For cholecystitis is characterized by pain or heaviness in the right hypochondrium after exercise, plentiful food intake, ingestion of fatty or fried foods, after excitement, with hypothermia. The pains may be dull, aching, or intense. Pain in cholecystitis can be given in the right hand, right shoulder blade.
Patients are also worried about nausea, empty belching, feeling of bitterness in the mouth. Possible increase in body temperature.
The development of acute and chronic cholecystitis predispose bile stasis and damage to the walls of the gallbladder.
Stagnant bile contribute to:
- violation of the diet (long breaks between meals, food dry rations);
- sedentary lifestyle;
- metabolic disorders ( diabetes, obesity, atherosclerosis );
- obstacles to the flow of bile ( opistorhi , for example).
Damage to the walls of the gallbladder can be caused by:
- bile with altered physicochemical properties;
- pancreatic enzymes flowing into the bile duct;
- gallbladder injuries.
Bed rest is shown only during an exacerbation, accompanied by abdominal pain, temperature. Long-term restrictions in movements adversely affect the course of cholecystitis, as they contribute to the stagnation of bile.
During an attack of biliary colic, it is important to eliminate pain syndrome as soon as possible. To this end, you can apply no-silos, spasmolitin .
During an attack of pain, apply moderate heat to the area of the right hypochondrium in the form of non-heated hot-water bottles, a warming compress.
The indication for the treatment of cholecystitis with antibiotics is an exacerbation of the inflammatory process in the biliary tract, accompanied by pain, temperature. The course of antibiotic therapy is non-durable (7-10 days). Antibiotics for cholecystitis should be used in combination with baktisubtil and always with vitamins (C, groups B, A).
They resort to broad-spectrum antibiotics – ampioks, amoxicillin, amoxiclav . If giardias are found in bile, treatment with antiglance agents is necessary.
Vitamin therapy (in the acute period, vitamins A, C, B1, B2, PP, and further courses of vitamins B6 and B12, B15, B5, E) should be a mandatory part of the treatment of patients with cholecystitis.
In the treatment of patients with cholecystitis, it is necessary to widely use cholagogue preparations, since, by reducing the stagnation of bile in the affected bladder, they also contribute to the more rapid elimination of inflammatory changes in it.
Most often combine magnesium sulfate as a 5% or 10% – of the solution according to the tea, dessert or tablespoon three times daily holosas (1 teaspoon three times a day), holagonom (tablets 2-3 times daily) or medicinal herbs.
One of the main factors in the treatment of patients with cholecystitis is diet . Some increase in meals is required (up to 4-6 times), as this will improve the flow of bile.
Food enrichment with bran bread, cottage cheese, egg white, oatmeal, cod, and yeast drinks is desirable.
Patients with cholecystitis poorly tolerate fat, fatty meats, poultry, fish. From animal fats it is recommended to use only butter. Very useful vegetable oils (corn, sunflower, olive). The unsaturated fatty acids ( arachidonic , linoleic, linolenic) contained in them stimulate bile secretion, improve the functional state of the liver. Vegetable oils should be added to vinaigrettes, salads, sauerkraut or given in tea, dessert, tablespoon 2-3 times a day before meals. Of carbohydrates limit only foods that contain a lot of poorly digestible fiber (cabbage, turnip, etc.). The amount of fluid increases as it improves the flow of bile.
Patients with exacerbation of cholecystitis are recommended only vegetarian soups. Exclude fried dishes (especially breaded), very cold drinks and dishes (ice cream, products from the refrigerator), seasonings (vinegar, pepper, garlic, onions, roots, mustard, horseradish), mushrooms, all sausages, ham, smoked meats, canned food, short pastry, cream cakes, any fried pies, pancakes, coffee and cocoa.
Dairy, vegetarian and fruit soups are given to the patient, from second courses – boiled vegetables in any form, cereals, puddings, boiled fish and meat (with the exception of pork, lamb, game meat, brains, kidneys as rich in extractive substances). Drinks are allowed – weak tea, compote, fruit drink, jelly, juices (but unpreserved), milk, yogurt, kefir, “Snowball”, ryazhenka, white and black bread (better than yesterday), processed (but not snack) curds – “Friendship” , “Yantar”, “Sour-milk”, not sharp cheeses. Useful products containing a lot of magnesium salts: bread and bran confectionery (for example, Health bread), buckwheat and oatmeal; raw fruits, vegetables, berries. Useful radish (but not radish). Dietary treatment should be carried out at home for 3 years after the last exacerbation with cholecystitis and 1.5 years with biliary dyskinesia.
Folk treatment of acute and chronic cholecystitis is the use of herbal decoctions.
The most widespread in cholecystitis was a collection according to N. G. Kovaleva:
- Calendula officinalis (aboveground part)
- garden dill (seeds) – 10 g, white birch (leaves) – 10 g,
- forest sticks (grass) – 10 g,
- juniper ordinary (fruits) – 10 g,
- Chamomile (flowers) – 20 g,
- wild strawberry (berries) – 20 g,
- white rose (petals) – 20 g,
- horsetail (shoots) – 30 g,
- corn silk – 30 g,
- wild rose brown (fruit crushed) – 40 g
5–6 g of collection are brewed with 500 ml of boiling water, infused and taken in 50–150 ml 3 times a day for 10–15 minutes. before meals. The taste is bitter, the smell is pleasant.
In recent years, they have found widespread use in the treatment of patients suffering from diseases of the gallbladder and biliary tract, preparations containing essential oils (in particular, German – rovauhol and enatin ). As a choleretic, you can use black radish juice and 1 tablespoon 3 times daily before meals for 10–20 days.
The choleretic effect of polyatomic alcohols (sorbitol, mannitol and xylitol) has been convincingly proven . Sorbitol stimulates the production of endogenous cholecystokinin , increases the bacterial synthesis of vitamins B1 and B2, enhances the absorption of vitamin B12. Sorbitol can be used in the form of a 10–15% solution of 50–75 ml 3 times a day instead of magnesium sulfate. Xylitol is also prescribed in the same dose.
In chronic cholecystitis, it is widely prescribed to drink mineral waters of low and medium mineralization with a predominance of hydrocarbonates, sulfates, chlorine, magnesium, sodium, and calcium. Thermal water (35–42 ° C) or hyperthermal (42–50 ° C) temperature is used.
Mineral waters stimulate the secretion of bile, the excretion, the decrease in viscosity and its dilution. Drink water in the amount of 3 ml per 1 kg of body weight in small sips. Essentuki number 4, 17, 20, Smirnovskaya, Borzhom, Slavyanovskaya are used more often.
If cholecystitis is complicated by gastritis with high acidity, then mineral water is given 1–1.5 hours before meals, gastritis with normal or low acidity – 40 minutes. before meals. The course of treatment with mineral waters 1-1.5 months. with a break between the next course of 3-6 months.