In the article we will understand why choleretic drugs are prescribed for choleretic diarrhea.
Diarrhea, regardless of the causes that provoked it, delivers a lot of inconvenience, and is also the main factor in the development of such a dangerous phenomenon as dehydration. Important nutrients are no longer absorbed, washed out with feces from the intestines. As a result, the body suffers from acute exhaustion.
Chologenic diarrhea occurs due to excessive intake of bile into the intestines. This is accompanied by sharp pains in the right hypochondrium.
Symptoms
Differentiation of this type of diarrhea is made according to some external clinical manifestations, which include:
- Features of feces that are excessively liquid, have a rich green or yellow color. Thick transparent or gray mucus can be visualized on the surface of the stool.
- Pain in the right hypochondrium - the patient complains of stabbing and sharp pains in the right iliac region of the abdomen, which can be aggravated by breathing and sudden movements.
- In the process of defecation, the pain becomes very severe, almost unbearable, which can provoke the development of a state of shock.
- Severe nausea and weight loss.
- Dry skin and mucous membranes.
- Increase in body temperature, which indicates the addition of an infection in the intestines, which is provoked by excessive irritation of the bile of its mucosa.
- The presence of bile in the feces is the most reliable factor that allows you to determine hologenic diarrhea, as well as to establish the main cause of its development.
This and other types of diarrhea with similar symptoms require close medical monitoring. Otherwise, the likelihood of a state of dehydration is extremely high, which can lead to death.
Causes of disease
Chologenic diarrhea occurs, as a rule, due to the ingress of large amounts of bile acids into the intestinal lumen. Such a process is directly related to the following factors:
- Resection of the gallbladder. If this organ is absent, all the ducts that come from the liver are excreted into the intestines. In this case, the pathological phenomenon is chronic, since it is impossible to stop the production of bile. What other causes of hologenic diarrhea are known?
- Excessive malabsorption syndrome is a polysymptomatic collective disease characterized by impaired absorption of nutrients in the intestines, which is caused by accelerated peristalsis.
- Surgical interventions in the area of the small intestine, in which its innervation and microflora are disturbed, which subsequently provokes an acceleration of the transport of feces.
Very often there is hologenous diarrhea after cholecystectomy, since without the gallbladder bile cannot accumulate, it constantly penetrates into the intestine. This pathology is considered as a syndrome that manifests itself after the removal of the organ.
Crohn's disease
In addition, such a disorder of the stool mixed with bile can cause a very serious systemic pathology - Crohn's disease. This is a polysymptomatic disease, which is determined by the presence of an inflammatory process in the digestive organs of a chronic nature, is of an autoimmune nature.
Why is pathology dangerous?
The main danger of hologenic diarrhea is that the majority of all cases have a very unfavorable prognosis, that is, the symptoms cannot be eliminated. This provokes the transition of the disease to the chronic stage, which makes the patient a drug hostage.
First Aid Rules
In case of symptoms of such a pathological process, an ambulance should be called, otherwise the condition will worsen, and the clinical pictureacquire new symptoms. First aid involves drinking plenty of water, which is taken in small sips. In addition, there will be the use of saline solutions that do not allow the development of dehydration, there is a replenishment of the deficiency of lytic substances in the body. Further therapy is carried out under the supervision of a specialist.
It is strictly forbidden to take antispasmodic and analgesic drugs that distort the clinical picture of the pathology, which, in turn, significantly complicates the diagnosis and provokes an imaginary relief, after which, as a rule, an irreversible process follows.
Let's look at the treatment of hologenic diarrhea, but for now let's talk about the diagnosis.
Diagnostic methods for this pathology
It is not possible to independently determine the causes of the pathology. The presence of such a violation is indicated by the presence of bile in the fecal masses. In this case, feces can have an exclusively liquid consistency. The patient, as a rule, is given a referral for the initial and main examination - a colonoscopy. With this diagnostic procedure, the presence of bile on the walls of the intestines is observed. It can be observed in quite significant quantities. Directly in the feces, its indicators sometimes exceed 100 mg / g. To determine the diagnosis, the patient may be referred to the following laboratory tests:
- blood and urine tests;
- endoscopy;
- coprogram;
- Ultrasound.
Coprogram and positive stercobilin
The norm is considered to be a dense texturefeces, their cylindrical shape, brown color, no pungent odor. On microscopic examination, the stool should be free of blood cells, connective tissue fibers, starch, fat, parasite eggs, protozoa, and yeast.
How are stercobilin and hologenic diarrhea related?
With such a disease, it is considered mandatory to conduct a coprogram - a study of feces, which determines the presence or absence of stercobilin in the masses - a pigment substance that gives the feces a characteristic brown color. With such diarrhea, this enzyme is usually absent in the stool.
The treatment of hologenic diarrhea with drugs will be described below.
Drug therapy
The main task of treatment is to eliminate the harmful effects of bile acids on the intestinal mucosa, which cause irritation. It should be noted that therapy in such a case should be comprehensive and aimed at neutralizing the main pathogenic factors that provoke diarrhea.
Most often, patients are prescribed adsorbents - these drugs stick together molecules of bile acids, reducing their concentration. In addition, these drugs neutralize them, which reduces the harmful effects on the intestinal mucosa.
Drugs
Of these, the most common are:
- Activated charcoal, but not used for peptic ulcers. The use of this medication promotes the capture of nutrients, stopping their absorption. Applied therapeuticcourse no more than seven days.
- "Polysorb" - solutions for the preparation of a liquid that has an adsorbing effect.
- "Carbolen" - removes toxins from the body, capturing molecules of bile acids. This medicine contains activated charcoal. Before taking, you must make sure that there is no ulcerative lesion of the stomach.
- Enterosorbents - this type of medication allows you to reduce the concentration of harmful substances in the intestines, neutralizing and binding them. These funds have an extensive spectrum of action, allowing you to normalize metabolic processes and reduce the level of pathogenic microbes. The most popular medication in this category is Enterosgel, which has a viscous gel-like consistency. The drug is extremely unpleasant to use, but it has the highest efficiency of all currently known enterosorbents.
- Antibiotics that are prescribed regardless of whether the patient has a pathogenic microflora in the feces or not. This is due to the fact that with prolonged irritation of the intestine, local immunity decreases, that is, the level of beneficial bacteria drops. The most popular of these drugs is Cefazolin, which is used as an intramuscular injection for a course of five days. The drug is well tolerated, practically does not contribute to the development of side effects.
- Cholagogue medicines that help to lower the concentration of excreted bile, which ensures the elimination of its harmful effects on the intestines. The most common of the choleretics are:"Allohol" is a remedy based on natural elements that neutralizes bile acid, "Oxaphenamide" is a very strong choleretic that has a spastic effect and reduces pain.
- Probiotics - this category of medications normalize the intestinal microflora, which is necessary for frequent diarrhea. The most commonly used tools from this group are Lineks, Laktiale, Bifiform.
Chologenic diarrhea after cholecystectomy
After removal of the gallbladder, the patient's life changes significantly. He needs to constantly follow a diet, exclude fried and fatty foods from the diet. Meat is used only in stewed or boiled form: rabbit, chicken, turkey, veal. In addition, in order to avoid the development of pathology after cholecystectomy, you can not use sweet carbonated drinks, strong coffee and cocoa. Alcohol is strictly prohibited, as it significantly increases the load on the liver and stimulates excessive production of bile.
A patient is prescribed medication for chologenoic diarrhea after cholecystectomy. In the first weeks of rehabilitation, strong antibiotics, hepatoprotectors and holistics are used. In the future, maintenance therapy is prescribed, which is aimed at maintaining the body and eliminating the negative manifestations of the absence of the gallbladder.
Folk treatments
There are traditional medicine recipes that help eliminate diarrhea of a hologenous nature of occurrence, that is, provoked by a high amountbile in the intestines. The most effective and safe of them are:
- Decoction of sage and chamomile - herbs are taken in the same proportions and poured with two glasses of boiling water. After this, the broth must be insisted until it cools completely and take 3 tablespoons before meals. These herbs normalize the microflora in the intestines and have an anti-inflammatory effect.
- Decoction of chamomile and oak bark - 3 tablespoons of oak bark pour 250 ml of water, bring to a boil, then add 1 spoon of chamomile flowers into it. The broth should cool, after which it is filtered and drunk in half a glass twice a day.
- Decoction of St. John's wort - 100 g of chopped grass is poured into 1 liter of cold water and heated in a water bath. After boiling, the broth must be boiled for another 15 minutes. After cooling, it is filtered and 3 tablespoons are taken every 2-3 hours.
Reviews
Chologenic diarrhea develops mainly in people who have certain diseases of the gallbladder, or after its removal. In such cases, patients note that this phenomenon is very specific and very painful. They experienced severe pain in the right side of the abdomen, nausea and loose stools. The solution to this problem, judging by the information from the reviews, is the constant observance of the correct diet. Patients note that at the slightest violation of the diet, the first symptoms of hologenic diarrhea appear, which is subsequently very difficult to deal with. ExceptIn addition, these people are constantly taking certain medications to normalize the functioning of the liver, stomach and intestines.
