Inflection of the gallbladder

The excess of the gallbladder refers to a fairly common pathologies of this human organ. The natural, anatomically determined shape of the gallbladder is deformed when bending, which can lead to functional impairment, in particular, a decrease in biliary tract motility.

Considering the main factors of pathogenesis, clinical medicine distinguishes inborn (true and acquired forms). There is also a diagnostic division of this pathology - depending on which specific parts of the gallbladder have undergone deformations.

[1], [2], [3], [4]

Causes of the inflection of the gallbladder: congenital and acquired

Causes of gallbladder inflection that occurs during embryonic development are associated with impaired formation of this organ that occurs during the fifth week of pregnancy (simultaneously with the formation of the liver, bile ducts and duodenum). The future gallbladder is formed by cords of glandular epithelial cells of the abdominal (ventral) part of the embryo - from a common diverticular liver. To various adverse effects on the formation of the biliary system, the fetus is most sensitive during this period. And it is at this stage that the congenital inflection of the gallbladder can be “laid down”, which is associated with a violation of proportions during the growth of an organ.

The disease of a given etiology most often is permanent, which doctors define either as persistent or as a fixed inflection of the gallbladder. But, since the bladder is a hollow organ with a muscular coat (that is, quite mobile), the deformation can change its location and shape. And then the so-called labile break of the gallbladder is diagnosed.

Acquired bending of the gallbladder in an adult may be due to such reasons as:

• enlarged gallbladder, liver, or right kidney;
• increased mobility of the gallbladder (due to its atypical location outside the right longitudinal groove on the lower surface of the liver);
• constant violation of the diet (alternation of prolonged fasting and overeating);
• weight lifting, sudden movements or a long stay in a sitting position (functional bending of the gallbladder);
• significant omission of internal organs relative to the anatomical norm in old age (physiological bending of the gallbladder);
• obesity.

In this case, the bend may occur in different parts of the bladder - in the area of its body, bottom or neck. And according to localization during the diagnosis, gastroenterologists distinguish the inflection of the lower third of the gallbladder, the upper third, bottom, wall and duct of the gallbladder. More often than other types of diagnosed inflection of the neck of the gallbladder, and the most dangerous consequences causes the inflection of the gallbladder in the body.

By the way, the forms taken by the gallbladder as a result of deformation are very diverse and depend on the place and degree of pathology. So, it can bend the hooked form, in the form of an arc or an hourglass. Moreover, there may be a double inflection of the gallbladder, which doctors define as S-shaped and consider it the main cause of biliary dyskinesia in young children.

In rare cases, a woman may have a gallbladder inflection during pregnancy - when the uterus is enlarged to such a size when it begins to “press” the liver and gallbladder. But more often it is just a congenital pathology that didn’t bother the patient and was detected only when a woman was examined for pregnancy.

[5], [6], [7], [8], [9], [10]

Symptoms of the inflection of the gallbladder

In most clinical cases, symptoms of gallbladder inflection are absent. However, when the degree of deformation of this organ is significant, signs of pathology appear as:

• bouts of nausea accompanied by vomiting;
• bitter taste in the mouth (due to throwing bile into the stomach);
• heartburn and belching with air;
• heaviness in the stomach and abdominal distention;
• pains in the right hypochondrium or epigastria;
• excessive sweating;
• constipation or diarrhea;
• decrease or complete loss of appetite.

Pain in the inflection of the gallbladder is defined as aching or dull (often arching), can radiate to the scapula (right), the spine or in the region of the right clavicle.

[11], [12], [13]

Inflection of the gallbladder in a child

The inflection of the gallbladder in a newborn is certainly inborn, and the details of the occurrence of this pathology were considered earlier.

With more severe pathology, symptoms may appear - in the form of a crying baby after breastfeeding, or when the baby begins to be given supplementary foods. Children over 2–3 years old may have complaints of abdominal pain or nausea after eating, vomiting or diarrhea. Parents should not be put off with a visit to a doctor, since the degree of gallbladder deformity can be quite significant. And the violation of the outflow of bile affects not only the state of health of the child, but also the metabolism in his body.

According to pediatricians, a slight inflection of the gallbladder in a child may not manifest itself either in childhood or with age.

[14], [15]

Consequences of the gallbladder bend

The consequences of the gallbladder bend are expressed in the fact that bile (necessary for the digestive process) can accumulate and stagnate. On the one hand, this leads to incomplete splitting of fats that enter the body with food. As a result, the blood content of fatty acids increases, and this, in turn, reduces the activity of glucose utilization and oxidation. With this “scenario”, there is a high probability of reducing the body's tolerance to carbohydrates and the development of diabetes mellitus, as well as the deposition of unsplit lipoproteins in the fat depots - that is, obesity. In addition, a violation of fat absorption for a long time leads to a deficiency of fat-soluble vitamins (A, D, E and K), which is expressed in deterioration of vision, weakening of the contractile activity of muscles (including myocardium), decrease in the elasticity of blood vessels, etc.

On the other hand, the bend of the gallbladder creates all the conditions for the development of inflammatory diseases (most often chronic cholecystitis), as well as the formation of calculus in the gallbladder, which results in cholelithiasis or calculous cholecystitis.

[16], [17], [18]

Diagnosis of the inflection of the gallbladder

The main method by which the diagnosis of the inflection of the gallbladder is performed is ultrasound (synonyms - echography, sonography). Ultrasonography makes it possible not only to determine the functional state of the organ and the exact localization of the pathology, but also to examine its walls, cervical and duct zones.

According to experts, it is not so easy to find out the reasons for the gallbladder to be bent during its ultrasound examination. To determine the nature of the pathology (congenital or acquired), ultrasound is first done before and then after taking the egg yolks, which cause an increased secretion of bile. When the inflection of the gallbladder is congenital, the deformity of the organ remains unchanged.

The echo signs of bending of the gallbladder (or echographic symptoms) with longitudinal and transverse scanning of an organ on a linear-type apparatus are expressed in that the image clearly shows a change in the normal form of the organ in the form of echo-positive linear formations of various localization. Most often, the bend is fixed at the junction of the body of the bubble in the neck. At the same time, bile, located in the bladder, has the appearance of an echo-negative formation.

In addition, during the study of motility of the gallbladder, the presence and degree of biliary dyskinesia, which occurs in 80% of diagnostics of gallbladder bending, is determined.

[19]

Treatment of the gallbladder bend

If the congenital inflection of the gallbladder does not reveal anything, then a person can live with him all his life and discover pathologies by accident - during an ultrasound examination for a completely different reason. In such cases, treatment of the inflection of the gallbladder is not carried out. Especially since the treatment itself is directed not at the cause, but at the symptoms.

If there are signs and confirmation of the diagnosis, treatment of the gallbladder inflection includes taking medications and following a gentle diet.

Gastroenterologists most often prescribe cholagogue in the inflection of the gallbladder.

The preparation Flamin in the form of tablets is used as a choleretic agent in many pathologies of the gallbladder. Its active ingredient is purified polyphenolic flavonoids and glycosides of the medicinal plant of the immortelle sandy. Assigned to one tablet (0.05 g) three times a day - a day 30 minutes before meals, with 100 ml of warm boiled water. Children 3-7 years old should take half a pill three times a day, children 7-12 years old - three quarters pills, over 12 years old - dosage as adults. The course of treatment ranges from 10 to 40 days (determined by the attending physician, taking into account the severity of symptoms of the gallbladder inflection).

The choleretic agent Odeston (synonyms - Himekromon, Cantabilin, Adesine C, Cholestil, Gimecromon) not only accelerates the evacuation of bile into the intestinal lumen, but also removes the spasm of the bile ducts. This drug is prescribed in the dosage: one tablet (0.2 g) three times a day half an hour before meals. The duration of the course of therapy is two weeks. The use of Odeston can cause side effects: diarrhea, urticaria, headaches and epigastric pain, ulceration of the gastrointestinal tract and flatulence. Contraindications to the use of this drug are: childhood, pregnancy and lactation, liver and kidney failure, gall bladder obstruction, ulcerative diseases of the gastrointestinal tract, Crohn's disease, hemophilia.

The combined drug Aristochol (alcoholic extract in vials) contains alcoholic extracts of yarrow herb, celandine, wormwood, dandelion roots, fruits of the cat's paws and thistle. Their cumulative action is aimed at emptying the gallbladder and relieving spasms. In addition, with constipation, Aristochol acts as a laxative. Appointed only to adults - 20-25 drops in a small amount of water 2-3 times a day (after meals).

The drug Hofitol in the inflection of the gallbladder, which has choleretic and hepatoprotective effects, and is often prescribed in the treatment of this pathology in children. The active component of this drug is a dry water extract from the leaves of the field artichoke. Hofitol tablets are taken by adults and children over 12 years old - 1-2 tablets three times a day (before meals); children 6-12 years old - one tablet each. The course of treatment is 2-3 weeks.

Hofitol in the form of a solution is prescribed inside 2.5-3 ml three times a day (before meals); a quarter or half of the adult dose is prescribed to children under 12 years old (as prescribed by the doctor). A side effect with prolonged use of this drug is expressed by diarrhea. And among the contraindications are: obstruction of the biliary tract, acute inflammatory diseases of the kidneys, liver and biliary tract, liver failure, as well as the presence of stones in the gallbladder.

Synthetic cholagogue agent Tsikvalon (synonyms - Beveno, Flavugal, Vanilon, Divanil, Divanon) in the form of tablets of 0.1 g helps relieve the symptoms of the bending of the gallbladder. His doctors prescribe 0.3 g per day (3 tablets) in the first two days treatment. Then taken on a tablet 4 times a day. The course of treatment lasts 3-4 weeks. Before the second course, a break for 30 days is required.

Contraindications of Tsikvalon are individual hypersensitivity, acute hepatitis, blockage of the bile ducts, peptic ulcer of the stomach and duodenum, cirrhosis of the liver. Side effects include a feeling of pressure in the liver and gallbladder and increased bitterness in the mouth.

Treatment of bending of the gallbladder with herbs

The most popular and affordable remedy for treating the gall bladder with herbs is the Pharmaceutical Choleretic Fee No. 3. It consists of medicinal plants such as chamomile, calendula and tansy flowers, peppermint leaves and yarrow herb.

The broth is prepared in a water bath for 10-15 minutes at the rate of 2 tablespoons of the collection per cup of boiling water. For receiving the resulting broth must be diluted with boiled water to the original volume of 200 ml.

The broth should be drunk on a third cup at least three times during the day - half an hour before meals (shake the broth before taking). The maximum duration of treatment is one month. For calculous cholecystitis, pregnancy and lactation, as well as for children under 12 years old, this remedy is prohibited. Possible side effects - heartburn and allergic reactions.

Diet in the bend of the gallbladder

To alleviate the main symptoms of this pathology, gastroenterologists recommend adhering to the principles of therapeutic nutrition. Dieting when the gallbladder bends involves eating small amounts at least 5 times a day (with 4-hour breaks between each meal).

It is necessary to exclude from the diet:

• fatty, fried, smoked and spicy;
• spices and seasonings;
• canned food and snacks;
• pulses and whole grains;
• grapes, raisins, dried apricots and dried apricots;
• carbonated drinks and alcohol.

Limitations are: salt, butter, chocolate, coffee, cocoa, honey, sugar, jam.

You can eat lean meat and poultry, fish, seafood, vegetables and fruits (not sour), cereals, pasta, dairy products, vegetable oil (refined). Cooking, roasting and steaming should be used in cooking.

[20]

Gymnastics in the inflection of the gallbladder

With properly selected exercises, gymnastics in the excesses of the gallbladder can be not only a medical measure, but also a preventive means of preventing deterioration. Although all gastroenterologists are unanimous that the prevention of bending the gallbladder is by definition impossible (of course, if we talk about congenital pathology).

To improve the work of the gallbladder, it is recommended to perform the following exercises when bending the gallbladder:

• Exercise 1

Starting position: lying on the stomach, arms stretched along the body, feet rest with fingers on the floor. On the exhale, the head, the thorax, the arms and the legs (even at the knees) are lifted simultaneously from the floor plane. It is necessary to fix the pose for a few seconds, but do not hold your breath. Then slowly, as you exhale, return to the starting position. Perform 5-6 times.

• Exercise 2

Starting position: lying on his back, straight arms extended behind his head, loin pressed to the floor. On the exhale, raise straight legs 20 cm from the floor and hold for 3-5 seconds, then raise the legs higher - 50 cm from the floor and also linger for 5 seconds (do not hold your breath). As you exhale, slowly lower your legs and relax. Repeat 4 times.

• Exercise 3

Starting position: supine, legs straight, arms extended along the body.

Make the deepest breath in as much as possible, hold your breath for 3 seconds, and then slowly exhale the air, “squeezing out” it, straining the muscles of the abdominal wall. Repeat 8-10 times.

[21], [22]

Gallbladder Inflection Prediction

The prediction of the inflection of the gallbladder is unfavorable only in one case. When this pathology completely overlap the flow of bile. As a result, gallbladder wall rupture may occur. And then the gallbladder is removed surgically.

Qualified medical care, proper nutrition, good physical exertion and a positive emotional attitude will help to avoid biliary dyskinesia or chronic cholecystitis, which are usually threatened by the bending of the gallbladder.

[23], [24]