How are gallstones and constipation connected. What role does slow intestinal transit play in gallstone formation. Can chronic constipation affect gall bladder motility. How does deoxycholic acid impact cholesterol secretion and crystallization. What are the implications of impaired gall bladder emptying in constipated patients.

The Intriguing Link Between Gallstones and Constipation

Recent research has shed light on the complex relationship between gallstones and constipation, revealing fascinating connections between gall bladder function and bowel health. A study by Penning et al. has uncovered abnormal gall bladder behavior in patients with chronic constipation, sparking interest in the medical community and raising important questions about the interplay between these two conditions.

The growing evidence suggesting that cholesterol gallstones can result from slow intestinal transit has drawn attention to the state of the gall bladder in patients with constipation. This connection has led researchers to explore the intricate mechanisms linking bowel function to gall bladder health.

The Role of Slow Intestinal Transit in Gallstone Formation

Slow intestinal transit allows the colon to absorb excessive amounts of bacterially degraded substances, including the toxic bile acid, deoxycholic acid (DCA). When DCA reaches the liver, it prompts the secretion of more cholesterol into bile. Additionally, when DCA reaches the gall bladder, it accelerates the crystallization of cholesterol. These factors contribute to an increased risk of gallstone formation in patients with slow transit constipation.

Gall Bladder Motility Defects in Constipated Patients

The study by Penning et al. revealed intriguing findings regarding gall bladder motility in patients with chronic constipation. Impaired gall bladder emptying is a known feature of patients with cholesterol gallstones and is considered a key factor in stone pathogenesis. However, the constipated patients in this study exhibited some unexpected characteristics.

Unusual Gall Bladder Volume in Constipated Patients

Contrary to the typical motility defect observed in patients with gallstones, where the resting volume of the gall bladder is large, the constipated patients in Penning et al.’s study had smaller than normal resting volumes. This finding is both unusual and curious, challenging existing assumptions about the relationship between constipation and gall bladder function.

Sham Feeding and Gall Bladder Emptying

The researchers used sham feeding to demonstrate impaired gall bladder emptying in constipated patients. However, it’s important to note that these results cannot be directly extrapolated to the natural stimulus of eating a meal. Interestingly, the response to cholecystokinin—the mediator of food-induced contraction—was normal in these patients.

Exploring Potential Causes of Gall Bladder Dysfunction in Constipation

The study’s findings raise several questions about the underlying mechanisms of gall bladder dysfunction in constipated patients. While the gall bladder muscle itself does not appear to be the culprit, other factors may contribute to the observed abnormalities.

Vagal Neuropathy: A Possible Explanation?

Penning et al. suggest that the failure of the gall bladder to respond to sham feeding may be a sign of vagal neuropathy. This conclusion is based on the fact that the gall bladder’s response to sham feeding involves vagal cholinergic stimulation. However, further research and tests of vagal function are needed to establish a definitive link between vagal neuropathy and gall bladder dysmotility in constipated patients.

The Role of Psychological Factors

An often overlooked aspect of gastrointestinal function is the influence of psychological factors. The cephalic phase response to sham feeding involves higher brain centers, and the experience of chewing and spitting out a meal may elicit strong emotional reactions in some participants. It’s possible that constipated patients, who may be more prone to anxiety and psychic distress, could have stronger emotional responses to the sham feeding procedure, potentially affecting their gall bladder function.

Comparing Gall Bladder Function in Constipation and Other Gastrointestinal Disorders

To better understand the implications of the study’s findings, it’s helpful to compare gall bladder function in constipated patients with other gastrointestinal disorders.

Irritable Bowel Syndrome (IBS) and Gall Bladder Function

While some researchers have suggested that constipated people may have a widespread smooth muscle disorder affecting both the gall bladder and intestine, the evidence for abnormal gall bladder function in IBS is inconsistent. Moreover, patients with IBS tend to have larger fasting gall bladder volumes, in contrast to the smaller volumes observed in Penning et al.’s constipated patients.

Functional Dyspepsia: A Potential Analogy

A more apt comparison might be drawn with functional dyspepsia, where impaired relaxation of the stomach is a common feature. Similarly, impaired relaxation of the gall bladder could explain the small fasting volume observed in constipated patients in Penning et al.’s study.

The Complexity of Functional Gastrointestinal Disorders

The study by Penning et al. highlights the complexity of functional gastrointestinal disorders and the challenges associated with studying them. These conditions, which include chronic constipation, IBS, and functional dyspepsia, often present with overlapping symptoms and poorly understood underlying mechanisms.

The Importance of a Biopsychosocial Approach

While Penning et al. focused primarily on the physiological aspects of gall bladder function in constipated patients, a comprehensive understanding of these disorders requires a biopsychosocial approach. This holistic perspective takes into account the interplay between biological, psychological, and social factors in the development and manifestation of functional gastrointestinal disorders.

Future Research Directions

The findings of this study open up new avenues for research into the relationship between gall bladder function and constipation. Future studies should aim to:

• Investigate the long-term implications of altered gall bladder function in constipated patients
• Explore the potential role of vagal neuropathy in gall bladder dysmotility
• Examine the influence of psychological factors on gall bladder function in functional gastrointestinal disorders
• Develop more comprehensive models of gastrointestinal function that incorporate the complex interactions between different organs and systems

Clinical Implications and Treatment Considerations

Understanding the relationship between gall bladder function and constipation has important implications for clinical practice and treatment strategies.

Screening for Gall Bladder Dysfunction in Constipated Patients

Given the potential link between chronic constipation and altered gall bladder function, healthcare providers may need to consider screening for gall bladder dysfunction in patients presenting with persistent constipation. This could involve ultrasound examinations or other imaging techniques to assess gall bladder volume and motility.

Tailoring Treatment Approaches

The recognition of gall bladder dysfunction in constipated patients may necessitate a more tailored approach to treatment. This could include:

1. Addressing both bowel motility and gall bladder function in treatment plans
2. Exploring the use of prokinetic agents that target both intestinal and gall bladder motility
3. Incorporating lifestyle modifications that support both bowel and gall bladder health
4. Considering the potential benefits of psychological interventions in managing functional gastrointestinal disorders

The Broader Implications for Digestive Health

The study by Penning et al. serves as a reminder of how little we understand about the intricate workings of our digestive systems. It underscores the need for continued research into functional gastrointestinal disorders, which are becoming increasingly prevalent and troublesome for patients.

Holistic Approaches to Digestive Health

As our understanding of the complex relationships between different components of the digestive system grows, there is a growing need for more holistic approaches to digestive health. This may involve:

• Integrating knowledge from multiple medical specialties, including gastroenterology, hepatology, and neurogastroenterology
• Developing comprehensive diagnostic tools that can assess the function of multiple digestive organs simultaneously
• Exploring the potential of personalized medicine in treating functional gastrointestinal disorders
• Investigating the role of the gut-brain axis in modulating digestive function and overall health

As research in this field progresses, it is likely that our understanding of the intricate relationships between different components of the digestive system will continue to evolve. This knowledge will be crucial in developing more effective strategies for diagnosing, treating, and preventing functional gastrointestinal disorders, ultimately improving the quality of life for millions of patients worldwide.

The Role of Bile Acids in Gastrointestinal Health and Disease

The study’s findings highlight the importance of bile acids, particularly deoxycholic acid (DCA), in the complex interplay between gall bladder function and intestinal transit. Understanding the role of bile acids in gastrointestinal health and disease is crucial for developing targeted therapies and preventive strategies.

Bile Acid Metabolism and Circulation

Bile acids play a vital role in the digestion and absorption of dietary fats and fat-soluble vitamins. They are synthesized in the liver from cholesterol and undergo a complex process of enterohepatic circulation. In patients with slow transit constipation, this circulation may be disrupted, leading to increased absorption of potentially harmful secondary bile acids like DCA.

Bile Acid Signaling and Gastrointestinal Motility

Recent research has revealed that bile acids act as signaling molecules, influencing various aspects of gastrointestinal function. They can modulate intestinal motility, secretion, and inflammation through interactions with specific receptors in the gut and other tissues. This emerging understanding of bile acid signaling opens up new possibilities for therapeutic interventions in functional gastrointestinal disorders.

Potential Therapeutic Targets

The role of bile acids in gastrointestinal health suggests several potential therapeutic targets for managing constipation and related disorders:

• Bile acid sequestrants to reduce the absorption of toxic secondary bile acids
• Synthetic bile acid analogues that can modulate intestinal motility and secretion
• Probiotics or other interventions to modify the gut microbiome and bile acid metabolism
• Targeted therapies that influence bile acid signaling pathways in the gut and liver

As our understanding of bile acid biology continues to grow, it is likely that new therapeutic approaches will emerge, offering hope for more effective treatments for constipation, gallstone disease, and other functional gastrointestinal disorders.

The complex relationship between gallstones, constipation, and gall bladder function revealed by Penning et al.’s study underscores the need for a multidisciplinary approach to digestive health. By considering the interconnected nature of various gastrointestinal processes, researchers and clinicians can develop more comprehensive and effective strategies for managing these challenging conditions. As we continue to unravel the mysteries of the digestive system, we move closer to providing better care and improved quality of life for patients suffering from functional gastrointestinal disorders.

Gall bladder and bowel: the links multiply

Penning et al’s paper is a brain-teaser (see page 264). It clearly shows is that, in the laboratory, the gall bladder behaves abnormally in patients with chronic constipation. What is much less clear, but very intriguing, is what the findings mean. Recently, the state of the gall bladder in patients with constipation has been attracting attention because of growing evidence that cholesterol gallstones can result from slow intestinal transit.1-3 Slow transit allows the colon to absorb excessive amounts of bacterially degraded substances, including the toxic bile acid, deoxycholic acid (DCA). When DCA reaches the liver, it makes it secrete more cholesterol into bile and when it reaches the gall bladder it hastens the crystallisation of cholesterol.2
,4 So, patients with slow transit constipation should be at high risk of gallstones. Puzzle number one is that the patients in Penning et al’s study seem to have escaped gallstones (although this is not explicitly stated).

But was their gall bladder motility defect likely to lead to gallstones? Impaired gall bladder emptying is certainly a feature of patients with cholesterol gallstones.5 Indeed, it is believed to be a key factor in stone pathogenesis, if only because it favours the growth and retention of calculi within the gall bladder. Latest thinking is that the gall bladder of patients with gallstones may be a poor contractor because its wall is infiltrated with cholesterol, and perhaps inflamed by the high DCA concentrations in the bile inside it.4
,6 It is tempting to welcome Penninget al’s findings as fitting in with this scheme, the slow transit of their patients having led to bile toxic to the gall bladder. However, there is a snag with this interpretation. In the characteristic motility defect of patients with gallstones the resting volume of the gall bladder is large,4 whereas in these constipated patients, the resting volume was smaller than normal—a finding which is unusual and curious.

Another difficulty in comparing these new data with published ones is the method used to demonstrate impaired gall bladder emptying, namely sham feeding. The results cannot be extrapolated to the natural stimulus of eating a meal. The response to cholecystokinin—the mediator of food induced contraction—was normal; indeed, in another study of constipated patients (who also had irritable bowel syndrome (IBS)), the response to a cholecystokinin analogue was actually greater than normal.7 So at least we can be sure of one thing—the gall bladder muscle is not to blame. Is it a problem of understimulation? Because the gall bladder’s response to sham feeding involves vagal cholinergic stimulation, Penning et al conclude that failure to respond is a sign of vagal neuropathy. This sounds logical but would be more convincing if tests of vagal function had been carried out and a relation shown between these and the gall bladder dysmotility.

Penning et al ignore the possibility of psychological factors. The response of the gastrointestinal tract to sham feeding is called the cephalic phase and it involves the higher centres of the brain. Having to chew and spit out a meal cannot be a pleasant experience. Suppose that some participants found it positively disgusting, would their gastrointestinal tracts, including their gall bladders, have reacted normally? The emotional reaction of the patients might have been stronger than that of the normal controls. Almost by definition, patients are anxious people (why else do they go to the doctor?) and so more liable to strong emotional reactions. Constipation can itself be a somatic expression of psychic distress8(though patients with functional gastrointestinal disorders who reach specialists are likely to deny their distress9).

In discussing their findings, Penning et al have avoided the biopsychosocial approach but, more conventionally perhaps, have suggested that constipated people have a widespread smooth muscle disorder encompassing the gall bladder as well as the intestine (not a new idea3). This is the language used in the past about IBS but the evidence that gall bladder function is abnormal in IBS, protean though that condition is, is inconsistent.10 Also, the trend in IBS is towards larger fasting volumes,11 not smaller as in Penninget al’s patients. A better analogy might be with functional dyspepsia, where impaired relaxation of the stomach seems to be a feature12 because impaired relaxation of the gall bladder could explain the small fasting volume in Penninget al’s patients.

This study, like many, raises more questions than it answers. It reminds us how little we understand the behaviour of our digestive systems. Functional disorders are difficult to study but study them we must because, more and more, these are the disorders which trouble the patients who face us in our clinics. And every study of a functional disorder should take account of psychosocial factors.

Chronic Constipation and the Role of the Gallbladder

Constipation is becoming an increasingly chronic issue for Americans. Some children and adults deal with the uncomfortable issue, and higher amounts of seniors deal with this issue. There are many different products on the market to help provide relief and move the bowels. While these are needed to reduce discomfort, what is also needed is for us to look at some of the possible root causes of constipation. If you aren’t addressing the root, you may just be putting a bandaid on the situation.

There are several factors that can contribute to constipation:

• Not drinking enough water
• Not eating enough fiber (mainly this comes from lack of fruits and veggies, though flax seed and chia seeds can be helpful)
• Stress
• Lack of exercise/excess sitting
• Lack of probiotics
• Gallbladder not functioning optimally

All these factors combined and separately have an impact, but what I wanted to focus on today is how the gallbladder can be one of the culprits in chronic constipation. Most everyone has bouts of occasional constipation, and that is usually created from life circumstances like traveling or being dehydrated. Chronic constipation is an ongoing issue dealt with on a daily and weekly basis.

The Gallbladder’s Job

The gallbladder’s main job is to store, concentrate and release bile. Bile is made by the liver and then transported to the gallbladder to be stored. As it sits there, it is concentrated into a more potent product that is made up of fatty acids and cholesterol and designed to be excreted when fat from food we ingest enters into the duodenum (the start of the small intestines). Bile has two main jobs. It carries toxins out of the liver and it enhances the digestion and utilization of fats that we eat by emulsifying them and breaking them up into smaller fat globules in the small intestines. Once the fats are broken down, they can be absorbed by the body and utilized for fuel.

The other key component of bile is that it helps move things along in the intestines, meaning it moves stools through the intestines and out as waste. If the body is not digesting something well, it tends to stay around for a while, which is what can happen with undigested fat when there is limited bile. This decreases GI motility (or bowel movements).

Without appropriate amounts of bile to break up fat, you will have a harder time digesting the fat soluble vitamins A, D, E, and K. It is important that we eat good fats as they play many important roles in the body. Fats are used in the body as fuel, to satiate us and keep us fuller longer, and they help us to regulate inflammation (omega-3 and omega-6 are important in the right balance for this). Fats also make up part of the structure of our cell walls, and are used to form key hormones.

Signs of a poorly functioning gallbladder

Intense cravings of sugar and fat can be a sign that your gallbladder needs a little more support. If you aren’t digesting fats well, you can tend to crave them, or crave sugar, as fats are like the slow burning fuel and give us longer sustained energy and satiate us. When we don’t eat fats or aren’t digesting them well, we are hungrier more often and can turn to sugar instead to give us quick energy as it digests very quickly and the body uses the glucose for fuel. Of course, dysregulated blood sugar and a constant intake of sugary foods will also contribute to cravings for more sugar, so limit your intake as much as possible. Other signs of gallbladder issues can be pain under the right rib cage where the gallbladder is located, motion sickness/nausea, frequent diarrhea or fatty stools that float due to not digesting fats. If you increase your fiber content and your constipation gets worse or you take liver cleansing herbs and don’t do well, it could be because the bile is not flowing freely like it should and so the fiber isn’t being effectively moved along or the liver cannot get rid of the toxins through the bile appropriately. Fiber helps bind up the bile and toxins and safely escort it out of the body in the form of stools.

Bile and Fats

To have a healthy gallbladder with healthy bile, we need to be eating healthy fats regularly. Healthy fats are fats like coconut oil, olive oil, avocado oil, butter, and ghee. Unhealthy fats are highly processed vegetable oils like canola oil, soybean oil, and any liquid oil that is heated and refined. These oils are not heat stable, are sensitive to light and therefore should be stored in opaque jars, and are often from gmo crops. Unhealthy fats also include consumption of trans fatty acids and fried foods as these fats have been altered and can be rancid and oxidized, contributing to inflammation and poor quality bile. You need healthy fats to make healthy bile!

When you don’t eat fat regularly, meaning you eat low fat or no fat, your gallbladder doesn’t get the signal to release bile regularly, as it is released due to the presence of fat in the duodenum (the beginning of the small intestines). When the bile doesn’t move out regularly, it gets thick and viscous and can lead to gallstone formations. This can lead to inflammation and pain down the road, but also means limited fat digestion takes place. Remember, fats are needed for a healthy inflammation response, cell structure, hormones, and more, so it is important that we digest them to use them.

So how do you take care of your gallbladder?

• Eat healthy fats like olive oil, ghee, tallow, butter, lard, avocado oil, and oils that support healthy inflammation pathways like borage oil, hemp oil, fish oil, flax seed, chia seeds, and black currant seed oil.
• If you no longer have a gallbladder or have trouble digesting fats due to a sluggish gallbladder, coconut oil is a good fat to use for cooking and baking, as it is high in MCTs and gets digested quickly and doesn’t need as much bile to digest it. Our goat ghee is also high in MCTs and therefore should be easier to digest.
• Eat foods that thin the bile and support the liver like beets, lemons, apples, dandelion greens (and other bitter foods or Swedish Bitters), carrots, and flaxseed oil.

Want a tasty recipe that helps support a healthy gallbladder and bile flow? Check out our Gallbladder Salad recipe.

EZ-Go Herbal Stool Softener for ease of bowel movements

For those that do need some extra support, Mt. Capra offers an excellent product that enhances elimination. It is called EZ-Go and is an herbal stool softener that is gentle and non-irritating. It includes mucilaginous herbs like aloe, slippery elm, and marshmallow root that soothe, as well as magnesium, and triphala to add some bulk to the formulation for ease of movement.

Please note: Nothing in this blogpost is making any health claims. This information is for informational purposes only and does not substitute the advice from a qualified medical professional. If you have any concerns about your health, see your primary care provider.

Gallbladder Referred Pain, Constipation, & Gallstones

Gallbladder problems including gallbladder attacks are very common reasons for which people seek medical care. The pain and discomfort can unfortunately result in the removal of the little green organ followed by dietary restrictions (often low fat). But of course, all of our organs are there for one reason or another and although we can live without the gallbladder, removing it is simply removing a symptom of a problem, not the actual cause. In this two-part article on the gallbladder I’ll discuss why you have a gallbladder, why you should want to keep it (and keep it healthy), warning signs that your gallbladder isn’t working well, risk factors, and natural treatments and lifestyle changes you can make to improve your gallbladder and overall health; yeah! If I can just save one more gallbladder I’ll be a happy guy.

Gallbladder Physiology: Bile is so Good for You

Let’s take a brief lesson in gallbladder physiology here, and I’ll make it interesting and relevant to your everyday health. The gallbladder is a small organ that sits tucked up underneath the liver in the upper right side of your abdomen. It concentrates and stores bile produced by the liver, and along with the enzyme lipase secreted by the pancreas, it aids in the digestion of fats in the gut. When fats from food enter the digestive tract they stimulate the secretion of a type of hormone called cholecystokinin (CCK) in the upper part of the small intestine – the duodenum. This, along with the stomach’s secretion of hydrochloric acid, signals the gallbladder to release some of its approximately 50mL of bile into the gut to help aid in digestion of those fats. Since by most, it’s viewed as a “storage tank” and nothing more, it’s often seen as only a nuisance when it comes to digestive problems and pain – expendable at the first sight of problems and removable with surgical ease. But there’s so much more to it than just storage.

Bile is a lovely dark green/yellow-brown fluid and contains about 10% bile salts. The bile acids (salts) have a strong relationship to hormonal regulation as they share many of the same synthesis pathways as hormones. This is why people with hormonal problems, especially women with estrogen dominance, are more susceptible to gallbladder problems. The more hormonal stress on the body the lower the bile acids which in turn disrupts normal hormonal metabolism. It’s not a coincidence that many women have their gallbladder removed at the same time they have a hysterectomy.

Speaking of hormones, just a few years ago it was demonstrated that the gallbladder also plays a role in insulin regulation and that β-like cells that produce insulin in the pancreas also occur in the gallbladder. Insulin is also metabolized by the liver and can therefore have an effect on the bile salts – so diets high in refined carbohydrates and those with insulin resistance will also be more likely to have troubles with their gallbladder.

Bile also increases the absorption of fats and especially the fat soluble vitamins A, D, E, and K. We all know the push for vitamin D by every doctor and health food store today. Consider that if you have an unhealthy gallbladder then your absorption of vitamin D, as well as the other fat soluble vitamins necessary for good health, will also be impaired. So just because your vitamin D level may be low as revealed by a blood test, doesn’t mean you should go vitamin D supplement-crazy; that’s not necessarily addressing the problem.

Bile and Cholesterol

A small percentage of bile is cholesterol but the majority of bile acid is made from cholesterol; actually about half of the cholesterol our body makes per day is used to make bile acid. These bile acids are recycled from the intestines and back to the liver and gallbladder. However if there are problems with digestion, such as an all-too-common poor diet, then the salts can become “dirty” – the bile becomes thick like a vehicle’s oil that is way past the oil change date.

Stones in the gallbladder

Eventually this thick, dirty bile can accumulate and form a gallstone, also known as a cholelithiasis. Usually these stones contain some or a significant amount of cholesterol, so it’s often cholesterol that gets blamed for causing the stones when really it’s an issue with oxidative stress, inflammation, and digestive problems caused by other factors, (discussed in a bit).  Gallstones in the gallbladder can lead to cholecystitis, which is an inflammatory condition of the gallbladder. The stones leaving the gallbladder can also obstruct the bile ducts which can be life threatening, especially if a stone blocks the pancreatic duct leading to pancreatitis.

Also, low levels of bile salts can be a reason for gallstones; this problem would ultimately fall on a production problem with the liver.

Should You Remove Your Gallbladder – You Don’t Need it Anyway (?)

The surgical removal of the gallbladder is called a cholecystectomy. This is a common procedure that with rare exception, is unnecessary and does not address the problem. Some people who have had their gallbladder removed will see absolutely no change in their symptoms while others may have their symptoms 100% resolved. Others who have had a cholecystectomy may no longer be able to eat high fat foods as their body is unable to handle too much fat digestion at once due to the removal of their bile storage tank. However, the body in its infinite wisdom can often form a new little storage pouch in the area of the common bile duct to store some bile for when it’s needed.

So how do you know if your gallbladder is at the point of becoming a life threatening emergency or you’re simply experiencing gallbladder troubles that perhaps can be dealt with in a non-surgical manner? Well, without giving specific medical advice for every situation, a good rule is to look at the severity of the signs and symptoms. Someone who is having a gallstone attack typically has pain in the upper right side of the abdomen and/or pain in-between the shoulder blades, more often below the right shoulder. It’s uncomfortable and can get to the point of being very painful. Sometimes nausea and vomiting can occur which can last for minutes to hours. Now if the pain and vomiting get worse and worse then you should of course seek medical attention. (Gallbladder attacks and heart attacks can have very similar symptoms – heart attacks don’t always have pain down the left arm only.) Typically gallbladder attacks don’t just come out of nowhere where the person never had any symptoms of a gallbladder problem and now all of a sudden they have a huge stone lodged in their bile duct. So you have to know the symptoms of poor gallbladder function so you can address the issue before it gets too out of hand.

Gallbladder referred pain

When Your Gallbladder Isn’t Working Too Well – Gallbladder Referred Pain – Signs & Symptoms

There are many signs and symptoms of a gallbladder that isn’t functioning very well and most people just think they’re common “normal” symptoms so they think nothing more of it. Then, “all of a sudden” they get a major gallbladder attack and are puzzled as to how it could have happened to them. Well, I’m hopefully going to keep you from being surprised!

• Constipation, actually gallbladder constipation. Yes, a major reason for constipation is a poorly functioning gallbladder. When fat enters the small intestine it has to be metabolized by those bile salts and the lipase from the pancreas; (you learned this already, right?). But if the bile isn’t released efficiently from the gallbladder then the food and its fatty contents must wait longer and longer in the small intestine to be metabolized. So they wait. And wait. And wait. And you get constipated. So don’t necessarily think that you need more fiber, or you need probiotics if you’re constipated – consider your gallbladder.

• Aside from constipation and the gallbladder referred pain areas discussed (upper right abdomen and right shoulder area), another symptom of an unhappy gallbladder is burping after or while eating a meal – especially one containing fat. Typically this person will also feel “heavy” and even perhaps bloated if they’re having problems digesting a fatty meal because their gallbladder isn’t doing its job. Burping can be from eating too quickly too but burping from a gallbladder problem usually accompanies heaviness.

• Another symptom of a gallbladder issue is peeling of the skin on the palms of the hands and the soles of the feet. This is due to an inefficient fat metabolism system as well as metabolism problems with vitamin A (fat soluble). I’ve seen patients present with some pretty wild looking palm and sole peeling that nobody was ever able to understand why. This too, is often a gallbladder problem.

• Finally, and I discuss this in my articles on sleep, the horary time (acupuncture meridian) for the gallbladder is 11pm to 1am. So if you can’t fall asleep until after 1am or if you’re asleep before 11pm but then awaken between 11pm-1am it could very well mean your gallbladder is stressed. Also note that liver is next, from 1-3am, and this is the most common time a person has sleep difficulties for many, many reasons – caffeine, hormones, stress, medications – just to name a few, and all these can also affect the gallbladder too as well as bile production in the liver.

In Part II of Gallbladder Health I’ll discuss how to prevent problems with your gallbladder as well as natural treatments for optimum function of your gallbladder PLUS emergency help to calm down or resolve a gallbladder crisis.

Learn What a Gallbladder Attack Feels Like: Hyon S. Kang, D.O.: Board Certified Gastroenterologist

The gallbladder is a small organ that sits below the liver and stores an important digestive fluid called bile. Gallstones are the most common cause of gallbladder issues, and about 20 million Americans have the little stones. Many people with gallstones have no symptoms. When symptoms do arise, it’s best to seek professional evaluation for diagnosis and treatment. 

Gallbladder function

The gallbladder plays a key role in helping your body digest fats. It’s also needed to absorb fat-soluble vitamins A, D, E, and K. When you eat fat-containing foods, the gallbladder contracts and releases bile into the common bile duct that connects to the intestines. A number of gallbladder disorders can cause attacks of pain and discomfort. The gallbladder can become inflamed, develop growths, or form calcified stones called gallstones. 

Gallstones explained

When the gallbladder develops gallstones, they can cause symptoms known collectively as a gallbladder attack. Gallstones are pebble-like stones made primarily of hardened cholesterol and bile. The stones can be a small as a grain of sand or as large as a golf ball. While golfball-size gallstones are extremely rare, large gallstones can block the flow of bile. Small stones can clump together and cause problems as well.

Cholecystitis refers to inflammation of the gallbladder and is another common cause of gallbladder attacks. While gallstones can cause inflammation, it’s possible to have inflammation without gallstones. 

Gallbladder attack symptoms

Gallbladder attacks can range from mild to severe and typically cause pain in the upper right area of the abdomen. Symptoms include:

• Nausea
• Abdominal pain
• Bloating
• Vomiting
• Dull pain on right side near the liver

Attacks are more likely to occur immediately after a fatty meal. The pain can radiate to the middle of the abdomen and between the shoulder blades. Seek immediate help if you experience symptoms such as fever and chills as these may point to more severe complications. 

Recurrent gallbladder attacks

Whether you have one gallbladder attack or they recur, it’s necessary to see a specialist. A gallbladder attack is a warning sign that something is amiss with the gallbladder. Repeated attacks can cause the gallbladder to lose its ability to function properly. 

Gallbladder attack complications

Don’t take gallbladder attacks lightly. Even mild attacks can signal a serious underlying problem. Gallstones and gallbladder disease can cause serious complications. Gallstones can block the ducts that transport bile. This prevents bile from traveling from the liver to the intestines, and can cause serious health issues, including:

• Weight loss
• Severe abdominal pain
• Jaundice
• Fatigue
• Nutrient deficiency

Who’s at risk?

Gallstones develop when substances that make up bile, such as cholesterol and calcium, harden. Anyone can develop gallstones. Some people are more at risk than others due to various factors including:

• Overweight and obesity
• Rapid weight loss
• Certain medications, such as estrogen
• Family history
• Pre-existing liver disease
• Diabetes
• Inflammatory bowel disease

Women are more at risk of developing gallstones than men, and gallstones are more common as you age. Patients over 60 are a higher risk for gallstones.

Treatment for gallbladder issues

Here at Gastroenterology Consultants of West Houston, our expert gastroenterologist Dr. Hyon Kang diagnoses and treats a wide variety of gastrointestinal diseases, including those that affect the gallbladder. Prompt evaluation and treatment is necessary to avoid complications when gallbladder attacks occur. 

Sometimes lifestyle changes such as losing weight and adopting a lower-fat diet are enough to remedy mild gallbladder problems. Surgery to remove the gallbladder is often a necessary treatment. For this minimally-invasive surgery, Dr. Kang makes small incisions and uses special tools to remove the gallbladder. 

Take symptoms of gallbladder disease seriously. Prompt evaluation is the best way to avoid potentially serious complications. If you notice any pain or discomfort in your abdomen, especially after eating, schedule a visit with Dr. Kang at our office in Katy, Texas. Call 281-729-5758 to speak with one of our team members today. 

Your Complete Guide to Causes of Constipation and Finding Relief – Part 2: Low Bile Flow

Your Complete Guide to Causes of Constipation and Finding Relief – Part 2: Low Bile Flow

Constipation is incredibly uncomfortable for those who suffer from being stopped up. Often you feel uneasy, bloated, full, as though everything isn’t coming out, and even nauseous.

But constipation is more than discomfort. Stool that doesn’t pass fully through the digestive system actually rots and prevents absorption of nutrients from new food. Defined as fewer than three stool movements a week, it’s the most common gastrointestinal problem in the United States.

When you’re suffering from constipation, it seems easy to take over-the-counter laxatives or stool softeners – but you’d just be treating the symptom, not the underlying cause.

If you only treat the symptoms, you might continue to struggle with constipation for the rest of your life. How to get rid of constipation depends on the underlying causes, which we aim to help you identify in this guide.

In this six-part series, we are looking at the different causes of constipation in an effort to find you true constipation relief. The first part of the series, we discussed low hydrochloric acid or stomach acid levels, an often-overlooked cause of constipation.

The second part of this series, we are going to take a closer look at low bile flow, what causes it, and what helps constipation caused by low bile levels.

Part 2: Low Bile Flow

Bile is a digestive fluid created by your liver and stored in your gallbladder. Bile is important in digestion and absorption of fat in the small intestine. Bile’s makeup includes:

• Water
• Bile acids (also called bile salts)
• Bilirubin
• Fats (cholesterol and fatty acids)

Fat is digested differently than carbohydrates and proteins, it requires the help of bile to break it down after it passes through the stomach. When fat reaches the small intestine, it looks like large fat droplets. Your bile then breaks down these large fat droplets, with bile salts, which emulsifies (breaks)  them into fatty acids and monoglycerides. These particles are then small enough to pass through the intestine wall. Bile is also important in breaking down bilirubin (old blood cells byproduct) and cholesterol.

When your liver isn’t producing enough bile or it is too thick to flow freely (peanut butter vs water-like) fat can build up in the intestinal wall and cause slower movements via digestive tract therefore cause constipation. If your constipation is due to low bile flow, symptom treating medications won’t help you in the long run. Identifying low bile flow as the cause of your constipation brings you one step closer to lasting relief.

The Importance of Bile Flow

Why is bile so important? Bringing to mind a yellowish, green slime, it’s a common reaction to think of bile as vile, but it’s critical to gut health and smooth digestion. Bile is important in a number of critical roles, including:

• Aid in fat digestion and absorption (and some digestion of proteins and starches)
• Emulsify fats (the detergent-like reaction done by bile salts)
• Assist in absorption of fat-soluble substances, such as vitamins A, D, E, and K
• Helps regulate your intestinal microflora
• Encourages fecal matter movement through your digestive tract
• Serve as a route of excretion of bilirubin
• Help your liver rid your body of waste products
• Aid in destroying unwanted organisms that invade the body through the digestive system

When your body isn’t making enough bile, you can experience several uncomfortable and sometimes painful symptoms, such as:

• Fatigue
• Mood swings
• Constipation
• Acid reflux
• Acne
• Gastro-Esophageal Reflux Disease (GERD)
• Gall bladder disease (stones and inflammation)
• Migraines
• Vitamin deficiencies
• Jaundice
• Poor gut microflora
• Impaired liver function
• High cholesterol
• Greasy, foul smelling, and light colored stools

If your body has low bile flow, your constipation is also probably contributing to nutritional deficiencies, even if you’re eating healthy. This is why it’s so important to find the cause of your constipation instead of reaching for a quick fix.

Nutritional deficiencies can lead to conditions that may appear unrelated to your constipation. If you experience regular constipation it’s important that you share that information with your functional medicine doctor.

Causes of Low Bile Flow

Since bile is produced in the liver, any impairment to the liver can cause low bile flow. Impairments of the liver include:

• Jaundice
• Bleeding in the liver
• Infection of the liver
• Liver inflammation
• Vitamin D deficiency

Additionally, because bile is stored in the gallbladder, any impairment of the gall bladder could lead to low bile flow, including:

• Gallstones
• Cholecystitis
• Gallbladder cancer
• Gallbladder polyps
• Abscess

Other causes of low bile flow could include:

• Obesity
• Having a high-cholesterol diet
• Diabetes
• Old age

If you suspect you are suffering from constipation caused by low bile flow, it should be taken very seriously – schedule an appointment with a certified  functional medicine doctor to get your constipation cause pinned down and be on your way to smooth digestion.

Home Remedies for Constipation Caused by Low Bile Flow

Remember, what helps constipation best is determined by the underlying cause. With that in mind, there are several natural remedies for constipation caused by low bile flow that you can take at home, including:

• Lemon juice – Lemon juice activates the liver and stimulates digestion. Try this in warm water on an empty stomach in the morning.
• Healthy, raw oils – Fish oil, olive oil, flaxseed oil, nuts, seeds, and avocados are good sources.
• Promote good gut health – By reducing sugar, processed foods, and grains you’ll be encouraging a healthy gut.
• Foods believed to stimulate bile production – Add garlic, beets, radicchio, kale, endive, arugula, celery, and radish to your diet.

There’s also Betafood and Cholachol, two additional natural remedies that your functional medicine doctor may recommend.

• Betafood** – This is an extract derived from organic beet root and tops. It mobilizes the bile and transforms it from a thick, peanut butter consistency, to a water-like consistency.

With as much as 10 percent of the population suffering from gallstones, this is a great supplement that helps prevent and reduce gallstones and aid in fat metabolism.

• Cholacol** – These are purified bile salts, which are great for stasis and gallbladder relief. If you’ve had your gallbladder removed, these are a necessity. You’re missing the bolus bile release that occurs during normal food digestion. Those without a gallbladder suffer from fat digestion and therefore lack nutrients that are fat absorbent such as vitamin A, K, D, and E (and many others).

If you’ve had your gallbladder removed (cholecystectomy) and were left disabled in your ability to digest fats and other nutrients, you are not alone. Every year about 700,000 people have their gallbladder removed and require purified bile salts to aid in normalizing digestion.

These foods and supplements are a great way to start supporting your bile production. Be sure to see your functional medicine doctor in the early stages of your constipation issues. By seeing your doctor when constipation starts, prevents low bile production from going untreated and potentially leading to a cascade of conditions.

**To order these products you can call our office at 212-696-HEAL(4325)

When to See Your Functional Medicine Doctor for Constipation

As with many conditions, treating symptoms ignores the underlying cause. Additionally, waiting to see your doctor about your constipation can make diagnosis more difficult and the treatment more complicated. If you experience constipation that lasts longer than a couple of weeks, it’s time to schedule an appointment with your functional medicine doctor.

By working closely with a functional medicine doctor, you can discover constipation remedies that helps stimulate bile production and relieve your constipation discomfort for good.

Elena Klimenko, MD, a certified functional medicine physician, will help you choose the right course of action to identify the root cause and relief your unsettled symptoms. Call today to find out more about functional medicine and speak with Dr. Klimenko at 212-696- HEAL(4325).

If you want more information about Functional Medicine, contact us to receive a FREE copy of Dr Klimenko’s E-book.

Gallstones – Illnesses & conditions

Your treatment plan for gallstones depends on how the symptoms are affecting your daily life.

If you don’t have any symptoms, a policy of ‘active monitoring’ is often recommended. This means you won’t receive immediate treatment, but you should let your GP know if you notice any symptoms.

As a general rule, the longer you go without symptoms, the less likely it is that your condition will get worse.

You may need treatment if you have a condition that increases your risk of developing complications, such as:

Treatment may also be recommended if a scan shows high levels of calcium inside your gallbladder, as this can lead to gallbladder cancer in later life.

If you have episodes of abdominal pain (biliary colic), treatment depends on how the pain affects your daily activities. If the episodes are mild and infrequent, you may be prescribed painkillers to control further episodes and given advice about eating a healthy diet to help control the pain.

If your symptoms are more severe and occur frequently, surgery to remove the gallbladder is usually recommended.

The gallbladder isn’t an essential organ and you can lead a perfectly normal life without one. Some people may experience symptoms of bloating and diarrhoea after eating fatty or spicy food. If certain foods do trigger symptoms, you may wish to avoid them in the future.

Keyhole surgery to remove the gallbladder

If surgery is recommended, you’ll usually have keyhole surgery to remove your gallbladder. This is known as a laparoscopic cholecystectomy.

During a laparoscopic cholecystectomy, 3 or 4 small cuts are made in your abdomen. One larger cut (about 2-3cm) will be by the belly button and the others (each 1cm or less) will be on the right side of your abdomen.

Your abdomen is temporarily inflated using carbon dioxide gas. This is harmless and makes it easier for the surgeon to see your organs.

A laparoscope (long thin telescope with a tiny light and video camera at the end) is inserted through one of the cuts in your abdomen. This allows your surgeon to view the operation on a video monitor. Your surgeon will then remove your gallbladder using special surgical instruments.

If it’s thought there may be gallstones in the bile duct, an X-ray or ultrasound scan of the bile duct is also taken during the operation. If gallstones are found, they may be removed during keyhole surgery. If the operation can’t be done this way or an unexpected complication occurs, it may have to be converted to open surgery (see below).

After the gallbladder has been removed, the gas in your abdomen escapes through the laparoscope and the cuts are closed with dissolvable stitches and covered with dressings.

Laparoscopic cholecystectomies are usually performed under a general anaesthetic, which means you’ll be asleep during the procedure and won’t feel any pain while it’s carried out. The operation takes 60-90 minutes and you can usually go home the same day. Full recovery typically takes around 10 days.

Single-incision keyhole surgery

Single-incision laparoscopic cholecystectomy is a newer type of keyhole surgery used to remove the gallbladder. During this type of surgery, only one small cut is made, which means you’ll only have one barely visible scar.

However, single-incision laparoscopic cholecystectomies haven’t been carried out as often as conventional laparoscopic cholecystectomies, so there are still some uncertainties about it. Access to this type of surgery is also limited because it needs an experienced surgeon with specialist training.

The National Institute for Health and Care Excellence (NICE) has more information on single-incision laparoscopic cholecystectomy.

Open surgery

A laparoscopic cholecystectomy may not always be recommended, for example if you:

• are in the third trimester (the last three months) of pregnancy
• are extremely overweight
• have an unusual gallbladder or bile duct structure that makes a keyhole procedure difficult and potentially dangerous

In these circumstances, an open cholecystectomy may be recommended. During this procedure, a 10-15cm (4-6in) incision is made in your abdomen underneath the ribs so the gallbladder can be removed. This is done under general anaesthetic, so you’ll be asleep and won’t feel any pain.

Open surgery is just as effective as laparoscopic surgery, but it does have a longer recovery time and causes more visible scarring. Most people have to stay in hospital for up to 5 days and it typically takes 6 weeks to fully recover.

Endoscopic retrograde cholangio-pancreatography (ERCP)

An endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that can be used to remove gallstones from the bile duct. The gallbladder isn’t removed during this procedure, so any stones in the gallbladder will remain unless removed using the surgical techniques mentioned above.

ERCP is similar to a diagnostic cholangiography (see diagnosing gallstones for more information), where an endoscope (long, thin flexible tube with a camera at the end) is passed through your mouth down to where the bile duct opens into the small intestine.

However, during ERCP the opening of the bile duct is widened with a small incision or an electrically heated wire. The bile duct stones are then removed or left to pass into your intestine and out of your body.

Sometimes a small tube called a stent is permanently placed in the bile duct to help the bile and stones pass.

An ERCP is usually carried out under sedation, which means you’ll be awake throughout the procedure but won’t experience any pain.

The ERCP procedure lasts about 30 minutes on average, but can take from 15 minutes to over an hour. You may need to stay overnight in hospital after the procedure so you can be monitored.

Medication to dissolve gallstones

If your gallstones are small and don’t contain calcium, it may be possible to take ursodeoxycholic acid tablets to dissolve them.

However, these aren’t prescribed very often because:

• they’re rarely very effective
• they need to be taken for a long time (up to 2 years)
• gallstones can recur once treatment is stopped

Side effects of ursodeoxycholic acid are uncommon and are usually mild. The most commonly reported side effects are feeling sick, being sick and itchy skin.

The use of ursodeoxycholic acid isn’t usually recommended for pregnant or breastfeeding women. Sexually active women should use either a barrier method of contraception, such as a condom, or a low-dose oestrogen contraceptive pill while taking ursodeoxycholic acid, as it may affect other types of oral contraceptive pills.

Ursodeoxycholic acid tablets are occasionally also prescribed as a precaution against gallstones if it’s thought you’re at risk of developing them. For example, you may be prescribed ursodeoxycholic acid if you’ve recently had weight loss surgery, as rapid weight loss can cause gallstones to grow.

Constipation – Gallbladder Attack

Understanding what causes constipation is paramount in learning how to change it.
 

Symptoms of Constipation

Symptoms of constipation may vary from person to person and also from time to time. I have had patients think they are not constipated because they moved their bowels regularly, even though the frequency was every 7 days. A healthy digestive system moves the bowels at least once daily and the longer food stays in the colon, the drier and harder it becomes. There are differing opinions on this but most people find they feel better the more regular they are.
 

The most common symptoms of constipation are:

• difficulty passing stool
• hard, dry stools
• infrequent stool
• pain with passage of stool
• abdominal bloating and/or pain
• abdominal distention
• feeling of incomplete evacuation after bowel movement

 
Relying on stool softeners, laxatives, colonics or enemas is not addressing the root of the problem, nor is this dependency good for the colon. Any of them are fine for an occasional short-term aid, but know that constipation is not normal and it is worth it to the health of your whole system to figure out the underlying cause and fix it.
 

Causes of Constipation

• gallstones
• lack of hydrochloric acid from antacids, PPIs, stress, overeating, etc.
• deficiency of bile
• lack of bile flow
• hypothyroidism
• infections such as H. pylori
• lack of digestive enzymes
• deficiency of good bowel flora
• food allergies
• gluten intolerance
• dairy intolerance
• lack of water
• lack of fiber, soluble and insoluble
• lack of exercise
• side-effects of drugs- pain killers, antidepressants, antihistamines, high blood pressure meds and many more
• some vitamin supplements such as those containing iron
• nerve degeneration
• pregnancy
• stress
• regularly not taking the time to evacuate

Treatment For Occasional Constipation

• Take ¼ to 1 tsp of olive oil 4x a day for 4 days. Take 3 days off. Repeat.
• Pre- and probiotics
• Soluble and insoluble fiber
• Relaxation and massage
• Castor oil packs over the lower abdomen
• Eliminating food allergens like dairy, wheat and other glutinous grains
• Laxatives
• Digestive supplements to improve bile flow, HCl, enzymes and bile salts with taurine, and bitters designed for bile and gallbladder

Travel Constipation

One of my favorite travel constipation remedies is to take whole flax seeds with me and take 1 tsp, pour it into my mouth and down it with a glass of water, 1 or 2 times a day. Simple and very effective. I don’t grind them; I don’t chew them. I just get them down the hatch.
 

Enemas – Instant Constipation Relief

Enemas? Wait! Before you discount the idea, know that enemas have been used for centuries for a reason – they work! And they’re not difficult to do. All the suggestions above can help, but every one of them does take some time. Sometimes what we need is fast constipation relief. In other words, NOW. What works instantly and faster than a laxative is an enema.

While we recommend ordering an enema bucket online for regular use with the coffee enema (which flushes the bile as well as the bowel), you can get a fleet enema kit or an enema bag in your local drug store today.
 

Gallstones And Constipation

According to studies, there is a definite correlation between constipation and gallstones. Constipation or “slow intestinal transit” time is associated with the formation of gallstones. A slow metabolism, such as caused by a hypothyroid, simply slows down all bodily processes from the movement of bile to the movement of bowels. It can even slow down thinking processes. A diet of refined foods (such as flour, bread, pasta and white sugar) has been shown to contribute to both of these conditions as has a sedentary lifestyle.

Stones in the gallbladder | For patients

Stones from relatives

Stones from relatives

Hello! I have been working as a doctor for 21 years. My name is Georgy Olegovich Sapego. In this article, I’ll tell you something useful about how gallstones appear, and explain how they fool you by slipping inaccurate information on this topic. For some reason, there are a lot of lies on this topic.

Stones in the gallbladder are common. On the one hand, these stones usually do not manifest themselves in any way.On the other hand, if an adult is admitted to the hospital with some kind of abdominal problems, then this is often associated with stones.

Gallstones are extremely rare in children.

Risk factors

The main ones are age and female sex.

If the stones were from relatives, then with a probability of 25% it is inherited.

Pregnant women are more likely to develop stones.

Obesity is often accompanied by the formation of gallstones.Stones come from cholesterol, and with obesity there is a lot of cholesterol.

On the contrary – rapid weight loss and fasting also leads to the formation of stones.

What protects us from the formation of stones

Ascorbic acid. It influences the conversion of cholesterol into bile in a clever way.

Unsaturated fatty acids (especially from nuts). It’s unclear exactly why this happens, but nuts reduce the risk of gallstones.

Coffee. It is also unclear why this is happening.

Physical activity. It dispels bile.

Statins. Their effect appears after 1 – 1.5 years of use. Also, probably, associated with cholesterol.

Alcohol. Very noticeably reduces the likelihood of stone formation. No one in their right mind would recommend it, because instead of stones they will get hepatitis or cirrhosis.

It turns out that different foods and medications affect the risk of gallstones in different ways.It is impossible to figure out these issues on your own. If you think that something is wrong with you, then be sure to consult with your doctor.

Now it’s a lie

It’s just an unreal amount in this thread.

I will immediately quote crazy ideas in one paragraph:

Alcohol makes the gallbladder produce a lot of bile. Then the bile thickens there, and stones are obtained. Constipation blocks not only intestinal contents, but also bile. From this, stones are obtained.You need to eat foods that are low in fat. Honey liquefies bile. A warm heating pad dilutes bile if something is sick there.

The entire previous paragraph is nonsense.

Alcohol protects against stones (I have already told about this).

The gallbladder does not produce bile. He accumulates it, and then throws it away. Bile is produced in the liver. If the gallbladder is removed, then bile will still be produced, only it will be ineffectively secreted into the intestines.

Constipation does not cause stone formation.Conversely, gallstones interfere with the flow of bile and lead to constipation. Bile normally acts as a laxative. If a person after a long fasting eats a little fat, then he may have diarrhea, because a lot of bile will immediately pour out of the gallbladder.

If you eat a little healthy fats, then gallstones can appear. Unsaturated fat is good for cholesterol and makes bile move. Therefore, people who are hungry have stones.

If you liked the article, then like it and subscribe to my channel.Read my articles on related topics:

Vivid symptoms of liver disease

Diet for cirrhosis

Constipation with gallstone disease: what to do?

Gallstone disease is characterized by the appearance of solid formations in the gallbladder. Stones obstruct the flow of bile, which can lead to constipation. Depending on the characteristics of the pathological process, two types of constipation are distinguished:

• spastic;
• atonic.

Symptoms of constipation with gallstone disease

Atonic constipation occurs against the background of an increased tone of the gallbladder. At the same time, the contractility of the intestinal walls deteriorates, leading to a delay in defecation. The following manifestations are observed:

• weakness;
• heat;
• pain during emptying.

Spasmodic constipation is associated with a weak tone of the gallbladder.In the intestines, spasms occur, interfering with the movement of feces. Patients complain of unpleasant symptoms:

• nausea;
• stomach ache;
• gas and bloating in the intestines.

Folk recipes

Fiber is considered an effective remedy for improving stool flow. It is a dietary fiber that has the ability to absorb water and increase the volume of feces.In addition, the product cleanses the intestines from toxins, toxins and other deposits. With this remedy, you will forget about constipation!

The easiest way to saturate your body with fiber is to include more fresh vegetables and fruits in your diet. Fermented milk products, dried fruits, nuts, juices with pulp and greens will be useful.

Pharmacy products

Phytomucil Norm is a unique product containing Psyllium psyllium seed shells. The benefits of plantain seeds first became known in India.Since then, Psyllium Fiber has helped millions of people around the world return to their normal lives without constipation.

The composition also includes the pulp of homemade plum. It is a natural laxative that stimulates the intestines to empty safely and gently. In addition, the fruit plays the role of a prebiotic, improving the intestinal microflora.

Looking for an effective remedy for constipation? You found it! Fitomucil Norm is suitable for adults, children and the elderly. The product is approved even during pregnancy and lactation.Do not forget to read the instructions for the product before use.

90,000 Constipation as a disease of civilization

Fixation or absence of daily stool – who has not encountered this problem in the modern lifestyle? As statistics show, there are practically no such people. At the same time, the topic is so intimate that it is unacceptable to talk openly about it, discuss it with family or with friends, not to mention the idea of ​​contacting and telling the doctor everything.Another thing, for example, peptic ulcer disease. They talk a lot about her, discuss and consult. Although few people know that constipation is a very serious symptom and the most important risk factor for colon cancer. With stool retention, toxins accumulate in the intestine, which damage the cells of the colon mucosa and trigger the mechanism of neoplasm, thereby increasing the risk of developing intestinal cancer. Conversely, daily bowel movement is the prevention of gastrointestinal cancer.It becomes clear how important this topic is in the period of a serious increase in the number of oncological diseases.

What is chronic constipation?

Quite often doctors and patients mean different manifestations under the term “constipation”. For the patient, this is, most often, a decrease in the frequency of going to the toilet. At the same time, for one person, stool every 5 days is familiar and does not cause anxiety, and for another, stool in a day will already be constipation.

In medicine, there is a clear definition of this concept.Constipation is a dysfunction of the colon with a decrease in stool frequency less than 3 times a week, with a change in its consistency to dense (in the form of “separate hard lumps of feces or nuts” or “feces of normal form, but with hard lumps”), with forced straining occupying more than 25% of the time spent on the toilet.

Lack of regular bowel movements – is it a diagnosis or a symptom?

From the point of view of experts, chronic constipation is an independent disease, but often it is also a harbinger of the development of other chronic diseases and not only of the gastrointestinal tract.It has now been established that the appearance of hard and irregular stools may precede the development of Parkinson’s disease by more than 10 years. Hence, it follows that constipation is a factor reflecting the likelihood of developing age-related neurological (neurodegenerative) diseases, including Alzheimer’s disease and age-related dementia, which are especially difficult to detect at an early stage.

Now consider a situation where constipation is a symptom of other diseases.

Constipation and colon polyps

As you know, polyps and other neoplasms occupy a leading position in oncopathology at the present time, especially in older age groups.In the presence of colon polyps and other neoplasms, there is a mechanical obstacle to the passage of intestinal contents, therefore, stool retention occurs and chronic constipation is formed. Screening examination with fecal occult blood analysis and the presence of inflammation, and, if necessary, video colonoscopy is an important diagnostic tool in clarifying the diagnosis of chronic constipation.

Constipation and thyroid gland

Constipation can be a symptom of a thyroid disorder, namely hypothyroidism.With a deficiency of thyroid hormones, the intestines become “lazy”, which leads to the formation of a fixed stool. Determination of the level of thyroid hormones is recommended for everyone when a fixed stool occurs.

Constipation as a side effect of drug therapy

Chronic constipation is a common complaint in patients who have to take 5 or more medicines at the same time due to concomitant chronic diseases. It turns out that the very fact of taking a large number of drugs at the same time causes a tendency to fix the stool.In such situations, the validity and expediency of taking each “pill” is necessary.

Constipation and emotional state

There is such a phrase that from stinginess to constipation is one step. It is noticed that if a person has excessive frugality and tries in every possible way to avoid spending of any kind, then he is so much afraid to part with his “good” that, in the end, he begins to suffer from problems with the chair. According to experienced specialists, the inability to let go of something is often projected onto the emotional state.A person prone to super-economy is often unable to “let go” of old grievances, hatred, disappointment and other negative feelings, as a result of which they experience stress. Meanwhile, the modern rhythm of life: hard work, disturbances in work and rest, the need for night work also leads to excess production of stress hormones – adrenaline and cortisol, which reduce the motor activity of the large intestine. The ability to organize your work and rest regime, find a way to escape from the daily hustle and bustle and give an outlet to accumulated emotions is a guarantee not only of the health of the gastrointestinal tract, but of the whole organism as a whole.

Nutrition – as the basis for normal bowel function

By the 21st century, the development of the food industry led to the fact that a person eats refined, repeatedly processed, often artificial foods that are well “digested”, which leads to problems not only of obesity, but also of chronic constipation. Lack of fiber in the diet negatively affects the tone of our intestines, which becomes “lazy”. The main task of the intestine is to “take” everything the body needs and “remove” everything harmful, toxic, unused.And in order to “push” that unnecessary intestinal contents, active motor work of the large intestine is required. Consumption of sufficient amounts of coarse dietary fiber (dietary fiber) triggers this motor mechanism, and due to the ability of fibers to retain water, additionally leads to an increase in the volume of intestinal contents, thereby normalizing the motility of the “lazy” intestine.

Foods rich in dietary fiber include baked goods made from whole grains or containing a significant amount of bran, buckwheat, barley, oatmeal, nuts (almonds, peanuts, pistachios), fresh vegetables and fruits.According to the recommendations of the World Health Organization, the generally accepted norm is the intake of 25–35 g of fiber per day with the food eaten. An interesting fact is that the inhabitants of some African tribes, who eat mainly vegetables, fruits and milk and hardly eat meat, do not have constipation at all, while they naturally have a decrease in the level of colon cancer.

How many times a day should you eat?

It turns out that regular food intake affects intestinal peristalsis.And all because after a meal, the active work of the entire gastrointestinal tract begins: there is a release of enzymes and substances necessary for the digestion process, among which there is bile. And bile (a product of the activity of liver cells) is a natural stimulant of intestinal peristalsis. The formation of bile occurs continuously, but the entry into the small intestine is periodically and directly related to food intake. It is optimal to eat 4-5 times a day for the full functioning of the biliary system of our body and regular bowel movements.

Why is drinking water so important?

One of the main functions of the colon is the reabsorption of water. In the “lazy” intestine, the contents spend more time, the time of reabsorption of water increases, as a result of which the contents “dry up”, become denser, and decrease in volume. And the volume of feces is a necessary factor in the motor work of the intestines. Adequate drinking regime is one of the most important conditions for the normal functioning of the intestine. It is recommended to consume at least 1.5-2.0 liters of drinking water during the day, especially in the morning from 6 to 9 am.A glass of water on an empty stomach in the morning is a habit that can save your life in the future and will certainly improve its quality.

Constipation and physical activity

At present, everyday life and everyday life are arranged in such a way that a person lacks movement. Physical inactivity is the result of a modern urban lifestyle: transportation to and from work, office work, in turn, leads to the formation of a “lazy intestine”. It has been established that on the heels of a person there are receptors responsible for the functioning of the intestines, therefore, for example, walking for about 30 minutes a day improves the blood supply to the intestines, and thereby normalizes its work.Doing yoga, swimming or morning exercises at home on a regular basis, which will bring you pleasure and inner satisfaction, will tone not only the gastrointestinal tract, but the entire body as a whole.

Constipation that we create ourselves

Particular attention should be paid to the emergence of a sensation of urge and the need to go to the toilet. The urge itself arises reflexively as the contents enter the lower parts of the colon, but we can directly control the process of emptying the intestines thanks to the central nervous system of a person.However, the moment of urge and the possibility of visiting the toilet does not always coincide. What happens as a result? Frequent conscious suppression of the natural urge due to an unfavorable or unusual environment, lack of time or disgust of using a public toilet leads to a loss of reflex mechanisms for the emergence of urge and the occurrence of chronic constipation.

Therefore, it is important, starting from childhood, to form the habit of going to the toilet. Learn to take time for yourself, organize work and rest, monitor what we eat, and then the work of the gastrointestinal tract will not create inconveniences.

You can get advice on the diagnosis and treatment of constipation from the gastroenterologists GC Expert. To diagnose bowel diseases, we suggest using the comprehensive Check-up program. Colon examination.

ALLOHOL – an assistant of the biliary tract and liver

The history of the study of diseases of the biliary system goes back centuries. However, for many years, both the reasons and the mechanisms of their development remained unclear. Diseases of the biliary system are one of the urgent problems of modern medicine.So, early diagnosis and treatment of pathology of the biliary tract and liver are of great clinical importance. Among the medicines for the treatment of these disorders, special attention should be paid to the choleretic drug Allohol, with experience of use in several generations, which has successfully passed the test of time and has not lost its relevance.

Diseases of the liver and biliary tract, as a rule, require complex treatment. Among the drugs for the treatment of these disorders, choleretic drugs occupy a special place.They are prescribed by therapists as well as family doctors, gastroenterologists and even surgeons.

All choleretic drugs can be roughly divided into choleretics – drugs that enhance the production of bile by the liver, and cholekinetics – drugs that increase the contraction of the gallbladder and accelerate the evacuation of bile from it into the duodenum. However, choleretic drugs usually have both choleretic and cholekinetic properties. Allochol (Gubergrits N.B. et al., 2007).

The main indications for the use of choleretic drugs are:

• normalization of digestion processes in a number of physiological and pathological conditions,
• primary and secondary dyskinesias of the gallbladder;
• chronic non-calculous cholecystitis without exacerbation;
• sphincter of Oddi dysfunction;
• hypomotor dyskinesias of the small and large intestine;
• liver disease without signs of cholestasis.

The role of choleretic drugs in the treatment of diseases of the hepatobiliary system cannot be overestimated. Among these drugs, a special place belongs to ALLOCHOLA – a drug with 50 years of experience of use for various dysfunctions of this system.

Allohol – a successful composition of plant and animal components

The drug Allochol has been produced by the Borshchagovsky Chemical-Pharmaceutical Plant since 1964. This drug is quite widely known and has been successfully prescribed by doctors for many years to correct pathological disorders of the hepatobiliary system.

The composition of the allochol was developed by a group of scientists led by N.G. Belenky. The components of this drug are carefully selected in optimal proportions to be able to influence a number of symptoms that occur in diseases of the hepatobiliary system. So, Allochol contains active ingredients of plant and animal origin: dry bile, garlic powder, crushed nettle leaves and activated carbon. Why are the biologically active substances that make up the drug so useful?

BALL takes part in the digestion process by activating pancreatic enzymes.In this process, bile acids play an important role, which make up most of the bile. They promote the dissolution of fatty acids, and also have the ability to influence metabolic processes in the intestinal wall, stimulate the motor activity of the intestine, and suppress the development of intestinal helminths. Also, the absorption of fat-soluble vitamins – A, D, E, K – depends on bile acids (Mayev I.V. et al., 2003).

In folk medicine, gall is used to treat diseases of the liver, stomach, inflammation, as well as to restore liver function in case of alcohol abuse (Begletsov O.A., Kaiser A.A., 2008).

GARLIC contains a wide range of biologically active components, which are characterized by antimicrobial, cholesterol-lowering and antithrombotic properties. One of the most important groups of active substances that make up GARLIC is a group of sulfur-containing substances, one of the most famous representatives of which is allicin (Kesaev A.T., 2013).

As a result, the active components of garlic, which are part of allochol, like bile acids secreted into the intestinal lumen, contribute to the emulsification of lipids in the gastrointestinal tract.This, in turn, leads to an acceleration of their metabolism and excretion from the body, prevents an increase in the level of lipids in the blood and accumulation in tissues (Mukhammed A.A. et al., 2013). Also, the components of garlic can contribute to the suppression of fermentation processes in the intestine, hindering the growth of pathogenic microflora in it, thereby reducing flatulence (Shulpekova Yu.O., 2003).

Nettle is widely used both in folk and traditional medicine. The composition of the drug Allochol includes components of the crushed leaves of this plant.The active substances of nettle are vitamins K, B ₂ , C, carotene, pantothenic acid, phytoncides, proteins, sugars, chlorophyll, tannins, silicic and formic acids, macro- and microelements (iron, vanadium, manganese, chromium, copper, aluminum), as well as other components (Ushanova V.M. et al., 2001).

Biologically active substances of nettle have hemostatic and choleretic properties, help to enhance the activity of the digestive system, reduce flatulence, lower blood cholesterol levels (Rychkova Yu.V., 2008).

Activated carbon, one of the most common representatives of enterosorbents, is also included in the allochol. It is characterized by detoxification properties, which are manifested in the adsorption of toxic substances before their absorption in the gastrointestinal tract (Sadovnikova I.I., 2010).

Thus, the active components that make up allochol are characterized by a wide range of different effects:

• improvement of the secretory function of liver cells;
• stimulation of the synthesis of bile acids;
• Acceleration of the flow of bile along the biliary tract, as a result of which digestion is improved, including the elimination of atonic constipation;

90,085 prevention of the spread of infection;

• reduction in the intensity of the inflammatory process;
• Reducing the possibility of cholesterol precipitation with the subsequent formation of stones.

Advantages of Allochol production technology

The Borshagovskiy Chemical-Pharmaceutical Plant started production of allochol 50 years ago, and during this time more than 33.5 billion yellow tablets of this drug known to many people have been produced.

The manufacturing company carried out a number of technological changes to ensure the quality assurance of the drug, and today Allochol is produced in accordance with the requirements of GMP standards.

The production technology of the preparation consists in mixing dry components, which excludes the effect of moisture and heat on all the ingredients of the preparation.In turn, this technology ensures the safety of the active substances of garlic, bile, nettle and the sorption activity of activated carbon.

Since 2009, the company began production of allohol, which differs from the previously produced one in the composition of excipients and shell. The updated Allochol has retained all the qualitative characteristics and therapeutic effect in relation to the previously produced drug.

Replacing the sugar coating of the drug with a film one not only made it possible to ensure the integrity of the tablet core and protect it from moisture and light, but also promotes a faster release of active components.It is also important that the film shell does not contain sucrose, which allows long-term use of Allochol for patients with diabetes mellitus.

In order to get rid of microbiological contamination, sterilization of plant materials that are part of the allochol is carried out by a special method without exposure to temperature and chemicals, which allows you to preserve the active components.

It should be noted that for the convenience of customers in 2014 Allohol will be produced in new, more convenient packaging.

Features of the use of allochol

Allochol is known for many years of experience in the complex therapy of patients with chronic cholecystitis, gallbladder dyskinesia, postcholecystectomy syndrome, atonic constipation and uncomplicated cholesterosis of the gallbladder.

This drug is used in adults 1-2 tablets 3-4 times a day after meals for 3-4 weeks. Then – 1 tablet 2-3 times a day after meals for 1-2 months. If necessary, the course of treatment can be repeated 2-3 times with a break of 3 months.Choleretic preparations containing plant components, which include Allochol, have a gradual mild effect on the functions of the biliary tract and liver (Gubergrits N.B. et al., 2007).

Thus, Allochol normalizes the functions of the biliary tract and liver without stress for the body, which manifests itself in improving the general condition of the patient, reducing the severity of pain in the right hypochondrium, as well as the disappearance of dyspeptic symptoms.

You should also pay attention to the possible interaction of allochol with various drugs: other choleretics of synthetic or plant origin, laxatives, antiseptics or chemotherapeutic drugs.The use of allochol can help to improve the absorption of fat-soluble vitamins.

Allochol can be used in clinical practice for the treatment of various disorders of the biliary tract and liver. Many years of experience in using this drug testifies to the confidence in it on the part of patients and doctors.

So, in the complex therapy of constipation, an important role is played by drugs containing bile acids and having a choleretic effect, such as Allochol (Zvyagintseva T.D., Gridneva S.V., 2008). For the primary prevention of cholelithiasis in patients with a tendency to constipation after a meal, it is advisable to use Allohol 3-4 tablets per day (Grigoriev P.Ya. et al., 2002).

It is known to use allochol for the rehabilitation of patients in the early stages after cholecystectomy in order to prevent postcholecystectomy syndrome (Pribylova N.N. et al., 2008).

The use of choleretic drugs, which include Allochol, is justified in the main forms of chronic cholecystitis, in the phases of a dying exacerbation or remission within 3 weeks.(Polunina T.E., Polunina E.V., 2004).

In the treatment of chronic acalculous cholecystitis in the phase of fading exacerbation, choleretic drugs are used, for example, Allochol (Yakovenko E.P. et al., 2004).

In the treatment of hypomotor dyskinesia of the gallbladder, drugs are used that enhance its motility. For this purpose, choleretics containing bile can be used, for example, Allohol (Minushkin ON, 2003).

So, known to many “yellow pills” for many years have been used to treat a wide range of disorders of the biliary tract and liver in order to normalize their functions.

time-tested choice!

Today, the shelves of pharmacies are full of an abundance of drugs, more and more new products appear, which means to give preference to? Despite such a long way of allochol in the market of choleretic drugs, over 50 years of use, it not only has not lost its relevance, but rather the opposite – it has earned the trust of both consumers and pharmacists themselves.

It should be noted that the popularity of the drug is also facilitated by the fact that the company “Borshchagovsky Chemical-Pharmaceutical Plant” keeps up with the times, modernizes production and renews the drug itself.

Producers have taken care of convenience for the consumer, and from May of this year Allohol will be produced in a new package: a cardboard box with 5 blisters of 10 tablets each, which will allow you to always have proven “yellow pills” on hand.

Trust is formed on the basis of positive experience and time. 50 years of successful use is a weighty argument when choosing a drug.

Allohol is a biliary tract and liver helper that has been trusted for several generations.

Press service
“Weekly APTEKA”

Information for you:

90,000 How to get rid of constipation?

Constipation can be caused by various reasons, both physiological (the nature of the diet) and diseases of the gastrointestinal tract. One of the most common causes is intestinal dysbiosis. No less often, constipation accompanies violations of the liver and gallbladder. In addition, constipation is often provoked by stress and nervous strain, which lead to intestinal spasms.

Constipation itself is not so terrible as its consequences, because chronic constipation leads to poisoning of the body, a decrease in immunity, the development of neuroses and even provokes the development of intestinal cancer.

Enemas and laxatives will not solve the problem; in order to get rid of constipation, it is necessary to exclude the causes that caused it. Dysfunction of the liver and poor bile secretion have a huge impact on the appearance of constipation, since bile is the best laxative. With normal bile secretion and a normal structure of bile, a person practically does not have constipation.Bile triggers the activity of many enzymes in the intestine, and thus not only intestinal cleansing occurs, but also the normalization of digestion. Therefore, the effectiveness of the treatment of constipation largely depends on the elimination of liver dysfunctions and the normalization of bile secretion.

Medicines usually used in such conditions are designed to normalize the functions of the liver, gallbladder and biliary tract, as well as to have a general beneficial effect.

One of these drugs is Holiver.HOLIVER has a beneficial effect on the body, thanks to its natural ingredients: extract of the fruit of ARTICHOK, powder of turmeric root and medical bile.

The combination of active components of HOLIVER provides hepatoprotective (restores and strengthens liver cells), choleretic, antitoxic, antioxidant, anti-inflammatory and antiulcer effect with virtually no side effects.

The drug HOLIVER stimulates the formation of bile and promotes its outflow, thereby increasing the absorption of fats and fat-soluble vitamins.Improves intestinal motility (work) and acts as an intestinal antiseptic, creates a favorable environment for pancreatic enzymes, regulates digestion and acts as a pain-relieving agent, preventing hepatic colic.

Its ability to remove toxins is especially important in conditions such as acute (convalescent) and chronic hepatitis, dysbiosis, as well as after treatment with antibiotics, anthelminthic and other drugs toxic to the liver.

HOLIVER is available in tablets. Before using HOLIVER, we recommend that you read the instructions or instructions on the package. This medicine is sold over the counter without a doctor’s prescription. If you experience any side effects, ask your pharmacist or doctor.

! One package of HOLIVER (100 tablets) is enough for the average recommended prophylactic or therapeutic course. The cost of HOLIVER is available to everyone!

Telephone for inquiries in Chisinau – “hot line” 22-12-41, 21-00-78

Your health

gastroenterologist, doctor of medical sciences, professor Mukhutdinova Farida Ibrahimovna.

19 November 2019

Family Health Magazine

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

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

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

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

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

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

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

SAMPLE DIET MENU No. 5 A.

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

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

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

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

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Do not wash, do not wipe! Chief gastroenterologist of the Chelyabinsk region answered questions | Health

Zinaida VASILENKO, the chief gastroenterologist of the Chelyabinsk region, is on a direct line with the readers.

Don’t pick up your grandchildren

I am 92 years old and suffer from constant heartburn. I drink “Reni” – it does not help.

Ekaterina Emelyanovna Zh., Chelyabinsk

– Simple pills that neutralize acid will not get rid of heartburn. We need drugs that lower the acid level in the stomach. But before going to the pharmacy, I still strongly recommend that you see a gastroenterologist at your place of residence.

A year ago my gallbladder was removed due to stones.Since then, they have suffered from belching, heartburn and pain in the stomach. FGS showed the presence of cloudy bile in the stomach. The gastroenterologist prescribed pills: while I drink them, everything is fine, but as soon as I stop, everything starts again.

N. Sannikova, 68

– Yes, people who have undergone cholecystectomy, unfortunately, experience the so-called postcholecystectomy syndrome, which manifests itself precisely in pain, heartburn and belching with air. We must try to be treated without medication.Firstly, plentiful and rare meals are contraindicated for people without a gallbladder; meals should be regular and fairly frequent. The last meal is 3-4 hours before bedtime.

Second, you need to sleep in a functional bed. Buy dense furniture foam rubber and make a wide slide, the length of which will be measured from the top of your head to your lower back. The height at the crown of the head should be 30-35 cm, and the hill should come to naught to the lower back. You put this slide under the sheet and sleep on it instead of a pillow.Then your torso will always be higher than the abdominal cavity. Thus, the contents of the stomach will not be thrown, the esophagus will not be irritated.

And limit your lifting! Never raise your grandchildren, no matter how much you want to. A woman can only carry 6 kg – 3 kg in both hands. After eating, do not lean forward – do not wash by hand, do not wash the floor. Otherwise, you simply will not get rid of your unpleasant symptoms.

They removed my gallbladder with a stone, and now I am constantly experiencing discomfort: sometimes gas, sometimes belching … The gastroenterologist prescribed medications, it became better, but still I don’t feel as I would like.

Lyudmila Vladimirovna T., 65 years old

– Of course, the operation to remove the gallbladder is not harmless, since it creates conditions for an irregular, untimely flow of bile into the duodenum. Usually, with gallstone disease, bile is infected and is an excellent breeding ground for microorganisms to multiply. Hence, increased gas production, bloating, the appearance of girdle pain and a symptom of the so-called relative enzyme deficiency of the pancreas.

People who develop similar symptoms after removal of the gallbladder need courses of decontamination therapy. These are courses aimed at curing the microorganisms that colonize the intestines. Normally, they should not be. The courses are 5-7 days long and usually take place 3-4 times a year. After them, prebiotics are prescribed for a long course (drugs that maintain the intestinal environment in a normal state and promote the reproduction of natural microorganisms).

The intestines are lazy

I am 88 years old, I have chronic gastritis, very often pains in the stomach and intestines, heartburn, occasionally nausea.But most of all I suffer from constipation. For two years now I have been living on laxatives, there is no independent chair at all.

Maria Alexandrovna M., Chelyabinsk

– In the elderly, the motor activity of the gastrointestinal tract is very often affected. Because of this, the so-called lazy intestines develop. But it is not safe to use exclusively laxatives. Moreover, without the advice of a gastroenterologist. In your case, you need laxatives that would not cause side effects.We are talking about prebiotics, such as, for example, “Duphalac” or “Mucofalk”. They create a normal microflora in the intestines, which helps to improve digestion and bowel emptying. They can be used for a long time – about one month. And the courses of admission can be repeated three times a year and even more often.

But most importantly, you need to follow an anti-constipation diet. Eat cereals, vinaigrettes, vegetable salads, drink chilled plum broth. In the morning on an empty stomach, it is recommended to drink 1% kefir with the addition of a dessert spoon of olive oil.Massage the abdomen clockwise from right to left is of great importance. You can put a fingertip on your finger, lubricate it with petroleum jelly and gently massage the anus. The better your bowels work, the less complaints of belching and heartburn you will have. And, if possible, still show yourself to a gastroenterologist.

I have been constipated for over 20 years. I can’t live without a laxative. I was examined, diagnosed with dolichosigma, but I still did not understand what it meant and how to treat it.I was offered an operation …

Olga Vladimirovna D., Troitsk

– Dolichosigma is a pathological lengthening of the sigmoid colon. Its main symptom is stool retention, as well as bloating. With such a pathology, it is, of course, not easy to deal with constipation. But constantly taking laxatives is not the case. The operation is also not a panacea: in 20 years you have already formed the so-called lazy intestines. He may refuse to work well after the operation.

Therefore, it is necessary to deal with constipation in non-drug ways.Your lifestyle should be based on diet. Eat grain breads, cereals, vegetables and fruits. Eliminate coffee, chocolate, sweets, fatty foods. Of the meat products, only young beef is shown, but not daily! You can eat white meats – rabbit, turkey, skinless chicken. You can also fish, but also only white varieties, low-fat. Walking and jogging, abdominal massage, water treatments, circular showers are recommended. Gymnastics of the perineum is very useful: regularly pull in and out the perineum.

Stomach pain

I have chronic cholecystitis. An ultrasound scan showed that the walls of the stomach were thickened, and there were no stones. But sometimes I have such pains, even under the scapula it starts to hurt. What medications would you recommend?

F. Zaripov, Nyazepetrovsk

– I cannot give any recommendations on medicines without examination. You need to see a local gastroenterologist. After a thorough examination, you will find out if you need medication or if you can limit yourself to dietary recommendations.After all, cholecystitis does not like late meals, does not like fatty, fried, smoked and strong alcoholic beverages. Therapeutic cholecystitis, which does not give rise to fever and does not have stones, is treated mainly with dietary recommendations. And keep in mind that drinking choleretic and thereby expelling bile from the body without a doctor’s permission is dangerous: it can be thrown into the stomach, irritate its walls and cause gastritis and even erosion.

In September I was examined and found out that I have two polyps in my stomach (2 and 3 mm each) and stones in the gallbladder Do I need to do an operation?

Olga V., Chelyabinsk

– Polyps are benign tumors. As with gallstone disease, gastroenterological surgeons deal with them, so you need to see the surgeon at your place of residence. If your polyps are wide-based, then they do not need to be removed. They must be observed in dynamics. If they have a short stem, they are removed endoscopically. But if gallstone disease makes itself felt with attacks and discomfort, then it already requires surgical treatment.

Does the condition of the gastrointestinal tract affect the pressure?

Nina Sergeevna Tabunova, Kasli

– Affects.An indicator of any inflammatory disease is the production of an inflammatory protein called C-reactive protein. British scientists have shown that people with a high content of this protein are more likely to suffer from myocardial infarction. In addition, C-reactive protein triggers the hypothalamus-adrenal gland mechanism, and this contributes to an increase in blood pressure.

By the way

About hemorrhoids

For a long time I have been troubled by acute pains in the rectum.The attacks are repeated at different intervals – there are once a month, and there are in a week. You even have to drink pain relievers. Sometimes there is constipation. She was examined, no neoplasms were found, but she was diagnosed with chronic internal hemorrhoids.

Tatiana Vyacheslavovna N., Miass

– I recommend that you contact a proctologist and ask for a referral to the Chelyabinsk Regional Clinical Hospital, because internal hemorrhoids require their appointment.Perhaps the pain occurs due to the fact that the hemorrhoidal nodules are thrombosed. With internal hemorrhoids, blood flow may slow down, and then you need to take drugs that will help thin the blood in the hemorrhoidal nodule. Then the pain will stop.

About nausea

A year ago, I had a hernia of the esophagus removed and, at the same time, my gallbladder with a stone. Since then I have been nauseous every morning. Has passed the tests. The doctor said that I have too much bile flow from the duodenum.Now I drink mineral water and Almagel at night and in the morning 30 minutes before meals.

Lyudmila Arsentieva, Magnitogorsk

– “Almagel” will not help: it does not bind bile. There are a number of other antacids that bind excess bile and prevent it from entering the digestive tract. Ask your gastroenterologist to prescribe these medications for you. There is also a group of prokinetic drugs, they contribute to the contraction of the gastrointestinal tract only from top to bottom and prevent the waves of reverse perilsation. Try not to eat after 6 pm.If you can’t stand it, eat something fat-free at night so that bile is not produced at night and is not thrown from the duodenum into the stomach. And one more thing: you should sleep on a functional bed so that your torso is always higher than the abdominal cavity.

Slimming

Today, the pharmacy freely sells teas and dietary supplements for weight loss, drugs that suppress the feeling of hunger. How effective are they for a person who dreams of losing weight?

N.Nesterenko, Zlatoust

– Today, the problem of losing weight is one of the most urgent. We have been saving up our weight for months, years, and we want to lose weight at once and by many kilograms at once. Yes, there is a wide range of different bioactive supplements in pharmacies today. Only those licensed and authorized by the Ministry of Health and the Ministry of the Pharmaceutical Industry for sale in pharmacy chains are allowed to sell in pharmacies. Of course, there are some benefits in dietary supplements.

But I want to say that dietary supplements are not a salvation from extra pounds. The principle of their action lies in the addition of herbal preparations, which either have a diuretic effect or give a laxative effect. It turns out that a person loses fluid from the body, frequent diarrhea occurs and electrolytes are lost. In addition, some people may have allergic reactions to dietary supplements. Therefore, the independent purchase of dietary supplements and their uncontrolled use is contraindicated. In addition, our FSB agencies monitor Chinese and Tibetan dietary supplements: they contain psychotropic substances similar to drugs.These substances are added so that a person who is upset because of the impossibility of losing weight in any way cheers up.

About Fast Food

After school, my son constantly buys sausages in dough and other nonsense at street stalls. I’m worried, they say, such snacks do not bring any benefit to the body?

M. Zaitseva, Korkino

– It is. It has long been known that when frying sausages and pies in such street stalls, they do not change the fat, and you cannot eat overfried dishes! In addition, the preparation of sausages in dough, shawarma, hamburgers, cheeseburgers and other fast food is based on refractory fats (cooking fat and margarine), which increase the cholesterol content in the body and have a carcinogenic effect.This is fraught with the development of gastrointestinal cancer! I will add that in order to achieve a certain taste, spices unknown to us are added to fast food. Allergic reactions up to toxic hepatitis may occur. And another thing: when people eat in a hurry, a lot of air is swallowed. Hence constipation, diarrhea, cholecystitis, gastritis, colitis and other gastroenterological diseases. Draw conclusions.

Numbers

It is believed that every tenth inhabitant of Russia suffers from one or another pathology of the gastrointestinal tract.In the Chelyabinsk region, gastroenterological pathologies are in 6-7th place. Over the past 5 years, the incidence of gastrointestinal diseases in our country has increased from 80.3 to 93.4 per 1000 population. The mortality rate decreased from 89.5 to 82.5 per 100 thousand of the population. The increase in morbidity is most likely associated with improved diagnostic methods, an increase in the culture of the population in relation to their health. In the structure of primary disability, by the main classes of diseases, diseases of the digestive system occupy 6th place.