A bile stone of any size is an unpleasant phenomenon. For men and women, the causes of appearance are different, but for both sexes the statement is typical: the treatment of gallstone disease is a complex process, it is not always possible to do without surgery.

The reasons for the formation of stones or the occurrence of acute attacks with turn out to be different, each to a certain extent depends on the individual qualities of the patient, starting with the history of diseases, ending with genetics.

Among the most common reasons are:

• interruptions in food intake: first - overeating (the cause is often accompanied by nausea, vomiting), then, on the contrary, prolonged fasting;
• overweight problems, including obesity;
• sedentary work that does not allow movement during the working day;
• side effect of hormonal contraceptives;
• pathology of the pancreas.

The occurrence of stones in the ducts of the gallbladder is an unpleasant thing, unrecognized in time, provokes serious complications. For example, cholelithiasis can easily lead to biliary cirrhosis of the liver.

The composition of the stone stuck in the duct

By the nature of the pain, it is impossible to determine the composition of the stone that provoked cholelithiasis. , for example, often contain an admixture of calcium, not fully processed in the body, forced to be released in bypass ways.

Sometimes lime gets into the stones - a rather rare but well-known phenomenon. The presence of a substance in the stones is determined using the diagnostic method - cholecystography.

Stones in the liver ducts often appear as a parallel disease: the defeat of the first organ of the excretory system leads to the defeat of the second. Of course, the treatment of two diseases at the same time complicates the process, it is better to monitor the timely release of stones in advance, preventing the appearance of new ones.

Specific Symptoms

The first signs of gallstones in men and women are the same. In fact, already formed stones are able to stay in the ducts of the gallbladder for a long time, until a certain trigger mechanism causes the first symptoms of gallstone disease:

• the appearance of hepatic colic;
• the appearance of heaviness in the right side;
• bitter sensation in the mouth;
• belching, nausea, vomiting.

If the time of formation of gallstones is small, the first attack of exacerbation ends within 10-15 minutes, as the disease develops, an increase in the duration of the attack is also observed. If the pain does not go away within half an hour, it is better to call an ambulance, providing first aid.

Are common

Signs of gallstone disease are the same for men and women and include:

• the appearance of heaviness in the abdomen or on the sides;
• change in skin color: some patients turn pale, the integument of others turn yellow, darken;
• increased pain after eating (it is difficult for the digestive tract to cope with the load that has rolled in, there are difficulties in digestion);
• nausea accompanied by heartburn and vomiting;
• change in stool, discharge - profuse diarrhea or persistent constipation;
• if already digested food returns to the stomach, belching, heartburn, increased gas formation, and in some cases, vomiting may occur.

Depending on the stage of development of the disease, the severity of the symptoms, the duration of the attacks, in which the patient feels worse, differ.

Typically masculine

Men suffer from gallbladder diseases 2 times less often than the opposite sex - the frequency is associated with a different system of the biological structure of the body, including the production of hormones. The symptoms of gallstone disease in men do not differ from the general classification, in women certain nuances are known.

Typically feminine

It is believed that gallstone disease is more common in older women, especially those who are overweight. The symptoms of gallstones in women are different from those of the opposite sex. Pathology is indeed observed in older women, but the change in the body under the influence of the fetus plays a significant role.

If a girl before pregnancy had a predisposition to the occurrence of a disease, difficulties with the functioning of the liver, problems with the excretion of bile are quite likely to occur. The occurrence of a disease during pregnancy is more dangerous, it is better to think about timely diagnosis and treatment as soon as possible.

Diagnosis of the disease

The diagnosis of "cholelithiasis" is made on the basis of the symptoms listed by the patient to the attending physician at the first appointment. A number of procedures are known that are mandatory for diagnosis, helping to confirm or refute the diagnosis:

• complete blood count (establishes the clinical stage of the disease, the presence of inflammation);
• biochemical blood test (with stones in the liver - the activity of substances directly involved in metabolism is detected);
• cholecystography (helps to determine whether the organ has increased in size);
• Ultrasound of the abdominal cavity (the most accurate analysis that allows you to determine the presence and size of stones, possible blockage of the ducts, cholecystitis is diagnosed and pathological complications are identified).

Only after establishing the correct diagnosis is it permissible to begin treatment.

Treatment of gallstone disease

If the bile ducts are not able to clear themselves due to the inactivity of the patient, it makes sense to prescribe a targeted treatment for gallstone disease. The main methods of dealing with stones in the ducts of the gallbladder include:

1. Compliance with a special diet.
2. Taking special preparations that allow you to dissolve stones directly into internal organ. The drugs are harmless, apart from possible side effects due to contraindications: the dissolved substances simply remain in the gallbladder or are excreted along with the bile. There is no stone that hinders the removal of bile, it is easier for the bile ducts to function. The disadvantages of such treatment include the ability to dissolve only stones of small size, not exceeding 1 cm, and the method does not stop the process of formation of calculi. After a year and a half of treatment, the stones reappear.
3. Lithotripsy is the destruction of stones in an alternative way: with the help of a strong shock wave created by special devices. It is used against accumulations of cholesterol, in a size not exceeding 3 centimeters. The number of destroyed accumulations at a time is three, if there are more stones in the ducts, another method is assigned. Thanks to such a forceful impact, accumulations of substances begin to break up into small grains that pass through the ducts with greater ease, excreted from the body in a completely natural way: urine and feces. The method does not cause pain, is carried out without hospitalization of the patient.

If the therapeutic course does not help, we are talking about surgery. It will not work otherwise to free the ducts from excess substances and formations. In selected cases, it is necessary to remove the gallbladder, it becomes obviously clear that it is better to forget about the normal functioning of the organ.

Treatment goals include:

• cleansing of the bile ducts;
• return of normal liver function;
• normalization of bile production in the body.

If, at the end of the course, the patient can safely say that digestion has improved, most of the unpleasant symptoms have disappeared, then the treatment has been successful. However, a weakened body needs reverent care, certain preventive measures must be observed. The postoperative regimen is prescribed by the doctor, according to the patient's medical history, there are also common features.

Preventive measures

After completion of treatment, preventing exacerbations, a special diet is prescribed, the products of which have a positive effect on the gallbladder and gastrointestinal tract, without creating an excessive load. With gallstones, a high risk of recurrence of deposits, a person's diet plays a huge role. The condition of the patient depends on the type of food eaten.

Gallstone disease is an unpleasant disease, but the disease will recede if you start fighting in time and stop the subsequent occurrence of stones in the bile and hepatic ducts.

The number and size of gallstones are very diverse: sometimes it is one stone large size, but more often - multiple stones, numbering in tens, sometimes hundreds. They range in size from a chicken egg to millet grain and less. Stones may vary in chemical composition. Cholesterol, lime and bile pigments are involved in their formation. Consequently, metabolic disorders in the body, bile stasis and infection play an important role in the process of stone formation. When bile stagnates, its concentration increases, conditions are created for the crystallization of cholesterol contained in it and excreted from the body with it. It has been scientifically established that excessive and irregular nutrition, as well as insufficient mobility, contribute to the creation of conditions for the formation of gallstones. The most common causes of biliary colic (the main manifestation of cholelithiasis) are the use of alcohol, spicy fatty foods, excessive exercise.

A common metabolic disease in which, due to a violation of the processes of bile formation and bile secretion, the formation of stones in the gallbladder occurs. Small stones (microliths) are sometimes also formed in the intrahepatic bile ducts, especially in older men and patients with cirrhosis of the liver. Once in the gallbladder, microliths can serve as a basis for cholesterol to settle on them and form large cholesterol stones. In addition to cholesterol stones, there are pigmented (bilirubin), calcareous, mixed and combined types of stones. Stone carrying is possible without clinical manifestations; often it is accidentally discovered at autopsy. Gallstones occur at any age, and the older the patient, the higher the frequency of the disease. In women, gallstone disease and stone carrying are observed several times more often than in men.

Cholelithiasis is often accompanied by chronic cholecystitis. With multiple stones, bedsores form in the gallbladder, which can lead to ulceration and perforation of its walls.

Classification

• In cholelithiasis, stages are distinguished: physicochemical (changes in bile), latent (asymptomatic stone-carrying), clinical (calculous cholecystitis, biliary colic).
• There are the following clinical forms of cholelithiasis: asymptomatic stone carrying, calculous cholecystitis, biliary colic.
• Gallstone disease can be complicated and uncomplicated.

The main manifestation of cholelithiasis is biliary, or hepatic, colic, which is manifested by bouts of very severe pain in the right hypochondrium. At the same time, they spread and give to the right shoulder, arm, collarbone and shoulder blade or to the lower back with right side body. The most severe pain occurs when the blockage of the common bile duct occurs suddenly.

An attack of biliary colic is accompanied by nausea and repeated vomiting with an admixture of bile in the vomit, which does not alleviate the condition of patients. Sometimes there are reflex pains in the region of the heart. Biliary colic usually occurs with an increase in body temperature, which lasts from several hours to 1 day.

Between attacks, patients feel practically healthy, sometimes they feel dull pains, a feeling of heaviness in the right hypochondrium, and nausea. There may be a decrease in appetite, dyspeptic disorders.

With prolonged blockage of the common bile duct, bile from the liver is absorbed into the blood, jaundice occurs, which requires appropriate treatment in a hospital setting.
The most reliable confirmation of the diagnosis of gallstone disease is the results of an X-ray examination with the introduction of a radiopaque fluid into the bile ducts.

In the clinical manifestations of cholelithiasis, functional disorders of the extrahepatic biliary tract are essential both in the early period before the formation of stones, and in the presence of such. Gallstone disease is quite common, especially in women, a disease accompanied by a number of complications and successive processes.
The size and number of gallstones fluctuate in different cases. The most voluminous are single, solitary stones (monoliths), and the weight of the stone can reach 25-30 g; Gallbladder stones are usually round, ovoid in shape, common bile duct stones resemble the end of a cigar, and intrahepatic duct stones may be branched. Small stones, almost grains of sand, may be among the several thousand in one patient.

The main components of the stones are cholesterol, pigments (bilirubin and its oxidation products) and lime salts. All these substances can be combined in various proportions. From organic substances, they contain a special colloidal substance of a protein nature, which forms the skeleton of a stone, and from inorganic, in addition to lime salts (carbonic and phosphate), iron, copper, magnesium, aluminum and sulfur were found in gallstones. For practical purposes, it is enough to distinguish three types of stones according to their chemical composition: cholesterol, mixed and pigmented.

1. Cholesterol, radiar stones consist almost exclusively (up to 98%) of cholesterol; they are white, sometimes slightly yellowish in color, round or oval in shape, ranging in size from a pea to a large cherry.
2. Mixed stones, cholesterol-pigment-lime, multiple, faceted, found in tens, hundreds, even thousands. These are the most common, most common stones. On the cut, one can clearly see a layered structure with a central core, which is a soft black substance consisting of cholesterol. In the center of mixed stones, fragments of the epithelium, foreign bodies (blood clot, dried roundworm, etc.) are sometimes found, around which stones falling out of bile are layered.
3. Pure pigment stones are of two types: a) observed in cholelithiasis, possibly with plant nutrition, and b) observed in hemolytic jaundice. These pure pigment stones are usually multiple, black in color, turn green when exposed to air; they are found in the bile ducts and in the gallbladder.

Causes of gallstone disease (stones in the gallbladder)

The development of gallstone disease is a complex process associated with metabolic disorders, infection and bile stasis. Undoubtedly, heredity also matters. Metabolic disorders contribute to the violation of bile eicolloidality. The stability of the bile colloidal system, its surface activity and solubility depend on the composition and correct ratio of bile ingredients, primarily bile acids and cholesterol (the so-called cholate-cholesterol index). An increase in the concentration of cholesterol or bilirubin in bile can contribute to their loss from solution. The prerequisites for increasing the concentration of cholesterol and reducing the content of cholates in bile are created during stagnation of bile. The infection promotes stone formation by inhibiting the synthesis of bile acids by the liver cells. All these mechanisms, closely related to each other, lead to the development of the disease, which is facilitated by neuro-endocrine and metabolic disorders. Hence the more frequent development of cholelithiasis among people with obesity, an unhealthy lifestyle, its frequent association with other metabolic diseases (atherosclerosis, diabetes), as well as the frequent occurrence of the disease during repeated pregnancy.

Of great importance in the formation of gallstones is, apparently, the abnormal composition of the bile produced by the liver (dyscholia), which contributes to the loss of sparingly soluble constituent parts bile, as well as a violation of the general metabolism with an overload of blood with cholesterol (hypercholesterolemia) and other products of slow metabolism. Infection leading to disruption of the integrity of the epithelium of the gallbladder mucosa with its desquamation, foreign bodies inside the gallbladder, easily causing the deposition of lime and other components of bile, are rather only secondary, more rare factors in stone formation. Excessive bile secretion of bilirubin in massive hemolysis is of the same importance.

At the heart of violations of the liver and changes in metabolism are the adverse effects of the external environment in the form of excessive malnutrition, lack of physical work. Of great importance are the neuroendocrine factors that affect the function of the liver cell and tissue metabolism, as well as the emptying of the gallbladder.
Gallstone disease is often combined with obesity, gout, the presence of kidney stones, sand in the urine, atherosclerosis, hypertension, diabetes, that is, it is observed in numerous conditions that occur: with hypercholesterolemia.

The disease most often manifests itself between the ages of 30 and 55, and women are 4-5 times more likely than men. Gallstones with inflammation of the gallbladder and hemolytic jaundice can be observed at an earlier age. Cholelithiasis, of course, often manifests itself clinically for the first time during pregnancy or in the postpartum period: pregnancy is accompanied, under normal conditions, by physiological hypercholesterolemia and increased liver cell function, which creates the best conditions for fetal development and milk production by the mammary gland. Particularly significant disturbances of metabolic and vegetative processes can be expected in violation of the physiological rhythm of the function of childbearing during repeated abortions or premature births without subsequent lactation, etc., when a delay in the emptying of the gallbladder is also possible due to altered activity of the nervous system. Family cases of gallstone disease, especially frequent in mother and daughter, are most often explained by the influence of the same environmental conditions mentioned above.

It has long been known that foods rich in cholesterol (fatty fish or meat, caviar, brains, butter, sour cream, eggs) contributes to the formation of stones, of course, in violation of oxidative-enzymatic processes.

Experimental studies of recent times have also found the effect of vitamin A deficiency on the integrity of the epithelium of the gallbladder mucosa; its desquamation contributes to the precipitation of salt and other precipitation.

Currently great importance in the precipitation of cholesterol in bile, as indicated, an abnormal chemical composition of bile is imparted, in particular, a lack of bile (and also fatty) acids, in which one can see a violation of the function of the liver cell itself.

Known value in cholelithiasis have infections and stagnation of bile. Of the transferred diseases, special attention was paid to typhoid fever, since it is known that typhoid bacillus can affect the biliary tract, excreted with bile.

Stagnation of bile contributes, in addition to a sedentary lifestyle, excessive fullness, pregnancy, clothing that squeezes the liver or restricts the movement of the diaphragm, prolapse of the abdominal organs, mainly the right kidney and liver; at the same time, an inflection of the bile ducts, especially the cystic one, located in the lig. hepato-duodenale. With swelling of the duodenal mucosa and scarring of ulcerative processes in it, the mouth of the common bile duct can be compressed, which leads to stagnation of bile. Catarrh resulting from a gross violation of the diet sometimes contributes to stagnation of bile and infection of the biliary tract. Usually, however, in addition to the mechanical factor, the action of the above liver-exchange factor is also noted.

The greatest importance in the origin of cholelithiasis should be given to a violation of the nervous regulation of various aspects of the activity of the liver and biliary tract, including the gallbladder, with their complex innervation device. The formation of bile, its entry into the gallbladder and its release into the duodenum is finely regulated by autonomic nerves, as well as by higher nervous activity, for which the great importance of conditioned reflex connections for normal bile secretion speaks.

At the same time, the receptor fields of the biliary tract, already with functional disorders of the biliary function, give rise to pathological signaling to the cerebral cortex. Thus, in the pathogenesis of cholelithiasis, it is possible to establish individual links that are also characteristic of other cortical-visceral diseases.

Metabolic-endocrine disorders play only minor role, subject to functional changes in the nervous regulation. With an initial lesion of adjacent organs and infectious causes, a violation of the activity of the hepatic-biliary system, leading to cholelithiasis, also occurs in a neuroreflex way.

Separate signs of gallstone disease, especially the signs accompanying biliary colic, characteristic of gallstone dyspepsia, etc., owe their intensity and variety, primarily to the abundant innervation of the gallbladder and biliary tract, and are undoubtedly mainly neuroreflex in nature.

Symptoms, signs of gallstone disease (stones in the gallbladder)

The clinical picture of gallstone disease is extremely diverse and difficult to brief description. Uncomplicated cholelithiasis is manifested by cholelithiasis dyspepsia and biliary, or hepatic, colic.

Complications of gallstone disease

• biliary colic.
• Cholecystitis.
• Acute pancreatitis.
• Fistula of the gallbladder, mechanical intestinal obstruction.
• Obstructive jaundice.
• Cholangitis and septicemia or liver abscess.
• perforation and peritonitis.

Cholelithiasis is characterized by a chronic course, leading to disability of patients and even threatening their lives during certain periods of the disease in the presence of certain complications, especially as a result of blockage of the biliary tract, intestinal obstruction and phlegmonous cholecystitis. Often, the disease takes a latent (latent) course, and stones are found only at the autopsy of patients who died from another cause.

Of the complications of cholelithiasis, almost as numerous as, for example, complications of peptic ulcer of the stomach and duodenum, obstruction of the biliary tract and their infection are described primarily separately, although very often the phenomena of obstruction and infection are combined.

Stones can get stuck in their movement at various points along the path of bile flow, causing special characteristic clinical symptoms. Most often it is necessary to observe blockage of the cystic and common bile duct.

A typical manifestation of the disease is an attack of biliary, or hepatic, colic. The pains come on suddenly, but sometimes they are preceded by nausea. Colic usually begins at night, more often 3-4 hours after an evening meal, especially fatty foods, drinking alcohol; accompanied by a rise in temperature (sometimes with chills), tension in the abdominal muscles, stool retention, bradycardia, vomiting, and bloating. Possible temporary anuria, in the presence of coronary disease - the resumption of anginal attacks. In the duodenal contents, a large number of cholesterol crystals, sometimes small stones are found. In some cases, stones can be found in the stool 2-3 days after the attack. In some cases, colic is repeated often, in others - rarely, proceeding in the form of gallstone dyspepsia.

With biliary colic, complications are possible, of which the most dangerous is blockage of the neck of the gallbladder with a stone; as a result of laying an artificial path to the intestine (fistula) with a stone, a severe infection of the biliary apparatus occurs with the development of abscesses, biliary peritonitis and sepsis in it. Gallstone disease favors the development of malignant neoplasms of the biliary system.

Diagnosis and differential diagnosis of cholelithiasis (gallstones)

The diagnosis of cholelithiasis is made on the basis of complaints of patients, anamnesis and the course of the disease. In the anamnesis, indications of the dependence of complaints on fatty and starchy foods, their connection with pregnancy, the fullness of patients (in the past), the presence of cases of cholelithiasis in the family (in the mother of the patient, sisters) under the same external living conditions are especially important.

When examining patients, the possibility of gallstone disease is indicated by the presence of at least slight jaundice, skin pigmentation (liver spots, chloasma), cholesterol deposition in the skin (cholesterol nodes - xanthelasma - in the thickness of the eyelids near the nose). Often, patients have overdeveloped subcutaneous fat. However, cholelithiasis affects, especially in connection with an infection of the biliary tract, also persons with normal and underweight. As a result of the severe course of cholelithiasis, its complications, patients can lose weight dramatically, even acquire a cachectic appearance. The content of cholesterol in the blood may fall below the norm, although often cholelithiasis is accompanied by elevated levels of blood cholesterol. Direct evidence of the presence of a stone can be given by cholecystography, the results of which are positive with modern technology in 90% of patients; detection of microliths in duodenal contents also matters.

As for the differential diagnosis, in various stages of cholelithiasis one has to keep in mind a number of diseases. With gallstone dyspepsia, it is necessary to exclude, first of all, gastric and duodenal ulcers, chronic appendicitis, colitis and many other causes of gastric and intestinal dyspepsia. Erased signs of gallstone dyspepsia, described in detail above, allow clinically clarifying the diagnosis.

Hepatic colic has to be differentiated from a number of diseases.

1. With renal colic, pain is localized below, in the lumbar region, and radiates to the groin, genitals and leg; often there is dysuria, anuria, blood in the urine, and sometimes sand; the vomiting is not so persistent, the febrile reaction is less common. We must not forget that both colic can be observed simultaneously.
2. With food poisoning, the manifestations begin suddenly with profuse food vomiting, often diarrhea, in the form of an outbreak of a number of diseases, there is no characteristic dyspepsia in the anamnesis.
3. In acute appendicitis, pain and tension of the abdominal wall (muscular protection) are localized below the navel, the pulse is more frequent, etc.
4. Duodenal ulcers and periduodenitis, due to their anatomical proximity to the gallbladder, are especially often mixed with biliary colic. Helps to establish a diagnosis detailed analysis pain syndrome, pain points and X-ray examination.
5. Myocardial infarction can give a similar picture, especially since pain and infarction can only be localized in the right upper quadrant of the abdomen (“status gastralgicus” due to acute congestive liver). The history of patients, electrocardiographic changes, etc., resolve the issue. Angina pectoris and even myocardial infarction can be caused by biliary colic. Nitroglycerin, according to some authors, also facilitates an attack of gallstone disease.
6. Acute hemorrhagic pancreatitis is characterized by more pronounced general phenomena (see when describing this form).
7. Intestinal colic is characterized by periodic pain with rumbling and is sometimes accompanied by diarrhea.
8. Mesenteric lymphadenitis (usually tuberculous) when located in the right upper quadrant is sometimes accompanied by pericholecystitis and periduodenitis without affecting the gallbladder itself, but is often mistakenly recognized as chronic cholecystitis.
9. Tabetic crises give less intense pain, vomiting with them is more abundant, the temperature is not elevated, there are neurological signs of dorsal tabes.
10. With lead colic, the pains are localized in the middle of the abdomen, they are spilled, they calm down with deep pressure; the abdomen is usually retracted and tense; blood pressure is increased; the gums have a typical lead border.

As stated above, biliary colic is almost always caused by stones, but in rare cases, it can be caused by ascaris stuck in the ducts or echinococcus bladder. The analysis of feces and the presence of other symptoms of ascaris invasion or echinococcal disease helps to establish the diagnosis.

Enlarged gallbladder with dropsy, it can be mixed with hydronephrosis, pancreatic cyst; the gallbladder is characterized by respiratory mobility and lateral displacement; the anterior echinococcal cyst of the liver is differentiated from hydrocele of the bladder according to the rest of the signs characteristic of echinococcal disease.

It is necessary to differentiate febrile cholecystitis, obstructive stone jaundice, pseudomalarial cholangitis fever, secondary biliary cirrhosis of the liver, gallstone ileus, etc. from other diseases that may resemble the corresponding complication of cholelithiasis along the course.

Forecast and working capacity of cholelithiasis (stones in the gallbladder)

The prognosis of cholelithiasis is difficult to formulate in a general form, the course of the disease is so diverse. In most cases, the disease proceeds with recurrent pain attacks and dyspepsia and, with the right regimen, is not prone to progression and does not significantly shorten life expectancy. Such is the course of cholelithiasis in most sanatorium-and-spa patients. In patients in the therapeutic departments of hospitals, a more persistent course with complications is usually observed; finally, in patients with surgical departments, the most serious complications of cholelithiasis are noted, giving a relatively high mortality rate.

With frequent exacerbations of cholelithiasis and severe inflammatory phenomena (fever, leukocytosis), which are not inferior to treatment, patients are completely disabled or their ability to work is limited. In milder cases of cholelithiasis with a predominance of spastic or dyskinetic phenomena in the gallbladder area, without pronounced symptoms of cholecystitis, patients should be recognized as limited able-bodied in the presence of significant severity and persistence of nervous disorders and frequent, mostly non-infectious, subfebrile condition. They cannot perform work associated with significant physical stress. With the development of severe complications of cholelithiasis, patients are completely disabled.

Prevention and treatment of gallstone disease (stones in the gallbladder)

To relieve a painful attack intravenously, intramuscularly, antispasmodics (drotaverine hydrochloride, papaverine hydrochloride) and analgesics (metamisole sodium, promedol) are administered. If it is still not possible to eliminate the attack and the jaundice does not go away, one has to resort to surgical treatment. To remove stones, lithotripsy is used - their crushing with the help of a shock wave.

Patients with gallstone disease must strictly observe the diet and diet, do not abuse alcohol.

Patients with chronic diseases of the gallbladder and biliary tract with insufficient bile secretion and a tendency to constipation, a diet with a high content of magnesium, calcium, carotene, vitamins of group B, A is recommended. If bile enters the intestine in insufficient quantities, then animal fat intake should be limited. It is also recommended to consume more honey, fruits, berries, raisins, dried apricots.

To prevent the development of the inflammatory process in the mucous membrane of the gallbladder, timely treatment of infectious diseases is necessary. In cases where cholelithiasis is combined with inflammation of the mucous membrane of the gallbladder (chronic cholecystitis), the disease is much more severe. Attacks of biliary colic are more frequent, and most importantly, severe complications (hydrops of the gallbladder, cholangitis, pancreatitis, etc.) can develop, the treatment of which is very difficult.

Hygiene is important for the prevention of gallstone disease. common mode sufficient exercise and proper nutrition, as well as the fight against infections, disorders of the gastrointestinal tract, elimination of stagnation of bile, elimination of nervous shocks. For people leading a sedentary lifestyle, it is especially important to avoid overeating, systematically take walks on fresh air, engage in light sports.

Treatment of gallstone disease at various stages of its development is not the same. However, regardless of temporary urgent measures, patients, as a rule, must observe a general and dietary regimen for years and decades, periodically carry out spa treatment in order to counteract metabolic disorders, cholesterolemia, to increase the activity of liver cells, to strengthen the nervous regulation of bile-hepatic activity. Of great importance is the fight against stagnation of bile, infection of the gallbladder and biliary tract, ascending from the intestine or metastasizing from distant foci, as well as eliminating difficult experiences. It is necessary to recommend fractional nutrition (more often and little by little), as it is the best choleretic agent. The daily amount of drinking should be plentiful to increase secretion and dilute bile. It is important to eliminate all causes that contribute to the stagnation of bile (for example, a tight belt); with severe ptosis, wearing a bandage is necessary. Constipation should be controlled by diet, enemas, and mild laxatives.

Dietary nutrition is very important in the treatment of gallstone disease. In acute attacks of biliary colic, a strict sparing regimen is necessary. Concomitant lesions of the gastrointestinal tract or other diseases (colitis, constipation, diabetes, gout) should be taken into account.

In cholelithiasis, it is usually necessary to limit patients both in terms of total caloric intake of food, and in relation to meat, fatty dishes, especially smoked foods, canned food, snacks, and alcoholic beverages. Egg yolks and brains, especially rich in cholesterol, should be excluded from food, and butter should be sharply limited. . The diet should be predominantly vegetarian with a sufficient amount of vitamins, for example, vitamin A, the lack of which in the experiment leads to a violation of the integrity of the epithelium of the mucous membranes and, in particular, to the formation of gallstones. Much attention is paid to the culinary processing of food, and fried meat, strong sauces, broths, and some seasonings should be avoided. It is necessary to take into account not only the physicochemical properties of food, but also its individual tolerance.

During the period of sharp exacerbations of the disease, a meager diet is prescribed: tea, rice and semolina porridge on the water, kissels, white unbread crackers. Only gradually add fruits (lemon, applesauce, compotes), cauliflower, other mashed vegetables, a little milk with tea or coffee, yogurt, low-fat broth or vegetable soup, etc. From fats, fresh butter is allowed in the future in a small amount , with breadcrumbs or vegetable puree; Provence oil is given as a medicine with tablespoons on an empty stomach. Patients for years should avoid those dishes that cause them attacks of colic or dyspepsia, namely: pies, cream cakes and pastry in general, saltwort, pork, fatty fish, cold fatty snacks, especially with alcoholic drinks, etc. .

The regimen of patients with cholelithiasis should not, however, be limited only to a properly selected diet and rational eating habits; patients must avoid excitement, hypothermia, constipation, etc., in a word, all those irritations which, according to their experience, lead with particular constancy to the return of colic, to a large extent, probably due to the zones of prolonged excitation created in the cerebral cortex. Taking drugs that strengthen the inhibitory process in higher nervous activity, distraction, and similar other methods should be used to prevent another attack even when exposed to the usual provoking factors.

In the treatment of cholelithiasis, one of the first places is occupied by sanatorium treatment, which is indicated after the passage of acute attacks (not earlier than 1-2 months) for most patients with uncomplicated cholelithiasis without signs of a pronounced decline in nutrition. Patients are sent mainly to Zheleznovodsk, Essentuki, Borjomi, etc. or to sanatoriums at the place of residence of patients for dietary and physiotherapy. In sanatorium treatment, complete rest, proper general regimen, nutrition, measured walks, topical application of mud to the liver area, which relieves pain and accelerates the cure of residual inflammatory processes, and drinking mineral waters are beneficial. Of the mineral waters, hot bicarbonate-sulphate-sodium (for example, the Zheleznovodsk Slavyanovsky spring with water at a temperature of 55 °), hydrocarbonate-sodium sources of Borjomi and others are used, which contribute to a better separation of more liquid bile and the cure of gastrointestinal catarrhs, as well as better loosening the intestines and diverting blood from the liver. Mineral or salt-coniferous baths are also used, which act favorably on the nervous system.

Under the influence of climate, mineral waters, hydrotherapy procedures, topical application of mud and, finally, an appropriate dietary regimen, the metabolism changes in a favorable direction, inflammation subsides, bile becomes less viscous and is easier to remove from the biliary tract, and normal nervous regulation is largely restored. activity of the hepatobiliary system.

Of the medicines, bile acids (decholine) can be important, which make it possible to ensure a normal ratio of bile acids and cholesterol and thereby counteract stone formation; herbal preparations rich in anti-spasmodic, anti-inflammatory, laxative ingredients; preparations from plants with choleretic properties (holosas extract from rosehip berries, infusion of sandy immortelle-Helichrysum arenarium and many others), choleretic and laxative salts - magnesium sulfate, artificial Carlsbad salt, etc.

Treatment of biliary colic consists in the vigorous application of heat to the area of ​​the liver in the form of heating pads or compresses; if the patient does not tolerate heat, ice is sometimes applied. Assign painkillers: belladonna, morphine. Usually vomiting does not allow oral medication, and most often it is necessary to inject 0.01 or 0.015 morphine under the skin, preferably with the addition of 0.5 or 1 mg of atropine, since morphine, apparently, can increase spasms of the sphincter of Oddi and thereby increase blood pressure. bile ducts.

Novocaine also relieves colic (intravenous administration of 5 ml of a 0.5% solution), papaverine. Many patients experience bloating during an attack; in these cases, warm enemas are prescribed; with persistent constipation, siphon enemas are used. Vomiting can be soothed by drinking hot black coffee or by swallowing pieces of ice.

Within 5-6 days after the attack, it is necessary to monitor whether the stone is excreted in the stool. In the prevention of a seizure, rest, the prohibition of bumpy driving, an appropriate diet with restriction of fatty and spicy foods, fractional nutrition with sufficient fluid intake and elimination of constipation are important.

In case of infection of the biliary tract, sulfazin and other sulfonamide drugs are used in an average dose, penicillin (200,000-400,000 units per day), hexamine, "non-surgical drainage" of the biliary tract in combination with agents that increase the body's resistance and improve the condition of the liver: intravenous infusion of glucose, ascorbic acid, campolone, blood transfusion, etc.

With obstructive jaundice, the same drugs are prescribed that improve the condition of the liver, and in addition, ox bile, vitamin K inside parenterally (against hemorrhagic diathesis).
Urgent surgical treatment is indicated for gangrenous cholecystitis, perforated peritonitis, intestinal obstruction on the basis of a stone (simultaneously with treatment with penicillin). Surgical intervention is subject to limited accumulations of pus with empyema of the gallbladder, subdiaphragmatic abscess, purulent cholecystitis, blockage of the common bile duct by a stone, dropsy of the gallbladder, purulent cholangitis. More often, an operation is performed to remove the gallbladder (cholecystectomy) or to open and drain the gallbladder or common bile duct. After the operation, the correct general and dietary regimen is also necessary in order to avoid recurrence of stone formation or inflammatory-dyskinetic phenomena, as well as spa treatment.

In some cases, it should be only conservative, in others, it must be surgical. Foods rich in cholesterol and fats (brains, eggs, fatty meats), rich meat soups, spicy and fatty foods, lard, smoked meats, canned food, rich confectionery, alcoholic beverages should be excluded from nutrition. Allowed dairy products, fruit and vegetable juices, vegetables, vegetarian soups, boiled meat, fish and pasta, cereals, berries, butter and vegetable oil, preferably corn. It is necessary to advise patients to eat moderately, regularly and often, with plenty of drink, giving preference to mineral waters (Essentuki No. 20, Borzhom, etc.).

Assign various choleretic drugs. Karlovy Vary salt, magnesium sulfate, sodium sulfate, allochol, cholecine, cholenzim, oxafenamide, cholagol, flamin, cholelitin, etc. are very effective. colic sometimes it is necessary to prescribe pantopon or morphine, always with atropine, since morphine preparations can cause spasm of the sphincter of Oddi. In the presence of symptoms of an "acute abdomen", the use of drugs is contraindicated.

In the presence of infection, antibiotics are used, taking into account the sensitivity of the flora isolated from bile, for 5-10 days; sulfa drugs.

Surgical treatment is carried out in cases of a persistent course of the disease, with frequent relapses of biliary colic that occur despite active treatment, with blockage of the gallbladder, perforation of the bladder, and the formation of biliary fistulas. Operative treatment of cholelithiasis should be timely.

Rhythm of life modern man does not imply a normal, nutritious diet. In most cases, an inadequate diet is a direct path to the development of diseases of the gastrointestinal tract. In addition to the notorious and well-known gastritis, many people suffer from a rarer disease - cholelithiasis or cholelithiasis. According to various estimates, up to 15% of the population suffers from them, the risk of developing the disease increases with age, and after 65 years the number of patients increases sharply to 40%.

Cholelithiasis is a serious, albeit for a long time, inconspicuous disease. Therefore, you should not take it lightly. It is important to be fully equipped.

Causes of gallstones

There are many reasons for the formation of stones (calculi) in the gallbladder. Only a doctor can determine with accuracy the initial factor that led to the development of the disease. What are the reasons that can provoke the formation of stones?

hereditary factor. According to studies, a significant role in the development of cholelithiasis has a genetic predisposition. If there is a person in the family suffering from this pathology, with a probability of 35%, you can get the same disease. It's about about close relatives. Of course, the disease itself is not inherited. The features of metabolism are transmitted. But just metabolic disorders are the cause of gallstones.

Race. The racial traits themselves significant role don't play. However, cultural factors are important, especially those related to nutrition. So, immigrants from Latin America and Europe suffer from gallstone disease three times more often than Asians.

Gender identity. Women suffer from cholelithiasis almost three times more often than men due to the peculiarities hormonal background. Therefore, women produce more bile, which is necessary to neutralize the estrogen hormone.

Peak hormonal levels in women. Menopause, pregnancy, etc. These conditions increase the risk of the disease.

Hormone treatment. Treatment with hormonal-type drugs doubles the likelihood of developing cholelithiasis.

The age of the person. Age plays a huge role. Children practically do not suffer from stones. There are a few more middle-aged patients, but the main category of patients is the elderly.

Diseases of the gastrointestinal tract, endocrine pathologies.

Obesity.

This is just the most common causes stones in the gallbladder. There are many more of them.

The first symptoms of gallstones

Symptoms and signs of gallstones depend on the severity of the organ damage. In general, the manifestations are as follows:

The most characteristic of the first symptoms of gallstones is pain. Pain vary significantly, depending on the cause. In the case of cholelithiasis, we can talk about simple biliary colic or onset cholecystitis. In the first case, the pain is of medium intensity, dull or aching. It is localized in the right side of the abdomen, two fingers to the right of the epigastric region. Accompanied by a feeling of heaviness in the abdomen. In addition, it lasts no more than three hours, begins daily at almost the same time and intensifies after taking squeaks.

A completely different nature of pain in cholecystitis. Pain is cutting and persists for a long time (days, weeks).

Nausea and vomiting. Frequent companions of a patient with cholelithiasis.

The phenomena of general intoxication of the body. Among them, the rise in body temperature, headache, weakness, fatigue. These are signs of gallstones complicated by cholecystitis.

Bloating, diarrhea, heaviness in the abdomen, heartburn, belching. These symptoms are not directly manifestations of gallstones. Their cause is stomach problems. But the root of evil lies precisely in the problems with the gallbladder.

As the course of the disease becomes more complicated, the development of the so-called obstructive jaundice is possible. With the blood flow, bile, which cannot pass through the gastrointestinal tract, is distributed throughout the body and tints the whites of the eyes and skin yellow.

For the same reasons, the feces acquire a yellowish-white tint. The consistency is sticky. This happens due to concomitant damage to the pancreas.

Severe pain in the right side under the ribs, which does not stop after taking analgesics, should alert the patient. This may be a symptom of an infectious lesion of the gallbladder, which often acts as a complication of cholelithiasis. In addition to pain, in this case, symptoms of general intoxication of the body, vomiting and diarrhea are added. These are formidable manifestations with which you need to urgently seek medical help.

Diagnosis of stones in the gallbladder

Diagnosis of gallstones begins in the office of the treating specialist. A doctor who deals with problems of the gastrointestinal tract is a gastroenterologist. He should be contacted.

At the initial consultation, the doctor will begin to interview the patient for complaints and their nature: what hurts, how, when it started, etc. After collecting an anamnesis (as it is called in medical language), it is the turn of a physical examination or palpation.

The doctor feels the place where the gallbladder is located and asks the patient to evaluate the pain reaction. In addition, in this way a specialist can assess the structure and size of the liver, which also often suffers from cholelithiasis.

Diagnostics is mainly instrumental. Laboratory methods are uninformative.

Ultrasound is the most informative. It makes it possible to assess the condition of the gallbladder and identify sand and stones in the structure of the organ.

If ultrasound does not provide any valuable information, controversial issues are resolved through CT diagnostics or echo endoscopy.

With stones in the gallbladder, it is also important to assess the functional state of the organ. For these purposes, scintigraphy is prescribed (a study similar to MRI).

Together, these methods are sufficient for an accurate diagnosis.

Treatment of gallstones

In most cases, the treatment of gallstones proceeds without pronounced symptoms. In this case, only one dynamic observation is sufficient: this means that doctors take a wait-and-see approach and monitor the progress of the process. In this case, general supportive therapy for the gallbladder and liver is prescribed:

Analgesics. For relief of pain syndromes in cholecystitis and gallbladder colic.

Herbal preparations for the maintenance of the liver.

Hepatoprotectors: to protect the liver from the adverse effects that are possible with cholelithiasis.

In more severe cases, there is no way to do without surgical intervention. Doctors do not risk starting with it, relying on dynamic observation, but when the symptoms become apparent, the operation cannot be abandoned.

Cavity operations are increasingly fading into the background, giving way to minimally invasive laparoscopic ones. This makes it possible to abandon traumatic procedures in favor of minimally invasive ones, which significantly reduce the risk of complications and the postoperative period of rehabilitation.

Prevention of gallstones

There are several ways to reduce the risk of developing gallstones:

Optimize your diet. The main type of stones in the gallbladder is cholesterol. They are formed with the immoderate consumption of animal fats. Therefore, it is worth reducing their consumption and introducing as many plant products as possible into the diet: vegetables, fruits, etc.

Exclude choleretic products and remedies for diagnosed cholelithiasis: apples, etc.

Eat often (5-7 times a day) in small portions.

Maintain a moderate level of physical activity.

Together, these methods will help to avoid stones in the gallbladder or, if the problem already exists, reduce the risk of complications and aggravation of the course of the disease.

Gallbladder stones are not nearly as simple as they might seem. This is a serious disease that can lead to a lot of complications, up to death. Therefore, you should not neglect your health. At the first symptoms, it is recommended to immediately consult a doctor.

The human digestive system is very complex and consists of several organs at once (stomach, duodenum, pancreas, liver, etc.). One such organ is the gallbladder, which stores bile. It is periodically released into the duodenum, thereby contributing to the rapid breakdown of food. But when this does not happen, signs of gallstone disease begin to appear.

This happens due to the formation of crystalline compounds in the gallbladder, which are popularly called stones. Their occurrence is associated with prolonged stagnation of bile, which contains bilirubin and cholesterol.

The latter begins to secrete a precipitate that resembles its appearance ordinary sand. If it is not excreted naturally, the grains of sand begin to stick together, forming stones. This process is very long and often takes from 5 to 10 years.

As practice shows, cholelithiasis is most often observed in women over the age of 40 years. In men, this disease is much less common. Perhaps this is due to the lifestyle, the more active it is, the less likely it is to develop the disease.

The first symptoms of gallstones

The formation of crystalline compounds (stones) in the gallbladder cannot go unnoticed by a person, since it contributes to the manifestation of a severe pain syndrome - an attack of biliary colic or, as it is also called, an attack of hepatic colic.

The formation of a pain syndrome is associated with the infringement of a crystalline compound in the cystic duct as a result of spastic contraction of the smooth muscles of the organ, which occur when trying to empty it (ejection of bile into the duodenum).

Often, the Vater nipple, located on the duodenum, is involved in this process. Stones can penetrate into it, thereby causing severe pain in a person.

As a rule, an attack is observed a few hours after eating heavy food (pastries, fatty meat and lard, egg white in large quantities, etc.). In men, pain syndrome can be observed after a long ride in a vehicle, which is caused by the movement of stones through the bile ducts as a result of shaking.

And since women today also take an active part in driving cars, they may also experience such manifestations of the disease for the same reason.

Symptoms of gallstones during colic

The most common symptom of gallstone disease is hepatic colic. As a rule, for her symptoms begin to appear suddenly and quickly increase their character. It is accompanied by a very strong pain syndrome, which a person can hardly endure. There are situations when the patient even loses consciousness from pain.

The symptoms of hepatic colic are as follows:

• there is pain in the epigastrium and right hypochondrium, which can radiate to the neck, shoulder blade and even to the neck;
• however, there may be bloating and increased pain when pressing on the diseased organ;
• nausea and vomiting.

Most often, patients do not have a sign of peritoneal irritation, protective muscle tension may also be absent. But at the same time, all the symptoms of tachycardia may appear. The heartbeat can reach 100 beats per minute or more.

All these signs of hepatic colic can also suddenly disappear, as well as begin. As a rule, their duration does not exceed 30 minutes. However, even after the complete disappearance of the attack, pain in the right hypochondrium can persist for another 20-40 hours.

If the symptoms of hepatic colic are observed for a long time (more than 1-2 hours), then we are already talking about an intractable attack. This already gives reason to assume that the patient is developing a more serious disease - cholecystitis, in which the inflammatory process begins to develop.

Blockage of the bile duct and inflammation of the walls of the gallbladder can occur for several reasons:

1. Development of a bacterial environment in the intestines and gallbladder;
2. Long-term use of drugs that enhance the functionality of the liver and other digestive organs;
3. The impact of mechanical factors (stretching of the walls of the diseased organ, increasing pressure on them, etc.).

Diagnostic symptoms in the gallbladder on the background of cholecystitis

Manifestations of hepatic colic and acute cholecystitis have their similarities. In terms of their duration, the attacks are almost the same, however, with the latter, a strong muscle tension is observed in the right hypochondrium, and when you press on the diseased organ, a sharp sharp pain occurs.

The main symptom of acute cholecystitis is the appearance severe pain when pressing on the gallbladder, which is localized between the legs of the sternum and clavicular-mastoid muscle. This symptom is the main one when stones are found in the bile ducts.

The development of gallstone disease can also be determined by a slight tapping along the right costal arch. If there are complications in the form of cholecystitis, then a sharp pain will be observed at the site of palpation.

Also, the diagnosis of gallstones occurs by palpation of the right hypochondrium during a deep breath. In the presence of a disease accompanied by cholecystitis, the pain begins to intensify.

In the absence of timely treatment and further progression of the disease, symptoms of local peritonitis begin to appear. This complication occurs against the background of the spread of infection outside the gallbladder.

However, even in this case, the symptoms of peritoneal irritation may be absent, despite the fact that cholecystitis has a pronounced symptomatic picture of the inflammatory process and has already contributed to destructive changes in the walls of the diseased organ.

This condition is caused by the presence of an omentum on the liver, which, as it were, envelops the focus of inflammation. Some symptoms of the appearance of stones in the gallbladder can be observed only with a breakthrough of the formed perivesical pustular formation or with severe perforation of the walls of the organ.

The diagnosis is made on the basis of a general survey of the patient, the presence of a sudden pain syndrome, elevated body temperature and leukocytosis. Also, when diagnosing a disease, it is necessary to conduct an ultrasound examination.

In women and men, the development of gallstone disease occurs in the same way. Therefore, every person who observes prolonged pain attacks, muscle tension in the right hypochondrium and an increase in body temperature during their manifestation should be alert and immediately contact a specialist. Such symptoms are signs of severe changes in the functioning of the gallbladder.

Symptoms of complications

The manifestation of gallstone disease in women and men begins with a severe pain syndrome - hepatic colic. However, jaundice is often observed with it - the acquisition of icteric staining by the skin and sclera.

This symptom of the manifestation of gallstones indicates serious complications. Namely, blockage of the common bile duct. It occurs due to the penetration of stones into the ducts and their stagnation in them. They block the lumen and contribute to the stretching of their walls, resulting in an inflammatory process, which is accompanied by pain.

The patient has all the symptoms of obstructive jaundice, which include:

• discoloration of feces;
• the appearance of foamy formations in the feces;
• dark urine;
• itching of the skin.

Most often, it is the last symptom that worries patients, as it prevents them from sleeping normally, and frequent scratching leads to the appearance of painful wounds on the body.

When the penetration of stones occurs in the nipple of Vater, the symptoms of the manifestation of the disease are slightly different. The pain occurs in the epigastrium and immediately radiates to the left and right hypochondrium.

This is due to the simultaneous stagnation of bile and pancreatic juice. Such changes in the body can be observed during or after an attack, which are characterized by a change in the color of urine.

Gallstone disease develops over several years. At first, it may be accompanied by short-term pain syndromes, which are associated with the natural removal of stones from the body.

Often seizures go away on their own without medical attention. But in the absence of treatment of the disease, strong changes occur in the gallbladder, as a result of which the natural excretion of stones slows down, and then stops altogether.

Against this background, the attacks intensify and become the most prolonged. There are complications in the form of cholecystitis and other diseases. In this case, the removal of stones from the body without the use of modern medical devices is impossible.

Therefore, if you observe at least a few of the above symptoms of gallstone disease, contact a specialist immediately. Only in this way can you protect yourself from possible complications.

- This is a disease characterized by the formation of stones in the gallbladder and its ducts due to a violation of certain metabolic processes. Another name for the disease is cholelithiasis.

The gallbladder is an organ adjacent to the liver and acts as a reservoir for liquid bile produced by the liver. Gallstones, or stones, can be found both in the gallbladder itself and in its ducts, as well as in the liver and the trunk of the hepatic duct. They differ in composition and can have different sizes and shapes. Gallstone disease often provokes development (inflammation of the gallbladder), as the stones irritate its walls.

Calculi in the gallbladder are formed from cholesterol crystals or calcium pigment-lime salts (in more rare cases). Gallstone colic occurs when one of the stones blocks the duct that carries bile from the gallbladder to the small intestine.

The formation of stones in the gallbladder is a fairly common disease that affects about 10% of the adult population in Russia, Western Europe and the United States, and in the age group over 70 years this figure reaches 30%.

In the second half of the twentieth century, the frequency of surgical interventions performed on the gallbladder surpassed the frequency of surgical operations to remove appendicitis.

Gallstone disease is predominantly found among the population of industrialized countries, where people consume a large amount of food rich in animal proteins and fats. According to statistics, cholelithiasis is diagnosed in women 3-8 times more often than in men.

Symptoms of gallstones

In most cases, gallstone disease is asymptomatic and has no clinical manifestations for several (usually five to ten) years. The appearance of symptoms depends on the number of stones, their size and location.

The main features of GSD are:

Paroxysmal drilling or stabbing pains in the liver and right hypochondrium;

Nausea, in some cases;

Bitter taste in the mouth due to flow of bile into the stomach, ;

Hepatic (biliary) colic usually develops after eating fatty, heavy foods, spicy and fried foods, alcohol, as well as in conditions of increased physical or stressful stress. Pain begins on the right under the ribs, may radiate to right hand(shoulder and forearm), shoulder blade, lower back, right half of the neck. Sometimes the pain may extend beyond the sternum, which is similar to a seizure.

The pain appears due to a spasm of the muscles of the gallbladder and its ducts, which occurs in response to irritation of the walls of the bladder with stones, or due to excessive stretching of the walls of the bladder as a result of an excess of bile accumulated in it.

A strong pain syndrome is also noted when stones move along the biliary tract and blockage of the bile duct lumen by stones. Complete blockage leads to an increase in the liver and stretching of its capsule, which causes constant dull pain and a feeling of heaviness in the right hypochondrium. In this case, obstructive jaundice develops (the skin and sclera of the eyes become yellow), which is accompanied by discoloration of the feces. Other symptoms of a complete blockage of the duct may be high fever,.

Sometimes biliary colic resolves on its own after the stone passes through the bile duct into the small intestine. Usually the attack lasts no more than 6 hours. To relieve pain, you can apply a heating pad to the area of ​​\u200b\u200bthe right hypochondrium. If the stone is too large, it cannot leave the bile duct itself, further outflow of bile becomes impossible and the pain intensifies, immediate surgical intervention is required.

A common symptom of cholelithiasis is vomiting with an admixture of bile, which does not bring a feeling of relief, since it is a reflex response to irritation of certain areas of the duodenum.

An increase in temperature to subfebrile values ​​\u200b\u200b(not higher than 37 ° - 37.5 ° C) indicates the attachment of an infection and the development of an inflammatory process in the gallbladder. The development of cholecystitis is accompanied by a decrease in appetite and increased fatigue.

Healthy bile has a liquid consistency and does not form stones. The factors that provoke their formation include:

Perforation (rupture) of the gallbladder and its consequences in the form of peritonitis;

Entry of large stones into the intestines and intestinal obstruction;

Too large stones;

A history of operations on the stomach, spleen, intestines and adhesions on the abdominal organs;

• Diet for gallstone disease

  

  The composition of the diet is of great importance in this disease. It is recommended to adhere to fractional nutrition, eat 5-6 times a day. The intake of food itself has a choleretic effect, so the intake of a small amount of food into the stomach at the same hours stimulates the outflow of bile and prevents its stagnation. But with a large portion of food, the gallbladder can instinctively contract, and this will cause an exacerbation.

  There should be a sufficient amount of animal protein in the diet, animal fats are also not prohibited, but are usually poorly tolerated, so vegetable fats are preferred. With gallstone disease, it is useful to eat foods rich in magnesium.

  radish, eggplant,