If you experience unpleasant sensations and pain on the right side under the rib, it is important to recognize the cause in a timely manner. Diseases of the liver and biliary tract are a threat to the condition of a person and his full life. In the absence of proper treatment methods, ailments that affect the biliary system of the body are able to go into more severe forms, removing even the central nervous system from a failure.
How do biliary tract diseases manifest themselves?
At the first symptoms of the pathologies described below, you should immediately contact a specialist. To take action, the doctor must see an objective picture of the patientās health, which means that it is extremely important to undergo a comprehensive examination. You can get detailed information about how bile ducts are affected by the disease only after the first stages of diagnosis, which include:
- initial examination by a gastroenterologist;
- ultrasound of the abdominal organs;
- results of laboratory tests of blood, urine and feces.
In case of suspicion of the development of a pathological process in the biliary system of the body, the doctor, as a rule, appoints the patient to undergo more thorough studies:
- gastroscopy;
- radiography of the biliary tract using a contrast agent;
- biochemical composition of bile.
In general, diseases of the biliary tract are distinguished by the characteristic features of the course.
Their therapy largely depends on the severity of the disease, the symptoms and the complications available at the time of contacting the specialists.
Pathological processes that can develop in the gallbladder and biliary tract are most often:
- dyskinesia;
- cholelithiasis;
- cholingitis;
- various forms of cholecystitis.
Causes of dyskinesia in the biliary system
The first disease that occurs quite often in patients at any age is dyskinesia of the biliary tract. Symptoms and treatment of the disease are interrelated concepts, since this pathology is a direct functional violation of the biliary system due to the abnormal work of the sphincters of Oddi, Mirizzi and Lutkens, as well as contractions of the gallbladder.
Most often, the disease manifests itself in women aged 20 to 40 years. To date, not a single expert can unequivocally explain the causes of the development of the disease. The most likely factors that pushed the disease to progression can be considered:
- Hormonal failure (disturbances in the production of substances that affect the contractile function of the gallbladder and bile ducts lead to malfunctions of the muscular mechanisms).
- Improper diet and unhealthy lifestyle.
- Frequent anaphylactic and allergic reactions of the body to food products.
- Pathology of the gastrointestinal tract, acting directly on the biliary tract. Symptoms, treatment of such ailments are concomitant problems during the treatment of the underlying disease.
- Infection with hepatitis B, C groups (pathogenic microorganisms of this type negatively affect the neuromuscular structure of the organs under consideration).
In addition, other biliary tract diseases (e.g., chronic cholecystitis) can also provoke dyskinesia. Ailments of the liver, pancreas, abnormalities in the development of the biliary system also often lead to the failure of most digestive organs.
How to cure dyskinesia?
Treatment of the biliary tract has its own characteristics. As for dyskinesia, then general therapy can be divided into two blocks.
The first often includes therapeutic measures of non-drug content, for example:
- Compliance with the diet (the complete exclusion of fatty, fried, smoked, canned and other harmful products from the daily diet; the preparation of a daily menu based on foods rich in fiber, choleretic foods).
- Drinking plenty of fluids throughout the day.
- Active lifestyle, therapeutic breathing exercises.
- Prevention of stressful situations, disorders, experiences.
Drug treatment is a mandatory component in the treatment of such an ailment as biliary dyskinesia. The drugs that experts recommend taking to patients are mainly aimed at relieving muscle tension, providing sedative and antispasmodic effects. The most common with dyskinesia are Papaverine, No-shpa, Novocaine. The therapeutic complex includes, including the use of saline water.
Features of the course of dyskinesia in children
A disease that affects the biliary tract of children is not uncommon these days. Dyskinesia is detected by doctors in children older than three years of age. By the way, experts distinguish this disease among children's pathologies of the biliary tract as often ascertained. In fact, the reasons for the development of disorders in the hepatobiliary system in a child are the same provoking factors as in adults.
The danger to children's organisms is often hidden in the effects of dyskinesia, which affects the biliary tract. Symptoms of an illness in a child are often supplemented by specific manifestations of the nervous system and psychoemotional state.
As a rule, signs of dyskinesia in children are considered:
- tearfulness;
- fatigue;
- decreased attention span, performance;
- muscle hypotension;
- hyperhidrosis;
- heart rhythm malfunctions.
Recommendations for preventing the recurrence of an ailment in a child
Since the symptoms and diagnostic procedures are exactly the same for both adult patients and babies, treatment tactics will also be based on the canons of good nutrition. It is imperative that the child consumes healthy food in accordance with a clear schedule, not only during an exacerbation of a biliary tract disease or when undergoing a therapeutic course, but also for the purpose of prevention. Ideally, this style of nutrition should become the norm for a growing organism on an ongoing basis.
It is also worth noting that the dyskinesia detected in a child determines the need for his placement on a dispensary account for a periodic examination. The only way to prevent the development of the disease. The best prevention of dyskinesia in a healthy baby pediatricians call these principles:
- Eating every 2.5 hours throughout the day in small fractional portions.
- Prevention of overeating.
- Lack of emotional overstrain, stress.
What is the danger of cholelithiasis?
The next ailment affecting the biliary tract no less often than dyskinesia is considered to be cholelithiasis. This pathology occurs due to the formation of calculi in the gallbladder and is characterized by significant inflammation in its walls. Doctors call the danger of the disease its latent manifestations and the almost complete absence of symptoms in the early stages of the disease. In the period when it is easiest to cope with the disease, the patient cannot even assume that his bile ducts and gall bladder require help.
With the gradual progression of the pathology, the pace of which is largely determined by the patientās lifestyle, the first signs of the disease become noticeable. The most common of these is biliary colic, which patients almost always take for pain in the liver, explaining this by participating in a satisfying feast or drinking alcohol the day before. Despite the fact that these factors are really capable of provoking an exacerbation of cholelithiasis, taking the symptoms lightly can be extremely dangerous for the patient's health. Among the complications that an untreated cholelithiasis threatens in time, patients are diagnosed with:
- cholecystitis;
- pancreatitis
- malignant tumors affecting the liver and biliary tract.
Disease risk group
Since the main and only reason for the formation of stones in the gallbladder and ducts is a violation of metabolic processes in the body (in particular, cholesterol, bilirubin and bile acids), it is natural that medical and restoration measures will be aimed at eliminating the formations.
Stones that interfere with the outflow of bile occur in women several times more often than in men. In addition, people are most at risk of getting cholelithiasis:
- Obese
- leading a sedentary lifestyle;
- the kind of activity which determines mainly the sitting position during working hours;
- not following the regimen in meals.
Methods for treating cholelithiasis
To determine for sure whether stones are present in the patientās gall bladder, an ultrasound examination of the abdominal organs is sufficient. To date, when confirming the diagnosis, doctors most often make a decision about cholecystectomy.
However, the specialist may not induce the patient to radical surgical treatment if the formations practically do not cause discomfort. In this case, experts recommend a course of treatment aimed directly at the biliary tract. Symptoms of the disease that do not manifest themselves in any way allow you to use the method of influencing the ducts with ursodeoxycholic and chenodeoxycholic acids.
Its advantage is the ability to get rid of stones in a non-surgical way. Among the shortcomings is a high probability of relapse. A therapeutic course lasting about a year in most cases gives an imaginary, short-term result, since patients often notice the occurrence of repeated inflammation literally a few years after prolonged treatment.
It is also worth noting that this treatment option is available only in the presence of cholesterol stones, not exceeding a 2-centimeter diameter.
What is "cholangitis": its symptoms and complications
Inflammation of the bile ducts is also considered a pathological condition, whose name is cholangitis. A feature of this ailment, doctors consider its course in an independent form or concomitant cholecystitis. The disease has various degrees of intensity and danger to the health and life of the patient. There are 3 main stages, based on the intensity of the symptoms:
Symptoms of any biliary tract dysfunction affect the general condition of the patient almost identically, causing in all cases:
- chills;
- nausea and vomiting
- excessive sweating;
- high body temperature;
- itching of the skin;
- pain in the right hypochondrium.
When examining a patient, an enlarged liver and spleen can be detected in the patient. A reliable sign of cholangitis is the yellowness of the skin, but its presence is not necessary. This pathology of the biliary tract, which has a purulent character, has more pronounced signs. The patientās temperature can reach over 40 degrees. In addition, in this case, the risk of sepsis and abscess in the subphrenic region increases several times. Often, in advanced forms of the disease, doctors diagnose patients with hepatitis or hepatic coma.
Diagnosis and treatment of cholangitis
To finally confirm cholangitis in a patient, additional blood tests should be performed. The high value of leukocytes, accelerated ESR generally always serve as indications for the passage of the following series of examinations:
- cholangiography;
- gastroduodenoscopy;
- laparoscopy.
Treatment of bile ducts with cholangitis requires the use of a number of potent drugs. The patient can avoid surgery only with a comprehensive therapeutic approach based on the use of medicines of a different spectrum of actions. First of all, such preparations are necessary for the biliary tract, which are capable of exerting a choleretic effect on the diseased organ.
To relieve inflammation and suppress pathogenic microflora, antibiotics and drugs of the nitrofuran group are extremely important. In the presence of a painful syndrome in the right hypochondrium, the doctor may prescribe antispasmodics.
If the necessary course of treatment does not bring positive results, i.e., there is no noticeable dynamics in improving the patient's condition, the doctor can replace conservative therapy with more decisive surgical actions.
Cholecystitis during exacerbation
Against the background of the above cholelithiasis, a disease such as cholecystitis often develops. It can be characterized by the inflammatory process of the walls and ducts of the gallbladder, as well as by the entry of pathogenic microorganisms into its cavity. Although in the complete absence of stones, cholecystitis can also occur in women older than 30 years.
The main signs of acute cholecystitis
As a rule, exacerbation of cholecystitis, as well as other diseases affecting the biliary tract, occurs after the weakening of the patientās strict dietary regimen. Allowing himself even the smallest of something harmful, he will soon regret it. The painful symptoms of cholecystitis under the right rib, radiating to the subscapular region and supraclavicular area, do not allow to forget about the disease, even for a short time. It should be noted that pancreatitis is considered a frequent companion of cholecystitis, the simultaneous manifestations of which cause incredible discomfort and pain in the patient.
In older people who have had myocardial infarction, pain in the chest cavity may occur due to cholecystitis. Angina reflex type is further accompanied by nausea and vomiting. Vomit initially represents the contents of the stomach, that is, what the patient ate the day before, then only bile can be released.
An increase in body temperature cannot be considered an obligatory symptom of cholecystitis. The absence of fever does not indicate the absence of inflammation. Palpating the abdomen, the doctor in most cases notes tension of the abdominal muscles, soreness of the gallbladder, which is becoming more and more like a small ball in the right hypochondrium. The liver also begins to increase in size. A characteristic feature of acute cholecystitis are jumps in blood pressure. A couple of days after the detection of the disease, the skin may turn yellow.
Different degrees of severity of cholecystitis
Acute cholecystitis has the main stages of the course:
- The catarrhal phase of the development of the disease is not characterized by body fever. If pain is present, then it is moderate enough. The entire period lasts no more than a week, and most often it is possible to detect a disease at this stage by chance. It is quite possible to stop the progression of the disease at this stage if treatment is started immediately, preventing the onset of phlegmonous cholecystitis.
- The second stage of development of the disease is characterized by clearly expressed painful sensations, frequent vomiting, high fever, general weakness of the body. The patientās appetite is markedly reduced due to leukocytosis arising from the pathology.
- The most dangerous stage of the disease for the patient is gangrenous. Peritonitis often joins such an ailment, which has no treatment options other than emergency surgery. Statistics show a high probability of death without urgent surgery.
One of the most common causes of delayed recognition of cholecystitis is its manifestation, in most cases characteristic of other ailments of the abdominal organs. For example, they may also declare about themselves:
- acute appendicitis;
- exacerbation of pancreatitis;
- peptic ulcer of the stomach and duodenum;
- renal failure, colic, pyelonephritis.
Treatment of cholecystitis
As already mentioned, in the diagnosis, absolutely all research indicators play a role. If the bile ducts are full of stones, an ultrasound will definitely tell you about it. The fact that an inflammatory process takes place in the body will confirm the excessive number of leukocytes in the biochemical analysis of blood.
It is necessary to treat diseases affecting the biliary tract or gall bladder only in a hospital hospital. Conservative methods of therapy can alleviate the condition of the patient. He is prescribed strict bed rest, lack of meals. For pain relief, an ice warmer is provided under the right hypochondrium.
Before the start of drug therapy, a complete detoxification of the patient's body is carried out, after which antibiotics are prescribed. The lack of results during the day requires urgent intervention by surgeons.
What to change in nutrition with biliary tract ailments?
Diet for diseases of the biliary tract plays an important predetermining role. , - , .
During remission, it is extremely important to follow a suitable diet and eat according to a clear schedule. Food in itself is the best choleretic drug, so you need to eat at least 4-5 times during the day. The main thing is to exclude any, even the lightest snack for the night.
Adhering to the advice of nutritionists and gastroenterologists presented below, you can achieve the longest possible remission:
- It is undesirable to eat fresh wheat bread, especially only baked, hot. Ideally, if it is dried or yesterday.
- Hot dishes have a positive effect on the general condition of the digestive system. Passion onions, carrots, etc. should not be pasped during cooking.
- Only low-fat varieties should be selected for meat and fish. The ideal cooking method is stewing, boiling and baking.
- It is not forbidden to consume any oil of vegetable or animal origin in small quantities, but in the absence of heat treatment.
- In diseases of the biliary tract, the best cereal products are buckwheat and oatmeal.
- Dairy and sour-milk drinks, as well as cottage cheese can be consumed.
In any case, at the first manifestations of the disease, it is worth going to the doctor, the patient risks self-medication to aggravate his condition.