Can gallbladder cause constipation: Side Effects of Gallstones and Gallbladder Removal
Side Effects of Gallstones and Gallbladder Removal
Q1. Do gallstones cause constipation and bloating? I take a laxative every day for relief, and I’m reluctantly considering gallbladder removal.
— Terrie, Maryland
The most common symptom of gallstones is biliary colic, a crampy abdominal pain that often occurs right after meals, particularly fatty meals. The bloating you mention is very common during these attacks, which usually last anywhere from a few minutes to an hour.
Gallstones can also cause cholecystitis, or inflammation of the gallbladder, when one of the gallstones blocks the flow of bile from the gallbladder. Symptoms can include fever, abdominal pain, and jaundice (yellowing of the eyes and skin). Less commonly, gallstones can cause inflammation of the pancreas or cholangitis, the latter a very serious bacterial infection of the biliary tree. Constipation can occur, though rarely, as a complication of gallstones, most commonly because of pancreatitis or gallstone ileus, a pretty rare event in which a large gallstone passes from the gallbladder into the intestine and blocks the flow of digested food from the small intestine into the colon (large intestine).
Q2. Now that I’ve started menopause, I’m dealing with an increasing number of gallstones that leave me with nausea and indigestion. Will this stop once I’m postmenopausal, or should I have my gallbladder removed?
— Rae, West Virginia
Unfortunately, your gallstones — and the suffering they cause — aren’t likely to go away in the future. In fact, they’ll probably worsen. Developing gallstones (or cholecystitis) is a very common problem for people in their fifties, especially postmenopausal women. Once gallstones begin causing symptoms that disrupt quality of life, such as the nausea and indigestion you describe, it becomes pretty clear that it’s time to have your gallbladder removed.
If you’re looking for nonsurgical options, most will probably fall short. Some people do find that they’re able to lessen their symptoms by making lifestyle changes, such as losing a modest amount of weight and avoiding fried or fatty foods. If you haven’t tried making these changes yet, by all means do so. But know that they’re rarely successful in the long term; at best, they only delay the need for gallbladder surgery. This is because most people aren’t vigilant enough to make these changes stick, and others don’t get adequate relief. In fact, even when diet and lifestyle changes do work, and a patient puts his or her symptoms on pause, most doctors will still recommend having the gallbladder removed.
In my opinion, while all patients are different, there’s little to be gained from waiting to undergo gallbladder surgery. The risks of not having your gallbladder removed can include rupture, gallbladder infection, and sepsis (a general blood infection). While such problems are relatively uncommon and usually not life threatening, they add to the argument that the benefits of having your gallbladder surgically removed outweigh the risks.
Compared with the surgeries of decades past, which required a week in the hospital and a long period of healing, newer, less-invasive laparoscopic procedures require small incisions, have a very low risk of complications, and allow most patients to go home the next day. Some patients are even able to return home in as little as eight hours after surgery. If you’re interested in this option, ask your doctor if you’re a candidate for laparoscopic cholecystectomy, which is the technical name for this surgery.
Q3. I am 52 years old and I have multiple gallbladder stones. I’ve read about a remedy for gallstones where you drink apple juice for five days and then take a lot of lemon juice with olive oil. Do you think this really works?
— Ashok, New Delhi
There is no proof that a regimen of apple juice, lemon juice, and olive oil can dissolve gallstones. Some people who have tried this so-called gallstone cure have reported passing stones in their stool, but what they are actually seeing are the remnants of the oil and juice.
There are basically two types of gallstones, pigmented — which occur mostly in patients with chronic hemolytic anemias, a group of conditions where red blood cells are destroyed prematurely in the bloodstream — and cholesterol stones, which are the most common. Although some cholesterol stones can be dissolved by taking a prescription medication called ursodeoxycholic acid (Actigall), this only works for small stones that have no calcium deposits. Most stones, unfortunately, contain calcium and may not dissolve even with long-term treatment. Bottom line: Surgery is still the best way to get rid of gallstones.
Learn more in the Everyday Health Gallbladder Center.
Gallstones – Complications – NHS
A small number of people with gallstones may develop serious problems if the gallstones cause a severe blockage or move into another part of the digestive system.
Inflammation of the gallbladder (acute cholecystitis)
If a bile duct becomes permanently blocked, it can lead to a build-up of bile inside the gallbladder. This can cause the gallbladder to become infected and inflamed.
The medical term for inflammation of the gallbladder is acute cholecystitis.
- pain in your upper abdomen that travels towards your shoulder blade (unlike biliary colic, the pain usually lasts longer than 5 hours)
- a high temperature (fever) of 38C or above
- a rapid heartbeat
An estimated 1 in 7 people with acute cholecystitis also experience jaundice.
Acute cholecystitis is usually first treated with antibiotics to settle the infection and then keyhole surgery to remove the gallbladder.
The operation can be more difficult when performed as an emergency, and there’s a higher risk of it being converted to open surgery.
Sometimes a severe infection can lead to a gallbladder abscess (empyema of the gallbladder). Antibiotics alone don’t always treat these and they may need to be drained.
Occasionally, a severely inflamed gallbladder can tear, leading to inflammation of the inside lining of the abdomen (peritonitis).
If this happens, you may need antibiotics given directly into a vein (intravenous antibiotics), and surgery may be required to remove a section of the lining if part of it becomes severely damaged.
Read more about acute cholecystitis.
You can get jaundice if a gallstone passes out of the gallbladder into the bile duct and blocks the flow of bile.
Symptoms of jaundice include:
- yellowing of the skin and eyes
- dark brown urine
- pale stools
Sometimes the stone passes from the bile duct on its own. If it doesn’t, the stone needs to be removed.
Find out more about treating gallstones
Infection of the bile ducts (acute cholangitis)
If the bile ducts become blocked, they’re vulnerable to infection by bacteria. The medical term for a bile duct infection is acute cholangitis.
Symptoms of acute cholangitis include:
- pain in your upper abdomen that travels towards your shoulder blade
- a high temperature
- itchy skin
- generally feeling unwell
Antibiotics will help treat the infection, but it’s also important to help the bile from the liver to drain with an endoscopic retrograde cholangio-pancreatography (ERCP).
Find out more about treating gallstones
Acute pancreatitis may develop when a gallstone moves out of the gallbladder and blocks the opening (duct) of the pancreas, causing it to become inflamed.
The most common symptom of acute pancreatitis is a sudden severe dull pain in the centre of your upper abdomen, around the top of your stomach.
The pain of acute pancreatitis often gets steadily worse until it reaches a constant ache.
The ache may travel from your abdomen and along your back, and may feel worse after eating.
Leaning forward or curling into a ball may help relieve the pain.
Other symptoms of acute pancreatitis can include:
- feeling sick
- being sick
- loss of appetite
- a high temperature
- tenderness of the abdomen
- less commonly, jaundice
There’s currently no cure for acute pancreatitis, so treatment focuses on supporting the body’s functions until the inflammation has passed.
This usually involves admission to hospital so you can be given:
- fluids into a vein (intravenous fluids)
- pain relief
- nutritional support
- oxygen through tubes into your nose
With treatment, most people with acute pancreatitis improve within a week and are well enough to leave hospital after 5 to 10 days.
Read more about acute pancreatitis.
Cancer of the gallbladder
Gallbladder cancer is a rare but serious complication of gallstones. Around 980 cases of gallbladder cancer are diagnosed in the UK each year.
Having a history of gallstones increases your risk of developing gallbladder cancer. About 4 out of 5 people who have cancer of the gallbladder also have a history of gallstones.
But people with a history of gallstones have a less than 1 in 10,000 chance of developing gallbladder cancer.
If you have additional risk factors, such as a family history of gallbladder cancer or high levels of calcium inside your gallbladder, it may be recommended that your gallbladder be removed as a precaution, even if your gallstones aren’t causing any symptoms.
The symptoms of gallbladder cancer are similar to those of complicated gallstone disease, including:
- abdominal pain
- a high temperature
Gallbladder cancer can be treated with a combination of surgery, chemotherapy and radiotherapy.
Gallstone ileus is another rare but serious complication of gallstones. It’s where the bowel becomes obstructed by a gallstone.
Gallstone ileus can occur when an abnormal channel, known as a fistula, opens up near the gallbladder. Gallstones are able to travel through the fistula and can block the bowel.
Symptoms of gallstone ileus include:
- abdominal pain
- being sick
- swelling of the abdomen
A bowel obstruction requires immediate medical treatment. If it’s not treated, there’s a risk that the bowel could split open (rupture). This could cause internal bleeding and widespread infection.
Contact your GP as soon as possible if you think you have an obstructed bowel. If this isn’t possible, phone NHS 111.
Surgery is usually needed to remove the gallstone and unblock the bowel. The type of surgery you have will depend on where the obstruction in the bowel is.
Page last reviewed: 10 October 2018
Next review due: 10 October 2021
Cholecystitis (Gall Bladder Infection): Symptoms, Causes, Treatment
What Is Cholecystitis?
Cholecystitis is a swelling and irritation of your gallbladder, a small organ in the right side of your belly near your liver.
The gallbladder’s job is to hold a digestive juice called bile. It releases bile into your small intestine when your body needs it to break down fats. But if the path to your small intestine is blocked, bile gets trapped. That backup can irritate your gallbladder. That’s how cholecystitis happens.
Nausea and vomiting are common symptoms. They often show up after you’ve eaten a big or especially fatty meal.
It’s easy to mistake cholecystitis for other health problems, but another telltale sign is intense pain — in your belly, in your back, or under your right shoulder blade.
If you don’t see a doctor and get treatment, it can lead to dangerous infections or become a long-term condition. The most common solution is surgery to remove your gallbladder.
Cholecystitis can mimic other health problems, so you’ll need to see a doctor for a diagnosis.
You might feel a sharp, sudden pain in the upper right side of your belly. You may also feel pain in your back or below your right shoulder blade. Deep breaths may make it worse. Some other symptoms to watch out for include:
Symptoms may get worse after a high-fat meal. If you can’t get comfortable or sit still because your pain is so strong, head to an emergency room.
The usual reason bile backs up is that gallstones — lumps of bile turned solid — block the way to the small intestine. Gallstones are common. About 10% to 20% of Americans have them. About half of people with gallstones will get cholecystitis.
But gallstones aren’t the only problem that can cause this condition. Others include:
- Gallbladder sludge, a thick liquid, builds up in the organ. This can happen if you’re pregnant or if you’ve lost a lot of weight quickly.
- Tumors block bile’s path. A growth in your pancreas or liver can stop it from draining.
- Your gallbladder doesn’t have a good blood supply. People with diabetes can have this problem.
- An infection affects your gallbladder. Bacteria can damage the system that drains bile, causing it to back up.
Cholecystitis can come on suddenly. You may hear a doctor or nurse call it an “acute” case. Or it can be a long-term problem. Those cases are called “chronic.”
Cholecystitis Risk Factors
You have a higher chance of getting cholecystitis if you:
- Are a woman older than 50
- Are a man older than 60
- Are overweight
- Have diabetes
- Are pregnant
Or if you have:
You also run a bigger chance of getting it if your diet is high in fat and cholesterol or your ancestry is Native American, Hispanic, or Scandinavian.
The doctor will examine you, ask a few questions about your symptoms, and probably order some tests. You should be ready to:
- Detail when your symptoms started. Have you felt this way before?
- Describe how severe your pain is.
- Talk about whether anything makes your pain better or worse.
Your doctor can tell from blood tests whether you have an infection and whether your liver is working the way it should. They may also want you to have some imaging tests. These may include:
- X-ray of your belly, which will show your internal organs, bones, and tissues
- Ultrasound, which will show your gallbladder and liver and let doctors check blood flow
- CT scan, which gives doctors a more detailed look at organs, muscles, and bones than an X-ray can
- HIDA scan, which checks how your gallbladder moves and shows if bile is blocked. You get a shot of a chemical, and then a scanner traces it as it moves through your body.
- PTC, which uses a dye injected into your liver to show how bile is moving through your body
- ERCP, which uses a long, flexible tube threaded down your throat, through your stomach, and into your small intestine. It has a light and camera at the end. This test also uses a dye to check how bile is flowing through your system.
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If you have cholecystitis, especially an acute case, you may have to spend some time in the hospital.
You will have to keep your stomach empty so your gallbladder can rest. You’ll probably get fluids through a tube put into a vein. You may get pain medicine and, if doctors are concerned about infection, an antibiotic. Once treatment begins, you should start to feel better.
If gallstones caused your problem, doctors may try medications to dissolve them and give you a prescription drug to keep them from forming again. A very low-fat diet may also keep them from coming back.
What if I Need Surgery?
By far the most common treatment is to take out the gallbladder.
Your doctor may decide to do the surgery right away, unless you’re too sick. If you need to wait, doctors can ease symptoms by putting a tube through your skin straight into the gallbladder and draining some bile.
Surgery to remove your gallbladder, called a cholecystectomy, usually takes about an hour and is considered low-risk.
You’ll get general anesthesia, so you won’t be awake or feel any pain during the procedure. The doctor will make a small cut in your bellybutton to take a look inside with a special instrument. They’ll then take out the gallbladder through another small cut.
You can live a healthy life without your gallbladder.
You can take steps to lower your chances of getting gallstone and cholecystitis. They include:
- Lower your cholesterol.
- Exercise regularly.
- Eat a diet rich in fruits, vegetables, and healthy fats. Eggs, soybeans, and peanuts are great choices.
Obesity is a major risk factor for getting gallstones. Losing weight can reduce your chances, but be sure you do it in a healthy way. If you’re planning a rapid weight loss program, such as weight loss surgery, your doctor or nurse should monitor you. They may recommend bile acid pills to prevent gallstones as you lose weight.
If you don’t get treatment, your gallbladder can become infected, and some of the tissue may die. Infection can also spread to other parts of your body, including your pancreas (pancreatitis) and the lining of your belly (peritonitis).
If the tubes that carry bile are damaged too much, cholecystitis can harm your liver, too. You could have repeated bouts of painful symptoms. Eventually, your gallbladder will shrink and not work as well. The condition would become a long-term, or chronic, problem.
How to Handle Simultaneous IBS and Gallbladder Problems
Irritable bowel syndrome (IBS) can be associated with gallstones. Although IBS is primarily a disorder of the large intestine, you can also experience other problems affecting your digestive system when you have IBS.
Peter Dazeley / Getty Images
Your gallbladder is a small, sac-like organ located on the right side of your upper abdomen, tucked under your liver. The gallbladder’s main job is to store bile, a substance that helps digest the foods we eat. Bile is produced by the liver and then stored in the gallbladder. When we eat foods that have fat in them, the gallbladder secretes bile into the small intestine where the bile breaks down fat, allowing it to be absorbed into our bloodstream.
Although some gallbladder problems, including gallstones, may develop without any noticeable signs, the following symptoms may be indicative of gallbladder disease:
- Bloating after meals, particular meals with a high-fat content
- Chronic diarrhea
- Nausea after meals
- Pain in the middle or right side of your abdomen
You might experience biliary colic, also described as a gallbladder attack. Such an attack may occur within a few hours of eating a large or fatty meal. You may experience pain in your upper right abdomen, and this pain may radiate to the upper back, between your shoulder blades, under your right shoulder, or behind your breastbone. Some gallbladder attacks result in nausea and vomiting. Usually, these attacks only last for an hour or so. Such an attack should be reported to your doctor, even if symptoms subside.
If you experience the following symptoms, seek immediate medical attention:
- Clay-colored stools
- Fever and chills alongside nausea and vomiting
- Signs of jaundice
- Severe and persistent pain in your upper right abdomen
When you get medical attention for your digestive symptoms, your doctor will do a physical examination and recommend blood tests.
Further testing may include:
- An ultrasound that can identify the location and size of gallstones
- A computerized tomography (CT) scan that may indicate the presence of gallstones, as well as show any inflammation or injury to the gallbladder and the bile ducts
- A cholescintigraphy (HIDA scan) that involves the injection of a radioactive substance to help evaluate how your gallbladder is functioning and to assess for the presence of gallbladder infection or blockage in the bile ducts
- An endoscopic retrograde cholangiopancreatography (ERCP), which is an interventional procedure used to identify and remove stones from the bile duct
The most common treatment for gallbladder problems is cholecystectomy, which is surgical removal of the gallbladder. The procedure is most often done laparoscopically, with very small incisions.
IBS and Gallbladder Problems
Unlike some other health problems, there does not seem to be any evidence that people who have IBS are more likely to suffer from gallbladder disease than those who don’t have IBS.
One interesting avenue of research explores whether impaired gallbladder motility may contribute to IBS symptoms. Studies on the subject are few and have yielded very mixed results. For example, one study found no difference in rates of gallbladder contractions between IBS patients and healthy control subjects.
Another study found higher rates than would be expected in patients who suffer from constipation-predominant IBS (IBS-C) and lower rates than would be expected in those who suffer from diarrhea-predominant IBS (IBS-D). An additional study found no difference between IBS patients and healthy controls in terms of gallbladder contraction rates two hours after eating but found a significant difference three hours after eating.
At present, the clinical research about the interrelationship between IBS and gallbladder problems remains inconclusive.
Is It IBS or Gallbladder?
Because IBS is a functional disorder, many people with IBS lack full confidence in their diagnosis, ad wonder whether other digestive disorders may be present. Because some people with IBS experience nausea and because abdominal pain can radiate, it’s reasonable to wonder whether you may also have gallbladder problems.
The best place to address your concerns is by having a conversation with your doctor, who can explore your symptoms and order appropriate diagnostic tests.
Problems, removal, diet, and treatment
Most people do not pay much attention to their gallbladder until it starts causing trouble. However, when there is a problem, it can be quite painful and require immediate action.
The gallbladder is a 4-inch-long, pear-shaped organ found under the liver in the upper right region of the abdomen. It stores bile, a compound produced by the liver to digest fat, and helps the body absorb fat-soluble vitamins and nutrients.
In a healthy gallbladder, this process happens painlessly. However, when blockage occurs in the gallbladder, or it stops functioning correctly, considerable pain and discomfort can occur.
In this article, we look at the function of the gallbladder, some common gallbladder problems and their symptoms, treatment options, and the long-term outlook.
Share on PinterestThe gallbladder is found just below the liver. Its job is to store bile used to digest fat.
Some common gallbladder problems include:
Gallstones, or cholelithiasis
Gallstones are solid masses of cholesterol or pigment that can be different sizes.
They occur when high levels of fat and bile cause crystals to form. These crystals may combine over time and expand into stones.
Stones can be as small as a grain of sand or as large as a golf ball and may or may not cause symptoms.
Common bile duct stones, or choledocholithiasis
Small tubes transport bile from the gallbladder and deposit it in the common bile duct. From there, it is moved to the small intestine. Sometimes, gallstones can lodge or form in the common bile duct.
Most often, these stones begin their life in the gallbladder and migrate to the common bile duct. This is a secondary stone or a secondary common bile duct stone.
If the stone forms within the duct itself, it is a primary stone, or primary common bile duct stone. These are less common but are more likely to cause an infection than secondary stones.
Gallbladder cancer is very rare, affecting less than 4,000 Americans per year; but if it does occur, it can spread to other parts of the body.
Risk factors include gallstones, porcelain gallbladder (described below), female gender, obesity, and older age.
Inflamed gallbladder, cholecystitis
Acute or sudden cholecystitis occurs when bile can’t leave the gallbladder. This commonly happens when a gallstone obstructs the tube that bile uses to travel into and out of the gallbladder.
Chronic cholecystitis occurs if there are recurrent acute attacks.
When the bile duct is blocked, bile builds up. The excess bile irritates the gallbladder, leading to swelling and infection. Over time, the gallbladder is damaged, and it can no longer function fully.
If gallstones are left untreated, they can lead to a perforated gallbladder – in other words, a hole in the wall of the organ can develop. Perforation also occurs as a complication of acute cholecystitis.
This breach in the gallbladder’s wall can allow leakage of infection into other parts of the body causing a severe, widespread infection.
Common bile duct infection
If the common bile duct becomes blocked, it can lead to an infection. This can be treated if it is caught early; however, if it is missed, it can spread and develop into a severe, life-threatening infection.
Dysfunctional gallbladder or chronic gallbladder disease
Repeated episodes of gallstone attacks or cholecystitis may damage the gallbladder permanently. This can lead to a rigid, scarred gallbladder.
In this case, symptoms can be hard to pinpoint. They include abdominal fullness, indigestion, and increased gas and diarrhea.
Gallstone ileus is rare but can be fatal. It occurs when a gallstone migrates to the intestine and blocks it. Often, emergency surgery is needed to clear the blockage.
Sometimes, a patient with gallstones will also develop pus in the gallbladder; this is called empyema. The condition can produce severe pain in the abdomen. It can be life-threatening if it is not treated.
Individuals with diabetes, reduced immune system, and obesity have an increased risk of developing this complication.
Porcelain (calcified) gallbladder
Porcelain gallbladder is a condition where, over time, the muscular walls of the gallbladder develop a buildup of calcium. This makes them stiff, limiting the gallbladder’s function and increasing the risk of gallbladder cancer.
The word “porcelain” is used because the organ becomes bluish and brittle.
Polyps are a type of growth that is typically benign (noncancerous). Smaller gallbladder polyps often do not cause any problems and rarely produce any symptoms. Larger polyps may need to be removed.
Symptoms of gallbladder problems include:
- Pain in the mid- or upper-right section of the abdomen: Most of the time, gallbladder pain comes and goes. However, pain from gallbladder problems ranges from mild and irregular to very severe, frequent pain. Gallbladder pain often causes pain in the chest and back.
- Nausea or vomiting: Any gallbladder problem may cause nausea or vomiting. Long-term gallbladder diseases and disorders may lead to long-standing digestive problems that cause frequent nausea.
- Fever or shaking chill: This signals an infection in the body. Alongside other gallbladder symptoms, fever and chills may point to a gallbladder problem or infection.
- Changes in bowel movements: Gallbladder problems often cause changes in bowel habits. Frequent, unexplained diarrhea can signal a chronic gallbladder disease. Light-colored or chalky stools may point to a problem with the bile ducts.
- Changes in urine: Patients suffering from gallbladder issues may notice darker than normal urine. Dark urine may indicate a bile duct block.
- Jaundice Yellowing of the skin occurs when liver bile does not successfully reach the intestines. This normally happens due to a problem with the liver or due to a blockage in the bile ducts caused by gallstones.
When to see a doctor
Anyone with gallbladder symptoms should seek medical attention. Mild, intermittent pain that goes away on its own does not need immediate attention. However, patients with this type of pain should make an appointment with their doctor to be examined further.
If the symptoms are more severe and include the following, a patient should be seen immediately:
- upper-right quadrant pain that does not go away within 5 hours
- fever, nausea, or vomiting
- changes in bowel movement and urination
This combination of symptoms can indicate a serious infection or inflammation that needs immediate treatment.
Doctors previously thought that a low-fat diet could assist with treating gallstones or at least preventing their growth.
However, new evidence has debunked this approach, suggesting that losing too much weight too rapidly might even lead to gallstones becoming larger rather than shrinking.
A balanced diet that includes a variety of foods will not cure gallstones, but it can preserve overall health and health keep any pain caused by gallstones under control.
The National Institute of Diabetes and Digestive and Kidney Diseases recommends:
- eating high-fiber foods, such as beans, peas, fruits, whole grains, and vegetables
- reducing carbohydrate and sugar intake
- consuming fats that are good for you, for example, the fats found in fish oil and olive oil
If a doctor suspects a patient has a gallbladder problem, they will likely order the following:
- Imaging tests of the gallbladder: Ultrasound and CT scans are commonly used to image the gallbladder. These will then be checked for gallstones.
- Tests to examine bile ducts: These tests use dye to show if a gallstone is causing a blockage in the bile ducts. Tests to check the bile ducts for stones include MRI, hepatobiliary iminodiacetic acid (HIDA) scans, and an endoscopic retrograde cholangiopancreatography (ERCP).
- Blood tests: Doctors can use blood tests to reveal signs of infection, inflammation of the bile ducts, pancreatitis, or other complications caused by gallstones.
Gallstones and cholecystitis are treatable conditions.
Gallstones that do not cause symptoms will not need immediate treatment other than an alert for potential future gallbladder problems.
However, gallstones that cause symptoms or infections of the gallbladder do need treatment.
Treatment options include surgically removing the gallbladder, medications to break up gallstones, and antibiotics to treat infections.
Share on PinterestMost gallbladder removals are carried out using a laparoscope – a thin tube with a tiny camera attached.
According to the University of California San Francisco (UCSF), gallbladder removal surgery is one of the most commonly performed surgeries.
Laparoscopic gallbladder removal (keyhole surgery) is most common. In this procedure, a surgeon inserts a thin tube with a tiny video camera attached into a small incision in the abdomen. The camera transmits images from inside the body to a video monitor.
While watching the enlarged images on the monitor, the surgeon carefully removes the gallbladder through one of the small incisions.
Most gallbladder removals occur this way. These surgeries are often outpatient procedures, meaning that the patient can often go home the same day.
A much smaller number of gallbladder patients need open surgery. During open surgery, a surgeon removes the gallbladder through a 4-6-inch-long incision in the abdomen.
These surgeries often happen when the gallbladder is too inflamed or infected to remove laparoscopically or if a problem occurs during a laparoscopic procedure. This is not an outpatient procedure and may require a hospital stay of up to 1 week afterward.
If a person is too ill to tolerate surgery, gallbladder drainage with a tube is possible. The doctor inserts a tube through the skin directly into the gallbladder.
While the outright prevention of gallbladder problems is not possible, people can take steps to decrease the risks of developing gallstones or other infections.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) state that the following people have an increased risk of gallstones:
- people over 40
- people with a family history of gallstones
- native and Mexican Americans
- individuals with obesity
If a person falls into a category that increases the risk of gallstones, they should avoid the following to reduce their risk:
- rapid weight loss
- diets high in calories but low in fiber
- excess weight gain
Gallbladder problems are generally easy to resolve.
Long-term complications are unlikely after removing the gallbladder or treating the infection. Those without a gallbladder can lead a normal, healthy life after recovery.
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Diagnosing Digestive Problems After Gallbladder Surgery
You followed the pre-op instructions to a T. The procedure went swimmingly. And while the pain has disappeared with your gallbladder, now you’re dealing with some less than ideal side effects.
We’ve gathered a list of the potential side effects that you may experience following a laparoscopic or open gallbladder removal procedure, as well as steps for treating these unfortunate side effects.
Let’s check it out.
Temporary/Chronic Diarrhea: Patients can sometimes experience temporary diarrhea following a gallbladder removal surgery because the gallbladder is no longer there to regulate the flow of bile, which can result in a smaller, more constant flow of bile into your small intestine. While each person adapts differently to surgery and it may take a variable amount of time for different people, you should not be suffering from distressing symptoms, especially due to postcholecystectomy diarrhea. If your symptoms persist for more than a few days, please contact your gastroenterologist. Chronic diarrhea can be managed with a low-fat diet as well as medication for binding excess acids in the digestive system. It is amazing (and sad) to see how many patients come years after their gallbladder surgery, having been troubled by chronic diarrhea for years, only to be fixed easily by a gastroenterologist.
Constipation: Post-surgery pain medication immediately after surgery—especially if they are opioid—may cause constipation. By consuming a diet high in fiber, you can prevent/relieve constipation. Sometimes you need other laxatives to be prescribed as well. It is best to rectify the problem ASAP, before it causes fecal impaction and abdominal pain, etc.
Retained stone: If stones traveled from your gallbladder prior to its removal, they can still cause pain, fever, nausea, vomiting, bloating, and jaundice. You may need an additional procedure to remove gallstones that are retained in your common bile duct.
If you have persistent symptoms after surgery, you need evaluation to decide if the cause of pain is something else. Retained stones in the bile duct or even new stones that may develop after surgery cause symptoms and abnormal labs that help in the right diagnosis if evaluated appropriately.
Intestinal injury: Instruments used in surgery could damage your intestines—resulting in abdominal pain, nausea, vomiting, and fever. It’s vital to seek immediate medical attention if you experiencing any of these symptoms.
If you are experiencing these or any other symptoms that you believe may be linked to your gallbladder removal, please contact a gastroenterologist immediately. The digestive specialists at GI Alliance are here to guide you on your path to digestive health.
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Gallbladder Disease | Johns Hopkins Medicine
What is gallbladder disease?
Gallbladder disease includes inflammation, infection, stones or blockage of the gallbladder. The gallbladder is a sac located under the liver. It stores and concentrates bile produced in the liver. Bile aids in the digestion of fat and is released from the gallbladder into the upper small intestine in response to food (especially fats). Types of gallbladder disease include:
- Cholecystitis (inflammation of the gallbladder)
- Chronic acalculous gallbladder disease (in which the natural movements needed to empty the gallbladder do not work well)
- Gangrene or abscesses
- Growths of tissue in the gallbladder
- Congenital defects of the gallbladder
- Sclerosing cholangitis
- Tumors of the gallbladder and bile ducts
The mildest and most common symptom of gallbladder disease is intermittent pain called biliary colic. Typically, a patient experiences a steady gripping or gnawing pain in the upper right abdomen near the rib cage, which can be severe and can radiate to the upper back. Some patients with biliary colic experience the pain behind the breastbone. Nausea or vomiting may occur.
Between 1 percent and 3 percent of people with symptomatic gallstones develop inflammation in the gallbladder (acute cholecystitis), which occurs when stones or sludge block the duct. The symptoms are similar to those of biliary colic but are more persistent and severe. They include pain in the upper right abdomen that is severe and constant and may last for days. Pain frequently increases when drawing a breath. About a third of patients have fever and chills. Nausea and vomiting may occur.
Chronic gallbladder disease involves gallstones and mild inflammation. In such cases, the gallbladder may become scarred and stiff. Symptoms of chronic gallbladder disease include complaints of gas, nausea and abdominal discomfort after meals and chronic diarrhea.
Stones lodged in the common bile duct can cause symptoms that are similar to those produced by stones that lodge in the gallbladder, but they may also cause:
- Dark urine, lighter stools or both
- Rapid heartbeat and abrupt blood pressure drop
- Fever, chills, nausea and vomiting, with severe pain in the upper right abdomen
- Blood tests
- Ultrasound and other imaging techniques
Surgery may be warranted to remove the gallbladder if the patient has gallstones or the gallbladder is not functioning normally. Most of the time this can be performed laparoscopically (through small incisions) as an outpatient procedure.
90,000 Causes of constipation: bile deficiency
Constipation becomes a delicate problem for many people, due to which the digestion process is disturbed.
Almost all people have encountered such a problem as constipation at least once in their life, but for some adults this delicate nuisance becomes a frequent companion.There are many reasons for the formation of constipation – these are nutritional problems and a lack of fiber in the diet, violation of the drinking regime and dehydration, diseases of the digestive system and nervous disorders, leading to spasm or atony of the intestinal wall. Often, the causes of constipation are pathologies of the gallbladder, leading to a deficiency of bile in the intestine, and it has a peristalsis-stimulating effect. Is it possible to solve the problem through dietary changes, are there laxative dishes, desserts or drinks?
What is constipation: how to define it?
The term constipation is understood as a violation of defecation due to the formation of excessively dense feces, which are difficult to separate.In this case, the frequency of stool may not be violated, or the process of emptying becomes rare and painful, often only with the participation of certain drugs or enemas. Constipation affects children and adults, with age, due to a lack of active physical activity, the problem becomes more common. Intestinal motility slows down, less stress on the abdominal press, food is not so varied and is rich in fresh vegetables and fruits. More information about constipation can be found on the website – https://medaboutme.ru/zdorove/spravochnik/slovar-medicinskih-terminov/zapor/.It is important not to run the problem and fix stool problems as soon as they occur.
The role of bile and gallbladder problems in provoking constipation
Often, with stagnation of bile and problems with the work of the gallbladder, persistent and persistent constipation is formed. This is due to the effect of bile on digestion and intestinal motility. Bile contains many active bile acids, which have an irritating and stimulating effect on mucous membranes. Regular bile secretion in response to nutritional stimuli with a healthy gallbladder aids in fat absorption and bowel movements.Pathologies of the gallbladder – bend, stones or cholecystitis, can form digestive disorders. More information about the problems of the gallbladder can be found in the article – https://medaboutme.ru/zdorove/spravochnik/slovar-medicinskih-terminov/zhelchnyy_puzyr/. Inflammatory, stagnant processes lead to cholecystitis, including calculous, with the formation of stones in the lumen. It is important to solve the problem of constipation and stimulate the work of the gallbladder, not only through drugs and various medicinal effects.A significant role in the prevention of pathologies and their treatment is played by medical nutrition, specially selected dishes and products that help to normalize the tone of the intestine and its regular emptying.
Weak foods, desserts, drinks
Many foods are known for their laxative properties due to their fiber and coarse fiber content. Adequate intake of these foods – grains, vegetables, fruits, and their combinations – can help regulate bowel movements and bowel movements.Usually, dishes and desserts with these products are used – you can find out more about possible desserts on the website – https://medaboutme.ru/obraz-zhizni/publikacii/stati/desert/. You can cook them fresh or boiled, infusions and drinks with laxative effects, use fruits in the form of salads and mashed potatoes, slices or in combination with ice cream, cream, fermented milk drinks. Plums and prunes, dried apricots, peaches, cucumbers and tomatoes are perfect for relaxing. It is important to consume them fresh and in a volume of at least 300 grams in order to have a significant effect.Infusion of prunes can be used for constipation as a means to relax and replenish fluid reserves.
90,000 When to run to the gastroenterologist ?! – Euromed clinic
– Elena Evgenievna, with what complaints do patients most often address?
– Most common: abdominal pain and heartburn.
There are many causes of abdominal pain: from functional disorders associated with stress to serious illness.
Often worried about pain in the right hypochondrium due to dysfunction of the biliary tract, a feeling of discomfort in the epigastric region due to gastritis. In spring and autumn, peptic ulcer disease is often exacerbated.
The situation can worsen against the background of stress and inaccuracies in nutrition. Moreover, as a rule, these two factors are interrelated: a stressful state for many is a trigger for eating disorders: someone’s appetite increases or, conversely, disappears, and a person eats irregularly or overeats, reduces control over the quality of food, etc.e. All this inevitably leads to problems with the gastrointestinal tract.
Heartburn is not a separate disease, but a symptom: a burning sensation behind the breastbone. In fact, this is a chemical burn with the acidic contents of the stomach when it is thrown into the esophagus, where the environment is more often alkaline. This leads to damage to the esophageal mucosa with hydrochloric acid and, which breaks down proteins, the enzyme pepsin. Sometimes with reflux disease there is no heartburn, but there is a feeling of a lump in the throat, difficulty swallowing, chest pain, which are confused with angina pectoris.All this significantly reduces the patient’s quality of life. It is possible and necessary to treat this disease. Frequent reflux of acid from the stomach into the esophagus, especially with an admixture of bile from the duodenum, can even lead to oncological diseases of the esophagus.
Treatment is usually long, since the situation has been developing for years, and it will not be possible to change it instantly. In addition to medication, changes in lifestyle and dietary habits are required. With the help of drugs, we can reduce the amount of acidic products produced, which will lead to the fact that less of it will be thrown into the esophagus, respectively, less heartburn is manifested.There are also a number of drugs that adsorb acid and remove it. These are quick action tools. They help get rid of heartburn for 30-40 minutes. Usually these drugs are actively promoted in advertising and they will be offered by the pharmacist in the pharmacy. The patient, however, must, of course, be guided by the doctor’s recommendations
Food for reflux disease should be in small portions so that the volume eaten does not exceed the volume of the stomach, and for better control of appetite – frequent: 4-5 times a day.Food must be thoroughly chewed to crush it as much as possible and release more saliva, which, having an alkaline reaction, neutralizes the acid.
For reflux disease, boiled, baked, stewed vegetables, liquid cereals, pasta, lean meats, poultry, seafood, eggs, cottage cheese, stale bread and crackers, jelly, mousses, jelly, mashed soups, dairy products are recommended.
Increase acid formation in the stomach and therefore are not recommended: smoked meats, fatty, spicy, salty, mushrooms, raw vegetables, sour fruits and juices, carbonated drinks, black bread, buns, fast food, strong tea and coffee
– Leads to heartburn nutritional error or is its appearance due to genetics?
Genetically determined by the feature of the sphincters between the esophagus and the stomach. A fairly common problem is connective tissue dysplasia, that is, its increased elasticity, resulting in flat feet, varicose veins, “unstable vertebrae”, weakness of many sphincters, including the gastroesophageal and esophageal opening of the diaphragm. That is, they do not close tightly enough, and food easily enters the stomach from the esophagus.
The number of parietal cells in the stomach is also genetically determined, which determines the quantity and quality of hydrochloric acid produced by them.
Heartburn in pregnant women
Pregnant women often complain of heartburn. This is due to two main points. Firstly, in the process of the growth of the baby and the enlargement of the uterus, intra-abdominal pressure increases, the load on the stomach and intestines increases, which can provoke the reflux of acid and bile into the esophagus. By the way, this often leads to constipation in pregnant women. Secondly, pregnant women have a special hormonal background aimed at reducing the tone of the uterus and, at the same time, the esophageal sphincters relax, as a result of which acid reflux can occur.
If you have such problems, do not have to endure and wait that “after childbirth it will pass by itself” … Immediately contact a gastroenterologist. The doctor will select the treatment: there are drugs that are approved for use during pregnancy. You will also discuss with your gastroenterologist how to change your diet and lifestyle in order to get rid of this problem.
Ideally, contact a gastroenterologist at the stage of pregnancy planning – this way you can avoid many problems with the gastrointestinal tract that arise during this period in a woman’s life.
– One of the most common diagnoses is gastritis. What is the reason and how is it treated?
– Gastritis is an inflammation of the stomach lining. This diagnosis is, indeed, very often made, and often – without proper reason. This diagnosis is made morphologically, that is, after the morphologist describes the existing inflammatory changes as a result of a biopsy of the gastric mucosa. Then it’s gastritis. Only on the basis of complaints can a competent doctor write in the diagnosis only “functional dyspepsia syndrome”.
Complaints with gastritis are quite diverse: it can be pain, a feeling of a full stomach even with a small amount of food eaten, belching, vomiting, etc. individually.
Probably everyone has heard the opinion: “if you eat dry food, you will get gastritis.” In fact, it is not! The food should just be without additional liquid, it does not need to be washed down with water, tea, coffee, etc.The liquid dilutes the acidic contents in the stomach and impairs the quality of food digestion. But there is really no need to eat “on the run” – the most important thing for a good digestion process is to chew food thoroughly! A large amount of saliva released when chewing is necessary for the assimilation of food.
What provokes gastritis? Stress, systematic violation of the diet, violation of the frequency of nutrition, abuse of semi-finished products, concentrates, spices, sour, spicy, peppery, salty, smoked, fried, too hot, too cold or otherwise thermally, chemically or mechanically irritating food, carbonated drinks, coffee , alcohol, smoking; lack of thorough chewing of food.
In addition, gastritis is often caused by the bacterium Helicobacter pylori. This bacterium needs acid-free conditions to exist, for this it “envelops” itself with a cloud of urease – an enzyme that creates an alkaline environment. All this damages the mucous membrane up to its atrophy, and can also lead to the development of gastric and duodenal ulcers, significantly increasing the risk of developing stomach cancer. 95% of stomach ulcers and 85% of duodenal ulcers worldwide are associated with Helicobacter pylori infection.Other causes of damage to the mucous membrane of the stomach and duodenum is the frequent use of non-steroidal anti-inflammatory drugs.
In the treatment of gastritis and peptic ulcer, drugs are used that reduce the acid production of the gastric mucosa, improve its healing, and if Helicobacter pylori is detected, a course of antibiotic therapy is used. The patient must be prescribed a gentle diet.
All these measures are prescribed only by a doctor. Self-medication can be not only ineffective, but also harmful to the patient.
– Is stress also one of the reasons for the development of irritable bowel syndrome (IBS)?
– Yes, the classic triad for making this diagnosis: stress, pain, stool disorder (diarrhea, constipation or their alternation). The very name of the disease contains its essence: the intestine is irritated, the sensitivity is increased.
The peculiarity of this disease is that the patient has no visible damage to the intestinal mucosa. No examinations can establish what actually happens to the human body, and the disease is clearly manifested.
The mechanism of the onset of symptoms is associated with the peculiarities of the intestine. The intestine has its own nervous system, which is part of the autonomic nervous system. In stressful situations, malfunctions of the entire nervous system of the body begin, the brain gives the wrong signals to the intestines, and the intestine incorrectly informs the brain about the processes taking place in it. As a result, intestinal motility is impaired, the threshold of pain sensitivity decreases, and even minor discomfort causes severe bouts of pain.
In addition to stress and a low pain threshold, the risk of developing IBS is increased by eating disorders, a sedentary lifestyle, hormonal disruptions (for example, in pregnant women), and a genetic predisposition. IBS can also develop after some infectious bowel disease.
The main difficulty in IBS is that the symptoms are very unpleasant, and the correction must be carried out, first of all, of the psychoemotional state, which is quite difficult without the help of a competent psychologist. At the same time, there is still a problem that often patients do not even admit to themselves that they need psychological help.
When making this diagnosis, it is very important to show an oncological condition. However, in our time it is always important, even in young patients, but especially in older people. IBS more often appears in young people, so if similar symptoms are observed in mature patients, first of all, the doctor should exclude cancer.
– For antibiotic therapy, doctors often advise taking probiotics or prebiotics. Is it really necessary?
– Antibiotics affect the intestinal flora, this is undeniable.Often, against the background of antibiotic therapy, the patient develops dysbiosis (“dysbiosis”), that is, a qualitative and / or quantitative change in the ratio of microorganisms that live in the intestine. Dysbiosis is manifested by a violation of the stool, flatulence (excessive gas formation), the presence of inflammation on the mucous membrane. As a prophylaxis for the development of this unpleasant condition, it is recommended to take pro- and prebiotics.
Probiotics are medicines or biologically active food supplements that contain live microorganisms that are representatives of the normal human microflora.They are designed to restore the disturbed balance of microorganisms inhabiting various mucous membranes of a person, and therefore are used for the treatment and prevention of immunodeficiency, dysbiosis and related diseases. Probiotics stimulate the immune system at all levels, as proven by numerous clinical studies.
Prebiotics are food ingredients that are not digested by human enzymes or absorbed in the upper gastrointestinal tract. They stimulate the growth and vital activity of beneficial microflora: by breaking down to fatty acids, they increase acidity in the colon, inhibiting the growth of opportunistic microflora, which also creates favorable conditions for the development of normal microflora.
Prebiotics are found in dairy products, cornflakes, cereals, bread, onions, chicory, garlic, beans, peas, artichokes, asparagus, bananas, and many other foods. They also exist in the form of dietary supplements.
It is believed that probiotics in tablet and liquid forms are less effective, since they cannot always pass through the highly acidic environment of the stomach, which is aggressive to bacteria, bile. And only capsules are designed to dissolve in the colon – where bacteria should live.
Not so long ago, symbiotics also appeared on the market – combination preparations that combine pre- and probiotics. Today they are considered to have the most advanced mechanism of action.
I recommend choosing drugs that normalize the microflora together with a doctor – because it is quite difficult for a non-specialist to understand the whole variety of existing means, and it is unlikely that it will be possible for a non-specialist to understand what is suitable in each specific case.
– Why are constipation dangerous?
– Constipation is a condition characterized not only by a decrease in the frequency of bowel movements: less than 3 times a week, but also by the appearance of dense, dry feces or the absence of a feeling of complete emptying of the bowel or emptying of the bowel with tension or the use of additional techniques for bowel emptying by patients.
Long-term constipation causes:
chronic intoxication (poisoning), which leads to sleep disturbance, unmotivated fatigue, increased fatigue and, finally, to depression, deterioration of the skin and hair;
the formation of intestinal diverticula (wall protrusions), which can cause abdominal pain, and when an infection joins, inflammation of the intestinal mucosa (diverticulitis) and the need for intensive antibiotic therapy or surgical treatment if intestinal obstruction occurs;
varicose hemorrhoidal veins, chronic anal fissures;
It is necessary to start solving the problem of constipation not with self-medication, but with a visit to a gastroenterologist. There are many reasons for constipation. These can be very serious diseases. Only a competent specialist can understand this. Solving constipation on your own can make your condition much worse.
– Can a delicate problem like flatulence be treated?
– Flatulence (increased gas production) is associated with fermentation. There can be many reasons: insufficient bile secretion, insufficiently concentrated bile, disturbances in the secretion of pancreatic juice – as a rule, problems with the sphincter of Oddi.All this leads to a change in the intestinal bacterial flora. As a result, flatulence develops. This is a common problem, but it can be solved. Although I will not say that it is always simple and fast. The main thing is to find the root cause, since flatulence can be a symptom of various diseases.
– Sometimes a person suffers from bad breath or bad taste in the mouth. Is this a symptom of some kind of disease?
– Halitosis – bad breath – can occur for various reasons.First of all, I would recommend going to the dentist and checking the condition of the teeth and oral cavity. ENT diseases are in second place. If everything is in order in these areas, then, indeed, halitosis can be a consequence of digestive problems.
As for the taste in the mouth, it can be a symptom of certain diseases. But here everything is very individual: the taste can be sweet, bitter, sour, metallic, etc. It can be constant or appear only after eating or, conversely, on an empty stomach, etc.Therefore, we must look and look for the reason.
– Often, patients who have performed an ultrasound of the abdominal organs find out that they have a kinked gallbladder – how serious is it?
– Deformities of the gallbladder – kinks, membranes, etc. increase the risk of bile stagnation. The gallbladder should normally be emptied almost completely after every meal. Because this gallbladder has to work harder to contract, some patients may experience pain.After its contraction, part of the bile can remain behind the bend and “stagnate”, which can lead to the formation of stones. For patients with deformity of the gallbladder, I recommend monitoring their condition: see a doctor, do an ultrasound of the abdominal organs once a year to see the state of the bile and gallbladder. If an ultrasound diagnostic doctor notes that bile is “viscous”, “heterogeneous”, “inhomogeneous”, etc., it is important to immediately consult a gastroenterologist and undergo a course of therapy to prevent the formation of stones.It is especially important to take the prevention of gallstones seriously if any of your close relatives have these problems.
– What methods of preventing gastrointestinal diseases can be used? Maybe you need to take medications or do tyubazhi?
– No prophylactic drugs should be used without a doctor’s prescription. All medications have side effects and are not recommended to be taken without indications.
To carry out a tubazh (a procedure that is the intake of choleretic agents for the simultaneous emptying of the gallbladder), certain indications and contraindications are also required.More often the doctor prescribes this procedure in combination with other therapeutic measures, selects drugs, etc.
The best prevention of gastrointestinal diseases is proper nutrition: in small portions, with thorough chewing of food until gruel. You need to take food at least 4-5 times a day, be sure to have breakfast within an hour after a night’s sleep. The volume of water drunk per day must be at least 1.5 liters.
Try to minimize the amount of food that provokes the development of diseases.We have already listed them above: fast food, pickles, smoked meats, fried, spicy, etc. Add physical activity: A sedentary lifestyle has been proven to contribute to gastrointestinal problems, while abdominal exercise, brisk walking, and yoga are beneficial for bowel function.
Organize your lifestyle so that you stay healthy for a long time – and you will protect your body from many unpleasant problems.
Biliary dyskinesia, constipation, dysbiosis – causes of the disease, methods, prevention
Osteopathic methods solve problems associated with diseases of internal organs , for example, the liver and biliary tract.For example, if there are restrictions on the diaphragm on one side and the outflow of bile from the gallbladder is impaired, then biliary dyskinesia will develop. In this case, the osteopath will relax all the ligaments of the liver and increase its mobility. As a result, the liver will be able to perform compression-expansion movements without hindrance in order to collect and purify blood, and, accordingly, there will be no need to give the child choleretic drugs.
Regular bowel function is the basis of your baby’s well-being and mood.All parents are well aware of this, which is why they closely monitor the child’s digestion.
And yet they do not always manage to prevent constipation: according to statistics, every fourth baby faces this problem.
Constipation can have a variety of reasons: malnutrition, teething, complementary feeding, a change in the usual environment, violation of the daily routine, and many others. What to do if this problem affects your baby?
- When faced with the problem of constipation in a child, it is imperative to consult a doctor to clarify the diagnosis.
- It is necessary to change the baby’s diet so that it contains more foods that enhance the motor function of the intestines. Depending on age, it can be various vegetables and fruits (especially melons, carrots), bran bread, sour milk drinks.
- It is important to follow the drinking regimen and give your child drinks that can help prevent constipation, such as juices or a decoction of prunes.
- It is not recommended to include in the diet foods that delay bowel movement: broths, pureed soups, gruel, jelly, strong tea and astringent fruits (pears, quince, pomegranates).
- It is necessary to regularly massage the tummy, stroking it in a circular motion clockwise, and then from the lateral surfaces to the navel. When the baby grows up a little, you need to do everything so that he moves as much as possible.
Constipation is not only about not having a bowel movement for a long time or lengthening the usual intervals between bowel movements. We can talk about constipation, even if the baby walks “in a big way” every day, but at the same time strains too much or his stool is changed (“sheep” feces or very large fragments of feces).
Constipation can be caused by taking medications, for example, it often occurs with antibiotic treatment. Stool frequency in healthy children – normal options:
- 0-6 months – 2-6 times a day;
- 6-12 months – 5-28 times a week;
- 4 years and older – 3-14 times a week.
90 160 1-4 years – 4-21 times a week;
Biliary dyskinesia (BAD) is a functional disease (disruption) of the gastrointestinal tract, impaired outflow of bile into the duodenum.Diseases in which it is not possible to detect genetic, morphological, metabolic and other changes in organs are referred to as functional diseases. The biliary tract includes the ducts, duodenum, and sphincters.
Biliary dyskinesia is one of the most developed diseases among children. This disease manifests itself in a disturbed outflow of bile and its inconsistent flow into the intestines. This disrupts the work of the digestive tract, as well as affects the general condition of the body.Bile is a multicomponent biochemical that provides many functional processes. These combes include: emulsification of fats, participation in the hydrolysis of fats, neutralization of pepsin and hydrochloric acid, activation of pancreatic and intestinal enzymes, increased absorption of vitamins K, E, A, D, fixation of enzymes on the villi, antibacterial action, support of intestinal tone, together with bile excretes toxic drugs, xenobiotic metabolites.
If dyskinesia has a hypertensive form, then the symptoms are as follows: loose stools, vomiting, nausea often appear.A yellow coating is visible on the tongue. Children lose their appetite, they can hardly tolerate physical activity, they get tired very quickly. Often there is a headache, general weakness, after eating sweets or after excitement in the intestines, a burning sensation is felt. With a mixed form of dyskinesia, there are constipation, bitterness is felt in the mouth. Edema appears on the body and face, appetite decreases, heaviness and tingling are felt in the right hypochondrium. If you reduce the level of food consumption, then there will be an increase in body weight, belching with the smell of a rotten egg.The hypotonic form of dyskinesia is very rare in childhood. It is manifested by a decrease in the activity of the muscles of the gallbladder, as well as the duodenum. Children with this disease have almost no appetite, body weight is greatly reduced, weakness is felt under the right rib, since the gallbladder is distended. In infants, the gallbladder can be felt through the abdomen as muscle tone decreases. The gallbladder is larger than usual. Babies may have problems with stool, babies may be lethargic and do not gain weight well.They are very excited, they often move their legs to the tummy in order to somehow reduce pain. If children are older, they may report a symptom such as bitterness in the mouth.
If children have dyskinesia, then the following happens in the body:
- Stones may occur;
- Food cannot be properly digested;
- Metabolism is disturbed;
- Bile stagnates in the gallbladder;
- Symptoms of a digestive system disorder occur.
A type of biliary dyskinesia
Dyskinetic disorders in children are of two types: hypokinetic and hyperkinotic. With the hyperkinetic type of dyskinesia, bile is excreted very often and quickly. The process is accompanied by spasmodic sensations of the sphincters at the end of the bile ducts. Hypokinetic dyskinesia is characterized by a relaxed state of the sphincters. Bile is secreted slowly and stagnates in the gallbladder.Both in the first and in the second case, appropriate treatment will be required.
One of the most accessible and reliable methods for diagnosing the state of the ways of excretion of bile is ultrasound. Ultrasound diagnostics are performed on an empty stomach. If there are no deviations, then the gallbladder should be round, pear-shaped or oval. Normally, its wall thickness is no more than four mm. The structure of the wall must be uniform, and the bile lumen must be echo-negative.The size of the bladder does not depend on age; it can be of different sizes for each person. It happens that in a baby it can be 7 cm, and in a teenager – 4 cm.The following dimensions of the gallbladder are acceptable: length – 4-7 cm, width – 1.2-2.4 cm.
One should not forget about the fact that the size of the bladder, recorded on ultrasound, does not correspond to the real anatomical dimensions. So, on the basis of only ultrasound studies, establish a diagnosis of DVP. A functional study should be performed.Dyskinesia can also be diagnosed using duodenal intubation. This method consists in laboratory testing of bile within half an hour after receiving it. This is necessary for biochemical research (the level of cholesterol, bilirubin, bile acids is determined), for microscopic (the composition and number of cells in bile, the presence of microbes) and for immunological research. There are also X-ray methods of research. They are prescribed by a doctor for both young children and older children.
Nutrition for dyskinesia
Children with dyskinesia should stick to a diet. You need to eat at least five to six times a day. This will contribute to the intense secretion of bile. In the morning and in the evening, you need to eat foods rich in lactic acid bacteria, which will help restore normal intestinal microflora. All fermented milk products have this property. The child should not overeat. Eating in the evening should be light, at least two hours before bedtime.If the child’s condition has worsened, meat, mushrooms, garlic, onions, hot spices, sorrel, salty and fatty should be removed from his diet. The body will better absorb plant substances, in order to process them, the body does not need a large amount of bile.
Limit the consumption of sweets. If a child has a hypertensive form of DVP, rye bread and legumes should be deleted from his menu. Food should be warm, as cold affects the sphincter function in a negative way, and this increases pain.Also, you can not use carbonated water and sweets. For a while, you need to give up fresh milk. All food should be boiled or steamed. It is very good to use jelly, oatmeal in water, dairy products, cottage cheese. With a hypotonic form of DVP, it is recommended to take sour cream, cream, fruits, vegetables, eggs, vegetable oil. The course of the diet should last at least one year. If the attacks recur, the diet should be extended.
The treatment of this disease is carried out in three stages:
- Therapy of the underlying disease, elimination of the cause of the condition;
- Elimination of all possible consequences (antispasmodic drugs, antibacterial therapy, enzymes that restore).
- The diet must be followed for an extended period of time.
Children should avoid any physical activity during the treatment of DVP. This is necessary so that the gallbladder and the capsule in the liver do not burst. Babies are treated in a hospital, older children under the strict supervision of a doctor at home. We need such laboratory examinations: FGDS, complete blood count, ultrasound examination of the gallbladder and liver. Hypokinetic dyskenesia is treated with choleretic drugs.These include choleretics, they affect the increased formation of bile (cholenzin, alochol), cholekinetics, they affect the secretion of bile.
It is necessary to respond in a timely manner to any autonomic disorders that have arisen in the child. Children should regularly undergo a pediatrician so that the disease does not start, but is detected as early as possible. In order to prevent ADHD, you need to eat properly and rationally.
Dysbacteriosis is a state of microbial imbalance in or within the body.
Having been born, the child gets from the absolutely sterile environment of the mother’s body into the world inhabited by a huge number of various microbes. He cannot remain sterile for a long time. Almost immediately after birth, his body begins to be populated by representatives of the microbial world. The baby’s intestines are partially colonized by microbes during childbirth, when the baby moves along the mother’s birth canal.After the first portion of food enters the stomach, the intestines become a habitat for many microorganisms. Their number gradually increases and eventually becomes so significant that for every 3 grams of a child’s feces, there is 1 gram of microbes! Living in the intestines of such a number of microbes is very useful not only for microbes, but also for humans. This mutually beneficial coexistence of the human body and the microbes existing in its intestines is called symbiosis.
An infant, in whose intestines the quantitative and qualitative composition of the microflora is disturbed, often behaves restlessly, his sleep is disturbed due to painful intestinal spasms, which are paroxysmal in nature and appear after 1.5-2 hours.after feeding. This is almost always accompanied by bloating due to increased gas formation, rumbling along the intestines. Due to bloating and a violation of the movement of food through the intestines, regurgitation and vomiting are noted. In especially severe cases, intestinal dysbiosis is accompanied by malabsorption syndrome (impaired absorption of nutrients in the small intestine), which is manifested by diarrhea (frothy feces with a sour or putrid odor) and a decrease in the rate of weight gain.And since intestinal dysbiosis is always a secondary process, developing against the background of some basic trouble in the child’s body (intestinal infections, taking antibiotics, prematurity, improper feeding), the addition of malabsorption syndrome further aggravates the severity of the course of this disease.
In many babies, against the background of dysbiosis, persistent constipation develops, since in the absence of a normal number of bifidobacteria, a substance that stimulates the contractile activity of the intestine is not produced in the proper amount.
In its course, dysbiosis is compensated and uncompensated.
With compensated intestinal dysbiosis, there are no clinical manifestations. The child feels quite satisfactory, and the violation of the microbial landscape becomes an accidental find when the analysis of feces (by the way, this study serves as the main laboratory criterion for dysbiosis) is handed over for a completely different reason.
Uncompensated dysbiosis is accompanied by all the clinical signs mentioned above.In such cases, there are a lot of complaints and the question of whether the child needs treatment or not is not raised. The baby’s parents are committed to the most effective treatment possible as soon as possible to relieve the child from suffering.
As for the first case, when there are practically no complaints, the baby is gaining weight well, sleeping well or quite satisfactorily, there are no obvious manifestations of allergies, then the parents ask the traditional question: “Why treat the child if nothing bothers him?” In older children, this is the case – if compensated intestinal dysbiosis is found, then, as a rule, it does not need treatment.This issue is solved in a completely different way in infants – their dysbacteriosis needs treatment in any case, because in such young children, compensation for disturbed intestinal microflora is a temporary and very unstable condition due to imperfect immunity. At the slightest violation of this balance (and it can be caused by teething, and vaccination, and hypothermia and transfer to artificial feeding, and a simple cold, and even stress), dysbiosis becomes uncompensated.That is why any dysbiosis in infants needs treatment, which should be strictly individual, balanced, based on laboratory data, and complex.
Treatment and prevention
One of the most important points in the treatment of dysbiosis is breastfeeding. Every baby needs breast milk for as long as possible during the first year of life. Children with manifestations of intestinal dysbiosis – especially.As already mentioned, maternal colostrum contains many substances that contribute to the formation of normal microflora and protection against opportunistic microorganisms. But mature mother’s milk is no less valuable from the point of view of preventing intestinal microflora disorders. It not only provides optimal conditions for the growth of healthy microflora, but also maintains the existing balance between bifidobacteria, lactobacilli and Escherichia coli, helping to promote proper digestion and preventing the development of allergic reactions.
However, if breastfeeding is impossible, preference should be given to adapted formulas enriched with protective factors. These are fermented milk mixtures; and mixtures containing live bacteria; and mixtures, which include prebiotics – substances that help the assimilation and reproduction of healthy microflora. All these mixtures can only be used as directed by a doctor.
After bacteriological examination of feces and diagnosis, treatment (microflora correction) should consist of two stages.
The first stage includes suppression of the growth of opportunistic microorganisms. This is achieved either with the help of special immunopreparations (bacteriophages), which have the ability to absorb and dissolve microbial cells inside themselves, or with the help of intestinal antiseptics or antibiotics. Almost always, when conducting a bacteriological examination of feces, the sensitivity of opportunistic microbes to a particular bacteriophage or antibiotic is also determined. Undoubtedly, the use of bacteriophages is preferable.If, for some reason, their use is impossible, then from a number of antibacterial drugs it is necessary to choose those that, acting only in the intestinal lumen, do not enter the bloodstream and do not have a general effect on the body.
The second stage of correction of the microbial landscape of the intestine is aimed at colonizing it with healthy flora and creating conditions suitable for its growth. Along with the already mentioned prebiotics, probiotics are used for this – preparations that contain live microorganisms, such as the bifidobacteria, lactobacilli and Escherichia coli, known to us, as well as their waste products that help them successfully settle in the intestines.The course of treatment is prescribed in each case by the doctor. Prebiotics contain indigestible substances that have a beneficial effect on the growth of healthy microflora and activate it. These include lactulose, oligosaccharides, fiber. These ingredients also stimulate bowel movement, helping to relieve constipation.
So how to prevent the development of dysbiosis in a baby? First of all, when planning a pregnancy, the expectant mother needs to be examined by a gynecologist in order to identify and cure possible disorders of the genital flora in time.If the pregnancy has already begun, then it is not too late to take care of it now – there are currently enough funds to allow such treatment during pregnancy. It is necessary to carefully monitor your diet, avoid taking antibiotics, and lead a healthy lifestyle in all respects. In addition, it is useful to inquire in advance in the maternity hospital whether the mother and the child are living together in it and how soon after the birth the newborns are applied to the breast.
OSTEOPATHY AND TREATMENT OF DISEASES OF THE INTERNAL ORGANS IN CHILDREN
The goal of osteopathic treatment in babies is to restore the correct functioning of the abdominal organs and the formation of the normal microflora of the body.And thanks to this – the restoration of health.
Visceral osteopathy involves working with internal organs. The osteopathic doctor relieves spasms in the muscles and ligaments of the abdomen, eliminates venous and lymphatic stasis, returns organs to their place in case of their prolapse and helps them to start functioning again in a natural rhythm. In addition to this, a medical massage of the abdomen is recommended.
About health: how to determine the stagnation of bile in the body was told to patients in the “School of Health” of the Tsivilskaya Central District Hospital
At the initial stages, the stagnation of bile is easily corrected, but if you start the situation, the case may even end in an emergency operation.
Probably everyone knows the sensation: eat a piece of fatty food, but the feeling remains that you have overeat. There is heaviness in the right side, food, it seems, is not digested for a long time. This is one of the symptoms of bile stagnation.
Together with the doctor of ultrasound diagnostics of the Tsivilsky central regional hospital Maria Alekseeva in the “School of Health” for patients, they analyzed the main signs of trouble in the gallbladder and found out how it can be treated.
Signs of bile stagnation:
- aching and pulling pain in the right side after exercise;
- Sensation of discomfort in the right side – as if there was something interfering or squeezing;
- Right pain on bending and turning;
- when sitting for a long time in the wrong posture, the right hand begins to ache, pain appears in the right shoulder blade;
- dry or bitter mouth, slight changes in skin tone.
Bile stagnation, harmless at first glance, can turn into a big disaster.
Cholestasis (stagnation of bile) ranks third among diseases and pathologies of the digestive tract and is getting younger from year to year.
It affects people of retirement age, women over 40, pregnant women, office workers and schoolchildren (long restriction in movement and improper posture at the desk).
Bile is a product of the secretion of liver cells. It is produced in the liver, then through the hepatic and bile ducts it enters the gallbladder, where it accumulates.As soon as food has entered the oral cavity and the process of digestion has begun, bile enters the intestine (duodenum), where it neutralizes the remains of hydrochloric acid, breaks down fats (emulsifies to the desired condition so that they can be absorbed into the blood), helps the body absorb fat-soluble vitamins A, E, D, K, disinfects food and removes excess pathogenic bacteria in the small intestine, participates in other enzymatic reactions for complete digestion of food and assimilation of nutrients.For example, it activates lipase (pancreatic enzyme).
When digestion does not occur, bile accumulates in the gallbladder, a small pear-shaped organ located at the right intercostal arch.
If bile for any reason stagnates and does not enter the intestines, this leads to disruption of the entire digestion process. Cholestasis can lead not only to a dysfunction of the gastrointestinal tract, but also serious diseases associated with metabolic disorders: vitamin deficiency, osteoporosis, cholelithiasis, cholecystitis, in severe cases – cirrhosis of the liver (accumulation of bile, its increased concentration changes and processes liver cells) , and can also cause the formation of diabetes.Therefore, this state cannot be triggered.
So that bile does not stagnate, the doctor, specialist of the first category, Maria Mikhailovna, warned about what patients need to remember.
The stagnation of bile is partly promoted by the liver itself, which produces bile, and the ducts along which it moves, and the gallbladder.
To avoid problems, bile should always be liquid, not viscous or jelly-like.
Bile is a highly concentrated secretion, when it is immobile for a long time, a sediment begins to form, first in the form of flakes, then they form stones.Do not forget that bile is secreted at every meal and the role of proper regular nutrition is very important in the prevention of stone formation!
The movement of bile is carried out along the ducts surrounded by muscles. It will not be superfluous to remember that any stress leads to spasm, including muscle spasm, which can lead to a banal clamping of the ducts themselves and their inlet and outlet sphincters. Bile can get stuck in the ducts. Therefore, eating should always be in a calm atmosphere and in the correct posture: give yourself pleasure – have breakfast, lunch and dinner beautifully.
Formed bile stagnation can be recognized by the following signs:
- dull pain in the right hypochondrium;
- enlarged liver;
- dark urine and light stool;
- constipation or diarrhea;
- bad breath;
- chronic fatigue, drowsiness;
- bitterness in the mouth;
- persistent itching of the skin;
- yellow color of the skin and whites of the eyes.
90 160 frequent belching;
At the first sign of stagnation, it is better to immediately do an ultrasound. If you feel unwell, you should consult a doctor. With prolonged stagnation, both sand and stones in the gallbladder can form, and with any stimulation of the movement of bile, the movement of stones can also be provoked. If the stone is small, then, although with pain, it will come out of the duct, and a large one is able to clog the duct. And in this case, an emergency operation is indicated.
For an accurate diagnosis of bile stasis, additional examination and treatment is required:
- Ultrasound of the liver and bile ducts.It will help assess the extent of the lesion and the presence of stones. The presence of a bile sediment will indicate that the bile is thick and viscous, it is difficult to move along the bile ducts, and therefore may stagnate. The accumulation of bile in the ducts causes the liver to increase in volume.
- General blood and urine tests will help assess the general condition of the body.
- Blood biochemistry will give a complete picture of the work of the liver and gallbladder.
- Analysis of bile will determine its composition.
- Coprogram will help assess the work of the intestines, as well as the quality of the digestive process.
After all examinations, the doctor will prescribe a treatment. This is easily corrected in the early stages.
For prophylactic purposes, it is useful to make a blind tubage, it brings relief, to drink choleretic herbs or preparations and add foods with a mild choleretic effect to your diet (bitterness, herbs, coarse fiber).
Remember that stagnation of bile is in most cases a problem created by a person’s lifestyle, and it has its own prerequisites (inappropriate nutrition, stress, lack of exercise …).
Enjoy life, clean up the premises and live healthy!
90,000 How to get rid of constipation?
Constipation can be caused by various reasons, both physiological (the nature of the diet) and diseases of the gastrointestinal tract. One of the most common causes is intestinal dysbiosis. No less often, constipation accompanies violations of the liver and gallbladder. In addition, constipation is often provoked by stress and nervous strain, which lead to intestinal spasms.
Constipation itself is not so terrible as its consequences, because chronic constipation leads to poisoning of the body, a decrease in immunity, the development of neuroses and even provokes the development of intestinal cancer.
Enemas and laxatives will not solve the problem; in order to get rid of constipation, it is necessary to exclude the causes that caused it. Dysfunction of the liver and poor bile secretion have a huge impact on the appearance of constipation, since bile is the best laxative. With normal bile secretion and a normal structure of bile, a person practically does not have constipation.Bile triggers the activity of many enzymes in the intestine, and thus not only intestinal cleansing occurs, but also the normalization of digestion. Therefore, the effectiveness of the treatment of constipation largely depends on the elimination of liver dysfunctions and the normalization of bile secretion.
Medicines usually used in such conditions are designed to normalize the functions of the liver, gallbladder and biliary tract, as well as to have a general beneficial effect.
One of these drugs is Holiver.HOLIVER has a beneficial effect on the body, thanks to its natural ingredients: extract of the fruit of ARTICHOK, powder of turmeric root and medical bile.
The combination of active components of HOLIVER provides hepatoprotective (restores and strengthens liver cells), choleretic, antitoxic, antioxidant, anti-inflammatory and antiulcer effect with virtually no side effects.
The drug HOLIVER stimulates the formation of bile and promotes its outflow, thereby increasing the absorption of fats and fat-soluble vitamins.Improves intestinal motility (work) and acts as an intestinal antiseptic, creates a favorable environment for pancreatic enzymes, regulates digestion and acts as a pain-relieving agent, preventing hepatic colic.
Its ability to remove toxins is especially important in conditions such as acute (convalescent) and chronic hepatitis, dysbiosis, as well as after treatment with antibiotics, anthelminthic and other drugs toxic to the liver.
HOLIVER is available in tablets. Before using HOLIVER, we recommend that you read the instructions or prescriptions on the packaging. This medicine is sold over the counter without a doctor’s prescription. If you experience any side effects, ask your pharmacist or doctor.
! One package of HOLIVER (100 tablets) is enough for the average recommended prophylactic or therapeutic course. The cost of HOLIVER is available to everyone!
Telephone for inquiries in Chisinau – “hot line” 22-12-41, 21-00-78
Functional disorders of the gallbladder
Diseases of the biliary system are the most common diseases of the abdominal organs.Currently, they affect up to 20 percent of the adult population in developed countries, and these diseases are tending to further increase. Says Professor of the Department of Therapy FUV Krasnoyarsk Medical University, gastroenterologist Elena GRISCHENKO .
Among the diseases of the biliary system, functional disorders of the gallbladder and the sphincter of Oddi, acalculous inflammatory cholecystitis and gallstone disease are distinguished. These conditions are one pathological process that stretches over time: first, there is a violation of the motility of the gallbladder – dyskinesia, then the inflammatory process joins – an acalculous cholecystitis is formed, which eventually transforms into gallstone disease
Functional disorders of the gallbladder are violations of the tone and motility of the biliary system.There are no organic changes in the biliary system, but it functions incorrectly: either the outflow of bile is too fast, or, conversely, bile is not evacuated in time and stagnates in the gallbladder.
There are many reasons for the disorder. Most often, the regulatory system of bile outflow is disturbed: the sympathetic and parasympathetic nervous systems are unbalanced, it is easier to say – this is a neurosis. Disorders in the endocrine system also lead to dysfunction. It is known that with obesity, diabetes mellitus, women taking oral contraceptives often develop hypofunction of the biliary system.The motility of the gallbladder can be influenced by occupational hazards, taking medications, various diets, alcohol and tobacco.
With an increased outflow of bile, there are quite intense paroxysmal pains in the right hypochondrium, reminiscent of colic. There is a lot of bile, it enhances intestinal peristalsis – dyspeptic disorders begin, more simply – diarrhea.
Stagnation of bile is characterized by a feeling of heaviness, distention in the right hypochondrium, pronounced intestinal discomfort and frequent constipation.
Pain can be constant, moderate or intense. They disrupt the patient’s physical activity, forcing him to see a doctor. Especially if they interfere with sleep or are accompanied by nausea, and sometimes vomiting.
The diagnosis “Functional disorder of the gallbladder” is made when there are characteristic pains and laboratory and instrumental examination data, excluding the presence of organic pathology in the biliary system, for example, stones or inflammation of the gallbladder. And also there are no functional disorders of other organs of the gastrointestinal tract that can mimic such pain.To do this, take a clinical and biochemical blood test, do an ultrasound of the abdominal cavity and retroperitoneal space, conduct a microscopic examination of bile obtained during duodenal intubation or retrograde cholangiopancreatography.
Duodenal sounding. First, various stimuli are introduced into the body (for example, a warm solution of magnesia) to stimulate contractions of the gallbladder and relax the sphincter of the common bile duct, which leads to the release of bile into the duodenum.The released bile is collected through a probe inserted into the duodenum and examined in the laboratory.
Retrograde cholangiopancreatography is a method that combines endoscopy with simultaneous fluoroscopic examination.
The gold standard for diagnosing gallbladder dysfunction is dynamic cholescintigraphy – a method for studying the movement of bile in the body.
A functional disorder of the gallbladder is said if
– the level of liver enzymes, bilirubin, amylase / lipase in a biochemical blood test is normal;
– no inflammatory reaction was found in the bile under study;
– no stones in the gallbladder were found;
– the ejection fraction with cholescintigraphy is less than 40 percent, that is, the norm.
Stagnation of bile, even temporary, leads to the development of inflammatory changes in the wall of the gallbladder, and in the future – gallstone disease, therefore, it is necessary to correct the functional disorders of the biliary system.
Cholecystitis is an inflammation of the gallbladder. It happens acute and chronic.
Acute cholecystitis is the most dangerous form of this disease. In most cases, it is accompanied by the formation of calculi (stones) in the gallbladder itself or its ducts.This disease is also called gallstone disease or calculous cholecystitis.
The danger of calculous cholecystitis is the excessive accumulation of cholesterol, calcium salts and bilirubin in the gallbladder cavity. These constituents are first deposited on the walls of the bladder in the form of calcifications – small flocculated deposits. But over time, the deposits increase in size, interfering with the normal functioning of the organ. There are frequent cases of stones getting into the bile ducts, where they create a serious obstacle to the outflow of bile from the bladder.All this leads first to a certain discomfort and heaviness in the abdomen, and then there is an acute intense pain in the right hypochondrium, nausea, vomiting, the temperature rises to 38 degrees, chills may appear. Often, inflammation of the gallbladder spreads to the surrounding tissue, which leads to peritonitis. The course of calculous cholecystitis is acute, therefore it requires urgent medical treatment, often surgical intervention
Acute acalculous cholecystitis is rare, usually proceeds without complications and ends with recovery, sometimes it can become chronic.
Chronic acalculous cholecystitis. This is a chronic recurrent inflammation of the gallbladder wall, accompanied by a violation of its motor-tonic function.
Chronic cholecystitis is considered as a physicochemical stage of cholelithiasis, in which it is necessary to prescribe preventive therapy in order to prevent the formation of true stones.
The factors leading to the development of chronic cholecystitis can be divided into basic and additional.
– infection: Escherichia coli, cocci, sometimes other microbial factors;
– chronic diseases of the liver, pancreas, which often lead to failure or increased tone of the sphincter of Oddi;
– disorders of intestinal microflora.
Additional factors include:
– functional disorders of the neuromuscular apparatus of the biliary system, as a rule, develop in chronic cholecystitis, lead to impaired outflow and stagnation of bile;
– congenital anomalies of the gallbladder;
– all kinds of stressful situations;
– sedentary lifestyle;
– irregular food intake and unbalanced nutrition, excessive consumption of food rich in animal fats: fatty meat, eggs, oil – which disrupts the normal composition of bile;
– hereditary factors;
– parasitic diseases: giardiasis, opisthorchiasis, ascariasis;
– atherosclerosis, hypertension lead to disruption of the blood supply to the biliary system;
– endocrine disorders: obesity, diabetes mellitus, menstrual dysfunction, irregular sex life;
– allergic and immunological reactions.
All additional factors create conditions for the development of inflammation and prepare a fertile ground for the introduction of microbial flora.
The liver is the largest and most important gland in our body. Liver cells continuously produce bile up to one liter per day, day and night. Bile is essential for the digestion of food, mainly fats. From the liver, bile enters the common bile duct and is secreted into the duodenum (Duodenum). The flow of bile from this duct into the duodenum is regulated by a muscle – the sphincter of Oddi, which is located at the outlet of the duct into the duodenum.When there is no food in the duodenum, the sphincter is closed and bile cannot enter the duodenum. It enters the gallbladder from the main duct. This is a reservoir of bile. It contains about 50 milliliters of bile, which can be stored in it for a long time and then becomes more concentrated, since part of the water is absorbed from the bile. When, after eating, the food mass from the stomach enters the duodenum, the sphincter of Oddi expands and bile from the common bile duct enters the duodenum. At the same time, the gallbladder contracts and pushes the accumulated bile into the common bile duct and further into the duodenum.The pancreas closely cooperates with this system, which secretes its own pancreatic juice – one and a half to two liters per day. This juice is rich in powerful digestive enzymes and plays a leading role in the digestion of food. The juice enters the duodenum through the pancreatic duct, which connects to the common bile duct at the duodenum itself. Thus, the sphincter of Oddi regulates the flow of both bile and pancreatic juice into the duodenum. The general regulation of the coordinated work of these organs is carried out by the nervous and endocrine systems of the body.
It should be understood that this model is simplified and devoid of details. Each individual has its own characteristics – its own sizes of the liver and gallbladder, different shapes, length, width of the cystic and other ducts. The gallbladder and bile ducts are combined into the biliary system.
In Western clinics it is recommended for patients with hypomotor dysfunction of the gallbladder cholecystectomy – removal of the gallbladder – as the most acceptable method of treatment.In Russia, this method is perceived with caution, and drug correction of these disorders is widely used. In the treatment of hypermotor dysfunction, antispasmodics, anticholinergics, and sedatives are used. In order to correct hypokinetic dysfunction, choleretic drugs, enzymes containing bile acids are prescribed.
Cholecystitis is divided into two large groups: calculous (Latin Calculus – stone) and non-calculous (stoneless). Elena Grishchenko, professor of the FUV Department of Therapy, Krasnoyarsk Medical University, gastroenterologist, talks about the manifestations and treatment of non-calculous cholecystitis.
The disease begins gradually, often in adolescence. Complaints arise under the influence of a violation of the diet, psycho-emotional overstrain. The manifestations of chronic cholecystitis are diverse and do not have specific features. A “symptom of the right hypochondrium” is considered a classic: a dull, aching pain in the right hypochondrium of a constant nature or arising one to three hours after taking plentiful and especially fatty and fried foods. The pain radiates up to the area of the right shoulder and neck, right shoulder blade.Periodically, there may be a sharp pain resembling biliary colic.
With a long course of the disease, the solar plexus is involved in the inflammatory process, and then there is a burning pain in the navel, radiating to the back.
Dyspeptic symptoms are not uncommon: a feeling of bitterness and a metallic taste in the mouth, belching with air, nausea, flatulence, impaired bowel movements: often alternating constipation and diarrhea. Irritability, insomnia is often due to itchy skin. It occurs when the bile pigments accumulated in the blood begin to irritate the skin receptors.And if a person suffers from allergies, an allergic reaction may develop, up to Quincke’s edema. Painful attacks can be accompanied by weakness, sweating, palpitations, headache, chills, fever.
The course of cholecystitis in most cases is long, with alternating periods of remission and exacerbations; the latter often result from malnutrition, alcohol intake, hard physical work, acute intestinal infections, hypothermia.
To confirm the diagnosis, exacerbation of chronic non-calculous cholecystitis, the gastroenterologist will prescribe laboratory and instrumental studies.
1. Complete blood count – detects inflammation.
2. Biochemical blood test – quantitative changes in bilirubin, alkaline phosphatase and other indicators will indicate dysfunction of the biliary system.
3. The main diagnostic criterion for chronic cholecystitis is ultrasound of the gallbladder.First of all, the presence of stones in the gallbladder and in the ducts is excluded. The severity of the inflammatory process is evidenced by the thickness and density of the gallbladder wall. And also the so-called “sludge” – stagnation and thickening of bile and deformation of the gallbladder.
4. In some cases, an ultrasound scan with a choleretic breakfast is performed – an opportunity to determine how the gallbladder functions in dynamics. For breakfast, use egg yolks, fatty sour cream or cream.
5.Duodenal intubation – performed only in the absence of stones in the gallbladder. Bile intake through an umbrella inserted into the duodenum is carried out every ten minutes. This allows you to determine the type of bladder motility (hyper- or hypo-), the tone of the sphincter of Oddi. When examining bile, inflammatory elements are revealed – mucus, leukocytes, as well as the presence of bacterial flora, for example, eggs of the Siberian fluke.
6. Drug tests with choleretic drugs.
7. ECG – to exclude diseases of the cardiovascular system.
8. Computed tomography and nuclear magnetic resonance – studies are carried out in cases that are difficult to diagnose.
Biliary tract dysfunctions often appear under the mask of cholecystitis. Therefore, for the diagnosis of chronic cholecystitis, a careful comparison and scrupulous analysis of all studies is required. This will be done by a gastroenterologist. If necessary, he will consult the patient with other specialists – a surgeon, cardiologist, gynecologist, psychotherapist.
When the exacerbation of chronic non-calculous cholecystitis is confirmed by laboratory tests, antibacterial treatment is prescribed. The choice of antibiotics is made by the doctor, taking into account the ability of this drug to concentrate in bile.
To normalize the function of the biliary tract and eliminate pain, myospasmolytics, anticholinergics, analgesics are prescribed.
In the phase of fading exacerbation and in the phase of remission, when hypomotorism of the gallbladder is detected, choleretic drugs are prescribed – choleretics.By increasing the secretion of bile, they increase its flow through the bile ducts, which reduces the intensity of the inflammatory process and prevents the spread of the ascending infection. Choleretics should not be used in the midst of inflammation and with concomitant pathology of the liver, pancreas; after removal of the gallbladder.
For the correction of intestinal disorders, choleretic drugs are used together with enzymes.
Mineral water is used as a choleretic agent during remission.It stimulates the contraction of the gallbladder. It has anti-inflammatory properties. What kind of mineral water to drink, warm or hot, before or after meals, is selected by the doctor individually for each patient.
Physiotherapy and spa treatment is an important component of the comprehensive rehabilitation of patients. Physiotherapy courses are selected by a physiotherapist individually for each patient. Sanatorium treatment is indicated not earlier than two to four months after exacerbation of cholecystitis.Patients are sent to the balneo-mud resorts: Essentuki, Zheleznovodsk, Truskavets, Morshin.
Adequate therapy of chronic cholecystitis and correction of motor-evacuation disorders of the gallbladder give good results and prevent the development of gallstone disease.
During an exacerbation, in the first two days, only the intake of warm liquid is prescribed: weak sweet tea, juices from fruits and vegetables diluted with water, mineral water without gas in small portions up to 1.5 liters per day and several crackers.As the pain subsides and the general condition improves, the dietary table expands. Recommend:
– mashed soups from vegetables and cereals,
– porridge: oatmeal, rice, semolina, buckwheat,
– jelly, mousse, jelly, low-fat cottage cheese,
– low-fat boiled fish,
– mashed and boiled meat, steamed cutlets: veal, chicken, turkey, rabbit,
– white crackers.
After stopping the exacerbation of cholecystitis, patients are recommended the following diet:
– dairy soups, fruit, vegetable broth with cereals, noodles;
– boiled meat, steamed cutlets, meatballs: beef, rabbit, chicken, turkey;
– low-fat varieties of sea or river fish, boiled or baked, without a crust;
– eggs, up to one or two per day – soft-boiled, in the form of steam omelets;
– dairy products: low-fat milk, cottage cheese, kefir, yogurt, yogurt;
– boiled, baked vegetables, partially raw.
– fruits and berries;
– porridge – buckwheat, oatmeal, rice, semolina, with the addition of milk, if tolerated;
– sweet dishes – marshmallow, marmalade, md, jams, preserves, jelly;
– flour products – wheat and rye bread, yesterday’s, white bread rusks, dry uncooked biscuits.
It is necessary to eat in small portions, slowly, five to six times a day. Long breaks between meals, fasting are not recommended. Breakfast is required, dinner two to three hours before bedtime, not abundant.
Products are not recommended:
– with a high content of animal fats: fried foods, fatty fish, pork, lamb, duck, sausages, smoked meats, mayonnaise, creams, cakes, pastries;
– raw onions, garlic, radishes, sorrel, spinach, mushrooms, peas, beans;
– cold and carbonated drinks, concentrated juices, coffee, cocoa, alcoholic beverages.
To the topic
If not treated, the disease progresses, complications begin.
1. Pericholecystitis occurs when all the walls of the gallbladder and the serous membrane (peritoneum) are involved in the pathological process. In this condition, the pain syndrome is constant and intense, extends to the right side, and intensifies when turning and tilting the body.
2. Cholangitis is an inflammatory process in the bile ducts. The main symptom is an increase in temperature up to 40 degrees with tremendous repeated chills, nausea, vomiting, cramping pains in the right hypochondrium.
3. When other organs of the digestive systems are involved in the pathological process, along with pain in the right hypochondrium there are painful sensations of a “girdle” nature, loosening of the stool – possibly involving the pancreas in the pathological process. If the pain spreads to the entire area of the liver and is accompanied by its increase – the addition of reactive hepatitis. The emergence of late, hungry pain in the upper abdomen indicates the presence of duodenitis of the duodenal inflammation.
Complications not only cause disability, but also pose a threat to the patient’s life, therefore, when the first symptoms of the disease appear, you should immediately consult a doctor – a therapist or gastroenterologist.
Constipation due to the gallbladder: why it can occur
Today, constipation due to the gallbladder is the most common problem, which is systematic. Inflammatory diseases of the gallbladder are manifested by difficult defecation and require immediate therapy.
With this pathology, self-medication with laxatives can cause irreparable harm to the body, so you need to figure out what effective methods of treatment exist.
The relationship between constipation and the gallbladder
The main cause of stool retention in diseases of the gallbladder is insufficient flow of bile into the intestine. In the gallbladder, it constantly accumulates and becomes concentrated in order to break down fatty compounds that enter the intestines with food.Bile improves the contractile activity of the intestinal walls and slows down the secretion of the duodenal glands.
A deficiency in the flow of bile into the digestive system slows down peristalsis and can provoke atonic constipation. Also, intestinal motility depends on the level of production of hydrochloric acid, with a low content in the large intestine, the movement of feces slows down, which leads to the development of constipation.
The main functions of bile in the intestine:
- Activates enzymes for the process of food digestion.
- Prevents the multiplication of pathogenic microflora in the intestine.
- Removes toxic compounds from the intestines.
Classification of diseases of the gallbladder
Violation of defecation is observed in most patients with diseases of the gallbladder.
Stool retention in diseases of the gallbladder manifests itself in the following types:
- biliary dyskinesia;
- gallstone disease;
- acute and chronic cholecystitis;
- after cholecystectomy.
The reasons for the development of these diseases are different, but all of them are united by the symptom of difficult defecation.
Manifestations of constipation in cholecystitis
Acute cholecystitis is a pathological condition characterized by acute inflammation of the gallbladder. Acute cholecystitis develops with gallstone disease, when there is a difficulty in the outflow of bile due to a mechanical obstacle. In diseases of the biliary tract, changes in the composition of bile can be observed, which leads to functional changes in the intestines.Against the background of inflammation, bile ceases to be produced in the required amount, which slows down the digestion of food, especially fatty ones. The passage of intestinal contents becomes difficult, and the patient experiences discomfort during emptying.
Constipation with cholecystitis is manifested by various symptoms:
- hard and dry chyme;
- undigested food in the feces;
- increased gas accumulation;
- abdominal pain;
- decreased or no appetite;
- bitter taste in the mouth;
- colic in the gallbladder;
- fast fatigability;
- burning behind the breastbone;
- traumatism of the anus by hard feces.
When chronic cholecystitis develops, constipation is systematic and normalizes after taking laxatives and adjusting the diet.
Chronic cholecystitis is manifested by a more pronounced stool retention, it can last 3-4 days, accompanied by severe gas formation and abdominal pain.
Constipation with gallstone disease
Gallstone disease is a widespread disease in which stones are formed in the gallbladder.A gallstone is formed by increasing the amount of salts. Stagnation of bile leads to constant constipation due to a decrease in the contractile activity of the intestinal walls.
Constipation with biliary dyskinesia
Biliary dyskinesia is characterized by impaired outflow of bile from the gallbladder cavity. The disease is caused by a violation of the motor activity of the gallbladder ducts, as a result of which bile enters the duodenum in small quantities.
Depending on the mechanism of the pathological process, the following types of constipation are distinguished:
- Hypotonic dyskinesia of the biliary tract (spastic constipation develops).
- Hypertensive biliary dyskinesia (atonic constipation is formed).
Atonic constipation is the result of loss of tone in a specific area of the colon. With this pathology, the contractility of the intestinal walls is disrupted, the movement of feces slows down.
Typical symptoms of atonic constipation with dyskinesia:
- general weakness;
- subfebrile body temperature;
- reduction of stool frequency up to 2 times a week;
- pain during the act of defecation;
- bowel movement does not bring relief.
Spastic constipation caused by spasm in various parts of the large intestine, as a result of which the passage of the chyme is delayed.
Patients with spastic constipation reveal complaints of the following symptoms:
- obstructed defecation;
- Painful sensations in the abdomen;
- A feeling of fullness in the rectum.
Biliary dyskinesia can develop against the background of prolonged intake of alcoholic beverages, the predominance of fatty and spicy foods in the diet.
Features of constipation when the gallbladder is bent in a child
Curl of the gallbladder in a child is a condition in which the gallbladder is deformed. It is the cause of impaired bowel movement due to obstructed outflow of bile.
In a child, the causes of bending of the gallbladder are:
- anomalies of intrauterine development;
- errors in power supply mode;
- weight lifting;
- excessive physical activity.
When the bile ducts are bent, bile stagnates, it cannot enter the intestines and, as a result, cannot break down fats.
With stool retention, children may reveal the following complaints:
- Difficulty passing out feces;
- blood-streaked feces;
- intestinal contents in the form of dry lumps;
- abdominal pain;
- Bitter taste in the mouth.
Stagnation of bile with deformation of the organ complicates the normal process of digestion, which negatively affects the evacuation ability of the intestines in a child.
Constipation after removal of the gallbladder
Stool retention after surgery on the gallbladder is an integral part of it. When the gallbladder is removed, constipation accompanies the patient throughout the entire postoperative period. The main reason for the violation of bowel movement lies in the deficiency of enzymes that the gallbladder produces. After removal of the organ, stagnation of bile occurs, food is not processed in a timely manner and stagnates in the digestive tract. The second important cause of constipation is drug therapy, which upset the balance of the intestinal microflora.A sedentary lifestyle also contributes to a decrease in peristalsis and retention of feces.
To clarify the diagnosis of constipation in diseases of the biliary tract, it is necessary to visit a gastroenterologist and proctologist. The doctor must collect anamnesis, conduct an examination, palpation of the rectum and abdominal cavity, then he will prescribe a number of necessary studies.
- general urine analysis;
- general blood test;
- glucose level;
- tank for seeding feces for intestinal microflora.
In a biochemical blood test, it is necessary to determine the level of the following enzymes:
- AlAt and AsAt;
- alkaline phosphatase;
- Thyroid hormones.
Apparatus research methods:
- Ultrasound of the abdominal cavity;
- duodenal intubation;
Principles of treatment
Therapy of constipation in diseases of the biliary tract includes the following actions:
- Changes in lifestyle (increased physical activity, rejection of bad habits).