Update: December 2018
Gallstone disease (ICD) is a pathology in which
желчном the bubble или в желчных протоках формируются камни
(cholecystolithiasis, choledocholithiasis). The occurrence of stones due to
the precipitation of several components of bile: cholesterol,
protein, calcium salts and bile pigments. They cause stagnation
желчи в the bubble, нарушение липидного обмена и даже приводят к
bile infection. Основными симптомами камней в желчном the bubble
are: pain in the right hypochondrium and jaundice.
Stones in the gall and ducts are most often formed due to
violations of the composition of bile, namely the quantitative ratio of its
constituents. In this case, the solid components of bile fall in the form
sediment, it is they who subsequently grow and form stones.
Cholelithiasis often develops with an increase in the content in the bile
cholesterol (such bile is called lithogenous).
Increased cholesterol in bile may be due
different reasons, provoking factors:
- overuse of foods containing
cholesterol (how to lower cholesterol without drugs)
- a decrease in the concentration in the bile of bile acids
hepatocyte function, reduced bile secretion);
- decrease in the content of phospholipids (prevent the loss of
- violation of the outflow of bile (stagnation)
- in women, female admission is a provocative factor
hormones – estrogen, as well as frequent childbirth
- surgery – vagotomy, removal of the lower lobe
ileum and others
- related diseases – diabetes, cirrhosis of the liver,
hemolytic anemia, Caroli syndrome, Crohn’s disease
Застой желчи в желчном the bubble может иметь механический или
functional genesis. Mechanical stagnation of bile due to the presence of
obstacles to the flow of bile, (adhesions, swelling, swelling
the walls of the bladder, the inflection of the bile duct, the narrowing of the duct,
swollen lymph nodes, etc.). Functional disorders
caused by impaired motility of the biliary tract
Причиной возникновения камней в желчном the bubble может быть
infectious and inflammatory process in the biliary system,
autoimmune conditions, various types of allergies, sedentary
lifestyle, fasting, pregnancy, injury, endocrine
diseases, liver pathology, etc. (see drastic weight loss
увеличивает риск появления камней в желчном the bubble).
Symptoms of gallstone disease
В зависимости от размеров конкрементов (камней) в желчном the bubble
and their localization clinical picture of diseases can be
The main symptoms that appear in the presence of
конкрементов в желчном the bubble являются:
- pain, localized in the right hypochondrium;
- nausea (sometimes vomiting);
- weakness, malaise;
- belching air or bitterness
- stool discoloration;
- flatulence – bloating;
- bitter taste in the mouth
- unstable chair.
При камнях в желчном the bubble, основным симптомом являются боли в
right hypochondrium area (place of localization of the gallbladder). These
pain is called biliary (hepatic) colic. The pain is sharp, wears
cutting character, can give in the back, right scapula,
right shoulder and right half of the neck. Sometimes pain spreads to
the region of the heart is in the left side of the sternum and causes an attack
Pain is most often caused by the consumption of acute, fatty,
fried foods, as well as the use of alcohol, the effect of increased
physical or stressful work. In the pathogenesis of pain
lies reflex spasm of the smooth muscles of the gallbladder and its
duct irritation of the bladder wall with gallstones or in
the result of overstretching the gallbladder walls abundance
accumulated in it bile (obstructive nature of pain).
Complete blockage of the bile duct causes significant
enlargement of the hepatic bile duct that causes an increase
the liver and stretching its capsule, which contains a lot
pain receptors. The irritation of these receptors causes a sensation
constant dull pain in the right hypochondrium and feeling of heaviness.
Symptom of gallstone disease is often nausea and
vomiting, which, unfortunately, does not bring the patient feelings
relief. Vomiting is a reflex reaction to irritation.
a specific area of the duodenum (its parathyroid
zones). When the inflammatory process spreads to
pancreas, unrestrained vomiting occurs with admixture
The patient may also have a fever (sign
intoxication) from subfebrile indicators to high numbers. If a
concretions clogged the lumen of the common bile duct, occurs
obstructive jaundice, accompanied by discoloration of feces.
With long-term presence of stones in the gall, occurs
constantly mucosal injury, which can cause inflammation –
calculous cholecystitis, which is characterized by a decrease
appetite, fever, fatigue.
How to treat камни в желчном the bubble?
If a в желчном the bubble имеются камни, но отсутствуют выраженные
clinical symptoms and complications of the disease, the need for
there is no specific treatment. At the same time, specialists
occupy the waiting tactics. With the development of pronounced acute
or chronic calculous cholecystitis, recommended
surgical treatment, the main purpose of which is to remove
Today there are many treatments that allow
maintain the integrity of the gallbladder and bile ducts:
- This is achieved by dissolving the stones with special
preparations containing acids (enofalk, ursosan). However, when
such treatment after a while the stones in
желчномжелчнокаменной могут образовываться снова.
- Отлично разрушает конкременты в желчном the bubble и желчных
ducts shock wave lithotripsy. This method is most often
used for grinding single calculus in patients with
which there is no concomitant inflammation of the gallbladder either
Conservative treatment of cholecystolysis during remission
based on proper nutrition and mode, active lifestyle,
systematic oral use of drugs that promote
the destruction of stones.
In addition to taking medicines how to treat stones in the gall
the bubble? When cholelithiasis shows a balanced diet.
in small portions (diet number 5 see what you can eat with cholecystitis).
It is necessary to limit the amount of food intake, exclude
from the daily diet of fatty foods, fried and spicy foods, as well as
cholesterol-rich foods that can trigger an attack of colic.
Frequent consumption of fiber (vegetables,
Patients are recommended moderate physical activity (they
improve the flow of bile), in the presence of excess weight – his
normalization, in the presence of endocrine diseases – their
timely treatment. If a желчекаменная болезнь сопровождается
infectious lesions of the biliary tract, the patient
antibiotics are prescribed.
For the treatment of gallstone disease are prescribed in parallel
- stimulators of bile acid secretion (phenobarbital,
- preparations that promote the normalization of the composition of bile
- enzyme preparations that improve digestion, in
features – lipid digestion processes (creon).
- When pain caused by contraction of the gallbladder, the patient
various muscle relaxants are recommended (platafillin,
Drotaverine, no-spa, metacin, pyrencipin).
По мере увеличения размеров камней в желчном the bubble, для лечения
the patient is recommended lithotripsy (drug,
shock wave) or surgery. Indications for
- large and multiple stones,
- frequent bouts of pain,
- presence of concomitant diseases
Medical lithotripsy is carried out with drugs xenochol and
Henofalk, which can be taken quite a long time – dozens
years old. При таком лечении крупные конкременты в желчном the bubble
crushed to smaller sizes, after which their remnants
dissolve with oral medications (their
usually prescribed a few weeks before the shock wave
One of the fairly effective methods of treatment for gallstone.
the disease is percutaneous transhepatic litholysis. With this in
the gallbladder is injected with a thin catheter through which drip is injected
methylterbutyl ether, dissolving most of the calculi.
This treatment can be used at any stage.
Surgical treatment is recommended for patients in whom the disease
accompanied by frequent relapses, bouts of severe pain,
large sizes of stones, high body temperature, various
complications. Surgical treatment can be laparoscopic and
open (cholecistolithotomy, cholecystectomy,
papillosphincterotomy, cholecystostomy). Operational option
Interventions are determined for each patient individually.