How do doctors diagnose gallstones. What tests are used to identify gallbladder problems. When should you seek medical attention for gallbladder symptoms. What are the warning signs of gallbladder disease. How is gallbladder cancer diagnosed. What imaging techniques are most effective for detecting gallstones.

Understanding Gallbladder Function and Common Issues

The gallbladder is a small, pear-shaped organ located near the liver that plays a crucial role in the digestive system. Its primary function is to store and concentrate bile, a fluid produced by the liver that aids in the digestion of fats. However, this vital organ can be susceptible to various problems, including gallstones, inflammation (cholecystitis), and in rare cases, gallbladder cancer.

Gallstones are one of the most common gallbladder issues, affecting millions of people worldwide. These small, hardened deposits can form when there’s an imbalance in the substances that make up bile. While many individuals with gallstones remain asymptomatic, others may experience severe pain and complications that require medical attention.

Are gallstones always symptomatic?

Interestingly, up to 90% of people with gallstones don’t experience any symptoms at all. These “silent” gallstones often go undetected and may not require treatment. However, when symptoms do occur, they can be quite severe and warrant immediate medical attention.

Recognizing the Warning Signs of Gallbladder Problems

While many gallbladder issues can be asymptomatic, it’s essential to be aware of the potential warning signs that may indicate a problem. Recognizing these symptoms early can lead to prompt diagnosis and treatment, potentially preventing more serious complications.

• Severe pain in the right upper abdomen, sometimes extending to the right chest or back
• Pain that occurs after eating, particularly following high-fat meals
• Discomfort that worsens at night
• Fever accompanied by shaking and chills, especially if it occurs with or after abdominal pain
• Nausea and vomiting
• Heartburn and indigestion
• A feeling of fullness in the abdomen
• Excess gas

If you experience any of these symptoms, particularly if they are severe or persistent, it’s important to consult with a healthcare professional. They can help determine whether your symptoms are related to gallbladder issues and recommend appropriate diagnostic tests.

Can gallbladder problems be mistaken for other conditions?

Yes, gallbladder symptoms can sometimes be confused with other gastrointestinal or cardiac issues. For example, upper abdominal pain and nausea can also be signs of peptic ulcers or gastritis. Similarly, chest pain associated with gallbladder problems might be mistaken for a heart attack. This is why proper diagnostic testing is crucial for accurate diagnosis and appropriate treatment.

The Diagnostic Process for Gallbladder Disease

When a patient presents with symptoms suggestive of gallbladder problems, healthcare professionals employ a systematic approach to diagnosis. This process typically involves several steps, including a thorough medical history, physical examination, and various diagnostic tests.

Medical History and Physical Examination

The diagnostic journey often begins with a comprehensive medical history. A healthcare professional will inquire about the nature and duration of symptoms, any triggering factors (such as fatty meals), and family history of gallbladder issues. They will also ask about other health conditions or concerns that may increase the risk of gallstones.

During the physical examination, the doctor will carefully examine the abdomen, checking for tenderness, particularly in the upper right quadrant where the gallbladder is located. They may also look for signs of jaundice, which can occur if a gallstone is blocking the bile duct.

Laboratory Tests

Blood tests are often ordered to check for signs of infection, inflammation, or liver function abnormalities. These tests can help identify complications such as cholecystitis (inflammation of the gallbladder) or cholangitis (infection of the bile ducts).

Advanced Imaging Techniques for Gallbladder Diagnosis

Imaging tests play a crucial role in the diagnosis of gallstones and other gallbladder conditions. These non-invasive procedures allow healthcare professionals to visualize the gallbladder, bile ducts, and surrounding structures, helping to identify any abnormalities or obstructions.

Ultrasound: The Gold Standard for Gallstone Detection

Ultrasound is considered the best imaging test for detecting gallstones. This safe and painless procedure uses high-frequency sound waves to create detailed images of the gallbladder and surrounding tissues. Ultrasound can effectively identify the presence of gallstones, even in asymptomatic individuals.

During an ultrasound examination, a technician applies a gel to the skin over the upper right abdomen and moves a handheld device called a transducer across the area. The transducer emits sound waves that bounce off internal organs and structures, creating real-time images on a monitor.

How accurate is ultrasound in detecting gallstones?

Ultrasound has a high sensitivity and specificity for detecting gallstones, with accuracy rates of 95% or higher in most cases. It’s particularly effective at identifying stones larger than 2mm in diameter. However, very small stones or those located in difficult-to-image areas may occasionally be missed.

Computed Tomography (CT) Scans

CT scans combine X-rays with computer technology to produce detailed cross-sectional images of the body. While not as sensitive as ultrasound for detecting gallstones, CT scans can be valuable in identifying complications such as infection or blockage of the gallbladder or bile ducts.

CT scans are particularly useful when there’s suspicion of other abdominal conditions that may be causing similar symptoms. They can provide a broader view of the abdomen and pelvis, helping to rule out other potential causes of pain or discomfort.

Magnetic Resonance Imaging (MRI)

MRI uses powerful magnets and radio waves to create detailed images of internal structures without the use of ionizing radiation. In gallbladder diagnostics, a specific type of MRI called magnetic resonance cholangiopancreatography (MRCP) is often used.

MRCP is particularly effective at visualizing the biliary tract, including the gallbladder and bile ducts. It can detect gallstones within the ducts, as well as other abnormalities such as tumors or strictures. This technique is especially valuable when there’s suspicion of bile duct obstruction or when other imaging methods have been inconclusive.

Specialized Diagnostic Procedures for Gallbladder Disease

In some cases, more specialized diagnostic procedures may be necessary to fully evaluate gallbladder function or to address specific concerns. These tests are typically reserved for situations where standard imaging techniques have not provided sufficient information or when therapeutic intervention may be required.

Cholescintigraphy (HIDA Scan)

Cholescintigraphy, also known as a HIDA scan (hepatobiliary iminodiacetic acid scan), is a nuclear medicine procedure that evaluates the function of the gallbladder and bile ducts. This test involves injecting a small amount of radioactive tracer into a vein, which is then taken up by the liver and excreted into the biliary system.

A special camera tracks the movement of the tracer through the biliary tract, providing information about bile production, flow, and gallbladder contraction. This test is particularly useful for diagnosing functional gallbladder disorders or identifying blockages in the bile ducts.

What can a HIDA scan reveal that other tests cannot?

A HIDA scan can provide unique insights into gallbladder function that other imaging tests may miss. It can help diagnose conditions such as biliary dyskinesia (abnormal gallbladder contractions) or cystic duct obstruction. Additionally, it can assess the gallbladder’s ability to fill and empty properly, which is crucial information in cases where gallbladder removal is being considered.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP is a specialized procedure that combines endoscopy with X-ray imaging to diagnose and treat problems in the bile ducts and pancreatic duct. During this procedure, a thin, flexible tube with a camera (endoscope) is passed through the mouth and into the small intestine. A contrast dye is then injected into the bile ducts, allowing them to be visualized on X-ray.

ERCP is particularly valuable for locating gallstones stuck in the common bile duct and can often be used to remove them during the same procedure. It’s also useful for diagnosing and treating other biliary tract disorders, such as strictures or leaks.

Diagnosing Gallbladder Cancer: A Rare but Serious Concern

While gallbladder cancer is relatively rare, it’s important to be aware of its possibility, especially in individuals with long-standing gallbladder disease. The diagnosis of gallbladder cancer often involves a combination of imaging studies and, in some cases, tissue biopsy.

Initial suspicion of gallbladder cancer may arise during routine imaging for gallstones or other gallbladder issues. If a mass or abnormal thickening of the gallbladder wall is detected, further investigation is warranted. This may include:

• Advanced imaging techniques such as contrast-enhanced CT or MRI scans
• Positron emission tomography (PET) scans to detect areas of increased metabolic activity
• Endoscopic ultrasound (EUS) to obtain detailed images of the gallbladder and surrounding tissues
• Biopsy procedures to obtain tissue samples for microscopic examination

Are there specific risk factors for gallbladder cancer?

While the exact cause of gallbladder cancer is not always clear, several risk factors have been identified. These include:

• Chronic gallstone disease
• Gallbladder polyps
• Chronic inflammation of the gallbladder (cholecystitis)
• Older age (most cases occur in individuals over 65)
• Female gender (gallbladder cancer is more common in women)
• Obesity
• Certain ethnic backgrounds (e.g., Native American and Hispanic populations have higher rates)

Individuals with these risk factors should be particularly vigilant about reporting any unusual symptoms to their healthcare provider and may benefit from more frequent health screenings.

The Importance of Timely Diagnosis and Treatment

Prompt diagnosis of gallbladder issues is crucial for several reasons. First, it allows for timely treatment, which can prevent complications such as acute cholecystitis, pancreatitis, or bile duct obstruction. Second, early intervention can often lead to less invasive treatment options and better outcomes.

For individuals experiencing symptoms suggestive of gallbladder problems, seeking medical attention promptly is essential. Healthcare providers can then determine the appropriate diagnostic tests based on the individual’s symptoms, medical history, and physical examination findings.

Can gallbladder problems resolve on their own?

While some minor gallbladder issues may resolve spontaneously, many gallbladder problems require medical intervention. Small gallstones may pass on their own, but larger stones or chronic inflammation typically need treatment. Ignoring persistent symptoms can lead to more serious complications that may require emergency care.

It’s important to note that even “silent” gallstones, which don’t cause symptoms, should be monitored by a healthcare professional. In some cases, preventive treatment may be recommended to avoid future complications.

Future Directions in Gallbladder Diagnostics

As medical technology continues to advance, new diagnostic techniques for gallbladder disease are emerging. These innovations aim to provide more accurate, less invasive, and more efficient ways to diagnose gallbladder problems.

Emerging Diagnostic Technologies

Several promising technologies are on the horizon for gallbladder diagnostics:

• Advanced ultrasound techniques: New developments in ultrasound technology, such as contrast-enhanced ultrasound and elastography, may improve the detection and characterization of gallbladder abnormalities.
• Artificial intelligence (AI) in imaging: AI algorithms are being developed to assist in the interpretation of gallbladder imaging studies, potentially improving diagnostic accuracy and efficiency.
• Molecular imaging: Novel tracers and imaging techniques may allow for earlier detection of gallbladder cancer or more precise evaluation of gallbladder function.
• Minimally invasive diagnostic procedures: Advancements in endoscopic and laparoscopic technologies may lead to new ways of directly visualizing and sampling gallbladder tissue with minimal patient discomfort.

How might these advancements improve patient care?

These emerging technologies have the potential to revolutionize gallbladder diagnostics in several ways:

• Earlier detection of gallbladder problems, including cancer, leading to better treatment outcomes
• More accurate differentiation between benign and malignant gallbladder conditions
• Reduced need for invasive diagnostic procedures
• Improved ability to personalize treatment plans based on more detailed diagnostic information
• Faster and more efficient diagnostic processes, potentially reducing healthcare costs and patient anxiety

As these technologies continue to develop and undergo clinical validation, they may soon become integral parts of the diagnostic toolkit for gallbladder disease, complementing or even replacing some of the current standard techniques.

Diagnosis of Gallstones – NIDDK

How do doctors diagnose gallstones?

Doctors use your medical history, a physical exam, and lab and imaging tests to diagnose gallstones.

A health care professional will ask you about your symptoms. He or she will ask if you have a history of health conditions or health concerns that make you more likely to get gallstones. The health care professional also may ask if you have a family history of gallstones and what you typically eat. During a physical exam, the health care professional examines your body and checks for pain in your abdomen.

A health care professional will ask if you have a history of health conditions that make you more likely to get gallstones.

What tests do health care professionals use to diagnose gallstones?

Health care professionals may use lab or imaging tests to diagnose gallstones.

Lab tests

A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show signs of infection or inflammation of the bile ducts, gallbladder, pancreas, or liver.

Imaging tests

Health care professionals use imaging tests to find gallstones. A technician performs these tests in your doctor’s office, an outpatient center, or a hospital. A radiologist reads and reports on the images. You usually don’t need anesthesia or a medicine to keep you calm for most of these tests. However, a doctor may give you anesthesia or a medicine to keep you calm for endoscopic retrograde cholangiopancreatography (ERCP).

Ultrasound. Ultrasound is the best imaging test for finding gallstones. Ultrasound uses a device called a transducer, which bounces safe, painless sound waves off your organs to create an image or picture of their structure. If you have gallstones, they will be seen in the image. Sometimes, health care professionals find silent gallstones when you don’t have any symptoms.

Computed tomography (CT) scan. CT scans use a combination of x-rays and computer technology to create images of your pancreas, gallbladder, and bile ducts. CT scans can show gallstones, or complications such as infection and blockage of the gallbladder or bile ducts. However, CT scans also can miss gallstones that you may have.

Magnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed images of your organs and soft tissues without x-rays. MRIs can show gallstones in the ducts of the biliary tract.

MRIs can show gallstones in the ducts of the biliary tract.

Cholescintigraphy. Cholescintigraphy—also called a hydroxyl iminodiacetic acid scan, HIDA scan, or hepatobiliary scan—uses a safe radioactive material to produce pictures of your biliary tract. You’ll lie on a table while a health care professional injects a small amount of the radioactive material into a vein in your arm. The health care professional may also inject a substance that causes your gallbladder to squeeze. A special camera takes pictures of the radioactive material as it moves through your biliary tract. Doctors use cholescintigraphy to diagnose abnormal contractions of your gallbladder or a blockage in the bile ducts.

Endoscopic retrograde cholangiopancreatography (ERCP). ERCP combines upper gastroendoscopy and x-rays to treat problems of your bile and pancreatic ducts. ERCP helps the health care professional locate the affected bile duct and the gallstones. This test is more invasive—or involves more instruments inside your body—than other tests. Doctors use it selectively, usually to remove a gallstone that is stuck in the common bile duct.

Diagnostic Tests for Gallbladder Disease

The gallbladder — a sac located near the liver that serves as a storage space for bile — can be stricken with various problems, such as gallbladder cancer or inflammation (called cholecystitis).

Gallstones are also a common gallbladder problem, and infection can occur if the gallbladder remains blocked by a gallstone or continues to be inflamed.

Gallbladder disease is the term used to describe many of these maladies that can plague the gallbladder. But in many forms of gallbladder disease, a person may have no symptoms — up to 90 percent of people with gallstones, for example, don’t have any symptoms at all. So how can gallbladder disease be diagnosed?

Gallbladder Disease: When Diagnostic Tests Are Needed

Your doctor isn’t going to test you for something that you’re not complaining about, so generally, the only time diagnostic tests for gallbladder problems are done is when a person experiences symptoms. Warning signs of gallbladder problems include:

• Bouts of severe pain in the right upper abdomen and sometimes the right chest or back
• Pain after eating, particularly high-fat foods, or at night
• Fever, with shaking and chills, especially if occurring with, or after, abdominal pain
• Nausea and perhaps vomiting
• Heartburn and indigestion
• A feeling of fullness in the abdomen, or excess gas

If you don’t have symptoms, that doesn’t mean your gallbladder is perfectly normal. Often, doctors will spot signs of gallbladder problems during diagnostic testing for some other symptom or health condition.

Gallbladder Disease: Eliminating Other Causes

If you have some combination of these symptoms, your doctor probably will start by asking detailed questions about them. He may ask for more details about the pain — what it feels like, when it happens, and where in your belly it hurts. Your doctor will also ask questions to look for other possible causes of abdominal pain, like:

• Irritable bowel syndrome (IBS)
• Crohn’s disease or ulcerative colitis
• Cancer or inflammation of the pancreas
• Kidney stones or urinary tract infections
• Pneumonia (when it involves the lower part of the right lung, it can be confused with gallbladder discomfort)
• Viral hepatitis
• Appendicitis
• Gastroesophageal reflux or ulcers in the stomach
• Diverticulitis or diverticulosis — conditions affecting the lining of the colon

Gallbladder Disease: Diagnostic Imaging Tests

After asking questions about your symptoms, doing a physical exam, and eliminating some causes from the list of possibilities, your doctor probably will perform some imaging tests to look at your gallbladder.

Imaging tests used to diagnose gallbladder problems include:

• An ultrasound. This is the most commonly used of the diagnostic tests for gallbladder problems. While very effective in diagnosing even very small gallstones, it can’t always clearly diagnose cholecystitis (inflammation of the gallbladder).
• X-rays. An abdominal X-ray can spot gas and some types of gallstones containing calcium. Some X-ray types require that a patient swallow a dye or have dye injected into the body so the X-ray can capture a clearer picture of the gallbladder.
• Computed tomography (CT) scan. This imaging test uses a computer and X-rays to spot gallbladder problems, but isn’t the most effective method of diagnosing gallstones. CT scans can help spot ruptures (tears in the gallbladder wall) and infections inside the gallbladder or its bile ducts.
• Magnetic resonance imaging (MRI) . Regular MRI, or another type called magnetic resonance cholangiography (MRC), can help diagnose stones in the bile ducts. MRC uses regular MRI imaging technology plus a dye administered into the bile duct. This test is very useful for diagnosing biliary tract (gallbladder and surrounding ducts) cancer, but may not be able to spot tiny stones or persistent infections.
• Endoscopic retrograde cholangiopancreatography (ERCP) . This test uses an endoscope (a tube fitted with a tiny camera and light) that is inserted into the throat, down through the stomach, and into the small intestine. This test can help spot gallstones or problems in the bile ducts of the gallbladder — it’s considered the “gold standard” when it comes to diagnosing stones blocking bile ducts, and allows for removal (using a small basket-like device) during the test. But there is a risk of complications, so the test is typically only given to people who are thought to be very likely to have stones blocking the bile ducts.
• Cholescintigraphy (also called DISIDA, HIDA scan, or gallbladder radionuclide scan). A small amount of radioactive dye is administered, and then a scanning device is used to track the dye as it moves into the gallbladder. This screening method can spot a blocked duct and acute inflammation, but not chronic gallbladder inflammation or gallstones.

Gallbladder Disease: Blood and Urine Tests

A blood test may also be performed to help diagnose gallbladder disease. A complete blood count, or CBC, can help confirm an infection if there is a high white blood cell count. Other specific blood tests can also reveal high bilirubin levels (the cause of jaundice, a complication of gallbladder problems) or elevated enzymes suggesting an obstruction in the gallbladder.

Urine tests may also be performed to help diagnose problems with the gallbladder by looking for abnormal levels of chemicals like amylase, which is an enzyme that aids in the digestion of carbohydrates, and lipase, another enzyme that helps break down fats.

Even if signs and symptoms are not directly suggesting gallbladder disease, your doctor has many ways to visualize the gallbladder. With these tests, your gallbladder disease can usually be promptly diagnosed — and just as importantly, properly treated.

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How to check the gallbladder, what tests to take?

05/31/2021

In most cases, when patients come to me, interviewing them, I hear the diagnoses and pathologies that accompany the patient throughout life and are related to the gallbladder.

What is the gallbladder, what is it for and what does it cause?

The gallbladder is, relatively speaking, a “depot” for bile, formed by the liver, then it gets to it for “maturation” – there it concentrates (due to a decrease in the amount of fluid – dehydration is possible up to 10 times!) And waits for a signal if it needs to stand out for inclusion in the digestive system.
The control of the synchronous contraction of the gallbladder, bile ducts and the valve that regulates the supply of bile to the duodenum occurs due to the nervous and humoral (hormones) systems.
A healthy person produces about 2 liters of bile per day. Of course, with a gallbladder volume of up to 90-120 ml, filling it 20 times and reducing it is not very rational. Therefore, bile does not always accumulate in the bladder, but is also released in parallel into the intestine at a rate of several drops per minute. This immediately helps to solve several issues. Bile is an excellent antiseptic and regulates the normal composition of microflora in the intestine. It is a stimulant of peristalsis and thus will help maintain normal bowel contractility. With the help of bile, incl. metabolic products that are not very properly stored in the body, and therefore, bile also performs an excretory function.
But when we ate, bile secretion increases significantly, as it takes part in the primary processing of fats (the so-called “emulsification” – the dissolution of fats). Only after this, the lipase enzyme secreted by the pancreas can digest fats.

But there are a number of conditions (sometimes mythical) when there are problems with the work of the biliary system.
The mythical problem is the shape of the gallbladder and any “obstacles” that prevent the gallbladder from working, but we have everything in a row – “kinks”, “constrictions”, “curvature” and others. According to modern concepts, the shape of the gallbladder does not affect its function, but the presence of these problems is simply a 3D visualization of the gallbladder itself, which, like any organ, can change its shape. Yes, there are a number of conditions when, after an independent recovery from acute inflammation of the gallbladder, its deformation took place, but this is such a liquid state that, in extreme cases, several such people can be identified in Ukraine.
Billiard dysfunction is one of the most common functional disorders of the biliary system, and is associated with asynchrony of the gallbladder, ducts and valve apparatus. Usually it is manifested by heaviness, pain, discomfort in the right hypochondrium after a meal and can last up to 30 minutes, and it is possible to pass until the next meal. In this case, it is imperative to consult a doctor to rule out an organic pathology of the biliary tract – inflammation, calculi (stones).
It is not worth it to independently examine the function of the gallbladder (without a doctor’s referral to undergo an examination) or self-medicate (take the so-called “choleretic”) is not worth it, since self-interpretation of the results of examinations or taking medications is contraindicated in certain diseases, we can miss a serious illness or worsen gallbladder problem.
First of all, when any health problems arise, you should contact your family doctor, who, if necessary, will refer you to a gastroenterologist. In the presence of private medicine, it is possible to get an appointment with a gastroenterologist without a referral from your family doctor.
Further, the doctor, if there is a suspicion of a violation of the biliary system, prescribes an additional examination. Basic in this situation:

• Abdominal ultrasound
• Liver tests
• Blood alpha-amylase, blood lipase (since the pancreas has a common duct system with bile ducts)
• Complete blood count, C-reactive protein.

Determining the function of the gallbladder by functional load is not a protocol study, but rather a historical diagnostic method and is indicative for the doctor. The doctor cannot rely on this examination as a determining one, since it is very conditional and subjective.
It is important to remember that the diagnosis is not made via the Internet or the similarity of symptoms with the illness of a work colleague. Diagnosis is the result of a complex search and comparison of patient complaints, examination results and response to treatment.

We wish you good health!

05/31/2021

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About health: how to determine the stagnation of bile in the body was told to patients at the “School of Health” Tsivilskaya Central District Hospital

At the initial stages, bile stasis is easily corrected, but if the situation is started, the matter can end even with an emergency operation.

Probably everyone is familiar with the feeling: you eat a piece of fatty food, but the feeling remains that you overeat. There is heaviness in the right side, the food seems to be not digested for a long time. This is one of the symptoms of stagnation of bile.

Together with Maria Alekseeva, , a doctor for ultrasound diagnostics at the Tsivilsky Central District Hospital , at the “School of Health” for patients, we analyzed the main signs of trouble in the gallbladder and found out how it can be treated.

Signs of bile stasis:

• aching and pulling pain in the right side after exercise;
• feeling of discomfort in the right side – as if something were blocking or squeezing there;
• right pain when bending and turning;
• when sitting for a long time in the wrong position, the right hand begins to ache, pain appears in the right shoulder blade;
• dryness or bitterness in the mouth, slight changes in skin tone.

Innocent at first glance, stagnation of bile 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 incorrect posture at the desk).

Bile is a secretion product 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 enters the oral cavity and the digestion process begins, bile enters the intestine (duodenum), where it neutralizes hydrochloric acid residues, 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 the full digestion of food and absorption 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 for some reason bile stagnates and does not enter the intestines, this leads to disruption of the entire digestion process. Cholestasis can lead not only to dysfunction of the gastrointestinal tract, but also to serious diseases associated with metabolic disorders: beriberi, osteoporosis, cholelithiasis, cholecystitis, in severe cases – cirrhosis of the liver (accumulation of bile, its increased concentration changes and recycles liver cells) and can also lead to diabetes. Therefore, this state cannot be started.

To prevent stagnation of bile, doctor Maria Mikhailovna, a specialist of the first category, warned patients about what to remember.

The stagnation of bile is partly facilitated by the liver itself, which produces bile, and the ducts through which it moves, and the gallbladder.

To avoid problems, bile should always be liquid, not viscous or jelly-like.

Bile is a highly concentrated secret, when it is in a stationary state for a long time, a precipitate 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 preventing the formation of stones!

Bile moves through 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 right posture: give yourself pleasure – have breakfast, lunch and dinner beautifully.

The formed bile stasis can be recognized by the following features:

• dull pain in right hypochondrium;
• frequent belching;
• enlarged liver;
• dark urine and light stools;
• constipation or diarrhea;
• bad breath;
• chronic fatigue, drowsiness;
• bitterness in the mouth;
• persistent pruritus;
• yellow color of the skin and whites of the eyes.

At the first signs of congestion, it is better to have an ultrasound immediately. 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 albeit with pain, it will come out of the duct, and a large one can block the duct. And in this case, an emergency operation is indicated.

An accurate diagnosis of bile stasis requires additional examination and treatment:

1. Ultrasound of the liver and bile ducts. It will help to assess the extent of the lesion and the presence of stones. The presence of bile sediment will indicate that the bile is thick and viscous, difficult to move through the bile ducts, and therefore can stagnate. The accumulation of bile in the ducts causes an increase in the liver in volume.
2. General blood and urine tests will help assess the general condition of the body.