Help the development of the site, sharing the article with friends!

You may suspect that stones have formed in your gallbladder if you have frequent liver aches, nausea, bloating. When gall bladder ailments are rare and not severe, you can use antispasmodics and anti-inflammatory agents. However, if the pains recur and persist for a long time, consult a doctor.

The gallbladder, popularly known asgall bladder , stores the bile we need to digest fat. During digestive processes, it is transported through the bile ducts from the sac to the duodenum. During this journey, cholesterol and bile s alt crystals can precipitate and clump together. They are sometimes the size of a grain of sand, but also of a walnut. These aregallstones .

Ailments that indicate gall bladder stones

Stones often irritate the mucosa of the pouch, disrupting its work. Weight, a feeling of fullness or crushing in the area of ​​the right hypochondrium are some of the signs that our pouch is defective. Such ailments are usually the result of a dietary error - it is enough to eat something fatty or hard to digest, or simply eat too much.

Sometimes stones don't cause any discomfort. They can be detected by chance, e.g. during an ultrasound of the abdominal cavity. However, when the stone blocks the flow of bile from the gall bladder into the bile ducts, acute vesiculitis occurs. Then we have very severe pains (colic) on the right side of the abdomen, which often radiate towards the right shoulder blade or back. Usually, spikes are accompanied by nausea or vomiting, flatulence. Sometimes there is a fever.

As a result of blockage of the pouch, more and more inflammatory tissue fluid accumulates in it. The bubble grows larger and is hard. As the bile pigments are systematically absorbed into the blood, a watery fluid eventually remains in the pouch. This condition is referred to by specialists as gallbladder hydrocele. If the contents (contents) of the vesicle become infected, an empyema forms in it.

Important

Who is at risk of urolithiasis

Bile deposits (the so-called stones) are much more common in women than in men. Every fifth 40-year-old has them, but they also happen in 20-year-olds. People who are genetically prone to urolithiasis, i.e. those who arewhose parents or grandparents suffered from this condition. In addition, they happen more often to obese people, but also to fasting or drastic slimming diets. Gallstones is also a problem for women who have given birth or take hormonal contraceptives (high levels of estrogen in the blood promote the formation of stones).

When a medical consultation is needed

If the gallbladder ailments occur sporadically and are not severe, you can use antispasmodics (e.g. Nospa) as well as choleretic and anti-inflammatory drugs with silymarin (e.g. Sylimarol, Legalon, Liverin) or herbal preparations with similar action (e.g. Raphacholin C, Terpichol, Cholegran).

If the pain recurs or the crushing in the liver area persists for a long time, consult a doctor. Jaundice also requires a quick visit to a specialist (it is a sign of serious liver disorders). However, if a colic attack lasts more than three hours, you must call an ambulance immediately. Persistent acute vesiculitis can lead to serious complications, such as inflammation of the pancreas or peritoneum.

Stones in the gallbladder - what kind of research

Based on the classic symptoms - a characteristic pain and an enlarged bag that gives an elastic resistance to pressure - the doctor makes an initial diagnosis. But decisive for diagnosis is radiological and biochemical blood analysis.

  • Ultrasound of the abdominal cavity. During this examination, the doctor assesses the size of the gallbladder, the thickness of its walls, the location and size of the stones, and the patency of the bile ducts. In most cases, even the smallest deposits can be detected. The image may be unreadable if you are obese or if there is a large amount of gas in your gut.
  • Computed tomography. It is done when the doctor has doubts about the location of the stones or, for example, suspects a tumor of the pouch. Neoplastic changes are not visible on ultrasound.
  • Liver tests. This is what is said about testing the level of liver enzymes in the blood. Important for confirming the diagnosis is the level of alkaline phosphatase (the norm is 38-126 IU / L) and bilirubin (0.2-1.3 mg%). Elevated values ​​are evidence of illness. The standards may slightly differ from each other - they depend, among others, on from equipment and reagents used for analysis.

Excision of the gallbladder - when necessary

To get rid of stones permanently, you need to excise the gallbladder. The removal of plaque itself has a short-term effect, because after some time new ones will form.

Operationis performed immediately in the case of hydrocele and empyema of the sac. Acute inflammation, on the other hand, is first tried to be healed with strong intravenous antispasmodics, analgesics and anti-inflammatory drugs. Only after the inflammation has subsided, surgery is proposed - most often it involves removing the pouch.

Gallstone in the Duct

Sometimes stones get from the bladder into the bile ducts and block them (they rarely form in them first). If the doctor suspects that there is a stone in the tract, he or she orders endoscopic ascending cholangiopancreatography (ERCP). The examination consists in introducing an endoscope (optical fiber) through the mouth to the place where the bile ducts enter the duodenum and - after administering a contrast - observing the bile duct on the screen. If the suspicions are confirmed, the coagulator (electric surgical knife) is introduced in the same way, with which the bile duct sphincter is cut. As a result, its mouth rapidly widens and the stone, under the influence of bile pressure, falls into the duodenum and is then excreted in the faeces. Sometimes the stone is so big that it doesn't want to "pop out" by itself. Then it is removed using the so-called Dormia basket.

Treatments are performed under general anesthesia. They bring relief immediately. However, this does not solve the problem as there is still a risk that further stones may block the bile ducts. When the symptoms of inflammation disappear (usually one week after the procedure), the follicle with the deposits remaining in it is removed. The operation is also performed when there are no deposits in it, because the bubble that once produced the stones will sooner or later produce new stones.

Diet after gallbladder surgery

Before the body adjusts to the fact that bile flows directly from the liver into the duodenum, you must be on a liver diet for 4-6 weeks after the surgery (see below). Then you can gradually expand the menu, observing how the body behaves. Most people go back to their normal diet after the removal of the follicle. As a result of the direct flow of bile from the liver to the duodenum, biliary gastritis sometimes develops. Some of the symptoms are heartburn, bitter belching, and diarrhea. If symptoms persist, it is better to consult a doctor. He will then prescribe medications to alleviate the inflammation of the mucosa, neutralize hydrochloric acid and accelerate the emptying of bile from the stomach.

You must do it

Principles of a liver diet

  • Less fat (65-90 g) and more carbohydrates per day (345 g). Eat lean ham, poultry cold cuts, white meat in jelly, stock soupsvegetables, lean dairy and lean fish (cod, pike, tuna, pollock, hake).
  • Give up egg yolks, coarse-grained products, fresh bread, chocolate, hot spices, mayonnaise, strong coffee and carbonated drinks.
  • Eat only steamed, stewed or foil-baked food, no sauces.
  • Choose apples and pears (peel them from the skin), bananas, citrus fruits, strawberries, raspberries, blackberries, melons, kiwi, peaches, apricots. Avoid plums, gooseberries, currants, avocados, nuts, and almonds. Cook compotes because they are best absorbed by the body.
  • Don't eat raw onions, cabbage, peas, beans, soybeans. Season the salads with wine vinegar or lemon juice. Stewed or steamed vegetables are best for you.
  • Eat more often, but in small amounts - preferably 5 meals a day.

6 Ways To Get Rid Of Gallstones

Depending on the severity of the disease and the general he alth of the patient, the doctor chooses the method of removing deposits from the gallbladder. Often the entire follicle needs to be removed.

  • Laparoscopic . In this way, the follicles are removed "easier" when the doctor does not expect any complications or complications from the operation. This method is not used in the case of acute pouchitis or in very obese people, because the carcass could prevent the tools from reaching the diseased follicle. Adhesions after operations may also be an obstacle. The doctor warns the patient that if it becomes necessary during the operation, he can change to the traditional method. Through four small cuts in the skin on the abdomen, tools are inserted into the abdomen, e.g. laparoscope through which the doctor observes the course of the operation on the screen. The artery and the vesicular duct are closed with clips made of titanium (a metal inert to the body); they are not ligated as in traditional surgery. The gallbladder is then excised and removed. If the blister wall is very thin and there is a risk of rupture, a condom is inserted into the abdomen, the bladder is inserted into it and the bladder is pulled out. On the day of surgery, you can get out of bed, the next day you can drink. On the second day, dietary food is served and you can leave the hospital. When the week is over, the stitches are removed, and after two weeks - you go back to work.
  • Traditional . In acute disease states and when laparoscopy could cause complications, the surgeon makes an incision under the right costal arch to get to the follicle. After the operation, he puts sutures on the wound, which are removed after 7 days. Illstays in the hospital only a day longer than in the case of laparoscopy, but heals longer (approx. 4 weeks). Until the postoperative wound is completely healed, the convalescent experiences a nagging pain in the abdomen that prevents him from functioning normally. He relies more, breathes shallower (worse ventilation promotes pneumonia). To prevent this from happening, you have to walk and do breathing exercises every day.
  • Minimal operation . In exceptional situations, when the patient is in a very serious condition and there is a fear that he may not survive general anesthesia (anesthesia), the procedure is performed under local anesthesia. After incision of the abdominal cavity and the bottom of the gallbladder, the surgeon sucks out the deposits, the so-called a mammal, or he takes them out with forceps, without removing the bubble itself.
  • Endoscopic . If a stone is stuck in the bile duct, an endoscope is inserted through the patient's mouth under general anesthesia. With the endoscope, you can either push the stone through or remove it.
  • Dissolving . Supporters of alternative medicine propose to dissolve stones using oral preparations (they can be purchased in some herbal and he alth food stores). During such treatment, you need to take medications every day and perform a check-up ultrasound every 1-2 months. The stones dissolve slowly (about 1 mm per month), so treatment may take up to two years. It is possible to dissolve only cholesterol deposits, without calcification, with a diameter of no more than 10-15 mm, but also not in all of them. Unfortunately, even if the treatment is successful, there is no guarantee that new stones will not form.
  • Crushing stonei. Lithotripsy is a procedure that involves crushing stones using an ultrasonic wave. This wave is produced by a special device and directed at the gallbladder and the deposits in it. The procedure takes several dozen minutes and is painless. Unfortunately, it can cause serious complications. A piece of a pebble can get stuck in the bile duct, clog it and cause painful colic, mechanical jaundice, and even pancreatitis. For this reason, surgeons are against lithotripsy.

To cut out the gallbladder or not to cut it out?

There is still some confusion about what to do when a bubble full of plaque does not cause any discomfort. The prevailing view is not to operate. There is no medical evidence that chronic gallstones lead to bladder cancer. However, such a hypothesis can be drawn on the basis of statistical data. Therefore, in order to prevent the possible development of such a dangerous disease, surgeons sometimes suggest removalbubble.

"Zdrowie" monthly

Help the development of the site, sharing the article with friends!

Category:

Gastrology