Cholangitis is an inflammatory lesion of the bile ducts with acute and chronic course. With cholangitis, intra- or extrahepatic bile ducts can be affected. The disease occurs more often in women aged 50-60 years. In gastroenterology, cholangitis is diagnosed in conjunction with gastroduodenitis, cholecystitis, hepatitis, cholelithiasis, pancreatitis. The code assigned to the cholangitis in ICD-10 is assigned to: K83.0.
Today we will talk about different forms of cholangitis, see a video, consider the treatment of cholangitis with folk and medical products at home and in a hospital.
Symptoms of cholangitis
Cholangitis develops when a variety of microbial flora, most often E. coli, is introduced into the bile ducts.
There are basically two types of cholangitis: catarrhal and purulent. But there are many more additional forms: sclerosing, autoimmune, primary, secondary. You will see this video at the end of the publication.
With cholangitis, the following symptoms are noted:
- marked pain in the right upper quadrant,
- fever with chills,
- dyspepsia disorder,
- jaundice.
The main complaints of patients with this disease are dyspeptic disorders, decreased appetite, nausea, sometimes vomiting, pain and heaviness in the right upper quadrant. Sometimes jaundice may appear, but it is usually short-lived.
Diagnosis of cholangitis includes analysis of blood biochemical parameters, fractional duodenal sounding with bacteriological examination of bile, ultrasound, cholangiography, RCP.
In the treatment of cholangitis, antibiotic therapy, detoxification therapy, administration of enzymes, PTF( mud therapy, sodium chloride baths, paraffin and ozoceritherapy, UHF, diathermy) are used, sometimes surgical decompression of the biliary tract.
Treatment of cholangitis with folk remedies
Treatment of cholangitis, both acute and chronic, should be directed primarily at suppressing the infection. You can be treated by domestic means only with the permission of a doctor!
Seeds of thistle .Due to the presence in them of the biologically active substance - silymarin, the seeds have a pronounced choleretic and choleretic effect. Seeds rub into powder, 30 g pour half a liter of water, boil 10 minutes, strain. Drink 1-2 tablespoons 3-4 times a day.
Peppermint .1 tablespoon dry( or 2 tablespoons fresh) herbs pour a glass of boiling water. Insist 1 hour, strain. Take one third of the glass three times a day.
Shandra .From the aboveground part of the plant, prepare the infusion. Application and preparation - as in the previous recipe. Dandelion for medicines .1 tablespoon of leaves and flowers, brew a glass of boiling water and leave for 1 hour. Strain. Drink one third of a glass three times a day. Bulgarian folk medicine believes that the strongest action is the fresh juice of dandelion, obtained by pressing fresh plants. This juice is taken 1 tablespoon 3-4 times a day for at least 4 weeks.
Barberry common. The bark and roots of barberry are used to prepare the infusion in a ratio of half a teaspoon of crushed raw material to a glass of boiling water. Take 2 tablespoons three times a day.
From fruits barberry is prepared with infusion: two teaspoons of chopped fruit into a glass of boiling water. Insist 1 hour, strain. Drink 2 tablespoons three to four times a day.
Cleaner large .A tablespoon of leaves and flowers, pour 0.5 liters of boiling water, insist 1 hour, strain and take 50 ml 3-4 times a day.
Chicory ordinary .Two teaspoons of ground roots into two glasses of water to prepare a decoction. Take it within two days.
Dymyary the drug .Three teaspoons of herbs for 400 ml of boiling water. Insist 4 hours, strain and take 1 tablespoon 4-5 times a day.
Immortelle ( cumin sand ).Three teaspoons of chopped colored baskets fill with 2 glasses of cold water. Insist 8 hours, strain. This is a daily dose.
Decoction of : 15 g of raw material pour a glass of water, boil 10 minutes, strain. Take 2 tablespoons three times a day for half an hour before meals for 3 weeks.
Hot infusion : 1 tablespoon of flowers for a glass of boiling water. Insist 1 hour, strain. Drink 1 tablespoon half an hour before meals.
Black turnip .Take turnip juice 3-4 times a day for 50 ml.
According to ancient Tibetan medicine, all plants that have yellow flowers or fruits, help with diseases of the liver and biliary tract, all plants that resemble a heart shape, are good for heart disease. This is such a simple and touching approach.
Medications: drugs and medications
A patient with suspected cholangitis needs urgent hospitalization, since the treatment of this disease is primarily operational. At the pre-operative stage, antispasmodic and anti-inflammatory agents are prescribed, broad-spectrum antibiotics that do not have hepatotoxic properties.
The main antibacterial stroke should be wide spectrum and cover the family of enterobacteria and anaerobes, therefore, as a rule, combined therapy is required. Below is a brief description of the main antibiotics used in the treatment of cholangitis.
With a mild condition of the patient, an antibiotic can be prescribed in the form of monotherapy:
- Piperacillin / tazobactam 4.5 g 3 times a day intravenously;
- Ticarcillin / clavulanate 3.1 g 4-6 times a day intravenously;
- Ampicillin / sulbactam 1.5-5 g 4 times a day intravenously;
- Cephalosporins of the third and fourth generation, for example Ceftriaxone 1-2 g once a day or 0.5-1 g 2 times a day intravenously.
In case of severe course of cholangitis, combined use of antibiotics is recommended in the form of the following regimens:
- Ureidopenicillin( Piperacillin 3-4 g 4-6 times a day intravenously or Mezlocillin 3 g 6 times a day intravenously) + Metronidazole( 0.5 g 3once a day intravenously).Dosage is very individual, it is better to consult a doctor;
- is the same, but instead of Metronidazole Aminoglycoside( Amikacin 0.5 g 2 times a day intravenously);
- Aminoglycoside( Amikacin 0.5 g 2 times a day intravenously) + Ampicillin( 1 g 4 times a day intramuscularly) + Metronidazole( 0.5 g 3 times a day intravenously;
- Aminoglycoside + Ureidopenicillin + Metronidazole( doses are similar);
- Cephalosporin II-III generation( Ceftriaxone 1-2 g once a day intravenously or Cefoxytin 2 g 6 times a day intravenously) + Aminoglycoside( Amikacin 0.5 g 2 times a day intravenously)
Tactics management of patients with cholangitispresents significant difficulties, they are caused by the presence of a purulent process, mechanicallyjaundice and acute destructive cholecystitis
Each of these moments requires an early resolution, but patients with mechanical jaundice do not tolerate prolonged and traumatic surgical interventions. Therefore, it is advisable first of all to provide adequate outflow of bile, which simultaneously reduces the clinical manifestations of cholangitis, intoxication
The second stage is a radical intervention aimed at eliminating the cause of cholangitis.
In hospital, detoxification and antibacterial therapy is carried out and the patient is prepared for surgical intervention. The most common in acute cholangitis were endoscopic methods of drainage of the bile ducts, which provides a normal outflow of bile.
Prognosis of catarrhal cholangitis in a timely treatment is favorable. With purulent, diphtheritic and necrotic cholangitis, the prognosis is more serious and depends on the severity of the morphological changes, the general condition of the patient, and also on the cause that caused cholangitis.
With long-term chronic cholangitis, biliary cirrhosis or abscessed cholangitis may develop, the prognosis of which is unfavorable. Prevention is the timely detection and treatment of diseases of the bile duct and the area of the large duodenal papilla.
For the purpose of decompression of bile ducts, endoscopic papillo-sphincterotomy is performed after preliminary retrograde cholangiography. With residual stones of choledochus, after papillo-sphincterotomy, the passage of concrements from the bile ducts is sometimes noted, the phenomena of cholangitis stop and the question of the need for a repeated operation disappears.
With stenosing cholangitis, treatment is only surgical.
Health food: diet: table 5a and 5
Table № 5a
It is prescribed for acute liver diseases, hepatic colic, inflammation of the gallbladder and bile ducts. All products are given in a grated kind.
Table No. 5a - mainly milk and vegetable;meat and fish( low-fat varieties) are resolved no more often than once a day and only in boiled and ground form. Give soups dairy and vegetarian, milk porridge, non-acidic jelly and compotes with mashed fruits. Butter is allowed in a limited amount: you can give cottage cheese, sour cream and curdled milk, white stale bread. Exclusive substances, spices and spicy dishes are prohibited: pickled and smoked products, sausages and other snacks, spicy cheeses, meat, fish and mushroom soups, coffee and cocoa, and eggs;and from vegetables - spinach, sorrel and tomatoes.
At attacks of hepatic colic meat and fish from a diet are completely excluded. Drinking patients is prescribed in large quantities.
Table No. 5
Recommended for chronic liver diseases, and therefore mostly homogeneous with table number 5a, but not so strict.
Table No. 5 is also mainly dairy-vegetable, but the products included in it can be given to the patient and not in the garbled form. Black bread, egg whites in the form of omelets and souffle, low-fat varieties of meat and fish in cooked form are allowed. From snacks occasionally you can give caviar. All sorts of salads, berries, sweet fruits and compotes are recommended. From animal fats only butter is allowed, and from vegetable - olive as choleretic, as well as sunflower and corn.
Elena Malysheva: symptoms and treatment of cholangitis - congestion of bile
In this issue of the TV program "Live healthy!" With Elena Malysheva you will learn how to treat stagnation of bile in the gallbladder. What food can cause cancer?
Knock yourself in the right hypochondrium. If there are unpleasant feelings, it is worthwhile to see a doctor.
All liver cells have bile ducts that merge into single ducts, and bile enters the gallbladder.
At every meal, the gallbladder shrinks and throws the bile into the duodenum to emulsify( break up into tiny parts) fats that will then be absorbed into the intestines.
If bile is not excreted, all the fats come out, without splitting and not being absorbed. Also, no fat-soluble vitamin( vitamins A and D) can be metabolized, which means that a person is at risk of osteoporosis - brittle bones.
Cholangitis is an autoimmune disease.
With cholangitis, the body attacks the bile ducts. They narrow, bile stagnates, and then the bile itself begins to damage the liver tissue. Bile does not enter the duodenum, or becomes too small.
An inflammatory process develops, in which all bile ducts can be involved, which often leads to their narrowing and closing, and as a result to cirrhosis of the liver.
Symptoms of
- first of all unpleasant sensations in the right hypochondrium;
- weakness;
- of jaundice;
- dark urine;
- discolored feces;
- itching, which can appear due to cholestasis( decrease or termination of the secretion of bile).
How to treat
Diet. Exclude animal fats and foods in which they are: beef, pork, butter, chocolate, etc.
Treatment is symptomatic: there is no targeted drug for PSC.
Surgical method - endoscopic( seamless, through three punctures) dilated ducts.
Sclerosing cholangitis: XIII factor deficiency, leiomyoma
Huge bruises all over the body, severe pain in the left leg.
Deficiency of the XIII factor of blood coagulation. Leiomyoma of smooth muscles of the upper and lower extremities and the upper part of the trunk. What anesthetics to take? Constant strong weakness and depression. A video about sclerosing cholangitis.
Scientists say that one hour a day, spent on taking care of your health, can add 15-20 years of life. The TV station "About the most important" invites you to spend this hour together and take care of your health seriously.
Stay healthy!
Bile to cirrhosis leads: cholangitis
Primary sclerosed cholangitis
Video from Alexey Korneev.
Sclerosing cholangitis primary: causes, symptoms, diagnosis, treatment and pathology
What is primary sclerosing cholangitis? It is believed that the primary sclerosing cholangitis is an autoimmune disease in which cells of the bile ducts die, leading to fibrosis of the bile ducts and the ingress of bile into the blood.
This video discusses known pathophysiology, important signs and symptoms, diagnostic strategies and treatment options.
Ascending cholangitis acute: causes, symptoms, diagnosis and pathology
What is ascending cholangitis( acute cholangitis)?Ascending cholangitis is a condition in which the obstruction of the common biliary duct leads to the fact that the bacteria colonize the ducts, causing inflammation and, possibly, sepsis.
This video shows pathophysiology, the main manifestations and symptoms, the diagnosis and treatment of ascending cholangitis.
Primary biliary cholangitis: causes, symptoms, diagnosis, treatment and pathology
Primary biliary cholangitis is an autoimmune disease in which immune cells attack and destroy bile duct cells. Bile flows and damages the liver and surrounding tissues, leading to cirrhosis and liver failure.
Mechanisms for the development of autoimmune attacks still remain controversial, and this video considers one of the leading theories. It also addresses important complications, some clinical signs and symptoms, and treatment.
Hepatic cholestasis: causes, symptoms, diagnosis, treatment and pathology
What is cholestasis? Cholestasis or hepatic cholestasis is one of the diseases in which bile enters the liver tissue and blood, causing liver damage and various complications. Intrahepatic cholestasis occurs in the liver and is caused by liver cells, and extrahepatic cholestasis occurs outside the liver and is usually a consequence of bile duct obstruction.
This video discusses pathophysiology, common complications and clinical signs and symptoms of both intrahepatic and extrahepatic cholestasis.
Purulent cholangitis: photos, video, treatment
Alexey Avramov: high-definition video and photos.
. Source: NGNogov. Official and traditional medicine. The most detailed encyclopedia.- Moscow: Izd-vo Eksmo, 2012.
