Health ecology: An unpleasant bitter taste in the mouth and a lack of interest in food are familiar to many. Constipation and pain in the right hypochondrium
We offer to understand what threatens stagnation of bile, where it comes from, how to avoid it and how to treat it if the diagnosis has already been made.
Stagnation of bile: what is it
Cholestasis is manifested in a decrease in the flow of bile into the duodenum. This problem can be caused by gallbladder dysfunctions, pathology of the biliary tract, impaired synthesis of bile components, cirrhosis, malnutrition, parasitic infection, various disorders in the nervous and endocrine systems, or other causes, but in any case, the liver suffers from bile stasis.
- icteric staining of the skin, eye proteins and visible mucous membranes,
- itching of the skin, especially on the arms and legs,
- pain in the right hypochondrium,
- periodic nausea and even vomiting,
- bad breath
- dark urine and light feces,
- increase in liver size.
Stagnation of bile entails a violation of the coordinated work of the entire digestive system. For cholestasis, diseases such as:
- cirrhosis of the liver,
- liver failure,
- vitamin deficiency and osteoporosis, as a result of a lack of vitamins A and D, the absorption of which is prevented by the disease,
Stagnation of bile in the gallbladder is facilitated by too long breaks between meals. Therefore, the frequent neglect of breakfast, lunch or dinner can automatically put you in line for an appointment with a hepatologist and gastroenterologist.
Nearby may be people who are not particularly keen on physical education and leading a sedentary lifestyle. Also at risk for cholestasis are alcoholics, people suffering from problems with the digestive tract, patients with stones in the biliary tract.
Sometimes a change in the hormonal background in pregnant women can affect the functioning of the gallbladder and cause cholestasis. Usually problems with the flow of bile appear in the third trimester of pregnancy. Cholestasis is dangerous both for the child and for the mother carrying him.
A doctor should be consulted immediately at the first manifestations of these symptoms, for example, with frequent nausea and loss of appetite.
Methods for treating bile stasis
Cholestatic syndrome is diagnosed by the above clinical signs, using ultrasound, sounding, as well as laboratory tests. For this, the doctor can prescribe blood and urine tests that determine the level of bilirubin, bile acids, alkaline phosphatase, cholesterol and other enzymes and substances.
The treatment of cholestasis is carried out simultaneously in several directions:
- relief of itching
- fight against stagnation of bile,
- support and improvement of the liver.
Itching is removed with special ointments and creams, corticosteroids or antihistamines. In parallel, the patient is prescribed drugs responsible for reducing the concentration of bile acids, and choleretic drugs.
Drugs based on ursodeoxycholic acid have been shown to be effective, displacing and eliminating toxic bile acid. To improve and protect the liver, various hepatoprotectors can be recommended, including drugs of natural origin: Bondjigar, Allohol, LIV-52, Karsil and others, as well as preparations from pig liver cells, for example, Hepatosan ".
During treatment and recovery, a patient with cholestasis is prescribed a diet that removes foods based on or containing animal fats from the diet, restricts acidic and fried foods, and alcohol and drugs that have a toxic effect on the liver are prohibited. Cold drinks and foods, canned food, chocolate, cocoa, mushrooms are also excluded.
In the absence of contraindications, the doctor may prescribe a blind tubage to the patient, washing the bile ducts and eliminating stagnation of bile.
In severe cases, the doctor may recommend surgery to expand the bile ducts.The operation is done by the endoscopic method through several punctures, which allows the patient to recover quite quickly from treatment, and also eliminates the need to stitch.
15-20 minutes before a meal, it is recommended to drink a cup of hot vitamin infusion from gooseberries, currants, lingonberries, cranberries, viburnum, rose hips or hawthorn. Berries can be brewed together or alternated. These tasty and healthy drinks will help relieve cramps in the digestive tract and prepare it for a meal.
The normal work of the gatekeepers that regulate the pressure of bile will be helped by products containing silicon and germanium - they can be distinguished by a bright garlic smell. This is garlic itself, wild garlic, as well as asafoetida - an oriental spice from the plant of the same name.
Problems with the flow of bile in folk medicine have long been treated with herbal teas taken after meals. Bitter choleretic herbs and berries are preferred: gentian, knotweed, wormwood, tansy, immortelle, oregano, milk thistle, chicory, St. John's wort, roots and leaves of dandelion, roots of Oregon grapes, red mountain ash and many others.
It is worth noting that many of the healing broths and infusions not only normalize the outflow of bile, but also improve the liver, help it recover, help remove toxins from the liver and cleanse the blood.
In oriental medicine, for the treatment and prevention of stagnation of bile, grass grass, mummy, ginger, mountain arnica, and aloe juice are recommended.
Prevention of stagnation of bile
According to statistics, one fifth of the world's population suffers from cholestasis. Fast foods, lack of diet and sedentary work, frequent experiences and stresses - all this can cause the disease.
There are many different ways to stimulate the gallbladder, thereby preventing stagnation of bile:
What is the danger of stagnation of bile?
This pathology is being diagnosed more often, so you should know what is dangerous stagnation of bile for the body. After eating, the fats contained in it begin to emulsify, but in order for lipids to be digested and lipophilic vitamins to be fully absorbed, bile acids and their salts, the main components of bile, are needed in addition to gastric juice and pancreatic enzymes. From the gall bladder they enter the duodenum, where the process of emulsification and colloidal hydrolysis of fats continues.
If bile stagnates (that is, it does not enter the intestinal tract of the digestive tract), the activity of the intestinal enzyme lipase decreases, and fats do not completely break down and enter a significant amount into the blood, making glucose transformation into glycogen difficult (which is fraught with the development of diabetes mellitus). Stagnation of bile is dangerous by reducing the elimination of excess cholesterol, which is present in the bile itself: it causes hypercholesterolemia (high cholesterol in the blood) and accelerates the development of atherosclerosis.
Stagnation of bile in the gallbladder often leads to its inflammation (secondary cholecystitis) or gallstone disease (cholelithiasis). It is in the presence of stones in the gallbladder that acute and chronic cholecystitis with bile stasis most often develops.
It is possible to simultaneously diagnose gastritis and stagnation of bile, when the mucous membrane of the esophagus and stomach are exposed to bile acids that get there in a “reverse way” from the duodenum - with chronic duodenogastric reflux (which occurs due to weakness of the cardiac sphincter of the esophagus).
The so-called sclerosing cholangitis - inflammation, fibrosis and strictures of the bile ducts - can lead to stagnation of bile ducts.
With a violation of the circulation of bile acids in the digestive tract, the absorption of fats (fat malabsorption) and fat-soluble vitamins: retinol (vitamin A), ergocalciferol (vitamin D), tocopherol (vitamin E), phylloquinones (group K vitamins) is reduced.The most famous consequences and complications of vitamin A deficiency are worsening of twilight vision, and vitamin D is osteomalacia (when a decrease in bone mineralization leads to softening). At the same time, a simultaneous deficiency of vitamins A and D interferes with the absorption of calcium, which makes bone tissue even less dense, that is, osteoporosis develops. A lack of vitamin K threatens to reduce blood coagulation and the occurrence of hemorrhagic diathesis and bleeding.
Quite a real threat posed by chronic stagnation of bile - an increase in intestinal acidity, because bile - due to the presence of calcium cations in it - reduces the acidity of the stomach-soaked gastric juice, which passes into the intestinal stage of digestion. With stagnation of bile (cholestasis), an acid-base imbalance of the gastrointestinal tract is noted, and the result of acidification is ascites (dropsy) and poor bowel function due to the multiplication of pathogenic microbes.
When prolonged stagnation of bile in the liver occurs, an increase in the level of chenodeoxycholic bile acid produced in the liver can lead to the death of hepatocytes and focal necrosis of the parenchyma. This is a very serious complication, as the liver is responsible for very important functions.
If stagnation of bile in the intestine is observed, the toxicity of conjugated metabolic products and exogenous toxins (including bacterial origin) is enhanced. Also, the consequences and complications relate to the synthesis of hormones, which is significantly reduced, since lipids are necessary for their production.
Causes of stagnation of bile
In clinical gastroenterology, the causes of bile stasis are associated with the destruction of hepatocytes due to primary biliary or alcoholic cirrhosis of the liver (hepatocellular congestion), with liver damage by infections or parasites (viral hepatitis A, C, G, hepatic tuberculosis, amoebiasis, opisthorchiasis, giardiasis, etc.). , with exposure to the liver of various toxins or components of drugs (including sulfonamides, penicillin antibiotics, analgesics, hormones).
According to experts, stagnation of bile in the liver occurs, if any liver cyst, malignant neoplasms or metastases.
Among the reasons why bile congestion occurs in the gallbladder and bile ducts include:
- gallbladder dyskinesia,
- kink of the gallbladder,
- tumors of the gallbladder or bile ducts,
- inflammation in the neck of the gallbladder,
- cystic formations of the common bile duct or its compression by a cyst located in the pancreas,
- compression and narrowing of the initial section of the common hepatic duct (Mirizzy syndrome),
- dysfunction of the valve system of the biliary tract (sphincters of Oddi, Lutkens, Mirizzy, Geister),
- failures of the endocrine and paracrine mechanisms of the gastroduodenal stage of digestion associated with an imbalance of secretin, cholecystokinin, neurotensin and other intestinal hormones.
Closely connected are physical inactivity and stagnation of bile: the less a person moves, the slower the metabolic processes in his body and the higher his risk of developing dyskinesia of biliary ducts or the formation of gallstones.
And stagnation of bile after removal of the gallbladder, experts call part of the typical postoperative consequences that arise due to the formation of scar tissue, which narrows the gaps of the bile ducts.
An important food risk factor for biliary obstruction due to stones in the gallbladder can be excessive sugar intake, as well as fat-containing foods that cause bile congestion.
Also, the real risk factors for bile stasis are alcohol abuse, overeating, obesity, an inherited genetic predisposition to metabolic disorders.
The pathogenesis of bile stasis in the intrahepatic ducts is associated with infections, endocrine disorders, genetic metabolic disorders (thyrotoxicosis, amyloidosis of the liver or intestines) and iatrogenic effects. And the pathogenesis of bile stasis in the extrahepatic ducts (cystic, total hepatic and common bile) is due to changes in the composition of bile and an increase in its lithogenicity, anomalies of the biliary tract and their partial or complete obstruction.
Symptoms of bile stasis
First of all, it should be borne in mind that this condition may be asymptomatic. And the intensity and sequence in which the symptoms of bile stasis are manifested depend on the specific cause and individual characteristics of the hepatobiliary system of the body. But the first signs are skin itching and changes in feces and urine. Itching is believed to be associated with stasis of bile in response to an increase in the level of bile acids in blood plasma, where they enter as a result of damage to liver cells by chenodeoxycholic acid.
Feces with stagnation of bile have a characteristic discoloration due to a violation of the elimination of the bile pigment bilirubin (which normally oxidizes to stercobilin, which stains feces in brown, and urine in straw yellow). Urine with stagnation of bile, on the contrary, becomes dark, because the level of urobilin (urinary stercobilin) increases in it.
Constipation and diarrhea with stagnation of bile are typical symptoms of this condition. Since bile acids play an important role in intestinal motility, their reduction in the intestinal lumen leads to constipation. And diarrhea with stagnation is associated either with an increased content of unsplit fats in the feces (steatorrhea), or with changes in the intestinal microflora.
Changes in the color of the skin - yellowness - are not observed in all patients, however, at sufficiently high plasma levels of conjugated bilirubin, the skin, sclera, mucous membranes become yellow. Yellow eyelids (xanthelasma) may appear on the eyelids, and focal skin neoplasms interspersed with cholesterol (xanthomas) appear around the eyes, in the palm folds, under the chest, on the neck and in the diaper area of infants.
Characteristic pain in bile congestion is dull paroxysmal, localized in the right upper quadrant of the abdomen (in the hypochondrium), can be given up and back (to the clavicle, shoulder or shoulder blade), acute attacks in the form of colic are possible.
Heartburn with bile congestion is often accompanied by a constant feeling of bitterness in the mouth, and dry mouth with bile congestion is also characteristic. Bile helps break down proteins and nitrogenous bases in food, and bad breath due to stagnation of bile occurs due to poor digestion and absorption of proteins. By the way, stagnant bile often manifests itself and bile stasis after removal of the gallbladder.
Fever - temperature with bile congestion - evidence of infection, for example, phlegmonous or gangrenous cholecystitis with cholelithiasis. Sepsis, which develops after endoscopic diagnostic procedures, can give high temperature.
In addition, symptoms of bile stasis include nausea and vomiting, dizziness and a feeling of general weakness, an enlarged liver (hepatomegaly), and an increase in pressure in the portal vein system leading to the liver. With stagnation of bile in children, a lack of essential polyunsaturated fatty acids (linoleic, linolenic, arachidonic) can lead to stunted growth, damage to the peripheral nervous system, and dermatitis. Alopecia, that is, hair loss with stagnation of bile, is also the result of a deficiency of triglycerides.
Stagnation of bile during pregnancy
Clinical studies of recent years have shown that stagnation of bile during pregnancy is initiated by estrogens, which regulate most of the processes in the body of the expectant mother.So, pregnant women produce large secretion hormones, and, therefore, more bile. But at the same time, the secretion of growth hormone growth hormone (STH) increases, and it blocks the hormone cholecystokinin, which is responsible for the contraction of the gallbladder and common bile duct.
Stagnation of bile during pregnancy (idiopathic pregnancy jaundice or obstetric cholestasis) is most often manifested by excruciating skin itching (especially the palms of the hands and soles of the feet) by the middle of the second or third trimester - as the estrogen level reaches its maximum. In addition, a significant increase in serum levels of aminotransferase, alkaline phosphatase and unconjugated bile acids was noted, other symptoms rarely appear. Within two to three weeks after giving birth, spontaneous relief and the disappearance of all symptoms occur.
The epidemiology of stagnation of bile in pregnant women demonstrates a 0.4-1% susceptibility to this condition for women in most regions of Central and Western Europe and North America, while in the countries of Scandinavia and the Baltic states this indicator reaches 1-2%, and in some regions of Latin America - up to 5-15%.
At the same time, the following effects and complications of stagnation of bile in pregnant women are noted: premature birth (20-60%), staining of meconium in amniotic fluid (more than 25%), fetal bradycardia (14%), fetal distress (22-40%), fetal loss (0.4-4%).
Stagnation of bile in 45-70% of women happens in all subsequent pregnancies.
By the way, with itching and the absence of jaundice, bile congestion and allergies often do not differentiate, and patients turn to dermatologists who can not help them.
Stagnation of bile in a child
There are many reasons that cause stagnation of bile in a child, in particular:
- the absence of the gallbladder (agenesis),
- doubling of the gallbladder (full or rudimentary),
- deepening of the gallbladder into the liver parenchyma,
- diverticulum (protrusion of part of the wall) of the gallbladder,
- congenital expansion of the bile ducts inside the liver (Caroli syndrome),
- congenital strictures in the presence of cysts of the common bile duct,
- quite common congenital (due to mutations in the gene of serine digestive enzymes), a violation of the synthesis of hepatic alpha-1-antitrypsin,
- genetically determined reduction or complete absence of intrahepatic ducts (biliary atresia),
- heterogeneous bile formation disorder - progressive familial intrahepatic stasis (Bayler's disease), pathogenesis is associated with mutations in the genes of the hepatocellular transport system, it is diagnosed in one newborn from 50-90 thousand
In addition, stagnation of bile in a child of preschool and school age can have the same reasons as in adults (see above). But most often, the etiology is associated with impaired gallbladder motility and functional disorders of the biliary tract.
Diagnosis of stagnation of bile
In clinical practice, the diagnosis of bile stasis is carried out by examination, during which, in addition to collecting an anamnesis and examining a patient, such tests are taken as:
- general blood analysis,
- biochemical analysis of blood for levels of bilirubin, cholesterol, bile acids, 5-nucleotidase, aminotransferases, as well as liver enzymes - alkaline phosphatase, leucine aminopeptidase (LAP) and gamma-glutamyl transpeptidase (GGTP),
- blood test for antibodies to parasites,
- urine analysis for urobilin,
- analysis of feces for parasitic infestations.
Instrumental diagnosis of pathologies with stagnation of bile is carried out using:
- ultrasound examination (ultrasound) of the gallbladder, liver and small intestine,
- dynamic cholecintigraphy,
- radioisotope hepatobiliscintigraphy,
- endoscopic cholangiography,
- endoscopic retrograde radiography of the bile ducts and pancreas (ERCP).
- CT or MRI of the digestive organs.
The task that differential diagnosis solves is a clear distinction between the problems of the hepatobiliary system that caused bile congestion from hereditary defects in bile excretion (Rotor syndrome, Dubin-Johnson syndrome), unconjugated hyperbilirubinemia (Gilbert syndrome), parenchymal jaundice, hematuria, carotinemia, erythritis hepatic form of infectious mononucleosis, etc.
Treatment of bile stasis
The principles on which the complex treatment of bile stasis is based: if the cause can be eliminated - etiological treatment, including surgical treatment, when the cause cannot be eliminated - symptomatic therapy with the maximum possible effect on individual pathogenetic components.
If stagnation of bile in the gallbladder or liver does not cause obstruction of the ducts, then drugs based on ursodeoxycholic acid, which is part of bile, are used. These include a hepatoprotective drug with choleretic (increasing the synthesis of bile) and choleretic actions of Ursofalk (Ursokhol, Holazid, Ursosan, Ursoliv, Ukrliv, Holudexan and other trade names) in the form of capsules and suspensions for oral administration. It also reduces the production of cholesterol and its absorption in the small intestine, which reduces the likelihood of cholesterol-containing calculi. Capsules and suspension are prescribed for 10-15-20 mg per kilogram of body weight per day (the specific dose is determined by the doctor), the treatment is long.
Ursofalk cannot be used for cirrhosis of the liver, acute cholecystitis or cholangitis, with calcified stones in the gallbladder and its dyskinesia, as well as in case of obvious functional insufficiency of the liver, pancreas or kidneys. And among the side effects of ursodeoxycholic acid, the occurrence of pain in the upper abdomen, moderate diarrhea, and the formation of bile calcifications are noted.
Almost always choleretic drugs are prescribed for stagnation of bile, such as Allohol, Hofitol (Artichol, Tsinariks), Holiver, Odeston (Gimekromon, Cholestil, Holstamin forte, etc.). The most effective hepatoprotector is Ademethionine (Heptor, Heptral).
Allochol (consisting of dry bile, nettle and garlic extracts, and activated charcoal) promotes the production of bile, so it is not used for acute forms of hepatitis, liver dysfunction, and obstructive jaundice. Allochol tablets are taken after meals - 2 tablets three times a day. In some, the drug can cause skin allergies and diarrhea.
Tablets (and solutions for oral and parenteral administration) Hofitol contain leaf extract of inoculated artichoke, which helps to promote bile, increase urine output and cholesterol metabolism. The drug in the form of tablets is taken three times a day for 1-2 tablets (before meals), a solution of 2.5 ml (for children, 0.6-1.25 ml). Hofitol can cause hives, it is contraindicated for use with stones in the gall bladder, obstruction of the biliary tract and liver failure.
A choleretic agent Holiver, in addition to artichoke extract, contains extracts of bile and turmeric, stimulating the synthesis of bile acids and the output of hepatic bile. The tool is also effective for constipation associated with intestinal dysbiosis, and flatulence. Contraindications are similar to Hofitol, the standard dosage is 2-3 tablets 3 times a day (before or after meals).
Cholagogue tablets Odeston (based on 7-hydroxy-4-methylcoumarin) not only accelerate the circulation of bile, but also relieve spasms. It is recommended to take within 10-14 days, one tablet (0.2 g) three times a day, half an hour before meals. Odeston is contraindicated in ulcerative colitis and any diseases of the gastrointestinal tract with ulceration, obstruction of the bile ducts, hemophilia, is not used in the treatment of children.Side effects of the drug are manifested in the form of diarrhea, epigastric pain, increased formation of intestinal gases.
Ademethionine (S-adenosyl-methionine) helps normalize liver function and metabolism. 2-3 tablets per day are prescribed, contraindications of the drug relate to individual intolerance, use in the treatment of children and pregnant women (in I-II trimesters). A possible side effect is discomfort in the hypochondrium.
In addition, in the treatment of stagnation of bile, pharmacy choleretic collections of medicinal plants are used. For example, choleretic collection No. 2 (flowers of sandy immortelle, yarrow grass, peppermint leaves, coriander seeds) or collection No. 3 (flowers of calendula, tansy and pharmacy chamomile and mint leaves). A decoction is prepared from dry raw materials - a tablespoon in a glass of water (boil for no more than 10 minutes and insist for half an hour in a sealed container, strain and add boiled water to the original volume). Cholagogue fees should be used, in consultation with a doctor, drink broths before meals twice a day - 100 ml each.
Rosehip also has choleretic properties: you can prepare an infusion of dried berries or take Holosas (for a dessert spoon per day, for children - half a teaspoon). You should also take vitamins A, C, D, E, K.
From homeopathic remedies for the treatment of bile stasis, Galstena (tablets for resorption under the tongue and drops) and Hepar composite (solution in ampoules for parenteral use) can be used.
Both preparations contain many components, but each contains thistle (Silybum marianum) or milk thistle (in the form of an extract of plant seeds). Among the active substances of milk thistle, the flavonolignan complex (silibinin, silibin, isosilibin, silicristin, isosilicristin, silidianin and dihydroquercetin) has a particular benefit to the liver. Milk thistle also contains vitamin K and ω-6 fatty linoleic acid.
The drug Galsten stimulates the production of bile and activates its movement from the liver to the gall bladder and further, relieves spasms and inflammation. Doctors recommend taking this remedy one tablet (under the tongue) twice a day, drops - 7-10 drops three times a day (in between meals). In the instructions, adverse allergic reactions are noted, and only increased sensitivity is indicated in contraindications. However, Galstena contains Chelidonium majus, that is, celandine, and this plant is known to be toxic (due to the presence of isoquinoline alkaloids) and can cause cramps, intestinal cramps, salivation and uterine muscle contractions.
Homeopathic medicine Hepar compositum consists of 24 active substances (one of which is milk thistle). It is used by intramuscular or subcutaneous injection - one ampoule every 3-7 days for 3-6 weeks. Among the side effects marked urticaria and itching.
To date, depending on the etiology and localization of bile stasis, surgical treatment includes such types of surgical intervention as:
- laparoscopic removal of stones with gallstone disease and calculi of the bile ducts (endoscopic lithoextraction),
- removal of a cyst or tumor that prevents the outflow of bile,
- installation of stents in the bile ducts,
- balloon expansion (dilatation) of the lumen of the bile duct during obstruction,
- drainage of the common bile duct (choledochostomy),
- expansion of the gallbladder or its ducts with stenting and the formation of bilidigestive anastomoses,
- operations on the sphincters of the gallbladder,
- gallbladder removal (cholecystectomy).
With biliary atresia (see section - Stagnation of bile in a child), ducts in the liver are created surgically: children undergo reconstructive surgery (portoenterostomy) for the first two months, but liver transplantation may be required.
Among the variety of recipes for alternative treatment of this pathology, the most appropriate tips can be distinguished:
- To use for 1-1.5 months a mixture of home-prepared juices - carrot, apple and beetroot (in equal proportions), you should drink 150 ml of this juice (one hour after eating).
- Drink natural apple cider vinegar by adding a tablespoon to a cup of apple juice or water with lemon juice, you can put a teaspoon of honey in the same place.
- Take the mummy dissolved in water for two weeks (0.2 g per 500 ml tablet), drink the entire amount per day (in several doses, half an hour before meals). Between courses of application are advised to take 5-7-day breaks. And the full cycle of such mummy therapy can last 3-5 months. True, in the folk recipe it is not mentioned that with such volumes of use of this biostimulant, there may be diarrhea, increased heart rate and increased blood pressure.
Alternative treatment also suggests using oats and preparing a decoction from it: a tablespoon of whole grains is poured with two glasses of water and boiled for about half an hour, drunk 15-20 minutes before meals 3-4 times a day (drink the entire amount per day). However, it should be borne in mind that oats act as a laxative and lower blood pressure.
Persimmon with stagnation of bile will help to cope with diarrhea (for this it is recommended to prepare a decoction). Persimmon contains a lot of beta-carotene and vitamin C, as well as manganese, a cofactor for the synthesis of the antioxidant enzyme superoxide dismutase, which increases the stability of the mucous membranes. Other powerful antioxidants found in persimmons include lycopene and cryptoxanthin. But pomegranate not only promotes hematopoiesis, but also has choleretic properties, but this fruit contributes to constipation.
So, it is safer to use cholagogue herbs for stagnation of bile: medicinal smoky, sandy immortelle, bird highlander (knotweed), three-leafed shift, naked hernia, corn stigmas, melilot, gorse dye, mountain arnica. Decoctions are prepared and accepted, as well as pharmacy choleretic fees (see earlier).
Diet for stagnation of bile
The therapeutic diet for stagnation of bile is diet No. 5 and the introduction of certain restrictions and even prohibitions into the diet.
That is, fatty foods (animals and cooking fats, rich broths, fatty meat and fish, whole fatty milk, cream, butter, sour cream, etc.), canned food and meat gastronomy with preservatives, convenience foods and snacks, refined sugar should be excluded , fructose and sweets, bread and white flour buns. See also - Diet for diseases of the gallbladder
You need to eat: fresh vegetables and fruits, boiled, baked or stewed lean meat and poultry, seafood (source of protein), legumes (vegetable protein), healthy fats (walnuts, almonds, flaxseed, pumpkin seeds).
Whole grains are needed, such as brown rice, barley, oats, buckwheat, healthy oils with polyunsaturated fatty acids ω-3 and ω-6: olive oil, sesame oil, linseed oil.
Exercise for stagnation of bile
Doctors warn: without movement, all processes in the body, including the secretion of bile, are disturbed. Therefore, gymnastics with stagnation of bile is needed, but it should not aggravate pathology and exacerbate symptoms.
Walking is recommended (at least an hour a day), as well as such exercises for stagnation of bile, which do not need to do low forward bends, sharp turns, strong swing movements and jumps.
Remember the simple morning exercises: most of its elements are suitable for stagnation of bile. For example:
- Legs shoulder-width apart, arms on the belt - alternately rotate the body to the right and left sides.
- Legs shoulder-width apart, arms behind head — tilts left and right.
- In the same starting position - bend the right leg in the knee and reach for it with the elbow of the left hand, then bend the left leg and do the same with the elbow of the right hand.
- Lie on your back (legs are straight, arms are extended along the body), on inhalation the right leg bends at the knee closer to the stomach, on exhalation the initial position is assumed, the same is done with the other leg.
- Lying on your back, bend your legs at the knees, put the palm of one hand on your stomach, take deep breaths with raising your diaphragm and protruding the abdominal wall, and draw in your stomach as you exhale.
- Perform similar respiratory movements lying on the right and left side.
By the way, the last exercise is a kind of internal self-massage of almost all organs located exactly where bile congestion occurs. But a special therapeutic massage for bile stasis should be prescribed only by a doctor who has the results of an examination of the patient’s gall bladder and liver.
Why is cholestasis formed?
The congestive process in the gallbladder develops due to a violation of its work, as well as liver problems. Medicines and therapeutic physical exercises will help correct the situation, provided that they are regularly used. Treatment with alternative means of stagnation of bile helps to increase the effectiveness of the applied therapy, but any treatment at home should always be coordinated with the treating doctor.
Healing herbs can eliminate stagnation of bile in a child, this property is also actively used in pharmacology, where manufacturers produce some drugs based on plant extracts. The treatment of stagnation of bile in the gallbladder is often supplemented with herbs and phyto-collections in combination with dietary nutrition on table No. 5.
It is almost impossible to systematize all the possible causes of stagnation, but it is extremely necessary to find out the source. The doctor carefully chooses an effective regimen, which takes into account the age and condition of the patient. Cholestasis in children and pregnant women differs from the usual treatment of adult patients.
What factors provoke cholestasis?
- Abundant drinking regularly
- insufficient protein intake with an abundance of fat in daily diet foods, foods that are poorly absorbed,
- the presence of diabetes
- the use of certain drugs during the treatment of concomitant diseases. This is a tetracycline group, glucocorticoids and non-steroidal pain relievers,
- violation of the digestive process and absorption in the gastric and intestinal tract,
- polyp in the gallbladder, directed into the lumen,
- genetic predisposition.
Only a qualified specialist can understand what to do in this condition according to the factors provoking its development. These are gastroenterologists or therapists. These same doctors can tell how the polyp of the gallbladder is treated.
What is the danger of stagnation in the biliary system?
The gallbladder is necessary for the accumulation of bile and its release through the sphincter of Oddi into the duodenum. Secretion occurs when food enters the esophagus. Bile actively breaks down fats, contributes to the proper absorption of carbohydrates and proteins that are contained in food masses.
Stagnation in the gallbladder leads to excessive accumulation of bile (up to 300 ml), an increase in its viscosity and concentration. The process is accompanied by a violation of metabolic mechanisms and a decrease in ejection into the duodenum. If the bile secretion stagnates, this leads to an increase in bilirubin. When it accumulates in the ducts, the substance is reabsorbed into the blood and bilirubinemia occurs, which provokes intoxication of the body.
Types of Cholestasis
Clinical medicine combines under the term cholestasis a complex of changes in liver cells and bile ducts.
Cholestasis is distinguished by the place of its appearance:
- outside the liver (extrahepatic),
- inside the liver (intrahepatic),
- icteric or without jaundice,
Bile stasis inside the liver can be accompanied by cell bilirubinostasis, it is noted in cases where bile stagnates in the liver cells, as well as canalicular bilirubinostasis, when the substance is in the form of small drops in the liver canaliculi.With cholestasis outside the liver, the substance accumulates in the bile ducts, the interlobular parts of which are expanded.
Most often, stagnant bile can be found with stones in the bile duct, causing changes in the hepatic parenchyma. In this case, the study of bile resembles a small lake. In the acute phase, a change occurs in the tissues affected by blood clots. The cell membranes are broken and the permeability in the cells is greatly increased. The manifestation of microabscesses due to tissue edema is possible.
How is the development of cholestasis?
The development of congestion in the gallbladder is influenced by several factors, some of which lead to the development of cholecystitis:
Also, cholestasis can occur with congenital anomalies in the structure, as well as from the effect of stress hormones - cortisol, norepinephrine and adrenaline. They inhibit the contractile function of the gallbladder and provoke stagnation. An increase in the viscosity of bile can occur with an increased cholesterol.
Consequences of cholestasis
What threatens the lack of treatment of cholestasis for the patient:
- the appearance of osteoporosis due to a malfunction in the absorption of vitamins D and A,
- dyspepsia in the form of alternating diarrhea and constipation due to the evacuation of food masses from the intestine in an unsplit form,
- the formation of stones or sand due to thick bile and biliary sludge,
- reproduction of pathogenic bacteria,
- transition of stagnation to pancreatitis and acute cholecystitis, hepatic hepatosis.
The most striking signs of stagnation of bile are as follows:
- constant nausea and belching, bitterness in the mouth, vomiting reflex,
- in the area of the right hypochondrium there is a dull dull pain,
- it smells bad from the mouth
- possible yellowness of the skin and eye sclera.
First of all, the patient should pay attention to itchy skin. This is the body’s first signal of stagnation. Then feces become discolored, urine becomes dark.
Symptoms of stagnation in children
In children, cholestasis may also appear, while the pathology has the following reasons:
- damage to the bile duct with roundworms, foci of reproduction overlap the lumen (parasites should be disposed of with antibiotics),
- narrowing of Vater's nipple, congenital anomaly in the distal duct,
- disturbances in the work of the sphincter of Oddi, responsible for the release of bile. There is a functional or organic disorder that is more difficult to remove.
If stagnation is not treated, cholecystitis and noticeable symptoms appear:
- itchy skin in the limbs and forearm, chest and stomach, buttocks can also be affected,
- in the upper right side of the stomach there is pain under the ribs,
- the skin turns yellow
- xanthoma is manifested, a slight bulge on the skin, a soft touch with a yellow tint. It is found near the eyes, on the palms of the child, at the neck and on the back, under the mammary glands.
How to treat cholestasis?
Before treating stagnation of bile, it is necessary to undergo a comprehensive diagnosis to determine adequate therapy. Any therapy should be carried out comprehensively. The course of taking traditional medicines, which eliminates stagnation, is supplemented by folk remedies, then treatment is carried out at home. Physical complexes and medical diet are connected.
It is important to know! 78% of people with gallbladder disease suffer from liver problems! Doctors strongly recommend that patients with gallbladder disease undergo a liver cleanse at least once every six months. Read more.
How to cure cholestasis in the liver and biliary system? Only comprehensively, first of all, in the treatment regimen include the following groups of drugs:
- antibacterial agents
- cholekinetics that reduce the number of contractions of the gallbladder,
- choleretics to improve bile synthesis,
- anti-vomiting drugs.
Stagnation of bile in the gallbladder is traditionally treated with Holosas, Flamin, Berberin-Gommakord, Sorbitol.Mannitol, Cholemax and Magnesia solution are also effective.
Tinctures and decoctions of medicinal herbs will help improve the composition in bile and normalize its passage through the ducts. If stagnation has formed, traditional medicine experts recommend the following plants for use:
- phyto-collection from the bark of buckthorn, mint, immortelle, wormwood and St. John's wort. Brewed like tea. Regular intake ensures the normal functioning of the intestinal tract. The presence of an immortelle contributes to the withdrawal of bile, which will prevent stagnation,
- a decoction of rose hips, you can add stigmas of corn and mint to the mixture,
- a decoction of coriander seeds can be supplemented with aloe leaves, ginseng, yarrow, mint and calendula. A mixture of these plants has always been used as a cleaning agent for stagnation and viscosity of the secretion of the biliary system,
- when taking corn (unrefined) or sunflower oil, bile secretion can be stimulated. One spoon is used on an empty stomach, 40 minutes before breakfast,
- removes stagnation of beetroot juice. To do this, it is taken on an empty stomach, you can drink a little oil before taking it, since in its pure form it can greatly irritate the mucous membranes in the gastric tract,
- valerian or motherwort tablets will be useful for normalizing the nervous system.
The effectiveness of the tubing has been proven by clinical practice. This procedure is called blind sensing using mineral water.
It is necessary to dissolve a spoonful of magnesia in a glass of water, add salt. Take an infusion in the morning on a day off, on an empty stomach. After that, it is necessary to lie on your left side and wrap yourself warmly by putting it on the right heating pad with warm water. After 2 hours, remove heat, you can still lie down. Determination of effectiveness occurs according to the act of defecation - green discharge means the release of bile. Contraindicated in pregnancy.
The diet of every day with congestion is compiled on the basis of a balanced content of proteins, carbohydrates and fats. You must stop eating pickled, spicy, smoked and salty foods. Mucous soups and boiled cereals should be consumed more than usual, they also increase the number of dairy products, low-fat fish and meat. Useful will be the use of mineral water, the composition of which the attending doctor will tell. Food is carried out in strict mode, without skipping reception. A portion is cut to 300 gr.
If there is stagnation of bile in the gallbladder, experts recommend dry, non-fried pumpkin seeds containing alkaloids. These substances can contribute to the production of bile, and also eliminate parasites - nematodes. It is necessary to monitor the level of cholesterol, in case of its increase, the doctor prescribes a traditional drug that fights the increase to normal levels.
What else can eliminate stagnation?
It is recommended, in the absence of exacerbation, to introduce complexes of therapeutic exercises. This will help to avoid unpleasant symptoms characteristic of stagnation of bile. Physiotherapy is considered no less important component of the complex treatment of cholestasis than taking medication or diet. Exercises are performed to improve bile flow. It can be an inclination to the legs or a well-known “birch”.
Visceral massage can be added to the exercises. To do this, push the fist on the projection zone of the gallbladder. Uniform pressure allows you to massage the body deep enough, which means an improvement in the movement of bile and permeability in the ducts. It is important to get a doctor’s recommendation that takes into account possible contraindications. With stones or polyps that hit the gallbladder, this type of massage is not recommended.
The biliary system closely interacts with the work of the main laboratory of the human body - the liver.Directly in it, bile is formed, which takes a diverse part in digestion. The bile produced by the liver enters the bile ducts into the gall bladder and then into the intestines, where it is involved in the complex process of chemical and mechanical processing of food. Violations of its outflow lead to failures in the process of digestion and absorption of fats and other substances of a lipid nature.
Thus, bile is a kind of launch of the entire chain of transformations necessary for the complete assimilation of food. Normal digestion is impossible without it.
If problems arise in the described ligament, the liver is first affected, which also took care of the correct ratio of substances in the composition of bile. And their imbalance cannot prevent precipitation and the formation of cholelithiasis.
Stagnation of bile in the gallbladder complicates the work of all organs of the digestive system, contributes to a failure in the metabolism.
The role of bile in digestion
The disturbed outflow of bile, its irregular inflow into the intestinal lumen is reflected in the whole organism. Being a biochemical multicomponent substrate, bile provides a number of important functional processes:
- emulsification of fats,
- neutralization of hydrochloric acid and the proteolytic enzyme pepsin,
- activation of pancreatic enzymes,
- fixation of enzymes on the villi,
- support and improvement of intestinal motility and tone,
- antiprotozoal and antibacterial effect (withdrawal of medicinal and toxic substances).
Stagnation of bile in the gallbladder can be associated with the occurrence of functional disorders of the motility of this organ and sphincter apparatus. The reason for the failure lies in the insufficient, untimely or excessive reduction of these organs. We are talking about violations of the biliary tract - dyskinesia, which can be primary and secondary.
The causes of primary dyskinesias are a disorder of the autonomic nervous system, neurosis, hereditary predisposition, physical inactivity, endocrine pathologies, chronic food poisoning, atopic diathesis, and food allergy. An important factor is also errors in the diet. This is an irregular diet, excessive consumption of fried, fatty foods.
The causes of secondary dyskinesias are abnormalities of the development of bile, a transferred form of viral hepatitis, a chronic form of gastroduodenal pathology, parasitic infections (giardiasis and others).
There are two forms of dyskinesia:
- hypertonic, or hyperkinetic (increased tone of the gallbladder),
- hypotonic (decreased bile tone).
These variants of dyskinesias are often combined with hypertension or hypotension of biliary tract sphincters and Oddi sphincter. At the beginning of the disease, the first forms of pathology prevail, with a long course, its hypokinetic variants develop.
Clinical manifestations suggest bile congestion in the gallbladder. Symptoms of the disease are quite characteristic and are expressed in the form of pain in the right hypochondrium, vomiting, nausea, and a feeling of heaviness.
With hypokinetic dyskinesia, the pain on the right side in the hypochondrium may not be strong, but rather long, dull, bursting. Hypertensive type dyskinesia is characterized by acute, colicky pain in the hypochondrium, often extending to the right scapula. Nausea and heartburn may occur.
Digestive disorders caused by stagnation of bile are often caused by anomalies of the biliary tract. These can be congenital malformations and developmental defects: atresia, abnormal forms of the hepatic ducts and anomalies of the gallbladder itself. Such modifications are also possible among the deformations of the last organ, such as its constriction, bending of the neck, twisting and others. They are congenital and acquired, and can be deformed in the process of human life.The most common is kink of the gallbladder. Stagnation of bile with such a modification of the organ is inevitable. Anatomical disorders are fraught with the development of cholelithiasis, digestive disorders, chronic inflammation.
Deformation of this organ is often diagnosed in the elderly. With kidney diseases, omission of organs, deformation of the gallbladder is also often detected. Stagnation of bile in such cases also causes digestive disorders and is manifested by such uncomfortable sensations as pains felt in the right hypochondrium and often radiating to the sternum, intestines, and right clavicle.
The liver suffers regardless of the reasons that provoked stagnation of bile in the gallbladder. Symptoms that indicate a violation in the work of an organ that plays an important role in digestion immediately manifest themselves in a deterioration in overall well-being. There are complaints of weakness, constant fatigue and lethargy. The most characteristic sign of stagnation of bile is pain in the right hypochondrium. Moreover, with reduced dyskinesia, it is dull and bursting, with hyperkinetic - paroxysmal.
Stagnation of bile in the gallbladder is also expressed by such signs as a feeling of bitterness, belching, nausea, broken stools, itching of the skin, slight yellowing of the sclera of the eyes, and possibly the skin.
Stagnation of bile during deformations of the gallbladder due to its inflammation directly affects the general condition of the patient. In this case, the characteristic signs are the taste of bitterness in the mouth, increased sweating, and changes in the color of the skin on the face are possible. It takes on a grayish tint.
Treatment based on alternative methods is permissible only as a supplement to the main drug therapy. But at the same time, consultation with your doctor is mandatory. It is he who must pick up healing broths and infusions that normalize the outflow of bile, improve the liver, and help it recover.
For the preparation of decoctions, such medicinal plants as immortelle flowers, peppermint, rosehips, medicinal dandelion, corn stigmas, dill seeds, barberry root, and others are usually recommended.
What it is
The disease developing as a result of stagnation of bile is called cholestasis. The main signs of its initial stage are loss of appetite, the appearance of a bitter taste in the mouth, stool disorders in the form of constipation and pain in the right hypochondrium. Since the role of the liver in the body is very large, changes in its condition do not allow to fully perform its functions. This primarily affects metabolic processes, as well as inadequate cleansing of the body of unnecessary substances and toxins obtained in the course of its life. As a result, a person’s well-being worsens, he becomes lethargic, with a feeling of constant fatigue.
Bile plays an important role in the functioning of the liver and gall bladder itself; disturbances in their condition affect the digestion process and the absorption of nutrients. Due to the content of specific bile acids in it, it is involved in the breakdown of fats and removes excess cholesterol.
Cholestasis can be of several types in the form of intrahepatic and extrahepatic, and stagnation of bile can take an acute or chronic form. Extrahepatic - most often develops from compression of the bile ducts with cholelithiasis, and intrahepatic stasis is a consequence of inflammation inside the organ itself.
According to the form of the development of the process with the formation of stagnation of bile, cholestasis is divided into several types:
- Morphological, with the accumulation of bile in the ducts of an organ,
- Functional, expressed in slowing down the outflow rate of bile contents in violation of the ratio of components in its composition,
- Clinical when any components of bile penetrate the blood.
Pathological changes in the gallbladder can take on an icteric or anicteric form of the skin. There are differences in the disease in connection with the mechanism of development of cholestasis in the form of a total condition in which bile does not penetrate into the duodenum, partial when the intake occurs, but in a much smaller amount. There is another type of violation in the work of the gallbladder with a change in its basic functions, this refers to a dissociative state, manifested in a delay in the release of not all bile, but its individual components.
How is bile stasis treated?
Treatment of biliary congestion occurs in the form of an etiological and symptomatic direction. If the cause of pathological changes in the state of the gallbladder is eliminated, then the chosen direction is used as the main one. If it is impossible to eliminate the etiology of the disease, use therapy, the purpose of which is to reduce the severity of the symptoms of the disease. In the treatment of using hepatoprotectors, choleretic drugs, antispasmodics, anti-inflammatory and antibacterial drugs. In some cases, when bile congestion is accompanied by jaundice and itching of the skin, enterosorbents are prescribed to remove excess bilirubin and bile acids from the intestines.
In addition to pharmacy drugs, the relief of patients is facilitated by the use of choleretic fees based on medicinal plants, which are brewed and consumed in the form of tea. As a choleretic agent, rose hips or ready-made syrup Holosas are used. A course of vitamin therapy with the use of B vitamins, as well as A, E, C, K or multivitamin complexes is considered mandatory.
Stagnation of bile in the gallbladder cannot be removed without the use of medications designed to eliminate itching of the skin, improve the outflow of urine, and also to restore the liver itself. In this capacity, the following medications are prescribed to the patient:
- Antipruritic topical products in the form of ointment, cream or gel,
- Hepatoprotective agents
- Drugs that improve the outflow of bile,
- Antibiotics as choleretics for the production of bile and cholekinetics to reduce the gallbladder,
- Medications with antihistamine effect.
In order to rinse the bile ducts and facilitate the passage of bile, duodenal sounding is performed with warm mineral water. If it is not possible to eliminate stagnation in the gallbladder using traditional therapeutic methods, an operation can be performed on the patient, with the help of which the bile ducts are dilated using an endoscope.
Treatment in the presence of stagnation of bile in the gallbladder is prescribed only by a doctor, otherwise uncontrolled medication can cause the formation of stones in this organ.
In addition to pharmacy drugs to eliminate stagnation of bile, you can use recipes of traditional medicine, from a variety of which you can choose the most suitable for each patient, namely:
- For a month and a half, use a mixture of juices that are prepared on their own and drunk freshly prepared. In this capacity, carrot, beet and apple juices mixed in equal amounts will be most effective. This mixture is drunk an hour after eating in an amount of 150 ml.
- Natural apple cider vinegar will bring benefits, a teaspoon of which is added to any drink or water with lemon and honey.
- Mummy dissolved in water can alleviate the condition of patients. To this end, 0.2 g of the mummy is dissolved in 0.5 l of water and drunk during the day for several meals before meals.
- A decoction of oats improves the flow of bile and is considered an effective tool for the treatment of this pathological condition. For cooking 1 tbsp. Lodge. Grains are brewed with two glasses of boiling water and kept on low heat for about half an hour. Drink the entire amount 20 minutes before meals during the day.
- As medicinal plants for cholestasis, they use bird knotweed, immortelle sand, corn stigmas, melilot, yarrow, arnica and many others. You can also use ready-made choleretic fees, which are on sale in every pharmacy.
However, when using any folk remedy, you must first consult with your doctor. It is impossible to appoint and take any means to eliminate biliary congestion on your own.
Diet therapy for stagnation of bile
Of great importance in the treatment of congestion in the gallbladder is proper nutrition, which includes the restriction of certain products and even a complete rejection of them. For this category of patients, diet number 5 is used, which provides for the exclusion of fatty foods, canned foods, processed foods, and this list also contains foods with a high content of carbohydrates, sugar, fructose and any sweets. It is recommended to include in the daily diet more fresh vegetables and fruits, a source of protein in the form of seafood, boiled lean meat and poultry, all kinds of legumes, nuts, a wide variety of cereals, olive, sesame or linseed oil.
Stimulation of the outflow of bile can be carried out using a tube, a procedure that relaxes the circular muscles of the gallbladder, its ducts and sphincters. Simultaneously with these processes, there is a reduction in the smooth muscles that form the walls of these organs. As a result of the changes, conditions are created for the unobstructed outflow of bile into the cavity of the duodenum and its participation in digestion.
Tubing can take place in two ways:
- Probe tube using a duodenal probe inserted through the mouth and esophagus,
- Probeless tube with the use of choleretic drugs.
If the probe procedure is performed on an outpatient basis or even in a hospital, the probeless method is simpler and more affordable. It can be carried out at home on the recommendation of a doctor.
A procedure such as massage can only be performed after a preliminary ultrasound. This study will show the presence or absence of stones in the gallbladder, which as a result of massage movements can budge and lead to blockage of the bile ducts. In the absence of contraindications, massage in the region of the gallbladder is carried out independently, and as a result of its influence, the peristalsis of this organ increases and the bile moves more quickly along the bile ducts.
They carry out the procedure in a supine position, and you need to tune in that it will not be a very pleasant sensation and in some cases even painful. During the massage, the pain point in the right hypochondrium is determined, and by connecting the fingers in the form of a beam, the body area around this point is massaged. Such circular motions are repeated at least six times, moving in a clockwise direction.
The second movement is carried out while sitting, breathing in, protruding the stomach and pushing the fist on the liver, you can move the fist up and down. When you exhale, the stomach is pulled in and the fist pressure is weakened. After these movements, it is recommended to hold the breath for several seconds.
Return to supine position, during exhalation, retract the abdomen and massage the liver area with the palm of your hand for two minutes in a clockwise direction. When breathing in, pressure is relaxed.
What can be the complications of the disease?
In case of violation of the outflow of bile, normal and complete splitting and absorption of fats does not occur.They are not processed into the bloodstream, which will lead to impaired functions of various organs, primarily to the development of diabetes. The development of atherosclerosis is also often caused by the accumulation of bile, as it contains cholesterol. During stagnation, an excess of this substance is not excreted from the body, causing sclerotic changes in the state of the vessels. With stagnation of bile in the gallbladder, the likelihood of calculus formation in this organ increases.
With an untimely withdrawal of bile, the gall bladder and liver ducts suffer, as a result of inflammation in them, liver tissue changes with the development of necrotic processes in separate parts of the parenchyma. Untimely medical care and lack of treatment can lead to conditions such as:
- The development of gastritis as a result of the accumulation of bilirubin and general intoxication of the body.
- Vitamin deficiency - due to metabolic disorders.
- Provoke diseases with cholecystitis and cholangitis.
- Cause cholelithiasis.
- Lead to a serious complication in the form of cirrhosis.
- Disrupt liver function and lead to liver failure.
- Violation of the skeletal system with the development of osteoporosis.
- The last stages of the disease with the occurrence of stagnation of bile in the gallbladder can lead to death.
In order to prevent the development of such complications, it is necessary to follow the recommendations of specialists and follow all the rules for the prevention of such changes in the gallbladder.
Danger of disease
Cholestasis triggers the development of cholecystitis, osteoporosis, liver failure, cirrhosis. Crystals form in the gallbladder and stones form. Blockage of the ducts is accompanied by intolerable pain. Often the way out is surgery to remove the gallbladder along with stones. Procrastination may result in the death of the patient.
Causes of Cholestasis
Problems with the liver lead to stagnation of bile when its cells cease to function due to high-calorie foods, which contain a lot of animal fats, preservatives, and dyes.
The second reason is associated with the tone of the bile ducts, and it depends on the state of the nervous system, its autonomic department, which controls all vital processes in the body. As a result of overwork, neurosis, stress spasms occur, which leads to a violation of the outflow of bile.
One-time bursts of emotions are not terrible, but regular shaking of the psyche leads to chronic spasms and provoke stagnation of bile in the gallbladder. Even children who have nervous excitability above normal suffer from dyskinesia of the ducts of the liver, cholecystitis and gastritis. Four provoking factors lead to stagnation of bile.
In particular, the accumulation of roundworms in the biliary tract, which provokes jaundice of a mechanical nature. Helminthiasis manifests itself in the form of bursting pain in the right hypochondrium, itching, nausea, and vomiting. The addition of pathogenic bacteria leads to purulent inflammation and liver abscesses.
When infected with echinococcus, a parasitic cyst develops, which presses on the bile ducts and provokes cholestasis. Like an enlarged liver, it is detected by palpation.
May be congenital or acquired. Kinks occur in different parts of the tank. Detected by accident. A modified organ is not able to cope with physiological functions. There is a lack of secreted bile, since it is not excreted in full, which causes stagnation. Outwardly, pathology does not occur, occasionally, appetite loss, nausea, flatulence, discomfort in the upper right abdomen may disturb.
Modern gastroenterology associates the causes of cholestasis mainly with liver injuries of a medicinal, alcoholic, toxic or viral nature.
A patient diagnosed with cholestasis can be recognized by the following signs of stagnation:
- Very tired at work.
- There are few vegetables, cereals, a lot of fast food, fatty foods, and flour products in the diet.
- Rarely eats, breakfast is practically absent, but dinner is always plentiful.
- Low stress resistance, insomnia, pain in the right hypochondrium.
- Had hepatitis, was treated for worms.
Stagnation of bile leads to the following serious complications in youth:
- Unstable chair.
- Tendency to allergies.
- Bad skin.
- Constant fatigue.
In adulthood, the following are diagnosed:
Cholestasis is detected through physical examination, history taking, as well as laboratory and instrumental studies using various methods, including:
- Complete blood count with the identification of hemoglobin level, white blood cell count, ESR.
- Biochemical blood test Treatment of stagnation of bile is impossible without identifying such components as alkaline phosphatase, hepatic enzymes, and cholesterol during the diagnosis process.
- Urine test to detect bile pigment.
- Assessment of immune status.
- Fecal analysis for the detection of worm eggs.
Among instrumental methods, those are assigned that allow you to visualize the liver, gall bladder and duct system. This is achieved, as a rule, in the process of ultrasound. Clarify the diagnosis using the method of retrograde endoscopic cholangiopancreatography.
Pharmacologists offer a large arsenal of choleretic drugs. Self-administration is extremely dangerous. The fact is that under the influence of drugs, the existing stones begin to move and with their sharp edges can break the bile ducts.
You can treat cholestasis using the following drugs:
- Hepatoprotective actions that protect liver cells from destruction and restore efficiency.
- From the group of choleretics, enhancing the secretion of bile and diluting it. Among them are yellow Allohol tablets.
- Ursodeoxycholic acid from the composition of drugs to reduce the concentration of bad cholesterol in the blood. In addition, it dissolves calculi. True, treatment involves a long therapeutic course (at least 30 days).
- Anthelmintic, bactericidal pharmacy compounds.
- Antihistamines. Antispasmodics that dilate the bile ducts.
- Antioxidants and vitamin and mineral complexes.
Stagnation of bile in pregnant women
The issue under consideration often worries expectant mothers in the last trimester. This is due to the relaxing effect of the hormone progesterone, which leads to incomplete emptying of the gallbladder, the appearance of stones in it. The same consequences arise due to a growing uterus, diabetes mellitus, excess weight, infection of the pregnant woman.
The condition is dangerous for both the woman and the fetus. Diet therapy is recommended, during an attack, taking No-shpa or Papaverine. With increased pain, urgent hospitalization will be required. In emergency cases, surgery is possible.
Features of treatment in children
The selection of therapeutic measures is influenced by the clinical picture and the baby’s reaction to the medicines used. Among them:
- Vitamins K, E, D, A, supporting the vital functions of the body.
- Triglycerides that restore fat absorption, reduce steatorrhea, and improve calorie absorption.
- Taking Phenobarbital to reduce skin itching, increase the production of bile acids.
- The use of cholestyramine in the absence of problems with duct obstruction.
Treatment is often adjusted by a pediatrician, which helps prevent the development of unpleasant consequences.
Those who have biliary tract dysfunction may experience conditions such as:
- Dry skin, its darkening. This is due to a deficiency of vitamins, as well as an excess of bilirubin.
- Gallstone disease and, as a result, obstruction of the ducts.
- Contraction of the gallbladder and the resulting aching pain.
- Alternating diarrhea and constipation.
- In a healthy body, the elimination of harmful metabolites occurs along with bile, so stagnation causes tissue intoxication.
- Delayed severe cholesterol disrupts peripheral as well as cerebral circulation.
- The result of insufficient digestion of nutrients is a sharp weight loss.
- Immunity disorders due to lack of energy and fat.
Bile is a dark brown with a green tint liquid, which consists of digestive enzymes, proteins, amino acids, bile acids, salts, fats, vitamins and other substances. The production of bile occurs in the cells of the liver, and storage - in the gall bladder.
The main function of bile is participation in the digestive processes, namely:
- emulsification of fats,
- dissolution of fat breakdown products,
- increased activity of pancreatic juice enzymes,
- stimulation of the formation of bile in hepatocytes,
- stimulation of bile secretion by the gallbladder,
- stimulation of intestinal motility,
- neutralization of the acidity of the chyme and pepsin blockade in the chyme entering the duodenum,
- help in absorbing nutrients from the intestines,
- stop the growth and reproduction of pathogenic organisms in the intestine.
Stagnation of bile in the liver and gall bladder: causes
All causes of stagnation of bile in the gallbladder and liver are divided into 3 groups.
- Dysfunction of the liver and bile ducts.
- Diseases of the internal organs.
- Harmful environmental factors.
But if we talk about specific factors that violate the secretion of bile from the gallbladder, then they can the following prerequisites:
- improper and unbalanced nutrition. Overeating, fasting, dry food, the prevalence of fatty, fried or spicy foods in the daily diet,
- exacerbation of chronic diseases of the digestive system on the background of a strict diet,
- sudden changes in diet,
- severe psycho-emotional shock,
- pelvic diseases,
- peptic ulcer of the stomach and duodenum,
- intestinal infections
- food poisoning
- bad habits (alcohol abuse, smoking),
- taking certain groups of drugs (non-steroidal anti-inflammatory, hormonal and antibacterial agents),
- sedentary lifestyle,
- congenital diseases of the gallbladder and biliary tract,
- genetic addiction
- chronic inflammation of the pancreas,
- food allergy
- atopic dermatitis,
- endocrine diseases (diabetes, obesity),
- gallbladder removal and others.
Stagnation of bile in the gallbladder: symptoms
Stagnation of bile in the gallbladder in medicine is called cholestasis.
With stagnation of bile, the symptoms may be as follows:
- constant taste of bitterness in the mouth,
- nausea sometimes with vomiting,
- occasional heartburn,
- bad breath
- belching bitter
- epigastric pain and right hypochondrium,
- disruption of the intestines in the form of diarrhea,
- acholic feces. Feces become light due to the lack of stercobilin pigment in it,
- urine the color of dark beer
- general weakness
- fast fatiguability,
- itchy skin
- the appearance of rashes on the skin,
- yellowing of the skin, especially the sclera and mucous membrane under the tongue,
- sleep rhythm disturbance: insomnia at night and sleepiness during the day.
Cholestasis in pregnant women
Stagnation of bile in pregnant women is a fairly common problem, since hormonal changes occur in the body: the level of progesterone increases by several times, which relaxes all smooth muscle muscles, including the biliary tract.
An important role in the development of stagnation of urine is played by an increase in the size of the uterus and the displacement of the abdominal organs upward, as a result of which an excess of the gallbladder or its duct can occur.
Most often, signs of cholestasis appear in the third trimester of pregnancy.The clinical picture of stagnation of bile in pregnant women is the same as in non-pregnant women.
Stagnation of bile after removal of the gallbladder: symptoms and treatment
The operation during which the gallbladder is removed is called cholecystectomy. The main indication for such surgery is cholelithiasis.
Very often after cholecystectomy, patients develop symptoms such as:
- pain under the right rib and epigastrium, which can radiate to the right shoulder and shoulder blade,
- yellowing of the skin
- itching of the skin,
- bitter taste in the mouth
- stool instability,
This symptom complex is called postcholecystectomy syndrome.
The most common cause of this syndrome is the presence of calculi in the biliary tract. Indeed, cholecystectomy with gallstone disease does not exclude the appearance of new calculi in the biliary tract.
If pain occurs, patients are prescribed antispasmodics (No-shpa, Drotaverin, Riabal).
In violation of digestive processes, the use of enzymatic preparations is indicated, such as Festal, Mezim, Panzinorm.
With the ineffectiveness of conservative therapy, surgical treatment is indicated, during which the obstruction of the outflow of bile in the bile ducts is eliminated.
What is the danger of stagnation of bile?
Bile stasis syndrome threatens with the following consequences:
- insufficient absorption of calcium in the body, which is manifested by osteoporosis,
- cirrhosis of the liver,
- vitamin deficiency
- the development of inflammation of the biliary tract and gall bladder,
- liver failure.
What diagnostic methods are used for stagnation of bile?
The main methods for diagnosing cholestasis are biochemical analysis of blood and bile, duodenal sounding, as well as ultrasound of the abdominal organs.
In the biochemical analysis of blood, the main sign of stagnation of bile is an increase in the level of total bilirubin. Also, depending on the causes of cholestasis, a change in the amount and balance of proteins, the appearance of C-reactive protein, and an increase in hepatic transaminases can be determined.
Bile is taken in the process of duodenal sounding. Also, this method makes it possible to estimate the rate of bile secretion into the duodenum and its amount.
Biochemical analysis of bile allows you to evaluate the composition of bile.
With the help of ultrasound examination of the liver and biliary tract, birth defects, calculi and the presence of functional disorders can be detected.
As an additional diagnosis, cholecystography and cholangiography can be used. These methods are radiological imaging of the biliary tract and gall bladder using contrasts.
For the treatment of cholestasis, the attending doctor can prescribe the following groups of drugs:
- hepatoprotectors - drugs that protect and restore liver cells. The drugs of choice may be Heptral, Essential, Silibor, Gepabene and others,
- antispasmodics that help relieve spasm of the biliary tract and gall bladder, and, accordingly, relieve pain. For this purpose, No-shpa, Spazmolgon, Riabal and other antispasmodic drugs are used,
- painkillers (Analgin, Baralgin, Ketanov, Ibuprofen and others), which are used for severe pain in the right hypochondrium.
- cholekinetics - agents that improve the outflow of bile. High efficacy in cholestasis is observed in such drugs as Holosas, Sorbitol, Cholecystokinin, Xylitol and magnesium sulfate,
- antibacterial drugs that are indicated for signs of inflammation in the gallbladder and biliary tract. In this case, Biseptol, Metronidazole, Clarithromycin or Ciprofloxacin can be used,
- antihistamines, the purpose of which is to reduce skin itching.The most commonly prescribed are diphenhydramine, cetrin, tavegil and suprastin,
- antipruritic drugs (creams, gels, ointments), the use of which is justified for severe itching of the skin.
Also, with cholestasis, therapeutic duodenal sounding can be used, during which the bile duct is washed with warm mineral water.
With unsuccessful conservative treatment, various types of surgical interventions (endoscopic expansion of the bile duct, removal of calculi, cholecystectomy) are performed.
Treatment with folk remedies for stagnation of bile in the body
The most effective and safe traditional medicine that are used for stagnation of bile are the following:
- treatment with herbs that have a choleretic effect. Highly effective are decoction of peppermint, wormwood, shift, St. John's wort or immortelle, as well as a decoction of rose hips. Decoctions and infusions from choleretic herbs take 20 minutes before meals,
- daily consumption of raw pumpkin seeds in the morning on an empty stomach
- consumption of freshly squeezed beet juice half an hour before a meal,
- gallbladder massage
- exercises that strengthen the muscles of the anterior abdominal wall,
- tyubazh. To do this, drink 250 ml of magnesium sulfate solution on an empty stomach (1 tablespoon of magnesia per 250 ml of water), lie on the left side, and put a heating pad on the right hypochondrium. This procedure helps to improve the outflow of bile.
Stagnation of bile in cats and dogs: causes, symptoms and treatment
The first place among the causes of stagnation of bile in pets is taken by parasitic and helminthic invasions, namely opisthorchiasis, alveococcosis and echinococcosis.
Other causes of cholestasis in animals include liver and gall bladder cancer, cholelithiasis, poisoning, and infectious diseases.
You can suspect stagnation of bile in a dog or cat by the following signs:
- yellowness of the sclera, mucous membranes and skin,
- increased appetite or refusal to eat,
- weight loss,
- stool discoloration
- dark urine
- increased bleeding wounds,
- lethargy and drowsiness.
The treatment of cholestasis in cats and dogs is based on the same principles as in humans. First of all, it is necessary to eliminate the cause - remove parasites and worms, remove stones or tumors of the gallbladder and paths.
Drug therapy involves the use of antispasmodics, painkillers, choleretic and enzyme preparations.