What are the common symptoms of gallbladder disease. How is gallbladder disease diagnosed. What treatment options are available for gallbladder problems. Why do some people develop gallstones. When should you seek medical attention for gallbladder issues.

The Basics of Gallbladder Disease

Gallbladder disease is a common condition that affects millions of Americans each year. The gallbladder is a small organ located under the liver that stores and concentrates bile, a digestive fluid produced by the liver. When problems arise with the gallbladder, it can lead to various symptoms and complications.

There are several types of gallbladder disease, including:

• Chronic cholecystitis (long-term inflammation)
• Acute cholecystitis (sudden, severe inflammation)
• Calculous cholecystitis (with gallstones)
• Acalculous cholecystitis (without gallstones)

Gallstones are the most common cause of gallbladder problems, affecting up to 15% of the U.S. population. However, many people with gallstones remain asymptomatic. Each year, over 750,000 Americans undergo cholecystectomy (surgical removal of the gallbladder) due to various gallbladder issues.

Recognizing the Symptoms of a Gallbladder Attack

A gallbladder attack can be a painful and distressing experience. Recognizing the symptoms is crucial for seeking timely medical attention. Common signs of a gallbladder attack include:

1. Intense pain in the upper right abdomen, often under the ribs
2. Nausea and vomiting
3. Indigestion, bloating, and excessive gas
4. Pain radiating to the upper back or behind the breastbone
5. Loss of appetite
6. Jaundice (yellowing of the skin and eyes)
7. Changes in urine color (dark brown or bright yellow)

These symptoms can sometimes be mistaken for other conditions, such as a heart attack or indigestion. If you experience persistent or severe abdominal pain, it’s important to seek medical evaluation promptly.

Risk Factors for Gallbladder Disease

Several factors can increase your risk of developing gallbladder problems. Understanding these risk factors can help you take preventive measures and recognize potential issues early on.

Common risk factors for gallbladder disease include:

• Female gender (women are more prone to gallbladder issues)
• Obesity
• Age over 40
• Rapid weight loss
• Diabetes
• Liver disease
• Hormonal factors (pregnancy, hormone replacement therapy)
• Family history of gallbladder problems

Can you reduce your risk of gallbladder disease? While some risk factors are beyond your control, maintaining a healthy weight, eating a balanced diet, and exercising regularly can help lower your risk of developing gallbladder issues.

Diagnosing Gallbladder Disease

Accurate diagnosis of gallbladder disease is crucial for proper treatment. Healthcare providers use a combination of methods to identify gallbladder problems:

Physical Examination

A thorough physical exam is often the first step in diagnosing gallbladder disease. The doctor may check for tenderness in the upper right abdomen and perform a Murphy’s sign test, which involves pressing on the abdomen while the patient takes a deep breath. Pain during this maneuver can indicate gallbladder inflammation.

Imaging Studies

Various imaging techniques can help visualize the gallbladder and detect abnormalities:

• Ultrasound: The most common and initial imaging test for suspected gallbladder disease
• CT scan: Provides detailed images of the gallbladder and surrounding structures
• HIDA scan: A nuclear medicine test that evaluates gallbladder function
• MRI: Offers high-resolution images and can be useful in complex cases

Blood Tests

Blood tests can help assess liver function and detect signs of infection or inflammation associated with gallbladder disease.

How accurate are these diagnostic methods? While no single test is perfect, combining multiple diagnostic approaches can significantly improve the accuracy of gallbladder disease diagnosis.

Treatment Options for Gallbladder Disease

The treatment for gallbladder disease depends on the severity of symptoms and the underlying cause. Options range from conservative management to surgical intervention:

Conservative Management

For mild cases or asymptomatic gallstones, lifestyle changes and medical management may be recommended:

• Dietary modifications (low-fat diet, avoiding trigger foods)
• Pain management with over-the-counter or prescription medications
• Ursodeoxycholic acid to dissolve small gallstones (in select cases)

Surgical Treatment

For recurrent or severe gallbladder problems, surgical removal of the gallbladder (cholecystectomy) is often the recommended treatment:

• Laparoscopic cholecystectomy: A minimally invasive procedure with smaller incisions and faster recovery
• Open cholecystectomy: Traditional surgery used in complex cases or when laparoscopic approach is not feasible

Is gallbladder removal always necessary? While many cases of gallbladder disease ultimately require surgery, some patients may successfully manage their condition with conservative measures under close medical supervision.

Living Without a Gallbladder

After gallbladder removal, most people can lead normal, healthy lives. The liver continues to produce bile, which flows directly into the small intestine. However, some individuals may experience changes in digestion or bowel habits:

• Increased frequency of bowel movements
• Looser stools
• Difficulty digesting fatty foods

These symptoms usually improve over time as the body adjusts. Dietary modifications and, in some cases, supplementation with bile salts can help manage post-cholecystectomy symptoms.

Preventing Gallbladder Problems

While not all gallbladder issues can be prevented, certain lifestyle choices can help reduce your risk:

• Maintain a healthy weight
• Eat a balanced diet rich in fruits, vegetables, and whole grains
• Limit intake of high-fat and processed foods
• Stay hydrated
• Exercise regularly
• Avoid rapid weight loss or yo-yo dieting

By adopting these healthy habits, you can support overall digestive health and potentially lower your risk of developing gallbladder problems.

When to Seek Medical Attention

Knowing when to seek medical help for gallbladder issues is crucial. Contact your healthcare provider if you experience:

• Severe abdominal pain, especially in the upper right quadrant
• Pain that radiates to your back or shoulder
• Fever and chills
• Persistent nausea or vomiting
• Jaundice (yellowing of the skin or eyes)
• Dark urine or light-colored stools

Early intervention can prevent complications and ensure proper treatment. Don’t hesitate to seek medical attention if you’re concerned about your gallbladder health.

Understanding gallbladder disease and its symptoms can help you recognize potential problems early and seek appropriate care. By maintaining a healthy lifestyle and being aware of risk factors, you can take proactive steps to support your gallbladder health. Remember, if you experience persistent or severe symptoms, consult with a healthcare professional for proper evaluation and treatment.

Recognizing a Gallbladder Attack: Surgical Consultants of Northern Virginia: Bariatric & General Surgery

We’ve all experienced stomach pain and heartburn after over-indulging in unhealthy, greasy foods.

Most of the time, this pain passes once the food has time to settle. But some people become so concerned about their symptoms that they end up going to the ER. More often than not, the diagnosis is a gallbladder attack.

What causes a gallbladder attack?

Having an unhealthy gallbladder from poor food choices can restrict the organ’s ability to aid in the digestive process. This can cause gallstones to form and block the bile duct, which leads to a painful inflammation from bile buildup. Because the symptoms can be mistaken for other medical conditions, such as a heart attack, it’s important to recognize the symptoms of a gallbladder attack so you know the proper measures to take.

Recognizing the symptoms of a gallbladder attack

The symptoms of a gallbladder attack are similar to other digestive conditions, but the location and severity of the symptoms are what signal a gallbladder attack:

1.  Belly Pain. Belly pain that begins in the upper right portion of the stomach under the ribs is one of the most common symptoms of a gallbladder attack. The pain can be dull, sharp, or cause cramping.
2. Indigestion. Most people suffering from a gallbladder attack often complain about nausea, gas, belching, and bloating, but it might be difficult to distinguish those symptoms. Gallbladder attacks can also cause a pain that radiates to the upper back and behind the breastbone, similar to a heart attack.
3. Loss of appetite. As gallstone pain worsens, most people lose their appetite. Nausea and heartburn following meals might also cause a person to avoid eating altogether.
4. Jaundice. The bile duct being blocked will cause bile to get trapped in your bloodstream, which can lead to your skin turning a yellowish hue.
5. Changes in urine color. If bile pigment forms in the gallbladder, it can cause urine to turn a dark brown or bright yellow color.
What happens if I have gallbladder disease?

Gallbladder disease is a serious condition that requires immediate medical attention. If you experience any of the symptoms above, it’s important to consult a physician. They might suggest gallbladder removal if your condition is serious enough. Click here to learn more about Gallbladder Disease from Surgical Consultants of Northern Virginia.

Dr. Brett Sachse at Surgical Consultants of Northern Virginia will provide you with the proper treatment if you believe you’re suffering from gallbladder disease.

Call (571) 512-5300 to schedule an appointment with Dr. Sachse today!

Contact Us

Gallbladder Imaging – StatPearls – NCBI Bookshelf

Introduction

There are several variations and etiologies of gallbladder disease. Chronic and acute cholecystitis are the two ways this condition can present. Calculous and acalculous (with or without gallstones or cholelithiasis) are also variants of this disease. The most common form of gallbladder disease is chronic cholecystitis with cholelithiasis. Up to 15% of the population of the United States has asymptomatic gallstones. On the other hand, 15% of all cases of cholecystitis are acalculous or without stones.

Twenty to 25 million Americans have gallstones. Annually, more than 750,000 individuals undergo cholecystectomy in the United States. Many factors have been linked to gallbladder disease. Female gender, obesity, hormone exposure, diabetes, liver disease, age older than 40 years, and drastic weight loss are just a few factors that are associated with a higher incidence of gallbladder disease and gallstones.

Symptoms of cholecystitis must be distinguished from other conditions such as irritable bowel, peptic ulcer disease, gastroesophageal reflux disease, and cardiac issues.

Cases of chronic cholecystitis present as progressing right upper abdominal pain with bloating, food intolerances (especially greasy and spicy foods), increased gas, nausea, and vomiting. Pain in the midback or shoulder may also occur. This pain could be present for years until correctly diagnosed. Cases of acute cholecystitis have similar symptoms only more severe. Often, symptoms are mistaken for cardiac issues. The finding of right upper abdominal pain with deep palpation, Murphy’s sign, is usually classic for this disease. Often, there is a specific dietary event leading to the acute attack, “I ate pork chops and gravy last night.” The most important and useful test when diagnosing acute or chronic cholecystitis is a thorough history and physical exam performed by an experienced practitioner who is familiar with gallbladder disease.

Gallbladder cancer is somewhat rare, annually affecting 3 out of 100,000 individuals in the United States. It may present with symptoms similar to cholecystitis or may be asymptomatic until it becomes advanced.http://www.ncbi.nlm.nih.gov/pubmed/28991561

Anatomy

Acute and chronic cholecystitis is caused by either a mechanical blockage of the biliary system, usually of the cystic duct, or by a functional hypokinetic condition of the gallbladder.

Gallstones most often cause mechanical anatomic blockages of the biliary outlet. Other etiologies responsible for mechanical obstruction are neoplasms, external compression, and stenosis of the bile duct.

Functional obstructions are caused by the hypokinetic emptying of the gallbladder from situations of decreased stimulus to the gallbladder such as in fasting states, critical illnesses, and nerve disruption associated with vagotomies, and gastric surgeries.[1]

Plain Films

There are several diagnostic tests used make the determination of gallbladder disease. A simple abdominal x-ray can be used to identify calcified gallstones. Because only 10% of all gallstones are calcified, this imaging study has limited usefulness. Porcelain gallbladders can also be seen in plain x-rays. This condition is somewhat uncommon and results from calcification of the gallbladder wall. In 1924, two American surgeons developed the oral cholecystogram or OCG. The OCG is done by administering iopanoic acid by mouth. This is an iodine-based material that is absorbed by the intestines and concentrated in the gallbladder. When it combines with bile salts, it becomes a very radio-opaque liquid present within the gallbladder. This will outline any gallstones present in the gallbladder. The intervenous cholangiogram was developed in 1954. It was chiefly used to evaluate the bile ducts and to look for stones or strictures within these bile ducts. An iodine-based dye is injected intravenously. It is then concentrated in the liver and excreted into the bile ducts. The intervenous cholangiogram was a poor test to evaluate the actual gallbladder because sometimes the gallbladder was bypassed entirely as the dye went directly from the bile ducts into the small bowel. Both the oral cholecystogram and the intravenous cholecystogram are seldom used today.

Computed Tomography

Acute gallbladder disease, gallstones, polyps, and occasionally, gallbladder sludge, can be diagnosed with a CT scan. The scan is most often done when the patient is undergoing an initial workup in the emergency department, and the specific diagnosis is unclear. Pericholic fluid and a thickened gallbladder wall may be seen in cases of acute cholecystitis. Chronic cholecystitis may have nonspecific findings of a thickened gallbladder wall. Gallstones and gallbladder sludge may also be identified with a CT scan.

The CT scan is probably the most useful test when doing a workup for suspected gallbladder cancer. This test is noninvasive and can evaluate the size of the tumor, areas or metastasis, and whether or not there is a gross direct extension into the liver.[2]

Magnetic Resonance

MRIs may identify the same findings as a CT scan. An MRCP (magnetic resonance cholangiopancreatogram) is a noninvasive imaging study useful when evaluating the biliary ducts. It can detect bile duct stones, strictures and neoplasms as small as several millimeters. An endoscopic retrograde cholangiopancreatogram (ERCP) is an invasive procedure that is also used to diagnose stones, strictures, and neoplasms of the biliary system. This procedure can also be used to treat and make a more definitive diagnosis by using biopsies, placing stents and removing retained bile duct stones. This does, however, add the risk of iatrogenic complications such as pancreatitis. Endoscopic ultrasonography is another procedure that allows good visualization of the bile ducts and pancreatic head.[2]

Ultrasonography

The best diagnostic test to confirm gallbladder disease is the abdominal ultrasound. It is noninvasive and is 90% to 95% accurate in detecting gallstones. Pericholic fluid and thickened gallbladder walls can also be identified as in acute cholecystitis. Gallbladder sludge and occasionally common bile duct stones can also be seen with abdominal ultrasounds.

The gallbladder ultrasound may also be useful in detecting possible gallbladder neoplasms.

The EUS or endoscopic ultrasound is not a first-line test for diagnosing gallbladder disease. There is no place for it as a diagnostic tool for cholecystitis. It is useful when evaluating and staging tumors of the gallbladder, pancreas, and bile ducts. Biopsies can also be done for tissue diagnosis.[3]

Nuclear Medicine

If acute cholecystitis is suspected and there is a negative gallbladder ultrasound, then a hepatobiliary iminodiacetic acid or HIDA scan is indicated. This is done by injecting technetium Tc 99m intravenously. It is taken up by the liver and excreted into the biliary system. If there is no filling of the gallbladder, then this would indicate complete mechanical or functional blockage of the cystic duct. This finding is close to 100% accurate for diagnosing acute cholecystitis. If a patient has characteristic symptoms of nonacute cholecystitis or biliary cholic and the gallbladder ultrasound is negative, they could have chronic acalculous cholecystitis. This is a functional problem caused by the hypokinetic emptying of the gallbladder. The best diagnostic test for this condition is a HIDA scan with KINAVAC (cholecystokinin-CCK). Tc 99m is administered as with a routine HIDA scan. Once the gallbladder is visualized, then the KINAVAC is administered intravenously. This simulates eating and causes the gallbladder to contract and empty. The percent that the gallbladder empties, called ejection fraction (EF), is measured digitally. An ejection fraction of below 30-35% is considered abnormal and possibly indicative of acalculous cholecystitis. Documented reproduction of symptoms with administration of the KINAVAC may also be indicative of gallbladder disease. Some studies have shown a 95% accuracy rate in detecting acalculous cholecystitis with a low EF in a HIDA scan. Other studies found that the accuracy of a HIDA scan may be altered in the presence of other ailments, especially other gastrointestinal (GI) conditions.http://www.ncbi.nlm.nih.gov/pubmed/28861635

Clinical Significance

Correct imaging tests are vital when diagnosing cholecystitis or carcinoma of the gallbladder because a missed diagnosis could lead to a significant increase in patient morbidity and mortality. Various indications and knowledge of the appropriate tests to be ordered as well as obsolete tests are crucial when dealing with gallbladder disease.

References

1.

Salazar MC, Brownson KE, Nadzam GS, Duffy A, Roberts KE. Gallbladder Agenesis: A Case Report. Yale J Biol Med. 2018 Sep;91(3):237-241. [PMC free article: PMC6153629] [PubMed: 30258310]

2.

de Savornin Lohman EAJ, de Bitter TJJ, van Laarhoven CJHM, Hermans JJ, de Haas RJ, de Reuver PR. The diagnostic accuracy of CT and MRI for the detection of lymph node metastases in gallbladder cancer: A systematic review and meta-analysis. Eur J Radiol. 2019 Jan;110:156-162. [PubMed: 30599854]

3.

Negrão de Figueiredo G, Mueller-Peltzer K, Zengel P, Armbruster M, Rübenthaler J, Clevert DA. Contrast-enhanced ultrasound (CEUS) and gallbladder diseases – A retrospective mono-center analysis of imaging findings with histopathological correlation. Clin Hemorheol Microcirc. 2019;71(2):151-158. [PubMed: 30584127]

Could Your Abdominal Pain Actually Be Gallstones? – Cleveland Clinic

There’s a lot going on in your body between your chest and your pelvis. So when abdominal pain strikes, it can be nearly impossible to tell where it’s coming from.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

If the pain is in the upper part of the abdomen, some people
wonder if they should blame their gallbladder – the tiny, pear-shaped organ
that sits under the liver on the right side of your abdomen. It’s a fairly
common cause of upper abdominal pain, but it’s not the only potential cause.

Are there certain clues that suggest a gallbladder problem? Gastroenterologist Michael Kirsch, MD, explains how this organ works and some of the classic gallbladder symptoms.

What exactly is the gallbladder, anyway?

Most of the time, the gallbladder just stores bile produced by the liver. Bile helps to break down fats, so when you eat a meal, the gallbladder gets to work squeezing some of that bile into the intestine to help with digestion.

If bile contains too much of one or more of its components, it can harden into pebble-like gallstones, which can block the flow of bile.

“In most people, stones never cause any symptoms,” Dr.
Kirsch says. (You could have one right now and not even realize it!) If these
“silent” stones are discovered accidentally during other medical tests or
procedures, there’s no need to do anything about them.

But sometimes, the blockage creates a buildup of pressure in the gallbladder and causes pain. That’s a gallbladder attack.

Where do you feel gallbladder pain?

Even for a skilled physician, it can be difficult to tell whether someone’s gallbladder is the source of their abdominal pain. That’s because a number of things can cause localized pain in the abdomen, including a peptic ulcer or a heart attack.

In typical cases, gallbladder pain:

• Is an achy pain felt in the mid-upper abdomen.
• Can radiate to the right shoulder or back.
• Lasts for 20 minutes to an hour.
• Recurs in an identical fashion.
• May be accompanied by other digestive symptoms, such as nausea or vomiting.

“The pain can be spontaneous and not necessarily restricted
to meal time — it can awaken someone at night,” Dr. Kirsch says.

Certain people are more likely to have gallbladder problems,
including anyone who is:

• Female.
• Pregnant.
• Diabetic.
• Obese.
• Over the age of 40.
• Losing weight quickly.
• Eating a high-fat diet.
• Taking birth control pills or hormone replacement therapy.

If the gallbladder might be the culprit…

Sometimes, gallstones resolve themselves. Other times, they
get stuck in the gallbladder or in the bile ducts and cause recurring pain.

If you have pain that you suspect is related to your
gallbladder, see a gastroenterologist to help you get to the bottom of it.

It might be helpful to keep a record of when and where you
experience symptoms.

“The most important tool for a physician is listening very carefully to the patient’s medical history,” Dr. Kirsch says. “That is by far the most valuable piece of data that the physician will have available – even more valuable than an ultrasound or CAT scan or laboratory blood tests.”

If your doctor suspects gallstones as the culprit, they may
order one of those tests for confirmation.

If the gallbladder is deemed to be the source of the problem, your doctor might recommend gallbladder removal surgery.

This probably sounds like a dramatic step, but the reality
is that you don’t actually need your gallbladder to live a happy, healthy life.
Your liver can release bile directly into the intestines to help with
digestion. And, the gallbladder can be removed with a laparoscope.

“The vast majority of everyone who has their gallbladder removed lives perfectly well,” Dr. Kirsch says.

If you’re unsure, find your way to a doctor ASAP

Because of all of the possible causes, it’s important to
tread carefully when it comes to abdominal pain.

If the pain is severe, gets worse or is accompanied by sweating, shortness of breath, or bloody vomit or stool, it’s worth a trip to the ER.

“It can be a difficult call with all the abdominal pain that
we see as to whether the gallbladder is responsible or there’s some other
cause,” Dr. Kirsch says. “It takes experience and judgment.”

Gallbladder and Gallstones – Gastrointestinal Society

The gallbladder is a small sac-like organ located below the liver. Its primary function is to store and concentrate bile, an important digestive fluid made by the liver. When fat enters the upper portion of the small intestine (duodenum), bile flows from the liver through bile ducts to the duodenum. When the small intestine is empty, bile flows back into the gallbladder for storage. Bile consists of water, cholesterol, fats, bile salts (also called bile acids), and a yellow pigment product known as bilirubin.

Gallstones (cholelithiasis) are the most common gallbladder disorder, and affect about one-fifth of men and one-third of women at some point in their lives. ¹ Stones form when cholesterol and other elements of the bile are abnormally concentrated or they are in disproportion. Three types of gallstones exist. Pigment stones, comprised primarily of bilirubin, are more common in some populations and parts of the world than in others and occur most frequently among persons who have types of anemia characterized by rapid destruction of red blood cells. Mixed stones, the most widespread type of stone, develop from crystalline particles of cholesterol mixed with other bile substances. Sometimes mixed stones are referred to as cholesterol stones, since they are comprised mostly of cholesterol. However, the third type of stones, comprised of pure cholesterol, is rare.

Symptoms & Diagnosis

About half of all patients with gallstones are asymptomatic, however, you may have heard of, or even had, what many refer to as a gallstone ‘attack,’ an episode of mild to intense pain in the lower or upper right abdomen, which can spread to your right upper back or shoulder blade area. This is the most common presentation. Other symptoms include vomiting, tenderness in the area of the gallbladder, and a low-grade fever. If shaking and chills occur, this usually indicates a bacterial infection in the gallbladder. Sometimes symptoms can increase in severity when a stone blocks a portion of, or the entire, biliary tract. After symptom assessment occurs, abdominal ultrasound or x-ray generally confirms diagnosis.¹

Risk Factors

The following are some risk factors for gallstone formation:^2,3

• Female gender
• Age over 55 years
• Obesity
• Rapid weight loss
• Diabetes
• High calorie diet
• High cholesterol diet
• Pregnancy
• Gastric bypass surgery
• Maternal family history of gallstones
• Alcoholic cirrhosis
• The following medications: Post-menopausal estrogen, cholesterol-lowering medication

Other Risks

According to a number of scientific studies, patients with Crohn’s disease are at a significantly increased risk of developing gallstones. A recent study demonstrated a two-fold increase in risk, and researchers found that the disease site (namely ileocecal and ileocolonic involvement) was a specific risk factor, as was duration of disease.⁴ After 15 years of disease activity, Crohn’s patients’ risk of gallstone development rose to 4 times greater than the general population.

Additionally, patients with more and longer hospital stays, a higher number of total parenteral nutrition treatments, and ileal resection had greater risk. However, patients with ulcerative colitis did not have an increased incidence of gallstones.

Treatment

Asymptomatic or uncomplicated gallstones usually do not require treatment. If you have a mild gallstone attack, your doctor may prescribe pain medication, however, after your first incidence, you have a much higher likelihood of repeat attacks. If subsequent episodes occur, then the most direct and effective course of treatment is surgical gallbladder removal (cholecystectomy). The gallbladder is a non-essential organ, and this very safe procedure, usually performed laparoscopically, with minimal incisions, is the most commonly performed bowel surgery in medicine, with approximately 600,000 performed annually in Canada.^3,5 Some surgeons are experimenting with gallbladder removal via the vagina in women.⁶ Without the presence of the gallbladder, bile flows directly from the liver into the small intestine, and this leads to diarrhea in about 1% of patients, although for most this is a temporary effect.⁷

In patients for whom surgery carries an abnormally high risk, such as the elderly or those with otherwise compromised health, sound waves can be used to breakup the gallstones non-invasively, during a procedure called lithotripsy. Physicians may also prescribe medication to dissolve the stones. These options are less effective treatments than surgery and carry a considerably greater risk of stone recurrence.²

Prevention

Gallstone prevention focuses on specific lifestyle changes that echo common advice for general health and well-being and for reduction of many other disease risk factors. ²

• Keep a healthy weight and avoid weight fluctuations. If trying to achieve weight loss, do so slowly, aiming for about a 0.5 kg loss per week.
• Discuss taking post-menopausal hormones with your doctor and consider the pros and cons, as some medications may increase your risk of gallbladder disease.
• Get enough exercise. A number of studies show that regular physical activity correlates with a decrease in risk of gallstone disease in men and women.⁸
• Eat regular meals containing some fat and plenty of whole grains and fibre and avoid saturated fat and cholesterol. Make sure you get adequate dietary calcium.

Some more specific research looks at the following prevention measures:

Eat more vegetables As part of the large prospective Nurses’ Health Study, researchers discovered a strong link between increased consumption of vegetable protein and a decreased risk of cholecystectomy.⁹ This research followed animal studies that reported significantly inhibited gallstone formation with higher vegetable protein intake. After controlling for various risk factors including age, body mass index, recent weight change, physical activity, diet and more, this study found that increased vegetable protein intake had a protective effect on gallstone formation independently of total protein intake or intake of animal protein. The authors suggest that “substituting vegetable protein for part of the animal protein supply or other macronutrients in the Western diets could be effective in primary or secondary prevention of gallstones at the earliest stage of crystal formation in humans”. Good vegetable sources of protein are peas, beans, and lentils, soy-based foods such as tofu and soymilk, and nuts and seeds.¹⁰ (check out our article on how dietary fibre can reduce your risk for gallbladder surgery).

If you’re a man, try magnesium Supported by numerous previous findings, this editorial in the American Journal of Gastroenterology, indicates that men who consume the most magnesium in their diets have a considerably lower risk of developing symptomatic gallstone disease, compared to men who consume the least amount of magnesium. ¹¹ This association was evident for dietary magnesium consumption, but not for those taking supplements, most likely because only a very small percentage of study subjects used magnesium supplements. Furthermore, the presence of asymptomatic gallstones, which form the majority of all gallstones, was not taken into account. Green vegetables, beans and peas, nuts and whole grains are all good sources of dietary magnesium. (note: since the study only looked at male participants, researchers related their conclusions to men only.)

Outlook

Fortunately, most patients function very well without their gallbladder, and thus adequate management of gallstones through surgical removal of the gallbladder is an excellent treatment with very few complications and mild or no side effects in most patients.

A note on gallbladder cancer: Although extremely rare, comprising less than 0.5% of all cancers, gallbladder cancer presents with symptoms similar to gallstone disease: nausea, vomiting, pain, and anorexia. Gallstones are evident in 75% of patients with gallbladder cancer (although the incidence of gallbladder cancer among patients with gallstones is still extremely low at 0.2%). The highest risk is for patients with symptomatic gallbladder disease. Surgery is the only curative treatment for this type of cancer.¹²

First published in the

Inside Tract® newsletter issue 170 – 2009

1. Shaffer EA, Barkum AN. The Biliary System. In: Thomson AB, Shaffer EA, eds. First Principles of Gastroenterology: The Basis of Disease and Approach to Management. 4th ed. Mississauga, ON: AstraZeneca Canada Inc.; 2000.

2. British Columbia Ministry of Health Services. HealthLinkBC. Gallstones. Available from: http://www.healthlinkbc.ca/kbase/topic/major/hw107151/descrip.htm Accessed. March 11, 2009.
3. Ahmed A, Cheung RC, Keefe EB. Management of gallstones and their complications. American Family Physician. 2000; 61(6):1673-1680.
4. Parente F, et al. Incidence and risk factors for gallstones in patients with inflammatory bowel disease: A large case-control study. Hepatology. 2007 May;45(5):1267-1274.
5. MediResource Inc. Gallstones (Condition Factsheet). Canwest Publishing Inc. Available from: http://bodyandhealth.canada.com Accessed March 17, 2009.
6. Marescaux J, et al. Surgery without scars: Report of transluminal cholecystectomy in a human being. Archives of Surgery. 2007;142(9):823-826.
7. The National Digestive Diseases Information Clearinghouse. Gallstones. National Institutes of Health, Unites States Department of Health and Human Services. Available from: http://digestive.niddk.nih.gov/ddiseases/pubs/gallstones/#8 Accessed March 17, 2009.
8. Leitzmann MF et al. Recreational physical activity and the risk of cholecystectomy in women. New England Journal of Medicine. 1999;341(11):777–783.
9. Tsai C, et al. Dietary protein and the risk of cholecystectomy in a cohort of US Women: The Nurses’ Health Study. American Journal of Epidemiology. 2004;160(1):11-18.
10. HealthLines Services BC. Dial-a-Dietitian. Quick Nutrition Check for Protein. Available from: http://www.dialadietitian.org/nutrition/Quick%20Nutrition%20Check%20for%20Protein.pdf. Accessed March 11, 2009.
11. Ko C. Magnesium: Does a mineral prevent gallstones? American Journal of Gastroenterology. 2008;103:383-385.
12. British Columbia Cancer Agency. Gastrointestinal Cancer Management Guidelines, Gallbladder. Available from: http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/Gastrointestinal/10.Gallbladder/default.htm Accessed March 17, 2009.

Image: © Tharakorn | bigstockphoto.com

What You Need to Know About Your Gallbladder

If you’re asked to point to your gallbladder, you can probably guess it’s somewhere between your hips and your heart.

But you probably know little else about the pear-shaped member of your digestive system, which sits below your liver in your upper right abdomen.

So we’ve done a little detective work to figure out what the gallbladder really does—and how you can ensure yours is healthy. Read on for 8 need-to-know facts about your most overlooked organ.

1. Your Gallbladder Helps With Digestion
Your gallbladder stores bile, a goopy liquid produced by your liver to help break down fats.

As your stomach begins to digest food, your gallbladder kicks into action, releasing this bile to your small intestine.

“The gallbladder just serves as a ‘booster’ when you eat a meal that is higher in fat,” says Rahul Nayak, M.D., a gastroenterologist at Kaiser Permanente Atlanta. “So the next time you eat fried chicken, mac and cheese, and chase it with some Southern chess pie, you can thank your gallbladder for not having diarrhea.”

2. Gallstones Are the Most Common Gallbladder Problem
According to some estimates, up to 20 million Americans may have gallstones, the most common type of gallbladder disorder.

Gallstones form when the substances that make up bile—such as cholesterol, electrolytes, and water—are out of proportion.

The stones, which can be very painful, range in size from small grains of sand to golf balls.

3. You May Have Gallstones and Not Even Know It

Gallstones aren’t always problematic. They’re often too small to cause a blockage. You might not even know you have them unless you are doing tests for other medical issues.

Even if you do have gallstones, you don’t need to worry about them or have them treated if they aren’t causing issues.

4. Abdominal Pain Is Your Biggest Sign Something May Be Wrong
Signs that your gallbladder may be getting clogged include indigestion after eating foods high in fat or protein, severe and sudden pain in the upper right side of the abdomen, or pain under the right shoulder or in the right shoulder blade.

If your bile duct gets completely blocked, it can cause nausea and vomiting, fever, jaundice, and dark urine.

While these symptoms may go away once the gallstone moves, complications can arise if the bile duct remains clogged, so it’s important to share your symptoms with your doctor.

5. The Best Defense Is a Good Offense
Keep your gallbladder functioning properly by focusing on overall body health. That means eating a heart-healthy diet and exercising, says Dr. Nayak.

Limiting your intake of unhealthy fats like trans fatty acids will keep your gallbladder from working overtime.

And savor that morning cup of coffee with your avocado toast.

“Coffee consumption and increased vegetable-based protein [consumption] also seem to protect against gallstone disease,” says Dr. Nayak.

7. You Can Live Without It
The most common treatment for gallbladder problems is to remove it. Fortunately, you can live without this particular organ.

Your liver is the source of your body’s bile; the gallbladder only acts as a vessel for holding it. So removing your gallbladder doesn’t have any discernable impact on a person’s digestion, says Dr. Nayak.

“The bile in the liver goes directly to the small intestine, bypassing the gallbladder,” he says.

8. Gallbladder Cancer Is Rare but Serious
Although it’s not common, gallbladder cancer has a high mortality rate since it’s not often caught in the early stages.

If discovered in Stage 0 or 1, the five-year survival rate runs between 50 to 80 percent. In a later stage, that survival rate drops to single digits.

The article Do You Actually Need Your Gallbladder? originally ran on WomensHealthMag.com.

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Possible Gallstone with Biliary Colic (Presumed)

Your abdominal pain is may be due to spasm of the gallbladder. This is called gallbladder or biliary colic. The gallbladder is a small sac under the liver, which stores and releases bile. Bile is a fluid that aids in the digestion of fat. Eating fatty food stimulates the gallbladder to contract, and release the bile. A gallstone may form in this sac. Although most people don’t have symptoms, when the stone moves and blocks the passage of bile out of the bladder, it can cause pain and even an infection.

To be more certain of the diagnosis, you may need to have an ultrasound, CT-scan or other special test.

A number of things increase the risk for developing gallstones:

The most common symptoms are:

Many illnesses can cause these symptoms. This pain usually starts in the upper right side of your abdomen. Sometimes it can radiate to your right shoulder, back and arm. It usually starts suddenly, becomes more intense quickly, and then gradually decreases and disappears over a couple of hours. Elderly people and diabetics may have trouble showing where the pain is exactly. The pain may occur after meals, especially a high fat meal.

Home care

• Rest in bed and follow a clear liquid diet until feeling better. If pain or nausea medicine was given to help with your symptoms, take these as directed.

• You can take acetaminophen or ibuprofen for pain, unless you were given a different pain medicine to use. Note: If you have chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding or are taking blood thinner medicines, talk with your healthcare provider before using these medicines.

• Fat in your diet makes the gallbladder contract and may cause increased pain. Therefore, limit fat in your diet over the next 2 days and follow a low-fat diet after that. If you are overweight, a low fat diet will help you lose weight.

Follow-up care

If a test was already scheduled for you, keep this appointment. Be sure you know how to prepare yourself for the test. Usually, you will be asked not to eat or drink anything for at least 8 hours before the test. Schedule an appointment with your own healthcare provider after your test is complete to discuss the findings. Biliary colic tends to recur and so treatment is usually needed. This treatment usually includes surgical removal of the gallbladder, called a cholecystectomy.

When to seek medical advice

Call your healthcare provider if any of the following occur:

• Pain gets worse or moves to the right lower abdomen

• Repeated vomiting

• Swelling of the abdomen

• Pain lasts over 6 hours

• Fever of 100.4º F (38º C) or higher, or as directed by your healthcare provider

• Weakness, dizziness

• Dark urine or light colored stools

• Yellow color of the skin or eyes

• Chest, arm, back, neck or jaw pain

Call

911

Call 911 if any of these occur:

Sex and ethnic/racial-specific risk factors for gallbladder disease | BMC Gastroenterology

90,000 Everything about the gallbladder, why is it needed and what products he likes – Spoon!

I haven’t written anything about organs for a long time 🙂 once I already simply and easily told about our little helper – the pancreas and why we need a liver. Now I will tell you a little about what the gallbladder is, where it is located and why even know about its existence (shortly). Let’s dwell on a special menu for him in more detail. What the gallbladder loves, what to eat to make him feel good and keep him healthy.

As you can see in the diagram, the gallbladder is a small green “sac” the size of a small chicken egg, which is hidden below, in the cavity between the lobes of the liver. Bile accumulates in it. To explain it very simply: the liver produces bile, constantly, it is necessary for normal digestion. But since in the very process of digesting food, it is needed only periodically, the body has a special reservoir for it – the gallbladder, which doses the release of fluid with the help of bile ducts and “valves”, this happens when food appears in the stomach.

Bile is a special secretion produced by liver cells. It helps the digestion process, increases the activity of pancreatic and intestinal enzymes, is responsible for the breakdown and absorption of fats, is able to stop the action of gastric juice, and has bactericidal properties. The body produces from 1 to 1.8 liters of bile per day.

Diseases associated with the gallbladder are fraught with serious consequences. Abusing products that stimulate bile secretion, gallstones can form in the body (hence the violation of fat metabolism and an increase in body weight).Or vice versa, products that give a weak effect of muscle contraction and the secretion of bile form its deficiency (hence the lack of essential fatty acids, fats and vitamins in the body, as well as pathology of the lower intestines). And so that there are no problems with fat metabolism, sometimes it is worth making the gallbladder pleasant and eating its favorite foods that support its health and normalize its important functions.

Products that stimulate strong bile secretion

Meat, egg yolks, milk and dairy products (except fermented milk), fats (vegetable oils, foods rich in essential oils, fatty fish, etc.)NS.). These foods should be kept to a minimum, especially if you have liver disease. If you are completely healthy, you can arrange fasting days for yourself. In this case, for the day, in addition to the above products, it is worth excluding sour berries and fruits, spicy pickled vegetables and cold drinks.

What the gallbladder likes

To make your gallbladder enjoyable and to make it work, you should often use boiled or baked foods, first courses, boiled semi-viscous cereals and legumes, drink warm drinks.And with good health, it is quite enough just to eat more rice, oatmeal, eat more fruits and vegetables, drink vegetable juices (carrots, beets, you can add ripe sweet apples) and smoothies (recipes for vegetable smoothies), and, of course, do sports.

What else is interesting in this rubric?

90,000 About health: how to determine the stagnation of bile in the body was told to patients in the “School of Health” of the Civil Central District Hospital

At the initial stages, the stagnation of bile is easily corrected, but if you start the situation, it can even end up in an emergency operation.

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

Together with the doctor of ultrasound diagnostics of the Tsivilskaya central regional hospital Maria Alekseeva in the “School of Health” for the patients, they analyzed the main signs of trouble in the gallbladder and found out how it can be treated.

Signs of bile stagnation:

• aching and pulling pain in the right side after exercise;
• Feeling of discomfort in the right side – as if there was something interfering or squeezing;
• pain on the right 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;
• dry or bitter mouth, slight changes in skin tone.

Bile stagnation, harmless at first glance, can turn into a big disaster.

Cholestasis (stagnation of bile) ranks third among diseases and pathologies of the digestive tract and is getting younger from year to year.

It affects people of retirement age, women over 40, pregnant women, office workers and schoolchildren (long restriction in movement and incorrect posture at the desk).

Bile is a product of the secretion of liver cells. It is produced in the liver, then through the hepatic and bile ducts it enters the gallbladder, where it accumulates.As soon as food has entered the oral cavity and the process of digestion has begun, bile enters the intestine (duodenum), where it neutralizes the remains of hydrochloric acid, breaks down fats (emulsifies to the desired condition so that they can be absorbed into the blood), helps the body absorb fat-soluble vitamins A, E, D, K, disinfects food and removes excess pathogenic bacteria in the small intestine, participates in other enzymatic reactions for complete digestion of food and assimilation of nutrients.For example, it activates lipase (pancreatic enzyme).

When digestion does not occur, bile accumulates in the gallbladder, a small pear-shaped organ located at the right intercostal arch.

If bile for any reason stagnates and does not enter the intestines, this leads to disruption of the entire digestion process. Cholestasis can lead not only to a violation of the gastrointestinal tract, but also serious diseases associated with metabolic disorders: vitamin deficiency, osteoporosis, cholelithiasis, cholecystitis, in severe cases – cirrhosis of the liver (accumulation of bile, its increased concentration changes and processes liver cells) , and can also cause the formation of diabetes mellitus.Therefore, this state cannot be triggered.

To prevent bile from stagnating, the doctor, specialist of the first category, Maria Mikhailovna, warned about what patients need to remember.

Stagnation of bile is partly promoted by the liver itself, which produces bile, and the ducts along which it moves, and the gallbladder.

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

Bile is a highly concentrated secretion, when it is immobile for a long time, a sediment begins to form, first in the form of flakes, then they form stones.Do not forget that bile is secreted at every meal and the role of proper regular nutrition is very important in the prevention of stone formation!

The movement of bile is carried out along the ducts surrounded by muscles. It will not be superfluous to remember that any stress leads to spasm, including muscle spasm, which can lead to a banal clamping of the ducts themselves and their inlet and outlet sphincters. Bile can get stuck in the ducts. Therefore, eating should always be in a calm atmosphere and in the correct posture: give yourself pleasure – have breakfast, lunch and dinner beautifully.

Formed stagnation of bile can be recognized by the following signs:

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

At the first sign of stagnation, it is better to immediately do an ultrasound. If you feel unwell, you should consult a doctor. With prolonged stagnation, both sand and stones in the gallbladder can form, and with any stimulation of the movement of bile, the movement of stones can also be provoked. If the stone is small, then, although with pain, it will come out of the duct, and a large one is able to clog the duct. And in this case, an emergency operation is indicated.

For an accurate diagnosis of bile stasis, additional examination and treatment is required:

1. Ultrasound of the liver and bile ducts.It will help assess the extent of the lesion and the presence of stones. The presence of a bile sediment will indicate that the bile is thick and viscous, it is difficult to move along the bile ducts, and therefore may stagnate. The accumulation of bile in the ducts causes the liver to increase in volume.
2. General blood and urine tests will help assess the general condition of the body.
3. Blood biochemistry will give a complete picture of the work of the liver and gallbladder.
4. Analysis of bile will determine its composition.
5. Coprogram will help assess the work of the intestines, as well as the quality of the digestion process.

After all examinations, the doctor will prescribe treatment. This is easily corrected in the early stages.

For prophylactic purposes, it is useful to do blind tubing, it brings relief, to drink choleretic herbs or preparations and add foods with a mild choleretic effect to your diet (bitterness, herbs, coarse fiber).

Remember that stagnation of bile is in most cases a problem created by a person’s lifestyle, and it has its own prerequisites (inappropriate nutrition, stress, physical inactivity …).

Enjoy life, clean up the premises and live healthy!

Emphysematous carbuncle description

EMKAR (emphysematous carbuncle) in cattle is a dangerous disease. And even though at present there are only isolated outbreaks of infection in cows, the likelihood of mass infection is quite high. This pathology of an infectious nature can cause significant damage to livestock farming, since dairy and meat products obtained from affected individuals are prohibited for consumption.In order to avoid the loss of the entire herd, it is important to learn how to recognize the signs of the disease in time and start treatment.

What animals get sick with emphysematous carbuncle.

Epizootology. Cattle, rarely sheep and goats, get sick. The most susceptible are young animals aged 3 to 4 years. Corpulent animals are more susceptible to infection because the muscle tissue of such farm animals stores more glycogen, which is necessary for the formation of a microbe.

Infection mainly occurs through alimentary or contact.

The source of the causative agent of the infection is unhealthy animals. The main factors of transmission are environmental objects (food, water, soil, etc.), contaminated with spores of the causative agent of this disease. As a rule, animals get sick during the grazing stage, during the hot dry months. There are known cases of the disease at other times.

Usually, emphysematous carbuncle manifests itself sporadically.

What is the disease

EMKAR is an acute disease that affects most of the cattle.Goats, buffaloes and sheep are less susceptible to this pathology. The disease is also called a noisy carbuncle.

This disease is not highly contagious and is not considered an endemic disease. Among the characteristic signs should be noted the presence of swelling (carbuncles) and lameness. The bulk of infected individuals die in speed. The disease is widespread throughout the world, but the implementation of immunization and preventive measures allows you to avoid an epidemic – infection is often recorded as isolated cases of infection.

The course of the disease.

Pathogenesis. Penetrating into the body through the digestive tract or damaged skin, spores with the blood stream are introduced into the muscles. Here, in a glycogen-provided environment, vegetative forms of the pathogen are formed. In the place where microbes are located, a rapid disintegration of tissues occurs with the formation of a significant amount of exudate and gases. As a result, crepitant edema is formed – a carbuncle.

The toxins that are released by the causative agent of the disease and the products of decay of tissues give rise to the strongest intoxication of the body, as a result of which the activity of almost all vital systems of the body is disturbed and the animal often dies.

Causes of emkar

Emphysematous carbuncle occurs for the following reasons:

• unsanitary conditions for keeping cows;
• grazing in areas with a dangerous or unknown epizootic situation;
• Water consumption by animals from swampy bodies of water;
• Ingestion of manure from sick animals into food or water;
• Early weaning of calves from mothers.

See also

Symptoms of anaplasmosis in cattle and diagnosis, methods of treatment and preventionRead

The causative agent of the disease – the rod bacterium Clostridium – belongs to pathogenic and opportunistic microorganisms.It is present in the intestinal microflora, and with normal immunity, its vital activity is suppressed by beneficial microorganisms.

But with a decrease in immunity or a violation of microflora, living conditions become favorable for the growth of vegetative cells and the development of Clostridia.

When conditions change back to unfavorable conditions and accumulation around a large amount of waste products, bacteria form spores. Vegetative cells gradually die off.Spores can withstand arctic cold, chemicals, and vacuum.

Clostridia enter the intestines of cattle when they eat plants on pastures that have been fertilized with manure from sick animals. From the digestive tract, they spread through the organs and into the muscles. Weakening of general immunity, due to another infectious disease, or local, as a result of a blow, removes spores from suspended animation. A favorable factor for the development of Clostridia and the emergence of emkar is the large amount of glycogen in the muscles of beef cows.

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The impetus for the emergence of a focus of infection is also the injury of a cow while walking or in a fight with relatives.

Signs of an emphysematous carbuncle.

Features. The incubation period is from 1 to 5 days. The disease is acute and is accompanied by an increase in body temperature indicators up to 41-42 ° C. As a rule, in places with formed muscle tissue (neck, chest, thigh and others), there are limited hot, painful swellings that give a tympanic sound with percussion, and with palpation – directly felt crepitus.

After some time, the soreness almost disappears, the local body temperature of the animal decreases. The general condition of the animal quickly deteriorates, the functions of the affected muscle groups are significantly impaired. Usually, the lethal outcome occurs within 1-3 days.

Sometimes an atypical or abortive form of the disease is noted, characterized by some oppression of animals, weak soreness of some muscles, lack of visible edema. The disease is benign, after a few days the animal recovers.

Less often, as a rule, in farm animals younger than three months, a septic form of the disease is formed, when, against the background of intense oppression, the animal dies during the day.

Historical background and etiology

For a long time emkar was identified with anthrax on the basis of similar clinical signs. For the first time, the differentiation of diseases was carried out by F. Chabert at the end of the 19th century. After a short time, scientists Feather and Bolinger proved the bacterial nature of emkar, and a little later Kitozato was able to isolate the culture of the causative agent of the disease in its pure form.

Already in the 1920s, it was proposed to use the culture of the emkar pathogen grown on nutrient media for active immunization of animals, and in 1929 the Soviet scientist S. Muromtsev made the first formol vaccine.

The causative agent of emkar is a bacterium from the genus Clostridium, namely Cl. chauvoei. The genus Clostridia is extremely widely represented in the external environment. Among the microorganisms belonging to Clostridia, both free-living species and pathogenic for humans and animals are noted.Pathogenic Clostridia have an inherent ability to produce extremely powerful poisons. So the diseases caused by this microflora include:

• emkar
• sheep bradzot
• gas gangrene
• botulism and some others.

In total, more than 100 species are attributed to the genus Clostridia, some of which are the normal microflora of the organism, living mainly in the large intestine.

Cl. chauvoei – anaerobic, positively stained according to Gram, has a characteristic appearance for Clostridia (the genus name itself is formed from the Latin form of the word “spindle”) sticks with rounded ends and an endospore having a diameter slightly larger than the cell itself.

The formed spores determine the extremely high resistance of Clostridia in the external environment. So it was found that in the soil Cl. chauvoei can remain active for at least 25 years, in bodies of stagnant water for about 10 years. In the corpses of animals that died from emkar, the pathogen lives for six months. Boiling inactivates the causative agent of the disease only after 2 hours, and the processing of instruments in an autoclave takes 30–45 minutes. At the same time, under conditions of exposure to direct sunlight, Clostridia die within 20-24 hours.

Diagnostics of the emphysematous carbuncle.

Diagnostics. When establishing a diagnosis, they attach importance to clinical, epizootological, pathological data, as well as the results of laboratory studies.

Pathological diagnosis of the disease does not give rise to difficulties. It is prohibited to dissect corpses to avoid contamination of the area.

The corpses are swollen with gases posthumously forming in the abdominal cavity and subcutaneous tissue. A frothy bloody fluid exudes from the natural openings.The muscles in the affected areas are dark red and filled with gas bubbles. The liver is enlarged, filled with blood, sometimes with foci of necrosis. The gallbladder stores a significant amount of bile.

Inflammation of the serous membranes is often observed. Pathological material for study (specimens of tissues of affected muscles, liver, spleen, blood from the heart, edematous fluid) is taken no later than 2-3 hours after the death of an agricultural animal.If necessary, the material is preserved in 40% glycerin.

Laboratory studies contain bacteriological research and a biological sample.

Differential diagnosis is made for carbunculous anthrax and malignant edema.

In case of anthrax, the carbuncle does not crepit; in blood smears during this study, typical forms of the anthrax microbe are found. Malignant swelling is mainly formed due to injury, the final diagnosis is established based on the results of bacteriological examination.

Pathological changes

The bodies of dead animals are opened only on the territory of the cattle burial ground or in a special area that is allocated for the disposal of corpses. Such precautions are necessary in order to avoid the rapid spread of the infection in the natural environment.

After postmortem diagnosis, a positive result for the presence of EMCAR is established when the following changes are detected:

• the carcass is swollen, but there are no obvious signs of decomposition;
• There is marked swelling and swelling in the thighs, croup, chest and neck;
• integument and partially bone tissue underwent necrotic changes;
• In the area where the carbuncle appears, the skin acquires a purple hue, becomes hard when touched;
• in the vascular cavity, the presence of blood clots is noticeable;
• necrotic transformations are noticeable on the internal organs;
• A significant amount of foamy exudate is found in the mouth, nose and digestive system.

The disease is finally diagnosed only after receiving the results of all three examinations.

In addition, a differential diagnosis is carried out, since anthrax and some other pathologies of cattle, which are characterized by the appearance of edema and swelling on the skin of cows, can be mistaken for an emphysematous carbuncle.

Emphysematous carbuncle treatment.

Treatment. With the acute development of the disease, the treatment of sick animals is not effective enough.Antibiotic-based therapy (penicillin, diometrine, etc.) is used, usually parenterally for 5-7 days. Antiseptics are introduced into the thickness of the edema – 1-2% hydrogen peroxide solution, 0.1% essence of potassium permanganate, 5% essence of lysol.

Intramuscularly: make an injection of chlortetracycline at the rate of 3-5 mg per 1 kg of animal weight 1 time per day for 3-5 days, a one-time suspension of diomycin in the amount of 40 thousand units per kilogram of weight.

Prevention

It is important to recognize the symptoms of emkar at an early stage in order to maintain livestock.Sick cows are transferred to a separate room. The rest of the animals are vaccinated. The farm is being quarantined and disinfected. The planned slaughter is canceled. The bodies of dead animals are burned in cattle burial grounds.

How to avoid an outbreak:

• vaccinate every six months; 90 046 90 045 purchased animals to keep in quarantine for two weeks, separately from the herd;
• disinfect stalls during summer grazing;
• To study the terrain when choosing a pasture, epizootic situation;
• Do not graze the herd near cattle burial grounds, in swampy areas;
• Inspect the skin of cows, monitor the cleanliness of the hooves.

Meat and milk of sick cows are prohibited for sale. Timely vaccination, control over appetite and physical activity of animals will help to avoid the spread of Clostridia and emkar.