Probably everyone has heard that the process of digestion is carried out with the participation of bile, which is constantly produced by the liver. And the repository of this secret is the gallbladder. On which side it is located, what functions it performs and what violations occur in its work, we will consider in this article.
Anatomical features
Outwardly, the gallbladder resembles a pear. It is located below the liver between its lobes. Bile, regularly produced by the liver, is necessary for the digestion process. It is required not constantly, but periodically, therefore, a special reservoir has been created for its storage and concentration - the gallbladder. It doses out liquid when food appears in the stomach. It, together with pancreatic enzymes, promotes the digestion of food, participates in the breakdown and absorption of fats, and has bactericidal properties.
The gallbladder consists of:
- neck - the narrowest part of the body;
- body - its length does not exceed 15, and its width is 4 cm, the volume is about 70 ml;
- bottom –a wide area protruding beyond the lower edge of the liver.
The walls of the gallbladder have a multilayer structure. They contain the following skins:
- Mucus - consists of elastic fibers and glands that produce mucus.
- Fibromuscular - smooth muscle cells are mixed with collagen and elastic fibers.
- Serous - built from fibrous dense connective tissue.
In the normal state, the gallbladder is not palpable, and when enlarged, its position can be determined by palpation.
Functions
Why do you need a gallbladder? Firstly, it acts as a container where bile is stored. Secondly, in the bubble there is a concentration of liquid due to the separation of water. The liver produces more than a liter of bile per day. If necessary, it enters the duodenum through the cystic and common bile duct. The main components of bile are: water, bile acids, bilirubin, cholesterol, mucus, proteins, vitamins and minerals.
In the body, it performs the following functions:
- neutralizes gastric juice;
- increases the activity of intestinal and pancreatic juice;
- kills pathogens in the gut;
- removes toxins from the body;
- improves intestinal motility.
Characteristics of gallbladder pathologies
The main ailments of the body are most often associated with malnutrition. These include:
- Cholelithiasis –the formation of stones inside the body. It develops due to congestion, when bile lingers in the bladder for a long time, or if metabolic processes are disturbed, a precipitate forms, from which solid particles form over time. As long as the stones are inside the bubble, they are not a cause for concern. As soon as their movement along the ducts begins, the patient experiences sudden sharp pains on the right, i.e. on which side the gallbladder is located.
- Cholecystitis is an inflammation of the gallbladder. It is caused by infection, intoxication, mechanical irritation of the mucosa, and most often by cholelithiasis. The discomfort is either acute or chronic. In the first case, there are sharp, and in the second - dull painful sensations. They can radiate to the back of the head and neck, nausea and malfunction of the digestive organs are possible.
- Dyskinesia - the contractile activity of the gallbladder and its ducts is disturbed. Pathology contributes to malnutrition, stressful situations, diseases of the gastrointestinal tract. The pain is localized in the upper right side of the abdomen, where the liver and gallbladder are located. In the hyperkinetic form it is sharp and short, in the hypokinetic form it is long, dull and bursting.
- Neoplasms - tumors are extremely rare and do not manifest themselves at the initial stage. With an increase, they block the bile ducts, at first pain appears as with dyskinesia, then it intensifies, spreading to the entire right side of the abdomen. Malignant tumors often arise as a result of complications of chronic inflammatory processes,that affect the inner membranes and ducts of the bladder. In this case, metastases quickly appear, affecting nearby organs.
If any discomfort appears in the right hypochondrium, where the gallbladder is located, you should definitely contact your doctor and undergo an examination to prevent serious complications.
Symptoms of diseases
With any dysfunction of the gallbladder, problems are accompanied by almost the same symptoms. The most basic sign indicating inadequate functioning of the organ is severe, not passing pain under the right rib. The condition worsens when eating spicy, fried or fatty foods. After all, it is known from the school anatomy course what the gallbladder does. He throws out a portion of the enzyme for the breakdown of fats in the duodenum 12. And in case of violation of the functions of the passage of the secret is often clogged, so there is pain.
In addition to pain, the patient may experience:
- nausea and vomiting;
- diarrhea or constipation;
- allergies - skin rashes and itching;
- belching after eating;
- bloating, flatulence;
- yellowness of the eye proteins and skin;
- irritability;
- insomnia;
- bitter in the mouth.
The appearance of such symptoms cannot be ignored and it is advisable to visit a doctor as soon as possible.
Diagnosis of pathology
Pain under the right rib is disturbing. What is there? In this place are locatedtwo important organs are the liver and the gallbladder, which is the repository of bile. When contacting a doctor to determine the exact diagnosis, the patient undergoes examinations. The set of measures depends on the age of the individual, his complaints and chronic ailments.
The main methods include:
- Collecting an anamnesis. In a conversation with the patient, the doctor finds out the time of onset of the disease, the features of the onset of pain, their nature.
- External examination of the patient - the presence of obstructive jaundice of the skin and whites of the eyes is revealed.
- Palpation in the peritoneum - checking for pain at certain points on the right side.
- Complete blood count - draws attention to the number of leukocytes to determine the inflammatory process.
- General and bioanalysis of urine - detection of urobilirogen levels.
- Coprogram - shows digestive disorders.
- Duodenal sounding - bile sampling to study its composition.
- Ultrasound - allows you to identify the features of the anatomical structure of the gallbladder, determine the presence of polyps, inflammation, stones.
- MRI and CT are performed if there is any doubt after the ultrasound.
- Biopsy - examination of the material to determine malignant neoplasms.
Having received all the test results and having consulted with narrow specialists, the doctor prescribes the appropriate treatment using conservative therapy or surgery.
Stones in the gallbladderbladder: symptoms and treatment
This disease can manifest itself at any age. Often it is asymptomatic and the person is unaware of its development for a long time. Gallstones are crystals that form from abnormal bile when the concentration of s alts in it increases and the flow from the gallbladder slows down. The formation of stones is often associated with a genetic predisposition. In addition, risk factors are: diabetes, high-calorie diet and obesity. Moreover, it is noted that women get sick more often than men.
Pregnancy and childbirth are associated with impaired metabolic processes and predispose to the formation of deposits in the gallbladder. Signs of the disease begin to appear when the stone moves from the bladder along the ducts. In this case, the following symptoms appear:
- Intense pain, which is localized in the right hypochondrium, i.e. which side is the gallbladder. It is so strong that it is not stopped by antispasmodics. Often gives to the lower back, shoulder blade and arm. Then the acute pain disappears, but aching and pulling appear, which are aggravated by eating fatty and spicy foods.
- Nausea and vomiting.
- Fever - usually an inflammatory process occurs.
- Weakness, fatigue, irritability.
- Yellowness of the sclera of the eyes, darkening of the urine, discoloration of the feces.
- Diarrhea.
If you have colic and pain in your right side, you should consult a doctor. Ultrasound will help determine the disease. When stones are found ingallbladder symptoms can be treated with medication or surgery. The decision is made by the attending physician. For conservative treatment, drugs based on bile acids are used. They are used when the stones are small and the gallbladder remains functional, and the ducts are patency. The treatment is long, but if the size of the stones does not decrease within six months, then it stops, the individual begins to prepare for the operation.
Types of transactions
Currently, there are several types of surgery that are used to remove the gallbladder:
- Abdominal - performed when serious lesions of the bile ducts are detected, the neck of the gallbladder is ruptured or blocked, peritonitis has begun. Its advantages are direct access, good visibility, the ability to examine nearby organs. This type of intervention is used in emergency and severe cases. After it, complications and a long recovery period are possible.
- Laparoscopy is one of the most common techniques. Its advantages are: small incisions, less painful, reduced risk of infection, short recovery period.
- Mini-access cholecystectomy - used for patients who are medically contraindicated for other interventions. The path to the gallbladder, which is located under the right rib, is provided through a small incision in this area.
- Transvaginal method - applied to women through an incision about a centimeter long, which is madein the posterior fornix of the vagina. Its advantages: no pain after surgery, full motor activity, one day hospitalization, no external scars.
The choice of the type of operation to remove a diseased organ is determined by the attending physician.
Surgical treatment of the gallbladder
Intervention by laparoscopy is performed under general anesthesia. Its average duration is forty minutes. The essence of the operation to remove the gallbladder in this way is as follows:
- Carbon dioxide is injected into the abdominal cavity with a special instrument to create space for the instruments to work with.
- Special tubes - trocars - are inserted into the abdominal cavity through minor incisions. In them, the surgeon places the necessary tools for work.
- A laparoscope with a video camera is inserted into the area near the navel.
- On installed monitors with a forty-fold increase, the operating team monitors the progress of the operation.
- The cystic artery and duct are clamped with titanium clips.
- The gallbladder is separated from the liver and brought out. Stones are crushed beforehand.
After surgery, a drainage device is left to drain fluid, which, if the outcome is favorable, is removed the next day. The patient is in the hospital for no more than two days.
Diet rules after surgery
Nutrition after gallbladder removal plays an important role. Immediately after surgery from food is desirablerefuse. From dryness in the mouth, wipe the lips with a swab dipped in boiled water, and rinse the mouth after five hours. On the second day, it is allowed to drink a little alkaline water, weak tea or low-fat kefir. Light meals are suitable for eating: vegetable broth, boiled chicken meat, low-fat cottage cheese. Take food in small portions, observing an interval of 3-4 hours.
If the condition is satisfactory, mashed potatoes, boiled fish and vegetable soup are allowed on the third day. At the end of the week, you can eat cereals on the water, low-fat cutlets and meatballs. The diet after laparoscopy of the gallbladder must be observed both during the recovery period and throughout life. It is recommended to consume the following foods:
- dietary meat - rabbit, chicken, turkey, veal;
- fish – zander, cod, pike;
- cereal porridge;
- mashed soup with vegetable or low-fat meat broth;
- stewed or steamed vegetables;
- milk and low-fat dairy products;
- egg - once a week;
- fresh fruits, natural drinks and compotes;
- dry, lean cookies and white croutons.
The diet is not very strict, but the restrictions still need to be observed. Food will have to be baked, boiled, stewed or steamed. Avoid fried and grilled foods.
Neoplasms in the gallbladder
Often, ultrasound examination reveals polyps - this is a benign growth of the epithelium in the lumen of the gallbladderbubble. They are formed in the form of small, large or mesh large-scale formations. There are four types:
- Inflammatory - formed on the inner membrane of the bladder when a bacterial infection enters.
- Cholesterol - mucosal proliferation occurs due to the deposition of cholesterol.
- Adenomatous - formed from glandular tissue, often degenerate into malignant.
- Papillomas are small nipple growths on the mucosa.
The reasons for the formation of polyps are: hereditary predisposition, inflammatory processes, metabolic disorders or contractile activity of the bladder, malnutrition. When the growths take on a significant size, the patient has the following symptoms:
- Aching, dull pain - the volume of the organ exceeds the norm of the gallbladder due to an increase in growths and accumulating bile. The condition worsens after stress and fatty foods.
- Hepatic colic - associated with clamping of the neck or its torsion, when polyps hang from the walls of the bladder. Severe, cramping pains cause high blood pressure and rapid heartbeat.
- There is a bitter taste in the mouth, vomiting after eating, nausea.
In addition, the patient begins to lose weight, yellowness appears on the mucous membranes, urine becomes dark, itching and dry skin appear.
How to treat polyps in the gallbladder?
Therapy largely depends on the type of neoplasm. Most often, cholesterol growths appear. They have a loose structure, a small height up to 1 cmand can dissolve on their own under the influence of bile. To speed up the process, drugs are prescribed that stimulate the quality and formation of a secret. The course of treatment is long and is at least three months. In this case, the following drugs are used:
- "Simvastatin" - cleanses the blood of cholesterol.
- "Holiver" - increases the production of bile.
- "No-shpa" - relaxes the smooth muscles of the bladder and ducts.
- "Allohol" - reduces inflammation and stimulates the synthesis of bile acids.
Be sure to consult a doctor before starting treatment, otherwise you can only do harm. In addition, the course of treatment includes vitamin complexes to strengthen the body. But when asked how to treat polyps in the gallbladder, doctors say that the most effective method is only surgery. Neoplasms do not respond well to conservative treatment, they have to be constantly monitored so that they do not increase and cannot degenerate into stones or a malignant tumor. The operation is carried out in a gentle way - laparoscopy, after which the patient quickly recovers and starts to work. The only condition after surgery is a lifelong diet.
Interaction of two digestive organs
The gallbladder and pancreas are located next to each other. The most basic is that the bile duct and the pancreatic duct join together and enter the duodenum (duodenum). Their functions are aimed atdigestion of incoming food. The role of these organs during the digestion process is not the same, but they both contribute to the breakdown of food components, providing the body with useful substances and energy. The pancreas produces pancreatic juice, which contains a large amount of enzyme substances. When they enter the duodenum, they are activated and affect the digestion of the food contained in it.
The main functions of the gallbladder, the shape of which is similar to an elongated pear, is to accumulate bile constantly produced by the liver and to carry out its penetration into the duodenum. The accumulated secret, upon receipt of the food coma, is released into the duodenum and is involved in the breakdown and absorption of lipids. Digestion of food cannot occur both without pancreatic secretion and without bile. Failures in their production and entry into the duodenum cause diseases of the digestive system and provoke complications.
Conclusion
Now you know why you need a gallbladder. To keep it in working condition for a long time, it is imperative to monitor your he alth: move a lot and exercise, do not smoke or abuse alcohol-containing drinks, limit the consumption of spicy and fatty foods. It is especially necessary to pay attention to maintaining he alth when there is a family predisposition to ailments associated with the gallbladder.
