Where does it hurt with gallstone disease. Gallstone disease: symptoms and treatment

Today, the symptoms of gallstone disease can be found in almost every person, regardless of age and lifestyle. Moreover, this pathology has become "younger" and manifest itself much more often than before. If earlier it was most common in people over 40 years old, now it can be found even in young boys and girls. There can be many reasons for this.

What is the disease?

Before considering the symptoms of gallstone disease, it is imperative to find out the mechanism of its development. Pathology can be chronic or acute. It develops gradually. It is characterized by the appearance of small or large stones in the bile ducts and bladder. This process is quite long.

The formation of stones begins with the fact that bile thickens. Granules appear in it, on which molecules of unabsorbed calcium and cholesterol settle. It should be noted that stones can be multiple and single. In addition, they have different sizes. When they begin to move, an acute attack occurs, which is accompanied by a very strong pain syndrome.

Signs of gallstone disease may not appear immediately, that is, the pathology develops for a certain time. In addition, large elements can “sit” in the ducts for a long time and not move anywhere. Although this also causes a lot of problems. It should be noted that this disease is very common, and the number of cases is constantly growing.

It must be said that there are several types of stones:

• pigment;
• cholesterol;
• calcareous;
• pigment-cholesterol;
• complex stones, consisting of the three components listed above.

Causes of the appearance of pathology

Before considering the symptoms of gallstone disease, it is necessary to understand why it happens at all. So, among the reasons contributing to the development of pathology, we can distinguish the following:

• age (after 40 years, the nervous and humoral systems of the body begin to act differently on the internal organs, less effectively);
• high weight (especially if a person eats too fatty, spicy foods rich in cholesterol);
• violations of metabolic processes in the body;
• malnutrition;
• unsuitable climate and bad ecology;
• an infection of the biliary tract (in which cholesterol precipitates, which then accumulates, rams and turns into stones);
• insufficient amount of acids that can dissolve lipids;
• any other pathologies of internal organs (physiological, infectious or inflammatory).

Signs of pathology

The symptoms of gallstone disease are not specific, so at first it is quite difficult to recognize it. An accurate diagnosis can only be made by a doctor. However, the disease manifests itself as follows:

There are other signs of gallstone disease: allergic reactions, fatigue, sleep disturbance and lack of appetite, lethargy. I must say that they can appear singly or simultaneously.

Diagnosis of the disease

Symptoms of gallstone disease in adults cannot give a complete picture, which is necessary for the appointment of adequate treatment. Naturally, you will have to visit an experienced doctor who will carry out the entire range of diagnostic measures. They help to establish the size of the stones, the degree of development of the pathology, its type.

Various tools, both technical and clinical, are used for diagnosis. In the second case, the doctor performs palpation of the gallbladder and ducts, in which the patient may feel discomfort and pain. In addition, colic may be accompanied by the passage of very small stones, which also indicates the presence of the disease.

During the diagnosis, the symptoms of gallstone disease in adults and children (if any) are taken into account. In addition, the patient will need to undergo the following procedures:

• ultrasound examination of internal organs;
• blood and urine analysis (for the content of duodenal elements, cholesterol, bilirubin, for indicators of fat metabolism and alpha-amylase activity);
• careful analysis of the patient's medical history and anamnesis of his family;
• analysis of feces (in it you can often see which elements of food are not digested);
• study of the inner surface of the stomach, duodenum and esophagus (esophagogastroduodenoscopy);
• cholangiopancreatography (examination of the bile ducts from the inside with a duodenofibroscope);
• computed tomography of internal organs;

It is necessary to take into account the non-specificity of symptoms, so the diagnosis should be made as accurately as possible. Otherwise, the doctor may simply treat the wrong disease, which will lead to unpredictable consequences.

Features of the course of an acute attack and first aid

This pathology can develop gradually, but the time will come when it will make itself felt. Therefore, you must know how to relieve an attack of gallstone disease. I must say that the worst thing a person feels is at the moment when solid particles begin to move along the ducts and clog them. In this case, severe pain and other symptoms appear. In this case, most often the attack occurs at night. It usually lasts up to 6 hours. If you have had an attack of gallstone disease, what to do, you must know for sure. So, you will have to take the following steps:

1. A heating pad or warm compress should be applied to the gallbladder. As a last resort, it is necessary to organize a warm bath to reduce the manifestations of pain and alleviate the condition.
2. Now you need to take any painkiller that can relieve spasms ("Atropine", "Papaverine", "No-shpu").
3. Must be called ambulance and hospitalize the victim. And you need to go to the hospital if there is an exacerbation of the pathology. It is in the hospital that you can carry out all the necessary diagnostics and perform surgical intervention (if absolutely necessary).
4. Along with painkillers, it is necessary to take anti-inflammatory, as well as antibacterial drugs.

I must say that timely measures taken can significantly alleviate the patient's condition. Now you know how to relieve an attack of gallstone disease. However, this does not mean that the pathology should not be treated.

Features of the treatment of pathology

Now you can figure out how to deal with this problem using traditional, non-traditional and radical methods. Let's start with the first. Treatment of gallstone disease should be comprehensive. That is, it is not enough to simply eliminate stones from the ducts and bladder. It is necessary to carry out drug therapy for a long time, to observe a certain diet, to follow the prescriptions of doctors.

Specialists use various drugs for gallstone disease:

1. To eliminate the pain syndrome, intramuscular and intravenous analgesics are used ("Talamonal", analgin solution). In extreme cases, narcotic substances can be used: morphine, Promedol.
2. To eliminate spasms in the ducts, it is necessary to use the preparations "Papaverine" or "No-shpa", and under the skin. To improve the circulation of bile, you can use special preparations ("Holenzim"). However, try not to use stronger drugs, as this can lead to an acute attack, which will end in surgery.
3. Treatment of gallstone disease is accompanied by the passage of solid elements. For this, warm teas and heating pads are usually used.
4. If the pathology has already passed into chronic stage, try to periodically take courses of treatment prescribed by your doctor. For example, drugs such as Liobil and others are taken.

In any case, you can not choose medicines on your own, since you can only harm yourself. It is better to consult with a specialist and undergo a thorough examination.

Features of treatment with folk remedies

Naturally, drug therapy is not a panacea and does not always help. Self-prepared substances can also enhance the effect. For example, the treatment of gallstone disease with folk remedies will significantly increase your chances of getting rid of the pathology, but you should not use them without the consent of the doctor. So, the following recipes can be useful:

1. Red beet juice. Long term use this drink will help you quickly deal with the stones. And they dissolve completely painlessly. You can use not only juice, but also a decoction of beets. To do this, the vegetable needs to be cooked for a long time. Keep in mind that not all people like this drink.
2. Treatment of gallstone disease, folk remedies, in particular, can be done using mixtures of various plants, each of which has its specific effect. For example, to remove the pain syndrome, cleanse the internal organs, improve their blood supply, such a remedy can be used: calamus, valerian and buckthorn roots, rosemary grass, mint, hawthorn, chamomile, lily of the valley and rose hips are mixed in equal amounts. Before this, all plants should be crushed. The maximum amount of each herb is 5 grams. Next, pour the mixture with 1.5 liters of water and put on fire. The liquid should boil for no more than five minutes. In addition, give the product time to infuse (about 6 hours). You need to take it several times a day, 100 ml. It is necessary to drink the remedy until complete recovery.
3. In order to eliminate the stagnation of bile in the ducts, use a decoction of berries and wild strawberry leaves. Take it three times a day for a glass.
4. Ordinary dill is also considered useful. To prepare the decoction, you will need two large spoons of seeds and 2 cups of boiling water. Next, the mixture must be put on fire. It should boil no more than 12 minutes. Try to drink the remedy every day for half a glass. Moreover, the liquid should be warm. You will need several weeks to heal.
5. An infusion of chicory root will help you effectively dissolve the stones and remove them from the body. To prepare a drink, take 60 grams of crushed raw materials and pour 200 ml of boiling water over it. The decoction should be infused for at least 20 minutes. Then take the drink in small portions throughout the day. It is best if the broth is fresh every time.
6. Black radish juice and honey will help you cleanse your gallbladder and dissolve gallstones. Try to drink 1 tablespoon of the mixture on an empty stomach in the morning. After that, you can eat only after a quarter of an hour. Please note that this procedure is lengthy and takes at least six months.

Also, try to improve the secretion of bile. To do this, take the juice of carrots and cabbage every day.

Indications for surgery and types of operations

There are cases when it is impossible to use medicines for cholelithiasis or folk recipes they just don't help. In addition, acute attacks require the intervention of a surgeon. In this case, surgical removal of stones is performed. There are certain indications for intervention:

There are also contraindications to the operation: the patient's serious condition, any oncological diseases of other organs, severe inflammatory processes in the body, as well as individual characteristics.

Removal gallstones produced in several ways:

1. Traditional (laparotomy). To do this, the doctor must open the anterior abdominal wall and remove the bubble along with all the contents. Such an operation is performed if the stones are too large or the organ no longer performs the function assigned to it.
2. Laparoscopic. This does not require cutting the peritoneum. Specialists simply make small holes in the bladder area and take out the stones through them. At the same time, recovery after such an operation is much faster, there are practically no scars on the skin. That is, this type of intervention is used most often.

If you have gallstone disease, the operation can be performed without a scalpel. For example, now in medicine specialized technical means are used that are capable of crushing the formed elements. This method is called shock wave lithotripsy. You can't go through this process everywhere. After the procedure, small stones are simply dissolved with the help of drugs and excreted from the body.

Nutrition Features

For more effective treatment, the patient is prescribed diet No. 5. For cholelithiasis, it is considered optimal. So, the caloric content of nutrition with such a diet is about 2800 kcal daily. If the patient is obese, then these figures can be reduced to 2300 kcal. You need to eat at least 5 times a day in small portions.

Need to drink clean water, and as much as possible (from two liters per day). Try not to drink carbonated water, alcohol is prohibited. Best for tea, juices and herbal decoctions. Products for gallstone disease should be fresh and safe. It is forbidden to eat fatty, fried, smoked, spicy foods, chocolate, canned food, sausages and semi-finished products, fish and meat broths. Also, try not to use garlic, pepper, fat, onion, sorrel, and excessive salt when cooking.

Allowed products are: bran bread, vegetables and fruits, low-fat dairy products, lean meat and fish. Moreover, the latter should be baked in the oven or steamed. Eat cereals and boiled eggs (no more than 1 per day). Instead of sunflower, use olive oil. If you have a period of exacerbation, then the products should be frayed.

You can't make your own diet. Try to consult with an experienced specialist in this field, as well as your doctor. If you do not know what can be cooked for gallstone disease, the recipes presented in this article will be very useful to you.

So, take 300 g of potatoes, 25 g of carrots, 19 g of butter, 350 g of water, 7 g of parsley and 25 g of onion. All vegetables must be boiled. Gradually add oil and parsley to the "soup". It is advisable to chop carrots and potatoes.

Useful and very tasty during the disease is mashed potatoes and carrots. All vegetables must be boiled and ceiling (grind). Next, add a little milk and a little salt to the mixture. Now the puree can be brought to a boil and served.

A very useful vegetable in this situation is eggplant. It can be stewed in sour cream sauce. To prepare such a dish, take 230 g of eggplant, greens, a little butter and salt. For the sauce you will need 50 g of water, 50 g of sour cream, a little oil and flour. The eggplant is cooked last. The sauce is made as follows: fry the flour in a preheated pan, add oil and water to it. Boil the mixture for about 20 minutes. Lastly, sour cream is added. Now peel and cut the eggplant, salt it and leave it for a few minutes to remove the bitterness from it. Next, put the pieces in the pan and simmer a little over low heat. Lastly, add the sauce to the eggplant and leave the dish to stew for another 5 minutes. Enjoy your meal!

Disease prevention

It is necessary to treat the presented pathology, but it is best to prevent it. That is, you must follow all the necessary preventive measures that will help you avoid the disease. Otherwise, the treatment will be long and painful.

For example, try to maintain optimal body weight. Obesity only contributes to the appearance of this pathology and other health problems. Therefore, force yourself to move, do morning exercises, do gymnastics or some kind of active sport. Walk more, go hiking, run, bike, swim.

Highly effective way prevention is a balanced and proper diet. You should not overload your digestive tract, so do not overeat, try to give up harmful foods, dishes and habits. For example, stop smoking, drinking alcohol, eating at fast food establishments. Exclude spicy, fatty, smoked foods and canned food from the menu. Limit sweets, muffins, lard, oily fish and other heavy foods. After all, what is not digested in the stomach turns into a harmful sediment, from which stones are subsequently formed. If you do not know how to correctly calculate your diet, contact a nutritionist. He will build you a nutrition system that will allow you to get rid of the threat of the onset of the disease and bring your body into shape.

If you want to lose weight, then you need to do it very carefully so that the activity of the body systems is not disturbed. No need to lose weight abruptly and quickly. It can only hurt.

However, if the disease does appear, it is urgent to stop its development. That is, try not to delay treatment after the first symptoms are detected and the correct diagnosis is made.

As for questions about the elimination of stones, here you need to consult with your doctor. If necessary, you can get advice from other experts in this field. Self-medication is not worth it, as the consequences can be very serious. It is better to combine all traditional and unconventional ways elimination of the disease under the supervision of a doctor. Be healthy!

Chronic calculous cholecystitis- This is a disease in which stones form in the cavity of the gallbladder, which subsequently cause inflammation of the walls of the gallbladder.

Cholelithiasis refers to common diseases - occurs in 10-15% of the adult population. In women, this disease occurs 2-3 times more often than in men. Cholecystitis is an ancient human disease. The first gallstones were discovered during the study of Egyptian mummies.

Anatomy and physiology of the gallbladder

The length of the gallbladder is from 5 to 14 centimeters, and the capacity is 30-70 milliliters. In the bladder, the bottom, body and neck are distinguished.

The wall of the gallbladder consists of mucous, muscular, and connective tissue membranes. The mucosa consists of epithelium and various glandular cells. The musculature is made up of smooth muscle fibers. At the neck, the mucous and muscular membranes form a sphincter that prevents the release of bile at the wrong time.

The bladder neck continues into the cystic duct, which then merges with the common hepatic duct to form the common bile duct.
The gallbladder is located on the lower surface of the liver so that the wide end of the gallbladder (bottom) slightly extends beyond the lower edge of the liver.

The function of the gallbladder is to store, concentrate bile and excrete bile as needed.
The liver produces bile and, as unnecessary, bile accumulates in the gallbladder.
Once in the bladder, bile is concentrated by absorption of excess water and trace elements by the epithelium of the bladder.

The secretion of bile occurs after eating. The muscular layer of the bladder contracts, increasing the pressure in the gallbladder to 200-300 mm. water column. Under the action of pressure, the sphincter relaxes, and bile enters the cystic duct. The bile then enters the common bile duct, which opens into the duodenum.

The role of bile in digestion

Bile in the duodenum creates the necessary conditions for the activity of enzymes found in the pancreatic juice. Bile dissolves fats, which contributes to the further absorption of these fats. Bile is involved in the absorption of vitamins D, E, K, A in the small intestine. Bile also stimulates the secretion of pancreatic juice.

Causes of the development of chronic calculous cholecystitis

Fixed Factors:

• Floor. Most often, women get sick due to the use of contraceptives, childbirth (estrogens, which are elevated during pregnancy, increase the absorption of cholesterol from the intestines and its abundant excretion with bile).
• Age. Persons aged 50 to 60 years are more likely to suffer from cholecystitis.
• genetic factors. These include - family predisposition, various congenital anomalies of the gallbladder.
• ethnic factor. The greatest number of cases of cholecystitis is observed in Indians living in the southwestern United States and in the Japanese.

• Food . Increased consumption of animal fats and sweets, as well as hunger and rapid weight loss can cause cholecystitis.
• Obesity. The amount of cholesterol in the blood and bile increases, which leads to the formation of stones
• Diseases of the gastrointestinal tract. Crohn's disease, resection (removal) of a part small intestine
• Medications. Estrogens, contraceptives, diuretics (diuretics) - increase the risk of cholecystitis.
• Hypodynamia (fixed, sedentary lifestyle)
• Decreased tone of the muscles of the gallbladder

How are stones formed?

First phase- violation in bile of the ratio of cholesterol and solvents (bile acids, phospholipids).
In this phase, there is an increase in the amount of cholesterol and a decrease in the amount of bile acids.

An increase in cholesterol occurs due to a malfunction of various enzymes.
- decreased hydroxylase activity (affects cholesterol lowering)
- decreased activity of acetyl transferase (converts cholesterol to other substances)
- increased breakdown of fats from the fatty layer of the body (increases the amount of cholesterol in the blood).

decline fatty acids occurs for the following reasons.
- Violations of the synthesis of fatty acids in the liver
- Increased excretion of bile acids from the body (impaired absorption of fatty acids in the intestine)
- Violation of intrahepatic circulation

Second phase - bile saturated with cholesterol forms a stasis of bile (stagnation of bile in the bladder), then a crystallization process occurs - forming crystals of cholesterol monohydrate. These crystals stick together and form stones of various sizes and compositions.
Cholesterol stones may be single or multiple and are usually round or oval in shape. The color of these stones is yellow-green. The sizes of stones vary from 1 millimeter to 3-4 centimeters.

Bile pigment stones are formed due to an increase in the amount of unbound, water-insoluble bilirubin. These stones are composed of various polymers of bilirubin and calcium salts.
Pigment stones are usually small in size up to 10 millimeters. Usually there are several pieces in the bubble. These stones are black or grey.

Most often (80-82% of cases) there are mixed stones. They consist of cholesterol, bilirubin and calcium salts. By the number of stones are always multiple, yellow-brown.

Symptoms of gallstone disease

Symptoms appear only if the stone moves through the cystic canal, which leads to its blockage and inflammation.

Depending on the stage of cholelithiasis, the symptoms presented in the next section of the article are also distinguished.

Clinical stages of gallstone disease

2. Latent stage.
At this stage, there are no complaints from the patient. There are already stones in the gallbladder. Diagnosis can be made by ultrasound.

3. The stage of onset of symptoms of the disease.
- Biliary colic is a very severe, paroxysmal and sharp pain that lasts from 2 to 6 hours, sometimes more. Attacks of pain usually appear in the evening or at night.

The pain is in the right hypochondrium and spreads to the right shoulder blade and right cervical region. Pain occurs most often after a rich, fatty meal or after a lot of physical activity.

Products after taking, which may cause pain:

• Cream
• Alcohol
• cakes
• Carbonated drinks

Other symptoms of the disease:

• Increased sweating
• Chills
• Increase in body temperature up to 38 degrees Celsius
• Vomiting bile that does not bring relief

At this stage, complications such as:
Acute cholecystitis This disease requires immediate surgical intervention.

Hydrocele of the gallbladder. There is a blockage of the cystic duct by a stone or narrowing to a complete blockage of the duct. The release of bile from the bladder stops. Bile is absorbed from the bladder through the walls, and a serous-mucous secret is secreted into its lumen.
Gradually accumulating, the secret stretches the walls of the gallbladder, sometimes to a huge size.

Perforation or rupture of the gallbladder leads to the development of biliary peritonitis (inflammation of the peritoneum).

hepatic abscess. Limited accumulation of pus in the liver. An abscess forms when a section of the liver is destroyed. Symptoms: heat up to 40 degrees, intoxication, liver enlargement.
This disease is treated only surgically.

gallbladder cancer. Chronic calculous cholecystitis greatly increases the risk of cancer.

Diagnosis of gallstone disease

Conversation with a doctor
The doctor will ask you about your complaints. Reveal the causes of the disease. He will dwell in particular detail on nutrition (after taking, what foods do you feel bad about?). Then he will enter all the data into the medical record and then proceed to the examination.

Inspection
The examination always begins with a visual examination of the patient. If the patient at the time of examination complains of severe pain, then his face will express suffering.

The patient will be in a supine position with the legs bent and brought to the stomach. This position is forced (reduces pain). I would also like to note very important feature, when the patient is turned over to the left side, the pain intensifies.

Palpation (palpation of the abdomen)
With superficial palpation, flatulence (bloating) of the abdomen is determined. It is also defined hypersensitivity in the right hypochondrium. There may be muscle tension in the abdomen.

With deep palpation, an enlarged gallbladder can be determined (normally, the gallbladder is not palpable). Also, with deep palpation, specific symptoms are determined.
1. Murphy's symptom - the appearance of pain during inspiration at the time of probing the right hypochondrium.

2. Ortner's symptom - the appearance of pain in the right hypochondrium, when tapping (percussion) on the right costal arch.

Ultrasound of the liver and gallbladder
On ultrasonography, the presence of stones in the gallbladder is well determined.

Signs of the presence of stones on ultrasound:
1. Presence of solid structures in the gallbladder
2. Mobility (movement) of stones
3. Ultrasonographic hypoechoic (visible as a white gap in the picture) trace below the stone
4. Thickening of the walls of the gallbladder more than 4 millimeters

x-ray abdominal cavity
Clearly visible stones, which include calcium salts

Cholecystography- study using contrast for better visualization of the gallbladder.

CT scan- performed in the diagnosis of cholecystitis and other diseases

Endoscopic cholangiopancreatography- used to determine the location of a stone in the common bile duct.

The course of chronic calculous cholecystitis
The asymptomatic form of cholecystitis lasts a long time. From the moment of detection of stones in the gallbladder within 5-6 years, only 10-20% of patients begin to develop symptoms (complaints).
The appearance of any complications indicates an unfavorable course of the disease. In addition, many complications are treated only surgically.

Treatment of gallstone disease

In the asymptomatic stage of chronic cholecystitis, the main method of treatment is diet.

Diet for gallstone disease

Prohibited Products:

Alcoholic drinks
- legumes, in any kind of preparation
- high-fat dairy products (cream, full-fat milk)
- any fried food
- meat from fatty varieties (goose, duck, pork, lamb), lard
- fatty fish, salted, smoked fish, caviar
- any kind of canned goods
- mushrooms
- fresh bread (especially hot bread), croutons
- spices, spices, salinity, pickled products
- coffee, chocolate, cocoa, strong tea
- salty, hard and fatty types of cheese

Cheeses can be eaten, but low-fat

Vegetables should be consumed in boiled, baked form (potatoes, carrots). It is allowed to use finely chopped cabbage, ripe cucumbers, tomatoes. Green onion, parsley to use as an addition to dishes

Meat from non-fat varieties (beef, veal, rabbit), as well as (chicken and turkey without skin). Meat should be consumed boiled or baked. It is also recommended to use minced meat (cutlets)

Vermicelli and pasta allowed

Sweet ripe fruits and berries, as well as various jams and concoctions

Drinks: not strong tea, not sour juices, various mousses, compotes

Butter (30 grams) in dishes

Low-fat types of fish are allowed (perch, cod, pike, bream, perch, hake). It is recommended to use the fish in boiled form, in the form of cutlets, aspic

You can use whole milk. You can also add milk to various cereals.
Not sour cottage cheese, non-sour fat-free yogurts are allowed

Effective treatment of cholecystitis, when symptoms are present, is possible only in a hospital setting!

Drug treatment of biliary colic (pain symptom)

If anticholinergics do not help, antispasmodics are used:
Papaverine 2% - 2 milliliters intramuscularly or Drotaverine (Noshpa) 2% - 2 milliliters.

Baralgin 5 milliliters intramuscularly or Pentalgin also 5 milliliters are used as painkillers.
In case of very severe pain, Promedol 2% - 1 ml is used.

Method of direct destruction of stones
The method is based on the direct injection of a strong stone dissolver into the gallbladder.

Extracorporeal shock wave lithotripsy- crushing stones using the energy of shock waves generated outside the human body.

This method is carried out using various devices that produce different kinds waves. For example, waves created by a laser, an electromagnetic installation, an installation that produces ultrasound.

Any of the devices is installed in the projection of the gallbladder, then waves from various sources act on the stones and they are crushed to small crystals.

Then these crystals are freely excreted along with bile into the duodenum.
This method is used when the stones are no larger than 1 centimeter and when the gallbladder is still functioning.
In other cases, in the presence of symptoms of cholecystitis, surgery is recommended to remove the gallbladder.

Surgical removal of the gallbladder

The first type has been used for a long time. The standard method is based on abdominal surgery (with an open abdominal cavity). Recently, it has been used less and less due to frequent postoperative complications.

The laparoscopic method is based on the use of a laparoscope apparatus. This apparatus consists of several parts:
- high magnification video cameras
- different kinds of tools
Advantages of the 2nd method over the first:
1. Laparoscopic surgery does not require large incisions. The incisions are made in several places and are very small.
2. The seams are cosmetic, so they are practically invisible
3. Health is restored 3 times faster
4. The number of complications is ten times less

Prevention of gallstone disease

Secondary prevention is to prevent complications. The main method of prevention is effective treatment chronic cholecystitis described above.

Why is gallstone disease dangerous?

Gallstone disease is dangerous, first of all, with the following complications:

• Gallbladder perforation. A perforation is a rupture of the gallbladder. It can be caused by the movement of stones or too much contraction ( spasm) smooth muscle of the organ. In this case, the contents of the organ enter the abdominal cavity. Even if there was no pus inside, the bile itself can cause serious irritation and inflammation of the peritoneum. The inflammatory process extends to intestinal loops and other neighboring organs. Most often, in the cavity of the gallbladder there are opportunistic microbes. In the abdominal cavity, they multiply rapidly, realizing their pathogenic potential and leading to the development of peritonitis.
• Empyema of the gallbladder. An empyema is a collection of pus in a natural body cavity. With calculous cholecystitis, the stone often gets stuck at the level of the bladder neck. At first, this leads to dropsy - the accumulation of mucous secretion in the cavity of the organ. The pressure inside increases, the walls stretch, but may contract spastically. This leads to severe pain - biliary colic. If such a clogged gallbladder becomes infected, the mucus turns into pus and empyema occurs. Usually pathogens are bacteria from the genera Escherichia, Klebsiella, Streptococcus, Proteus, Pseudomonas, less often Clostridium and some other microorganisms. They can be ingested through the bloodstream or travel up the bile duct from the intestines. With the accumulation of pus, the patient's condition worsens greatly. The temperature rises, headaches intensify ( due to absorption of waste products into the blood). Without urgent surgery, the gallbladder ruptures, its contents enter the abdominal cavity, causing purulent peritonitis. At this stage ( after the break) the disease often ends in the death of the patient, despite the efforts of doctors.
• Reactive hepatitis. The inflammatory process from the gallbladder can spread to the liver, causing inflammation. The liver also suffers from a deterioration in local blood flow. Typically, this problem unlike viral hepatitis) passes quite quickly after removal of the gallbladder - the main center of inflammation.
• Acute cholangitis. This complication involves blockage and inflammation of the bile duct. In this case, the outflow of bile is disturbed by a stone stuck in the duct. Since the bile ducts are connected to the ducts of the pancreas, pancreatitis can also develop in parallel. Acute cholangitis occurs with severe fever, chills, jaundice, severe pain in the right hypochondrium.
• Acute pancreatitis. Usually occurs due to lack of bile ( that is not released from the clogged bladder) or blockage of the common duct. Pancreatic juice contains a large amount of strong digestive enzymes. Their stagnation can cause necrosis ( death) of the gland itself. This form of acute pancreatitis poses a serious threat to the patient's life.
• Biliary fistulas. If gallstones do not cause severe pain, the patient may ignore them for a long time. However, the inflammatory process in the organ wall ( directly around the stone) is still evolving. The destruction of the wall and its “soldering” with neighboring anatomical structures gradually occur. Over time, a fistula may form, connecting the gallbladder with other hollow organs. These organs can be the duodenum ( most often), stomach, small intestine, large intestine. There are also options for fistulas between the bile ducts and these organs. If the stones themselves do not bother the patient, then fistulas can cause air accumulation in the gallbladder, violations of the outflow of bile ( and intolerance to fatty foods), jaundice, vomiting of bile.
• Paravesical abscess. This complication is characterized by the accumulation of pus near the gallbladder. Usually, an abscess is delimited from the rest of the abdominal cavity by adhesions that have arisen against the background of an inflammatory process. From above, the abscess is limited to the lower edge of the liver. The complication is dangerous by the spread of infection with the development of peritonitis, impaired liver function.
• Scar strictures. Strictures are places of narrowing in the bile duct that prevent the normal flow of bile. In cholelithiasis, this complication may occur as a result of inflammation ( the body responds with excessive formation of connective tissue - scars) or as a consequence of an intervention to remove stones. Either way, strictures can persist even after recovery and seriously affect the body's ability to digest and absorb fatty foods. In addition, if stones are removed without removing the gallbladder, strictures can cause bile stasis. In general, people with these duct narrowings are more likely to relapse ( repeated inflammation of the gallbladder).
• Secondary biliary cirrhosis. This complication can occur if gallstones prevent the flow of bile for a long time. The fact is that bile enters the gallbladder from the liver. Its overflow causes stagnation of bile in the ducts in the liver itself. It can eventually lead to the death of hepatocytes ( normal liver cells) and their replacement with connective tissue that does not perform the necessary functions. This phenomenon is called cirrhosis. The result is serious violations of blood clotting, impaired absorption of fat-soluble vitamins ( A, D, E, K), accumulation of fluid in the abdominal cavity ( ascites), severe intoxication ( poisoning) organism.

Can calculous cholecystitis be cured without surgery?

The main advantages of surgical treatment of calculous cholecystitis are:

• Radical solution to the problem. Removal of the gallbladder guarantees the cessation of pain ( biliary colic), since colic appears due to contractions of the muscles of this organ. In addition, there is no risk of recurrence ( repeated exacerbations) gallstone disease. Bile can no longer accumulate in the bladder, stagnate and form stones. It will go directly from the liver to the duodenum.
• Patient safety. Nowadays endoscopic removal gallbladder ( cholecystectomy) is a routine operation. The risk of complications during surgery is minimal. Subject to all the rules of asepsis and antisepsis, postoperative complications are also unlikely. The patient recovers quickly and can be discharged ( in consultation with the attending physician) a few days after the operation. After a few months, he can lead the most normal life, apart from a special diet.
• Ability to treat complications. Many patients go to the doctor too late, when complications of calculous cholecystitis begin to appear. Then surgical treatment is simply necessary to remove pus, examine neighboring organs, and adequately assess the risk to life.

Nowadays, there are several ways of non-surgical treatment of calculous cholecystitis. This is not about symptomatic treatment. muscle spasm relief, pain relief), namely, getting rid of stones inside the gallbladder. The main advantage of these methods is the preservation of the organ itself. With a successful result, the gallbladder is freed from stones and continues to perform its functions of accumulating and dosed bile secretion.

There are three main methods of non-surgical treatment of calculous cholecystitis:

• Medical dissolution of stones. This method is perhaps the safest for the patient. long time the patient should take drugs based on ursodeoxycholic acid. It promotes the dissolution of stones containing bile acids. The problem is that even to dissolve small stones, it is necessary to take the medicine regularly for several months. If we are talking about larger stones, the course can be delayed for 1 - 2 years. However, there is no guarantee that the stones will dissolve completely. Depending on the individual characteristics metabolism, they may contain impurities that will not dissolve. As a result, the stones will decrease in size, the symptoms of the disease will disappear. However, this effect will be temporary.
• Ultrasonic crushing of stones. Today, crushing stones with the help of ultrasonic waves is a fairly common practice. The procedure is safe for the patient, easy to perform. The problem is that the stones are crushed into sharp fragments, which still cannot leave the gallbladder without injuring it. In addition, the problem of stagnation of bile is not solved radically, and after a while ( usually several years) stones can form again.
• Laser stone removal. It is used quite rarely due to the high cost and relatively low efficiency. Stones are also subjected to a kind of crushing and fall apart. However, even these parts can injure the mucous membrane of the organ. In addition, there is a high risk of recurrence ( re-formation of stones). Then the procedure will have to be repeated.

When is surgery needed for gallstone disease?

Cholecystectomy involves the complete removal of the bladder along with the stones it contains. With an uncomplicated course of the disease, it guarantees a solution to the problem, since the bile formed in the liver will no longer accumulate and stagnate. The pigments simply won't be able to form stones again.

There are many indications for cholecystectomy. They are divided into absolute and relative. Absolute indications are those without which serious complications can develop. Thus, if the operation is not performed when there are absolute indications, the life of the patient will be endangered. In this regard, doctors in such situations always try to convince the patient of the need for surgical intervention. There are no other treatments available or they will take too long and increase the risk of complications.

Absolute indications for cholecystectomy in cholelithiasis are:

• A large number of stones. If gallstones ( regardless of their number and size) occupy more than 33% of the organ volume, cholecystectomy should be performed. It is almost impossible to crush or dissolve such a large number of stones. At the same time, the organ does not work, since the walls are very stretched, they contract poorly, stones periodically clog the neck area and interfere with the outflow of bile.
• Frequent colic. Attacks of pain in cholelithiasis can be very intense. Remove them with antispasmodic drugs. However, frequent colic suggests that drug treatment does not bring success. In this case, it is better to resort to the removal of the gallbladder, regardless of how many stones are in it and what size they are.
• Stones in the bile duct. When the bile ducts are blocked by a stone from the gallbladder, the patient's condition worsens greatly. The outflow of bile stops completely, the pain intensifies, obstructive jaundice develops ( due to the free fraction of bilirubin).
• Biliary pancreatitis. Pancreatitis is an inflammation of the pancreas. This organ has a common excretory duct with the gallbladder. In some cases, with calculous cholecystitis, the outflow of pancreatic juice is disturbed. The destruction of tissues in pancreatitis endangers the life of the patient, so the problem must be urgently solved by surgical intervention.

Separately, it should be noted the surgical treatment of complications of acute cholecystitis. In this case, we are talking about the spread of the inflammatory process. Problems with the gallbladder are reflected in the work of neighboring organs. In such situations, the operation will include not only the removal of the gallbladder with stones, but also the solution of the resulting problems.

Surgery without fail, it may also be necessary for the following complications of gallstone disease:

• Peritonitis. Peritonitis is an inflammation of the peritoneum, the membrane that covers most of the abdominal organs. This complication occurs when the inflammatory process spreads from the gallbladder or perforation ( gap) of this organ. Bile, and often a large number of microbes, enters the abdominal cavity, where intense inflammation begins. The operation is necessary not only to remove the gallbladder, but also to thoroughly disinfect the abdominal cavity as a whole. It is impossible to postpone surgical intervention, since peritonitis is fraught with the death of the patient.
• Bile duct strictures. Strictures are called narrowing of the canal. Such narrowing can be formed due to the inflammatory process. They obstruct the outflow of bile and cause stagnation in the liver, although the gallbladder itself can be removed. Surgery is needed to remove strictures. As a rule, the narrowed area is expanded or a bypass is made for bile from the liver to the duodenum. Apart from surgery, there is no effective solution to this problem.
• accumulation of pus. Purulent complications of gallstone disease occur when an infection enters the gallbladder. If pus accumulates inside the organ, gradually filling it, such a complication is called empyema. If pus accumulates near the gallbladder, but does not spread through the abdominal cavity, they speak of a paravesical abscess. The patient's condition with these complications is greatly deteriorating. The risk of spreading the infection is high. The operation includes removal of the gallbladder, emptying the purulent cavity and thoroughly disinfecting it to prevent peritonitis.
• Biliary fistulas. Gallbladder fistulas are pathological openings between the gallbladder ( less commonly by biliary tract) and neighboring hollow organs. Fistulas may not cause acute symptoms, but they disrupt the natural process of outflow of bile, digestion, and also predispose to other diseases. The operation is performed to close pathological openings.

How to treat gallstone disease with folk remedies?

Possible effects of medicinal plants in gallstone disease are:

• Relaxation of smooth muscles. Some medicinal plants relax the muscular sphincter of the gallbladder and the smooth muscles of its walls. This relieves pain attacks usually caused by spasm).
• Decreased bilirubin level. Elevated levels of bilirubin in bile especially if it's been stuck for a long time) may contribute to the formation of stones.
• outflow of bile. Due to the relaxation of the sphincter of the gallbladder, the outflow of bile occurs. It does not stagnate, and crystals and stones do not have time to form in the bubble.

Thus, the effect of the use of folk remedies will be predominantly preventive. Patients with abnormal liver function or other factors predisposing to gallstone disease will benefit from periodic treatment. This will slow down the formation of stones and prevent the problem before it occurs.

For the prevention of gallstone disease, you can use the following folk remedies:

• radish juice. Black radish juice is diluted with honey in equal proportions. You can also cut a cavity in a radish and pour honey into it for 10-15 hours. After that, a mixture of juice and honey is consumed 1 tablespoon 1-2 times a day.
• barberry leaves. Green leaves of barberry are thoroughly washed with running water and filled with alcohol. For 20 g of crushed leaves, 100 ml of alcohol is needed. Infusion lasts 5 - 7 hours. After that, the tincture is drunk 1 teaspoon 3-4 times a day. The course lasts 1 - 2 months. It can be repeated after six months.
• Rowan tincture. 30 g of rowan berries pour 500 ml of boiling water. Insist 1 - 2 hours ( while the temperature drops to room temperature). Then the infusion is taken half a glass 2-3 times a day.
• Mummy. Shilajit can be taken both for the prevention of stone formation, and for cholelithiasis ( if the diameter of the stones does not exceed 5 - 7 mm). It is diluted in a ratio of 1 to 1000 ( 1 g mummy per 1 liter of warm water). Before meals, drink 1 glass of solution, three times a day. This remedy you can use no more than 8 - 10 days in a row, after which you need to take a break of 5 - 7 days.
• Mint with celandine. Equal proportions of the dry leaves of these herbs are consumed as an infusion. For 2 tablespoons of the mixture, 1 liter of boiling water is needed. Infusion lasts 4 - 5 hours. After that, the infusion is consumed 1 glass per day. Sediment ( grass) is filtered before use. It is not recommended to store the infusion for more than 3 - 4 days.
• Highlander snake. To prepare a decoction, you need 2 tablespoons of dry chopped rhizome, pour 1 liter of boiling water and cook for 10-15 minutes over low heat. 10 minutes after turning off the fire, the broth is decanted and allowed to cool ( usually 3 - 4 hours). The decoction is taken 2 tablespoons half an hour before meals twice a day.

To prevent stagnation of bile using blind probing, pharmacological preparations or some natural mineral water. Water or medicine should be drunk on an empty stomach, after which the patient lies on his right side, placing it under the right hypochondrium ( on the area of ​​the liver and gallbladder) warm heating pad. You need to lie down for 1 - 2 hours. During this time, the sphincter will relax, the bile duct will expand, and the bile will gradually come out into the intestines. The success of the procedure is indicated by dark stools with an unpleasant odor after a few hours. It is advisable to consult with your doctor about the method of blind probing and its expediency in each specific case. After the procedure, you need to follow a low-fat diet for several days.

Thus, folk remedies can successfully prevent the formation of gallstones. At the same time, the regularity of treatment courses is important. It is also advisable to pass preventive examinations at the doctor's. This will help to detect small stones ( using ultrasound) if folk methods won't help. After the formation of stones, the effectiveness of traditional medicine is greatly reduced.

What are the first signs of gallstone disease?

Usually, gallstone disease manifests itself for the first time as follows:

• Heaviness in the abdomen. A subjective feeling of heaviness in the abdomen is one of the first manifestations of the disease. Most patients complain about it when they see a doctor. The severity is localized in the epigastrium ( under the pit of the stomach, in the upper abdomen) or in the right hypochondrium. It can appear spontaneously, after physical exertion, but most often - after eating. This feeling is due to stagnation of bile and an increase in the gallbladder.
• Pain after eating. Sometimes the first symptom of the disease is pain in the right hypochondrium. In rare cases, it is biliary colic. It is a severe, sometimes unbearable pain that can radiate to the right shoulder or shoulder blade. However, often the first attacks of pain are less intense. It is rather a feeling of heaviness and discomfort, which, when moving, can turn into stabbing or bursting pain. Discomfort occurs an hour and a half after eating. Especially often pain attacks are observed after taking a large amount of fatty foods or alcohol.
• Nausea. Nausea, heartburn, and sometimes vomiting can also be the first manifestations of the disease. They also usually appear after eating. The connection of many symptoms with food intake is explained by the fact that the gallbladder normally releases a certain portion of bile. It is needed for emulsification ( a kind of dissolution and assimilation) fats and activation of certain digestive enzymes. In patients with gallstones, bile is not excreted, food is digested worse. Therefore, nausea occurs. Backward reflux of food into the stomach leads to belching, heartburn, gas accumulation, and sometimes vomiting.
• Stool changes. As mentioned above, bile is necessary for the normal absorption of fatty foods. With uncontrolled secretion of bile, prolonged constipation or diarrhea may occur. Sometimes they appear even before other symptoms typical of cholecystitis. In later stages, the stool may become discolored. This means that the stones clogged the ducts, and bile is practically not excreted from the gallbladder.
• Jaundice. Yellowing of the skin and sclera of the eyes is rarely the first symptom of gallstone disease. It usually occurs after digestive problems and pain. Jaundice is caused by stagnation of bile not only at the level of the gallbladder, but also in the ducts inside the liver ( where bile is produced). Due to a violation of the liver, a substance called bilirubin accumulates in the blood, which is normally excreted with bile. Bilirubin enters the skin, and its excess gives it a characteristic yellowish tint.

It is usually difficult to make a correct diagnosis based on the first symptoms and manifestations of gallstone disease. Nausea, vomiting and indigestion can also occur with disorders in other organs of the digestive system. To clarify the diagnosis, an ultrasound is prescribed ( ultrasound procedure) of the abdominal cavity. It allows you to detect a characteristic increase in the gallbladder, as well as the presence of stones in its cavity.

Can calculous cholecystitis be treated at home?

• Acute forms of the disease. In the acute course of calculous cholecystitis, a serious inflammatory process develops. Without proper patient care, the course of the disease can become very complicated. In particular, we are talking about the accumulation of pus, the formation of an abscess or the development of peritonitis ( inflammation of the peritoneum). In the acute course of the disease, hospitalization should not be postponed, since the above-mentioned complications can develop within 1 to 2 days after the first symptoms.
• The first signs of the disease. It is recommended that patients who present with symptoms and signs of calculous cholecystitis be admitted to the hospital for the first time. There they will do all the necessary research within a few days. They will help to figure out what kind of disease the patient has, what his condition is, whether there is a question of urgent surgical intervention.
• Accompanying illnesses. Cholecystitis can develop in parallel with other health problems. For example, in patients with chronic heart failure, diabetes mellitus or other chronic diseases, it can cause an exacerbation and a serious deterioration in the condition. To carefully monitor the course of the disease, it is recommended to put the patient in the hospital. There, if necessary, he will be quickly provided with any assistance.
• Patients with social problems . Hospitalization is recommended for all patients who cannot be provided with urgent help at home. For example, a patient with chronic cholelithiasis lives very far from the hospital. In the event of an exacerbation, it will not be possible for him to quickly provide qualified assistance ( usually about surgery.). During transportation, serious complications may develop. A similar situation arises with older people who have no one to look after at home. In these cases, it makes sense to operate even a non-acute process. This will prevent an exacerbation of the disease in the future.
• Pregnant women. Calculous cholecystitis in pregnancy carries a higher risk for both mother and fetus. In order to have time to provide assistance, it is recommended to hospitalize the patient.
• Patient's wish. Any patient with chronic cholelithiasis can voluntarily go to the hospital for the surgical removal of gallstones. This is much more profitable than operating on an acute process. First, the risk of complications during surgery and in postoperative period. Secondly, the patient himself chooses the time ( vacation, scheduled sick leave, etc.). Third, he deliberately eliminates the risk repeated complications illness in the future. The prognosis for such elective operations is much better. Doctors have more time to carefully examine the patient before treatment.

At home, the disease can be treated under the following conditions:

• chronic course of gallstone disease ( no acute symptoms);
• final diagnosis;
• strict adherence to the instructions of a specialist ( regarding prevention and treatment);
• the need for long-term medical treatment ( for example, non-surgical dissolution of stones can take 6 to 18 months);
• the possibility of caring for the patient at home.

Is it possible to play sports with gallstone disease?

One of the important conditions of the preventive regimen is the limitation of physical activity. This is necessary after the discovery of stones, during the acute stage of the disease, as well as during treatment. At the same time, we are talking not only about professional athletes, whose training requires all the strength, but also about everyday physical activity. At each stage of the disease, they can affect the development of events in different ways.

The main reasons for limiting physical activity are:

• Accelerated production of bilirubin. Bilirubin is a natural metabolic product ( metabolism). This substance is formed during the breakdown of hemoglobin - the main component of red blood cells. The more physical activity a person performs, the faster red blood cells break down and the more hemoglobin enters the blood. As a result, the level of bilirubin also rises. This is especially dangerous for people who have bile stasis or a predisposition to the formation of stones. The gallbladder accumulates bile with a high concentration of bilirubin, which gradually crystallizes and forms stones. Thus, people who already have cholestasis ( bile stasis), but the stones have not yet formed, heavy physical activity is not recommended for preventive purposes.
• Movement of stones. If the stones have already formed, then serious loads can lead to their movement. Most often, stones are located in the area of ​​the bottom of the gallbladder. There they can cause a moderate inflammatory process, but do not interfere with the outflow of bile. As a result of physical activity, intra-abdominal pressure rises. This is reflected to some extent in the gallbladder. It is compressed, and the stones can set in motion, moving to the neck of the organ. There, the stone gets stuck at the level of the sphincter or in the bile duct. As a result, a serious inflammatory process develops, and the disease acquires an acute course.
• Progression of symptoms. If the patient already has digestive disorders, pain in the right hypochondrium or other symptoms of gallstone disease, then physical activity can provoke an exacerbation. For example, pain due to inflammation can turn into biliary colic. If the symptoms are caused by the movement of stones and blockage of the bile duct, then they will not disappear after the cessation of exercise. Thus, there is a chance that even a single exercise ( running, jumping, lifting weights, etc.) can lead to urgent hospitalization and surgery. However, we are talking about people who already suffer from a chronic form of the disease, but do not comply with the regimen prescribed by the doctor.
• Risk of complications of gallstone disease. Calculous cholecystitis is almost always accompanied by an inflammatory process. At first, it is caused by mechanical trauma to the mucous membrane. However, many patients also develop an infectious process. As a result, pus may form and accumulate in the bladder cavity. If, under such conditions, intra-abdominal pressure rises sharply or the patient makes a sharp bad turn, the swollen gallbladder may burst. The infection will spread throughout the abdominal cavity, and peritonitis will begin. Thus, sports and physical activity in general can contribute to the development of serious complications.
• Risk of postoperative complications. Acute cholecystitis often has to be treated surgically. There are two main types of operations - open, when an incision is made in the abdominal wall, and endoscopic, when removal occurs through small openings. In both cases, after the operation, any physical activity is contraindicated for some time. At open operation healing takes longer, more sutures are placed, and the risk of divergence is higher. With endoscopic removal of the gallbladder, the patient recovers faster. As a rule, full-fledged loads are allowed to be given only 4-6 months after the operation, provided that the doctor does not see other contraindications for this.

• daily walks for 30 - 60 minutes at an average pace;
• gymnastic exercises without sudden movements with limited load on the abdominal press;
• swimming ( not for speed) without diving to great depths.

Is pregnancy dangerous with gallstone disease?

The prevalence of this problem during pregnancy is explained as follows:

• Metabolic changes. As a result of hormonal changes, the metabolism in the body also changes. This can lead to accelerated stone formation.
• Motility changes. Normally, the gallbladder stores bile and contracts, releasing it in small portions. During pregnancy, the rhythm and strength of its contractions are disturbed ( dyskinesia). As a result, bile stasis can develop, which contributes to the formation of stones.
• Increased intra-abdominal pressure. If a woman already had small gallstones, then the growth of the fetus can lead to their movement. This is especially true in the third trimester, when the growing fetus pushes up the stomach, colon, and gallbladder. These organs are compressed. As a result, the stones located near the bottom of the bubble ( at the top of it), can enter the bile duct and block it. This will lead to the development of acute cholecystitis.
• Sedentary lifestyle. Pregnant women often neglect walks or elementary exercise, which contribute, among other things, to the normal functioning of the gallbladder. This leads to stagnation of bile and acceleration of the formation of stones.
• Diet change. Changing food preferences can affect the composition of the microflora in the intestine, worsen the motility of the bile ducts. If at the same time the woman had a latent ( asymptomatic) form of gallstone disease, the risk of exacerbation greatly increases.

Exacerbation of gallstone disease during pregnancy is especially dangerous for the following reasons:

• high risk of rupture due to increased intra-abdominal pressure;
• high risk of infectious complications ( including purulent processes ) due to weakened immunity;
• fetal intoxication due to the inflammatory process;
• malnutrition of the fetus due to poor digestion ( food is absorbed worse, as bile does not enter the duodenum);
• limited treatment options not all drugs and treatments that are commonly used for gallstone disease are suitable for pregnant women).

In the absence of complications of gallstone disease, the prognosis for the mother and child remains favorable. If the patient turned to a specialist too late, and the inflammatory process began to spread in the abdominal cavity, the question of extracting the fetus by caesarean section may be raised. At the same time, the prognosis worsens somewhat, since we are talking about a technically complex surgical intervention. It is necessary to remove the gallbladder, remove the fetus, carefully examine the abdominal cavity to prevent the development of peritonitis.

What are the types of calculous cholecystitis?

From the point of view of the main manifestations of the disease(clinical form)There are the following types of calculous cholecystitis:

• stone carrier. This form is latent. The disease does not show up. The patient feels great, does not experience any pain in the right hypochondrium, or problems with digestion. However, the stones have already formed. They gradually increase in number and size. This will happen until the accumulated stones begin to disrupt the functioning of the organ. Then the disease will begin to manifest. Stone carriers can be detected during a preventive ultrasound examination. It is more difficult to notice stones on a plain x-ray of the abdomen. When a stone carrier is found, there is no question of an emergency operation. Doctors have time to try other treatments.
• Dyspeptic form. In this form, the disease is manifested by a variety of digestive disorders. It can be difficult to suspect cholecystitis at first, since there are no typical pains in the right hypochondrium. Patients are concerned about heaviness in the stomach, in the epigastrium. Often after a large meal especially fatty foods and alcohol) there is an eructation with a taste of bitterness in the mouth. This is due to violations of bile secretion. Also, patients may have problems with the stool. In this case, an ultrasound examination will help confirm the correct diagnosis.
• biliary colic. In fact, biliary colic is not a form of gallstone disease. This is a common specific symptom. The problem is that in the acute stage of the disease, severe pain attacks often appear ( every day and sometimes more). The effect of antispasmodic drugs is temporary. Gallbladder colic is caused by painful contraction of smooth muscles in the walls of the gallbladder. They are usually observed with large stones, overstretching of the organ, ingress of a stone into the bile duct.
• Chronic recurrent cholecystitis. The recurrent form of the disease is characterized by repeated bouts of cholecystitis. The attack is manifested by severe pain, colic, fever, characteristic changes in blood tests ( increases the level of leukocytes and the erythrocyte sedimentation rate - ESR). Relapse occurs when unsuccessful attempts are made. conservative treatment. Medications temporarily bring down the inflammatory process, and some healing procedures may temporarily improve the outflow of bile. But as long as there are stones in the gallbladder cavity, the risk of recurrence remains high. Surgery ( cholecystectomy - removal of the gallbladder) solves this problem once and for all.
• Chronic residual cholecystitis. This form is not recognized by all experts. It is sometimes spoken of in cases where an attack of acute cholecystitis has passed. The patient's temperature decreased, and the general condition returned to normal. However, the symptoms remained moderate pain in the right hypochondrium, which is aggravated by palpation ( palpation of this area). Thus, we are not talking about a complete recovery, but about a transition to special form– residual ( residual) cholecystitis. As a rule, over time, the pain disappears or the disease worsens again, turning into acute cholecystitis.
• angina pectoris form. Is rare clinical form calculous cholecystitis. Its difference from others is that the pain from the right hypochondrium spreads to the region of the heart and provokes an attack of angina pectoris. There may also be disturbances heart rate and other symptoms from the cardiovascular system. This form is more common in patients with chronic ischemic heart disease. Biliary colic in this case plays the role of a kind of "trigger". The problem is that due to an attack of angina pectoris, doctors often do not immediately detect the main problem - the actual calculous cholecystitis.
• Saint's syndrome. It is a very rare and under-researched genetic disease. With it, the patient has a tendency to form stones in the gallbladder ( actually calculous cholecystitis), which appears to be due to the absence of certain enzymes. In parallel, there is diverticulosis of the large intestine and diaphragmatic hernia. This combination of defects requires a special approach in treatment.

is a disease accompanied by the formation of stones in the gallbladder (cholecystolithiasis) or in the bile ducts (choledocholithiasis). Stones are formed as a result of precipitation of bile pigments, cholesterol, certain types of proteins, calcium salts, infection of bile, its stagnation, lipid metabolism disorders. The disease may be accompanied by pain in the right hypochondrium, biliary colic, jaundice. Requires surgical intervention. Pathology can be complicated by cholecystitis, fistula formation, peritonitis.

General information

- a disease characterized by a disorder in the synthesis and circulation of bile in the hepatobiliary system as a result of a violation of cholesterol or bilirubin metabolism, resulting in the formation of stones (calculi) in the bile ducts and gallbladder. Pathology is dangerous by the development of severe complications with a high probability of death. The disease is much more common in women. Treatment is carried out by specialists in the field of clinical gastroenterology and abdominal surgery.

The reasons

In case of violation of the quantitative ratio of bile components in the body, solid formations (flakes) are formed, which, with the course of the disease, grow and merge into stones. The most common cholelithiasis occurs with impaired cholesterol metabolism (excessive content in bile). Cholesterol-rich bile is called lithogenic. Excess cholesterol is formed due to the following factors:

• With obesity and the use of a large amount of cholesterol-containing foods.
• With a decrease in the amount of bile acids entering the bile (reduced secretion with estrogen, deposition in the gallbladder, functional insufficiency of hepatocytes).
• With a decrease in the number of phospholipids, which are similar to bile acids do not allow cholesterol and bilirubin to pass into a solid state and settle.
• With congestion in the bile circulation system (bile thickening due to absorption of water and bile acids in the gallbladder).

Stagnation of bile, in turn, can be mechanical and functional. With mechanical stagnation, there is an obstruction to the outflow of bile from the bladder (tumors, adhesions, kinks, enlargement of nearby organs and lymph nodes, scars, inflammation with swelling of the wall, strictures). Functional disorders are associated with a disorder of the motility of the gallbladder and biliary tract (biliary dyskinesia of the hypokinetic type). Also, infections, inflammation of the organs of the biliary system, allergic reactions, and autoimmune conditions can lead to the development of cholelithiasis.

Risk factors for the development of cholelithiasis are advanced and senile age, taking medications that interfere with the metabolism of cholesterol and bilirubin (fibrates, estrogens in menopause, ceftriaxone, ocreotide), genetic factors (cholelithiasis in the mother), malnutrition (obesity, sudden weight loss, starvation , elevated levels of cholesterol and high-density lipoproteins in the blood, hypertriglycerinemia).

The likelihood of developing pathology is increased by multiple pregnancies, metabolic diseases ( diabetes, fermentopathy, metabolic syndrome), diseases of the gastrointestinal tract (Crohn's disease, diverticula of the duodenum and bile duct, infection of the biliary tract), postoperative conditions (after gastric resection, stem vagoectomy).

Pathoanatomy

Gallstones are diverse in size, shape, there can be a different number (from one calculus to hundreds), but they are all divided according to their predominant component into cholesterol and pigment (bilirubin).

cholesterol stones yellow color, consist of undissolved cholesterol with various impurities (minerals, bilirubin). Almost the vast majority of stones are of cholesterol origin (80%). Pigment stones of dark brown to black color are formed with an excess of bilirubin in bile, which happens when functional disorders liver, frequent hemolysis, infectious diseases bile ducts.

Classification

According to modern classification gallstone disease is divided into three stages:

• Initial (pre-stone). It is characterized by changes in the composition of bile) is not clinically manifested, it can be detected by biochemical analysis of the composition of bile.
• Stone formations. Latent stone carrying is also asymptomatic, but with instrumental diagnostic methods it is possible to detect stones in the gallbladder.
• Clinical manifestations. It is characterized by the development of acute or chronic calculous cholecystitis.

Sometimes a fourth stage is distinguished - the development of complications.

Symptoms of gallstone disease

The symptomatology manifests itself depending on the localization of stones and their size, the severity of inflammatory processes and the presence of functional disorders. A characteristic pain symptom in cholelithiasis is biliary or hepatic colic - a pronounced acute sudden pain under the right rib of a cutting, stabbing character. After a couple of hours, the pain is finally concentrated in the projection of the gallbladder. It can radiate to the back, under the right shoulder blade, to the neck, to the right shoulder. Sometimes irradiation to the region of the heart can cause angina pectoris.

Pain often occurs after eating spicy, spicy, fried, fatty foods, alcohol, stress, heavy physical exertion, prolonged work in an inclined position. The causes of the pain syndrome are a spasm of the muscles of the gallbladder and ducts as a reflex response to irritation of the wall with calculi and as a result of overdistension of the bladder with excess bile in the presence of obstruction in the biliary tract. Global cholestasis with blockage of the bile duct: the bile ducts of the liver expand, increasing the organ in volume, which responds with a pain reaction of an overstretched capsule. Such pain has a constant dull character, often accompanied by a feeling of heaviness in the right hypochondrium.

Accompanying symptoms - nausea (up to vomiting, which does not bring relief). Vomiting occurs as a reflex response to irritation of the peripapillary region of the duodenum. If the inflammatory process has captured the tissues of the pancreas, vomiting can be frequent, with bile, indomitable. Depending on the severity of intoxication, there is an increase in temperature from subfebrile numbers to severe fever. With blockage of the common bile duct by a calculus and obstruction of the sphincter of Oddi, obstructive jaundice and discoloration of the feces are observed.

Complications

Most frequent complication GSD is inflammation of the gallbladder (acute and chronic) and obstruction of the biliary tract by a calculus. Blockage of the lumen of the bile ducts in the pancreas can cause acute biliary pancreatitis. Also, inflammation of the bile ducts - cholangitis is considered a common complication of cholelithiasis.

Diagnostics

If symptoms of hepatic colic are detected, the patient is referred for a consultation with a gastroenterologist. Physical examination of the patient reveals symptoms characteristic of the presence of calculi in the gallbladder: Zakharyin, Ortner, Murphy. Skin tenderness and muscle tension of the abdominal wall in the area of ​​the gallbladder projection are also determined. Xanthemas are noted on the skin, with obstructive jaundice, a characteristic yellow-brownish color of the skin and sclera.

A general blood test during a clinical exacerbation shows signs of nonspecific inflammation - leukocytosis and moderate increase in ESR. Biochemical research blood allows to reveal hypercholesterolemia and hyperbilirubinemia, increased activity of alkaline phosphatase. With cholecystography, the gallbladder is enlarged, has calcareous inclusions in the walls, the stones with lime present inside are clearly visible.

The most informative and most widely used method for examining the gallbladder is abdominal ultrasound. It accurately shows the presence of echo-impermeable formations - stones, pathological deformations of the bladder walls, changes in its motility. Ultrasound clearly shows the presence of signs of cholecystitis. Also, MRI and CT of the biliary tract allow visualization of the gallbladder and ducts. Informative in terms of identifying bile circulatory disorders, it can always be transferred to an open abdominal operation if technically necessary.

There are methods for dissolving stones with the help of ursodeoxycholic and chenodeoxycholic acid preparations, but this kind of therapy does not lead to a cure for cholelithiasis and, over time, the formation of new stones is possible. Another way to destroy stones is shock wave lithotripsy - it is used only in the presence of a single calculus and in patients who do not suffer from acute inflammation gallbladder or ducts.

Forecast and prevention

The prognosis directly depends on the rate of formation of stones, their size and mobility. In the vast majority of cases, the presence of stones in the gallbladder leads to the development of complications. With successful surgical removal of the gallbladder - a cure without pronounced consequences for the quality of life of patients. Prevention consists in avoiding factors that contribute to increased cholesterolemia and bilirubinemia, bile stasis.

A balanced diet, normalization of body weight, an active lifestyle with regular physical activity help to avoid metabolic disorders, and timely detection and treatment of pathologies of the biliary system (dyskinesia, obstruction, inflammatory diseases) reduces the likelihood of bile stasis and sedimentation in the gallbladder. Special attention cholesterol metabolism and the state of the biliary system should be given to persons with a genetic predisposition to stone formation.

In the presence of stones in the gallbladder, prevention of attacks of biliary colic will be following a strict diet (exclusion from the diet of fatty, fried foods, muffins, confectionery creams, sweets, alcohol, carbonated drinks, etc.), normalization of body weight, drinking enough liquid. To reduce the likelihood of movement of calculi from the gallbladder through the ducts, work associated with a long stay in an inclined position is not recommended.

Cholelithiasis, also known as cholelithiasis or cholelithiasis, is a disease in which stones form in the gallbladder or bile ducts. Cholelithiasis, the symptoms of which are noted in patients, as shown by the results of medical practice, is ineffective in treatment using conservative therapy and various types methods, therefore the only way to cure the disease is surgery.

general description

Gallstone disease is a fairly common diagnosis, and the peculiarity lies in the fact that susceptibility to it, as well as the causes provoking its development, is quite difficult to trace. The fact is that in most people, gallstone disease occurs latently, that is, in a latent form without any special manifestations. In the structure of various diseases that affect the digestive organs, cholelithiasis occupies a significant place precisely because of its prevalence.

Industrialized countries have statistics on this score of about 15% incidence, while it can be noted that the prevalence directly depends on the age and sex of patients. In particular, men suffer from this disease twice as rarely as, respectively, women. Every fifth of women aged 40 and over is faced with gallstone disease, while men of the same age experience it in every tenth case. Up to 50 years, gallstone disease is observed in about 11%, from 50 to 69 - up to 23%, from 70 years and more - up to 50%.

Let us dwell directly on the features of the course of the disease. The movement of bile, carried out by it along the biliary tract, occurs due to the coordination of the functions of the gallbladder, liver, pancreas, bile duct and duodenum. Already due to this, in turn, bile enters the intestines in a timely manner during digestion, in addition to this, it accumulates in the gallbladder. With the stagnation of bile and with a change in its composition, the process of formation of stones begins, which is also facilitated by inflammatory processes in combination with motor-tonic disorders of bile secretion (that is, dyskinesia).

Gallstones are cholesterol (the vast majority, about 90% of the variants of gallstones), as well as stones pigmented and mixed . So, due to a supersaturation of bile with cholesterol, the formation of cholesterol stones, its precipitation, and the formation of crystals occur. Violation in the gallbladder of the motility leads to the fact that these crystals do not enter the intestine, which ultimately leads to their gradual growth. Pigment stones (they are also called bilirubin stones) are formed during increased decay, which occurs with actual hemolytic anemia. As for mixed stones, they are a kind of combination based on the processes of both forms. Such stones contain cholesterol, bilirubin and calcium, the very process of their formation occurs as a result of inflammatory diseases affecting the biliary tract and, in fact, the gallbladder.

As for the reasons that contribute to the formation of gallstones, among them are the following:

• unbalanced diet (in particular, when it comes to the predominance of animal fats in it with simultaneous damage to vegetable fats);
• hormonal disorders (with a weakening of the functions characteristic of thyroid gland);
• sedentary lifestyle;
• disorders associated with fat metabolism, which intersects with an increase in body weight;
• inflammation and other abnormalities that occur in the gallbladder;
• various kinds of liver damage;
• spinal injuries;
• pregnancy;
• starvation;
• heredity;
• spinal injuries;
• diseases small intestine etc.

As factors provoking the development of the disease we are considering, the following are distinguished:

• helminthiases;
• (due to the use of alcohol);
• biliary tract infections (in chronic form);
• chronic hemolysis;
• demographic aspects (relevance of the disease for rural residents, as well as Far East);
• elderly age.

Gallstone disease: classification

Based on the features of the disease accepted today, the following classification is distinguished according to the stages that are relevant to it:

• physico-chemical (initial) stage - or, as it is also called, the pre-stone stage. It is characterized by changes occurring in the composition of bile. There are no special clinical manifestations at this stage, the detection of the disease at the initial stage is possible, for which it is used biochemical analysis bile on the features of its composition;
• formation of stones stage, which is also defined as latent lithology. In this case, there are no symptoms of cholelithiasis, but the use instrumental methods diagnosis allows you to determine the presence of stones in the gallbladder;
• clinical manifestations – stage, the symptoms of which indicate the development of an acute or chronic form of calculus.

In some cases, the fourth stage is also distinguished, which consists in the development of complications associated with the disease.

Gallstone disease: symptoms

Manifestations characteristic of cholelithiasis are determined based on the specific localization and size of the formed stones. Based on the degree of severity relevant to inflammatory processes, as well as on the basis of functional disorders, the severity of the manifestations of the disease, as well as the features of its course, are subject to change.

With cholelithiasis, in particular, a pronounced pain symptom (biliary or) is noted - this is an acute pain that suddenly occurs in the region of the right hypochondrium. It can be piercing or cutting. After a few hours, the final concentration of pain is concentrated within the projection of the gallbladder. It is also possible to radiate pain to the right shoulder, neck, right shoulder blade, or back. In some cases, the pain radiates to the heart, which provokes the appearance.

Mostly pain occurs due to the use of spicy, fatty, fried or spicy foods and alcohol, against the background of severe stress or significant physical exertion. Also, pain can be provoked by a long stay in an inclined position during work. Causes pain spasm, which is formed in the area of ​​the muscles and ducts of the gallbladder, which is a reflex response to the acting irritation experienced by the wall due to stones.

In addition, the cause of spasm is the overdistension of the bladder, formed by excess bile, which occurs as a result of obstruction (blockage) that has arisen in the biliary tract. For the global, in the presence of blockage in the bile duct, the characteristic manifestations are the expansion of the bile ducts of the liver, as well as an increase in the volume of the organ, resulting in a corresponding pain reaction of the pain capsule. The pain in this case is constant, often in the right hypochondrium there is a characteristic feeling of heaviness.

As concomitant symptoms, nausea is also distinguished, which in some cases may be accompanied by vomiting without proper relief after it. It is noteworthy that vomiting is also a reflex response to the stimulus. At the same time, the capture of pancreatic tissues by the inflammatory process is a factor leading to an increase in vomiting, which in this case has an indomitable character and is accompanied by the release of bile with vomit.

Based on the severity of intoxication, there may be fever, fluctuating in subfebrile indicators, but in some cases reaching a pronounced fever. Blockage of the bile duct by a calculus in combination with obstruction of the sphincter leads to discoloration of the feces and jaundice.

Late diagnosis of the disease often indicates the presence of empyema (accumulation of pus) in the wall of the gallbladder, which arose against the background of the closure of the bile ducts with a calculus. Vesicoduodenal fistulas and biliary tract may also develop.

Diagnosis of gallstone disease

Identification of symptoms characteristic of hepatic colic requires consultation with a specialist. Under the physical examination that he conducts, it means the identification of symptoms characteristic of the presence of calculi in the gallbladder (Murphy, Ortner, Zakharyin). In addition, a certain tension and soreness of the skin in the region of the muscles of the abdominal wall is revealed within the framework of the projection of the gallbladder. The presence of xanthomas on the skin is also noted ( yellow spots on the skin, formed against the background of a violation in the body of lipid metabolism), icterus of the skin and sclera is noted.

The results of the surrender determine the presence of signs indicating non-specific inflammation at the stage of clinical exacerbation, which in particular consist in the moderation of the increase and in leukocytosis. When hypercholesterolemia is determined, as well as hyperbilirubinemia and increased activity characteristic of alkaline phosphatase.

Cholecystography, used as a method for diagnosing cholelithiasis, determines an increase in the gallbladder, as well as the presence of calcareous inclusions in the walls. In addition, in this case, the stones with lime that are inside are clearly visible.

The most informative method, which is also the most common in the study of the area of ​​interest to us and for the disease in particular, is. When examining the abdominal cavity, in this case, accuracy is ensured with respect to identifying the presence of certain echo-impermeable formations in the form of stones in combination with pathological deformities that the walls of the bladder undergo during the disease, as well as with changes that are relevant in its motility. Well seen with ultrasound and signs indicating cholecystitis.

Visualization of the gallbladder and ducts can also be done using MRI and CT techniques for this purpose in specific areas. Scintigraphy, as well as endoscopic retrograde cholangiopancreatography, can be used as an informative method indicating violations in the processes of bile circulation.

Treatment of gallstone disease

Patients with a diagnosis of cholelithiasis are prescribed general type hygienic regimen, rational nutrition, as well as a systematic load in dosed volumes. Diet No. 5 is also shown with the exclusion of certain foods in it (fats in particular). It is recommended to eat meals "by the hour". In general, the absence of complications often excludes the use of specific treatment - in this case, first of all, the emphasis is on waiting tactics.

With the development of an acute or chronic form of calculous cholecystitis, the removal of the gallbladder is required, which in this case occurs in the process of stone formation. The specificity of the surgical intervention is determined on the basis of the general condition of the body and the changes accompanying the pathological process, concentrated in the area of ​​the walls of the bladder and the tissues surrounding it, and the size of the calculi is also taken into account.

If symptoms relevant to cholelithiasis occur, it is necessary to contact a gastroenterologist; in addition, a surgeon's consultation may be prescribed.

Gallstone disease attack what to do? This problem is usually faced by people aged 40 and over. However, the pathology begins to develop 10-15 years before the onset of symptoms. Doctors call this the latent stage. Stones have already formed in the gallbladder, but have not yet overflowed it, have not begun to clog the ducts. When the process starts, patients suffer from pain. How to cope with the situation at home and under what circumstances should you call an ambulance?

What are the reasons for the attack? The gallbladder before it can not be felt. At the moment of the attack, pain begins in the area of ​​\u200b\u200bthe organ (in the right hypochondrium).

Doctors claim that they are caused by:

1. Physical exercise. Lifting weights or changing body position is the most common cause of an attack. A prolonged stay of the body in an inclined position also leads to a shift in the conglomerate.
2. Finding the patient in a stressful state. It provokes spasms of the muscles of the gallbladder. Shrinking, the walls of the organ push out the accumulated stones.
3. Drinking large amounts of liquid. Its excess leads to liquefaction of bile. Having become more fluid, the secret picks up stones, carrying them to the ducts, like grains of sand.
4. Presence in the body viral infection. In this case, an attack of cholelithiasis is caused by a general weakening of the immune system, inflammatory processes.
5. Violation of the recommended diet. The patient's condition worsens when eating fatty or fried foods. Also, alcoholic beverages are the cause of seizures.

An attack of cholelithiasis is a condition when a stone begins to move in the patient's ducts. This is due to increased bile flow or spasms. In order not to provoke them, patients should not eat foods that activate the work of the gastrointestinal tract and liver. Any pressure on the organ also leads to colic.

An attack in the diagnosis of gallstone disease is observed in pregnant women in the third trimester. During this period, the fetus presses on the internal organs, interfering with the normal movement of bile.

Typical and atypical seizure patterns

Pain in cholelithiasis manifests itself in the right hypochondrium. However, there are also atypical symptoms.

An attack of gallstone disease can take several forms:

1. Dyspeptic. Pain is practically absent. The patient periodically feels nausea and a bitter taste in the mouth. The patient has a violation of the digestive system, abundant gas, heartburn and belching.
2. Painful torpid form. There are also dyspeptic symptoms. To them is added pain in the stomach and right hypochondrium. In some cases, it is given to the right shoulder and under the shoulder blade. The sensation is aching in nature with periodic amplification.
3. Painful paroxysmal form of the disease. Feelings are acute. Pain during an attack is localized in the right hypochondrium, radiating throughout the right half of the body, up to the jaws. The attack begins suddenly and also ends. Pain lasts from several hours to 2-3 days.

How to relieve the pain of the gallbladder, every patient with a diagnosis of gallstone disease should know. But in order to follow the doctor's recommendations, it is necessary to accurately recognize the pathology. There are also atypical signs of an attack of gallstone disease.

With atypical symptoms, pain is given to the left side of the body. In this case, the symptoms are easily confused with manifestations of angina pectoris. Atypical manifestations include an increase in temperature. The latter testifies to inflammation accompanying the movement of stones.

The initial diagnosis of gallstone disease largely depends on the sensation of the patient himself. Without fail, along with pain, the manifestations of the disease are associated with disruption of the gastrointestinal tract.

Stool disorders, flatulence, nausea and other signs clearly indicate the presence of problems with conglomerates in the gallbladder. Sometimes the patient has skin problems. How does an attack of gallstone disease manifest itself on the integument of the body? Jaundice and itching. This is a reaction to intoxication of the body with bile.

Emergency help

What to do with an attack of gallstone disease? The first step is to relieve the symptoms. For this, there are both medical and folk methods. Next, it is advisable to visit a doctor.

Relief of colic drugs

To relieve an attack of gallstone disease, use the following methods:

• observe complete rest;
• take painkillers and anti-spasm medications;
• contribute to the expansion of blood vessels;
• drink a lot of warm, boiled water.

Taking only pills often cannot relieve pain in the gallbladder. What explains this? Medications are not able to make a person stop moving sharply, lifting weights, playing sports. Meanwhile, the movement of stones often provokes physical activity. Medicines will relax the muscles. But the patient needs to "help" the drugs, keeping calm. You need to lie down with your legs stretched out.

It is desirable that during colic there is a relative or close person nearby. In an emergency, he can call an ambulance. medical care

Preparations for relieving an attack of gallstone disease are used only prescribed by the attending physician. Doctors recommend the use of proven means. Various antispasmodics are used. Often prescribed No-shpu, Drotaverine, Platifilin, Papaverine. It can be not only tablets, but also solutions for injections. Injections are more effective because they deliver the active substances to the blood faster.

Taken with stones in the gallbladder and painkillers, anti-inflammatory medications. They also come in tablets and liquid.

After an attack, health will support curative fasting. It is necessary to refuse food for at least 12 hours. After that, the diet for 2-3 days consists of fresh vegetable-based soups. Instead of tea, a rosehip decoction is used. After 3 days, the diet is expanded. Added low-fat dairy products Rye bread, cereals and non-acidic vegetables.

If the attack does not recur, then the variety of dishes increases, but in strict accordance with the diet. It is better to add products gradually, observing the reaction of the body. If it is negative, the added product is excluded from the diet.

Contacting a doctor

An attack of gallstone disease is stopped at home. But it is still advisable to be examined by a doctor. First aid for an attack of cholelithiasis ─ his profile.

The disease gives serious complications:

1. Inflammation of the gallbladder. The complication requires medical intervention in which antibiotics are used.
2. Peritonitis. This inflammation of the abdominal cavity can be fatal.
3. Pancreatitis. A disease in which bile is not released into the duodenum.
4. Renal or liver failure.

The described complications affect the general condition of a person and lead to serious health consequences. For this reason, a visit to the doctor during attacks of gallstone disease is mandatory. This is especially true for cases in which pain do not go away for a long time, even after using the recommended medications and keeping calm.

Prevention of exacerbation of gallstone disease

The disease has periods of exacerbation and remission. How to relieve an attack with gallstone disease is described above. And how to prevent exacerbation? How to make sure that there are no attacks and complications in cholelithiasis? The most reliable way is surgery. Removal of stones from the gallbladder is a 100% guarantee of the absence of pain and other symptoms. But surgery is risky and has contraindications.

It is easier to control the state of health with the help of a diet for cholelithiasis.

The patient adheres to certain rules:

• food should not be fatty;
• spicy foods are excluded - turnips, onions, garlic, horseradish and dishes with the addition of a large amount of seasonings;
• any smoked products are excluded;
• instead of coffee and strong tea, herbal decoctions or juices are included in the diet for cholelithiasis;
• eggs are allowed, but not more than one per day;
• to provide the body with proteins, low-fat dairy products are introduced into the diet;
• there should be a lot of vegetables on the table, first of all, this applies to zucchini, carrots, cauliflower and pumpkin;
• you should limit the use of bakery products made from white flour.

To prevent seizures, it is also important to prevent weight gain. Overweight people suffer from gallstones more often than slender people. However, doctors associate this with addiction to food.

Not only diet, but also moderate exercise helps to keep weight under control. In addition to them, you need to give up bad habits. This is especially true for the consumption of alcoholic beverages. Alcohol adversely affects the functioning of the liver and gallbladder.