What is cholecystitis and how to treat it?
Cholecystitis is one of the most common liver pathologies. About a fifth of the world's population suffers from this disease. Knowing the causes of development and measures to prevent this disease, in most cases it can be prevented.
Cholecystitis. What it is?
The inflammatory process that develops in the walls of the gallbladder and leads to stagnation of bile, and with the progression of the disease - to the formation of stones in the gallbladder, is called cholecystitis.
Causes of the disease
Cholecystitis is a disease that in most cases is of an infectious origin. Bacteria and viruses enter the gallbladder with blood, lymph, or intestinal lumen. As a rule, this is a conditionally pathogenic microflora( staphylococcus aureus, streptococcus, proteus, E. coli), that is, one that inhabits the surface of the mucous membranes and a healthy person, but under the condition of a decrease in immunity or dysbacteriosis, causes the disease.
More rarely it can be pathogenic microflora( dysentery bacillus, hepatitis A, B, C, D, E. Recently, cases of cholecystitis caused by helminths( roundworms or lamblia) are becoming more and more frequent:
- infectious and inflammatory diseasesintestine( enterocolitis, appendicitis, dysbacteriosis) or pancreas( pancreatitis)
- foci of chronic respiratory tract infection( sinusitis, tonsillitis, stomatitis)
- infectious diseases of the genitourinary system( cystitis, pyelonephritis,adnexitis, prostatitis)
- liver( viral hepatitis, lambliasis)
Factors contributing to the development of cholecystitis:
- DZHVP( biliary dyskinesia) Depending on the type, there is a spasm of the muscles of the biliary system or too strong relaxation of them.stagnation of bile in the gallbladder and inflammation of its walls.
- Congenital changes of the gallbladder( bends, irregular shape, small size).
- Diseases of the biliary tract, which results in the transfer of pancreatic juice into the gallbladder. Enzymes are strong irritants for the walls of the bladder, which causes cholecystitis.
- Disturbance of the diet in the direction of fatty foods leads to a change in the chemical composition of bile and irritation of the walls of the biliary tract( bladder and ducts).
- Endocrine diseases( diabetes, obesity, menstrual disorders in women).
- Hereditary predisposition.
- Allergies, autoimmune diseases.
Symptoms of gallbladder inflammation
Cholecystitis in form is divided into acute and chronic. An acute attack of cholecystitis is manifested by sharp pain under the costal arch on the right, an increase in body temperature to 38-390C, nausea, vomiting, and swelling of the intestine. As a rule, the acute form of the disease occurs against the background of cholelithiasis and passes into a chronic course.
Chronic cholecystitis is a sluggish disease with periods of exacerbation and remission( symptom reduction).It begins against the background of a violation of diet and dyskinesia biliary tract. The manifestations of the exacerbation period depend on the type of dyskinesia.
- Pain. With hypomotor dyskinesia( reduced muscle tone), the pain will be painful, aching, accompanied by nausea. With hypermotor dyskinesia( increased muscle tone), the pain will be sharp, paroxysmal, manifested in the right hypochondrium and accompanied by vomiting. Pain extends to the right side of the chest and back.
- Dyspeptic manifestations( nausea, vomiting, flatulence, increased salivation).
- During the exacerbation, the inflammatory process spreads to nearby organs, exposing them to toxic effects. This can lead to cholecystocardial syndrome, manifested by rapid heart rate, rhythm disturbance, pain in the heart.
In patients with cholecystitis, the skin becomes icteric, and a rash appears in the skin in the form of vascular "stars".It arises as a result of irritation of the skin with bile acids.
What is the danger of cholecystitis?
Each disease has its complications. They develop when non-compliance with the recommendations of the doctor, with late treatment of the patient or with incorrect treatment. Complications of cholecystitis include:
- empyema of the gallbladder - is the meltdown of the walls of the bladder;
- perforation of the wall of the bladder is a breakthrough of the wall, as a result of which the purulent contents enter the lumen of the abdominal cavity, then peritonitis develops;possibly the formation of a fistula is a course between the gallbladder and the intestines, through which a stone can enter the lumen of the gut, clog it, causing intestinal obstruction;
- dropsy of the gallbladder is an accumulation of inflammatory fluid between the sheets of the membranes of the bladder, which can threaten the rupture of the walls and the ingress of bile into the lumen of the abdominal cavity;
- obturation( blockage) of the gallbladder lumen: large stones can clog the bile duct, which leads to stagnation of bile and development of gangrene( tissue death);
- adhesive disease: in the inflammatory process, spikes are formed with neighboring organs( intestines, liver);
- sepsis is the most threatening complication that occurs when the infection spreads throughout the body with blood flow.
Treatment for cholecystitis
Do not self-medicate. How to treat the disease - a qualified specialist decides. Treatment of cholecystitis is handled by a surgeon or a gastroenterologist.
- Antibiotics. Antibacterial therapy is prescribed after receiving the results of bile and laboratory tests. Depending on the type of pathogen, an antibiotic is prescribed.
- Pain therapy. Pain is the main symptom of cholecystitis. With the aim of stopping the attack of pain, spasmolytic drugs( Papaverin, No-shpa) and analgesics( Analgin, Baralgin) are prescribed.
- Cholagogue preparations are prescribed with reduced tone of the muscles of the biliary tract and stagnation of bile. Used Alohol, Cholenzim.
- Drugs of ursodeoxycholic acid( Ukrliv) are used in the presence of gallstones and stagnation of bile.
- Hepatoprotectors are drugs that strengthen liver cells( Galstena, Gepabene, Liv-52).
- Physiotherapy. Electrophoresis with novocaine or papaverine is used to eliminate pain, UHF on the liver region to reduce the inflammatory process, mud treatment.
What should I do to prevent the development of cholecystitis? Prevention of the disease
The main component of the prevention of this disease is diet.
Food should be well shredded, should not have an aggressive effect on the gastrointestinal tract;should not promote stagnation of bile and the formation of gallstones. It should not be hot or cold.
During the exacerbation of the disease for 1 to 2 days, only drinking regime is prescribed( water, juices, fruit drinks, compote).After easing the pain, mashed vegetable soups, porridges( rice, oatmeal), jelly are allowed. Subsequently, the diet is expanded by introducing low-fat varieties of meat and fish, butter, dairy products.
Prohibited during an attack of cholecystitis:
- alcoholic beverages;
- fried and fatty foods( lard, pork);
- spices and seasonings, garlic, onion;
- marinades, smoked sausages;
- fatty dairy products( cottage cheese with high fat content, sour cream);
- baking, ice cream, chocolate;
- strong coffee and tea;
- fizzy drinks;
- fresh bread of 1st grade.
Why do I need to follow a diet?
During eating, the body starts producing bile acids and bile. If a person eats "as necessary", with large intervals of time, then the bile is ejected, triggering muscular spasm of the gallbladder and an attack of pain. Therefore, the diet of the patient with cholecystitis should be fractional, in small portions, every 3 to 4 hours. In addition, the food should be low-calorie, saturated with vegetable fats and should not contain a large amount of fat and cholesterol. This establishes the chemical composition of bile and prevents the formation of bile and cholesterol stones.