Dyskinesia of bile ducts - symptoms and treatment

DyskinesiaDyskinesia of bile ducts is a disease in which gallbladder motility is disrupted and occurs failure in the operation of the bile ducts, which causes bile stagnation or excessive discharge.

This disorder is found mainly in women. As a rule, dyskinesia of the bile ducts affects young patients (20-40 years old), lean physique. In some women, the relationship between exacerbation of complaints and the period of the menstrual cycle is expressed (exacerbation occurs 1-4 days before the onset of menstruation), and the disease can worsen in the menopausal period.

Since this disease causes changes in the properties of bile, the absorption of certain important substances and fat-soluble vitamins is impaired. At risk are women who have diseases related to the genital area, as well as people who are often exposed to stress.

There are two main forms of dyskinesia of the gallbladder:

  • Hypertonic (hyperkinetic)- tone of the gallbladder is elevated;
  • Hypotonic- The tone of the gallbladder is lowered.

Causes

Why does dyskinesia of bile ducts arise, and what is it?Primary Causesdyskinesia of bile ducts:

  1. Prolonged, systematic violation of diet (irregular intake of food, overeating, the habit of nourishing eat before bed, acute abuse. fatty foods).
  2. Disorders of neurohumoral regulatory mechanisms of bile ducts.
  3. A sedentary lifestyle, an innate underdeveloped muscle mass.
  4. Neurocirculatory dystonia, neuroses, stress.

Secondary causesdyskinesia of bile ducts:

  1. Previously transferred acute viral hepatitis.
  2. Helminths, infections (giardiasis).
  3. At inflexions of the neck or body of the gallbladder (organic causes).
  4. With cholelithiasis, cholecystitis, gastritis, gastroduodenitis, peptic ulcer, enteritis.
  5. Chronic inflammatory processes of the abdominal cavity (chronic inflammation of the ovaries, pyelonephritis, colitis, appendicitis, etc.).
  6. Hormonal disorders (menopause, menstrual cycle disorders, endocrine gland failure: hypothyroidism, estrogen deficiency, etc.).

Most often, dyskinesia of the biliary tract is a background symptom, not a separate one. It indicates the presence of stones in the gallbladder, the occurrence of pancreatitis, or other abnormalities in the function of the gallbladder. Also, the disease can develop due to the use of certain foods: sweet, alcohol, fatty and fried foods. Strong psychological or emotional stress can lead to the onset of dyskinesia.

Classification

There are 2 types of dyskinesia:

  1. Dyskinesia of the hypokinetic type: the gallbladder is otanic (relaxed), it does not contract well, it stretches, it has a much larger volume, therefore there is a stagnation of bile and a violation of its chemical composition, which is fraught with the formation of stones in the gallbladder. This type of dyskinesia is much more common.
  2. Dyskinesia of the hyperkinetic type: the gallbladder is in a constant tone and reacts sharply to food intake in the lumen of the duodenum by sharp contractions, throwing out a bile portion under a great deal of pressure.

Accordingly, depending on what type of dyskinesia bile ducts you have found, the symptoms of the disease and the ways of treatment will vary.

Symptoms of biliary dyskinesia

Considering the symptoms of dyskinesia, it is worth noting that they depend on the form of the disease.

Mixed variants of DZHVPusually manifested:

  • pain and heaviness in the right side,
  • constipation or alternating with diarrhea,
  • a violation of appetite,
  • soreness with palpation of the abdomen and right side,
  • fluctuations in body weight,
  • belching, bitterness in the mouth,
  • general violation of the condition.

For hypotonic dyskinesiathe following symptoms are typical:

  • pains of noisy character, arising in the right hypochondrium;
  • heaviness in the abdomen;
  • a constant feeling of nausea;
  • vomiting.

For the hypotonic form of the diseasethis set of characteristics is typical:

  • pains of an acute nature, periodically arising in the right hypochondrium, with the return of painful sensations to the back, neck and jaw area. Typically, such pain lasts about half an hour, mainly after eating;
  • a constant feeling of nausea;
  • vomiting with bile;
  • decreased appetite;
  • general weakness of the body, headaches.

It is important to know that the disease not only manifests itself as a gastroenterological clinical picture, but also affects the general condition of patients. Approximately every second large with the diagnosis of dyskinesia of the biliary tract addresses initially to the dermatologist due to the symptoms of dermatitis. These symptoms on the skin indicate problems with the gastrointestinal tract. In this case, patients are concerned about regular skin itching, accompanied by dryness and scaling of the skin. Bubbles may occur with watery contents.

Diagnosis of biliary dyskinesia

As laboratory and instrumental methods of examination appoint:

  • a general analysis of blood and urine,
  • the analysis of a feces on ljamblii and koprogramma,
  • hepatic assays, blood biochemistry,
  • an ultrasound examination of the liver and gallbladder with a choleretic breakfast,
  • carrying out fibrogastroduodenoscopy (swallow "paw"),
  • if necessary, gastric and intestinal sounding is carried out taking samples of bile by stages.

Nevertheless, the main method of diagnosis of DZHVP is ultrasound. With the help of ultrasound it is possible to evaluate the anatomical features of the gallbladder and its pathways, check the presence of stones and see inflammation. Sometimes a loading test is performed to determine the type of dyskinesia.

Treatment of biliary dyskinesia

With diagnosed dyskinesia biliary tract treatment should be a comprehensive focus, including the normalization of the regime and the nature of nutrition, sanitation of foci infection, desensitizing, antiparasitic and anthelminthic therapy, elimination of intestinal dysbacteriosis and hypovitaminosis, elimination of symptoms of dysfunction.

  • Treatment of hyperkinetic form of dyskinesia. Hyperkinetic forms of dyskinesia require restrictions in the diet of mechanical and chemical food irritants and fats. Use table number 5, enriched with products containing magnesium salts. To remove spasm of smooth muscles used nitrates, myotropic antispasmodics (no-spa, papaverine, mebeverin, gimecromone), cholinolytics (gastrotsepin), as well as nifedipine (Corinfar), reducing the tone of the sphincter of Oddi in a dose of 10-20 mg 3 times a day.
  • Treatment of a hypokinetic form of dyskinesia. You should use a diet in the table number 5, with hypokinetic dyskinesias, food should be enriched with fruits, vegetables, foods containing vegetable fiber and magnesium salts (food bran, buckwheat porridge, cottage cheese, cabbage, apples, carrots, meat, broth of wild rose). Emptying the gallbladder is also promoted by vegetable oil, sour cream, cream, eggs. It is necessary to establish the normal functioning of the intestines, which reflexively stimulates the contraction of the gallbladder. Also assigned cholekinetics (xylitol, magnesium sulfate, sorbitol).

Patients with dyskinesia of the bile ducts are shown the observation of a gastroenterologist and neurologist, annual health improvement courses in balneological sanatoria.

Physiotherapy

In the hypotonic-hypokinetic variant, diadynamic currents, faradization, sinusoidal modulated currents, low-impulse currents, low-intensity ultrasound, pearl and carbon dioxide baths.

In the case of a hypertonic hyperkinetic form of dyskinesia, patients are recommended inductothermy (electrode-disk placed above the right hypochondrium), UHF, microwave therapy (UHF), high intensity ultrasound, novocaine electrophoresis, ozocerite or paraffin applications, galvanic mud, coniferous, radon and hydrogen sulfide baths.

Dyskinesia diet

Any advice how to treat dyskinesia bile ducts will be useless if you do not follow certain rules in the diet, which help to normalize the bile duct.

Proper nutrition will contribute to the creation of favorable conditions for the normal functioning of the digestive tract and the normalization of the biliary tract:

  • forbidden all heavily salty, sour, bitter and pungent;
  • spices and spices are limited, fried is forbidden;
  • sharply limited in nutrition fat, replacing it as much as possible with vegetable oils;
  • a strict ban on potentially harmful and irritating foods (chips, nuts, soda, fast food, salted fish) is imposed;
  • all meals at first are given in warm and semi-liquid form, especially with painful attacks;
  • all food is boiled, cooked steamed or stewed, baked in foil.

Sample menu for the day:

  1. Breakfast: soft-boiled egg, milk porridge, tea with sugar, a sandwich with butter and cheese.
  2. Second breakfast: any fruit.
  3. Lunch: any vegetarian soup, baked fish with mashed potato, vegetable salad (eg cabbage), compote.
  4. Afternoon snack: a glass of milk, yogurt, ryazhenka or kefir, a pair of marshmallows or marmalade.
  5. Dinner: steamed meatballs with vermicelli, sweet tea.
  6. Before going to bed: a glass of yogurt or drinking yogurt.

Recommended frequent intake (up to six times a day) of small portions of food. Last reception should be before a dream that there was no stagnation of bile.

Treatment of children with biliary dyskinesia

In children with biliary dyskinesia, the treatment is carried out until the stagnation of the bile and signs of a violation of the cholic outflow are completely eliminated. With severe pain, it is advisable 10-14 days to treat a child in a hospital, and then - in a local sanatorium.

Timely diagnosis of bile duct disorders and proper treatment of children, depending on the type of abnormalities detected, can prevent the formation in the further inflammatory diseases of the gallbladder, liver, pancreas and prevents early stone formation in the gallbladder and kidneys.

Prevention

To avoid pathology, observe the following rules:

  • a full night's sleep for at least 8 hours;
  • lie down not later than 11 pm;
  • alternate mental and physical labor;
  • walks in the open air;
  • Eat fully: consume more plant foods, cereals, boiled animal products, less -
  • fried meat or fish;
  • exclude psycho-traumatic situations.

Secondary prophylaxis (i.e., after the onset of dyskinesia of the bile ducts) is the earliest detection, for example, with regular preventive examinations. Dyskinesia of the biliary tract does not decrease the life span, but affects its quality.


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