stones in the gallbladder - it's pretty hard, dense formations.Number stones in the gall bladder may be different - from one to many hundreds or even thousands.Varies as the value of stones - from a grain of sand and a pinhead to plum and chicken eggs.The more gallstones , so they are smaller.Most often stones are in the gallbladder, at least - in the bile and hepatic ducts in the intrahepatic bile ducts.
How to treat stones folk ways see here.
presence of stones in the gall bladder and bile ducts causes Well elchnokamennuyu disease.
Contribute ailment biliary dyskinesia, gastritis, duodenitis, enteritis, colitis and other diseases of the gastrointestinal tract, but it is especially dangerous in this respect, cholecystitis - inflammation of the gallbladder.
For gallstone disease characterized by attacks of intense pain in the right upper quadrant radiating to the right scapula, shoulder, neck, accompanied by vomiting, bitter, dry mouth, pruritus, fever.Perhaps the deve
By the nature of the disease distinguish latent, dyspeptic, pain and paroxysmal pain torpid form .
1. latent form gallstones often observed in the presence of single, usually cholesterol stones.Patients feel well, the presence of stones is determined by chance on ultrasound.Latent form gallstones bowl common in older people and men.
2. diarrheal form gallstones observed about 1/3 of cases of gallstone disease.For years, patients may experience periodic or constant nausea, heaviness after eating, belching, bitter taste in the mouth, dyspepsia, which are usually associated with the consumption of fatty, fried or spicy foods, carbonated beverages.Local symptoms of gallbladder are mild or absent for a long time.Very often, these symptoms blamed on the bacteria overgrowth, and most often it is indeed present, but as a secondary pathology.
3. Pain paroxysmal form gallstones - the most common and easily diagnosed.It characterized by recurrent course: severe pain attacks occur suddenly and for no apparent reason, or after eating disorders, physical exertion, etc.
4. Pain torpid form gallstones distinguished by the absence or rarity of attacks...The pain is dull, constant or periodic.Under the influence of dietary disorders, physical exertion pain increases, but it does not reach the severity of typical colic.Increased pain in most cases short.At an exacerbation is observed increase in body temperature, white blood cell count and erythrocyte sedimentation rate of remain normal.
According to the severity of the clinical course distinguish 3 form gallstones.
1. Mild gallstone disease is characterized by occasional attacks of biliary colic (from 1 to 5 times a year), lasting from 30 minutes to 1 hour (rarely more), short-term fever without jaundice, while maintaining the concentration and motor function of the gallbladder.Seizures can be easily removed by means of medication.In between bouts of pain and dyspeptic symptoms are mild.
2. form of moderate severity gallstone disease is characterized by moderate, persistent pain syndrome and periodic bouts of biliary colic.Seizures occur 6-12 times a year lasting 3-6 hours or more, accompanied by fever, recurrent vomiting, jaundice often.Fever, icteric sclera coloration persist for 2-3 days after the attack.By the pronounced changes of the biliary tract (cholangitis) and liver (hepatitis) join secondary symptoms of pancreatitis.In between bouts of stored Moderate persistent pain syndrome, dyspeptic symptoms.May impair concentration (ability to make bile more concentrated, allowing the liver to produce it smoothly) and motor function of the gall bladder, moderate changes in liver function, exocrine function of the pancreas.
3. Severe gallstone disease is characterized by frequent (2-3 times a week) and long bouts of biliary colic.Seizures are removed only repeated taking strong painkillers.In between bouts of pronounced observed persistent pain, dyspepsia, low-grade fever.Violated the concentration and motor function of the gallbladder, liver and exocrine pancreatic function.
To identify cholelithiasis there are many reliable ways.But the main analysis of the human remains of general condition.
experienced gastroenterologist already on closer examination can determine how big the problem of his patient: whether the gallbladder is increased, the degree of its sensitivity, etc. But, of course, only a thorough analysis of all the clinical symptoms and the results of the study support methods allows..put the correct diagnosis.
the wire ultrasound examination of the gallbladder (US) and cholecystography , that can detect changes in the gall bladder and the presence of stones.In addition, laboratory tests are carried out: give up the blood, urine, and sometimes the gallbladder bile (taken by duodenal intubation).
1. Surgical treatment
operation to remove stones should not frighten patients.Currently, these operations are performed at a high level in virtually any hospital, and in some hospitals performed a laparoscopy, t. E. The mini-incision surgery with a point.After surgery, the patient quickly returns to normal life.For anesthesia used only high-quality products: they do not cause serious trouble the body, its excretory system, do not cause severe intoxication, besides their action can be paused at any time.Therefore, if the operation is shown, if the US and analyzes confirm the presence of stones, do not wait for complications.Better still, at a time when worsening passed, go to the hospital, to prepare for the surgery and after two weeks what some feel healthy, able-bodied man, and not "kamnenositelem" at risk.
Besides surgery, there are other treatments - therapeutic .First of all, drugs that have to take the attack to provide emergency aid for therapeutic biliary colic, relieve the person of excruciating pain.To this end, various antispasmodic drugs administered.
Choosing a specialist of various drugs and their method of administration (intravenous, intramuscular, subcutaneous) depend on attack strength and condition of the patient.The most common injection attack is removed platifillin, papaverine or Dibazol.During an acute attack of biliary colic is an effective and intramuscular shpy or aminophylline.Naturally, each of these drugs have contraindications, so doctors choose the desired drug only after examination of the patient.
Typically, antispasmodics are administered simultaneously with painkillers.Especially effective Baralgin (it relieves spasms and soothes pain).You can use analgesics, or to make an intravenous injection of Novocain.
If the attack is very hard and take it off with the help of these funds can not, in the course is the "heavy artillery": are special strong drugs such as Tramal in combination with atropine or other antispasmodics.In some cases, effective use of nitroglycerin.In a hospital setting is carried out right-sided perirenal blockade.
When severe vomiting introduced Reglan (it regulates the motor function of the gastrointestinal tract, perfectly relieves nausea and vomiting of different nature), can also be used diphenhydramine, or Aminazin pipolfen, but better to the combined administration of these drugs.Also appointed drink solutions or rehydron Tsitroglyukosolana.
If the attack is not very strong: there are no sharp pain, vomiting (nausea only), you can do without injections.In this case, the doctor prescribes antispastic agents: 5-10 drops of 0.1% solution of atropine, or extract of belladonna, Besalol or tablet papaverine, no-spa or Dibazol.Together with one of these drugs for the complete removal of pain - a pill baralgin.
But often because of nausea may be difficult to drink the medicine.In this case, the drugs are administered with enemas - efficient and yet secure way.For enemas usually takes a combination of aminophylline, Belladonna and Analgin.
After the cease of pain and nausea recedes, the patient may be given a laxative, but not salt.Saline laxatives have a marked choleretic effect, and in the early days they should not be accepted after the attack.
appetite in patients with absent, and there is no need to force them to eat.There shall be only a warm drink: sweet tea, cranberry juice (sweet) juice, fruit drinks, heated water «Essentuki» number 4. Needed complete rest and strict bed rest.
So the attack is removed.And, as you can see, a lot of possibilities for this.It is important to use only their skill, on the one hand, as soon as possible to help the person - to save him from the pain and remove all the other unpleasant symptoms, on the other - does not cause unwanted side pharmacological action.
But there is an equally important task - prevent the recurrence of attacks, to maintain a state of health to be good, to help the work of the gallbladder and biliary tract and prevent the formation of new stones.For this purpose, other means are used.
Some people naively and unknowingly do not listen to the opinion of the physician, and try to help yourself by using cheaper and simpler version of the usual cholagogue.In them a glimmer of hope that the stones themselves will come.In vain: it will not happen!Exit the stones will not be able, but to move from "a familiar" place - easily.As a result, they clog the bile duct - and a person can be in a hospital bed with an attack of biliary colic.
That's why when gallstone disease without consulting a doctor is very dangerous to take cholagogue preparations: allohol, holenzim, berberine, and other liobil.First you need to pass ultrasound to determine if there are stones in the gallbladder or not.If the stones do not show up, it means that pain gives cholecystitis and cholagogue drugs in this case will not bring harm.
Many people think that when cholelithiasis can safely drink infusions and decoctions of herbs.But this is not the case.Everlasting, corn silk, aloe, barberry, St. John's wort, marjoram, wild rose, calendula and even valerian - all of these plants also have a choleretic effect and can be potentially dangerous for people suffering from gallstone disease, as they can cause an attack of biliary colic.
3. Dissolving stones
litholysis Medical ( "lithos" - stone, "lysis" - dissolution) - a method of treatment of gallstone disease, which began to develop in the 70-ies of the last century.Initially dissolving gallstones conducted using chenodeoxycholic acid which Propafenone inhibits cholesterol synthesis in the body and promotes the dissolution of gallstones.But the use of chenodeoxycholic acid in therapeutic doses causes a large number of side effects, so it is now as a preparation for litholysis urzodeoksiholevaya most commonly used acid, which is also hepatoprotector.
However, when using this acid as a "solvent", there are some limitations, namely: the gallstone should be radiolucent (cholesterol);the gallbladder must function (cystic duct must pass);fullness of the lumen of the gallbladder stones should not exceed half and others. In addition, the dissolution by means of bile acids are subject to a density of stones no more than 70-100 units on a scale of Hounsfield.
Given these limitations, the direction of the dissolution of stones can only get 20% of the total number of patients with cholelithiasis.But even with the most careful selection of the therapeutic effect is noted not all patients (25 to 50%).
General contraindications to dissolve the stones by any method:
• acute infectious diseases;
• acute illness requiring hospital treatment;
• complicated forms of cholelithiasis;
• Disabled gall bladder, and others.