Dyskinesia of the biliary tract. Biliary dyskinesia (JVP): causes, symptoms, diagnosis and treatment. Correlation of terms denoting functional disorders of the biliary tract: biliary dyskinesia, gallbladder dyskinesia

Dyskinesia biliary tract - this is the presence in a person of a whole complex of certain disorders of the biliary system that occur in connection with violations motor function gallbladder and bile ducts. At the same time, there are no organic changes in these organs. Patients very often have either too strong or insufficient contraction of the gallbladder.

Medical practice indicates that women are more susceptible to the occurrence of dyskinesias. There is evidence that biliary dyskinesia in women occurs 10 times more often than in men. With biliary dyskinesia, it does not enter the duodenum in sufficient quantities, as a result of which the patient manifests pain in the right hypochondrium. Dyskinesia is usually divided into hyperkinetic (if the condition provokes too high contractile activity of the biliary system) and hypokinetic (if the condition provokes too low contractile activity of the biliary system). It is noted that the incidence of hyperkinetic dyskinesia is more often observed in young people, and hypokinetic dyskinesia is typical for those who are already forty years old, and it also develops in people who suffer from mental instability.

Causes of biliary dyskinesia

Almost always, dyskinesia is diagnosed as a secondary disease. It manifests itself in humans as a consequence of some factors leading to disruption of the biliary tract.

So, the disease occurs in people who suffered at one time spicy viral hepatitis , neurocirculatory dysfunction . In children, dyskinesia may develop due to some features of the constitution of the child, with vegetative , with a too sedentary lifestyle, due to, pathologies of the gastrointestinal tract , in the presence of foci of infection in the body. In addition, the development of biliary dyskinesia can be affected by malnutrition, a number of endocrine diseases. As a rule, with an immobile lifestyle, asthenia, malnutrition The patient develops hypokinetic dyskinesia.

Biliary dyskinesia in children and adults is considered as a disease psychosomatic nature which may be provoked mental trauma and also strong. It has been proven that the motor activity of the gallbladder directly depends on stress and strong negative emotions: in this case, it slows down significantly, and stagnation of bile occurs in the gallbladder. Very often, when studying the case histories of such patients, it turns out that they once had psychological problems varied nature.

In addition, the trigger for the development of gallbladder dyskinesia may be impaired nervous regulation gallbladder, period, insufficiency of function endocrine glands.

There is also the possibility of attaching dyskinesia to,. In patients with peptic ulcer , there is a reflex occurrence of hyperkinetic dyskinesia. This form of the disease also threatens those who eat irregularly, too often eat very spicy foods that irritate the mucous membrane.

The main symptoms of biliary dyskinesia appear depending on which factor provoked the development of dyskinesia. As a rule, most people suffering from this disease complain of a complex of symptoms of nervosa. That's too much high level fatigue, bouts of tearfulness and irritability, palpitations, sweating, recurrent headaches. In this case, patients feel pain in the right hypochondrium. If a we are talking about hypertensive dyskinesia , then such pain is distinguished by paroxysmal character. In this case, the pain is quite acute, but lasts a short period of time. Pain may radiate to right shoulder or spatula. Especially often such attacks occur after the use fatty foods, strong tension, both physical and emotional. Very often, patients with hypertensive dyskinesia note a manifestation, which most often happens in the morning.

If the patient is suffering from symptoms hypotonic dyskinesia , then this condition is characterized by dull and aching pain, in which there is also a feeling of fullness in the region of the right hypochondrium. Such pain constantly worries the patient, while his appetite noticeably decreases, the person often feels sick, and belching appears. The rise in body temperature is not observed, a clinical blood test also does not indicate the presence of abnormalities.

In addition, symptoms of biliary dyskinesia in men may include decrease in sexual activity . At the same time, women may experience monthly cycle . Common signs of dyskinesia are depression, emotional as well as physical weakness. During an attack biliary colic the patient may have a feeling of a strong heartbeat or a feeling of cardiac arrest. He may be accompanied by a feeling of fear, numbness of the limbs.

The disease continues for a long period, with severe exacerbations periodically observed, which provoke stress and other elementary disorders. After the attacks, there is a periodic relief of the condition. Over time, dyskinesia can cause inflammation in the gallbladder and ducts, and cause gallstones to form.

Diagnosis of biliary dyskinesia

To accurately determine the form of dyskinesia, an ultrasound examination is performed. abdominal cavity and contrast cholecystography. Appointed laboratory research blood. To determine what changes contractile activity functions of the biliary tract take place (too high or too low), the patient is assigned to conduct duodenal sounding or ultrasound, before which it is important to use a choleretic breakfast.

Treatment of biliary dyskinesia

It should be borne in mind that the treatment of biliary dyskinesia directly depends on what causes provoked the manifestation of this disease. When prescribing therapy, it is necessary to take into account the fact that dyskinesias are classified as psychosomatic illnesses. Therefore, psychotherapeutic measures are important in their treatment. However similar treatment can only be prescribed by a psychotherapist. Patients, on the other hand, consider their problems to be exclusively somatic, therefore they rarely turn to a doctor of this profile. If the patient has symptoms depression, the patient is often prescribed a course of treatment tranquilizers , antidepressants , light preparations antipsychotics .

All further methods treatment of dyskinesia directly depends on which form of the disease is diagnosed in the patient. If a patient has developed hypokinetic dyskinesia, he should observe a special one, including products with a choleretic effect and with a high content of certain minerals.

In the process of therapy, patients are prescribed regular use of mineral waters. a certain kind. They need to drink one glass about three times a day, about half an hour before meals. In addition, with biliary dyskinesia, the use of massage and physiotherapy exercises is effective. Periodic spa treatment is also recommended. Sometimes it is advisable for the patient to prescribe duodenal sounding in order to free the gallbladder from bile. There is also the so-called "closed tubage" technique, which the patient can undertake independently, thus stimulating the contraction of the gallbladder.

If the patient suffers from the manifestation of hyperkinetic dyskinesia, then it is important for him to adhere to a diet that is characterized by restriction of irritant products, fats. To eliminate acute conditions, patients are shown the use of antispasmodic drugs, mineral waters. Surgical methods in this case are not effective.

In general, to improve the condition of patients, it is recommended to normalize the diet, rest and work, to exclude a number of products from the diet. You can also use some folk remedies, in particular decoctions of herbs. For the treatment of dyskinesia, decoctions of coriander, anise, corn silk, St. John's wort, mint, sage, celandine, valerian root, immortelle grass. Traditional medicine also recommends the use grapefruit juice some time before meals.

The doctors

Medications

Diet, nutrition for biliary dyskinesia

Despite the fact that biliary dyskinesia is an ailment that is not classified as a dangerous disease, dieting is extremely important to prevent further development. cholecystitis and other dangerous diseases. observed depending on which form of the disease occurs. However, in general, nutrition should contribute to the normalization of the motor functions of the biliary tract. If the patient suffers from manifestations of hypertensive dyskinesia, he needs to very sharply reduce the content in the diet of those products, the use of which helps to reduce the gallbladder. In this case, we are talking about too rich broths, animal fats, vegetable oils. But not very rich broths, fish soup, vegetable oils, dairy products make up the diet in the development of hypotonic dyskinesia.

The diet for biliary dyskinesia, which is hypertonic in nature, excludes the use of smoked, fried foods, alcohol, and spicy foods. Do not eat ice cream and drink carbonated drinks. Such food can provoke a severe spasm of the biliary tract. It is important to always eat only warm and fresh food. The diet should be a lot of vegetables, but it is desirable to limit the number of meat dishes. It is necessary to adhere to such dietary habits for a long time.

It is necessary to take food in small portions, doing this up to 6 times a day. It is advisable to eat some food just before going to bed. light dish. In general, the diet for this disease is similar to the principles of nutrition in the Mediterranean countries: it is dominated by vegetables, fruits, fish dishes. By the way, bran has a very good effect on the state of motility of the biliary tract: they should be taken by adding 1 tablespoon to everyday meals.

Prevention of biliary dyskinesia

In order to prevent the manifestation of this unpleasant ailment, it is necessary, without delay, to treat all disorders of a neurotic nature, to prevent serious stressful situations, regularly, at the same time to eat every day. More important is also a normal, full sleep and rest.

Intestinal dyskinesia

A variety of disorders of the large intestine of a functional nature are ailments that are very widespread today. (this disease is also called irritable bowel syndrome , spastic colitis ) is a condition in which the motor function of the intestine is impaired. To a greater extent, dyskinesia of the large intestine is manifested, to a lesser extent - dyskinesia of the small intestine. Wherein organic lesions not typical for this disease. In patients with intestinal dyskinesia, pain is manifested, their bowel function noticeably changes. In some cases, there is also too high a level of mucus secretion: a similar phenomenon is typical for about half of all patients.

Intestinal dyskinesia develops as a consequence of some neurotic disorders, serious stressful situations, conflicts, autonomic dystonia nervous system, endocrine disorders. Also, a factor influencing the manifestation of intestinal dyskinesia is a hereditary predisposition to this disease. As in the case of biliary dyskinesia, this disease may manifest both hyperkinetic (spastic) and hypokinetic (atonic) changes. Quite often, both types of these disorders occur simultaneously.

A patient with progressing intestinal dyskinesia is very often concerned about pain in the abdomen, which is characterized by the absence of a clearly defined localization. There may also be disorders of the stool, too active production of mucus. The pain can have different intensity: sometimes there is a feeling of pressure in the lower abdomen, pressure in the lower abdomen, sometimes enough severe colic. They can last for several minutes or several days. Quite often, patients perceive such colic as the beginning of an attack of appendicitis. In some cases, even up to surgical intervention on suspicion of appendicitis. Sometimes patients with intestinal dyskinesia note a periodic alternation of constipation and diarrhea. Especially often diarrhea overcomes a person in the morning, after he has taken food. In this case, feces with mucus impurities often come out.

Diagnosis of intestinal dyskinesia involves, first of all, the exclusion of possible organic ailments, the symptoms of which are similar to those of dyskinesia. The patient is scheduled for endoscopy, which reveals hyperemia of the mucous membrane of the colon. Microscopic examination of stool shows no changes.

It is important for all patients to follow healthy lifestyle life, avoid. If a person constantly manifests himself, he is recommended to introduce porridge from whole grain, dairy products, baked apples.

List of sources

• Sherlock S. Diseases of the liver and biliary tract / S. Sherlock - M .: GEOTAR-MED, 2002;
• Diseases of the liver and biliary tract: A guide for physicians / Ed. V.T. Ivashkin. - M., 2002;
• Ilchenko A.A. Cholelithiasis. Moscow: Anaharsis, 2004;
• Maev I.V., Samsonov A.A., Salova L.M. etc. Diagnosis and treatment of diseases of the biliary tract: Tutorial. - M .: GOU VUNMTs of the Ministry of Health of the Russian Federation, 2003;
• Ilchenko A.A. Diseases of the gallbladder and biliary tract: A guide for physicians. M.: Ana-harsis, 2006.

Update: November 2018

Dyskinesia is not called curvature or bending of the gallbladder or the pathways leading from it, as most people think. The term comes from the Greek word "kinesis" which means "movement" and the prefix "dis-" means "violation". Thus, biliary dyskinesia is a condition in which the tone or motility of the system that carries bile from the liver to the duodenum is disturbed. This causes pain in the right hypochondrium, problems with stools, and sometimes bitterness in the mouth, but no damage to these organs is noted during examination.

Most often, dyskinesia occurs in people who have anomalies in the development of the biliary organs, who have a love for unbalanced diet, as well as in persons who are often exposed to various traumatic situations. There are other reasons given state. Women are most susceptible to this pathology. Treatment of dyskinesia is aimed at relieving the symptoms and also, especially if the biliary tract has slow movement or poor contractility, at preventing stone formation.

A little about anatomy and physiology

Bile is a brownish-yellow liquid that is essential for digestion. Its main function is to separate fats from food from each other, increasing their surface area. Then they are well processed by the lipase enzyme, as a result of which the components of fats - fatty acids - are absorbed into the blood. In addition, bile affects the absorption of proteins and carbohydrates. Under the influence of this substance, produced by the liver by ¾, and by ¼ - by the hepatic passages, it works normally small intestine: absorption processes take place in it nutrients, as well as the division and death of its own cells.

In order for all of the above processes to occur correctly, bile must have a normal concentration. The gallbladder is engaged in this, which “gives” excess water to the vessels. If bile does not stay in the bladder, it enters the intestines in a diluted form and irritates it, causing diarrhea. In the case of an excessively long stay of bile in the bladder, it comes in too concentrated, which is also not useful.

Bile is produced in the liver. Further, it must reach the gallbladder through the bile ducts, and from it enter the duodenum 12. The movement of the secret is provided by the pressure difference in the biliary tract, which occurs due to the work of the circular muscles - sphincters. So, the sphincter that passes bile into the gallbladder is closed - it drains from the liver. Then it opens, and the secret flows into the bubble, which was almost empty, and in which the pressure was less than in the duct. When enters the duodenum fatty food, the gallbladder, which is an organ equipped with muscles, contracts. In this case, the sphincter in the neck of the bladder opens, and the one with which the entrance to the duodenum begins is closed, and it opens when the first one closes. The biliary tract contractions are regulated by the sympathetic nervous system and some substances produced in the stomach and pancreas.

What is dyskinesia, its types

Having considered the anatomy, it is possible to explain in more detail the essence of the pathology. So, dyskinesia is a condition:

• if the sphincters (one or more) located in the bile ducts do not relax in time;
• or, on the contrary, despite eating, the sphincters do not want to relax;
• if there is a strong contraction of the gallbladder;
• if the gallbladder or ducts are reduced very sluggishly, reducing the rate of outflow of bile.

Depending on violations of motor function and tone, dyskinesia can be:

• hypertonic: the tone of the sphincters is increased;
• hypotonic: the tone, on the contrary, is reduced;
• hypokinetic: the movement of the biliary tract is slowed down, bile is ejected slowly;
• hyperkinetic: the outflow of bile is active, its portions are thrown out sharply.

Usually, increased tone is combined with increased motor skills, forming a hypertonic-hyperkinetic (or spastic) type of dyskinesia. The same happens in the opposite situation: with weak motor skills, the tone of the biliary tract is weakened - hypotonic-hypokinetic (atonic) type. There is also a mixed type.

Spasmodic dyskinesia is characterized by an increase in the tone of the parasympathetic department. The atonic type of the disease develops with the predominance of the influence of the sympathetic part of the autonomic nervous system.

Causes of the disease

The following reasons lead to a violation of the tone or movement of the bile ducts:

• Congenital malformations of the biliary tract and gallbladder:
  • doubling of the bile ducts;
  • congenital weakness of the bladder wall;
  • intrahepatic gallbladder;
  • inflection of the gallbladder;
  • gallbladder separated by a septum;
  • valves in the bile duct;
  • accessory gallbladder;
  • movable bubble;
  • abnormally located bubble.

All these pathologies cause dyskinesia called "primary". Next, we list acquired diseases (occurring during life), which can cause secondary biliary dyskinesia.

• Eating habits: long periods of fasting, avoiding vegetable fats or, conversely, eating a large amount of fatty, smoked and spicy foods.
• Constant stress or traumatic situations.
• Transferred pancreatitis or other inflammatory pathology of the gastrointestinal tract or female organs.
• Chronic cholecystitis.
• Neurocirculatory dystonia, when the control of the normal sequence of contractions of the biliary tract is disturbed.
• Constantly existing foci of infection in the body (caries, chronic tonsillitis).
• Diseases of the endocrine organs: obesity, diabetes mellitus, thyrotoxicosis.
• Food allergies.
• Transferred viral hepatitis.
• Worm diseases.
• Giardiasis, in which flagellar protozoa colonize the gallbladder.
• The period of menopause, when the regulation of contractility of the biliary tract is disturbed.
• Dysbacteriosis.
• Transferred intestinal infections.

Signs of the disease

Symptoms of biliary dyskinesia differ depending on the type of pathology: whether it is hyperkinetic or hypokinetic.

The main difference between the main types of the disease is pain in dyskinesia:

Both types of dyskinesia can cause other symptoms:

• irritability;
• increased sweating;
• recurrent headaches;
• bad breath;
• bloating;
• loss of appetite;
• bitterness in the mouth;
• yellow coating on the tongue;
• decreased libido in men;
• some women have problems menstrual cycle.

An extreme manifestation of the hyperkinetic variant is biliary colic. It appears suddenly severe pain on the right under the rib, which is accompanied by a panic attack, numbness of the limbs.

The maximum manifestation of hypokinetic dyskinesia is cholestasis - stagnation of bile in the biliary tract. The following symptoms indicate this:

• severe itching of the entire skin;
• yellowing of the skin and whites of the eyes;
• dark urine;
• feces acquire a light yellow or even grayish color.

Diagnostics

Symptoms alone are not enough to establish a diagnosis, because similar symptoms can develop with more serious illnesses liver. Secondly, it is necessary to establish the cause (for example, malformations of the biliary tract) that caused the disease in order to subsequently eliminate it.

Biliary dyskinesia is a condition in which the structure of these organs is not disturbed. That is, the diagnosis is made on the fact of a violation of contractility or tone on the way from the liver to the duodenum. How to see it?

ultrasound

Performing an ultrasound of the gallbladder with a choleretic breakfast. Initially, after following a three-day diet, a “normal” abdominal ultrasound is performed. With its help, volumes, sizes, deformations, anomalies of the biliary tract are evaluated, an examination is performed for gallstones. Next, a person takes products that should cause the release of bile into the duodenum (this can be: 100 grams of cream or fatty sour cream, full-fat yogurt, chocolate or a couple of bananas), and the doctor looks at the sequence and how the bile moves.

duodenal sounding

By evaluating portions of the contents of the duodenum 12. For this, a study called "duodenal sounding" is being carried out: a person needs to swallow a thin probe, from which, upon reaching the duodenum 12, its contents will be obtained. The study is carried out on an empty stomach. First, a portion of the usual contents of the intestine is obtained from the probe, which consists of bile, the fluid secreted there by the pancreas and the juice of the duodenum itself. Next, a choleretic drug, magnesia sulfate, is introduced into the probe. The gallbladder contracts, and the bile contained in it enters the intestine. She is also taken for research. After a while, bile flows here, which was previously in the intrahepatic bile ducts. She is also taken for analysis. To establish the diagnosis of dyskinesia, the time that passes from the moment the choleretic is introduced to the second and then the third portion is important. The content of various lipids in the last two portions is also important.

Cholecystography

By using contrast methods radiography - cholecystography (extrahepatic bile ducts are examined) and cholangiography (intrahepatic bile ducts are examined). In the first case, a person needs to take an x-ray contrast agent through the mouth, after which x-rays it will be seen how the contrast reaches the gallbladder, how it leaves it, in what sequence the contraction and relaxation of the sphincters occur. The second method involves an injection: a radiopaque substance is injected directly into the bile ducts, and then the radiologist monitors its progress along the bile ducts.

ERCP

When performing ERCP (endoscopic retrograde cholangiopancreatography), when a probe with an optical fiber is inserted into the duodenum, and through it a contrast agent is injected directly into the biliary tract, the retrograde (that is, the opposite of normal current) progress is examined using x-rays.

Cholescintigraphy

By radiological examination - cholescintigraphy, in which a radioisotope preparation is introduced into the body, and in the light of special radiation, visualization occurs as it passes into the liver, is released into the bile ducts, goes to the gallbladder, and then reaches the duodenum.

Magnetic resonance cholangiography

In difficult cases, magnetic resonance cholangiography is shown - a non-invasive research method, when a contrast agent is injected into the body, and its path is observed in a magnetic resonance tomograph. To carry out such a diagnosis, a person will need to be in the chamber of the device for about 40-50 minutes, keeping still.

Blood tests for lipids and bilirubin with its fractions, fecal analysis for dysbacteriosis, helminth eggs and coprogram are methods to determine the safety of the function of the biliary tract, as well as to exclude possible cause diseases - worms. These tests do not make a diagnosis.

Treatment

Treatment of biliary dyskinesia consists of:

• diet therapy: it differs in hypo- and hyperkinetic forms of pathology;
• taking decoctions or infusions of various herbs: it is prescribed by a gastroenterologist, taking into account the type of disease, is an integral part of the treatment;
• drug therapy: prescribed by courses, aimed at stopping an attack, preventing their occurrence in the future, as well as for preventing complications.

diet therapy

Nutrition for dyskinesia is the main "whale" of treatment. Only he, with strict observance of the rules, allows you to avoid seizures and prevent such surgical complications as acute cholecystitis and gallstone disease.

Diet for dyskinesia contains general rules nutrition, but there are also moments that are radically different in hypokinetic and hyperkinetic variants.

General rules

You need to take food so that the gallbladder is completely emptied, but at the same time there is no pain attacks. For this:

• eat little, 4-5 times a day;
• eat small meals;
• observe 3-4 hour intervals between meals;
• have dinner 2-3 hours in advance, while at the same time do not eat meat at night;
• in the morning and in the evening, eat low-fat dairy products;
• avoid cold or too hot foods;
• Do not heat food with animal or trans fats such as margarine, pork, goose, or lamb.

Features of nutrition in hypomotor dyskinesia

In the diet, there must be foods that stimulate the motility of the biliary tract:

• fruit;
• vegetables (baked, stewed, boiled);
• butter and vegetable oils;
• sour cream;
• black bread;
• eggs;
• cream.

Features of nutrition in hypermotor dyskinesia

With this form of the disease, it is imperative to exclude from the diet products that stimulate bile formation and bile secretion: animal fats, black bread, fatty dairy and sour-milk products, fresh vegetables, broths and soda.

Medical therapy

She also has general purpose, and is also based on the type of dyskinesia.

Since dyskinesia is considered a disease, the main cause of which is nervous regulation, which depends directly on the psyche. Therefore, before treating a violation of the motor activity of the biliary tract with the help of choleretic drugs, you need to start with restoring the mental background. If the pathology arose against the background of a depressive state, a course of mild antidepressants is prescribed. If the violation of bile secretion was provoked by neuroses, expressed anxiety, it is advisable to start with tranquilizers or antipsychotics.

Such appointments are made by a psychotherapist or psychiatrist.

In addition, the cause of dyskinesia is treated: antihelminthic therapy, allergy treatment, elimination of hypovitaminosis, correction of dysbacteriosis.

Hypotonic-hypokinetic form

In this case, choleretic drugs are needed, which:

• will increase the tone of the gallbladder: magnesium sulfate, xylitol;
• improve motility of the biliary tract: for example, cholecystokinin, pancreozymin.

In addition to choleretic, tonic preparations are also needed: ginseng tincture, eleutherococcus extract, lemongrass tincture.

Hypertonic-hyperkinetic form

Here, drugs are needed that increase the formation of bile: it will become more, the bile ducts will work longer, and not rapidly contract, causing an attack of pain. These are medicines such as ocafenamide, flamin, nikodin.

Also, if the sphincters are overstretched, they are relaxed. This is done with antispasmodic drugs: no-shpa, buscopan.

In addition, we need such means that normalize the balance of the parasympathetic and sympathetic systems: valerian tincture, potassium bromide, motherwort tincture.

Treatment with folk methods

Biliary dyskinesia is a pathology in the treatment of which folk remedies are an excellent addition to drug therapy, and sometimes its only component (for example, in children).

If the tests show the presence of cholestasis (bile stasis), and at the same time the liver tissue is not affected (the levels of ALT and AST are not elevated in the “liver tests” analysis), blind soundings are performed: a solution of sorbitol, mineral water of high mineralization or magnesium sulfate is drunk on an empty stomach. Then you need to lie on your right side and put under it. Lie down like this for 20-30 minutes.

Complementary Therapies

In the treatment of biliary dyskinesia, the following are used:

• physiotherapy: diadynamic currents, electrophoresis, microwave;
• acupuncture;
• acupressure;
• treatment with leeches;
• treatment in sanatoriums of a gastroenterological profile, in which therapy with mineral waters is carried out.

Complications of biliary dyskinesia

This functional violation can lead to the following consequences:

• the formation of chronic inflammation of the gallbladder wall (chronic cholecystitis);
• inflammation of the intrahepatic bile ducts (cholangitis);
• cholelithiasis;
• inflammation of the pancreas;
• gastritis, gastroduodenitis - inflammation of the stomach or stomach, or 12 duodenal ulcer. This is due to the fact that unconcentrated bile is often thrown into the stomach and duodenum in this disease, which leads to their inflammation;
• allergization of the body, which is manifested by a skin rash;
• weight loss, metabolic disorders, which occurs due to impaired absorption of the necessary substances without proper bile processing.

Prevention of the disease and its prognosis

To prevent pathology from developing, observe the following rules:

1. sleep at least 8 hours;
2. go to bed no later than 11 pm;
3. alternate mental and physical labor;
4. walk in the fresh air;
5. eat fully: eat more plant foods, cereals, boiled animal products, less - fried meat or fish;
6. Avoid stressful situations.

If the pathology has already developed, it is worth following the recommendations of your gastroenterologist, paying attention to the psycho-emotional background.

Biliary dyskinesia does not reduce life expectancy, but affects its quality.

Dyskinesia in children

Biliary dyskinesia in children younger age develops due to their abnormal structure. Most often, this is an inflection of the gallbladder or the presence of partitions in it, less often - doubling or an abnormal location of the bile ducts.

In older children, the cause is emotional stress. These are the quarrels of the parents, and the relocation of the family, and the team in the kindergarten and school, and a large study load.

Other causes of dyskinesia are:

• hypoxia or;
• frequent sinusitis, chronic tonsillitis;
• transferred hepatitis A, dysentery, salmonellosis;
• helminthic invasions: giardiasis, roundworms;
• allergic diseases;
• vegetative-vascular dystonia;
• neuroses;
• neuro-arthritic diathesis.

Dyskinesia in children is a more dangerous disease: without normal emulsification of fats, there will be no absorption of a sufficient amount needed for the body. fatty acids and other substances, as well as fat-soluble vitamins - A, D, E and K, each of which is important for a growing organism.

If parents pay attention that the child is withdrawn, irritable, gets tired quickly or cries for the slightest reason, it is worth contacting a pediatric gastroenterologist to rule out biliary dyskinesia. If on this moment it is not detected, this does not mean that the danger has passed; this suggests that there is a predisposition to it, but the pathology has not yet had time to debut. In this case, you should pay attention Special attention on the diet and daily routine of the child, in order to prevent its formation.

The following symptoms indicate that the pathology has developed:

• alternating constipation and diarrhea;
• periodically - especially after eating fatty or fried foods - the appearance of pain in the right hypochondrium;
• itching of the skin that appeared on for some unknown reason, not after an injection, not after a bite, a new food or a new medication.

Diagnosis of pathology is carried out according to ultrasound with a choleretic breakfast. X-ray contrast, and even more so, radioisotope techniques in children are carried out according to strict indications, and with the advent of magnetic resonance cholangiography, they are almost never performed.

Treatment in children

For therapy in children, preference is given to herbal preparations. They are selected depending on the type of pathology.

So, with hypomotor dyskinesia, the following are prescribed:

• drugs that stimulate the formation of bile: cholagol, holosas, allochol, liobil;
• medicines that increase the tone of the biliary tract: magnesium sulfate, sorbitol or xylitol;
• herbal therapy: decoctions of dandelion, wild rose, corn stigmas, mint;
• "blind probing" with the intake of sorbitol or xylitol;
• mineral water: "Essentuki 17".

With hypermotor dyskinesia, treatment is carried out:

• antispasmodic drugs: eufillin, riabal;
• herbal therapy: decoctions of St. John's wort, chamomile, nettle dioecious;
• low-mineralized waters: "Slavyanovskaya", "Smirnovskaya";
• electrophoresis with novocaine on the gallbladder area.

After stopping the attack, rehabilitation is carried out in a sanatorium, where mineral waters and other physiotherapy are prescribed:

• microwave therapy;
• galvanic collar according to Shcherbak;
• sodium chloride baths;
• to eliminate spasm of the biliary tract: magnetotrapy, electrophoresis of antispasmodics (no-shpy,) on the area of ​​the biliary tract;
• for sedative purposes: coniferous baths, bromelectroson;
• to improve the motor activity of the biliary tract: SMT therapy, magnesium sulfate electrophoresis.

The diet described above fully applies to children. A strict diet is prescribed for a year, then - in the absence of attacks of biliary colic - you can gradually expand the diet.

Children with dyskinesia are registered with a pediatric gastroenerologist, neurologist and pediatrician. They are assigned twice a year scheduled ultrasound. Also, once every 6 months, courses of choleretic therapy are carried out. Once or twice a year, the child is given referrals for sanatorium treatment.

Biliary dyskinesia is a disorder that leads to a deterioration in the functioning of the organ. This ailment leads to excessive reflux of bile into the intestines. As a result of this process, the patient may complain of pain in the right side of the abdomen, loose stools and deterioration in the general condition. If the patient began to feel such symptoms, then you should take care of how to treat biliary dyskinesia, immediately contact a gastroenterologist.

Treatment of hypotonic dyskinesia

If a patient has biliary dyskinesia, symptoms, treatment should be determined as soon as possible. If this is not done on time, then the patient runs the risk of being left without a gallbladder.

Dyskinesia of the biliary tract and gallbladder is divided into two types: hypertonic and hypotonic.

Nicodin

This medication has a choleretic, choleretic, anti-inflammatory, antimicrobial, bactericidal and bacteriological effect. The composition of the drug includes a derivative of formaldehyde and amide nicotinic acid. As a result, there is an increase secretory function liver, increasing the secretion of bile and facilitating its release into the intestines.
It has a contraindication in the form of increased susceptibility to the components of the drug. With extreme caution, you can take the medication with the development of cholestasis and gastritis of the antacid form.

When taken, it can cause side symptoms in the form of a disorder digestive function, the occurrence of severe pain and the development of an allergic reaction.

A medicine that contains natural bile and digestive enzymes. Refers to combined remedy, which provides not only choleretic action, but also improves the digestion of food due to enzymes.
This remedy is prohibited for acute pancreatitis, obstructive jaundice, stomach and intestinal ulcers during an exacerbation.

With extreme caution, it is worth taking the remedy during the period of gestation and lactation. It can cause side symptoms in the form of heartburn, itching, rashes on the skin, diarrhea and an increase in the amount of transaminase in the blood.

Cerucal

It is prescribed to prevent nausea and vomiting in a patient. The action is based on blocking the urge to vomit, which are sent by impulses to the brain. Produced in the form of tablets and solution for injection.
Has a number of limitations in the form of pheochromocytoma, intestinal obstruction, development of bleeding in the intestine, perforation gastrointestinal tract, the presence of tumor-like formations, epilepsy and a convulsive state.

Cerucal is strictly forbidden to be used by women during the period of gestation and lactation. The drug in tablet form is also prohibited. But if absolutely necessary, you can make an injection with a solution.

Possible development adverse reactions in the form of dizziness, tinnitus, pain in the head, increased fatigue, depression, development of tachycardia, agranulocytosis, jumps in blood pressure, dry mouth, stool disorders, development of an allergic reaction or spastic colitis.

This medication is designed to support the liver. With the development of dyskinesia, she also begins to suffer. Hofitol has not only a hepatoprotective property, but also a choleretic one. The effect of the drug is aimed at normalizing the production of enzymes that the liver produces. As a result of this, metabolic processes are being established, and much less cholesterol enters the bile.

It also contains many vitamins and biological substances that lead to the normalization of the liver and gallbladder. It is prescribed to patients of any age, as it has natural composition and is non-toxic.

The drug is available in several forms: tablets, solution for internal and injection use.

It has a number of restrictions in the form of obstruction of the biliary tract, cholelithiasis, kidney disease, severe hepatic and renal failure and increased susceptibility to the components of the drug.

In most cases, it is well tolerated, but it can cause side symptoms in the form of diarrhea, an allergic reaction, swelling of the skin and subcutaneous tissue.

It is also recommended to carry out a tubage with mineral water, sorbitol or magnesia. These manipulations should be carried out up to three times a year. Before the procedure the night before, it is necessary to cleanse the intestines with an enema, laxative or glycerin suppository.

In the morning you need to drink the prepared solution, consisting of mineral water, sorbitol or magnesia. After that, you need to attach a heating pad to the right side of the abdomen and hold it there for about two hours. Throughout the day, a sparing diet should be observed, which consists of vegetables and fruits.

The treatment process lasts from two to three months. At the same time, you must comply proper diet, which includes the use of eggs, vegetable oils, bran, vegetable dishes and rye flour bread.

Treatment of hypertensive dyskinesia

Prescribed treatment of biliary dyskinesia and treatment according to hypertonic type has its own characteristics. With this type of disease, drugs that have a choleretic effect are prohibited, since bile without this in large numbers thrown into the intestines.

If a patient has been diagnosed with hypertensive dyskinesia of the gallbladder, treatment consists in taking antispasmodics.

You can use papaverine. The drug is produced in three forms: tablets, suppositories and injections. The main component is papaverine hydrochloride, which has the ability to act on smooth muscle structures and relax them.

It has several limitations in the form of increased susceptibility to the components of the drug, disruption of the heart muscle, the development of glaucoma, severe liver failure, is contraindicated in the elderly and babies under six months.

Relative limitations include traumatic brain injury, kidney failure chronic nature, the development of a state of shock, hypothyroidism, tachycardia, insufficient work of the adrenal glands. In such situations, the medication should be taken under the strict supervision of a doctor.

At long-term use or non-compliance with the dosage can cause a number of side effects in the form of a decrease in pressure, drowsiness, the development of allergic reactions, nausea, bloating and constipation.

The most popular remedy in this group is No-shpa. It is also prescribed as a spasm reliever of the muscle structure. Can be taken with the development of pain or the occurrence of acute colic. It is often prescribed in situations where the patient has contraindications to other drugs in the form of glaucoma or hypertrophy. prostate.

It has a number of limitations in the form of severe renal and hepatic insufficiency, severe heart failure, childhood under six years of age, lactation period, hereditary galactose intolerance, increased susceptibility to the components of the drug.

With extreme caution, the medication can be taken during the gestation period, with arterial hypotension and in children.

In most cases, No-shpa is well tolerated, but with prolonged use or taking the above dosage, side symptoms may occur in the form of nausea, constipation, heart palpitations, headaches and dizziness, sleep disturbances and the development of an allergic reaction.

Drotaverine

There is also a cheaper analogue called Drotaverine. It has an antispasmodic effect, when taken, the vessels quickly expand, the tone of smooth muscles decreases. The medicinal product has greater efficiency than Papaverine, as it is evenly distributed over the tissues.

Compared with No-shpa and Papaverine, it has fewer contraindications. These include increased susceptibility to the components of the drug, congenital lactose intolerance, severe heart failure, severe renal and hepatic failure.

Drotaverine is not recommended for children under two years of age and during breastfeeding.

Use with extreme caution this remedy follows with low pressure, atherosclerosis, glaucoma, prostatic hyperplasia and during the gestation period.

The patient is also advised to drink mineral water daily.

In addition to all these drugs, a patient with hypertensive dyskinesia is advised to take sedatives in the form of Valerian or Motherwort tincture.

Other drugs for the treatment of dyskinesia

No matter what kind of gallbladder dyskinesia is observed, the symptoms and treatment are almost always general.

Fervital

Without fail, the doctor prescribes Fervital. This medication belongs to the most powerful sorbent, which has an antitoxic property, acts as an antagonist in the presence of pathogenic microbes. Also, the action of Fervital is aimed at restoring the natural microflora of the intestines and stomach, thereby normalizing the number of lactobacilli in the digestive system.

When using Fervital, the amount of sugar and cholesterol in the blood returns to normal. Also, the drug has a symptomatic property, as a result of which disappear unpleasant symptoms in the form of heartburn, pain, nausea, vomiting, diarrhea.

It has no contraindications, except for increased susceptibility to the components of the drug. The drug is well tolerated by patients. It is prescribed for adults, children, newborns, women during the period of gestation and feeding. But it can cause side symptoms in the form of an allergic reaction, a violation of the digestive function.

Often healing process with dyskinesia of the biliary tract and gallbladder, it includes the use of hepatoprotective agents. They allow you to restore and protect liver cells from destruction.

One of the most popular is Essentiale Forte. The product is sold in the form of capsules that have a brownish color. The composition of the drug includes phospholipids and various vitamins that the body needs in the development of biliary dyskinesia.

What is remarkable Essentiale Forte turns cholesterol and other hard-to-digest fats into lightweight forms, which allows them to be easily disposed of from the digestive system.

It has no contraindications, but can cause side symptoms in the form of diarrhea, pain in the abdomen, and allergic reactions. But in most cases it is well tolerated. It can be prescribed to children, adults, pregnant and lactating women.

Analogues include Hofitol, Ovesol, Hepatrin, Karsil.

To improve digestive function are prescribed enzyme preparations. This group of medicines includes Pancreatin, Creon, Mezim, Festal, Vestal.

The treatment process must be comprehensive. It is aimed at normalizing the outflow of bile and preventing further development her stasis in the gallbladder.

Treatment of biliary dyskinesia includes not only taking medications, but also following some recommendations:

• First of all, it is necessary to normalize the mode of work and rest, and then constantly maintain it. It should include sleep for eight to nine hours a day. At the same time, departure for a night's rest must be carried out no later than eleven o'clock in the evening.
• Be sure to alternate physical and mental work. For example, for every two hours of computer work, there should be one hour of physical activity.
• Also, every day the patient needs to exercise walks in the fresh air. They must be at least thirty minutes long.
• Follow a strict diet. It excludes the use of fatty, fried and spicy foods. All food should be steamed, stewed or boiled. The diet should include fruit and vegetable dishes. Meat should not be excluded, but it should be lean, which includes beef, rabbit, chicken and turkey.
  Sweets and bakery products restricted in acceptance. It is better to replace them with nuts, honey, jam, pudding or casserole. Proper nutrition must be observed for twelve weeks. In this case, the diet may also differ based on the form of the disease. With hypotonic dyskinesia, sugar, boiled sausages, fish, caramel, marmalade and marshmallow can be included in the diet. But with hypertensive dyskinesia, these products are excluded. Sugar is replaced with xylitol, and beef with young veal.
• Observe drinking regimen. This rule is the most basic, because it is the liquid that allows the bile not to thicken. The daily volume of fluid consumed with dyskinesia should be at least two liters. The diet should include ordinary and mineral water, fruit drinks from lingonberries, cranberries and currants, compotes from dried apricots, raisins and prunes, green tea. At night before going to bed, to improve bowel function, it is advised to take kefir and fermented baked milk.
• To carry out tubages of a closed nature and duodenal sounding. This type procedures are prescribed only for hypotonic dyskinesia.
  For manipulations, you need to take magnesium sulfate and dissolve it in warm water. Take in the morning on an empty stomach, then lie on your right side, applying a heating pad. The solution can be replaced with mineral water, beet juice and egg yolks. The duration of the procedure should be from thirty to forty minutes. Tubage should be done once a week. In this case, it is worth carrying out another six such procedures.
• As additional method treatment may include physiotherapy. With a low motor function of the gallbladder, electrophoresis is prescribed using medications in the form of Pilocarpine or Carbocholine. Such manipulations allow stimulating the smooth muscles to perform the corresponding movements.
• Diadynamic therapy, amplipulse therapy and magnetotherapy are also shown. These methods are carried out directly in the area of ​​the gallbladder.
• With a strong motor function of the gallbladder and ducts, the patient is prescribed electrophoresis with Papaverine, UHF therapy on the area of ​​the right hypochondrium, paraffin applications and coniferous baths.
• With JVP, acupuncture is often prescribed. This method of treatment allows you to normalize the tone of the walls and the outflow of bile. Specialists with the help of the thinnest needles act on special points that are responsible for the functioning of the liver and gallbladder.

The main methods of treatment of biliary dyskinesia are commonly referred to as physiotherapy exercises and massage. The impact of such procedures is aimed at normalizing the work of organs and improving psycho-emotional state. It also turns out to be an analgesic and restorative property.
Massage and physiotherapy carried out only during the period of remission. Exercises are based on strengthening the muscular frame and the respiratory system. Daily exercises should be performed for twenty to thirty minutes. But physical education classes depend on what form of the disease is observed in the patient.

With hypertensive dyskinesia, therapeutic exercises should be carried out on the right and left sides, as well as lying on your back. Exercises should be aimed at relaxing the muscles. In this case, the pace should be slow and moderate.

With hypotonic dyskinesia, therapeutic training is also shown on the back, left and right side, standing on the feet and knees with emphasis on the hands. During the period of remission, gymnastics should be carried out in a standing and sitting position. In training, the patient needs to include exercises for the press, walking, abdominal breathing. At the same time, the pace and load should be of medium strength.

During the massage, the collar lumbar region is affected. There is also a massaging of the abdomen with slight pressure under the ribs. One procedure lasts ten minutes. BUT treatment course should last up to ten to fifteen sessions.

• Diseases of the biliary tract
  • Cholecystitis is an inflammatory process
• Diseases of the liver and biliary tract: diet
• Common Liver Diseases
  • Diagnosis: cirrhosis of the liver
• Diet for liver disease
  • Nutrition according to diet No. 5

Diseases of the liver and biliary tract have characteristic symptoms that can be used to put provisional diagnosis to the patient. Modern medicine identifies several major diseases of these organs.

Diseases of the biliary tract

The main diseases include: dyskinesia, cholecystitis and cholelithiasis.

Dyskinesia is a disease that is characterized by a violation of the contractile function of the gallbladder and organ ducts, dysfunction of the sphincter of Oddi. As a result, the process of excretion of bile is disrupted. There are 2 forms of dyskinesia:

1. Hyperkinetic. It is characterized by an increase in the tone of the gallbladder, strong and rapid contractions of the organ, insufficient opening of the sphincters. Young people are more often affected. Symptoms:

• paroxysmal pain that is sharp in nature;
• pain in the hypochondrium on the right.

These signs are aggravated after emotional experiences, during menstruation.

2. Hypokinetic. This form is characterized by insufficient contraction of the gallbladder. Elderly people are more often affected. Symptoms:

• pain in the hypochondrium on the right of a dull character, weakly expressed;
• bursting pains.

Allocate and general symptoms diseases:

• a bitter taste in the mouth in the morning;
• general weakness;
• decrease in emotional background;
• pain in the hypochondrium on the right after taking spicy dish or unrest;
• insomnia;
• decreased libido;
• violation of the menstrual cycle;
• diarrhea or constipation that is regular.

With dyskinesia, the stage of exacerbation is replaced by remission - and so on in a circle.

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Cholecystitis is an inflammatory process

With this disease, the wall of the gallbladder becomes inflamed. Allocate acute and chronic form. Acute symptoms:

• acute, sharp pain in the abdomen, which is permanent;
• feeling of nausea;
• repeated vomiting;
• elevated temperature;
• intense signs of jaundice;
• rapid pulse.

Chronic cholecystitis often occurs without symptoms and manifests itself only during an exacerbation.

Gallstone disease is another pathology. It is characterized by the formation of stones in the bile ducts. In most cases, the disease proceeds without symptoms. The most common signs include:

• biliary colic, that is, acute paroxysmal pain;
• pain in the hypochondrium with right side, which "give" to the shoulder;
• vomit.

At the first symptoms, you should consult a doctor.

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Diseases of the liver and biliary tract: diet

Compliance with the diet is important in both chronic and acute forms of diseases. The diet promotes long-term remission, and in case of exacerbation it alleviates the condition. The rules for compiling the diet are as follows:

1. Excluded: oily, spicy food, alcohol, cold dishes, carbonated drinks.
2. Protein. Meat and fish are not fatty varieties, milk, cheese, cottage cheese are very useful. Allowed moderate use raw eggs or omelets.
3. Cereals. Oatmeal and buckwheat are especially valuable.
4. Creamy and vegetable oil. It is an excellent source of fats. But fat, meat and fish of fatty varieties, canned food, margarine, etc. are strictly prohibited.
5. Carbohydrates. Vegetables, fresh fruits. But radishes, garlic, onions, radishes, etc. must be discarded. Useful and greens, especially with stones. Sorrel, spinach is better not to include in the diet.
6. Juices. If the patient suffers from diarrhea, it is better to consume vegetables and fruits in the form of juices or pureed. Blueberries, pomegranates, quince are especially good.

It is very important to observe the diet. You need to eat often and fractionally, especially with cholecystitis.

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Common Liver Diseases

The main diseases are: hepatitis, cirrhosis, fatty degeneration and liver cancer.

Hepatitis is an infection of the liver by a virus. Allocate acute and chronic forms of hepatitis. acute form characterized by the following symptoms:

• signs of intoxication;
• signs of jaundice: the skin and sclera have a yellow tint;
• feces acquire a whitish-clay tint;
• urine darkens to a rich dark color;
• hemorrhagic signs:
• nosebleeds;
• skin itching;
• bradycardia;
• depressed psycho-emotional state;
• irritability;
• damage to the central nervous system;
• enlargement of the liver and spleen.

In more mild form exacerbation of hepatitis symptoms may not be expressed. In a severe form of exacerbation, necrotic changes in the liver and a decrease in its size are observed.

In chronic hepatitis, the following symptoms are observed:

• the liver and spleen increase in size;
• painful sensations in the area of ​​the organ of a blunt nature;
• skin itching;
• feeling of heaviness;
• loss of appetite;
• belching;
• flatulence;
• hyperhidrosis.

Patients can hardly tolerate fatty foods and alcohol.

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Diagnosis: cirrhosis of the liver

With this liver disease normal structure organ is replaced by scar tissue and acquires a nodular form. This prevents the full functioning of the body. The disease in most cases proceeds without symptoms. Cirrhosis is characterized by the following symptoms:

• general weakness;
• decrease in working capacity;
• pain in the hypochondrium on the right side;
• bloating;
• urine becomes darker;
• weight loss;
• reddened palms.

If the disease is not treated, complications begin:

• accumulation of fluid in the abdomen;
• impaired state of consciousness and memory;
• stomach bleeding;
• jaundice.

Cirrhosis in most cases causes liver cancer. Oncology manifests itself as progressive cirrhosis and is accompanied by pain syndrome in the abdomen.

Another disease is fatty degeneration, or steatosis. In this case, the tissue of the organ is rebuilt, while there is an excessive accumulation of fat in the cells of the organ. The disease can occur without symptoms, and may be accompanied by the following symptoms:

• an increase in the size of the liver;
• pain in the organ area;
• feeling of nausea;
• pain in the hypochondrium on the right side.

Steatosis differs in duration. In this case, the phases of exacerbation are replaced by remissions.

Biliary tract dyskinesias (BBD) are contractile disorders motor ability, changes in the tone of the gallbladder, bile ducts and their sphincters, leading to a violation of the outflow of bile. Dyskinesias are mainly functional in origin and very rarely organic.

The basis of dyskinesia is a violation of the sequence of contraction and relaxation of the biliary tract and the sphincter system. Depending on the etiology, primary and secondary features biliary dyskinesia. Primary Symptoms dyskinesia: functional diseases biliary system caused by a disorder of neurohumoral regulatory mechanisms.

Bile is produced in the liver from 0.6 to 1.5 liters per day. Regular production of bile is necessary for normal digestion. First, bile from the liver enters the hepatic ducts, from there through the common bile duct and cystic duct into the gallbladder. The gallbladder, contracting, in portions removes bile into the duodenum in the region of Vater's nipple. The portioned flow of bile and pancreatic juice into the duodenum is regulated by the sphincter (muscular ring) of Oddi.

Biliary dyskinesia is more common in women than in men.

Types of biliary dyskinesia (JVP).

• Hypotonic (decreased tone of the sphincters)
• Hypertonic (increased sphincter tone)
• Hypokinetic (hypomotor) - a decrease in the motor function of the biliary tract
• Hyperkinetic (hypermotor) - increased motor function of the biliary tract

The reasons.

Primary causes of biliary dyskinesia.

• Disorders of neurohumoral regulatory mechanisms of the biliary tract,
• Long-term, systematic violation of the diet (irregular meals, overeating, the habit of eating hearty before bedtime, abuse of spicy fatty foods),
• , stress,
• sedentary image life, congenital underdeveloped muscle mass.

Secondary causes of biliary dyskinesia.

• Previously transferred acute viral hepatitis,
• infections
• Hormonal disorders(, menstrual disorders, insufficiency of the endocrine glands: hypothyroidism, lack of estrogen, etc.),
• With cholelithiasis, cholecystitis, gastritis, gastroduodenitis, peptic ulcer, enteritis,
• Allergic diseases,
• Chronic inflammatory processes abdominal cavity ( chronic inflammation ovaries, colitis, appendicitis, etc.),
• With bends of the neck or body of the gallbladder (organic causes).

Clinical signs.

General symptoms.
Patients complain of weakness, fatigue, irritability, insomnia, headaches, tachycardia, sweating, chilliness, cold extremities.

specific symptoms.
There are heaviness, pain in the right hypochondrium, the right region of the epigastric zone, bloating, rumbling, flatulence, belching with air, bitterness in the mouth (especially in the morning), increased salivation, nausea, vomiting, frequent constipation, less often diarrhea.

Hypermotor dyskinesia is characterized by paroxysmal sharp pains different intensity in the right hypochondrium, often radiating to the right shoulder blade and shoulder, bitterness in the mouth, upset stool. Attacks can provoke spicy, fatty foods, physical stress, stress.
Hypomotor dyskinesia is characterized by dull, aching pain, heaviness in the right hypochondrium, decreased appetite. Because of the stagnation of bile, nausea, belching, and constipation often appear. Basically, these symptoms appear 1 hour after eating, but can occur regardless of the meal.

In women, the symptoms of dyskinesia increase in the premenstrual period and the first days of menstruation, often accompanied by nausea and vomiting. Biliary dyskinesia in men can also lead to sexual disorders.
The manifestation of certain symptoms, their severity depends on the type and degree of development of dyskinesia, as well as comorbidities, nervous system of the patient. The disease can manifest itself for years only general fatigue, weakness, emotional lability, discomfort and heaviness in the right hypochondrium, without pain.

The disease is manifested by periods of exacerbation and remission. Seizures are often provoked by violations of the diet, stress, physical activity, colds and etc.

Complications.

Prolonged dyskinesia of the gallbladder can lead to chronic cholecystitis, the formation of stones.

Diagnosis of dyskinesia of the gallbladder.

Anamnesis, examination of the patient.
At pronounced violation outflow of bile, cholestasis, yellowness of the sclera, skin is possible, the tongue can be coated with a white or yellowish coating.
Palpation is painful in the area of ​​the gallbladder, especially on a deep breath, as well as in the epigastrium and choledochopancreatic Chauffard-Rive zone(choledochopacreatic triangle between the midline of the abdomen and the line drawn from the navel to the right upwards at an angle of 45 degrees). The liver may be enlarged.

• ultrasound - determine the volume of the gallbladder before and after (after 30 minutes) a choleretic breakfast. Normally, after a choleretic breakfast, the volume of the gallbladder is reduced by 40%.
• duodenal sounding e for the purpose of research and analysis of bile, received in portions
• X-ray methods: cholecystography and cholangiography.

TREATMENT OF BILE TRACT DYSKINESIA.

First of all, it is important to comply therapeutic diet, finding out the cause of dyskinesia, treatment of the underlying disease.

Diet therapy.

Frequently shown fractional nutrition in small portions up to 5-6 times a day, appoint
The diet includes foods that help remove fat from the liver (cod, dairy products, especially cottage cheese), vegetables, fruits, and vegetable oil.
Eggs, meat, fish and mushroom broths, gravies and soups, animal fats are limited in the diet, except a small amount butter.

Excluded:

• spicy, fried foods, carbonated, cold drinks, alcohol, legumes, onions, garlic. Such food can provoke a severe spasm of the biliary tract.

It is important to always eat only warm and fresh food. Products are consumed boiled or baked. Meat and fish can be baked after preliminary boiling. You can salt food normally (with an exacerbation, salt is limited).
Dinner should be light, no later than 2-3 hours before bedtime. With exacerbation of diseases of the liver and gallbladder, accompanied by gastritis, diet No. 5 is prepared in a pureed form, excluded from the diet raw vegetables and fruits, black bread; all dishes are steamed or in water (not baked).

You can include wheat bran in the diet, take 1 tablespoon per day with meals.

In the hyperkinetic form, products that stimulate bile secretion are limited (fatty meat, fish, poultry, vegetable oil, spices, mushrooms, broths, smoked meats, carbonated foods, etc.). In the hypokinetic form, vegetables, fruits, butter, cream, sour cream, eggs (in limited quantities).

Drug therapy.

Choleretic agents: Choleretics and Cholekinetics,
Antispasmodics,
enzyme preparations,
Sedatives.

At Hypotonic Dyskinesia prescribed Choleretics.

Choleretics -- drugs that stimulate bile formation, increase the secretion of bile and the formation of bile acids. Choleretics are with the content of bile acids (true choleretics), synthetic, plant origin.

• Preparations containing bile acids: Holenzim, allohol, Holiver, Liobil,Dehydrocholic acid (Hologon).
• Preparations of synthetic origin: Nicodin, Osalmid, Cyclovalon
• Herbal preparations: Ziflan, Flamin(immortelle flowers) Hofitol(artichoke leaves) Tanacehol(common tansy), Berberine Bisulfate, Febihol(turmeric root) Holosas (dog-rose fruit),
• Mineral water also have choleretic properties.

To correct the functioning of the autonomic nervous system, Tonic drugs :
Eleutherococcus extract, 20-30 drops inside half an hour before meals in the morning. Course - 25-30 days
Ginseng tincture, 15-25 drops inside three times a day for half an hour before meals. Course - 30-40 days.

With Hypertensive Dyskinesia, Cholekinetics are prescribed.

cholekinetics - choleretic drugs that stimulate the contractile function of the gallbladder and at the same time reduce the pressure and tone of the biliary tract, the sphincter of Oddi, have an antispasmodic effect.

• Hymecromon (Odeston), Cholecystokinin, Magnesium sulfate, Pituitrin, Sorbitol, Xylitol, Mannitol, Gepabene, Flacumin (leaves of skumpii),Convaflavin(grass lily of the valley Far East).

Antispasmodics - drugs that relax the muscles of the biliary tract and sphincters, lower the pressure in the biliary tract, reduce pain.

• Platifilin, Papaverin, No-shpa, Mebeverin (Duspatalin), used in courses to prevent the development of seizures.
• Narcotic pain relievers (eg. Promedol) are used for severe pain syndrome.

Sedatives: Bromides (Sodium bromide and Potassium bromide), Motherwort tincture, Valerian.

Enzymes: Festal, Digestal, Mezim-forte, Creon-10, etc.

During remission, without exacerbations.

• Can be carried out Tubeless tubages according to Demyanov with weak choleretic or mineral water with an average mineralization.

Xylitol, Sorbitol, Magnesium sulfate(Epsom salt).
Dissolve in 100 ml warm water medicine and drink it for 10-15 minutes in small sips. During this, you can walk around or after that lie down for 30-40 minutes on your right side, putting a warm heating pad on your right side.
You can make tubazhi with heated mineral water, mineral water with honey.Tubazhi are repeated every 7-10 days. Course - up to 8-10 procedures.

With dyskinesia with increased tone mineral waters of weak mineralization are recommended - Slavyanovskaya, Smirnovskaya, Essentuki No. 4 and 20, Narzan. Water should be drunk 1/2 cup 3 times a day 30 minutes before meals, without gas, heated form.

With dyskinesia with reduced tone, mineral waters of strong mineralization are also prescribed - Essentuki N17, Jermuk, Arzni, and others. It also needs to be drunk 1/2 cup 2-3 times a day 30-60 minutes before meals, without gas, in a heated form.

• Good help Massage and Therapeutic exercise.
• It is also recommended to periodically Spa treatment.
• With stagnation of bile, you can periodically appoint duodenal sounding to empty the gallbladder.
• Physiotherapy: electrophoresis, amplipulse therapy, paraffin applications, laser therapy.

Prevention of biliary dyskinesia.

In order to prevent the manifestation of this unpleasant ailment, one should, without delay, treat all disorders of a neurotic nature, avoid serious stressful situations, regularly, at the same time, eat every day. More important is also a normal, full sleep and rest.