In the presence of various pathologies and disorders of the biliary tract , stagnation of bile can occur. Symptoms of cholestasis and its causes depend on the particular course of the disease. It can be manifested by a decrease in bile production or its complete absence.
Stagnation in the gallbladder in children provokes a number of pathological changes in the biliary system that disrupt the functioning of the stomach and intestines. Such a violation is quite rare. Basically, cholestasis acts as a symptom of a digestive system disease. The lack of treatment provokes very serious complications that adversely affect the condition of the child.
Main classification
Stagnation of bile in the gallbladder in children or cholestasis is a pathology associated with a violation of the production of bile and its entry from the gallbladder through the excretory channels into the duodenum. The disease can be intrahepatic and extrahepatic.
Intrahepatic pathology develops in the cells of the liver and biliary tract. The cause of its occurrence is damage to the ducts. Extrahepatic pathology occurs due to clogging of the bile ducts located outside the liver. Often clogging occurs with stones of different sizes.
In addition, stagnation of bile can be in acute and chronic form. In the acute course of the pathology, the symptoms appear completely unexpectedly, and the subsequent manifestation of the disease has quite pronounced symptoms. The chronic form of cholestasis is characterized by a gradual increase in the signs of the disease, and this pathological process can occur within a few weeks or months. Symptoms are rather mild.
In addition, cholestasis is classified by the mechanism of occurrence. A disease can be:
- partial;
- total;
- dissociative.
The partial form is characterized by the fact that the volume of produced bile is significantly reduced. With dissociative cholestasis, the constituent elements of bile are not produced in sufficient quantities. The total form is characterized by the fact that the process of receipt of bile from the gallbladder into the duodenum is disrupted.
Reason for occurrence
Symptoms of stagnation of bile in children are quite pronounced, which is why it is possible to recognize the pathology even at the initial stages. In order for the treatment to bring the required result, it is necessary to know for what reason the pathology arose. Among the provoking factors, it is necessary to distinguish such as:
- congenital metabolic disorders;
- taking medications;
- viral diseases;
- heart failure;
- malignant neoplasms;
- hereditary factor;
- the presence of helminths.
In some cases, the transferred viral diseases lead to serious consequences that affect the process of bile production. Especially dangerous complications provoke various stages of hepatitis. Almost always, this liver disease leads to stagnation of bile. Tuberculosis has a similar effect on the child’s body.
Quite often, heart failure leads to cholestasis, as well as taking medications. Damage to the liver occurs not only after an overdose of certain drugs, but also in the case of dangerous exposure to hepatotoxic substances.
Often in the children's body, helminths parasitize, which provoke a violation of the functioning of the stomach and intestines, which can lead to the development of cholestasis. In addition, certain genetic diseases, in particular, such as Caroli syndrome, can provoke stagnation of bile. It is characterized by the expansion of the bile ducts. Another disease that provokes cholestasis is sclerosing cholangitis. It is characterized by inflammation of the bile ducts, which leads to their subsequent narrowing.
Symptomatology
Symptoms of stagnation of bile in children depend on many different factors. Of great importance is the peculiarity of the body, the age of the child. Among the features of the symptoms of bile stasis in a child, it is necessary to highlight such as:
- rashes and skin itching;
- nausea and vomiting;
- icteric shade of the skin;
- temperature rise;
- bleeding gums;
- dull pain on the right side.
Rashes and pruritus are often observed in adolescence. It all starts with the fact that on the hands, stomach, buttocks and legs, the skin becomes dry and flaky. This provokes a very severe itching, and then a rash. Sometimes parents do not attach much importance to this symptom of biliary dyskinesia in children, taking a similar problem simply for the manifestation of an allergy.
Self-medication is especially dangerous in this case, since without timely complex therapy, the disease can go into the chronic stage. The child becomes irritable, nervous, periodically suffers from impaired appetite and sleep. This is due to the fact that during stagnation of bile, the body experiences an acute deficiency of vitamin A, which provokes irritation of certain areas of the skin. In children up to a year, these signs are absent.
The most common symptom of stagnation of bile in infants is jaundice. In case of impaired liver function, an increase in bilirubin level in the blood is observed. This leads to the fact that the skin acquires a somewhat yellowish tint. The same color may be mucous.
Symptoms of bile stasis in children can manifest as nausea and vomiting. Such signs occur when the disease begins to turn into an acute form and requires urgent treatment. With the course of the disease, a change in the nature of the emptying is noted. Urine turns dark, and feces are completely discolored. When conducting laboratory tests, one can note an increased content of fat in feces.
When the course of the disease is aggravated, there is a deterioration in well-being, fever, pain in the right side, as well as bleeding gums. If there are causes and symptoms of stagnation of bile in a child, you need to immediately diagnose and comprehensive treatment.
Diagnostics
Diagnosis of stagnation of bile in a child begins with an initial examination and collection of anamnesis, on the basis of which the doctor decides on the use of certain diagnostic tests. Since many pathologies of the gallbladder have similar symptoms, then a comprehensive examination can not do. To prescribe the required treatment for bile stagnation in a child, the diagnosis must necessarily be comprehensive and include:
- blood analysis;
- analysis of urine and feces;
- ultrasound diagnostics;
- tomography;
- duodenal sounding;
- cholecystography.
A blood and urine test allows you to determine the presence of inflammation during an exacerbation. During remission, all indicators will remain within normal limits. With a prolonged course of the disease, the number of leukocytes may even decrease. Fecal analysis helps detect worms in the body.
When conducting ultrasound diagnostics, it is possible to determine an increase or decrease in the volume of the gallbladder, reveal its deformation, thickening of the walls, the presence of stones, and also evaluate the contractility of this organ. Cholecystography for diagnostics is used very sharply, since a similar research method carries radiation exposure. A similar technique allows us to assess the location and shape of the gallbladder, as well as the speed of its emptying.
Ultrasound diagnostics need to be done several times, since such a study allows you to trace the peculiarities of the pathology, the results of treatment and the state of the organ after the end of therapy.
Treatment features
To eliminate the causes and symptoms of bile stasis, treatment should be carried out in several directions at once. Therapy should be aimed at combating the accumulated bile, supporting the functioning of the liver and eliminating the existing symptoms. For the treatment, medications are used, which are prescribed only by the attending physician.
Choleretics are prescribed to normalize the production of bile, and if inflammatory processes are present, then antibacterial drugs are used. In addition, for the treatment, cholekinetics may be required, which activate the production of bile, antihistamines to eliminate skin itching.
In especially severe cases, an operation may be prescribed to expand the bile ducts. Basically, it is performed using minimally invasive techniques. Often, the operation involves endoscopic punctures, which allows the patient to quickly recover, and eliminates the need for suturing. In addition, a classic operation can be performed, during which the bile ducts are drained, stones are removed, and patency is restored.
The treatment must necessarily be long and throughout the entire period of therapy, a special diet is required. It helps to normalize the functioning of the liver, as well as reduce the likelihood of developing gallstone disease.
To eliminate the symptoms and treat the gallbladder, the doctor may prescribe physical therapy classes under the supervision of highly qualified specialists, and some types of physiotherapeutic procedures may also be required.
Drug therapy
A sufficiently dangerous and complex disease is cholestasis. Treatment of stagnation of bile in a child must necessarily be complex and implies the use of medications. There are a number of choleretic drugs that are recommended for children. Such funds are represented by the following groups:
- choleretic drugs ("Allohol", "Osalmid", "Nicodine");
- choleretics ("Holosas", "Flaming", "Holos");
- cholekinetic drugs ("Magnesia", "Valerian");
- anticholinergic drugs (Papaverine, No-shpa, Atropin, Spazmol).
To eliminate the existing symptoms, for the treatment of the gallbladder in children, it is recommended to take plant choleretic drugs if there is no allergy to certain herbs and their components or individual intolerance. It is important to calculate the dosage, which largely depends on the weight of the child. The dosage is strictly indicated in the instructions for use of the drug and for each agent can be completely different. Before using any product, you must first consult your doctor.
In addition to taking choleretic drugs, the doctor may recommend the consumption of alkaline mineral drinks, such as Essentuki or Borjomi. Such water is considered a very good natural choleretic and has a corresponding effect, diluting bile, reducing its viscosity and contributing to a faster and easier outflow.
To eliminate the symptoms of bile stasis in children, treatment is also carried out with the use of antispasmodics and painkillers, which help eliminate spasms, as well as relieve pain. If there are signs of inflammation in the biliary tract and gall bladder, antibacterial drugs can be indicated, in particular, such as Metronidazole, Biseptol, Clarithromycin.
To reduce skin itching, antihistamines are indicated, for example, Cetrin, Diphenhydramine, Suprastin, Tavegil. With severe itching, you can use antipruritic drugs, in particular, gels, creams, ointments.
Methods of treating bile stasis in the gallbladder in children are selected only by a qualified doctor, taking into account the characteristics of the course of the disease. It is worth remembering that children under the age of 12 are not recommended to take choleretic herbs, since they contain many active components, therefore, it is impossible to predict their effect on the child.
Folk techniques
With obstruction of the bile ducts or pathologies of the gallbladder, cholestasis begins to develop. Treatment of stagnation of bile in a child is also carried out using folk remedies and methods, however, before using them, you must always consult a doctor so as not to harm the children's body. In addition, it is worth noting that decoctions and infusions of medicinal herbs can only be used as a complement to the main treatment, since their effectiveness is not enough to completely cope with the existing disease.
The most effective and most safe means of traditional medicine, which are used for stagnation of bile, are such as:
- treatment with herbs having a choleretic effect;
- daily fasting pumpkin seeds;
- consumption of freshly squeezed beet juice;
- exercises that strengthen the abdominal muscles;
- gallbladder massage;
- tyubazh.
Highly effective is a decoction of peppermint, immortelle, wormwood, St. John's wort, as well as a decoction of wild rose. All these funds must be taken 20 minutes before eating food.
Dieting
Very important is the diet in the treatment of stagnation of bile. Symptoms of pathology can be eliminated much faster if proper nutrition is observed. Be sure to adhere to such principles of nutrition:
- consume food in small portions;
- the menu should be dominated by vegetables and fruits, dairy products;
- from protein foods, preference should be given to low-fat varieties of fish and meat.
In the usual diet, it is necessary to limit the amount of sweets and fats. It is strictly forbidden to consume spicy, fried, salted, spicy dishes, as well as carbonated and alcoholic drinks. It is not recommended to eat freshly baked bread. It is better to exclude sorrel, green onions, radishes from the diet.
What could be the consequences
To eliminate the symptoms of stagnation of bile in the gallbladder, treatment must be carried out comprehensively, as this alone guarantees a quick and successful disposal of the existing pathology. If you do not conduct complex therapy on time, then various kinds of complications and dangerous consequences may arise, in particular, such as:
- lack of calcium absorption in the body;
- lack of vitamin;
- cirrhosis of the liver;
- development of gallbladder inflammation;
- liver failure.
All these consequences can be very dangerous for the health and life of the child, which is why when the first signs of the disease occur, you should definitely consult a doctor for a comprehensive diagnosis and treatment.
Prophylaxis
Any disease is much easier to prevent than then treat for a long time. That is why a simple set of preventive measures will avoid the occurrence of dangerous complications and problems with the gallbladder, the most common of which is stagnation of bile.
The main measure for the prevention of cholestasis in children is to prevent the occurrence of pathologies of the digestive system. It is necessary to try as often as possible to walk in the fresh air, strictly observe the sleep and rest regimen. It is important to ensure that the child regularly and correctly eats. If the initial stage of the pathology was discovered, then you need to strictly follow a diet.
Children require moderate physical activity, as physical inactivity is considered one of the triggering factors. Morning exercises, swimming in the pool, walking, sports games in the fresh air are well suited as exercises.
To prevent bile stasis, it is useful to regularly consume mineral water, such as Essentuki, Borjomi, and Narzan. Natural herbal teas made on the basis of medicinal plants, such as St. John's wort, wormwood, mint, oregano, will also be useful. A very good preventive measure will be an annual visit to special sanatoriums with complex treatment.
Stagnation of bile for a long time can occur without any symptoms. The lack of timely treatment leads to liver failure, cirrhosis, osteoporosis and many other serious pathologies. For the timely detection of the disease, at least once a year, ultrasound diagnostics of the abdominal organs is necessary.
If the child began to complain of pain in the side, lost his appetite or he had other unpleasant signs of pathology, then you should not try to treat him yourself. Only a qualified specialist should prescribe treatment.
Most cases of acute cholecystitis with timely therapy ends in a complete recovery of the child. However, after exacerbation, dyskinesia may persist for a long time, so you need to follow all the doctor's recommendations.