I have biliary dyskinesia. Indirect signs of biliary dyskinesia. JVP by hypotonic type: treatment

If your child often complains of pain and heaviness in the right hypochondrium, in no case should these complaints be ignored. Consult a gastroenterologist. After all, the cause of pain of this nature can be biliary dyskinesia. This is not to say that this disease is life-threatening. But it, like any other, has its consequences. And it, like other diseases, needs to be treated. What kind of ailment is this? And how to deal with it? Let's sort it out in order.

Biliary dyskinesia in children

In children, as in adults, bile is produced by the liver. And it is stored, for the time being, for the time being, in the gallbladder. As soon as the food eaten by the child enters the duodenum for further digestion, the gallbladder immediately contracts and releases the necessary portion of bile. Which, before reaching its destination, passes through the ducts and sphincters.

Why is it so important that bile is delivered to the duodenum on time and in the right amount? Yes, because it performs a very important function - it breaks down fats into fatty acids. For the best understanding.

Now imagine that the gallbladder did not shrink in time. The bile was not secreted. The food was left undigested due to a deficiency of essential enzymes. And the baby's body received less energy and building material for its growth and development. Of course, this, especially in childhood, is unacceptable.

Biliary dyskinesia in children: liver and gallbladder (video)

Hypokinetic biliary dyskinesia: symptoms

With hypokinetic (hypotonic) DZHVP, the child may complain of constant aching pain and heaviness in the right hypochondrium. Such pain periodically increases or decreases. Dyskinesia of the hypotonic type is also characterized by weakness and fatigue. The child has a violation of appetite, nausea and even vomiting, plus bitterness in the mouth and frequent constipation. It is not uncommon for children with hypokinetic dyskinesia to experience swelling of the face and extremities. Due to stagnation of bile in the bladder with hypotonic JVP, it may occur, with a characteristic increase in temperature (up to 37.2-37.5 ° C).

JVP by hypotonic type: treatment

Treatment of DZHVP according to the hypokinetic type is based on three principles.

1. Treatment of the underlying disease. This may be gastritis, cholecystitis, disorders of the autonomic nervous system, etc.
2. Treatment of cholestasis and its consequences. It is carried out with antispasmodics, enzymatic agents.
3. Restoration of normal gallbladder function and prevention of JVP. Long-term adherence to a strict diet and daily routine. Water therapy. Spa treatment.

Do not forget about traditional medicine, which are quite effective in the treatment of JVP. Rosehip broth and grapefruit juice have a very good choleretic effect.

Hypotonic type of biliary dyskinesia: diet

Patients with hypomotor JVP should follow a rather strict diet to alleviate their condition. And, for a very long time. Doctors recommend for JVP - table number 5. What does it mean?

• You need to eat often, but little by little. This is 5 - 6 meals a day.
• Eliminate foods containing animal fats from the diet.
• Fried, salted and, of course, smoked is also impossible.
• Chocolate, cocoa, coffee, soda, sweets are taboo.
• Eggs and legumes, due to the fact that they can provoke increased gas formation, are also undesirable to eat.
• Limit your child's salt intake as much as possible.
• Steam food. Can be stewed and boiled.
• Be sure to observe the drinking regime and the use of mineral waters on the recommendation of a doctor.

Hypomotor JVP in children: consequences and prognosis

With the timely diagnosis of hypomotor JVP in children, its adequate treatment and strict adherence to the diet, the prognosis is very favorable. Most young patients recover after a couple of years and lead a normal life.

If due attention is not paid to this problem, JVP in children can lead to a number of chronic diseases of the gastrointestinal tract, as well as metabolic disorders and slow growth and development. The prognosis is rather disappointing, isn't it? Parents have a lot to think about here. After all, any disease, especially in childhood, is easier to cure at the initial stage of its development. And hypomotor JVP is by no means an exception to the rule.

During his life, a person is faced with various kinds of diseases, one of the most common ailments is gallbladder dyskinesia. The essence of the pathological process is associated with impaired motility and tone of the gallbladder, as well as the bile ducts.

Due to the anatomical features and hormonal levels, the disease is more often diagnosed in women. It is noticed that women with asthenic physique suffer more. In sixty percent of the case, hypomotor dyskinesia of the gallbladder is diagnosed.

The disease causes inconsistency in the work of the digestive tract. This leads to the fact that the bile secretion is not thrown into the intestinal lumen in the amount that is necessary and at the wrong time.

In the hypermotor type, the sphincters of the gallbladder do not relax and there are excessively strong contractions of the walls of the biliary tract. With hypomotor dyskinesia, on the contrary, insufficiently intense contractions of the walls are observed.

The pathological process can cause anomalies in the development of the biliary tract, neurotic and hormonal disorders, cholecystitis, gastritis, diabetes mellitus. Even stressful situations can cause disruption of the gallbladder.

What is the difference between hypomotor and hypermotor dyskinesia?

Bile is a special fluid that is produced in the liver. The bile secret improves the absorption of fats and activates the movement of the food bolus through the intestines. Before getting into the intestines, bile passes a complex path through the bile ducts.

With dyskinesia of the gallbladder, there is a violation of the contractile function that occurs for a number of reasons (often against the background of parallel pathologies)

With dyskinesia of the biliary tract, there are problems with the excretion of bile. Experts distinguish two main forms of the disease: hyperkinetic and hypomotor. First, let's talk about the hyperkinetic type. In this case, the tone of the organ is increased, it contracts too quickly and strongly. Along with this, the sphincters do not open enough.

This leads to severe pain in the right hypochondrium. In some cases, the pain attack can be short-lived, and sometimes it lasts for an hour. Stress, anxiety can provoke a new attack. During critical days, the tone of the gallbladder is increased, so in women, the exacerbation of the disease is associated with the menstrual cycle.

If the hypertensive form of dyskinesia often affects young people and adolescents, then the hypotonic type is more common in older people. In this case, the pain is longer, but it has a mild character. Aching pain can last for days.

Now let's talk about the symptoms of the hyperkinetic form:

• pain syndrome in the form of colic. Intense pain in the right hypochondrium occurs after stress or nutritional errors. Typically, a painful outbreak lasts about half an hour and occurs several times a day. Soreness radiates to the back, arm, shoulder blade and even to the region of the heart, due to which the disease can be confused with an angina attack;
• loss of appetite due to a spasmodic and excessively contracted gallbladder;
• weight loss due to poor digestion of food and insufficient absorption of nutrients;
• an attack of nausea and vomiting;
• diarrhea;
• disorders of the autonomic nervous system: hypertension, sweating, weakness, tachycardia, headache.

With hypokinetic biliary dyskinesia (JVP), a more pronounced clinical picture is observed. In addition to pain, nausea and vomiting, belching, bitterness in the mouth, bloating, obesity and more appear.

In both forms of JVP, jaundice of the skin and mucous membranes is observed. This is due to a violation of the outflow of bile secretions. Along with this, the feces become discolored and the urine becomes dark. Also, with the reverse reflux of bile, a white or yellowish coating appears on the tongue.

With hypotonic biliary dyskinesia, symptoms from the ANS are observed: dizziness, headache, tachycardia

Causes

JVP is primary and secondary. It should be noted that pathology rarely occurs as a separate disease. The primary process can be caused by the following reasons: nervous strain (while structural changes in the organ are not observed), dietary disturbances: overeating, starvation, quick snacks, abuse of fatty, fried foods, sedentary lifestyle, muscle weakness, underweight, allergies, bronchial asthma and more.

The secondary process occurs against the background of existing diseases:

• diseases of the digestive tract: gastritis, duodenitis, colitis, peptic ulcer;
• chronic diseases of the abdominal cavity and pelvic organs: adnexitis, pyelonephritis, ovarian cyst;
• violation of the liver, gallbladder and biliary tract;
• bacterial inflammation of the gastrointestinal tract;
• giardiasis;
• congenital anomalies of the gallbladder;
• endocrine disorders.

The cause of dyskinesia can be nervous strain.

Characteristic symptoms

The disease is characterized by the following symptoms:

• a constant attack of pain, which has a dull, bursting, aching character. Soreness appears in the region of the right hypochondrium, while there is no clear place of localization. The pain usually gets worse after eating. This is due to stagnation of the bile secretion and stretching of the bottom of the gallbladder;
• belching that occurs after eating or in between meals. This is due to the swallowing of air during meals;
• an attack of nausea, which may result in vomiting. Bile impurities appear in the vomit. Usually nausea appears after an error in nutrition;
• bitterness in the mouth, which increases after eating, in the morning and after exercise. This is due to the reflux of bile secretions from the duodenum into the oral cavity;
• bloating. The feeling of fullness may be accompanied by pain. Usually, after the passage of gases, the pain outbreak subsides. Flatulence arises from putrefaction and fermentation;
• constipation. It occurs due to a slowdown in the movement of the food bolus through the intestines. Fecal masses become dense and decrease in volume. Also, stool retention is associated with a lack of bile acids;
• obesity. It occurs due to insufficient breakdown of fats. They begin to debug on the subcutaneous fat and internal organs;
• autonomic disorders: bradycardia, hypotension, dizziness, sweating. It is believed that neurological disorders arise due to the instability of the cardiovascular system to stressful situations. Due to psycho-emotional experiences, less oxygen enters the internal organs.

The disease causes pain in the right hypochondrium

Dyskinesia in children

The immaturity and lability of the nervous system can cause the development of JVP in childhood. In children under one year old, the disease is often the result of damage to the central nervous system during pregnancy or childbirth.

If we talk about older children, the cause of dyskinesia can be stress, emotional overload, malnutrition, physical inactivity, food allergies. JVP in children manifests itself in the form of such symptoms:

• the appearance of a white coating on the tongue;
• yellowness of the sclera;
• the appearance of cracks in the corners of the mouth;
• the skin becomes white or even grayish;
• violation of the heartbeat.

The hypomotor form is treated with massage, water procedures and physiotherapy exercises. Tonic medicines give a good effect: Ginseng, Wild pepper extract, Aralia tincture, as well as magnesium preparations.

Diagnosis and treatment

To make an accurate diagnosis, a gastroenterologist will need the results of the following studies: general and biochemical blood tests, ultrasound diagnostics of the liver and gallbladder, duodenal sounding, drug tests, cholecystography.

The treatment process of dyskinesia includes the use of drugs that stabilize the motor activity of the biliary tract. In addition, for a complete cure, it is necessary to follow a diet and normalize the psycho-emotional state.

Neurotic disorders can be corrected by creating comfortable conditions at home and at work, observing the correct daily routine, observing a psychotherapist and taking sedatives or psychostimulants.

Nutrition Features

• buckwheat;
• bran;
• cottage cheese;
• cabbage;
• carrot;
• apples;
• vegetable oil;
• fatty dairy products.

Also, do not forget about products that have a choleretic effect: sour cream, cream, vegetables, black bread, vegetable and butter, hard-boiled egg.

Compliance with diet is the key to a speedy recovery

During an exacerbation of the disease, it is better to exclude such foods: fatty meat and fish, smoked meats, fatty, fried, alcoholic beverages, confectionery, canned food, marinades, whole milk, legumes.

Products are best consumed in boiled, baked form. It is also useful to steam food. It is allowed to eat yesterday's bread, sour-milk products, lean meats and fish, cereals, vegetables, vegetable soups.

Medical treatment

To enhance the production and separation of the bile secretion, choleretic drugs are prescribed, which include bile. Let's highlight the effective choleretics prescribed for JVP:

• Holenzim. Tablets stimulate the production of bile, improve the functioning of the gallbladder and generally normalize digestion;
• Allohol. The drug eliminates the processes of decay and fermentation. Tablets promote bile secretion and improve the motor ability of the gallbladder;
• Holiver. In addition to the fact that the remedy normalizes bile secretion, it has a hepatoprotective effect and helps to eliminate bad cholesterol.

An auxiliary role in the treatment of dyskinesia is played by herbal preparations: peppermint infusion, immortelle decoction, corn stigma decoction. To cleanse the liver, gallbladder and ducts, a blind probing technique is used. It helps to improve the contractile function of the gallbladder, due to which bile and pathogens are released.

Blind probing will help in the treatment of JVP

For the procedure, vegetable oil, choleretic herbs, honey, sorbitol, yolks, magnesia and more are used. After a person drinks the drug, he should lie on his right side and apply a heating pad to the liver area. In this position, you should lie without turning over for an hour.

As a supplement, traditional medicine can be prescribed. In order to increase the outflow of bile, try these tips:

• drinking green tea;
• bathe in a Russian bath once a week using a broom;
• before meals, take a teaspoon of olive oil;
• the use of infusion of birch leaves;
• take a mixture of tomato juice and sauerkraut brine daily.

The disease threatens the development of cholecystitis, pancreatitis, gastritis, and also contributes to the formation of stones. Due to a violation of the normal breakdown of fats, the development of anemia, vitamin deficiency is possible. Uncontrolled weight loss may also occur. With timely treatment, the prognosis is favorable. The disease is characterized by a long course with exacerbations.

Preventive measures will help prevent the development of the disease, but if JVP is already present, they will help to delay the onset of relapse or even completely eliminate it. Prevention is, first of all, the observance of the right lifestyle, including dietary nutrition. A diet is not a temporary phenomenon, but a decision to eat the right foods every day.

Moderate exercise is a good way to prevent congestion. Also, do not forget about proper sleep and adherence to the correct mode of work and rest. Conduct preventive examinations in a timely manner.

If alarming symptoms appear, do not let the condition take its course, but contact a specialist.

So, hypokinetic dyskinesia of the gallbladder can cause a lot of problems. Treatment of the disease should not be delayed until later. Timely measures taken contribute to a speedy recovery. If you follow simple preventive measures, you can prevent the onset of the disease, or at least forget about the problem for a long time.

A qualified specialist is engaged in diagnostics, prescription of a diet and medicines. In extreme cases, when conservative methods do not give any results, the specialist may decide to perform surgery.

Biliary dyskinesia (JVP) is considered one of the most common diseases of the gastrointestinal tract, which provokes dysfunction of the gallbladder, liver, adversely affects the overall system of cooking and assimilation of food, and also disrupts the activity of the pancreas. As soon as there is a violation of the stable process of moving bile through the ducts, biliary dyskinesia develops, which causes various kinds of disorders in the work of most abdominal organs, a person experiences severe pain, metabolism is disturbed, adjustments are urgently made to the nutrition system, a special diet is selected . The sooner the treatment of the disease begins, the greater the chances for a speedy recovery and reduced risk of unwanted complications.

Signs of stagnation of bile in the ducts of the gallbladder, or vice versa, its too rapid movement with entry into the cavity of the duodenum with an insufficiently saturated consistency, leads to the fact that a sick person begins to experience the following symptoms of the disease:

• in the right hypochondrium, from the side of the location of the liver, aching pain appears, which periodically passes into an exacerbation phase and takes on a cutting character;
• the first urge to nausea occurs, and after eating fatty foods, the release of vomit is not excluded;
• the stool is disturbed (an adult suffers from liquid diarrhea, or from prolonged constipation lasting 2-3 days or more);
• urination becomes more frequent, and the urine itself acquires a rich brown hue;
• appetite decreases and the patient may not feel hungry for a long period of time;
• there is increased gas formation, belching with air appears, and bloating, which is an integral sign of flatulence, can be observed with the naked eye, or by palpation of the abdominal cavity.

Symptoms of intoxication in biliary dyskinesia are completely absent, which is almost always confirmed by blood tests.

In particularly difficult cases, if inflammation of the gallbladder walls occurs, the overall body temperature may slightly increase, which reaches 37.2 - 37.4 degrees Celsius, but such a clinical picture is recorded extremely rarely.

Causes of biliary dyskinesia

There are a large number of direct and indirect factors that affect the stable functioning of the organs of the digestive system and the process of bile synthesis. Based on this, JVP is classified according to the type of dysfunction and the causes of its development are distinguished. They look like this.

hypotonic type.

In patients with this type of disease, there is a weakness in the muscle fibers responsible for the production of bile secretion, as well as its movement through the ducts with further delivery to the duodenal cavity to break down complex fatty acids that have entered the human body along with food.

Reduced activity and weakened tone of the gallbladder walls can be triggered by a lack of food hormones, poor heredity on the part of parents, a sedentary lifestyle and reduced physical activity of the person himself. In the hypotonic type, bile is secreted in insufficient quantities, or it moves too slowly through the channels.

By hypertensive type

This type of JVP, in contrast to the hypotonic type of the disease, is characterized by excessive activity of the walls of the gallbladder. They are constantly reduced under the influence of nerve impulses coming to the organ from the centers of the cerebral cortex, which are responsible for regulating the activity of organs located in the abdominal cavity.

As a result of the incessant spasm, bile also loses the ability to calmly move through the channels and ensure the normal process of digestion. The most common cause of hypertensive dyskinesia is neurological diseases associated with dysfunction of nerve endings.

Hypokinestic type.

This diagnosis is made to patients most often, as it is characterized by a deficiency of bile. As a result of frequent overeating, eating too much fatty foods, alcoholic beverages, improperly organized nutrition, there is a lack of bile. It begins to be produced in much smaller volumes than the gastrointestinal tract requires.

In this regard, dysfunctions develop in the digestive system, fatty foods are not digested, a person develops liquid diarrhea, nausea and vomiting appear.

hypomotor type

Difficult and most rare dyskinesia (hypokinesia) of the biliary tract, as it is immediately characterized by a whole complex of disorders in the gallbladder. Not only the lethargy of the work of this organ is noted, but also the complete or partial lack of motility of the muscle fibers located in the circumference of the channels through which the bile secret is transported to the duodenum is recorded.

This pathology is very difficult to treat, and the causes of its occurrence may be acute liver failure, helminthiasis, giardiasis, viral liver damage, oncological processes in the digestive tract.

By hypermotor type

JVP with increased activity of the gallbladder and all its departments that are involved in the process, which includes the stage of bile synthesis up to the final stage of its reflux into the duodenum. In the presence of biliary dyskinesia of the hypermotor type, the patient has an ongoing reflux of bile into the organs of the gastrointestinal tract with a significant excess of it. A person begins to experience a strong bitterness in the mouth, appetite disappears, nausea and vomiting appear, and the stool becomes a rich dark color with a greenish tint. Most often, the cause of the disease is hidden in malnutrition, alcohol abuse, recent food poisoning, or severe intoxication of the body with chemicals.

Differentiation and allocation of DZHVP by type enables the attending gastroenterologist to more correctly diagnose the patient and further form a course of treatment that allows, in the shortest possible period of time, to eliminate not only the symptoms of the disease itself, but also to stop the causative factors of its occurrence.

Methods of treatment of adults with biliary dyskinesia

Therapy of any disease that affects the mucous membrane, muscle fibers and dense layers of epithelial tissues of the organs of the human digestive system consists of two main areas. These are traditional methods of treatment, consisting of a drug effect on the focus of pathology, or the use of folk medicines based on the healing properties of herbs.

Let us consider in more detail how, in both cases, to stabilize the movement of the bile secretion without harm to health.

Cholagogue preparations

Modern pharmacology offers a wide range of tablets that are designed to increase the activity of bile movement in the bladder and its ducts, or to eliminate spasm and reduce the intensity of its reflux into the duodenum.

The following drugs have the best therapeutic effect:

• Allochol (choleretic, which contains natural bile and is used for hypodyskinesia);
• Nicodin, Osalmid, Oxafenamide (synthetic agents that stimulate the gallbladder);
• Urosan, Holosas, Flamin, Hofitol, Febihol (combined preparations, which include both chemical components and part of the extracts obtained from medicinal plants).

How exactly to take a particular medication, in what dosage and duration, is determined solely by the gastroenterologist based on the diagnosis made to the patient, as well as based on the general clinical picture of the course of the disease.

Cholagogue herbs

Among a large number of the most diverse plants with choleretic properties, it is recommended to brew such herbs as:

• dandelion leaves collected from May to the end of June;
• stigmas from corn cobs;
• rosehip berries;
• calamus marsh;
• common apricot;
• burdock root;
• stalks of wormwood;
• St. John's wort;
• wild strawberry leaves.

The ratio of the dry mass of the medicinal plant and the volume of boiling water with which they are poured to obtain a medicinal mixture is determined based on the type of dyskinesia. More detailed information is displayed in the instructions for use of a particular herb. At all stages of therapy, it is necessary to periodically do an ultrasound of the gallbladder, controlling the condition of its walls and ducts.

Diet

Compliance with the norms of proper nutrition takes the process of treating JVP to a completely different level, which ensures an accelerated recovery. Patients with biliary dyskinesia are advised to completely stop taking the following products:

At the same time, for the treatment and prevention of biliary dyskinesia, an adult needs to saturate his diet with foods such as:

• lean skinless chicken breasts;
• pasta and cereals boiled in water or low-fat milk;
• vegetables, boiled or steamed (can also be baked in the oven);
• wheat bran;
• egg omelet;
• low-fat fermented milk products (kefir, fermented baked milk, sour cream, milk, yogurt, and butter and spicy cheeses are strictly prohibited);
• white bread that has lain down for 1 day and has become a little stale;
• dry diet cookies "Maria", biscuits, crackers;
• lean fish species;
• honey, natural marshmallow, marshmallow, marmalade;
• not strong green tea;
• salads from fresh vegetables and fruits, with the exception of those listed above;
• dairy and vegetable soups prepared according to fat-free vegetarian recipes.

Compliance with this diet makes it possible to avoid exacerbation of biliary dyskinesia, to ensure the stable functioning of the gallbladder and other organs of the gastrointestinal tract. Also, this menu is perfect for pregnant women who are undergoing JVP treatment and at the same time need a sufficient amount of vitamins, minerals, proteins, amino acids and carbohydrates to enter the body.

Possible complications and consequences in adults

In the absence of timely treatment, the patient can expect the development of secondary diseases, which include the following pathologies:

• chronic cholecystitis;
• the appearance of stones in the gallbladder and its channels;
• liver failure with an increase in the effect of intoxication;
• inflammatory processes of the intestinal mucosa and stomach;
• weight loss and poor digestibility of food eaten.

The most dangerous complication of biliary dyskinesia is the formation of a large number of stones in them, which exclude the possibility of further bile patency and lead to the fact that the patient gets an appointment with a surgeon. In 85% of cases, this ends with an operation and complete removal of the gallbladder, and the person becomes forced to adhere to a diet until the end of the remaining days.

Biliary dyskinesia (BDB) is a malfunction of the gallbladder.

The gallbladder contains bile, which is secreted by the liver, then the bile is injected into the small intestine, where it breaks down fats that have entered the body with food. Bile enters the intestine from the gallbladder through the common bile duct.

If the bile is not removed from the gallbladder, or cannot pass through the common bile duct, then it returns back to the gallbladder, resulting in the development of biliary dyskinesia.

You can get dyskinesia at any age. There are also statistics, JVP in young people is characterized by excessive bile secretion, and at a more mature age, its insufficiency for digestion is observed. The treatment of this disease has positive prognosis if the patient consults a doctor at the first symptoms.

According to statistics, women suffer most from biliary dyskinesia. Some statistics indicate that women are 10 times more susceptible to this disease than men.

Causes of biliary dyskinesia

Biliary dyskinesia is formed partly through the fault of the person himself or for independent reasons.

Improper nutrition since childhood

• lack of hot meals;
• dry food;
• lack of vegetables and fruits;
• "hungry" diets for weight loss;
• long breaks (in childhood - violation of the daily routine and nutrition);
• one-time overeating;
• fatty and fried foods with spicy sauces;
• pickles;
• fast food;
• carbonated drinks.

stress

Protracted stressful situations and mental trauma can cause functional disorders of the biliary tract. They proceed against the background of vegetovascular dystonia.

lack of movement

Any movement stimulates muscle contractions of the biliary system. The absence of this mechanism leads to stagnation of bile. We see such an example in cases of prolonged stay in bed with serious illnesses.

Diseases

Transferred viral hepatitis, infection with lamblia, worms causes a mandatory disruption of regulation.

Hormonal disbalance

The importance of the hormonal system is indicated by the increase in the incidence of women in menopause.

Symptoms of biliary dyskinesia

Symptoms of biliary dyskinesia include various painful sensations that differ depending on the type of disease.

With hyperkinesia of the biliary tract and hypertension of the sphincter of Oddi (excessive secretion of bile), the symptoms are as follows:

Pain in the right hypochondrium after physical and emotional stress, eating fatty, spicy, smoked foods.

Besides:

• nausea;
• vomit;
• bitterness in the mouth.

Hypokinesia of the biliary tract and hypotension of the sphincter of Oddi in JVP can be distinguished by the following symptoms:

• dull pain in hypochondrium after eating;
• feeling of fullness in the right hypochondrium;
• stool disorder.

There are also common symptoms of biliary dyskinesia, regardless of the forms of the disease:

• biliary colic;
• liver enlargement;
• jaundice;
• pain on palpation in the gallbladder area;
• feces and urine change color;
• stool disorder;
• flatulence;
• dry mouth;
• bad breath;
• chronic fatigue.

Treatment of biliary dyskinesia

In the treatment of dyskinesia, two directions are used: surgical and conservative. If there are general symptoms of the disease in the form of neurotic disorders, it is necessary to consult a psychotherapist.

Which doctors to contact for biliary dyskinesia:

Medical treatment

In the case of dyskinesia of the hyperkinetic type, sedative drugs of the hypokinetic type are prescribed - stimulant drugs (eleutherococcus and pantocrine). To stimulate the secretion of bile into the duodenum, cholekinetics are prescribed, for example, berberine sulfate (3 times a day, 5-10 ml before meals). For the same purpose, an alcohol tincture of barberry leaves, a decoction of tansy or a solution of sorbitol can be used.

In addition to cholekinetics, choleretics (allochol, cholenzyme and holagon) are used to facilitate the flow of bile into the intestine and enhance its secretion in the liver. A good effect is the use of mineral water 1 hour before meals, as well as physiotherapy exercises. In the case of biliary dyskinesia of the hyperkinetic type, fats and food irritants are limited.

Antispasmodics are widely used: noshpa, papaverine, etc. Anticholinergics, such as gastrocepin, are also used. To reduce the muscle tone of the sphincter of Oddi, nifedipine is prescribed 10-20 mg 3 times a day. Low-mineralized mineral waters are also recommended. Electrophoresis with novocaine, antispasmodics and magnesium sulfate has a good effect. The use of choleretic agents is not recommended.

Additional procedures

Besides:

• acupuncture;
• diadynamic therapy;
• acupressure;
• hirudotherapy (treatment with leeches).

Surgery

With unsuccessful long-term conservative therapy, surgical treatment is indicated. The operation must guarantee the free outflow of bile into the duodenum; the most appropriate method should be considered the imposition of choledochoduodenoanastomosis. If this is not possible, choledochotomy with submersible drainage should be used.

Folk remedies for the treatment of biliary dyskinesia

Folk remedies for the treatment of biliary dyskinesia should be used only after consultation with your doctor.

Diet for biliary dyskinesia

Healthy and proper nutrition is an important part of the treatment of biliary dyskinesia. When the first signs of the disease appear, you need to reconsider your diet.

The functioning of the gallbladder depends entirely on the type and amount of food consumed. Therefore, the diet menu must be planned from products that contribute to the proper functioning of the gallbladder.

• honey, sugar and non-chocolates;
• teas: regular and herbal;
• bran or rye bread;
• vegetarian soups and borscht;
• boiled lean meat, preferably poultry;
• fruits and vegetables in any form;
• chicken eggs (but not more than one yolk per day, there are no restrictions on protein);
• vegetable oils and fats;
• dairy products, low-fat;
• fruit and vegetable juices;
• berries of sweet varieties;
• cereals and pasta.

Prohibited Products

• all types of sausages;
• strong tea, coffee and cocoa;
• desserts containing refined fats;
• garlic, onion, radish, mushrooms;
• fried foods;
• rich pastries, puff and shortbread dough, fresh bread from premium flour;
• chocolate products;
• spicy seasonings and sauces;
• mineral water with gas and carbonated drinks;
• broths from meat, fish, poultry;
• alcoholic drinks of all kinds;
• beans, beans and other legumes;
• meat products of fatty breeds (lard, red meat, liver, heart, kidneys);
• smoked products.

Basic nutrition rules

Proper nutrition is one of the most effective ways to improve the condition of the gallbladder and biliary tract. Thanks to the food you eat, you can easily adjust the secretion of bile. You need to eat in small portions (about 150 grams), but often (4-6 times a day). The diet for biliary dyskinesia has a fractional nature of food intake.

Between meals should be an equal interval in time. Do not load your stomach before going to bed, it is better to drink a glass of kefir or tea. Often, just by maintaining a diet, it is possible to completely normalize the condition of the bile ducts. Remember that cholesterol leads to stagnation of bile in the bladder, which in turn leads to the formation of stones.

Therefore, it is necessary to prepare food from products that do not contain a high concentration of cholesterol in their composition. You should also remember about the water balance of the body. It is necessary to drink at least two liters of liquid per day, which can be in the form of: water, tea, juices, fresh juices, milk, etc. Preference should be given to non-carbonated drinks, preferably without sugar.

Biliary dyskinesia in children

Biliary dyskinesia in children is a functional disorder of the gastrointestinal tract, a disturbed outflow of bile into the duodenum, in other words, a change in the tone and motility of the biliary system that disrupts the full outflow of bile.

In order to diagnose biliary dyskinesia in children, ultrasound of the gallbladder is performed on an empty stomach and after taking a choleretic breakfast, duodenal sounding, less often - cholecystography, hepatobiliscintigraphy.

Causes of biliary dyskinesia in children

The causes of functional diseases are mainly disorders of the regulation of the organ in which the functions are impaired. Changes in the regulation of the nervous system occur mainly due to the occurrence of stress and psycho-emotional factors and are caused by organic disorders of the central nervous system or disorders of the autonomic system. This causes the development of autonomic dysfunction.

Organic DZHVP also arise as a result of impaired development of internal organs, with the pathological development of the gallbladder, as well as the excretory ducts. JVP often accompanies diseases of other organs of the digestive system.

Symptoms of biliary dyskinesia in children

The main manifestations of biliary dyskinesia in children are pain syndrome, dyspeptic syndrome and positive bladder symptoms. The nature of manifestations depends on the form of dysfunction.

Children, with this disease, complain of a painful formation in the right side, often spreading to the right shoulder blade. There are also a number of symptoms that periodically disturb children. These symptoms of dyskinesia are caused by a violation of nutrition, lifestyle, daily routine, nervous situation, stress, mental or physical stress, etc.

The disease is manifested by pain in the abdomen, mainly in the right hypochondrium. Aching or cramping pains are accompanied by dyspeptic disorders:

• nausea;
• vomit;
• bitterness in the mouth;
• intolerance to fatty foods;
• unstable chair.

A characteristic feature is the connection of pain with neuropsychic and physical overload.

Treatment of biliary dyskinesia in children

The basis of the productive treatment of children with biliary dyskinesia is dietary nutrition with the restriction of the use of fatty, fried, spicy, salty, sweets, soda. Fractional (5-6 times a day) meals are recommended, enrichment of the diet with foods high in vegetable fiber, vitamins A, B, C, bifidus and lactobacilli, vegetable refined oils. It is necessary to regulate the motor mode of the child, create a favorable emotional background. In all cases, attention should be paid to the treatment of the underlying disease.

Children with hyperkinetic-hypertonic type of biliary dyskinesia are prescribed sedatives (herbal teas, novopassitis, persen), antispasmodics to relieve pain attacks (papaverine, no-shpa). The basis of the treatment of hypertensive-hyperkinetic biliary dyskinesia in children is choleretics and cholespasmolytics (flamin, allochol, cholenzym).

Psychotherapy, acupuncture, physiotherapy (paraffin baths, diathermy, inductothermy, electrophoresis with antispasmodics), massage of the cervical-collar zone have proven themselves well in the treatment of biliary dyskinesia in children.

With hypotonic-hypokinetic biliary dyskinesia in children, stimulating procedures are prescribed:

• physiotherapy;
• hydrotherapy;
• massage.

Choleretic drugs with anticholinergic effect are used:

• xylitol;
• sorbitol;
• magnesium sulfate.

Herbal infusions are used:

• corn silk;
• rose hip;
• calendula.

Medical choleretic tubes are carried out. Of the physiotherapeutic methods used;

• galvanization;
• electrophoresis with magnesium sulfate;
• Bernard currents.

Types of biliary dyskinesia

Allocate the main indicators of the work of the biliary tract - the tone of the muscles and sphincters and kinesia (outflow of bile along the passages). Based on these two indicators, there are several options for JVP:

• hypotonic (with a decrease in the tone of the sphincters);
• hypertonic (with increased tone);
• hypokinetic (with slowing down and lethargy of the outflow of bile);
• hyperkinetic (with outflow activations, a sharp release of portions).

In practice, doctors use a dual classification, for patients, knowledge of the hypotonic and hypertonic types is sufficient, in addition, a mixed type is also distinguished. Manifestations of various types of the disease vary significantly.

Diagnosis of biliary dyskinesia

Diagnosis is based on the analysis of complaints, examination data and the results of additional research methods.

A valuable diagnostic method for this pathology is ultrasound. Ultrasound allows you to identify the nature of motor disorders of the gallbladder, to diagnose anomalies of the biliary tract (kink, torsion, etc.). Very often, it is precisely such structural features of the biliary tract or gallbladder that are the direct cause of dyskinesia.

Differential Diagnosis

Biliary dyskinesia in the diagnosis must be differentiated from:

• cholecystitis;
• duodenitis;
• pancreatitis (hypotonic form of dyskinesia);
• peptic ulcer (hypertensive form of dyskinesia);
• adnexitis.

The hyperkinetic form of gallbladder dyskinesia must also be differentiated from:

• an attack of angina pectoris;
• myocardial infarction (abdominal form);
• intestinal obstruction;
• hepatic colic.

Prevention and prognosis of biliary dyskinesia

Prevention of primary biliary dyskinesia requires adherence to the principles of healthy eating, timely correction of disorders of the psycho-emotional sphere; prevention of secondary dyskinesia - elimination of the underlying disease.

Primary biliary dyskinesias have a favorable prognosis, however, it should be taken into account that the long-term stagnation of bile in the gallbladder with hypokinetic dyskinesia contributes to the development of inflammation, as well as bile dyscrinia and stone formation. The course, development of complications and prognosis in patients with secondary dyskinesias depend on the course of the underlying disease.

Questions and answers on the topic "Biliary dyskinesia"

Question:Hello! I was diagnosed with JVP and chronic gastritis (according to the results of ultrasound and FGDS). It hurts constantly in the left side (the pain subsides for a while and reappears. I drank a course of De-nol, Omeprazole, Itopride, it didn’t get any better, Hofitol, Festal and Nosh-pa were prescribed. Please tell me what kind of examination can still be done?

Answer: Ultrasound and FGDS enough. Treatment should be accompanied by a strict diet.

Question:Hello. Tell me, JVP can somehow influence the weight? I mean the ratio of body weight to height. I am worried about my body weight, or rather lack of mass. There are no deviations in symptoms. Sometimes the pain in the hypochondrium bothers me when I eat fat. As a child, Botkin was ill.

Answer: Hello. With any type of biliary dyskinesia, digestion is disturbed, the absorption of nutrients worsens, and fat metabolism is especially affected. In addition, with a lack of bile, appetite decreases. With a prolonged course of the disease, patients begin to slowly lose weight.

Question:Hello, I am 31 years old. I was diagnosed with dyskinesia of the duodenum and biliary tract 7 years ago, then I underwent a course of treatment and still did not bother. Now the pains have begun again and are stronger in the area of ​​the solar plexus, sometimes they are accompanied by pains in the area of ​​the liver and seizes the whole stomach, it also happens with strong spasms that fills the mouth with some kind of liquid. I drink the medicines that were prescribed to me then, i.e. mezim, allohol, I also drank a decoction of calendula and a decoction of corn stigmas, befungin - it does not help. Tell me what it is and how to treat it.

Answer: Hello, you need to do an ultrasound of the abdominal cavity and FGDS with a test for H. pylori, with the results for a consultation with a gastroenterologist. You can take Duspatalin 1 capsule 2 times a day.

Question:Hello! The child is 4 years old. Call into question biliary dyskinesia. They did an ultrasound: gallbladder after a trial breakfast 6.1 cm * 1.4 cm. V=5.3 cm3. The walls are thin 0.1 cm. The form is normal, the content is heterogeneous. There are no concretes. Contractile function 65%. Gallbladder after 40 min. after a trial breakfast 4.8 * 0.8, V = 1.9 cm3. Ultrasound on an empty stomach was not done, I did not understand the doctor. Is it possible to determine the diagnosis in this way or not? Haven't been in yet.

Answer: Hello. Ultrasound with a choleretic breakfast is done on an empty stomach, then breakfast is given and ultrasound is watched in 15-30-45-60 minutes. More often, polyclinic doctors are limited to research on an empty stomach and after 30 or 45 minutes.

Question:Hello! I am 23 years old, after examination (ultrasound, swallowing a tube, probing the gallbladder) I was diagnosed with gastroduodenitis, pancreatitis, biliary dyskinesia. Concerns about nausea, especially in the morning, poor appetite, weakness. Help please, what treatment will be the most effective?

Answer: Hello. It is impossible and impossible to give any recommendations abstracted from the patient and the examination data. Your symptoms are not specific, they can occur in almost any disease of the digestive system. Everything should be discussed with your doctor.

Dyskinesia of the gallbladder and biliary tract (JBP) is a disease that occurs when there is a violation of the motor (motor) function, as well as the tone of the gallbladder and ducts. At the same time, there is a violation of the flow of bile into the duodenum, which is accompanied by digestive disorders.

More than 70% of diseases of the biliary (biliary) system are accounted for by this pathology. More often, females are sick, especially young people with asthenic (thin) body type.

If the disease could not be identified and cured in time, then the following conditions may develop over time: cholecystitis (inflammation of the gallbladder), cholangitis (inflammation of the bile ducts), cholelithiasis (formation of sand and stones in the bile ducts).

Dyskinesia of the gallbladder and biliary tract is primary or secondary. There is a theory about the possibility of hepatocytes to synthesize already pathologically altered bile.

Primary JVP

Primary dyskinesia of the gallbladder and biliary tract appears under the influence of various pathological factors in the primary unchanged biliary tract.
The main reasons for the formation of primary JVP are:

• Acute or chronic stressful situations and, as a result, dysfunction of the autonomic nervous system.
• Abuse of food with a high content of fats, fast food, frequent overeating and other nutritional errors.
• Hypodynamia, asthenic (thin) body type, weight deficit.
• Allergic diseases, especially chronic ones.
• Taking certain medications, for example, combined oral contraceptives, estrogens, which can change the composition of bile.

Secondary JVP

Secondary dyskinesia of the gallbladder and biliary tract appears against the background of human diseases and pathological conditions, complicating their course:

Psychosomatics is one of the types of alternative medicine that studies the influence of psychological causes on the development and course of somatic (bodily) diseases. A psychosomatic disease is a disease in which a medical examination did not reveal the organic or physical causes that caused it.

Psychosomatics is based on identifying emotional manifestations that affect the course of the disease.

Among people suffering from diseases of the biliary tract, there are two dominant psychological portraits:

1. People are conflicted, greedy and evil. Usually such individuals are very touchy, easily enter into conflicts and disputes, often provoke them themselves.
2. People prone to excessive self-sacrifice for others. The meaning of life of such individuals is service to humanity. They are practically devoid of ambition, tend to suppress negative emotions and “hide” them inside themselves. They do not give themselves the right to make a mistake and for a long time they “digest” any, even minor, mistakes.

Psychosomatics involves the treatment of such patients in the form of psychotherapeutic methods, a revision of their life principles and positions. Lifestyle adjustments are being made. According to the principles of psychosomatics, most of these diseases are inherited.

Therefore, their treatment is mandatory, at least from the point of view of the health of future children. For example, the first type of people will be recommended to learn to forgive other people, to control anger and irritability.

A child suffering from JVP is characterized by such traits as punctuality, strict fulfillment of promises, conscientiousness. And at the same time, such children are vulnerable, suspicious, especially to everything new. Differ in the increased cleanliness. They are closed with a tendency to self-accusation.

JVP classification

There is no single classification of dysfunctional disorders of the biliary tract. In clinical practice, the following criteria are distinguished:

1. According to the localization of the process - dysfunction of the gallbladder (by hyper or hypomotor type), dysfunction of the sphincter of Oddi.
2. By nature of occurrence - primary and secondary.
3. According to the state of functioning - hyperfunction and hypofunction.

Symptoms

Clinical manifestations are due to the type of JVP. The tone of muscles and sphincters, as well as the intensity of bile secretion (kinesis) are the main criteria for their work. Based on this, four types of violations are distinguished:

• Hypotonic (hypomotor) - a decrease in the tone of muscles and sphincters.
• Hypertonic (hypermotor) - increased muscle tone.
• Hypokinetic - sluggish outflow of bile, slowing down the release.
• Hyperkinetic - active outflow of bile, a sharp release.

Such a detailed distinction of JVP is used by physicians. To understand the topic, it is enough to divide into hypotonic and hypertonic types. There is also a mixed one, which is characterized by symptoms of both types of varying severity.

DZHVP on hypertonic type

Often diagnosed in children and young adults.

Pain occurs in the liver during exercise, running.

Her character is sharp, sharp, piercing. Similar to that in hepatic colic or attack. The pain sometimes radiates to the right arm, shoulder blade.

Pronounced dyspeptic symptoms develop: nausea and vomiting at the height of pain, a tendency to diarrhea. The tongue is often coated with white.

There are manifestations of asthenovegetative syndrome: fatigue, decreased performance, weakness, frequent headaches, appetite disorders - anorexia (decrease or absence of it). There is weight loss.

JVP by hypotonic type

It usually develops in people over 40 years of age.
Pain also appears in the right hypochondrium, however, its intensity is somewhat less.

Dyspeptic symptoms usually occur after eating.

The most pronounced belching, bitter taste in the mouth, nausea. Vomiting is rare. Often there is flatulence (accumulation of gases in the intestines). Chair unstable, tendency to constipation. Obesity often develops.

Hypotension of the gallbladder leads to stagnation of bile, as a result of which stones form in it and cholelithiasis develops. And the addition of an infection, which is facilitated by hypotension of the gallbladder, usually leads to the development of cholecystitis or cholangitis.

Features of JVP in children

The disease occurs in children older than three years. More common hypermotor and mixed type, less often - hypomotor.

JVP is the most common and early pathology of the hepatobiliary system in children.

The causes and mechanisms of the development of JVP in a child practically do not differ from those in an adult.

With the development of JVP in children, symptoms from the nervous system often appear. The child becomes whiny, gets tired quickly, schoolchildren's working capacity decreases. Also, the child may have hypodynamia, sweating, palpitations and other symptoms.

The main symptoms and diagnosis of JVP are identical in a child and in an adult.
In the treatment of JVP, the main emphasis is on the nutrition of the child both during an exacerbation and outside it.

Dispensary observation of a child with dysfunctional biliary disorders is carried out for three years from the last exacerbation.

To prevent the development of a child's JVP, it is necessary to monitor his diet, to prevent overeating. It is also necessary to protect the child from stressful situations, prevent emotional overstrain and correct autonomic disorders in a timely manner.

Diagnostics

Diagnosis of JVP is based on the patient's complaints, their connection with food intake.
Laboratory and instrumental research methods are also used.

In primary JVP, there are usually no changes in laboratory tests. In the secondary - changes are due to the nature of the pathological process, during which there was dyskinesia of the gallbladder and biliary tract.

If necessary, analyzes are made for the presence of helminths in the body.
Among the instrumental methods of examination, the most widely used are:

Treatment must be comprehensive. In addition to DZHVP, treatment is aimed at eliminating all possible causes, under the action of which dysfunction of the gallbladder and biliary tract appears.

It is mandatory to treat all primary diseases, against the background of which DZHVP occurs - cholecystitis, hepatitis, peptic ulcer, etc.
The main condition is the correction of lifestyle and nutrition.

Diet

In the treatment of JVP, proper nutrition is very important. With an exacerbation of the disease, a special diet should be observed. Sometimes only a change in diet and lifestyle adjustments can cure the disease.

The special diet that is prescribed for JVP corresponds to Pevzner's diet No. 5.

The diet involves limiting fat while maintaining calorie content and the ratio of other components - proteins and carbohydrates.

The diet is based on the application of the principle of fractional nutrition: food is consumed often and in small portions. You should avoid overeating and try to take food at the same time whenever possible. This diet regime allows you to regulate the release of bile and prevent its stagnation.

Food consumed during the diet should be cooked in the form of cooking or baking, sometimes stewing. Dishes are served warm.

With diet No. 5, moderate salt restriction and an increase in fluid intake to 2–2.5 liters per day are recommended. Alcohol should be excluded. It is necessary to have fiber in the daily diet menu and enrich it with vitamins and minerals.

In clinical nutrition - diet number 5 there is a list of allowed and prohibited foods. We won't stop there. It is only important to note that when dieting, it is necessary to exclude foods that affect the tone of the biliary tract, provoke irritation of the digestive tract, and also cause stagnation and thickening of bile.

When following the basics of therapeutic nutrition, in most cases digestion and stool improves, the production and release of bile is normalized. Symptoms of JVP become less pronounced or completely disappear.

Non-compliance with the diet can provoke an aggravation of the symptoms of JVP and the development of diseases such as cholecystitis, cholelithiasis, cholangitis, diseases of the gastrointestinal tract, etc.

Medical treatment

Drugs used in the treatment of JVP are selected according to the type of disease (hypo or hypermotor). Related diseases and conditions are also treated.

Hypotonic type, drugs

With the hypotonic type of JVP, choleretics are used - drugs that increase the production and secretion of bile. These drugs contain bile acids and bile.

Prescribed drugs that have a tonic property on the autonomic nervous system, for example, Eleutherococcus tincture.
During the period of remission, a probeless tubage can be used.

Hypertensive type, drugs

In the hypertensive type, cholekinetics and antispasmodics are used. These drugs relieve spasm of sphincters, improve bile secretion. Sedative drugs are used for the proper functioning of the nervous system. These include bromine compounds - bromides and valerian preparations.

Some traditional medicines are also used.

With JVP, taking into account its type, physiotherapy can be used. Sanatorium treatment should be carried out without exacerbation. Recommended specialized sanatoriums.

Reception of medicinal mineral waters is highly recommended. Their selection should also take into account the type of JVP. For example, with hyperkinesia, water with a low content of minerals is used - Slavyanovskaya, Narzan, Essentuki 2 or 4, and with hypokinesia - with high mineralization (Arzani, Essentuki 17).