Cholelithiasis (GSD), also known as cholelithiasis, is a serious disease characterized by the formation of stones (calculi) in the gallbladder and ducts. This is a common, complex developing disease that does not manifest itself at all in the first 5-10 years.
What to do? How to detect it? Are there any specific symptoms? How it to treat and what forecasts can be? Well, there are many questions and all relevant. So now is the time to answer them.
Etiology
Cholelithiasis, like many other pathologies, is not sufficiently studied. Modern physicians know only about some factors of an exogenous and endogenous nature that increase the likelihood of its formation.
According to statistics, women develop cholelithiasis on average 3-5 times more often than men. As a rule, most often stones begin to form in women who have given birth to several children.
Scientists also claim that people with picnicphysique (full). Approximately 2/3 of people with gallstone disease are overweight.
In addition, congenital anomalies are a provoking factor, due to which the outflow of bile is difficult. These include hepaticocholedochal cyst, stenosis, duodenal diverticula, etc. Of the acquired diseases, the risk of developing cholelithiasis increases cirrhosis of the liver and chronic hepatitis.
More doctors assure that nutrition also plays an important role. Most often, cholelithiasis is formed in people who consume food with a high content of animal proteins and fats.
Types of gallstones
These specific neoplasms have a classification. And before moving on to consider the symptoms and treatment of gallstone disease, it is worth studying it. So, there are the following types of stones:
- Cholesterol. Most common. Cholesterol not processed by the body makes up either most of them, or all of them. They are soft, large, crumble easily, have a layered structure.
- Black pigment stones. They occur in 10-25% of cases in residents of the United States and Europe, but in Asia this figure is much higher. They are small and fragile. They consist of calcium bilirubinate or its polymer-like compounds with impurities of mucin-glycoproteins and copper. They have absolutely no cholesterol. Usually seen in people with cirrhosis of the liver and chronic hemolytic conditions. Often migrate to bile ducts.
- Brown pigment stones. Consist of calcium s alts with impurities of protein, cholesterol and a small amount of cytoskeletonsbacteria. Formed both in the bladder itself and in the ducts.
Pigment stones are formed due to a violation of acidification. Bile is supersaturated with calcium phosphate and carbonate, causing bilirubin to precipitate and form stones. But, by the way, people with black pigment stones do not have problems with the motor function of the gallbladder.
Symptoms
As mentioned at the very beginning, the process of development of cholelithiasis lasts a very long time. It can take 5-10 years from the moment the stones begin to form to the initial signs of manifestation.
The fact is that stones do not disturb a person at all. Pain can manifest itself only if stones enter the bile ducts. They will be injured because of this, and the person will, of course, feel discomfort.
But in general, the first symptoms of gallstone disease include the following manifestations:
- Inflammation of the oral mucosa.
- Appearance of yellowness of the skin.
- Inflammation of the connective tissue membrane of the eyeball.
- Unpleasant sensations in the right hypochondrium, manifested by colic. This is due to the fact that the stone moves along the bile ducts.
- Frequent burping, persistent nausea and heaviness in the abdomen even after eating a light meal.
- Bitterness in the mouth.
Then other signs begin to show themselves:
- Hepatic and biliary colic. Pain occurs in the right hypochondrium and is given to the neck, sternum, forearm, lower back, arms and shoulder blade. especiallyfelt after eating fatty, fried, spicy, s alty and spicy. Also a provoking factor is alcohol, stress, shaking the body and physical activity.
- Vomiting, often with bile. It doesn't get any easier for a person after it.
- Diarrhea or constipation, bloating.
- Severe malaise and weakness.
Also, symptoms of gallstone disease include excessive sweating and fever (37-38.5 ° C), colorless feces, cramps and dull pain in the liver.
Complications
If you do not pay attention to an attack of gallstone disease in time, then you can pay for it. Complications are serious, and here is what they most often manifest themselves in:
- Cholecystitis. This is an inflammation of the gallbladder, which is manifested by constant pain in the upper right side of the abdomen and fever. With cholecystitis, the bile duct is heavily clogged. There is a risk of occurrence and development of dangerous infections.
- Cholangitis. This is inflammation of the bile ducts. It occurs due to the penetration of infection into them straight from the bladder, blood vessels and intestines. It manifests itself in elevated temperature and an increased number of white blood cells. May cause liver abscess or sepsis.
- Acute biliary pancreatitis. Disease of the pancreas, starting which can lead to death. It manifests itself in frothy mushy stools, severe pain in the upper abdomen, dehydration and severe weakness.
- Fistulas. These are unnatural channels that form between organs. Showing severe painand digestive disorders.
- Peritonitis. This is the name of inflammation of the serous cover of the abdominal cavity, which manifests itself in a general deterioration in the condition of the whole organism.
- Toxic hepatitis. Serious inflammatory liver disease, manifested by symptoms of intoxication. Specific signs include dark urine, sudden pain in the right hypochondrium, nosebleeds.
The most severe consequence of gallstone disease of the gallbladder is cancer of the gastrointestinal tract.
Worse
Exacerbation of cholelithiasis, as a rule, manifests itself in dyspeptic syndrome. That is, in a functional disorder of intestinal digestion, which is accompanied by belching, nausea, vomiting, bloating, a feeling of heaviness, as well as severe pain in the epigastric region and discomfort in the intestines.
Clinical manifestations during exacerbation of gallstone disease depend on the development of complications and on the presence or absence of blockage of the ducts.
The last case is especially dangerous. Because blockage usually leads to dropsy, and this is accompanied by terrible pain. Also, an infection usually joins this disease, as a result of which not only the general condition of the patient worsens, but also the composition of the blood changes. In such cases, there is an increase in the erythrocyte sedimentation rate and leukocytosis. So it is better to respond to pain in gallstone disease and not be afraid of treatment, otherwise the consequences can be disastrous.
Stagnation of bile
A few words should also be said about this phenomenon. After all, it often becomes the cause of gallstone disease of the gallbladder.
Stagnation, of course, contributes to a sedentary lifestyle, pregnancy, excessive fullness, as well as clothing that compresses the liver or restricts the movement of the diaphragm. All this affects the bending of the bile ducts.
When stagnation occurs, in addition to the formation of cholelithiasis, the following consequences also arise:
- Decreased activity of the intestinal enzyme lipase.
- Inadequate breakdown of fats and their entry into the bloodstream, as a result of which the transformation of glucose into glycogen is difficult. This, by the way, is fraught with the development of diabetes.
- Reducing the amount of cholesterol excreted from the body. It not only forms the notorious stones, but also accelerates the development of atherosclerosis and provokes hypercholesterolemia.
- Inflammation of the gallbladder, the appearance of acute and chronic cholecystitis.
- Gastritis.
- Sclerosing cholangitis.
- Increased intestinal acidity.
- Local necrosis of the parenchyma.
After all, an attack of gallstone disease is not the worst consequence. If stagnation occurs, the toxicity of conjugated metabolic products increases significantly. The body is simply poisoned.
Operation - problem solving
Let this be a radical method, but the most effective one. With its help, you can definitely get rid of gallstone disease. The operation is aimed at removing the container for calculi and eliminating the likelihoodoccurrence of repeated colic.
It can also be used to prevent the occurrence of such consequences as peritonitis, cholangiogenic sepsis and obstructive jaundice. The operation is considered safe, and the chance of a complete recovery after it reaches 95%. It is shown under the following conditions:
- The stones are larger than 1 cm in diameter.
- There is not one stone - there are many of them.
- The calculi are formed by bilirubin s alts and s alts or have a mixed origin.
- Gallbladder "off".
- The location of the calculi threatens with an early blockage of the ducts.
- A person has diabetes.
- A patient was diagnosed with a "porcelain" gallbladder - its walls seem to be encrusted with calcium s alts.
For cholelithiasis and stones in the bladder, the operation can be performed in two ways.
The first one is abdominal. The person is given general anesthesia and a large incision is made in the anterior wall of the abdomen. So surgeons get the opportunity to feel and examine all the ways of excretion of bile, to take x-rays and ultrasound.
The second one is laparoscopic. Several small incisions are made on the wall of the abdomen, and the progress of the intervention is monitored through a fiber-optic device connected to a monitor. However, there are many contraindications. However, the doctor will still determine the method of the operation, taking into account all the individual characteristics of the patient.
Diet
Every patient needsobserve a special diet for cholelithiasis. Detailed recommendations are prescribed by the doctor, but here are the foods that you definitely need to exclude from the diet:
- Butter dough and white bread.
- Fried pies.
- Smoked meats and sausages.
- Meat broths.
- Sour and unripe fruits, spinach, sorrel, parsley.
- Fatty dairy and meat products.
- Pasta.
- Soda, coffee, alcohol.
Diet for gallstones and bladder stones allows the use of the following foods:
- White crackers and black rye bread.
- Chicken eggs and butter.
- Fish and lean meats. These include river fish, chicken, beef and rabbit.
- Cereals: oatmeal, wheat, buckwheat, rice, semolina.
- Weak tea without sugar, puddings, fruit compotes, mousses and jelly.
Can I have dairy products with cholelithiasis? Yes, but only fat-free. Soups are allowed, but without meat and exclusively on vegetable broth. It must be remembered: everything fatty, heavy, s alty, spicy and spicy provokes a contraction of the gallbladder and the movement of stones. And this entails blockage of the ducts.
Medicated treatment
It can be effective for cholelithiasis, but only if the patency of the cystic duct and its contractility is preserved, and the size of the stones is less than 15 mm. As a rule, the doctor prescribes such drugs:
- "Allohol". Choleretic drug, which is based on natural ingredients -activated charcoal, garlic, nettle. Has an extensive effect - stimulates the production of bile acids, eliminates stagnation and intoxication, relieves inflammation of the bladder and ducts.
- "Urolesan". The composition includes spruce and mint oil, extract of hop cones and wild carrot fruits. Increases bile production and stimulates its excretion.
- "Holosas". Its basis is sugar and rose hips. In addition to the effects listed above, it improves intestinal motility.
- "Berberine bisulfate". It is an alkaloid isolated from barberry leaves. The drug stimulates the outflow of bile.
- "Flamin". The main component is sandy immortelle flowers. Has antibacterial, anti-inflammatory and choleretic effect.
- "Holagol". Contains magnesium salicylate, eucalyptus and peppermint oils, as well as frangulamodine and turmeric root pigments. The drug not only stimulates the production and outflow of bile, but also disinfects it.
Every drug has contraindications. Treatment of gallstone disease with their help can only be started if the doctor has allowed it.
Folk remedies
Most doctors are skeptical about them. With cholelithiasis, especially in advanced stages, folk remedies are unlikely to help. But as a preventive measure, they can be useful. Here are some easy recipes:
- In equal amounts (1 tbsp each), mix sandy immortelle, chamomile, corn columns with stigmas, fennel,dandelion, wormwood, calendula, tansy, peppermint and great celandine. Pour 10 grams of the resulting collection with a glass of boiling water and send for 15 minutes in a water bath. Then cool, strain and dilute with clean water to 200 ml. Drink the resulting volume per day in three doses (each time before meals). Prepare this concoction every day.
- Two tablespoons of dried birch leaves pour a glass of boiling water and boil over low heat until half of the water has evaporated. Then cool and strain. Drink one dessert spoon three times a day one hour before meals. The course lasts 3 months.
- Carrot seeds (3 tablespoons) pour three glasses of water. Send at least 6 hours in the oven. Drink this amount in three doses per day.
- Make fresh black radish juice. Mix in a 1:1 ratio with honey. Drink 3 tablespoons daily. It is recommended to stretch this volume into 3 doses - morning, afternoon and evening.
- Blackcurrant berries (fresh or frozen) and liquid honey are thoroughly mixed in equal proportions. It is advisable to beat the mass with a blender. Take once a day for a teaspoon half an hour before meals. The course is 2 months minimum.
- 30 grams of fresh or frozen rowan pour three cups of boiling water. Let it brew for 10 minutes, then crush the berries and leave for some more time. Drink one glass three times a day.
Also, with cholelithiasis, it is recommended to drink such waters as Essentuki (No. 17 and No. 4), Borjomi, Smirnovskaya, Slavyanovskaya. An excellent prevention is an active lifestyle, the rejection of cholesterol-containingfoods and maintaining a normal body weight.
