Biliary dyskinesia is a common gastrointestinal disease. According to unofficial data, almost one in three suffers from this disease. There are no exact statistics, because not all patients seek medical help: the pathology causes a lot of trouble, but life is not in danger. However, in some cases, the disease can lead to complications. That is why it is worth knowing how to treat biliary dyskinesia.
Pathology Description
Dyskinesia of the gallbladder and biliary tract is a pathological condition that is characterized by uneven bile secretion and impaired contractions of the smooth muscles of the excretory system and sphincters. To understand what this disease is, it is necessary to delve deeper into the anatomy, having studied the functions of bile and biliary tract.
Bile is called a yellowish-brown biological fluid that contains active substances and is involved in digestive processes. It is formed in the liver or liver passages, then through the ducts it enters the gall bladder, where it acquires the necessary concentration during the removal of excess water. From the gall bladder, fluid enters the duodenum.
The main function of this biological fluid is to break down complex fats, as a result of which they are converted under the action of enzymes into fatty acids. The latter can be absorbed by the body without any problems. In addition, bile is involved in the process of complete absorption of fats and carbohydrates.
Through the system of bile ducts, this fluid moves with the help of smooth muscles. Transportation speed is regulated by ring muscles (sphincters), which are “controlled” by hormones produced in the pancreas and stomach. If bile moves too quickly, then it enters the stomach in a diluted form, too slowly - it becomes too saturated. Both that, and another negatively affects health.
Classification
Depending on whether bile moves too slowly or excessively quickly, the disease is divided into two types. Hyperkinetic type of biliary dyskinesia (DZHVP) is too fast transportation of bile to the duodenum, hypokinetic - slow.
These two types of the same disease differ not only in symptoms and treatment principles, but also in the categories of people who are most exposed to them. For example, the hyperkinetic form of dyskinesia of the biliary tract is more often diagnosed in young patients, and the hypokinetic form is detected in people who are over forty years old and people with an unstable psyche. In general, more women are affected than men. Biliary dyskinesia occurs in children, although not as often as in adults.
Doctors adhere to another classification based on how high is the tone of the sphincters that “control” the movement of bile. If it is higher than normal, then the disease is called hypertonic biliary dyskinesia, if lower - hypotonic. In some cases, the doctor can diagnose a mixed type of disease, that is, both hypokinetic and hyperkinetic disorders.
The ICD code for biliary dyskinesia is K83.9. ICD-10 is an international classification of diseases, a document used as the main statistical and qualification in health care.
Causes of DZhVP
According to the causes of the pathology, dyskinesia of the biliary tract is divided into primary and secondary. The primary occurs quite rarely, it is usually caused by some kind of anatomical defect in the development of the gallbladder or bile ducts. This can be an inflection of the bladder, weakness of the walls, the presence of a septum inside, a doubled number of ducts, an abnormal location or mobility of the gallbladder.
In the case of the secondary form, other cause diseases occur. Viral hepatitis, liver dysfunction and other diseases, various gastrointestinal pathologies (gastritis, ulcers, duodenitis), gallstone disease, appendicitis, allergic reactions, cholecystitis, pathologies of the female reproductive system, inflammatory processes that occur in the abdominal can provoke the development of dyskinesia of the gallbladder and biliary tract cavity, menopause.
DZhP can be observed at any chronic infections, including, for example, tonsillitis or caries. Also, the disease can appear due to giardiasis, with other infections and helminthic invasions.
In some cases, the main cause of biliary dyskinesia symptoms is poor nutrition and unhealthy eating habits. A negative effect is the use of a large number of sweets, spicy food, spices and seasonings, too fatty foods, vegetable oil, alcoholic beverages, snacks. Harmfully prolonged fasting and irregular meals.
Recently, the point of view according to which biliary dyskinesia occurs due to prolonged nervous overstrain, stress and anxiety, and neurotic conditions has become widespread. This is not a new statement, because for a long time there is a stereotype that all diseases are from nerves. For all pathologies, this, of course, is an exaggeration, but in the case of dyskinesia, the statement looks plausible.
The progress of bile is regulated by the autonomic nervous system, which in some way depends on the central nervous system and responds to the hormones produced. So, any experiences can affect the functioning of the biliary tract. In addition, with severe stresses, people cease to care about regularity and quality of nutrition, which also affects the development of the disease.
Other factors that can cause disturbing symptoms, which will require treatment for biliary dyskinesia, include:
- sedentary work, lack of physical activity;
- hormonal changes, disorders;
- obesity or asthenic physique;
- lack of vitamins and nutrients in the body;
- dysbiosis and some other pathological conditions.
Main symptoms
For hyperkinetic and hypokinetic forms of biliary dyskinesia, the symptoms are slightly different, but there is a common symptom - pain. In the first case, it is sharp, usually occurs at night or after eating, has a paroxysmal character. There is discomfort in the right hypochondrium, it can give to the shoulder blade or shoulder, reminders of pain in osteochondrosis. The attack usually lasts about half an hour. Additionally, the patient may complain of a rapid heartbeat, numbness of the extremities and very severe pain under the rib.
With a hypokinetic form, the pain is constant, aching, localized under the rib. Discomfort can often be replaced by a feeling of heaviness and bursting. Bloating is characteristic of this form of the disease. Attacks are longer, can last for hours. The pain subsides after a meal or choleretic drugs. With stagnation of bile, changes in the color of the stool and urine are characteristic (feces become light, and urine darkens), yellowing of the sclera of the eyes and skin, severe itching of the skin.
Symptoms of biliary dyskinesia in both cases occur against the background of malnutrition, stress, and sometimes physical activity can cause an attack. In both hypokinetic and hyperkinetic DW, belching, nausea, stool disorders, decreased or complete lack of appetite, profuse urination, bitterness in the mouth, bad breath, signs of the autonomic nervous system: insomnia, headaches, heart palpitations fatigue and sweating. In women, menstrual irregularities can be observed, in men, potency decreases.
Complications
Symptoms of biliary dyskinesia are often completely ignored by patients during exacerbations. But if you treat a disease without proper attention, it can cause cholecystitis, liver diseases. It is also dangerous DZhP with cholestasis - stagnation of bile, which can lead to colic and gallstone disease, that is, the formation of stones in the gallbladder. The inflammatory process that began in this organ can affect the pancreas, as a result, the doctor diagnoses pancreatitis.
Patient Actions
It is necessary to consult a gastroenterologist if symptoms of biliary dyskinesia occur. The doctor will prescribe treatment that is optimal for the type of disease that the patient diagnoses. Self-diagnosis and self-medication are unacceptable here, because what is suitable for, for example, with a hypokinetic form can be ineffective or even harmful with a hyperkinetic one. The specialist will conduct diagnostic procedures and tell you how to treat the disease.
Diagnostics
At the patient’s first visit to a gastroenterologist, the doctor will palpate the painful area. When the disease is characterized by sharp pain when inhaling and pressing on the area of the gallbladder. But this method does not allow you to accurately determine dyskinesia, so you can not determine the complexity and form of the disease. That is why it is recommended to conduct a number of studies.
An analysis of feces for lipids, the level of bilirubin, helminths, dysbiosis can be prescribed. More important is ultrasound, which will help determine the condition of the bile ducts and gallbladder. Often, duodenal sounding is performed, during which the doctor gets the opportunity to determine the chemical composition of bile and enzymes, the time of receipt of bile from various departments of the biliary system.
Dzhp treatment
Treatment of biliary dyskinesia is performed by several methods. Firstly, the patient is recommended to change the diet and diet, a therapeutic diet is prescribed, secondly, medications are indicated, thirdly, psychotherapy shows good results, but this method is not always used. If the disease is caused by another pathology, then the cause is eliminated first.
Therapeutic diet
A therapeutic diet for biliary dyskinesia is prescribed for therapeutic purposes. Such nutrition contributes to the complete emptying of the gallbladder, but does not cause bouts of pain. A patient with dyskinesia is recommended to eat four to six times a day with an interval of three hours. You do not need to overeat, you should eat dishes in a warm form. The last meal should be two to three hours before bedtime, but you don’t need to go to bed hungry either.
There are products that should not be consumed at all, those that are better to limit during the period of exacerbation, and recommended. The specific list in each case depends on the characteristics of the course of the disease and associated pathologies, so nutrition should be determined by a nutritionist or gastroenterologist.
In the most general case, we can only say that it is undesirable to eat fried, too spicy or fatty foods. Cooked steamed or stewed foods should prevail in the diet. When heating food, it is necessary to abandon vegetable fats and margarine. Dairy products should be consumed daily.
In case of exacerbation, the food should come in crushed or mashed form. It is necessary to abandon fat, smoked meats and marinades, nuts, canned foods, snacks, millet porridge, fatty meat, offal, mushrooms.
With a slow movement of bile along the ducts, eggs and black bread, cream, sour cream are shown. If the patient is too fast, it is recommended to limit rich broths, fatty fish, vegetable oils, while it is advisable to include these dishes in the diet in the hypokinetic form of DW. In both cases, you should abandon the use of chocolate, ice cream, white bread. A large amount of fresh vegetables and fruits, bran (one tablespoon before each meal) is recommended.
It is advisable to abandon highly carbonated drinks, strong coffee and tea, alcohol. You can drink weak tea and mineral water. The exact brand of recommended water is best clarified by a gastroenterologist. The wrong choice can lead to the fact that the mineral water does not help cope with the unpleasant manifestations of dyskinesia, but only exacerbates the disease. The point here is that the waters have different composition and proportional content of minerals.
Medicines
Preparations for biliary dyskinesia are markedly different for hypokinetic and hyperkinetic forms of the disease. For example, in the first case, the doctor may prescribe medications that accelerate the withdrawal of bile, for example, Allochol, which will aggravate the condition with hyperkinetic dyskinesia. In this case, No-shpa, Papaverin or Drotaverin are prescribed. Also, the number of medications that normalize the flow of bile through the ducts include Flamin, Oxafenamide, Nicodine.
ethnoscience
In the case of dyskinesia, official medicine is rather supportive of non-traditional. Dyskinesia of the biliary tract after removal of the gallbladder and in other cases can be successfully treated (as maintenance therapy, of course) using decoctions of medicinal herbs. They help to remove many unpleasant symptoms of St. John's wort, coriander, immortelle, sage, mint, anise, corn stigmas. Good results are given by eating grapefruit juice before meals. In the hypotonic form of the disease, tinctures are shown that have a tonic effect, for example, ginseng, lemongrass or eleutherococcus. The tinctures of motherwort and valerian have a beneficial effect on the autonomic nervous system.
Psychotherapy
Symptoms of biliary tract dyskinesia, if they are caused by disturbances in the functioning of the autonomic nervous system, are relieved by psychotherapy. But most patients who turn to a gastroenterologist are usually not ready to go to a psychotherapist and categorically reject this method of treatment. Therefore, here we can limit ourselves to general recommendations only. It is necessary to avoid stress whenever possible, take light sedatives, sleep a sufficient amount of time. If it is possible to establish that the cause of the disease is constant stress, then the doctor may prescribe stronger drugs, for example, tranquilizers, antipsychotics, or antidepressants.
Dyskinesia can be caused by an inactive lifestyle, so physiotherapy exercises and walks are useful. Physiotherapeutic procedures and massages are used in the treatment process, the effect of ultrasound is applied, there are special techniques that can free the bile from excess body fluid. In general, DZhP therapy remains conservative, in rare cases (if lifestyle changes and prescription of medications do not give any results), surgical intervention can be used.
Forecast
Dyskinesia is not a fatal disease, but it can significantly impair the quality of life. As a rule, the patient is forced to constantly adhere to a special diet, and with exacerbations, additionally take medications. Regular maintenance therapy and taking care of your health will reduce the frequency of exacerbations to a minimum and extend the period of remission.
DZHVP in children
Dyskinesia of the biliary tract in children is diagnosed, as a rule, in the first years of life and in primary or secondary school age. This is caused by the immaturity of the bile ducts and malnutrition. It affects long breaks between eating at home and at school, conflict situations, stress, the use of inappropriate foods.
Symptoms in children are the same as in adults. There are: stool disorders, nausea and pain in the right hypochondrium. Treatment is carried out according to the same scheme. So, the main thing is the correction of the diet and the change in eating habits, the elimination of the negative effects of stress on the body.
Prevention
Prevention measures coincide with those lifestyle recommendations that are given when confirming the diagnosis. You should avoid stress, engage in viable sports, or at least walk more, regulate your own daily routine, alternate rest and work, normalize diet and eating habits, and maintain a healthy diet. This is especially important for those people who are at risk. These are workaholics, leading a sedentary lifestyle, those who live in constant stress, eat wrong foods (convenience foods, on the go), are a fan of diets and therapeutic fasting. , .
Finally
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