The gallbladder is inflamed than to treat. Gallbladder inflammation symptoms and treatment. Causes of the appearance of cholecystitis

Cholecystitis (inflammation of the gallbladder). The main symptom of the disease is severe pain in the right side when the position of the body changes. From year to year the number of these diseases increases by 15%, and the occurrence of stones increases by 20% annually among the adult population. Men are less prone to cholecystitis than women after 50 years.

Classification

Diseases of the digestive system belong to the category of constantly diagnosed serious health problems. The constantly deteriorating ecology, violations in the technology of food preparation, the introduction of various chemicals into the method of growing vegetables and fruits, as well as when feeding animals and poultry, have led to a sharp increase in the incidence rates of the digestive tract and the entire human digestive system.

There are subspecies, with the mention of ICD 10 codes:

• calculous;
• non-calculus.

And also the stages:

• Chronic cholecystitis (K81.1) can last up to 6 months (in difficult cases, the period increases);
• Acute (K81.0) - this form is more transient (on average, about 3 months).

Chronic cholecystitis can be (other forms of cholecystitis K 81.8):

• Phlegmonous (the bladder contains pus, the walls of the organ are completely inflamed);
• Catarrhal (the gallbladder membrane is red, edematous, but the mucous membrane is inflamed only superficially);
• Gangrenous (pronounced form, up to fragmentary tissue necrosis).

Reasons 👩‍⚕️

The gallbladder is a significant organ in the digestive system, but under certain conditions it can become inflamed, and then the diagnosis is made - cholecystitis. Of the many diseases of the abdominal cavity, this is the most common, and has already been proven to strive for further growth.

The main reasons for the development of cholecystitis: impaired motility, hypodynamia of the gallbladder. Poor bile circulation has the following consequences:

• Firstly, its thickening contributes to the formation of stones, they disrupt its acid-base balance, structure, and the integrity of the bladder membrane.
• Secondly, pathogenic bacteria enter the gallbladder from the intestines, through the blood or lymph from the foci of infection, and as a result - inflammation.

The reasons for the violation of the outflow of bile (dyskinesia) and as a result of inflammation of the gallbladder:

Chronic inflammation of the gallbladder is mainly a consequence of the formation and prolonged course of diseases of the gastrointestinal tract and liver.

Spicy

In 90% of cases, stones are the cause of the development of an acute form of cholecystitis. Already in the early stages of their appearance, the microflora of the gallbladder and the composition of bile change, and the motor function of the pathways responsible for its evacuation also deteriorates. Ultimately, the mucous membrane is injured, and the lesion becomes a favorable site for an infectious agent. This further contributes to internal inflammation.

Symptoms 🤒

The main symptoms of gallbladder inflammation are pain in the hypochondrium on the right, nausea, indigestion and indigestion. The signs of cholecystitis also depend on the stage, we will consider them separately:

Chronic

Chronic cholecystitis develops slowly over a long time, periodic exacerbations alternate with relative rest. At moments of deterioration, which can last for several weeks, the pain is mild, dull, aching, localized in the right hypochondrium. Possible belching with bitterness, nausea, sometimes vomiting is present. The body temperature rises slightly.

With atypical symptoms, dull pain in the heart, bloating, food is difficult to swallow. Acute periods usually occur with the intake of unwanted and harmful products, carbonated drinks, stress and hypothermia.

With a prolonged course of the disease, adhesions can form, the bladder is deformed and there is a possibility of its adhesion to the adjacent organs.

The presence of stones in the gallbladder aggravates the situation and significantly worsens the prognosis. It happens that the chronic stage develops into an acute one, and then it can threaten with perforation of the gallbladder wall, purulent inflammation.

Symptoms depending on the subspecies of cholecystitis:

• For gangrenous inflammation of the gallbladder clinical picture characterized by a period of apparent recovery due to the death of nerve endings.
• The most difficult case is a phlegmonous appearance, intoxication causes severe fever, the patient shivers, suffers from severe bouts of thirst, irritation of the peritoneum is observed, the painful sensations become especially strong. The cure occurs after a few days, but this form often becomes chronic.

Sharp

If the pain is paroxysmal and lasts for several days, it is given to the right to the collarbone, shoulder or under the scapula, nausea and even vomiting appears, and after it does not become easier, we can talk about an acute form of cholecystitis.

Symptoms intensify when the body cannot cope with inflammation and intoxication, the body temperature rises steadily to 38 degrees and above, the body seizes with chills, and the pulse quickens.

In the resulting erosions and ulcers, pus appears, over time, the abscess can open up, breaking through the bladder membrane, and its contents rush into the intestines. Then peritonitis sets in.

Diagnostics 🔍

The final conclusion is formed from several components. When interviewing a patient, the doctor, based on complaints, working conditions, lifestyle, eating habits, concomitant diseases, can already make a preliminary verdict. Palpation of the abdomen reveals pain in the gallbladder region. Further, laboratory and instrumental studies are carried out to make the final diagnosis.

Laboratory

• General and biochemical blood test;
• Feces on the eggs of the worm;
• Analysis of urine;
• Examination of bile;
• Immunoassay blood test;
• Analysis of feces for elastase;

Instrumental

1. Ultrasound and radiography. They contribute to the detection of stones, stagnation of bile, determine the thickening of the walls of the inflamed organ along the contours, and show whether dyskinesia is present.
2. Duodenal intubation. It will help determine the state of secretion of the gallbladder.
3. In especially difficult cases, the doctor prescribes computed tomography.

🏥 If an acute form is detected, patients are hospitalized in the surgery department, with chronic indicators, the patient is sent to the therapy or gastroenterology department.

Treatment 🚑

Cholecystitis treatment methods:

Medication

Taking pills means prescribing antibiotics, antioxidants, and drugs that can prevent inflammation. To enhance the outflow of bile, antispasmodics, choleretic drugs are prescribed. Special diet for conservative treatment is of great importance. With its strict adherence, the exclusion of irritating food is provided.

Surgical

An urgent operation (cholecystectomy) is indicated in case of an acutely expressed form, with suspicion of peritonitis or in the presence of symptoms of purulent intoxication of the body. A common reason for immediate intervention is to diagnose stony deposits.

Diet

During the period of exacerbation of the disease, the patient is admitted to a hospital in a therapeutic or gastroenterological department. At first, a gentle diet involves drinking plenty of small portions, a few croutons, weak, slightly sweetened tea, juices diluted with water. After the pain subsides, the list of products can be expanded. If a diagnosis is made that confirms the disease, the patient will have to carry out a serious correction of his taste preferences and follow all the doctor's prescriptions.

⛔️ The basic rule is to protect the body from excessive thermal, chemical, or mechanical overload. You need to try to forget about fried, spicy, fatty foods. The use of alcohol and chocolate is strictly prohibited.

Sample menu

• Soups from cereals and vegetables, only pureed;
• Semi-liquid buckwheat porridge oatmeal;
• Low-calorie cottage cheese;
• Kissels and mousses;
• Boiled low-fat fish;
• Boiled and mashed meat, dietary (rabbit, chicken, turkey);
• Steamed cutlets;
• White crackers;
• Sour milk products with low fat content only, and butter should be limited;
• Vegetables and fruits can be eaten fresh, boiled and baked.

☝️ Food is taken frequently, in small doses, 6 times a day.

Exercises

We have selected for you a very useful video with a selection of exercises for the treatment of cholecystitis, since we consider it ineffective to describe in text form.

Folk remedies

You can cure inflammation of the gallbladder using funds traditional medicine... This is a more gentle way, many carriers of the disease deliberately choose herbal infusions and teas against the appointment of tablets and mixtures that have a chemical basis.

Especially often folk recipes used by women during pregnancy, as well as elderly citizens. Cholecystitis can be treated with herbs that can improve the passage of bile through the ducts. Choleretic plants relieve pain, normalize the outflow of bile, and eliminate stagnation.

Choleretic collection

One of the most common and popular choleretic charges is considered to be a composition that includes the following components:

1. mint;
2. immortelle flowers;
3. Dill seeds;
4. rose hip;
5. corn silk;
6. barberry root.

Ingredients in the same amount are mixed in a clean bowl, then crushed, 1 spoon of the resulting mixture is brewed in 1 glass of water, consumed 3 times a day before meals. The dosage is a third of a glass. Cucumber juice relieves pain well - it is enough to take 100 ml of fresh medicine once a day.

From other means are recommended: well-steamed dried apricots (will help to eliminate bile stagnation), infusion from the collection: yarrow, knotweed, dandelion flowers, calendula. Dried herbs are brewed in boiling water for 3 hours (proportion of st. L / 0.5 l), used after straining.

First aid

Chronic cholecystitis is often exacerbated by acute attacks of the disease resulting from:

• great physical exertion;
• received hypothermia;
• infectious attack.

When the condition worsens sharply and the pain increases, it is necessary to give the patient first aid- lay on the right side, release the pressure of the clothes. If it is precisely known about stones in the gallbladder, then heat is applied to the sore spot, if inflammation has begun, cold is needed. Pain relievers should be used with extreme caution.

When an attack occurs, the patient needs an urgent health care, because only specialists can correctly assess what is happening and take the necessary measures. However, if the reasons feeling unwell have not been established and there is no understanding of how to relieve an attack - an urgent need to call medical help, since wrong actions can only aggravate the patient's condition.

How can complications be avoided?

With age, the risk of developing a disease only increases, so you need to listen carefully to your body, health should be treated more responsibly. Disease prevention is the foundation of well-being.

Fatty and fried foods, smoked and salted foods, alcohol should disappear from the diet. The correct measured lifestyle will help maintain immunity. And if the first signs of cholecystitis appear, an urgent examination and tests are necessary. Then the ailment will be detected in the early stages, and it is much easier to eliminate it at the very beginning than to treat it in a neglected state.

Conclusion

When the treatment is not late, and all the measures are carried out correctly, then the patient can count on recovery and restoration of working capacity, although he will always have to remember that if the necessary diet is not followed, the disease can return again. But in especially advanced cases, when it has gone too far, a rupture of the gallbladder may occur, and peritonitis may develop. Here, even with the maximum efforts of doctors, no one can guarantee that it will be possible to save the patient's life.

Related videos 🎞

• sedentary way of life;
• excessive consumption of fatty foods of animal origin (oil, fatty meats, eggs);
• the development of endocrine disorders (diabetes mellitus, obesity);
• taking oral remedies against unwanted pregnancy (in women).

There are a lot of diseases of the biliary tract:

1. functional disorders (dyskinesia);
2. inflammatory processes (cholecystitis);
3. exchange failures (gallstone disease).

The states indicated are stages in the same process. At the very beginning, there are problems with the motility of the gallbladder, then the joining of the inflammatory process begins, which develops into gallstone disease.

The main causes of the development of cholecystitis

A disease such as cholecystitis primarily causes an infectious factor. The infection enters the organ through the blood, passes into the lymph and the ascending pathways through the intestines.

This inflammatory disease is acute and chronic.

Acute cholecystitis. For the acute course of the disease, in the absence of stone formation, rapid recovery is characteristic without the development of complications. In some cases, the disease can become chronic. Such conditions are extremely rare.

As a rule, cholecystitis is actively developing in the presence of stones in the gallbladder, which is a complication of the course of gallstone disease.

At the very beginning of the process, there is intense pain in the abdomen on the right. Painful sensations arise in seizures and may be accompanied by vomiting, nausea and an increase in body temperature up to 38-39 degrees. In addition, chills, stool retention, excessive flatulence, yellowing of the skin and sclera may occur.

Acute calculous cholecystitis can also show itself as the spread of inflammation to the organs and tissues surrounding the gallbladder. Its complication can be expressed as an abscess, inflammation of the bile ducts (local or diffuse peritonitis), pancreatitis. In such cases, the maximum emergency medical care from the surgeon or the referral of the therapist to the surgical department for hospitalization is required.

Chronic cholecystitis can begin slowly, starting in adolescence. Complaints start to arise as a result of violations of norms diet food, as well as emotional and mental stress.

The ailment manifests itself as painful sensations under the right rib and can shift to the left or upper abdominal cavity. Non-calculous cholecystitis can be associated with any form of secondary dyskinesia, which causes the development of pain syndrome.

With the development of gopomotor dyskinesia, there may be aching pains, constant and not clear. Quite often, an analogue of pain can be heaviness or burning under the rib. With a hyperkinetic type of inflammation of the gallbladder, the pain becomes quite intense and is paroxysmal. Can give to the supraclavicular fossa, heart or under the scapula.

Cholecystocardial syndrome involves pain near the heart, attacks of rapid heartbeat of this organ, and disturbances in its rhythm. This happens due to the toxic and infectious effects on the heart muscle.

In cases where the disease is started or lasts too long, the solar plexus can be connected to the pathological process and the polar syndrome begins to develop. Its main symptom is quite intense and burning pain in the navel, which can radiate to the lower back. A similar process, and in particular an increase and the occurrence of pain, can be caused by deficiencies in the diet, physical activity, vibration, alcohol abuse, hypothermia and emotional stress on the body.

How is cholecystitis treated?

If there are clinical symptoms of the disease, and it has been confirmed by laboratory tests, then positive dynamics can be achieved with the help of antibiotics. Their choice should be dealt with by the doctor, assessing the ability of bile to concentrate.

To relieve symptoms and normalize bile drainage, the attending physician may prescribe:

1. "Riabal" 2 mg intramuscularly or 1-2 tablets three times a day (anticholinergic agent);
2. "No-shpu" 2 tablets three times a day, "Papaverin" 2 ml of a 2 percent solution intramuscularly 2-3 times a day, "Mebeverin" 1-2 tablets 3 times a day (myotropic antispasmodics);
3. "Platyphyllin" (anticholinergics);
4. "Analgin", "Baralgin" (analgesics).

If there are symptoms of hypotension of the gallbladder, in the absence of calculi, drugs for the outflow of bile can be prescribed, for example, "Allochol" 1-2 tablets three times a day, "Cholenzym" 2 pieces 3 times a day, as well as herbal medicine.

Herbal treatment

Modern medicine widely practices traditional medicine recipes and uses herbal treatments. The most effective can be:

• immortelle and St. John's wort. It is necessary to take 15 g and 10 g of plants, respectively, and pour half a liter of water. After that, boil the mixture for 5 minutes and strain. The resulting product is taken half a glass three times a day 15 minutes before meals;
• corn silk. They need to take 10 g and pour a glass of boiling water. The mixture is boiled for 5 minutes and consumed in a quarter of a glass 3 times a day before meals;
• tansy. 5 g of the plant is insisted in a glass of boiling water for half an hour. After this time, take the remedy for a tablespoon 3 times a day;
• rose hip. On its basis, the preparation "Holosas" (condensed rosehip and sugar extract) is prepared. The remedy is taken 2 teaspoons before meals. You can use rosehip infusion. To do this, pour 10 grams of it with 400 ml of boiling water, keeping it in a water bath for 15 minutes.

These agents increase the production of bile, reduce its viscosity and are characterized by the ability to relieve inflammation. They can be prescribed during remission for 14 to 28 days.

Other treatments

Mineral waters, which answer how to treat cholecystitis in their own way, will be no less effective. Depending on their composition, the waters will be able to stimulate the contraction of the bladder. Water without gas is used on the recommendation of a doctor three times a day, a glass. This should be done for a time from 30 minutes to 1.5 hours before eating food in a heated state.

If microliths are present in the bile, hypotension of the gallbladder, cholestatic syndrome are observed, then such conditions provide for drugs in the form of ursodeoxycholic acid for 1-3 months, but subject to supervision by the attending physician.

To ensure normal liver function is used. For example, it can be "Hofitol" - a plant liver protector. It contains an aqueous extract of field artichoke leaves. The tool is used in 2 tablets 3 times a day 20 minutes before the intended meal. It can also be recommended "Gepabene" - it is also a herbal preparation made on the basis of the fruits of milk thistle and fume. The medicine is taken 1 capsule three times a day.

With the development of vegetative-vascular dystonia, sedatives are used, for example, "Motherwort" or "Valerian". It can be recommended "Adaptol" 500 mg 3 times a day for 2 months.

Daily regimen and medical nutrition

At a time when cholecystitis begins to turn into an exacerbation stage, the doctor recommends a stay in a therapeutic or gastroenterological hospital. It is also important to adhere to strict bed rest and emotional rest. After the severe symptoms have been eliminated, bed rest may be extended to a general one.

In the first days after the onset of acute cholecystitis, it is important to consume only warm liquid:

• sweet weak black tea;
• fruit juices well diluted with boiled or purified water;
• low concentration vegetable juices;
• still mineral water.

All this can be consumed in a maximum daily volume of up to one and a half liters. As soon as the pain syndrome begins to subside, doctors recommend:

1. vegetable soups based on cereals;
2. porridge cooked in water (rice, semolina, buckwheat, oatmeal);
3. jelly, mousse or low-fat cottage cheese;
4. lean boiled or steamed fish;
5. white croutons;
6. boiled or steamed meat (chicken, rabbit, turkey).

Such food should be taken in small portions at least 5 times a day.

• day on cottage cheese and kefir. The use of 900 g of kefir is provided, which must be divided into 6 equal servings. In addition, they eat low-fat cottage cheese in a volume of 300 g, divided into 3 meals;
• day on rice and compote. On such days, it is possible to consume 1.5 liters of compote based on 1.5 kilograms of fresh or 240 g of dried fruit. It is necessary to drink liquid 6 times. Rice (50 g) should be boiled in water and eaten in 3 sessions.

After blocking the active course of cholecystitis, the doctor will prescribe a special diet at number 5, recommended for an ailment. The patient will be allowed to:

1. use vegetable, dairy, fruit soups;
2. boiled meat, steam;
3. lean varieties of sea or river fish without skin;
4. maximum 2 soft-boiled eggs;
5. fat-free dairy products;
6. boiled or baked vegetables;
7. fruits and berries;
8. cereal porridge;
9. flour products in the form of dried bread.

Do not forget that any food must be taken in small portions. This should be done slowly 5 or 6 times a day. Fasting or taking long breaks between meals is not recommended. It is important to have a hearty breakfast every day, and to have dinner no earlier than 3 hours before the expected bedtime, and not too much.

The fluid intake can not be limited, however, excessive portions of food taken at one time can disrupt the rhythm of bile flow, and can also cause gallbladder spasms and pain.

If the cholecystitis is chronic, then you can increase the use of those foods that will help improve the outflow of bile as well.

Cholecystitis is an inflammatory disease of the gallbladder. It is the most common disease of the abdominal organs. Currently, 10-20% of the adult population suffers from cholecystitis, and this disease tends to further increase. This is due to a sedentary lifestyle, the nature of the diet (excessive consumption of food rich in animal fats - fatty meat, eggs, butter), the growth of endocrine disorders (obesity, diabetes mellitus). Women get sick 4 times more often than men, this is due to the use of oral contraceptives, pregnancy.

Among the numerous diseases of the biliary tract, functional disorders (dyskinesias), inflammatory (cholecystitis), metabolic (cholelithiasis) are distinguished. These conditions are phases of one pathological process: first, there is a violation of the motility of the gallbladder - dyskinesia, then it joins inflammatory process- Acalculous cholecystitis is formed, which eventually transforms into gallstone disease (cholelithiasis).

The causes of cholecystitis: main and additional.

The main reasons include the infectious factor. The infection enters the gallbladder through the blood, lymph and ascending from the intestines.

Primary sources of infection can be:

Additional factors:

1. Dyskinesia of the biliary tract. These are functional disorders of the tone and motility of the biliary system (gallbladder and bile ducts). It occurs in any case of chronic cholecystitis, leads to a violation of the outflow and stagnation of bile.
2. Congenital malformations of the gallbladder.
3. Pancreatic reflux. Throwing content duodenum into the biliary tract. Pancreatic juice with active enzymes causes enzymatic damage to the walls of the gallbladder. It occurs in diseases of the pancreas, duodenum.
4. Violation of the blood supply to the gallbladder. They arise against the background of atherosclerosis, hypertension, diabetes mellitus, and lead to a narrowing of the vascular lumen.
5. Violation of the normal composition of bile (dyscholia). A change in the composition of the gallbladder and the ratio of its components leads to damage to the wall of the gallbladder. This is facilitated by the intake of monotonous, fat-rich food.
6. Allergic and immunological reactions cause inflammatory changes in the wall of the gallbladder.
7. Hereditary factor.
8. Endocrine changes (pregnancy, taking oral contraceptives, obesity, menstrual irregularities).

Additional factors create conditions for the development of inflammation and prepare a fertile ground for the introduction of microbial flora.

Cholecystitis symptoms.

Cholecystitis is acute and chronic.

Acute cholecystitis

Acute acalculous cholecystitis is rare, usually proceeds without complications and ends with recovery, sometimes it can become chronic. The disease most often develops in the presence of stones in the gallbladder and is a complication of cholelithiasis. At the onset of the disease, intense paroxysmal pain appears in the right hypochondrium, nausea, vomiting, body temperature rises to 38-39 degrees. There may be chills, yellowness of the sclera and skin, stool and gas retention.

For acute calculous cholecystitis characterized by a severe course with the spread of the inflammatory process to the surrounding organs and tissues.

Cholecystitis is complicated by an abscess of the liver, local or diffuse peritonitis (inflammation of the bile ducts),. In this condition, you should immediately consult a doctor - surgeon, therapist to resolve the issue of hospitalization in a surgical hospital.

Chronic cholecystitis

The disease begins gradually, often in adolescence. Complaints arise under the influence of a violation of the diet, psychoemotional overstrain.

The main manifestation of the disease is pain in the right hypochondrium. It can be displaced to the left hypochondrium, the upper half of the abdomen. Non-calculous cholecystitis is accompanied by some form of secondary dyskinesia, this often determines the nature of the pain. With concomitant hypomotor dyskinesia, pain is constant, aching, not intense. Often the equivalent of pain is a feeling of heaviness or burning in the right hypochondrium. In cases of hyperkinetic dyskinesia, the pain is intense, short-term, paroxysmal. The pain radiates to the supraclavicular fossa, to the lumbar region, to the subscapularis region, to the region of the heart.

Cholecystocardial syndrome - includes pain in the region of the heart, palpitations, disturbances in the rhythm of cardiac activity, this is associated with an infectious and toxic effect on the heart muscle.

With a prolonged course of the disease, involvement of the solar plexus in the pathological process is possible, and solar syndrome occurs. Its main symptom is burning, intense pain in the navel, radiating to the back.

The onset and intensification of pain is associated with errors in diet, physical activity, vibration, hypothermia, emotional overload, alcohol consumption.

Nausea, vomiting occurs in 30-50% of cases, it is of a reflex nature and is associated with a violation of the tone of the gallbladder or is caused by concomitant gastroduodenitis or pancreatitis. An admixture of bile is found in the vomit. Vomiting, like pain, is provoked by alcohol intake, dietary errors.

Feeling of bitterness in the mouth, "bitter" belching - these complaints are most common with inflammation of the gallbladder.

Itching, its appearance is associated with impaired bile secretion and is the result of irritation of skin receptors by bile acids accumulated in the blood. Violation of the outflow of bile leads to a short-term appearance of jaundice.

Chills, an increase in temperature is noted with an exacerbation of the inflammatory process in the gallbladder.

Patients often suffer from severe vegetative-vascular dystonia. Painful attacks in them are accompanied by neurotic syndromes such as weakness, sweating, palpitations, headache, emotional lability (mood instability), sleep disturbance.

Patients with allergies, exacerbation of chronic cholecystitis can cause allergic reactions (urticaria, angioedema).

Women may develop premenstrual tension syndrome. 2-10 days before menstruation, headaches, swelling of the face, hands, feet, and mood instability appear. In the same period, symptoms of exacerbation of chronic cholecystitis are also observed.

Video about the causes, symptoms and treatment of chronic cholecystitis:

The manifestations of chronic cholecystitis are diverse, they consist of different signs, a physician - therapist, gastroenterologist can establish an accurate diagnosis and prescribe the necessary set of examinations.

Diagnostics of the cholecystitis

Laboratory research:

Mineral waters have the same effect. Depending on the composition, they can have a stimulating effect on the contractile function of the gallbladder. Mineral water without gas is taken as directed by a doctor 3 times a day, 1 glass 30 minutes - 1.5 hours before meals (depending on the state of gastric secretion) in warm or hot form (40 - 50 degrees);

Blind probing - tyubage, once a week, 3-5 times.

It is carried out in the morning on an empty stomach. Slowly (in small sips), you should drink 150-200 ml of warm (40-45 degrees) mineral water with the addition of 20-25 g of sorbitol or xylitol. Lie on your right side, on your back for an hour. A warm heating pad is placed under the right side. After emptying the intestines, it is recommended to take a shower and rest for 20 minutes. First meal 1-1.5 hours after the end of the procedure. This is a glass of tea with honey, cottage cheese.

In the presence of microliths in the bile, hypotension of the gallbladder, cholestatic syndrome, bile acid preparations (ursodeoxycholic acid) are used for 1-3 months, under the supervision of a physician.

In order to normalize the biliary function of the liver, hepatoprotectors with choleretic properties are prescribed. Hofitol is a hepatoprotector of plant origin, containing a dry aqueous extract from the juice of the leaves of a field artichoke. Take 2 tablets 3 times a day 20 minutes before meals for a month. Hepabene is a combined herbal preparation containing an extract of medicinal smoke and dry extract of milk thistle fruit. Take 1 capsule 3 times a day after meals.

Regimen and medical nutrition.

During the period of pronounced exacerbation of cholecystitis, patients are recommended to be treated in a hospital - therapeutic or gastroenterological, adherence to bed rest, a state of psychoemotional rest. After the elimination of the pronounced signs of exacerbation, the patient's regimen expands to general.

During the period of exacerbation, in the first two days, only the intake of warm liquid (weak sweet tea, juices from fruits and vegetables diluted with water, mineral water without gas) is prescribed in small portions up to 1.5 liters per day and several crackers. As the pain subsides and the general condition improves, the dietary table expands. Recommend:

Mashed soups from vegetables and cereals,
- porridge (oatmeal, rice, semolina, buckwheat),
- jelly, mousse, jelly, low-fat cottage cheese,
- lean boiled fish,
- mashed and boiled meat, steam cutlets(veal, chicken, turkey, rabbit),
- white crackers.

Food is taken in fractional portions 5-6 times a day.

During the period of exacerbation, it is recommended to carry out fasting days 1 day a week:
- curd - kefir day. 900 g of kefir for 6 doses, 300 g of low-fat cottage cheese for 3 doses and 100 g of sugar;
- rice - compote. 1.5 l of compote prepared from 1.5 kg of fresh or 240 g of dry fruit for 6 meals, rice porridge, boiled in water from 50 g of rice - for 3 meals.

After stopping the exacerbation of cholecystitis, a diet is prescribed, table number 5, which is the main one in this disease.

Patients are advised to:
- dairy, fruit, vegetable broth soups with cereals, noodles;
- boiled meat, steamed cutlets, meatballs (beef, rabbit, chicken, turkey);
- low-fat varieties of sea or river fish in boiled or baked form, without a crust;
- eggs, up to 1-2 per day - soft-boiled, in the form of steam omelets;
- dairy products: low-fat milk, cottage cheese, kefir, yogurt, yogurt, butter (limited);
- vegetables in boiled, baked form, partially raw. Potatoes, beets, carrots, tomatoes, cucumbers, pumpkin, bell peppers, eggplants, cauliflower, zucchini;
- fruits and berries. Pears, melons, bananas, peaches, apricots, watermelons, non-acidic apples;
- porridge - buckwheat, oatmeal, rice, semolina, with the addition of milk, if tolerated;
- sweet dishes - marshmallow, marmalade, honey, jams, preserves, jelly;
- flour products - wheat and rye bread, yesterday's, white bread rusks, dry uncooked biscuits.

It is necessary to take food in small portions, slowly 5-6 times a day. Long breaks between meals, fasting are not recommended. Breakfast is required, dinner 2 - 3 hours before bedtime, not abundant. The amount of liquid is not limited. An abundant amount of food, taken once, disrupts the rhythm of bile flow, causes a spasm of the gallbladder and provokes pain.

In chronic cholecystitis, it is necessary to increase the consumption of foods that improve the outflow of bile and lower cholesterol levels:

Rich in dietary fiber (bran, vegetables, fruits, berries). The bran is pre-steamed and added to dishes, 1-1.5 tablespoons 3 times a day;
- rich in magnesium salts (buckwheat and oat groats, dried fruits, bran);
- containing essential polyunsaturated fatty acids, phospholipids, vitamin E (corn, olive, sunflower and other oils);
- containing lactic acid bacteria (fermented milk drinks, cottage cheese).

High in animal fats (fried foods, fatty fish, pork, lamb, duck, sausages, smoked meats, mayonnaise, creams, cakes, pastries);
- raw onions, garlic, radishes, sorrel, spinach, mushrooms, beans (peas, beans);
- cold and carbonated drinks, concentrated juices, coffee, cocoa, alcoholic drinks.

Rehabilitation.

Physiotherapy and spa treatment is an important component of the comprehensive rehabilitation of patients. Inductothermy, UHF electric field are used as thermal procedures for the correction of gallbladder hypertonicity, anti-inflammatory and analgesic effects. The course of treatment is 12-15 procedures daily. In order to stimulate the emptying of the gallbladder, a pulsed current of low frequency is prescribed. To reduce dyskinetic phenomena, electrophoresis of 5% novocaine, 2% papaverine is recommended. To normalize the functional state of the nervous system, a galvanic collar according to Shcherbakov, electrophoresis with bromine is used. For the same purpose, coniferous, oxygen and carbon dioxide baths are prescribed. Spa treatment is indicated not earlier than 2-4 months after exacerbation of cholecystitis. Patients are sent to the balneo-mud resorts: Essentuki, Zheleznovodsk, Truskavets, Morshin.

Complications of cholecystitis.

Complications include: pericholecystitis, pancreatitis, cholangitis, reactive hepatitis, duodenitis.

Pericholecystitis occurs when all the walls of the gallbladder and the serous membrane (peritoneum) are involved in the pathological process. In this condition, the pain syndrome is constant and intense, spreads to the right side, and intensifies when turning and tilting the body.

Cholangitis is an inflammatory process in the bile ducts. The main symptom is an increase in temperature up to 40 degrees with tremendous repeated chills, nausea, vomiting, cramping pains in the right hypochondrium.

With non-calculous cholecystitis, other organs of the digestive system are often involved in the pathological process: if along with pain in the right hypochondrium there are painful sensations of a "girdle" nature, loosening of the stool - it is possible that the pancreas may be involved in the pathological process. If the pain extends to the entire area of ​​the liver and is accompanied by its increase - the addition of reactive hepatitis, the occurrence of late, hungry pain in the upper abdomen indicates the presence of duodenitis.

Complications not only cause disability, but also pose a threat to the patient's life, therefore, when the first symptoms of the disease appear, you should immediately consult a doctor - a therapist or gastroenterologist.

Prevention of cholecystitis.

You should adhere to a long-term diet with restriction of fatty, fried foods, frequent fractional meals are recommended, the exclusion of alcoholic and carbonated drinks. Gradual normalization of body weight.

Remediation of foci of chronic infection of the oral cavity and nasopharynx.

Annual dispensary examination by a doctor with ultrasound of the hepatobiliary system.

Doctor's consultation on cholecystitis

Question: Can you remove an attack of biliary colic with calculous cholecystitis on your own using folk remedies or medicines?
Answer: No, you need to urgently consult a doctor - surgeon. With late treatment, life-threatening complications may develop.

Question: What are the contraindications for blind sensing?
Answer: Blind probing is contraindicated in cholelithiasis, acute infectious diseases, active hepatitis and cirrhosis of the liver, severe diseases of cardio-vascular system... It is not recommended to carry out the procedure for women during menstruation, pregnancy.

Vostrenkova Irina Nikolaevna, physician therapist of the highest category

Among chronic diseases in one of the first places is cholecystitis. This diagnosis is made by doctors so often that this ailment is sometimes completely overlooked. But what it is, we begin to truly understand only at the moment of exacerbation. However, most of us make the mistake of trying to start medication for cholecystitis right away. This disease is quite difficult to treat, most often the condition stabilizes only slightly, but without a special diet, unpleasant symptoms will return again after a few days. Therefore, it is imperative to constantly adhere to healthy eating, avoid alcoholic beverages and stressful situations. Then the treatment of cholecystitis with drugs may not be required.

What is cholecystitis?

This is an inflammatory disease of the gallbladder, and the cause of its appearance is most often the vital activity of a colony of bacteria. At first glance, everything is simple, you need to take an antibacterial drug, and everything will be fine again. However, before you go to the pharmacy and ask the pharmacist to choose medication for cholecystitis for you, it is a good idea to understand the causes of this disease, its etiology and features of the course. There are many subtle points that are difficult to understand without medical education.

Development mechanism

The main reason, as we have already noted, is microorganisms. That is, all the same streptococci and staphylococci, Pseudomonas aeruginosa or Proteus (as well as Shigella, typhoid bacillus, sometimes various fungi, etc.) enter the bile ducts from the intestines, where they are in small quantities even in a perfectly healthy person. This is the usual contact path. In addition, they can enter with the blood and lymph flow from any focus of inflammation, be it caries, tonsillitis or pyelonephritis. Therefore, the treatment of cholecystitis with drugs is not always the right regimen. Antibiotics, of course, will defeat the colony of microorganisms in the gallbladder, but they will be replaced by others from the remaining chronic foci. Therefore, this problem must be approached comprehensively.

How can cholecystitis manifest?

Before starting treatment, you need to know what you are dealing with, whether a person really has chronic cholecystitis. Symptoms and treatment are something a professional gastroenterologist must deal with. Therefore, do not flatter yourself with hopes that you can buy a magic pill at the pharmacy and forget about the problem. The fact is that the symptoms of cholecystitis are skillfully disguised as dozens of other diseases.

The patient may complain of chest pain, palpitations, emotional lability. Dozens of patients come to a neurologist with complaints of dizziness and headache, sweating, which can also be caused by this disease. Gastrointestinal symptoms are a little closer, which also do not always directly indicate cholecystitis. It can be causeless nausea and vomiting, frequent heartburn, and bloating. Finally, this disease can provoke allergic reactions. As you can see, even a therapist may not always be easy to determine the cause and diagnose cholecystitis. Treatment - drugs, a special diet and folk remedies - gives good results, but only if the scheme is selected correctly.

Disease development catalysts

Sometimes a person has the prerequisites for its occurrence for many years in a row, but at one point one or more factors are added and the rapid development of the disease begins. In order for us to present the picture in its entirety, it is necessary to analyze in detail how chronic cholecystitis arises. We will consider the symptoms and treatment for informational purposes only, this does not replace a visit to the doctor. Low physical activity and irregular or too abundant nutrition contribute to the appearance of problems. In addition, overweight and intestinal dysbiosis, constipation can be distinguished among the predisposing factors.

How does cholecystitis develop?

The process is not too fast. Usually, the pathogenic flora enters the gallbladder and contributes to the development of inflammation of its membrane. If at the first stages this can manifest itself in minor discomfort, then the disease will only progress further. The inflammatory process goes to deeper layers, submucosal, and then muscle. In the affected area, connective tissue grows, which deforms the gallbladder. Bile begins to thicken, that is, there are prerequisites for the formation of stones. With a strong decrease in immunity, serious errors in diet and constant stress, acute cholecystitis can develop. We will consider the symptoms, treatment and features of the course a little later.

Symptoms

If you happen to be faced with this disease, then get ready for an endless chain of remissions and exacerbations. Moreover, the more carefully you monitor your diet, the less chance that an exacerbation of cholecystitis will develop. Treatment of the disease in remission is not performed. The main symptom of chronic cholecystitis is pain. It is often localized in the right hypochondrium, and it can be different. In some, it is constant, but mild, most often aching. If, on the contrary, the tone of the gallbladder is increased, then the pain is manifested by attacks, it is cramping, very intense. Most often, the reason is food inaccuracies, fried and fatty foods, and alcoholic beverages.

Patients tend to complain of bitterness in the mouth, especially at night and in the morning. They are tormented by bitter belching, sometimes it is accompanied by vomiting. In addition, digestive problems are common symptoms, itchy skin, fever up to 38 degrees during exacerbations. In addition, fatigue and irritability are common.

Treatment

Methods for treating cholecystitis have been known for a long time; diet therapy is the most popular and recognized among gastroenterologists. A hunger strike for several days will help smooth out acute symptoms. Next, you should gradually introduce broths and mashed potatoes, cereals into the diet. Gradually, you should enter a full-fledged diet table number 5. This diet should be observed constantly. Even on holidays, one should not deviate too much from it, so as not to cause aggravation. It should be noted that effective treatment cholecystitis is possible only with proper nutrition.

Basic nutritional principles

Forget about the lack of breakfast and a plentiful dinner, you need to eat at least five times a day, little by little. You can only eat freshly prepared food, warm. A complete, varied diet is required, and its basis should be steamed or boiled dishes. Baked foods are allowed. Alcohol is strictly prohibited. In the chronic form of the disease, it is quite easy to maintain a normal state, for this you need to adhere to the above principles of healthy eating, and if discomfort appears for several days, switch to a light or completely drinking regimen.

The main treatment for cholecystitis

If the patient comes with severe pain, then first of all the doctor must take care of its relief. Such complaints are not uncommon if you have been diagnosed with cholecystitis. Symptoms (treatment should take place under the guidance of an experienced doctor) may differ in intensity, and depending on this, either the traditional No-shpa is prescribed, 2 tablets three times a day, or, if the pain is severe, a more effective drug called Duspatalin. Unlike drotaverine, its active substance acts more directly on the site of pain.

Removal of the inflammatory process

Here, the choice of drugs will depend on the patient's condition. Stronger antibiotics are used to treat acute cholecystitis. Symptoms (treatment at first will be aimed specifically at relieving acute symptoms) are primarily expressed in increased pain, spasms and severe bloating. The choice of gastroenterologists is usually ciprofloxacin and amoxicillin. These drugs are quite gentle, because an extra load on the liver with this disease is completely useless. We emphasize once again that it is especially important to prescribe antibiotics if we are talking about acute cholecystitis. Symptoms that require immediate treatment include severe pain, nausea and vomiting, fever, chills, and retained stool and gas. We would like to draw your attention to the fact that the acute form is treated quite effectively and rarely turns into a chronic one.

After the condition has returned to normal, the doctor often recommends tyubage, or "blind probing". To do this, you need a bottle of mineral water without gas, which you need to drink early in the morning (best at 6 am) for 20 minutes, then lie down on your right side on a warm heating pad and lie down for about an hour. The doctor prescribes choleretic agents depending on the individual characteristics of the course of the disease.

If bile stasis prevails (hypokinesis)

That is, insufficiently intense contraction of the gallbladder occurs. In this case, the pain is usually unexpressed, dull, constant. In this case, tyubage also helps well. From drugs holokinetics are often prescribed: these are "Flamin" and "Berberine", "Sorbitol", "Magnesium sulfate". In addition, choleretic herbs help very well in this case. It can be immortelle and corn silk, St. John's wort. They can be brewed and drunk for a long time, like regular tea. In the autumn and spring, they connect to them a radiola pink and lemongrass, eleutherococcus, ginseng, which can increase the tone of the gallbladder and vitality in general.

Hyperkinetic dyskinesia

In this case, the tone of the gallbladder is increased, it contracts too quickly and often, and the sphincters do not open enough. In this case, there are sharp attacks of pain, which usually do not last more than one hour. In this case, choleretics are used, these are preparations containing bile, such as Allohol and Liobil. In addition, these are vegetable "Holagol" and "Olimethyl", as well as synthetic "Nikodin" and "Oxafenamide". There are herbs that help well, these are mint and chamomile, motherwort and valerian, they help relieve spasms and normalize the outflow of bile. In addition, coniferous baths are recommended, in courses of 10 days, the water temperature is not higher than 35-40 degrees, the time in the bath is not more than 15 minutes.

Cholelithiasis

Gradually stagnation of bile leads to the formation of stones. That is why you cannot just give up on the inflamed gallbladder (cholecystitis). Treatment of gallstone disease is more complicated and requires a special examination and long-term medical support. Moreover, the form of this disease can be different, latent, or dyspeptic, in which the attacks of pain are periodic, and they themselves are not too pronounced. The most severe pain is characterized by hepatic colic, which occurs with acute obstruction of the gallbladder and duct. In any case, if the process of stone formation has already begun, it is treated only with surgical intervention.

Treatment with folk remedies

If there is an exacerbation of cholecystitis (symptoms, treatment we briefly discussed above), then you should not engage in herbal medicine on your own, you need to seek help from a doctor. But when the stage of remission comes, then it's time to prolong it with the help of special fees. In the autumn-winter period, you will need a tincture from the following mixture of medicinal herbs. These are yarrow and wormwood, mint and fennel fruits, immortelle flowers. Pour boiling water over two tablespoons of the mixture, insist overnight and take a third of a glass three times a day before meals. In the spring, an infusion of birch leaves is made (2 teaspoons of crushed leaves in a glass of boiling water). In summer, dandelion leaf and root juice is a great option. It is diluted with water one to one and taken in a tablespoon three times a day. This is how herbal medicine for such a complex disease as cholecystitis passes. Treatment (drugs should only be selected by a doctor) should be systemic, therefore, in addition to herbs, you will also have to take various medications and follow a diet. However, this disease very often develops simultaneously with other ailments of the gastrointestinal tract, so we will devote a little more time to describing them.

Treatment of cholecystitis and pancreatitis

In fact, they very often develop at the same time, because the provoking factors in most cases are the same. Signs and symptoms, complications also coincide, and even the treatment regimen itself is largely the same. Pancreatitis is an inflammation of the pancreas, which is also most commonly caused by bacteria. With cholecystitis, bile stagnates in the bladder and inflammation begins, and with pancreatitis, instead of entering the intestines, pancreatic juice remains in the gland and digests itself. First of all, the doctor will prescribe you antispasmodics, and only then he will deal with the disease. If the pancreas produces too much secretion, then drugs such as "Omeprazole" are prescribed, if, on the contrary, it is not enough, then "Festal", "Pancreatin".

Inflammation of the gastric mucosa and cholecystitis

Also a frequent duet. Moreover, if gastritis, cholecystitis develop together, the treatment can be carried out quite successfully, if pancreatitis also develops along with them, then you are guaranteed a long and difficult path of rehabilitation. All three of these organs are prone to self-destruction, since they contain enzymes involved in the digestion of food. So, gastritis is an inflammation of the stomach lining. Pain and discomfort with it are localized in the central, upper abdomen. For the treatment of gastritis, drugs such as Omeprazole and Pariet are used. Additionally, it is recommended to drink fresh potato juice, motherwort and valerian, licorice, plantain and calendula.

Improper nutrition, the presence of bad habits, a poor environmental background - all these factors contribute to the development of various diseases of the gallbladder in a person. Chronic cholecystitis is one of the most common such ailments. It is worth talking in more detail about what this disease is, how to identify and cure it.

What is chronic cholecystitis

The name cholecystitis was given to the disease (ICD code 10 - K81.1), in which the walls Bladder inflamed. It affects adults, and more often women than men. The chronic course is characterized by periods of remission (when the patient is not worried about anything) and exacerbations (symptoms of the disease appear).Inflamed gallbladderaffects the body as follows:

1. Food is digested too slowly, because it is difficult for the cells of the organ to cope with the increased load.
2. The outflow of bile is disturbed, so its biochemical composition changes.
3. The inflammatory process proceeds slowly, but this leads to a gradual degeneration of the walls of the gallbladder.
4. The general condition of the patient is unsatisfactory.

Classification

There are several types of the disease.Classification of chronic cholecystitisby etiology and pathogenesis:

In clinical forms, the disease can be:

• stoneless;
• with a predominance of the inflammatory process;
• calculous;
• with a predominance of dyskinetic phenomena.

By the nature of the flow:

• with rare relapses (no more than one attack per year);
• monotonous;
• with frequent relapses (two or more attacks per year);
• camouflage.

There are such phases of the disease:

• decompensation (exacerbation);
• subcompensation (fading exacerbation);
• compensation (remission).

Causes

Absolutely no one is immune from the disease, so everyone should know what provokes it and who is at risk. As a rule, it occurs with infections in other organs, because in a person everything is interconnected with each other. Possiblecauses of chronic cholecystitis:

There are a number additional factors that increase a person's chances of developing chronic cholecystitis:

1. Biliary dyskinesia.
2. Pancreatic reflux.
3. Congenital abnormalities of the gallbladder and its poor blood supply.
4. Heredity.
5. Wrong composition of bile.
6. Any endocrine changes as a result of pregnancy, menstrual irregularities, taking hormonal contraceptives, obesity.
7. Allergic or immunological reactions.
8. Improper diet (abuse of fatty foods, fried foods).
9. Taking drugs that have the property of making bile thicker.
10. Sedentary lifestyle, lack of physical activity, constant stress.

Complications

If untreated, the disease will progress, which can cause a number of negative consequences... Scrollcomplications of chronic cholecystitis:

• reactive hepatitis;
• gallstones;
• chronic duodenitis (ICD code 10 - K29.8);
• peritonitis;
• sepsis;
• chronic hepatocholecystitis;
• reactive pancreatitis;
• cholangitis;
• fistulas;
• destructive cholecystitis;
• pleurisy;
• choledocholithiasis;
• duodenal stasis (bile stasis), chronic;
• acute pancreatitis (ICD code 10 - K85);
• pericholecystitis;
• purulent abscess in the abdominal cavity.

If a person is worried about any symptoms, he must definitely seek help from a doctor. The specialist will conduct all the necessary studies and analyzes, make an accurate diagnosis and prescribe treatment. The patient should visit a gastroenterologist.Diagnostics of the chronic cholecystitisbegins with a detailed survey of the patient, then additional laboratory and instrumental studies are assigned:

The list of signs indicating a disease depends on a huge number of factors.Chronic cholecystitis symptomscan be both pronounced and hidden. Some patients go to the doctor with many complaints, others with only one. The main signs of chronic cholecystitis:

1. Dull pain localized in the right hypochondrium. Gives it under the spoon, in the shoulder, scapula. As a rule, the stomach begins to ache after consuming something fatty, spicy, fried, alcohol and does not subside from several hours to a day. May be accompanied by vomiting, fever.
2. Sharp abdominal pain after overeating.
3. Mussey's vesicle symptom. Pain when pressing on the phrenic nerve on the right.
4. Dyspeptic syndrome. Bitter taste in the mouth, unpleasant belching, plaque on the tongue.
5. Flatulence.
6. Ortner's symptom. Pain when tapping on the ribs on the right side.
7. Stool disorders. Constipation may alternate with diarrhea.

Aggravation

During the period of remission, a chronic disease may practically not manifest itself. However, there are a number ofsymptoms of exacerbation of cholecystitisrequiring immediate medical attention:

1. Biliary colic. Strong pain on the right, it can be either permanent or paroxysmal. After vomiting, it becomes more noticeable. Calms down with a warm compress.
2. In the presence of inflammation in the peritoneum, there is an increase in pain when bending, moving the right hand, turning.
3. Dizziness, nausea, vomiting with bile.
4. Bitter eructation, leaving an unpleasant taste in the mouth, dryness.
5. Heartburn.
6. Itchy skin.
7. Chills, high fever.
8. In some cases, pain in the region of the heart.

Chronic cholecystitis - treatment

The disease is very serious and requires constant monitoring and control.Chronic cholecystitis treatmentassigned taking into account its form, the degree of compensation is taken into account. The patient must always follow the recommendations of specialists, take medications as prescribed. It is very important to take care of your health on your own: eat right, observe the daily routine, give up bad habits. The use of folk remedies is permissible. All this in combination will help to significantly prolong the periods of remission and reduce the number of exacerbations.

Calculous cholecystitis - treatment

A form of disease in which inflammation is caused by gallstones. As a rule, whenchronic calculous cholecystitisthe main treatment is diet and adherence to other conditions aimed at maximizing the prolongation of remission. It is allowed to take painkillers, for example, No-shpy. Only surgical intervention will help to completely get rid of chronic cholecystitis.

Currently, the following types of operations are performed:

1. Laparoscopic. Removal of the gallbladder through small incisions in the abdomen. Only the duct remains, which is directly connected to the liver.
2. Percutaneous cholecystostomy.
3. Cholecystectomy.

Chronic stoneless

From the name it is clear that calculi (stones) with this form of the disease are not formed.Chronic acalculous cholecystitisduring the period of remission does not require treatment. You need to follow a diet, take measures to prevent exacerbations, engage in exercise therapy. If pain begins, pain relievers should be taken. Be sure to drink tablets containing enzymes to improve digestion, stimulate bile production.

Aggravation

This condition needs to be treated in a clinic, in a hospital setting. The strictest diet is required. Therapeutic scheme forexacerbation of chronic cholecystitis aimed to:

• decreased bile production;
• anesthesia with non-narcotic analgesics, antispasmodics;
• elimination of infection with antibiotics;
• increased outflow of bile;
• elimination of dyspepsia with antisecretory, antiemetic, enzyme drugs, hepaprotectors.

How to treat chronic cholecystitis - medications

Inflammation of the gallbladder is a serious and dangerous disease that should never be left to chance.Medicines for chronic cholecystitisare taken, in most cases, in an exacerbation stage, while in remission, supportive therapy will suffice. You must follow a diet, take vitamins. The use of folk remedies will also be effective.

Drug treatment

Prescribed medications are aimed at suppressing the manifestations of the disease and normalizing the gastrointestinal tract.Drugs for the treatment of chronic cholecystitis:

1. Pain relievers. If you experience severe discomfort in the right hypochondrium, it is recommended to take pills. No-shpa, Baralgin, Renalgan, Spazmolgon, Trigan, Drotaverin, Ibuprofen are suitable.
2. Antiemetic. If a person is nauseous, vomiting opens, or bitterness is felt in the mouth, it is recommended that he be treated with Motilium, Cerucal.
3. Hepatoprotectors. Essentiale forte, Cerucal.
4. Antibiotics They are prescribed for exacerbation to fight infection. Suitable Ampicillin, Erythromycin, Rifampicin, Ceftriaxone, Metronidazole, Furazolidone.
5. Choleretic. The drugs have a wide spectrum of action. For chronic cholecystitis, Liobil, Hologon, Nikodin, Allohol, Tsikvalon, Festal, Oxafenamide, Digestal, Cholenzym, Heptral can be prescribed.

Vitamins

There is a list of substances that are especially beneficial for the gallbladder. List of importantvitamins for cholecystitisto be taken during an exacerbation:

• C (deficiency leads to the formation of stones);

During remission chronic illness it is recommended to drink complexes containing the following vitamins:

• AT 12;
• B15;
• E (prevents the appearance of stones).

Folk remedies

Alternative medicine gives a positive result for this disease.Chronic cholecystitis treatment folk remedies best done in remission. Use these recipes:

1. Stir 200 grams each honey, peeled pumpkin seeds, butter... Boil for three minutes from simmering over low heat. Pour the mixture with a glass of vodka, cork and refrigerate. Strain after a week. Drink a tablespoon on an empty stomach.
2. 2 tbsp. l. elecampane pour 0.2 liters of alcohol. Insist 10 days. Strain. In half a glass of water, dilute 25 drops of tincture and take on an empty stomach once a day.

Diet

In case of illness, it is required to strictly adhere to table number 5 even during the period of remission for prophylaxis. Basic principlesdiets for chronic cholecystitis:

1. In the first three days of exacerbation, you cannot eat. It is recommended to drink rosehip broth, still mineral water, sweet weak tea with lemon. Gradually, mashed soups, cereals, bran, jelly, low-fat steamed or boiled meat, fish, cottage cheese are introduced into the menu.
2. You need to eat in small portions at least 4-5 times a day.
3. Vegetable fats should be preferred.
4. Drink plenty of kefir, milk.
5. Be sure to eat a lot of vegetables and fruits.
6. What can you eat with chronic cholecystitis? Boiled, baked, steamed, but not fried foods are suitable.
7. With a stoneless form of chronic disease, you can eat 1 egg per day. With calculus, this product must be completely excluded.

• alcohol;
• fatty foods;
• radish;
• garlic;
• Luke;
• turnips;
• spices, especially spicy;
• canned food;
• legumes;
• fried foods;
• smoked meats;
• mushrooms;
• strong coffee, tea;
• butter dough.

Video

The onset of an inflammatory process in the pancreas and gallbladder is often simultaneous. Therefore, the treatment of pancreatitis and cholecystitis should be carried out together, using drugs that affect different links in the pathogenesis of these diseases.

The onset of an inflammatory process in the pancreas and gallbladder is often simultaneous.

Contraindications

The methods of therapy for pancreatitis and cholecystitis are determined by factors such as the stage of the inflammatory process, the presence of complications, and the patient's age. Contraindications are determined individually by the attending physician. In the acute period, physiotherapeutic procedures are contraindicated. In addition, during treatment, hypersensitivity reactions to the components of therapy may occur. In this case, the drug that caused the allergy is canceled.

Surgical

Indications for surgical treatment are determined by the doctor on the basis of anamnesis data and additional research methods. Pancreatitis and cholecystitis are required to operate in the following cases:

• the development of a necrotic process in the pancreas;
• peritonitis;
• severe pain syndrome in chronic pancreatitis or acute cholecystitis, not amenable to drug therapy;
• combined pathology of the pancreas and gallbladder;
• chronic inflammation of the pancreas, complicated by jaundice;
• empyema;
• cholelithiasis.

Gallstone disease is an indication for surgical treatment.

Pancreas surgery

With acute pancreatitis surgical treatment carried out urgently. Surgical intervention for chronic pancreatitis is planned in advance, only with the complete elimination of the inflammatory process. The doctor determines the scope of the operation based on the degree of organ damage.

Subtotal resection involves the removal of the tail, body, and most of the head of the gland. This type of operation is used in case of extensive spread of the inflammatory process in the organ.

With distal resection of the gland, its tail and body are removed. This method can be used for partial organ damage.

Gallbladder surgery

Acute cholecystitis is rarely operated on urgently - only with the development of jaundice or peritonitis. If the patient's condition is extremely serious, cholecystostomy is performed - the imposition of a fistula on the bladder in order to decompress the biliary tract.

In acute pancreatitis, surgery is performed urgently.

With cholecystitis, complete removal of the organ is most often performed - cholecystectomy.

The operation can be postponed if there is mild inflammation in the gallbladder and there is no necrosis of the pancreatic tissue.

Physiotherapy

With cholecystopancreatitis, it is possible to prescribe physiotherapeutic procedures only during the period of remission.

The goals of treatment are:

• removal of inflammation and spasms of smooth muscles of the affected organs;
• reducing pain;
• restoration of external secretion of the pancreas;
• improvement of trophism of organs.

The inflammatory process is stopped by the use of UHF, microcurrent therapy, laser treatment. To normalize the function of the pancreas, galvanotherapy is used. UFOs and cryotherapy have analgesic action.

The inflammatory process in the pancreas is stopped by microcurrent therapy.

What medications to take

With inflammation of the gallbladder and pancreas, there is an insufficient supply of enzymes to the intestines, which impairs the digestion of food.

Therefore, when cholecystopancreatitis occurs, drug treatment should be directed not only directly to the affected organs, but also to improve the digestive processes.

Cholekinetics

These drugs affect the tone of the muscles of the bladder, helping to remove bile from it. This group includes Euffilin, Sorbitol, Cholecystokinin.

Hydrocholeretics

Used to enhance the action of choleretics. Increase the volume of bile due to the water component. This group includes: sodium salicylate, alkaline mineral waters (Essentuki 17 and 4, Borjomi, Narzan).

Most often, the drug Ceftriaxone is used for cholecystopancreatitis.

No-shpa - reduces spasm in the gallbladder and biliary tract, thereby facilitating the process of removing bile into the intestines.

Alkaline mineral waters are used to enhance the action of choleretics.

Choleretics

Medicines that promote the production of bile by the liver - Carsil, Allohol, Odeston, Holenzym.

Cholespasmolytics

Reduce spasm in the gallbladder and biliary tract, thereby facilitating the process of removing bile into the intestines. This group includes: No-shpa, Papaverine, Platyphyllin.

Antibiotics

The most effective in the treatment of cholecystitis and pancreatitis are cephalosporins and penicillins.

Cephalosporins are divided into 4 generations, most often 3-generation drugs are used for cholecystopancreatitis: Cefixime, Ceftriaxone.

In the penicillin group, the most commonly used is Amoxicillin. Antibiotic therapy can only be carried out under the supervision of a physician.

Herbs

Herbal treatment can be carried out only during the period of remission. At inflammatory diseases the pancreas and gallbladder are used:

• choleretic herbs - tansy, immortelle, barberry;
• herbs with antispasmodic action - anise, fennel, St. John's wort, belladonna, chamomile.

On the basis of medicinal plants, decoctions are prepared for oral administration. You can buy ready-made fees at the pharmacy, however, before starting treatment, you should make sure that there is no allergic reaction to the components of therapy.

For inflammatory diseases of the pancreas and gallbladder, herbs with an antispasmodic effect are used.

Charger

Exercise is necessary to prevent exacerbations of cholecystitis and pancreatitis and should be performed only during remission. The following exercises are recommended daily:

1. Simultaneous raising of an arm and a leg while lying on its side.
2. Bending the legs and bringing them to the chest while lying on the back.
3. Get on all fours, while raising your right arm and left leg, and then left hand and the right leg.

Diet

The effect of the treatment is enhanced if the dietary rules are followed:

• it is necessary to exclude smoked, pickled, spicy, salty, fatty foods from the diet;
• carbonated and alcoholic drinks are strictly prohibited;
• it is useful to eat vegetables, low-fat varieties of fish and meat, cereals;
• fermented milk products should be present on the menu every day.

Diet food for pancreatitis includes fermented milk products.

Preferred cooking methods are boiling, stewing. The portions should be small, the number of meals should be 5-6 times a day. Dishes should be served warm. Food must be chewed thoroughly

Possible complications after therapy

After surgical treatment pancreatitis and cholecystitis may develop complications such as:

• wound infection;
• septic shock;
• bleeding;
• multiple organ failure;
• obstructive jaundice - after gallbladder surgery;
• development of diabetes mellitus and exocrine pancreatic insufficiency.

Medical treatment can be complicated by the appearance of an allergic reaction. With an incorrectly prescribed treatment, the progression of the inflammatory process is possible, as a result of which a surgical operation is required.

Prophylaxis

You should not abuse alcoholic beverages. No smoking. You need to lead a healthy lifestyle: daily walks in the fresh air, morning exercises, proper nutrition, while excluding overeating. Stress must be avoided.

To avoid the occurrence of pancreatitis, one should not abuse alcoholic beverages.

Many drugs, if used uncontrolled, can damage the digestive organs, so you need to take medicines only as directed by a doctor.

Many drugs, especially when taken uncontrollably, can damage the digestive system. Therefore, you can not self-medicate. You need to take medications only as directed by your doctor.

The state of health will be good only if all organs and systems are working fully. What is cholecystitis? What are the symptoms and treatment of this disease? How to identify the first signs of the disease? What are the causes of the pathology? In this article, you will learn all about cholecystitis and how to cope with the disease.

What is cholecystitis

Cholecystitis is a condition that affects the gallbladder. The pathology is inflammatory. It can be acute and chronic.

Cholecystitis is diagnosed in both men and women. Usually adult patients aged 40-60 years suffer. In children, such a pathology develops extremely rarely, and there is almost never a calculous type of disease.

Often cholecystitis occurs as a complication of cholelithiasis. At that time, there are cases when an untreated disease led to the formation of calculi inside the organ.

The prevalence of cholecystitis is striking. About 20% of the adult population of the planet suffers from it. The disease proceeds in different stages, so some do not go to the doctor and do not carry out treatment.

The development of the disease is provoked by infection of pathogenic microflora. Often, cholecystitis is preceded by giardiasis, and some bacterial infections.

Why do women get sick more often

Cholecystitis is diagnosed in women several times than in men. This is due to the following factors:

• since the gallbladder is located directly under the diaphragm, bile stagnation often begins during pregnancy;
• progesterone, a female hormone, in high doses can reduce the activity of the organ;
• poor nutrition, diet and fasting affect the contractility of the gallbladder.

These are just the main reasons why women are more likely to suffer from this pathology.

Disease classification

To cure cholecystitis, it is very important to see a doctor at the first sign of illness. Treatment without surgery is possible, but the treatment regimen must be carefully selected and the patient must strictly follow all the doctor's recommendations.

The classification includes several types of disease:

• stoneless;
• calculous.

If inflammation of the gallbladder is accompanied by the formation of calculi inside the organ (that is, stones), doctors diagnose calculous cholecystitis. If no solid particles are formed, a diagnosis of non-calculous cholecystitis is made.

Note! With gallstones (cholelithiasis), the size of calculi can be different: from the diameter of a small pea to a chicken egg. The type, composition and form of formations also differ.

By the nature of the flow, there are:

• spicy;
• chronic.

In acute cholecystitis, the symptoms of the disease appear suddenly. In some cases, emergency surgery is even indicated. Chronic cholecystitis develops gradually. The patient may not recognize the signs of the disease and, as a rule, the pathology is detected at later stages.

Types of calculous cholecystitis

Acute and chronic calculous cholecystitis can take several forms:

• catarrhal;
• phlegmonous;
• gangrenous.

Each of these types of pathology develops against the background of the action of infectious agents. Their vital activity leads to disruption of the normal outflow of bile. In the presence of other risk factors, the disease begins.

As a rule, calculous cholecystitis is accompanied by pericholecystitis. This means that the area where the gallbladder is located is affected by the formation of multiple adhesions. In this case, the patient's condition is usually more severe, since pain occurs even with minor physical exertion.

Features of catarrhal cholecystitis

Catarrhal cholecystitis is characterized by a relatively mild course of the disease and a favorable prognosis. With this type of disease, irreversible changes do not occur in the gallbladder.

At the catarrhal stage of calculous or acalculous cholecystitis, superficial changes in the organ can be found:

• significant increase in size;
• redness of the walls;
• moderate swelling.

During the examination, the doctor may see congestion in the bladder and thickening of its walls.

Features of phlegmonous cholecystitis

In addition to the symptoms characteristic of the catarrhal stage, additional signs may appear. An ultrasound will show that the thickening of the gallbladder walls has become even more pronounced. The organ cavity is filled not only with bile, but also with purulent contents. Failure to provide timely assistance causes the development of irreversible changes in the gallbladder.

With this course of the disease, the mucous membrane can become covered with plaque, ulcers and fibrin. The patient's condition is gradually deteriorating. Not treating the disease at this stage can be very life-threatening.

Features of gangrenous cholecystitis

This form of the disease is the most dangerous in terms of possible consequences. At any time, the bladder can rupture, which will lead to the outpouring of bile acids and pus into abdominal cavity... This complication is called peritonitis. In this case, life can be saved only with the help of an emergency operation. Otherwise, sepsis occurs and the person dies.

With gangrenous cholecystitis, some part of the gallbladder undergoes gangrene, the tissues die off. As a rule, this form of pathology occurs only in elderly patients.

What is obstructive cholecystitis?

Obstructive cholecystitis is a form of inflammation that occurs against the background of a chronic course of gallstone disease. Problems appear when one of the stones completely blocks the bile duct.

Important! With the obstructive form of the disease, most often it is necessary to completely remove the gallbladder.

This type of cholecystitis never occurs as an independent pathology, therefore, the obstructive form is spoken of as a symptom, and not as a separate disease.

Causes of the disease

To get rid of cholecystitis, it is necessary to exclude the negative impact of factors-provocateurs of the disease.

The main reasons for the development of the disease include:

• dyscholia;
• infectious diseases;
• dyskinesia;
• metabolic disease.

Dyscholy of the gallbladder is a condition in which there is stagnation of bile. This often occurs in patients who are accustomed to not having breakfast in the morning. The production of bile acids is carried out continuously. When food does not enter the digestive tract, these acids accumulate in the bladder. During the morning meal, the gallbladder should contract, which will allow it to empty, and the acids necessary for processing food will enter the digestive tract.

When a person does not eat breakfast or simply drinks coffee, a full contraction does not occur. Meanwhile, bile production continues. It stagnates, which over time can affect the risk of stone formation.

The lithogenicity of bile is affected by the level of bilirubin and cholesterol. People suffering from atherosclerosis, overweight gout and diabetes are most at risk of developing gallstone disease. At the same time, with proper nutrition, this can be avoided.

When the inflammatory process in the gallbladder develops against the background of the throwing of enzymes into the organ cavity from the pancreatic ducts, enzymatic cholecystitis develops.

Risk group

The following factors can affect the likelihood of cholecystitis:

• vitamin deficiency (especially group A);
• violation of contractile function (dyskinesia);
• congenital structural features;
• prolonged constipation;
• sedentary lifestyle;
• irregular and improper nutrition;
• the use of hormonal drugs.

If the patient is provided with high-quality first aid, and with the correct diagnosis, the chances of a successful cure are much greater.

Symptoms

Regardless of whether there are signs of illness in a child or an adult, it is important to pay close attention to them.

The first signs of cholecystitis include the following sensations:

Flatulence, that is, bloating, does not occur in all patients. With the aggravation of the condition, for example, with the development of a purulent abscess, the body temperature begins to rise, dizziness and general weakness occur.

Sometimes all symptoms occur at the same time. In the chronic form of the course of cholecystitis, the symptoms can be blurred and occur periodically. Most often, vivid symptoms occur after overeating, abuse of fatty and fried foods, severe emotional stress. The photo shows which food has the worst effect on well-being.

When a stone blocks the bile duct, the patient develops jaundice:

• the color of urine darkens;
• the skin turns yellow;
• the color of the sclera of the eyes changes.

Due to abnormalities in the liver, itching on the skin and other complaints are possible.

Features of pathology in children

In order to prevent an exacerbation of the disease in children, it is necessary to get rid of cholecystitis in the early stages. To do this, it is important to quickly recognize the symptoms of childhood inflammation of the gallbladder:

• pain in the right hypochondrium on palpation;
• severity that increases after eating;
• instability of the stool, when diarrhea is replaced by constipation;
• irritability of the baby;
• troubled sleep or insomnia.

Only a doctor can choose a medicine that will be as effective as possible to fight the disease.

Diagnostics

Differential diagnosis will help to clarify the pathogenesis of the disease that has arisen.

Cholecystolithiasis can be detected with the help of such studies:

• ultrasound diagnostics;
• detailed blood test;
• cholecystocholangiography.

As a rule, 1-2 studies are enough to make an accurate diagnosis.

During the examination, it is necessary to distinguish cholecystitis from the following pathologies:

An attentive doctor with an ultrasound scan will recognize the echo signs of each pathology and will be able to correctly identify the disease.

What to do with an attack of cholecystitis

An attack of cholecystitis is a condition that occurs after exposure to irritating factors. It is typical for both primary acute cholecystitis and the chronic form of the disease.

Symptoms:

• acute sharp pain;
• vomiting and nausea;
• temperature.

You can relieve the spasm with the use of pain relievers. You can take "No-shpu", or another antispasmodic. After that, you should call ambulance or go to the hospital yourself.

Cholecystitis treatment

The most effective means can be selected by a doctor after a comprehensive examination.

Note! For non-calculous cholecystitis, surgery is not used.

Sometimes antibiotics are prescribed for cholecystitis:

Antibiotic therapy is prescribed only after the exact determination of the causative agent of the disease. The prescription is given by a doctor. To protect the gastric mucosa during the use of such drugs, "" can be recommended.

If the cause of inflammation is microbial penetration, "" can be recommended for treatment.

Drugs that reduce the lithogenicity of bile and help dissolve stones will help relieve inflammation:

In most cases, treatment is carried out at home. Only during therapy with surgical methods, the patient is urgently admitted to the hospital.

In order to normalize digestion processes and help the body absorb nutrient compounds from foods, enzymatic preparations can be prescribed:

During periods of exacerbation, when patients suffer from severe vomiting, the use of "" may be recommended.

Power features

Diet for cholecystitis of the gallbladder is a prerequisite for a successful cure. Although treatment with folk remedies is carried out only along with the main therapy and only after agreement with the attending physician, proper nutrition for cholecystitis will help to rehabilitate the gallbladder faster and normalize well-being.

Note! One of folk ways relief of well-being with cholecystitis - a complete refusal to eat during the first two days after the onset of the disease.

With cholecystitis, it is necessary to refuse such products:

• chicken eggs;
• quail eggs;
• sweets;
• coffee;
• chocolate;
• hard cheese;
• garlic;
• pasta;
• not fully ripe fruits;
• wine;
• beer;
• Salo;
• mushrooms;
• ice cream;
• carbonated mineral water;
• cinnamon and other spices.

The following nutritional components can be included in the treatment menu program:

• linseed oil;
• sea ​​buckthorn;
• fish fat;
• olive oil;
• milk thistle oil.

Choleretic products include the following:

• some fruits (apples, pears, lemons, prunes, melons, watermelons, cranberries, dates, bananas, dried apricots);
• Dill;
• stewed cabbage;
• kefir;
• cottage cheese;
• celery;
• tomatoes;
• pumpkin seeds;
• avocado;
• tomato juice;
• sauerkraut;
• cabbage juice;
• red boiled beets;
• pumpkin juice;
• baked pumpkin.

In limited quantities, you can eat nuts, including peanuts, seeds. Fish is allowed, but should not be fried. These foods contain Omega-3, a polyunsaturated fatty acid that contributes to normal bile acid production.

Marshmallow and marmalade allowed. It is useful to consume bran. It is undesirable to use oats for cholecystitis, as this can provoke an exacerbation of the disease.

It is also better to refuse strong tea. Lightly brewed will do. green tea, in which you can grate a little ginger. Milk can be added.

Some experts recommend using choleretic herbs. It is effective to periodically take a decoction of chamomile and immortelle. Do not use chicory, as it strengthens the stool and worsens the outflow of bile. You can prepare a rosehip decoction.

Potato juice with pancreatitis and cholecystitis has a wound healing and anti-inflammatory effect. Therefore, the product is recommended for use by everyone who has problems with gallbladder and the pancreas.

It is worth remembering that soda is ineffective for cholecystitis. It only reduces acidity and can relieve heartburn, if it is caused by increased rates. In other cases, its use is useless.

Prophylaxis

The main rule of prevention is proper nutrition. If the menu always contains a list of foods useful for the gallbladder, bile stagnation will never form inside this organ and the formation of calculi will not begin.

It is important to give up bad habits, including alcohol abuse and smoking. Then destruction (destruction) or enlargement of the liver and gallbladder will never occur.

Since cholecystitis is a serious pathology that can turn into a chronic stage, the key to a successful cure is timely started therapy. To protect your body, it is necessary to seek medical help at the first alarming symptoms.

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