In the presence of various pathologies and disorders of the biliary tract, stagnation of bile may occur. Symptoms of cholestasis and its causes depend on the course of the disease. It can be manifested by a decrease in bile production or its complete absence.
Stagnation in the gallbladder in children provokes a number of pathological changes in the biliary system that disrupt the functioning of the stomach and intestines. Such a violation is quite rare. Basically, cholestasis acts as a symptom of a disease of the digestive system. Lack of treatment provokes very serious complications that adversely affect the child's condition.
Main classification
Stagnation of bile in the gallbladder in children or cholestasis is a pathology associated with a violation of the production of bile and its flow from the gallbladder through the excretory channels into the duodenum. The disease can be intrahepatic or extrahepatic.
Intrahepatic pathology develops in the cells of the liver and biliaryways. The cause of its occurrence is damage to the ducts. Extrahepatic pathology occurs due to blockage of the bile ducts located outside the liver. Often the blockage occurs with stones of different sizes.
In addition, bile stasis can be in acute and chronic form. In the acute course of the pathology, the signs appear quite unexpectedly, and the subsequent manifestation of the disease has quite pronounced symptoms. The chronic form of cholestasis is characterized by a gradual increase in the signs of the disease, and this pathological process can take place over several weeks or months. Symptoms are rather mild.
In addition, cholestasis is classified according to the mechanism of occurrence. Illness can be:
- partial;
- total;
- dissociative.
The partial form is characterized by the fact that the amount of bile produced is significantly reduced. With dissociative cholestasis, the constituent elements of bile are not produced in sufficient quantities. The total form is characterized by the disruption of the flow of bile from the gallbladder into the duodenum.
Cause of occurrence
Symptoms of bile stasis in children are quite pronounced, which is why it is quite possible to recognize the course of the pathology even at the initial stages. In order for the treatment to bring the desired result, it is imperative to know for what reason the pathology arose. Among the provoking factors, it is necessary to highlight such as:
- congenitalmetabolic disorders;
- taking medication;
- viral diseases;
- heart failure;
- malignant neoplasms;
- hereditary factor;
- presence of helminths.
In some cases, past viral diseases lead to serious consequences that affect the process of bile production. Especially dangerous complications provoke various stages of hepatitis. Almost always, this liver disease leads to stagnation of bile. Tuberculosis has a similar effect on a child's body.
Quite often, heart failure leads to cholestasis, as well as taking medications. Liver damage occurs not only after an overdose of certain drugs, but also in the case of dangerous exposure to hepatotoxic substances.
Often in the child's body helminths parasitize, which provoke a violation of the functioning of the stomach and intestines, which can lead to the development of cholestasis. In addition, some genetic diseases, in particular, such as Caroli's syndrome, can provoke bile stasis. It is characterized by dilation of the bile ducts. Another disease that provokes cholestasis is sclerosing cholangitis. It is characterized by inflammation of the bile ducts, which leads to their subsequent narrowing.
Symptomatics
Symptoms of bile stasis in children depend on many different factors. Of great importance is the peculiarity of the organism, the age of the child. Among the features of the symptoms of stagnation of bile in a child, it is necessary to highlight such as:
- rashes and itchy skin;
- nausea and vomiting;
- icteric skin tone;
- temperature increase;
- bleeding gums;
- dull pain on right side.
Rashes and itchy skin are often observed in adolescence. It all starts with the fact that on the hands, stomach, buttocks and legs, the skin becomes dry and flaky. This provokes a very strong itching, and then a rash. Sometimes parents do not attach much importance to such a symptom of biliary dyskinesia in children, taking such a problem simply as an allergy.
In this case, self-treatment is especially dangerous, since without timely complex therapy, the disease can go into a chronic stage. The child becomes irritable, nervous, periodically suffers from impaired appetite and sleep. This is due to the fact that during the stagnation of bile, the body experiences an acute lack of vitamin A, which provokes irritation of certain areas of the skin. Children under one year old do not have these signs.
The most common symptom of bile stasis in infants is jaundice. In violation of the functioning of the liver, an increase in the level of bilirubin in the blood is observed. This causes the skin to take on a slightly yellowish tint. Mucous can be the same color.
Symptoms of bile stasis in children can manifest as nausea and vomiting. Such signs occur when the disease begins to turn into an acute form and requires urgent treatment. During the course of the diseasethere is a change in the nature of emptying. Urine becomes dark in color, and feces become completely discolored. When conducting laboratory tests, an increased content of fat in the feces can be noted.
When the course of the disease worsens, there is a deterioration in he alth, fever, pain in the right side, and bleeding gums. If there are causes and symptoms of stagnation of bile in a child, it is necessary to immediately conduct a diagnosis and comprehensive treatment.
Diagnostics
Diagnosis of bile stasis in a child begins with an initial examination and anamnesis, on the basis of which the doctor decides on the use of certain diagnostic studies. Since many pathologies of the gallbladder have similar symptoms, a comprehensive examination is indispensable. To prescribe the required treatment for stagnation of bile in a child, the diagnosis must be comprehensive and include:
- blood test;
- analysis of urine and feces;
- ultrasound diagnostics;
- tomography;
- duodenal sounding;
- cholecystography.
A blood and urine test allows you to determine the presence of inflammation during an exacerbation. During the remission period, all indicators will remain within the normal range. With a prolonged course of the disease, the number of leukocytes may even decrease. Fecal analysis helps to detect worms in the body.
When conducting ultrasound diagnostics, it is possible to determine an increase or decrease in the volume of the gallbladder,identify its deformation, thickening of the walls, the presence of stones, as well as assess the contractility of this organ. Cholecystography for diagnosis is used very sharply, since such a research method carries a radiation load. This technique allows you to assess the location and shape of the gallbladder, as well as the speed of its emptying.
Ultrasound diagnostics should be done several times, since such a study allows you to trace the course of the pathology, the results of the treatment and the condition of the organ after the end of therapy.
Features of treatment
To eliminate the causes and symptoms of bile stasis, treatment should be carried out in several directions at once. Therapy should be aimed at combating the accumulated bile, supporting the functioning of the liver and eliminating the existing symptoms. For treatment, medications are used, which are prescribed only by the attending physician.
To normalize the production of bile, choleretics are prescribed, and if inflammatory processes are present, then antibacterial drugs are used. In addition, treatment may require cholekinetics, which activate the production of bile, antihistamines to eliminate itching.
In particularly severe cases, surgery may be prescribed to dilate the bile ducts. Basically, it is carried out using minimally invasive techniques. Often, the operation involves endoscopic punctures, which allows the patient to very quickly come toitself, and also eliminates the need for suturing. In addition, a classic operation can be performed, during which the bile ducts are drained, stones are removed, and patency is restored.
Treatment must be long-term and a special diet is required throughout the entire period of therapy. It helps to normalize the functioning of the liver, as well as reduce the likelihood of developing gallstone disease.
To manage the symptoms and treat the gallbladder, a doctor may prescribe exercise therapy under the supervision of highly qualified specialists, and some types of physical therapy may also be required.
Drug therapy
Cholestasis is a fairly dangerous and complex disease. Treatment of stagnation of bile in a child must necessarily be complex and implies the use of medications. There are a number of choleretic drugs that are recommended for children. Such funds are represented by the following groups:
- choleretic drugs ("Allohol", "Osalmid", "Nicodin");
- choleretics ("Holosas", "Flamin", "Holos");
- cholekinetic drugs ("Magnesia", "Valerian");
- anticholinergics ("Papaverine", "No-shpa", "Atropine", "Spazmol").
To eliminate the existing symptoms, for the treatment of the gallbladder in children, it is recommended to take herbal choleretic agents if there is no allergy to certain herbs and their components or individual intolerance. At the same time, it is importantcalculate the dosage, which largely depends on the weight of the child. The dosage is strictly indicated in the instructions for use of the drug and for each agent it can be completely different. Before using any remedy, you must first consult with your doctor.
In addition to taking choleretic drugs, the doctor may recommend the consumption of alkaline mineral drinks such as Essentuki or Borjomi. Such water is considered a very good natural choleretic and has a corresponding effect, diluting bile, reducing its viscosity and promoting faster and easier outflow.
To eliminate the symptoms of bile stasis in children, treatment is also carried out with the use of antispasmodics and painkillers, which help eliminate spasms and relieve pain. If there are signs of inflammation in the biliary tract and gallbladder, antibacterial drugs may be indicated, in particular, such as Metronidazole, Biseptol, Clarithromycin.
To reduce itching, antihistamines are indicated, such as Cetrin, Dimedrol, Suprastin, Tavegil. With severe itching, antipruritic agents can be used, in particular, gels, creams, ointments.
Methods of treating stagnation of bile in the gallbladder in children are selected only by a qualified doctor, taking into account the characteristics of the course of the disease. It is worth remembering that children under the age of 12 are not recommended to take choleretic herbs, as they contain many active ingredients, therefore, predict their effect on the child.impossible.
Folk techniques
With obstruction of the biliary tract or the flow of pathologies of the gallbladder, cholestasis begins to develop. Treatment of stagnation of bile in a child is also carried out with the help of folk remedies and methods, however, before using them, it is imperative to consult a doctor so as not to harm the child's body. In addition, it is worth noting that decoctions and infusions of medicinal herbs can only be used as an addition to the main treatment, since their effectiveness is not enough to completely cope with the existing disease.
The most effective and safest traditional medicine used for bile stasis are:
- treatment with herbs that have a choleretic effect;
- daily fasting intake of pumpkin seeds;
- consumption of freshly squeezed beetroot juice;
- abdominal strengthening exercises;
- gall bladder massage;
- tubage.
A decoction of peppermint, immortelle, wormwood, St. John's wort, as well as a rosehip decoction is highly effective. All these remedies should be taken 20 minutes before eating.
Dieting
Diet is very important in the treatment of bile stasis. Symptoms of pathology can be eliminated much faster with proper nutrition. Be sure to adhere to these principles of nutrition:
- eat small meals;
- vegetables andfruits, dairy products;
- from protein foods, preference should be given to low-fat varieties of fish and meat.
In the usual diet, be sure to limit the amount of sweets and fats. It is strictly forbidden to consume spicy, fried, s alty, spicy foods, as well as carbonated and alcoholic drinks. It is not recommended to eat freshly baked bread. It is better to exclude sorrel, green onions, radishes from the diet.
What could be the consequences
To eliminate the symptoms of stagnation of bile in the gallbladder, treatment must be carried out comprehensively, since only this guarantees a quick and successful disposal of the existing pathology. If complex therapy is not carried out in time, then various complications and dangerous consequences may occur, in particular, such as:
- lack of calcium absorption in the body;
- vitamin deficiency;
- cirrhosis of the liver;
- development of inflammation of the gallbladder;
- liver failure.
All these consequences can be very dangerous for the he alth and life of a child, which is why when the first signs of illness appear, you should definitely consult a doctor for a comprehensive diagnosis and treatment.
Prophylaxis
Any disease is much easier to prevent than to treat it for a long time. That is why a simple set of preventive measures will avoid the occurrence of dangerous complications and problems with the gallbladder, the most common of whichis bile stasis.
The main measure for the prevention of cholestasis in children is to prevent the occurrence of pathologies of the digestive system. You need to try as often as possible to walk in the fresh air, strictly observe the regime of sleep and rest. It is important to ensure that the child eats regularly and properly. If the initial stage of the pathology was detected, then you must strictly follow the diet.
Children need physical activity of moderate intensity, as physical inactivity is considered one of the provoking factors. Morning exercises, swimming in the pool, hiking, outdoor sports are well suited as exercises.
For the prevention of bile stagnation, it is useful to regularly consume mineral water, such as Essentuki, Borjomi, Narzan. Natural herbal teas prepared on the basis of medicinal plants, such as St. John's wort, wormwood, mint, oregano, will also be useful. A very good preventive measure would be an annual visit to special sanatoriums with complex treatment.
Stagnation of bile for a long time can occur without any symptoms. Lack of timely treatment leads to liver failure, cirrhosis, osteoporosis and many other serious pathologies. For timely detection of the disease, it is necessary to undergo ultrasound diagnostics of the abdominal organs at least once a year.
If a child began to complain of pain in his side, lost his appetite or had other unpleasant signs of pathology, then you should not try to treat him yourself. Only a qualified specialist must prescribe treatment.
Most cases of acute cholecystitis with timely therapy ends in complete recovery of the child. However, after an exacerbation, dyskinesia may persist for a long time, so you need to follow all the doctor's recommendations.
