastroesophageal reflux disease (GERD): GERD can cause heartburn, upper abdominal pain, and nausea, which can be confused with symptoms of GERD.
6. Heart problems: Myocardial infarction or other heart disease can manifest with upper abdominal pain and even nausea, which can be misidentified as VHD.
7. Liver disease: Variousliver diseases, such as hepatitis or cirrhosis, can cause upper abdominal pain and symptoms similar to LDD.

Treatment of the biliary dyskinesia

Treatment for biliary dyskinesia (BD) may include the use of various medications that help improve gallbladder and biliary tract function. Your doctor may recommend the following groups of medications:

1. Pain and spasm medications: These medications can help reduce pain and discomfort associated with contractions of the gallbladder and biliary tract. Examples include Drotaverine (No-shpa), papaverine, etc.
2. Drugs to normalize gallbladder contractility: Some drugs can help balance the contractile activity of the gallbladder. These may be antispasmodics or myorelaxants.
3. Drugs thatimprove digestion: Drugs containing choleretic components, such as cholecystokinin, may help stimulate bile secretion and improve digestion.
4. Diuretic medications: These medications help improve the secretion of bile from the gallbladder. Examples include ursodeoxycholic acid (Ursofox), cholecystokinin, and others.
5. Medications to reduce inflammation: In cases where the GI tract is associated with inflammation of the gallbladder or biliary tract, your doctor may prescribe anti-inflammatory medications such as NSAIDs (non-steroidal anti-inflammatory drugs) or glucocorticoids.
6. Drugs to improve gastrointestinal motility: In some cases, GI tract motility may be impaired. Medications such as metoclopramide may help improve motility.

Other medications:

1. Carsyl: Is a drug that contains sylmarin, an active ingredient isolated from the Mariana thistle plant. Sylmarin may have antioxidant and anti-inflammatory properties and may help protect the liver. It is commonly used in the treatment of liver diseases such as cirrhosis and fatty liver dystrophy. In some cases, it can be used in cases of LDL to improve liver function.
2. Ursosan: Contains ursodeoxycholic acid, which may help dissolve cholesterol in the bile and prevent the formation of gallstones. This medication may be used to treat a variety of biliary tract conditions, including BPS.
3. Allochol: This is a combination medicine that contains bile acids and dry bile. It can improve digestive processes and help manage some symptoms of GI symptoms such as nausea and bloating.
4. Ursofalc (Ursodeoxycholic acid): Ursofalc is a choleretic drug that can be prescribed in cases of GI. It helps to improve bile secretion, reduce bile viscosity, and prevent gallstone formation. Ursofalc may also have anti-inflammatory and liver-protective properties.
5. Duspatalin (Mebeverine): Duspatalin is an antispasmodic medicine that helps relieve spasms of the smooth muscles of the biliary tract and gallbladder. It may help reduce the pain and discomfort associated with bile contractions.
6. Trimedate (Trimebutine): Trimedate is also an antispasmodic drug and can be used to improve symptoms associated with BPH. It helps to relax smooth muscles and relieve spasms in the biliary tract.
7. Hofitol: This is a phytopreparation that contains artichoke extract. Artichoke can help improve digestion and stimulate bile production. It is sometimes recommended for liver and biliary tract support. It is best to consult a physician for use and dosage.
8. No-shpa(Drotaverine): No-shpa is an antispasmodic medicine that may help relieve cramps and spasms in the bile ducts and abdomen. It may be helpful in relieving the pain and discomfort associated with GI tract pain and discomfort. The dosage is determined by your doctor.
9. Magnesium: This is an important micronutrient that can soothe muscle cramps and spasms. Some people with GERD may experience biliary tract spasms, and taking magnesium may help improve symptoms. The dosage can also be prescribed by a doctor.

Diuretics for biliary dyskinesia

In biliary dyskinesia, choleretic medications are often used to improve gallbladder contractility and relieve symptoms. These medications help stimulate the normal excretion of bile and prevent the formation of gallstones. Here are some examples of choleretic medications that can be used for GERD:

1. Cholenetic drugs: Drug s in this class help stimulate gallbladder contractility and bile secretion. They are often used in hypotonic (mild) GI tracts. Examples include cholecystokinetics such as the drug Cerucal (metoclopramide).
2. Bile-based medications: Some medications contain bile or its components and help improve fat digestion and reduce symptoms associated with GERD.
3. Sorbentmedications: Sorbents, such as Activated Charcoal or Smecta, can help bind and eliminate toxins and bile acids from the body, which can relieve symptoms.
4. Phytopreparations: Some herbal preparations, such as Artichoke or Chicory, can help normalize gallbladder function and improve the process of bile excretion.
5. Gallbladder decompression medications: In rare cases where GIJP is accompanied by increased gallbladder pressure (hypertensive form), pressure-lowering medications such as Drotaverine or Haloship are used."

6. Milk of succession preparations: This herbal preparation (silymarin) may help protect the liver and improve bile excretion.

Tubage for biliary dyskinesia

The gallbladder tubage procedure is performed in a medical facility under the supervision of a physician or medical staff. Here is a general overview of how tubage is done:

1. Patient preparation: Before the procedure, you may need to take some preparatory measures, such as following a diet for a few days before the procedure or stopping certain medications. Your doctor will always have a pre-procedure consultation with you and give you detailed instructions.

2. Equipment preparation: The health care provider will prepare a special tube (catheter) and tubing solution.

3. Conducting the procedure:

   • You will be in a treatment room where you will be asked to assume a comfortable position, usually lying on your back.
   • The healthcare provider will insert a thin tube (catheter) through your mouth and throat into your gallbladder.
   • A special solution that stimulates gallbladder contraction will be delivered through this tube.
   • The gallbladder will begin to contract and bile will be discharged through the tube.
   • The procedure may continue for several minutes until the gallbladder is completely empty.

4. Completionof the procedure: After the tubing is completed, the tube is removed and you are monitored for a while to make sure there are no unpleasant side effects or complications.

5. Post-procedure care: You may be asked to follow a special diet and limit physical activity for some time after the procedure.

Tubage can be an effective method of relieving the symptoms of biliary dyskinesia, but it is only performed for medical reasons and under the supervision of specialists. Therefore, it is important to discuss the possibility of tubage with your doctor and follow his or her recommendations.

Diet in biliary dyskinesia

Aimed at reducing symptoms associated with gallbladder and biliary tract dysfunction. The goal of this diet is to reduce pain, bloating, nausea, and dyspeptic disorders. It is important to remember that the diet may vary depending on whether the GI is hyperkinetic (overactive contraction) or hypokinetic (underactive contraction) type.

Here are the general dietary recommendations for FJP:

1. Limit fatty foods: Reducing your intake of fatty foods such as oil, fatty meats, butter and fast food can reduce the strain on the gallbladder. Limiting fats can also reduce the frequency and strength of gallbladder contractions.
2. Increase your fiber intake: Fiber -rich foods such as vegetables, fruits, grains and nuts can help regulate digestion and prevent constipation.
3. Divide your meals: D ividing your meals into 5-6 small portions throughout the day can reduce the burden on the gallbladder and biliary tract.
4. Avoid spicy seasonings: Sp icy and burning spices can stimulate gallbladder contractions and increase symptoms.
5. Drink enough fluids: Drinking enough water throughout the day helps in maintaining normal biliary function.
6. Avoid alcohol and hard liquor: Alcohol can stimulate gallbladder contraction and cause pain.
7. Consider individual reactions: People with LDD may react differently to different foods, so it's important to keep track of which foods worsen or improve symptoms.
8. Follow your doctor's recommendations: Your doctor may offer individualized diet recommendations, depending on your condition.

Menu for biliary dyskinesia

When you have biliary dyskinesia, it is important to follow a diet that helps reduce the strain on the gallbladder and biliary tract. Here is an example of a menu that may be recommended for this condition:

Breakfast:

• Egg whites omelet with vegetables (tomatoes, spinach, mushrooms).
• Oatmeal on water or low-fat milk.
• A cup of green tea.

Afternoon snack:

• Apple or pear.

Lunch:

• Chicken soup with vegetables (no fat).
• Steamed chicken breast with herbs and lemon juice.
• Quinoa or buckwheat.
• Fresh vegetable salad (without oil).
• Nonfat yogurt.

Afternoon snack:

• Nuts (walnuts, almonds) or carrots.

Dinner:

• Buckwheat or quinoa with steamed chicken breast or fish (salmon, cod).
• Asparagus or broccoli.
• Green tea or herbal tea.

Afternoon snack:

• Curd with low-fat milk and honey.

Note:

• Avoid fatty foods, fried and greasy foods, as well as spicy condiments and smoked meats.
• Drink enough water throughout the day to maintain normal biliary function.
• Food should be in small portions and meals divided into 5-6 meals per day.
• Consider your individual reactions to different foods and avoid those that exacerbate symptoms.
• Taking medications prescribed by your doctor, such as ursodeoxycholic acid or antispasmodics, should be in accordance with your doctor's recommendations.

With biliary dyskinesia, it is important to avoid certain foods and consider the specifics of the diet. Here is a list of what is better to exclude or limit in the diet in this condition:

What is not recommended for biliary dyskinesia:

1. Fatty foods: Butter, cream, lard, fatty meats and friedfoods should be limited or eliminated from the diet as they can cause severe gallbladder contractions.
2. Spicy Spices: Spicy spices and condiments can irritate the bile ducts and cause pain.
3. Alcohol: Alcoholic beverages can stimulate gallbladder contractions and increase symptoms.
4. Chocolate and cocoa: Chocolate and foods high in cocoa can cause bile duct contractions.
5. Fast food and ready meals: These foods are often high in fat and can negatively affect the biliary tract.
6. Smokedand can ned foods: Smoked and canned foods can contain a lot of additives and fat, which should be avoided.

What can be included in the diet for biliary dyskinesia:

1. Lean proteins: Skinless chicken meat, turkey, low-fat fish, eggs (proteins).
2. Vegetables: Plenty of fresh vegetables including broccoli, spinach, carrots, cauliflower and zucchini.
3. Fruit: Low-fat fruits such as apples, pears and bananas.
4. Grains: Buckwheat, quinoa, oatmeal and crumble.
5. Non-fat dairy products: Non-fat yogurt, skim milk and cottage cheese.
6. Herbs and Spices: Light herbs and spices such as basil, parsley and lemon juice can be used to add flavor without irritating the bile ducts.
7. Honey: Honey in moderate amounts can serve as a natural sweetener.

Folk remedies

Biliary dyskinesia can be an unpleasant condition, and in some cases, certain folk remedies can help reduce symptoms. However, before using any folk treatments or adding new foods to your diet, it is important to consult your doctor to rule out serious medical problems and to make sure that the chosen remedies will not cause the condition to worsen.

1. Herbs: Some herbs may have choleretic and antispasmodic effects and may help relieve symptoms of PJD. Examples of such herbs include melissa, chamomile, peppermint, yarrow, and immortelle.
2. Teas: Herbal teas with the above-mentioned herbs or blends can be beneficial. You can prepare such a tea yourself by adding the herbs to boiling water, letting them steep and then drinking it. However, keep in mind that excessive consumption of tea with melissa or mint can cause sphincter relaxation and worsen symptoms.
3. Oils: Various oils, such as olive oil or vegetable oil, can help soften feces and improve bowel emptying. They are sometimes used to treat constipation that may be associated with FTD.
4. Honey: Honey can improve digestive processes and help shrink the gallbladder. However, its consumption should be limited as honey is a caloric product.

Folk remedies can be used as an adjunct to mainstream treatment for biliary dyskinesia (BD). Here are a few folk medicine recipes that may be useful in the treatment of biliary dyskinesia:

1. Herbal tea:

   • Ingredients: melissa, chamomile, mint (1 teaspoon of each herb), 500 ml of boiling water.
   • Mix herbs in boiling water and let steep for 10-15 minutes.
   • Drink a cup of this tea in the morning and evening.

2. Garlic infusion:

   • Ingredients: 3-4 garlic cloves, 1 cup of water.
   • Crush the garlic and pour a glass of water over it.
   • Allow to infuse overnight.
   • Drink the resulting infusion in the morning on an empty stomach.

3. Honey and lemon:

   • Ingredients: 1 tablespoon of honey, juice of half a lemon.
   • Mix honey and lemon juice.
   • Take this mixture in the morning on an empty stomach.

4. Olive oil:

   • Ingredients: 1-2 tablespoons of olive oil.
   • Consume olive oil in the morning, on an empty stomach, to help stimulate the gallbladder.

5. Immortelle (flower):

   • Ingredients: 1 teaspoon of dried immortelle flowers, 1 cup of boiling water.
   • Brew immortelle flowers in boiling water and let infuse for 10-15 minutes.
   • Drink this tea several times a day.

These recipes may help relieve some of the symptoms of FJP, but they should not replace the main treatment prescribed by your doctor. It is important to follow your doctor's recommendations and make sure the recipes you choose are safe for you, especially if you have other medical conditions or are taking medications.

Vitamins for biliary dyskinesia

Vitamins and minerals can play an important role in maintaining the health of the biliary tract and the overall condition of patients with biliary dyskinesia (BD). However, vitamin and mineral supplements should be taken with caution, and only after consulting a doctor, as uncontrolled use can have unwanted side effects and interactions with other medications. Your doctor can perform tests to determine if you have a deficiency of certain vitamins or minerals and recommend appropriate supplements.

Here are a few vitamins and minerals that may be helpful for JVP:

1. Vitamin D: Vitamin D helps with calcium absorption and may be helpful in maintaining bone health. Biliary dyskinesia can lead to impaired absorption of fat and therefore vitamin D. However, the dosage of vitamin D should be determined by a physician.
2. Vitamin K: Vitamin K is essential for normal blood clotting. Deficiency of this vitamin can occur in biliary tract disorders, as bile is necessary for the absorption of fat, which in turn aids in the absorption of vitamin K.
3. Magnesium: Magnesium plays an important role in muscle function and can help relieve the cramps and spasms that sometimes accompany GI tracts.
4. Vitamin E: Vitamin E is an antioxidant that may help improve liver function.
5. Vitamin C: Vitamin C is also an antioxidant and can help strengthen the immune system.

Clinical Guidelines

May include the following activities and tips:

1. Nutrition:
   • Follow a diet rich in fiber and low in calories. Avoid excessively fatty, fried, spicy and spicy foods that may aggravate symptoms.
   • Divide meals into several smaller meals throughout the day to reduce the strain on the biliary tract.
2. Avoid Alcohol: Alcohol can worsen the symptoms of GERD, so it is recommended to eliminate it from your diet.
3. Physical activity: Regular physical activity can help improve biliary motility and relieve symptoms. However, consider your physical capabilities and consult your doctor before engaging in vigorous exercise.
4. Avoid stress: Stress can worsen the symptoms of FGID, so try to avoid stressful situations and practice relaxation techniques such as yoga or meditation.
5. Drug therapy: Your doctor may prescribe medications to improve biliary motility and reduce pain and discomfort. These medications may include antispasmodics and choleretic medications.
6. Follow your doctor's orders: It is important to follow all recommendations and treatment regimens prescribed by your doctor. Periodic medical monitoring and check-ups will help to evaluate the effectiveness of treatment and make adjustments if necessary.
7. Surgery: In some cases, when conservative treatment is ineffective and there are serious complications, surgery such as gallbladder removal (cholecystectomy) may be necessary.
8. Weight management: If you are overweight or obese, working on weight loss can improve your symptoms of GI symptoms.

Prevention

Prevention of biliary dyskinesia (BD) aims to reduce the risk of developing this condition or to improve symptoms in those who have already experienced it. Here are some recommendations for preventing BJP:

1. Adherence to a healthy lifestyle:

   • Maintain a normal weight and avoid obesity, as being overweight can increase the risk of LDL.
   • Moderate physical activity promotes normal motility of the biliary tract and digestive system.

2. Proper nutrition:

   • Follow a balanced, low-fat diet rich in vegetables, fruits, lean proteins and grains.
   • Avoid frequent consumption of fatty, fried, spicy and smoked foods.
   • Limit your alcohol consumption.
3. Moderate caffeine consumption: In some people, moderate caffeine consumption may help reduce the risk of gallstones.
4. Gradual weightloss: If you need to lose weight, do it slowly and methodically to avoid a sudden decrease in biliary function.
5. Medication management: If you are taking medications that may affect gallbladder function, discuss this with your doctor and follow their recommendations.
6. Avoid long intervals between meals: Regular meals promote normal biliary tract contraction and digestion.
7. Avoid stress: Stress can affect the motility of the bile ducts, so practice stress management and relaxation techniques such as yoga and meditation.
8. Regular check-ups: If you have risk factors or a predisposition to LDD, get regular physical exams and consult with your doctor to detect problems early.

Biliary dyskinesia and the army

A citizen's acceptance into the military depends on many factors, including his or her health and medical conditions. Biliary dyskinesia can affect military enlistment, but the decision is made by the military medical commission based on medical data and legislation.

If you have a VWD and are a conscript, you should follow the official draft procedures and undergo a medical evaluation by a military medical board. The doctors of this commission will assess your condition and decide whether you are fit for military service.