Cholecystitis is non-calculous. Stagnation and dyscholia of bile. How to diagnose long-term non-calculous cholecystitis

Non-calculous cholecystitis-what it is? Chronic non-calculous cholecystitis is an inflammation that covers the gallbladder, occurs against the background of a violation in the work of the biliary tract. There are no stones in the lumen. As the disease progresses, the patient develops severe discomfort in the area of ​​the right hypochondrium, develops dyspeptic disorder. During the progression of the pathology, body temperature may increase. In frequent cases, the disease occurs in the female half of humanity. Often, an ailment is diagnosed in girls during the period of bearing a baby, calculi are basically not formed.

Features of the pathology

Non-calculous cholecystitis - what is it? As the disease progresses, the gallbladder deforms and its structure changes. The walls of the organ thicken and atrophied tissue appears. Under such conditions, in the muscle membrane are formed fibrous tissue. In the process of development of pathology, adhesions may occur. Bile duct mates with the surrounding tissue and organs, microabscesses, pericholecystitis develop. The disease develops due to the introduction pathogenic microorganisms from the intestines or through the bloodstream. It can be:

• enterococci;
• staphylococci;
• coli and other pathogenic microorganisms.

There are several factors that provoke the appearance of the disease, namely:

• bowel disease;
• colitis;
• enterocolitis;
• dysbacteriosis;
• advanced form of chronic pancreatitis;
• development of periodontal disease, pyelitis, pneumonia;
• appendicitis.

Non-calculous cholecystitis - what is it and what are the causes of exacerbation of the disease? This type of cholecystitis is characterized by inflammation of the gallbladder, while stones are absent. The disease is aggravated against the background inactive image life, systematic stress, malnutrition, sphincter dysfunction biliary tract.

Symptoms of the disease

During the development of the pathology, the patient experiences discomfort and discomfort. What are the signs chronic cholecystitis? They appear as:

1. Periodic bouts of pain, which is localized in the right hypochondrium. Most often, discomfort occurs after eating or minor physical activity.
2. Nausea.
3. Bitter belching and heartburn.
4. Vomiting.
5. Intestinal disorders.

Pain may appear in the area chest or belly. In some cases, patients confuse such symptoms with cardio problems or lung diseases. Symptoms and treatment of non-calculous cholecystitis - this is the topic that is important to discuss with the doctor.

cholecystitis is independent disease, which appears due to traumatic injury or severe illness. Provoke the appearance of signs of chronic cholecystitis can be surgical interventions that did not even touch digestive system. The disease is dangerous because it can actively progress and move into more complex forms. Doctors recommend treating the disease in a timely manner, as this will help prevent the development serious complications. At home, it is impossible to carry out a thorough diagnosis of diseases. It is important to visit a qualified doctor. Based on the results of the study, the attending physician will prescribe a treatment that will help overcome the disease.

Diagnostic process

According to ICD-10, cholecystitis includes several subheadings. Namely:

• K81.0 - Acute cholecystitis.
• K81.1 - Chronic cholecystitis.
• K81.8 - Other forms of cholecystitis
• K81.9 Cholecystitis, unspecified

Based on the results of the patient's diagnosis, the doctor determines the form of the disease. In the process of examining a patient, it is important to carry out a biochemical blood test, ultrasound, cholecystography, bacterial culture bile to detect pathogenic microorganisms. AT without fail the doctor examines the patient by palpation. Those people who have been diagnosed with diseases of the biliary tract or ulcerative colitis, it is necessary to visit a doctor regularly and carry out careful medical research This will help prevent the development of other diseases. Signs of acalculous cholecystitis practically do not differ from other forms of pathology, so it is important to visit a doctor.

Based on the results of the diagnosis, the doctor makes a diagnosis and prescribes complex therapy which will help to overcome the disease.

Treatment process: eat right

During therapy, it is important to follow a diet. It is recommended not to eat spicy and smoked foods. Avoid alcohol and chocolate. Only complex treatment requires non-calculous cholecystitis. Clinical guidelines include diet. It is necessary to remove from the diet those foods that provoke active bile secretion. All foods must be boiled or steamed. After the moment when the disease goes into remission, it is necessary to bake all the ingredients. It is necessary to take food fractionally, in small portions.

Drug therapy

To eliminate pain, the doctor prescribes an anesthetic. With the help of "Platifillin" and "No-shpa" spasms are stopped. In a state of remission, chronic non-calculous cholecystitis does not cause severe discomfort to the patient, but still needs to be destroyed. pathogenic microflora, for this you should take an antibacterial drug.

To increase bile secretion, it is necessary to stimulate the gallbladder. For this you need to take the following drugs: "Holenzim" and "Allohol". In the event that there is no positive dynamics in the process of treatment with medications, while the gallbladder is deformed and there is severe inflammation that covers the pancreas, surgical intervention should be performed. Choice of method surgical intervention based on the overall clinical picture. Much depends on the severity of the disease and physiological characteristics the patient's body. AT rare cases apply abdominal surgery because the patient needs a lot of time to recover. During the period of exacerbation of non-calculous cholecystitis, it is important to eliminate inflammatory process through proper nutrition and herbal medicine.

How to eliminate the inflammatory process with alternative methods of therapy?

Before you carry out treatment with a folk remedy, it is important to consult a doctor. Do not underestimate the various herbal infusions, as they have exactly the same strong effect as antibiotics. If you use such drugs not as prescribed by the attending physician, then there will be health complications. Among the most effective means, which will help relieve the inflammatory process, emit:

1. 2 tbsp. l. corn stigmas must be poured with two glasses of boiling water. Let it brew for about an hour. Drink every 4 hours for 1.5 tbsp. l. until the pain disappears.
2. Veronica drink is brewed in the same way. For 2 st. l. plants need to take 2 cups of boiling water. Pour boiling water over the herb. When the healing agent is infused, it is necessary to drink 200 ml per day - divide this amount into several doses. The duration of the course of treatment is determined strictly by the doctor.
3. 1 st. l. sage must be poured with a glass of boiling water. Let it brew and use 2 tbsp. l. 2 times a day.
4. 4 tsp hop seedlings pour a glass of boiling water, let it brew. Drink 150 g before meals.
5. With the help of a decoction of plantain, you can relieve inflammation and improve general state patient's health. To prepare a healing agent, you need to pour 40 g of the plant into 450 ml of boiling water. Let it brew for 20 minutes. Cool and strain. Drink 150 ml several times a day.

Before use healing remedy you should consult your doctor, as there may be side effects.

Folk methods of treatment

To improve the general state of health and eliminate the inflammatory process, it is necessary to drink mineral water with dissolved Sorbitol. Then you should drink 90 ml vegetable oil. Next, you need to lie on your right side and place a heating pad under the gallbladder area.

In some cases, the doctor recommends doing a specific exercise, twisting, squatting, or bending over. The gallbladder is cleared within 2 hours. If a stool become yellowish or greenish tint, no need to worry - this way excess bile is removed from the body.

Before implementing any method of therapy, it is necessary to consult a doctor, since self-medication at home can be fatal.

With the help of milk thistle, lingonberry leaves, bearberry, plantain, wild rose, calendula, mint, corn stigmas, fennel, wormwood, celandine, folk treatment cholecystitis. Depending on the individual characteristics the body of the patient, the doctor combines herbs. Thanks to diet and folk remedies, you can eliminate the inflammatory process and improve your overall health. You should know that only complex treatment will help to completely cure the disease. In some cases, you can not do without potent drugs.

Effective medicines

Acute cholecystitis according to ICD-10 is assigned code 81.0. This is a non-specific inflammatory process of the gallbladder, during the treatment of which it is important to eliminate the inflammatory process. To suppress the infection in the biliary tract, doctors prescribe an antibiotic. Among the most effective are:

• "Norfloxacin";
• "Nolitsin";
• "Norbaktin".

• "Ofloksatsin", "Tarivid", "Zanotsin" 0.5 g 2 times a day.
• "Ciprofloxacin", "Tsiprobay", "Tsiprolet", "Cifran" 2-4 g several times a day.
• "Levofloxacin", "Tavanic" or "Levofloxacin" 2-4 g several times a day.
• During therapy, the doctor prescribes semi-synthetic penicillins. "Ampicillin" 0.4 g - several times a day. "Oxacillin" 0.4 g twice a day.
• With advanced disease, treatment is carried out with the help of "Klaforan", "Cefepima".

You should be aware that only approximate dosages are indicated in the instructions for the use of drugs. The duration of the course is determined strictly by the attending physician, depending on the individual and physiological characteristics of the organism of each patient. Self-medication can harm and provoke active development illness.

If an allergy to antibiotics is detected, then experts prescribe Biseptol or Bactrim. It is recommended to take one tablet several times a day. With the help of "Gastrocepin", "Buscopan", "Platifillin" you can eliminate a strong painful sensation, which causes discomfort, prevents you from fully moving and leading a familiar lifestyle.

Chamomile treatment

In the process of treating acalculous cholecystitis, experts recommend drinking chamomile tea. To prepare it, you need 2 tsp. raw materials pour a glass of boiling water and let it brew. Strain and drink before meals, several times a day. This approach will not only improve general well-being, but also strengthen the immune system and help you recover faster. Chamomile tea will strengthen sleep, help a person to fully relax and gain strength to fight the disease. You can add a spoonful of honey to the drink, so it will not only be tasty, but also healthy. Honey strengthens the immune system and saturates the body useful elements.

Note to the patient

Now it is clear what it is - non-calculous cholecystitis. it serious illness, which is able to progress and move into more complex forms. In the process of development of the pathology, the patient experiences pain and severe discomfort in the affected area.

At home, it is impossible to carry out a thorough diagnosis of diseases. For this reason, it is important to consult your doctor and carry out a thorough medical diagnostics. Under these conditions, the doctor will be able to put reliable diagnosis and appoint effective treatment, which in as soon as possible will improve overall well-being. It is forbidden to self-medicate and take medications without a doctor's prescription. The doctor studies the case history of chronic non-calculous cholecystitis and selects effective therapy depending on the general health of the patient and individual clinical picture. Folk remedies should be used only according to the recommendations medical worker. Herbs and infusions have exactly the same strong effect as strong drugs, so misuse can even lead to death.

To prevent the development of pathology, it is important to treat other diseases in a timely manner and undergo regular medical examinations. In the treatment of non-calculous cholecystitis, diet plays a role important role and affects the speed of the recovery process of the patient. healthy image life, proper nutrition, regular examination by a doctor will help reduce the risk of developing pathology.

The inflammatory process in the wall of the gallbladder is caused by pathogens:

1. Staphylococci;
2. Escherichia (E. coli);
3. Streptococci;
4. Enterococci;
5. Proteus;
6. Pseudomonas aeruginosa.

They enter the gallbladder ascending path from the intestines, as well as with blood and lymph. Therefore, the risk group includes people with infectious lesions of the intestines and liver.

On the initial stage disease when disturbed motor function of the gallbladder, especially in combination with a change in the composition of bile, a focus of inflammation appears in its mucosa. After this, the infection joins and a chronic inflammatory process begins to develop, followed by deformation of the organ and thickening of its walls.

Symptoms and types

For acalculous cholecystitis, pain in the right hypochondrium is characteristic, arising or intensifying, as a rule, after taking "harmful" food. The pain is aching in nature and can last for several hours or even days, sometimes giving to the right lumbar region, shoulder blade or shoulder. During the exacerbation of the disease appear additional symptoms such as: high fever, nausea, bitter taste in the mouth, jaundice.

The development of chronic non-calculous cholecystitis can occur slowly and almost imperceptibly, over many months, or occurs after an episode acute cholecystitis. According to its severity, the disease can be mild, moderate and severe. The stage of exacerbation of the disease is gradually replaced by the stage of remission, which is persistent and unstable.

Diagnosis of the disease

The first step is to examine and palpate the patient. Already on the basis of the patient's complaints of pain in the right side, aggravated after taking fried and fatty foods, and coated tongue (evidence of bile stasis), the doctor may suggest the presence of chronic cholecystitis. To clarify the diagnosis, a general and biochemical blood test is prescribed, during an exacerbation of ESR and the number of leukocytes is usually overestimated.

Diagnostics acute form non-calculous cholecystitis is carried out much faster, due to the presence of high temperature, pain on palpation in the right hypochondrium and leukocytosis.

If there are no characteristic symptoms, diagnosis is carried out using instrumental methods:

• ultrasound of the biliary tract,
• duodenal sounding,
• oral cholecystography,
• intravenous cholegraphy and others.

This disease does not always proceed classically, sometimes it manifests itself in a number of syndromes, which at first glance are not characteristic of it:

1. Dyspetpichekie disorders - belching, nausea, bloating and a feeling of heaviness in the abdomen.
2. Syndrome of vegetative-vascular dysfunction - instability blood pressure and pulse.
3. Neurotic syndrome - suspiciousness, a tendency to anxiety and hypochondria. In some cases, these symptoms overshadow the slight pain in the right hypochondrium.
4. Increasingly, this disease occurs under the "allergic mask". Recurrent urticaria is observed when the biliary tract is affected by Giardia.
5. Cardiac syndrome, manifested by reflex angina, is mainly observed in elderly patients with calculous cholecystitis who have overweight or obesity.

Treatment and prevention

Treatment for non-calculous cholecystitis is usually conservative methods in a hospital setting.

The exception is patients who have:

• frequent exacerbations,
• severe pain,
• gallbladder deformity,
• a significant decrease in contractile function.

Treatment of the acute stage of the disease

At severe exacerbation treatment starts with antibacterial drugs. Intramuscular or intravenous antibiotics a wide range actions (Cefazolin, Cefatoxime and others). May be assigned internal reception Clarithromycin, Erythromycin and Ciprofloxacin.

Severe intoxication is eliminated by intravenous drip administration of Hemodez. The course consists of 3-4 introductions.

To relieve spasm of the gallbladder and improve the outflow of bile, No-shpu (drotaverine), Papaverine is prescribed.

Creon, Pancreatin, Mezim-forte and other enzyme preparations restore normal digestion. They are recommended to be taken within two weeks.

Choleretic drugs (Allochol, Cholenzim), which enhance the formation of bile, are used with caution, as they can provoke pain.

Patients who have reduced motor function of the gallbladder, cholecystokinetics are also recommended, which, along with increased bile secretion, stimulate the contraction of the gallbladder.

Treatment without exacerbation

After it was possible to eliminate pain and relieve inflammation in patients with chronic non-calculous cholecystitis (with insufficient motor activity gallbladder) it is recommended to do blind tubes once a week with a solution of magnesium sulfate, sorbitol, xylitol.

Improving well-being during periods of remission contributes Spa treatment near springs mineral waters(Zheleznovodsk, Truskavets, Essentuki). Successful treatment both stages of chronic non-calculous cholecystitis cannot be imagined without observing special diet and phytotherapy.

If you have been diagnosed with this diagnosis, you must be registered with a general practitioner or gastroenterologist and undergo preventive examination.

1. Normalization of body weight
2. Drinking at least 2 liters of fluid throughout the day
3. Regular bowel movements
4. Compliance with the diet
5. Daily physical activity
6. Early detection and treatment acute stage diseases

Possible complications and further prognosis

In most cases, when mild form acalculous cholecystitis, further prognosis is favorable. However, frequent exacerbations in combination with comorbidities can contribute to the development chronic cholangitis, reactive hepatitis and most dangerous complications- education purulent sac in the cavity of the gallbladder (empyema) and perforation of its wall, with the subsequent development of peritonitis.

Treatment of chronic non-calculous cholecystitis is selected individually for each patient only after the doctor compares the symptoms of the disease with the results. clinical research and make an accurate diagnosis. Therefore, if you find signs of cholecystitis in yourself, do not postpone a visit to the hospital.

Non-calculous cholecystitis (calculous) is a disease of the gallbladder, which is characterized by long-term inflammation. In this case, fibrosis of the walls of the organ occurs and peristalsis is disturbed. The most common form of the disease is chronic. It develops against the background of infection or malnutrition.

It is assumed that this disease is a prerequisite for the further appearance of cholesterol calculosis, which is characterized by the presence of stones in gallbladder.

This disease is an inflammation of the gallbladder, in which:

• the walls of the organ are deformed and compacted;
• the mucous membrane becomes thinner;
• scarring occurs;
• muscle fibers increase.

As inflammation progresses, adhesive process bladder with neighboring organs and other diseases of the gastrointestinal tract develop. Cholecystitis is mild, moderate and severe.

Also, the disease is divided according to the nature of the course:

• monotonous;
• recurrent;
• variable.

Another classification of cholecystitis is its form - typical and atypical. In chronic non-calculous cholecystitis, the percentage deaths higher than in calculous disease. But the acute form of the disease is much more common than the chronic form.

Clinical symptoms

Chronic cholecystitis can turn into an acute form in the presence of diabetes, as well as at prolonged fasting, bile stasis and surgical intervention. According to statistics, this disease develops in 7 people out of a thousand. Women and children are more susceptible to it than men.

Clinical manifestations of non-calculous cholecystitis are determined by the progressive course of the disease with relapses, remissions and exacerbations. The main symptom of the disease is pain in the right hypochondrium. Duration pain may be up to several weeks.

The pain may increase if the diet is not followed, i.e. when using spicy and fatty foods, eggs, carbonated and alcoholic drinks.

If the inflammation spreads to neighboring tissues, then pericholecystitis develops, in which the pain becomes constant and more intense. It can occur when changing the position of the body or tilt, giving to the lower back, right shoulder blade, shoulder and neck. In some cases, there is a feeling of pain in the region of the heart.

Other symptoms of chronic cholecystitis are:

In the acute stage, symptoms may appear that have common features with intoxication (chills, headaches, worsening sleep, weakness and general malaise). If the body temperature is above 38 degrees, then complications such as bladder empyema or have probably developed.

In some cases, patients may show signs uncharacteristic of acalculous cholecystitis:

• bloating;
• tachycardia;
• constipation or diarrhea.

On the initial stage disease, there is a decrease in the motor activity of the bladder, and then an infection develops. In the future, the body becomes inoperable and stagnation of bile develops. Then changes in the shape and structure of the organ begin, accompanied by the appearance of adhesions with the nearest organs.

Causes of the disease

Many people are interested in the question of this disease- non-calculous what is it , and what are its causes? Most often, it develops due to infection of the gallbladder with staphylococci, E. coli, Proteus, enterococci, or other pathogens.

Infection enters the body through the intestines in the presence of dysbacteriosis, chronic pancreatitis, colitis and other diseases of the gastrointestinal tract. Infection through the lymph or blood is also possible against the background of inflammation of the lungs, appendages, appendix.

Other causes of cholecystitis include:

• reduced tone of the gallbladder;
• anomalies in the structure of the organ (squeezing, bending or constriction);
• prolapse of the abdominal organs;
• violation of peristalsis;
• deterioration of the outflow of bile;
• stress;
• inflammatory processes.

This disease often appears in women during pregnancy, especially if they are sedentary image life and malnutrition ( large portions and rarely).

Diagnosis

It is possible to decide how to treat non-calculous cholecystitis only after setting accurate diagnosis. For this, the patient's medical history and his complaints about well-being are taken into account, and medical checkup, during which the doctor determines the localization of pain and the degree of their severity.

In most patients, plaque forms on the tongue, which is a sign of bile stasis.. In addition, there are still such symptoms for determining the presence of acalculous cholecystitis, such as the symptoms of Chauffard, Murphy and Mussy.

The most accurate diagnosis requires laboratory tests:

• General blood analysis. During the period of exacerbation of the disease, the number of leukocytes contained in the blood increases, and during remission they decrease.
• Analysis for biochemistry.

Also, to make a diagnosis, they resort to instrumental methods of examination.:

1. Oral cholecystography necessary to establish the state of the bubble, its shape and location. This method is rarely used.
2. Gastroduodenal sounding to detect pathologies of organ peristalsis. In this way, infectious agents are identified. During an exacerbation, the level of protein in bile increases, and at the stage of remission, on the contrary, it decreases. For chronic stage cholecystitis is characterized by an increase in bilirubin and free amino acids. Also this way diagnostics will reveal cholesterol crystals.
3. Intravenous cholegraphy used for severe course diseases when there is no shadow of the organ in the pictures.
4. Ultrasound of the biliary tract, allowing to determine the parameters of the bladder, its contractile function and wall thickness.
5. celiacography for the study of the cystic artery. This method allows you to explore the walls of the body with a thickness of 2 mm.
6. bubble.
7. x-ray.

Therapy

Symptoms and treatment of non-calculous cholecystitis depend on the form of the disease - acute or chronic. At chronic form prescribed medication and diet therapy.

Drug therapy consists of taking the following drugs:

AT recent times of antibiotics, Clarithromycin has become increasingly prescribed for chronic cholecystitis or exacerbation.

Treatment of the acute form of the disease is carried out in the gastroenterological or surgical department. The duration of such treatment is from 1.5 to 2 months, and then the patient is transferred under dispensary observation. The gastroenterologist will have to constantly examine the patient and prescribe necessary drugs taking into account the current nature of the course of the disease.

To avoid the possibility of recurrence, it is necessary preventive measures including elimination of ductal dyskinesia and diet. With untimely detection of cholecystitis, diseases of other organs can develop, leading to inflammation and serious pathologies. That is why it is important to diagnose the disease in time and start its therapy.

This disease is also treated folk remedies. For example, herbal decoctions of yarrow, licorice, buckthorn, tansy and marshmallow. Pharmacies sell ready-made choleretic fees which will improve the secretion of bile. But before using them, you should consult your doctor.

diet therapy

Also assigned to medicinal purposes the diet should be easy. For its compilation, the general condition of the patient and the course of the disease are taken into account. An important component of the treatment of cholecystitis is proper nutrition. Meals should be taken in small portions 4-6 times a day.

In the event of an exacerbation of the disease, it should be excluded from the diet.:

Products must be taken warm, because cold food may cause, main function which is the regulation of the outflow of bile.

It is also necessary to adhere periodically unloading days on the fermented milk products. With the onset of remission, the patient's diet expands slightly, but you should still adhere to the basic prohibitions.

Prevention

To avoid exacerbation of acalculous cholecystitis, it is worth observing the basic preventive measures:

Conclusion

In order to prevent non-calculous cholecystitis, you must carefully monitor your health and observe general hygiene standards. It is also necessary to empty the intestines as needed, which will help to avoid biliary dyskinesia and remove cholesterol from the body. In addition, inflammation of the peritoneal organs should be treated in time and pathogens should be avoided. food allergies.

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Non-calculous cholecystitis or stoneless cholecystitis affects every seventh person per 1000 cases. The frequency of diseases in the female half of the population is 4 times higher than the recorded cases in men. The disease affects adults and young people. Presumably, chronic non-calculous cholecystitis is a prerequisite for cholesterol calculosis with the formation of stones.

Description of the disease

Non-calculous cholecystitis develops in the gallbladder in the form of inflammation with changes in the structure and tissues of the organ, in which:

• compaction and deformation of the walls;
• thinning of the mucosa, which becomes like a grid;
• increase in muscle fibers;
• scarring.

If the inflammation goes deeper, adhesions form at the border with neighboring tissues and organs. Other diseases of the gastrointestinal tract begin to develop.

There are 3 stages of cholecystitis:

• light;
• middle;
• severe degree.

The disease is characterized by phases:

1. Exacerbations.
2. Subsidence of the acute phase.
3. Persistent or unstable remission.

By the nature of the flow:

• monotone;
• recurrent;
• variable.

The form of the disease is distinguished:

• typical;
• atypical esophagalgic, intestinal, cardiological form.

Chronic acalculous cholecystitis is diagnosed more often than it occurs. Diagnosis can only be made in the outpatient clinic. According to statistics, the disease is 5-10% total number cases of acute cholecystitis. The chronic acalculous form has more high percent mortality compared to calculous disease.

Etiology with pathogenesis

The first indicator of the onset of the disease - pain syndrome after eating on the right under the ribs. Feeling dull, constantly aching pain given to cervical region, right shoulder with a spatula. The condition is characterized by nausea with vomiting, a bitter taste in the mouth, which is caused by the outflow of bile into the esophagus and stomach.

The chronic form of acalculous cholecystitis is characterized by stages of exacerbations and remissions, which replace each other.

The disease is diagnosed on the basis of the patient's medical history, heredity, complaints, examination, and according to the results laboratory tests with ultrasound. On palpation of the abdominal muscles, the patient feels pain on the right and in the navel area. Yellowness of the integument is not visualized.

It is possible to increase the temperature to subfebrile indicators (37-37.5 ° C), which persist for a stable time. A blood test shows signs of an inflammatory process: leukocytosis, high ESR, percentage change different types leukocytes. Ultrasound shows an increase in the gallbladder with compacted walls, its inflection, dyskinesia (dysfunction) of the bile ducts with bile stasis.

The cause of the pathology is an infection, the causative agents of which are coli, staphylococcus, enterococcus, proteus or mixed pathogenic flora. The infection enters the organ on the way back - from the intestines with dysbacteriosis, enteritis, colitis, chronic pancreatitis and other pathologies of the gastrointestinal tract. It is possible to infect the gallbladder through the bloodstream or lymph with inflammation of the appendix, uterine appendages, lungs, gums, or with chronic tonsillitis.

The main predisposing factor is biliary stasis, which occurs due to dysfunction of the gallbladder and ducts due to:

• developmental anomalies (constrictions, kinks, compression);
• decrease in peristalsis;
• endocrine dysfunction;
• psycho-emotional stress;
• existing inflammatory processes;
• prolapse of the peritoneal organs;
• sedentary work with prolonged immobility;
• rare and plentiful food;
• pregnancy.

Symptoms

The disease proceeds for a long time with attacks and improvements. To characteristic symptoms relate:

• aching pain on the right under the ribs, which are aggravated after eating eggs, cold, hot, fried, fatty, smoked, carbonated, alcoholic;
• nausea with vomiting;
• bitter taste with frequent belching.

Atypical symptoms are characterized by:

• long, dull pain attack in the area of ​​the projection of the heart after eating;
• severe heartburn;
• swallowing dysfunction;
• bloating in the intestines;
• constipation.

Seizures may recur with severe physical activity and severe stress. You may also experience:

• arrhythmia with increased heart rate;
• pain attacks with diarrhea.

Diagnostics

There are several ways to diagnose a non-calculous disease:

1. Clinical studies with blood biochemistry, general analysis blood and urine.
2. Examination of the patient with the analysis of the patient's complaints. When examining the oral cavity, a scalloped plaque is found, which indicates stagnation of bile.
3. Palpation with an assessment of the patient's pain sensations.
4. Ultrasound examination of the gallbladder.
5. HIDA scintigraphy on a gamma tomograph using radiopharmaceuticals.
6. Duodenal study of the contents of the 12 duodenal process, consisting of bile with intestinal, gastric and pancreatic juice.
7. X-ray examination of the bladder after oral intake contrast agent.
8. X-ray examination of the bladder after intravenous infusion of contrast.
9. Classic X-ray examination.

Treatment

With a strong pain syndrome, a gross change in the structure of the gallbladder, a significant reduction in peristalsis, especially if exacerbation occurs frequently, it is recommended to treat cholecystitis in a hospital for 10-14 days. Therapeutic goals:

• elimination and prevention of exacerbations;
• prevention of inflammation of other organs that have arisen against the background of pathology;
• treatment of complications;
• elimination of pain;
• stabilization of the functions of the bile and motility of its tubules;
• inhibition of infection and inflammation in the bladder;
• restoration of normal digestive function, disturbed biliary system.

Treatment methods:

1. Diet with nutritional optimization. For this, foods that irritate digestion are excluded, fractional and frequent use food in small portions. This will allow the gallbladder to regularly eject bile. Dishes need to be boiled, steamed. Vegetables and fruits are best baked in the oven. The diet must be followed for a long time.
2. Drug therapy is based on taking medications: antispasmodics, antibiotics, detoxifiers, enzyme preparations, choleretics, cholecystokinetic agents.

At the stage of remission, which occurs against the background of hypokinesia of the gallbladder, the treatment is supplemented by other methods:

1. The use of blind tubes or soft washing of the liver with bile and their ducts. To do this, a solution is prepared on xylitol, sorbitol in a 30% solution of MgSO4 or mineral water. Do from 6 to 8 tubes every 7 days.
2. Admission Based Phytotherapy herbal decoctions yarrow, marshmallow, tansy, buckthorn, licorice.
3. Sanatorium treatment in health resorts.

Article prepared by:

Non-calculous cholecystitis pathological condition flowing in the gallbladder, and at the same time is not characterized by the formation of stones. The disorder can be acute or chronic. Symptoms of acalculous cholecystitis depend on the type of disease. A deviation is formed most often against the background of malnutrition and infectious lesions. Defeat always has inflammatory character. Treatment of pathology should be comprehensive. With a deviation, the biliary function is disturbed. Women are most susceptible to the formation of pathology. Violation can develop against the background of other diseases. The disease occurs regardless of age and gender.

In this article you will learn:

Reasons for the formation of the disease

Pathology is formed in interaction with some internal and external factors. The underlying causes and risk factors are listed in the table.

Become the root cause of the pathology may be the wrong lifestyle and diet. The disorder may be the result of irregular meals and the abuse of alcohol-containing drinks and harmful products.

The symptoms and treatment of acalculous cholecystitis depend on the individual patient. Pathology often occurs in women during the period of bearing a child. This is due to the active restructuring of the body and a decrease in immune system. Therapy should be selected by the attending physician. Accept any medical preparations during pregnancy should be used with caution.

A prerequisite for the development of the disease may be an insufficient amount of fruits and vegetables consumed.

Chronic or acute acalculous cholecystitis may result from impaired functioning endocrine system. At timely treatment pathology will not cause any discomfort. The deviation can be located not only in the gallbladder, but also in the ducts.

Pathology can also form as a complication of hepatitis. In this case, the deviation proceeds in a chronic form. In the presence of all the root causes, natural motor skills are disturbed. There is an active development of the disease.

How the disease manifests itself

Pathology is characterized by a protracted and progressive course. Periodically there are attacks of exacerbation. The main signs of deviation include:

• vomiting reflex;
• bitter belching;
• bitterness and dryness oral cavity;
• alternating constipation with diarrhea.

Symptoms and treatment of non-calculous cholecystitis cause significant discomfort to the patient. The patient has severe pain in the right hypochondrium. The character of the sign is dull and aching.

A painful sensation can be present for a long period - from 3 hours to several days.

The intensity of symptoms increases after the use of:

• high-calorie;
• alcoholic beverages;
• sodas;
• acute;
• overly salty.

At the advanced stage, the inflammatory process spreads to the area around the gallbladder. In this case, the painful sensation becomes regular. The symptom is able to change localization and move to right side neck, shoulder, waist.

The patient is worried metallic taste in the oral cavity. The patient complains of fever and an increase in body temperature. Efficiency is rapidly declining and there is pain in the temples and the back of the head.

You can suspect the occurrence of complications in the presence of a temperature above 38 degrees. The figures are increasing rapidly. However, in the initial forms of pathology, they do not exceed 37.9.

You need to go to the doctor immediately if you have:

• prolonged pain syndrome under the right rib, which radiates to the lumbar region;
• gag reflex with impurities;
• metallic taste in the mouth;
• significant increase in body temperature.

In the presence of an advanced form of pathology, the patient may experience pain in the region of the heart. Also, the patient is faced with sleep disturbance and irritability.

Diarrhea alternates with constipation. Fever is present and constant weakness. When spreading to the intestines, flatulence and pain in the organ occur. If left untreated, the condition will deteriorate rapidly.

Possible Complications

Treatment of acalculous cholecystitis will help prevent the formation of complications. With a mild form of the disease and timely therapy, the risk of developing concomitant diseases is low, and the prognosis is favorable.

Regular exacerbations can cause the formation of chronic cholangitis and reactive hepatitis. The neglected form of the disease leads to the development of:

• pathological opening in the wall of the abdominal cavity;
• gangrene of the gallbladder;
• peritonitis;
• sepsis.

If untreated, the contents of the gallbladder through the opening enters digestive organ. Decomposition of mucous membranes may occur. The patient's condition is rapidly deteriorating. The usual way of life becomes impossible due to the ever-present discomfort.

Diagnostic methods

Diagnosis begins with an initial examination. Symptoms and treatment of acalculous cholecystitis are individual. Ignore the need to visit medical institution it is forbidden. Therapy should be selected only by a doctor on the basis of a comprehensive study.

Palpation of the abdomen in the presence of pathology is painful. The intensity of the sign increases with exhalation. When establishing preliminary diagnosis"non-calculous cholecystitis", the patient is given a referral for laboratory tests:

• general blood examination;
• blood chemistry.

You can not do without instrumental diagnostic methods. The patient is directed to:

• duodenal sounding;
• intravenous cholegraphy;

At biochemical analysis blood is determined by an increased level of transaminases and alkalis. With the help of duodenal sounding, it is possible to assess the degree of inflammation of the gallbladder. In pathology, turbidity of bile is diagnosed.

In the bile there are extraneous flakes and mucus. The level of leukocytes in the liquid is increased. There is a microbial flora. Among the echographic signs of pathology, deformation of the walls is distinguished. They become thicker and cause poor contractility of the gallbladder. Ultrasound is one of the most informative diagnostic methods. It allows you to estimate the size of the gallbladder. The organ is usually enlarged.

Treatment of pathology

Treatment directly depends on the form of pathology. Therapy is carried out during the period:

• remissions;
• exacerbations.

In remissions, emphasis is placed on sparing nutrition. The diet is selected individually, depending on the neglect of the pathology and some features of the body.

With exacerbations, it is important to give preference to taking medication. Drug therapy comprises:

• antibacterial drugs;
• antispasmodics;
• anti-inflammatory drugs.

The patient needs constant medical supervision. Therapy acute type illness lasts for several months. Periodic re-examination is required.

Even after complete recovery, the patient must observe strict diet. It is recommended to restore the immune system with the help of spa treatment. It is also necessary to give preference to preventive measures.

The patient should exclude fried and fatty foods from the diet. Treatment of chronic acalculous cholecystitis with folk remedies is effective only in combination with medications. Before using any natural ingredients you need to consult a doctor.

They have high efficiency corn silk and immortelle grass. Decoctions are prepared from these plants. You can pre-mix them. To prepare the medicine, take 3 tbsp. l. mixtures. The components are poured with boiling water in an amount of 500 ml. The medicine is insisted for 3 hours. Consume after each meal 100 ml.

Forecast

The initial stage of the disease with rare exacerbations has a favorable prognosis. Therapy does not take away a large number time. Pathology proceeds easily and does not provoke the appearance of complications. If there is no treatment for chronic acalculous cholecystitis, the patient's condition will worsen.