Pain when digesting: Gallbladder Surgery: What to Expect
Gallbladder Surgery: What to Expect
If you’re having gallbladder symptoms caused by gallstones or other conditions, your doctor may recommend a surgical procedure as part of your treatment.
In most cases, surgery means removing the gallbladder. But there may be other alternatives in certain situations, and there’s more than one way to perform gallbladder removal surgery.
Here are three surgical options that your doctor may discuss with you, and what to expect from each procedure.
Cholecystectomy (Gallbladder Removal)
This is the medical term for surgery to completely remove the gallbladder.
In the United States, cholecystectomy is a very common operation.
Most gallbladder removal surgeries are performed because of gallstones. Specific reasons for the surgery include:
- Gallstones in the gallbladder that cause pain
- Gallstones in the bile ducts that cause pain
- Gallbladder inflammation, usually due to obstructed bile ducts from gallstones
- Pancreas inflammation (pancreatitis) due to gallstones
There are two main methods of performing gallbladder removal: laparascopic and open. Both methods are performed under general anesthesia, so you’ll be completely “out” during the procedure. (1)
Most surgeons will opt for this method if possible, in which the gallbladder is removed through a series of small incisions in the abdomen.
Laparoscopy “is a ‘Band-Aid’ surgery, and the recovery is much easier,” says Harold Berenzweig, MD, a gastroenterologist and the executive vice president at Texas Health Harris Methodist in Fort Worth, Texas.
Some patients can go home the same day, Dr. Berenzweig adds. Others may need to spend one night in the hospital. (1)
In this surgery, three to four small incisions are made in the abdominal wall. Your surgeon inserts a laparoscope — a flexible tube containing a light and tiny video camera — into one incision, and surgical instruments into the others.
Your surgeon performs the procedure while looking at a video monitor, and then the gallbladder is pulled out through one of the incisions.
At this point, your surgeon may order an imaging test, such as an X-ray or ultrasound, to look for gallstones or other problems in your bile ducts that weren’t visible using the laparoscope.
If everything looks fine, your incisions will be sutured and you’ll be taken to a recovery area. The entire procedure takes 1 to 2 hours. (1,2)
It’s possible that your surgeon won’t be able to reach your gallbladder using the laparoscopic method, potentially due to scar tissue from previous surgeries that makes a larger incision necessary.
If this happens, or if other complications occur, your surgeon may opt for an open surgery. This method involves making an incision measuring roughly 6 inches (15 centimeters) on the upper right side of your abdomen.
This larger incision cuts through muscles, which results in more pain and discomfort later. These muscles and other tissue are pulled back to expose your liver and gallbladder, which your surgeon then removes.
Your incision will then be sutured, and one or more drains may be placed in it to allow fluid or pus to flow out.
While an open cholecystectomy takes about the same amount of time to perform as the laparoscopic version, it results in a longer recovery time due to the larger incision.
You can expect to spend two to three days in the hospital, after which you’ll need four to six weeks to recover from the surgery.
After either type of surgery, a dressing or adhesive strips will be applied to your sutured incisions. Your gallbladder will be sent to a lab for analysis. (1,2)
Endoscopic Retrograde Cholangiopancreatography (ERCP)
This procedure is used to view and treat a bile duct that has become blocked or narrowed.
A blockage can happen when one or more gallstones migrate out of the gallbladder and into the common bile duct, which carries bile to the small intestine.
During ERCP, an endoscope — a flexible tube with a light and tiny camera on it — is guided down your throat into your stomach and small intestine.
A thin tube called a catheter is inserted through the endoscope and into the opening of the bile ducts, where a special dye is injected to make the ducts more visible on an X-ray.
If blockages or narrowed areas are then seen on an X-ray, surgical tools can be inserted through the endoscope to fix the problem.
You’ll probably be awake during an ERCP, but you’ll be given a sedative to help you relax.
ERCP is often performed in conjunction with gallbladder removal. (3)
Cholecystostomy (Gallbladder Draining)
Draining the gallbladder is usually done only as a temporary measure to relieve swelling when surgery to remove the gallbladder can’t be performed right away.
It’s sometimes a good option for people with severe gallbladder problems who have other conditions that would make gallbladder removal a risky procedure.
During this minimally invasive procedure, your doctor will insert a needle through your abdomen into the gallbladder. A tiny tube called a catheter will be inserted through the needle to drain the gallbladder of bile and decompress it.
A drainage bag or bulb will be attached to the end of the catheter to collect excess bile. The catheter and bag will be attached for a few days to several weeks.
With cholecystostomy, “you’re still left with a gallbladder full of gallstones,” Berenzweig notes. That’s why it’s almost always done with an eye toward future gallbladder removal. (4)
A Nonsurgical Option
A rarely used method for treating gallstones is lithotripsy, which uses high-energy sound waves to break the stones into tiny pieces so they can drain out of the gallbladder.
This procedure is sometimes used in combination with oral drugs that can help dissolve or break up gallstones. (5)
But it’s unlikely that your surgeon will recommend lithotripsy for your gallstones.
“I don’t know of anyone who’s had that done lately,” Berenzweig says.
Additional reporting by Quinn Phillips
Stomach Problems – Symptoms, Causes, Treatments
Conditions that affect digestion or cause pain or discomfort in the abdomen are often perceived and described as stomach problems, although the stomach may not always be involved. Most stomach problems are related to the digestive tract, although symptoms may also be due to conditions of the body wall, blood vessels, urinary tract, reproductive organs, or organs of the chest.
When pain is present, stomach problems may be due to the organs near the site of the pain, such as the stomach or gallbladder in the upper abdomen, or the appendix in the lower abdomen. Generalized stomach problems may be associated with diet, infection or inflammation. In women, stomach problems may be related to the menstrual cycle or to infection or other conditions of the reproductive organs.
Problems specific to the stomach and upper gastrointestinal tract include belching, heartburn, gastroesophageal reflux disease (GERD), hiatal hernias (weakened area of the diaphragm that allows the stomach to protrude into the chest), gastritis (inflammation of the stomach lining), or peptic ulcers. Symptoms may be brought on by certain foods and may worsen when lying flat. Gas, bloating, constipation and diarrhea, which may arise from the intestines, can also be related to food intake or may be related to intestinal infection or inflammation.
Pain associated with shingles, a reactivation of the chickenpox virus, may be attributed to stomach problems until the characteristic blistering rash becomes apparent. Abdominal trauma, poisoning, heart attack, pneumonia, pleurisy (inflammation of the lining around the lungs), reproductive system conditions, and stones or infections of the urinary tract can also cause symptoms that are perceived as stomach problems.
Stomach problems that are severe or that do not improve within a day or two can be symptoms of serious medical conditions.
Seek immediate medical care (call 911) for severe pain that comes on suddenly, an inability to have bowel movements, bloody stool, vomiting blood, abdominal rigidity, breathing difficulties, or pain in the neck, chest, shoulders, or between the shoulders. You should also seek immediate care if you have stomach problems and have cancer or might be pregnant and experience vaginal bleeding or abdominal cramps.
If your stomach problems are persistent or cause you concern,
seek prompt medical care.
What causes stomach pain after eating?
If your tummy hurts after eating, a simple bout of indigestion might be to blame. But there are also times when pain after eating can be a sign of something more serious.
Read on to learn about some of the common causes of stomach ache, abdominal pain or stomach cramps after eating, how to treat and manage the discomfort, and when to see a doctor.
Indigestion is a common condition that affects up to 41% of people in the UK and 1 in 4 people in the US.
It happens when acid from your stomach irritates the sensitive, protective lining of your stomach, food pipe (oesophagus) and the top part of your bowel.
Symptoms vary, but it often causes discomfort after eating, which can feel like a burning pain in your tummy.
Other symptoms can include feeling uncomfortably full bloating, feeling sick (nausea), having excess gas and a burning pain in your chest (heartburn). You may also bring up a small amount of food, or bitter-tasting fluid.
Treatment for indigestion
Indigestion can usually be treated at home by:
- changing your diet – some foods are more likely to cause indigestion, including rich, fatty and spicy foods, and chocolate. It may also help to cut down on drinks containing caffeine (such as coffee) and fizzy and alcoholic drinks
- maintaining a healthy weight – being overweight puts more pressure on your stomach, which can push stomach acid into your food pipe and cause indigestion
- giving up smoking (if you smoke) – chemicals in cigarettes can cause the muscle between your stomach and food pipe to relax, so stomach acid moves into your food pipe
- sleeping in a more upright position – this can help stop stomach acid from rising up your food pipe during the night. Try putting an extra pillow behind your head and shoulders when you go to bed
- avoiding ibuprofen or aspirin – these can make indigestion worse
- not eating 3 to 4 hours before going to bed
For fast relief, antacid medicines may ease your symptoms, as they neutralise the acid in your stomach.
Read more about ways to get rid of indigestion here
If your indigestion doesn’t go away, or keeps coming back, see your doctor. They may prescribe stronger medication and run checks to rule out other conditions, such as gastro-oesophageal reflux disease, where stomach acid moves up into your food pipe.
You should also see a doctor if you have indigestion and you:
- feel a lump in your tummy
- are in a lot of pain
- are 55 or older
- lose weight without trying to
- have difficulty swallowing (dysphagia)
- are being sick (vomiting)
- have iron deficiency anaemia
- notice blood in your vomit or poo
Irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS) is a long-term (chronic) condition that causes episodes of tummy pain or cramps, bloating, diarrhoea and/or constipation. The symptoms are often worse after eating. The pain can be sharp, but may ease after doing a poo.
Other IBS symptoms include backache, nausea and feeling tired. Occasionally, you may find that you can’t control when you poo (incontinence) or have problems peeing, like needing to go more often.
Treatment for IBS
The exact causes of IBS are unknown, but the symptoms can often be managed by making changes to your diet and lifestyle. If you think you have IBS, a doctor can check your symptoms and offer advice.
However, you should see a doctor right away if you:
- lose a lot of weight without trying to
- notice bleeding from your bottom or blood in your poo
- have a hard lump or swelling in your tummy
- have shortness of breath and pale skin
Stomach ulcers are open sores inside the body that form when the layer that protects your stomach lining from acid breaks down, damaging the lining of your stomach.
They can be caused by an infection or taking non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen.
The most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of your tummy (abdomen). This can get better or worse after eating, depending on where the ulcer is. You may also get indigestion, heartburn or nausea.
Treatment for stomach ulcers
If you think you have a stomach ulcer, you should see a doctor, as they may prescribe treatment.
If you take NSAIDs, they will review this, and may recommend an alternative painkiller – but you shouldn’t stop taking any prescribed medication without talking to your doctor first.
You should get medical help urgently if you:
- vomit blood
- pass dark-coloured poo
- feel a sharp pain in your tummy that gets worse
Gallstones are small stones that form in your gall bladder. It’s estimated that 1 in 10 people may have them, but not everyone gets symptoms.
They’re usually harmless, but they can cause tummy pain if they get stuck in one of the tubes (ducts) that lead to your gall bladder.
The pain can come on suddenly, be severe and usually last for up to 5 hours. The pain may also get worse when you eat a heavy meal.
Treatment for gallstones
If you think your pain may be caused by gallstones, you should see a doctor, as you may need to have them removed.
Painkillers can help to ease your symptoms. You should also try to avoid foods that can make symptoms worse, such as foods high in saturated fat.
Is it stomach pain or abdominal pain?
Some people refer to all abdominal pain as ‘stomach ache’ or ‘tummy ache’. Abdominal pain is any pain that occurs in the area between your chest and your groin.
Your liver, appendix, pancreas and intestines as well as other organs sit in this part of your body. So, conditions affecting any of these organs can cause abdominal pain.
The different conditions that can cause abdominal pain tend to affect specific areas. The 4 locations to consider are:
- upper abdomen
- lower abdomen
- right side of the abdomen
- left side of the abdomen
Read more about these 4 types of abdominal pain and what you can do about them here.
- stomach pain after eating can be due to digestive problems
- there are times when stomach pain can be serious
- indigestion can feel like a burning pain in the tummy and often comes on after eating
- IBS is a long-term condition where you get episodes of tummy pain, bloating and changes from diarrhoea or constipation
- stomach ulcers can cause a gnawing, burning pain in your tummy, which may get better or worse after eating
- gallstones can cause tummy pain, which may be worse after a heavy meal
- if you have persistent stomach pain after eating, or you’re worried, see your doctor
Still worried about pain after eating?
If you’re still concerned about your tummy pain, check your symptoms or see a doctor for more guidance.
CHECK YOUR SYMPTOMS
7 Common Gastrointestinal Digestive Problems & Symptoms
Last updated on 1 February 2021
Digestive problems refer to any gastrointestinal disorders that occurs in the digestive tract, which is also called the gastrointestinal (GI) tract. The first signs of a digestive tract issue commonly include bleeding, bloating, constipation or diarrhoea, and heartburn.
If you’re experiencing abdominal pain, nausea or bloating, it could either be a virus that will go away in time, or a sign of a gastrointestinal condition that may require medical attention or a change in lifestyle habits.
You should always consult your doctor to identify the exact cause of your symptoms, but here are a few of the common culprits!
Gastritis is the inflammation of the lining of the stomach. It has many causes, but the most common are infectious agents, especially Helicobacter pylori (H. pylori), aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) like Ponstan, and alcohol.
Some common symptoms of gastritis:
- abdominal pain (intermittent or constant burning, or gripping or gnawing pain)
- nausea and vomiting
- loss of appetite
- bloating, burping and belching
Try to avoid common aggravating foods such as spicy, fatty and fried foods, chilli powder, alcohol and coffee as they may increase the severity of symptoms.
Treatment of gastritis depends on its cause. For gastritis associated with of H. pylori, treatment involves a combination of antibiotics and acid suppressants, while gastritis due to aspirin, NSAIDs and alcohol may require an acid suppressant. Where possible, the consumption of alcohol and the medication responsible for the gastritis should be stopped.
Gastritis is often associated with peptic ulcers. Peptic ulcers are sores that develop in the lining of the stomach, lower oesophagus, or first part of the small intestine. They are usually formed as a result of inflammation caused by H. pylori, aspirin and NSAIDs.
Common symptoms of peptic ulcers
The most common symptoms of a peptic ulcer are upper abdominal discomfort, abdominal pain or bloating. You may also notice loss of weight, loss of appetite, nausea, bloody or dark stools, and vomiting.
With proper treatment, most peptic ulcers heal. However, if left untreated, they can worsen over time and lead to more serious health complications such as a perforated ulcer, a bleeding ulcer (which can cause significant blood loss) or scar tissue that may cause strictures, making it difficult for food to pass through your digestive tract.
Gastro-oesophageal reflux disease
Gastro-oesophageal reflux disease (GERD) is a condition where stomach contents move backwards or reflux from the stomach into the oesophagus. The oesophagus is the tube that connects the throat to the stomach.
Reflux is a normal process that may happen in people who have no bothersome symptoms of acid reflux. In contrast, GERD is diagnosed in patients who have episodes of acid reflux that cause troublesome symptoms.
People with GERD may experience symptoms caused by acid irritating and damaging the oesophagus or the back of the throat. These include:
Symptoms of GERD
- chest pain
- nausea or vomiting
- difficulty with or pain when swallowing
- hoarseness of voice and sore throat
Acid reflux occurs more frequently in patients with GERD, compared to those who do not have symptoms of this disease.
It occurs more frequently if the lower oesophageal sphincter (LES), a muscular valve at the lower end of the oesophagus, opens too often or doesn’t close tightly enough to keep the stomach contents inside. It happens when you overeat, or when there is too much pressure on your stomach, often due to obesity or pregnancy. Smoking, alcohol and caffeine may also loosen the LES.
Fortunately, symptoms can generally be controlled through lifestyle changes. These include quitting smoking, reducing alcohol and caffeine consumption, eating less fatty foods, and losing weight. In persistent cases, if antacids and anti-reflux medication don’t work, surgery can be a last resort.
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is part of a group of gastrointestinal disorders known as functional bowel disorders. It is a common problem affecting 10 – 20% of Singapore’s population. Patients with IBS have abdominal discomfort or pain that is associated with either diarrhoea or constipation, and the discomfort is usually relieved after bowel movements.
Symptoms of IBS
The symptoms of IBS vary from person to person but are usually present for a long time.
Common symptoms include:
- Pain, cramping, or bloating in the abdomen during bowel movements
- Changes in stool appearance
- Changes in frequency of bowel movements
- Persistent bloating
- Fatigue and difficulty sleeping
Diarrhoea in IBS usually occurs during the day and after meals. Some IBS patients may have constipation instead of diarrhoea and have hard pellet-like stools. Some patients have a combination of both diarrhoea and constipation.
The cause of IBS is unknown. It is often triggered by an episode of gastrointestinal infection or food poisoning. The immune system in the gut is activated during the infection, and produces cells and proteins that increase the sensitivity of the nerves in the gut. The extra sensitive nerves cause the gut to sense normal amounts of gas and movements as bloating and pain.
Stress and anxiety will exacerbate IBS symptoms. However, it is not known if anxiety on its own will cause IBS. Food intolerances are often found in IBS patients but food allergy is not thought to cause IBS.
There is no investigation which will definitively diagnose IBS. Doctors managing IBS patients will often start with a history of the abdominal symptoms and simple blood and stool tests to rule out common disorders. Some doctors may also order more invasive tests, such as colonoscopy and CT scans, if they are thought to be relevant.
Treatment of IBS is aimed at symptom relief and the majority of IBS patients will not require long-term medication. It is usually managed by modifying the person’s diet and lifestyle, avoiding foods and other events that trigger symptoms.
Common foods that may aggravate IBS include dairy products, fried foods, indigestible sugars and beans. Some natural foods such as ginger, peppermint and chamomile may help to reduce some IBS symptoms. If lifestyle modification is not sufficient, the doctor may prescribe medication to reduce loose stools, constipation and bloating, or to reduce sensitivity of the intestines.
Read the complete guide to managing IBS.
Chronic diarrhoea is defined as frequent loose stools that last for more than 4 weeks.
Causes of chronic diarrhoea
The most common cause of chronic diarrhoea in Singapore is IBS. Another common cause is medicines including antibiotics, painkillers (eg. Ponstan) and diabetic medication (eg. metformin).
Most infections of the intestines cause diarrhoea that lasts for less than 4 weeks. Exceptions include tuberculosis, giardiasis, amoebiasis and tropical sprue, all of which may cause chronic diarrhoea.
In adults, food intolerance may sometimes cause chronic diarrhoea. Lactose intolerance is common in Asians and this can cause diarrhoea and bloating with dairy products. Alcohol and artificial sweeteners may also cause diarrhoea in some patients.
Both non-intestinal and intestinal diseases can cause chronic diarrhoea.
Common non-intestinal diseases that cause diarrhoea include thyroid disease and diabetes.
Hyperthyroidism is a condition where the thyroid produces and releases more hormones than is needed. Thyroid hormones are used to regulate metabolism (the process that transforms the food that is consumed into energy), therefore too much of the hormones can result in symptoms related to high metabolism. In some people, an overactive thyroid causes the digestive system to speed up resulting in diarrhoea and more frequent bowel movements.
Some people with diabetes may experience a complication called diabetic enteropathy. In this condition, nerves of the digestive system are damaged, which may lead to diarrhoea. Additionally, diarrhoea may also occur as a side effect of some diabetes medications.
Chronic pancreatitis is the persistent inflammation of the pancreas. This can happen due to many causes but the most common one is long-term alcohol abuse. Chronic pancreatitis results in lower levels of pancreatic enzymes and hormones in the body, making it harder for food digestion. One of the symptoms of the condition is diarrhoea.
Coeliac disease occurs when the body’s immune system attacks its own tissues when gluten is consumed. This causes damage to the intestinal lining, resulting in problems with nutrient absorption (malabsorption). Diarrhoea is the most common symptom of coeliac disease. Malabsorption can also lead to stools containing high levels of fat, causing an unpleasant smell.
Ulcerative colitis is a type of chronic inflammatory bowel disease (IBD). In this condition, inflammation and ulcers are present in the lining of the colon and rectum. Bloody diarrhoea is a common symptom of ulcerative colitis. The severity of the symptom depends on the severity of inflammation and ulceration in the colon.
Crohn’s disease is a type of inflammatory bowel disease causing inflammation and ulcers in any part of the digestive tract. This is a chronic condition where symptoms may develop gradually or suddenly. There may also be periods where no symptoms are experienced. Symptoms of Crohn’s disease include diarrhoea, blood in stools and malnutrition.
If you have chronic diarrhoea, your doctor may perform blood tests, stool tests and if necessary, gastroscopy and colonoscopy, to diagnose your condition. Treatment of the diarrhoea will depend on the cause identified.
If you have a decreased stool frequency of less than 3 times per week, hard or small pellet-like stools, or feel the need to strain at stools when passing motion, you may have constipation.
Causes of constipation
There are many causes of constipation. The majority of patients with chronic constipation do not have a disease causing the constipation.
Common causes include:
- Not eating enough fibre, such as fruit, vegetables and cereals
- Not drinking enough fluids
- Being inactive and not exercising
- Often ignoring the urge to go to the toilet
- A change in the diet or daily routine
- A side effect of medications
- Stress, anxiety or depression
Treatment for these patients involve changes in lifestyle, diet and fluid intake, and if necessary, medication.
Non-intestinal diseases associated with constipation include thyroid hormone insufficiency and diabetes. Patients with Parkinson’s disease are also more prone to constipation. Some medication including painkillers (eg. morphine) and anti-depressants (eg. amitriptyline) may cause constipation.
If you have constipation, your doctor may evaluate it using blood tests, stool tests, colonoscopy and where appropriate, measurement of anal muscle function.
Treatment for constipation will depend on the cause, and is usually managed by modifying diet and lifestyle, increasing physical activity and fluid intake, and taking natural foods that may help in passing motion (eg. prunes). If lifestyle modification is not sufficient, laxatives may be prescribed.
Inflammatory bowel diseases (Crohn’s disease and ulcerative colitis)
Crohn’s disease and ulcerative colitis are collectively known as the inflammatory bowel diseases (IBD).
Patients with ulcerative colitis develop ulcers only in the large intestine. Patients with Crohn’s disease develop ulcers in the gut, anywhere between the mouth and the anus. The most common parts of the gut affected by Crohn’s disease are the large intestine and the second half of the small intestines.
Symptoms of inflammatory bowel diseases
Symptoms of IBD include abdominal pain, diarrhoea, bloody stools, fever, fatigue, weight loss and malnutrition. In some patients, parts of the body other than the intestines (eg. skin, eyes, joints, or liver) may become inflamed.
Causes of inflammatory bowel diseases
It is not known what causes IBD. It is thought that an environmental factor sets off the gut immune system, which then runs out of control and causes inflammation and ulcers in the intestines of people with the correct genetic predisposition.
There is no cure for IBD as it is a chronic disease. However, it can be controlled with treatment, and patients with controlled disease can still lead normal lives. To diagnose this disease, a series of investigations, including blood tests, stool tests, colonoscopy and CT scans or MRI, will be performed.
If you experience any of the above digestive conditions and are concerned about your gut health, consult a gastroenterologist.
Article reviewed by Dr Ling Khoon Lin, gastroenterologist at Mount Elizabeth Hospital
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Irritable Bowel Syndrome (IBS) and Functional Bowel Disorders
- Your symptoms must have begun at least 6 months ago
- You have stomach pain or discomfort for at least 3 days a month for the last 3 months
- At least two of the following statements are true: Pain is relieved by having a bowel movement; pain is linked to a change in how often you have a bowel movement; pain is linked to a change in the appearance of your stool.
To meet Rome III criteria for functional dyspepsia:
- Your symptoms must have begun at least 6 months ago
- You have one or more of the following symptoms: Bothersome fullness after eating a meal; you become full quickly while eating; pain in upper central portion of the abdomen; burning in upper central portion of the abdomen;
- And there is no evidence of structural disease that is likely to explain the symptoms.
Your doctor may order tests through our comprehensive gastrointestinal lab to rule out other conditions, which can include:
- Colonoscopy and flexible sigmoidoscopy: Used for initial diagnosis, both use a thin, flexible fiberoptic scope with camera to examine different areas, including the colon, small intestine and large intestine to see any ulcers, bleeding and inflammation.
- Upper endoscopy: Uses a thin, flexible fiberoptic scope with camera inserted through the mouth, following the tract to the stomach and upper small intestine to look for bleeding, ulcers and inflammation.
- Esophageal manometry: Uses a thin, flexible tube to measure the muscles of the esophagus and the function of the lower esophageal sphincter to see how well you are swallowing and digesting food.
- Anorectal manometry: A thin, flexible tube with a balloon at the end is inserted into the rectum to measure the tone in the anal sphincter and rectal muscles to determine problems with moving the bowels.
- Laboratory tests: Blood work plus stool samples to check for bacteria and intestinal bleeding.
- Imaging tests: Collaborating with experts in Radiology for imaging and interpreting gastrointestinal abnormalities, including abdominal x-rays, barium enema, computed tomography (CT scan), magnetic resonance imaging (MRI) and assessment of stomach emptying.
Treatment Options for Irritable Bowel Syndrome and Functional Dyspepsia
There are no cures for functional bowel disorders. Patients suffering from these gastrointestinal disorders will all experience abdominal pain and discomfort, but then have varying degrees of constipation, diarrhea, bloating and urgency. To treat effectively, it’s important for our team—which includes gastrointestinal physicians, a board-certified dietician, physical therapists, and a behavioral therapist—to understand your frequency and severity of symptoms, from being a nuisance to mapping out every bathroom from home to the workplace to avoid an accident, so we can create an individualized plan that’s right for you.
Diet plus lifestyle changes, such as decreasing stress and adding an exercise program, are often all that’s needed for those whose symptoms are mainly a nuisance. Our team, which includes a board-certified dietitian, will create a treatment plan individualized for your needs. Learn more about how we are exploring the links between food and health by visiting our Culinary Medicine and Culinary Medicine Classes pages, where you can also learn about classes designed to demonstrate recipes related to specific medical conditions.
Over-the-counter or prescription medication is an option when diet and lifestyle changes aren’t enough. A variety of medications are available, and your doctor will determine which medicine(s) is right for you based on your symptoms and needs.
Physical therapy and/or biofeedback training (an alternative therapy that uses the mind to control a body function using guidance from a biofeedback instructor) can be used to help retrain the muscles of the pelvic floor and/or anal sphincter.
Clinical trials are an option for those who qualify. We are a key site for the development of virtually every drug to treat IBS in the last 10 years.
Clinical Research Studies at the Functional Bowel Disorders Clinic
There are several ongoing clinical studies related to functional bowel disorders at the University of Michigan. These studies are designed to improve our ability to diagnose and treat these disorders. If you are interested in learning more or participating in a study, talk with your health care provider, or go to umhealthresearch.org, the University of Michigan’s website about clinical studies for health research, and follow these steps to find FBD clinical studies:
- Click on the Volunteers heading
- In the drop-down menu, click on Find Studies
- On the next page, click on Search by Condition
- The next page will be a list of conditions—scroll down to Stomach/Esophagus/Bowel Conditions
Other Information About Digestive and Liver Health
To see related gastroenterological services we offer, visit our Digestive and Liver Health overview page.
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Dyspepsia – IFFGD
Dyspepsia is a common disorder that affects up to 30% of the general population.
Symptoms of dyspepsia include upper abdominal pain or discomfort and frequently include symptoms of burning, pressure, or fullness often, but not necessarily, related to meals.
Tratamiento la Dispepsia Funcional: Cuáles son sus opciones?
Other common symptoms include early feeling of fullness (satiety), nausea, belching, and bloating.
While dyspeptic symptoms may develop due to diseases such as peptic ulcer or gastritis, the vast majority of people who see doctors for dyspeptic symptoms are ultimately diagnosed as having functional dyspepsia.
Functional dyspepsia (FD) is a heterogeneous disorder; in other words a variety of causes can lead to similar symptoms. Some studies suggest that FD is a chronic condition for many people, with approximately 50% of patients still experiencing symptoms over a 5-year follow-up period.
While the definition of FD has changed somewhat over the years, the disorder is generally regarded as a group of symptoms thought to originate in the upper digestive tract (stomach and upper small intestine) in the absence of any structural or metabolic disease likely to explain the symptoms. Frustratingly, symptoms of FD do not reliably guide therapy.
Causes of Functional Dyspepsia
The causes of functional dyspepsia are largely unknown and likely multiple. Some evidence exists to implicate a genetic predisposition. Although H. pylori infection may produce dyspeptic symptoms in a small subset of patients, there is little data to support this bacterium as a cause of symptoms in a majority of patients. Psychological factors may influence the symptom experience in some patients with functional dyspepsia.
Changes in gastric function have been identified in many patients with FD. In approximately 40% of patients with dyspepsia, the stomach does not relax normally in response to a meal. This is known as “impaired accommodation” and may be associated with symptoms of fullness and pressure in some patients. Impaired stomach contractions and abnormal stomach emptying may also be seen in a similar percentage of patients.
Impaired stomach emptying has been associated with symptoms of bloating and early feeling of fullness. As many as two-thirds of patients with functional dyspepsia have heightened perception of stomach activity, which is termed visceral hypersensitivity. While frequently seen, visceral hypersensitivity in functional dyspepsia has not been strongly associated with any specific symptoms.
Treatment options for functional dyspepsia generally include one or a combination of:
- Eradication of H. pylori
- Acid-lowering medications
- Prokinetic and antiemetic agents
- Centrally acting therapies
Diet – Most patients with FD have symptoms associated with the ingestion of food. As such, a variety of dietary recommendations are often made, although no clinical trials have formally evaluated specific dietary interventions for the treatment of FD. There are limited data to suggest that dietary fat may induce or exacerbate symptoms and patients often report improvement by eating low-fat meals, and more frequent, smaller meals.
Eradication of H. pylori – Although testing and treating H. pylori infection is recommended and often employed, the eradication of H. pylori infection generally does not improve symptoms outside of those associated with peptic ulcer disease. In patients with FD, there is little benefit beyond placebo in eradicating H. pylori infection and a recent analysis found that only one out of every fourteen H. pylori-infected patients with FD would benefit from treatment.
Acid-lowering Medications – h3 blockers such as ranitidine (Zantac)**, cimetidine (Tagamet), nizatidine (Axid) or famotidine (Pepcid) are the initial agent used by many primary care providers, and are marginally better than placebo at improving upper-center abdominal (epigastric) pain, although they do not improve other dyspeptic symptoms.
If h3 blockers fail to improve symptoms, most doctors then use a proton pump inhibitor (PPI) – omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), or esomeprazole (Nexium). Short-term risks of this strategy are low, and this may provide relief of symptoms in a small number of people, many of whom may have had silent acid reflux. As a group, PPIs are approximately 10% better than placebo at improving dyspeptic symptoms. However, long-term use of PPIs can be expensive.
There is emerging data suggesting that long-term PPI use – when combined with other risk factors – may place some patients at increased risk for Clostridium difficile colitis, community acquired pneumonia, and hip fractures. Nonetheless, overall risk of long-term PPI use seems to be relatively small.
Prokinetic and Antiemetic Agents – Patients with nausea will respond to medications that target that specific symptom. Limited data suggests that symptoms of early feeling of fullness, upper abdominal fullness, and discomfort after eating may respond to the use of medicines that increase gastrointestinal motility (prokinetic agents). The drugs metoclopramide (Reglan) and domperidone (Motilium) are now the most commonly employed agents.
Unfortunately, metoclopramide often has significant side effects including anxiety, drowsiness, decreased libido, and breast tenderness as well as movement disorders. Talk to your doctor before you use metoclopramide. The FDA requires a boxed warning and risk mitigation strategy for metoclopramide-containing drugs. Read more here.
Domperidone is not commercially available in the United States although it is widely used throughout much of the rest of the world. The utility of prokinetic therapy in functional dyspepsia, to date, is largely unproven.
Centrally Acting Therapies – Much of the control of digestive function and sensation is under central nervous system guidance; therapies that target central control mechanisms may have value in relieving symptoms. Tricyclic antidepressants, used in doses lower than required to treat depression, may improve symptoms of dyspepsia in patients who have failed to benefit from treatment with h3 blockers or prokinetics.
Another type of antidepressant, selective serotonin reuptake inhibitors (SSRIs), have not been well studied for the treatment of FD, however they appear effective in the treatment of other functional digestive disorders.
Hypnotherapy may improve dyspeptic symptoms in some patients, and a recent study found that hypnotherapy was better than medical therapy and supportive therapy at improving quality of life and symptom scores. Although not well studied, psychological therapies, including cognitive behavioral therapy, may also relieve symptoms of dyspepsia.
Functional dyspepsia is a common digestive disorder that remains poorly understood. Ongoing investigations seek to define causes and effective therapies. Currently, the National Institutes of Health (NIH) is sponsoring a nationwide, multi-center study that hopes to better define causes and treatments for FD.
A description of the study is available at: http://www.clinicaltrials.gov/ct2/show/NCT00248651
** Beginning September 2019, the US Food & Drug Administration (FDA) is alerting health care professionals and patients of specific recalls of ranitidine (Zantac). Find FDA details here
Stomachaches (for Kids) – Nemours Kidshealth
What’s a Stomachache?
You wake up in the middle of the night with stomach cramps, clutch a pillow and curl your body around it. That helps a little and you go back to sleep. But in the morning, the pain is still there. “Ouch, I have a stomachache!” you tell your mom or dad.
Why Does Belly Pain Happen?
Pain is the body’s way of telling us that something’s going on. Belly pain alerts us to something that’s happening inside us that we might not know about otherwise.
Some reasons for belly pain are easy to spot, like when someone gets hit in the gut or eats spoiled macaroni salad. Oher times, it might be hard to figure out.
When you get a pain in your stomach, it might be an actual problem right in your stomach, but not necessarily. Your abdomen is more than your stomach. It’s more than your intestines. It’s the whole area between your chest and your pelvic (hip) bones. With so many organs in the abdomen, different problems can have similar symptoms.
Types of Tummy Troubles
Here are some of the things that cause tummy troubles:
- Constipation is a top reason kids get belly pain. If you haven’t had a bowel movement (poop) for a while or if it hurts to go to the bathroom or your bowel movements are hard, you are probably constipated.
- Diarrhea is often caused by an infection that some people call “the stomach flu.” When you have diarrhea — runny, watery bowel movements — you may also feel sick to your stomach. The pain is one way your body tells you to stay near a bathroom!
- Other belly troubles. Belly pain also can happen with a urinary tract infection or a blocked intestine. Infection by bacteria or a parasite, heartburn, irritable bowel disease, or inflammatory bowel disease also can cause it.
- Something you eat. Some kids get belly pain because they ate too much of something, a food that was too spicy or greasy, or food that sat around in the fridge for too long and went bad.
- Food intolerance or food allergy. Some people have foods that are hard for them to digest. This is called a food intolerance. For example, people with lactose intolerance have a tough time digesting lactose, a type of sugar found in milk and other dairy foods. A food allergy is different, and some can be very serious. Food allergies can cause immune system reactions that can harm the body. Someone with a food allergy must always avoid that food.
- Appendicitis. If the pain starts by your belly button and then moves to the lower right side of your belly, it might be appendicitis. Fever or vomiting, along with pain that gets worse and worse and a loss of appetite, also can be signs of appendicitis.
- An infection someplace else in your body may cause belly pain too. A sore throat, pneumonia, an ear infection, or a cough can sometimes cause tummy trouble.
- Stress. Many, many kids (and adults, too) have a “nervous stomach” when they are worried or stressed.
How Do Doctors Find the Cause of a Bellyache?
Your doctor will first ask you some questions, examine you, and maybe do some tests. Your doctor may suggest you take some medicine or might give you special instructions for eating to help your body heal the bellyache.
If it turns out that you have appendicitis, you will need an operation called an appendectomy (say: app-en-DEK-tuh-mee).
If stress is behind your stomach problems, your doctor may recommend a specialist, such as a psychologist. These experts can help kids figure out the source of the stress and help them come up with some ideas for how to fix the problems or handle them better.
How Can I Prevent Belly Pain?
If you’d like to prevent bellyaches, here are some good tips to follow:
- Don’t overeat.
- Eat fiber-rich foods, such as fruits and vegetables, so your bowel movements are regular.
- Drink lots of fluids, especially water.
- Wash your hands before eating.
- Don’t eat right before bedtime.
- Get lots of sleep so your body doesn’t get run down.
If you have a bellyache, be sure to let an adult know what’s going on!
How to prevent diseases of the gastrointestinal tract – Rossiyskaya Gazeta
According to statistics, almost 90 percent of the urban population to one degree or another suffer from diseases of the gastrointestinal tract.
The length of this path, where useful substances are extracted from food, in an adult is approximately seven meters. And along its entire length – in the esophagus, stomach, intestines – troubles can lie in wait for us.
Trifle harmful and useful
One of the most common stomach diseases is chronic gastritis.Doctors see the main reason in negative factors that destroy the gastric mucosa. This is alcohol, poor quality food, drinking too hot drinks, aspirin, acids and alkalis. But not so long ago it became clear that gastritis (as, indeed, an ulcer) can be caused by our tiny roommate – a microbe called Helicobacter pylori, which lives in the stomach. This means that (as in the case of other infectious diseases) gastritis and ulcers are contagious. And they can be transmitted from person to person.
Dysbacteriosis is also a common disease today. And, what is important, it also brings other ailments along with it. And again it’s a matter of living little things. The fact is that beneficial bacteria live in our intestines, without which the digestion process simply would not take place. But taking antibiotics (or other reasons) can lead to changes in the normal composition of the microflora. As a result, digestion processes are disrupted. Poorly absorbed nutrients, vitamins … Deficiency of vitamin PP causes irritability, imbalance, depressed mood… Poor absorption of vitamin B2 is characterized by hair loss, changes in the shape of nails, seizures, stomatitis, dermatitis of the wings of the nose … Lack of vitamins B1 and B6 leads to headaches, weakness, intestinal atony, dystrophic changes in the myocardium …
It is impossible to list all the consequences of dysbiosis. After all, immunity suffers from it first of all – the main guardian of the health of our body.
When should you be alert?
The first alarm, of course, is pain.It can be sharp or dull, cramping or, on the contrary, aching.
In addition to pain, other symptoms are characteristic of gastrointestinal diseases:
– discomfort in the abdomen, for example, a feeling of fullness and heaviness, for a long time;
– nausea, heartburn or bitterness in the mouth;
– decreased appetite, aversion to any foods, especially meat;
– unnatural thirst;
– the appearance of a plaque on the tongue;
– increased gas production;
– bad breath;
– increased salivation;
– vomiting of “coffee grounds” or blood;
– isolation of blood from the rectum;
– upset stool lasting more than several weeks;
– alternation of constipation and diarrhea;
– significant decrease in body weight;
– phenomena of anemia (anemia) – weakness, increased fatigue, dizziness;
– prolonged increase in body temperature.
Almost any of these symptoms, let alone their combination, means that an urgent need to see a doctor. Self-medication is unacceptable. It is because of such self-directed attempts, as a rule, that the disease becomes chronic. And then it is very difficult to cope with it. Only a doctor, after a thorough examination, can determine which pathology causes certain symptoms, which, by the way, can be similar in a wide variety of gastrointestinal diseases: gastritis, gastric ulcer and duodenal ulcer, gallstone disease, irritable bowel syndrome, dysbiosis.
It all starts with food
But no matter what treatment the doctor prescribes, everything can be useless if you do not follow a certain diet. After all, our main “cauldron for food” often helps to save the food itself.
First of all, it is necessary to refuse to eat dry food, from spicy, salty, smoked and any other indigestible food, and also not to allow overeating, monotonous malnutrition.
Long breaks in food are harmful; it is better to eat in small portions.
Particular attention should be paid to the temperature of the food. Disorders of the digestive system are caused by both very cold and excessively hot foods and drinks.
Exclude foods and dishes that increase the secretion of the digestive system, fermentation and putrefaction in the intestines. Well, of course, those who suffer from gastrointestinal diseases should definitely give up alcohol and tobacco.
Stomach in numbers
– 0.5 liters – the volume of an empty stomach, which after eating can stretch from one to four liters;
– 2 – 4 hours the stomach spends on digesting dinner, then the food enters the small intestine, where digestion continues for another 4 – 6 hours.Then the remnants go to the large intestine and can remain there for another 15 hours;
– 3 – 4 days – the period during which the stomach completely changes its shell. Without this, gastric juice would simply dissolve our main digestive organ;
– 5 glasses of gastric juice is produced by the stomach of an adult during the day;
– 50% of Russians suffer from gastritis;
– 100 glands that produce digestive enzymes fit on one square centimeter of the gastric mucosa;
– 22,000 kilograms of food is digested on average by the human stomach during a lifetime;
– 5,000,000 of the finest villi, through which nutrients are absorbed, are located in the small intestine.
Indigestion – causes, diseases, diagnosis and treatment
The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct prescription of treatment, you should contact your doctor.
Indigestion: causes of occurrence, in what diseases it occurs, diagnosis and methods of treatment.
Diseases of the gastrointestinal tract that cause indigestion are among the most common in the population. Signs of indigestion to one degree or another are observed in almost a quarter of the world’s population, however, most do not seek help from doctors and are treated on their own, which in some cases threatens the development of complications.
Diseases of the digestive system can occur even in childhood or adolescence and acquire a chronic course.
Varieties of digestive disorders
Digestive disorders can be divided into two large groups.
The first includes diseases caused by a lack of pancreatic enzymes and substances necessary for the digestion of food – gastric juice, bile. In these cases, the characteristic symptoms are heartburn, belching, bloating, colic, and pain in the iliac region.
The second group combines disorders caused by impaired absorption in the intestine.These disorders are characterized by spastic pain, increased peristalsis (rumbling) in the abdomen, a feeling of fullness, unstable defecation (constipation or diarrhea), exhaustion, and muscle weakness.
Possible causes of digestive upset
One of the most common causes of digestive upset doctors call esophageal motility disorders . Pathologies of the motor activity of the esophagus lead to difficulty in the movement of food into the stomach and, conversely, an easy hit (throw) of concentrated gastric juice onto the walls of the esophagus.
Another significant cause is functional dyspepsia , which combines conditions caused by temporary (no more than 3 months) disruption of the stomach, duodenum and pancreas. Patients complain of pain or discomfort in the iliac region, heaviness, a feeling of fullness in the stomach after taking the usual amount of food, bloating, nausea, vomiting, belching, heartburn. Pain is characterized by periodicity (on an empty stomach or at night) and rapid cessation after ingestion of food or drugs that lower the acidity in the stomach.
If the pains are localized in the left hypochondrium or are of a shingles in nature, then problems with the pancreas can be suspected, if in the right – dysfunction of the liver and gallbladder.
When examining such patients, it is often not possible to identify “organic” diseases (ulcers, tumors, pancreatitis).
Problems with digestion can occur as a result of functional disorders of the biliary tract (biliary system). They are based on a violation of synchronicity in the work of the gallbladder and the sphincter of Oddi, through which bile enters the duodenum.With a spasm of the sphincter, not only stagnation of bile in the gallbladder occurs, but also a malfunction of the pancreas, which together leads to the appearance of acute pain, which is more often localized in the right hypochondrium and can be given to the back. Attacks are provoked by the intake of fatty and spicy foods, cold drinks, stressful situations. Pain in the right hypochondrium can be combined with a feeling of fullness. Typical symptoms are also nausea, bitterness in the mouth, bloating, and constipation.
Another cause of indigestion is irritable bowel syndrome – painful conditions in which pain or discomfort in the abdomen disappears after bowel movement.At the same time, the stool is characterized by irregularity with a predominance of diarrhea (diarrhea) or constipation.
As the causes of irritable bowel syndrome, infectious diseases, nervous stress, poor-quality nutrition, the use of a large amount of gas-forming products, overeating are called.
The main symptoms of this disease are bloating, a cramping abdominal pain that usually worsens after eating and improves after a bowel movement.It is noteworthy that at night the pain stops.
With diarrhea, the number of bowel movements can be up to 5 times a day, and the urge to defecate may occur after each meal. There is often a feeling of incomplete bowel movement. In case of constipation, the character of feces resembles “sheep’s”, consisting of small dense pellets. So-called constipation diarrhea may occur – loose stools after several days of its delay.
Which doctors should I contact for digestive upset
It is important to remember that the initial symptoms of esophageal spasm and motility disorders occur most often in childhood (regurgitation, sudden vomiting of unchanged food immediately after eating, pain when swallowing) and require consultation with a pediatrician.If such symptoms appear in an adult for a long time (more than a month), you should visit a general practitioner to receive a referral for an examination of the gastrointestinal tract and make an appointment with a gastroenterologist.
Therapists, gastroenterologists and psychotherapists are involved in the treatment of functional digestive disorders, including irritable bowel syndrome.
Diagnostics and examinations for digestive disorders
If you suspect a disease of the esophagus, an X-ray is prescribed, which allows you to detect a violation of the passage of barium suspension into the stomach and an expansion of the esophagus.To exclude organic lesions of the esophagus, esophageal manometry and esophagoscopy are performed.
Diagnosis of functional dyspepsia usually includes a CBC; blood chemistry; analysis of feces for occult blood; C-urease test for the diagnosis of Helicobacter pylori infection; gastroduodenoscopy in order to visually assess the condition of the stomach wall and exclude its ulcerative lesions and tumors; Ultrasound of the liver, gallbladder and pancreas to clarify their condition.
Stomach hurts during pregnancy: what to do?
Pregnancy is the time when the body works in a special way. Most women experience a range of physiological changes. They affect everything, even the susceptibility to various diseases.
Many expectant mothers may experience stomach pains. This means that it is worth making an appointment with a gastroenterologist. First, it is worth deciding where the stomach hurts in order to distinguish pain from other possible problems with internal organs.
Usually pain is felt in the hypochondrium from one or both sides. Depending on the nature of the sensations, they talk about different processes.
- If the pain is aching, pulling, similar to muscle fatigue – most likely, the help of a doctor will not be needed. It is enough to tell the local gynecologist about this. In the second trimester, the fetus begins to grow actively. As a result, all internal organs are slightly displaced. This may be accompanied by unpleasant sensations that will soon pass, and after childbirth, they will be completely forgotten.
- Acute cutting pain. This situation indicates a serious disruption of the digestive tract. If it is accompanied by additional symptoms: diarrhea, vomiting, fever, you should immediately visit a free or paid appointment with a gastroenterologist. This may indicate an infectious disease. It is impossible to hesitate, it is especially dangerous in the first, second and beginning of the third trimester, when the fetus is actively forming.
- Periodic sharp pain and spasm. Indicates gastritis or ulcerative conditions without other symptoms.
- A single attack of severe pain may indicate an inappropriate diet. When carrying a fetus, the female body is sensitive to everything, food is no exception.
There are frequent cases of heaviness in the stomach, and literally after every meal. This is also not a problem if there are no other symptoms. The fact is that the metabolism of a pregnant woman is significantly weakened. All processes in the body are slow, food digestion is no exception.
What to do for stomach pain and how to prevent it?
Even at the beginning of pregnancy, it is worth making an appointment with a gastroenterologist in order to further know how to deal with stomach pains.
Diet can prevent unpleasant sensations. Of course, it is far from the same as in the treatment of obesity. The diet for a pregnant woman is reduced to a proper balanced diet, the intake of a sufficient amount of fluid.
Meals should be in small portions, but with a short period of time. Then there will be no heaviness, and food will be better absorbed.
Another harmless way for cramps or cramps in the stomach (periodic, without the presence of chronic problems, as well as other symptoms) – you can take activated charcoal.This is the most harmless absorbing agent, which, in the case of a slight intoxication (poisoning), will clear the stomach of irritants. As a result, the feeling will improve.
But even if the pain does not stop for several days, the situation worsens, it is better to find out the hours of the gastroenterologist’s appointment and visit the doctor at the Movement clinic. Even for prevention purposes.
Dyskinesia treatment | Clinic “Medline” in Kemerovo
Biliary dyskinesia is a violation of the outflow of bile from the liver along the biliary tract (gallbladder and cystic duct).
There is either too strong or insufficient contraction of the gallbladder. As a result, not enough bile enters the duodenum. The disease is 10 times more common in women than in men.
Pain in the right hypochondrium
- With a hyperkinetic variant of dyskinesia (that is, with increased contractile activity of the biliary system), the pain is acute, paroxysmal, short-term, can be given to the right shoulder or right shoulder blade.As a rule, pain occurs after physical or emotional stress, eating fatty foods
- In hypokinetic variant of dyskinesia (that is, with reduced contractile activity of the biliary system), the pain is dull, aching, almost constant, with rare episodes of absence of pain, accompanied by a feeling of fullness in the right hypochondrium
- Attacks of biliary colic – severe pain in the right hypochondrium, arising suddenly, accompanied by a rapid heartbeat or a feeling of cardiac arrest, fear, numbness of the extremities
This is a whole complex of symptoms arising from a decrease in the flow of bile into the duodenum – the initial section of the small intestine. It develops in less than half of the cases.
Manifestations of cholestatic syndrome:
- jaundice (yellow staining of the skin, mucous membranes (for example, the oral cavity), body fluids (for example, saliva, lacrimal fluid, etc.)
- lighter than usual, feces
- darker than usual urine
- hepatomegaly (enlarged liver)
Dyspeptic manifestations (digestive disorders):
- decreased appetite
- nausea and vomiting
- bitterness and dry mouth in the morning
- bad breath
Manifestations of neurosis:
- increased fatigue
- increased sweating
- recurrent headaches
- decrease in sexual activity
Causes of primary biliary dyskinesia associated with congenital malformations of the biliary tract:
- doubling of the gallbladder and bile ducts
- narrowing of the gallbladder
- constrictions and septa in the gallbladder
The causes of secondary biliary dyskinesias (developing throughout life) are various diseases, for example:
- gastritis (inflammation of the gastric mucosa)
- duodenitis (inflammation of the duodenal mucosa)
- peptic ulcer (formation of ulcers – deep defects) of the stomach or duodenum
- pancreatitis (inflammation of the pancreas)
- cholecystitis (inflammation of the gallbladder)
- viral hepatitis (a systemic disease with predominantly liver damage caused by viruses)
- neuroses (perceived by the patient to be treatable mental disorders)
- hypothyroidism (decreased hormone production), e. g. hypothyroidism – hypothyroidism
- Hereditary predisposition
- Inappropriate nutrition (eating large amounts of fatty, fried and spicy foods)
- Worms (flat and round worms) and lamblia (unicellular organisms with flagella).
- Intestinal infections (infectious diseases with a predominant lesion of the digestive system)
- Hormonal disorders (violation of the ratio of hormones – biologically active substances that regulate all types of body activities). For example, increased or decreased production of hormones, violation of their composition or transport
- Vegetovascular dystonia (VVD), or neurocirculatory dystonia (NCD) – disorders of the autonomic nervous system (part of the nervous system that regulates the activity of internal organs)
- Psychoemotional stress (psychoemotional stress)
- Excessive physical activity
- Sedentary lifestyle
Diagnostics in the clinic Medline
Analysis of medical history, complaints, life and physical examination. On examination, the normal color of the skin or its yellowness, decreased or increased nutrition is determined. On palpation (palpation), pain in the right hypochondrium is assessed, which increases with inspiration. When tapping, the size of the liver and spleen is determined.
Laboratory research methods:
- A complete blood count may not show abnormalities. In the presence of inflammatory diseases, leukocytosis appears (an increase in the number of leukocytes – white blood cells), an increase in the sedimentation rate of erythrocytes – red blood cells (ESR is a nonspecific laboratory indicator reflecting the ratio of varieties of blood proteins)
- Urinalysis reveals darker coloration of urine than normal and may contain bile pigments (colorants secreted by bile).
- Biochemical blood test. The level of creatinine (a protein breakdown product), uric acid (a breakdown product of substances from the cell nucleus), total protein and its fractions (varieties), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT or ALT), aspartate amiminotransferase (AST or AST), bilirubin (bile pigment – a dye, breakdown product of erythrocytes), electrolytes (potassium, sodium, calcium, magnesium)
- Lipidogram (analysis of the content of lipids, fat-like substances in the blood). It can reveal abnormalities in the normal content of various lipids.
- Markers of viral hepatitis (signs of the presence in the body of viruses that can damage the liver)
- Examination of feces for the presence of flat and round worms, as well as protozoa (unicellular organisms)
Instrumental research methods:
- Ultrasound examination (ultrasound) of the abdominal organs reveals changes in the size and shape of the gallbladder, the presence of stones, kinks or constrictions in it
- Ultrasound examination of the gallbladder with a test breakfast.After performing an ultrasound examination of the gallbladder on an empty stomach, the patient is given a test breakfast containing a large amount of fat (for example, a glass of sour cream or two egg yolks). After 30 and 60 minutes, ultrasound examination of the gallbladder is performed again. The doctor assesses how timely and completely the gallbladder contracted after eating. This study makes it possible to assess the form of biliary dyskinesia – hyperkinetic (that is, with increased contractility of the muscles of the biliary tract) or hypokinetic (that is, with decreased contractility of the muscles of the biliary tract)
- Duodenal sounding. In this study, a probe (tube) is inserted into the duodenum through the nose or mouth for a long time. Periodically, portions of bile are taken through a probe for examination. When examining bile, signs of inflammation, stone formation, etc.
- Fibroesophagogastroduodenoscopy (FEGDS) is a study of the state of the surface of the esophagus, stomach, duodenum using endoscopes (optical instruments). It is carried out if a disease of these organs is suspected as the cause of biliary dyskinesia
- Oral cholecystography is a study method in which the patient drinks a contrast agent (that is, makes the places of its accumulation visible on x-rays), a substance that accumulates in the gallbladder.Allows you to assess the size and shape of the gallbladder, the presence of anomalies (violations) of its development
- Intravenous cholecystography is a test method in which a contrast agent that accumulates in the gallbladder is injected intravenously. Allows you to assess the size and shape of the gallbladder, the presence of anomalies (violations) of its development. Contraindicated in case of allergy (individual hypersensitivity) to iodine preparation
- Endoscopic retrograde cholangiopancreatygraphy (ERCP) – a combination of endoscopic and radiological methods, which gives an image of the biliary tract
- Hepatobiliary scintigraphy is a radioisotope research method in which a radioactive drug is injected intravenously, selectively accumulating in the liver and biliary tract, which allows them to get an accurate image
Treatment of biliary dyskinesia
The purpose of therapeutic measures for biliary dyskinesia is to normalize the outflow of bile and prevent its stagnation in the gallbladder.
Compliance with the regime of work and rest:
- Full night sleep for at least 8 hours
- go to bed no later than 11 p.m.
- alternation of mental and physical activity (for example, doing gymnastics after two hours of computer work)
- outdoor walks
Diet therapy: diet number 5.
- Eating 5-6 times a day in small portions to improve the excretion of bile
- Exclusion from the diet of spicy, fatty, fried, smoked food, canned food
- Reduced salt (up to 3 grams per knock) and spices in food to reduce fluid retention in the body
- Mineral water intake:
- high mineralization (that is, with a high salt content) with hypomotor dyskinesia of the biliary tract (with reduced contractile activity of the biliary system)
- low mineralization (that is, with a low salt content) with hypermotor dyskinesia of the biliary tract (increased contractile activity of the biliary system)
Conservative (non-surgical) treatment.
- Choleretic (choleretic) drugs facilitate the outflow of bile
- Cholespasmolytics (drugs that reduce the increased tone of the muscles of the biliary tract) are used for hypermotor dyskinesia
- Enzyme preparations facilitate food digestion in hypomotor dysfunction
- Medicinal herbs are prescribed in courses 2 times a year. The composition of the herbal collection depends on the type of dyskinesia (hyperkinetic or hypokinetic)
- Duodenal intubation – removal of the contents of the duodenum through a tube (tube) after administration of drugs that stimulate the release of bile from the gallbladder
- Closed tubing (cleansing) of the gallbladder, or “blind” probing – taking choleretic drugs in conditions that facilitate the outflow of bile (in the position on the right side, with a warm heating pad on the right hypochondrium)
- Treatment with neurotropic (affecting the nervous system) drugs on the recommendation of a psychotherapist
- Diadynamic therapy (therapeutic effect of electric current of various frequencies on the right hypochondrium)
- Electrophoresis (exposure of the body to direct electric current and medicinal substances introduced with its help) with magnesium preparations on the liver area
Acupuncture (acupuncture) is a method of treatment in which the effect on the body is carried out by the introduction of special needles into special points on the body
Massage (especially acupressure) – that is, with the impact on certain points of the human body, affecting the activity of the gallbladder
Prevention of biliary dyskinesia
Primary prevention of biliary dyskinesia (that is, before it occurs)
- Compliance with work and rest regime
- A complete diet with restriction of fatty, fried, smoked, salty foods, with a sufficient content of vegetables and fruits
- Exclusion of psychoemotional (stressful) situations
- Timely treatment of neuroses
Secondary prevention (that is, after the onset of biliary dyskinesia) consists in its earliest detection – with regular preventive examinations.
Dyspepsia is a term used to refer to one or more signs of a malfunction of the upper digestive system: the esophagus, stomach, part of the small intestine. Symptoms of dyspepsia occur in every fifth person.
In 60-70% of all cases, dyspepsia is functional, that is, the cause of unpleasant symptoms cannot be established. The rest of the cases of dyspepsia can be a consequence of other diseases of the digestive system, and diseases of other organs and systems, taking certain medications.
Dyspepsia, as a rule, does not lead to serious complications, although it can cause considerable inconvenience to a person. In only 10% of cases, people experiencing dyspeptic symptoms seek medical attention. Signs of dyspepsia most often bother a person not constantly, but only at times – sometimes increasing, then weakening. The mechanism of such a wave-like flow is not fully understood.
Dyspepsia caused by other diseases, as a rule, disappears after treatment of the underlying disease. Functional dyspepsia can bother a person for years or even throughout their life. However, the fact that the symptoms of dyspepsia are associated with food intake can be triggered by inaccuracies in the diet. Knowing this, it is possible to control unpleasant manifestations.
In any case, if a person often shows any signs of digestive disorders, it is necessary to consult a doctor to find out the cause of dyspepsia and exclude a more serious pathology of the gastrointestinal tract or other organs.
Digestive disorders, functional dyspepsia.
Dyspepsia, indigestion, upset stomach, functional dyspepsia, non-ulcer dyspepsia.
Dyspepsia is a fairly common condition, but symptoms may vary from person to person. The manifestations of dyspepsia are usually associated with food intake and are aggravated by overeating, eating spicy, fried, fatty foods. Patients typically experience:
- pain, discomfort, burning sensation in the upper abdomen;
- Rapid feeling of fullness, fullness of the stomach while eating.
Less commonly, dyspepsia may be accompanied by other symptoms: belching, nausea, increased gas production.
General information about the disease
Dyspepsia is a set of symptoms that appear when there is a violation of the digestion of food in the stomach and the initial sections of the small intestine.This is more of a functional pathology. The concept of “functional” in this case means that the functioning of the stomach is impaired, since the work of muscles in the wall of the organs of the gastrointestinal tract and the nerves (including the spinal cord and brain) that control them is hindered. At the same time, in the process of examining the patient, it is impossible to identify any pathology that provokes indigestion. In only a small proportion of cases, dyspepsia can be attributed to other diseases or conditions.
Depending on the causes of dyspepsia, it can be divided into several groups.
- Functional dyspepsia. It occurs most often – in 60-70% of cases. The causes of its occurrence are not well understood.
- Dyspepsia caused by diseases of the gastrointestinal tract, most often gastric ulcer and duodenal ulcer (15-25% of dyspepsia) and gastroesophageal reflux (5-15%). Less commonly, dyspepsia is caused by diseases of the biliary tract, pancreatitis, gastroparesis, Crohn’s disease, cancer of the stomach or esophagus, and other diseases.
- Peptic ulcer of the stomach and duodenum (peptic ulcer). Most cases of the disease are associated with infection with the microorganism Helicobacter pylori, an important role is played by hereditary predisposition and the adverse effects of external factors: stress, alcohol, nutritional disorders and others.
- Gastroesophageal reflux is the throwing of part of the stomach contents into the esophagus. It can be a normal physiological manifestation if it appears rarely, after eating, and does not cause unpleasant sensations. If reflux recurs frequently, it can damage the acidic stomach contents of the esophageal wall and cause inflammation of the esophagus, which is accompanied by unpleasant symptoms.
- In diseases of the biliary tract (for example, with gallstone disease), the release of bile into the intestine, which is necessary for the normal breakdown of fats, is disturbed. This can lead to difficulty in digestion and symptoms of dyspepsia.
- Pancreatitis is an inflammation of the pancreas, accompanied by impaired production of pancreatic enzymes involved in the digestion of proteins, fats and carbohydrates.
- Gastroparesis is a malfunction of the muscles of the stomach and intestines, as a result of which gastric emptying is slowed down. The most common cause of gastroparesis is diabetes mellitus: high blood sugar damages the blood vessels and nerves that control the stomach.
- Crohn’s disease is a severe chronic inflammation of the gastrointestinal tract. The process captures the entire wall of the organ and can affect any part of the digestive system – from the mouth to the rectum.
- Dyspepsia caused by diseases of other organs and systems. Symptoms of dyspepsia can be associated with diabetes mellitus, diseases of the thyroid and parathyroid glands, severe kidney disease, and parasites. However, the mechanism of the onset of dyspepsia against their background is not fully understood.
- Taking medications. Many medicines can cause digestive problems in some people. Most often, dyspepsia occurs due to non-steroidal anti-inflammatory drugs (aspirin, ibuprofen), antibiotics, estrogens (synthetic analogs of female sex hormones).
Who is at risk?
- Alcohol abusers.
- Eating improperly, that is, overeating, eating very fatty or spicy foods, large quantities of coffee or carbonated drinks.
- Taking medications.
- Experiencing constant stress.
Careful questioning and examination of the patient allows the physician to determine the suspected cause of the dyspepsia. However, for a more accurate diagnosis, it is necessary to conduct a number of laboratory and instrumental studies.
Other research methods
- Radiography of the abdominal organs. Allows you to determine the degree of damage to the digestive system. In particular, radiography with barium suspension is used – a contrast agent that is clearly visible on the images. As the barium suspension passes through the gastrointestinal tract, the peristalsis and the condition of the stomach and intestine walls are assessed.
- Computed tomography. A method that resembles an X-ray, but allows you to get a clearer picture of the digestive system. It is more often used to examine the small intestine.
- Endoscopic examination. It is carried out using an optical device in the form of a tube and equipped with a camera and a light source – an endoscope. Distinguish fibroesophagogastroduodenoscopy (FEGDS), that is, the study of the upper gastrointestinal tract up to the duodenum, and colonoscopy – the study of the large intestine. During endoscopy, it is possible to take a biopsy – a tissue sample for further microscopic examination – and determine Helicobacter pylori in this sample.
Capsule endoscopy can be performed to examine the small intestine, which is the use of a coated miniature camera that moves through the intestine by peristalsis and continuously captures the inside of the intestine.
- Helicobacter pilori breath test.The test is based on the ability of a microorganism to destroy urea, a product of protein metabolism. The patient exhales into a test tube, after which he takes a urea solution and exhales into another test tube. Then, using a special device, an analysis and comparison of the amount of gas formed during the decomposition of urea in both test tubes is carried out.
In most cases, changes in lifestyle and diet have a positive effect. If the treatment is unsuccessful, it is possible to use drugs that reduce the acidity of the stomach and normalize the contractile activity of the stomach and intestines.
With a known cause of dyspepsia, treatment of the underlying disease usually leads to the disappearance of its symptoms.
- Correct diet.
- Refusal from alcohol, smoking, coffee abuse.
- Regular preventive examinations.
- Harrison’s Principles of Internal Medicine, 18ed.Part 2, section 6, chapter 39 – Nausea, Vomiting, and Indigestion.
Does the pancreas hurt? Symptoms and treatment
The pancreas is a unique organ, because it simultaneously belongs to two systems in the human body, performing one of the most important roles. Its main function is that it produces special enzymes that break down fats, proteins and carbohydrates, which contributes to better assimilation of food in the human body.The pancreas is the only organ that produces insulin.
Insulin is a very important hormone of the pancreas, because it affects absolutely all cells in the body. Its main function is to reduce the amount of glucose in human blood.
That is why, at the first symptoms of pain in the pancreas, an urgent need to go to a medical institution.
Main symptoms of pancreatic disease:
- Pain after eating fatty, heavy food, after drinking alcohol and overeating.Most often, girdle pain appears.
- Pain accompanied by nausea and vomiting.
- When pressing on the abdomen, discomfort appears in the navel.
- A sharp rise in temperature is the most common symptom of pancreatic disease.
- Frequent bouts of diarrhea.
- Pain decreases when bending forward.
Treatment of diseases of the pancreas
The most common problem is that the symptoms associated with diseases of the pancreas are very often confused with those of various other diseases.Accordingly, a misdiagnosis is an inappropriate treatment that takes up valuable time. Namely, diseases affecting the pancreas, as a rule, develop very rapidly, which is why even the smallest problem can quickly develop into a chronic form.
The most common diseases of the pancreas:
- Diabetes mellitus.
- Cystic fibrosis.
- Pancreatic necrosis.
The last three diseases are extremely rare.
Consider the two most common diseases of the pancreas:
Diabetes mellitus – the most insidious disease of the pancreas caused by insulin deficiency in the body and in need of urgent treatment.
Diabetes mellitus symptoms:
- severe permanent fatigue;
- long-term wound healing;
- drastic weight loss for no apparent reason;
- tingling in the limbs;
- impairment of hearing, vision;
- constant unquenchable thirst.
Pancreatitis – inflammation of the pancreas that occurs when its duct is blocked. Many people confuse pancreatitis with other diseases, such as osteochondrosis, pyelonephritis, or shingles. However, the onset of pancreatitis always goes away with acute pain, so an experienced doctor will immediately be able to determine the inflammation of the pancreas by palpation. Indeed, with pancreatitis, tapping in the area where it hurts is not felt, and with other diseases, it is quite noticeable.
In order for the pancreas to be healthy, it is necessary to lead a correct lifestyle. After all, it is from the abuse of alcohol and junk food that the work of the pancreas is disrupted, after which there is a stagnation of juice in the body. Accordingly, the process of digestion of food fails and the person begins to suffer from inflammation of the pancreas – acute pancreatitis.
The acute form of pancreatitis is treated strictly in a hospital. Moreover, doctors need to act quickly in order to “calm” the pancreas, otherwise the patient may be fatal.The acute form of the disease leads to mortality in 15% of cases. Basically, death occurs due to untimely access to a specialist. Therefore, at the first symptoms of pain in the pancreas, an urgent need to consult a doctor.
The main symptoms of acute inflammation of the pancreas:
- Acute pain around the navel;
- temperature rise;
There is also a chronic form of pancreatitis . It is formed due to various diseases of the gastrointestinal tract. For example, cholecystitis, gallstone disease or hepatitis.
Symptoms of the chronic form of pancreatic disease:
- sudden weight loss;
- during physical exertion, pain in the hypochondrium is felt;
- loss of appetite;
- aversion to fatty foods;
- Stool violation.
Depending on the symptoms, 4 forms of chronic pancreatic disease are distinguished:
- Asymptomatic when the patient is unaware of his illness;
- Painful, when the patient sometimes feels pain in the hypochondrium;
- Recurrent – pain is constantly manifested;
- Pseudotumor, when the head of the pancreas is enlarged and overgrown with fibrous tissue.
Drugs required for the treatment of inflammation of the pancreas:
Do not self-medicate, because doctors select drugs for each patient individually, based on the patient’s condition and the diagnosis. However, absolutely all patients suffering from a disease of the pancreas will need to follow a strict diet for several months. Avoiding fried, highly salty, sour and spicy, as well as heavy foods. It is imperative to drink purified mineral water, which concerns not only sick people, but also healthy people.
Author: Gastroenterologist-therapist Burbaeva S. A.
90,000 Pain in the liver area: can the liver hurt?
How does the disease manifest
Signs of liver problems
The liver is the largest gland in the human body, so its diseases have a heavy impact on health in general. At the same time, she is very sensitive and extremely susceptible to various violations. Doctors often hear the complaint “I have a pain in the area of the liver.” But can the liver itself hurt and what sensations does a person experience when various diseases appear?
How the disease manifests itself
This organ is located in the abdominal cavity under the diaphragm, in the upper right quadrant of the abdomen.Many people who suspect they have certain diseases are interested in three questions: “How does the liver hurt and where?”, “What does the pain and discomfort in the right hypochondrium mean?” It should be noted here that there are no nerve endings in the organ itself, so the sensation of pain in the liver is impossible. However, there are a lot of nerve endings in the outer shell (capsule) of the liver. Therefore, if the liver enlarges and begins to press on the capsule, the person experiences discomfort. In this case, acute pain never occurs. As a rule, she is stupid and persistent, does not let go for a long time.With the growth of problems, the pain intensifies, becomes constant, especially clearly manifests itself when moving. In some cases, there are unpleasant sensations in the right shoulder blade and back. If the pain is strong and cramping, then, as a rule, it already speaks of diseases not of the liver, but of the gallbladder and biliary tract.
Signs of liver problems
We found out where and how the liver hurts in a person, now we should talk about the symptoms. Liver disease manifests itself in different ways.There are external and internal symptoms of liver disease. Let’s take a closer look at each group.
- The appearance of spider veins . Spider veins are a pronounced capillary network of dilated small vessels located in the superficial layers of the skin. This symptom is typical for serious liver dysfunctions associated with intoxication, viral and alcoholic hepatitis, cirrhosis. Spider veins most often appear in the lower torso, but sometimes appear on the cheeks and back.
- Change in pigmentation of the skin and mucous membranes . With liver diseases, regardless of the cause, a person has a jaundice syndrome. For example, in the acute form of hepatitis, the skin becomes yellowish as early as 2-3 days after the onset of the disease. The color of the mucous membranes may change even earlier. This is due to the fact that the concentration of hepatic pigment fractions (bilirubin) is greatly increased in the blood of an infected person.
- Discoloration of palms and soles .A symptom of liver disease is also pronounced pigmentation in places of physiological folds. As a rule, it has a bronze or smoky hue.
- Hair loss . Accelerated hair loss is often observed with liver disease. The liver processes almost all the nutrients that enter the body. If liver function is impaired, the supply of the body with “building materials” for growing tissues also suffers. For example, wounds heal more slowly or hair may fall out faster.
- Onset of rash . Along with a change in skin color in liver diseases, the appearance of rashes is observed. They can be of very different nature. Pustular elements (folliculitis and furunculosis) are caused by an immune imbalance due to a decrease in the liver’s ability to synthesize immunoglobulin. An allergic rash (papules and spots) occurs against the background of a violation of the detoxification function of the liver. This reaction is triggered even in familiar environmental conditions. Hemorrhagic rash (small hemorrhages on the surface of the skin) appears when the synthetic function of the liver decreases.Patients have an increased tendency to form hematomas (“bruises”), even with minor injuries.
- Asthenia . It is characterized by general weakness and lethargy, drowsiness, fatigue, decreased performance. These symptoms, as a rule, appear the very first with liver damage. Their occurrence is due to the inability of the organ to completely neutralize the products of nitrogen metabolism, which affect the functioning of the brain.
- Dyspepsia . With liver diseases, dyspeptic manifestations can be observed in the form of belching, nausea and vomiting, diarrhea or constipation, a feeling of heaviness after eating, bloating due to increased flatulence. Due to the violation of the digestion and absorption of fats, qualitative changes in the stool occur. There is steatorrhea (“fatty stool”). Any liver disease, as a rule, is accompanied by a change in peristalsis (intestinal motor activity), the secretion of the intestinal glands.
- Cytolysis. The first sign of liver damage is cytolysis – destruction of hepatocytes. When liver cells (hepatocytes) are destroyed in the blood, the level of enzymes such as ALT and AST increases. If these enzymes are elevated in the biochemical blood test, then this indicates an inflammatory process in the liver tissue.
- Increased body temperature . Often, people with constant pain in the liver area have a slight rise in temperature (up to 37.8 ° C).With cirrhosis, thermometer readings can reach 38 ° C. In some cases, fluctuations are observed throughout the day, but most often appear with the onset of the evening. A higher temperature (from 39 ° C) is a symptom of purulent processes in the gallbladder or bile ducts and is not associated with liver disease. Accordingly, treatment is prescribed for another organ.
To find out more about the causes of pain in the liver region and what to do when they appear, you should consult a specialist.He will conduct an examination, on the basis of which a diagnosis and treatment will be prescribed. In most cases, the main minimum recommendation of doctors is to avoid alcohol and junk food.
Liver aid with Phosphogliv *
If liver problems are detected, the patient is prescribed diet and physical activity, if this is not enough, therapy is supplemented with drugs. Often it includes the use of hepatoprotectors – drugs for the treatment of the liver.One of these drugs is Phosphogliv *. Phosphogliv * is used as a means of pathogenetic therapy. This tool includes 2 active ingredients: glycyrrhizic acid and essential phospholipids.
Glycyrrhizic acid has anti-inflammatory, antioxidant and antifibrotic effects, which allows the drug to be used both at the stage of treating inflammation and for preventing its development, and essential phospholipids restore damaged liver cell membranes.The use of the drug Phosphogliv * ensures the normalization of the general condition of the patient, relief of the inflammatory process in the liver – a decrease in the enzymes ALT and AST, and also helps to prevent the development of fibrosis and cirrhosis.