Cholecystitis is an inflammatory disease of the gallbladder or bile ducts. Let's look at what symptoms characterize this disease, in which cases it is possible to keep the problem under control with diet and when it is necessary to resort to surgery.
Cholecystitis - definition and types
Like almost all types of inflammation, cholecystitis can manifest itself in an acute or chronic form.
Acute inflammation of the gallbladderalso known as acute cholecystitiscan be of two types:
- calculous cholecystitis (if there are stones in the gallbladder)
- acalculous cholecystitis (if there are no stones in the gallbladder)
Chronic inflammation of the gallbladderalso known as chronic cholecystitis, Is a condition in which episodes of exacerbation of inflammation alternate with periods of remission. Symptoms are the same as for acute cholecystitis.
When chronic inflammation of the gallbladder becomes persistent, the only hope for healing is operation... In addition, if left untreated, chronic cholecystitis can lead - in a small percentage of cases - to the development of gallbladder cancer.
Causes of inflammation of the gallbladder
Let's look at the main reasons that can lead to the development of various types of cholecystitis.
Among them, we will certainly name gallstones... Typically, the liver synthesizes cholesterol, which enters the bile solution, which consists of phospholipids and bile acids, as well as water and bilirubin (the pigment in bile).
Sometimes the balance of bile acids or cholesterol can be disturbed; this leads to the formation of crystalline aggregates that can be fixed at the level of the bile ducts, resulting in the accumulation of bile inside the gallbladder with subsequent inflammation of the organ.
If this condition is not treated, then a gallbladder infection may develop. Gallstones plague most of the male population, but they are even more common in women.
Cholecystitis without stones Is a more rare disorder and can result from conditions such as:
- bacterial or viral infections;
- serious surgery or injury;
- burns;
- sepsis;
- fractures.
As a result of these conditions, stagnation of bile and this can lead to inflammation of the gallbladder.
Symptoms of acute cholecystitis
Like all acute inflammatory phenomena, cholecystitis is manifested by symptoms such as:
- Severe and continuous pain (the so-called colic), at least six hours, in the abdomen, in particular, at the level of the hypochondrium with irradiation from behind below the scapula on the right.
- Fever, even very high, associated with phenomena of an inflammatory or infectious nature.
- Nausea and vomiting may occur, but cholecystitis does not necessarily accompany these symptoms.
- Chills.
- Jaundice (more often observed with calculous cholecystitis), that is, a yellowish color of the skin and conjunctiva, light stools and dark urine due to an increase in the level of bilirubin in the blood.
If within 24 hours after the patient was subjected to drug therapy, the symptoms of acute calculous cholecystitis persist, then surgical intervention is necessary to remove the organ, which is currently carried out, mainly laparoscopically, if there are no contraindications related to the general state of the patient's health.
In the case of non-calculous cholecystitis, the operation is used only if it is really necessary.
The consequences of inflammation of the gallbladder
The consequences of calculous cholecystitis may be different depending on presence or absence of infection.
Cholecystitis without bacterial infection caused by stones that interfere with the bile duct, causes the organ to fill with bile and mucus.
Bacterial cholecystitis characterized by the presence of an infection in which pus is produced, which infects the bile that accumulates in the gallbladder. Failure to stop the infection can lead to necrosis of the organ wall, followed by gangrene.
Both bacterial and nonbacterial cholecystitis can lead to perforation of the gallbladder (cholecystitis with perforation) and the release of bile fluid into the peritoneum, followed by peritonitis.
Diagnostics - analysis and ultrasound
Diagnosis of cholecystitis is based on symptom analysis and ultrasound. This can also be complemented by a blood test that should show increased white blood cell counts, which confirm inflammation and possible local infection.
Treatment of gallbladder inflammation
As it is easy to understand from what was said earlier, the main therapy in the treatment of cholecystitis is operations.
It is clear, however, before the intervention is necessary eliminate symptoms... This happens by taking analgesics to treat pain and reduce inflammation (use, inter alia, nonsteroidal anti-inflammatory drugs such as diclofenac or paracetamol, in the presence of fever, opioid analgesics) and antibiotics, in the case of a bacterial infection (the most common are beta-lactam antibiotics, in particular penicillin and cephalosporin), antispastic drugs, such as buscopan, to relax the smooth muscles of the gastrointestinal tract and relieve colic pain.
In patients with calculous cholecystitis who choose not to undergo the procedure cholecystectomy, or in patients who, for whatever reason, cannot undergo surgery to remove the gallbladder, is very useful and actively used ursodeoxycholic acidwhich can partially dissolve cholesterol stones.
Diet for cholecystitis
After reading all this, of course, the question arises: “Is it possible to prevent the development of cholecystitis with nutrition? If so, how? What diet should you follow? "
Considering that stones in the gallbladder, formed during the deposition of crystals of bile acids and cholesterol, are the main cause of cholecystitis, the most important thing is, of course, following a low fat diet, especially cholesterol. Thus, it is necessary to limit the consumption of foods such as cheeses, butter, lard, fatty meats (including sausages), eggs, milk (especially whole, goat, sheep), vegetable oils.
Also, you must follow low protein dietby limiting the consumption of foods such as sausages (including ham), cheese, tuna, and various meats (especially lamb, pork, and fatty chicken).
Chronic cholecystitis is an inflammatory process localized to the mucous membrane of the gallbladder. Distinguish between chronic and acute stages of the disease. Conservative treatment of the disease with medication is possible only in the absence of serious complications that require immediate surgical intervention. With timely medical attention, only a small percentage of patients require surgery.
In most cases, cholecystitis is provoked by elements of the intestinal microflora. They enter the gallbladder through the bloodstream, which provokes inflammation and irritation. An improper diet rich in flour, fried and spicy foods can also cause the disease.
The disease manifests itself with the following symptoms:
- first, there are small aching sensations in the right hypochondrium, gradually the pains become pulling and stitching;
- most often, discomfort manifests itself after eating a meal rich in fatty and fried foods;
- pain worsens even after a small amount of alcohol, including gin and tonics and beer;
- a few days after the development of cholecystitis, appetite may disappear, severe lethargy will appear, intellectual and physical performance will decrease;
- the patient may begin to rapidly gain excess weight, the chair will become rare, and constipation will often torment;
- first, the disease affects the membrane of the organ, gradually moving into its cavity, which significantly increases the density of bile and provokes the appearance of stones;
- the general level of immunity decreases, a person becomes very nervous and irritable.
Attention! Cholecystitis is most often diagnosed in women suffering from excess weight. Maintaining a normal UTI and proper nutrition can significantly reduce the risk of developing pathology.
Video - Cholecystitis
Antibiotics for cholecystitis
Azithromycin
Available in capsules and tablets, patients with cholecystitis can take both forms of medication. With the development of gastrointestinal diseases, patients are advised to take Azithromycin one hour before meals or two after. The dosage is always one and is 1 g of the active ingredient at a time. The duration of therapy is three days, while it is imperative to include the medication in the combination therapy.
Azikar capsules
Also a powerful and well-tolerated antibiotic that allows antibiotic therapy in three days. If you have problems with the gastrointestinal tract and gallbladder, in particular, it is recommended to take one 1000 mg capsule one hour before meals or two after it. This will significantly improve absorption and speed up recovery. It is also allowed to take the medication in powder form, in which case the patient should drink two 500 mg sachets of the active ingredient at once.
Sumalek
The drug is produced in the form of tablets and powder. The dosage of Sumalek for each patient is selected individually, taking into account his weight. The classic dose is 20 mg of active ingredient per kilogram. The prescribed amount of the active substance is taken at one time outside the meal The duration of use of Sumalek is also three days.
Zitrolide
A medication is produced in the form of capsules, which should be taken strictly at the same time. A single dose of the medication is prescribed per day, the dosage for all patients is the same and is 1 g of the active ingredient. Treatment with an antibacterial drug is short-term and lasts 3 days. Without fail, Zitrolide is combined with a strict diet and other medications. Antibiotic monotherapy is prohibited.
Attention! Antibiotics are usually taken in the acute stage of the disease. It provides not only for taking these medications, but also for a complete refusal to eat for two days. The patient is allowed to drink only water, juices, herbal teas.
Antispasmodics against cholecystitis
Took
The drug is made in India. It is taken as directed by the attending physician. Taking into account the intensity of pain, patients are advised to take 1-2 tablets of Bral up to three times a day. In addition to the noticeable analgesic effect, the medication has a slight relaxing effect. The antispasmodic should not be taken for more than five days. In some cases, Bral intensified the symptoms of cholecystitis, so one should be sure that the medication is well tolerated.
Maxigan
Also available in pill form, the prescribed dosage is taken after meals. For mild pain, take no more than one tablet up to three times a day. With increased intensity of the pain syndrome, it is allowed to drink up to six Maxigan tablets a day. The maximum allowable duration of drug use is five days.
Revalgin
A more modern analogue to the medicines described above, which should also be taken after meals. You can take Revalgin 30-60 minutes after eating. The maximum daily dosage of the drug is 6 tablets. It is advisable to take no more than one tablet at a time; in severe cases, two doses can be taken at once. The duration of therapy with the use of Revalgin is 5 days.
Attention! In the acute stage of cholecystitis, it is allowed to use antispasmodic drugs in the form of injections, which can quickly relieve pain, but this can have a negative effect on the pancreas.
Choleretic medicines for cholecystitis
Allohol
You can take the medication in the acute and chronic stages of cholecystitis. With an exacerbation of the disease, it is recommended to take one tablet of the medication up to three times a day. The duration of therapy in this case is 4-8 weeks. In the chronic stage of the disease, it is recommended to drink 1 dose up to four times a day. The duration of treatment is one month. The course of therapy can be repeated only 12 weeks after the end of the last one.
Tsikvalon
The medication should be taken according to a specific scheme. In the first three days of treatment of the acute stage of the disease, the patient is prescribed 0.3 g of the active substance, divided into three doses. After that, you should take one tablet of Cicvalon four times a day. Therapy continues for 21-30 days, the duration is influenced by the complexity of the course of cholecystitis. The drug is taken strictly before meals, washed down with half a glass of water.
Artihol
The drug not only significantly improves the function of the gallbladder, but also has a beneficial effect on the liver and kidneys. To achieve the desired result, take up to two tablets of Artihol three times a day. The maximum daily dosage is six tablets. The duration of therapy is determined for each patient individually. Usually, treatment with Artihol lasts no more than three weeks.
Glutargin
Usually, for cholecystitis, the drug is taken in the form of a powder, which provides maximum effect and rapid absorption. The exact dose and number of daily intake is determined by the attending physician, taking into account the severity of the inflammation and the form of the disease. The dose can range from 750 mg to 2 g. The duration of therapy is influenced by the body's response to the treatment. If necessary, the powder can be replaced with tablets.
Attention! This group of medicines allows you to normalize the consistency of bile, which will protect against bubble rupture and the formation of fractions.
Drugs against concomitant symptoms in cholecystitis
Motilium
This drug should be taken when cholecystitis is accompanied by severe vomiting, nausea, or flatulence. The drug is taken 15 minutes before the main meal three times a day. The recommended dosage is 1 tablet. In severe cases, you should not exceed the daily amount of the active ingredient of 80 mg, which is equal to 8 tablets. The therapy continues until the unpleasant symptoms are eliminated.
Cerucal
The drug also helps to eliminate the unpleasant symptoms of cholecystitis in the form of nausea, vomiting, belching, heartburn and gas. Take the recommended dosage of Cerucal, which is usually one tablet, half an hour before the main meal. The recommended amount is four tablets per day. In severe cases, it may be necessary to prescribe the drug intravenously, while the dose is calculated individually.
Metoclopramide
They take the drug for concomitant intestinal disorders, which help to significantly alleviate the patient's general condition. Use Metoclopramide 30 minutes before the main meal. At one time, the patient can take 10 mg of the active ingredient, which is equal to 1 tablet of the medication. The daily amount of the active substance cannot exceed 30 mg. The therapy continues until all unpleasant symptoms are completely eliminated.
Sulfonamides against cholecystitis
Fervital
The drug should be taken 20 minutes before eating or taking the prescribed medication as a combination therapy. Fervital for acute intestinal disorders, including cholecystitis, should be taken 2 teaspoons of the active ingredient up to four times a day. The powder is taken within 4-6 weeks. A strict diet is mandatory.
Take the medicine three times a day with meals. Patients are advised to eat one packet of minerals and nutrients with each meal. Before use, the contents of the sachet are poured with half a glass of water, stirred and drunk immediately. The treatment continues for two months. The minimum therapeutic course of therapy is 4 weeks.
Attention! These drugs are taken for patients with acute intolerance to antibiotics. It is also worth using the described medicines with the simultaneous manifestation of cholecystitis and enterocolitis.
The cost of drugs against cholecystitis
A drug Picture Price in RF in rubles Price in RB in rubles Price in Ukraine in UAH Azithromycin 150 5 62 Azikar 660 22 270 Sumalek 150 5 62 Zitrolide 1500 50 615 Took 75 2,5 31 Maxigan 100 3,3 41 Revalgin 100 3,3 41 Allohol 75 2,5 31 Tsikvalon 400 13 164 Artihol 120 3,9 50 Glutargin 120 3,9 50 Motilium 700 23,3 278 Cerucal 120 3,9 50 Metoclopramide 30 1 17 Fervital 120 3,9 50 2000 66 820 Attention! The prices for the medicines listed may not be the same as those in your pharmacies. Drugs with the same name are produced in several countries, which affects their cost.
A lot of people who have crossed the 30-year mark are faced with. At the same time, similar symptoms often occur after feasts at which fried, fatty food is served, alcohol is consumed. Feeling such discomfort, cholecystitis can be suspected. However, pathology is often diagnosed by chance, during the examination. It is noticed that the symptoms of cholecystitis are most often observed in women. Many factors contribute to this.
Characteristics of the disease
What is this disease? It is leaking in the gallbladder. This organ is localized in the right hypochondrium. That is why, when the fair sex has pain in this area, one can suspect that these are symptoms of cholecystitis in women.
Accumulates bile produced by the liver. Such a secret is excreted through special ducts into the duodenum and takes part in the digestion of food. If the sphincters and the parasympathetic nervous system function normally, then bile moves in only one direction.
But if, as a result of certain violations, asynchronous work of the sphincters occurs, then the secret does not come out in full from the bladder, provoking pain and pressure in it. In this case, the throwing of contents from the intestine back into the ducts is often observed. Often, it is in it that the infection is contained, which easily penetrates the bile duct, leading to its inflammation.
The mechanism of development of pathology is clear. Now let's consider why symptoms of cholecystitis occur in women, what are the sources of the development of pathology?
Causes of the disease
So, the main factor in the development of the disease is the penetration of the infection into the bladder.
Additional factors play an important role in the development of pathology:
- Dyskinesia of the bile ducts. With this ailment, its outflow is disrupted.
- Reflux pancreatic. This is a pathology in which the contents of the intestine are again thrown into the ducts. As a result, the walls of the bladder are damaged by enzymes and pancreatic juice.
- Congenital anomalies. It is about the individual structure of the bubble. Various partitions, bends of this organ can lead to pathology.
- Impaired blood supply to the bladder. Such a clinic can provoke ailments: hypertension, diabetes mellitus, atherosclerosis. The course of these diseases is characterized by a narrowing of the vascular lumen.
- Dyscholia. An ailment in which the walls of the bladder are disturbed and damaged. An unpleasant clinic is most often caused by an unhealthy diet (excessive addiction to fats or a monotonous diet).
- Allergy, immunological reactions.
- Endocrine disorders. Often, symptoms of cholecystitis occur in a woman taking oral contraceptives. In addition, menstrual irregularities, overweight and pregnancy can be the causes of the disease.
- Hereditary factor.
Varieties of the disease
Pathology, depending on the course, can be:
- Sharp. The disease develops over several days or hours. It is characterized by pronounced symptoms. Such a pathology in the case of timely treatment for medical help proceeds quite favorably.
- Chronic. If the acute form of the disease was not given due attention or the disease was treated incorrectly, then the patient develops precisely this stage. The disease may be asymptomatic. It develops, as a rule, gradually. Chronic cholecystitis (symptoms and treatment) deserves special attention. Diet plays one of the most important roles in the fight against pathology.
Chronic cholecystitis is subdivided into:
- sluggish (latent);
- recurrent;
- purulent ulcerative.
According to the presence of calculi, 2 forms are distinguished:
- stoneless (without cholelithiasis);
- calculous.
For a chronic ailment, stages are characteristic:
- remission;
- exacerbation.
So, let's consider the features of such a pathology as chronic cholecystitis. Symptoms and treatment, diet and prevention of the disease are presented below.
Clinical manifestations of the disease
An acute attack of cholecystitis is very clearly manifested. Symptoms typical for this form:
- sharp pain, greatly aggravated after eating;
- vomiting;
- diarrhea may occur;
- metallic or bitter taste in the mouth;
- hyperthermia.
However, in the acute form of the disease, only inflammation of the bladder mucosa is found. A slightly different picture is observed if the patient is diagnosed with chronic cholecystitis. Symptoms of the disease in this form are less pronounced. However, atrophic and sclerotic changes are revealed on the walls of the bile. The chemical and physical parameters of bile also change.
The following symptoms of cholecystitis in women are observed (photos demonstrate such an unpleasant condition):
- the presence of constant pain in the area of \u200b\u200bthe right hypochondrium;
- discomfort increases significantly after eating fatty foods;
- bitterness and dryness in the mouth in the morning;
- periodic occurrence of nausea;
- bloating;
- loose loose stools.
The pain syndrome in chronic pathology is not as pronounced as in the acute form. It is often characterized as a nagging, dull discomfort. Some patients experience constant, exhausting pain. Other patients are faced with acute manifestations of the disease, which occur, as a rule, after the abundant use of the wrong food. In this case, biliary colic may even appear.
Symptoms of an exacerbation of the disease
With a chronic course of pathology, the patient periodically has an attack of cholecystitis. Symptoms at this stage are very similar to the acute form of the disease. This condition is characterized by general signs and local manifestations, signaling inflammation of the bladder.
The following symptoms indicate an exacerbation of chronic cholecystitis:
- pronounced general malaise;
- hyperthermia;
- frequent constipation;
- headache;
- itchy skin may occur.
Along with such a clinic, local symptoms appear. They also characterize the exacerbation of chronic cholecystitis.
The symptoms are as follows:
- Pain. It can be moderate or rather harsh. Discomfort is localized in the upper abdomen, usually in the right hypochondrium.
- Bad taste in the mouth. The patient may experience bitterness or complain of a metallic taste. He has belching with air, nausea. The person is tormented by flatulence. Often there is a disturbed process of defecation, as a rule, diarrhea and constipation alternate.
- Feeling of heaviness in the right hypochondrium.
- The onset of insomnia, excessive irritability.
The intensity of the pain syndrome depends on the presence of stones in the bladder. With calculous cholecystitis, the discomfort is sharp, intense. For a stoneless pathology, aching, dull pain is characteristic, which overly tires the patient. Discomfort is able to manifest itself not only in the right hypochondrium. Very often he gives to the right hand, the shoulder blade.
Chronic pathology is paroxysmal. During an exacerbation, the symptoms are pronounced. After an attack, all signs of the disease subside. The stage of remission comes. At this time, the patient believes that he has recovered from the disease and the unpleasant symptoms will not return. However, a thoughtless violation of the diet, excessive stress, hypothermia, alcohol consumption can again lead to an attack.
Complications of the disease
The signs of cholecystitis should not be ignored. Symptoms that give the patient discomfort are a signal from the body about the need for adequate treatment.
Prolonged inactivity can lead to the development of rather unpleasant complications:
- cholangitis;
- fistula formation in the stomach, hepatic flexure, duodenum;
- reactive hepatitis;
- "Shutting down" the bladder (the gallbladder no longer fulfills its functions in sufficient volume);
- pericholedocheal lymphadenitis (inflammation develops in the bile ducts);
- empyema of the bladder (purulent inflammation);
- intestinal obstruction;
- gangrene of the gallbladder with the appearance of peritonitis;
- perforation (rupture of the bladder).
Diagnosis of the disease
It is very important, if there are symptoms of chronic cholecystitis in women, see a doctor.
To make a diagnosis, the following activities are carried out:
- collection of anamnesis;
- examination of the patient;
- laboratory examinations;
- instrumental research.
Initially, the doctor will ask in detail about what manifestations the patient is facing, how long ago they arose, as a result of which they appear. The doctor will examine the presence of the patient's diseases, such as diabetes mellitus, gastrointestinal tract pathologies, hepatitis. He will clarify whether any of the relatives had similar pathologies.
During the examination, attention is paid to the symptoms that indicate the presence of the disease:
- A sign of muscle protection. The patient's abdomen tightens to protect the sore stomach.
- During palpation, pain intensifies in the right hypochondrium.
- Tapping the right costal arch is accompanied by discomfort.
The patient is prescribed laboratory methods:
- Blood test.
- Research for the presence of hepatitis viruses in the body.
- Blood biochemistry. This analysis is informative only after suffering an attack of colic.
- Study of fat lipid metabolism.
- Coprogram.
- Ultrasound of the peritoneum.
- Esophagogastroduodenoscopy. The analysis allows you to study the state of the esophagus, duodenum, stomach. During the study, a biopsy is taken.
- Plain radiography of the peritoneum. Allows you to identify the presence of stones in the bladder, but only those that contain calcium.
- CT. The analysis allows a more detailed assessment of the state of the internal organs. With the help of this study, difficult to diagnose tumors that compress the bile ducts are detected.
- Cholecystoangiography. This is an X-ray diagnosis, in which several images are taken under the control of an ultrasound machine. This analysis takes place using a filling duct.
- Retrograde cholangiopancreatography. With the help of a special device - a duodenofibroscope, which is introduced to the patient through the mouth into the duodenum, the doctor launches a radiopaque substance into the biliary tract. This allows you to detect stones or a narrowing of the duct. When such an obstacle is identified, the doctor performs an endoscopic operation to remove the obstacle.
- MRI. A study that determines changes in the walls of the bladder and adjacent organs invisible to X-ray and ultrasound.
- Hepatobiliary scintigraphy. Examination of the biliary tract and liver, characterizing the functioning of organs and the motor activity of the ducts.
Treatment of an ailment in the acute stage
The methods of therapy completely depend on the symptoms of cholecystitis in women. The treatment of chronic pathology in the remission stage is significantly different from the fight against the disease during an exacerbation.
If the patient has an attack, then therapy is aimed at eliminating symptoms and stopping the pathogenetic reactions of the disease. In the remission stage, treatment involves the prevention of relapse.
Drug therapy for chronic cholecystitis during an exacerbation is based on the following pharmaceutical preparations:
- Antibiotics: "Erythromycin", "Doxycycline", "Ciprofloxacin", "Biseptol", "Furozolidone", "Metranidazole", "Oxacillin".
- Antispasmodics: "Papaverine", "Pitofenon", "Drotaverin", "Platifillin".
- Choleretic drugs: Sorbitol, Nikodin, Allohol, Tsikvalon.
- NSAIDs: "Baralgin", "Spazgan".
- Propulsants (drugs that stimulate peristalsis), such as Domperidone.
- Antiemetics: "Cerucal", "Diprazin".
- Polyenzyme medicines: "Festal", "Pancreatin".
- Sedatives: tincture of valerian, motherwort.
In the fight against chronic cholecystitis, such an event as tubeless tubing is very popular. Its essence is to flush the ducts with subsequent stimulation of the bile secretion process.
Cholecystitis therapy
During remission, treatment consists of:
- from diet therapy;
- the use of choleretic medicines: "Holenzim", "Liobil", "Allohol", "Flamin", "Holosas", "Holagol", "Olimetin", "Rosanol";
- physiotherapy (procedures are effective: balneotherapy, inductothermy, electrophoresis with "Novocain").
When calculous pathology is detected, the patient is assigned a planned cholecystectomy. This is a surgical procedure that removes the bladder.
Diet food
Regardless of the form of the course, this is an important link in successful treatment. Therefore, all patients are recommended (it allows you to eliminate such painful symptoms characteristic of an ailment called cholecystitis) a diet.
With this disease, table number 5 is assigned. Particular attention should be paid to exacerbation of cholecystitis.
Symptoms that exhaust the patient require not only drug treatment, but also dietary adjustments:
- During an attack, it is necessary to create conditions that are as gentle as possible for the digestive tract. For this, during the first two days, doctors only allow the patient to drink liquid. For these purposes, non-carbonated mineral water, non-acidic berry and fruit juices diluted in half with boiled water are suitable. Rosehip decoction is useful for a sick person.
- As the pain discomfort subsides, the patient is allowed to switch to the use of pureed food. A person is recommended to use slimy cereals, soups (rice, oatmeal, semolina), berry, fruit (necessarily sweet) mousses, jelly, jelly. However, food should be eaten in small quantities so as not to provoke an overload of the digestive system. The diet is very important. Food should only be taken at specific times.
- Then the patient's diet includes low-fat cottage cheese, boiled fish, steamed meat. White bread croutons are recommended.
- After 5-10 days after the attack, the patient is carefully transferred to the dietary table No. 5a.
Patients should clearly understand that cholecystitis is a very serious illness. Observance of proper nutrition allows you to get rid of it much faster. The diet is aimed at reducing acidity and bile secretion.
Experts, prescribing proper nutrition to patients, recommend the following:
- Refuse fried, excessively fatty foods.
- Build your diet on baked, boiled, stewed foods.
- Do not eat food that is too hot or cold.
- Reduce the use of sweet and flour products.
- Eat often, but in small portions.
- Strictly observe the diet - eat food at the same time.
- Give preference to plant and dairy foods. Fiber perfectly normalizes bowel movements and stimulates motor skills. Milk helps to restore the acid-base balance in the body.
- Strong tea, coffee is not recommended.
- Eggs should be eaten no more than 2-3 times a week. It is better to exclude the yolk altogether.
In addition, patients need to consume plenty of fluids. Foods that are high in fat and cholesterol should be completely eliminated from your diet.
is an acute inflammatory process that occurs in the human gallbladder.
Normally, the gallbladder has a volume of 40–70 cm3. The human liver produces , which is necessary for the digestion process. It is stored in the gallbladder. If metabolic processes are disturbed in the body, stones may appear in the lumen of the gallbladder, and with the simultaneous occurrence of an infectious inflammatory process, acute cholecystitis develops.
Causes of cholecystitis
The most common reason for the development of cholecystitis is the ingress of microbes into the body and their subsequent development. Cholecystitis can provoke streptococci , enterococci , staphylococci ... That is why for treatment acute or chronic cholecystitis trick is often used ... As a rule, the penetration of microorganisms into the gallbladder occurs through the bile ducts from the intestine. This phenomenon occurs as a consequence of the lack of function of muscle fibers, which separate the common bile duct from the intestine. This is often seen as a consequence dyskinesia of the gallbladder and biliary tract , too low secretory activity of the stomach, high pressure in the duodenum.
Very often, the development of cholecystitis occurs as a result of impaired outflow of bile. This can happen in a person who suffers from ... If a fireplace is present in the gallbladder of a person, then they not only create a mechanical barrier to the outflow of bile, but also irritate the walls of the gallbladder. As a result, the gallbladder initially develops aseptic , and later - microbial inflammation of the gallbladder. Thus, the patient develops chronic cholecystitis, which periodically worsens.
However, microbes can end up in the gallbladder, having got there with the flow of blood and lymph, because the vascular network is developed in the gallbladder. In this regard, the symptoms of cholecystitis are often manifested in people who suffer from ailments of the intestines, organs of the genitourinary system, or the presence of other foci of inflammation.
Sometimes cholecystitis is provoked roundworm , lamblia , Availability liver injury and gallbladder and etc.
Cholecystitis symptoms
The symptoms of cholecystitis are clearly manifested already at the earliest stages of the development of the disease. The early manifestations of this disease are very diverse. As a rule, they occur after a person has noticeably violated his usual diet, for example, ate a lot of spicy or very fatty foods, drank a fairly large amount of alcohol, etc. In this case, initially the pain arises at the top of the abdomen and radiates to the area of \u200b\u200bthe right hypochondrium. Pain sensations can be either constant or growing periodically. Sometimes with cholecystitis, there is a very sharp pain that resembles biliary colic ... As symptoms of acute cholecystitis, the occurrence of dyspeptic symptoms is also possible. This is a bitter and metallic taste in the mouth, constant nausea, belching, ... The person becomes very irritable, often suffers from insomnia.
A patient with cholecystitis vomits bile from time to time, but after such vomiting it does not become easier for him. In addition, the symptoms of cholecystitis are often manifested by an increase in body temperature, an increased heartbeat, the patient's skin may turn slightly yellow. Dryness of the tongue is noted.
If the disease is not treated immediately after the onset of the described symptoms, it may subsequently develop peritonitis , which is a very dangerous condition.
Chronic cholecystitis usually lasts long, sometimes it can last for many years. Chronic cholecystitis is usually subdivided into several types. When stoneless cholecystitis stones are not formed in the lumen of the gallbladder. In the same time calculous cholecystitis characterized by the appearance of stones in the lumen of the bladder. Consequently, calculous cholecystitis is a manifestation of gallstone disease.
At the same time, a person periodically develops exacerbations, alternating with remissions. Exacerbations of the chronic form of the disease, as a rule, are the result of overeating heavy food, alcohol abuse, physical stress, hypothermia, intestinal infections. In chronic cholecystitis, symptoms similar to those of the acute form of the disease appear. However, their intensity is less pronounced, the patient's condition is not so severe.
Diagnosis of cholecystitis
Diagnosis of cholecystitis is carried out by a specialist, first of all, by interviewing the patient and getting to know his medical history. Analysis of the history and clinical course of the disease provides the necessary information for further research. Next, the patient is prescribed a special research method, which is used for cholecystitis, - duodenal intubation ... This method is used in the morning, because it is important to conduct such a study on an empty stomach.
It is also important to conduct a thorough bacteriological examination (for this, bile is sown). It is especially important to do this if the patient has a decreased acid-forming function of the stomach. In the process of diagnosing cholecystitis, the physicochemical properties of bile should be determined.
It is important to differentiate the chronic form of the disease from chronic cholangitis , gallstone disease .
Cholecystitis treatment
If a patient develops acute cholecystitis, then in most cases he is immediately hospitalized in a surgical hospital. Basically, the treatment of cholecystitis begins with the use of conservative therapy. It is important that the patient is constantly in a state of complete rest. Initially, the patient is forbidden to eat: his nutrition is carried out by intravenous administration of nutritional mixtures.
If there is severe inflammation with the corresponding symptoms and jumps in body temperature, then the complex treatment of cholecystitis may include taking antibiotics of a wide spectrum of action. It is especially important to prescribe antibiotic therapy to elderly patients, as well as people who have diabetes.
At the stage of exacerbation, treatment of cholecystitis is primarily aimed at relieving severe pain, reducing inflammation, and eliminating the manifestations of general intoxication. In the process of using conservative treatment, the patient's condition is closely monitored. And if there is an improvement, then the patient continues to be treated with conservative methods.
However, in the absence of the effect of such treatment, the attending physician often decides on surgical intervention. If there is a suspicion of phlegmon of the gallbladder , , perforation , peritonitis , then the operation is performed urgently.
If a person is diagnosed with calculous cholecystitis and, therefore, there is a fireplace in the gallbladder, then the treatment of the disease is more difficult. Accordingly, the prognosis of the course of the disease worsens.
With a calculous form of cholecystitis, a very painful hepatic colic ... This phenomenon is somewhat similar to the symptoms of acute cholecystitis, but the patient suffers from more intense pain. Typically, these attacks begin at night or in the morning. A little later, the patient shows signs of jaundice: the shade of the skin, urine, mucous membranes changes. In this case, a person's feces acquire a light, sometimes white color. With these symptoms, hospitalization should be carried out immediately.
Treatment of chronic cholecystitis is primarily aimed at stimulating the process of bile flow, eliminating spasmodic phenomena in the biliary tract and gallbladder. A set of measures is also being taken to destroy the causative agent of inflammation. With calculous cholecystitis, stones are also crushed using different methods. Subsequent measures of therapy are aimed at preventing the appearance of new stones.
The doctors
Medicines
Prevention of cholecystitis
As preventive measures that are used to prevent the manifestation of acute cholecystitis, it is important to adhere to all general hygiene measures. An important point in this case is adherence to the norms of proper nutrition: you need to eat at the same time, at least four times a day, while the calorie content of the daily food volume should not be exceeded. You can not take a large amount of food at night, especially negatively such meals have an effect if alcohol is consumed in parallel. An important preventive measure is drinking enough fluids every day. You need to drink at least one and a half to two liters of water or other drinks, while drinking should be distributed evenly throughout the day.
Another important point is to ensure regular bowel movements. This process must be controlled in order to prevent the occurrence of biliary dyskinesia, as well as excretion .
Experts recommend periodically holding fasting days, during which one type of food should be consumed (for example, milk, apples, cottage cheese, fruits, meat, etc.). Everyone should know which foods are causing them an allergic reaction and exclude them from the diet.
To stimulate the passage of bile, it is important to do gymnastic exercises every day and maintain an active lifestyle in general.
In addition, it is important to take all measures in time to heal the manifested inflammation of the abdominal organs.
Diet, nutrition for cholecystitis
Both during treatment and during periods of remission in the chronic form of the disease, the patient is shown a special one. A specially selected diet, while following such a diet, is aimed at stimulating the release of bile from the bladder and stopping the inflammatory process.
It is important that the diet for cholecystitis includes exceptionally easily digestible ... In this case, vegetable oils (oil from sunflower, corn, olives), butter are suitable for patients. Such fats activate the process of bile secretion.
In addition, the diet should include a product containing a large amount of magnesium salts. These are fruits, vegetables, buckwheat. They not only speed up the secretion of bile, but also relieve pain and spasm.
The diet for cholecystitis should not contain products that are irritating: these are broths from meat and fish, sauces, smoked, fatty foods, too sour and spicy foods. Alcohol, very cold food and drinks should not be consumed. Fried foods are excluded. It is important to stick to a proper diet by eating five meals a day.
The diet for cholecystitis includes soups, lean meat and fish, wheat bread crumbs, scrambled eggs, boiled vegetables, cereals, dairy products. Fruit juices are also included in the diet, and it is recommended to use jelly, gingerbread, jelly, jam, honey as sweets.
Complications of cholecystitis
As complications of this disease, some ailments are determined that run in parallel with cholecystitis, joining it. it chronic cholangitis , hepatitis ... Often it is cholecystitis that is the initial cause of the appearance gallstones .
In addition, the patient may develop secondary inflammation of the pancreas... In this case, the person also feels pain in the left hypochondrium. Such inflammation is diagnosed by ultrasound.
In patients with calculous cholecystitis due to blockage of the common bile duct, subhepatic jaundice followed by ... Also, complications of cholecystitis are often dropsy and perforation of the gallbladder ... The latter disease is very dangerous and difficult to treat.
List of sources
- Bolotovsky G.V. Cholecystitis and other diseases of the gallbladder. SPb .: Nevsky Prospect, 2003;
- A.V. Kuchanskaya Cholelithiasis. Modern view of treatment and prevention: IG Ves, 2007;
- Dadvani S.A., Vetshev P.S., Shuludko A.M., Prudkov M.I. Cholelithiasis. M .: Vidar-M, 2000;
- Diseases of the gallbladder. Cholecystitis, cholangitis; AST, Poligrafizdat, Sova - Moscow, 2010.
Good day, dear readers!
In this article we will consider with you such a gallbladder disease as cholecystitis, as well as its causes, symptoms, treatment and prevention of cholecystitis. So...
Cholecystitis - disease (inflammation) of the gallbladder, the main symptom of which is severe pain in the right side when changing body position. Cholecystitis is a type of complication.
Gall bladder - an organ involved in the digestion of food, designed to accumulate bile, produced by the liver, located in the right hypochondrium. That is why, most often, a patient with cholecystitis complains of pain under the ribs, in the right side.
Cholecystitis, i.e. inflammation of the gallbladder, develops mainly due to a violation of the outflow of bile from the gallbladder, which in turn is associated with:
- with stones in the gallbladder that block the bile outflow channel (cholelithiasis) or damage the walls of the organ;
- violation of the blood supply to the walls of the gallbladder, provoked;
- damage to the mucous membrane of the gallbladder by pancreatic juice, when the secretion of the pancreas returns back to the bile ducts (reflux)
- the presence of pathogenic microflora in the gallbladder.
Most often, women over 40 years old are prone to cholecystitis.
Cholecystitis - ICD
ICD-10: K81
ICD-9: 575.0, 575.1
Types and forms of cholecystitis
Cholecystitis is classified in the following way:
By the form of the disease:
Acute cholecystitis. This form of cholecystitis is characterized by dull pain in the right half of the abdomen, with a return to the right shoulder blade, shoulder. The pain can be variable, then intensify, then disappear altogether. In this case, the disease may be accompanied by yellowing of the skin and itching. A dangerous complication of acute cholecystitis is -.
Chronic cholecystitis. Inflammation of the gallbladder occurs slowly and gradually, often without clear signs of the disease. As in the acute form, the patient may be haunted by pain in the right side, in the hypochondrium, especially after a sharp shake of the body. Bloating is periodically observed. After eating poor-quality food, especially fatty, fried and smoked, after a few hours, it often appears.
By the etiology of the disease:
Calculous cholecystitis. It is characterized by the presence of stones in the gallbladder. Often the presence of stones does not bother a person, but this happens before they enter the gallbladder duct, and getting stuck there, cause colic. Over time, they impede the outflow of bile, which begins to stagnate, and over time, with other unfavorable factors, the processes of inflammation of the bladder begin;
Acalculous cholecystitis. It is characterized by the absence of stones in the gallbladder.
For signs of the disease:
Acute cholecystitis is subdivided into the following types:
Catarrhal cholecystitis. It is characterized by severe pain under the ribs, on the right side, radiating to the right shoulder blade, shoulder, side of the neck, and also the lumbar region. At the beginning of the development of the disease, the pains come (during the intensified contraction of the gallbladder, to cleanse the internal contents) then go away. Over time, due to overstrain of the organ, the pain turns into a permanent symptom of the disease. The patient experiences frequent vomiting, first of the stomach, and then of the duodenal contents, after which, relief does not come. The temperature rises to 37-37.5 ° C. Themselves attacks of catarrhal cholecystitis can last for several days.
Additionally, with catarrhal cholecystitis, a small (up to 100 beats / min.), Small, moist tongue, sometimes with a whitish coating, sharp pain in the right side of the abdomen, during its palpation, moderate leukocytosis (10-12 * 10 9 / l or 10000-12000), an increase in ESR.
The cause of catarrhal cholecystitis lies mainly in improper nutrition: eating dry food and with long breaks, as well as eating fatty, fried and smoked foods.
Phlegmonous cholecystitis. In comparison with the catarrhal type, it is characterized by more severe pain and increased signs of the disease. Pain occurs when changing body position, breathing, coughing. The patient is constantly accompanied by nausea with bouts of vomiting. The temperature rises to 38-39 ° C, the patient's general condition worsens sharply, chills appear. There is some bloating in the abdomen, tachycardia increases to 120 beats / minute. Palpation of the abdomen is extremely painful, the gallbladder is enlarged, and can be palpated. A blood test shows leukocytosis with indicators of 20-22 * 10 9 / l or 20,000-22000 and an increase in ESR
With phlegmonous cholecystitis, the wall of the gallbladder is thickened, and fibrinous plaque is observed on the peritoneum covering it, purulent exudate is observed in the lumen, on the walls of the organ, sometimes with abscesses. A pronounced infiltration of the walls of the gallbladder with leukocytes is manifested.
Gangrenous cholecystitis. In fact, gangrenous cholecystitis is the third stage in the development of acute cholecystitis. All processes of damage to the gallbladder are enhanced. The immune system is weakened so much that it is no longer able to arbitrarily restrain organ damage by pathogens. Symptoms of severe intoxication with manifestations of purulent peritonitis appear. Body temperature is 38-39 ° C. Tachycardia up to 120 beats per minute. Breathing is shallow, rapid. Tongue dry. The abdomen is swollen, the peritoneum is irritated, intestinal motility is strongly depressed or absent. Blood tests show high leukocytosis, increased ESR, a violation of the acid-base balance and electrolyte composition of the blood. In addition, proteinuria and cylindruria are observed.
The cause of gangrenous cholecystitis often lies in thrombosis of the gallbladder artery, the cause of which is mainly the manifestation of atherosclerosis and a decrease in tissue regeneration. In this regard, gangrenous cholecystitis most often pursues the elderly.
Causes of cholecystitis
The development of cholecystitis is most often provoked by the following reasons:
The main symptom of cholecystitis, which patients most of all complain about, is pain under the ribs in the right side, especially when changing the position of the body, which can also be felt in the right shoulder, scapula, side of the neck.
Other symptoms of cholecystitis are:
Before washing the gallbladder, be sure to consult with your doctor!
Medicines for cholecystitis
Medicines for cholecystitis should be taken with great care, because with the wrong selection or the order of their intake, the risk of exacerbation of the disease increases. This is especially true if there are stones in the choleretic bladder. Be sure to consult a doctor, who, based on the diagnosis, will prescribe a course of treatment for cholecystitis, following which the positive prognosis for recovery increases significantly!
Cholecystitis medications
Anti-inflammatory drugs: Diclofenac, Meperidine.
Antispasmodics (pain relievers): "Baralgin", "Dicetel", "Duspatalin", "No-shpa", "Odeston", "Papaverin".
Choleretic drugs (indicated only in remission of inflammatory processes):
- choleretics (stimulate bile formation) - "Allochol", "Hepabene", "Deholin", "Silimar", "Tanacekhol", "Holagol", "Holenzim", as well as mineral waters.
- cholekinetics (stimulate bile secretion) - Karlovy Vary salt, xylitol, olimetin, rovachol, sorbitol, magnesium sulfate, as well as cholespasmolytics (Dicetel, Duspatalin, No-shpa, Odeston, Platifillin.
The choice of choleretic drugs - choleretics or cholekinetics - depends on the type of dyskinesia.
Antibiotics:
- fluoroquinolones: Levofloxacin ("Lefokcin", "Tavanik"), Norfloxacin ("Girablok", "Nolitsin", "Norbactin"), Ofloxacin ("Zanocin", "Tarivid"); Ciprofloxacin ("Tsiprolet", "Tsiprobay")
- macrolides: Azithromycin ("Azitral", "Sumamed"), Clarithromycin ("Klacid", "Clerimed"), Midecamycin ("Macropen"), Roxithromycin ("Roxid", "Rulid"), "".
- Semi-synthetic tetracyclines: Doxacyclin ("Vibramycin", "Medomycin"), "Metacyclin".
In severe cases: Cephalosporins ("Ketocef", "Claforan", "Rocefin", "Cephobid").
If the pathogenic microflora does not respond to antibiotics, it is recommended to take additional nitrofuran drugs: Metronidozole (0.5 g / 3 times a day - up to 10 days), Furadonin, Furazolidone.
With dysfunction of the gallbladder due to hypomotor dyskinesia: "", "Motilak", "".
Phytotherapy
Herbal medicine has recently become more and more one of the key components of the complex treatment of cholecystitis, as well as strengthening the positive result of drug therapy for diseases of the gallbladder and bile ducts.
Like pharmaceutical products - medicines, various medicinal plants in the treatment of cholecystitis are also divided into 2 groups that have choleretic and bile-stimulating properties, and some of the plants can have both properties at the same time.
Plants - choleretics: , corn stigmas, sandy immortelle flowers (flamin), common barberry fruits, tansy, dandelion root, root, centaury grass, black radish juice.
Plants - cholekinetics: , lavender, tansy, sandy immortelle, blue cornflower flowers, flowers, smoky herb, fruits and bark of common barberry, fruits, seed, caraway seed, root, root, wild chicory root.
All medicinal plants are used in the form of decoctions and infusions for several months, usually up to 3-4. You need to cook them for 1-2 days so that the product is always fresh.
You need to drink cooked decoctions 100-150 g, 2-3 times a day, 30 minutes before meals.
All medicinal herbs can be combined, but in such a way that the collection includes no more than 5 plants. They are arranged depending on their useful properties. Of course, it will be better if a doctor does it, because in addition to useful properties and beneficial effects on the body, some plants have certain contraindications, which are very problematic to understand, especially without diagnosing the health of the body. If you still decide to use decoctions and infusions yourself, then at least be guided by the individual tolerance of certain plants.
Diet for cholecystitis
When treating cholecystitis, a diet must be prescribed. This is due to the fact that the presence of the disease itself is actually a sign of the failure of the gallbladder and biliary tract to cope with their role in the digestive system - the production and release of bile for the proper processing of food.
In this regard, a gentle menu is prescribed, which in turn is designed to minimize irritation of the digestive organ that produces bile.
In case of acute cholecystitis, or its exacerbation, it is prescribed, during remission,.
During the diet, frequent (4-6 times a day) and fractional meals are prescribed (eating in small portions).
The menu for cholecystitis excludes the following foods: fried, fatty, smoked, spicy, canned food, cold (chilled) dishes, carbonated drinks, alcohol (especially beer and wine), baked goods, egg yolks, nuts, cocoa, chocolate, raw vegetables and fruits.
- for the first: vegetarian, milk and fruit soups;
- for the second: cereals, boiled vegetables, vinaigrette, boiled fish and meat, puddings;
- drinks: tea, juices, jelly, compote, milk and fermented milk products, mineral waters.
- additional products: watermelon, melon, dried apricots, raisins, prunes.
The calorie content of the diet must correspond to the physiological norm - 2500 calories, of which - proteins (90 g), fats (85 g), carbohydrates (350 g), and in the stage of exacerbation of the disease - 2000 calories.
Surgical treatment of cholecystitis
Often, especially if cholecystitis is accompanied or provoked, surgery may be prescribed to treat it. This is due, first of all, to complications in the removal of large stones from the organs, the removal of which with conservative therapy can lead to a detrimental effect of treatment on the human body as a whole.
Surgical treatment of cholecystitis also has other indications for use, for example, removal of a large amount of pus, as well as pathological changes in the gallbladder and its channels.
The decision on the need for surgical treatment of cholecystitis is made by the attending physician, mainly referring to diagnostic data, in particular, ultrasound.
Types of operations: Cholecystostomy, Cholecystectomy.
Spa treatment of cholecystitis
In the absence of an exacerbation of cholecystitis, patients are prescribed physiotherapeutic treatment of the disease at resorts, where patients then consume nutrition balanced for diseases of the digestive system, as well as medicinal mineral waters.
Popular health resorts: Borjomi, Dorokhovo, Essentuki, Zheleznovodsk, Karlovy Vary, Morshin, Truskavets, etc.
When using folk remedies for cholecystitis, you must adhere to the diet, which is described in the article just above.
Important! Before using folk remedies for cholecystitis, be sure to consult with your doctor!
Juice tincture. Mix thoroughly in even 500 ml portions of fresh carrot juice, red beetroot, black radish, (adult, from 3 years old) and vodka. The mixture can be poured into a 3 liter jar and tightly closed with a nylon lid. Put the jar in a cool, dark place for two weeks. You need to take the tincture in 1 tbsp. spoon 30 minutes before meals. A positive result is the secretion of stagnant bile in the form of mucous tapes during bowel movements.
Horseradish. Grate 1 cup of horseradish and pour 4 cups of hot water over it. Mix everything thoroughly, and pour into an enamel bowl. Let it brew for 1 day in a cool dark place, then store it in the refrigerator. Before using the product, it must be filtered and heated. You need to take an infusion of 50 g 3 times a day, 15 minutes before meals. To improve the taste, the infusion can be taken with sugar. In addition to biliary, diuretic and disinfecting, this infusion also has a number of other beneficial properties.
Collection of herbs 1. Chop one part each, parsley, dill seed, yarrow, peppermint and two parts immortelle, oregano, perforated and valerian root. Pour everything into 1 glass of boiling water and let it brew for 2 hours. Then strain the product and take it in 1-1.5 tbsp. spoon 3 times a day, 30 minutes before meals, for 3 weeks, 3-4 times a year.
Collection of herbs 2. 1 part of grass, 2 parts of tansy flowers, 2 parts of peppermint, 2 parts of toadflax, 4 parts of dandelion roots and 4 rhizomes of Potentilla erect, chop, mix, and pour hot water, at the rate of 1 tbsp. a spoonful of herbal collection in 1 glass of water. The product should be allowed to brew for 30 minutes, then strain it through a strainer. It is necessary to consume the infusion 50-70 g 3 times a day, 20 minutes before meals. The course of treatment is 21 days, with a frequency of 1-2 times a year.
Oil, honey and seeds. Mix in equal portions, 100 g each butter, peeled white seeds (from pumpkin), sunflower oil, etc. Next, the mixture must be poured into a saucepan and brought to a boil, then boil for another 3-4 minutes, and set aside in a cool place to cool. Then add 100 g of alcohol to the resulting mixture, mix and put in the refrigerator, covering the pan with a lid. You need to take this drug for cholecystitis in the morning, on an empty stomach, 1 tbsp. spoon 1 time per day.
Which doctor should I contact for cholecystitis?
Video about cholecystitis
