Chronic cholecystitis is a prolonged inflammation of the gallbladder. The main reason for the development of this disease is conditionally pathogenic microflora, represented by streptococcus, staphylococcus, Escherichia coli. The infection enters the gallbladder with a flow of blood, lymph, from the intestinal lumen and intrahepatic bile ducts. The development of cholecystitis also leads to prolonged stagnation of bile in the biliary tract and gall bladder, a change in the physical properties and chemical composition of bile. Long stagnation of bile provokes the formation of stones - chronic calculous cholecystitis develops.
Clinical picture
The clinic of the disease is characterized by a long progressive course with a periodic exacerbation of the process. The main symptom of the disease is pain, localized in the right hypochondrium. This painful aching, often extending to the right upper body, less often there is an irradiation of pain in the left hypochondrium.
Dyspeptic syndrome is manifested by nausea, often turning into vomiting, which does not bring relief. Often there is a rise in body temperature to subfebrile or even elevated numbers. The patient is in a forced position on his right side or on his back. Pulse is frequent, low blood pressure. A typical positive symptom of Ortner is soreness when tapping on the edge of the right costal arch.
Calculous chronic cholecystitis, symptoms whose treatment differs from ordinary inflammation of the gallbladder, is manifested by the periodic development of attacks of hepatic colic.
The diagnosis is confirmed by ultrasound, thermography, cholecystography, data from a general blood test.
Treatment of chronic cholecystitis
If a patient is diagnosed with chronic cholecystitis, treatment should be comprehensive, long-term and continuous. In the phase of exacerbation of the disease, inpatient treatment is indicated, in the period of remission - outpatient. The complex therapy of chronic cholecystitis includes the appointment of a diet, medications and physiotherapeutic methods of treatment.
Features of nutrition have a significant impact on the pathology of the digestive system, which also includes chronic cholecystitis. Treatment should begin with the appointment of a diet. The diet provides for the exclusion of fatty and fried foods from the diet, the predominant use of dairy products, vegetables and fruits, low-fat varieties of fish and meat. The patient should adhere to a diet both in remission and in the phase of exacerbation.
In the treatment of chronic cholecystitis, antibacterial drugs, antispasmodics, analgesics, choleretic drugs are used. During the period of subsidence of exacerbation, a heating pad is applied to the region of the right hypochondrium. At this time, the appointment of physiotherapeutic procedures is shown: paraffin or ozokerite applications, UHF, diathermy, electrophoresis. In the phase of remission, the use of exercise therapy, spa treatment is useful.
In the event that calculous chronic cholecystitis is revealed during instrumental studies, the treatment can be both therapeutic and surgical. With calculous cholecystitis, the tactics of treatment depend on the size of the stones in the gallbladder. Small stones and sand can independently exit the gallbladder without leading to the development of complications. In this case, the treatment of calculous cholecystitis is no different from the treatment of conventional chronic cholecystitis.
In the presence of large stones, the appointment of choleretic drugs, thermal procedures in the right hypochondrium is contraindicated.
Indications for surgical intervention are frequent bouts of hepatic colic, obstructive jaundice, suppuration and dropsy of the gallbladder, rupture of the wall of the bladder with the development of biliary peritonitis.
The patient should remember that if chronic cholecystitis is detected, treatment will be effective only with the full implementation of all medical recommendations.