Cholelithiasis

February 10, 2012

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Cholelithiasis   - A pathological process in which the gall bladder and channels are formed stones   ( concretions ). Due to the formation of gallstones in the patient develops cholecystitis .

In order to understand the nature of gallstone disease, it is necessary first of all to understand how the education and transportation bile . Human liver cells produce a day from 500 ml to 1 liter bile every day. Bile is required for the processing of food, especially fat .

Bile from the liver (from bile capillaries) first turns in the hepatic duct and then enters the duodenum through the common bile duct of a liver. The transition process of bile into the duodenum from this flow passes via the muscle, which is called " sphincter of Oddi ". If the duodenum is empty, the sphincter is closed and enters the bile. In this case, it may be stretching the gallbladder. It may be an accumulation of bile, which can be stored there for a long time.

Features gallstones

Gallstones   ( concretions ) Is the main manifestation of gallstone disease. These formations are made up of components of bile: in the stone enters bilirubin . calcium . cholesterol . Size stones can vary: they may be the size of sand grains, and to be more education, several centimeters in diameter. Increasing the stone over time: for example, with the size of a grain of sand for half a stone can grow up to 1 cm. The stones have different shapes: there are oval, rounded stones formation in the form of a polyhedron, and others. The strength of stones also varies: there are both very strong stones, so and fragile, crumbling from touching. On the surface of the stones are sometimes observed cracks, spikes, but it can also be smooth. The most common gallstones. This condition is called cholelithiasis   or kalkulez   gallbladder. In more rare cases, a person manifests choledocholithiasis That is, there are stones in the bile ducts of the liver. Stones in the biliary tract are formed one by one, and a few dozen. Sometimes their number in the hundreds. Even a stone can trigger a serious complication of the disease. At the same time more dangerous are small stones.

Causes of gallstones

Today there is no single precise theory, which would explain the cause and process of formation of gallstones. The most likely cause of this disease is considered to be in violation of the metabolic processes of the body, inflammation arising in the gallbladder wall, stagnant processes in the biliary tract, as well as other phenomena. As a rule, the main reasons due to which a person has symptoms of gallstones, called an unhealthy lifestyle in general and poor nutrition in particular. And other important factors: the lack of activity, overeating or irregular eating, sedentary work may trigger the development of gallstones. In women, the disease appears more often than men, and the most susceptible to gallstones women who have had multiple births.

Symptoms of gallstones

In view of the probability of stagnation processes in the gallbladder that is where the stones are formed most often. In some cases, the symptoms of gallstones does not appear for a long period of time after the formation of stones. Stones sometimes do not affect the function of the gallbladder, so people may not suspect that he had a stone.

However, very often the stones that appeared in the gallbladder, provoke a spasm or cause dilation of the gallbladder. In this case, the symptoms of gallstones appear painful attacks. Pain that is localized under the right costal arch, may be short or long, with pain have a different intensity. If inflammation of the gallbladder wall is not shown, the pain may disappear without any consequences. In this case, such phenomena are called hepatic or bile colic .

If cholelithiasis pain sometimes gives to the blades, especially under the right shoulder blade. Sometimes the pain and gives to the heart. It is sometimes seen arrhythmia : The rhythm of heartbeats violated. Often the pain occur after a person has eaten anything spicy or fatty. For the digestion of such products need bile, thus having gallbladder contraction. Sometimes vomiting may occur.

If there is an acute inflammation of the gallbladder, the pain can last, not poetry, several days or even weeks. The temperature sometimes rises slightly. It is important to consider that some subsidence of pain is not always a sign that the inflammation goes down. On termination of the inflammatory process can speak only when the pain is completely absent for several days, while a person's body temperature normalizes.

If there is chronic inflammation, the pain in the right upper quadrant appears occasionally, it can be both strong and dull. Also, a person feels discomfort in the area.

With the development of pancreatitis   as a consequence of the disease symptoms of gallstones are complemented by expression of severe pain in the upper abdomen near the navel. Sometimes the pain can give to the waist, and the patient is shown abdominal distention , Frequent vomiting.

Complications of cholelithiasis

The appearance of the stones is fraught not only a violation of the functions of organs, but also the occurrence of inflammatory changes in the gallbladder and organs near .  So, because of the rocks can injure the bladder wall, which in turn, provokes inflammation .  Provided that the stones pass through the cystic duct with bile from the gallbladder, bile flow may be hampered .  In the most severe cases, the stones can block the entry and exit from the gallbladder, stuck in it .  When such phenomena occur bile stasis, and this - a prerequisite to the development of inflammation .  Inflammation can develop over several hours and several days .  Under these conditions, the patient may develop an acute inflammation of the gall bladder .  Thus the degree of injury, and speed of development of inflammation could be different .  So, how can a slight swelling of the wall and its destruction and, as a consequence, the gap gallbladder .  Such complications are cholelithiasis life-threatening .  If the inflammation extends to the abdominal organs and the peritoneum, the patient develops peritonitis . As a result, complication of these phenomena can become toxic shock and multiple organ failure. Thus there is a disruption of the blood vessels, kidneys, heart, brain. If a strong inflammation and high toxicity of germs breeding in diseased gallbladder wall, toxic shock can occur immediately. In this case, even resuscitative measures do not guarantee that the patient will be able to deduce from this state and avoid death.

Diagnosis of gallstones

The main research method in the diagnosis of cholelithiasis is ultrasonography   abdominal cavity. Also, the patient is assigned to conduct cholangiography . holetsistografii . Ultrasound method will significantly improve the accuracy of diagnosis. It is important that the study carried out by experts with experience in the definition of such diseases and their characteristics. So, it happens that the rocks take the contents of the intestine, and other anatomical structures. There is a possibility that stones will not be detected during the study, particularly difficult to determine their presence in bile ducts.

Treatment of gallstones

To date, treatment of gallstones often consists in carrying Cholecystectomy That is, the removal of the gall bladder, where the stones were found. Removal of the gallbladder does not have a decisive influence on the life of man.

If the stones are located in a cavity freely gallbladder while they consist entirely of cholesterol, and their size is not larger than 2 cm, is sometimes carried out by dissolving the stones. This procedure is performed using henodezoksiholevoy   and ursodeoxycholic   acids. It is important to note that in this case, the treatment lasts at least a year, and very often after a while in patients re-formed the fireplace. However, the method can be quite effective. Also destroy the stones, using the power of a special wave created by special generators. In this case it is important that the composition was extremely cholesterol stones, their number does not exceed three, and the size is no greater than two centimeters. Also, there are a number of contraindications for this method of treatment: inflammation of the gall bladder, pancreas, liver, pregnancy . aneurysm   abdominal vessels and others.

Today, treatment of gallstones is also carried out using a technique called laparoscopic cholecystectomy. This surgery is less traumatic and produced by puncturing the abdominal wall and through the introduction of punctures microsurgical instruments. This method has several drawbacks. First of all, since the gallbladder can be removed in every case. If the structure of the zone atypically, use traditional cholecystectomy. Also, this method of treatment can not be used in the presence of adhesions and severe inflammation in the gallbladder.

Diet for gallstones

In order to prevent further formation of stones in the gallbladder disease, the patient should follow the principles of good, healthy food, as well as specially designed to comply with diet   for patients with this disease. The main feature of the diet, which should be used in the treatment of gallstones, is to ensure the proper cholesterol metabolism . To do this, it is important to reduce calorie intake, removing from the daily diet of a certain amount of fat, carbohydrates, and stop eating those foods which contain a lot of cholesterol. First of all, the latter concerns the liver, egg yolks, fatty fish and meat, lard and other products. Diet for gallstones should not include dishes from these products.

Excrete excess cholesterol can help magnesium salts . Consequently, dietary ration should be those products that have a high content of magnesium salts. Diet for gallstones should include apricots, oats and buckwheat.

The cholesterol in the bile to be contained in dissolved form. To do this, raise the level of alkali in the bile. In this case, it is important to include in the diet foods of plant origin, alkaline mineral water, food and foods high in lecithin (available in butter and other dairy products). In addition, the diet for gallstones include many vegetable dishes. It is important to note that all dishes should be steamed, baked, or stew. There should be six times a day, with portions should not be too large.

If cholelithiasis is recommended to drink soup, stale bread in the form of (white and gray), lean fish and meat, vegetables, herbs, cereals and dairy products.

To salt the food should be moderate, is to limit the muffins baked goods.

Foods prohibited cholelithiasis patients, experts attributed sausages, smoked foods, sauces, fried foods, animal fats, legumes, spices and seasonings, cream cakes and pastries, coffee, cocoa, chocolate. Such a diet patients should be observed for several years.

Prevention of cholelithiasis

As the prevention of gallstones, it is important to eliminate all risk factors for its occurrence. It should try to lead a healthy lifestyle, adhere to the principles of good nutrition, prevent obesity. If a person already diagnosed gallstone disease, he should always be inspected and consultation with a specialist.