Pain in the gallbladder

If the gallbladder is aching, then a person knows by the characteristic localization of pain, where his anatomical place is. Not all people correctly orient themselves and are familiar with the biliary system, which includes the gall bladder and ducts.

This small organ accumulates bile, synthesized in the liver, secretes it into the intestines and, thus, participates in digestion. Pain in the gallbladder is an abnormal phenomenon. The symptom indicates a pathology caused by various diseases. To find out why the gallbladder is hurting, it is necessary to remember its structure and tasks.

Features of the structure and functioning of

Primary bile ducts are located in the center of the hepatic lobules along with the vessels. They collect synthesized bile in a storage place - a pear-shaped hollow formation, a bubble( lies under the bottom surface of the liver).The organ can contain up to 70 ml of secretion.

The wall of the bladder is rather thin, but has layers:

• mucous - from epithelial cells;
• muscular - formed by circular muscle fibers;
• serous - the most external for external protection.

Projected in the region of the anterior abdominal wall to the right hypochondrium. The inner membrane contains glands. Their function is to produce mucus, an anticholecystonin hormone, absorption of bile water, salts, amino acids.

In the bladder, bile is not only stored, but also brought to the required state in viscosity, composition. In addition to water, it includes mucus, bile acids, proteins and amino acids, bilirubin, inorganic substances, cholesterol, phospholipids, vitamins.

The biliary duct carries bile into the duodenum. It opens next to the pancreatic duct in a place called the sphincter of Oddi. Reduction of the bubble and release of the contents occurs simultaneously with the pancreatic secret when food enters the intestine.

Bile performs important functions:

• neutralizes the acidity of gastric juice;
• protects the intestinal mucosa from the proliferation of pathogenic microorganisms;
• stimulates the work of enzyme systems necessary for proper digestion;
• activates peristalsis;
• helps to remove toxins and toxins.

The main causes of bladder pathology

In humans, the main problems of gallbladder pain are determined by infection and stagnation of the contents with the hyperextension of the walls. These causes are exacerbated and form a vicious circle: with congestion of bile, convenient conditions are created for pathogenic microorganisms, and inflammation changes the composition, the viscosity of the bile and contributes to stagnant phenomena.

Infection occurs:

• directly from the intestine( parasites, pathogenic strain of Escherichia coli, helminths);
• from the liver - with hepatitis, abscess, echinococcosis;
• with blood in the spread of infection from untreated chronic foci( in men more often - prostatitis, sinusitis, in women - adnexitis, tonsillitis).

Predisposing factors include:

• obesity - breaks the bile composition, causing an increase in cholesterol concentration;
• hormonal disorders - it is found that sex hormones affect the excretion of cholesterol, a decrease in activity during menopause promotes gallbladder disease.

Provoking causes may be:

• irregular feeding with long interruptions, followed by overeating;
• use of hungry diets for weight loss;
• high blood cholesterol in the elderly;
• structure anomalies( deformation, kinks, curvature);
• metabolic disorder in diabetes mellitus;
• disease of the pancreas and liver;
• functional disorders of coordination of contractions in diseases of the nervous system.

Importance is attached to: professional contact with toxic substances at chemical industry enterprises, low physical activity of the person, chronic intestinal atony, stress, long-term use of certain medicines( Octreotide, Clofibrate, Ceftriaxone), diuretic drugs, statins, oral contraceptives.

What diseases of the bile excretory system are accompanied by pain?

Pain in the gallbladder causes:

• inflammation in cholecystitis and cholangitis;
• dyskinesia of bile ducts( breach of contractility);
• cholelithiasis( writing "cholelithiasis" is wrong, which can be checked by the International Classification);
• malignant tumor.

All these diseases disrupt the function of transporting bile, causing a digestive process to fail. This is accompanied by a similar symptom, differing only in intensity and course.

Features of pain caused by the pathology of the gallbladder

How the gallbladder hurts the doctor recognizes by characteristic distinctive features. By the nature and intensity of the painful syndrome, the optimal treatment is chosen, judging the tone of the outgoing tract. With chronic inflammation, dyskinesia of the hypotonic type, the gallbladder always hurts.

Symptoms intensify after taking alcohol, fatty and fried foods, physical activity. The pain is localized in the right hypochondrium, can take on a bursting character. It is not removed by spasmolytics.

If the inflammation is acute( cholecystitis) or pain caused by movement of the stone, the symptoms of gallbladder pain are manifested by a sudden intense cutting character with irradiation from the right hypochondrium to the side, back, upwards to the clavicle and shoulder.

Diagnosis is complicated by the ability of pain to become stronger on inspiration, as well as atypical irradiation into the heart area. Sometimes, instead of pain, patients feel a burning sensation in the right side.
To distinguish whether pain can be caused by spasm of the coronary vessels, and not by the gall bladder, electrocardiography helps.

"Solar" syndrome with inflammation of the solar plexus occurs with severe burning pain in the epigastrium, around the navel, with irradiation in the back. When palpation is determined by the local muscle tension in the hypochondrium on the right. With severe pain, patients try to take a bent position with their knees pressed to the chest.

In addition to the pain syndrome in the diagnosis, it is necessary to consider what symptoms of a general nature and digestive disorders accompany the pathology of the gallbladder. Patients are able to:

• high fever with chills( with acute cholecystitis), moderate increase in chronic course;
• nausea, eructation, vomiting bitterness;
• intestinal disorders( diarrhea or constipation);
• unpleasant bloating;
• lack of appetite;
• moderate weight loss;
• dryness and bitterness in the mouth;
• skin itching;Insomnia and increased irritability.

Pain in the gallbladder area in the background of various diseases

Where and how the gallbladder hurts with a particular pathology, we'll look at the example of the most common diseases.

Cholecystitis

The disease proceeds in acute and chronic form, against the background of stones in the bladder( calculous cholecystitis) and without them. The connection with concrements is more typical for full middle-aged women, and the stoneless form is more common in men.

When examined in bile, they detect:

• staphylococci,
• streptococci,
• E. coli,
• enterococci,
• Pseudomonas aeruginosa,
• proteus,
• lamblia,
• ascarids.

Acute cholecystitis occurs with typhoid fever and paratyphoid. Intensive pain in the right hypochondrium with chills and fever indicates an inflammation of the inner membrane of the bladder. With successful treatment, the pain subsides. Transition to a chronic course is possible.

This causes a constant blunt pain, aggravated after an error in nutrition, exercise. Gradually, the wall becomes thinner, replaced with scar tissue, and loses its ability to contract. Favorable conditions are created for the formation of stones, bedsores can break through the wall and exit into the abdominal cavity.

Pulsating nature of pain and constant high temperature indicate a possible gangrene of the bladder with subsequent necrosis and peritonitis. How much can the gallbladder be ill before the likely transition to gangrene and complications depends on the immunity of a particular person.

Dyskinesia of the biliary tract

The disease is typical of people in a neurasthenic warehouse, children. Pain is associated with altered muscle tone of the gallbladder and outflow ducts. Instead of the necessary reduction and excretion of bile in the intestine, there is relaxation( hypokinetic form), an increase in volume, and bursting pain.

And, on the contrary, spasm suddenly interrupts the necessary relaxation( hyperkinetic variant).In the first case, in addition to blunt pain, the patient has constipation, nausea, vomiting. In the second - the main sign of cramping pain on the right in the hypochondrium. The type of violation must be considered in therapy.

Cholangitis

Isolated inflammation of the bile ducts is rarely without cholecystitis. The most common is seen as a complication of surgical intervention after removal of the gallbladder, filled with stones.

Types of cholangitis are determined by the causes:

• obstructive - caused by a stone or other mechanical obstruction;
• bacterial - there is a clear dependence on inflammation;
• recurrent - flow wavy with frequent exacerbations;
• sclerosing - as a complication of inflammation.

Gallstone disease

The basis of origin of stones in the gallbladder and strokes is the impaired exchange of salts of cholesterol and bilirubin. Increase in the density of the bile composition, stagnation cause precipitation of salts, and gluing into stony structures. The concrements can be located inside the bladder and in the ducts.

The pain causes stagnation of bile with muscle stretching or movement of the stone. The attack is very intense, the pains cutting, radiating to the back, right shoulder blade, shoulder, collarbone, half of the abdomen. Provokes an attack ride in transport, on a bicycle, any shaking, drinking alcohol, fatty foods.

If the flow of bile into the intestine is impaired, its components enter the bloodstream. The discharge of bilirubin is manifested by the symptoms of mechanical jaundice: the urine becomes dark, the feces become discolored, looks gray, the icterus appears on the sclera and skin.

Malignant tumors

The risk of gallbladder cancer increases in patients with a prolonged course of inflammation. The most common are histological types: squamous solid cancer, adenocarcinoma, mucosal tumor.
A very high degree of malignancy, a rapid spread of metastases, a tendency to germinate in neighboring organs is characteristic.

How to eliminate pain in the gallbladder?

To find out the reasons that caused pain, it is necessary to undergo a survey. Blood, urine and feces can detect inflammation, high levels of bilirubin and cholesterol, and a general malfunction in the digestive system.

The method of cholecystography with a contrasting substance shows well the abnormalities of the structure, the shadow of the stones. Before prescribing medicines, a doctor will advise you to follow a diet. People with excess weight are recommended weekly unloading days.

Patients are contraindicated:

• any fried foods, sausages, fatty meat products( meat dishes must be boiled, steamed, stewed);
• fatty and rich broths of meat and fish;
• all kinds of alcohol;
• carbonated beverages;
• spicy seasonings;
• canned food, homemade pickles;
• cream cakes;
• beans.

Power mode is built according to the scheme: 6 times a day, but in small portions. Nutritionists recommend: low-fat meat and fish dishes, cereals, drink light green tea, broth of wild rose( if fresh fruit juices, then in breeding), low-fat dairy products.

Do not take any medication yourself. There are many contraindications. A specific choice can only be made by a specialist. When cholecystitis antibiotics must be prescribed. The best are the broad-spectrum drugs( Amoxiclav, Ceftriaxone, Moxifloxacin, Gatifloxacin).

Apply them followed by courses in 7-10 days, taking breaks is not advisable. They contribute to the development of a stable flora. When detecting parasites, they may be prescribed: Furazolidone, Trichopolum, Chloksil, Combantrin, Vermox, Fazijin).

Spastic pains are removed by injections of Atropine, Platifillin, No-shpy. Instead of injections, rectal candles with bellies are recommended. In the case of an attack of cholelithiasis, strong pain relievers( Nalbuphin, Ketanov, Promedol) are used.

When hypokinetic form of dyskinesia is prescribed cholecystokinetics. In therapy, it is necessary to observe the correct regime, taking sedatives of plant origin( tinctures of valerian, motherwort, Novopassita).Physician-physiotherapist will select the most effective physiotherapy - inductothermia, galvanic collar or diadynamic currents.

Whether it is necessary to do an operation will tell the course of the disease, the persistence of the pain syndrome, the effectiveness of therapy. The question of removal of the gallbladder according to emergency indications can arise in the purulent nature of inflammation, the threat of peritonitis. In the planned order, the readings for the removal of stones together with the bladder are discussed.

Most clinics refused lithotripsy technology( stone crushing).Negative effects on surrounding tissues lead to a large number of complications. The cancerous tumor is tried to be removed as soon as possible, often with resection of the liver part, lymph nodes.

Patients undergo cytostatics and radiation therapy. The connection of the pathology of the gallbladder with the liver and pancreas involves the appointment of drugs of hepatoprotective action and enzymes.

Popular advice

Traditional medicine offers to remove the pain syndrome to use herbal decoctions. Recommended herbs with choleretic and anti-inflammatory effect:

• flowers of marigold and chamomile;
• corn stigmas;
• immortelle;
• tansy;
• peppermint;
• dandelion roots;
• bitter wormwood;
• celandine;
• fruit of fennel.

. The method of "blind sounding" is to take an empty stomach of a spoonful of vegetable oil, Xylitol, Sorbitol and keep the lying position on the right side for about an hour. This helps to release the bubble from accumulated bile, to eliminate stagnation. There is advice: to empty the bladder after taking herbal tea, lie on your left side and beat yourself on the right hypochondrium.

Pain syndrome in diseases of the biliary organs requires the establishment of a connection with the stones, the type of dyskinesia, inflammation. It is recommended that patients take care of chronic foci of infection. Even after removing the bladder, you must adhere to the diet and take medication.