26.01.2021

Therapy of chronic cholecystitis

The chronic form of the disease is a complication of the acute form, but can occur as an independent disease. Let’s consider in more detail what is chronic cholecystitis, why it occurs and how to treat.

Chronic cholecystitis is inflammation of the gallbladder often directly microbial etiology. This disease is a frequent complication of gallstone disease. Most common in people older than 40 years. However, recently recorded cases of the disease in children. In the international classification of diseases 10th revision (ICD code 10) is a chronic form of cholecystitis is a Class of 80.1.

Factors of

Causes inflammation can be the following factors:

  • congenital changes in the shape of the biliary tract;
  • a variety of mechanical damage or injury to the layers of the gallbladder;
  • violation of proper nutrition (non-food);
  • gemodinamicheski lifestyle;
  • violation of metabolic processes (diabetes, a disease Itsenko-Kushinga, atherosclerosis, etc.);
  • changes in the circulation with age;
  • dyskinesia of the biliary or excretory systems;
  • parasitic and microbial infestation (strepto-, Staphylococcus, ascariasis, AMIBIOS, giardiasis);
  • genetic factors;
  • obesity.

When violations of the structure of the mucous or muscular tunic of the bladder, when paraphasia of bile flow due to narrowing or total closure of the lumen of the paths in the wall of the bladder developed inflammatory reaction, after a long period (months, years) lead to the formation of fibrous tissue the inner layers of the gallbladder wall. The formation of these tissues leads to compaction of the walls, and subsequently, to reduce their mobility is reasons cover the scars of the mucosa. All of this contributes to an even greater obstruction of bile outflow and deteriorating condition of the patient.

The bile in chronic stasis changes its pH and becomes more dense, it increases the risk of stones.

In connection with this feature, the following classification of chronic inflammation of the gallbladder:

  • chronic acalculous cholecystitis (HNH) occurs without the formation of stones;
  • chronic calculous cholecystitis (cholelithiasis) is characterized by the appearance of gallstones, rarely in bile ducts.
Clinical manifestations

Diagnosis of chronic cholecystitis is performed in hospitals, but you can see some of the signs and in everyday life. The disease is characterized by continuous progressive development with periods of exacerbations and remissions.

The first symptom is the pain which is very often localized in the right hypochondrium, it is aching in nature and increases after each meal. Can go on the shoulder or shoulder blade.

In addition, there are such signs:

  • bitter taste in mouth, which is especially pronounced in the morning;
  • nausea, vomiting;
  • belching air;
  • heaviness in the right hypochondrium;
  • flatulence;
  • periodic change of constipation and diarrhea with the manifestation of dyspeptic syndrome.

Can sometimes be detected are not high (37.5-38.2) body temperature.

Chronic cholecystitis in children occurs mainly as adults. Common blood test shows elevated white blood cell count and increased erythrocyte sedimentation rate. In the chronic form there is often a aggravation and pain symptoms. The disease can last from 2 to 10 years. In some cases, the disease can appear adhesions. They are usually detected by cholegraphy. They can lengthen the course of the disease.

If the above symptoms, should immediately contact the relevant specialist as the final diagnosis can be put only on the basis of additional investigations such as ultrasound or cholecystocholangiography.

Therapy of chronic cholecystitis

The main condition for the treatment of disease is the strict adherence to the diet (diet №5 by Pevsner), the main fundamental principles which carry:

  • split meals with small portions 5-7 times a day;
  • consumption of fresh vegetables and fruits, warm foods;
  • combine different entrees;
  • complete abstinence from drinks that contain alcohol.

Usually doctor may prescribe these medicines:

  • cholagogue (Haensel);
  • antispasmodics (no-Spa, Spazmalgon) – for acute pain;
  • in the presence of progressive inflammation can group antibiotics;
  • in disorders of the autonomic nervous system prescribe sedatives.

In remission prescribed therapy mineral waters, thermal fizioterapevticheskie procedure. 2-3 months after acute prescribed health resort treatment.

Often use the method of blind tyubazh. In the morning patient drinks on an empty stomach slightly heated mineral water, after that, his right side impose prepared a hot water bottle and lie down for about 1.5 hours. If the result is positive, then the patient’s stool will be greenish, which directly indicates the admixture of bile in the feces.

The number of treatments the doctor prescribes. To do tubeless tyubazh recommended 2-3 times per week, duration of the course is not less than 3-4 months. This procedure is strictly prohibited during exacerbation of diseases such as cholecystitis, gastric ulcer or duodenal ulcer.

When there is no exacerbation, patients recommend physical treatments and exercise therapy in sanatoriums, which are located in Essentuki, Borjomi, Truskavets, Morshyn, Dorokhovo.

In the case of calculous cholecystitis the only and the most necessary method of treatment is cholecystectomy, that is, the operation for complete removal of the bladder.

In the preventive purposes it is recommended to follow a diet, maintain normal body weight, the therapy is to eliminate focal infections, physical exercise.

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