Signs of gallstones in women and men. Gallstones: removal surgery (reviews). Treatment with folk remedies

To understand how to get rid of gallstones, you need to get general idea about the disease. The presence of a stone in the gallbladder or bile ducts means the development of cholelithiasis. More often this happens due to improper metabolism or stagnation of bile.

Gallstones are made up of cholesterol crystals or bilirubin salts. The formations are common, occurring in every tenth person, even more often in old age. There are various shapes and sizes ranging from fine bile sludge and pebbles measuring 2 cm (20 mm) to huge stones with a diameter of 16 cm (160 mm) or more.

• Disorders of metabolism and the qualitative composition of bile with a predominance of calcium, bile pigments or cholesterol.
• Cholecystitis.
• Biliary dyskinesia.
• Stagnation of bile due to various pathologies(large duodenal papilla, biliary tract).

Predisposing factors include:

• Belonging to the female gender.
• Excessive body weight.
• Frequent pregnancies.
• Estrogen therapy.
• Genetic predisposition.
• Poor diet with a lot of fat.
• Exhausting diets.
• Certain diseases (hemolysis, diabetes, liver cirrhosis, Crohn's disease and others).
• Laparotomy surgical operations.

Clinical course

Quite often the disease is asymptomatic. Gradually, with the accumulation of stones, the following symptoms begin to bother patients:

• Cramping pain in the epigastrium on the right, varying in intensity.
• Sensation of bitterness on the tongue.
• Nausea, vomiting, belching.
• Hyperthermia.
• Yellow discoloration of the skin and sclera.

Manifestations of biliary colic

This condition often accompanies gallstones. Colic is characterized by intense unbearable pain on the right side. The pain is preceded by an error in diet or shaking.

The pain is so severe that the patient cannot find a comfortable position. Colic may be accompanied by vomiting, if inflammation develops in the gallbladder, and high fever occurs.

Diagnostics

The doctor is obliged to conduct diagnostic measures determine the severity of the condition in full, excluding other pathologies. As a rule, patients consult a doctor after an attack of hepatic colic; the pain causes considerable discomfort and is prone to recurrence.

It is important that the doctor collect a complete history and find out how the disease began, how it progressed, what medications helped, the nature of the attacks, and trace the connection of the disease with nutrition. Then an examination is carried out and the symptoms of calculous (cholelithiasis) cholecystitis are identified - Kera, Murphy, Ortner-Grekov and others. The color of the bile lining and sclera is assessed, and jaundice begins from there.

After the consultation, instrumental diagnostics gallstones:

1. Ultrasound examination - in the vast majority of cases reveals a cystic calculus.
2. X-ray abdominal cavity:

• A survey radiograph is aimed at identifying a calculus with a large amount of calcium in its composition.
• A study with the introduction of contrast into the gallbladder - allows you to find stones that are not visible on standard x-rays.

1. CT and MRI can distinguish even small stones in the gall bladder and are used for differential diagnosis.
2. Endoscopic retrograde cholangiopancreatography helps assess the condition bile ducts, detect stones and voluminous neoplasms.

Held laboratory diagnostics– the level of bilirubin and inflammatory markers (CRP, ESR, leukocytosis and others) is determined in the blood.

Treatment

Patients who do not know where to turn for gallstone disease should make an appointment with a gastroenterologist. The doctor will conduct full examination and determine further treatment steps. Self-medication is strictly prohibited as it can cause harm. For example, the use of choleretic drugs in the presence of stones leads to complications.

If the stones are small (up to 3 cm), there are few formations, it is permissible to try conservative therapy. This includes resorption of stones through the administration of special medications, external shock wave lithotripsy, percutaneous transhepatic cholelitholysis and others.

Drug dissolution of stones

For this method of therapy, drugs containing ursodeoxycholic and chenodeoxycholic acids are used. The substances dissolve stones containing excess cholesterol. Typically, the method is used when the stones are small (4-16 mm). When choosing a method, the contractility of the gallbladder should remain normal.

Medicines are used over a long course from six months to two years under the supervision of a doctor. In most cases, the method helps, but the disease can reappear. To prevent relapse, you will need to continue taking medications in small dosages.

External shock wave lithotripsy

The method is designed to break up a large stone in the gall bladder into many small ones, often used in combination with the previous method. The first step is to crush large stones. The second is medicinal dissolution of the resulting small fragments.

Shock wave lithotripsy is fraught with many dangers; the procedure can clog the bile duct or damage the gallbladder. There is a need for surgical intervention.

Percutaneous transhepatic cholelitholysis

A rare minimally invasive method of therapy. It involves catheterization of the gallbladder through the skin and liver tissue. An agent (methyl butyl ether) is injected through the catheter, resolving a calculus of any origin.

Surgical treatment

When conservative treatment is contraindicated or ineffective, a decision on surgical intervention must be made. Often carried out endoscopic operations through a small laparoscopic opening. The interventions are minimally invasive, do not leave large scars, are relatively inexpensive and are less likely to be complicated by hernias.

Perhaps either the entire bladder with a calculus. More often the organ is removed, metabolic disorders do not disappear, and stones can appear again. If the stone is large, for other indications (adhesions, obesity, pregnancy), an open laparotomy operation is performed.

Postcholecystectomy syndrome

The operation helps most patients; rarely (two out of ten cases) there are consequences of treatment or residual effects, which did not disappear after surgery, are united under the name postcholecystectomy syndrome. These include:

• Lesions of the biliary tract not related to the gallbladder (disturbances in the sphincter of Oddi, common bile duct stone).
• Postoperative complications (adhesions, hernias, damage to the bile ducts, formation of stones in the bladder stump, etc.).
• Diseases caused by gallstones, but not stopped after surgery (biliary pancreatitis, hepatitis).

Properly selected treatment brings relief from the disease, it is necessary to seek medical care.

Diet

If a person has a tendency to form or formations appeared but were removed, it is extremely important to adhere to a special diet. You need to eat often (6 times a day) in small portions. With such a diet, the release of bile through the duodenal papilla is constantly stimulated, the secretion does not stagnate. If the portion is too large, the motility of the gallbladder increases, which, in the presence of a calculus, can lead to inflammation.

The diet is supposed to be balanced, filled nutrients, vitamins and microelements. It is recommended to consume low-fat varieties of meat and seafood, low-fat dairy products, cereals, especially oatmeal and buckwheat, plant foods(fruits, vegetables, herbs, dried fruits), compotes, juices, mineral waters. It is not recommended to consume fatty, fried, spicy foods, foods with increased content caffeine, smoked meats, canned food, garlic, cucumbers, beans.

Prevention

If predisposing factors are identified, you will have to follow the rules:

• News correct mode and diet (described in the article).
• Maintain normal body weight through exercise and diet.
• Taking medications that improve metabolic processes in bile.
• Timely seeking medical help when the first symptoms of the disease occur.
• Do not self-medicate, do not take choleretic drugs on your own. In case of severe pain, you can take a tablet of no-shpa or a similar antispasmodic.

Complications

In case of incorrect or untimely treatment the following complications arise:

• Cholecystitis is an inflammatory disease of the gallbladder.
• Biliary colic.
• Inflammation of the bile ducts.
• Biliary peritonitis - occurs due to rupture of the bladder with the flow of bile into the abdominal cavity. Extremely dangerous.
• Biliary pancreatitis - appears due to increased pressure in the bile ducts and bile entering the pancreatic ducts and damage to the ducts and pancreatic cells.
• Septic complications in case of infection.
• Malignant tumors that arise due to permanent damage to the walls of the bladder.

Symptoms of gallstones in women have their own characteristics. Doctors studying the disease and practitioners believe that there is a connection between gallstone disease and the patient’s gender. Women are diagnosed with the disease 8 times more often than men. What explains this?

Statistics explained by structure female body. He tends to gain weight faster than men. Female nature assumes an increase in mass, as if in reserve in case of pregnancy, childbirth, and feeding. Meanwhile, exactly overweight─ one of the risk factors for the development of gallstone pathology.

Symptoms of the disease in women are as follows:

1. Sharp pain in the right side. They can radiate under the shoulder blade, into the lower back and back. The syndrome is called hepatic colic. The pain is unbearably strong. Attacks often begin after eating fatty, spicy, salty foods.
2. Nausea. Vomiting attacks become frequent and uncontrollable. Vomiting reflex does not always end with the release of masses. More often than not, these are simply attacks that do not provide relief.
3. Pain in the pit of the stomach. It is accompanied by bitterness in the mouth. The taste appears on its own and is not associated with food intake.
4. Colic. Gallstone pain is not permanent. It comes in tides. Together with periods of rest, the attack lasts 1-2 days. Having subsided, the disease returns with greater force.

If you miss the first signs of gallstones, the bile duct becomes blocked. This is the result of the stones leaving the bubble. Hepatic colic becomes more frequent and intensifies. It is important to start treatment on time and notice the disease in the first stages.

The first symptoms of gallstone pathology in women include:

• bowel dysfunction;
• heaviness in the stomach;
• jaundice.

Doctors explain them by disruptions in the process of secretion outflow, which affects digestion.

In women, stones form in the bladder more often not only because of the physiological tendency to be overweight. Pathology is also provoked strict diets And wrong mode eating.

Indirect symptoms

Signs of gallstones are not only obvious, but characteristic of the development of diseases internal systems, but also indirect, associated with a general deterioration of the condition. An increased amount of liver secretion acids affects, for example, the functionality of the brain.

The first signs of gallstones are mainly associated with the patient’s mood characteristics.

He becomes:

• irritable for no reason;
• uncontrollably impulsive;
• gets tired quickly.

The temperature with gallstones may increase. A woman’s mood and condition worsens after physical and mental stress. Emotional stress, stress, fear and depression arise due to improper functioning of the gallbladder. Food that is fatty or spicy also leads to a deterioration in well-being.

In women during pregnancy, the symptoms of the disease are no different. The signs and sensations are the same.

Characteristic symptoms

Some signs are obligatory and characteristic of the disease. Standard symptoms are considered:

Pain from gallstones

Pain syndrome specialists divide groups according to location:

1. Biliary.
2. Hepatic.

The pain itself is called colic. This is an attack that causes sharp, sharp sensations. Colic appears at the intersection of the costal arch with the abdominal muscle. Attacks last from 10 minutes to several hours. The pain is severe, radiates to right shoulder, compresses the back, moves to the abdominal area. The latter forces women to attribute symptoms of the disease to premenstrual syndrome.

It is dangerous to endure pain that lasts more than 5 hours. Complications develop and worsen accompanying illnesses.

The frequency of attacks depends on individual characteristics body. Sometimes a year may pass after the first manifestation of the disease. Then the attacks become more frequent.

Increased body temperature

The presence of fever is characteristic of cholecystitis in acute form. Inflammation of the bladder walls often accompanies gallstone pathology. Cholecystitis leads to penetration into the blood active substances, causing a rise in temperature.

Fever and colic warn of illness. If the temperature rises to 38 degrees in waves, cholangitis is often diagnosed - inflammation of the bile ducts.

Sometimes, with cholelithiasis accompanied by cholecystitis, the temperature remains normal. The symptom is characteristic, but not obligatory.

Jaundice

Pathology occurs due to the concentration of bile in the blood. Penetrating into it, the secretion also enters the skin. Distributed in it, yellow-green bile colors the integument.

The pigment bilirubin is responsible for yellowness. When its production is normal, toxic elements are excreted from the body in feces. If excess pigment remains in the organ, it leaks into the blood. With it, bilirubin spreads throughout all systems and begins to accumulate in tissues, giving them a yellow tint.

First, yellowness appears on the sclera of the eyes, then on the skin. The change in skin tone is subtle. Even an experienced doctor may miss a symptom. Yellowness is especially noticeable on dark-skinned people.

At the same time as the color of the eyes and skin changes, the urine becomes cloudy. Urine becomes dark yellow. Some bilirubin is excreted through the kidneys.

Bilirubin accumulates in excessive quantities in other diseases:

• hepatitis;
• cirrhosis of the liver;
• hematological pathologies;
• poisoning

A doctor can identify the causes of jaundice, so if you notice changes, you should contact him for advice.

Reaction to fats

Intolerance to fats entering the body is one of the common manifestations of gallstone disease in women. If the conglomerate blocks the duct of the bladder, the fluid cannot exit it. Meanwhile, the liver secretion is designed to dissolve and break down fats. In their new form, they are absorbed by tissues and absorbed.

Gallstone disease disrupts intestinal function. Diarrhea and flatulence begin. The symptoms are characteristic of many diseases, so one cannot immediately say that the problem is cholelithiasis.

Sometimes large stones are located at the bottom of the bladder and do not interfere with the release of bile. With this course of the disease, fatty foods are digested normally.

Specifics of treatment of gallstone disease in women

Therapy is based on several options:

1. Operation.
2. Reception medicines.
3. Using recipes from healers and herbalists.

The treatment method must be selected by a doctor. Folk recipes prescribed as additional to the main therapy.

Operating method

Removing the gallbladder along with the stones is considered a radical way to eliminate the problem.

Standard elective surgery– laparoscopy. The surgeon makes 3-4 incisions in the abdomen. Special medical instruments The patient's insides are illuminated. A microvideo camera is also inserted into the peritoneum. It provides an overview by displaying information on the monitor.

Patients are often interested in why an organ should be removed if instruments and a camera allow one to see the bile from the inside. Why can't you just take the stones out and leave the bubble? Experts explain that by removing stones it is impossible to eliminate the cause of their formation. Recurrence of gallstone disease is possible. Its development cannot be avoided if you continue to lead a sedentary lifestyle, overeat, and eat junk food.

What happens if you refuse surgical treatment:

• peritonitis develops;
• obstructive jaundice appears;
• pancreatitis begins.

When prescribing an operation, the doctor examines the condition of the organ, looks at the size of the stones and whether there is any crystallization of salts on their surface. Survey data influences timing surgical intervention.

Treatment with medications

It is possible to dissolve tumors without surgery. But medications destroy only small cholesterol stones without calcium content.

To dissolve conglomerates use:

1. Ursosan;
2. Henofalk.

In China, preparations based on the saxifrage plant are popular. Russian products are made mainly from animal bile and its synthetic analogues.

Stones can also be crushed. The process is called lithotripsy in medicine. More often, the method is chosen for crushing pathological formations in the kidneys. Conglomerates are destroyed remotely using ultrasonic waves.

Folk remedies

The use of prescriptions begins after an accurate diagnosis is made: neoplasms of cholesterol content. The herbalist selects a combination medicinal plants or recommends a ready-made collection. The use of natural drinks is combined with dietary nutrition.

Recipes healing compounds:

1. Lingonberry leaves are collected and dried. A tablespoon of raw material is poured with boiling water (150 ml) and left for 30 minutes. Drink the product up to 5 times a day, 2 tablespoons.
2. Green tea. It prevents stones from forming. Drink intake is unlimited.
3. Ivan tea is collected, washed and dried. Brew 2 tbsp in a half-liter thermos. spoons of dry mixture. You can drink 100 ml up to 3 times a day.

Doctors warn that the herb should not be brewed again. For each thermos or glass they take fresh composition.

Treatment of gallstone disease in women can be complicated by pregnancy. It eliminates the use of many medications, especially surgery. If symptoms of the disease appear during pregnancy, you should immediately consult a doctor. Muscle contractions during colic can cause premature birth.

Prevention of gallstone disease in women

The diagnosis can be avoided if you take care of your health, follow a diet, and monitor your weight.

The prevention system is based on:

• controlled physical exercise;
• quitting tobacco and smoking;
• exclusion of alcoholic beverages from the diet;
• body weight control;
• balanced regimen and diet.

Stagnation of bile, leading to its thickening, can be delayed by eating often, but little by little. Recommended serving weight ─ 200 grams. There should be an interval of at least 3 hours between meals.

Another method of liquefying bile is to increase fluid consumption: compotes from fresh and dry fruits, kefir, and natural juices.

Should be excluded from the diet the following vegetables:

• garlic;
• radish.

A preventive measure would be The right way cooking.

Need to:

• soar;
• cook;
• stew.

Problems of other organs and systems lead to gallstone pathology:

• diabetes;
• liver disease (chronic stage);
• pathologies of the blood system.

To the complex preventive measures against cholelithiasis and the pathologies preceding it include tinctures.

They are prepared from medicinal herbs:

An article about the symptoms of cholelithiasis, diet therapy for it and ways to prevent the formation of gallstones.

Gallstones affect one in four adult men and one in three adult woman in Europe and America. Many people have illness long time is asymptomatic, and they do not even suspect that they need any treatment.

But if the bladder becomes inflamed or the stones begin to move, the patient experiences pain and discomfort. He faces difficult questions: how to cure gallstone disease, is it possible to do this without surgery.

What are the symptoms of a gallstone?

Gallstones are diagnosed in children and adults, men and women, generally healthy or with a “bouquet” of chronic diseases. But a certain trend is still emerging:

• In most cases, gallstone disease is found in people over 40 years of age.
  At this age people suffer from the disease more women than men.
• Typically, gallstones are found in obese people.

In addition to excess weight, risk factors for stone formation are:

1. Poor nutrition. Excesses in both directions are harmful – both overeating and undernutrition.
2. Increased cholesterol levels.
3. Endocrine diseases and hormonal imbalances, including during pregnancy.
4. Diseases of the pancreas.
5. Physical inactivity.
6. Other.

IMPORTANT: Stones are compacted particles of bile that have a different composition. Typically, they include the bile pigment bilirubin, cholesterol and calcifications.

Small stones can “float” for quite a long time in a bladder filled with bile, without making themselves felt. But only until, due to the strong physical activity, during a trip in transport, after a magnificent feast, they will not move. Then:

1. Their sharp ends scratch and irritate inner surface gallbladder, causing it acute inflammation. This is a separate disease, acute cholecystitis).
2. They can move into the ducts connecting the organ to the liver, causing stagnation of bile and an acute attack of colic.
3. Inflammation from the gallbladder spreads to neighboring organs: the pancreas, stomach and intestines.

In many patients, the disease manifests itself unexpectedly, with sharp pain during an attack of biliary colic:

• Pain in the upper abdomen, usually in the right hypochondrium.
• The pain seems to spread throughout the body - radiating to the right: to the back, collarbone and arm.
• A bitter taste appears in the mouth.
• Nausea and vomiting begin.
• Pain when touching the gallbladder area.
• Yellowing of eyes and skin.

IN best case scenario, the attack ends on its own when the stone, which due to its size can pass through the ducts, enters the duodenum and is evacuated from the body with feces. Too large stones can block the bile ducts.

IMPORTANT: There are also certain signs by which one can suspect cholelithiasis even before its symptoms appear. When they appear, it is advisable to undergo examinations, and if suspicions are confirmed, appropriate treatment.

These signs are:

• heaviness under the right rib
• bitterness in the mouth
• heartburn
• belching
• occasional nausea

Types of gallstones and their diagnosis

As mentioned above, stones in the gallbladder can have different compositions.

Firstly, they can be single-component, but these are extremely rare. These are the stones:

1. Cholesterol. They are usually round and small (up to 1 cm). The reason for their appearance is poor nutrition and metabolic disorders.
2. Pigment (bilirubin). There are a lot of such pebbles small size there is a lot in the gallbladder and its ducts.
3. Calcareous (calcifications). Formed from calcium salts.

Secondly, stones can be of mixed composition, and such are found in 80% of patients. Their composition is as follows:

• cholesterol - 90%
• bilirubin – up to 5%
• calcium salts – up to 3%
• other substances

Mixed stones come in different sizes, and the larger they are, the more dangerous the disease.

IMPORTANT: Medicine knows of cases when the entire cavity of the gallbladder was occupied by one large stone weighing up to 100 g.

The shape of stones formed in the gall bladder can be:

• round
• barrel-shaped
• ovoid
• multifaceted
• other

After examination by a gastroenterologist who observes abdominal pain in the area of ​​the gallbladder, a patient with suspected stones is sent for examination:

1. Blood tests. General will show elevated white blood cells and ESR, biochemical – elevated cholesterol and bilirubin.
2. Cholicestography ( x-ray examination bile with contrast).
3. Ultrasound. This method is very effective; it can be used to determine not only the presence of stones, but their number, shape, size and composition.
4. MRI and CT. Modern and very informative methods.

How do gallstones pass out?

If the stone is of a significant size, its exit from the gallbladder is accompanied by an attack of colic.

1. The calculus, driven by bile, enters the mouth of the duct. Blockage and disruption of the flow of bile occurs.
2. Under the influence of the calculus and the pressure of the bile, the mouth of the duct is stretched, which causes severe pain to the person.
3. The stone is pushed through the ducts and enters the duodenum. The pain goes away and the person feels relief.
4. The calculus is passed out along with the feces.

Gallstones during pregnancy

In pregnant women, cholelithiasis is detected quite often. Because:

1. During this period, the woman undergoes a thorough medical examination. She had stones before, but they did not make themselves felt. Unfortunately, few young women have their bodies examined for preventive purposes, so no one suspected the disease before pregnancy.
2. Pregnancy provoked the formation of stones. The fact is that while carrying a baby in a woman’s body, increased quantities The hormone progesterone is produced, one of the functions of which is to relax smooth muscles. The outflow of bile under its influence becomes slower, due to its stagnation and stones are formed.

For a woman diagnosed with cholelithiasis during pregnancy, the doctor prescribes:

• diet therapy
• antispasmodic type
• easily choleretic agent if the stones are small

IMPORTANT: If the duct is blocked by a stone during pregnancy, laparoscopic removal of stones from the gallbladder is possible.

Is it possible not to have surgery for gallstones?

If stones are detected in the gall bladder, the doctor will immediately advise about an operation to remove them and the bladder itself. Of course, such a prospect is scary. You can try to cope without it.

IMPORTANT: The operation can be postponed only if the disease is asymptomatic, there are few gallstones, and their size is small.

If surgery cannot be avoided, cholecystectomy is most often performed using laporoscopy, which is considered the least traumatic. But sometimes classic open operations are also performed.

VIDEO: Laparoscopy: surgery to remove the gallbladder

Nutrition menu for gallstones: what is possible and what is not

Patients with cholelithiasis are prescribed therapeutic diet No. 5. Its basic principles are as follows:

1. Fast food and snacks prohibited.
2. Baking, confectionery must be limited to a minimum.
3. Soda, low alcohol and alcoholic drinks, coffee is prohibited.
4. Recommended there are warm first courses. If they are on meat broth, the meat should be lean, and the broth should be second.
5. Vegetables are also the basis of the diet. You can eat everything except raw cabbage and legumes.
6. Necessary consumption of fresh fruits and berries. These are apples, bananas, melon, strawberries, etc.
7. Sharply limited eating fried and fatty foods, in particular, of animal origin, which is a provocateur of increased cholesterol and, as a consequence, the formation of gallstones.
8. Recommended fractional and frequent food consumption, from 4 to 6 times a day. This ensures optimal movement of bile.
9. Concerning consumption food: fats need to be reduced. The norm of carbohydrates (complex) on diet No. 5 is up to 350 g, fats and proteins – up to 90 g.
10. Reduce daily norm calorie intake is not necessary. With stones in gall man should consume about 2500 kcal per day. If he has excess weight, this point is discussed with the doctor.
11. Doctors also advise introduce fiber and healthy fats in the form of bran into the diet, food additives Omega3.

VIDEO: Diet for Gallstones

Prevention of gallstones

The health of all digestive organs, and indeed the entire body, is interconnected. Therefore, preventing the formation of gallstones is general health improvement and strengthening, which includes:

• healthy eating
• gradual weight loss if necessary
• sufficient physical activity
• timely identification of health problems and their correction

VIDEO: Cholecystitis. How to prevent the formation of gallstones?

Cholelithiasis is also called cholelithiasis. Gallstones are a very unpleasant pathology of the body, expressed characteristic symptoms. However, the danger of the disease lies in the fact that at an early stage the symptoms of gallstones are mild. The reason for this is that the manifestation of the disease may be minor, or even hidden. In addition, the symptoms are extremely difficult to treat and eliminate, and in some cases it becomes necessary to resort to more drastic measures.

Signs of gallstone disease

Signs of gallstones may vary depending on the location, size and stage of the disease. Due to the fact that the appearance of stones may not be expressed by any symptoms, there is a risk of complications. Also, symptoms may differ depending on whether the inflammatory process has already begun or not. As the disease progresses, symptoms may also change.

Any violation in proper operation the body is always due to deterioration general well-being person. With stones in the gall bladder, the patient begins to feel a very acute malaise, expressed in the following symptoms:

• elevated temperature;
• severe pain syndrome;
• renal colic;
• nausea;
• fever;
• chills;
• peritonitis;
• stool discoloration;
• jaundice;
• liver enlargement;
• feeling of heaviness in the right hypochondrium;
• empyema.

Detailed description of symptoms of gallstones

A wide range of symptoms for gallstones has numerous nuances that the patient needs to know about.

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Increased negative effects and the appearance of symptoms can be caused by an incorrect lifestyle, Not proper nutrition and some external factors.

Pain syndrome

The first and most basic symptom of gallstone disease is pain. It is pain that makes it clear what is happening in the body serious violation in its normal operation.

Pain syndrome due to cholelithiasis occurs unexpectedly, at any time of the day. The gallbladder is directly adjacent to the liver, therefore, if there are stones in the organ, the main pain syndrome is localized in the area of ​​the right hypochondrium.

Painful sensations can be triggered by the food that the patient takes. Fatty, salty and fried foods have a particularly powerful negative impact. Severe pain can also occur when drinking alcoholic beverages.

It is not only the food and drinks consumed that worsens the patient’s well-being during illness (gallstones). Regular stress, nervousness, anxiety, excessive physical activity and active sports training cause severe pain in the right hypochondrium.

The pain can be stabbing, cutting, sharp, sharp or moderate. The pain syndrome can radiate to the back, neck, and shoulder blade. The most dangerous is a painful lumbago in the heart area, which can lead to angina pectoris.

Fever, fever, chills

An increase in the temperature of the human body is a sign that an inflammatory process has begun. Cholelithiasis (cholelithiasis) is characterized by an increase in temperature to medium levels, usually not higher than 37.5°. However, with excessively severe intoxication, the temperature can reach more than high level and lead to fever. Cramps and chills are an indispensable component inflammatory process with cholelithiasis accompanied by high temperature.

Empyema, peritonitis

A late detected disease can carry the risk of extremely negative signs for a person’s health and life. First of all, this is the formation and accumulation of pus, which is scientifically called empyema. It occurs due to blockage of the passages of the gallbladder with stones. Regardless of size, the calculus blocks the passage and disrupts the normal production of bile. This eventually leads to the accumulation of pus.

Blockage of the passage can also cause gallbladder fistulas and peritonitis.

Nausea and vomiting

A fairly common symptom in the presence of gallstones is nausea. And when there is an excess of bile, due to blockage of the bile ducts, vomiting occurs with a large content of bile mass.

Feeling of heaviness in the right hypochondrium, enlargement of the liver

The presence of gallstones leads to the accumulation of bile. Excess and accumulation of bile leads to a feeling of heaviness in the right hypochondrium. If treatment is started at the wrong time, the next step is an increase in the size of the liver. At this stage of the disease, severe, incessant pain is a constant companion.

Symptoms of gallstone disease in women

The symptoms of gallstone disease in women and men have some differences, since the female body structure is very different from the opposite sex.

The danger of gallstone disease is especially significant during a woman’s pregnancy. In addition to the characteristic pain in the right hypochondrium, the woman feels internal pressure peritoneal organs to the uterus. The presence of stones in the gall bladder provokes enlargement of the liver, as well as the proliferation of stones and an increase in their size, which can pose a serious danger to the fetus.

Symptoms of gallstone disease in men

In men with cholelithiasis, a violation of potency is observed. Since gallstones provoke disruption of the functioning of the entire peritoneal cavity, not only the normal outflow bile, but also urination. Impaired urination leads to problems in men's health.

It is also worth noting that men are more likely than women to suffer from cholelithiasis. Women quite often get carried away with all kinds of diets and regular cleansing of the body, and also actively monitor proper nutrition. While men bypass such hobbies.

When gallstones occur, the symptoms of the disease occur more mildly if the person previously led a relatively healthy lifestyle. The body is more protected from negative impacts, therefore it is easier to tolerate the disease that arises, with less brightness severe symptoms. Based on statistics, it is women who tolerate cholelithiasis more easily than men.

What to do if you notice symptoms

To effectively eliminate gallstone disease, it is important to detect the pathology as early as possible. The sooner measures are taken, the less harm will be detrimental to health. How do you know if there are stones in your gall bladder? The most effective way is to diagnose using a magnetic resonance imaging scanner. But since this type The examination is quite expensive; it is possible to determine that stones are in the gallbladder using ultrasound.

Treatment is based on symptoms in the presence of gallstones. Depending on what signs of the disease the patient has, as well as at what stage of the disease it was possible to determine the presence of stones, the attending physician individually establishes the treatment method.

Inflammation of the gallbladder (cholecystitis) and dissolution of stones can be treated using a number of medications. Also, treatment with patented drugs can be combined with the use of traditional methods based on the use of natural, natural ingredients.

IN in rare cases When drug treatment does not have the desired effect, surgery may be used.

The danger of not taking measures

Initially, the disease is asymptomatic, but gradually numerous symptoms appear, indicating the presence of pathology. However, many patients ignore emerging signs developing disease, mistaking them for a normal, temporary ailment. The cause of this malaise can be considered overwork, stress and other reasons.

Such a negligent attitude to symptoms can lead to the appearance and development of not only complications due to cholelithiasis, but also the appearance of a serious disorder. This disorder is called biliary cirrhosis. Biliary cirrhosis is one of the types of complications of gallbladder disease. Gallstones reach their largest sizes and begin to actively damage both the walls of the gallbladder and neighboring organs. The main cause of biliary cirrhosis is impaired outflow of bile due to blockage of the bile ducts.

Biliary cirrhosis as the most dangerous complication of cholelithiasis

Biliary cirrhosis is the most dangerous complication of gallstone disease, as it leads to fatal outcome. Life expectancy at this complication cholelithiasis – no more than 8 years.

However, by detecting the symptoms of a dangerous complication in time, you can save the patient’s life. The main symptoms of the disease include:

• Skin itching that appears periodically and cannot be treated with special ointments and creams. Itching appears spontaneously and also disappears on its own. At night itchy skin begins to be as active as possible. Based on the comments of patients regarding this fact, most of them claim that itching is especially disturbing at night.
• Darkening skin. Initially, only certain areas of the body darken (the area of ​​the shoulder blades, the depth of the cell, the main large joints). Gradually, the patient’s entire body turns dirty brown.
• Small flat growths gradually begin to appear on the patient’s body. They appear first near the eyes. Over time, such neoplasms appear on various parts body, including on the palms. Neoplasms are benign and do not pose a threat of developing a malignant form. They only serve as symptoms of the development of complications of gallstone disease.
• The next stage is a significant enlargement of the spleen. This pathology can only be discovered through ultrasound examination or by magnetic resonance imaging.
• The patient is unable to detect the appearance of a new symptom on his own; he only feels a significant deterioration in his general health.
• A slight increase in the patient's body temperature, usually slightly above 37°.
• A feeling of bitterness in the mouth indicates that bile has entered the patient’s body.
• The patient feels constant severe pain in the right hypochondrium, as well as pain and aches in the muscles.
• The patient loses his appetite. The longer the disease poisons the human body, the less the patient feels the feeling of hunger. As a result, this can lead to a complete loss of interest in food for the patient. The body is subject to exhaustion and loss of body weight. Total loss loss of appetite leads to a new disease - anorexia.
• As the disease progresses, the condition of the patient's skin deteriorates significantly. The skin becomes rough and loose. Appears varicose veins veins in the legs.
• The extreme degree of neglect of the disease is internal bleeding.

To avoid exposing your body to this dangerous complication, it is important to carefully consider the treatment of gallstone disease.

If you detect even one symptom from the above list, it is recommended to immediately seek advice from an experienced doctor. Early diagnosis can help prevent dangerous consequences for human life. Disease is easier to provide than to cure.

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The gallbladder is an organ that stores bile produced by the liver. The latter is necessary for digesting food. If necessary, it is released into the duodenum. Bile is a complex substance containing a large number of bilirubin and cholesterol.

Gallstones are formed due to stagnation of bile, during which cholesterol is retained in the bladder and precipitates. This process is called the process of formation of “sand” - microscopic stones. If the “sand” is not eliminated, the stones adhere to each other, forming stones. Stones in the gall ducts and in the gallbladder itself take a long time to form. This takes 5-20 years.

Gallstones may not manifest themselves for a long time, but it is still not recommended to start the disease: the stone can injure the wall of the gallbladder and the inflammation will spread to neighboring organs (patients often also suffer from gastritis, ulcers, pancreatitis). We will look at what to do if gallstones occur and how to treat this problem without surgery in this article.

How are gallstones formed?

The gallbladder is a small sac that holds 50-80 ml of bile, a fluid that the body needs to digest fats and maintain normal microflora. If bile stagnates, its components begin to precipitate and crystallize. This is how stones are formed, which increase in size and quantity over the years.

Moreover, one of the most common causes of illness are considered:

1. Severe inflammation in the gallbladder.
2. The contractility of the gallbladder decreases, which causes stagnation of bile.
3. When bile contains large amounts of calcium, cholesterol, bile pigment, it is water-insoluble bilirubin.
4. Most often, in women, the disease is provoked by obesity, a large number of births, and the use of hormones - estrogens.
5. Heredity. The formation of gallstones is caused by a genetic factor. If parents suffered from an illness, their child also has a risk of developing pathology.
6. Drug treatment – ​​Cyclosporine, Clofibrate, Octreotide.
7. Diet. Fasting or long intervals between meals can cause gallstones. Limiting your fluid intake is not recommended.
8. Gallstones can occur due to, hemolytic anemia, due to Caroli syndrome, .
9. As a consequence of an operation during which they remove bottom part intestines.
10. Alcohol. Abuse of it provokes stagnation in the bladder. Bilirubin crystallizes and stones appear.

As is known, bile consists of various components, therefore the stones may differ in composition. Highlight following types stones:

1. Cholesterol - have a round shape and a small diameter (approximately 16-18 mm);
2. Calcareous – contain a lot of calcium and are quite rare;
3. Mixed - characterized by a layered structure, in some cases consisting of a pigmented center and a cholesterol shell.

In addition, bilirubin stones, which are small in size and localized both in the bag and in the ducts, can form in the gallbladder. However, most often the stones are mixed. On average, their sizes range from 0.1 mm to 5 cm.

Symptoms of gallstones

The clinical picture of symptoms when gallstones appear is quite varied. Symptoms depend on the composition, quantity and location of stones. Most patients with single large stones located directly in the gallbladder are often not even aware of their disease. This condition is called the hidden (latent) form of cholelithiasis.

As for specific signs, then gallstones make themselves felt with such symptoms:

• (projection of the liver and biliary tract) – intensity from mild discomfort to hepatic colic;
• dyspeptic syndrome - manifestations of digestive disorders - nausea, unstable stool;
• an increase in body temperature is a consequence of the addition of a secondary bacterial infection.
• if the stone descends along the bile duct, then the pain is localized in the groin and radiates to the femoral part.

In 70% of people, this disease does not cause any discomfort at all; a person begins to feel discomfort only when the stones have already grown and blocked the bile duct and the typical manifestation is biliary colic, this is an attack acute pain with periodic blockage of the bile duct by a stone. This attack of acute pain, that is, colic, can last from 10 minutes to 5 hours

Diagnostics

Diagnosis is carried out by a gastroenterologist. The diagnosis is established using the patient's complaints and some additional studies.

First, the patient undergoes an ultrasound of the abdominal organs. – the main and most effective method diagnosis of cholelithiasis. Detects the presence of stones in the gallbladder, thickening of the walls of the gallbladder, its deformation, and dilation of the bile ducts. Its main advantages are non-invasiveness (non-traumatic), safety, accessibility and the possibility of repeated use.

If the situation is more serious, then doctors resort to cholecystocholangiography (x-ray examination with the introduction of a contrast agent).

Consequences

The course of gallstone disease can be complicated by the following conditions:

• phlegmon of the gallbladder wall;
• biliary fistulas;
• Mirizzi syndrome (compression of the common bile duct);
• gallbladder perforation;
• biliary pancreatitis;
• spicy and ;
• hydrocele of the gallbladder;
• intestinal obstruction;
• gallbladder cancer;
• acute purulent inflammation(empyema) and gangrene of the gallbladder.

In general, the presence of a stone in the bladder is not dangerous as long as it does not block the bile duct. Small stones usually pass on their own, and if their size is comparable to the diameter of the duct (about 0.5 cm), then pain occurs with passage - colic. The grain of sand “slipped” further into small intestine- the pain disappears. If the pebble is so large that it gets stuck, then this situation requires immediate medical intervention.

Gallstones: treatment without surgery

Detection of gallstones does not always imply mandatory surgical intervention; in most cases, treatment without surgery is indicated. But uncontrolled self-medication at home is fraught with blockage of the bile ducts and an emergency end to the operating table of the surgeon on duty.

Therefore, it is better not to drink questionable cocktails from strictly prohibited choleretic herbs and vegetable oil, which are recommended by some traditional healers, and make an appointment with a gastroenterologist.

For conservative treatment of cholelithiasis The following medications are prescribed:

1. Drugs that help normalize the composition of bile (ursofalk, lyobil);
2. Enzyme preparations that improve digestive processes, in particular the processes of lipid digestion (Creon).
3. For pain caused by contraction of the gallbladder, patients are recommended to use various muscle relaxants (plataphylline, drotaverine, no-spa, metacin, pirencipin).
4. Stimulators of bile acid secretion (phenobarbital, zixorine).

Modern conservative treatment, which allows preserving the organ and its ducts, includes three main methods: dissolving stones with drugs, crushing stones using ultrasound or laser, and percutaneous cholelitholysis (invasive method).

Dissolution of stones (litholytic therapy)

Dissolving gallstones with medicines helps cure gallstones without surgery. The main drugs used to dissolve gallstones are ursodeoxycholic acid (Ursosan) and chenodeoxycholic acid (Chenofalk).

Litholytic therapy indicated in the following cases:

1. The stones are small in size (from 5 to 15 mm) and fill no more than 1/2 of the gallbladder.
2. The contractile function of the gallbladder is normal, the patency of the bile ducts is good.
3. The stones are of cholesterol nature. Chemical composition stones can be identified using duodenal intubation (duodenum) or oral cholecystography.

Ursosan and Henofalk reduce the level of substances in bile that contribute to the formation of stones (cholesterol) and increase the level of substances that dissolve stones ( bile acids). Litholytic therapy is effective only in the presence of small cholesterol stones, early stages diseases. The dose and duration of medication is determined by the doctor based on ultrasound data.

Stone crushing (extracorporeal lithotripsy)

Extracorporeal shock wave lithotripsy (pulverization) is a technique based on the generation shock wave, leading to the crushing of the stone into many grains of sand. Currently this procedure used as preparatory stage before oral litholytic therapy.

Contraindications are:

1. Bleeding disorders;
2. Chronic inflammatory diseases of the gastrointestinal tract (cholecystitis, pancreatitis, ulcers).

TO side effects Ultrasound lithotripsy includes:

1. Risk of bile duct blockage;
2. Damage to the walls of the gallbladder by stone fragments as a result of vibration.

The indication for ESWL is the absence of patency obstruction. biliary tract, single and multiple cholesterol stones with a diameter of no more than 3 cm.

Percutaneous transhepatic cholelitholysis

Rarely used because it refers to invasive methods. A catheter is inserted into the gallbladder through the skin and liver tissue, through which 5-10 ml of the mixture is injected dropwise special drugs. The procedure must be repeated; in 3-4 weeks, up to 90% of the stones can be dissolved.

You can dissolve not only cholesterol, but also other types gallstones. The number and size of stones do not matter. Unlike the previous two, this method can be used not only in individuals with asymptomatic cholelithiasis, but also in patients with severe clinical manifestations diseases.

Surgery to remove gallstones

However, it is worth understanding that without surgical treatment can't be avoided with:

• frequent biliary colic;
• “disabled” (lost contractility) bladder;
• large stones;
• frequent exacerbations of cholecystitis;
• complications.

In most cases, surgery to remove stones from the gallbladder is recommended for patients whose disease is accompanied by frequent relapses, attacks of severe pain, large stones, high body temperature, and various complications.

Surgical treatment can be laparoscopic and open (cholecystolithotomy, cholecystectomy, papillosphincterotomy, cholecystostomy). Option surgical intervention determined for each patient individually.

Nutrition

Usually, a diet is prescribed as soon as the first signs of gallstones appear. It is specially designed for such patients, it is called therapeutic diet No. 5, and you must adhere to it constantly.

• fat meat;
• various smoked meats;
• margarine;
• spicy seasonings;
• hard-boiled eggs;
• strong coffee;
• canned meat and fish;
• pickled products;
• broths: meat, fish and mushroom;
• fresh bread and yeast baked goods;
• carbonated drinks;
• alcohol.

Food is prepared by boiling or baking, and you need to eat it often - 5-6 times a day. The diet for gallstones should contain a maximum of vegetables and vegetable oils. Vegetables, due to vegetable protein, stimulate the breakdown of excess cholesterol, and vegetable oils improve intestinal motility, promote contraction of the bladder, and thereby prevent the accumulation of bile in it.