Cholecystitis – what it is, causes, signs,symptoms, treatment in adults, diet and prevention

Cholecystitis – заболевание (воспаление) желчного пузыря,
the main symptom of which is severe pain in the right side with
changing body position. Every year the number of these diseases
increases by 15%, and the occurrence of stones increases annually by 20%
among the adult population. It is noticed that men are less susceptible
cholecystitis, rather than women after 50 years.

What is this disease, what are the causes and characteristics of
adults, as well as treatments and diet for normal
functioning of the gallbladder, consider later in the article.

Cholecystitis: what is it?

Cholecystitis у взрослых

Cholecystitis (cholecystitis) is an acute inflammatory process,
happening in the gallbladder of a person. Basic principles of development
inflammatory process in the gallbladder wall:
наличие микрофлоры в просвете пузыря и нарушения
оттока желчи.

The role of bile in the physiology of digestion:

  • Dilutes food processed by gastric juice, changes
    gastric intestinal digestion;
  • Stimulates peristalsis of the small intestine;
  • BUTктивизирует выработку физиологической слизи, выполняющей
    protective function in the intestines;
  • Neutralizes bilirubin, cholesterol and a number of other substances;
  • It launches digestive enzymes.

AT настоящее время холециститом страдает 10-20% взрослого
population, and this disease tends to grow further.
Связано это с малоподвижным образом жизни, характером  питания
(excess consumption of animal-rich foods is fatty
meat, eggs, butter), increasing endocrine disorders (obesity,
diabetes).

Classification

AT зависимости от длительности течения заболевания различают:

Acute cholecystitis

Острый бескаменный холецистит встречается редко, протекает
usually without complications and ends with recovery, sometimes
go into the chronic form. The disease most often develops with
the presence of gallstones and is a complication
gallstone disease.

Chronic form

Chronic cholecystitis. ATоспаление желчного пузыря
occurs slowly and gradually, often without bright signs
diseases. As in acute form, the patient may be hurt by pain.
in right side, in hypochondrium, especially after a sharp shake
body.

Both acute and chronic cholecystitis may be:

  • calculous (i.e., associated with formation in the bladder
    stones, its share reaches 80%);
  • stoneless (up to 20%).

In young patients, as a rule, bezkamenny found
cholecystitis, but since the age of 30 the frequency of verification
calculous cholecystitis is increasing rapidly.

By the nature of inflammation, they are:

  • Catarrhal;
  • Purulent;
  • Gangrenous;
  • Phlegmonous;
  • Mixed.

Withчины

The most common cause of cholecystitis is
microbes entering the body and their subsequent development. Cholecystitis
могут спровоцировать стрептококки, кишечная
палочка, энтерококки, стафилококки. That is why for
лечения применяется прием антибиотиков.

Common causes:

  • ATрожденные аномалии развития желчного пузыря, беременность,
    prolapse of the abdominal organs
  • Biliary dyskinesia
  • Cholelithiasis
  • The presence of worm infestation – ascariasis, giardiasis, strongyloidosis,
    opisthorchiasis
  • BUTлкоголизм, ожирение, обилие жирной, острой пищи в рационе,
    violation of the diet.

ATоспалительные процессы в самом желчном пузыре или соседних
bodies lead to a change in the natural balance of biochemical
indicators and tumors. The lack of an adequate response leads to
disruption of metabolic processes, in particular to the poor flow of bile,
and, therefore, to cholecystitis.

Provocative factors:

  • poor nutrition with the dominance of fatty, spicy, spicy
    and salty foods;
  • failure to comply with the diet (long intervals between receptions
    food, plentiful evening night meals, lack of hot
    food);
  • alcohol abuse;
  • tobacco smoking;
  • hypodynamia;
  • chronic constipation and intoxication of the body;
  • allergic reactions;
  • age disorders in the blood supply to the abdominal organs
    cavities;
  • injuries;
  • hereditary factor.

Symptoms of cholecystitis in adults

The main symptom of cholecystitis, which is most complaining
patients – pain under the ribs in the right side, especially when changing
body position, which can also be felt in the right shoulder,
scapula, side of neck. Pain goes away after a while itself
alone or after taking painkillers, but later
there is a gradual increase, and then it becomes
regular.

Typical symptoms of cholecystitis:

  • the presence of dull pain on the right, above the waist, responding to the shoulder blade,
    lower back, arm;
  • отсутствие appetite;
  • digestion problems;
  • endless nausea;
  • belching bitter;
  • violation of gas formation;
  • chilliness;
  • signs of jaundice on the skin.

Patients may experience far from all of the above.
symptoms. Their severity varies from barely perceptible (with
sluggish chronic course) to almost unbearable (for example, in
case of biliary colic – a sudden attack of intense pain).

Main symptoms chronic cholecystitis:

  • Digestive upset, vomiting, nausea, lack
    appetite
  • Dull pain on the right under the ribs, extending to the back,
    scapula
  • Bitterness in mouth, burping with bitterness
  • Heaviness in right hypochondrium
  • Yellowing of the skin is possible.

The occurrence of an attack

The attack of cholecystitis develops for many reasons. Here are the most
common:

  • cholelithiasis;
  • infection in the bile ducts; stomach diseases leading to
    disruption of bile movement;
  • bile stasis;
  • obstruction of biliary tract vessels as a result
    atherosclerosis.

With the onset of cholecystitis, the symptoms are as follows:

  • the appearance of acute, sharp pain on the right, above the waist;
  • yellowing of the skin;
  • vomiting after eating;
  • the patient cannot find a place for himself;
  • the occurrence of severe weakness;
  • pressure reduction;
  • increased heart rate;
  • acute bitterness in mouth.

In cases of repeated repetition of acute attacks of inflammation in
gallbladder disease is defined as chronic. This form
can occur both in the presence of gallstones and in their
absence of May develop slowly and imperceptibly throughout
a long period from several months to years, or occur
immediately due to acute cholecystitis.

How to remove an attack of cholecystitis?

The onset of acute cholecystitis is always sudden,
has acute symptoms.

Action during an attack What is forbidden to do
  • provide peace to the patient;
  • put a cold compress on the area of ​​severe pain (right
    part of the abdomen);
  • submit antispasmodic drug (no-shpa);
  • after vomiting attacks, supply mineral water without gas to
    sodium chloride, bicarbonate basis.
  • call emergency care.
First of all, analgesics and narcotic drugs are prohibited.
painkillers. Such help lubricates the symptoms of acute
cholecystitis, and the doctor may prescribe the wrong treatment. Besides
Moreover, during an attack it is strictly forbidden:

  • drink alcohol;
  • take any other medicines not prescribed by a doctor;
  • do enemas;
  • put a heating pad on the abdomen.

Complications

The presence of any cholecystitis is always fraught with possible development.
complications. Some of them are very dangerous and require
immediate surgery.

Long-term inaction can lead to development enough
unpleasant complications:

  • cholangitis;
  • fistula formation in the stomach, hepatic bend,
    duodenum;
  • reactive hepatitis;
  • �“Turn off” the bladder (gall no longer performs its functions in
    sufficient);
  • pericholecheal lymphadenitis (in the bile ducts develops
    inflammation);
  • эмпиеме пузыря (гнойное inflammation);
  • intestinal obstruction;
  • gangrene of the gall with the appearance of peritonitis;
  • perforation (rupture of the bubble).

Diagnostics

The treatment of cholecystitis is performed by a gastroenterologist. With
the chronic form of the disease will be helpful to consult
nutritionist. Additional help may be provided by a physiotherapist.

The following activities are carried out for diagnosis:

  • history taking;
  • examination of the patient;
  • laboratory tests;
  • instrumental studies.

Laboratory research:

  • General blood analysis. Detects signs of inflammation.
  • Биохимический анализ крови:  общий билирубин и его
    fractions, transaminases, alkaline phosphatase, cholesterol. Observed
    their moderate rise.
  • Blood sugar For the diagnosis of diabetes.
  • General urine analysis. For differential diagnosis with
    kidney disease.
  • Feces on the worms eggs. To identify Giardia, Ascaris.
  • Microscopic and bacteriological examination of bile.
  • Immunofermentative blood test for giardiasis.
  • Analysis of feces for elastase 1. For the diagnosis of pancreatitis.

Withменяются следующие методы диагностики:

  • Ultrasound diagnosis. Conducted to detect signs
    pathologically altered gallbladder tissues, in some
    cases of stones;
  • Holegrafiya. X-ray method supplementing
    Ultrasound. Used to identify hidden pathologies of gall
    a bubble;
  • Probing of the duodenum. Used for selection
    contents of the small intestine.

The best way to determine if a disease is
advance study. Most often identifying some
deviations in the chemical composition of bile may require only
compliance with a strict diet.

How to treat cholecystitis?

Medical tactics are determined by the form of cholecystitis, its stage and
weight. Acute forms of the disease are treated exclusively in the hospital. With
chronic options without hospitalization can do patients with
light and uncomplicated forms without intense pain
syndrome

Treatment of cholecystitis in adults consists of the following steps:

  • Diet therapy. Compliance with an adequate diet is extremely important.
  • Antibiotic therapy. Antibiotic prescription is possible after
    establishing the nature of inflammation, that is, which pathogen is caused
    pathogenesis of the disease.
  • Symptomatic treatment. Aims to eliminate symptoms
    diseases. It can be immunostimulating, antihistamine,
    sedatives, choleretic drugs, hepatoprotectors.
  • Compliance, physiotherapy, especially in periods
    remission.

Medications

Cholecystitis drugs should be taken with a large
caution because with the wrong selection or order of their reception,
увеличивается риск обострения diseases. This is especially true
in the presence of stones in the choleretic vesicle.

  1. Indication for the treatment of cholecystitis with antibiotics is
    exacerbation of the inflammatory process in the biliary tract,
    accompanied by pain, temperature. Antibiotic therapy course
    non-durable (7–10 days). Antibiotics must be used in
    combinations with baktisubtil and necessarily with vitamins (C, group B,
    BUT).
  2. antibacterial agents (biseptol, nevigramone, furazolidone,
    nitroxoline and others.);
  3. antiparasitic drugs (depending on the nature
    parasite is prescribed – macmorir, metronidazole, tiberal, nemozol,
    biltricid, vermox and others);
  4. With болях принимать спазмолитики. This is a traditional no-spa (2
    pills three times a day, but no more, read the side effects
    in the abstract and make sure that this is a serious drug and overdose
    unacceptable), papaverine (can be in the candlelight – many say that
    the effect is even better than from tablets), Duspatalin 1 tablet 2
    times, 20 minutes before meals.
  5. If you want to increase the secretion of bile, prescribed
    medication: “Allohol”; �”Cholenim”; �Oksaphenamid.
  6. To the gastrointestinal tract does not glitch, there was no severity
    indigestion is recommended to drink enzyme drugs: “Festal”;
    �Mezim; �Pancreatin.
  7. Mandatory component of the treatment of patients with cholecystitis
    should be vitamin therapy (in the acute period, vitamins A, C, B1,
    B2, PP, and in the future – courses of vitamins B6 and B12, B15, B5,
    E).

Be sure to consult a doctor who, on the basis of
diagnostics prescribe you a course of treatment for cholecystitis, following which
positive prognosis for recovery significantly
is increasing!

Дополнительные мероприятия:

  • phytotherapy – teas with immortelle, St. John’s wort, corn
    stigmas, mint;
  • blind sounding procedure (tubing) – is carried out 1 time in 7
    days, only in the absence of adhesions and pronounced narrowing of the biliary
    ducts;
  • physiotherapy – electrophoresis, diathermy, mud therapy,
    inductothermy.

Treatment of chronic cholecystitis is primarily aimed at
stimulation of the process of bile discharge, elimination of spasmodic
phenomena in the biliary tract and gall bladder. Also held
a set of measures that are designed to destroy the pathogen
inflammation.

Surgery

The operation is often prescribed for acute cholecystitis. AT
unlike acute appendicitis, the decision to have a surgical
manipulation is not taken immediately. Doctors for several days may
to observe his condition, to make a biochemical analysis
the contents of the gallbladder, perform an ultrasound, take blood for analysis, and
only when clarifying the full picture of the development of the disease is taken
final decision.

Most often it is the stone disease that causes
cholecystectomy. With несвоевременном лечении болезни разрушаются
gallbladder wall, and the digestive process is disturbed. 
The operation can be performed in two ways: laparoscopy and open
cholecystectomy.

The purpose of surgery for cholecystitis is to remove inflammatory
hearth, i.e. желчного пузыря, как первоисточника diseases. With
This must ensure that the bile ducts are completely passable,
remove obstacles and ensure free passage of bile in
intestines.

Of course, it is possible to avoid surgery if
seek treatment at the first symptoms, as well as adhere to
diet and comply with all the recommendations of doctors.

Diet

With холецистите рекомендуется принимать пищу небольшими
in portions, as often as possible, at least 4-5 times a day. Strongly
It is recommended to make a diet with a constant reception time
food. It is very important that the bile does not stagnate. Admission itself
food into the body by the clock can be considered as choleretic
remedy, the more it is natural for weakened
gastrointestinal system.

Three main directions of the diet for cholecystitis:

  • Unloading of the liver and other digestive organs.
  • Normalization of bile.
  • Improving the performance of the digestive tract.

It is allowed in the first days of illness to use:

  • freshly made (not canned!) juices from berries and
    fruits;
  • mineral water without gas;
  • sweet tea is not strong;
  • broth hips (if there are no contraindications to his
    addicting).

After subsiding the acute symptoms of the disease in question
(as a rule, this happens in 1-2 days) the patient is allowed
put into the diet wiped soups, mucous porridge, jelly, tea
sweet with crackers (they should be made from white bread).

Allowed foods during the diet Prohibited Products
  • vegetable broth soups with various cereals, vegetables,
    pasta, borscht, beetroot soup, cabbage soup,
    dairy with cereals, fruit with rice;
  • lean meats, poultry (chicken, turkey) and fish (cod,
    ice, pike perch, hake, navaga, etc.) in boiled, baked
    (pre-boiled), stewed (with the removal of juice) form;
    beef stroganoff, pilaf from boiled meat. Meat and poultry are cooking
    mainly a piece, it is also possible in the form of chops, cutlets,
    meatballs;
  • fresh tomatoes, cucumbers, carrots, cabbage;
    boiled and stewed carrots, potatoes, beets, zucchini, pumpkin,
    cauliflower.
  • Non-sour sauerkraut, fresh herbs (parsley,
    dill), from legumes – green peas. Onions are allowed to add to
    dishes after boiling;

The list of preferred fluids for cholecystitis includes:

  • non-carbonated mineral water;
  • juice from fruits and berries;
  • tea without sugar, weak;
  • compote rosehip.
  • Fatty foods are animal fats: pork, lamb, duck, eggs,
    butter, chocolate.
  • It is necessary to exclude fried. These products make it difficult
    digestion of patients with cholecystitis, since bile into the intestine
    doing badly.
  • Alcohol (especially beer and champagne) – it contributes
    the appearance of gallstones.
  • Salty, sour, spicy and smoked – they contribute to the production
    bile that can cause stretching of the inflamed organ.
  • Also have to forget about carbonated drinks and coffee.

Обратите внимание: никакие процедуры для разжижения и
bile output without prior examination to conduct
categorically impossible. If there is even a small stone in the gall
the bladder or ducts, then a sudden movement of bile can
bring the patient to the operating table to provide emergency
surgical care.

Folk remedies

Before using folk remedies for cholecystitis, be sure to
consult with a gastroenterologist.

  1. Corn rylets – 10 g pour 200 ml of water, boil for 5 minutes,
    take ¼ cup 3 times a day before meals.
  2. The juice of one lemon and a tablespoon of salt pour a liter of boiled
    water and drink in the morning on an empty stomach. Efficient way to empty
    gallbladder.
  3. Pumpkin. Cook as many pumpkin dishes as possible. Reception is useful
    freshly squeezed vegetable juice (200 ml per day).
  4. Add 2 tsp of immortelle flowers in boiling water, 2 tsp of leaves
    cowberries, 3 tsp of knotweed and 1 tsp of pharmacy chamomile flowers. Give
    will infuse for 2-3 hours. Withнимайте по ½ стакана три раза в сутки.
  5. Mix the ingredients in the specified amounts: peppermint,
    Chamomile pharmacy, kidney tea – 2 tablespoons; soapworm
    medicinal, common hops (cones) – 3 tbsp. l 1 l
    boiling water take 3 tablespoons of the collection. Withнимать по 100 мл 6 раз в
    day.
  6. ATзять 2 чайные ложки измельченного листа шалфея лекарственного,
    brew 2 cups of boiling water. Insist 30 minutes, strain.
    Withнимать по 1 столовой ложке через каждые 2 часа при воспалениях
    gallbladder, liver.

Prevention

The main prevention of cholecystitis is significant
decrease the likelihood for the occurrence of stones in the gallbladder. BUT
in order to prevent the formation of stones, it is necessary
pay attention to their food and to those products that
daily consumed.

To guard against the onset of symptoms of inflammatory processes.
in the walls of the gallbladder in adults, prevention is required
cholecystitis at home, including:

  1. Observe diet, limit fat intake and
    fried foods, exclude alcoholic and carbonated drinks,
    give preference to fractional feeding, strive for normalization
    body mass.
  2. ATовремя проводить санацию вероятных очагов попадания инфекции в
    организм – органов ротовой полости и носоглотки.
  3. Раз в год проходить диспансерное обследование с
    using the method of ultrasound therapy hepatobiliary
    system.

Early detected and prescribed symptoms and treatment
cholecystitis in adults, full compliance with regulations
the attending physician – all this makes a prognosis for the cure of acute
холецистита достаточно оптимистичным. But even in the case
chronic course of the pathological process the patient loses
ability to work only in the period of exacerbation. ATсе остальное время он
feels good.

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