Dyskinesia of the gallbladder

The disease, accompanied by a violation of the contractile activity of the gallbladder, occurs quite often.

Dyskinesia of the gallbladder appears mainly because of nutritional errors, but there may be other causes, both functional and organic.

[1], [2]

Causes of the dyskinesia of the gallbladder

Specialists came to an unambiguous conclusion that the main factors for the onset of dyskinesia of the gallbladder at any age are nutritional disorders and nervous stress.

Bile, which initially performs an important function - promotes the absorption of fats, is produced in the liver. Then, through special channels, it reaches the gallbladder, where it accumulates, and the dosed release into the 12-colon during the digestion of food.

Constant stressful situations, psychoemotional stresses, experiences can cause a spasm of smooth muscles of the organ. As a consequence, bile continues to be produced by the liver cells and enters the 12-colon regularly, regardless of the presence or absence of food in it. Simultaneously, part of the bile fluid is thrown to the pancreas, which provokes damage to the glandular tissue, prevents the release of pancreatic juice, resulting in destruction of the pancreas (rapid pancreatitis develops).

Excessively active entry of bile fluid into the 12-colon leads to tissue irritation: the inflammatory process - duodenitis. Over time, a digestive disorder is associated with it, which is associated with throwing bile into the stomach. Thus, there is a peptic ulcer and gastritis. Such a course of dyskinesia is called hypermotor (hypertonic), or hyperkinesia of the gallbladder.

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

The food factor in the development of the disease is as follows: some foods (pickles, spicy, fatty, hot and fried foods, alcohol) cause the production of a large amount of bile. If the listed products are consumed continuously for a long time, then dyskinesia will develop in a hypermotor type.

[3], [4],

Symptoms of the dyskinesia of the gallbladder

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

[5], [6], [7], [8]

Diagnostics of the dyskinesia of the gallbladder

To diagnose dyskinesia of the gallbladder, various methods are used: instrumental, radiologic and laboratory. Consider them in turn.

1. Instrumental diagnostic methods for the diagnosis of dyskinesia of the gallbladder. The main procedure of instrumental diagnosis is ultrasound. This study helps to determine changes in the structure of bile and anatomy of the gallbladder, detect atony of the gallbladder and check the condition of the bile duct. Ultrasound is done 12-14 hours after the last meal. To assess the function of the organ, measure its volume before and after a special "cholagogue" breakfast (2 fresh yolks beat with 2 tablespoons of sugar, or take up to 5 teaspoons of olive oil). A healthy body after such breakfast is reduced 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 rapidly and more than 40%.
2. Radiographic diagnosis of dyskinesia of the gallbladder. Of radiologic procedures for suspected dyskinesia, cholangiography or cholecystography is performed. The method of cholangiography suggests intravenous administration of contrast medium, and subsequent imaging every 15 minutes. Due to this, it becomes possible to determine the change in the lumen of the bile ducts and evaluate the contractility of the gallbladder. The method of cholecystography consists in the ingestion of iodine substance, which is capable of penetrating into the bile. Snapshots of the organ are carried out before and after the "cholagogue" breakfast.
3. Laboratory diagnostics for the diagnosis of dyskinesia of the gallbladder. One of the most important laboratory procedures is fractional duodenal sounding. This procedure helps to distinguish changes in tone and evacuation capacity of the gallbladder, as well as assess the state of the biliary duct sphincter. The procedure should not be accompanied by pain: if pain occurs, this may indicate that there are any obstructions in the biliary tract.

Dyskinesia of the gallbladder should be diagnosed differently from cholecystitis, pancreatitis, duodenitis, stomach ulcers and salpingitis.

[9]

Treatment of the dyskinesia of the gallbladder

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

• exposure to foci of chronic infection in the body;
• anthelmintic therapy;
• strengthening immunity, acquiring skills of proper nutrition and daily routine;
• weakening of the body's allergic mood;
• elimination of avitaminosis and restoration of the balance of microflora in the intestine.

Nutrition for dyskinesia of the gallbladder should be sparing in all senses: food should be consumed not hot and not cold, not rough, without the content of aggressive substances (preservatives, chemical additives, spicy spices and spices). From the list of medical diets it is recommended to use a dietary table №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 body. In the morning and in the evening it is desirable to use sour-milk products - fresh yogurt, yogurt, wiped cottage cheese. Supper should be easy, without heavy meat food, and pass for 2-3 hours before going to bed. When dyskinesia of the gallbladder should not be overeating!

Diet dyskinesia for the gallbladder

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

• sauces, including ketchup and mayonnaise;
• rich broth 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 abandon animal fats, fat. 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 the daily diet, especially muffins, chocolate, sweets, and also to refuse coffee and cocoa.

It is recommended to limit the use of products that provoke the formation of gases: peas, white cabbage.

The use of cholagogue products is welcomed: vegetable oil, eggs, sour-milk products. Necessarily in the menu must be present vegetables, greens, fruits, dark bread.

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 cakes and coca-cola. An approximate daily diet can consist of the following dishes:

• Breakfast: rice milk soup, boiled egg, a cup of tea, dark bread with curd pasta.
• Snack: apple.
• Lunch: a serving of vegetable soup, fish fillet steamed with potato mashed potatoes, cucumber salad, dark bread, fruit compote.
• Snack: yoghurt with biscuit biscuits.
• Dinner: vegetable ragout with pasta, bread, a cup of tea.
• At night: kefir.

When preparing the first dishes, give preference to vegetarian soups and borsch, or milk soup.

For second courses choose low-fat meat or fish (cooked in a double boiler or boiled), garnish - rice, buckwheat, pasta, vegetable purees. You can prepare a steam casserole from cottage cheese or vegetables, as well as boiled eggs or an omelette in a double boiler.

For dessert, it is allowed to eat vanilla crumbs, biscuits and unsalted crackers, dry biscuit, marmalade, marshmallows, berries and fruits. If there is no allergy to honey, you can eat it.

However, do not forget about the main thing: do not overeat!

[10]

Treatment of dyskinesia of the gallbladder with drugs

The first stage of treatment with medicines consists in stabilizing the psychoemotional state. For this purpose appoint or nominate sedative agents: preparations of a bromine, valeriana, Leonurus. It is possible to use the means that tones up the nervous system: ginseng, eleutherococcus, magnolia vine, etc.

Antibiotics for dyskinesia of the gallbladder are not prescribed, moreover, their reception is highly undesirable.

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

With all the variety of treatment procedures for dyskinesia, the number 1 drugs are cholagogue. Such drugs are different: some of them increase the production of bile, and others - stimulate its release from the bile duct and a bladder into the 12-colon. The first drugs include Allochol, Chololol, corn stigmas, Cholenzyme, Tsikvalon, etc. To the second - preparations of xylitol and sorbitol, spasmolytic agents, magnesium sulfate, etc. Spasmolytic agents are prescribed for hyperkinesia, combining treatment with potassium and magnesium preparations, as well as with reception of mineral waters in a warm form up to six times a day.

In hypokinesia, treatment with sorbitol, cholecystokinin, magnesium sulfate, Pancreosimine is recommended.

The standard treatment regimen includes the administration of the following drugs:

• but-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 2% solution p / k;
• eufillin - up to 5 ml 2.4% w / w;
• tincture valerian, 1% sodium bromide inside, seduksen - 1 tablet 3 times a day.

With stagnation of bile, it is recommended to carry out the tuba ("blind" drainage) up to 2 times a week. The procedure is carried out in the morning: on an empty stomach the patient is offered to take a "cholagogue breakfast" (yolks with sugar, or up to 5 teaspoons of vegetable oil). The patient lies down on the right side, placing a warmer under the liver area. So it is necessary to lie till 2 o'clock: during this time the organ will be released from the accumulated bile. If after the use of "cholagogue breakfast" the patient has pain, the procedure is continued after the patient takes the Drotaverina pill (No-shpy). Tubage is repeated once in 3-4 days, on a course of 5 to 7 procedures.

Alternatives for dyskinesia of the gallbladder

Medicinal plants are successfully used in the deficiency of bile production in the liver, with the difficulties of its release through the biliary tract, with congestion of bile or spasm of the gallbladder.

The hypertensive type of dyskinesia shows the herbal preparation Holosas (1 tsp up to 3 times a day half an hour before meals), corn stigmas (infusion, 2 tablespoons every 3 hours).

With spasms, you can brew a mixture of herbs:

• goose goatee, celandine, mint (1: 1: 1) - drink hot at 200-400 ml per day;
• watch three-leaved, wormwood, mint (1: 1: 1) - drink 2-3 tbsp. L. For half an hour before a meal.

In the hypomotor type of dyskinesia, immortelle and common tonic plants (lemongrass, ginseng, eleutherococcus, etc.) are shown.

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

You can prepare an infusion from the color of immortelle. It is consumed half an hour before a meal according to this scheme:

• I day - one third of the glass once (a glass - 200 ml);
• The second day - a third of the glass twice a day;
• III day - one third of a glass three times a day;
• IV days - half a glass three times a day;
• V day - half a glass twice a day;
• VI day - half a glass once.

If necessary, repeat the course in a week.

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

• three-leaved watch, gentian root, dandelion root, mint (1: 1: 2: 2) - drink 3-4 tablespoons. L. Half an hour before a meal;
• St. John's wort, dandelion root, color of the immortelle, three-leaved watch, chamomile, golden-thousandard (4: 4: 1,5: 1,5: 1,5: 1,5), drink in the morning and in the evening for 200 ml of infusion. Particularly well this tool helps with constipation against the background of intestinal atony.

Here are a few simple but effective recipes:

• drink every day every 2 hours for 2 tbsp. L. Fresh lemon juice;
• eat pumpkin in raw and boiled form, not less than ½ kg in one 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 the morning meal, use this mixture: 100 ml of fresh carrot juice + 100 ml of warm milk. Breakfast is allowed after 1-1,5 hours after taking the drink;
• drink a cocktail of cucumber, carrot and beetroot juice (equally) to 100 ml three times a day for half an hour before meals;
• drink after each meal one glass of equal mixture of brine from cabbage and tomato juice;
• add 2 tbsp. L. Natural honey in 400 ml of apple juice, take 100 ml to 4 times a day;
• when hypokinesia drink before eating 1 tbsp. L. Vegetable oil with lemon juice. If too acidic, you can add a little sugar;
• heat the oat flakes with boiling water, chill, and eat a couple of spoons half an hour before meals (in the morning and before dinner);
• Melon seeds dry and grind in a coffee grinder. The resulting flour pour boiling milk (1: 1), insist in a thermos until 2 hours, filter and drink in the morning to 100 ml on an empty stomach.

It is recommended to drink tea made of mint, dog rose, cowberry leaves.

[11], [12], [13]

Prevention

In order to prevent the onset of the disease, you must 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, spicy spices and seasonings. If possible, avoid pickled cucumbers and salted fish, sausages, marinades, dishes with preservatives, soda and chips, as well as alcoholic beverages.

In order to improve the digestive system, fresh vegetable and fruit dishes, salads, freshly squeezed juices, sour-milk products should be introduced in the menu. Such a diet will not only improve the digestive system, but will also improve the whole organism.

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

Make a schedule for the day, paying attention to both work and leisure. Do not forget about the importance of healthy full sleep, physical activity. Do morning exercises, go for a walk in the fresh air.

And last, not less important remark: timely treat diseases of the digestive system, do not overeat and do not go long hungry.

[14], [15], [16], [17]

Forecast

Dyskinesia of the gallbladder can occur without the development of exacerbations, if you observe the proper principles of nutrition, lead a healthy lifestyle, and in time treat associated gastrointestinal diseases. If these rules are ignored, then there may be complications in the form of cholelithiasis, cholecystitis and cholangitis.

With timely treatment and compliance with the diet, as well as stabilizing the psychoemotional state, the prognosis of dyskinesia of the gallbladder is quite favorable.

The disease is treatable, but the effect and positive result is possible only with the active participation in the treatment of the patient. No one will monitor the compliance with the diet and the regimen of the day, as the patient himself can do. Follow the doctor's recommendations, and dyskinesia of the gallbladder will necessarily recede.

[18], [19], [20]