Parents often lead to a pediatrician a small patient who complains of pain in the right hypochondrium, nausea and other unpleasant symptoms. And often during the examination it turns out that the child has an enlarged gall bladder. Is such a change pathological? How dangerous can it be? What symptoms should I look for? What treatment methods can modern medicine offer? The answers to these questions interest many.
Normal gallbladder sizes
Before considering the causes of gallbladder enlargement, it is worth examining the normal, natural size of the organ. By the way, this indicator directly depends on the age of the child.
- If we are talking about a baby 2–5 years old, then the length of the gallbladder becomes 50 mm, and the width - 17 mm.
- For children aged 6 to 8 years, this figure is 61 * 18 mm.
- The gallbladder of children 9-11 years old has a size of 64 * 23 mm.
- In adolescents aged 12 to 16 years, this indicator should be equal to 65 * 24 mm.
Of course, slight fluctuations are allowed. If the child has an enlarged gallbladder by 1–2 cm, then this is rarely accompanied by any physiological disturbances and is considered quite normal.
How does nutrition affect the work of the gallbladder?
As you know, the gall bladder is an organ in the cavity of which bile developed in the liver accumulates. Here it becomes more concentrated, after which it passes through the bile ducts into the cavity of the small intestine.
In the duodenum, bile neutralizes the activity of pepsin and creates an alkaline environment more suitable for intestinal digestion. Along with this, the acids that make up bile respond to the emulsification of fats, stimulate the production of mucus and gastrointensinal hormones.
In most cases, an increase in the gallbladder in childhood is associated with malnutrition. If the child is too early to transfer to fatty and fried foods, then this affects all digestion processes. The release of bile occurs inadequately, as a result of which the fluid collects in the ducts. In turn, this affects the processes of enzyme production and digestion - patients suffer from bloating and heaviness in the abdomen, discomfort. The liquid continues to accumulate in the bubble, which leads to an increase in its size.
What is the cause of the problem? Functional diseases
Is the gall bladder enlarged in a child? The reasons may be different, and their list is worth exploring.
- In this case, a genetic predisposition is a very important factor, especially when it comes to some anomalies in the anatomical development.
- Hormonal disorders are also considered risk factors, since these biologically active substances control the functioning of all digestive organs.
- Potentially dangerous are constant stress, nervous and emotional overload - this also affects the functioning of the endocrine glands.
- Sometimes an increase in the gallbladder occurs against a background of systemic allergic reactions.
- If we talk about physiological prerequisites, then the appearance of neoplasms in the ducts or cavity of the gallbladder can be attributed to the reasons, since they prevent the outflow of fluid.
Why does the child have an enlarged gall bladder? Inflammatory diseases
Of course, an increase in the size of this organ may indicate the presence of inflammatory pathologies. The reasons may lie in the following:
- hepatitis (regardless of origin and form);
- intestinal infections, especially if they spread to the gallbladder;
- various forms of gastritis;
- pancreatitis (in this case, the child has an enlarged gall bladder and pancreas);
- giardiasis and some other parasitic diseases (if parasites penetrated the bile ducts);
- cholecystocholangitis.
There are other causes of bladder enlargement. For example, the expansion of the organ cavity and the accumulation of fluid in it may be associated with the constriction of the gallbladder body, the formation of diverticula and the development of other pathologies.
Hyperkinetic form of pathology and its symptoms
What should I do if during the examination it was found that the child has an enlarged gall bladder? What signs are worth paying attention to? This question is asked by many parents. It is worth saying right away that the clinical picture largely depends on the type of pathology developing.
An increase in the gallbladder can acquire a hyperkinetic character - the walls of the organ contract much more often and more. This is accompanied by the appearance of certain symptoms:
- cramping or aching pain in the right hypochondrium (soreness often gives to the shoulder and shoulder blade);
- the appearance of attacks is often accompanied by nausea, and sometimes vomiting;
- blood pressure decreases (sometimes fluctuations of this indicator are insignificant);
- soreness appears or intensifies after intense physical exertion (for example, after running, brisk walking, active games);
- during the attack, you can notice that the baby's heartbeat becomes faster;
- palpation of the right hypochondrium is accompanied by very unpleasant sensations;
- attacks are often accompanied by headaches, increased sweating.
If there are similar symptoms, then it is possible that the child has an enlarged gall bladder. Of course, in this case, a complete diagnosis is necessary.
What symptoms are accompanied by a hypokinetic form of pathology?
Pathology can develop according to the hypokinetic type - in this case, both the frequency and intensity of contraction of the walls of the gallbladder and the decrease in motility of the entire digestive tract are slowed down. In this situation, characteristic symptoms also appear:
- There is a loss of appetite. If the gall bladder is enlarged in a 2-year-old child, then paying attention to such a sign is not so simple. Nevertheless, if the baby suddenly loses interest even in the most favorite dishes, then it is worth informing the pediatrician about this.
- There is no severe pain with this form of the disease, but the small patient is concerned about the constant discomfort in the right hypochondrium.
- A very characteristic symptom is a bitter taste in the mouth.
- The patient's tongue is often covered with white, sometimes yellowish coating.
- Feces become discolored, often become almost white.
- Urine, on the contrary, acquires a saturated yellow color.
- From time to time there are attacks of nausea.
- The list of symptoms includes constipation, belching with an unpleasant odor, flatulence.
Mixed Shape Features
There is also a mixed form, in which the walls of the gallbladder are either too tight and contract, then relax. A chaotic change in motility, of course, affects the state of the whole organism.
In this case, other disorders join the above symptoms - for example, pronounced edema appears on the face and body (in particular, on the limbs). Despite the fact that the child has no appetite and eats little, his body weight is constantly increasing. The little patient is bothered by constant belching with a very unpleasant smell of rotten eggs, which indicates the presence of serious digestive disorders.
Diagnostic measures
A general examination, a medical history in most cases is enough for the doctor to suspect the presence of problems with the gallbladder. During palpation of the right hypochondrium, the child complains of discomfort, which only confirms the hunch. Of course, more thorough examinations are needed to make a final diagnosis, because it is important to determine why the child’s gall bladder is enlarged (the reasons and treatment in this case are related).
First of all, a small patient is sent for ultrasound of the abdominal cavity. This is a simple and safe procedure during which you can accurately determine the size of the gallbladder (and, accordingly, find out how enlarged it is), check the body for the presence of stones, sediment, tumors and other neoplasms, assess the condition of the bile ducts, detect congenital anomalies and check pancreas condition.
Of course, you need to take blood and urine for analysis. Sometimes an additional radiography is performed. Duodenal sounding at this age is extremely rare, but a similar procedure allows you to take bile samples for analysis.
The child has an enlarged gall bladder: what to do?
Therapy in this case largely depends on the cause of the problem. If inflammatory processes occur, then therapy begins with the use of antibiotics and / or antiviral agents. Painful sensations can be removed with the help of antispasmodics, in particular, such drugs as No-shpa, Drotaverin, Papaverin.
Such drugs as “Allohol”, “Holagol”, “Digestal” accelerate the processes of bile secretion. Sometimes doctors recommend taking infusions and decoctions of immortelle, oregano, elecampane, bog calamus, as these plants have mild choleretic properties.
What else can be done in a situation where an enlarged gall bladder in a child. Komarovsky advises paying more attention to the nutritional nature of a small patient, especially if changes in the gallbladder are in no way associated with inflammatory processes or other diseases. It is important to refuse fatty and fried foods, pastries, sweets, carbonated drinks. Dishes are best steamed or boiled. Fractional nutrition will be useful - the child should eat often, but in small portions.
Naturally, in the presence of any deterioration, you need to contact a specialist.