Abdominal pain is a common symptom of many diseases of the digestive system. One of the pathologies is gallbladder dyskinesia - the disease is relatively harmless, but greatly impairs the patient's quality of life.
Quick reference
Dyskinesia of the gallbladder is a disease that is characterized by a violation of the transport function and tone of the gallbladder, as well as its ducts that excrete bile. In this case, there is an insufficient amount or an excess of bile, its stagnation. This condition is not fatal, but significantly worsens the patient's well-being and threatens the development of other pathologies.
Code of gallbladder dyskinesia according to ICD-10 - K82.8.0.
Types of biliary dyskinesia
Dyskinesia can be primary or secondary, hypertonic or hypotonic in nature. Primary and secondary pathologies differ depending on the causes. The hypotonic type of gallbladder dyskinesia is characterized by stagnation of bile due to a decrease in the contractile activity of the bile ducts. Hypertensivedyskinesia is characterized by an increased tone of the gallbladder.
Causes of primary dyskinesia
The most common causes of gallbladder dyskinesia (primary) are:
- frequent acute or chronic stress, malfunctions of the nervous system (vegetative);
- eating disorders: constant consumption of poor quality, too "heavy", fatty, spicy or smoked foods, overeating, irregular meals, insufficient chewing of food;
- low mobility coupled with underweight, muscle weakness;
- allergic diseases of various kinds that, by affecting the bile ducts and bladder, cause constant tension.
Causes of the secondary form of the disease
Secondary dyskinesia, as a rule, appears against the background of already existing diseases or pathological conditions. Common causes are as follows:
- gastric ulcer, duodenitis, colitis, gastritis, enteritis;
- cholecystitis, cholelithiasis, hepatitis, biliary tract inflammation;
- inflammatory processes in the peritoneum, which are chronic;
- any inflammatory diseases of the gastrointestinal tract that are caused by pathogenic microorganisms;
- congenital malformations of internal organs;
- endocrine disorders (estrogen deficiency, obesity, hypothyroidism, etc.);
- parasites in the bile ducts and gallbladder.
Symptoms of hypotonic dyskinesia
Signs of gallbladder dyskinesia depend on the type of disease,activity of the organ and its ducts. The main symptom of the disease according to the hypotonic type is pain that occurs in the right hypochondrium. Discomfort is prolonged, has a aching character. Pain with dyskinesia of the gallbladder does not have a specific localization, increases after eating.
Involuntary release of gases into the oral cavity, that is, belching, occurs in patients after eating, and can also occur between meals. Appears due to the fact that the regulation of the work of the bile from the nervous system is disturbed, as a result, when swallowing, the patient captures air.
Some patients complain of nausea and bouts of vomiting. Vomiting may be mixed with bile, which indicates the reflux of bile into the stomach. There are symptoms after eating and after breaking the diet, that is, eating too fatty foods, overeating, and so on.
Gallbladder dyskinesia of the hypotonic type is often accompanied by bitterness in the mouth. Basically, bitterness occurs in the morning, after exercise (physical) at the next meal. It occurs due to relaxation of the sphincters of the gastrointestinal tract and impaired motor movement, as a result of which food moves back.
Flatulence, or bloating, a feeling of fullness is often accompanied by pain that subsides after the gas passes. Patients also complain of decreased appetite. Bile is a stimulant for intestinal hormones, intestinal motility and appetite, so a lack of it can be accompanied by its absence.
Rarely among the symptoms of gallbladder dyskinesia are calledindigestion, manifested in diarrhea. Occurs some time after eating. More often, constipation occurs with a disease. This symptom of gallbladder dyskinesia is characterized by regular insufficient bowel movements or the absence of stools for 48 hours or more.
With long-term dyskinesia without treatment (a chronic form of the disease), many patients are obese. Due to stagnation of bile, the digestion process is completely disrupted, the amount of fat increases, splitting slows down, as a result, fats accumulate in the subcutaneous fat.
The list of symptoms includes disorders of the nervous system. Characterized by a decrease in blood pressure, sweating, a decrease in the number of heart contractions, salivation, redness of the skin (hyperthermia is noticeable on the face).
Signs of hypertensive dyskinesia
With dyskinesia of the gallbladder of the hypertonic type of pain, there are more intense, cramping in nature. There is discomfort and pain, as a rule, against the background of physical discomfort, nervous strain, and dietary errors. The attack lasts from 20 to 30 minutes, it can be repeated several times during the day. Often the pain radiates to the arm or shoulder blade on the right side. In some cases, the pain repeats an attack of angina pectoris, giving to the left. Between attacks, the patient has a feeling of heaviness under the ribs (right).
Also characterized by decreased appetite and weight loss. Nausea and vomiting often accompany an attack; outside an attack, such signs, as a rule, are completely absent. Athypertensive dyskinesia of the gallbladder often develops diarrhea, a disorder occurs a short time after eating, or accompanies an attack.
Characteristic for many patients are symptoms of disorders in the nervous system. Sleep disturbances, irritability and fatigue appear. There may be a headache, increased blood pressure, increased frequency of contractions of the heart muscle, sweating. Some patients complain of aching pain in the region of the heart.
Symptoms for all forms of the disease
As with hypertonic and hypotonic dyskinesia of the gallbladder, yellowness of the skin, mucous membranes, and whites of the eyes may appear. The symptom develops quite rarely, is the result of a violation of the outflow of bile. At the same time, stool becomes colorless, and urine takes on a dark shade. Plaque on the tongue is not a specific sign of dyskinesia, as it can also appear with some other diseases, such as gastritis or colitis. The plaque may be yellowish or white.
Diagnosis
The following methods are used to diagnose gallbladder dyskinesia:
- Ultrasound, which can be used to determine the presence of congenital anomalies, the degree of emptying of the bladder, its shape;
- a blood test that allows you to determine the presence of an inflammatory process in secondary dyskinesia;
- blood biochemistry can diagnose bile stasis, pancreatitis, inflammation, fat metabolism disorders;
- cholecystography to study the excretory and storage functions of the bilebubble, its structure and presence of stones;
- infusion cholecystography to determine sphincter tone;
- cholangiography with the introduction of a contrast agent for the study of the bile ducts;
- duodenal probing to study the function of the gallbladder, bile and so on.
Hypotonic type treatment
The main task of treating gallbladder dyskinesia is to fight parasites and infections, inflammation, improve the activity of the gastrointestinal tract and the outflow of bile. The approach to drug treatment varies depending on the type of dyskinesia. In hypotonic patients, choleretics, tonic drugs to improve the functions of the nervous system and tubeless tubes are used.
Use of choleretics
Choleretics are substances that stimulate the synthesis of bile. "Holenzim", for example, contains acids, pancreatic enzymes. Take the drug should be one tablet three times a day after meals. The course of treatment lasts two to three weeks. The medicine improves the contractile and transport functions of the gallbladder and bile ducts, normalizes digestion, promotes the absorption of the maximum amount of nutrients from food. The drug stimulates the synthesis of bile.
"Aplohol" contains nettle leaves, bile and garlic. It is recommended to take the medicine one to two tablets after meals three or four times a day. The course of therapy is one to two months. The drug also stimulates the production of bile, eliminates or reduces the processes of decay in the intestines,improves the transport function of the digestive system.
"Holiver", which contains turmeric, artichoke seed and bile, is recommended to take two to four tablets after or during meals. The recommended duration of therapy is ten to twenty days. The drug protects the liver from toxins, removes cholesterol from the blood, improves the movement of food through the digestive tract and digestion in general, stimulates the production and excretion of bile.
Tonic drugs
To normalize the activity of the nervous system, tonic drugs are used, such as eleutherococcus, ginseng. The first drug should be taken twenty to thirty drops thirty minutes before meals up to twelve hours during the month. The second should be drunk 15-25 drops three times a day thirty minutes before meals, 30-40 days is the course. Such drugs increase blood pressure, physical and mental performance, reduce fatigue and drowsiness, improve the body's ability to adapt to environmental conditions, and stimulate the adrenal glands.
Probeless tubes
Tubeless tubes (allowed only between exacerbations of gallbladder dyskinesia) are mineral water (still), Xylitol, magnesium sulfate, Sorbitol. Dissolve the drugs in 0.5 cups of water and drink the solution for ten minutes in several small sips. Then it is recommended to lie down on the right side on a heating pad for half an hour. The procedure should be repeated approximately once every seven to ten days. The course of therapy consistsof six to eight treatments.
Therapy for hypertensive dyskinesia
In hypertensive dyskinesia, cholekinetics are used - drugs that lower the tone of the biliary tract. Also shown are antispasmodics that relax the tone of the sphincters. These drugs reduce the intensity of pain. Sedatives are used to normalize the nervous system.
Cholekinetic treatment
Patients for the treatment of gallbladder dyskinesia (hypertonic type) are often prescribed "Oxaphenamide". You need to take the medicine 1-2 tablets thirty minutes before meals. The course is 15-20 days. The drug enhances the synthesis of bile and accelerates its excretion, reduces the content of leukocytes in bile, reduces the amount of cholesterol in the blood, and reduces discomfort during attacks.
Gepabene is also used. The medicine contains a dry extract of fumes officinalis. Consume one capsule three times daily for a minimum of two weeks. For pain at night, you can take one capsule at night. The drug reduces the synthesis of bile, stimulates its discharge, protects liver cells from toxins.
Anspasmodics to reduce pain
Anspasmodics relax sphincter tone and reduce discomfort. Courses (for less development of seizures) are assigned "Gimekromon". You need to drink one or two tablets thirty minutes before meals three times a day. The course lasts two to three weeks. The drug improves the excretion of bile, relaxes the muscles of the biliary tract and reduces pressure in the ducts.
"Papaverine", "Drotaverine","No-shpa" contain different active substances, but have a similar mechanism of action. With severe pain, intramuscular injections of 2 ml are prescribed twice a day. After pain relief, it is recommended to take the tablets orally. Take two tablets two to three times a day.
In case of severe pain, the patient may be prescribed narcotic drugs for gallbladder dyskinesia. "Promedol", for example, is administered by intramuscular injection of one milliliter twice or thrice a day. This substance disrupts the transmission of nerve impulses through the central nervous system.
Sedatives
Sedatives are used to correct the nervous system. In powders, tablets or mixture, potassium or sodium bromide is prescribed. Powder should be used once a day (two sachets), tablets - three to four times a day (one or two tablets at a time). The duration of therapy is two to three weeks. Medicines have a calming effect, restore the natural balance between the processes of excitation and inhibition. Valerian or motherwort tinctures also reduce the excitability of the nervous system, normalize the heart rate, improve the functioning of the heart and blood vessels, have a mild hypnotic effect, and return blood pressure to normal limits.
Other Therapies
For both forms of dyskinesia, physiotherapeutic procedures are recommended: laser therapy, paraffin applications, electrophoresis. Be sure to carry out therapy for diseases that led to dyskinesia. Outside of exacerbations, that is, during remission, mineral waters are used, alsotreatment in sanatoriums is recommended.
Diet food
Indicated for dyskinesia of the gallbladder nutrition medical, dietary. The diet is prescribed for a long period of time, its duration is at least three to four months. The main purpose of such nutrition is the normalization of the function of the gastrointestinal tract and biliary tract. The diet for gallbladder dyskinesia suggests that during an exacerbation they are completely excluded:
- Alcoholic drinks, soda, black coffee, cocoa.
- Foods that increase the formation of gases, that is, peas, cabbage, beans.
- Fatty broths, hot spices.
- Whole cow's milk and cream.
- Fatty meat and fish.
- Marinades and preservation.
- Any fatty, s alty, fried, smoked, spicy or sour food.
- Confectionery, rolls, any muffin.
Eat should be in small portions, but often. Products need to be boiled, steamed. In the early days of an exacerbation, it is better to eat dishes in liquid or grated form. This will no longer be necessary once the acute symptoms have subsided.
Folk methods
Alternative medicine is also used in the treatment of dyskinesia of the gallbladder and biliary tract. To relieve pain during attacks, in addition to the main therapy, decoctions of medicinal herbs are used. With hypotonic dyskinesia, it is allowed to take:
- Decoction of immortelle. A glass of boiling water will require three tablespoons of flowers. Infuse the decoction in a water bath for thirty minutes. Be sure to stir constantly. Afterremove the decoction from the stove and cool, and then strain through a strainer. It is recommended to take half a glass thirty minutes before meals. The course of treatment is 14-21 days.
- Infusion of corn stigmas. Pour a teaspoon of crushed stigmas with a glass of boiling water and leave for thirty minutes. Strain through a sieve or cheesecloth and take three tablespoons three times a day thirty minutes before meals. The course is three weeks.
For patients suffering from hypotonic dyskinesia, folk recipes are offered as follows:
- Decoction of licorice root. Two teaspoons of dry raw materials should be poured with one glass of boiled water (hot) and put on fire for twenty minutes. When the broth has cooled, strain it. You need to take a third of a glass 30 minutes before meals three times a day for 14-21 days.
- Infusion of peppermint. Pour two tablespoons of raw materials in a dry form with a glass of water and let stand for about thirty minutes, and then pass through gauze. Take a third of a glass twenty minutes before meals twice a day. The course is two to three weeks.
With both types of biliary dyskinesia, it is useful to drink a decoction or tea from chamomile officinalis. You can drink it in unlimited quantities, but, of course, within reason.
Other recommendations include feasible physical activity (but not during exacerbations), minimizing stressful situations, following the general principles of a he althy lifestyle. The patient needs to observe the regimen of the day, not to overwork, physical overload is also contraindicated, sincethey can be the root cause of the next attack. It is also advisable to completely abandon bad habits, namely smoking and drinking alcohol.
Prognosis for dyskinesia is comforting. If you follow the recommendations of the doctor, then the frequency of attacks can be significantly reduced.
