Excretion of gallbladder stones

Stones in the gallbladder are formed as a result of a violation of the metabolism of cholesterol and bilirubin. Because of the glut of bile cholesterol, cholesterol stones are formed, and with increased amounts of bilirubin, bilirubin or pigmented stones are formed. Most often there are cholesterol stones, extremely rarely the calcite consists of calcium carbonate or phosphorus.

The condition for the formation of stone is not only lithogenic bile, but also impaired function of the gallbladder. When inflammation in the body reduces the contractility of the bladder( dyskinesia), the bile stagnates and precipitates, which eventually forms a calculus. The stone can "grow" 5-11 years before its existence becomes noticeable.

It is not uncommon for stones to be found on an overview radiograph or during ultrasound of the abdominal cavity by accident, when the patient is treated on another issue. If the disease has not developed to clinical manifestations( "dumb" stones), then specialists choose expectant tactics( do not operate), since in most patients the symptoms of cholelithiasis will not manifest.

The stones from the gallbladder rarely come out on their own, more often they are removed surgically or medically. Tactics of treatment is chosen based on the type of stones, their size and quantity, and also takes into account the stage of the disease and accompanying pathologies.

Chemical dissolution and excretion of stones can take years and in most cases can not be avoided without surgery. It is not necessary to hope, that concrements will find their own way, so if symptoms of cholelithiasis have appeared, then consultation with a specialist is necessary.

Surgical removal of

The presence of stones in the ducts hampers the outflow of bile and leads to hepatic( biliary) colic, which is extremely painful. Provoke the movement of the stone is capable of fatty or spicy food, severe physical stress, prolonged stagnation, infection, stress, childbirth.

Pain occurs not as a result of the mechanical action of the stone on the bladder mucosa, but because of the overstretch of its wall, as intravesical pressure rises and spastic contraction occurs. The patient with hepatic colic is hospitalized and the surgeon determines the further treatment tactics.

Gallbladder removal surgery is indicated if early clinical symptoms of calculous cholecystitis are attached, and if stones are more than 3 cm, calcium deposits or polyps are found on the walls of the organ. With cholecystectomy, the gallbladder is removed, and with cholecystolithotomy the organ remains, only the stones are eliminated.

Both methods are performed with laparoscopy or laparotomy. As a rule, doctors recommend removing the organ, since if this is not done, the stones are more likely to reappear. If the concrements are large or drug therapy does not produce the desired result, lithotripsy( fragmentation of the stone by ultrasound or laser) or contact litholysis( dissolution of the stone with acid) will help to remove stones from the gallbladder.

Lithotripsy is used if it is necessary to get rid of one stone that is less than 2 cm. The stone is affected by ultrasound that passes through the tissues without damaging it, but in the solid structures it causes vibration.

The calculus under the influence of ultrasound bursts and disintegrates, after which it is eliminated naturally. Since stones should not be in the ducts, this method can be used only in 20% of patients. In some cases, several sessions are required until the concrement is less than 0.5 cm.

After lithotripsy, drug therapy is prescribed, which lasts 12-18 months.

The stone can be crushed by a laser. In order for the beam to reach the stone, it is necessary to make a puncture in the area of ​​the gallbladder. Where the laser is directed by a specialist, he observes using an ultrasound machine. Contact litholysis is applied only if other methods are ineffective. With its help, only cholesterol stones can be dissolved, there are no restrictions on location and size.

The operation is performed as follows:

• in the gallbladder is introduced a drainage tube, which is necessary to remove bile;
• estimates the amount of stones and calculates the required volume of the solvent;
• , methyl-t-butyl ether is introduced into the bladder cavity, which dissolves the calculi;
• is absorbed by bile along with litholytics;
• is poured with an anti-inflammatory agent that will help restore the mucosa of the gallbladder.

Chemical dissolution of

If there are no indications for organ removal, then preparations containing chenodeoxycholic and ursodeoxycholic acid are used to dissolve cholesterol stones. They reduce the concentration of cholesterol in the bile, promote the normalization of bile secretion, quickly dissolve and remove small and large concretions from the gallbladder and bile ducts.

Chenodeoxycholic acid is synthesized in the human body by hepatocytes and enters the gallbladder. It is necessary for the cleavage and emulsification of fats, for the transport of decomposition products of hemoglobin and bile pigments, provides lipid absorption, improves peristalsis, and has antiseptic properties.

Every day about 250 ml of acid is synthesized, which is approximately 15% of the total volume of bile secreted. If the concrement is large, then chenodeoxycholic acid is not prescribed, since the bile duct may become clogged or the movement of the stone will lead to rupture of the blood vessels.

Also, the drug is not suitable for patients with hepatitis, renal or hepatic insufficiency, acute cholecystitis, peptic ulcer. The agent will not help if the calcified stones are in the gallbladder. Preparations containing chenodeoxycholic acid:

• Henofalk;
• Henosan;
• Genohol.

Therapeutic course may be from several months to 3 years.

During medical therapy, the patient should be under medical supervision. Periodically conducted studies to determine the course of the disease. If within 6 months there is no positive dynamics, then the treatment tactics change. During the medication, side effects( dizziness, abdominal pain, nausea, vomiting, diarrhea, rashes on the skin) may occur, which will require drug discontinuation.

Ursodeoxycholic acid is also synthesized in the liver. It has choleretic, immunomodulating, hepatoprotective, cholelitholitic, hypocholesterolemic action. Acid stabilizes the membrane of liver cells, reduces the concentration of toxic acids, reduces absorption of cholesterol.

Because the drug helps reduce cholesterol and bile acids, its administration leads to the dissolution of stones and prevents the appearance of new ones. Appointed drugs containing acid, if identified cholesterol stones with a diameter of no more than 2 cm, the gallbladder retains its functions and is filled with concrements less than half.

Indications for use are also various diseases of the hepatobiliary system( cirrhosis, hepatitis, cystic fibrosis of the liver, dyskinesia or cholecytopathy).Contraindicated in acute inflammatory processes in the gallbladder and its ducts, with cirrhosis, Crohn's disease, ulcerative colitis, with renal failure.

Ursodeoxycholic acid may cause pruritus, constipation, nausea, abdominal pain, liver enzyme activity may increase. Calcification of gallstones was rarely observed. The duration of the therapeutic course, as well as the dosage is determined individually.

At the beginning of therapy, it is necessary to check the activity of liver enzymes every month and to undergo ultrasound and X-ray examinations every six months. After dissolution of stones, it is recommended to take the drug for a few more months with a prophylactic purpose.

Drugs in which the active substance ursodeoxycholic acid:

• Ursosan;
• Ursodez;
• Urdoks;
• Ursoliv;
• Ursofalk;
• Livedoksa;
• Grinterol et al.

Ursodeoxycholic acid is considered more safe and effective than chenodeoxycholic acid. With the help of medicines dissolution of cholesterol stones is observed in 15% of patients. Such a low percentage of the favorable outcome is due to the fact that long-term therapy is required( 1.5-2 years) and it is necessary to comply with the diet, to completely abandon alcohol.

Dietary food

In case of detection of concrements in the gallbladder or the appearance of signs of the inflammatory process in the organ( pain or dyspeptic syndrome), it is necessary to adjust the nutrition. In diseases of the hepatobiliary system, the No5 treatment table is prescribed, which requires chemical and mechanical shaking of the digestive system.

From the diet for ever should disappear:

• rich broths( fish or meat);
• fried, fatty or spicy dishes;
• by-products;
• marinades, smoked meat, pickles;
• eggs hard boiled;
• baking, fresh bread;
• strong coffee and tea;
• alcoholic and carbonated drinks;
• canned meat and fish.

The menu should contain a lot of fiber and vegetable oils. Neither butter nor vegetable oil should be heat treated. You should eat more foods containing magnesium, because the microelement helps reduce cholesterol in the blood. Useful buckwheat, beans, peas.

If there is a violation of the diet, stone movement may start, which will cause the hepatic colic

. The food should be fractional( frequent and small portions) to ensure a uniform outflow of bile from the gallbladder. Very bad for cholelithiasis fasting or skipping meals, as this leads to stagnation of bile and precipitation of cholesterol, calcium and bilirubin.

Folk methods

Folk healers recommend the following prescriptions for the excreta:

• mixture of beet, carrot and cucumber juice. The juice is mixed in equal proportions and is consumed 100 g three times a day;
• tincture of horseradish leaves. Vegetable raw materials are densely packed in a liter jar to half and filled with 500 ml of vodka. Leave to infuse for 14 days, then filter. Fasting tincture of 20 ml is used;
• tincture from the bark of a juniper. For 100 grams of bark, 400 ml of vodka is taken and settled in a dark place for two weeks. Drink a remedy for 30 grams 15 minutes before meals three times a day. It is recommended after the tincture is over to take a break in 5 days, and then repeat the course 4 more times;
• infusion of horsetail. So, 10 grams of horsetail is poured a glass of boiling water and leave to stand for 40 minutes. Drink three meals a half an hour before meals;
• radish black juice. The agent drink one teaspoon one hour after a meal. If there are no unpleasant sensations in the area of ​​the liver, the dosage gradually rises and is brought to half a cup. For the course of therapy you need to drink about 3 liters of juice;
• decoction of oats. A glass of unpeeled oats is poured with a liter of boiling water and kept on low heat for about an hour. Drink all the broth for a day. Duration of the course is 50 days;
• mixture of honey and sunflower oil. Honey and butter are mixed in equal proportion( by a teaspoonful) and eaten before eating. After a 10-day course, take a three-day break and repeat the course anew 3 more times;
• strawberry juice. Fresh berries are drunk, the juice is drunk before meals three times a day. Single dose of about 100 ml;
• cranberry juice. Three tablespoons of juice are bred in 100 ml of water. They drink before meals three times a day;
• infusion of calendula. Plant flowers( 1 spoonful) are poured with a glass of boiling water. Drinking broth on an empty stomach in the morning and evening;
• juice of sauerkraut. Drink the juice of 100 ml before meals three times a day.
• pumpkin with honey. Pumpkin flesh, add honey and leave in the cold for 7-10 days. Drink juice before meals 50 ml 4 times a day.

Traditional medicine recipes recommend the use of drugs with a strong cholagogue effect for the excretion of gallstones. It is believed that the more bile is excreted, the more quickly the sand and small concretions come out of the gallbladder.

In this case, if the patient feels pain in the area of ​​the projection of the gallbladder( in the right hypochondrium), it is recommended to attach a heating pad to relieve the spasm. These methods of treatment can work only if the stone can come out on its own, otherwise there will be blockage of the ducts.

Before starting treatment with folk methods, it is necessary to get expert advice from

. Thus, you can remove stones from the gallbladder in several ways. Not always therapy is justified, because in most cases, stones do not provoke any symptoms and do not affect the condition of the body in any way. Doctors recommend to adhere to dietary nutrition, to lead an active lifestyle.

Removal of calculi is advisable only with the development of an inflammatory or other pathological process in the gallbladder, or with a large accumulation of stones that can lead to blockage of the bile duct. The most effective surgical removal of stones( removal of the entire organ, crushing stones with a laser or ultrasound).

It is also possible to excrete cholesterol stones with drugs containing chenodeoxycholic and ursodeoxycholic acid. However, therapy is not always effective. Remove small stones from the gallbladder, provoking increased bile secretion, and this can be achieved with the help of traditional medicine recipes. For example, a good habit will drink tea from birch leaves, calendula flowers or immortelle, and coffee can be replaced with chicory.