Diagnosis and treatment of cholangitis. Acute form of cholangitis. Cholangitis - treatment, nutrition

Cholangitis is an inflammation of the bile ducts that can be acute or chronic. Most often, this disease worries women aged 50-60 years and develops against the background of other pathologies of the liver, gallbladder or pancreas. In chronic cholangitis, the symptoms are usually erased, so the patient for a long time does not pay attention to ailments. In this case, the disease itself can be quite dangerous. How to suspect inflammation bile ducts and why it occurs, understood MedAboutMe.

The ducts carry the bile produced in the liver to the duodenum, a fluid important for proper digestion and digestion of fats. Its release occurs during meals, and during breaks bile accumulates in the gallbladder. Directly in front of the intestine, the ducts connect with the channels of the pancreas. That is why, on the one hand, inflammatory process here it can be associated with the gallbladder, liver and pancreas. And on the other hand, without treatment, cholangitis can cause complications that affect the state of these organs, for example,.

The main reason for the development of the inflammatory process in the ducts is the stagnation of bile, which occurs when the gallbladder is damaged. Most often, the fault of this process is bacterial. Among the pathogens leading to chronic cholangitis, doctors distinguish:

Staphylococci.
Enterococci.
Escherichia coli.
Pneumococcus.
Mycobacterium tuberculosis (less common).

Bacteria enter the ducts and gallbladder through the duodenum, but can also be carried with blood. In addition, if the inflammation affects the small hepatic canals, the doctor may assume the presence of viral hepatitis.

Cholangitis can be a consequence of the pathology of the development of the ducts, gallbladder, liver or pancreas. In this case, it appears in childhood. Surgical manipulations can also lead to damage to the bile ducts.

Separately from other inflammations, doctors mention sclerosing cholangitis. it autoimmune disease arising as a complication of vasculitis, rheumatoid arthritis, ulcerative colitis, Crohn's disease and others.

Jaundice and other symptoms of cholangitis

Symptoms of acute cholangitis are always quite pronounced and are described in medical practice like Charcot's triad. Signs of inflammation include:

Acute pain in the liver, often radiating to right shoulder and even the neck.
Increasing the temperature to 38-40°C. At the same time, the person is shivering, he is actively sweating.
. This symptom appears later than the others.

If a person is not given medical care, signs of inflammation begin to increase. Acute process causes severe intoxication of the body, so pain and fever are accompanied by nausea and vomiting, dizziness, aching joints, diarrhea, confusion. The patient in this condition should immediately receive qualified assistance because cholangitis in this case can lead to septic shock and death.

Chronic inflammation appears similar symptoms, but they are much less pronounced. In addition, the patient has periods of remission, when the signs of the disease practically disappear. The constant stagnation of bile leads to jaundice, against which a pronounced pruritus. It usually intensifies at night, and in a patient with chronic cholangitis, the doctor finds multiple scratching on the skin. Pain in this form of the disease is dull and pulling - the right side aches for a long time, especially after a heavy meal.

Diagnosis of inflammation of the bile ducts

Acute cholangitis can be identified already by severe symptoms, but to confirm the diagnosis, tests are always carried out. additional examinations. In particular, an ultrasound abdominal cavity and liver, which shows the state of extrahepatic channels.

Highly important survey with any form of inflammation is endoscopic retrograde cholangiopancreatography (ERCP). The method allows not only to detect congestion, but also to eliminate their causes and ensure the outflow of bile. For example, duct stenting may be performed during the procedure. In this case, ERCP is contraindicated in such diagnoses:

Acute cholecystitis.
Acute pancreatitis.
Viral hepatitis.
Pancreas cancer.
Pancreatic cysts causing various complications- purulent processes, bleeding and more.

With cholangitis, tests can be prescribed, since they indirectly confirm the presence of bile stasis. So, with such a pathological condition, bilirubin, alkaline phosphatase and alpha-amylase increase. If you suspect bacterial inflammation bile is taken for bakposev by the method of fractional duodenal sounding.

Treatment of cholangitis is conservative and surgical methods. the main task therapy - to ensure a normal outflow of bile, since stagnation will only aggravate the symptoms and increase intoxication.

With any form of treatment, the patient must adhere to strict diet(No. 5 according to Pevzner) and get infusion therapy. Patients are also prescribed the following medications:

Physiotherapeutic methods are used for patients with chronic cholangitis, courses of procedures are prescribed during periods of remission. Commonly used methods include:

Electrophoresis.
Diathermy.
Mud applications.
Sodium chloride baths.

In some cases, get rid of inflammation conservative methods impossible, so patients undergo various surgical interventions. The list of operations that improve the functioning of the bile ducts includes:

ERCP: installation of stents that increase the lumen of the canals, removal of stones, expansion of the mouth of the Vater papilla.
Percutaneous drainage (used if there are contraindications for ERCP).
Various Methods removal of the gallbladder (laparoscopic or open cholecystectomy).

Take the test Only by answering the questions honestly, you will get a reliable result.

Inflammation of the bile ducts (cholangitis) can be an independent disease, but most often, the pathological process develops in conjunction with damage to the liver and gallbladder. The disease can spread to the ducts inside the liver and outside it. At risk are people between 50 and 60 years old.

Causes of inflammation

In addition to the main causes, inflammation of the bile ducts can occur due to:

congenital anomalies in the development of the bile ducts;
cholelithiasis;
autoimmune and oncological diseases;
pancreatobiliary reflux (reflux of pancreatic juice into the bile ducts);
surgical operations on the biliary tract.

Forms of cholangitis

Cholangitis may have. acute form inflammation of the bile ducts has a rapid development and vivid symptoms: the temperature may suddenly rise, the patient feels severe pain in the right hypochondrium, skin and mucous membranes. All these listed signs are called Charcot's triad.

The chronic form of this pathological process much more common than acute. It may be the result of untreated acute inflammation or develop independently. The clinical picture in this case is more moderate, but it often leads to various changes in the wall of the bile ducts.

Diagnostics

Diagnosis of cholangitis is based on the patient's condition. However, in without fail needs to be additional methods research. These include biochemical analysis blood, ultrasound diagnostics and ultrasonography. plays a decisive role in the detection of this disease endoscopic methods such as endoscopic retrograde cholangiopancreatography.

Prevention

For the prevention of inflammation of the bile ducts, the use of Populin concentrate is useful. It is based on the extract of aspen bark. Effective for any bacterial infection and all types of inflammation. is a choleretic and diuretic in diseases of the biliary and urinary systems, such as cholecystitis, cholangitis, gallbladder dyskinesia and others.

If you have a “temperature”, alas, this is not always from “hot feelings”. Sometimes fever is one of the formidable signs of a serious illness - cholangitis. What is this disease and how to prevent it, read on.

Fact. Choleresis - the process of bile formation - occurs continuously. And cholekinesis - the process of bile entering the duodenum - during meals.

Distinguish:

Acute cholangitis - its causative agents are a variety of bacteria, which penetrate from the lumen of the intestine and gallbladder into the bile ducts. Sometimes they enter the ducts through the bloodstream and lymph. Almost at any clinical picture the disease is formed on the basis of stagnation of bile.
Chronic cholangitis often develops after surgical interventions on the ducts, against the background of regularly recurring attacks of pancreatitis, gastroduodenitis (inflammation of the mucous membrane of the duodenum and adjacent stomach area) and cholecystitis.
Sclerosing cholangitis - due to an inflammatory process or after surgery, the bile ducts gradually overlap and often a liver disease - cirrhosis occurs.

Fact. There is no definite trend, who exactly suffers from cholangitis more often. In this situation, there are no age and gender distinctions.

Symptoms of cholangitis

Acute cholangitis "grabs" unexpectedly. It is characterized by:

chills, fever
paroxysmal colic in the right hypochondrium, palpable even in the neck and shoulder, as well as the scapula
state of weakness and loss of appetite associated with intoxication
headache

This type of disease often takes a complicated form of jaundice, accompanied by a change in color. skin membrane and sclera, itching.

Fact. The ancient Roman physician Galen considered bile to be a marker of human behavior. The predominance of light bile attributed to a direct connection with such human traits as irascibility and imbalance. And he associated an excess of dark bile with the dominant pessimistic mood in temperament. "Chole" in Greek means "bile".

Signs of chronic cholangitis

intermittent fever
muffled pains of low intensity in the right hypochondrium
feeling "bloated" upper divisions belly
at a severe stage, it may be accompanied by obstructive jaundice
subfebrile temperature body (within 37-38 degrees)
frequent fatigue

Symptoms of sclerosing cholangitis are similar to acute and chronic subspecies. But sometimes it can be aggravated by the development of multiple abscesses (purulent inflammation of the tissue) of the liver, sepsis ("blood poisoning"), toxic shock.

Who will come to the rescue?

AT medical house Odrex will provide you emergency assistance and help to remove the inflammatory process in a timely manner. surgeons work here the highest category who thoroughly master the most complex operational techniques. Here they fight for the life of everyone and preserve the most valuable thing - health.

Diagnosis of cholangitis

ultrasound examination of the abdominal organs
Abdominal MRI with virtual cholangiography
general analyzes
ERCP is an x-ray endoscopic examination of the bile ducts and the main pancreatic duct with the introduction of contrast agents.

Fact. During the day, a person accumulates approximately 15 ml of bile per kg of body weight.

Treatment of cholangitis

The doctor prescribes either conservative or surgical treatment to the patient. If the bile ducts are completely blocked, then obviously you will need surgical intervention, if not, then it is still permissible to use a medication course in relation to the patient. It provides for:

Surgical intervention is:

external transhepatic drainage of the bile ducts (establishment of drainage in the lumen of the bile ducts to remove pathological fluid accumulations)
endoscopic bougienage of a tumor stricture of the extrahepatic bile ducts - expansion of the narrowed bile ducts with the help of special bougies (instruments for expanding channels) inserted through a duodenoscope (equipped with a video camera optical instrument). This helps to restore the violation of the outflow of bile into the duodenum 12.

The postoperative period lasts on average from two days to a week. And the process of restoring the body takes about six months and provides for independent regulation of the level physical activity on the body, its maximum reduction, and adherence to the diet.

Question answer

What role does balanced diet in the treatment of cholangitis?

The operated patients are recommended diet No. 5 according to Pevzner, aimed at reducing calorie intake by reducing fat (up to 100 grams per day) and proteins in daily diet. There should be boiled, warm, preferably unsalted food - 5-6 times a day in small portions.

Allowed:

semi-viscous cereals
vegetables, greens, sauerkraut
boiled eggs
creamy or vegetable oil- no more than 50 g per day
chicken meat, lean fish baked, boiled or steamed
vegetable soups
if the bread is rye, lean dough in minimal quantities
skim cheese
if juices are non-acidic, compote, weak tea
honey, jam

Forbidden:

soups in broths
sour fruits and berries
fatty meat and fish
fried food
strong coffee, alcohol, ice cream, confectionery with chocolate and cream filling
fresh bread
smoked meats
conservation
pickled vegetables
alcohol

Does it happen chronic cholangitis The child has?

Yes, sometimes. Sometimes it can be a consequence of acute cholangitis, but mostly develops "on the basis" chronic cholecystitis and pancreatitis. The child may have itching; subfebrile temperature, weakness appears; he loses weight, often experiences heartburn, constipation or diarrhea, feels bad taste in the mouth. The volume of the liver increases, its tissues become denser, which even leads to cirrhosis. But timely treatment able to stop destructive processes in the digestive system.

I heard that bile is "light" and "dark". And how do they differ?

In the liver, bile is a transparent golden color. In the gallbladder, the substance becomes more saturated in concentration, acquires a dark shade, since mucin is attached to it biliary tract and bubble. Scientists also explain the change in color by the absorption of bile carbonates and the formation of salts with its help. bile acids. Bile levels destructive action enzyme gastric juice pepsin.

Cholangitis is an inflammation of the bile ducts that occurs as a result of infection through the blood or lymph coming from the gallbladder or intestines. The syndrome rarely develops on its own, most often occurring as a complication of hepatitis, pancreatitis, gallstone formation, gastroduodenitis, if the patient ignored their symptoms and was not treated.

Classification

Determination of the type of disease plays important role when developing a treatment plan. Cholangitis is classified into several groups of signs. According to the nature of the course, acute and chronic forms are distinguished. According to pathomorphological changes, the acute form is divided into subtypes:

purulent - characterized by the melting of the walls of the bile ducts and the formation of many internal abscesses;
catarrhal - it is characterized by swelling of the mucous membranes lining inner surface bile ducts, excessive blood flow to them and oversaturation with leukocytes with further exfoliation of epithelial cells;
diphtheritic - begins with the appearance of ulcers on the mucous membranes, desquamation of the epithelium and leukocyte infiltration walls with subsequent tissue death;
necrotic - passes with the formation of dead areas that occur under the influence of aggressive enzymatic activity of the pancreas.

Chronic cholangitis is divided into the following forms:

sclerosing (with proliferation of connective tissue);
latent;
recurrent;
septic for a long time;
abscessing.

According to the location of the inflammatory process, there are:

choledochitis (inflamed common duct);
angiocholitis (affected intra- and extrahepatic bile ducts);
papillitis (inflamed large duodenal papilla).

By origin, cholangitis happens:

The chronic form of the disease is more common than the acute form and develops after an exacerbation of the disease and as independent disease, initially taking a protracted course.

Sclerosing type cholangitis is a special form of the disease. Initially having a chronic form of the course, inflammation in the bile ducts occurs without prior infection. The inflammatory process leads to tissue sclerosis - hardening, they completely block the lumen of the ducts, thereby causing cirrhosis of the liver. This disease is not treatable, slow progress (about 10 years) ends with the formation severe violations followed by death.

Main reasons

In most cases, cholangitis occurs as a result of an infection in the bile ducts. The most common infectious agents are:

coli;
staphylococcus;
enterococcus;
non-clostridial anaerobic infection;
pale spirochete;
typhoid stick.

The infection can spread ascending way. Wherein pathogenic bacteria enter the bile ducts:

from duodenum;
through the blood through the portal vein;
through the lymph (as a complication of pancreatitis, enteritis, cholecystitis).

The main prerequisite for the formation of a pathological condition of the bile ducts is their impaired patency, which contributes to stagnation of bile and is unfavorable factor upon infection. The patency of the biliary tract is impaired in such diseases:

choledocholithiasis - stone formation in the biliary system;
chronic cholecystitis, accompanied by narrowing of the lumen of the ducts as a result of tissue scarring;
postcholecystectomy syndrome - pathological condition coming after excision of the gallbladder;
cystosis or tumor process of another etiology with localization in the bile duct;
stenosis of the duodenal papilla;
cholestasis - obstructed bile secretion, occurring with biliary dyskinesia.

With the development of infection in a descending type, microorganisms affect the extra- and intrahepatic bile ducts, penetrating from the affected abdominal organs located above the gallbladder.

Cholangitis can also be provoked by endoscopic manipulations for the treatment or examination of the bile ducts, as a result of which the integrity of the walls was violated: choledochal stenting, retrograde cholangiopancreatography, sphincterotomy. Damaged mucous membranes become especially vulnerable to bacteriological infections therefore, after any invasive examination or operation, you should regularly visit a doctor in order to monitor the healing process.

Symptoms

In adults and children early age cholangitis develops in different ways. Adult patients rarely complain of pain in acute stage. Their primary symptoms are mild, but if left untreated, the disease progresses rapidly, turning into a purulent complicated form, with extensive internal inflammation fraught with general sepsis.

In children, the acute form of cholangitis practically does not occur. Most often it begins after the attachment of the secondary streptococcal infection. The signs of the disease are nonspecific, the symptoms largely coincide with other diseases of the gastrointestinal tract, so if they occur, you should consult a doctor who will differential diagnosis, on the basis of which it will be compiled efficient scheme treatment.

The following signs indicate the development of acute cholangitis:

pain in the right hypochondrium of a aching nature, radiating to shoulder joint or in the region of the scapula;
fever, accompanied by chills and intense sweating;
bouts of nausea leading to vomiting;
jaundice with the addition of severe skin itching.

In the absence of adequate measures for the treatment of acute cholangitis, the pathology becomes chronic, which is characterized by the following manifestations:

decreased performance, constant weakness;
hyperemic and itchy skin (most often on the palms);
an increase in body temperature outside of colds;
thickening of the distal (nail) phalanges of the fingers.

In childhood, cholangitis leads to weight loss, as the child is constantly sick and refuses to eat. Intoxication caused by the activity of microorganisms and decay products formed during extensive purulent inflammation leading to the development of an anemic state. The patient's skin is pale, the sclera are colored in yellow. The child may complain of constant headaches. If at this stage of cholangitis is not treated, the progress of the disease can lead to a slowdown in physical development.

Diagnosis of the disease

Since this disease is recognized by outward signs is not possible, on the basis of a physical examination only a presumptive diagnosis is made. Its refinement is based on comprehensive survey patient, including the following laboratory and hardware examinations:

Liver tests will determine biochemical composition blood (to draw up a treatment plan, the doctor will need information about the level of bilirubin, transaminases, alkaline phosphatase, alpha-amylase).
Examination of the contents of the duodenum by duodenal sounding and bacteriological culture bile will help identify the type of microorganisms that caused cholangitis.
Analysis for helminthic infestations(roundworm, lamblia, etc.).
On ultrasound, CT, ultrasonography, the nature of pathological changes in the biliary tract, their narrowing or expansion, localization of inflamed areas and the nature of local blood circulation. Hardware examination will make it possible to assess the condition of the bile ducts and liver themselves.
In combination with hardware methods, endoscopic research methods are used in the diagnosis: transhepatic cholangiography, retrograde pancreatocholangiography.

Diagnosis begins with delivery laboratory tests, according to the results of which the doctor will determine the necessary additional research he needs to formulate a treatment plan.

Complications

If you ignore the first signs of cholangitis and do not diagnose and treat this disease in time, the inflammatory process in the biliary tract can lead to the following serious conditions:

Crohn's disease;
cirrhosis of the liver;
the development of hepatic coma;
acute liver or kidney failure;
hepatitis;
blood poisoning;
peritonitis;
infectious-toxic shock.

Treatment

When the diagnosis of cholangitis is confirmed, the main vector of treatment is the removal of the internal inflammatory process. At the same time, intoxication of the body is eliminated and measures are taken to stop the processes that cause compression of the bile ducts. In the presence of concomitant diseases biliary system, gastrointestinal tract, liver or kidneys, a medication course is required to correct them.

For suppression pathogenic microflora recommended combinatorial drug treatment antibiotics a wide range actions (cephalosporins, metronidazole, aminoglycazides). In order to remove intoxication as soon as possible, blood plasma is purified (plasmapheresis). To consolidate the result of treatment outside the acute stage of cholangitis, stabilization of the patient's condition is facilitated by physiotherapeutic procedures.

On the general well-being the patient during this period is well affected by the use of therapeutic mud, treatment paraffin applications, sodium chloride baths with high concentration, physiotherapy with the use of high-frequency magnetic fields, medicinal electrophoresis, deep heating currents.

advanced cholangitis in chronic form not amenable to conservative treatment. At this stage, the ducts are often so deformed that it is no longer possible to restore their patency with a course of antibiotics.

Surgical treatment is recommended when all methods conservative therapy have already been applied, but it was not possible to normalize the outflow of bile. by the most effective method surgical treatment advanced forms of cholangitis are considered endoscopic procedures- minimally invasive and having a brief rehabilitation period. Endoscopic techniques are contraindicated in necrotic and purulent processes, and are also excluded in the presence of multiple abscesses in the lumen of the biliary tract.

Surgical interventions are carried out in order to eliminate the decompression of the affected pathways. Their format is determined by the prevalence of the inflammatory process and the nature of pathological changes. So, as part of the surgical treatment of sclerosing type cholangitis, doctors recommend a liver transplant.

Diet

Diet therapy is an integral part of the treatment of all diseases associated with impaired functionality of the organs responsible for digestion. Nutrition during inflammatory processes in the bile ducts should be organized in such a way as to normalize the functioning of the biliary system and reduce the load on the liver.

For this, fasting is prescribed in the first 2 days of treatment of acute cholangitis. After that, gradually introduced into the diet easily digestible foods. At the time of treatment, food is completely excluded from high content fats, smoked meats, salted, spicy and fried foods.

wholemeal bread;
dairy products with a minimum fat content;
vegetables - it is allowed to take it raw, but preference is given to stewed or boiled, as well as steamed vegetable dishes;
eggs;
pasta;
porridge.

If the patient feels well, boiled or baked meat of low-fat diet varieties (rabbit, turkey, veal) can be added to the diet.

To avoid intense bile formation, throughout the course of treatment, you need to eat fractionally, in small portions, taking breaks between meals at 2-3 hours.

Of particular importance in the treatment of cholangitis is drinking regimen. Drinking up to 1.5 liters per day clean water without gas, the patient will provide favorable conditions to remove toxins. Instead of water, you can drink a decoction of wild rose or dried fruits, ginger or green tea- they well relieve nausea and promote detoxification of the body.

Eating food from the list of prohibited foods will reduce the effectiveness of treatment and may cause a recurrence of cholangitis even during a period of long-term remission.

Prevention and prognosis

With timely treatment of the acute form of the disease, not complicated by sepsis, abscess formation or functional insufficiency of the liver or kidneys, the pathology is cured by conservative methods. Factors that worsen the prognosis are elderly age, chronic course illness, fever persisting for 14 days or longer, anemia, female sex.

Chronic forms of cholangitis often occur with complications that require surgical intervention. The inflammatory process lasting for years can lead to disability, also in this case there is high probability lethal outcome. The cause of death becomes septic shock, which occurs as a result of systemic blood poisoning and occurs when the patient refuses treatment.

Filtering toxins, storing vitamins, producing glycogen - these are the main tasks that the liver performs in the body of every person. If for some reason these functions cannot be fully executed, then . Yellowing of the skin or sclera of the eyes is clear signs when the liver begins to fail.

What is it - cholangitis?

What is it - cholangitis? This is inflammation of the bile ducts. Their obstruction with the addition of infection is a sure sign of the disease.

Types and forms

Cholangitis has its own types and forms of development. The forms are divided into:

Spicy. By inflammatory character acute cholangitis is divided into types:

Catarrhal - swelling of the bile ducts with their further scarring and narrowing.
Purulent - affects the liver and gallbladder, characterized by the accumulation of pus and bile in the bile ducts.
Necrotic - the formation of necrosis of sections of the bile duct after the ingestion of pancreatic enzymes.
Diphtheritic - manifestations and necrosis of the mucosa, destruction of the walls of the bile duct, purulent fusion of the surrounding tissue.

Chronic. According to the inflammatory nature, they are divided into types:
- Hidden (latent).
- Septic.
- Recurrent.
- Abscessing.
Sclerosing (autoimmune) cholangitis - it is assumed that it develops as a result of an autoimmune reaction of the body to itself. Hardening, narrowing and overgrowth of the bile ducts occurs, which leads to cirrhosis of the liver.
Bacterial.

The reasons

What could be the reasons for this unpleasant illness like cholangitis? Consider the most common:

Gallstone disease in the bile ducts (choledocholithiasis).
Scarring and narrowing of the bile duct due to removal of a cyst, tumor, or chronic cholecystitis.
Roundworm, helminthic invasion.
Hepatitis.
Penetration of infection from the intestines, through the flow of lymph or blood. A favorable environment for her becomes a violation of the outflow (stagnation) of bile.

Predisposing factors for these anomalies are:

genetic predisposition.
psychogenic factor.
congenital anomalies.
Giardiasis.
Dyskenesia.
endocrine disorders.
immunological reactions.
Pancreatobiliary reflux.
Dyscholia, which develops for the following reasons:
- Eating disorder.
- Obesity.
- Overweight.
- Hormonal disruptions.
- Taking hormonal medications.
- Violation of the blood supply to the liver and gallbladder.
- Dishormonal disorders.
- Alcoholism, smoking.

Symptoms and signs of cholangitis of the bile ducts

Symptoms and signs of cholangitis of the bile ducts should be considered in the form of their course:

Spicy:
- Attack of pain in right side chest(shoulder, shoulder blade) and abdomen.
- Raising the temperature to 40ºС.
- Nausea.
- Lowering blood pressure.
- Weakness.
- Vomit.
- Skin itching.
- Chills.
- Yellowness of the skin, mucous membranes, sclera.
- Violation of consciousness.
- Perhaps the development of hepatic coma.
Chronic:
- Pain is mild, but intense in the presence of stones.
- Skin itching.
- Bursting or squeezing in the right hypochondrium.
- Weakness.
- Intermittent high fever.
- fatigue.
- Thickening of the fingers, redness of the palms.
Sclerosing:

Pain in the upper abdomen and right hypochondrium.
Violation of the stool, as in ulcerative colitis or Crohn's disease.
Jaundice and pruritus.
Temperature up to 38ºС.

Cholangitis in children

In children, cholangitis occurs mainly due to genetic or congenital causes. In other cases, the disease is not observed in children.

Cholangitis in adults

In adults, cholangitis develops due to genetic, congenital and in women, it occurs when hormonal disruptions during pregnancy or childbirth. It occurs in men due to the presence bad habits or untreated diseases. unhealthy image life and poor nutrition are the main factors of cholangitis in adults.

Diagnostics

Diagnosis of inflammation of the bile ducts begins with a general examination and collection of complaints. According to some external signs, the doctor has reasons for the following procedures:

Ultrasound of the liver.
Blood analysis.
Magnetic resonance cholangiography.
Analysis of feces for eggs of worms.
Endoscopic retrograde cholangipancreatography.
Analysis of urine.
duodenal sounding.
X-ray cholegraphy.
Cholangiomanometry.
Choledochoscopy.
Liver biopsy.
Radioisotope examination of the bile ducts.

Treatment

Treatment of cholangitis is carried out only in a hospital. Folk remedies, which a person wants to spend at home, do not contribute to recovery. This requires medical, therapeutic and sometimes surgical treatment.

What is the treatment for cholangitis? The doctor prescribes medications if there is a normal outflow of bile:

Antibiotics.
Antispasmodics.
Sulfonamides.
Drugs that reduce toxicity.
Medications that improve the outflow of bile.
Anthelmintic drugs.

In case of inefficiency conservative treatment resort to surgery. Endoscopy is performed with drainage of the bile ducts, elimination of narrowing, removal of stones. With purulent inflammation, abdominal operation to remove purulent or necrotic areas. Sometimes a cholecystectomy is performed - the removal of the gallbladder or a complete liver transplant.

In the treatment of cholangitis, a rigid diet is actively used:

Small meals at least 5 times.
Avoid eating before bed.
Exception from the menu fresh bread, spicy, fried, spicy, onion, bacon, sour berries and fruits, garlic, strong tea, alcohol.
Included in the menu lean fish, cottage cheese, buckwheat, oatmeal, warm milk, egg whites, boiled meat, vegetables, milk soups, kefir, stale bread, honey, jam.
Prohibition on hunger strike.
Tea drinking special collections of herbs. Compotes, jelly, mineral waters.

Sclerosing cholangitis is treated as follows:

Vitamin therapy.
Antihistamines.
Ursodeoxysolic acid.
Sedative drugs.

Physiotherapy procedures are used:

Amplipulse therapy.
Diathermy.
microwave therapy.
Paraffin and mud applications.
Sanatorium treatment.
Physiotherapy.

Lifespan

How long do people live with cholangitis? The disease itself does not affect life expectancy, but provokes such complications that lead to death:

Peritonitis.
Abscess of the abdomen.
Liver failure.
Intrahepatic abscesses.
Sepsis.
biliary cirrhosis.
Cholangiocarcinoma.

Here you should not delay treatment and do not self-medicate. Contact for medical assistance at the first symptoms.