What to do with biliary dyskinesia. Symptoms and treatment of biliary dyskinesia (JVP). The structure of the gallbladder wall

Every mother tries to feed her baby well, chooses the right and healthy food. However, sometimes it happens that the child does not eat well, refuses even his favorite dishes. Such behavior can become serious reason to visit a gastroenterologist. Especially if the refusal of food is accompanied by pain in the abdomen and a violation of the stool.

If the baby is also added pain under the right rib, a bitter taste in the mouth, there is reason to suspect DZHVP - biliary dyskinesia - and seek the advice of a specialist.

If the child has lost his appetite and complains of pain under the right rib, you should immediately seek medical help and undergo a complete examination of the body.

What is JVP and what types of this disease are found?

Biliary dyskinesia often occurs in preschool children. Some experts call it the most common violation to date. This is a disease in which the normal outflow of bile is disturbed. The gastrointestinal tract can not cope, and bile stagnates in the gallbladder or, conversely, comes too quickly.

Why is bile needed in the body and why is its transportation to the body so important? duodenum? it digestive juice required for normal functioning digestive systems. Bile is produced in the liver and delivered to gallbladder and stored there. When food enters the duodenum, bile is expelled through the bile ducts.

Its significant function is the breakdown of fats into fatty acids. When bile does not arrive on time, digestion useful substances from food is broken. Stagnation also carries a threat to the child's body, because harmful substances are excreted with bile ( medications, toxins, metabolic products).

Disorders of bile secretion are distinguished by hyperkinetic and hypokinetic type: too fast or too slow flow of bile. If we talk about the age of the patient, then babies from three years old and young people are at risk. JVP can be a temporary phenomenon during the period of rapid growth of the musculoskeletal system in adolescents.

Why does biliary dyskinesia occur in children?

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Like any dysfunction in the body, biliary dyskinesia in children does not occur suddenly. This is facilitated by a long process of illness or a violation right image life.

It is customary to divide JVP into primary and secondary. When talking about primary violations of the outflow of bile, the impact on the body of various pathogenic factors is implied:

• disturbed diet: long periods of time between meals, overeating, an abundance of fatty and fried foods in the diet, excessive consumption of sweets and unhealthy foods (fast food, sweet sparkling water);
• violations nervous system due to constant psychological and emotional upheavals;
• inertia, sedentary lifestyle;
• allergies, including chronic;
• taking medications that contribute to a change in the composition of bile.

Secondary violations of the outflow of bile occur as a manifestation of existing diseases. These include:

An important role is played by heredity. If there is such a diagnosis in the anamnesis of the closest family members, the baby is also likely to have a violation. It happens that the root cause of JVP is associated with congenital anomalies such as gallbladder dysplasia.

Symptoms in a child

Symptoms of the disorder depend on the type of biliary dyskinesia - hypertonic or hypotonic.

Hypertensive JVP

Hypertensive DZHVP is expressed in the increased removal of bile, which is secreted quickly and often.

Her signs:

• acute pain under the ribs after exercise, stress, diet violations (it happens that children complain of pain after running in physical education classes);
• episodes of vomiting, nausea;
• profuse urination;
• gastrointestinal upset (constipation or diarrhea);
• lack of appetite;
• yellowing of the tongue;
• sudden weight loss, tired, haggard appearance.

extreme hypertensive dyskinesia ZhVP becomes biliary colic. She is recognized by her sudden severe pain, palpitations, panic attacks, and numbness in her limbs.

Hypotonic JVP

The hypotonic type occurs when the tone of the gallbladder is low. When bile does not enter the duodenum in a normal volume, stagnation occurs.

Symptoms of this type of biliary dyskinesia:

• a feeling of heaviness, dull, implicit pain in the hypochondrium on the right, which occurs after eating junk food or stress;
• bitterness is felt in the mouth;
• nausea, bloating, belching;
• appetite decreases;
• the baby suffers from constipation;
• one of the telling symptoms is constant desire something to chew;
• temperature 37.2-37.5 ° C due to the inflammatory process caused by bile stasis (in this case health care must be provided immediately).

Babies are very worried, often pulling their legs to the tummy. Children under one year old are underweight, often spit up.

AT last resort hypotonic JVP occurs stagnation of bile in the biliary tract. It can be recognized by intense itching all over the body, yellowness of the skin and whites of the eyes, dark urine and light yellow or grayish stools.

Mixed JVP

AT pure form the hypotonic form is rare, more often there is a mixed form of dyskinesia, when the hypertonic form is replaced by a hypotonic one. This disease is characterized by dysfunction of the autonomic nervous system, the child becomes whiny, irritable, unbalanced, appears fast fatiguability, schoolchildren become inattentive and restless. Between attacks, the baby may not be bothered by anything, he feels satisfactory.

Why is biliary dyskinesia dangerous? Violation of the outflow of bile negatively affects general condition organism. Dysfunction of the outflow of bile can cause the development of serious diseases:

• cholangitis (inflammation bile ducts);
• cholecystitis (inflammation of the gallbladder);
• cholelithiasis (formation of sand and stones in the bile ducts) and others.

Timely diagnosis, normalization of the process of digestion and removal of bile will prevent complications. It is not worth delaying contacting a specialist - children's body sensitively responds to any violations and deviations in his work.

Diagnosis of the disease

Identified biliary dyskinesia requires immediate treatment to a gastroenterologist and treatment. No self-treatment in this case is unacceptable, therapy should be prescribed by a qualified specialist.

Basic Treatments

Once a diagnosis of ADHD is made, treatment should begin immediately. The specialist will determine the root cause that led to the development of the disorder, and appointments will be directed to cures for the underlying disease. They are made individually, because various ailments lead to dysfunction of the gallbladder.

Newborn children are necessarily placed in a hospital, older children are at home under supervision medical worker. Children are also admitted to the hospital serious condition or if not possible complete care for the baby at home.

Usually, recovery occurs in three weeks in an adult, in a child in two weeks, provided that all prescriptions are observed. First time shown bed rest, gradually returns physical activity, walks are added to fresh air.

Particular attention is paid to the psychological climate in the family. It is necessary to protect the child from excessive emotional and physical stress, to create a friendly and calm atmosphere. Frequent stress leads to spasms and recurrence of seizures.

Correct daily routine good sleep and regular nutrition will have a beneficial effect on the health of the child. Additionally will be appointed physiotherapy, physiotherapy, massage, psychotherapy. If possible, it is better to send the child to a sanatorium or resort.

Medications

To eliminate acute unpleasant manifestations of dyskinesia, the baby will be prescribed pharmaceutical preparations:

• to reduce tone smooth muscle internal organs and pain relief is prescribed Papaverine, No-shpu;
• for normalization psycho-emotional state take preparations containing motherwort and valerian;
• to enhance the formation and secretion of bile, Allohol, Cholenzim, Vigeratin will be used;
• since the absorption of vitamins is difficult, vitamin preparations will be prescribed.

Traditional medicine

• with hypomotor form of biliary dyskinesia, 1 tbsp is taken orally. a spoonful of olive oil and drink lemon juice with sugar;
• oatmeal is infused hot water, after complete cooling, take 2 times a day - 30 minutes before breakfast and dinner;
• it is useful to use swede in raw or boiled form 20 minutes before a meal - it promotes the release of bile;
• grind dried rose hips in a coffee grinder, pour hot water, boil for 3 minutes, strain the broth, add honey if desired and drink half a glass 3 times a day before meals.

Whatever folk recipe you choose, its use must be agreed with your doctor. Otherwise, you can harm the child and provoke new attacks of the disease.

What diet is needed for a child with JVP?

The specialist will make a diet that should be followed. Sweets are excluded flour products, fresh milk, soda, nuts, legumes and more. Salty, spicy, fried foods are absolutely contraindicated. The mandatory list of prohibited foods includes fast food (chips, salted nuts, crackers, etc.). unhealthy food).

Cold food can provoke spasm, so it should be served warm. Preference is given to steamed dishes and boiled products. It is best to chop the dish and serve it as a puree. The products are of high quality. It is preferable to cook more often so that the dishes are fresh.

You need to eat small meals 4-5 times a day every three hours to reduce the load on the gallbladder. It is desirable that the meal takes place at the same time. Snacks between main meals are excluded. It is not recommended to eat before bedtime, it is better to drink low-fat fermented milk drink- yogurt or kefir. Mandatory use a large number water - an average of 2-2.5 liters per day - to avoid stagnation of bile.

This diet will need to adhere to more than six months. After the cure, harmful products are strictly excluded in order not to get a relapse of the disease.

Dyskinesia is a collective name for disorders of coordinated motor acts (usually smooth muscles of internal organs).

Esophageal dyskinesia is a disorder of the esophagus. motor function, which can lead to a slowdown in the movement of food from the pharynx into the stomach or its retrograde, i.e., reverse movement. Esophageal dyskinesia is a fairly common pathology, one or another of its forms is detected in about 3% of patients who undergo esophagogastroduodenoscopy. To a greater extent, esophageal dyskinesia affects females (approximately 79% of cases) older than 30 years.

Dyskinesia of the stomach is functional impairment contractile function of the stomach, which is one of the most common gastroenterological pathologies. Dyskinesia of the stomach is most often diagnosed in individuals young age, as well as in patients with organic or functional diseases central nervous system.

Lead to gastric dyskinesia can be both exogenous and endogenous causes. Risk factors include:

• diseases of the central nervous system;
• organ diseases gastrointestinal tract;
• cardiovascular pathologies;
• beriberi;
• irrational nutrition (systemic dry food, too fast food intake, the predominance of carbohydrates, spicy and fatty foods etc.);
• bad habits;
• stress;
• heat environment(living in a hot climate);
• impact on the body of ionizing radiation;
• taking certain medicines.

With dyskinesia of the esophagus, it is not recommended to eat foods with high content fiber, spicy and spicy dishes, alcoholic drinks.

The etiological factors of biliary dyskinesia include:

• congenital malformations;
• endocrine disorders;
• diseases of the digestive system;
• susceptibility to stress;
• sexual disorders;
• food allergy;
• overweight.

Source: online.org

The main cause of intestinal dyskinesia is acute or chronic stress. Risk factors: genetic predisposition, acute infections gastrointestinal tract, neurotic temperament, increased anxiety.

Forms of dyskinesia

Esophageal dyskinesia can be primary and secondary, as well as hypomotor and hypermotor.

Depending on the type of motility disorder, gastric dyskinesia is divided into hypertonic, hypotonic and atonic forms. Depending on the etiological factor the pathological process can have exogenous or endogenous forms.

Biliary dyskinesias are divided into primary (developing against the background of violations of the neurohumoral regulation of the hepatobiliary system) and secondary (due to other diseases of the gastrointestinal tract), as well as hypokinetic (atonic) and hyperkinetic (spastic).

Depending on the change in the consistency of the feces, intestinal dyskinesias are classified into the following forms:

• with constipation (more than 25% of all defecation acts occur with constipation, less than 25% with diarrhea);
• with diarrhea (more than 25% of bowel movements occur with diarrhea, less than 25% with constipation);
• mixed (defecation with both diarrhea and constipation occurs in more than 25% of cases);
• unclassified.

With intestinal dyskinesia, the prognosis for life is also favorable, but it is possible to achieve long-term remission only in 10% of cases.

Depending on the etiological factor, intestinal dyskinesia is divided into stress-related, post-infectious, consumption-related. certain products nutrition.

Hypomotor dyskinesias of the esophagus are asymptomatic in about 20% of cases. In other cases, their main symptoms are: belching, swallowing disorder (dysphagia), a feeling of heaviness in epigastric region after eating, aspiration of stomach contents into Airways, inflammatory processes in the mucous membrane of the esophagus.

Hypermotor esophageal dyskinesia is usually manifested by difficulty in swallowing, pain behind the sternum, which can radiate to the scapula, left half chest and left hand. Pain behind the sternum resembles an attack of angina pectoris, however, unlike the latter, they are not associated with physical exertion, and in some cases are stopped with a sip of water. With severe spasm, the patient experiences a sensation foreign body in the esophagus, which is aggravated by excitement and / or swallowing, accompanied by a lack of air and a burning sensation behind the sternum. An increase in motor activity and tone in hypermotor dyskinesia of the esophagus is noted not only when swallowing food, but also outside the act of swallowing.

Symptoms of esophageal dyskinesia are exacerbated by alcohol abuse, smoking, frequent stress, as well as when eating too hot food.

With gastric dyskinesia, patients experience abdominal pain without a clear localization. Duration pain attack it can range from several minutes to several weeks. The pain can be cramping, aching, pressing.

In all forms of dyskinesia, a sparing diet is indicated, frequent fractional nutrition overeating should be avoided.

The appearance of pain is usually associated not with meals, but with emotional and psychological factors. In the presence of antiperistaltic contractions and the reflux of the contents of the stomach into the esophagus, patients complain of heartburn, sour belching. In the event of a decrease contractile activity stomach occurs belching rotten. With dyskinesia of the stomach, caused by pathologies of the central nervous system, repeated vomiting is observed, which does not bring relief. Symptoms of gastric dyskinesia usually subside at night.

Among the main symptoms of biliary dyskinesia, there are pains in the epigastrium, as well as in the region of the right hypochondrium, which radiate to right shoulder and a spatula. With hyperkinetic biliary dyskinesia, pain, usually acute, occurs when physical activity, stress, errors in the diet. Patients with this form of pathology may experience sleep disturbances, headaches, excessive sweating, irritability, fatigue.

Pain in the hypokinetic form of biliary dyskinesia is usually constant and not intense, may be dull, aching, accompanied by a feeling of heaviness. Patients complain of bitterness and/or dry mouth, bad smell from the mouth, belching air, loss of appetite, nausea, vomiting, flatulence, constipation or diarrhea. With dyskinesia in children, intolerance to sweet and fatty foods, the use of which is accompanied by nausea and vomiting.

With intestinal dyskinesia, flatulence occurs (increases in evening time, after eating), diarrhea and constipation, feeling incomplete emptying intestines, pain in the abdomen, usually localized in the iliac region, which can be sharp or aching, dull.

The first signs of intestinal dyskinesia may appear already in childhood, but more often occur after 15 years.

The pain intensifies after eating, subsides after defecation and gas discharge. There is an admixture of mucus in the stools. With constipation, semi-liquid stools come out behind dense stools. Patients with intestinal dyskinesia complain of persistent headaches, a feeling of lack of air, dissatisfaction with inspiration, tremor.

Source: myshared.ru

Diagnostics

Diagnosis of dyskinesias is based on data obtained during the collection of complaints and anamnesis, objective examination, as well as instrumental and laboratory research, the volume of which depends on the existing clinical manifestations.

If esophageal dyskinesia is suspected, esophagoscopy, esophagomanometry, daily intraesophageal pH monitoring, and esophageal radiography are indicated. To identify complications or concomitant diseases, a fecal occult blood test is performed.

When diagnosing gastric dyskinesia, first of all, organic pathology should be excluded. Gastric motility disorders can be detected by electrogastrography. With the aim of differential diagnosis fluoroscopy of the stomach, esophagogastroduodenoscopy with a mandatory biopsy is performed.

Source: gastroscan.ru

To diagnose biliary dyskinesia, duodenal sounding, radiography, ultrasound, and, if necessary, hepatobiliary scintigraphy and magnetic resonance imaging of the liver and biliary tract are prescribed.

With dyskinesia in children, radiopaque studies are carried out relatively rarely and only under strict indications.

From laboratory methods diagnostics, a biochemical blood test is used (in particular, the determination of the concentration of cholesterol, high, low and very low density lipoproteins). Biliary dyskinesia is differentiated from inflammatory diseases of the gallbladder and biliary tract, neoplasms, cholelithiasis. Intestinal dyskinesia must be differentiated from infectious diseases bodies digestive tract, neoplasms of the intestine, endocrine disorders, urogenital pathology.

Treatment of dyskinesia

In the treatment of esophageal dyskinesia, antispasmodic and sedatives. With inefficiency conservative therapy and the development of complications may require surgical treatment.

Treatment of gastric dyskinesia is also carried out with the use of sedatives, and in case of violations secretory function stomach is shown replacement therapy(enzymes are prescribed). Physiotherapy is effective: electrophoresis, ozokeritotherapy, paraffin therapy, mud applications.

Correction of biliary dyskinesia begins with the establishment and elimination of the cause of its development. Medical therapy consists in the appointment of choleretic, enzyme preparations, neurotropic drugs. Physiotherapeutic procedures are used: electrophoresis, microwave therapy, paraffin and ozokerite applications, massage.

Biliary dyskinesia is one of the most common disorders of the hepatobiliary system, more often develops in women aged 20–40 years with an asthenic body type.

Therapy for intestinal dyskinesia depends on the form. With the predominance of constipation, laxatives are prescribed, in the case of a predominance in clinical picture diarrhea - antidiarrheal drugs. With a mixed form of intestinal dyskinesia, anticholinergic and antispasmodic drugs. In some cases, work with a psychologist or psychiatrist, taking antipsychotics or antidepressants is required.

In all forms of dyskinesia, a sparing diet is indicated, frequent fractional meals are recommended, and overeating should be avoided.

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

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

Biliary dyskinesia- This is a disease in which, due to a violation of the contractions of the gallbladder and its ducts, as well as defects in the work of the sphincter of Oddi, there are problems with the excretion of bile.

According to statistics, women are more likely to suffer from biliary dyskinesia.

The reasons

The development of the disease is facilitated by:

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

What's happening?

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

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

Biliary dyskinesia consists of a series of exacerbations and improvements. After some time in the gallbladder and ducts may occur inflammatory process cholecystitis, cholangitis) or formation of gallstones (cholelithiasis).

If in the morning you feel a bitter taste in your mouth, if you constantly Bad mood and a breakdown, it is possible that the cause of all the trouble lies in the disruption of the biliary tract. And if, besides, from time to time (worried or having a bite of a spicy salad) you feel pain in the right hypochondrium: dull aching or, conversely, acute cramping, immediately go to an appointment with a gastroenterologist. Seventy out of a hundred chances that you have dyskinesia.

Warning signs: constipation or diarrhea bad dream and appetite, decreased libido and disturbed menstrual cycle(among women).

Diagnostics

To put correct diagnosis, a gastroenterologist will definitely refer you to additional studies:

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

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

Treatment

It is important to establish the form of dyskinesia during the examination - the method of treatment will depend on this. Necessary condition treatment of dyskinesia - diet.

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

Of the drugs used mainly antispasmodics (no-shpa, etc.). It will not be superfluous choleretic drugs(holosas, cholenzim, flamin) and medicinal herbal preparations(corn stigmas, rose hips, peppermint, etc.).

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

If all of the above did not help, the doctor may prescribe tubazh - washing the biliary tract.

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

Apply choleretic agents- tsikvalon, 10% solutions of xylitol or sorbitol, Karlovy Vary salt and herbs - parsley decoction, decoctions and infusions of medicinal dandelion, common yarrow, calamus, barberry.

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

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

Dyskinesia is also treated with physiotherapy. Last years Increasingly, laser and acupuncture are being used.

Prevention

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

Treat diseases of the digestive tract in a timely manner.

Digestion is a complex of biochemical reactions combined with a mechanical effect on the food bolus. Many organs of the gastrointestinal tract produce own secret necessary at a certain stage of digestion. Bile is secreted upon ingestion food bolus into the lumen of the duodenum. Bile is produced by the liver, stored in the gallbladder, and, if necessary, enters the digestive tract through the bile ducts. There is a disease associated with dysmotility of these pathways and leading to the appearance of many unpleasant symptoms. This pathological process is called gallbladder dyskinesia.

The structure of the bile ducts

About the disease

In the course of statistical studies, it was noted that slightly more than a tenth of the entire population of the Earth suffers from biliary dyskinesia. In the vast majority of cases, these are women. reproductive age having an asthenic physique. It is assumed that gender differences in morbidity are associated with the production of hormones and metabolic processes in the female body.

Treatment

How to treat dyskinesia of the gallbladder? The principles of drug treatment are to prescribe, eliminating bacterial infection, normalizing the work of the nervous system and the digestive tract. Depending on the type of dyskinesia, appropriate therapy is selected.

Hypotonic dyskinesia:

• Choleritics are a group of drugs prescribed to improve the production and separation of bile. They are based on bile acids. Due to this effect, the motility of the biliary tract is stimulated, as well as the normalization of digestion and the breakdown of nutrients. The most common drugs are (Allohol, Cholenzym and Holiver).
• To improve tone vagus nerve Eleutherococcus extract and / or ginseng tincture are prescribed. These drugs normalize blood pressure, increase metabolism and resistance to physical stress.
• Tubeless tubes are substances that stimulate the secretion of bile. In this case, bile departs from the gallbladder and from the intrahepatic ducts. Tubages are often used when carrying out.

Allochol in tablet form

Treatment of hypertensive form of gallbladder dyskinesia:

• Cholekinetics are drugs used to increase the tone of the muscular wall of the gallbladder. In addition, drugs from the group of cholekinetics have a relaxing effect on the sphincters of Oddi and Lutkens. Due to their effect on the body, the intensity of the pain attack decreases, the rheological properties bile, the concentration of cholesterol in the blood decreases. Some drugs like Hepabene also have a hepatoprotective effect, protecting liver cells from the effects of toxins.
• – pharmacological preparations prescribed to reduce the tone of the sphincters. One of these drugs, Odeston, is similar to cholecystokinin in its effect on the body. When taken regularly this medicine there is an increase in bile production, relaxation of natural barriers and a decrease in pressure in the biliary tract.
• To normalize the work of the vagus nerve, sedatives are used, such as motherwort or valerian tincture.

Packing Odeston

Prevention

To prevent biliary dyskinesia, you must follow a few simple recommendations.

• You have to deal with stress. Severe psycho-emotional overstrain leads to a disorder of the parasympathetic nervous system. If possible, avoid stressful situations, do not accumulate irritation and anger in yourself. In the presence of severe depression, it is recommended to seek the help of a professional.
• D plays an important role in the treatment of this disease. The first step is to stop eating fast foods, convenience foods and other poor quality foods. The diet for JVP should include foods rich in vitamins, nutrients and beneficial trace elements.
• For patients with impaired motility of the biliary tract, it is indicated spa treatment. In such places, complex healing activities are carried out aimed at relaxing and eliminating signs of the disease. With biliary dyskinesia, sanatorium treatment with mineral waters is indicated.

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for acquaintance, contraindications are possible, consultation with the doctor is MANDATORY! Do not engage in self-diagnosis and self-treatment!

Biliary dyskinesia is not an independent disease - it is a consequence of improper flow of bile into the duodenum for digestion. JVP is accompanied by aching, dull, sharp pains in the abdomen, indirect sign an unpleasant odor from the mouth is considered. Treatment of pathology is aimed at correcting the underlying disease.

The main symptom of biliary dyskinesia is aching Blunt pain in a stomach

JVP - what is it?

Bile duct dyskinesia- this is a syndrome in which the normal motor activity of the biliary tract is disturbed, the tone of the gallbladder decreases. Isolate organic and functional type disorders.

The syndrome is observed in 70% of cases of diseases of the gastrointestinal tract. Of these, 10% of cases are primary dysfunctions that are not associated with other disorders of the digestive system.

With DZHVP, the motor activity of the biliary tract is disturbed

Pathology according to ICD-10 was assigned the code K82.8 - diseases of the bile ducts of unspecified origin.

Types of biliary dyskinesia

There are 3 types of JVP:

1. hypokinetic(hypomotor, hypotonic). In this case, there is a decrease in the tone of the gallbladder, a decrease in the motor activity of the ducts.
2. hyperkinetic(hypertonic, hypermotor). It is dominated by spastic phenomena, increased contractility of the organ.
3. mixed. With a mixed form, there is both a change in tone and colicky pains.

Hypomotor type dysfunction

It is characterized by a lack of bile for the process of digestion of food. The production of the substance does not suffer, but at the time of release there is not a sufficient contraction of the gallbladder. This leads to the fact that food is not digested and not absorbed in full.

Dysfunction of the hypomotor type in the vast majority of cases develops in elderly people.

A patient with dyskinesia hypotonic type This is a person over the age of 40. The main cause of dysfunction of this type of pathology is stress, psychological disorders.

A typical symptom is a dull arching pain that spreads to the back and right shoulder blade. The pain syndrome can last for several days.

DZHVP on hypertonic type

More often it develops in women from 30 to 35 years old, adolescents and children. The attack develops suddenly in the form of colic. At the same time, the pressure in the gallbladder increases sharply, a spasm of the sphincters of Lutkens or Oddi is observed. The pain syndrome lasts no more than 20 minutes. Develops after eating, at night.

The occurrence of JVP according to the hypertensive type is possible in children and adolescents

mixed form

It is characterized by the presence of signs of dysfunction in both hypokinetic and hypermotor types.

Causes of JVP

There are 2 types of biliary dyskinesia. The classification is based on the causes that caused a violation of the release of bile.

Causes of the primary syndrome:

1. stress factors- acute or chronic nervous tension both at work and in personal life. It provokes inconsistency in the work of the sphincters of the gallbladder.
2. Errors in the diet- disregard for the rules healthy eating, infrequent meals. This leads to a violation of the production of digestive enzymes, hormones. Over time, dyskinesia develops.
3. Diseases allergic nature in chronic form . The presence of an allergen leads to irritation of the sphincters, which provokes inconsistency in their activity.

Causes of secondary dysfunction:

1. Gastrointestinal diseases - gastritis, enteritis, ulcers, cell death of the mucous membranes of the stomach and duodenum.
2. Chronic inflammation in the reproductive area, cystic changes in the ovaries, kidney disease.
3. Liver pathologies - hepatitis, cholangitis, the presence of stones in the gallbladder.
4. Salmonellosis in history.
5. Other bacterial and viral diseases gastrointestinal systems.
6. Worm infestations.
7. Congenital malformations of the structure of the gallbladder - bends, constrictions.
8. Endocrine pathologies, menopause in women.

Symptoms of gallbladder dysfunction

The symptomatology of the pathological process depends on the type of dysfunction.

Table: Signs of JVP depending on the type of disease

An increase in temperature with dysfunction of the bile ducts is not observed. Its presence indicates the beginning of the inflammatory process, bacterial damage.

Which doctor should I contact?

In case of violation of the digestive system, consult a gastroenterologist

The treatment of dysfunction of the digestive system is engaged in:

According to indications, consultations are possible.

Diagnostics

The task of the doctor at the stage of examining the patient is to determine the type of pathology, identify the causes of dyskinesia and exclude other diseases, including tumor genesis.

The survey includes:

1. Inspection and questioning patient, palpation of the abdomen.
2. ultrasound- to determine the size of the organ, exclude developmental anomalies, tumors, assess the contractile activity of the gallbladder.
3. General blood analysis- at increase in ROE one can judge the inflammatory process, an increase in eosinophils and leukocytes - possibly a helminthic invasion.
4. Biochemistry of blood- there may be an increase in bilirubin and cholesterol, the appearance of C-reactive protein.
5. Cholecystography- X-ray of the digestive tract using contrast medium. As a contrast, iodine preparations are used orally or infusionally.
6. Cholangiography- according to indications - x-ray examination of the bile ducts after the introduction of a contrast agent. The drug is administered percutaneously by puncture method. At the same time, the doctor conducts drainage of the ducts. Manipulation is performed under local anesthesia.
7. Endoscopic cholangiography- according to indications - through oral cavity using an endoscope, a camera is inserted into the gallbladder. Contrast is introduced, pictures are taken. At the same time, stones can be removed.
8. duodenal sounding- according to indications - a study of the composition of bile, an assessment of the motor activity of the bile ducts.

Cholecystography using a contrast agent allows you to get complete picture about the state of the gastrointestinal tract

The method of examination of the patient is determined by the doctor. It may change depending on the symptoms and as the results of the study become available.

Treatment of biliary dyskinesia

Treatment of gallbladder motility disorders is carried out in a complex manner in both adults and children, and also depends on the type of dysfunction.

Patient management includes:

• mode;
• normalization of nutrition;
• drug therapy;
• physiotherapy;
• sanatorium treatment - if possible.

Physiotherapy is prescribed for gallbladder motility disorders

In addition, it is necessary to normalize the psycho-emotional state, sleep.

Medications

Drug treatment is long and depends on the type of bile duct motility disorder.

In the treatment of hypomotor dysfunction

Choleretics - Hofitol, Cholenzim, Allohol - they all contain either bile or bile acids, digestive enzymes, plant extracts.

The active ingredients of the preparations enhance contractile activity gallbladder, improve digestion. Against the background of the reception increases the production of bile.

Taking Hofitol enhances the contractile activity of the gallbladder

Individual dosages are selected by the doctor. The duration of treatment is from 20 days to 2 months.

The drugs are well tolerated. Against the background of the reception, diarrhea may develop, various allergic reactions. In this case, drug tactics are reviewed.

This group of drugs is not prescribed in the presence of:

• nephritis, hepatitis in the acute period;
• obstruction of the bile ducts;
• the presence of stones;
• individual sensitivity.

Tonics for plant-based normalizing the state of the nervous system:

• extract from ginseng root.

Take Eleutherococcus tincture to stabilize the nervous activity of the body

The drugs stimulate higher nervous activity, reduce fatigue, improve the body's adaptation to various stimuli.

Dosages depend on the age and condition of the patient and can range from 15 to 30 drops per 1 dose. Main side effect tincture is insomnia. Therefore, it is undesirable to take them in the evening.

Contraindications to the appointment:

• childhood;
• pregnancy, lactation;
• individual intolerance;
• insomnia in history;
• period of menstruation.

Tyubazhi - with mineral water, sorbitol, magnesia - only during the period of remission and in agreement with the doctor.

The procedure is aimed at improving the outflow of bile.

Tubazh help maintain the outflow of bile during the remission of the disease

You should take 100-200 ml of water or sugars dissolved in it, magnesium sulfate and lie on your right side on a heating pad for 40 minutes. It is forbidden for cholelithiasis, a history of ulcers, inflammation in the liver.

In the treatment of hypermotor dysfunction

Cholekinetics - relax the bile ducts, but increase the tone of the bladder itself, relieve spasms, reduce the level of lipids in the blood.

• Oxaphenamide;

Gepabene is prescribed to relax the bile ducts and relieve spasms

Both the one and the other drug are taken 1 capsule 3 times a day. From side effects only episodic cases of diarrhea have been observed. Medicines not prescribed for inflammatory processes in the liver in the acute period.

Antispasmodics - No-shpa, Papaverine - to relax smooth muscles. It stops pain syndrome during an attack.

No-shpa will help remove pain during an attack

Additionally shown sedatives doctor's choice.

Folk remedies

Phytotherapy belongs to folk methods treatment. But at the same time they use medicinal herbs applied in official medicine. The duration of treatment with phytocollections is from 2 to 3 weeks.

Decoction of immortelle flowers

Use immortelle flowers to make a medicinal decoction

It will take 60 g of vegetable raw materials and 1 liter of boiling water. Fill and wrap. Let it brew until the broth has completely cooled. Take 100 ml half an hour before meals 3 times a day.

Corn silk

Brew corn silk to make a medicinal infusion

Requires 4 tbsp. l. pour 1 liter of boiling water. Wrap and leave to cool. Take 1 tablespoon 3 times a day.

Chamomile tea

Replace regular tea with chamomile tea to improve the digestive tract

Take 1 tbsp. l. chamomile flowers and pour 1 cup of boiling water. Insist 5 minutes. Take 1 glass of tea 3 times a day.

Liquorice root

Boil licorice root to get effective remedy in the fight against JVP

You will need 2 teaspoons of chopped vegetable raw materials. Pour a glass of boiling water and simmer over low heat for 15 minutes. Strain and top up with water to a full glass. Take 100 ml 3 times a day before meals.

Mint tea

Accept Mint tea 3 times a day before meals

Need 2 tbsp. l. pour 1 cup boiling water. Insist 30 minutes. Take 100 ml 3 times a day before meals. The course of treatment is 4 weeks.

Diet for JVP

Diet is an essential component of the treatment of bile duct dysfunction. In the first few days, pureed soups, cereals, vegetable purees are recommended. Starvation is not shown.

sample menu

Nutrition should be fractional: during the day, make 5-6 meals.

When following a diet, it is important to split the food - divide the daily norm of food into 5-6 meals

First day:

1. Breakfast - vegetable salad, rice milk porridge, tea, bread and butter.
2. The second breakfast is an apple, baked or 250 ml of fruit juice.
3. Dinner - vegetable soup, baked chicken breast, braised cabbage, compote.
4. Snack - biscuit cookies, dried fruit compote.
5. Dinner - millet porridge, boiled beef, boiled beetroot salad with vegetable oil, tea.
6. At night - a glass of fermented milk product.

Second day menu:

1. Breakfast - oatmeal on the water, a glass of fermented baked milk.
2. The second breakfast is fruit puree.
3. Lunch - vegetable soup, pasta, steamed meat casserole, green tea, bread.
4. Snack - cottage cheese with raisins and dried apricots, sour cream.
5. Dinner - vegetable salad, steam omelet, tea.
6. At night - a glass of yogurt.

Features of treatment in children

According to medical statistics, 90% of children diagnosed with dyskinesia had episodes inflammatory diseases gastrointestinal tract, helminthic invasions. In adulthood, the development of this dysfunction contributes to vegetovascular dystonia. Girls are diagnosed with this disorder more often than boys.

A feature of the treatment of this condition in children is that diet therapy comes first. A specialized diet is not provided, it is enough to follow the recommendations for proper nutrition.

They include minimizing fast food, nuts, snacks, mineral water. In addition, nutrition is shown at the request of the child, according to appetite. Do not strictly adhere to regime moments.

Snacking with various goodies - nuts, sweets, buns - is strictly prohibited. The best choice in this case are fruits.

Drug therapy is represented by drugs for the normalization of microflora, antispasmodics for pain, sedatives plant-based, choleretic. Additionally, massages, electrophoresis with antispasmodics, a course of exercise therapy are shown.

Adequate motor activity should be present at all stages of treatment. Mandatory walks in the fresh air and positive emotions.

Features of treatment during pregnancy

On the early dates violation of the outflow of bile is the main cause of the development of severe forms of toxicosis. This manifests itself in the form of bouts of nausea, vomiting, lack of appetite, weight loss.

In this case best solution there will be a hospitalization of a woman in the gynecological department of a hospital.

Pregnant women with DVP require hospitalization and constant control doctors

A feature of the treatment of pregnant women with a diagnosis of JVP is that many drugs are prohibited during the gestational period. The main tactic of managing the patient is to follow the principles rational nutrition, food according to appetite. It is forbidden to "eat for two" as grandmothers recommend.

Permissible drug treatment- This is the reception of phytocollections. For example, decoctions of corn stigmas, dill, mint. Antispasmodics are allowed.

Self-administration of herbal remedies during gestation is inappropriate. Treatment is carried out only under the supervision of a gynecologist.

DZHVP is not an indication for termination of pregnancy, for caesarean section. Dysfunction does not affect the course of natural childbirth.

Possible Complications

JWP is not normal state for the body. Treatment should be carried out in full. Otherwise the following complications may develop:

• cholecystitis - an inflammatory process involving the gallbladder;
• the appearance of stones in the gallbladder;
• acute and chronic pancreatitis;
• duodenitis is an inflammatory process in the duodenum.

duodenitis and cholecystitis frequent complication at improper treatment JWP

Prevention

The best prevention of gallbladder dysfunction is timely treatment diseases of the gastrointestinal tract, helminthic invasions, pathologies of the nervous system. Normalization of nutrition, adequate physical activity, good rest for all categories of patients.

JVP is not a sentence, but the state of the body needs to be brought back to normal. Be sure to identify true reason dysfunction and follow the recommendations of a gastroenterologist.