Cholelithiasis

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The gallbladder is an oval-shaped hollow sac located on the lower surface of the liver. It is about the size of a chicken egg and serves as a reservoir for bile produced in the liver. Depending on the meal, bile from the bladder in portions enters the duodenum through the bile duct and is involved in digestion and absorption.

Cholelithiasis– the process of formation of stones in the gallbladder and bile ducts as a result of a violation of the metabolism of cholesterol, bile acids, changes in the composition of bile and activity of the gallbladder.

Risk factors for gallstone disease:

  • Obesity
  • Age over 40
  • Female

  • Elevated blood cholesterol

  • Sedentary lifestyle
  • Chronic diseases of the gallbladder (cholecystitis, biliary dyskinesia)

  • hereditary predisposition

  • Excess consumption of fatty foods and refined carbohydrates
  • Irregular meals

The formation of gallstones is greatly facilitated by chronic infection in the bile ducts and gallbladder.

Clinical manifestations:

Very often, gallstone disease is asymptomatic and is diagnosed by chance during a routine examination or with concomitant pathology.

In some cases, a person is concerned about dyspeptic disorders: nausea, a feeling of heaviness in the abdomen, unstable stools, bloating, bitterness in the mouth. There may be pulling and aching pains in the right hypochondrium, weakness, nervousness, irritability.

All these symptoms are very non-specific and may not attract the attention of both the patient and the doctor for a long time.

A striking manifestation of cholelithiasis is biliary colic.

biliary colic

Suddenly there is a sharp intense pain in the right hypochondrium. The nature of the pain is sharp, cutting, tearing. Patients rush about, scream, moan. During colic, nausea, vomiting, bitterness, and dry mouth may occur. Attacks of pain can last about 2-6 hours.

If colic develops as a result of blockage of the bile duct by a stone and a violation of the flow of bile into the stomach, obstructive jaundice develops, which usually requires surgical treatment.

Complication of gallstone disease:

  • destructive cholecystitis – inflammation of the gallbladder wall with tissue necrosis and destruction of the organ. May lead to perforation of the gallbladder and the development of peritonitis.
  • empyema (suppuration) of the gallbladderdevelops in the presence of infection
  • adhesive process in the abdominal cavity
  • pancreatic injury with the development of pancreatitis
  • liver damage with the development of hepatitis and cirrhosis of the liver

Treatment of gallstone disease

In case of an attack of biliary colic, it is necessary to provide rest to the patient, a warm heating pad can be placed on the stomach, in the region of the right hypochondrium. To relieve pain, antispasmodics are used, in some cases in combination with analgesics.

One of the key components of treatment is diet. It is recommended to take light meals with a restriction of fats and simple carbohydrates, foods containing cholesterol, spicy, spices, soda and chocolate.

With small sizes and a certain composition of stones (cholesterol stones) and the absence of inflammation, it is possible to conservatively treat gallstone disease by taking medications. Under the influence of long-term medication, the composition of bile changes, cholesterol metabolism changes, and stones gradually dissolve. The duration of treatment is about a year. After the dissolution of the stones, prophylactic medication in small doses is recommended.

For large stones, shock wave therapy is used: under the action of ultrasound, stones are crushed directly in the gallbladder into small pieces, which independently exit through the bile ducts into the intestine and are evacuated along with the intestinal contents.

If an infection joins, then antibacterial drugs are prescribed.

The main treatment is removal of the gallbladder. Currently, this is possible not only with the help of wide access, but also endoscopically – through tiny incisions on the abdominal wall. After such an operation, the recovery time is reduced and cosmetic results are better.

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