The diagnosis of "cholelithiasis" (GSD) is made to the patient when diagnosing the presence of stones in the gallbladder. The number, composition and size, their exact location may be different. According to statistics, in developed countries, 20% of the female population and 10% of the male population suffer from this disease. It is necessary to recognize the symptoms of cholelithiasis and clarify the diagnosis as early as possible so that the patient can adhere to certain dietary 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
GSD disease occurs due to a disorder in the production and circulation of bile in the body, a violation of the metabolism of cholesterol and bilirubin, resulting in the formation of stones.
Depending on the location of the stones, there are 2 types of disease:
- Cholecystolithiasis, or gallstone formation.
- Choledocholithiasis - stones in the bile ducts.
The formation of stones comes from-for sedimentation of cholesterol, bile pigments, calcium s alts, proteins, as well as due to infection and stagnation of bile, lipid metabolism disorders.
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, fistulas are formed. If the treatments used do not have the desired effect, then surgery is required.
Risk factors for cholelithiasis in patients:
- genetic predisposition from mother;
- malnutrition (starvation, obesity, high cholesterol, etc.);
- old age;
- taking medications that affect the metabolism of cholesterol or bilirubin (estrogen during menopause, fibrates, ceftriaxone);
- multiple pregnancies;
- diseases associated with metabolic disorders (diabetes, metabolism, fermentopathy);
- diseases of the gastrointestinal tract (GIT);
- state after surgery.
Causes of gallstone disease
Solid formations are formed in the human body with violations in the amount 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 compliance with the doctor's recommendations.
The most common reason for the formation of stones is the high content of cholesterol in bile, whichcalled lithogenic.
According to scientists, there are 3 main causes of stone formation:
- Stagnation of bile due to a mechanical obstruction to the normal process of its outflow or in case of functional impairment and biliary motility disorder (dyskinesia, etc.);
- Inflammatory process in the walls of the gallbladder due to infection, allergic reactions;
- Metabolic disorders, the formation of an imbalance between phospholipids, cholesterol and bile acids.
Calculations or stones formed in the gallbladder can be classified according to 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.
Stages of cholelithiasis: symptoms and treatment
The modern classification of this disease divides it into stages:
- initial (pre-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) occurs asymptomatically, latently, they can only be seen with ultrasound diagnostics;
- clinical stage - characterized by the appearance of symptoms of acute or chronic cholecystitis.
Some experts also distinguish the 4th stage, which is manifested by the development of complications.
Clinical manifestations of gallstone disease
Symptoms of cholelithiasis depend on the size and location of stones, the presence of an inflammatory process, adherence to dietary rules and other factors.
The following negative signs are possible:
- bitterness in the mouth after eating fried or fatty foods;
- drawing pains in the right side, which sometimes radiate to the back in the region of the scapula;
- flatulence, heartburn, signs of general weakness;
A characteristic and definite symptom of cholelithiasis is an exacerbation in the form of biliary colic, which is manifested by attacks of acute pain in the stomach or in the right hypochondrium, which can last up to several hours. At the same time, the patient also experiences repeated vomiting, after which there is no relief.
The following reasons can provoke biliary colic:
- eating fatty, spicy or fried foods, alcohol;
- nervous stress, overwork;
- work for a long time in an inclined position (when washing clothes, etc.);
- jumping, bumpy car ride.
The appearance of seizures is a reason for going to the doctor and further examination in order to clarify the diagnosis.
Diagnostics of cholelithiasis
To clarify the diagnosis when the above symptoms of gallstone disease appear, you should consult a gastroenterologist and undergo the following examinations:
- external examination, palpation of the abdominal wall andbubble;
- blood test for inflammation (increased leukocytes and ESR);
- blood biochemistry - will determine the level of cholesterol and bilirubin, high activity of phosphatase;
- Ultrasound examination in the abdominal region, which shows the presence of stones, the condition of the walls of the gallbladder, signs of cholecystitis;
- MRI or CT of the biliary tract - also provide information on the presence of cholelithiasis;
- endoscopy and X-ray examination.
Possible exacerbations of gallstone disease:
- acute cholecystitis - an inflammatory process of the bladder mucosa that occurs when a duct is blocked by a stone - is dangerous because it can turn into peritonitis;
- inflammation of the gallbladder;
- cholangitis - connects the inflammatory process in the ducts;
- choledocholithiasis - movement of stones into the bile ducts;
- narrowing of the gaps due to scarring after inflammation;
- appearance of biliodigestive fistulas, holes between the walls of the duct and intestines;
- dropsy gallbladder when it fills with mucus that interferes with the flow of bile.
JSD attack: symptoms, what to do
Most often, colic occurs in the evening or at night, the pains are felt as cutting, stabbing, occasionally pressing or dull. They can give to the neck, shoulder, right eye, forehead or jaw. Sometimes the pain migrates to the heart area, causing an angina attack.
Main symptoms of biliary colic:
- acute prolonged pain, the patient turns pale and screams from acutepain, possible shock;
- nausea and vomiting with leftover food and bile;
- bloating, excessive 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 reason for such severe pain is the 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, stretching your legs and relaxing: if the patient is alone in the apartment, it is advisable to call friends or relatives for help;
- take antispasmodic drugs to relieve pain and spasms of the gallbladder: "No-shpy", "Baralgina", Papaverine and others;
- with dry mouth it is better to drink pure water, but not tea or herbal decoctions;
- nothing to eat for 12 hours, even after the end of the attack;
- with gallstone disease it is recommended to put a warm heating pad in the area of the right hypochondrium;
- with exacerbation of chronic cholecystitis, put a cold heating pad so as not to cause peritonitis.
If it is not possible to stop the attack on its own in 20-30 minutes, then the patient needs urgent medical care and hospitalization.
Treatment of cholelithiasis
If a patient is diagnosed with gallstonedisease , then the doctor recommends a diet and the use of expectant tactics. In case of unfavorable development of the disease, frequent attacks, a surgical operation is recommended. With symptoms of gallstone disease, treatment can also be carried out using techniques to remove stones:
- dissolution of stones under the influence of special acid-containing preparations;
- Using shock wave therapy to crush 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 still continue.
Surgery (or cholecystostomy) is indicated for the patient in case of severe attacks of acute cholecystitis and a large number of stones. During the operation, the gallbladder itself is removed along with the stones. It can be carried out in 2 ways:
- open surgery under general anesthesia;
- laparoscopic intervention, which is more gentle for the patient's body.
Proper nutrition for gallstone disease
It should be strictly observed in order to prevent exacerbation and the appearance of negative symptoms in the treatment of gallstone disease, diet. It is she who is considered the most important factor, the purpose of which are:
- stimulating the release of bile from the bladder;
- normalization of the liver and pancreas;
- facilitate the functioning of all organs of the digestive tract;
- avoid gallbladder spasms.
Basic requirements for preparing and eating diet food:
- eating small meals 5-6 times a day;
- all foods must be boiled, steamed, stewed or baked;
- the temperature of the food consumed should be +37-+40 °С;
- eliminate foods high in cholesterol from the diet: fatty, fried, spicy, smoked, etc.;
- consume at least 1.5-2 liters of water per day (without gas);
- prefer cereals containing coarse fibers and foods with he althy fatty acids.
Diet: do's and don'ts?
Allowed products to eliminate the unpleasant symptoms of gallbladder gallstone disease and maintain the normal condition of the patient:
- lean meat (chicken or turkey, rabbit, veal);
- sea fish (pollock, hake, halibut);
- protein omelets;
- vegetable oils (olive, flaxseed, sunflower), butter are allowed only in remission;
- cereals (oats, rice, buckwheat);
- vegetable soups or broth only weak;
- wheat bread croutons;
- baked fruits and vegetables;
- honey - only in small portions;
- skimmed 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.
Forbidden foods that can cause a gallbladder attackcolic or negative symptoms in the treatment of gallstone disease (according to patients, this happens when the diet is violated):
- lard 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;
- bread and durum pasta;
- seasonings, vinegar, spices and sauces containing them.
Treatment of gallstone disease by folk methods
Many patients, in addition to dieting, try to improve their condition and prevent seizures by using herbal decoctions and infusions. To exclude unpleasant symptoms and treat gallstone disease with folk remedies, you should definitely seek the advice of 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:
- 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 clotting, so it should not be used by people suffering from a tendency to form blood clots.
- Infusion of seedsdill 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 r. per day.
- Treatment with chaga mushroom (birch): pour a piece of raw material with warm water and put for 3-4 hours, after softening, grate or grind, pour water +50 ° C in a ratio of 1:5, leave for 2 days, filter. Drink 1 tbsp. up to three times a day.
- Decoction of sunflower root: to prepare it, you need to dig up a ripe root, clean 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 decoction take 1 tbsp. dry roots, add 3 liters of water and boil for 5 minutes. During the day, drink 1 liter of solution in portions, store in the refrigerator. After 3 days, the remaining roots can be boiled in 3 liters of water again, but it should be boiled for 10 minutes, for the 3rd time - 20 minutes. The duration of treatment is 2 months, which will require 7 tbsp. dry roots.
- Decoctions of horsetail, shepherd's purse, herbal collection (yarrow, immortelle, rhubarb root) and other herbal remedies are similarly used.
For the treatment of cholelithiasis, many doctors recommend drinking bicarbonate and sulfate-sodium mineral waters: "Essentuki" (No. 1 and 17), "Mirgorodskaya", which contribute to the separation of bile. You can use them only in a warm state while maintaining a diet. The course of treatment lasts 4-6 weeks, it is allowed to carry it out only if there are no attacks of the disease for 2 months.
Prevention of the development of cholelithiasis
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 activities will become important prevention factors, which include:
- fractional meals every 3-4 hours, which helps to regularly remove the remaining bile from the bladder;
- following a special diet, weight normalization;
- increased physical activity and physical activity;
- don't starve;
- drink fluids at least 1.5 liters per day;
- avoid working in an inclined position, which can provoke the movement of stones;
- when symptoms of gallbladder disease appear in women, it is recommended to reduce the intake of estrogen hormones in the body, which contribute to the growth of stones;
- consume 1-2 tsp daily. olive oil, it can be used for frying and added to the diet;
- increase the intake of magnesium and zinc, which stimulate the intestines and the production of bile enzymes;
- refuse to drink coffee, which affects the contractions of the bladder, this threatens to block the duct and develop an attack.
Despite the negative symptoms, gallstone disease is not a sentence for the patient, but only a reason to be more attentive to your he alth. Compliance with the diet, regular monitoring of the condition of the gallbladder and stones will help to avoid complications. If doctors recommend a planned operation for he alth reasons, this will help to completely rid the patient of stones.and possible complications.
