Biliary dyskinesia - Causes, Symptoms and Treatment .MF .
Often patients there are complaints from the digestive tract due to functional impairment of its departments.In this case, no organic processes (inflammation, scarring, tumor), and the unpleasant symptoms are caused by a malfunction of the internal organs.One of these diseases is biliary dyskinesia.Normally
bile in an amount 1.2 liters formed in the liver cells and bile ducts flows into the gallbladder, and then into the duodenum, where it performs its function in the digestion of food, mainly fat cleaving molecule in the intestinal lumen.If bile formation occurs substantially continuously during the day, its delivery into the intestine occurs during digestion and neuro-regulated thin humoral mechanisms including caused by food intake into the stomach.The regulation of the outflow of bile from the gallbladder into the intestine leading role belongs to the sphincter of Oddi, located in the intestinal wall.It opens the common bile duct and pancreatic duct, which receives bile and enzymes necessary for d
In the case where the flow of bile changes due to functional disorders of the regulation of these processes, there is dyskinesia (a movement disorder), or dysfunction of the biliary ducts.Also, this disease can call the dysfunction of the biliary system, including dysfunction of the gall bladder, sphincter of Oddi dysfunction, or a combination of both.
There are two forms of psoriasis - by hyperkinetic and hypokinetic type, the first characterized by enhanced diverting bile ducts, and the second - delayed release of bile.Additionally, dyskinesia may be a primary, that is developed on the background of congenital anomalies of the biliary system, and secondary, i.e. acquired during the life against other diseases, most frequently, gastrointestinal diseases.
Biliary dysfunction is common, but still the population is found in two or three times less than cholelithiasis and cholecystitis.Often dysfunction precedes duct stone formation and inflammation in the gallbladder.
reasons biliary dyskinesia.
to primary dysfunction of the biliary tract causes include congenital biliary tract structure:
- constriction in the cavity of the gall bladder,
- bend and the doubling of the gallbladder.
Secondary dysfunction may develop on the background of diseases such as:
- pathology of the digestive tract - gastritis, pancreatitis, cholecystitis, stomach ulcer, hepatitis, and cirrhosis of the liver,
- vascular dystonia and neurosis-like states, causing disturbances in the activity of the autonomic nervoussystem, taking part in the regulation of bile secretion,
- surgery on the abdominal organs - resection (removal) of the stomach, gallbladder removal (leads to disruption of the rhythmic contraction of the sphincter of Oddi),
- hormonal disorders - premenstrual syndrome, pregnancy, menstrual disorders, diabetesdiabetes, obesity, lack of thyroid hormones (hypothyroidism).
disease risk factors act:
- a genetic predisposition,
- poor diet - intake of fatty, fried food and excess in the diet of foods rich in cholesterol (eggs, fatty meats, dairy products, liver, eggs and so on.).
- long psycho-emotional and physical overload, severe stress, sedentary lifestyle,
- the presence of parasites in the body - worms or protozoan, Giardia often.
Symptoms of biliary dyskinesia.
clinical manifestations of biliary tract dyskinesia can be divided into a number of syndromes:
- Pain Syndrome.The occurrence of pain caused by errors in diet or stressful situations.When the hyperkinetic form of dysfunction of the patient concerned about pain, spastic nature in the right half of the abdomen below the ribs, extending to the left side of the chest, or in the blade receiving zoster character.At hypokinetic form of pain are in the nature bursting pulling, radiating or without intensifying or threatened with a change in body position.Pain may disappear on their own and appear again at different intervals - from several seizures a day to rare episodes during the month.
- Dyspeptic syndrome is characterized by nausea, bitterness and dryness in the mouth, regurgitation with a bitter taste, bloating, unstable chair, with a predominance of constipation or diarrhea, fatty stools.These symptoms are caused by disorders of the digestive processes associated with insufficient or excessive flow of bile into the bowel lumen.
- Cholestatic syndrome occurs rarely when hypokinetic form of dyskinesia when continuing normally produces bile does not flow in the proper amount in the intestine and stored in the gall bladder, leading to the appearance of jaundice of the skin and sclera, skin itching, dark urine and pale feces, enlarged liver.
- asthenovegetative syndrome characterized by weakness, fatigue, feeling of constant weakness, drowsiness or insomnia, increased anxiety and other symptoms.
- symptoms of neurosis - panic attacks, phobias (fears), obsessive thoughts, compulsions, aggression, anger, tearfulness, resentment, etc.
to confirm the diagnosis in addition to clarifying complaints and examination of the patient, shows the following survey methods prescribed by the doctor physician or gastroenterologist:
- common blood and urine tests,
- biochemical blood analysis with determination of liver enzymes (ALT, AST), pancreatic enzymes(alkaline phosphatase), direct, indirect, and total bilirubin, cholesterol,
- immunological blood tests for suspected parasites (eg, antibodies to Giardia),
- determination of antibodies to the virus that causes hepatitis B and C, as well as the Human immunodeficiency virus (HIV),
- determining the level of hormones in the blood of suspected violation of hormone metabolism in the body (sex hormones, thyroid hormones, etc.),
- ultrasound of internal organs - liver, pancreas, gallbladder, kidney,
- ultrasound biliaryafter the test meal, consisting of a small amount of fatty foods in order to assess the flow of bile through the ducts in response to food stimulation of the biliary system,
- duodenal intubation - bile fence with a probe inserted into the stomach and the duodenum, followed by the study of bile chemical properties andthe ability of it to stone formation, as well as with the definition in the bile of the inflammatory process,
- gastroscopy under suspicion of gastritis or gastric ulcer,
- study of bile ducts using radiological diagnostic methods - cholecystography, which may be oral (the introduction of radiopaque substance through the mouth, followed byits accumulation in the bile in the gallbladder), intravenous (introduction of contrast into the bloodstream), and endoscopy (invasive studies with retrograde administration of contrast directly into the bile ducts),
- consultation of the neurologist, the therapist, according to testimony - an endocrinologist.
Treatment of biliary dyskinesia.
Therapy dyskinesias bile duct includes the following activities:
- lifestyle adjustment in compliance with the diet,
- spa treatments,
- drug treatment,
- physiotherapy methods of influence, often electrophoresis on the skin in the liver rates,
- massage, acupuncture, physiotherapy,
- spa treatment.
For the treatment of hypokinetic preferred form of the disease the following methods:
- reception of mineral water with a high degree of mineralization (Essentuki №17),
- holding tyubazh once a week for a month, followed by monthly repetition of the procedure - receiving cholagogue or mineralwater in the position on the right side with a warm hot-water bottle in the right hypochondrium,
- reception choleretic (drugs that stimulate the formation of bile - allohol, hofitol, corn silk, Nicodin, holenzim) and holekinetiki (preparations to facilitate the flow of bile through the ducts - olive oil,magnesium sulfate, sorbitol, xylitol).
For the treatment of hyperkinetic form of dyskinesia appointed:
- mineral water, moderate and weak mineralization (Essentuki №4, №20, Narzan, Borjomi, Slavyanovskaya),
- holespazmolitiki - drugs that eliminate the spasm of the muscle fibers in the wall of the bile ducts -Odeston, Duspatalin, no-spa, and others.
Lifestyle with dyskinesia.avoiding harmful habits,
- - moderate physical activity without physical overload,
- rational mode of work and rest,
- good night
, the concept of which includes for patients with biliary dyskinesia is very important to lead a healthy lifestylesleep,
- the main component of lifestyle - healthy eating - the exception of fatty, fried, spicy, salty, spicy foods, limiting animal products, increased consumption of plant foods.During treatment of dyskinesia should observe a strict diet, or medical table №5.
Complications of biliary dyskinesia.
Despite the fact that dyskinesia can occur against a background of diseases of the gastrointestinal tract, this very pathology in long-term absence of treatment may also cause the development of diseases such as cholecystitis, cholangitis (inflammation of the walls of the bile ducts), the formation of gallstones,chronic pancreatitis, weight loss, vitamin deficiency and anemia due to malabsorption of nutrients in the gut.Prevention of complications is early treatment and annual examination by a specialist.
prognosis for timely treatment is favorable, the threat of the disease for life can not be held.If dyskinesia accompanied by chronic diseases of the gastrointestinal tract, the health outlook is determined the severity of the underlying disease.
therapists Sazykina About Yu