Dyskinesia of the biliary tract treatment. Pain syndrome with hypertensive dyskinesia

Bile is a special fluid that is produced in the liver. Its main tasks are to improve the absorption of fats and activate the movement of food through the intestines.

Before bile enters the intestine, it passes a difficult path through the bile ducts. First, from the liver, it enters the hepatic ducts, and from there into the common bile duct, which connects to the gallbladder through the cystic duct. The place where the common bile duct flows into the duodenum is called the Vater papilla. He has his own muscle (sphincter of Oddi), which regulates the flow of bile into the intestines.

Biliary Dyskinesia  - This is a disease in which, due to a violation of the contractions of the gallbladder and its ducts, as well as defects in the functioning of the sphincter of Oddi, problems arise with the elimination of bile.

According to statistics, biliary dyskinesia often affects women.

Causes

The development of the disease contribute to:

• poor nutrition (a lot of fatty, spicy, long breaks between meals);
• diseases of the gastrointestinal tract, gastritis, duodenitis, peptic ulcer, pancreatitis);
• hormonal disorders;
• menopause;
• worms;
• food allergy;
• nervous experiences, stresses.

What's happening?

Doctors give out two main forms of dyskinesia.  At hyperkinetic  the form of the tonus of the gallbladder is increased and its contractions occur too quickly and strongly. Sphincters (muscle "gates") are not opened enough. This causes a sharp pain in the right hypochondrium. Attacks of pain are usually short-lived and rarely last more than one hour. As a rule, they arise not from scratch, but are provoked by negative emotions, unrest, nervous overload. In women, exacerbations of the disease are associated with the menstrual cycle, since during menstruation, the tone of the gallbladder is usually increased. The hyperkinetic form of dyskinesia is more common at a young age.

Hypokinetic a form of dyskinesia, on the contrary, is more likely to affect older people. Its cause is an insufficiently intense contraction of the gallbladder. It also manifests pain in the right hypochondrium. True, the pain is usually not strong, but prolonged, is dull, often bursting in nature. However, here, as in medicine in general, there is nothing absolute. All manifestations of the disease are very individual. Even an experienced doctor is not so easy to make an accurate diagnosis, based only on the patient's complaints.

Biliary dyskinesia consists of a series of exacerbations and improvements. After some time, an inflammatory process of cholecystitis, cholangitis) or gallstones can form gallstone disease in the gallbladder and ducts).

If in the morning you feel a bitter taste in your mouth, if you are constantly in a bad mood and a breakdown, it is possible that the cause of all the trouble lies in the disruption of the biliary tract. And if at the same time about time (worrying or snacking with a sharp salad) you feel pain in the right hypochondrium: dull aching or, conversely, sharp cramping, immediately go to a gastroenterologist for an appointment. Seventy chances out of a hundred that you have dyskinesia.

Alarming signs: constipation or diarrhea, poor sleep and appetite, decreased sex drive and an irregular menstrual cycle (in women).

Diagnostics

To make a correct diagnosis, a gastroenterologist will certainly refer you to additional studies:

1. Blood chemistry. During a pronounced exacerbation, an increase in the level of liver enzymes (alkaline phosphatase, etc.) is found in a blood test.
2. Ultrasound of the liver and gallbladder, which allows you to assess the condition of the gallbladder and its ducts, to identify stones.
3. Duodenal sounding - collecting bile for analysis using a gastric tube. The procedure is also used for therapeutic purposes to rinse the biliary tract with stagnation of bile. To do this, after collecting bile, heated mineral water is introduced into the probe. The procedure is performed on an empty stomach.
4. Tests using special drugs. A drug substance (e.g., secretin) is administered that enhances the production of bile. If there is a disease, then bile does not have time to stand out in the intestines, but accumulates in the gallbladder and ducts. There is an expansion of the ducts and an increase in the volume of the bladder, which is recorded using ultrasound.
5. X-ray methods - cholecystography.

It is very important not to confuse biliary dyskinesia with other serious diseases that have similar symptoms!

Treatment

It is important to establish a form of dyskinesia during the examination process - the treatment method will depend on this. A necessary condition for the treatment of dyskinesia is a diet.

Diet with hyperkinetic form   - this is frequent fractional nutrition (4-5 times a day), restriction of products that cause bubble contraction (fatty, meat products, vegetable oil, cakes and other products from fatty dough, beer, carbonated drinks). Dishes should be predominantly mashed and boiled, not too greasy or sharp. More fruits and berries in any form!

Of the drugs used mainly antispasmodics (no-spa, etc.). Cholagogue preparations (holosas, cholenzyme, flaming) and medicinal herbal preparations (corn stigmas, dogrose, peppermint, etc.) will not be out of place.

To this day, the ancient method of treatment is widely used - drinking mineral water. With this form of the disease, water with low and medium mineralization is recommended: Narzan, Navtusya, Slavyanovskaya, Smirnovskaya, Essentuki No. 4 and No. 20. Water should be drunk hot (40-25 degrees), ½ cup or 1 cup 3-4 times a day half an hour before meals.

If all of the above does not help, the doctor may prescribe a tubage - washing the biliary tract.

Diet with hypokinetic form   must include products with a choleretic effect: sour cream, butter and vegetable oil, cream, soft-boiled eggs, brown bread, vegetables. They stimulate the motor activity of the biliary tract. For the same purpose, aloe extract, eleutherococcus, ginseng are used. Vegetable choleretic fees help a lot. They usually include immortelle flowers, yarrow, mint leaves, coriander fruits, etc.

Cholagogue is used - cyclavone, 10% solutions of xylitol or sorbitol, Karlovy Vary salt and herbs - a decoction of parsley, decoctions and infusions of dandelion, yarrow, calamus swamp, barberry.

Mineral waters are also used here, but only with a high degree of mineralization. For example, Batalinskaya, Arzni, Yessentuki No. 17. They should be drunk cold in ½-1 glass 3-4 times a day for 30-60 minutes. before meals (within 3-4 weeks).

In addition, tubage with Karlovy Vary salt, magnesium sulfate or sorbitol is used.

Dyskinesia is also treated with physiotherapy. In recent years, laser and acupuncture have been increasingly used.

Prevention

1. Follow a diet and eat regularly (at least 4 times a day).
2. Avoid excessive physical and mental stress.

Timely treat diseases of the digestive tract.

Biliary dyskinesia and gall bladder  - is a functional disorder of the extrahepatic ducts, as well as the motor function of the gallbladder.

Biliary dyskinesia is a disease to which there is no unambiguous medical approach. In medicine, there are many similar examples. So in a particular case, there are two approaches to the disease, somewhat different in ideas about the causes and the mechanism of its occurrence.

An earlier view defines biliary dyskinesia as a violation of the flow of bile into the duodenum due to a disorder in the muscular system of the biliary tract, causing pain in the right hypochondrium.

Causes of the disease

The main causes of biliary dyskinesia include:

In the development of the disease, two main mechanisms are distinguished. The first is the pathology of hepatocyte function. As a result, the composition of bile, the functional state of the bile ducts and gall bladder are disturbed. The second mechanism is associated with a violation of the neurogenic regulation of the muscular wall of the bile ducts of both central (neurocirculatory dysfunction, neurosis) and peripheral (with pathology of the gastrointestinal tract) origin.

Types of Dyskinesia

Two forms of gallbladder dyskinesia are distinguished: hypertonic (hyperkinetic) and hypotonic (hypokinetic):

• At hypertonic  dyskinesia, the gallbladder does not secrete bile, as it is greatly reduced, the tone of the biliary tract sphincters will be increased.
• At hypotonic  dyskinesia, on the contrary, bile from the bladder constantly flows out, and the bladder practically does not contract, the tone and motor activity of the bile ducts will be reduced.

Primary and secondary dyskinesias are sometimes isolated, but in the vast majority of cases they are secondary, and therefore this classification is inappropriate. In primary dyskinesia, as a rule, an organic pathology of the gallbladder or biliary tract is not observed. With a prolonged course of dyskinesia, stagnation of bile in the gallbladder appears, the colloidal structure of bile is disturbed, which contributes to the onset of the inflammatory process and stone formation. Dyskinesia of secondary genesis is observed if calculous or stoneless cholecystitis, anomalies of the structure, excesses, narrowing of the biliary tract originally existed.

Primary and secondary dyskinesia of the gallbladder are most often observed in young women with reduced body weight, a connection with the menstrual cycle is often noted. Hormonal regulation disorders, unstable emotional background and various pancreatitis are direct pathways to the development of biliary dyskinesia. Taking certain medications can lead to congestion in the gallbladder and cramping of the sphincter of Oddi.

Symptoms

Symptomatic is slightly different depending on the type of dyskinesia (hyperkinetic or hypokinetic).

Symptoms of general neurosis are characteristic of both forms of dyskinesia: increased fatigue, tearfulness, irritability, temper, headaches, palpitations, sweating.

At hyperkinetic gallbladder dyskinesia  hallmarks are periodically occurring acute spastic pains in the right hypochondrium, which can give off to typical places: in the right shoulder blade, shoulder, or in the left half of the chest. The pain occurs suddenly, multiple repetition during the day is possible, rarely accompanied by nausea, vomiting, impaired bowel function. In the interictal period, severity in the right side may disturb.

When hypokinetic dyskinesia  characteristic signs are constant dull pain in the right hypochondrium, which does not have a clear localization, a feeling of fullness. Eating or an emotional factor can lead to increased symptoms. Most often, the patient complains of poor appetite, a bitter aftertaste, belching, increased gas and constipation. Mixed forms are often found when one is replaced by another.

Diagnostics

If you suspect biliary dyskinesia, it is necessary to conduct such studies:

• Blood chemistry.
• Ultrasound examination of the liver and gall bladder.
• Duodenal sounding.
• Cholecystography.

In the past few years, some authors have formulated a different approach to the causes of the development of biliary dyskinesia. It is more peculiar to foreign doctors. This approach is more specific. The cause of the disease is a violation of the function of the sphincter of Oddi. An incomplete opening of the sphincter occurs, as a result of a violation of the outflow of bile, its pressure in the bile duct and pancreatic duct increases, which causes pain. The cause of the disruption of the sphincter may be the growth of muscle, glandular or fibrous tissue.

However, regardless of the approach, the diagnosis of biliary dyskinesia is made with the exclusion of other diseases of the liver and biliary tract.

Treatment of dyskinesia

If the diagnosis of dyskinesia is confirmed by the results of the tests, appoint:

• Sedatives if dyskinesia proceeds according to the hypertonic (hyperkinetic) type: bromine preparations, tincture and Valerian tablets, motherwort tincture, new passit.
• Tonic drugs, if dyskinesia of hypotonic (hypokinetic) type: tinctures of ginseng, eleutherococcus, lemongrass.
• If necessary - anthelmintic and antiprotozoal drugs: levamisole, pyrantel, ornidazole, tinidazole.
• Cholagogue: allochol, cholenzyme, holagol, magnesium sulfate in powder, sorbitol.
• Antispasmodics used for the hypertonic type of dyskinesia: platifillin, drotaverin, papaverine, mebeverin.
• Prokinetics (drugs that improve gastrointestinal motility): domperidone, cisapride - with a hypokinetic type of disease.
• Hepatoprotectors: Carsil, Essential, Artichoke in tablets.
• Microbial preparations: linex, bifiform, lactobacterin, bifidumbacterin, yogurt in capsules.
• Infusions and decoctions of medicinal plants: immortelle sandy, tansy, chicory, peppermint, chamomile, rosehip.
• Mineral waters of weak mineralization - with a hypertonic type of disease, high mineralization - with a hypotonic type of dyskinesia.

A positive effect in the presence of biliary dyskinesia is exerted by physiotherapeutic procedures:

• Applications of paraffin and ozokerite, electrophoresis of solutions of novocaine or magnesium sulfate (for hypertensive type of disease).
• Coniferous baths and souls (fan, circular).
• Microwave therapy, inductothermy.
• Acupuncture.

Dyskinesia diet

When treating, it is very important to follow a diet.

In the menu of patients suffering from hypokinetic type dyskinesia, products with a high content of vegetable fats are introduced. A positive effect on the motility of the biliary tract has the use of raw vegetables, herbs, bran.

The hyperkinetic type of dyskinesia requires limiting the intake of animal fats, eggs, meat and mushroom broths.

Folk remedies and methods of treatment

• Rutabaga has a choleretic and anti-inflammatory effect. It is recommended to eat raw or boiled.
• It is recommended that every two hours take two tablespoons of freshly squeezed lemon juice daily.
• The pulp of boiled and raw pumpkin restores, rehabilitates the liver after an acute form of hepatitis, is also an excellent choleretic agent. Eat the pulp from 0.5 kg per day.
• Pumpkin juice improves sleep and soothes the nervous system. Therefore, it is recommended to drink one glass a day, as well as for a sedative effect - at night.
• It is recommended to take 50 ml of grapefruit juice half an hour before meals.
• Mix 100 ml of fresh carrot juice with 100 ml of warmed milk to 70-80 ° C. Drink in large sips, replacing breakfast with this mixture. If the obtained calories cannot provide the usual supply of strength for a hard day's work, you need to have a full breakfast, but only an hour after drinking.
• A mixture of carrot juice with beet juice and cucumber is taken in equal proportions three times a day, 100 ml 20 minutes before meals.
• Mix a glass of tomato juice with a glass of cabbage brine. Eat after meals three times a day.
• Take a glass of apple juice, add a tablespoon of honey. Take up to four times a day, 100 ml.
• Take 4 parts carrots, one part parsley and three parts celery. Make a juice mixture from these ingredients. Drink half an hour before meals three times a day, two tablespoons.
• It is recommended to take, with a hypotonic form of dyskinesia, a tablespoon of olive oil every day, washed down with sweetened lemon juice.
• Pour the wheat grains into a warm, dark place. Wait until the sprouts are 1 mm in size. Then rinse them and grind with a meat grinder, add a drop of vegetable oil. Eat in the morning on an empty stomach.
• Pour Hercules flakes with a glass of hot water. After the porridge has cooled, you can eat it. Eat half an hour before meals three times a day.
• Grind the root and six leaves of horseradish. For a week, insist on 500 ml of vodka. To eat before meals three times a day, one tablespoon.
• Grind dried melon seeds in a coffee grinder. Then pour 200 ml of boiled milk in a glass of the obtained flour. Let it brew in a thermos for 1-2 hours. Strain. Drink in the morning on an empty stomach half a glass.
• Take two fresh chicken yolks, beat in foam, drink. After which, after 5 minutes, drink 200 ml of warm mineral water. Lie down with a warm heating pad under your right side. Effectively eliminates pain in the liver.
  Attention!  You must be sure that the eggs do not contain salmonella.
• Take the fruits of anise, coriander, corn stigmas, knotweed grass, three-colored violet grass, St. John's wort grass, dandelion root, celandine grass - all in equal quantities. Pour 600 ml of boiling water into three tablespoons of the collection. Then insist for half an hour, strain. Drink three times a day, one tablespoon.
• It is necessary to take four parts of sandy immortelle flowers and St. John’s wort grass perforated, one part of pharmacy chamomile, three parts of knotweed grass, two parts of buckthorn bark. Pour four tablespoons of the mixture with a liter of cold water overnight. Boil in the morning, then keep on low heat for another 10 minutes. Allow to cool, strain. Fasting drink a glass of broth. The rest is divided into four times, after eating.
• Take equally the bean pods, knotweed grass, smooth hernia grass, corn stigmas, bear ears grass. Pour a glass of boiling water over a tablespoon of the collection. Insist for an hour, pre-wrapped (you can in a thermos). Then strain. Use infusion throughout the day, warming before taking.
• It is necessary to take in equal amounts of flowers of a pharmaceutical camomile, a sheet of three-leaved cotton wool, celandine grass. Pre-grind. To mix. Pour a glass of boiling water over a tablespoon of the collection. Let it brew for an hour. Then strain. Drink 100 ml in the morning and evening one hour after eating.
• Take one part of kidney tea, dioecious nettle grass, field horsetail grass, two parts of knotweed grass. Pour 500 ml of boiling water 2 two tablespoons of this mixture. Insist for six hours. Use before meals three times a day, 100 ml in warm form.
• Take an equal amount of grass golden beetroot, peppermint leaf, celandine grass. Pour 200 ml of boiling water a tablespoon of this collection. Insist for an hour, strain. To use twice a day half an hour before meals, one glass of infusion.
• Take an equal amount of sage leaves, caraway seeds, peppermint leaves, angelica roots, buckthorn bark. Pour 200 ml of boiling water a tablespoon of this collection. Use half an hour before meals three times a day, 100 ml.
• It is necessary to take three parts of an immortelle sandy, two parts of a root of a rhubarb, five parts of an ordinary yarrow. Pour 200 ml of boiling water a tablespoon of this collection. Then insist, strain. Drink 140 ml of infusion before bedtime.
• Take 1 part lemon grass lemon balm, 2 parts buckthorn bark, peppermint leaf, sandwort flowers, 6 parts chopped rose hips, 5 parts celandine grass. Brew 1 teaspoon of the collection in 300 ml of boiling water. Insist 15 minutes, drink in 1 dose with honey.
• Pour fresh hypericum flowers at the rate of one in ten with olive oil. Insist for 40 days. Use three teaspoons half an hour before meals, two teaspoons.
• Pour a glass of boiled water dried and chopped rose hips. Put on fire and boil for another half an hour. Insist in a thermos for four hours, strain. Eat 100 ml of infusion three times a day before meals, adding a small amount of honey.
• Pour a glass of boiling water with a tablespoon of lingonberry leaves, insist for half an hour, strain. Infusion take up to five times a day, two tablespoons.
• Pour 200 ml of boiling water with two teaspoons of peppermint grass, insist for half an hour, strain. Use during the day, taking in large sips.
• Pour 400 ml of boiling water into two tablespoons of dill seeds. Put on low heat for another 15 minutes, then cool and strain. Take up to four times a day, 100 ml of warm broth. The duration of treatment is up to three weeks.
• Mix equal amounts of gooseberry grass, celandine grass and peppermint leaf taken in equal amounts. 1 tablespoon of the mixture pour 1 cup of hot water, boil in a water bath for 15 minutes. Insist 30 minutes, strain, bring the volume of infusion with boiled water to 1 cup. Take 1-2 cups of hot infusion per day with the hypertonic form of biliary dyskinesia with cramping.

Self-massage of the abdomen

Self-massage of the abdomen improves intestinal motility, tones its work, helps to eliminate bile from the body, stimulates the activity of the pancreas and stomach, which fully explains its effectiveness, both for treatment and for the prevention of diseases of the abdominal organs. Self-massage is not carried out in acute forms of diseases of the abdominal organs. In order to avoid painful sensations of these organs in people with chronic diseases, self-massage is done easily and gently.

• Lying on your back, put your right hand on the lower abdomen (under the navel), and the left hand above it. Slightly pressing (preferably the lower part of the palm) on the stomach, shift the abdominal wall with the right hand to the left, and the left - to the right. Perform this technique while moving your arms toward each other. The wall of the abdomen will gently slip under the palms. Then change hands (right above, left - below) and make the same movements, but in opposite directions.
• Put the left palm on the navel, and the right on top and, slightly pressing on the stomach, make rotational movements clockwise and counterclockwise (10 rotations in total).
• Massage the periphery of the abdomen. The fingers of the left hand should be placed on the area between the navel and the right wing of the pelvis, slightly pressing, to perform movements clockwise and against it, while moving the hands slightly upward. Repeat similar movements under the right hypochondrium (region of the gallbladder), in the epigastric region, under the left hypochondrium, below it (region of the descending part of the large intestine) and on the left, between the navel and the left wing of the pelvis (region of the sigmoid colon). Make 20-30 circular movements.
    Attention! Massage the sigmoid colon can cause a stool.

Physiotherapy

A set of exercises for biliary dyskinesia  and chronic cholecystitis:

• PI (starting position) - lying on your back. At the same time, raise your right hand up and bend your left leg. A foot glides on the floor - a breath. Upon returning to the PI - exhale.
• IP - see point 1. Hands are on the belt. Raise his head and shoulders, eyes look at socks - exhale. When you return to the IP - a breath.
• IP is the same. Put your right hand on your stomach, left on your chest. The essence of the exercise is diaphragmatic breathing, that is, the stomach. Raise both hands, following the movements of the diaphragm and chest - inhale, when exhaling - lower your hands down.
• IP - lying on the left side, the left leg is bent, the left hand stretches up. When lifting the right hand up - inhale, while bending the right leg, pressing the knee with the right hand to the chest - exhale.
• IP - see point 4. When lifting the right arm and leg, inhale, while bending the leg and arm and pulling the knee to the stomach, tilt your head - exhale.
• IP is the same. When leading the straight right hand up and back at the same time - inhale, return to PI - exhale.
• IP is the same. Take both legs back - inhale, PI - exhale.
• IP - in the pose of a cat. Raise your head up inhale, moving, with sliding movements, put your right leg forward between your hands - exhale. Return to the PI and repeat the exercises, but with the other foot.
• IP is the same. Straighten your left hand, take it to the side and raise it up - inhale, return to PI - exhale.
• IP is the same. Take a breath and, bending your arms, take the position “lying on your stomach” - exhale, return to PI.
• IP is the same. You need to raise your head, bend in the shape of a boat in the lumbar region - inhale, with the head tilted, bend your back in an arc - exhale.

Breathing exercises

A series of respiratory exercises can be included in the complex of therapeutic exercises. These exercises are aimed at changing intra-abdominal pressure, so they must be performed during the rehabilitation period, making sure that unpleasant pain does not appear.

• PI (starting position) - standing, hands on hips. Inhale slowly (inhale of moderate depth), retract the abdomen, exhale strongly, abruptly.
• IP is the same. Exhale strongly and abruptly, maximally drawing in the stomach, hold your breath for 6-8 seconds. Abdominal muscles should be in a relaxed position.
• IP - sitting on the floor, legs tighten. Hands on knees, back straight. Eyes closed or raised, head down. The muscles of the shoulders, face, arms, neck, legs are completely relaxed. Take a slow breath (depth - moderate) and hold your breath for 1-2 seconds.
• IP is the same. Breathe in slowly (1-2 seconds), hold your breath for 2 seconds. Repeat a few more times.

Biliary dyskinesia is a disorder that leads to impaired functioning of the body. This ailment leads to excessive throwing of bile into the intestine. As a result of this process, the patient may complain of pain in the right side of the abdomen, loose stools and worsening general condition. If the patient began to feel such symptoms, then care should be taken about how to treat biliary dyskinesia, immediately consult a gastroenterologist.

Treatment of hypotonic type dyskinesia

If the patient has biliary dyskinesia, symptoms, treatment should be determined as soon as possible. If this is not done on time, then the patient runs the risk of being left without a gall bladder.

  Dyskinesia of the biliary tract and gall bladder is divided into two types: hypertonic and hypotonic.

Nikodin

This medication has a choleretic, choleretic, anti-inflammatory, antimicrobial, bactericidal and bacteriological effect. The composition of the drug includes a derivative of formaldehyde and nicotinic acid amide. As a result of this, there is an increase in the secretory function of the liver, increased secretion of bile and facilitation of its release into the intestine.
  It has a contraindication in the form of increased susceptibility to the components of the drug. With extreme caution, you can take medication for the development of cholestasis and gastritis antacid form.

When taken, it can cause side symptoms in the form of an upset digestive function, the occurrence of severe pain and the development of an allergic reaction.

  A medicine that contains natural bile and digestive enzymes. Refers to a combination product that has not only a choleretic effect, but also improves the digestion of food due to enzymes.
  This tool is prohibited for acute pancreatitis, obstructive jaundice, stomach and intestinal ulcers during exacerbation.

With extreme caution, it is worth taking the drug during gestation and lactation. It can cause side effects in the form of heartburn, itching, rashes on the skin, diarrhea and an increase in the amount of transaminase in the blood.

Tserukal

It is prescribed to prevent nausea and vomiting in the patient. The action is based on blocking vomiting, which are sent by impulses to the brain. It is produced in the form of tablets and injection.
  It has several limitations in the form of pheochromocytoma, intestinal obstruction, the development of bleeding in the intestine, perforation of the gastrointestinal tract, the presence of tumor-like formations, epilepsy and convulsive state.

Tserukal is strictly forbidden to use by women during gestation and lactation. The drug in tablet form is also prohibited. But if absolutely necessary, you can make an injection with a solution.

It is possible to develop adverse reactions in the form of dizziness, tinnitus, pain in the head, fatigue, depression, the development of tachycardia, agranulocytosis, spikes in blood pressure, dry mouth, stool disorders, the development of an allergic reaction or spastic colitis.

This medication is intended to maintain the liver. With the development of dyskinesia, she also begins to suffer. Chophytol has not only hepatoprotective property, but also choleretic. The effect of the drug is aimed at normalizing the production of enzymes that the liver produces. As a result of this, metabolic processes are being established, and much less cholesterol enters the bile.

  Also in its composition has many vitamins and biological substances that lead to the normalization of the liver and gall bladder. It is prescribed for patients of any age, as it has a natural composition and is not toxic.

The medication is available in several forms: tablets, solution for internal and injection use.

It has a number of limitations in the form of obstruction of the biliary tract, cholelithiasis, kidney disease, hepatic and renal failure of a severe nature and increased susceptibility to the components of the medication.

In most cases, it is well tolerated, but can cause side effects in the form of diarrhea, an allergic reaction, swelling of the skin and subcutaneous tissue.

Tubing with mineral water, sorbitol or magnesia is also recommended. These manipulations should be carried out up to three times a year. Before the procedure the night before, it is necessary to cleanse the intestines with an enema, laxative or glycerin suppository.

The next morning you need to drink the prepared solution, consisting of mineral water, sorbitol or magnesia. After this, you need to attach a heating pad to the right side of the abdomen and hold it there for about two hours. A sparing diet consisting of vegetables and fruits should be followed throughout the day.

The healing process lasts from two to three months. In this case, you must follow the correct diet, which includes the use of eggs, vegetable oils, bran, vegetable dishes and rye flour bread.

Hypertensive type dyskinesia treatment

The prescribed treatment for biliary dyskinesia and hypertensive treatment have their own characteristics. With this type of disease, drugs that have a choleretic effect are prohibited, since without this, bile is thrown into the intestines in large quantities.

If the patient was diagnosed with hypertensive dyskinesia of the gallbladder, treatment consists in taking antispasmodics.

You can use papaverine. The drug is made in three types: tablets, suppositories and injection. The main component is papaverine hydrochloride, which has the ability to act on smooth muscle structures and relax them.

It has several limitations in the form of increased susceptibility to the components of the drug, disruption of the heart muscle, the development of glaucoma, severe liver failure, it is contraindicated in older people and babies up to six months.

Relative limitations include traumatic brain injury, chronic renal failure, development of a shock condition, hypothyroidism, tachycardia, and insufficient adrenal gland function. In such situations, the medication should be taken under the strict supervision of a doctor.

With prolonged use or non-compliance, the dosage can cause a number of side effects in the form of lowering pressure, drowsiness, the development of allergic reactions, nausea, bloating and constipation.

The most popular remedy in this group is No-shpa. It is also prescribed as a relief of muscle spasm. It can be taken with the development of pain or acute colic. It is often prescribed in situations where the patient has contraindications to other drugs in the form of glaucoma or hypertrophy of the prostate gland.

It has a number of limitations in the form of severe renal and hepatic insufficiency, severe heart failure, childhood under six years of age, lactation, hereditary galactose intolerance, increased susceptibility to the components of the drug.

With extreme caution, the medication can be taken during gestation, with arterial hypotension, and in children.

In most cases, No-spa is well tolerated, but with prolonged use or taking the above dosage, side symptoms may appear in the form of nausea, constipation, palpitations, headaches and dizziness, sleep disturbances and the development of an allergic reaction.

Drotaverine

There is a cheaper analogue called Drotaverin. It has an antispasmodic effect, upon administration of which the vessels dilate rapidly, the tone of smooth muscles decreases. This drug is more effective than Papaverine, as it is evenly distributed throughout the tissues.

Compared with No-shpa and Papaverin, it has fewer contraindications. This includes increased susceptibility to the components of the drug, congenital lactose intolerance, severe heart failure, severe renal and hepatic failure.

Drotaverinum is not advised to be taken to children under two years of age and during lactation.

With extreme caution, use of this tool should be with low pressure, atherosclerosis, glaucoma, prostatic hyperplasia and during gestation.

Also, the patient is advised to drink mineral water daily.

In addition to all these drugs, the patient with hypertensive dyskinesia is advised to take sedative agents in the form of tinctures of Valerian or Motherwort.

Other drugs for the treatment of dyskinesia

No matter what gallbladder dyskinesia is observed, the symptoms and treatment are almost always general.

Fervital

Without fail, the doctor prescribes Fervital. This medication belongs to a powerful sorbent that has an antitoxic property, acts as an antagonist in the presence of pathogenic microbes. Also, the action of Fervital is aimed at restoring the natural microflora of the intestines and stomach, due to which the number of lactobacilli in the digestive system is normalized.

When using Fervital, the amount of sugar and cholesterol in the blood returns to normal. Also, the medication has a symptomatic property, as a result of which the unpleasant symptoms in the form of heartburn, pain, nausea, vomiting, and diarrhea disappear.

It has no contraindications, except for increased susceptibility to the components of the drug. The drug is well tolerated by patients. It is prescribed for adults, children, newborns, women during gestation and feeding. But it can cause adverse symptoms in the form of an allergic reaction, a violation of digestive function.

Often, the treatment process for biliary dyskinesia and the gallbladder involves taking hepatoprotective agents. They allow you to restore and protect against destruction of liver cells.

Essentiale Forte is considered one of the most popular. The product is sold in the form of capsules, which have a brownish color. The composition of the drug includes phospholipids and various vitamins that the body needs in the development of biliary dyskinesia.

What is noteworthy Essentiale Forte turns cholesterol and other hard-to-digest fats into lightweight forms, which makes it easy to dispose of them from the digestive system.

It has no contraindications, but can cause side symptoms in the form of the development of diarrhea, pain in the abdomen, allergic reactions. But in most cases it is well tolerated. It can be prescribed to children, adults, pregnant and lactating women.

As analogues, Hofitol, Ovesol, Hepatrin, Karsil can be attributed.

Enzyme preparations are prescribed to improve digestive function. This group of medicines includes Pancreatin, Creon, Mezim, Festal, Vestal.

The treatment process should be carried out comprehensively. It is aimed at normalizing the outflow of bile and preventing the further development of its stagnation in the gallbladder.

Treatment of biliary dyskinesia includes not only taking medications, but also following some recommendations:

• First of all, it is necessary to normalize the mode of work and rest, and then constantly maintain it. It should include sleep for eight to nine hours a day. At the same time, departure to night rest must be carried out no later than eleven o'clock in the evening.
• It is definitely worth alternating physical and mental work. For example, for every two hours of working at a computer, one hour of physical activity should occur.
• Also, every day the patient needs to carry out walks in the fresh air. They should last at least thirty minutes.
• Follow a strict diet. It eliminates the use of fatty, fried and spicy foods. All food should be steamed, stewed or boiled. The diet should include fruit and vegetable dishes. Do not exclude meat, but it should be lean, which includes beef, rabbit, chicken and turkey.
    Sweets and baked goods are limited in reception. It is better to replace them with nuts, honey, jam, pudding or casserole. Proper nutrition must be observed for twelve weeks. In this case, the diet may also vary based on the form of the disease. With hypotonic dyskinesia, sugar, boiled sausages, fish, caramel, marmalade and pastille can be included in the diet. But with hypertensive dyskinesia, these products are excluded. Sugar is replaced by xylitol, and beef by young veal.
• Observe drinking regimen. This rule is the most basic, because it is the liquid that allows bile to not thicken. The daily amount of fluid consumed with dyskinesia should be at least two liters. The diet should include plain and mineral water, fruit drinks from lingonberries, cranberries and currants, compotes from dried apricots, raisins and prunes, green tea. At night before bedtime, it is advised to take kefir and fermented baked milk to improve bowel function.
• Conduct closed tubing and duodenal sounding. This type of procedure is prescribed only for hypotonic dyskinesia.
    For manipulations, you need to take magnesium sulfate and dissolve it in warm water. Take in the morning on an empty stomach, then lie on your right side with a heating pad. The solution can be replaced with mineral water, beet juice and egg yolks. The duration of the procedure should be from thirty to forty minutes. Tubage should be performed once a week. At the same time, six more procedures are worthwhile.
• As an additional method of treatment, physiotherapy can be prescribed. With low motor function of the gallbladder, electrophoresis is prescribed using medications in the form of Pilocarpine or Carbocholine. Such manipulations allow you to stimulate smooth muscles to perform appropriate movements.
• Diadynamic therapy, amplipulse therapy and magnetotherapy are also indicated. These methods are carried out directly in the area of \u200b\u200bthe gallbladder.
• With strong motor function of the gallbladder and ducts, the patient is prescribed electrophoresis with Papaverine, DMV therapy for the right hypochondrium, paraffin baths and coniferous baths.
• With JVP, acupuncture is often prescribed. This method of treatment allows you to normalize the tone of the walls and outflow of bile. Specialists, using the thinnest needles, act on special points that are responsible for the work of the liver and gall bladder.

The main methods of treating biliary dyskinesia are usually physical therapy and massage. The impact of such procedures is aimed at normalizing the functioning of organs and improving the psychoemotional state. Also there is an analgesic and restorative property.
  Massage and therapeutic exercises are carried out only in the period of remission. Exercises are based on strengthening the muscular frame and respiratory system. Daily exercises need to be performed for twenty to thirty minutes. But physical education depends on what form of the disease is observed in the patient.

With hypertensive dyskinesia, therapeutic exercises should be carried out on the right and left side, as well as lying on the back. Exercise should be aimed at relaxation of muscle tissue. At the same time, the pace should be slow and moderate.

In hypotonic dyskinesia, therapeutic training is also shown on the back, left and right side, standing on the legs and knees with emphasis on the hands. During remission, gymnastics should be carried out in a standing and sitting position. In the training, the patient should include exercises for abs, walking, abdominal breathing. At the same time, the pace and loading should be medium strength.

During the massage, the collar lumbar region is affected. Also, the abdominal area is massaged with slight squeezing under the ribs. One procedure lasts ten minutes. A treatment course should last up to ten to fifteen sessions.

Update: November 2018

Dyskinesia is not the curvature or kink of the gallbladder or the paths leading from it, as most people think. This term comes from the Greek word “kinesis”, which means “movement”, and the prefix “dis-” means “violation”. Thus, biliary dyskinesia is a condition in which the tone or motility of the system that carries bile from the liver to the duodenum is impaired. This causes pain in the right hypochondrium, problems with the stool, and sometimes bitterness in the mouth, but when examining any damage to these organs, it is not noted.

Most often, dyskinesia occurs in people who have abnormalities in the development of biliary organs, who have a love of an unbalanced diet, and also in people who are often exposed to various traumatic situations. There are other reasons for this condition. Women are most susceptible to this pathology. Treatment of dyskinesia is aimed at eliminating symptoms, and also - especially if the bile ducts have a slow speed or poor contractility - to prevent the formation of stones.

A bit about anatomy and physiology

Bile is a brownish yellow liquid needed for digestion. Its main function is to separate fats from food, increasing their surface area. Then they are well processed by the lipase enzyme, as a result of which the constituent parts of fats - fatty acids - are absorbed into the blood. In addition, bile affects the absorption of proteins and carbohydrates. Under the action of this substance, produced by the liver on ¾, and on ¼ - by the hepatic passages, the small intestine normally functions: the processes of absorption of nutrients occur in it, as well as the division and death of its own cells.

In order for all of the above processes to occur correctly, bile must have a normal concentration. The gall bladder is engaged in this, which "gives" the vessels extra water. If bile does not linger in the bladder, it enters the intestines in a diluted form and irritates it, causing diarrhea. In the case of an excessively long stay of bile in the bladder, it enters too concentrated, which is also not useful.

Bile is formed in the liver. Further, it should reach the gallbladder through the bile ducts, and from it enter the duodenum. The movement of the secret is provided by the pressure difference in the biliary tract, which occurs due to the work of circular muscles - sphincters. So, the sphincter passing the bile into the gallbladder is closed - it flows from the liver. Then it opens, and the secret flows into a bubble, which was almost empty, and in which the pressure was less than in the duct. When fatty food enters the duodenum, the gall bladder, which is an organ equipped with muscles, contracts. In this case, the sphincter in the neck of the bladder opens, and the one that begins the entrance to the duodenum 12 is closed, and it opens when the first is closed. Contraction of the biliary tract regulates the sympathetic nervous system and some substances produced in the stomach and pancreas.

What is dyskinesia, its types

Having examined the anatomy, the essence of the pathology can be explained in more detail. So, dyskinesia is a condition:

• if the sphincters (one or several) located in the bile ducts do not relax on time;
• or, conversely, despite eating, sphincters do not want to relax;
• if a strong contraction of the gallbladder occurs;
• if the gallbladder or ducts contract quite sluggishly, reducing the rate of outflow of bile.

Depending on impaired motor function and tone, dyskinesia can be:

• hypertonic: the tone of the sphincters is increased;
• hypotonic: tone, on the contrary, is reduced;
• hypokinetic: the movement of the biliary tract is slowed down, bile is ejected slowly;
• hyperkinetic: the outflow of bile is active, its portions are ejected sharply.

Usually, increased tone is combined with enhanced motility, forming a hypertonic-hyperkinetic (or spastic) type of dyskinesia. The same thing happens in the opposite situation: with poor motility, the tone of the biliary tract is weakened - hypotonic-hypokinetic (atonic) type. There is also a mixed type.

Spastic dyskinesia is characteristic for increasing the tone of the parasympathetic department. The atonic type of disease develops when the influence of the sympathetic part of the autonomic nervous system predominates.

Causes of the disease

The following reasons lead to a violation of the tone or movement of the bile ducts:

• Congenital malformations of the biliary tract and gall bladder:
  • doubling of the bile ducts;
  • congenital weakness of the wall of the bladder;
  • intrahepatic gall bladder;
  • kink of the gallbladder;
  • partitioned gall bladder;
  • valves in the bile duct;
  • additional gall bladder;
  • moving bubble;
  • abnormally located bubble.

All these pathologies cause dyskinesia called "primary." Next, we list the diseases acquired (arising during life), which can become the causes of secondary biliary dyskinesia.

• Eating habits: long periods of starvation, refusal of vegetable fats or, conversely, the use of large amounts of fatty, smoked and spicy foods.
• Constant stress or traumatic situations.
• Postponed pancreatitis or other inflammatory pathology of the gastrointestinal tract or female organs.
• Chronic cholecystitis.
• Neurocirculatory dystonia, when the control of the normal sequence of contractions of the biliary tract is impaired.
• Constantly existing foci of infection in the body (caries, chronic tonsillitis).
• Diseases of the endocrine organs: obesity, diabetes mellitus, thyrotoxicosis.
• Food allergies.
• Postponed viral hepatitis.
• Helminthic diseases.
• Giardiasis, in which flagellar protozoa colonize the gallbladder.
• The period of menopause, when the regulation of bile duct contractility is disturbed.
• Dysbacteriosis
• Past intestinal infections.

Signs of the disease

Symptoms of biliary dyskinesia differ depending on the type of pathology: whether it is hyperkinetic or hypokinetic.

The main difference between the main types of disease is pain with dyskinesia:

Pain characteristics	Hyperkinetic type	Hypotonic type
Localization	In the right hypochondrium	In the hypochondrium on the right
Character	Sharp, colic	Dull, aching, not intense. Can be described as the severity or stretching of the area under the rib.
Where gives	In the right shoulder blade and shoulder	Feels only under the rib
What provoked	Exercise, stress, after fatty foods	Strong emotions, errors in diet
What other symptoms are accompanied by pain	Nausea, vomiting, separation of large quantities of urine, constipation / diarrhea. Against the background of an attack, there may be: irritability, sweating, lowering blood pressure, headaches	Bitterness in the mouth, nausea, loss of appetite, belching, feeling of bloating, constipation / diarrhea
What is eliminated	Drugs "No-spa", "Buscopan"	It goes by itself
In the period outside the attack	Nothing bothers, only short pains can appear in the right hypochondrium, “under the stomach”, near the navel	The disease reversibly changes the personality of a person: he becomes tearful, irritable, quickly tired, mood swings are noted. Outside the attack, nothing hurts

Both types of dyskinesia can cause other symptoms to appear:

• irritability;
• increased sweating;
• recurrent headaches;
• halitosis;
• bloating;
• decreased appetite;
• bitterness in the mouth;
• yellow plaque in the tongue;
• decreased libido in men;
• in some women, menstrual irregularities.

The extreme manifestation of the hyperkinetic variant is biliary colic. It is manifested by sudden severe pain on the right under the rib, which is accompanied by a panic attack, numbness of the limbs.

The maximum manifestation of hypokinetic dyskinesia is cholestasis - stagnation of bile in the biliary tract. The following symptoms indicate this:

• severe itching of the entire skin;
• yellowing of the skin and eye proteins;
• dark urine;
• feces becomes light yellow or even grayish.

Diagnostics

Symptoms to establish a diagnosis alone are not enough, because similar symptoms can develop with more serious liver diseases. Secondly, it is necessary to establish the cause (for example, malformations of the biliary tract) that caused the disease in order to subsequently eliminate it.

Biliary dyskinesia is a condition in which the structure of these organs is not disturbed. That is, the diagnosis is made on the violation of contractility or tone on the way from the liver to the duodenum. How to see it?

Ultrasound scan

Having performed an ultrasound of the gallbladder with a choleretic breakfast. Initially, after following a three-day diet, an “ordinary” abdominal ultrasound is performed. With its help, volumes, sizes, deformations, anomalies of the biliary tract are evaluated, and gallstones are examined. Next, the person takes foods that should cause the discharge of bile into the duodenum 12 (it can be: 100 grams of cream or fat sour cream, fat yogurt, chocolate or a couple of bananas), and the doctor looks in what order and how the movement of bile occurs.

Duodenal sounding

By evaluating portions of the contents of the duodenum 12. To do this, a study called “duodenal sounding” is conducted: a person needs to swallow a thin probe, from which, upon reaching the duodenum 12, its contents will be obtained. The study is carried out on an empty stomach. First, a portion of the normal contents of the intestine is obtained from the probe, which consists of bile, the fluid secreted by the pancreas, and the juice of the duodenum itself. Next, a choleretic drug, magnesia sulfate, is introduced into the probe. The gall bladder contracts and the bile contained in it enters the intestine. She is also taken for research. After a while, bile flows here, which was previously in the intrahepatic bile ducts. She is also taken for analysis. To establish the diagnosis of dyskinesia, the time that elapses from the moment of administration of the choleretic to receiving the second, and then the third portion is important. The content of various lipids in the last two servings is also important.

Cholecystography

Using contrast radiography methods - cholecystography (extrahepatic bile ducts are examined) and cholangiography (examination of the intrahepatic bile ducts is performed). In the first case, a person needs to take a radiopaque substance through the mouth, after which it will be seen in X-rays how the contrast reaches the gallbladder, how it comes out of it, in what order the sphincters contract and relax. The second method involves an injection: a radiopaque substance is injected directly into the bile ducts, and after a radiologist observes its progress along the bile ducts.

ERCP

When performing ERCP (endoscopic retrograde cholangiopancreatography), when a probe with an optical fiber is inserted into the duodenum, and a contrast agent is injected directly through it into the biliary tract, the retrograde (i.e., reverse normal current) progress of which is examined using x-ray.

Cholesintigraphy

By radiological research - cholescintigraphy, in which a radioisotope preparation is injected into the body, and in the light of a special radiation, visualization occurs as it passes into the liver, is secreted into the bile ducts, sent to the gall bladder, and then reaches the duodenum.

Magnetic resonance cholangiography

In complex cases, the performance of magnetic resonance cholangiography is shown - a non-invasive method of research, when a contrast medium is injected into the body, and its path is observed in a magnetic resonance imager. To conduct such a diagnosis, a person will need about 40-50 minutes to be in the camera apparatus, observing immobility.

Blood tests for lipids and bilirubin with its fractions, analysis of feces for dysbiosis, helminth eggs and coprogram are methods that determine the preservation of the function of the biliary tract, and also exclude the possible cause of the disease - worms. These tests are not diagnosed.

Treatment

Treatment of biliary dyskinesia consists of:

• diet therapy: it differs with hypo- and hyperkinetic forms of pathology;
• receiving decoctions or infusions of various herbs: it is prescribed by a gastroenterologist taking into account the type of disease, is an integral part of treatment;
• drug therapy: prescribed by the course, aimed at stopping the attack, preventing their occurrence in the future, as well as for the prevention of complications.

Diet therapy

Nutrition for dyskinesias is the main "whale" of treatment. Only he, with strict observance of the rules, allows avoiding seizures and preventing such surgical complications as acute cholecystitis and cholelithiasis.

The diet for dyskinesias contains general nutritional rules, but there are also moments that fundamentally differ with hypokinetic and hyperkinetic variants.

General rules

You need to take food so that the gallbladder is completely empty, but no pain attacks occur. For this:

• eat a little, 4-5 times a day;
• eat in small portions;
• observe 3-4 hour intervals between meals;
• have dinner in 2-3 hours, while at night do not eat enough meat;
• morning and evening eat low-fat dairy products;
• avoid taking cold or too hot dishes;
• do not heat food on animals or trans fats: margarine, pig, goose or lamb.

Exclude completely	Exclude only during exacerbation	Can eat
meat broths; sausage; fast food; chips; millet porridge; salted nuts; fried foods; fatty meats and fish; canned food; fish broths; baking; legumes; mushrooms; fat of any animal or bird; chocolate; ice cream; spicy dishes; cold drinks with gas; alcohol; chewing gum.	pepper; mustard; mushroom broths; salty foods; radish and radish; sorrel; hot sauces; horseradish; rye bread.	vegetarian soups; low-fat borsch; milk soups with cereals; boiled, baked or steamed low-fat varieties of meat, poultry or fish; cereals: buckwheat, rice - in water or milk; vegetables: baked, stewed, boiled; low-fat dairy products; boiled eggs and steam omelettes; biscuit cookies; sunflower and olive oil; some butter. A small portion of it should be taken in the morning as a sandwich; bread - yesterday; cheeses: unsalted and mild; fruits and berries: ripe, sweet; tea is weak; sweets: honey, marmalade, marshmallows, caramel, pastille, jam; juices - freshly squeezed, diluted with water

Features of nutrition with hypomotor dyskinesia

In the diet there must be products that stimulate the motility of the biliary tract:

• fruits;
• vegetables (baked, stewed, boiled);
• butter and vegetable oil;
• sour cream;
• black bread;
• eggs
• cream.

Features of nutrition in hypermotor dyskinesia

With this form of the disease, it is necessary to exclude from the diet products that stimulate bile formation and bile secretion: animal fats, brown bread, fatty dairy and sour-milk products, fresh vegetables, broths and soda.

Drug therapy

It also has general purposes, and is also based on the type of dyskinesia.

Since dyskinesia is considered a disease, the main cause of which is nervous regulation, which depends directly on the psyche. Therefore, before treating a violation of the motor activity of the biliary tract with choleretic drugs, you need to start by restoring the mental background. If the pathology arose against the background of a depressive state, a course of mild antidepressants is prescribed. If a violation of bile secretion was provoked by neurosis, expressed anxiety, it is advisable to start with tranquilizers or antipsychotics.

Such appointments are made by a psychotherapist or psychiatrist.

In addition, the treatment of the cause of dyskinesia is carried out: anthelmintic therapy, treatment of allergies, elimination of hypovitaminosis, correction of dysbiosis.

Hypotonic-hypokinetic form

In this case, choleretic drugs are needed that:

• will increase the tone of the gallbladder: magnesium sulfate, xylitol;
• improve motility of the biliary tract: for example, cholecystokinin, pancreosimin.

In addition to choleretic, tonic preparations are also needed: ginseng tincture, eleutherococcus extract, lemongrass tincture.

Hypertonic-hyperkinetic form

Here we need drugs that increase the formation of bile: it will become larger, the bile ducts will work longer, and not quickly contract, causing an attack of pain. These are medicines such as okafenamide, flaming, nicodine.

Also, if the sphincters are overstrained, they are relaxed. This is done with antispasmodic drugs: no-shpa, buscopan.

In addition, we need such means that normalize the balance of the parasympathetic and sympathetic systems: tincture of valerian, potassium bromide, tincture of motherwort.

Traditional treatment

Biliary dyskinesia is the pathology in the treatment of which folk remedies are an excellent addition to drug therapy, and sometimes its only component (for example, in children).

If the tests show the presence of cholestasis (stagnation of bile), and the liver tissue is not affected (the levels of ALT and AST are not increased in the analysis of “liver tests”), blind probes are performed: on an empty stomach a solution of sorbitol, mineral water of high salinity or magnesium sulfate is drunk. Then you need to lie on your right side and put under it. So lie down for 20-30 minutes.

Additional treatments

In the treatment of biliary dyskinesia are used:

• physiotherapy: diadynamic currents, electrophoresis, microwave;
• acupuncture;
• acupressure;
• leech treatment;
• treatment in sanatoriums of a gastroenterological profile, in which mineral water therapy is carried out.

Complications of biliary dyskinesia

This functional impairment can lead to the following consequences:

• the formation of chronic inflammation of the gallbladder wall (chronic cholecystitis);
• inflammation of the intrahepatic bile ducts (cholangitis);
• cholelithiasis;
• pancreas inflammation;
• gastritis, gastroduodenitis - inflammation of the stomach or stomach, or duodenum. This is due to the fact that in this disease, unconcentrated bile is often thrown into the stomach and duodenum with this disease, which leads to their inflammation;
• allergization of the body, which is manifested by a skin rash;
• weight loss, metabolic disorder, which occurs due to malabsorption of the necessary substances without proper treatment of bile.

Disease Prevention and Prognosis

In order for the pathology not to develop, observe the following rules:

1. sleep for at least 8 hours;
2. go to bed no later than 11 pm;
3. alternate mental and physical labor;
4. walk not in the fresh air;
5. eat fully: eat more plant foods, cereals, boiled animal products, less - fried meat or fish;
6. exclude traumatic situations.

If the pathology has already developed, it is worth following the recommendations of your gastroenterologist, pay attention to the psycho-emotional background.

Biliary dyskinesia does not reduce life expectancy, but affects its quality.

Dyskinesia in children

Biliary dyskinesia in young children develops due to their abnormal structure. Most often this is an excess of the gallbladder or the presence of partitions in it, less often - doubling or abnormal location of the biliary tract.

In older children, the cause is emotional stress. This is a quarrel between parents, family moving, a team in kindergarten and school, and a lot of workload.

Other causes of dyskinesia are:

• hypoxia or;
• frequent sinusitis, chronic tonsillitis;
• transferred hepatitis A, dysentery, salmonellosis;
• helminthic infestations: giardiasis, roundworms;
• allergic diseases;
• vegetative-vascular dystonia;
• neurosis;
• neuro-arthritic diathesis.

Dyskinesia in children is a more dangerous disease: without normal emulsification of fats, there will not be absorption of a sufficient amount of essential fatty acids and other substances for the body, as well as fat-soluble vitamins A, D, E and K, each of which is important for the growing body.

If parents pay attention that the child is closed, irritable, quickly tired or crying for the slightest reason, it is worth contacting a pediatric gastroenterologist to exclude biliary dyskinesia. If at the moment it is not identified, then this does not mean that the danger has passed; this suggests that there is a predisposition to it, but pathology has not yet had time to debut. In this case, it is worth paying special attention to the diet and the daily routine of the child in order to prevent its formation.

The fact that the pathology has developed is indicated by the following symptoms:

• alternating constipation and diarrhea;
• periodically - especially after eating fatty or fried foods - the appearance of pain in the right hypochondrium;
• itching of the skin, which appeared for some reason, not after an injection, not after a bite, a new meal or a new medication.

Diagnosis of the pathology is carried out according to ultrasound with a choleretic breakfast. X-ray contrast, and even more so, radioisotope techniques in children are carried out according to strict indications, and with the advent of magnetic resonance cholangiography, they are almost not performed.

Treatment in children

For therapy in children, preference is given to herbal preparations. They are selected depending on the type of pathology.

So, with hypomotor dyskinesia are prescribed:

• drugs that stimulate the formation of bile: holagol, holosas, allochol, lyobil;
• medicines that increase the tone of the biliary tract: magnesium sulfate, sorbitol or xylitol;
• herbal therapy: decoctions of dandelion, rosehip, corn stigmas, mint;
• "Blind sounding" with the use of sorbitol or xylitol;
• mineral waters: "Essentuki 17".

With hypermotor dyskinesia, treatment is carried out:

• antispasmodics: aminophylline, riabal;
• herbal therapy: decoctions of St. John's wort, chamomile, dioecious nettle;
• low-saline waters: “Slavyanovskaya”, “Smirnovskaya”;
• electrophoresis with novocaine on the gallbladder.

After stopping the attack, rehabilitation is carried out in the sanatorium, where mineral waters and other physiotherapy procedures are prescribed:

• Microwave therapy;
• galvanic collar according to Shcherbak;
• sodium chloride baths;
• to eliminate spasm of the biliary tract: magnetotrapia, electrophoresis of antispasmodics (no-shp,) on the biliary tract;
• with a sedative purpose: coniferous baths, Bromelectroson;
• to improve motor activity of the biliary tract: SMT therapy, magnesium sulfate electrophoresis.

The diet described above fully applies to children. A strict diet is prescribed for a year, then - in the absence of biliary colic attacks - you can gradually expand the diet.

Children with dyskinesia are registered with a pediatric gastroenerologist, neurologist and pediatrician. Twice a year, they are scheduled to perform an ultrasound scan. Also every 6 months there are courses of choleretic therapy. Once or twice a year, the child is given directions for sanatorium-resort treatment.

Biliary dyskinesia is a disease of the gastrointestinal tract, due to the progression of which the functioning of the bile ducts is disrupted. As a result of this, bile enters the duodenum incorrectly, which causes an imbalance in the work of the digestive tract. In the human body, the ailment usually progresses secondary, against the background of damage to other inflammatory processes of the gallbladder. It is noteworthy that it can manifest itself from an unstable mental state of a person.

Such a gallbladder disease does not pose a threat to human life. However, it can significantly reduce its level and comfort. But with untimely treatment, it creates favorable conditions for the occurrence and development of other diseases or disorders of the digestive tract. In children, the disease often appears due to inflammatory processes or abnormal development of the biliary tract and digestive tract organs.

Etiology

Various factors or causes can lead to the progression of this disease. Depending on this, clinicians divide the disease into:

• primary;
• secondary.

With primary biliary dyskinesia, only changes in the functional work of organs are observed. The main causes of the progression of this form of the disease:

• the constant impact of stressful situations on the human body;
• strict diets or improper diet, which involves a deficiency of vitamins and nutrients in the body, overeating and eating fatty foods;
• insufficient amount of physical activity in a person’s life;
• sedentary working conditions;
• muscle genetic abnormalities that lead to chronic muscle weakness;
• allergic reactions or diseases.

The secondary form of pathology is determined by diseases already existing in the human body, such as:

• chronic disorders of the digestive tract (, etc.);
• inflammation of the abdominal cavity, biliary tract, gall bladder and pelvis;
• congenital malformations of organs;
• excess body weight;
• lack of hormones in the body;
• cessation of menstruation in women.

Most of these causes provoke the development of this disease in children.

Varieties

In medicine, there is a classification of the disease associated with the amount of bile secreted:

• hypotonic type - characterized by an insufficient influx of bile. With this type of dyskinesia, a person feels a constant dull pain in the abdomen, with an indefinite place of manifestation;
• hypertonic type - bile comes in excess. The patient has a sharp and sharp pain in the right hypochondrium, which gives to the shoulder;
• mixed type - a person shows signs of both types of the disease with varying degrees of severity.

Symptoms

Symptoms of biliary dyskinesia for children and adults are almost the same, only the intensity of their expression is different. The main symptoms of such a disease by hypotonic type include:

• pain in the abdomen, aggravated by eating food;
• belching accompanied by an unpleasant odor;
• bouts of nausea that can cause vomiting;
• a feeling of bitterness in the oral cavity;
• sudden bloating;
• diarrhea;
• a sharp increase in body weight;
• decreased heart rate and blood pressure;
• increased salivation and sweat.

Signs of a hypertensive type of illness are:

• severe pain spreading across the abdomen, right side of the arm, back and moving to the shoulder blades;
• decreased or complete lack of appetite;
• weight reduction of a sick person;
• gagging;
• stomach upset;
• high blood pressure;
• irritability of the patient that arose against a background of sleep disturbance;
• heart pain and.

Common symptoms, regardless of the type of disease, include:

• skin yellowing;
• plaque in the tongue, usually white;
• weakness of the body;
• reduced ability to work;
• stay in a state of depression or apathy.

Diagnostics

Diagnosis of biliary dyskinesia is based on an assessment of the patient's external signs and discomfort. At the initial examination, the disease can be determined by:

• pallor and dry skin of the patient;
• complaints of pain and nausea.

Additional diagnostic measures include:

•   (including);
• sounding, followed by examination of the contents;
• analysis of feces for the presence of particles of worms;
•   to detect particles of bile.

Treatment

Treatment of biliary dyskinesia consists of several stages:

• drug treatment of symptoms of all types of disease;
• physiotherapy;
• treatment of diseases that led to the appearance of dyskinesia;
• treatment during the period of subsidence of the disease;
• the use of folk remedies;
• the appointment of a specialized diet;
• spa treatment.

Thus, the treatment of hypertensive dyskinesia includes:

• consultations of a gastroenterologist and psychotherapist;
• normalizing the level of bile secretion using pharmaceuticals;
• the exclusion of mental problems affecting the course of the disease;
• prescription of sedatives and sleeping pills;
• hormonal injections (only for women during the period of cessation of menstruation);
• electrophoresis;
• laser therapy.

The hypotonic type of disease is treated with:

• restoration of the correct sleep, labor and rest regimen;
• prescribing medications aimed at improving the outflow of bile;
• duodenal sounding for this type of dyskinesia is not only a diagnostic method, but also a treatment method.

After reducing the intensity or completely eliminating the signs and symptoms of the disease, treatment of the internal processes that become its causative agents begins. This includes combating:

During remission of dyskinesia, treatment can be carried out using mineral water:

• low in minerals - with a hypertonic form;
• with a high concentration - with hypotension.

It will be better for the patient to be in a sanatorium at this time.

Folk remedies for the treatment of biliary dyskinesia will be a good addition to drug therapy. Most effective in the hypotonic form of the disease decoctions and tinctures from:

• immortelle flowers;
• corn fiber;
• oregano.

These funds are aimed at:

• increased outflow of bile;
• improvement of the digestive tract;
• normalization of the nervous system;
• increased intestinal activity.

With hypertensive dyskinesia, the following infusions of:

• peppermint;
• licorice root.

They are characterized by:

• improved appetite;
• elimination of painful cramps and nausea;
• contribute to the outflow of bile.

An additional beneficial effect for these types of diseases is chamomile tea, which normalizes the digestive tract and nervous system, eliminates bloating, and accelerates the healing of ulcers.

The diet for biliary dyskinesia consists of eating:

• fruits and vegetables;
• any kind of cereals;
• rye and bran bread;
• first dishes prepared on water, not on fatty broth;
• meat, only boiled;
• dairy products;
• all kinds of juices, preferably freshly squeezed;
• tea, with the addition of honey, instead of sugar.

With a specialized diet, the use of:

• fried fatty meat or lard;
• hot spices;
• legumes;
• desserts;
• strong drinks (tea or coffee);
• alcohol;
• smoked sausages.

Prevention

Principles of prevention for dyskinesia:

• normalization of diet. Eat small meals five or six times a day. Monitor the temperature of dishes. They should not be very hot;
• give up alcohol and nicotine;
• timely treat not only gastrointestinal diseases, but also any infectious processes in the body;
• undergo a full clinical examination at least twice a year.