Among the diseases of the gastrointestinal tract is the gallbladder dyskinesia. The gall bladder is a hollow muscular organ located in the abdomen below the last rib. The size of this body may be different. Length varies from 5 to 14 cm, the width is from 3 to 5 cm the volume of the body is small (approximately 50-80 ml). It is known that digestion of food takes place in the presence of bile. The latter is produced by the liver.
The purpose of the gallbladder – the accumulation of bile secretion and bile flow in the 12-duodenum. Bile is a complex process that is regulated by the neurohormonal system. With psoriasis the process of removing the secret is broken, and the bile can accumulate. The volume of the body is increased. What are the etiology, clinic and treatment of dyskinesia of the gallbladder and its ducts?
Features of the disease
Dyskinesia of the gallbladder – a disease characterized by violation of the outflow of bile due to changes in muscle tone of the body. The disease are functional disorders, not organic. Production of bile is the prerogative of the biliary system. Bile is involved in digestion of lipids, promotes the absorption of vitamins A, D, E. This pathology is often diagnosed in children and adolescents and in women during pregnancy. Most common in teenagers. While females get sick more often.
Dyskinesia of the gallbladder can be primary and secondary. Most often there is a secondary form. The reason in this case may be a peptic ulcer 12 duodenal ulcer, inflammation of the large intestine, pancreatitis. Found hypotonic dyskinesia and hypermotor. Dyskinesia on hypotonic type is much more common.
The disease can occur in acute (spastic) or atonic form, which is characterized by dull pain.
Dyskinesia of the gallbladder it develops for different reasons.
The main etiological factors include:
- disruption of the autonomic nervous system;
- failure to follow the diet;
- hormonal disorders (during pregnancy);
- physical inactivity;
- reduced sensitivity of receptors;
- the presence of viral hepatitis;
- chronic diseases of the digestive tract;
- operations on the stomach, the intestines, the gallbladder;
- systemic diseases (diabetes, cirrhosis, celiac disease, cholelithiasis).
Important not only the causes, but also predisposing factors. These include: features of the human Constitution, sedentary lifestyle, alcohol abuse, Smoking, lack of vitamins, minerals, animal protein in the diet. The functioning of the gall bladder and liver depends on the activity of various hormones. Crucial gastrin, secretin, glucagon, cholecystokinin.
Bile flow may be hindered in the presence of stones in the cavity of the body or bile ducts. Thus there is mechanical obstruction. All this may cause cholangitis and cholecystitis, in which impaired contractile function of the body.
Less dyskinesia on hypotonic type develops on the background of parasitic diseases (giardiasis, opisthorchiasis). The causative agents of these infections can thrive in the biliary tract, causing inflammation. Dyskinesia of the gallbladder is often diagnosed during pregnancy. It is connected with change of a hormonal background. May be the result of congenital abnormalities of the body.
The motor dysfunction symptoms depend on the form of the disease. Hypotonic type develops most often in adults, in women during pregnancy and in elderly individuals. Signs of hypotonic dyskinesia diverse.
- pain syndrome;
- loss of appetite;
- violation of the chair-type diarrhea or constipation;
- unpleasant, bitter taste in the mouth;
- the increase of body weight;
- excessive sweating;
- the flushing of the face;
- the hypersalivation;
- the decrease in the heart rate.
Pain syndrome has its own characteristics. Pain when hypotonic dyskinesia dull, aching, constant. It is localized in the right hypochondrium. Pain syndrome becomes more intense after eating. Belching occurs after eating. Due to inadequate flow of bile becomes more intensive processes of fermentation. The gipomotornaya dyskinesia symptoms include the appearance of bitterness in the mouth. The bitterness bothers sick people in the morning and after meals.
Symptoms hypermotor forms of the disease are less diverse. They include pain, weight loss, nausea, vomiting, diarrhea, poor appetite. The pain is of a different nature: it is paroxysmal, resembles colic. Duration of pain – from 20 minutes for an hour. Often the pain radiates to the back or shoulder blade. Very often it is combined with heaviness in the right hypochondrium.
During pregnancy there are pronounced symptoms of impaired nervous system function. These include headache, weakness, tachycardia, increased pressure, irritability, sleep disturbance.
An experienced doctor needs to know not only the symptoms but also the methods of examination of the patient.
Diagnosis of gallbladder dyskinesia in children, women during pregnancy include:
- a careful history;
- palpation of the abdomen;
- external inspection;
- measurement of blood pressure;
- General and biochemical blood analysis;
- examination of the bile;
- special tests.
If in the course of ultrasound scans during pregnancy revealed an increase in the gallbladder, this could indicate a decline in his tone. When hypermotor dyskinesia of the size of the bodies decrease. Ultrasound during pregnancy can also detect stones, expansion or narrowing of the bile duct. Blood tests for primary dyskinesia normal. If the secondary can detect the acceleration of a sedimentation rate, leukocytosis. Eosinophilia may indicate parasitic disease. Biochemical analysis may show an increase in the amount of bilirubin, C-reactive protein, triglycerides, cholesterol.
Bile is studied by probing. The study is carried out on an empty stomach. The patient is positioned on his side, after which he is introduced through the mouth probe. Each phase excretion of bile lasts for a certain time. With psoriasis time changes. Often the person feels pain. Appreciate 3 servings of bile (A, B and C). Hypomotor dyskinesia is characterized by slow removal of portions B, increasing the amount of servings and large gaps between the release of portions.
The hypertensive form is characterized by an accelerated removal of portions B and a slowdown in output portion A.
Treatment of psoriasis
How to treat dyskinesia of the gallbladder? The main goal of treatment – normalization of tone of the gall bladder. Treatment of hypertonic dyskinesias involve administration of cholekinetica (M-anticholinergics, antispasmodics), sedatives, physiotherapy, diet. During pregnancy are selected less toxic drugs that do not affect the fetus. The mechanism of action of cholekinetica is to increase the tone of the body and lowering the tone of the biliary tract. Of the M-holinoblokatorov may be used “Atropine” or “Platifillin”. Good effect give antispasmodics myotropic action (“Drotaverine”, “no-Spa”, “Gimekromon”). Medications used in the period of exacerbation of the disease.
For the normalization of the nervous system are applied bromides, tincture of motherwort or Valerian. Of physiotherapy techniques electrophoresis is shown with “Platifillina”, the use of laser. Treatment must include addressing the root causes of psoriasis. This is especially important during pregnancy. Diet also has an important place in the treatment. When the symptoms subside, it is recommended SANATORNO-resort treatment and drinking mineral water.
Diet when gallbladder dyskinesia is both a preventative measure. When hypotonic form of the disease are accepted choleretic (“Allohol”, “Holenzim”, “Joliver”, herbal remedies).
Without exacerbation can be used “Sorbitol”, “Xylitol”. Organized amplipulse. Therefore, impaired motility of the gallbladder – frequent pathology of the digestive tract, which require early detection and treatment.