Biliary dyskinesia is a common gastrointestinal disease. According to unofficial data, almost every third person suffers from this disease. There are no exact statistics, because not all patients seek medical help: pathology causes a lot of trouble, but does not threaten life. However, in some cases, the disease can lead to complications. That is why it is worth knowing how to treat biliary dyskinesia.
Description of pathology
Dyskinesia of the gallbladder and biliary tract is a pathological condition characterized by uneven secretion of bile and impaired contraction of the smooth muscles of the excretory system and sphincters. To understand what kind of disease it is, you need to delve a little into the anatomy, having studied the functions of bile and biliary tract.
Bile is a yellowish-brown biological fluid that contains activesubstances and is involved in the digestive processes. It is formed in the liver or hepatic passages, then through the ducts it enters the gallbladder, where it acquires the necessary concentration during the removal of excess water. From the gallbladder, fluid enters the duodenum.
The main function of this biological fluid is to break down complex fats, as a result of which they are converted into fatty acids by the action of enzymes. The latter can already be absorbed by the body without problems. In addition, bile is involved in the process of full absorption of fats and carbohydrates.
Through the biliary tract, this fluid moves with the help of smooth muscles. The speed of transport is regulated by the ring muscles (sphincters), which are "ruled" by hormones produced in the pancreas and stomach. If the bile moves too fast, then it enters the stomach in a diluted form; if it moves too slowly, it becomes too saturated. Both have a negative impact on he alth.
Classification
Depending on whether the bile moves too slowly or too fast, the disease is divided into two types. Hyperkinetic type of biliary dyskinesia (JVP) is too fast transportation of bile into the duodenum, hypokinetic is slow.
These two types of the same disease differ not only in symptoms and principles of treatment, but also in the categories of people who are most susceptible to them. For example, the hyperkinetic formdyskinesia of the biliary tract is more often diagnosed in young patients, and hypokinetic is detected in people who are over forty years old and those with unstable mentality. In general, women are more susceptible to the disease than men. Biliary dyskinesia also occurs in children, although not as often as in adults.
Physicians adhere to a different classification based on how high the tone of the sphincters, which "control" the movement of bile, is. If it is higher than normal, then the disease is called hypertensive biliary dyskinesia, if lower - hypotonic. In some cases, a doctor may diagnose a mixed type of disease, that is, both hypokinetic and hyperkinetic disorders.
ICD code for biliary dyskinesia - K83.9. ICD-10 is an international classification of diseases, a document used as the main statistical and qualifying document in he althcare.
JVP Causes
According to the causes of pathology, biliary dyskinesia is divided into primary and secondary. Primary occurs quite rarely, it is usually due to some anatomical defect in the development of the gallbladder or bile ducts. This may be the inflection of the bladder, the weakness of the walls, the presence of a septum inside, a doubled number of ducts, an abnormal location or mobility of the gallbladder.
In the case of the secondary form, there are other diseases-causes. Provoke the development of dyskinesia of the gallbladder and biliary tract can viral hepatitis, liver dysfunction and other diseases, variouspathology of the gastrointestinal tract (gastritis, ulcers, duodenitis), cholelithiasis, appendicitis, allergic reactions, cholecystitis, pathologies of the female reproductive system, inflammatory processes occurring in the abdominal cavity, menopause.
JP can occur with any chronic infection, including, for example, tonsillitis or caries. Also, the disease can appear due to giardiasis, other infections and helminthic invasions.
In some cases, the main cause that caused the symptoms of biliary dyskinesia is poor nutrition and unhe althy eating habits. The use of a large amount of sweets, spicy foods, spices and seasonings, too fatty foods, vegetable oil, alcoholic beverages, and snacks has a negative effect. Prolonged fasting and irregular meals are harmful.
Recently, the point of view has become widespread, according to which biliary dyskinesia occurs as a result of prolonged nervous strain, stress and anxiety, neurotic conditions. This is not a new statement, because there has long been a stereotype that all diseases are from nerves. For all pathologies, this is, of course, an exaggeration, but in the case of dyskinesia, the statement looks plausible.
Promotion of bile is regulated by the autonomic nervous system, which in some way depends on the central nervous system and responds to the hormones produced. So, any experiences can affect the functioning of the biliary tract. In addition, under severe stress, people stop caring aboutregularity and quality of nutrition, which also affects the development of the disease.
Other factors that can cause worrisome symptoms requiring treatment for biliary dyskinesia include:
- sedentary work, lack of exercise;
- Changes in hormonal levels, disorders;
- obesity or asthenic physique;
- lack of vitamins and minerals in the body;
- dysbacteriosis and some other pathological conditions.
Main symptoms
For hyperkinetic and hypokinetic forms of biliary dyskinesia, the signs are somewhat different, but there is a common symptom - pain. In the first case, it is sharp, usually occurs at night or after eating, has a paroxysmal character. There is discomfort in the right hypochondrium, it can radiate to the shoulder blade or shoulder, reminders of pain in osteochondrosis. The attack usually lasts about half an hour. In addition, the patient may complain of palpitations, numbness of the limbs and very severe pain under the ribs.
In the hypokinetic form, the pain is constant, aching, localized under the rib. Discomfort can often be replaced by a feeling of heaviness and fullness. This form of the disease is characterized by bloating. Attacks are longer, can last for hours. The pain recedes after eating or choleretic drugs. With stagnation of bile, changes in the color of stool and urine are characteristic (feces become light, and urine darkens), yellowing of the sclera of the eyes and skin,severe itching of the skin.
Symptoms of biliary dyskinesia in both cases occur against the background of malnutrition, stress, sometimes the cause of an attack can be physical activity. Belching, nausea, stool disorders, decreased or complete lack of appetite, profuse urination, bitterness in the mouth, bad breath, signs of the autonomic nervous system may be present in both hypokinetic and hyperkinetic JP: insomnia, headaches, heart palpitations, increased fatigue and sweating. Women may experience menstrual irregularities, and men may experience reduced potency.
Complications
Symptoms of biliary dyskinesia are often completely ignored by patients during exacerbations. But if you treat the disease without proper attention, it can cause cholecystitis, liver disease. Also dangerous is JP cholestasis - stagnation of bile, which can lead to colic and gallstone disease, that is, the formation of stones in the gallbladder. The inflammatory process that began in this organ can affect the pancreas, as a result, the doctor diagnoses pancreatitis.
Patient actions
You need to see a gastroenterologist if you experience symptoms of biliary dyskinesia. The doctor will prescribe the treatment that is best suited for the type of disease that the patient diagnoses. Self-diagnosis and self-treatment are unacceptable here, because what is suitable for, for example, with a hypokinetic form canbe ineffective or even harmful when hyperkinetic. The specialist will conduct diagnostic procedures and suggest how to treat the disease.
Diagnosis
At the first visit of the patient to the gastroenterologist, the doctor will palpate the painful area. The disease is characterized by sharp pain when inhaling and pressing on the gallbladder area. But this method does not accurately determine dyskinesia, so it is impossible to determine the complexity and form of the disease. That is why more research is recommended.
A fecal analysis for lipids, bilirubin levels, helminths, dysbacteriosis may be prescribed. More important is ultrasound, which will help determine the condition of the bile ducts and gallbladder. Often, duodenal sounding is performed, during which the doctor gets the opportunity to determine the chemical composition of bile and enzymes, the time of receipt of bile from various parts of the biliary system.
JP treatment
Biliary dyskinesia is treated by several methods. Firstly, the patient is recommended to change the diet and diet, a therapeutic diet is prescribed, secondly, medications are indicated, and thirdly, psychotherapy shows good results, but this method is not always used. If the disease is caused by another pathology, then the cause is eliminated first.
Therapeutic diet
The therapeutic diet for biliary dyskinesia is prescribed for therapeutic purposes. Such nutrition contributes to the complete emptying of the gallbladder, but does not cause pain attacks. A patient with dyskinesia is advised to takefood from four to six times a day with an interval of three hours. You do not need to overeat, you should eat dishes in a warm form. The last meal should be two to three hours before bedtime, but you do not need to go to bed hungry either.
There are foods that should not be consumed at all, those that are best limited during an exacerbation, and recommended. The specific list in each case depends on the characteristics of the course of the disease and comorbidities, so nutrition should be determined by a nutritionist or gastroenterologist.
In the most general case, we can only say that it is undesirable to eat fried, too spicy or fatty foods. The diet should be dominated by boiled, steamed or stewed dishes. When heating food, it is necessary to abandon vegetable fats and margarine. Dairy products should be consumed daily.
When exacerbated, food should come in crushed or pureed form. It is necessary to abandon fat, smoked meats and marinades, nuts, canned foods, snacks, millet porridge, fatty meat, offal, mushrooms.
With the slow movement of bile through the ducts, eggs and black bread, cream, sour cream are shown. If the patient is too fast, it is recommended to limit rich broths, fatty fish, vegetable oils, while it is desirable to include these dishes in the hypokinetic form of JP. In both cases, you should stop eating chocolate, ice cream, white bread. A large amount of fresh vegetables and fruits, bran (according toone tablespoon before each meal).
It is advisable to give up highly carbonated drinks, strong coffee and tea, alcohol. You can drink weak tea and mineral water. The exact brand of recommended water is best checked with a gastroenterologist. The wrong choice can lead to the fact that the mineral water will not help to cope with the unpleasant manifestations of dyskinesia, but will only aggravate the disease. The point here is that waters have different composition and proportional mineral content.
Medicines
Drugs for biliary dyskinesia are markedly different for hypokinetic and hyperkinetic forms of the disease. For example, in the first case, the doctor may prescribe medications that accelerate the excretion of bile, for example, Allohol, which will aggravate the condition with hyperkinetic dyskinesia. In this case, "No-shpa", "Papaverin" or "Drotaverin" are prescribed. Also among the medicines that normalize the transport of bile through the ducts are Flamin, Oxafenamide, Nicodin.
Traditional medicine
In the case of dyskinesia, official medicine is rather favorable to non-traditional medicine. Biliary dyskinesia after gallbladder removal and in other cases can be successfully treated (as maintenance therapy, of course) with herbal decoctions. St. John's wort, coriander, immortelle, sage, mint, anise, corn stigmas help to remove many unpleasant symptoms. Good results are obtained by drinking grapefruit juice before meals. With hypotonicthe form of the disease shows tinctures that have a tonic effect, for example, ginseng, lemongrass or eleutherococcus. Motherwort and valerian tinctures have a beneficial effect on the autonomic nervous system.
Psychotherapy
Symptoms of biliary dyskinesia, if they are caused by disorders in the functioning of the autonomic nervous system, are removed with the help of psychotherapy. But most patients who turn to a gastroenterologist are usually not ready to go to a psychotherapist and categorically reject this method of treatment. Therefore, here we can limit ourselves to only general recommendations. It is necessary to avoid stress as much as possible, take light sedatives, sleep enough time. If it is possible to establish that constant stress is the cause of the disease, then the doctor may prescribe stronger drugs, such as tranquilizers, neuroleptics or antidepressants.
Dyskinesia can be caused by an inactive lifestyle, so exercise therapy and walking are helpful. Physiotherapeutic procedures and massages are used in the treatment process, the effect of ultrasound is applied, there are special techniques that allow you to free the bile from excess biological fluid. In general, therapy for ASD remains conservative, and in rare cases (if lifestyle changes and medications fail), surgery may be considered.
Forecast
Dyskinesia is not a fatal disease, but it can significantly worsenthe quality of life. As a rule, the patient is forced to constantly adhere to a special diet, and in case of exacerbations, additionally take medications. Regular maintenance therapy and taking care of your he alth will minimize the frequency of exacerbations and maximize the period of remission.
JVP in children
Dyskinesia of the biliary tract in children is diagnosed, as a rule, in the first years of life and in primary or secondary school age. This is caused by the immaturity of the bile ducts and malnutrition. Long breaks between meals at home and at school, conflict situations, stress, and the use of unsuitable products affect.
Symptoms in children are the same as in adults. There are: stool disorders, nausea and pain in the right hypochondrium. Treatment is carried out according to the same scheme. So, the main thing is the correction of the diet and the change in eating habits, the elimination of the negative impact on the body of stress.
Prevention
Preventive measures are the same as the lifestyle recommendations given when the diagnosis is confirmed. You should avoid stress, engage in feasible sports or at least walk more, regulate your own daily routine, alternate rest and work, normalize diet and eating habits, and follow a he althy diet. This is especially important for those people who fall into the risk group. These are workaholics leading a sedentary lifestyle, those who live in constant stress, eat improperly (semi-finished products, on the go), area fan of diets and curative fasting. Also at risk are children who may be malnourished at school or at home in the absence of their parents.
In conclusion
Dyskinesia symptoms are pains of varying intensity and duration, localized in the right hypochondrium. Indigestion and nausea may occur. Often, patients complain of general fatigue. To diagnose the disease and begin appropriate treatment, you should contact a specialist. Therapy involves a special diet and medication. In addition, it is very important to exclude the negative effects of stress, for which sedatives can be used. Dyskinesia is not life threatening, but can lead to more dangerous diseases.
