Cholelithiasis. Methods and methods of treatment of cholelithiasis. Causes of exacerbation and consequences

Today's topic: "Cholelithiasis, treatment with folk remedies" How to relieve attacks of biliary colic? How can you help yourself at home? Can stones be dissolved? Now you know everything. Go!

Peter is a real flint! During the service, he silently endured both a bullet in the shoulder and a sharpening in the side. But he retired - he became kind, lazy. When the pain seized, he didn’t understand what was happening to him, he was ready to climb the wall, roll on the floor. This has never happened before! It's a shame that it was not a gangster bullet that defeated him, but an insidious biliary colic ...
Hello friends!
Let's talk about what it is - cholelithiasis treatment with folk remedies. Trouble can come to anyone. It is better to know and warn than to suffer later.

What do you feel?

An insidious disease often sneaks up imperceptibly, is silent until it seizes you with an attack. But now, you are losing your appetite, you are worried about vague pains on the right under the ribs, indigestion, bloating.

In the mirror, you see that the skin has turned yellow and the eyes have acquired a shade of amber. Sometimes there is bitterness in the mouth. Pay attention that it becomes worse after fatty and spicy food. If there are such symptoms, it is time to run to the doctor for a diagnosis.

The most dangerous manifestation of the disease is an attack of biliary colic, from blockage of the bile duct by a stone:

there are sharp, unbearable pains in the abdomen on the right;

radiates to the shoulder and back, often to the heart, creating an appearance (Botkin's symptom);

the temperature rises;

nausea, vomiting that does not bring relief;

increased sweating;

the next day you will probably be all yellow.

The attack can be removed with antispasmodics, they are administered intravenously in the hospital, along with painkillers and antibiotics. But this is not a cure, but a temporary relief. We will talk about treatment below.

Cholelithiasis, treatment with folk remedies. How now to get rid of adversity?

The most unpleasant property of stones is that if they are, sooner or later you will end up on the operating table anyway. It is necessary to fight them at the initial stage, and even better - not to allow at all, without excess weight, and similar things. And of course, folk recipes will come to the rescue that will help get rid of problems.

Our natural doctors will improve the outflow of bile, help to liquefy it, dissolve small stones, relieve inflammation and spasms. They are able to help. But God forbid - to obey the advice of grandmothers and aunts, how to remove stones, such as: "after drinking a glass of lemon juice and two glasses of sunflower oil, lie down on a heating pad."

If you have a small sand, it’s not scary yet, but if the pebbles are larger than a couple of millimeters, the strongest biliary colic up to the rupture of the bladder, the operating table for an ambulance and cholecystectomy you are provided. It is better to act gradually and gently.

At home, you can make fees from mint, chicory, dill seeds, parsley roots and marshmallow. Very useful corn stigmas. They stimulate bile secretion, dilute it and help restore gallbladder motility. They can be bought at a pharmacy, along with instructions for use.

In addition to them, fennel, thyme, lemon balm, yarrow collections with pharmacy chamomile and buckthorn bark will help improve the condition.
Tansy flowers should be used with caution. They are not recommended if you already have stones, because they have a strong choleretic effect.

Cholelithiasis, treatment with folk remedies. Hurry up slowly

In the old days, our healers appreciated the slow impact, so that all processes take place gradually and gently. Ancestors recommended a decoction of beets.
All herbs and fees are applied in long courses, 2-3 months, with interruptions and repetitions. Of course, under the supervision of a doctor. Self-medication, as I said, threatens with troubles that can surpass the disease itself.

Could not prevent - have to cut

Conservative treatment is fraught with the fact that the bubble may burst due to a large number of stones. The outflow of bile is closed, the pressure inside is growing - the walls do not withstand. Imagine what will happen if concentrated bile spills into the abdominal cavity!

In most cases, if a diagnosis of calculous cholecystitis is made, surgery is indispensable. But it gives almost one hundred percent of a complete cure.

Operate either:

classical method cholecystectomy(scar on the belly up to 12 cm);
by laparoscopy (from 1 to 4 small incisions).

In the second case, the surgeon inserts tubes into the abdominal cavity through the holes, pinches the vessels and the gallbladder duct with titanium clips, separates the unnecessary with a laser scalpel, puts it in a special container and removes it through the incision at the navel. The wounds heal quickly, and after four to five days you can go home.

Medicine treats chronic calculous cholecystitis conservatively, only if the stones are cholesterol (that is, soluble), if there are few of them and they are no more than two centimeters in diameter.

Their composition can be determined on an x-ray (unlike pigment stones, they do not transmit radiation), and on special samples of bile. They dissolve in bile acids, for example ursodeoxycholic.
The process of dissolution of stones takes from one and a half to two years, and they almost always form again if not changed.

Cholelithiasis, treatment with folk remedies. Why is it important to eat right?

A general recommendation for everyone: you need to eat fractionally, often, and do not take long breaks.
Stones are formed in us from a violation of the metabolism of bilirubin and cholesterol. If the bladder contracts poorly, stretches, or no one needs its contents for a long time - it thickens - and the crystallization process begins. Women after forty develop ailments more often than men. Mostly adults are affected.
Contributes to the development of the disease:

elderly age;

obesity, overeating, refined carbohydrates;

passive lifestyle;

excess ;

rapid weight loss, hunger;

diabetes;

heredity;

pregnancy;

some medicines.

With cholelithiasis without exacerbation, a diet No. 5 is prescribed, which excludes fatty, spicy, fried, smoked, chocolate, soda, seasonings and alcoholic beverages. But the main thing is to understand that if we initially move a lot and give up bad habits, no stones will grow.

Add water and mode

So, prevention is better than cure.
Recovery with mineral water for cholelithiasis has been used for a long time. You can use hydrocarbon sulfate-sodium water, and in particular, "Narzan". For him, it is better to go to the sanatoriums of Kislovodsk. If there is a tendency to stagnation of bile - mineral water can bring significant relief. I hope the topic: “Cholelithiasis, treatment with folk remedies” is fully mastered.

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Cholelithiasis(also gallstone, gallstone and gallstone, abbreviated - GSD) - a disease of the gallbladder and bile ducts with the formation of stones. Although, the correct name of the medical term is like "" - ICD-10 code: K80.

The disease is complicated by inadequate liver function, hepatic colic, (inflammation of the gallbladder) and may obstructive jaundice with the need for surgery to remove the gallbladder.

Today we will consider the causes, symptoms, signs, exacerbation, treatment of cholelithiasis without surgery with medical and folk remedies when surgery is needed.

We will especially talk about the nutrition of patients (diet), menus that can and cannot be eaten during treatment without surgery and after it.

GSD is a very common disease in middle-aged and elderly people, which can be judged on the basis of the results of post-mortem (after autopsy of deceased people) studies: gallstones are found in every eighth person out of ten, although signs and symptoms of cholelithiasis can manifest themselves only in 10 % of cases out of 100.

The disease occurs mainly in adults, but there are rare cases when it occurs in children.

Causes of cholelithiasis

The causes of gallstone disease are varied. First of all, family predisposition plays a role in the development of the disease, especially along the female line. In addition, diseases such as gout, obesity, nephrolithiasis, etc. can contribute to the formation of stones in the bile. A very important factor in the occurrence of cholelithiasis is malnutrition: the disease is more common in obese people who lead a sedentary lifestyle.

Symptoms and signs: an attack of pain, what to do?

Symptoms

In general, the main symptom-sign of cholelithiasis is biliary colic, the manifestation of which is an attack of pain in the right hypochondrium. Attacks of biliary colic can last from several minutes to several hours, sometimes up to 1-2 days, during which they either stop or resume. Pain occurs in the right hypochondrium and spread throughout the abdomen.

An attack of pain can begin with good health, but of the signs, it is often preceded by nausea and a feeling of heaviness in the right hypochondrium or epigastric region.

Exacerbation of gallstone disease

Among the circumstances that provoke the appearance of colic, a fatty and plentiful dinner, and the intake of alcoholic beverages are of great importance. Hypothermia, overwork, shaking and riding, heavy physical exertion, harsh emotions, and so on play a role.

Colic can result in the release of a stone into the intestines and can sometimes be found in the stool 1-3 days after the attack.

What to do with an attack of biliary colic: first aid

Remember that during an attack of biliary colic, such patients need emergency medical care and hospitalization in the surgical department of a hospital.

The operation is always indicated when the early clinical symptoms of calculous cholecystitis are superimposed on the existing signs: fever, persistent colic, the absence of a relative calming of the pathological process between attacks.

So call an ambulance or yourself, if possible, go to the surgery hospital.

All you can do for the patient at home is:

Soothe the patient who is excited by pain and fear.
Lay him on his right side, placing a heating pad under the body (heat will help eliminate spasms in smooth muscles).
Give him an antispasmodic drug: No-shpu (Drotaverine).

So that can be taken at home, only No-shpa tablets according to the instructions for use attached to them, or inject Noshpa solution intramuscularly, you will not have anything else at hand. The doctors will do the rest.

Urgent care

When providing emergency therapeutic care, they begin with the subcutaneous injection of 1 ml of 0.1% Atropine sulfate or 1 ml of a 0.2% solution of Platyfillin and other strong antispastic agents.

Most patients have to administer, in addition to antispastic drugs, painkillers - Omnopon, Promedol (2 ml of a 1% solution). More often, with severe biliary colic, both Atropine and Omnopon are administered simultaneously. Sometimes pain relieves Nitroglycerin (under the tongue).

The use of heat is useful: hot general baths, heating pads, warming compresses.

Outside of an attack, a course of antispastic and choleretic therapy is carried out.

With stones in the gallbladder of large sizes, a surgical method for the treatment of gallstone disease is used, in which the surgical removal of stones occurs - cholecystectomy.

Treatment of gallstone disease

Treatment of cholelithiasis without surgical intervention with folk and medical means

I will immediately warn you that the treatment of cholelithiasis in an adult, and even more so in a child, should be prescribed by general practitioners and pediatricians, including alternative herbal treatment. Do not hope that everything will “resolve”, first go to the doctor, and then take on medicinal herbs and medicinal plants.

6‑12 flowers marigolds pour a liter of boiling water and cook for 3 minutes. Cool the broth, drain and save it. Pour the flowers again with 800 ml of boiling water, boil for 6 minutes. Combine the first and second decoctions, take 1 glass in the morning and evening.

With cholelithiasis, as well as with kidney stones, a strong decoction has a beneficial effect parsley(together with the root).

Three times a day after meals, drink a glass of mixed in equal proportions cabbage pickle and tomato juice(from fresh vegetables).

cook collection 1:

wormwood herb;
buckthorn bark;
madder root;
immortelle flowers;
dandelion root.

Take everything in equal parts. Steep 2 tablespoons of the mixture in a glass of boiling water. Insist 1 hour, strain. Drink morning and evening 1 glass.

Take leaves in equal parts peppermint and celandine grass. Pour 2 tablespoons of the mixture with a glass of boiling water, leave for 1 hour, strain. Drink morning and evening 1 glass.

beetroot syrup. Take a few heads of beets, peel, cut and boil them for a long time until the broth thickens and becomes like syrup. Take this decoction in a quarter cup 3 times a day before meals. Healers recommend drinking such a syrup for a long time, then the dissolution of stones in the gallbladder will occur gradually and painlessly.

Infusion of horseradish in milk. Grate 4 tablespoons of horseradish, mix with a glass of milk, heat almost to a boil (but do not boil) and leave in a warm place for 10 minutes. Then strain, squeeze out the thick and drink a little of everything throughout the day.

Drink right away 10 glasses very hot tea during 15 minutes. This greatly softens the stones, turns them into sand and makes it easier to exit.

Decoction of dandelion roots. Pour a teaspoon of crushed roots with 1 glass of water, boil for 20 minutes. Drink one fourth of a glass 4 times a day.

Birch leaf decoction

Option 1. Pour a glass of boiling water over a tablespoon with the top of birch leaves, boil for 20 minutes, insist for 1 hour, strain. Drink a glass of decoction for a long time 2 times a day half an hour before meals.

Option 2. Gather and dry a penny-sized spring birch leaf. Pour 2 tablespoons of a dry leaf with a glass of boiling water, boil over low heat until the volume is reduced by half, when it cools down - strain. Take 1 dessert spoon 3 times daily before meals. The course of treatment is 3 months. Good for small stones. When the stones come out, pain, nausea, cramps are possible.

Infusion birch leaves drink 3 cups daily.

Olive oil. Take the oil half an hour before meals, starting with half a teaspoon and working up to half a glass. Treatment lasts 2-3 weeks.

Infusion corn silk. A tablespoon of stigmas per 600 ml of boiling water. Brew, insist and drink one-fourth of a glass 3-4 times a day.

Rowan red. From stones in the liver and ducts, it is necessary to eat forest (not sweet) mountain ash for a month and a half. Eat with anything: bread, tea, sugar. During the day, eat 2 cups of fresh rowan.

Infusion immortelle flowers. Pour a tablespoon of flowers with a glass of boiling water, leave for 1 hour, strain. Take one third of a glass 3 times a day.

Herb infusion geranium meadow. Pour 2 teaspoons of herbs with 2 cups of cold boiled water, leave for 8 hours. Drink in sips throughout the day. The tool is used as a dissolving stones in the kidneys and liver.

Olive oil blend With grapefruit juice. Mix one-fourth of a glass of olive oil with the same amount of grapefruit juice, drink at night, but not earlier than an hour after eating. Before taking the mixture, make a cleansing enema. After that, lie down in bed on your right side, placing a warm heating pad under it. Repeat the enema in the morning. It is used for stagnation of bile and cholelithiasis.

Before starting treatment, you need to fast for a day, drink only water. Then put an enema, and after an hour, drink a glass of olive oil and grapefruit juice, one after the other. Usually after this there is a strong vomiting, to avoid it, you have to suck on a lemon. You can't drink water. If you are very thirsty, you can drink a sip of salt water.

15 minutes after taking olive oil with juice, you should drink a glass of laxative (epsom salt). And after 15 minutes you can drink water. You need to continue to starve. Repeat the treatment in a day.

When the stomach is cleared, you need to watch if the stones come out. Usually they float in water and have a greenish, brownish, creamy color, after a while they settle to the bottom. The treatment should be repeated until all the stones are gone.

An x-ray should be taken before starting treatment in order to know the size of the stones, and at the end of treatment, the picture should be repeated to make sure that they have completely disappeared.

Medications: drugs, medicines, remedies

Treatment of the disease in the framework of traditional medicine is conservative, that is without surgery and surgical With operation, which we will consider below.

Therapeutic method includes:

diet,
extracorporeal wave shock lithotripsy - the destruction of stones by a shock wave created by specialized equipment - the stones are crushed to a size of 1-2 mm and exit the body on their own,
dissolution of stones in the gallbladder with the help of special drugs.

Medicines that dissolve stones

These are Henofalk (Khenodiol, Henohol) and Ursofalk.

These drugs contribute to the dissolution of only gallstones of a certain chemical composition, namely, cholesterol gallstones (not calcified), single, small diameter (up to 2 cm).

Cholesterol stones are visible on ultrasound but are not detected on plain x-rays (non-contrast stones). The effectiveness of drugs is noted in a small percentage of cases, and then under the condition of long-term use (from 1.5 months to a year or more). After their cancellation, relapses are possible.

To control the treatment and after it, periodic x-ray and repeated ultrasound examinations are carried out.

The daily dose of henofalk for an adult is 15 mg per 1 kg of body weight (average 0.75 g). Assign 1 capsule (250 mg) in the morning and 2 capsules (0.5 g) in the evening. The maximum daily dose is 1.5 g (6 capsules).

Ursofalk is prescribed from 2 to 5 capsules per day (depending on body weight - 10 mg / kg). Take the entire dose daily at bedtime, without chewing.

If the stones in the gallbladder are small, cholesterol, and if a person is not bothered by pain in the right hypochondrium (asymptomatic stone carrying) and, moreover, he has the opportunity to buy and take these drugs for a long time, then it is worth trying a course of such medication. There are chances to get rid of the stones, but they are few.

At the same time, it is worth remembering that when pain appears, it makes no sense to increase the dose of drugs - they do not relieve pain.

In such situations, an urgent examination of the surgeon is necessary. These drugs can also be taken when surgery is contraindicated due to high operative risk in elderly patients and patients with severe comorbidities. In other cases, relying on such treatment is risky.

To conservative methods of treatment also applies:

The use of alkaline salts, mineral waters to facilitate the evacuation of bile from the gallbladder and its dilution (Carlsbad salt, burnt magnesia, Essentuki-20 and other mineral waters).
Compliance with a diet with restriction of products containing cholesterol, fats and animal proteins.
Regulation of meals; patients should be advised to eat moderately, regularly, and often, as eating is a natural means of facilitating the outflow of bile.
Appointment of antispasmodic and analgesic drugs, as well as drugs that dissolve stones.
Appointment of thermal procedures: heating pads, diathermy, compresses, etc.

Surgical treatment of cholelithiasis

Surgical treatment is advisable and necessary not only for acute cholelithiasis, but also for minor symptoms of chronic calculous cholecystitis.

Large stones - more than 30 mm create a risk of bedsores, and small stones - 5 mm or less can go into the bile ducts and clog them, which also leads to the need for surgery to remove stones or the entire gallbladder entirely.

Remember that a planned operation should be carried out before repeated attacks of biliary colic, in the absence of complications of cholelithiasis and concomitant pathology.

Laparoscopic cholecystectomy

This is a promising method that saves the patient from a long stay in a hospital bed in the postoperative period. Also minimal cosmetic defect. With a conventional abdominal operation, the postoperative scar is very large.

It must be understood that the removal of the gallbladder in calculous cholecystitis does not relieve patients of metabolic disorders, including hepatocellular dyscholia, which persists after surgery.

In many patients, lithogenic bile is determined in the laboratory, which disrupts the digestion and absorption of fat and other lipid substances. The bactericidal activity of bile decreases, which leads to microbial seeding of the duodenum, weakening the growth and functioning of the natural intestinal microflora.

There are many patients who, after resection of the gallbladder, have pain in the right hypochondrium and dyspeptic disorders.

The state of stable compensation and adaptation in patients undergoing cholecystectomy is achieved by observing the diet and using medications.

Nutrition: diet without surgery for cholelithiasis

There is a special therapeutic diet number 5, which contains a detailed menu of products that you can eat and what you can’t with diseases of the liver and biliary tract.

Food preparation technology: dishes are cooked boiled, baked, food is salted normally. The temperature of the food taken is warm. Eat at least 4 times a day, and preferably 5-6 times.

What foods can be eaten: allowed

Bread of yesterday's baking or dried wheat, rye, "doctor's" and other types of bread, biscuits from lean dough.
Soups - various, from vegetables, cereals, pasta on vegetable broth or dairy, fruit soups.
Meat and poultry dishes - from lean beef, boiled poultry or baked after boiling, in pieces or chopped. Milk sausages.
Fish dishes - various low-fat varieties of fish (cod, pike perch, navaga, pike, carp, silver hake) boiled or steamed.
Vegetables - various types of vegetables and herbs, non-acidic sauerkraut, canned green peas, ripe tomatoes.
Dishes from flour, cereals, legumes and pasta - crumbly semi-viscous cereals, puddings, casseroles, dishes from oatmeal, buckwheat porridge are especially recommended.
Eggs - no more than one per day in the form of adding to meals, protein omelet.
Fruits, berries, sweet dishes - various, except for very sour, fruit preserves, compotes, jelly, lemon (with tea), sugar, jam, honey.
Milk, dairy products - milk with tea, condensed, dry, fat-free cottage cheese, sour cream in a small amount, mild cheeses (Dutch, etc.). Cottage cheese and curd products are especially recommended.
Fats - butter, vegetable oil (up to 50 g per day).
Snacks - soaked herring, pressed caviar, salads and vinaigrettes, jellied fish.
Drinks - tea and weak coffee with milk, non-acidic fruit and berry juices, tomato juice, rosehip broth.

What not to eat: prohibited

Lamb and pork smoked meats, sausages, fatty fried foods; lamb, pork, goose fat, spicy sauces, margarine, meat, fish, mushroom rich broths.
Horseradish, onion, garlic, pepper, mustard, sorrel, peas, beans, radish, radish, mushrooms, salty foods.
Chocolate, chocolates, natural coffee, cocoa, carbonated drinks, chewing gum can have a negative effect.
Do not eat food or drinks from the refrigerator.

Nutrition: diet after gallbladder removal

In order to avoid complications after surgery to remove the gallbladder (cholecystectomy) - the term "postcholecystectomy syndrome", a diet menu has been developed - treatment table No. 5, which you have already read above. The most important thing: fractional nutrition and limiting fatty, smoked and spicy foods.

The post-operative strategy is to regularly open the sphincter to release bile from the ducts to avoid an increase in bile pressure in them, because there is no gallbladder.

Rehabilitation lasts about one year, so that the body of the operated person can adapt to new changes in his physiology.

I set out the rules of nutrition in time after the operation - six meals:

Breakfast: porridge - a carbohydrate dish, a protein omelet and tea.
Second breakfast after three hours: juice with crackers (low-calorie cookies or bran). In order to regularly open the sphincter to release bile and not increase its pressure in the ducts, you need to change the composition of bile, thereby nullifying the risk of the formation of new stones - bran is just what you need.
Lunch, after another three hours: 1st vegetable dish - soup, cutlet (boiled chicken breast) with boiled carrots and jelly (compote).
Snack, also after three hours: an apple.
Dinner: boiled fish with mashed potatoes, carrot and apple salad, tea with milk. Last meal 4 hours before bed.
1 hour before bedtime: a glass of kefir.

Alcohol intake is prohibited, it increases the load on the liver.

Therapeutic diet number 5: Nutritional value consists of: 100 gr. Belkov, 100 gr. Zhirov and 400 gr. Carbohydrates. Calorie content - 3200. Do not eat too hot and cold food.

general description

Gallstone disease is a fairly common diagnosis, and the peculiarity lies in the fact that susceptibility to it, as well as the causes provoking its development, is quite difficult to trace. The fact is that in most people, gallstone disease occurs latently, that is, in a latent form without any special manifestations. In the structure of various diseases that affect the digestive organs, cholelithiasis occupies a significant place precisely because of its prevalence.

Industrialized countries have statistics on this score of about 15% incidence, while it can be noted that the prevalence directly depends on the age and sex of patients. In particular, men suffer from this disease twice as rarely as, respectively, women. Every fifth of women aged 40 and over is faced with gallstone disease, while men of the same age experience it in every tenth case. Up to 50 years, gallstone disease is observed in about 11%, from 50 to 69 - up to 23%, from 70 years and more - up to 50%.

Let us dwell directly on the features of the course of the disease. The movement of bile, carried out by it along the biliary tract, occurs due to the coordination of the functions of the gallbladder, liver, pancreas, bile duct and duodenum. Already due to this, in turn, bile enters the intestines in a timely manner during digestion, in addition to this, it accumulates in the gallbladder. With the stagnation of bile and with a change in its composition, the process of formation of stones begins, which is also facilitated by inflammatory processes in combination with motor-tonic disorders of bile secretion (that is, dyskinesia).

Gallstones are cholesterol (the vast majority, about 90% of the variants of gallstones), as well as stones pigmented and mixed . So, due to a supersaturation of bile with cholesterol, the formation of cholesterol stones, its precipitation, and the formation of crystals occur. Violation in the gallbladder of the motility leads to the fact that these crystals do not enter the intestine, which ultimately leads to their gradual growth. Pigment stones (also called bilirubin stones) are formed by increased breakdown, which occurs with topical hemolytic anemia. As for mixed stones, they are a kind of combination based on the processes of both forms. Such stones contain cholesterol, bilirubin and calcium, the very process of their formation occurs as a result of inflammatory diseases affecting the biliary tract and, in fact, the gallbladder.

As for the reasons that contribute to the formation of gallstones, among them are the following:

unbalanced diet (in particular, when it comes to the predominance of animal fats in it with simultaneous damage to vegetable fats);
hormonal disorders (with a weakening of the functions characteristic of the thyroid gland);
sedentary lifestyle;
disorders associated with fat metabolism, which intersects with an increase in body weight;
inflammation and other abnormalities that occur in the gallbladder;
various kinds of liver damage;
spinal injuries;
pregnancy;
starvation;
heredity;
spinal injuries;
diseases of the small intestine, etc.

As factors provoking the development of the disease we are considering, the following are distinguished:

helminthiases;
(due to the use of alcohol);
biliary tract infections (in chronic form);
chronic hemolysis;
demographic aspects (relevance of the disease for residents of rural areas, as well as the Far East);
elderly age.

Gallstone disease: classification

Based on the features of the disease accepted today, the following classification is distinguished according to the stages that are relevant to it:

physico-chemical (initial) stage - or, as it is also called, the pre-stone stage. It is characterized by changes occurring in the composition of bile. There are no special clinical manifestations at this stage, the detection of the disease at the initial stage is possible, for which a biochemical analysis of bile is used for the features of its composition;
formation of stones stage, which is also defined as latent lithology. In this case, there are no symptoms of cholelithiasis, however, the use of instrumental diagnostic methods makes it possible to determine the presence of stones in the gallbladder;
clinical manifestations - stage, the symptoms of which indicate the development of an acute or chronic form of calculus.

In some cases, the fourth stage is also distinguished, which consists in the development of complications associated with the disease.

Gallstone disease: symptoms

Manifestations characteristic of cholelithiasis are determined based on the specific localization and size of the formed stones. Based on the degree of severity relevant to inflammatory processes, as well as on the basis of functional disorders, the severity of the manifestations of the disease, as well as the features of its course, are subject to change.

With cholelithiasis, in particular, a pronounced pain symptom (biliary or) is noted - this is an acute pain that suddenly occurs in the right hypochondrium. It can be piercing or cutting. After a few hours, the final concentration of pain is concentrated within the projection of the gallbladder. It is also possible to radiate pain to the right shoulder, neck, right shoulder blade, or back. In some cases, the pain radiates to the heart, which provokes the appearance.

Mostly pain occurs due to the use of spicy, fatty, fried or spicy foods and alcohol, against the background of severe stress or significant physical exertion. Also, pain can be provoked by a long stay in an inclined position during work. Causes pain spasm, which is formed in the area of the muscles and ducts of the gallbladder, which is a reflex response to the acting irritation experienced by the wall due to stones.

In addition, the cause of spasm is the overdistension of the bladder, formed by excess bile, which occurs as a result of obstruction (blockage) that has arisen in the biliary tract. For the global, in the presence of blockage in the bile duct, the characteristic manifestations are the expansion of the bile ducts of the liver, as well as an increase in the volume of the organ, resulting in a corresponding pain reaction of the pain capsule. The pain in this case is constant, often in the right hypochondrium there is a characteristic feeling of heaviness.

As concomitant symptoms, nausea is also distinguished, which in some cases may be accompanied by vomiting without proper relief after it. It is noteworthy that vomiting is also a reflex response to the stimulus. At the same time, the capture of pancreatic tissues by the inflammatory process is a factor leading to an increase in vomiting, which in this case has an indomitable character and is accompanied by the release of bile with vomit.

Based on the severity of intoxication, there may be an elevated temperature, fluctuating in subfebrile levels, but in some cases reaching a pronounced fever. Blockage of the bile duct by a calculus in combination with obstruction of the sphincter leads to discoloration of the feces and jaundice.

Late diagnosis of the disease often indicates the presence of empyema (accumulation of pus) in the wall of the gallbladder, which arose against the background of the closure of the bile ducts with a calculus. Vesicoduodenal fistulas and biliary tract may also develop.

Diagnosis of gallstone disease

Identification of symptoms characteristic of hepatic colic requires consultation with a specialist. Under the physical examination that he conducts, it means the identification of symptoms characteristic of the presence of calculi in the gallbladder (Murphy, Ortner, Zakharyin). In addition, a certain tension and soreness of the skin in the region of the muscles of the abdominal wall is revealed within the framework of the projection of the gallbladder. Also, the presence of xanthomas on the skin (yellow spots on the skin, formed against the background of a violation in the body of lipid metabolism) is noted, yellowness of the skin and sclera is noted.

The results of the surrender determine the presence of signs indicating non-specific inflammation at the stage of clinical exacerbation, which in particular consist in the moderation of the increase and in leukocytosis. When hypercholesterolemia is determined, as well as hyperbilirubinemia and increased activity characteristic of alkaline phosphatase.

Cholecystography, used as a method for diagnosing cholelithiasis, determines an increase in the gallbladder, as well as the presence of calcareous inclusions in the walls. In addition, in this case, the stones with lime that are inside are clearly visible.

The most informative method, which is also the most common in the study of the area of interest to us and for the disease in particular, is. When examining the abdominal cavity, in this case, accuracy is ensured with respect to identifying the presence of certain echo-impermeable formations in the form of stones in combination with pathological deformities that the walls of the bladder undergo during the disease, as well as with changes that are relevant in its motility. Well seen with ultrasound and signs indicating cholecystitis.

Visualization of the gallbladder and ducts can also be done using MRI and CT techniques for this purpose in specific areas. Scintigraphy, as well as endoscopic retrograde cholangiopancreatography, can be used as an informative method indicating violations in the processes of bile circulation.

Treatment of gallstone disease

Patients with a diagnosis of cholelithiasis are assigned a general type of hygienic regimen, rational nutrition, as well as a systematic load in dosed volumes. Diet No. 5 is also shown with the exclusion of certain foods in it (fats in particular). It is recommended to eat meals "by the hour". In general, the absence of complications often excludes the use of specific treatment - in this case, first of all, the emphasis is on waiting tactics.

With the development of an acute or chronic form of calculous cholecystitis, the removal of the gallbladder is required, which in this case is the process of stone formation. The specificity of the surgical intervention is determined on the basis of the general condition of the body and the changes accompanying the pathological process, concentrated in the area of the walls of the bladder and the tissues surrounding it, and the size of the calculi is also taken into account.

If symptoms relevant to cholelithiasis occur, it is necessary to contact a gastroenterologist, and a surgeon's consultation may be additionally prescribed.

If a person has developed an attack of gallstone disease, the symptoms will be quite specific. They are represented mainly by pain. Gallstone disease is a very common disease. With it, stones form in the cavity of the gallbladder and excretory ducts. The causes of the development of the disease are a violation of cholesterol metabolism, poor nutrition, obesity, diseases of the digestive system.

1 Development of the disease

The development of gallstone disease proceeds in 3 stages. There are no symptoms in the first two stages. They appear only when calculous cholecystitis develops. The transition is pretty hard. Lack of proper care can lead to complications and even death of a sick person. The main manifestation of an attack is hepatic (biliary) colic.

This is a pain syndrome. It occurs suddenly against the background of a normal state. The pain is acute, felt in the right hypochondrium or epigastric zone. The nature of the pain and its intensity are different. It is piercing, cutting. The symptom can last for several hours, which causes great discomfort to the patient.

After 1-2 hours, pain is felt in the projection of the gallbladder on the abdominal wall. Irradiation most often occurs in the back, right shoulder blade or shoulder. The pain may also radiate to the neck. In some patients, pain is felt in the region of the heart. It can easily be confused with an angina attack. In the event that the attack lasts more than 6 hours, acute cholecystitis can be suspected.

Colic is a symptom of both acute and chronic inflammation of the gallbladder in the acute stage. In 70% of patients, after the first attack, a second one develops. In the period between the onset of symptoms, the person feels well. A feature of pain in biliary colic is its increase in the first hour. Then the pain becomes permanent.

In most cases, the symptoms of the disease during an attack appear at night. Strengthening of the pain syndrome is observed in the supine position on the left side and when air is inhaled. Such patients often take a forced position (lying on the right side with the lower limbs pulled up).

2 Mechanism of colic

The appearance of pain during an attack of gallstone disease is due to the following factors:

irritation of the organ or its bile ducts with a stone;

stretching of the bladder wall;

increased pressure in the organ cavity;

muscle spasm.

Endocrine factors also play an important role. Against the background of cholelithiasis, the production of norepinephrine and serotonin is disrupted. The latter is responsible for the pain threshold. Its deficiency lowers the pain threshold, which negatively affects the condition of a sick person. Norepinephrine works in the opposite way. It activates the antinociceptive (pain-relieving) system of the body.

The presence of stones in the gallbladder leads to stretching of the membrane. This organ consists of several membranes, one of which is muscular. Stimulation of specific receptors leads to muscle spasm. The contraction is due to the active entry of calcium ions into the muscle cells. This process proceeds with the participation of various neurotransmitters (acetylcholine, norepinephrine, serotonin, cholecystokinin).
The attack itself occurs in the presence of provoking factors. Very often, colic appears with errors in nutrition. Provoke an attack can eat fatty foods (meat, mayonnaise, butter, bacon, fried potatoes), spices, smoked foods. It is possible to develop biliary colic against the background of stress, various infections, drinking alcohol and when working with a tilt of the body.

3 Other signs of illness

An attack of gallstone disease can be manifested by the following symptoms:

nausea;

vomiting;

bloating;

tension in the abdominal muscles;

an increase in body temperature;

chills;

jaundice;

impaired consciousness;

drop in blood pressure.

During an attack, pain is almost always combined with nausea.

In severe cases, vomiting develops, which does not improve the person's condition. There may be a bitter taste in the mouth. Jaundice is a common symptom of gallstone disease. It is also due to the increase in the level. In such people, the skin acquires a yellowish tint.

Possible yellowing of the sclera. In the case of blockage of the common bile duct by a stone, jaundice is very pronounced. Discoloration of feces and darkening of urine are often observed. Other symptoms of gallstone disease include loose stools. The temperature rarely exceeds 38ºC.

Severe fever and chills during an attack indicate the addition of a secondary infection and the development of purulent processes. In this situation, urgent hospitalization is required. Objective signs of a gallstone attack include abdominal tenderness, liver enlargement, positive Ortner, Ker, Murphy, and Mussy symptoms. Ortner's symptom is positive on the right.

To determine it with the edge of the palm, you need to beat on the lower costal arches on the right and left. If there is pain, then the symptom is positive. Gallstone disease can lead to the following complications:

inflammation of the bile ducts (cholangitis);

25.03.2016

Gallstone disease, or as it is also called, cholecystitis, is a disease associated with a violation in the metabolism of bilirubin and cholesterol. As a result of this, the formation of calculus (stones) in the gallbladder or its ducts occurs. An attack of gallstone disease is one of the most popular diseases after diabetes and cardiovascular pathology.

Gallbladder cholecystitis occurs more often in people in economically developed countries, whose work is associated with a sedentary lifestyle and stressful situations. However, recently, cholelithiasis in children is common.

Formation of stones in the gallbladder

An attack of gallstone disease occurs as a result of the accumulation of bile in the bladder. Through the bile ducts, the movement of bile is ensured by the work of the liver, common bile duct, gallbladder, duodenum and pancreas. This allows bile to enter the intestines in a timely manner during digestion and accumulate in the bladder on an empty stomach.

The reasons for the formation of stones are a change in the composition and stagnation of bile, the onset of inflammatory processes, motor-tonic disorders in the excretion of bile. Signs of gallstone disease are the development of cholesterol (up to 80-90% of all gallstones) mixed and pigment stones. As a result of the appearance of cholesterol stones, there is a supersaturation of bile with cholesterol, its precipitation, and the formation of cholesterol crystals. In case of gallbladder dysmotility, the crystals are no longer able to be excreted from the intestines, remain in it and begin to grow.

Bilirubin (pigment) stones occur during the accelerated breakdown of red blood cells during hemolytic anemia. Mixed stones are a combination of both forms. They contain cholesterol, bilirubin and calcium. Most often, such cholelithiasis, the symptoms of which will be described below, occurs during inflammatory processes in the biliary tract and gallbladder.

Causes of gallstone disease

The reasons for the appearance of stones in women and men are approximately the same. Among the main ones should be highlighted:

inflammation of the bile ducts (cholecystitis). Infection plays a role in stone formation. Bacteria can convert water-soluble bilirubin into insoluble, which can precipitate;
cholecystitis occurs as a result of a disruption in the endocrine system: diabetes mellitus, hypothyroidism (insufficient secretion of thyroid hormones), impaired estrogen metabolism in a number of gynecological diseases in women, pregnancy and taking contraceptives. As a result, a violation of the contractile function of the gallbladder and stagnation of bile begins;
violation of cholesterol metabolism: obesity, gout, atherosclerosis. If cholecystitis begins, ideal conditions are created for the formation of stones;
hyperbilirubinemia - an increase in the level of bilirubin with an increase in its content in bile - hemolytic anemia;
the reasons for the formation of stones may lie in a hereditary predisposition;
in women, gallstones are formed as a result of frequent diets, improper and irregular nutrition;
excessive consumption of food rich in animal fats and cholesterol. This leads to a shift to the acidic side of the reaction of bile, resulting in cholecystitis and the formation of stones.

Symptoms of gallstone disease

Often cholelithiasis occurs in children, so it is necessary to know not only the causes of its occurrence, but also the first symptoms. Long-term illness may not be accompanied by any symptoms and be a real find on ultrasound. Symptoms begin to appear with the migration of stones, the onset of infection in the gallbladder and ducts. Symptoms of the disease can directly depend on the location of stones, the activity of inflammation, their size, as well as the damage to other digestive organs.

During the release of stones from the gallbladder and their movement through the bile ducts, an attack of biliary colic occurs. If the diet for cholelithiasis is not followed, then this can provoke the movement of stones. The pain is sudden, as if cholecystitis has begun, in the upper abdomen, in the right hypochondrium, gives to the right shoulder and right shoulder blade. Often, the pain is accompanied by nausea, vomiting that is not able to bring relief, dry mouth. The skin may itch.

If you do not start treatment in a timely manner, yellowing of the skin and sclera occurs, the feces become discolored, and the urine, on the contrary, acquires a dark shade. The duration of the pain attack can last from several minutes to several hours, the pain goes away on its own or after taking painkillers.

Symptoms of biliary colic or cholecystitis may not always have standard manifestations, they often resemble other diseases: liver abscess, right-sided pneumonia, acute appendicitis, especially in case of its atypical position, renal colic in acute pancreatitis and urolithiasis. It can manifest itself as cholecystitis, in the form of pain in the heart. In order to make an accurate diagnosis in this case, it is recommended to urgently consult a general practitioner.

Treatment of gallstone disease

There are two ways to treat gallstone disease: conservative and operative.

Medical treatment

Treatment of gallstone disease without surgery is effective if the size of the stones does not exceed 15 millimeters, while maintaining the patency of the cystic duct and the contractility of the gallbladder. True, it is forbidden to treat cholecystitis with medication if:

the diameter of the stones is more than 2 centimeters;
acute inflammatory diseases of the biliary tract and gallbladder;
the causes of the appearance of stones lie in the existing diabetes mellitus, liver disease, chronic pancreatitis, peptic ulcer of the duodenum and stomach;
if the cause is obesity;
inflammatory disease of the large and small intestines;
pregnancy;
"disabled" - non-functioning gallbladder;
carbonate or pigment stones;
gallbladder cancer;
multiple stones occupying more than half of the volume of the gallbladder.

Methods of treatment with drugs can be as follows. The use of ursodeoxycholic acid preparations, whose action is aimed at dissolving exclusively cholesterol stones. Take the drug from 6 to 24 months. True, after the dissolution of the stones, the probability of recurrence is 50%. The duration of administration and the dose of the drug is determined only by a doctor - a gastroenterologist or therapist. Conservative treatment is allowed only under the supervision of a doctor.

Methods of shock wave cholelithotrepsy - treatment by crushing large stones into small fragments using shock waves, followed by the administration of bile acid preparations. The probability of re-formation of stones is 30%.

For a long time, cholelithiasis can occur with few or no symptoms at all, which creates certain difficulties with its definition in the early stages. This leads to late diagnosis, at the stage of already formed gallstones, when it is very problematic to use conservative methods, and surgical treatment remains the only way to treat.

Surgery

The patient undergoes a planned operation before the onset of the first attack of biliary colic or immediately after it. This is associated with a high risk of complications.

After surgical treatment, it is necessary to adhere to an individual dietary regimen (fractional, frequent meals with the exclusion or restriction of individually intolerant foods, fatty, fried foods). It is necessary to observe the regime of rest and work, physical education. Completely eliminate the consumption of alcohol. Subject to stable remission, spa treatment is possible immediately after the operation.

Treatment with folk remedies

Treatment of gallstone disease with folk remedies is possible at the initial stage, which can only be determined by a doctor. Some of the recipes below are great for getting rid of gallstones.

Chaga treatment

Treatment of gallstone disease with folk remedies is carried out with the help of birch fungus chaga. The recipes for its preparation are simple - a small piece of chaga must be softened by pouring warm water for 3-4 hours. After that, the mushroom should be grated or passed through a meat grinder. The mushroom crushed in this way should be poured with hot water and let it brew for another two days, then strain. Take infusion up to three times a day, one glass.

Decoction of sunflower root

During treatment with folk remedies for cholelithiasis, a decoction of sunflower root helps well. To do this, clean the root, cutting off all the thread-like processes, cut into small pieces and dry in the shade until completely dry. Next, take three liters of water and pour a glass of dried roots into it. Boil the resulting mass for about 5 minutes.

After cooling the broth, it must be put in the refrigerator. The contents should not be thrown away, because after three days you can use the roots again, filling them with three liters of water. And this time it takes 10 minutes to boil. Drink one liter of decoction every day for two months.

During treatment with sunflower roots, a burning sensation in the joints, an increase in pressure may occur, flakes or sand may appear in the urine. At the same time, treatment should not be stopped, only a slight decrease in dosage is possible.

Dill infusion

A decoction of dill is considered a good remedy in the treatment of gallstones. Take two tablespoons of dill seeds, pour 0.5 liters of boiling water, then boil for 15 minutes over low heat or a water bath. This decoction should be taken 3 times a day for 0.5 cups for three weeks.

Also, in the treatment of gallstone disease, a decoction of horsetail, wheatgrass juice, a decoction of a shepherd's purse, a collection of immortelle, yarrow and rhubarb root, as well as some other herbs are effective.

Complications of gallstone disease

In case of infection, acute cholecystitis, empyema (large accumulation of pus), cholangitis (inflammation of the bile ducts) develop, which can cause peritonitis. The main symptoms are intense, sharp pain in the right hypochondrium, fever, chills, impaired consciousness, severe weakness. Choledocholithiasis (stones in the bile duct) with the formation of obstructive jaundice. After another attack of biliary colic, yellowness of the skin and sclera, skin itching, darkening of the urine and discoloration of the feces are formed.

With prolonged blockage of the cystic duct and the absence of infection, dropsy of the gallbladder appears. Bile is absorbed from the bladder, but the mucosa continues to produce mucus. The bubble greatly increases in size. Attacks of biliary colic begin, in the future the pain decreases, only heaviness in the right hypochondrium remains.

Against the background of prolonged cholelithiasis, gallbladder cancer often appears, chronic and acute pancreatitis develops. With prolonged blockage of the bile intrahepatic ducts, biliary secondary cirrhosis develops. Large gallbladder stones hardly migrate, but they can cause a fistula between the duodenum and the gallbladder. When a stone falls out of the bladder, its migration begins, which can lead to the development of intestinal obstruction.

Untimely implementation of the operation to remove the gallbladder (cholecystectomy) becomes one of the main causes of the formation of postcholecystectomy syndrome. Complications can pose a threat to human life, and require urgent hospitalization in a surgical hospital.

Prevention of gallstone disease

Even after a successful surgical intervention, the prevention of gallstone disease will not be superfluous. Active rest, classes in the gym, contribute to the rapid outflow of bile, thereby eliminating its stagnation. It is necessary to normalize the total weight, as this reduces the hypersecretion of cholesterol.

Prevention of gallstone disease in patients who must take estrogens, clofibrate, ceftriaxone, octreotide, is to undergo an ultrasound examination. This is necessary to determine changes in the gallbladder. If the level of cholesterol in the blood is elevated, it is necessary to take statins.

Diet for gallstone disease

The diet for cholelithiasis should exclude or limit high-calorie, fatty, cholesterol-rich meals, especially in the case of a hereditary predisposition to the formation of stones.

First of all, there should be frequent meals (4-6 times a day), in small portions, this leads to a decrease in stagnation of bile in the gallbladder. The diet should contain a large amount of dietary fiber, due to fruits and vegetables. You can add bran to the menu (15 grams two to three times a day). This helps to reduce the lithogenicity (tendency to stone formation) of bile.

If you suspect the onset of gallstone disease, it is recommended to immediately consult a doctor. Depending on the stage of the disease, you will be prescribed one of the methods of treatment. In most cases, surgery can be dispensed with.

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Add water and mode

Causes of cholelithiasis

Symptoms and signs: an attack of pain, what to do?

Symptoms

Exacerbation of gallstone disease

What to do with an attack of biliary colic: first aid

Urgent care

Treatment of gallstone disease

Treatment of cholelithiasis without surgical intervention with folk and medical means

Medications: drugs, medicines, remedies

Medicines that dissolve stones

Surgical treatment of cholelithiasis

Laparoscopic cholecystectomy

Nutrition: diet without surgery for cholelithiasis

What foods can be eaten: allowed

What not to eat: prohibited

Nutrition: diet after gallbladder removal

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general description

Gallstone disease: classification

Gallstone disease: symptoms

Diagnosis of gallstone disease

Treatment of gallstone disease

1 Development of the disease

2 Mechanism of colic

3 Other signs of illness

Formation of stones in the gallbladder

Causes of gallstone disease

Symptoms of gallstone disease

Treatment of gallstone disease

Complications of gallstone disease

Prevention of gallstone disease

Diet for gallstone disease