Inexperienced parents associate any abdominal pain in their baby with the quantity and quality of food. They are sure that it is enough to give a dose of sorbents or enzymes, and everything will pass. But it's not always the case. The cause of pain can be an inflammatory process of the biliary tract system, that is, cholecystitis in a child. Oddly enough, inflammation of the gallbladder and ducts occurs quite often. The disease can be acute or chronic. In most cases, the chronic form is diagnosed at the time of exacerbation or relapse.
Disease provocateurs
Cholecystitis in a child can be provoked by E. coli, Proteus or cocci, which have fallen into a favorable environment. These conditions include infection with protozoa, that is, giardiasis, helminthic infestations, pathologies of the biliary system. The main causes of cholecystitis are divided into 2 groups:
Chronic cholecystitis in children is often associated with the presence of other foci of inflammation, for example, tonsillitis or tonsillitis. In many cases, the disease is provoked by previous diseases, such as gastritis, collibacillosis, duodenitis, appendicitis, influenza, scarlet fever, dysentery.
Inflammation of the gallbladder or bile ducts can be triggered by a systematic violation of the diet, the absorption of large amounts of fatty foods and carbohydrate-containing foods, a clear lack of vegetables and fruits in the diet.
The mechanism of the manifestation of the disease. Chronic cholecystitis
Cholecystitis in a child in chronic form can be purulent or catarrhal. The catarrhal form is associated with inflammation of the mucous membranes. In this case, the gallbladder wall becomes denser and thicker, and the mucous membrane lining the inside atrophies.
Purulent cholecystitis is characterized by the involvement of all wall tissues in the process. Abscesses form in the organ, which become a source of regular exacerbations of chronic cholecystitis. With relapses of the disease, swelling of the gallbladder occurs. A characteristic sign is a thickening of the mucosa, the appearance of polyps and ulcers.
When healing, ulcers are replaced by connective tissue, scars appear. Adhesions with closely spaced organs are occasionally formed. This process is called recholecystitis.
An ulcer can lead to the formation of a fistula and the development of biliary peritonitis. If cholecystitis in a child leads to blockage of the bile duct, dropsy of the gallbladder may develop. Chronic cholecystitis can affect the condition of the liver, diaphragm, and abdominal wall. An exacerbation of the process provokes an abscess in these organs. In difficult cases, external bile fistulas may appear.
Acute cholecystitis
Acute cholecystitis in children may require surgery. However, this happens infrequently. Usually, the development of the disease is associated with an infection spreading through the bloodstream or lymphatic current. At an early age, the most common factor in the development of the acute process is intestinal infections and stagnation of bile due to constipation or flatulence.
As a result of acute cholecystitis, a high concentration of lysolecithin is created. Bile salts damage the mucous membrane of the bladder, disrupting the permeability of cell membranes. Since the immune defense in children is not finally formed, edema and secondary biliary hypertension develop.
Symptoms
How is cholecystitis manifested in children? Symptoms may be bright or mild. Typically, these are complaints of bitterness in the mouth, a significant decrease in appetite, bouts of nausea and vomiting, constipation or diarrhea. However, the main sign of cholecystitis is considered pain in the right hypochondrium. Pain can be paroxysmal and last from a few minutes to several hours or permanent.
One of the main symptoms of the disease is soreness and enlargement of the liver. Sometimes during palpation, the tension of the abdominal wall above the gallbladder is felt. Many children have a low-grade fever for a long time. If you combine the symptoms in one list, then it will look like this:
- Pain of paroxysmal or persistent, localized to the right under the ribs. Strengthen several hours after eating, accompanied by a feeling of heaviness and overflow.
- Dyspepsia, i.e. an upset digestive system. Bitter or metallic taste, frequent burping, nausea, increased gas in the intestines, unstable stool.
- Low temperature for a long time, general irritability, insomnia.
Parents should understand that, despite the obvious manifestations of the disease, an independent diagnosis is unacceptable. Only a doctor is able to confirm cholecystitis in children. Symptoms and treatment of this disease depend on the severity of the patient's condition. The specialist, taking into account the clinical picture and based on the results of the analyzes, selects the appropriate type of therapy.
Diagnostics
First of all, the doctor talks with the patient or his parents and collects an anamnesis. Further, clinical and laboratory studies are carried out. This is a mandatory comprehensive blood test and biochemistry.
To confirm the diagnosis, an echography is prescribed. This examination allows you to determine the change in the size and thickness of the walls of the gallbladder. In addition, a violation of organ contractions is detected. In addition, it is desirable to conduct duodenal sounding and ultrasound.
Additionally, a study of bile is performed. The analysis shows a decrease in specific gravity and an increase in acidity.
Additional information on the form of the disease
It often happens that the professional speech of a doctor is not always understood by an unprepared person. For example, if a doctor informs the patient’s parents that he has a non-calculous form of cholecystitis, this means that the disease is not associated with the formation of gallstones. More simply, the infant form is called stoneless.
Treatment
Treatment of cholecystitis in children is carried out according to a certain scheme:
- Compliance with bed rest at home.
- Taking antibiotics as directed by a doctor.
- Reception of choleretic drugs.
- If necessary, receive antiparasitic drugs.
- A complex of vitamins with a high content of groups B and C.
- Taking antispasmodics to reduce pain.
- Prescribing drugs that improve liver function.
The chronic form of cholecystitis is usually treated at home, but with an exacerbation of the process, it is advisable to hospitalize the baby. The first day after an exacerbation, the child is prescribed complete starvation, and in the future, parents will have to monitor a strict diet. Children with cholecystitis are put on a dispensary account.
Dieting
It is impossible to cure a baby without following certain nutritional rules. The diet for cholecystitis in children involves boiled or steam food in crushed form. The doctor prescribes a dietary table No. 5 or 5a.
The diet should not be spicy and spicy additives, smoked meats, fatty foods and fried foods. Servings should be small, as the child should not overeat.
Sunflower oil, cottage cheese, fish and meat in steam or boiled form, fruits, vegetables or light salads from them are necessarily introduced into the diet of a small patient.
Preventive measures
All parents want to see their kids healthy. So that the child does not have cholecystitis, it is important to monitor his diet, not to let him overeat and eat enough at night. You can not give your child popular snacks in the form of snacks, crackers and chips. It is advisable to adhere to regular fractional and frequent meals.
Children must definitely lead an active lifestyle. This will help to avoid not only cholecystitis, but also many other problems. Morning exercises, sports groups, hiking, outdoor games - a normal pastime for a healthy child.
Try not to allow, or at least just in time to identify other gastrointestinal infections and diseases, as everything is interconnected in the body.
Take preventive treatment for helminth infections if you suspect that a child could have caught parasites in kindergarten, school, home, or in a common sandbox in the yard.
As directed by your doctor, take choleretic drugs and mineral water. And most importantly - monitor the condition of your child, because it is simple to miss the onset of the disease or its exacerbation, but treating is quite difficult. Subsequently, even surgery may be recommended to the baby.