Chronic acalculous cholecystitis

The daily rush, snacks on the go and the obligatory fast food on weekends with the whole family in the kit will sooner or later lead you to the gastroenterologist’s office. And the problem may affect not only our long-suffering stomach. Yes, yes, when you, clutching at the first-aid kit, tragically exclaim: “Gastritis has raged again,” it may not be him at all. And, for example, chronic acalculous cholecystitis. What kind of animal is this and how to treat it, our expert will tell, gastroenterologist, nutritionist Olga Smirnova.

What is chronic acalculous cholecystitis

The name is complicated, but we will try to put everything on the shelves.

 – Chronic acalculous cholecystitis is a disease with a relapsing course, which is based on an inflammatory process in the wall of the gallbladder, with secondary violations of its various functions and changes in the physicochemical properties of bile (dyscholia), – says Olga Smirnova.

But here’s what’s interesting – everyone will have the disease to varying degrees. It all depends on how quickly you reacted and went to the doctor.

“The symptoms and features of the clinical course of chronic acalculous cholecystitis depend on the severity and duration of the inflammatory process in the gallbladder, as well as on the presence of diseases of the organs adjacent to the gallbladder — the liver, pancreas, duodenum,” explains the gastroenterologist.

Causes of chronic acalculous cholecystitis

Of course, just burgers that you consume, perhaps extremely rarely, should not be sinned. The reasons, it turns out, are many – and some do not concern your diet at all.

According to Dr. Smirnova, chronic acalculous cholecystitis can be provoked by:

• infection (E. coli, cocci, viruses and other agents), and it does not matter how the infection penetrated: through the intestines, through the blood or otherwise;
• unbalanced nutrition;
• immune system disorders;
• pathology of the nervous and endocrine systems;
• parasitic invasion;
• pancreato-biliary reflux;
• congenital deformities of the gallbladder;
• microcirculatory disorders;
• bile stasis and dyscholia.

Symptoms of chronic acalculous cholecystitis

How to recognize this disease in yourself or loved ones?

Main symptoms:

1. Pain or feeling of heaviness, burning in the right hypochondrium.

– Pain in the right hypochondrium can radiate (give away – approx. Auth) to the right shoulder, shoulder blade, back, heart area. Attacks of pain are accompanied by bitterness and dryness in the mouth, nausea, vomiting, our expert notes.

2. Dyspeptic syndrome. Associated with impaired bile secretion and changes in the biochemical composition of bile:

• bitterness in the mouth and “bitter” eructation due to biliary hypertension;
• flatulence, burning, belching “rotten”, constipation or diarrhea, loss of appetite;
• the secretion of bile in periods between meals can cause biliary reflux, which can lead to the development of intestinal dysbacteriosis, the occurrence of cholangitis – inflammation of the bile ducts.

3. General manifestations: asthenia, decreased performance, insomnia, irritability, low-grade (relatively high for a long time – approx. Auth.) temperature, etc.

And, of course, these symptoms are also characteristic of other diseases of the gastrointestinal tract.

“The main task of a doctor is to make a correct differential diagnosis with such diseases as cholelithiasis, pancreatitis, peptic ulcer of the stomach and duodenum, gastroesophageal reflux disease, duodenitis/gastritis,” says Olga Smirnova. – Do not forget about the atypical forms of chronic acalculous cholecystitis – cardialgic, intestinal, lumbar and others.

Treatment of chronic acalculous cholecystitis

Whether it is necessary to treat? Or is it enough to observe and no-no yes take painkillers?

– There is such an opinion – chronic acalculous cholecystitis is the soil for the development of stones in the gallbladder, – says Dr. Smirnova. – Therefore, if you do not deal with the issue of normalizing the functioning of the gallbladder, do not carry out preventive measures, then complications such as a switched off (non-functioning) gallbladder may develop due to edema, accumulation of mucus or spasm of the bile duct; pericholedochal lymphadenitis (inflammation of the lymph nodes along the extrahepatic bile ducts); perforation, the occurrence of fistulas; the appearance of calculi (stones).

Diagnostics

As you probably already understood, a gastroenterologist is engaged in the diagnosis and treatment of chronic cholecystitis. Therefore, if the described symptoms are painfully familiar to you, make an appointment with the doctor. Doing “diagnostics” at home is like guessing on coffee grounds. But professionals have other methods.

“As a diagnostic tool, ultrasound is the most informative,” says our expert. – According to the results of the study, the thickness of the gallbladder wall (> 3-4 mm), its structure and the presence of lamination, inclusions, etc. are evaluated. If the ultrasound picture is uninformative, then an MRI of the gallbladder and its ducts is possible.

There are also laboratory methods.

– In the study of a clinical blood test during an exacerbation, neutrophilic leukocytosis, an increase in ESR are characteristic. In a biochemical blood test – an increase in alpha-2-globulin, positive “C” – reactive protein, fibrin, the level of conjugated bilirubin, transaminase, alkaline phosphatase, GGTP, – lists Dr. Smirnova. And if these tricky words don’t mean anything to you, you can always ask your doctor what it means.

Modern treatments

When we talk about diseases of the gastrointestinal tract, we always mean nutrition correction.

– It is impossible to achieve a stable remission of chronic cholecystitis without diet therapy! says the gastroenterologist. — Rational diet therapy is based on the principles of balanced adequate nutrition, enriched with dietary fiber (“green diet”), pectins, antioxidants, lipotropic substances, salts of magnesium, potassium, calcium. Food is taken fractionally, in small quantities, 4-5 times a day (the main diet is table number 5).

In more complex cases, you can not do without drugs.

“Exacerbations of moderate and severe chronic cholecystitis are usually treated in a hospital setting — massive infusion therapy is carried out, combined with antibiotics, antispasmodics, and more,” says Olga Smirnova. – In the period between attacks, i.e. during remission, choleretic drugs are recommended. The choice of a particular drug depends on the existing pathology, because. although they are all choleretic, they have different properties and application points.

Cholagogue is not only about pills, but also herbal preparations and special mineral water. In addition, according to our expert, enzymes are added to therapy on an individual basis – in a course with meals, as well as pro / prebiotics and sorbents.

Prevention of chronic acalculous cholecystitis at home

Don’t feel like taking on so much? And the soul does not ask for a hospital? Then it is better not to take it to extreme measures and play ahead of the curve. You just need to follow simple preventive measures.

According to Olga Smirnova, the prevention of chronic acalculous cholecystitis includes:

• Proper diet (4-5 meals a day) with a caloric content of the diet corresponding to the ideal weight, taking into account age, gender and profession. At the same time, you can’t eat a lot at night, especially fatty foods, especially when eating alcohol with it.
• Sufficient fluid intake – at least 1,5-2 liters during the day, evenly.
• Eating at the same time – avoid large breaks in eating (more than 4 hours).
• Regular bowel movements to prevent biliary dyskinesia (viscero-visceral reflexes) and cholesterol excretion.
• Weight loss through subcaloric nutrition (reduced diet).
• Daily morning exercises and a sufficient motor regime during the day contribute to the passage (outflow – approx. Auth) of bile through the biliary tract.
• Timely identification of foods that cause allergies or intolerances, and their exclusion from the diet.

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