Abdominal pain is a common symptom characteristic of many diseases of the digestive system. One of the pathologies is gallbladder dyskinesia - the disease is relatively harmless, but greatly worsens the patient's quality of life.
Quick reference
Gallbladder dyskinesia is a disease that is characterized by a violation of the transport function and tone of the gallbladder, as well as its ducts that remove bile. In this case, there is an insufficient amount or an excess of bile, its stagnation. This condition is not fatal, but significantly worsens the patient’s well-being and threatens the development of other pathologies.
The code for gallbladder dyskinesia according to ICD-10 is K82.8.0.
Types of biliary dyskinesia
Dyskinesia can be primary or secondary, have a hypertonic or hypotonic character. Primary and secondary pathologies vary depending on the cause. The hypotonic type of gallbladder dyskinesia is characterized by stagnation of bile due to a decrease in contractile activity of the bile duct. Hypertensive dyskinesia is characterized by an increased tone of the gallbladder.
Causes of primary dyskinesia
The most common causes of gallbladder dyskinesia (primary) are:
- frequent acute or chronic stress, malfunctioning of the nervous system (autonomic);
- eating disorders: constant use of low quality products, too “heavy”, fatty, spicy or smoked foods, overeating, irregular meals, insufficient chewing of food;
- low mobility in combination with lack of body weight, muscle weakness;
- various allergic diseases, which, acting on the bile ducts and bladder, cause constant tension.
Causes of the secondary form of the disease
Secondary dyskinesia, as a rule, appears against the background of existing diseases or pathological conditions. Common causes are as follows:
- stomach ulcer, duodenitis, colitis, gastritis, enteritis;
- cholecystitis, gallstone disease, hepatitis, inflammation of the biliary tract ;
- chronic inflammatory processes in the peritoneum;
- any inflammatory diseases of the gastrointestinal tract that are caused by pathogenic microorganisms;
- congenital malformations of internal organs;
- endocrine disorders (estrogen deficiency, obesity, hypothyroidism, and so on);
- parasites in the biliary tract and gall bladder.
Symptoms of hypotonic dyskinesia
Signs of gallbladder dyskinesia depend on the type of disease, the activity of the organ and its ducts. The main symptom of a hypotonic type of disease is pain that occurs in the right hypochondrium. The discomfort is long, has a aching character. Pain with dyskinesia of the gallbladder does not have a certain localization, increases after eating.
An involuntary release of gases into the oral cavity, that is, belching, occurs in patients after eating, can also occur between meals. Appears due to the fact that the regulation of the bile from the nervous system is disturbed, as a result of swallowing, the patient takes air.
Some patients complain of nausea and bouts of vomiting. Vomiting may be mixed with bile, which indicates the throwing of bile into the stomach. Symptoms occur after eating and after a diet violation, that is, eating too fatty foods, overeating, and so on.
Hypotonic dyskinesia of the gallbladder is often accompanied by bitterness in the mouth. Mostly bitterness occurs in the morning, after exercise (physical) at the next meal. It occurs as a result of relaxation of the gastrointestinal sphincters and motor disorders, as a result of which food moves back.
Flatulence, or bloating, a feeling of fullness is often accompanied by pain that subsides after the exhaustion of the gases. Patients complain of decreased appetite. Bile is a stimulant of the production of intestinal hormones, intestinal motility and appetite, so its lack may be accompanied by its absence.
Rarely among the symptoms of gallbladder dyskinesia is called an upset stomach, manifested in diarrhea. Occurs some time after eating. More often constipation occurs with the disease. This symptom of gallbladder dyskinesia is characterized by regular insufficient bowel movement or lack of stool for 48 hours or more.
With prolonged dyskinesia without treatment (a chronic form of the disease), many patients are obese. Due to stagnation of bile, the digestion process is completely disrupted, the amount of fat increases, the breakdown slows down, as a result, fats accumulate in the subcutaneous fat.
The list of symptoms includes disorders of the nervous system. Characterized by a decrease in blood pressure, sweating, a decrease in the number of contractions of the heart, salivation, redness of the skin (hyperthermia is noticeable on the face).
Signs of hypertensive dyskinesia
With dyskinesia of the gallbladder according to the hypertonic type of pain, more intense pains arise, have a cramping nature. Discomfort and pain occur, as a rule, against the background of physical discomfort, nervous strain, errors in nutrition. The attack lasts from 20 to 30 minutes, can be repeated several times during the day. Often the pain gives to the arm or shoulder blade on the right side. In some cases, the pain repeats the attack of angina pectoris, giving it to the left. Between seizures, the patient retains a feeling of heaviness under the ribs (right).
Also characterized by reduced appetite and weight loss. Often accompanied by an attack of nausea and vomiting, outside the attack, such signs, as a rule, are completely absent. With hypertensive dyskinesia of the gallbladder, diarrhea often develops, a disorder occurs shortly after a meal or accompanies an attack.
Symptoms of disorders in the nervous system are characteristic of many patients. Sleep disturbances, irritability and fatigue appear. A headache may occur, blood pressure rises, the frequency of contractions of the heart muscle, sweating increases. Some patients complain of aching pain in the heart.
Symptoms for all forms of the disease
Both with hypertensive and hypotonic dyskinesia of the gallbladder, yellowness of the skin, mucous membranes, and eye proteins may appear. The symptom develops quite rarely, is the result of a violation of the outflow of bile. Fecal masses become colorless, and urine takes a dark shade. Plaque on the tongue is not a specific sign of dyskinesia, as it can also appear with some other diseases, for example, with gastritis or colitis. The coating may be a yellowish tint or white.
Diagnostics
The following methods are used to diagnose gallbladder dyskinesia:
- Ultrasound, with which you can determine the presence of congenital anomalies, the degree of emptying of the bladder, its shape;
- a blood test that allows you to determine the presence of an inflammatory process with secondary dyskinesia;
- blood biochemistry can diagnose stagnation of bile, pancreatitis, inflammatory processes, impaired fat metabolism;
- cholecystography in order to study the excretory and accumulative functions of the gallbladder, its structure and the presence of stones;
- infusion cholecystography to determine the tone of the sphincter;
- cholangiography with the introduction of a contrast agent for the study of bile ducts;
- duomental sounding for the purpose of studying the function of the gallbladder, bile, and so on.
Hypotonic type treatment
The main objective of the treatment of gallbladder dyskinesia is the fight against parasites and infections, inflammations, improvement of the gastrointestinal tract and the outflow of bile. The approach to drug treatment varies depending on the type of dyskinesia. For hypotonic conditions, choleretics, tonic drugs to improve the functions of the nervous system, and tubeless tubes are used.
The use of choleretics
Choleretics are substances that stimulate the synthesis of bile. "Cholenzyme", for example, contains acids, pancreatic enzymes. Take the drug one tablet three times a day after meals. The course of treatment lasts two to three weeks. The medicine improves the contractile and transport functions of the gallbladder and bile ducts, normalizes digestion, and helps to absorb the maximum amount of nutrients from food. The drug stimulates the synthesis of bile.
"Aplohol" contains nettle leaves, bile and garlic. It is recommended to take the medicine one to two tablets after meals three or four times a day. The course of therapy is one to two months. The drug also stimulates the production of bile, eliminates or reduces the processes of decay in the intestine, improves the transport function of the digestive system.
"Holiver", which contains turmeric, artichoke and bile, it is recommended to take from two to four tablets after or during meals. The recommended duration of therapy is ten to twenty days. The drug protects the liver from toxins, removes cholesterol from the blood, improves the advancement of food through the digestive tract and digestion in general, stimulates the production and discharge of bile.
Tonic preparations
To normalize the activity of the nervous system, tonic medicines are used, for example, eleutherococcus, ginseng. The first drug should be taken twenty to thirty drops thirty minutes before meals, up to twelve hours a month. The second you need to drink 15-25 drops three times a day thirty minutes before meals, 30-40 days is the course. Such drugs increase blood pressure, physical and mental performance, reduce fatigue and drowsiness, improve the body's ability to adapt to environmental conditions, and stimulate the adrenal glands.
Probeless tubing
Probeless tubes (allowed only between exacerbations of gallbladder dyskinesia) are mineral water (still), Xylitol, magnesium sulfate, Sorbitol. Dissolve the medicine in 0.5 cups of water and drink the solution for ten minutes in several small sips. Then it is recommended for half an hour to lie on the right side on the heating pad. The procedure should be repeated approximately once every seven to ten days. The course of therapy consists of six to eight procedures.
Therapy of hypertensive dyskinesia
With hypertensive dyskinesia, cholekinetics are used - drugs that lower the tone of the bile ducts. Antispasmodics that relax the tone of the sphincters are also shown. These drugs reduce the intensity of pain. Sedatives are used to normalize the nervous system.
Cholekinetics treatment
Patients for the treatment of gallbladder dyskinesia (hypertensive type) are often prescribed "Oxafenamide." You need to take medicine 1-2 tablets thirty minutes before a meal. The course is 15-20 days. The drug enhances the synthesis of bile and accelerates its excretion, reduces the content of leukocytes in bile, reduces the amount of cholesterol in the blood, and reduces discomfort during attacks.
Gepabene is also used. The medicine contains dry extract of medicinal haze. Take one capsule three times a day for a minimum of two weeks. For pain at night, you can take one capsule at night. The medicine reduces the synthesis of bile, stimulates its passage, protects liver cells from toxins.
Antispasmodics to reduce pain
Antispasmodics relax the tone of the sphincters and reduce discomfort. The courses (for the lesser development of seizures) are assigned to Gimekromon. You need to drink one or two tablets thirty minutes before a meal three times a day. The course lasts two to three weeks. The drug improves the excretion of bile, relaxes the muscles of the biliary tract and reduces pressure in the ducts.
“Papaverine”, “Drotaverin”, “No-shpa” contain different active substances, but have a similar mechanism of action. For severe pain, intramuscular injections of 2 ml are prescribed twice in laziness. After reducing the pain, it is recommended that the tablets be taken orally. It should be taken two tablets two to three times a day.
With severe pain, the patient may be prescribed drugs with dyskinesia of the gallbladder. Promedol, for example, is administered intramuscularly one milliliter twice or thrice a day. This substance disrupts the transmission of a nerve impulse through the central nervous system.
Sedatives
Sedatives are used to correct the nervous system. In powders, tablets or medicine, potassium or sodium bromide are prescribed. The powder should be used once a day (two bags), tablets - three to four times a day (one or two tablets at a time). The duration of therapy is two to three weeks. Medicines have a calming effect, restore the natural balance between the processes of excitation and inhibition. Tinctures of valerian or motherwort also reduce the excitability of the nervous system, normalize the frequency of the heart, improve the functioning of the heart and blood vessels, have a light hypnotic effect, and return blood pressure to normal limits.
Other therapies
For both forms of dyskinesia, physiotherapeutic procedures are recommended: laser therapy, paraffin baths, electrophoresis. Be sure to treat the diseases that led to dyskinesia. Outside of exacerbations, that is, during remission, mineral waters are used, and treatment in sanatoriums is also recommended.
Diet food
It is indicated for dyskinesia of the gallbladder, medical, dietary food. The diet is prescribed for a long period of time, its duration is at least three to four months. The main purpose of such nutrition is to normalize the function of the gastrointestinal tract and biliary tract. A diet for gallbladder dyskinesia suggests that during an exacerbation, the following are completely excluded:
- Alcoholic drinks, soda, black coffee, cocoa.
- Products that enhance the formation of gases, i.e. peas, cabbage, beans.
- Fatty broths, spicy seasonings.
- Whole cow's milk and cream.
- Fatty meat and fish.
- Marinades and preservation.
- Any fatty, salty, fried, smoked, spicy or sour dishes.
- Confectionery, rolls, any pastry.
It should be eaten in small portions, but often. Products need to be boiled, steamed. In the early days of exacerbation, it is better to use dishes in liquid or grated form. This will not be needed when the acute symptoms disappear.
Folk methods
Alternative medicine is also used in the treatment of dyskinesia of the gallbladder and biliary tract. In addition to the main therapy, decoctions of medicinal herbs are used to relieve pain during seizures. With hypotonic dyskinesia, it is allowed to take:
- Immortelle broth. A glass of boiling water will require three tablespoons of flowers. Insist the broth in a water bath for thirty minutes. Be sure to constantly stir. After, remove the broth from the stove and cool, and then strain through a strainer. It is recommended to take half a glass thirty minutes before eating. The course of treatment is 14-21 days.
- Infusion of corn stigmas. Pour a teaspoon of chopped stigmas with a glass of boiling water and leave for thirty minutes. Strain through a sieve or cheesecloth and take three tablespoons three times a day thirty minutes before meals. The course is three weeks.
For patients suffering from hypotonic dyskinesia, folk recipes are offered the following:
- Licorice root broth. Two teaspoons of dry raw materials need to be poured with one glass of boiled water (hot) and put on fire for twenty minutes. When the broth has cooled, strain it. You need to take a third of a glass 30 minutes before meals three times a day for 14-21 days.
- Peppermint infusion. Pour two tablespoons of the raw material in a dry glass with a glass of water and let stand for about thirty minutes, and then pass through cheesecloth. Take a third of a glass twenty minutes before meals twice a day. The course is two to three weeks.
With both types of biliary dyskinesia, it is useful to drink a decoction or tea from chamomile. You can drink it in unlimited quantities, but, of course, within reason.
Other recommendations include feasible physical activity (but not during exacerbations), minimizing stressful situations, following the general principles of a healthy lifestyle. The patient needs to observe the daily regimen, not to overwork, physical overloads are also contraindicated, as they may be the root cause of the next attack. It is also advisable to completely abandon bad habits, namely from smoking and drinking alcohol.
The prognosis for dyskinesia is comforting. If you follow the doctor’s recommendations, then the frequency of seizures can be significantly reduced.