Medical treatment of HCB chronic calculous cholecystitis. Cholecystitis in pregnant women

Acute cholecystitis is a disease that develops in approximately 18% of patients with acute surgical diseases of the abdominal organs. At the same time, statistics indicate that women are sick with sharp cholecystitis 3 times more often than men.

A lot of factors can be attributed to the reasons for the development of acute cholecystitis. This, in particular, hypertension of biliary tract, biliary disease, infectious factors in biliary ways, power impairment, decrease in immunity, stomach disease, etc.

According to statistics, in 80% of cases, acute cholecystitis is a complication of a biliary disease. In this case, the concrections that have long been in the lumen of the gallbladder lead to a violation of the mucous membrane and the contractile function of the gallbladder. Often they clog the mouth of the bubble duct, which is why the inflammatory process develops.

In 100% of cases, the main factor starting the process of developing acute cholecystitis is food. Excessive use Fat and acute food leads to the intensive formation of bile. Spasm sphincter Oddi provokes hypertension in the protocal system. Food allergens can also affect the sensitized shell, which is also developing spasm.

There are a number of stomach diseases that can provoke the development of acute cholecystitis. In particular, it is chronic gastritis (hypoacide and ancoid), which is accompanied by a strong decrease in the amount of gastric juice, including hydrochloric acid. Acute cholecystitis is also developing against the background of local ischemia of the gallbladder mucosa and violations of blood quality. The presence of pathogenic microflora is enough to develop acute destructive cholecystitis.

Chronic cholecystitis is the inflammation of the gallbladder, originally caused by the infectious factor. The disease proceeds with change of periods of remission and exacerbations, in most cases has a complication in the form of a biliary disease. Also, often, pancreatitis develops against chronic cholecystitis.

In medicine, the calculous and non-calculous form of cholecystitis is isolated. The causes of the occurrence and exacerbation of chronic cholecystitis can be diverse, but the basis will always be infectious, as well as stagnation of bile with a further change in its physical and chemical properties.

The main factor in the development of chronic cholecystitis - bacterial infection. Microbes fall into the gallbladder on the bustling canal of the 12-rosewoman. They can also get with blood flow from the intestinal inflammation or lymphatic paths. Thus, streptococci, staphylococci, intestinal sticks can become foci of infection in the bustling bubble.

The aggravation in chronic cholecystitis occurs due to the stagnation of bile caused by: frequent strong stresses, disorders in power mode, insufficient quantity of fiber, hypodynamines, pregnancy, obesity, incorrect development of the gallbladder. A large number of acute, fried and oily food in the diet, allergies, improper metabolism, chronic dehydration - Additional causes of exacerbations in chronic cholecystitis.

Causes of cholecystitis

The cause of cholecystitis is the infection that falls into the gallbladder is most often from the intestine through bile docks, Or can get from other places with blood and lymph. Some factors can serve as a starting mechanism for the start of cholecystitis: overweight, fatty and harmful food, reduced gastric juice acidity, violation of biliary tract, intestinal dysbiosis and constipation.

The most common cause of cholecystitis is the grooming disease. The stones in the bustling bubble damage his wall or may make it difficult to outflow bile. More than 60% of patients in bile detect infection: intestinal wand, streptococci, salmonella and others.

The causes of acute cholecystitis may be the blockage of the gallbladder duct, along which the bubble is bile with a bile stone or the causative agent of infection. If the drainage function is normal and bile proceeds normally, the infection that fell into the gallbladder does not cause an inflammatory process. Otherwise, inflammation occurs.

The risk factors of the occurrence of cholecystitis may be previously sophisticated operations, acute diseases, pregnancy, stress, physical exertion and overwork.

Symptoms and types of cholecystitis

Nausea, bitterness in the mouth and severity in the field of right hypochondrium are signs of the disease not liver, but a gallbladder. Among the main symptoms of cholecystitis distinguish:

• The main symptom of cholecystitis is the pain that can be short-term and intense, occurring during incorrect nutrition and stress if the spasm of biliary tract is observed. Often gives to the clavicle. The pain can be stupid, novel and constant, intensify with active movements or sports, if a person has reduced pressure. With the most severe stages of cholecystitis, pain can immobilize a person.
• There is a frequent bitterness in the mouth, bitter belching. Patient is nauseous, there is vomiting with an admixture of bile, with harmful and improper nutrition. Patients often complain about sweating, fatigue, insomnia, nervous disorders and irritability.
• The patient has jaundice: yellowing the skin and eye proteins.
• In some forms of cholecystitis, the feces can be colorless, urine becomes a dark shade.
• The high temperature rises, the person is rich, the level of leukocytes in the blood increases when the disease is aggravated.
• Language becomes dry, with a yellowish brown bloom, the liver increases, pain in the area of \u200b\u200bthe gallbladder occurs when the belly is torn.

Besamen (non-calculous) cholecystitis

The basis of the development of a non-free cholecystitis - the area bladder infection. The infectious pathogen enters the body with blood flow or lymph, descending paths and other methods from organism organs and systems affected by infections. Cholecystitis almost never occurs in the form of a separate autonomous disease: most often this diagnosis is accompanying for hepatitis, pancreatitis and other diseases. This explains the fact that most often the inquired cholecystitis acquires a chronic form, and in the "clean" acute form it is very rare.

Chronic beamless cholecystitis can develop as a result of dyskinesia of the biliary tract and reflux (reverse cast) from the biliary ways of a field of stagnation or bile thickening. Also, the chronic form of the disease is developing after the formation of inflammation of the wall of the bubble after the pancreatic enzymes from the bile duct on it. This is especially often manifested in cirrhosis of the liver or cyst pancreatitis. For elderly patients, chronic beaman cholecystitis is the result of circulatory disorders in the wall of the gallbladder due to the defeat of its vessels.

Most often, the primary diagnosis can be determined by the following characteristic features:

• attach the stupid pain in the right hypochondrium;
• pools, which occur 1-2 hours after meals - especially if the patient used fried or fat;
• pain bosses that begin after lifting weights, loads, stress;
• attacks of nausea, vomiting, heartburn, belching, bitter taste;
• vomiting, bringing relief when overestimated or in aggravation stages.

Atypical forms of non-free cholecystitis: cardialgic (imitation of pain in the heart, arrhythmia. Arms after meals in the lying position); Ezophagic (belching, heartburn, pain behind the sternum, the feeling that food "stuck" in the esophagus); Intestinal (abdominal pain, bloating, diarrhea, intermitted with constipation).

Acute calculous cholecystitis

Acute calculse cholecystitis - Form of the inflammatory disease of the gallbladder, for which the presence of stones in the organ. One of the varieties of biliary disease. This diagnosis is approximately 10% of adult patients, most often crushing the age threshold at 40 years. At the same time, women are sick more than men. Sometimes the disease is developing in childhood.

Risk group:

• women, mainly during pregnancy;
• patients with obesity;
• people who sharply dropped weight;
• senior people and elderly people.

Under the sharp calculous cholecystitis imply a pronounced inflammatory process. It develops due to the infectious pathogen penetrated into the gall bubble against the background of violations of natural bile outflows (due to the blockage of the concrevents). The microbial flora can get into an upstream and downward organ (from a 12-risk, from the liver), blood and lymph.

Acute calculous cholecystitis is three types: catarrhal, phlegmonous, gangrenous. Regardless of the form, the process of inflammation is accompanied by pericholecystitis with a local or common adhesion process, limiting the area of \u200b\u200bdistribution of infection only by the right hypochine.

The symptoms of calculous cholecystitis in acute shape begin with a sharp attack of bile colic. It is manifested in the form of acute pain in the right hypochondrium. The pain can be given in a shoulder or blade (also right). By the provoking factors of pain syndrome can be used by alcohol, improper nutrition, stress. Against the background of the attack of pain, the patient feels nauseous. It begins repeated vomiting that does not bring relief. In the vomit masses are noticeable bile impurities.

The body temperature can also increase - up to 38-40 degrees Celsius. This is especially characteristic of gangrenous acute calculous cholecystitis. Blood pressure can fall sharply, the patient feels sweetness, covered with cold sweat. In some cases, the symptoms of jaundice begin: color changes skin cover, bleaching feces, etc.

With the catarrhal form of cholecystitis, painses increase with any cutting movement and any physical exertion. Symptoms develop quite rapidly. When examining, the doctor can identify such supporting symptoms of acute calculous cholecystitis: a dry tongue, a rigging abdomen, pain and muscle tensions in the area of \u200b\u200bthe gallbladder projection.

Phlegmosic cholecystitis develops with a purulent inflammatory process. It is characterized by strong pain increasing several times when changing body position, breathing, cough. The general state worsens, the pulse increases, the temperature rises, nausea and vomiting begins. There is a bloating abdomen. The absence of timely treatment will lead to a transition to a gangrenous form, which carries the danger of a rapid fatal outcome.

The gangrenous form of acute calculous cholecystitis is associated with partial or complete damage to the wall of the gallbladder. The form develops on 3-4 days of acute cholecystitis, left without adequate treatment. The integrity of the organ wall is broken, bile can penetrate the abdominal cavity. Especially often this form develops in people of old age.

Characteristic symptoms are a sharp increase in body temperature, deterioration of well-being. Pains in the field of right hypochondrium may appear, but discomfort will spread to the entire area of \u200b\u200bthe abdomen. Without treatment, acute gangrenous calculose cholecystitis leads to a painful fatal outcome.

Chronic calculous cholecystitis

Chronic calculous cholecystitis is an inflammatory disease of the gallbladder. The second name is a biliary disease (HCB). It is worth considering the causes of the disease.

All substances that are present in the composition of the bile are in chemical equilibrium. Any change of composition, provoked by an increase in the concentration of one substance, can lead to the formation of stones: part of the dissolved salts fall into the precipitate and gradually start crystallized. Since time, the councils are growing. Moving with bile current, they lead to damage to the wall of the gallbladder. The patient feels pain.

Stones can be different sizes, attend the bustling bubble in different numbers, have a smooth or sharp surface. According to statistics, 10% of the adult population of the planet is in the gall bubble (most cases - in women). In children, this problem is very rare. If the stones are located in the main duct, this leads to a mechanical overlap of the bile current. The gallbladder is stretched, slightly increases. The wall becomes fine, which is fraught with a gap and getting bile in the abdominal cavity. It will happen if you do not provide timely treatment of chronic calculous cholecystitis.

Calculse cholecystitis as a whole can occur in acute and chronic form. However, the sharp form is rarely diagnosed, as it is caused by the presence of a strong infectious factor Against the background of asymptomatic calculous cholecystitis.

Chronic form develops for several years. Therefore, the central affixing factor under this form is not an infection, but the overlap of the duct and the chemical change in the composition of bile. Predecessors of the disease:

• dyskinesia biliary tract;
• chronic gastritis viral hepatitis, ulcerative disease, chronic pancreatitis, liver cirrhosis;
• obesity, diabetes;
• pregnancy, climax;
• violations of a diet in chronic cholecystitis;
• pathology of biliary tract;
• work requiring limit physical exertion;
• hereditary factors.

Cholecystitis in pregnant women

In most cases, the cause of the development of cholecystitis in pregnant women is a decline contractile functions muscles controlling the tone of biliary ducts. This is due to the impact of the leading female hormone of progesterone on a smooth muscles. As a result, bile is output less intensively, congestive processes begin in the bustling bubble. On their background, infection penetrates the walls of the gallbladder and provokes the beginning of the inflammatory process.

Important fact: if cholecystitis was diagnosed with a woman even before pregnancy (or it is present in chronic form), doctors give almost 100% the likelihood of exacerbations during the waiting period of the child.

The main manifestation of cholecystitis in women during pregnancy is pain in the field of right hypochondrium. The pain may be of different intensity, but in most cases the patients complain about the feeling of gravity or new dull pain. However, the factor of pregnancy does not allow paying attention to this factor in time: a woman can explain the pain of fetal movements long enough and not think about other causes of sensations. It is worth noting that the movements of the fetus only enhance pain in the right hypochondrium.

The reason for appealing to the doctor in most cases becomes an acute grasp pain, it is impossible to pull out. Such pain syndrome Indicates that the disease is progressing, and there is a great risk of developing complications (for example, pancreatitis), which will threaten the lives of the fetus and mother. Therefore, it is better to pay attention to all kinds of pain during pregnancy.

It is important to note that when cholecystitis in pregnant women, pain in the right hypochondrium will increase after eating fried, oily, salt or acute food.

Characteristic symptoms of gallbladder inflammation in women:

• feeling of bitterness in the mouth;
• frequent belching;
• nausea and vomiting;
• heartburn;
• bloating;
• tightening toxicosis (until the 30th week instead of the 12th).

As can be seen, the symptoms of cholecystitis are very similar to the symptoms of the usual state of pregnant. This similarity negatively affects the timeliness of the diagnosis. The disease is delayed and brings more unwanted consequences.

Cholecystitis in children

Cholecystitis in children is not a very common disease, so it is important to diagnose it in time and correctly, providing high-quality treatment. The abdominal pain in the child is quite frequent, because of which many parents do not always attach them great importance. However, intense pain is one of the symptoms of cholecystitis.

The disease in children can manifest itself in acute or chronic forms. According to statistics collected in a large time interval, it can be seen that under the age of 8 years the diagnosis is more likely to put boys, the frequency of incidence is equal to 14 years old among the boys and among girls, after 14 years old are more often ill (about 3-4 times) .

Causes of cholecystitis development in children:

• the presence of infection in the gastrointestinal tract;
• dyskinesia biliary tract;
• not right rationcomprising a large amount of fats;
• incorrect power mode;
• violations of motility gastrointestinal tract;
• deformation of bile ducts;
• heredity;
• psycho-emotional factors.

Cholecystitis in acute form in children is rarely diagnosed - most often we are talking about chronic cholecystitis in catarrhal form. The stones in the bustle bubble are also rare enough.

Cholecystitis in children can manifest themselves in the form of several specific symptoms and general factors indicating the presence of an inflammatory process in the body. The smallest disease begins with symptoms of general intoxication. The first manifestations is important to notice the parents. This is real if you carefully control the condition of the child. To consult a doctor, if the kid: alternate diarrhea and constipation, in the language of a yellow flare, periodically missing appetite, there are complaints of severity or pain in the right hypochondrium. These are standard manifestations of cholecystitis in chronic form.

The acute chivest is characterized by a sudden beginning, without previous symptoms. The child complains about the parietal pain and gravity in the right hypochondrium. Nausea arises, belching, after greasy food is probably vomiting. The bloating begins, the body temperature rises to 39 degrees, is accompanied by chills and pale.

The same symptoms have pancreatitis, appendicitis, peritonitis, colors. In any case, it should be caused without delay emergency help for proper diagnosis and appointment of treatment (mainly stationary).

After examining the child, the doctor will be guided by the following symptoms for the diagnosis of "cholecystit":

• tension and bloody abdominal wall;
• hiring in the stomach;
• soreness when pressing in the region of the gallbladder, etc.

It is important to note that with the appearance of the above features, in no case cannot be given to the child painkillers - this will lead to lubrication of clinical symptoms and incorrect diagnostics.

Treatment of cholecystitis

How to treat cholecystitis? Since cholecystitis arises from infection, in the signs of its exacerbation, the patient must take antibiotics, which are appointed by the doctor after passing a bile analysis. To take pain, antispasmodics are prescribed to the patient. These include but-shpa, papaverine in tablets and candles, Duspatalin and others. In the treatment of cholecystitis, choleretic agents are applied, which are selected depending on the work of the biliary tract. If staggering bile is observed, you need to take the drugs of the Holes group: Berberin, sorbitol, xylitis and magnesia.

With cholecystitis, a tubaz method can help. With this method, washing the biliary tract and is stimulated by the selection of bile from the gallbladder. A glass of mineral non-carbonated water temperature, which can add one tablespoon of xylitis, sorbitol, or magnesia can be added to the hungry stomach in the morning. Then the patient should lie on the right side, substituting under it a warm height, and remain in this position of one and a half or two hours. The procedure can be done once every 3 days, 10 procedures are enough for the course.

It is definiciently impossible to carry out to tube to patients with a biliary disease, as it can cause a strong movement of bile and stones that close the passage of the bile duct, and it will take an urgent surgery. The most dangerous for the life of stones with a diameter of one centimeter, since small can pass, and large stuck in the gallbladder ducts.

The treatment of cholecystitis includes the use of mineral waters with high mineralization. They need to drink half an hour before meals, water should be room temperature. If there are no stones, it is recommended to drink choleretic decoctions from the herbs of immortals, cornflowers, a hunter. Cuts can be prepared and drink a long period in autumn or in winter, including herbs to increase immunity and strengthen the gallbladder: lemongrass, Ramiolo, Eleutherococcus, Zhen-Shen and others.

Medicines for cholecystitis

Treatment of cholecystitis drugs - the basis of therapy with such a disease. Physiotherapy and phytotherapy - methods that apply only after the removal of symptoms and the causes of exacerbation. Prior to this, the reception of the prescribed drugs of drugs is important, among which will be:

After reliving the inflammatory process, the treatment of cholecystitis and pancreatitis drugs may require dissolving stones using medicines. Doctors use the means of hanodoxychole or ursodeoxycholic acid for this purpose. Their effectiveness concerns only about 20% of patients, so it requires clear diagnostic testimony to assign drugs.

Dosage of medicines for each patient is individually set. A number of medicines must be taken a long period of time (about 12 months), periodically controlling the biochemical blood parameters and conducting ultrasound diagnostics. Corporation can lead to inflammation of the pancreas (pancreatitis), blockage of biliary tract.

In the remission phase, patients prescribe choleretic drugs (if diagnosis indicates the absence of confirmed stones). The choice of drugs is very wide: the milk, Nicodin, flimber, Pijma, Hofitol and many others.

Treatment of cholecystitis by folk remedies: the most effective

AIR. 1 teaspoon of crushed roots per 1 cup boiling water. Insist 20 minutes, strain and consume 0.5 cups 4 times a day.

Volodya. 5-10 g of roots pour 1 glass of water and boil until half of the original water volume evaporates. After cool and strain. Drink 0.5 glasses 3 times a day. With inflammation of the gallbladder, you can pour 5 g of the grass of the coat. Pour 1 cup of boiling water, insisted until it cools and strain. Drink at 0.5 glasses 3 times a day before meals.

Highlander bird. 1 tbsp. Spooning herbs pour 1 cup of water and boil half an hour on a water bath. 15 insist and further strain. Take 3-4 times a day for 1 tbsp. spoon.

Oregano 1 teaspoon of grass pour 1 cup boiling water. Insist for 2 hours. Consume ¼ cup 3 times a day.

Corn sniffs. 1 tbsp. A spoonful of corn columns with strokes pour 1 cup boiling water, insist 60 minutes, strain. Intense to use 1 tbsp. Spoon every 3 hours.

Vegetable oil with laurel. 200 g of sunflower, corn, cotton oil mix with 30 shredded leaflets of a noble laurel. Insist the mixture of 3-6 days, in the end to strain. Consume 10-15 drops, mixing with tea, 2-3 times a day. It is recommended for chronic cholecystitis and biliary diseases.

Honey, olive oil, lemon. Mix 1 kg of high-quality honey, 1 cup of olive oil, 4 lemon over a meat grinder (2 of them clean from the peel). Mix everything well and folded into the closed dishes. Keep refrigerated. Stir to each reception. Use 1 tbsp. A spoon 3 times a day for half an hour before meals. 3-4 courses are recommended for 1 year.

Large plantain. 1 tbsp. Spooning herbs pour 1 glass of boiling water and insist 10 minutes, after which it is strain. The daily rate is 1 cup (drink during the day in small sips).

Yarrow. 2 teaspoons brew in 1 glasses of boiling water, insist 60 minutes, after strain. Use ¼ cup 4 times a day before meals.

Sage medicinal. 2 teaspoons of leaves brew in 2 glasses of boiling water, insist of half an hour, strain. Intense to use 1 tbsp. Spoon every 2 hours.

How to remove the attack of cholecystitis at home?

The wise decision is to immediately cause emergency assistance. Alone to anesthetize the attack is prohibited. It is not recommended to apply to the patient location. The following measures will temporarily facilitate the state, but will not give a doctor to put the correct diagnosis due to the distortion of the clinical picture.

Apply for medical help is better at the very beginning of the occurrence of the attack of cholecystitis. Timely health care (In most cases, in the hospital conditions) will allow to remove acute inflammation in 3 days, eliminate symptoms fully in 10 days. In the future, to avoid repeated seizures, the development of pancreatitis and the need to surgically remove the gallbladder, it is recommended to stick to the diet and lead a healthy lifestyle with the observance of the day mode.

Diet with cholecystitis

The exacerbation of cholecystitis is the result of the stagnation of bile, provoked by a sedentary lifestyle, frequent stressful situations, alcoholism, incorrect meal (consuming fatty dishes, irregular meal). The patient's condition during the exacerbation period is heavy: if we are talking about acute calculous cholecystitis, then even non-intensive movements cause not only discomfort, but even hepatic colic.

Diet with exacerbation of cholecystitis is based mainly on nutrition exclusively with rubbed products. We will have to patiently treat this period, carefully fulfilling the requirements for dietary nutrition: after the end of the exacerbation, it will be possible not to adhere to this rule, more than meat with streaks. In the period of exacerbation, it should be limited to the rate of salt intake, exclude fried, fatty and sharp products from diet.

Balanced diet nutrition When cholecystitis, it is the correct ratio of plant and animal proteins, this providing the body with a sufficient amount of vitamins, minerals, plant fiber. In periods of exacerbations, it should be abandoned from the use of eggs in any form - they can contribute to the enhancement of pain syndrome and the row of hepatic colic. If for some reason I want to eat an egg - this is only permitted in the form of a steam omelet.

One of the most important points of therapy in acute and chronic cholecystitis is strict nutrition. With the sharp form of cholecystitis, it is better not two days there is nothing, you can drink fastening tea, frost, juices, diluted with water alone to one, or mineral water without gas. Then you can turn on the nutrition of puree and porridge, low-fat cottage cheese, boiled meat and fish for a couple. A week later you can go to the diet, excluding harmful products. Food techniques must be frequent, small portions 5-6 times a day. The food should be warm, not strong hot or cold so as not to provoke a re-attack.

Diet with cholecystitis allows you to eat vegetable soups, fruit, milk, cereals, borsch and soup without meat, on a simple broth. From dairy products you can milk with a low fatness percentage, dairy products, Kefir, Prostokvasha, Acidoofilin, low-fat cottage cheese. You can yesterday's bread or a little dried.

It is categorically impossible to be included in the nutrition under cholecystitis such products like: puff pastry, fresh pastries and bread, cakes, cakes and other sweets with cream, fried patties, meat and strong broths, sour coup, fatty meat grade (lamb and pork), game, roasted meat, smoked, sausages, canned food, fatty fish, caviar, salt and smoked fish, butter and fat, mustard and sharp seasonings, eggs in any form, green onions, mushrooms, radishes, garlic, horseradish, salted and pickled vegetables, chocolate, cocoa, ice cream, black coffee, carbonated cold drinks. Alcohol is strictly prohibited in any doses.

Diet with acute cholecystitis: therapeutic nutrition

5V diet refers to gentle, without mechanical and chemical irritant factors. It is understood by the reception only with the rubbish food. The chemical composition of this diet: 50 g of proteins, 40 g of fats, 250 g of carbohydrates per day. Daily calorie content - 1600 kcal. In diet No. 5, in particular, wheat crumbs, rubbed low-fat cottage cheese, rubbed meat and fish cooked for a couple.

Approximate 1 day diet menu №5 in acute cholecystitis:

• the daily rate of sugar - 40 g, dried bread (white) - 200 g;
• first breakfast: oatmeal rubbish, protein omelet for a couple, tea;
• the second breakfast: carrot puree, decoction of rose hips;
• lunch: half of the portion of potato soup puree, meat souffle for a couple, baked apple;
• afternoon: wipe compote fruit;
• dinner: cottage cheese pudding, tea;
• at night: a glass of low-fat kefir or bravery of rosehip fruit.

After 5-10 days of compliance with such a diet, subject to the relief of the aggravation stage, it is possible to move on diet No. 5.

Diet with chronic cholecystitis

Diet with chronic cholecystitis makes it possible to include the following products in the diet: wheat flour bread 1 and 2 varieties, rye from sprinkled and seeded flour. The main requirement for bread - it should be yesterday. You can eat dry biscuits, crackers. Local meat and fish, cottage cheese, apples as fillers for non-propulsive pies are allowed.

You can turn on the vermicellus, small pasta, dick, cheesecakes in the menu. From soups: Vegetable and greasy on vegetable broth, dairy with vermicellus, vegetarian or fruit borshs, beetners. Flour and vegetables for refueling need not to fry, but dried. In chronic cholecystitis, you can eat low-fat meat and degreased meat products based on beef, young lamb, meat pork, veal, rabbit meat. From the bird you can eat chicken and turkey meat without leather in boiled form, as well as baked (but after boiling).

The fish is allowed low-fat varieties (cod, pike perch, bream, navaga, perch, silver heck), cooked for a pair, boiled, in the form of meatballs. Milk and products can be used in natural form or in the form of additives in dishes (porridge, sauces). Sour cream used as seasonings to salads. Allowed types of cheeses: Russian, Yaroslavsky. Recommended cereals - oatmeal, rice and buckwheat. It is better to give the advantage of vegetable fats.

Vegetables can be used in cheese, baked or boiled species. Allowed spices: dill and parsley greens, ground red sweet pepper, cinnamon, bay leaf, Vanillin, Carnation (all in limited quantities).

Full nutrition in chronic cholecystitis is described in detail in the requirements for diet No. 5 - officially allowed diet at this type of disease. If you adhere to it constantly - you can reduce the number of exacerbations to a minimum and do not feel discomfort. Any diet is better to advance with the attending physician.

Honey at cholecystitis

Honey with cholecystitis is allowed and recommended due to a number of advantages. In particular, the product is distinguished by a choleretic effect, is able to level pain syndrome and ensure the prevention of stagnation of bile (relevant in chronic cholecystitis).

Take the product is recommended as follows: 1 tablespoon dissolve in a glass of warm water and drink on an empty stomach in the morning. After receiving, lie on the right side. Course of treatment from 5 to 7 days. When calculating cholecystitis, it is recommended to take corn cobs with honey - this is one of the means for dissolving stones. Naturally, any similar therapy must be agreed with the attending physician.

Honey therapy is not an alternative for medicinal and diet therapy. Honey is recommended to be used in a common treatment complex - only in such situations. beneficial features will be appropriate.

After the attending physician to determine the recommended daily dose of honey, you should not immediately use the entire volume. It is better to start using a 0.5 teaspoon and trace how the body will react. If there are no side effects in the form skin rash, dysbiosis - you can use honey in the recommended dosage. There are several methods of product use:

• in the morning and in the evening drink 100 ml of the divorced product;
• 3 times a day to eat 1 tbsp. spoon;
• each of these methods is designed to eat honey within 1-2 months with further breaks;
• with frequent constipation, you can eat 1 tbsp. spoonful of honey with 1 tbsp. Aloe juice spoon for 30 minutes. Before meals;
• honey can sweeten tea, compote, morse, kefir;
• admissible casserole with honey and other dishes.

Cholecystitis Prevention

The prevention of cholecystitis is aimed at reducing the likelihood of the formation of stones in the bustling bubble. First of all, it is necessary to monitor the quality and mode of food intake. I can not skip meals. Breakfast, dinner and dinner is recommended at the same time. People with chronic cholecystitis are encouraged to adhere to fractional nutrition, divide food intakes into small portions and is five times a day. The body will be easier to cope with food and you will prevent the re-crisis.

The prevention of cholecystitis includes a healthy diet, excluding saturated and animal fats, salt and sharp seasonings. Fatty products contribute to the formation of stones and extra weight setting. The diet should include lungs and healthy foods. You can use light dairy products, dishes from vegetables, fruits, croup. Smoked foods, treated products, fatty desserts should be excluded. Alcoholic beverages are better excluded forever.

Exercise I. active image Life is taken into measures to prevent cholecystitis. A sedentary lifestyle leads to a set of excess weight and stagnation in the body, which can begin the formation of stones in the bustling bubble. Work in the office should include hourly interruptions with a small warm-up of all parts of the body. It is best for health to engage in gymnastics, pilates, swimming or ordinary walking. If there is no possibility to attend the gym, more often walk on foot, walk in the fresh air to any weather. Avoid stressful and excessive physical exertion, as they can lead to a recurrence of cholecystitis.

One of the main causes of cholecystitis development is overweight. What he is higher, the greater the risk of stones in the bustling bubble. Therefore, it is necessary to monitor your diet, exercise, and if you need weight, you need to lose weight. During weight loss, be careful, do not sit on diet promising weight loss for ten kilograms. Fast weight loss weakens the body and increases the risk of rock formation in the bustle bubble. It is better to turn to a nutritionist who will make the right diet and a slimming program. A week can lose weight by 1.5 kilograms.

Calculose cholecystitis is a sharp or chronic inflammatory process. It is accompanied by irritation of body tissues and strong painful sensations due to the formation of stones of various sizes. Because of the disease can be occurring while moving the concrections and their accumulation and stretching the walls of the bile canals.

The disease is many years of character, it is characterized by periods of attacks and remission. At the same time, the disease does not weaken, and constantly complicates, the amount and size of stones grow up and starts to put pressure on biliary canals and bubble.

Among the entire population of the Earth with such pathology faces about 10%. At the same time, the main mass of the diseased is patients mature age in 40-50 years. In rare cases, cholecystitis is diagnosed in children under 14. The main threat to the development of the HCB is the clogging of the neck of the gallbladder and the ducts of the organ.

Attention!!! With such violations, symptoms of jaundice are developing, as well as the exacerbation of bile colic. In this case, the patient is experiencing a strong difficult pain. It is important not to confuse the problem with hepatitis and assign adequate therapy in a timely manner.

Types of calculous cholecystitis

Specialists distinguish between two forms of the disease - sharp and chronic. Each of the types of cholecystitis can also have two types - an aggravated-complicated and uncomplicated (smooth).

Acute complicated type Calculose cholecystitis is diagnosed in rare cases. This form can be manifested due to a long flow of a biliary disease without a manifestation of some symptoms. In case of acute complicated form, the concretion is completely scored by the overall dummy of the gallbladder. Because of this, there is inflammation of the walls of the body, which causes severe pain.

In addition, with such a disease, hazardous bacteria and infections from the surrounding organs penetrate into the cavity of the gallbladder. This phenomenon arises due to disorders in the antiseptic effects of bile. Gradually, under the influence of the disorders that occurred, the tissues of the gallbladder walls begin, then they gradually destruct (destroy). Due to the procurement of the biliary duct, the whole form resulting due to the inflammatory process will be copied in the gallbladder cavity. Such a state provokes bile peritonitis.

Chronic form Board can also flow for a long time and manifest itself only during serious exacerbations. In this case, infection and bacteria play a minor role. With this form of a developing disease, the main factors are problems with the composition of bile secretion, which is why she begins to thick and stammer, provoking irritation on the walls of the gallbladder. Launch pathological processes Incorrect meals, increased body weight, diabetes, diseases endocrine system and the presence in the body of constant malicious bacteria and dangerous infections.

Attention!!! Patients who were diagnosed with dyskinesia of biliary ducts, constant gastritis, liver disease, should more often check themselves for the possible formation of concrections.

Video - chronic cholecystitis and bile disease

Symptomatics of various forms of illness

Symptoms of calculus cholecystitis directly depend on the form of the disease. Thus, chronic and acute form of illness have different manifestations.

Complicated and acute form of housing

• unbearable cutting pains localized in the right side;
• pain sensations are given to the shovel on the right side or the right shoulder;
• such pain is provoked by disabilities in nutrition, depression, bad emotional state, alcohol abuse;
• the patient notes the attacks of nausea, which can move into vomiting;
• purification of the stomach does not lead to a decrease in unpleasant symptoms;
• in the vomiting masses, traces of bile secretion are noted;
• the body temperature increases, it reaches the highest indicators with a depression of a pus in the gallbladder cavity;
• there is a significant drop in blood pressure;
• the patient notes a great cold sweating;
• gradually arise symptoms of friable damage;
• urina and cavalous masses acquire an unhealthy color.

Chronic calculous cholecystitis

With this type of disease, the following characteristic symptoms are noted:

• long-term pain and stupid character;
• paints are localized in the area of \u200b\u200bthe right hypochondrium;
• the attacks are provoked three hours after meals rich in fats and salt, as well as hazardous heat treatment on sunflower or butter;
• attacks can serve themselves after partial digestion of harmful food;
• patients note the attacks of nausea;
• some patients are diagnosed with an extermination with a bitter taste;
• if the proper nutrition is too disturbing, strong vomiting will begin with big amount bile;
• there are no changes in body temperature or arterial pressure.

Attention!!! At the same time, with chronic cholecystitis, when the seizures subscribe, patients do not feel any discomfort and do not mention a significant deterioration in the overall condition and reduce immunity.

Diagnosis of the disease

If there is a suspicion of the development of calculous cholecystitis, urgent medical care is required. Delay threatens the development of peritonitis, which is dangerous for the patient's life. In most such cases, urgent operational intervention. The acute form of the disease is diagnosed with surgeons and they are eliminated.

If the disease is chronic, the diagnosis is made by a gastroenterologist. It is done in the usual clinic with a planned visiting or during hospitalization during colic attacks.

At the same time, to put an accurate diagnosis, the specialist is obliged to assemble the patient's characteristic disease, check it general state, designate laboratory research Total type of blood and urine. Additionally, the level of pancreas enzymes and its performance is measured. There will be no superfluous hepatic samples and the holding of a coprogram, so the procedure for the study of the carts.

A preliminary diagnosis is confirmed by the ultrasound examination of the gallbladder. If necessary, the patient is injected into the gallbladder to get clear X-rays with cholecystography.

Attention!!! To study the properties of the resulting stones and their possible danger, sensing is assigned. With this procedure, a laboratory assists part of the bile secretion and conducts its microscopic examination, it will help to choose a more accurate plan of therapy.

Treatment of calculous cholecystitis

To date, experts use two methods to eliminate the resulting pathology - surgery and traditional.

Acute form of manifestation of pathology

If the calculous cholecystitis occurs in a patient for the first time, the attending physician uses antibacterial, antispasmodic and painkillers. Poisoning substances are removed from the body with special solutions. IN obligatory The patient is prescribed a strict diet and provide recommendations for preventing repeated seizures. With this form therapy is carried out strictly in the walls medical institutionSince independent therapy can lead to a life-threatening situation.

If all the accepted drug and gentle methods did not give any result, or the patient has already accumulated a pus inside the gallbladder, a specialist without any doubt eliminates the body together with the stone fractions formed in it.

In most cases, surgeons try to conduct operational interference with the method of laparoscopy, which refers to one of the most gentle invasive techniques. To remove the gallbladder there are several punctures in abdominal region Special small scalpels strictly with constant monitor control. If the patient has already been manifested by peritonitis, the open-type laparotomy is carried out. Additionally, the abdominal cavity is carried out.

Chronic form of calculous cholecystitis

With this type of manifestation of the disease, a strict mandatory diet is prescribed. It must completely remove food from the diet, which is rich in carbohydrates and fat. It is necessary to minimize the amount of salt, sharp spices, to give up alcoholic beverages for life. At the same time, the patient should significantly reduce sports and physical exertion, to lead a quiet way of life, to avoid psycho-emotional shocks.

After it was possible to reduce the attack and the pain retreated a little, a litholitical course of treatment was carried out. For this, drugs are used that can smash the concrections in the bustling bubble and its ducts. These funds include Ursosan and Lithofalk. Additionally, you can drink medical preparations antispasmodic type.

Attention!!! Chronic form of illness, in contrast to acute, can be eliminated at home. Additionally, you can use methods for this. folk therapyBut it is important to consult with the attending physician on the possibility of their application.

Video - How to prevent the formation of stones in the gallbladder

Features of medicines for the treatment of HCB

A drug	Picture	Description	Price
Ursosan		Dissolves the concrections, restores the gastric mucosa and gallbladder	1000-1700 rubles
Lithofalk		Also contributes to the dissolution of stones in bile ducts, removes the manifestations of hepatitis, improves the state of the mucous	400-1500 rubles
DROTAVERIN		Perfectly removes the emerging spasm, weakens pain	50-1000 rubles
Libraks		Refers to the class of spasmodics, which simultaneously improve the overall condition of the patient. It is allowed to use children in acute necessity	800-1200 rubles
OSPEN		Provides antimicrobial effects, suppresses the production of pathogenic bacteria	780 rubles
Meratin		Removes the inflammatory process, prevents the formation of pus and the development of peritonitis	1550 rubles
Mebavserin		Eliminates the spasm of fabrics and pain effect, further improving the state of general well-being	750-2500 rubles

Attention!!! All described substances and drugs can be accepted strictly after prior consultation with the attending physician and the definition of individual dosage.

Folk Methods for the Treatment of HCBB

Korni Khrena

For the preparation of the means, it is necessary to thoroughly rinse the fruits of the horseradish and cut off all the diesel or fiddled areas. Pure rhizomes grate into a large grater. There should be no less than one glass of 250 ml. After that, the mass is poured with one liter of boiling water and insist under a dense lid strictly in enamelled or glass utensils.

After that, through a gauze bandage, strain the solution and put it in a cold place. Before use, the measured dose should be slightly warm. Take a medicine requires three times in the knocks of 50 g 10-15 minutes before the main meal. For taste, it is allowed to add some sugar or its substitute.

Juices of plants

Pretty time-consuming recipe, but giving nice results, Including in the period of exacerbation.

1. In the same proportions of 500 ml, it is necessary to take the freshly squeezed meal juice, the plant should be at least 3 years, beets, carrots and radish of the black grade.
2. Thoroughly mixing these ingredients, you should add the same amount of liquid honey to them, it can be melt in a water bath, as well as high-quality vodka.
3. All ingredients are stirred to a homogeneous state and poured with them a glass jar of three liters.
4. The bank should close a strictly caproic lid and put it in an impenetrable package.
5. Capacity bury into the ground with a neck for 14 days.
6. After that, the infused liquid is bottled at less tanks and is placed in the refrigerator. It should be monitored that the straight rays of the sun do not fall on the bottles.
7. The dosage of the drug is 15 ml before each meal.
8. The accumulated bile will begin to stand out with the cartoons in the form of mucus.
9. The course of treatment consists of the use of the whole tincture.

Regardless of how sharp or strong is the pain that appeared in the abdominal cavity, you should apply for a start to the therapist. It will help to exclude some diagnoses and direct to a narrow specialist. At the same time, if the pain is acute and is not necessarily localized on the right side, it is necessary to urgently cause ambulance. The state of peritonitis can manifest themselves pain in any location of the abdomen and abdominal cavity. Only timely treatment will help to avoid fatal outcome and return the patient to normal life.

Calculose cholecystitis is a disease of the gallbladder for which serious inflammatory processes are characteristic. Compared to the rest of the abdominal diseases, this disease is very common.

Today, this submission is subject to about 20% of the population, and these indicators are rapidly increasing. This is due to the fact that many people eat food with elevated fat content - oil, fat, fatty meat, eggs, and also adhere to a sedentary lifestyle. In addition, many people have a violation of the endocrine system as a result of diabetes mellitus or obesity. Most often, women are sickly cholecystitis - this is due to oral contraception and pregnancy.

Main reasons

Calculose cholecystitis has a major cause - these are infectious diseases. In the intestine of a person, microorganisms are inhabited, which contribute to the improvement of the digestion process, but they can sometimes be in themselves a considerable danger.

There are certain factors provoking an increase in microorganisms, which subsequently cause the authority to work:

Calculose cholecystitis has quite extensive etiology. The development of the disease is also noted against the background of autoimmune diseases and allergic reactions.

Many people suffer from chronic cholecystitis due to the omission of organs that are in the abdominal cavity, or as a result of an innate disruption of the structure of the gallbladder. Very often, this disease develops against the background of pancreatitis, as a result of the operational failure.

Symptoms

By clinical flow Calculose cholecystitis can be chronic and sharp, while in the first case remission is replaced by exacerbation. The exacerbation period is quite often reminded. clinical manifestation acute inflammation of the body.

The priority symptoms, leaving the idea of \u200b\u200bthe presence of cholecystitis, are:

• Vomiting and nausea.
• Heartburn.
• In the mouth feels bitterness.
• Feeling pain in the right hypochondrium.
• Belching.

The most vivid manifestation is a hepatic colic that has such clinical signs Chronic calculous cholecystitis:

In an objective examination, certain symptoms may be detected indicating this disease. All of them consist in the process of palpation there is a sharp pain.

At the stage of remission, calculous cholecystitis in most cases is a small-axipputic. Remissance in the errors in the diet is replaced by exacerbation.

Diagnostics

In suspected of this disease, the diagnostic search consists of additional methods Research:

• Ultrasound.
• X-ray.
• Biochemical study of blood with the definition of the overall level of protein, its fractions, as well as cholesterol, triglycerides.
• Fibrogastroduodenoscopy and others.

Complications

In case of late diagnosis or late treatment, calculous cholecystitis may apply to the following complications:

• Dropsy.
• Purulent inflammation (empya).
• Acute inflamed process in biliary ways, sharp cholangitis.
• Perforation gallged wall With the further development of peritonitis.
• Violation of suction in the intestine with all the ensuing consequences.
• Malignant oncological processes.
• Repeated inflammation of the pancreas.
• A narrowing (stenosis) of the Nipple Faters (large duodenal papillas).
• Mechanical jaundice developed by violation of the function of the outflow of bile (blocking the gallbladder, its outflows or a large duodenal nipple).
• Stone formation (choledocholiticiasis).

Differential diagnosis of chronic calculous cholecystitis

Cholecystitis is distinguished with renal columes, inflammation of the pancreas, appendicitis, trimming ulcers duodenal gut and stomach.

Compared to acute cholecystitis renal colic Acute pain is felt in the lumbar region. Pain gives to the hip zone and genital organs. At the same time, there is a violation of urination. With renal colic, leukocytosis is not recorded and the temperature does not increase. The urine analysis indicates the presence of salts and uniform components of the blood.

With a high arrangement of appendix, acute appendicitis can provoke acute calculous cholecystitis (the diet is described below). The difference between acute appendicitis from cholecystitis lies in the fact that in the latter case, the pain gives to the shoulder area and the right blade, and there is also vomiting with biliary. At appendicitis there are no symptoms of Mussi-Georgievsky.

In addition, acute appendicitis is much harder to flow, the development of peritonitis takes place actively. The differential diagnosis of chronic calculous cholecystitis is simplified by the presence in the history of the illness of information that the patient has stones in the bustling bubble.

In some cases, the peeling ulcer duodenal and the stomach is masked for acute cholecystitis. However, in contrast to ulcers in acute cholecystitis in the history of the disease, as a rule, there are guidance on the presence in the organs of the stones.

For acute cholecystitis, painful sensations are characteristic of the rest of the body, as well as vomiting with the content of bile. Initially, the feeling of pain is localized in the hypothered part of the right, increasing gradually, the heat begins.

Hidden probor ulcers show themselves acute. In the first hours of the disease, the muscles of the front area of \u200b\u200bthe abdominal wall is strongly tense. Very often, patients complain about painful sensations in the right iliac, due to the fact that the contents of the stomach flows into the cavity. With cholecystitis, hepatic stupidity is observed.

In case of acute pancreatitis, intoxication increases, the intestine paresis is observed, a rapid heartbeat is observed - it is its main difference from cholecystitis. In case of inflammation of the pancreas, the pain is often accompanied by strong vomiting. It is quite difficult to distinguish acute gangrenous calculous cholecystitis from acute pancreatitis, so the diagnosis is carried out in stationary conditions.

Diet

Cholecystitis is a rather severe disease. Proper nutrition with such a diagnosis favors rapid recovery. In this case medical nutrition should be directed to a decrease in acidity and the selection of bile.

From the diet, smoked and fried food is excluded. Include in the menu you need fresh vegetables and fruits, vegetable oil, cereal.

What can not eat if calculous cholecystitis is diagnosed? The menu must be drawn up with certain requirements:

• It should be discarded fried and oily food.
• You need to eat often, the portions should be small.
• Reduce the consumption of sweet and flour products.
• Avoid hot and cold food.
• Give preference to baked, boiled and stewed products.
• Minimize strong tea and coffee.
• There are no more than three eggs a week, while it is desirable to exclude yolks.
• To use more vegetable and dairy food, as the fiber improves the motorcy and leads a chair, and the milk normalizes the acid-alkaline balance.
• Stick to the power mode, is at the same time.

With such a disease, like calculous cholecystitis, a diet after surgery should be the same as in the chronic form of illness.

Food

Proper nutrition with such a disease is able to provide a long period of remission. From the diet, you should remove food, which contributes to the formation of stones and weighting of the liver.

It is necessary to include in the menu products containing fiber, milk proteins, vegetable oil, and consume a large amount of fluid. Reduce the amount of products with high fat and cholesterol.

List of allowed products

To prevent a possible attack of calculous cholecystitis, it is advisable to get acquainted with the list of permitted products:

• Milk products.
• Vegetable and cereal soups, greens (except for rhubarb, sorrel and spinach), vegetables, cereals, boiled meat and fish.
• Cheese, cod liver, sweeping herring.
• Wheat I. rye bread Yesterday's baking, non-propulsive cookies.
• Sunflower, olive and butter (small quantity).

Calculse cholecystitis: how to treat?

The classical therapy of this disease is the removal of pain syndrome and hospitalization. In the case of chronic form, treatment can be carried out as an outpatient basis. Bed regime are prescribed, sulfonilamide drugs or antibiotics, as well as fractional diet food. When inflammation subsides, physiotherapeutic procedures are allowed.

Treatment (exacerbation of calculous cholecystitis) is carried out in this way:

1. On the appointed research, the doctor defines the stage and the form of the disease.
2. It is diagnosed.
3. When the acute inflammatory process is detected, anti-inflammatory preparations ("but-shpa", "papaverine hydrochloride") and antibiotics having a wide range of action are prescribed to the patient.
4. After the inflammation is removed and the focus of infection is suppressed, bile preparations are prescribed, accelerating the emptying of the gallbladder and weaken the inflammatory process.

If stones are detected in the gallbladder ducts or in the organ itself, and the inflammatory process is pronounced, the operation is assigned. Depending on the localization of the concrections and their size, deposits or the gall bladder as a whole are removed. The unsuccessfulness of conservative treatment or the diagnosis of "gangrenous calculose cholecystitis" are absolute indicators for this purpose.

ethnoscience

At the moments of sacrament of the acute process allowed to use popular treatment. To restore the function of the organ, decoctions and infusions are used (from cornflowers, immortals, etc.), which have antimicrobial and astringent action.

• Patient is useful to include in the diet mineral water ("Yessentuki" №4 and №17, "Slavyanskaya", "Naftuya", "Mirgorodskaya") and choleretic teas. Alcohol and Holyagol are allowed from drug-based drugs based on plants.
• In chronic cholecystitis, it should be used 2-3 times a week a free-reason tube. On an empty stomach drinks warm water or decoction (1 cup). After 30 minutes it is necessary to drink "Allhol", and then - again decoction of herbs. Next, you need to lie on the left side, and the height should be put on the right. In this position it is recommended to stay 1.5-2 hours.

Therapy of such a disease, like calculous cholecystitis (treatment and diet, should be carried out only under the control of specialists), implies the use of funds of traditional medicine. In chronic form, such treatment significantly facilitates the state, and most importantly - leads to positive results.

In general, treatment with the means of traditional medicine can be divided into two main directions:

1. By means of choleretic herbs.
2. Homeopathic preparations involving the impact on stones that have a certain chemical composition similar to the composition. For example, if phosphate or oxoline acid was detected in the urine analysis, then the same acids are prescribed during treatment. When cholecystit without stones, preparations are used that activate the immune system.

Recipes of decoctions

1. The grass of the souls (teaspoon) should be boiled water (glass), and then insist for two hours. In the event of a disease of the biliary tract, you need to drink 3 times throughout the day 1/4 cup.
2. The sheets of medicinal sage (2 hours l.) Are brewed with boiling water (2 cups), then for half an hour they insist and fart. With inflammatory processes in the liver or bustling bubble, it is necessary to drink 1 tbsp. Spoon every two hours.
3. Veronica The stream (teaspoon) is brewed with boiling water (glass), after which it is insisted for half an hour. You need to drink 3 times during the day 1/4 cup.
4. Corn stilts (tablespoon) are brewed with boiling water (glass), and then insist for 60 minutes and focusing. You should drink every 3 hours of 1 tbsp. spoon.
5. The grass rebel (10 g) is brewed with water (3 glasses) and boiled for 10 minutes. Drinking decoction should be before eating three times a day in a glass.
6. Pornea rhizomes (20 g) are brewed with boiling water (1.5 glasses) and insist for several hours, and then focusing. With cholecystitis take 3 times a day one glass. The course is 1 month.
7. The grass of the reinforced Hypericum (tablespoon) is brewed with boiling water (glass), boils 15 minutes, and then focusing. You need to drink 3 times a day for 1/4 cup. For this brave, a choleretic and anti-inflammatory effect is characterized.
8. Hopnies (2 tbsp) is brewed with boiling water (1.5 glasses), covered and insisted for 3 hours. When cholecystit, drink decoction for half an hour before the meal of 1/2 cup 3-4 times a day.
9. Thoroughly grind the daisy flowers, immortals, a shader, dill seed and jox by the same number. All mix and pour the resulting mixture (3 hours l.) Boiling water (2 glasses). Next, the contents of the glass insisted 20 minutes and flickering. Take daily after eating in the morning and in the evening before bedtime 1/2 or 1/4 cup.
10. Finely chopped 3 pieces of sandmander flowers, 2 pieces of fennel fruit, hints, yarrow herbs or mint leaf and dill. Pour the resulting mixture (2 hours l.) Boiling water (2 glasses). Insist for 8-12 hours and strain. Use before eating 3-4 times a day for 1/3 cup.
11. Chamomile flowers (tablespoon) are brewed with boiling water (glass). When cholecystitis, use for enema in warm form. Clamps do 2-3 times over the week.
12. The depressive stiff (teaspoon) is brewed with boiling water (glass) and insisters about 60 minutes, then it is fastened. You need to drink 3 times a day for 1/3 cups (before meals).
13. The peppermint (tablespoon) is brewed with boiling water (glass) and half an hour is insisted. Throughout the day, drink small sips (at least three times).

In most cases, people are sick chronic cholecystitis throughout years. His current and frequency of exacerbations are directly related to the desire of a person to overcome this disease with all possible methods and means. If you are sick, try to stick to a healthy and proper lifestyle (exercise, rational food, the right recreation and labor mode). Also, do not forget about drug treatment, while during the periods of remission it is desirable to additionally use the funds of traditional medicine.

- This is a disease accompanied by the formation of stones in the bustling bubble (cholecystolithiasis) or in bile ducts (choledocholiticiasis). Stones are formed as a result of precipitation of bile pigments, cholesterol, some types of proteins, calcium salts, bile infection, its stagnation, lipid metabolism. The disease may be accompanied by pain in the right hypochondrium, bile columns, jaundice. Operational intervention is required. Pathology can be complicated by cholecystitis, the formation of fistula, peritonitis.

General

- a disease characterized by a disorder of synthesis and circulation of bile in the hepatobiliary system as a result of a violation of cholesterol or bilirubin exchanges, a result of which stones (concrections) are formed in bile ducts and a bustling bubble. Pathology is dangerous development heavy complicationshaving a high likelihood of death. The disease is much more often developing in women. Treatment is carried out by specialists in the field of clinical gastroenterology and abdominal surgery.

Causes

In case of violation of the quantitative ratio of bile components in the body, solid formations (flakes) are forming, which are growing and merged into stones over the course of the disease. The most commonly found choletiasis with the impaired cholesterol exchange (redundant content in bile). Oversaturated cholesterol bile is called lithogenic. Excess cholesterol is formed due to the following factors:

• In obesity and use large number Cholesterol-containing products.
• With a decrease in the amount of bile acids entering bile (reduced secretion in estrogen, deposit in the bustling bubble, functional insufficiency of hepatocytes).
• With a decrease in the number of phospholipids, which are like bulls do not give cholesterol and bilirubin to move into a solid state and settle.
• With stagnation in the bile circulation system (bile thickening due to suction in a bile bubble of water and bile acids).

Stagnation bile in turn may have a mechanical and functional nature. With a mechanical, the stool occurs an obstacle to the outflow of busty from the bubble (tumors, spikes, gears, an increase in nearby organs and lymph nodes, scars, inflammation with swelling walls, stricture). Functional disorders are associated with the disorder of the gallbladder motility and biliary tract (dyskinesia of biliary tract on hypokinetic type). Also, infections, inflammation of the biliary system organs, allergic reactions, autoimmune states may also be used to develop biliary diseases.

The risk factors for the development of gallstone disease are elderly and senile age, Receiving medicines interfering in the exchange of cholesterol and bilirubin (fibrats, estrogens in menopause, ceftriaxone, rally), genetic factors (gall-eyed disease in the mother), nutritional disorders (obesity, sharp weight, starvation, elevated level of cholesterol and high-density blood lipoprotections, hyperitriglisserine ).

The likelihood of pathology is raised multiple pregnancy, exchange diseases (diabetes mellitus, enzymesopathy, metabolic syndrome), diseases of the gastrointestinal tract (Crohn disease, digestive duodenal and bile duct, biliary tract infection), postoperative states (after resection of the stomach, stem vagoectomy).

Patanatomy

The bile stones are diverse in size, form, there can be a different amount (from one concrete to hundreds), but all of them are divided according to its preferential component on cholesterol and pigment (bilirubin).

Cholesterol stones yellow color, consist of undisputed cholesterol with various impurities (minerals, bilirubin). Almost the overwhelming majority of stones have cholesterol origins (80%). The pigment stones of dark brown up to black color are formed during an excess of bilirubin in bile, which happens with functional disorders of the liver, frequent hemolysis, infectious diseases biliary tract.

Classification

According to modern classification Gallgame disease is divided into three stages:

• Initial (proven). Characterized by changes in the composition of the bile) is not clinically manifested, it is possible to identify when biochemical analysis bile composition.
• Stone formation. Latent coinniestnium also proceeds asymptomatic, but instrumental methods Diagnostics It is possible to detect the accretions in the bustling bubble.
• Clinical manifestations. It is characterized by the development of acute or chronic calculous cholecystitis.

Sometimes they allocate the fourth stage - the development of complications.

Symptoms of gallway disease

Symptoms manifests itself depending on the localization of stones and their size, expression of inflammatory processes and availability functional disorders. A characteristic pain symptom with HCB - bile or hepatic colic - pronounced sharpness suddenly emerging pain under the right edge of the cutting, stitching. After a couple of hours, the pain is finally concentrated in the area of \u200b\u200bthe bubble projection. May be irradiated in the back, under the right blade, in the neck, on the right shoulder. Sometimes irradiation in the heart area can cause angina.

The pain occurs more often after the use of sharp, spicy, fried, fatty products, alcohol, stress, heavy exercise, long-term work in the inclined position. The causes of pain syndrome are the spasm of the muscles of the gallbladder and the ducts as a reflex response to the irritation of the wall by the concretions and as a result of relenting the bubble with an excess of bile in the presence of obturation in biliary tract. Global cholestasis when blocking the bile duct: the bile ducts of the liver are expanding, increasing the organ in volume, which responds with a painful reaction of a polished capsule. Such pain has a constant stupid character, often accompanied by a feeling of gravity in the right hypochondrium.

Related symptoms are nausea (up to vomiting, which does not bring relief). Vomiting arises as a reflex response to irritation of the nearby DPK region. If the inflammatory process captured the pancreas fabrics, vomiting may be frequent, with bile, indomitable. Depending on the severity of intoxication, there is an increase in temperature from subfebrile numbers to a pronounced fever. When blocking the concrete of the total bile duct and the obstruction of the sphincter, Oddi is observed obstructive jaundice and the discoloration of feces.

Complications

Most frequent complications GCB is the inflammation of the gallbladder (acute and chronic) and the obturation of the biliary paths of the concretion. The blockage of the gallway lumen in the pancreas can cause acute biliary pancreatitis. Also, the inflammation of biliary ducts is considered frequent complications of gallstone disease - cholangitis.

Diagnostics

When identifying symptoms of hepatic colic, the patient is directed to the consultation of the gastroenterologist. The physical examination of the patient reveals characteristic of the presence of concrections in the bubble bubble Symptoms: Zaharin, Oder, Murphy. It also determines the skin pain and the muscle tension of the abdominal wall muscle in the area of \u200b\u200bthe gallbladder projection. Xanthemia is celebrated on the skin, with obtulting jaundice, characteristic yellow-brownish skin and scler.

The overall blood test during the clinical exacerbation shows the signs of non-specific inflammation - leukocytosis and a moderate increase in ESR. Biochemical blood test allows you to identify hypercholesterolem and hyperbilirubinemia, an increase in the activity of alkaline phosphatase. With cholecystographic, the gallbladder is increased, it has lime inclusions in the walls, they are clearly visible in stones with lime.

The most informative and widestly used method of studying the gallbladder is an ultrasound abdominal ultrasound. It accurately shows the presence of echronized formations - stones, pathological deformations of the walls of the bubble, changes to his motility. On the ultrasound, the presence of signs of cholecystitis is clearly visible. Also visualize the gallbladder and ducts allows MRI and cholecystotomy) High or laparoscopic, depending on the body of the body, pathological changes in the walls of the bubble and the surrounding tissues, the size of the concrections. Cholecystectomy from the mini-seater can always be translated into an open extended operation in the event of a technical need.

There are methods for dissolving the concrections using ursodeoxycholic and minoroxycholic acid preparations, but this kind of therapy does not lead to curable disease and over time it is possible to form new stones. Another way to destroy the stones is shock-wave lithotripsy - applies only in the case of the presence of a single concrement and in patients who do not suffer acute inflammation gallbladder or ducts.

Prediction and prevention

The forecast directly depends on the rate of formation of stones, their magnitude and mobility. In the overwhelming incidence of stones in the bustling bubble leads to the development of complications. With successful surgical removal of the gallbladder - a cure without pronounced consequences for the quality of life of patients. Prevention lies in avoiding factors contributing to elevated cholesterolemia and bilirubinemia, stagnation of bile.

Balanced nutrition, normalization of body weight, active lifestyle with regular physical exertion can avoid exchange disorders, and timely detection and treatment of the pathologies of the biliary system (dyskinesium, obtasters, inflammatory diseases) reduces the likelihood of the busty and precipitation in the gallbladder. Special attention to the exchange of cholesterol and the state of the biliary system must be given to persons having a genetic predisposition to stone formation.

If there are stones in the bustling bubble prevention of bile colic seizures, there will be a strict diet (exception from the diet of fatty, fried foods, drums, confectionery creams, sweets, alcohol, carbonated drinks, etc.), normalization of body weight, consumption of sufficient liquid. To reduce the probability of movement of the gallbladder, the ducts are not recommended to work associated with prolonged in oblique position.

Calculse cholecystitis - what it is, an acute and chronic form - what kind of symptoms has and how is it treated? Dependence of the disease from the presence of the LCBC

What is a calculous cholecystitis?

Cholecystitis is called the process of inflammation of the walls of the gallbladder. There are many reasons for this, but the most common, which in the total mass of the diseases is about 90%This is the presence of stone deposits (or counters) in cavity and ducts. Such a form of pathology and called calculse cholecystitis, but causing her illness - bile-changing (HCB). It is acute and chronic, and the concrections in most cases consist of cholesterol and calcium elements.

Stones at the HCR, being an obstacle to the path of fluid flow, lead to the situation zolley stagnation. Broken outflow leads to problems of blood circulation In the shell of the organ, besides this, perhaps partial inverse movement of bile from ducts leading to the rectum, resulting in probably driva from there of various pathogenic microorganisms, naturally there live. All these factors, acting together, lead to inflammation.

Calculse cholecystitis proceeds as chronic illness With periodic exacerbations called acute cholecystitis. As a rule, in such periods, the patient feels strong pains and colic in the zone of the right hypochondrium. The painful sensations are able to give to the clavicle or even left side. It is possible to increase the temperature and nausea.

According to statistics, about the 1950s, the number of cases with a diagnosis "Calculse cholecystitis" and HCRs doubles every ten years. Currently, about 10% of all adults in developed countries are subject to this pathology, in Russia their number is about 15 million, and in America - 30 million people in the area.

The higher the age, the more sick. If a person has passed over 45 years, then the disease reaches 30%. Every year in the world there are about two, three million surgical operations for the treatment of calculous form of the disease.

Causes of the disease

"Calculse" means "stone"Thus, the reason is the presence of stones in the cavity of the gallbladder or ducts leading from it. Such a manifestation is called a "gall-eyed disease" or the abbreviation of the HCB. But where do the stones come from? Their occurrence occurs because of the qualitative change in the composition of bile. Due to excess cholesterol, it is crystallization, as a result of stagnant phenomena. You can list the following reasonscontributing to the appearance of concrections:

• A large amount in diet is rich in fats and carbohydrates
• Significant fasting periods associated with this diet for weight loss, lack of basic vitamins in such periods
• The presence of injuries in the right side of the bottom, the consequences of surgical interventions in this place
• Low motor activity
• Acute viral hepatitis
• Changes in the structure due to heredity and congenitivity
• Endocrine diseases. In the risk group, patients with diabetes, great weight, shifts of hormonal background

In addition to these reasons, calculous cholecystitis is able to be called:

• Dyskinesia of biliary tract when the gallbladder motor is broken
• Pancreatitis

Symptoms of calculous cholecystitis

Calculse cholecystitis is divided into two varieties - acute and chronic. If a person is subject to acute manifestation of the disease, then the following symptoms will be observed:

• Pain syndrome in the zone under the ribs on the right side, in another other than the "bile columan". It is able to have a strong manifestation, giving up to the area shoulder Sustav, clavicle
• Nausea appears, gilly impurities are noticeable in the vomit masses
• Increased temperature
• Sensation of ailment
• Probably manifestation of jaundice
• Reduced arterial pressure

During the chronic variety of calculous cholecystitis in the usual stage of flow, without exacerbation, the symptoms are about the same, but they will be smoothed and easily ported. Among the features of their manifestations can be allocated:

• The existence of characteristic stupid and overeating pain sensations down to the right on the right side. They manifest themselves constantly or occur a few hours after taking a significant amount of food. This is especially true of food with a fatty or cooked frying way. At the same time frequent symptom LCB
• Pouring symptom gives up Torch, Locating in the shoulder, cervical and bladder area on the right side. With some periodicity there are sharp pains that are very similar to those mentioned with colic. It should be noted that often the processes of changes in the bustling bubble caused by the presence of inflammation are capable of remaining without symptoms to a certain stage of the disease.
• In the chronic form of cholecystitis caused by the presence of concrections, usually not observed in high temperature.
• Sometimes probably manifestation nausea, vomiting
• Symptoms of jaundice are not observed
• The patient often happens irritated, suffer insomnia

During chronic form Pathology often occur periods of exacerbation, for which the following symptoms and manifestations:

• Sharp resistant in the area of \u200b\u200bthe liver, painful syndrome gives to the shovel, chest, heart
• Aggravation of nausea and vomiting
• Spirit a head
• Temperature is increasingly increasing
• The belly will be off, his muscles are tense
• Muscles posted in the peritoneum area are exposed to spasms
• Upset chair, maybe diarrhea, but more likely constipation

Calculse cholecystitis according to the degree of development, values, number of stones, as well as the influence of these indicators on symptoms, divide into the following stages:

• On the initial or "pre-book" stage formed by the Cutters and the HCRs yet. In such a phase of development there is a bile stas, thick bile and microliths. With this development, the disease is still reversible
• The period of development of the HCB, when the concrections are formed
• Chronic calculous cholecystitis
• Phase appearance of complications

It is not difficult to guess what proceeding from the stage, the method of treatment will have significant differences.

Diagnostics

The main purpose of the diagnosis in calculous cholecystitis is absolutely logical, it is the identification of signs of biliary disease (HCB). This is achieved, for example, the appointment of ultrasound examination, the procedures for x-ray, called cholecystography in this case. In addition, the results of the general analysis of blood and urine will be needed. In order to separate the "stone" disease from "Nekatenaya", the enzymes are studied generated by the pancreas and liver, surrendered to the analysis of the feces. Sometimes the patient is subjected to duodenal sensing for taking bile samples.

In diagnosis, the considered pathology is important to separate from other diseases having simplicity, eg:

• Dispense of biliary duksov
• Cholesteroza
• Chronic hepatitis
• Pancreatitis
• Gastritis
• and many others

In chronic disease, treatment is conducted at home special preparations. During exacerbations, the patient is subject to hospitalization, then he is either subjected conservative treatmentor surgical intervention.

Complications

Calculse cholecystitis can often have complications that exacerbate the patient's condition, imposing on already available symptoms, new ones. In addition, with the appearance of complications, treatment is significantly hampered. Most frequent species are complications:

• Purpose by obstacles to the general duct, called yet Khdocholithiasis
• Skipping pus under a diaphragm
• Stretching and atrophy of the walls of the gallbladder
• Breakthrough walls called peritonitis
• Various types of pancreatitis, hepatitis

It is important to exclude such a development of events without tightening with the appeal to the doctor, but to do this at the first signs of pathology. Treatment in late stages is almost always associated with a surgical operation.

How is the calculous cholecystitis

As mentioned above, treatment is chosen based on their shape and the stage of the disease. If evolved acute pariety Type of cholecystitis, the treatment is conducted in hospital hospital. Independent methods of treatment in this case will not help and will only lead to loss of time, giving more effects to inflammation. In the hospital, as a rule, treatment is carried out to suppress pathogenic bacterial medium, removal of spasms, degenericsication of the body.

After stabilizing the condition of the patient, when the aggravation subsided, go to litholithic therapy, or in a simple, attempt to destroy the concrections. This is done by taking special drugs dissolving cholesterol counters. With such drugs, in some cases, significant progress can be achieved and avoid surgical removal. However, after dissolving stones in such a way, there is a high probability of recurrence.

If the patient's condition after the attack and exacerbation, it is not possible to stabilize or the use of litholithic therapy does not give results, it is carried out surgical removal of gallbladder, Together with all the contents. Sometimes the bubble itself is not deleted, but only its contents are removed, that is, the stones. By the aggregate of the results of analyzes, surveys and the effectiveness of previous therapy, in each particular case, the question of one or another form of intervention is solved separately.

Removal operation

To date, a number of techniques are used in medicine to remove a gallbladder or stones from it. Acute calculous cholecystitis is treated by:

• Laparoscopy. Gentle reception surgical operation Through small cuts in the peritoneum. They are used to enter a special surgical instrument and the device, with which optical control of what is happening, called a laparoscope. The surgeon has the ability to track the course of the process on the monitor. Due to this method, the abdomen of the abdominal cavity is eliminated, the period of recovery of the patient is reduced after the operation, the rate of healing wounds, and not to deter appearance operated.
• Locking (perceltering) cholecystostomy. Also a small way. A small incision is made on the peritoneum, through which, with the help of a drainage tube, an audit of the gallbladder cavity is carried out, with the removal of some types of stones. Apply for very heavy patients who are contraindicated by the usual operation.

If it is impossible to implement the above methods, a classic surgical intervention is carried out open, which is called open cholecysthethomy. The testimony for its conduct is complicated forms of calculous cholecystitis.

Forecast recovery after surgery

Calculse cholecystitis well treated Using the removal operation. The prognosis of recovery is conditionally favorable with conservation of ability to work. Most dangerous the most extreme cases of pathology called peritonitis. This is a situation where the dead wall of the bubble breaks through. In this case, the patient's life is under threat, he needs urgent medical care and surgical treatment.

Diet to prevent LBK

No less important during treatment and after it, radically change your diet. After all, it is the substances obtained with food that cause the formation of stones and, as a result, acute or chronic calculous cholecystitis. Among the main principles of the diet can be allocated:

• Splitting up daily consumption Food for five, six times
• Receiving fluid in a different form, a volume of at least two liters per day
• Method of cooking: Cooking, pair, baking
• Eliminate fatty foods, spices, sharp, gas production, alcohol
• Very useful porridge on water from buckwheat, rice, millet, oats
• From drinks Preference for tea, compotes, diluted juice