ZHKB: symptoms and treatment, surgery, diet with cholelithiasis

The diagnosis of gallstone disease (cholelithiasis) is made to the patient when diagnosing the presence of stones in the gallbladder. The number, composition and size, their exact location can be different. According to statistics in developed countries, 20% of the female population and 10% of the male suffer from this disease. It is necessary to recognize the symptoms of cholelithiasis and to clarify the diagnosis as early as possible so that the patient can adhere to certain nutritional rules and prevent exacerbations. With a negative development of the disease, a surgical operation is performed to remove the gallbladder along with stones.

Description of the disease and its types

Disease of the cholelithiasis occurs due to a disorder in the production and circulation of bile in the body, a violation of the exchange of cholesterol and bilirubin, as a result of which the formation of calculi occurs.

Depending on the location of the stones, 2 types of disease are found:

• Cholecystolithiasis, or the formation of gallstones.
• Choledocholithiasis - stones in the bile ducts.

The formation of stones occurs due to the deposition of cholesterol, bile pigments, calcium salts, proteins, as well as due to infection and stagnation of bile, impaired lipid metabolism.

The main symptoms of cholelithiasis are pain in the right hypochondrium, yellowing of the skin (jaundice), biliary colic. With a negative development of the disease, complications appear in the form of cholecystitis, peritonitis, and fistulas form. If the methods of treatment used do not have the desired effect, then surgery is required.

Risk factors for the development of cholelithiasis for patients:

• genetic predisposition from the mother;
• eating disorders (starvation, obesity, high cholesterol, etc.);
• elderly age;
• taking medications that affect the exchange of cholesterol or bilirubin (estrogen during menopause, fibrates, ceftriaxone);
• several pregnancies;
• metabolic diseases (diabetes, metabolism, fermentopathy);
• diseases of the gastrointestinal tract (GIT);
• conditions after surgery.

Reasons for the development of cholelithiasis

Solid formations form in the human body with violations in the quantity and components of bile, they gradually merge and increase in size, forming stones. The first unpleasant symptoms of cholelithiasis appear, the treatment of which requires the identification of disorders in the patient’s body and the recommendations of the doctor.

The most common cause of calculus formation is the high cholesterol content in bile, which is called lithogenic.

According to scientists, there are 3 main causes of stone formation:

1. Stagnation of bile due to a mechanical obstacle to the normal process of its outflow or with functional impairment and impaired motility of the biliary tract (dyskinesia, etc.);
2. The inflammatory process in the walls of the gallbladder due to infection, allergic reactions;
3. Metabolic disorders, the formation of an imbalance between phospholipids, cholesterol and bile acids.

Calculi or stones formed in the gallbladder can be classified by their composition:

• cholesterol, found in 80% of cases due to the excess content of this substance in the body, they are yellow in color and also contain some impurities;
• pigmented - have a black or brown color and are formed with a large amount of bilirubin in bile;
• calcareous;
• mixed, i.e. consisting of components of bilirubin and cholesterol.

Stage of ZhKB: symptoms and treatment

The modern classification of this disease divides it into stages:

• initial (stone) - there are changes in the structure of bile, which can be detected only with its biochemical analysis, has no clinical symptoms;
• the formation of calculi (stones) is asymptomatic, latent, they can only be seen with ultrasound diagnostics;
• clinical stage - characterized by the appearance of symptoms of acute or chronic cholecystitis.

Some experts identify the 4th stage, manifested by the development of complications.

Clinical manifestations of cholelithiasis

Symptoms of cholelithiasis depend on the size and location of the stones, the presence of an inflammatory process, compliance with nutritional rules and other factors.

The following negative symptoms are possible:

• a feeling of bitterness in the mouth after consuming fried or fatty foods;
• drawing pains in the right side, which sometimes give to the back in the region of the scapula;
• flatulence, heartburn, signs of general weakness;

A characteristic and specific symptom of cholelithiasis is an exacerbation in the form of biliary colic, which is manifested by bouts of acute pain in the stomach or in the right hypochondrium, which can last up to several hours. Moreover, the patient also has repeated vomiting, after which relief does not occur.

The following reasons can provoke biliary colic:

• intake of fatty, spicy or fried foods, alcohol;
• nervous stress, overwork;
• work for a long time in an inclined position (when washing clothes, etc.);
• jumping, shaking a car ride.

The appearance of seizures is an occasion for seeking medical attention and further examination in order to clarify the diagnosis.

LCD Diagnostics

To clarify the diagnosis when the above symptoms of cholelithiasis appear, you should seek the advice of a gastroenterologist and undergo the following examinations:

• external examination, palpation of the abdominal wall and bladder;
• blood tests for inflammation (increased white blood cells and ESR);
• blood biochemistry - will determine the level of cholesterol and bilirubin, high phosphatase activity;
• Ultrasound examination in the abdominal region, which shows the presence of calculi, the condition of the walls of the gallbladder, signs of cholecystitis;
• MRI or CT of the biliary tract - also provide information about the presence of cholelithiasis;
• endoscopy and radiopaque examination.

Possible exacerbations of gallstone disease:

• acute cholecystitis - the inflammatory process of the mucous membrane of the bladder that occurs when a stone blocks the duct - is dangerous because it can go into peritonitis;
• gallbladder inflammation;
• cholangitis - the inflammatory process in the ducts is connected;
• choledocholithiasis - the movement of stones in the bile ducts;
• narrowing of the gaps due to the appearance of scars after inflammation;
• the appearance of biliodigestive fistulas, holes between the walls of the duct and intestines;
• dropsy of the gallbladder when it is filled with mucus, which interferes with the flow of bile.

ZhKB attack: symptoms, what to do

Most often, colic occurs in the evening or at night, pains are felt like cutting, stitching, sometimes crushing or dull. They can be given to the neck, shoulder, right eye, forehead or jaw. Sometimes pain migrates to the heart, causing an angina attack.

The main symptoms of biliary colic:

• acute prolonged pain, the patient turns pale and screams from acute pain, the onset of a shock state is possible;
• nausea and vomiting with food debris and bile;
• bloating, increased sweating;
• occasionally colic is accompanied by an increase in temperature in the form of a sharp jump;
• with a prolonged attack, yellowing of the skin (jaundice) is possible, which usually disappears in 3-4 days.

The cause of such severe pain is a spasmodic contraction of the muscles of the gallbladder, as well as its ducts, which occur in response to the displacement of stones and irritation of the walls. It is also possible to stretch it with excessive bile content.

First aid for an attack:

• lie down on the bed, legs stretched out and relaxed: if the patient is alone in the apartment, it is advisable to call friends or relatives with a request for help;
• take antispasmodic drugs to relieve pain and spasms of the gallbladder: "No-shp", "Baralgin", Papaverine, etc .;
• with dry mouth it is better to drink clean water, but not tea or herbal decoctions;
• for 12 hours you can’t eat anything, even after the end of the attack;
• with ZhKB it is recommended to put a warm heating pad in the region of the right hypochondrium;
• with exacerbation of chronic cholecystitis, the heating pad is set cold so as not to cause peritonitis.

If it is not possible to independently stop the attack in 20-30 minutes, then the patient needs urgent medical care and hospitalization.

Treatment of cholelithiasis

If the patient is diagnosed with gallstone disease, the doctor recommends a diet and the use of expectant tactics. In case of adverse development of the disease, frequent seizures, surgery is recommended. With symptoms of cholelithiasis, treatment can also be carried out using methods to remove stones:

• dissolution of calculi under the influence of special acid-containing preparations;
• the use of shock wave therapy for crushing stones is possible only with a single formation, but in the absence of negative indications.

Both methods do not lead to a complete cure of the disease, because the formation of new stones will continue anyway.

Surgical intervention (or cholecystostomy) is indicated to the patient in case of severe attacks of acute cholecystitis and a large number of calculi. During the operation, the gallbladder itself is removed along with the stones. It can be carried out in 2 ways:

• abdominal surgery under general anesthesia;
• laparoscopic intervention, which is more gentle for the patient’s body.

Proper nutrition with LCD

It should be strictly observed to prevent exacerbation and the appearance of negative symptoms in the treatment of cholelithiasis, diet. It is she who is considered the most important factor, the purpose of which is:

• stimulation of the secretion of bile from the bladder;
• normalization of the liver and pancreas;
• facilitate the functioning of all organs of the gastrointestinal tract;
• Avoid cramping in the gallbladder.

Basic requirements for the preparation and consumption of diet foods:

• meals in small portions 5-6 times a day;
• all products must be boiled, steamed, stewed or baked;
• the temperature of food consumed should be + 37- + 40 ° ;
• exclude foods with a high cholesterol content from the diet: fatty, fried, spicy, smoked, etc .;
• consume water per day at least 1.5-2 liters (without gas);
• give preference to cereals containing coarse fibers, and foods with healthy fatty acids.

Diet: what is possible and what is not?

Allowed products to eliminate unpleasant symptoms of cholelithiasis of the gallbladder and maintain the patient's normal condition:

• lean meat (chicken or turkey fillet, rabbit, veal);
• sea ​​fish (pollock, hake, halibut);
• protein omelettes;
• vegetable oils (olive, linseed, sunflower), cream is allowed only in remission;
• cereals (oats, rice, buckwheat);
• vegetable soups or broth only weak;
• crackers from wheat bread;
• baked fruits and vegetables;
• honey - only in small portions;
• skim milk, kefir and yogurt, low-fat cottage cheese casseroles;
• drinks: weak tea, chicory, berry compotes and fruit drinks, diluted with water, mineral water only warmed up.

Prohibited foods that can cause an attack of biliary colic or negative symptoms in the treatment of cholelithiasis (according to patients, this happens when the diet is violated):

• fat and fatty meat;
• coffee and alcohol;
• sausages and smoked meats;
• offal (liver, kidney, etc.);
• fat cottage cheese, sour cream, cheese, cream;
• fresh greens;
• berries and fruits with a sour taste;
• sweet carbonated drinks;
• store and home preservation;
• durum flour and pasta;
• seasonings, vinegar, spices and sauces containing them.

Treatment of cholelithiasis with alternative methods

Many patients, in addition to following a diet, try to improve their condition and prevent attacks, using herbal decoctions and infusions. To exclude unpleasant symptoms and treatment of cholelithiasis by folk remedies, you should definitely seek advice from your doctor, who can give useful advice.

Such herbal methods allow you to gradually dissolve the stones and remove them from the patient’s body, but they must be used with caution, under the constant supervision of a gastroenterologist.

Recipes for the treatment of gallstone disease:

• The infusion of corn stigmas is prepared from 100 g of raw materials per 1 tbsp. boiling water, insist in a dark place, after cooling, strain and drink every 60 minutes. It should be noted that the drink affects the increase in blood coagulability, therefore it can not be used for people suffering from addiction and blood clots.
• Infusion of dill seeds is prepared from 2 tbsp. l and 0.5 l of boiling water, hold for 15 minutes. in a water bath. Drink ½ tbsp. within 2-3 weeks 3-4 p. in a day.
• Treatment with chaga mushroom (birch): pour a slice of raw material with warm water and put for 3-4 hours, after softening, grind or grind, add water + 50 ° C in a ratio of 1: 5, insist 2 days, filter. Drink 1 tbsp. up to three times a day.
• A decoction from the root of a sunflower: to prepare it, you need to dig out the ripened root, peel it with a knife (do not wash), cutting off the processes in the form of threads. Then cut into torches and dry in the shade. Pieces can be stored in a linen bag. For broth take 1 tbsp. dry roots, add 3 l of water and boil for 5 minutes. During the day, 1 liter of the solution should be drunk in portions, stored in the refrigerator. After 3 days, the remaining roots can be boiled in 3 l of water repeatedly, but should be boiled for 10 minutes, for the third time - 20 minutes. The duration of treatment is 2 months. For which you need 7 tbsp. dry roots.
• Similarly, decoctions of field horsetail, shepherd’s bag, herbal collection (yarrow, immortelle, rhubarb root) and other herbal remedies are used.

For the treatment of cholelithiasis, many doctors recommend drinking hydrocarbonate and sulphate-sodium mineral waters: Essentuki (Nos. 1 and 17), Mirgorodskaya, which contribute to the separation of bile. They can be consumed only in a warm state while dieting. The course of treatment lasts 4-6 weeks, it is allowed to carry out it only if there are no attacks of the disease for 2 months.

Prevention of ZhKB development

In order to reduce the likelihood of an exacerbation of the course of the disease, to reduce unpleasant symptoms in the treatment of cholelithiasis, diet and some measures will become important factors in prevention, which include:

• fractional nutrition every 3-4 hours, which helps to regularly remove the remaining bile from the bladder;
• adherence to a special diet, normalization of weight;
• increased physical activity and physical activity;
• you can not starve;
• drink fluids of at least 1.5 liters per day;
• avoid working in an inclined position, which can provoke the movement of stones;
• with the appearance of symptoms of cholelithiasis in the gallbladder in women, it is recommended to reduce the intake of estrogen hormones in the body, which contribute to the growth of stones;
• consume daily 1-2 tsp. olive oil, it can be used for frying, and add to the diet;
• increase the intake of magnesium and zinc in the body, which stimulate the intestines and the production of bile enzymes;
• refuse to consume coffee, which affects the contraction of the bladder, it threatens to block the duct and the development of an attack.

Despite the negative symptoms, cholelithiasis is not a sentence for the patient, but only an excuse to pay more attention to your health. Compliance with a diet, regular monitoring of the state of the gallbladder and stones will help to avoid complications. If doctors for health reasons recommend a planned operation, this will help completely rid the patient of stones and possible complications.