Gallbladder dyskinesia

A disease accompanied by a violation of the contractile activity of the gallbladder is quite common.

Dyskinesia of the gallbladder appears mainly due to nutritional errors, but there may be other reasons, both functional and organic.

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Causes gallbladder dyskinesia

Experts have come to the unambiguous conclusion that the main factors in the occurrence of gallbladder dyskinesia at any age are nutritional disorders and nervous stress.

Bile, which initially performs an important function - it helps to digest fats, is produced in the liver. Then, through special channels, it reaches the gallbladder, where it accumulates and is released in a measured manner into the duodenum during the digestion of food.

Constant stressful situations, psycho-emotional stress, and experiences can cause spasms of the smooth muscles of the organ. As a result, bile continues to be produced by liver cells and enters the duodenum constantly, regardless of the presence or absence of food in it. At the same time, part of the bile is thrown to the pancreas, which provokes damage to the glandular tissues, prevents the release of pancreatic juice, as a result of which the pancreas is destroyed (rapid pancreatitis develops).

Excessive flow of bile into the duodenum leads to tissue irritation: an inflammatory process develops - duodenitis. After some time, digestive disorders associated with the throwing of bile into the stomach join in. Thus, peptic ulcer disease and gastritis occur. This course of dyskinesia is called hypermotor (hypertonic), or hyperkinesia of the gallbladder.

But sometimes the disease develops in a different way: nervous disorders can provoke bile stagnation, which will subsequently lead to chronic cholecystitis and the formation of gallstones. Bile is supplied so little that fats remain undigested, and this causes metabolic disorders, which in turn leads to the development of joint diseases, obesity, etc. This course of the disease is called hypomotor (hypotonic) dyskinesia, or hypokinesia.

The food factor of the disease development is as follows: some food products (pickles, spicy, fatty, hot and fried dishes, alcohol) cause the production of large amounts of bile. If the listed products are consumed constantly over a long period of time, then dyskinesia will develop according to the hypermotor type.

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Symptoms gallbladder dyskinesia

The appearance of various symptoms of gallbladder dyskinesia depends on the degree of impairment of the organ's motor function and the type of disease.

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Diagnostics gallbladder dyskinesia

Various methods are used to diagnose gallbladder dyskinesia: instrumental, radiological and laboratory. Let's consider them one by one.

1. Instrumental diagnostic methods for determining gallbladder dyskinesia. The main instrumental diagnostic procedure is ultrasound. This study helps to determine changes in the structure of bile and the anatomy of the gallbladder, detect atony of the gallbladder and check the condition of the bile ducts. Ultrasound is done 12-14 hours after the last meal. To assess the function of the organ, its volume is measured before and after a special "choleretic" breakfast (2 fresh yolks are beaten with 2 tablespoons of sugar, or up to 5 teaspoons of olive oil are taken). A healthy organ after such a breakfast decreases by 40%. With hypomotor dyskinesia, the gallbladder empties very slowly (more than half an hour) and less than 40%. With hypermotor dyskinesia, the bladder empties quickly and more than 40%.
2. X-ray diagnostics of gallbladder dyskinesia. Of the X-ray procedures, if dyskinesia is suspected, cholangiography or cholecystography is performed. The cholangiography method involves intravenous administration of a contrast agent, and subsequent imaging every 15 minutes. Thanks to this, it becomes possible to determine changes in the lumen of the bile ducts and assess the contractility of the gallbladder. The cholecystography method involves the oral use of an iodine substance that can penetrate into the bile. Images of the organ are taken before and after a "choleretic" breakfast.
3. Laboratory diagnostics for determining gallbladder dyskinesia. One of the most important laboratory procedures is fractional duodenal sounding. This procedure helps to distinguish changes in the tone and evacuation-contractility of the gallbladder, as well as to assess the condition of the bile duct sphincter. The procedure should not be accompanied by pain: if pain occurs, this may indicate the presence of some obstructions in the bile ducts.

Dyskinesia of the gallbladder should be diagnostically differentiated from cholecystitis, pancreatitis, duodenitis, gastric ulcer and salpingitis.

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Treatment gallbladder dyskinesia

Treatment of gallbladder dyskinesia should be comprehensive and consist of the following stages:

• impact on foci of chronic infection in the body;
• anthelmintic therapy;
• strengthening the immune system, acquiring skills for proper nutrition and daily routine;
• weakening of the body's allergic predisposition;
• elimination of vitamin deficiency and restoration of the balance of microflora in the intestines.

Nutrition for gallbladder dyskinesia should be gentle in every sense: food should not be hot or cold, not coarse, without aggressive substances (preservatives, chemical additives, hot spices and seasonings). From the list of therapeutic diets, it is recommended to use diet table No. 5. Meals should be taken every 2.5-3 hours, but little by little: this allows you to ensure the rhythm of bile secretion, while not overloading the organ. In the morning and evening, it is advisable to eat fermented milk products - fresh kefir, yogurt, strained cottage cheese. Dinner should be light, without heavy meat foods, and take 2-3 hours before going to bed. With gallbladder dyskinesia, overeating should not be allowed!

Diet for gallbladder dyskinesia

During the acute period of the disease, the following products should be excluded from the menu:

• sauces, including ketchup and mayonnaise;
• rich broth made from meat, fish or mushrooms;
• any salty foods;
• mushroom dishes;
• smoked products (fish, meat, cheese, sausage, etc.);
• radish, garlic and onion, sorrel, mustard and horseradish, red and black pepper.

It is necessary to give up animal fats and lard. Preference should be given to vegetable oils, as they are easier and faster to digest in the body.

It is advisable to exclude sweets from your daily diet, especially baked goods, chocolate, candy, and also to give up coffee and cocoa.

It is recommended to limit the consumption of foods that provoke gas formation: peas, white cabbage.

The use of choleretic products is encouraged: vegetable oil, eggs, fermented milk products. Vegetables, greens, fruits, dark breads must be present in the menu.

It is recommended to drink mineral water with a rich mineral composition (Morshin, Truskavets, Essentuki No. 17), several times a day for 30-50 days.

Forget about ice cream, chips, cream puffs and Coca-Cola. A typical daily diet might consist of the following dishes:

• Breakfast: rice milk soup, boiled egg, cup of tea, dark bread with cottage cheese paste.
• Snack: apple.
• Lunch: a serving of vegetable soup, steamed fish fillet with mashed potatoes, cucumber salad, dark bread, fruit compote.
• Afternoon snack: yogurt with biscuits.
• Dinner: vegetable stew with pasta, bread, cup of tea.
• At night: kefir.

When preparing first courses, give preference to vegetarian soups and borscht, or milk soup.

For main courses, choose low-fat meat or fish (steamed or boiled), for a side dish - rice, buckwheat, pasta, vegetable puree. You can make a steamed casserole from cottage cheese or vegetables, as well as boiled eggs or an omelette in a steamer.

For dessert, you can eat vanilla rusks, biscuits and unsalted crackers, dry sponge cake, marmalade, marshmallows, berries and fruits. If you are not allergic to honey, you can eat it too.

However, don’t forget the main thing: don’t overeat!

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Treatment of gallbladder dyskinesia with medications

The first stage of drug treatment is to stabilize the psycho-emotional state. For this purpose, sedatives are prescribed: bromine, valerian, motherwort preparations. It is possible to use agents that tonic the nervous system: ginseng, eleutherococcus, magnolia vine, etc.

Antibiotics are not prescribed for gallbladder dyskinesia; moreover, their use is highly undesirable.

If worms are detected, therapy is carried out to remove them.

With all the variety of treatment procedures for dyskinesia, the number one medicine is choleretic agents. Such drugs are different: some of them increase the production of bile, while others stimulate its secretion from the bile ducts and bladder into the duodenum. The first group of drugs includes Allochol, Cholagol, corn silk, Cholenzym, Tsikvalon, etc. The second group includes xylitol and sorbitol preparations, antispasmodics, magnesium sulfate, etc. Antispasmodics are prescribed for hyperkinesia, combining treatment with potassium and magnesium preparations, as well as with the intake of warm mineral waters up to six times a day.

In case of hypokinesia, treatment with sorbitol, cholecystokinin, magnesium sulfate, and pancreosimin is recommended.

The standard treatment regimen includes the following medications:

• no-shpa – from 0.01 to 0.04 g three times a day;
• papaverine - from 0.02 to 0.03 g three times a day, or 1 ml of a 2% solution subcutaneously;
• euphyllin - up to 5 ml 2.4% intravenously;
• valerian tincture, 1% sodium bromide orally, seduxen - 1 tablet 3 times a day.

In case of bile stagnation, it is recommended to perform tubage ("blind" drainage) up to 2 times a week. The procedure is performed in the morning: on an empty stomach, the patient is offered to take a "choleretic breakfast" (yolks with sugar, or up to 5 teaspoons of vegetable oil). The patient lies on his right side, placing a heating pad under the liver area. He should lie like this for up to 2 hours: during this time, the organ will be freed from accumulated bile. If after taking the "choleretic breakfast" the patient experiences pain, the procedure is continued after the patient takes a tablet of Drotaverine (No-shpa). Tubage is repeated once every 3-4 days, for a course of 5 to 7 procedures.

Folk remedies for gallbladder dyskinesia

Medicinal plants are successfully used in cases of deficiency of bile production in the liver, difficulties with its exit through the bile ducts, bile stasis or spasm of the gallbladder.

For the hypertonic type of dyskinesia, the herbal preparation Holosas is indicated (1 teaspoon up to 3 times a day half an hour before meals), corn silk (infusion, 2 tablespoons every 3 hours).

For spasms, you can brew herbal mixtures:

• goose cinquefoil, celandine, mint (1:1:1) – drink hot 200-400 ml per day;
• bogbean, wormwood, mint (1:1:1) – drink 2-3 tbsp. half an hour before meals.

For the hypomotor type of dyskinesia, immortelle and general tonic plants (schisandra, ginseng, eleutherococcus, etc.) are indicated.

Use of dry extract of immortelle is carried out in courses of 14-20 days with a break of a week. Take 1 g three times a day.

You can make an infusion from immortelle flowers. It is consumed half an hour before meals according to the following scheme:

• Day 1 – one third of a glass once (glass – 200 ml);
• Day 2 – a third of a glass twice a day;
• Day 3 – one third of a glass three times a day;
• Day 4 – half a glass three times a day;
• Day 5 – half a glass twice a day;
• Day 6 – half a glass once.

If necessary, the course is repeated after a week.

If hypokinesia is combined with low acidity of gastric juice, you can brew the following herbal mixture:

• bogbean, gentian root, dandelion root, mint (1:1:2:2) – drink 3-4 tbsp half an hour before meals;
• St. John's wort, dandelion root, immortelle flower, bogbean, chamomile, centaury (4:4:1.5:1.5:1.5:1.5), drink 200 ml of infusion in the morning and evening. This remedy is especially helpful for constipation due to intestinal atony.

Here are some more simple but effective recipes:

• drink 2 tablespoons of fresh lemon juice every 2 hours every day;
• eat pumpkin raw and boiled, at least ½ kg per day;
• drink freshly squeezed pumpkin juice, 100-200 ml per day, preferably in the evening;
• drink 50 ml of grapefruit juice half an hour before meals;
• Instead of a morning meal, consume the following mixture: 100 ml of fresh carrot juice + 100 ml of warm milk. Breakfast is allowed 1-1.5 hours after drinking the drink;
• drink a cocktail of cucumber, carrot and beetroot juice (equal parts) 100 ml three times a day half an hour before meals;
• drink one glass of an equal mixture of cabbage brine and tomato juice after each meal;
• add 2 tbsp. natural honey to 400 ml of apple juice, take 100 ml up to 4 times a day;
• in case of hypokinesia, drink 1 tbsp. of vegetable oil with lemon juice before meals. If it is too sour, you can add a little sugar;
• steam oatmeal with boiling water, cool, and eat a couple of spoons half an hour before meals (in the morning and before dinner);
• Dry the melon seeds and grind them in a coffee grinder. Pour boiling milk over the resulting flour (1:1), leave in a thermos for up to 2 hours, filter and drink 100 ml in the morning on an empty stomach.

It is recommended to drink tea made from mint, rose hips, and lingonberry leaves.

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Prevention

In order to prevent the occurrence of the disease, one should adhere to the principles of proper and healthy nutrition. Food should be taken regularly (at least 4 times a day), preferably at the same time. The diet should be limited in the use of sauces, hot spices and seasonings. If possible, one should avoid pickles and salted fish, sausages, marinades, dishes with preservatives, soda and chips, as well as alcoholic beverages.

In order to improve the condition of the digestive system, fresh vegetable and fruit dishes, salads, freshly squeezed juices, and fermented milk products should be included in the menu. Such a diet will not only improve the functioning of the digestive system, but will also improve the health of the entire body as a whole.

Try to avoid conflicts and stress, as such situations also play an important role in the development of the disease.

Make a daily schedule for yourself, paying attention to both work and rest. Do not forget about the importance of healthy, full sleep, physical activity. Do morning exercises, take walks in the fresh air.

And last but not least, a note: treat digestive system diseases promptly, do not overeat and do not go hungry for a long time.

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Forecast

Dyskinesia of the gallbladder can proceed without the development of exacerbations if you follow proper nutrition principles, lead a healthy lifestyle, and treat concomitant gastrointestinal diseases in a timely manner. If these rules are ignored, complications such as gallstone disease, cholecystitis, and cholangitis may occur.

With timely treatment and adherence to a diet, as well as stabilization of the psycho-emotional state, the prognosis for gallbladder dyskinesia is quite favorable.

The disease is treatable, but the effect and positive result are possible only with the active participation of the patient in the treatment process. No one will control the diet and daily routine as the patient can do it himself. Follow the doctor's recommendations, and gallbladder dyskinesia will definitely recede.

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