Physiotherapy for dyskinesia of the gallbladder and biliary tract

Dyskinesia of the gallbladder and bile ducts is a pathological condition manifested by a violation of the tonus and motor-evacuator function of the gallbladder and bile ducts caused by inflammatory-dystrophic diseases of the hepatobiliary and duodenopancreatic zones, dysfunction of the autonomic nervous system, and anomalies in the development of the gallbladder.

A complex of therapeutic measures, including the use of the influence of therapeutic physical factors, in patients with this pathology includes methods that promote either stimulation of the tone of the gallbladder and bile ducts (with hypotonic-hypokinetic form), or relaxation of their hypertonia (hypertonic hyperkinetic form) .

With reduced motor-evacuation function of the gallbladder and bile ducts, the following methods of physiotherapy are shown:

• electrophoresis of drugs stimulating the smooth muscles of the biliary tract (pilocarpine, carbocholine);
• diadynamic therapy of the gallbladder region by the current "syncope rhythm";
• amplipulse therapy (CMT-therapy) of the same area;
• interference therapy in a transverse technique (epigastric region - spin);
• high-intensity pulsed magnetic field of the gallbladder.

With increased motor-evacuation function of the gallbladder and bile ducts, relaxation methods of physiotherapy are shown:

• electrophoresis of papaverine, platyphylline;
• DMV-therapy of the right hypochondrium region;
• paraffin applications on the abdomen;
• coniferous baths.

With hypertension of the gallbladder and bile ducts, laser (magnetolaser) therapy of the right hypochondrium with infrared emitters is shown by the method described below.

Information-wave action is also shown using the Chrono-DMV apparatus using the following procedure. The radiator is located contact, stably on the area of the gallbladder projection in the right hypochondrium. The frequency of radiation generation is 10 Hz, the exposure time is 20 minutes, the treatment course is 10 to 15 daily procedures once a day in the morning.

The general practitioner (family doctor) often has to treat patients with this pathology in outpatient and outpatient settings and at home. At the same time, the following procedures, which are used by physiotherapy, are most practical and at the same time effective in hypotonic-hypokinetic form of dyskinesia.

1. Electrophoresis with the aid of the Elfor-I (El Form ™) device 0.1-0.5% pilocarpine hydrochloride solution from the positive electrode in the right hypochondrium region. A negative electrode is placed on the back in the region of the lower-thoracic spine (ThVl, -ThlX). The size of the electrodes is 15x20 cm. The current strength is 5 mA, the duration of exposure is 10-15 minutes, once a day in the morning hours (until 12 noon, but 2 hours after breakfast). The course of treatment 10 procedures daily.
2. Electroneurostimulating therapy with the aid of the apparatus "DiaDENS-T". The technique is contact, stable, the effect on the exposed surface of the skin by one field on the right hypochondrium. The mode is constant at a frequency of electrical pulses of 77 Hz. The voltage of the electric current is strictly individual (based on subjective sensations in the form of a weak "tingling" under the electrode). The exposure time is 10 minutes, once a day (morning on an empty stomach). The course of treatment 10 procedures daily.

In the hypertensive hyperkinetic form of dyskinesia, the following physiotherapeutic effects are recommended.

1. Electrophoresis with the aid of the Elfor-I (El-Form ™) device of 0.5% papaverine hydrochloride solution or 1 - 2% solution of no-shpa from the positive electrode (+) in the right hypochondrium. The procedure is similar to the procedure for the hypotonic-hypokinetic form of dyskinesia of the biliary tract.
2. Magnetotherapy with the help of the device "Pole-2D". The impact technique is contact, stable, one-field exposure to the right hypochondrium. The duration of the procedure is 20 minutes, once a day (morning on an empty stomach), for a course of treatment of 10 daily procedures.
3. Laser (magnetolaser) therapy. Influence of infra-red radiators (wavelength 0.8 - 0.9 μm) on contact and stable technique on bare skin of the patient's body is used.

Fields of influence: I - the outer edge of the right rectus abdominal muscle is 3 cm below the edge of the right costal arch; II - 1/3 of the distance from the middle of the right costal arch to the navel; III - the middle of the right hypochondrium.

The APM is 10 to 50 mW / cm ². Induction of the magnetic nozzle 20 - 40 mT. The optimum frequency of 10 Hz radiation modulation, however, is effective in the application of OR and in the continuous mode of radiation generation. Time of exposure to one field is 5 minutes, 1 time per day (morning on an empty stomach). The course of treatment 10 procedures daily.

Regardless of the form of dyskinesia of the gallbladder and bile ducts for normalizing the patient's psychoemotional status, it is advisable to carry out information-wave action with the help of the Azor-IC apparatus using a successfully tested technique:

• in the morning after awakening - exposure to two frontal lobes (modulation frequency of EMP of 21 Hz, 15 minutes per field);
• before a night sleep - the impact of two fields on the frontal lobes (the frequency of modulation EMR 2 Hz, 20 minutes per field).

Duration of treatment 10 procedures daily.

It is possible to consistently perform procedures for dyskinesia of the gallbladder and bile ducts in one day in outpatient and outpatient settings:

• electrophoresis of drugs in the epigastric region + information-wave action on the frontal lobes of the brain 2 times a day (in the morning - 21 Hz, in the evening - 2 Hz) with the help of the Azor-IC apparatus;
• electroneurostimulation therapy with DiaDENS-T apparatus + information-wave action on the frontal lobes of the brain 2 times a day (in the morning - 21 Hz, in the evening - 2 Hz) with the help of the Azor-IC apparatus;
• laser (magnetolaser) therapy + information-wave action on the frontal lobes of the brain 2 times a day (in the morning - 21 Hz, in the evening - 2 Hz) with the help of the Azor-IC apparatus;
• magnetotherapy (PeMP) of the collar area + information-wave action on the frontal lobes 2 times a day (in the morning - 21 Hz, in the evening - 2 Hz) with the help of the Azor-IC apparatus.

[1], [2], [3]