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Gallbladder burning sensation: How Do I Know If Pain Is Caused By My Gallbladder or Heartburn?

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How Do I Know If Pain Is Caused By My Gallbladder or Heartburn?

How Do I Know If Pain Is Caused By My Gallbladder or Heartburn?

Tuesday, September 6th, 2016 | Written by Premier Surgical Staff

 

The causes of heartburn and abdominal pain are often bewildering for many patients of Premier Surgical Associates in Knoxville. The leading symptoms of both heartburn and gallbladder disease are upper abdominal pain and heartburn, which understandably sends people’s minds racing.

Adding to the confusion is the fact that what typically causes heartburn can also trigger a gallbladder attack— a diet of fatty or spicy foods, lying down after eating, being overweight, and genetics.

If the symptoms and the sources of both heartburn and gallbladder are so overlapping, how do you know which you may be experiencing? Upper abdominal pain can be caused by a variety of disorders, including acid reflux and gallbladder disease, and even medical professionals may have difficulty distinguishing among these causes. However, the location, nature, and timing of your symptoms may help clarify a diagnosis.

Gallbladder

The gallbladder is a sac that sits in the upper right abdomen that stores bile produced by the liver. The bile aids in the digestion of the food you eat. Most of the time, the gallbladder functions normally, but when it becomes blocked or infected it can become a painful and potentially dangerous medical condition.

Being overweight, heredity, or hormones and pregnancy are common risk factors for both gallbladder attacks and gallstones. Gallbladder attacks are often triggered by diet, such as if you’ve just eaten a heavy or greasy meal. The pain usually occurs in the upper right abdomen, and may radiate to the right shoulder or back. Symptoms may also include diarrhea, fever, or chills. However, the key is that symptoms should ease after a half-hour to an hour.

In the case of gallstones, an imbalance in the bile causes pebble-like deposits to form which increases pressure on the gallbladder if they block the bile ducts. This can cause pain that, as with a gallbladder attack, may radiate to out the right shoulder or back.

The difference is that gallstones may cause mild symptoms for months or even years. The gallstones may pass on their own, but if the pain increases in intensity over time and becomes more generalized, the gallbladder may be infected.

Heartburn, or GERD

Heartburn and GERD, or Gastroesophagael Reflux Disease, is a very common medical condition, affecting up to 40% of adults. While reasons for developing GERD are numerous, diet and genetics play a role, and it’s more prominent with age and obesity.

If you have heartburn or other symptoms such as chest pain, sleep disruption, bloating, or intolerance of certain foods, you may have GERD. With GERD, the muscle valve between the esophagus and the stomach weakens, stomach acid goes back up into the esophagus. But the lining of the esophagus is not created to handle acid like the stomach can, which is why you feel heartburn.

Typically, heartburn symptoms can be alleviated by elevating the torso, managing one’s diet, and often with over-the-counter or prescribed medications. When a patient has tried lifestyle modifications and medications and still experiencing frequent symptoms, or has determined that being on medications long term is too great a risk, surgery may be an option.

When to stop guessing and seek immediate help

If heartburn pain doesn’t ease after an hour, your upper right abdomen is tender to the touch or you experience a sudden intensifying of pain, and you have a fever or the chills, your gallbladder may be diseased and you should seek medical attention. A diseased  gallbladder has the potential to be life-threatening and your gallbladder will likely need to be removed. Fortunately, the gallbladder isn’t necessary for survival, and the procedure to remove it his typically an out-patient procedure.

If you have persistent heartburn and upper abdominal discomfort, talk with your physician about the frequency and severity of your symptoms. There are several tests, although not always definitive, that can help pinpoint the source of your discomfort.

Premier Surgical Associates is the largest surgical group in the Knoxville region, providing comprehensive surgical care, with referrals from across the entire East Tennessee region. To learn more about our specialties, visit Premier Surgical Associates.

 

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Tags: Gallbladder, GERD, Heartburn, infection of the gallbladder

Gallbladder inflammation symptoms: Signs, complications, and causes

The gallbladder is a pear-shaped digestive organ located on the right side of the abdomen. Its role is to store and release bile for fat digestion.

When inflamed, it can cause abdominal pain, vomiting, and fever.

It connects to the liver by a duct. If a stone blocks this duct, bile backs up, causing the gallbladder to become inflamed. This is known as acute cholecystitis.

The gallbladder swells and becomes red during a bout of inflammation, and the buildup of fluid in the organ can develop a secondary infection.

This article identifies the symptoms of a gallbladder infection and how to treat the condition.

The most common symptoms of gallbladder inflammation are:

  • Upper-right quadrant pain: This pain often has a sudden onset, often occurring shortly after a high-fat meal. It may start just above the bellybutton but will eventually settle under the edge of the ribcage on the right side of the abdomen, around the location of the gallbladder.
  • Nausea and vomiting: Fats cannot be broken down for digestion due to the obstructed bile duct, resulting in a lack of appetite, feelings of nausea, and vomiting.
  • Fever: A fever over 100 °Fahrenheit (37.8 °Celsius) occurs in about one-half of individuals with cholecystitis.
  • Malaise: A person with an inflamed gallbladder may experience a general feeling of discomfort, illness, and uneasiness. Malaise is a common complaint with many illnesses and is often the first indication of inflammation or infection.

Additional gallbladder inflammation symptoms may vary based on age and overall state of health.

Gallbladder pain first presents in the form of spasmodic pains in the abdomen but over time will change to a steady, severe pain that resting, changing position, or using other measures does not resolve. Pain may also occur in the right shoulder or upper-right region of the back.

The pain will intensify over time, especially when taking a deep breath or with any kind of movement. Most people call their doctor within 4 of 6 hours of experiencing this type of pain.

In children and older adults, gallbladder symptoms may be vague. They may not experience pain or fever and complain only of malaise, lack of appetite, and weakness. Some people with gallbladder inflammation encounter a yellow tinge to the skin, known as jaundice. However, this is rare.

In an emergency room, a person with an acutely inflamed gallbladder will usually lie perfectly still on the examining table because the slightest movement can aggravate their pain.

The individual might also tense the abdominal muscles, which will feel similar to a spasm. Tensing these muscles, or guarding, helps protect the inflamed organ from the potential pain of examination.

In some cases, an inflamed gallbladder can rupture and progress to a life-threatening infection called sepsis.

Any individual experiencing symptoms of gallbladder inflammation must seek immediate medical attention to avoid any potentially serious or life-threatening complications.

A surgeon will often remove the gallbladder to prevent the progression of cholecystitis into more severe conditions.

Many gallbladder inflammation cases occur as a result of gallstones. These are small crystal-like masses made up of bile pigments, cholesterol, and calcium salts.

Roughly 10 to 15 percent of Americans have gallstones, and as many as one-third of these people will develop inflammation. Gallstones do not usually cause symptoms on their own.

The risk of gallbladder inflammation increases with age. Other risk factors include:

  • being female
  • pregnancy
  • obesity
  • diabetes
  • a history of gallstones
  • rapid weight loss

Tackling gallbladder inflammation is vital for preventing the development of any potentially fatal complications.

Gallbladder inflammation symptoms: Signs, complications, and causes

The gallbladder is a pear-shaped digestive organ located on the right side of the abdomen. Its role is to store and release bile for fat digestion.

When inflamed, it can cause abdominal pain, vomiting, and fever.

It connects to the liver by a duct. If a stone blocks this duct, bile backs up, causing the gallbladder to become inflamed. This is known as acute cholecystitis.

The gallbladder swells and becomes red during a bout of inflammation, and the buildup of fluid in the organ can develop a secondary infection.

This article identifies the symptoms of a gallbladder infection and how to treat the condition.

The most common symptoms of gallbladder inflammation are:

  • Upper-right quadrant pain: This pain often has a sudden onset, often occurring shortly after a high-fat meal. It may start just above the bellybutton but will eventually settle under the edge of the ribcage on the right side of the abdomen, around the location of the gallbladder.
  • Nausea and vomiting: Fats cannot be broken down for digestion due to the obstructed bile duct, resulting in a lack of appetite, feelings of nausea, and vomiting.
  • Fever: A fever over 100 °Fahrenheit (37.8 °Celsius) occurs in about one-half of individuals with cholecystitis.
  • Malaise: A person with an inflamed gallbladder may experience a general feeling of discomfort, illness, and uneasiness. Malaise is a common complaint with many illnesses and is often the first indication of inflammation or infection.

Additional gallbladder inflammation symptoms may vary based on age and overall state of health.

Gallbladder pain first presents in the form of spasmodic pains in the abdomen but over time will change to a steady, severe pain that resting, changing position, or using other measures does not resolve. Pain may also occur in the right shoulder or upper-right region of the back.

The pain will intensify over time, especially when taking a deep breath or with any kind of movement. Most people call their doctor within 4 of 6 hours of experiencing this type of pain.

In children and older adults, gallbladder symptoms may be vague. They may not experience pain or fever and complain only of malaise, lack of appetite, and weakness. Some people with gallbladder inflammation encounter a yellow tinge to the skin, known as jaundice. However, this is rare.

In an emergency room, a person with an acutely inflamed gallbladder will usually lie perfectly still on the examining table because the slightest movement can aggravate their pain.

The individual might also tense the abdominal muscles, which will feel similar to a spasm. Tensing these muscles, or guarding, helps protect the inflamed organ from the potential pain of examination.

In some cases, an inflamed gallbladder can rupture and progress to a life-threatening infection called sepsis.

Any individual experiencing symptoms of gallbladder inflammation must seek immediate medical attention to avoid any potentially serious or life-threatening complications.

A surgeon will often remove the gallbladder to prevent the progression of cholecystitis into more severe conditions.

Many gallbladder inflammation cases occur as a result of gallstones. These are small crystal-like masses made up of bile pigments, cholesterol, and calcium salts.

Roughly 10 to 15 percent of Americans have gallstones, and as many as one-third of these people will develop inflammation. Gallstones do not usually cause symptoms on their own.

The risk of gallbladder inflammation increases with age. Other risk factors include:

  • being female
  • pregnancy
  • obesity
  • diabetes
  • a history of gallstones
  • rapid weight loss

Tackling gallbladder inflammation is vital for preventing the development of any potentially fatal complications.

Gallbladder inflammation symptoms: Signs, complications, and causes

The gallbladder is a pear-shaped digestive organ located on the right side of the abdomen. Its role is to store and release bile for fat digestion.

When inflamed, it can cause abdominal pain, vomiting, and fever.

It connects to the liver by a duct. If a stone blocks this duct, bile backs up, causing the gallbladder to become inflamed. This is known as acute cholecystitis.

The gallbladder swells and becomes red during a bout of inflammation, and the buildup of fluid in the organ can develop a secondary infection.

This article identifies the symptoms of a gallbladder infection and how to treat the condition.

The most common symptoms of gallbladder inflammation are:

  • Upper-right quadrant pain: This pain often has a sudden onset, often occurring shortly after a high-fat meal. It may start just above the bellybutton but will eventually settle under the edge of the ribcage on the right side of the abdomen, around the location of the gallbladder.
  • Nausea and vomiting: Fats cannot be broken down for digestion due to the obstructed bile duct, resulting in a lack of appetite, feelings of nausea, and vomiting.
  • Fever: A fever over 100 °Fahrenheit (37.8 °Celsius) occurs in about one-half of individuals with cholecystitis.
  • Malaise: A person with an inflamed gallbladder may experience a general feeling of discomfort, illness, and uneasiness. Malaise is a common complaint with many illnesses and is often the first indication of inflammation or infection.

Additional gallbladder inflammation symptoms may vary based on age and overall state of health.

Gallbladder pain first presents in the form of spasmodic pains in the abdomen but over time will change to a steady, severe pain that resting, changing position, or using other measures does not resolve. Pain may also occur in the right shoulder or upper-right region of the back.

The pain will intensify over time, especially when taking a deep breath or with any kind of movement. Most people call their doctor within 4 of 6 hours of experiencing this type of pain.

In children and older adults, gallbladder symptoms may be vague. They may not experience pain or fever and complain only of malaise, lack of appetite, and weakness. Some people with gallbladder inflammation encounter a yellow tinge to the skin, known as jaundice. However, this is rare.

In an emergency room, a person with an acutely inflamed gallbladder will usually lie perfectly still on the examining table because the slightest movement can aggravate their pain.

The individual might also tense the abdominal muscles, which will feel similar to a spasm. Tensing these muscles, or guarding, helps protect the inflamed organ from the potential pain of examination.

In some cases, an inflamed gallbladder can rupture and progress to a life-threatening infection called sepsis.

Any individual experiencing symptoms of gallbladder inflammation must seek immediate medical attention to avoid any potentially serious or life-threatening complications.

A surgeon will often remove the gallbladder to prevent the progression of cholecystitis into more severe conditions.

Many gallbladder inflammation cases occur as a result of gallstones. These are small crystal-like masses made up of bile pigments, cholesterol, and calcium salts.

Roughly 10 to 15 percent of Americans have gallstones, and as many as one-third of these people will develop inflammation. Gallstones do not usually cause symptoms on their own.

The risk of gallbladder inflammation increases with age. Other risk factors include:

  • being female
  • pregnancy
  • obesity
  • diabetes
  • a history of gallstones
  • rapid weight loss

Tackling gallbladder inflammation is vital for preventing the development of any potentially fatal complications.

Gallbladder inflammation symptoms: Signs, complications, and causes

The gallbladder is a pear-shaped digestive organ located on the right side of the abdomen. Its role is to store and release bile for fat digestion.

When inflamed, it can cause abdominal pain, vomiting, and fever.

It connects to the liver by a duct. If a stone blocks this duct, bile backs up, causing the gallbladder to become inflamed. This is known as acute cholecystitis.

The gallbladder swells and becomes red during a bout of inflammation, and the buildup of fluid in the organ can develop a secondary infection.

This article identifies the symptoms of a gallbladder infection and how to treat the condition.

The most common symptoms of gallbladder inflammation are:

  • Upper-right quadrant pain: This pain often has a sudden onset, often occurring shortly after a high-fat meal. It may start just above the bellybutton but will eventually settle under the edge of the ribcage on the right side of the abdomen, around the location of the gallbladder.
  • Nausea and vomiting: Fats cannot be broken down for digestion due to the obstructed bile duct, resulting in a lack of appetite, feelings of nausea, and vomiting.
  • Fever: A fever over 100 °Fahrenheit (37.8 °Celsius) occurs in about one-half of individuals with cholecystitis.
  • Malaise: A person with an inflamed gallbladder may experience a general feeling of discomfort, illness, and uneasiness. Malaise is a common complaint with many illnesses and is often the first indication of inflammation or infection.

Additional gallbladder inflammation symptoms may vary based on age and overall state of health.

Gallbladder pain first presents in the form of spasmodic pains in the abdomen but over time will change to a steady, severe pain that resting, changing position, or using other measures does not resolve. Pain may also occur in the right shoulder or upper-right region of the back.

The pain will intensify over time, especially when taking a deep breath or with any kind of movement. Most people call their doctor within 4 of 6 hours of experiencing this type of pain.

In children and older adults, gallbladder symptoms may be vague. They may not experience pain or fever and complain only of malaise, lack of appetite, and weakness. Some people with gallbladder inflammation encounter a yellow tinge to the skin, known as jaundice. However, this is rare.

In an emergency room, a person with an acutely inflamed gallbladder will usually lie perfectly still on the examining table because the slightest movement can aggravate their pain.

The individual might also tense the abdominal muscles, which will feel similar to a spasm. Tensing these muscles, or guarding, helps protect the inflamed organ from the potential pain of examination.

In some cases, an inflamed gallbladder can rupture and progress to a life-threatening infection called sepsis.

Any individual experiencing symptoms of gallbladder inflammation must seek immediate medical attention to avoid any potentially serious or life-threatening complications.

A surgeon will often remove the gallbladder to prevent the progression of cholecystitis into more severe conditions.

Many gallbladder inflammation cases occur as a result of gallstones. These are small crystal-like masses made up of bile pigments, cholesterol, and calcium salts.

Roughly 10 to 15 percent of Americans have gallstones, and as many as one-third of these people will develop inflammation. Gallstones do not usually cause symptoms on their own.

The risk of gallbladder inflammation increases with age. Other risk factors include:

  • being female
  • pregnancy
  • obesity
  • diabetes
  • a history of gallstones
  • rapid weight loss

Tackling gallbladder inflammation is vital for preventing the development of any potentially fatal complications.

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)
  • Gallstones
  • 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

Symptoms

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:

  • Jaundice
  • 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

Diagnosis

  • Blood tests
  • Ultrasound and other imaging techniques

Treatment

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.

Acute cholecystitis – NHS

Acute cholecystitis is inflammation of the gallbladder. It usually happens when a gallstone blocks the cystic duct.

Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. The cystic duct is the main opening of the gallbladder.

Gallstones are very common, affecting about 1 in 10 adults in the UK.

They do not usually cause symptoms, but can occasionally cause episodes of pain (biliary colic) or acute cholecystitis.

Acute cholecystitis is potentially serious because of the risk of complications.

It usually needs to be treated in hospital with rest, intravenous fluids and antibiotics.

Symptoms of cholecystitis

The main symptom of acute cholecystitis is a sudden, sharp pain in the upper right-hand side of your tummy (abdomen). This pain spreads towards your right shoulder.

The affected part of the tummy is usually very tender, and breathing deeply can make the pain worse.

Unlike other types of abdominal pain, the pain of acute cholecystitis is usually persistent and does not go away within a few hours.

Some people may have additional symptoms, such as:

  • a high temperature (fever)
  • feeling sick
  • being sick
  • sweating
  • loss of appetite
  • yellowing of the skin and the whites of the eyes (jaundice)
  • a bulge in the tummy

When to seek medical advice

See a GP as soon as possible if you develop sudden and severe abdominal pain, particularly if it lasts longer than a few hours or is accompanied by other symptoms, such as jaundice and a high temperature.

If you’re unable to contact a GP immediately, phone your local out-of-hours service or call NHS 111 for advice.

It’s important for acute cholecystitis to be diagnosed as soon as possible, as there’s a risk serious complications could develop if it’s not treated promptly.

What causes acute cholecystitis?

The causes of acute cholecystitis can be grouped into 2 main categories: calculous cholecystitis and acalculous cholecystitis.

Calculous cholecystitis

Calculous cholecystitis is the most common, and usually less serious, type of acute cholecystitis. It accounts for around 95% of all cases.

Calculous cholecystitis develops when the main opening to the gallbladder, the cystic duct, gets blocked by a gallstone or a substance known as biliary sludge.

Biliary sludge is a mixture of bile, a liquid produced by the liver that helps digest fats, and small cholesterol and salt crystals.

The blockage in the cystic duct causes bile to build up in the gallbladder, increasing the pressure inside it and causing it to become inflamed.

In around 1 in every 5 cases, the inflamed gallbladder also becomes infected by bacteria.

Acalculous cholecystitis

Acalculous cholecystitis is a less common, but usually more serious, type of acute cholecystitis.

It usually develops as a complication of a serious illness, infection or injury that damages the gallbladder.

Acalculous cholecystitis can be caused by accidental damage to the gallbladder during major surgery, serious injuries or burns, sepsis, severe malnutrition or HIV/AIDS.

Diagnosing acute cholecystitis

If you have severe tummy pain, a GP will probably carry out a simple test called Murphy’s sign.

You’ll be asked to breathe in deeply with the GP’s hand pressed on your tummy, just below your rib cage.

Your gallbladder will move downwards as you breathe in. If you have cholecystitis, you’ll experience sudden pain as your gallbladder reaches your doctor’s hand.

If your symptoms suggest you have acute cholecystitis, your GP will refer you to hospital immediately for further tests and treatment.

Tests you may have in hospital include:

  • blood tests – to check for signs of inflammation in your body
  • an ultrasound scan of your tummy – to check for gallstones or other signs of a problem with your gallbladder

Other scans, such as an X-ray, CT scan or MRI scan, may also be carried out to examine your gallbladder in more detail if there’s any uncertainty about your diagnosis.

Treating acute cholecystitis

If you’re diagnosed with acute cholecystitis, you’ll probably need to be admitted to hospital for treatment.

Initial treatment

Initial treatment will usually involve:

  • not eating or drinking (fasting) to take the strain off your gallbladder
  • receiving fluids through a drip directly into a vein (intravenously) to prevent dehydration
  • taking medicine to relieve your pain

You’ll also be given antibiotics if it’s thought you have an infection.

These often need to be continued for up to a week, during which time you may need to stay in hospital, or you may be able to go home.

After initial treatment, any gallstones that may have caused acute cholecystitis usually fall back into the gallbladder and the inflammation will often settle down.

Surgery

Removing your gallbladder may be recommended at some point after initial treatment to prevent acute cholecystitis coming back and reduce your risk of developing potentially serious complications.  

This type of surgery is known as a cholecystectomy.

Although uncommon, an alternative procedure called a percutaneous cholecystostomy may be carried out if you’re too unwell to have surgery.

This is where a needle is inserted through your tummy to drain away the fluid that’s built up in the gallbladder.

If you’re fit enough to have surgery, your doctors will decide when the best time to remove your gallbladder is.

In some cases you may need to have surgery immediately or in the next day or 2, or it may be necessary to wait a few weeks until the inflammation has settled down.

Surgery can be carried out in 3 ways:

  • laparoscopic cholecystectomy – a type of keyhole surgery where the gallbladder is removed using special surgical instruments inserted through a number of small cuts in your abdomen
  • single-incision laparoscopic cholecystectomy – where the gallbladder is removed through a single cut, which is usually made near the bellybutton
  • open cholecystectomy – where the gallbladder is removed through a single larger cut in the tummy

Although some people who have had their gallbladder removed have reported symptoms of bloating and diarrhoea after eating certain foods, it’s possible to lead a perfectly normal life without a gallbladder.

The organ can be useful, but it’s not essential as your liver will still produce bile to digest food.

Find out more about recovering from gallbladder removal

Possible complications

Without appropriate treatment, acute cholecystitis can sometimes lead to potentially life-threatening complications.

The main complications of acute cholecystitis are:

  • the death of gallbladder tissue (gangrenous cholecystitis) – which can cause a serious infection that could spread throughout the body
  • the gallbladder splitting open (perforated gallbladder) – which can spread the infection within your tummy (peritonitis) or lead to a build-up of pus (abscess)

Emergency surgery to remove the gallbladder is needed to treat these complications in about 1 in every 5 cases of acute cholecystitis.

Preventing acute cholecystitis

It’s not always possible to prevent acute cholecystitis, but you can lower your risk of developing it by reducing your risk of getting gallstones.

One of the main things you can do to lower your chances of getting gallstones is to adopt a healthy, balanced diet and reduce the number of high-cholesterol foods you eat, as cholesterol is thought to contribute to the formation of gallstones.

Being overweight, particularly being obese, also increases your risk of developing gallstones.

You should therefore control your weight by eating a healthy diet and exercising regularly.

But low-calorie rapid weight loss diets should be avoided because there’s evidence they can disrupt your bile chemistry and actually increase your risk of developing gallstones.

A more gradual weight loss plan is best. 

Find out more about preventing gallstones

The gallbladder

The gallbladder is a small pear-shaped organ located beneath the liver. It’s main purpose is to store and concentrate bile.

The liver produces bile, a liquid that helps digest fats and carries toxins excreted by the liver.

Bile is passed from the liver through a series of channels called bile ducts into the gallbladder, where it’s stored.

Over time bile becomes more concentrated, which makes it more effective at digesting fats.

The gallbladder releases bile into the digestive system when it’s needed.

The gallbladder is an organ that’s useful, but not essential. It can safely be removed without interfering with your ability to digest food.

Page last reviewed: 07 August 2019
Next review due: 07 August 2022

90,000 Gallbladder diseases – symptoms and treatment

The first visit of a patient to a doctor about biliary colic does not mean that he has an acute process. Almost always, a careful examination reveals the presence of signs of chronic suffering of this organ. In other words, cholecystitis develops gradually and therefore an acute attack of cholecystitis is an exacerbation of a chronic, latent gallbladder disease.

In chronic cholecystitis, the most common symptoms are indications of pain in the right hypochondrium, bitterness in the mouth, poor appetite, nausea, and sometimes vomiting of bile in the morning.

An exacerbation of the disease is accompanied by attacks of unbearable cutting pain in the right hypochondrium or in the epigastric region. The pain has a typical irradiation (direction) – up, to the right and from behind – to the region of the right shoulder blade, to the right shoulder, to the right half of the neck, sometimes spreads over the entire abdomen, intensifies with a deep breath, in the position on the left side. Pain syndrome may be accompanied by nausea and repeated vomiting with an admixture of bile, which does not bring relief.Pallor and yellowness of the skin is noted. The tongue is coated with a yellow-brown bloom, dryish. The mobility of the abdominal wall in the upper right part is limited. Here, a zone of increased skin sensitivity, pain on palpation (pressure), and sometimes a symptom of muscle protection are determined.

It should be emphasized that the localization of pain in the right half of the chest, the right scapula is as characteristic of diseases of the gallbladder as ischemic heart disease is characterized by pain in the chest and in the left arm. It is important to find out the immediate, provoking cause of the pain syndrome. An attack of cholecystitis is most often associated with the abuse of fatty foods and other errors in food. Relapse of an attack is most often due to a stressful situation, nervous tension, mental trauma. In persons suffering from cholelithiasis, pericholecystitis, an attack often occurs in connection with physical exertion, horseback riding, cycling, or driving on bumpy roads.

Transient jaundice that develops after an attack is characteristic of cholelithiasis, but it can also be with hypermotor dyskinesia.In some cases, in violation of the outflow of bile, patients note the appearance of discolored feces (white-gray) within 1-2 days.

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In uncomplicated cholelithiasis, an attack of pain begins suddenly and just as suddenly stops, the patient already the next day feels quite satisfactory.

More often, chronic diseases of the biliary tract occur with so-called minor symptoms – general malaise, subfebrile condition, unexpressed dyspeptic symptoms, pain or discomfort from the heart. Such patients for a long time but unsuccessfully visit doctors of various specialties, who sometimes erroneously diagnose rheumatism, thyrotoxicosis, neurocirculatory dystonia, peptic ulcer, gastritis, neuralgia, etc., while the cause of all these symptoms lies in latent cholecystitis, dyskinesia, or cholelithiasis.It may be the other way around, the patient is being treated for various diseases of the gallbladder, in fact, the true cause is duodenal ulcer.

In elderly and senile people, there is a painless course of cholecystitis, which is associated with a change in the threshold of pain sensitivity, the body’s inactivity in old age.

In patients with chronic diseases of the biliary tract, the stomach may be involved in the process, while belching, bitter taste in the mouth, heartburn, nausea, and anacid are often noted. Stool disorders (diarrhea, constipation) are possible. All these disorders affect the state of the central nervous system, patients become nervous, irritable, and suffer from insomnia. Conversely, individuals suffering from chronic diseases of internal organs may develop gallbladder dyskinesia.

Hypotonic (atonic) dyskinesia

usually characterized by mild, dull pain (feeling of heaviness) in the right hypochondrium. Pain, as a rule, is accompanied by nausea when eating, an unpleasant taste in the mouth, poor tolerance of food odors.

90,000 symptoms, how to treat, causes of gallbladder pain

Why are there problems with the gallbladder and biliary tract, what are the symptoms of diseases, where does it hurt and how to treat such conditions?

Diseases of the biliary system are increasingly common in young men and women. These diseases usually proceed chronically, periodically exacerbating, and are accompanied by various symptoms, the most striking of which is pain 1 .

The gallbladder is a conical or pear-shaped organ located on the lower wall of the liver.In addition to the bladder, the bile duct includes the hepatic ducts, the cystic duct and the common bile duct. The main function of the gallbladder is to store bile. It is a greenish-yellow thick liquid composed of water, bile acids, electrolytes, cholesterol, lecithin and other components 1 .

Most of it is stored in the gallbladder. From there, through the bile duct, it enters the small intestine, where it is involved in digestion. The volume of the bladder is normally about 70-100 ml, however, in case of violations, for example, blockage of the common bile duct by a stone, the volume of the organ can increase several times and reach large sizes 1 .Violation of the process of bile secretion leads to the development of diseases of the biliary tract 1 .

Bile is produced by the liver – 500-600 ml per day 2 .

1

Pain in the right hypochondrium

2

Digestive disorders – bloating, flatulence, nausea, vomiting, constipation, diarrhea

3

Weakness, increased fatigue

4

Decrease or loss of appetite

5

Yellowness of the skin and visible mucous membranes

6

Sleep disorders

The main symptom of the disease is pain in the right hypochondrium. There are three main reasons why the gallbladder can hurt 1, 3 :

  1. When its walls are stretched, nerve endings are irritated. The pain is accompanied by heaviness in the upper abdomen, a feeling of the presence of a foreign body, sometimes – a burning sensation 1 .
  2. Cutting, pulling, seizing pains occur with spasm of the smooth muscles of the bladder. At the same time, the patient cannot find a place for himself, trying to take a comfortable position 1 .
  3. Pain can result from direct irritation of receptor endings during inflammation, ischemia, destruction of organ tissue 1 .

Gallstone disease (hereinafter referred to as gallbladder) is a chronic disease of the gallbladder, which can be asymptomatic, exacerbating only with the development of inflammation and blockage of bile ducts by stones. ZhKB is already found in 10% of the world’s population 3 .

Gallstone consists of substances poorly soluble in bile, in most cases cholesterol. There are various reasons for the formation of stones: genetic, demographic, dietary, as well as due to various concomitant diseases or taking certain medications.The structure of the once formed stone is constantly changing, anhydrous cholesterol 4 accumulates inside it.

  • Risk factors – age (40-69 years) 3 , heredity, predisposition, female sex.
  • The development of this disease in women is associated with hormonal changes during pregnancy and childbirth, contributing to the formation of stones 5 .

During menopause, due to a decrease in sex hormones, the contractility of the gallbladder weakens. 5 .

The relationship between ZhKB and the nature of nutrition has been proven. Excessive saturation of bile with cholesterol is promoted by food with a high content of animal fats (fatty meat, milk, cream, lard), simple carbohydrates (fast food, sweets, pastries). The formation of stones is provoked by the frequent use of hot spices, a deficiency in the diet of vitamins (especially vitamin E) 5 .

A tendency to stone formation occurs with increased reabsorption of bile acids. This occurs in conditions of slow movement of food through the intestines, which is facilitated by a lack of dietary fiber (vegetables, fruits) in the diet 5 .One of the main factors in the development of gallstone disease is obesity. Moreover, the risk of stone formation is directly proportional to excess weight. If with a body mass index (BMI) of 25 to 30, the risk of gallstones increases by 2 times, then with a BMI over 35 – already 20 times 6 .

A sharp weight loss also has a negative effect on stone formation. With a sharply limited unbalanced diet, the circulation of bile acids is disturbed, which leads to the formation of stones 5 .

There is information about the connection between the lack of physical activity and the process of stone formation.So, in people who spend 40 hours a week watching TV, LCD was detected 2 times more often. The disease occurs much less frequently in people engaged in manual labor 5 .

Some patients ask themselves the question: how to understand that the gallbladder hurts, are there any characteristic signs?

Symptoms depend on the location of the stones, their size, composition and number. A typical manifestation of the disease is biliary colic, with severe pain and a feeling of pressure in the right hypochondrium 2, 5 .

  • An attack of pain is often accompanied by nausea and repeated vomiting, reflex abdominal distention, stool and urine retention. There may be an increase in temperature due to the addition of cholecystitis. An attack of pain can last from several minutes to several hours, usually ends suddenly with an improvement in the patient’s condition. The frequency of attacks varies: both from multiple attacks per day, and to a single one in several years 5 . In case of pain in the abdomen, including in the right hypochondrium, it is important to visit a doctor on time. If the pain syndrome increases and is accompanied by fever, vomiting, nausea, then you should immediately seek medical help 7 .
  • Acute cholecystitis develops most often after blockage of a narrow cystic duct with a stone 3 . Pain, as in biliary colic, can spread to the right shoulder, scapula, interscapular region. The symptoms are quickly joined by jaundice and an increase in body temperature 2 .

The list of gallbladder diseases also includes less common pathologies:

  • Congenital anomalies of the biliary tract – changes in the size, shape of the biliary tract, the size of the gallbladder.Pain syndrome in these cases can occur with torsion or volvulus of the bladder 2 .
  • Congenital anomalies of the bile ducts – atresia (congenital absence), underdevelopment (hypoplasia). These abnormalities usually appear in early childhood 2 .
  • Cysts of the bile duct. They develop very slowly, so in about half of cases, symptoms appear after decades 2 .
  • Choledocholithiasis is the formation of stones in the common bile duct, usually occurring in old age.May not manifest itself in any way for several years 2 .

If symptoms of diseases of the gallbladder and biliary tract appear, you should consult a gastroenterologist or therapist. The doctor needs to tell in detail when the disease began, where it hurts, report the accompanying symptoms. The doctor will conduct an examination, identify the typical risk factors for the disease (age, gender, etc.) and tell you how to treat him 3 .


For the final diagnosis, the doctor prescribes an ultrasound examination of the abdominal organs.In some cases, an overview X-ray of the abdominal cavity, cholangiography (X-ray examination of the bile ducts using a contrast agent), CT or MRI 3 are prescribed.

Disease therapy can be surgical (surgery) and conservative. The operation is resorted to in case of gallstone disease, which is accompanied by severe colic, as well as in the case of the formation of large stones (more than 2 cm in diameter) 2 .

Conservative treatment of gallstone disease is based on the prescription of drugs that help dissolve stones.However, they are effective in only about 10% of patients with cholelithiasis 3 . The drugs are used for infrequent attacks of pain and small stones 3 .

An important stage in the treatment of symptomatic cholelithiasis is the relief of biliary colic 3 . For spasms of smooth muscles in diseases of the biliary tract, antispasmodics are prescribed, such as No-shpa ® forte. This drug helps to relax smooth muscles in the biliary tract and gallbladder, therefore its use helps to reduce spasm and relieve pain 8 . In addition, No-shpa ® forte promotes vasodilation and, due to this, an improvement in the blood supply to tissues, which can also have a positive effect on the relief of pain syndrome 8 .

In the period of exacerbation of diseases, a sparing diet is recommended with restriction of fatty, fried, smoked foods and dairy products 1 . It is better to take food in small portions – 5-6 times a day with intervals of no more than 4-5 hours (except for the night). The diet should be saturated with foods rich in dietary fiber – fresh fruits, vegetables, cereals.Remember the importance of regular physical activity to help prevent weight gain 3 .

No-shpa® forte acts selectively on smooth muscle spasm as the main cause of abdominal pain 9 , gently relaxing tense muscles 8

90,000 Treat biliary dyskinesia in men and women in Moscow

Dyskinesia of the biliary tract or DZhVP – an ailment in which a violation of the functionality of the gallbladder and ducts is diagnosed. As a result, bile does not enter the duodenum in a timely manner and unevenly, because of this, intestinal motility is disrupted, as well as the work of the digestive tract.

DWP is quite often observed in children from three years of age and older, however, the pathology is not a childhood disease, since it is also diagnosed in adult patients. Dyskinesia must be treated, as stones can form in the ducts and gallbladder due to constant stagnation of bile. In addition, bile itself loses its antimicrobial properties, disturbances are observed in the metabolic process (absorption of fat-soluble vitamins worsens).An improper diet and other factors can provoke the development of the disease.

Root causes of JVP:

  • Poisoning, gastritis, inflammatory processes in the intestines.
  • Genetic predisposition.
  • Endocrine disorders.
  • Certain medicines.
  • Food allergy.
  • Respiratory tract infections.
  • Parasites.
  • Neuroses.
  • Excessive fat intake, etc.p.

Biliary dyskinesia can be combined with obesity and diabetes mellitus.

Symptoms of biliary dyskinesia

There are several types of DWP:

  • hypertensive,
  • hypotonic,
  • hyperkinetic
  • hypokinetic type.

The symptoms of manifestation are different for each variant. Common signs of the manifestation of pathology include appetite disorders and other symptoms.

Symptoms of biliary dyskinesia:

  • Headaches and weakness.
  • Loose stools.
  • White coating on the tongue.
  • Pain in the right side, may worsen during exercise.
  • Nausea and vomiting with bile secretion.
  • A burning sensation in the intestines.
  • Chronic constipation.
  • Bitterness in the mouth.
  • Weight loss.
  • Increased sweating.

The intensity of the manifestation of malaise depends on the general condition of the organism.

Doctors of this direction

Diagnosis and treatment of biliary dyskinesia

An experienced physician may suspect an AVP by external signs, usually patients have an unhealthy complexion, dermatitis, and dry skin. But since many diseases can manifest themselves with the same symptoms, the doctor will prescribe laboratory tests to clarify the diagnosis: analysis of urine and blood, liver function tests, coprogram and examination of feces for lamblia.In addition, such diagnostic procedures as ultrasound of the gallbladder and liver, fibrogastroduodenoscopy, probing of the intestine, as well as the stomach (bile samples are taken in stages) are shown.

Normalization of nutrition is the cornerstone of therapy for biliary dyskinesia. The patient should adhere to a specially selected diet for him until the normal functioning of the biliary tract is restored. Patients are prohibited from eating junk food such as fast food, various nuts, crackers, etc.n. Cooking products should be steamed or stewed, as well as boiled. Fried foods, fatty, spicy and salty foods are taboo. The daily diet should be enriched with vegetables and fruits, fermented milk products, lean fish is useful, lean meat is allowed.

Drug treatment includes choleretic drugs, enzyme agents, as well as cholespasmolytics and nootropics. Physiotherapeutic procedures can also be prescribed to patients. The use of medicinal mineral water in a warm form is shown.

Treatment should only be prescribed by a doctor, especially if a child suffers from the symptoms of DVP, since improperly selected drugs can only harm a developing body. Untreated dyskinesia leads to the development of gallstone disease, hepatitis and other serious diseases.

For diagnosis and treatment of biliary dyskinesia, contact the President-Med medical centers in Moscow (near the Kolomenskaya metro station and VDNKh) and in Vidnoye

You may also be interested in:

Intestinal dysbiosis

Intestinal dyskinesia

Dyspepsia

Artist: Mamunts Tsovinar Alekseevna

Chief Physician President-Med g. Vidnoe

Higher Medical, Perm State Medical Institute, Faculty of General Medicine, specialty-general medicine

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Cholecystitis – inflammation of the gallbladder

Cholecystitis is an inflammation of the walls of the gallbladder.It can occur both in the presence of gallstone disease, and in the absence of stones in the gallbladder.

Classification

According to the severity and duration of symptoms, acute and chronic forms of cholecystitis can be distinguished.

Acute cholecystitis

It is characterized by a sudden onset – within a few hours after blockage of the cystic duct, severe pain in the right half of the abdomen, fever, changes in laboratory parameters (a significant increase in leukocytes, C-reactive protein).It is most often associated with a violation of the diet, excessive consumption of spicy and fatty foods, as well as sometimes with driving on uneven roads, stress, taking choleretic drugs

In 90% of cases, this occurs in patients with cholelithiasis, and only 5-10% occurs in patients with acalculous (non-stone) cholecystitis. Gangrene and rupture of the gallbladder can be severe and sometimes dangerous complications of acute cholecystitis.

Chronic cholecystitis

Chronic cholecystitis, as a rule, is caused by repeated attacks of biliary colic, which cause thickening of the walls of the gallbladder as a result of inflammation and impaired motor activity.Over time, chronic bile stasis occurs in the gallbladder, leading to an increase in its concentration and precipitation of cholesterol / bilirubin, followed by the formation of stones.

Reasons

With prolonged stagnation of bile in the gallbladder, the components of bile (most often cholesterol) begin to crystallize and precipitate. Microscopic crystals grow in size over time, merge with each other and form stones.

The gallbladder is normally pear-shaped.Its length is 7-10 cm, width – 3-4 cm, capacity – 40-70 ml (in women, the gallbladder in a state of functional rest has a slightly larger volume than in men, but it contracts faster). It distinguishes between the bottom, the body and the neck, passing into the cystic duct. The outflow of bile from the gallbladder is regulated by the sphincter of Lutkens, and from the common bile duct – by the sphincter of Oddi.

On average, up to 1.5 liters of bile are formed in the human body per day. However, its entry into the intestine normally occurs mainly during digestion.This is provided by the reservoir function of the gallbladder and its rhythmic contractions with successive relaxation of the said sphincter of Lutkens and then the sphincter of Oddi, located at the confluence of the common bile duct into the intestine. In the gallbladder, bile is concentrated 5-10 times.

Risk factors for gallstones:

  1. Genetic predisposition.

  2. Age from 40 to 70 years.

  3. Female gender: blood estrogen levels, oral contraceptive use, pregnancy significantly increase the risk.

  4. Improper diet and sudden weight change:

    • eating food with a high cholesterol content;

    • increase in consumption of fats, refined carbohydrates;

    • unbalanced diet, lack of diet;

    • long-term parenteral nutrition;

    • fasting, fast weight loss: loss of more than 24% of weight, weight loss of more than 1.5 kg per week, low-calorie diets by reducing the amount of fat.

  5. Metabolic disorders (metabolic syndrome, diabetes mellitus).

  6. Crohn’s disease (inflammatory bowel disease leading to impaired absorption of bile salts from the intestine), certain blood diseases, cirrhosis of the liver.

Signs and Symptoms

For cholecystitis, pain in the right hypochondrium or in the epigastric region, radiating to the right scapula, shoulder or collarbone, is typical.They are dull or paroxysmal in nature, varying in intensity and duration.

In biliary colic, the intensity of pain often increases for an hour, then the pain becomes constant for several hours, after which it gradually decreases and disappears when the mobile stone returns to the cavity of the gallbladder. There is no pain between attacks.

Complications

If an attack lasts more than 6 hours, is accompanied by vomiting and fever, there is a high probability of developing acute calculous cholecystitis (inflammation of the gallbladder), obstructive jaundice associated with blockage of the bile duct, or pancreatitis (acute inflammation of the pancreas).All of these conditions require urgent hospitalization and emergency surgical care.

Long-term carriage of stones is accompanied by secondary infection and the development of chronic cholecystitis, which entails various diseases of the liver and pancreas. In addition, long-term inflammation increases the risk of developing gallbladder cancer.

Diagnostics

When seeking medical help, the patient must be examined by a surgeon, and even before carrying out instrumental diagnostic methods, the doctor checks some specific symptoms indicating the presence of acute cholecystitis:

  1. Ortner’s symptom – pain that appears in the gallbladder area with light tapping with the edge of the palm along the right costal arch;

  2. Murphy’s symptom – an increase in pain that occurs at the time of palpation of the gallbladder with a deep breath of the patient.If the patient’s deep breath is interrupted, not reaching height, due to acute pain in the right hypochondrium under the thumb, then Murphy’s symptom is positive;

  3. Courvoisier’s symptom – an increase in the gallbladder is determined by palpation of the elongated part of its bottom, which quite clearly protrudes from under the edge of the liver;

  4. Mussey symptom (frenicus symptom) – pain on palpation in the area above the collarbone.

After examination, the patient undergoes a weight range of instrumental diagnostic measures (the volume of which may vary depending on the severity and duration of symptoms):

  • ultrasound examination (ultrasound) of the abdominal organs,

  • MSCT of the abdominal organs, in some cases MRCP (magnetic resonance cholangiopancreatography),

  • laboratory tests: general blood test with leukocyte formula, C-reactive protein, biochemical blood test.

Cholecystitis treatment

Treatment of patients with acute cholecystitis is aimed at reducing the severity of inflammation and, in most cases, subsequent removal of the gallbladder (cholecystectomy).

Conservative treatment

Within the framework of conservative (non-surgical) treatment, infusion (replenishment of fluid balance, correction of water-electrolyte disturbances) and antibiotic therapy are carried out. Antibiotics are used in almost all cases of cholecystitis (with the exception of a mild course and in the absence of stones).The duration of admission is determined by the rate of regression of clinical symptoms, as well as by the laboratory picture.

The following bacterial agents are most commonly detected in bile: Escherichia coli (41%), Enterococcus (12%), Klebsiella (11%) and Enterobacter (9%). An ideal antibiotic therapy regimen should be effective against all bacterial agents. The most commonly used amoxicillin with clavulonic acid is at least 5 days.

It is imperative to provide adequate pain relief and thereby reduce the suffering of the patient.The most commonly used drugs from the group of non-steroidal anti-inflammatory drugs (ibuprofen), but sometimes you have to resort to opioid analgesics. The latter are rarely used due to the fact that they can increase the pressure in the area of ​​the sphincter of Oddi and thereby further aggravate the patient’s condition.

We do not recommend for cholelithiasis the use of drugs that affect the rheology of bile, contribute to the dissolution of stones in the gallbladder, due to their potential danger – they can provoke choledocholithiasis (“loss” of small stones in the bile duct and blockage of the latter with the occurrence of severe and potentially life-threatening condition – obstructive jaundice).

Surgical treatment

With large stones and in the presence of certain concomitant diseases (for example, diabetes mellitus), with pathological changes in the gallbladder itself, the doctor may recommend removing the gallbladder.

Removal of the gallbladder – the “gold standard” in the treatment of calculous cholecystitis against the background of cholelithiasis. Patients who do not require emergency surgery (non-calculous cholecystitis, mild inflammation) should be risk stratified to determine whether they require early or delayed gallbladder surgery.

If the patient is concerned about biliary colic attacks, surgeons recommend elective cholecystectomy. Each subsequent attack can cause the development of acute cholecystitis with severe complications from the liver and pancreas.

Benefits of Cholecystectomy with EMC

Doctors of the surgical clinic perform surgical interventions for cholecystitis around the clock. In the clinic, removal of the gallbladder is performed by laparoscopic access (through several small punctures, or through one – a promising technique of single-puncture laparoscopic surgery), which is the “gold standard” for cholecystectomy all over the world.Cholecystectomy improves the patient’s condition and does not affect the digestive function.

In the postoperative period, the patient continues to be monitored at regular intervals by the EMC gastroenterologist, who corrects possible (but rather rare) side effects of surgical treatment.

Diet and Nutrition

Of course, adherence to a strict diet (and in some cases fasting is possible) is important in the presence of acute inflammation. The patient is recommended a diet with the exception of spicy, fried and fatty foods, 4-6 meals a day in small portions (in the presence of vomiting, food through a nasogastric tube).

Prevention

EMC doctors recommend that patients who have problems with the gallbladder, and when a small stone is discovered for the first time, should be regularly observed by a gastroenterologist and undergo an ultrasound examination of the abdominal organs once every six months. Active monitoring will allow you to find and eliminate the causes of stone formation and other complications without surgery.

There is no data indicating the effectiveness of adherence to a strict diet in the prevention of gallstone disease.All dietary recommendations are of a general nature and ultimately come down to moderation in the use of potentially unhealthy foods (fast food, fatty and fried foods, overeating).

90,000 gastroenterologist, doctor of medical sciences, professor Mukhutdinova Farida Ibragimovna.

19 November 2019

Family Health Magazine

Your gallbladder was removed.How should you behave? Should I continue to follow the diet? And if so, which one? It took a long or short time after the operation to remove the gallbladder, and again you had to visit the clinic or go to the hospital because of the recurrence of pain attacks, some kind of abdominal discomfort or other disorders. Your condition is now called Postcholecystectomy Syndrome (PCES) – a gallbladder absence syndrome.

Cholecystectomy (removal of the gallbladder) is the most frequent of all operations performed on the abdominal organs.Most of the patients after surgical treatment note good results, but 2-5 percent of patients develop PCES after surgery. It is noticed that the longer the disease was before the operation and the more attacks there were before it, the more often pain and other unpleasant sensations resume after the surgery. The immediate and long-term outcomes of the operation are more favorable if the cholecystectomy is performed in the early uncomplicated period of the disease, in a state of remission of the inflammatory process and in a planned manner.It is the emergency operation for cholecystitis in people with advanced forms of this disease that gives the greatest amount of PCES.

So, postcholecystectomy syndrome is a syndrome of functional restructuring of the biliary system after surgery. This is a condition in which recurrent pain that worried the patient before cholecystectomy and dyspeptic disorders (intolerance to fatty foods, diarrhea, bloating, etc.) remain after the operation. There are many reasons for this pathology.First of all, it should be remembered that removal of the gallbladder for calculous cholecystitis does not relieve patients of metabolic disorders, including hepatocellular dyscholia. Lithogenic bile with a low cholesterol coefficient is determined. The passage of bile is disturbed, which is accompanied by indigestion, absorption of fat and other substances of a lipid nature. A change in the chemical composition of bile leads to microbial contamination of the duodenum, weakening of the growth and functioning of normal intestinal microflora, disorder of the hepatic-intestinal regulation of bile acids and other components of bile.Under the influence of pathological microflora, bile acids undergo deconjugation, which is accompanied by damage to the mucous membrane of the duodenum, small and large intestine, causing, along with bacterial seeding, the development of duodenitis, reflux gastritis, enteritis, colitis. The total pool of bile acids in the body decreases. Duodenitis is accompanied by duodenal dyskinesia, functional duodenal insufficiency and reflux of contents into the common bile duct and pancreatic duct.Reactive pancreatitis and hepatitis join. The cause of the postcholecystectomy syndrome can be diseases of the gastrointestinal tract, which developed as a result of the long existence of gallstone disease and continue after surgical treatment. These are chronic pancreatitis, cholangitis, duodenitis and gastritis. Thus, the absence of the gallbladder syndrome is a true PCES and develops in connection with the loss of the function of regulating pressure in the biliary system and the deposition of bile, as well as reflex and, possibly, humoral influence on the sphincters.However, an obstructive variant of PCES formation is also possible, due to the formation of stones in the bile ducts. Patients with PCES complain of heaviness and dull pain in the right hypochondrium, intolerance to fatty foods, belching with bitterness. Sometimes the pain intensifies in paroxysms, accompanied by general weakness, palpitations, sweating. Signs of PCES appear at different times after surgery, are intermittent, periods of deterioration alternate with remission.

First of all, patients are advised a diet – limiting animal fats, foods high in cholesterol, easily digestible carbohydrates, spicy, sour, fried foods.Dietary restrictions begin immediately after surgery. Mashed soups, jelly, low-fat broths are used. Then vegetable purees, porridge on the water, steam cutlets, lean fish meat are added to the menu. In the future, the patient’s diet should contain a normal amount of protein, a reduced amount of fats and carbohydrates.

The main thing at PCES is to provide fractional food. Frequent meals (4-5 times a day) in small quantities at the same hours contribute to a better outflow of bile, thereby preventing its retention.Eating large amounts of food, especially when eating irregularly, can lead to pain and other disorders. In the period of a sharp deterioration in the condition, the maximum sparing of the digestive system should be ensured: in the first 2 days of the illness, only warm liquid can be taken. It can be sweet tea, juices from fruits and berries, diluted in half with water, rosehip broth. During the whole day, you can drink only 2 glasses, you need to drink in small sips. After 2 days, it is allowed to take pureed food in small quantities.These are slimy and mashed cereal soups – oat, rice, semolina, mashed porridge from the same cereals, jelly, mousse, jelly. Then you can include in the diet low-fat non-acidic cottage cheese, lean meat, low-fat fish.

Dishes are cooked mashed by steam or by boiling in water. Eat small meals 5-6 times a day. After 5-6 days, you can switch to diet No. 5 a, which must be adhered to for 3-4 weeks. The diet contains 100 g of proteins, 80 g of fats, 350 g of carbohydrates, 4-6 g of sodium chloride.Free liquid 1.5-2 liters. The mass of the daily ration is 3 kg. The daily calorie content is about 2800 kcal. Mechanical and chemical irritants are limited in the diet. Products that enhance the processes of fermentation and putrefaction in the intestine, sharply stimulating the secretory function of the stomach, pancreas, enhancing bile secretion and irritating the liver are excluded. Food is cooked in water or steamed, wiped. The temperature of cold dishes is not lower than 15 degrees, hot – not higher than 62 degrees C.

  • RECOMMENDED: yesterday’s wheat bread, soups are cooked in a slimy broth with grated cereals, vegetables or vegetable broths with finely chopped vegetables – potatoes, carrots, zucchini, pumpkin, boiled cereals – rice, semolina, oatmeal, noodles (you can add an egg-milk mixture to soups, which is prepared by combining a raw egg with an equal volume of milk, and seasoned with butter, sour cream), low-fat meats in the form of steam cutlets, soufflé or mashed potatoes, low-fat varieties of fish and poultry, mainly chopped, but soft varieties and parts are allowed periodically in a piece, boiled in water or steamed.Boiled and mashed vegetables: potatoes, zucchini, pumpkin, carrots, beets, cauliflower in the form of mashed potatoes, soufflés, casseroles, porridges are cooked in water with the addition of pureed milk, puddings are allowed, eggs are added to dishes and given in the form of steam protein omelets , milk in natural form or in dishes according to individual tolerance, fresh non-acidic cottage cheese in natural form or in dishes – casseroles, soufflés, puddings, mild cheese: Russian, Yaroslavl, sour cream in a small amount in a dish, jelly, mashed compote, jelly, baked apples, pears, preserves and jams from sweet berries and fruits, sugar, honey, fruit caramel, marmalade, with good tolerance, about 100 g per day is allowed.ripe strawberries, strawberries, raspberries, apple, cherry, strawberry juices in half with hot water, a small amount of parsley and dill, béchamel sauce with a little sour cream (do not fry flour), fruit and berry gravies, tea, coffee substitutes with milk, decoctions rose hips. Butter is added to the finished dish no more than 30 g per day, vegetable oil with good tolerance.
  • EXCLUDED: fresh white and rye bread, puff pastry, fatty meats (lamb, pork), poultry (duck, goose) and fish, fried, stew, sausages, smoked meats, canned food, liver, kidneys, brains, fried and salted fish, canned fish, fatty cottage cheese with high acidity, spicy cheese, refractory fats – mutton, beef, pork, legumes, pasta, millet, pearl barley, crumbly cereals, mushrooms, sauerkraut, radish, radish, onion, garlic, sorrel, meat and fish broths, cold snacks, sour fruits rich in fiber, chocolate, ice cream, halva, creams, spices, cocoa, strong coffee, cold carbonated drinks, alcohol.

SAMPLE DIET MENU No. 5 A.

  • Breakfast: protein steam omelet from two eggs, milk semolina, tea with milk.
  • 2nd breakfast: applesauce.
  • Lunch: slimy oatmeal soup, steamed meat cutlet, buckwheat porridge, strained compote. Afternoon snack: homemade pureed cottage cheese.
  • Dinner: steamed fish cutlets, mashed potatoes, tea.
  • At night: kefir, white bread 200 g, sugar 30 g, butter 20 g.

If you are intolerant to vegetable oil, you should refuse it.If you are severely obese, limit the calorie content of foods. Make adjustments for those dishes and products that you can not tolerate. They should be excluded from the diet. It can be milk, fats, eggs. Your health and condition after biliary tract surgery will largely depend on how persistently you follow dietary recommendations.

For the prevention of PCES, a diet enriched with fiber (wheat bran, carrots, cabbage, corn, oatmeal, etc.) is recommended 1.5-2 months after the operation.etc.). Such a diet normalizes the chemical composition of bile and, first of all, the cholesterol content.

Drug treatment of PCES depends on complaints and clinical manifestations of the disease and is prescribed only by a doctor. Antispasmodic drugs, agents that normalize the motility of the gastrointestinal tract and the function of the sphincters of the bile ducts and duodenum, adsorb deconjugated bile acids, reduce inflammation of the duodenal mucosa, inhibit the activity of pathological microbial flora, hepatoprotective agents, enzyme preparations are used.The increased excitability of the biliary tract sphincters can be reduced by psychotherapy, taking sedative and antispasmodic drugs, physiotherapeutic procedures – thermal applications, electrophoresis with novocaine and magnesium sulfate, diathermy, inductothermia and UHF therapy to the liver area. Spa treatment with courses of mineral water intake improves the well-being of patients.

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90,000 Stomach neurosis: symptoms and treatment

The expression “all diseases are from the nerves” is not so far from the truth.The body and psyche of a person are closely related – if you are in a state of stress, tension, excitement or fear for a long time, physiological problems will appear.

One of these is gastric neurosis or gastroneurosis.

What is stomach neurosis?

In general, neurosis is a generic name for dozens of disorders that arise from stress or psychological trauma. It seems that this applies only to the higher nervous system, but in fact, neurosis can occur in any organ, because all systems of our body are rich in nerve endings.So, when, due to psychological problems, the work of the stomach is disrupted, they talk about gastroneurosis.

This is a common disease. Mostly middle-aged people suffer from it, mainly women – more vulnerable emotionally and less resistant to stress than men.

Why does it arise?

There are many causes of stomach neurosis, and not all of them are as harmless as they seem.

  • Wrong lifestyle : irregular regime, severe constant stress, lack of sleep, overstrain – all this negatively affects the nervous system.
  • An unbalanced diet , eating unhealthy foods and snacks on the run harm the entire gastrointestinal tract (GIT).
  • Pathological formations : oncology, ulcers, gastritis and so on.
  • Effects on the digestive tract : poisoning, intoxication, bad habits and so on.
  • Viral diseases that weaken the organ.
  • Internal conflicts , dissatisfaction with oneself and life, conflicts with other people.

In general, most of the causes can be ruled out with a healthy lifestyle.

What are his symptoms?

Symptoms of gastric neurosis are easily confused with gastritis:

  • Feeling hungry, even if you have just eaten;
  • Colic and bloating;
  • Unpleasant sensations and pain in the stomach area;
  • Attacks of heartburn and burning behind the breastbone;
  • Uncontrollable belching with unpleasant odor and loud sound;
  • Persistent feeling of heaviness in the abdomen;
  • Aversion to the sight and smell of food;
  • Chewing reflex in the absence of food.

Therefore, you need to know which psychosomatic symptoms to look for:

  • Headaches, dizziness, high blood pressure;
  • Insomnia and agitation;
  • Rapid heartbeat;
  • Phobias and panic attacks;
  • Hypochondria.

But you need to be more careful: many of the above symptoms, both physiological and psychosomatic, accompany other diseases. Therefore, it is very important to first accurately diagnose and only then start treatment.

In what forms does it appear?

In order to diagnose stomach neurosis faster, it is worth knowing in what form it can manifest itself. Each form is dangerous in its own way – it is extremely important to diagnose and begin treatment as soon as possible.

  • Nervous vomiting , which occurs without urging and lack of feeling of nausea.
  • Belching , similar to hysteria, which occurs due to reflex swallowing of excess air.In this case, a person makes sounds that resemble screams.
  • Bulimia and anorexia . The patient either eats too much food, or practically does not eat – both forms of stomach neurosis are most dangerous and can lead to death.
  • Heartburn , which does not go away even with a special diet.

What if I have stomach neurosis?

If you have any of the physiological and psychosomatic problems, first of all you need to contact a neurologist and gastroenterologist, and then undergo a thorough examination.At the stage of diagnosis, a neurologist most often involves a psychiatrist to analyze the patient’s life and determine the causes of psychological problems. If only the symptoms are treated, the stomach neurosis itself will not go away. And this method helps to more effectively restore the psychological health of the patient.

It is very important not to self-medicate with either medicines or folk remedies – this can lead to irreversible pathologies and dramatically worsen the state of health.

Gastroenterology

Pain and cramps in the abdomen, pain under the ribs, pain after eating, belching, nausea, vomiting, loss of appetite, bitter taste in the mouth, burning sensation and pain behind the breastbone, frequent hiccups, bloating, weight loss, erratic stools, rashes on the skin and dry cough – all this indicates a malfunction and possible diseases from the digestive system, which include:

· diseases of the esophagus;

· diseases of the stomach and duodenum;

intestinal diseases;

· diseases of the liver and gallbladder;

· diseases of the pancreas.

To begin with, I would like to tell you about our first meeting with the patient. In our clinic, each patient is allocated from 30 to 60 minutes. The consultation includes a conversation with the patient, examination (palpation, percussion, auscultation), clarification of complaints and collection of anamnesis, then the doctor makes a preliminary diagnosis and makes an appointment. It is recommended to take the results of all previously performed studies with you and go to an appointment on an empty stomach in case of appointment of tests and referral for instrumental diagnostics.Also, in advance, before the consultation, it will not be superfluous to think over all the questions you are interested in regarding your state of health, complaints and history of your disease. This will help you not to forget anything important during the conversation with the doctor. For all other questions arising during treatment, our specialists answer in writing via the clinic’s official e-mail.

In Dzhi clinics, if necessary, you may be offered to undergo the following examinations:

1. Laboratory diagnostics: general clinical analysis and biochemistry of blood, general urine analysis, fecal analysis, which is necessary for the diagnosis of iron deficiency anemia in chronic atrophic gastritis, detection of latent bleeding ( erosion, peptic ulcer), determination of the severity of the inflammatory process, etc.

2. Survey ultrasound of the abdominal organs, contractility of the gallbladder, ultrasound of the intestines and stomach, which allows assessing the state of internal organs, identifying acute or chronic pathologies, possible neoplasms and the presence of stones.

3. Gastroscopy – endoscopic examination of the stomach and duodenum, which allows you to visually determine disorders of the mucous membrane of the gastrointestinal tract, erosion and ulcers, the presence of a hiatal hernia, identify polyps and other neoplasms.

4. Colonoscopy – an endoscopic examination of the intestine, which allows assessing the state of the mucous membrane and bends, signs of inflammation, areas of narrowing and the presence of adhesions, cracks, neoplasms, followed by biopsy sampling for histology.