When discomfort and pain appear on the right side under the rib, it is important to recognize the cause in a timely manner. Diseases of the liver and biliary tract pose a threat to the human condition and its full-fledged life. In the absence of proper methods of treatment, ailments that affect the biliary system of the body can turn into more severe forms, bringing even the central nervous system out of failure.
How do diseases of the biliary tract manifest themselves?
At the first symptoms of the pathologies described below, you should immediately contact a specialist. To start acting, the doctor must see an objective picture of the patient's he alth, which means that it is extremely important to undergo a comprehensive examination. You can get detailed information about how affected the biliary tract is only after the first stages of diagnosis, which include:
- primary examination by a gastroenterologist;
- passage of abdominal ultrasound;
- laboratory results of blood, urine and feces.
In case of suspicion of the development of a pathological process in the biliary system of the body, the doctor, asas a rule, appoints the patient to undergo more thorough research:
- gastroscopy;
- radiography of the biliary tract with the use of a contrast agent;
- biochemical composition of bile.
In general, diseases of the biliary tract differ in their characteristic features of the course.
Their therapy largely depends on the severity of the disease, symptoms and complications available at the time of contacting specialists.
Pathological processes that can develop in the gallbladder and bile ducts are most often:
- dyskinesia;
- gallstone disease;
- cholingitis;
- various forms of cholecystitis.
Causes of dyskinesia in the biliary system
The first disease that occurs quite often in patients at any age is biliary dyskinesia. Symptoms and treatment of the disease are interrelated concepts, since this pathology is a direct functional disorder of the biliary system due to abnormal work of the sphincters of Oddi, Mirizzi and Lutkens, as well as contractions of the gallbladder.
Most often the disease occurs in women aged 20 to 40 years. To date, no specialist can unambiguously answer the causes of the development of the disease. The most likely factors that pushed the disease to progression can be considered:
- Hormonal failure (disturbances in the production of substances that affect the contractile function of the gallbladder andbiliary tract, lead to malfunction of the muscular mechanisms).
- Unhe althy diet and lifestyle.
- Frequent anaphylactic and allergic reactions of the body to food.
- Pathologies of the gastrointestinal tract, directly affecting the biliary tract. Symptoms, treatment of such ailments are concomitant problems during the treatment of the underlying disease.
- Infection with hepatitis B, C virus (pathogenic microorganisms of this type negatively affect the neuromuscular structure of the organs in question).
In addition, other diseases of the biliary tract (for example, chronic cholecystitis) can provoke dyskinesia. Diseases of the liver, pancreas, anomalies in the development of the biliary system also often lead to failure of most of the digestive organs.
How to cure dyskinesia?
Biliary tract treatment has its own characteristics. As for dyskinesia, general therapy can be divided into two blocks.
The first often includes therapeutic measures of non-drug content, for example:
- Following a diet (complete exclusion of fatty, fried, smoked, canned and other harmful products from the daily diet; drawing up a daily menu based on food rich in vegetable fiber, choleretic products).
- Drink enough fluids throughout the day.
- Active lifestyle, therapeutic breathing exercises.
- Prevention of stressful situations, disorders, experiences.
Drug treatment is a mandatory component in the treatment of such an ailment as biliary dyskinesia. The drugs that experts recommend taking to patients are mainly aimed at relieving muscle tension, providing a sedative and antispasmodic effect. The most common for dyskinesia are Papaverine, No-shpa, Novocaine. The therapeutic complex includes, among other things, the use of mineralized waters.
Features of the course of dyskinesia in children
Disease affecting the biliary tract of children is not uncommon these days. Dyskinesia is detected by doctors in children older than three years of age. By the way, experts distinguish this disease among children's pathologies of the biliary tract as often ascertained. In fact, the causes of the development of disorders in the hepatobiliary system in a child are the same provoking factors as in adults.
The danger to children's organisms is often hidden in the consequences of dyskinesia that affects the biliary tract. Symptoms of an illness in a child are often supplemented by specific manifestations of the nervous system and psycho-emotional state.
As a rule, signs of dyskinesia in children are:
- tearfulness;
- fatigue;
- decrease in concentration, performance;
- muscular hypotension;
- hyperhidrosis;
- heart rate irregularities.
Recommendations forprevention of recurrence of the disease in a child
Since the symptoms and diagnostic procedures are exactly the same for both adult patients and babies, treatment tactics will also be based on the canons of rational nutrition. It is extremely important that the child consume he althy food in accordance with a clear schedule, not only during an exacerbation of biliary tract disease or during a therapeutic course, but also for the purpose of prevention. Ideally, this style of eating should become the norm for a growing organism on an ongoing basis.
It is also worth noting that the dyskinesia detected in a child predetermines the need for him to be registered with a dispensary for periodic examination. This is the only way to prevent the development of the disease. Pediatricians call the following principles the best prevention of dyskinesia in a he althy baby:
- Eating every 2.5 hours throughout the day in fractional small portions.
- Don't Overeat.
- Lack of emotional overstrain, stress.
What is the danger of gallstone disease?
The next ailment that affects the biliary tract no less often than dyskinesia is cholelithiasis. This pathology occurs due to the formation of stones in the gallbladder and is characterized by significant inflammation in its walls. Doctors call the danger of the disease its hidden manifestations and the almost complete absence of symptoms in the early stages of the disease. During the period when it is easiest to cope with the disease, the patient cannot even assume thathis biliary tract, gallbladder need help.
With the gradual progression of the pathology, the pace of which is largely determined by the lifestyle of the patient, the first signs of the disease become noticeable. The most common of these is biliary colic, which patients almost always mistake for pain in the liver, explaining this by participating in a hearty feast the day before or drinking alcohol. Despite the fact that these factors are really capable of provoking an exacerbation of cholelithiasis, taking the symptoms lightly can be extremely dangerous for the patient's he alth. Among the complications that are threatened by untreated cholelithiasis in time, patients are diagnosed with:
- cholecystitis;
- pancreatitis;
- malignant tumors affecting the liver and biliary tract.
At Risk Group
Since the main and only reason for the formation of stones in the gallbladder and ducts is a violation of metabolic processes in the body (in particular, cholesterol, bilirubin and bile acids), it is natural that medical and rehabilitation measures will be aimed at eliminating formations.
Stones that interfere with the outflow of bile occur in women several times more often than in men. In addition, people are most at risk of developing gallstone disease:
- obese;
- leading a sedentary lifestyle;
- whose occupation determines a predominantly sitting position during working hours;
- non-observantregimen in meals.
Methods of treatment of gallstone disease
To recognize for sure whether stones are present in the patient's gallbladder, it is sufficient to conduct an ultrasound examination of the abdominal organs. To date, when confirming the diagnosis, doctors most often decide on cholecystectomy.
However, a specialist may not incline the patient to radical surgical treatment if the formations practically do not cause discomfort. In this case, experts recommend undergoing a course of treatment aimed directly at the biliary tract. Symptoms of the disease, which do not manifest themselves in any way, allow using the method of influencing the ducts with ursodeoxycholic and chenodeoxycholic acids.
Its advantage is the ability to get rid of stones in a non-surgical way. Among the disadvantages is a high probability of recurrence. A therapeutic course lasting about a year in most cases gives an imaginary, short-term result, since patients often notice the occurrence of re-inflammation just a few years after prolonged treatment.
It is also worth noting that this treatment option is only available for cholesterol stones less than 2 cm in diameter.
What is "cholangitis": its symptoms and complications
Inflammation of the bile ducts is also considered a pathological condition, the name of which is cholangitis. A feature of this disease, doctors consider its course inindependent form or concomitant with cholecystitis. The disease has different degrees of intensity and danger to the he alth and life of the patient. There are 3 main stages, based on the intensity of symptoms:
- subacute;
- spicy;
- purulent.
Symptoms of any dysfunction of the biliary tract affect the general condition of the patient in almost the same way, causing in all cases:
- chill;
- nausea and vomiting;
- excessive sweating;
- high body temperature;
- itching of the skin;
- pain in the right hypochondrium.
When examining a patient, the patient may be found to have an enlarged liver and spleen. A reliable sign of cholangitis is the yellowness of the skin, but its presence is not at all necessary. This pathology of the biliary tract, which is purulent in nature, has more pronounced signs. The patient's temperature can reach over 40 degrees. In addition, in this case, the risk of sepsis and abscess in the subdiaphragmatic region increases several times. Often, in advanced forms of the disease, doctors diagnose patients with hepatitis or hepatic coma.
Diagnosis and treatment of cholangitis
In order to definitively confirm cholangitis in a patient, additional blood tests should be carried out. A high white blood cell count, an accelerated ESR, basically always serve as indications for the following series of examinations:
- cholangiography;
- gastroduodenoscopy;
- laparoscopy.
The treatment of biliary tract in cholangitis requires the use of a number of potent drugs. The patient can avoid surgery only with an integrated therapeutic approach based on the use of medications with a different spectrum of actions. First of all, such preparations for the biliary tract are needed, which can have a choleretic effect on the diseased organ.
To relieve inflammation and suppress pathogenic microflora, antibiotics and medicines of the nitrofuran group are extremely important. If there is a painful syndrome in the right hypochondrium, the doctor may prescribe antispasmodics.
If the necessary course of treatment does not bring positive results, i.e., there is no noticeable dynamics in improving the patient's condition, the doctor can replace conservative therapy with more decisive surgical actions.
Cholecystitis during exacerbation
Against the background of the above-described cholelithiasis, such an ailment as cholecystitis often develops. It can be characterized by the inflammatory process of the walls and ducts of the gallbladder, as well as the ingress of pathogenic microorganisms into its cavity. Although, in the complete absence of stones, cholecystitis can also occur in women over 30.
Main signs of acute cholecystitis
As a rule, an exacerbation of cholecystitis, like other diseases that affect the biliary tract, occurs after the patient relaxes a strict dietary regimen. Allowing yourself even the smallest of something harmful, inhe will soon regret it. Painful symptoms of cholecystitis under the right rib, radiating to the subscapular region and supraclavicular zone, do not allow you to forget about the disease even for a short time. It should be noted that pancreatitis is considered a frequent companion of cholecystitis, the simultaneous manifestations of which cause incredible discomfort and pain in the patient.
In elderly people who have had a myocardial infarction, due to cholecystitis, pain in the retrosternal space may occur. Reflex type angina pectoris is further accompanied by nausea and vomiting. Vomit initially represents the contents of the stomach, that is, what the patient ate the day before, then only bile can be excreted.
An increase in body temperature cannot be considered an obligatory symptom of cholecystitis. The absence of fever does not indicate the absence of inflammation. Palpating the abdomen, the doctor in most cases notes the tension of the abdominal muscles, the pain of the gallbladder, which becomes more and more like a small ball in the right hypochondrium. The liver also begins to increase in size. A characteristic feature of acute cholecystitis are jumps in blood pressure. A couple of days after the discovery of the disease, the skin may turn yellow.
Different degrees of severity of cholecystitis
Acute cholecystitis has main stages:
- Fever of the body is not characteristic of the catarrhal phase of the development of the disease. If there is pain, then it is quite moderate. The entire period lasts no more than a week, and most often it is possible to detect the disease at this stage by accident. It is quite possible to stop the progression of the disease at this stage if treatment is started immediately, preventing the onset of phlegmonous cholecystitis.
- The second stage of the development of the disease is characterized by pronounced pain, frequent vomiting, high fever, general weakness of the body. The patient's appetite is noticeably reduced due to leukocytosis that has arisen against the background of pathology.
- The most dangerous stage of the disease for the patient is gangrenous. Such an ailment is often accompanied by peritonitis, which has no treatment options other than emergency surgical intervention. Statistics show a high probability of death without an urgent operation.
One of the most common causes of belated recognition of cholecystitis is its manifestations, in most cases characteristic of other ailments of the abdominal organs. For example, they can also declare themselves:
- acute appendicitis;
- exacerbation of pancreatitis;
- gastric and duodenal ulcers;
- renal failure, colic, pyelonephritis.
Treatment of cholecystitis
As already mentioned, absolutely all research indicators play a role in making a diagnosis. If the bile ducts are full of stones, an ultrasound will definitely tell about this. The fact that an inflammatory process is taking place in the body will be confirmed by an overestimated number of leukocytes in a biochemical blood test.
It is necessary to treat diseases affecting the biliary tract or gallbladder only in a hospital setting. conservative methodstherapy can improve the patient's condition. He is prescribed strict bed rest, no meals. For pain relief, an ice pack is provided under the right hypochondrium.
Before starting drug therapy, a complete detoxification of the patient's body is carried out, after which he is prescribed antibiotics. Lack of results during the day requires urgent intervention of surgeons.
What to change in nutrition for diseases of the biliary tract?
Diet in diseases of the biliary tract plays an important predetermining role. As you know, during periods of attacks, it is forbidden to consume anything, since the naturally occurring release of bile as a reaction to incoming food can increase the symptoms of the disease.
During remission, it is extremely important to follow a proper diet and eat according to a strict schedule. Food itself is the best choleretic agent, so you need to eat at least 4-5 times a day. The main thing is to exclude any, even the lightest snack at night.
Adhering to the following tips from nutritionists and gastroenterologists, you can achieve the longest possible remission:
- It is undesirable to eat fresh wheat bread, especially only baked, hot. Ideally, if it is dried or yesterday.
- Hot meals have a positive effect on the general condition of the digestive system. Do not sauté onions, carrots, etc. during cooking.
- Meat and fish to choose only low-fat varieties. Ideal cooking methodis stewing, boiling and baking.
- Any oil of vegetable or animal origin is not forbidden to use in small quantities, but in the absence of heat treatment.
- In diseases of the biliary tract, the best cereal products are buckwheat and oatmeal.
- Milk and sour-milk drinks, as well as cottage cheese, can be consumed.
In any case, at the first manifestations of the disease, you should go to the doctor, self-treatment of the patient risks aggravating his condition.
