Cholecystitis provokes many unpleasant symptoms and makes the patient suffer from painful symptoms. Pathology can take several different forms. The disease occurs due to worsening outflow of bile or penetration into the lumen of the gallbladder of pathogens.
Cholecystitis can be with the formation of stones and stoneless. The latter type of pathology is found in patients much less often, but differs in a much larger number of cases of death. More often this disease is found in men.
Comprehensive treatment is required to avoid exacerbating the problem and developing complications.
Disease feature
Cholecystitis is an inflammation in the gallbladder. There are many reasons why this disease develops. According to the classification, cholecystitis can be acute or chronic. It is characterized by the presence of pain in the right hypochondrium, bitterness in the mouth and nausea. Often the disease is already in the chronic stage diagnosed in women older than 40 years. However, cholecystitis often occurs in children.
Among the main predisposing factors, it is necessary to highlight a violation of the outflow of bile, penetration of pathogens into the gallbladder. The most important thing is to timely recognize the course of the disease and conduct the correct treatment. The success of treatment and the exclusion of serious consequences depend on this.
Main classification
According to the classification of cholecystitis, doctors distinguish several forms and types of this disease. According to the course, it can be acute or chronic. According to the etiology, calculous and stoneless cholecystitis are distinguished. According to signs of inflammation, it can be:
- catarrhal;
- gangrenous;
- phlegmonous.
Often this is a pathology with a chronic course - with exacerbations and remission. However, there is an acute form of the disease, which is quite successfully cured. It develops against the background of the penetration of pathogens into the gallbladder. It is characterized by a fairly rapid development, in which the patient urgently needs to be hospitalized.
Chronic cholecystitis is a sluggish inflammation that provokes fibrous changes and thickening of the walls of the gallbladder, disrupting their motility. The disease is often found in women and can even affect young children. Acute and chronic cholecystitis often develop in patients who have problems with this organ.
With the calculous type of disease, the stones in the gallbladder, however, do not bother the patient until they penetrate the bile duct and become stuck in it, thereby disrupting the outflow of bile. As a result, inflammation begins to develop. The stoneless type of pathology is characterized by the fact that there are no stones in the gallbladder.
Catarrhal cholecystitis occurs with malnutrition. The consumption of fried, fatty, smoked food, as well as dry food can provoke inflammation. Acute phlegmonous cholecystitis is characterized by the fact that a fibrinous deposit forms on the walls of the thickened gallbladder. Pus accumulates in the lumen of this organ. Gangrenous cholecystitis is formed in the presence of gallbladder thrombosis.
Causes of occurrence
Regardless of the type of cholecystitis, it mainly develops against the background of gallstone disease. Stones lead to damage to the walls of the gallbladder or hinder the passage of bile. In addition, cholecystitis develops due to the penetration of pathogens into this organ, as well as the presence of parasites in the body.
Inflammation can trigger the flow of enzymes produced by the pancreas into the gallbladder. This mainly occurs in the presence of pancreatitis. Inflammation can also be caused by factors such as:
- allergy;
- congenital malformations;
- injuries
- dyskinesia;
- metabolic disease;
- constipation
- tumors in the abdominal cavity.
In some cases, cholecystitis can develop during pregnancy, as well as in the elderly due to age-related circulatory disorders.
Main symptoms
Depending on the form of cholecystitis, it can occur acutely or with a gradual increase in symptoms. The symptoms of the disease and the tactics of conducting the therapy largely depend on this. Among the main signs of an acute course of inflammation, it is necessary to distinguish such as:
- pain in the right hypochondrium;
- dyspeptic manifestations;
- general intoxication.
In addition, the symptoms and classification of cholecystitis largely depend on the severity of inflammation. With the catarrhal type of the disease, intense soreness is noted, the temperature rises slightly or remains within the normal range.
Purulent cholecystitis is characterized by the fact that the patient has severe pain that intensifies when moving, the temperature is very high, intestinal murmurs are observed, as well as severe tachycardia, even at rest. The gangrenous type of the disease develops as a result of the lack of treatment of the phlegmonous form, is characterized by a rapid course and severe condition of the patient.
Symptoms of the chronic form of cholecystitis often increase gradually and develop as a result of a prolonged violation of the diet or during the formation of stones. An exacerbation has exactly the same symptoms as acute inflammation. However, even during remission, the patient has low-grade fever, itchy skin, yellowness of the skin and sclera.
Diagnostics
What to do with cholecystitis can only be determined by a doctor after an examination. To determine the presence of pathology, a comprehensive diagnosis is needed. The gastroenterologist evaluates the patient's complaints, examines the tongue, determines the localization of the painful manifestations. If there are suspicions of a pathology, then a comprehensive diagnosis is required, which includes:
- duodenal sounding;
- blood test for biochemistry;
- celiography;
- cholegraphy;
- scintigraphy;
- roentgenography;
- ultrasonography.
After confirming the diagnosis, the patient is prescribed the appropriate therapy.
Treatment features
To eliminate the symptoms of cholecystitis in adults, treatment should be comprehensive, and it is also important to follow a diet. Since the disease mainly develops due to infection of the body, when the first signs of exacerbation occur, antibiotics are prescribed. With severe pain, antispasmodics, vitamin complexes, choleretic drugs are additionally taken.
In the chronic course of the disease, a diet is required. Spicy, fatty, smoked foods should be excluded from the usual diet. It is also not recommended to drink alcohol, carbonated drinks, canned food, chocolate. Fruits, vegetables, diet fish and meat will be beneficial. You can also use traditional medicine, in particular, decoctions of herbs.
In some cases, duodenal sounding or tubeless tubing may be prescribed. The main purpose of it will be washing the bile ducts and stimulating the secretion of bile in order to empty this organ. It is carried out with the use of a gastric tube or without it with a tube. If cholecystitis was provoked by cholelithiasis, then complex treatment is carried out, including surgically. Mineral water is very useful for cholecystitis, therefore, during exacerbation, patients are shown a spa treatment.
Drug treatment
To eliminate the symptoms of cholecystitis in adults, treatment is aimed at eliminating the infection. During an acute attack of biliary colic, it is important to quickly stop the attack of pain. For this, antispasmodics are used, in particular, such as Spazmolgon, No-Shpa. An indication for antibiotic therapy is the presence of inflammation in the biliary tract, accompanied by intense pain and high fever. The course of antibiotic therapy is approximately 7-10 days. Antibiotics should be taken in combination with vitamins. Often prescribed drugs such as Amoxicillin, Ampioks, Amoksiklav.
If giardia is detected in bile, treatment with special anti-giardia agents is required. An integral part of complex therapy in the acute period is vitamin therapy. For treatment, choleretic drugs should be used, since they help reduce bile congestion in the affected organ, which helps to more quickly eliminate inflammation.
To normalize the digestive function, enzymatic agents are prescribed, in particular, such as "Festal", "Pancreatin". To enhance the production of bile, it is recommended to take choleretics, for example, such as Allochol, Cholenzym, Oxafenamide.
Folk techniques
Treatment with folk remedies is used as an auxiliary technique. Very good means to eliminate the symptoms of the disease are considered to be such as:
- Dill seeds;
- calendula;
- chamomile;
- juniper;
- horsetail;
- strawberry berries;
- corn silk;
- dogrose.
As a choleretic agent, black radish juice can be used. In the chronic course of cholecystitis, mineral waters with a large amount of sulfates, bicarbonates, magnesium, and chlorine are prescribed. They stimulate the production of bile, its rapid release, a decrease in the degree of viscosity and liquefaction. Folk remedies are preferably used for treatment during remission.
Power Feature
Regardless of the classification of cholecystitis, one of the main factors for the treatment of patients is diet. You need to eat 4-6 times a day, as this will help normalize the outflow of bile. It is advisable to consume only healthy foods. Patients with cholecystitis tolerate fatty varieties of meat, fish, and fat rather poorly. Of animal fats, only butter can be consumed. Vegetable oils will be very beneficial. The fatty acids contained in them normalize the functioning of the liver, and also stimulate the production of bile.
Of carbohydrates, you need to limit only those foods that contain a lot of indigestible fiber. It is necessary to increase the amount of fluid consumed, as it normalizes the outflow of bile. With exacerbation of cholecystitis, it is recommended to consume only vegetarian soups. Dietary nutrition must be observed within 3 years after the last attack of exacerbation.
Without a special diet, taking medications will be useless, so you must strictly follow the instructions of a gastroenterologist.
Possible complications
Complications of cholecystitis largely depend on the form of the course of the disease. The chronic type of the disease can eventually become acute, which is very dangerous for the life and health of the patient. Among the complications of chronic cholecystitis, it is necessary to distinguish such as:
- purulent changes in the gallbladder;
- connective tissue inflammation;
- involvement in the pathology of adjacent organs.
With a calculous type of disease, the presence of stones in the gallbladder can lead to an exacerbation of inflammation, as well as necrosis of this organ. This form of cholecystitis necessarily requires surgery, since there is a high risk of various complications, in particular, such as:
- empyema and phlegmon;
- dropsy of the gallbladder;
- peritonitis, sepsis;
- biliary fistulas.
If all these violations are detected, surgery is urgently indicated. The rehabilitation period is several months.
Forecast and Prevention
With the timely detection of stoneless inflammation, the prognosis for cure is quite favorable. It will not be possible to completely eliminate the infection in the chronic course of the pathology, however, with the help of correctly selected therapy, prolonged remission can be achieved, eliminating relapse and exacerbation. If there is no comprehensive treatment, then the infection and inflammation spread to adjacent structures. Then the prognosis of the course of the disease becomes unfavorable, and at the same time there is a need for the operation.
For prophylaxis, you need to very strictly monitor your own health. You can not endure the urge to defecate for a long time. It is necessary to empty the intestines immediately, as this will remove excess cholesterol and prevent the occurrence of dyskinesia. Preventive measures also include the following:
- follow the rules of a balanced and balanced diet;
- strictly observe the daily routine;
- do not abuse alcohol;
- avoid stress and physical stress;
- lead a mobile lifestyle.
You also need to timely treat abdominal pathologies and avoid exposure to allergens. In the chronic course of the disease, as a prophylaxis of exacerbation, it is necessary to regularly undergo rehabilitation in sanatoria and use healing mineral water.