Stagnation of bile in the gallbladder in adults

Contents

What is bile
Useful information about bile
Causes of bile stasis in the gallbladder in adults
Symptoms of bile stasis
Effective treatment of bile stasis in the gallbladder in adults
Prevention of bile stasis
Popular questions and answers

Yellow skin color, excruciating itching of the skin, weakness – all this can indicate problems with the liver and biliary tract. We will find out what causes liver stasis, why it is dangerous and how to prevent cholestasis at home

Bile is produced in the body constantly, it has its own functions (see table below). In ancient times, doctors believed that bile is no less important for the body than blood, and even affects the character and temperament of a person. This connection was not confirmed, but the expression “bilious person” took root as a synonym for bad character.

For various reasons, the secretion of bile can be impaired. Its stagnation may occur, which in the language of medicine is called cholestasis. In this condition, substances accumulate in the blood, which should normally be excreted along with bile, and poison it.

What is bile

Bile is a bitter-tasting liquid with a specific odor that is produced by liver cells. For its storage there is a special “reservoir” – the gallbladder, where bile enters from the liver through the ducts. And the “place of work” is the duodenum, where bile is involved in the processing of food¹.

Useful information about bile

Color	Hepatic bile is yellow, in the gallbladder it is dark brown.
Where is produced	In baked.
Composition	Water (up to 98%), bile acids and pigments, fatty acids, cholesterol, lecithin, uric acid, urea, enzymes.
How much bile is produced per day	500-1000 ml.
gallbladder capacity	30-60 ml.
Functions of bile	– breaks down fats (without bile, the body will not be able to process fat-containing foods); – promotes the absorption of fat-soluble vitamins and other nutrients; – activates the motility of the small intestine; – activates enzymes that are involved in the digestion of proteins; – helps to remove excess cholesterol and toxins.

Causes of bile stasis in the gallbladder in adults

The main causes of bile stasis are blockage of the bile ducts (extrahepatic cholestasis) and liver disease, in which the process of bile formation is disrupted (intrahepatic cholestasis).

Extrahepatic cholestasis leads to:

the formation of stones in the ducts through which bile moves;
dyskinesia (dysmotility and tone) of the gallbladder and biliary tract;
pancreatitis, tumors or cysts of the pancreas;
tumors of the bile ducts (primary and tumors due to metastases);
cysts of the extrahepatic bile ducts that occur with parasitic infections (oscariasis, etc.).

The main causes of intrahepatic cholestasis:

underdevelopment of the intrahepatic bile ducts;
primary biliary cirrhosis of the liver;
primary sclerosing cholangitis (inflammation of the intra- and extrahepatic bile ducts;
liver tumors;
acute and chronic hepatitis;
some genetic diseases;
congenital metabolic disorders (cystic fibrosis, galactosemia).

Separately, it is worth highlighting benign cholestasis in pregnant women. It usually does not require treatment, but it is necessary to keep the level of liver enzymes and bilirubin under control.

There is also drug cholestasis, which can cause the use of psychotropic drugs, antibiotics, antiarrhythmic and anthelmintic drugs, oral contraceptives, anabolic steroids, etc.

Symptoms of bile stasis

Stagnation of bile can be asymptomatic, and can be manifested by such symptoms:

Itching of the skin causes the accumulation of bile acids in the blood, which irritate the nerve endings of the skin. Itching with cholestasis can be very pronounced and even painful. It makes a person irritable, disrupts sleep, leads to scratching and abrasions on the skin.
Jaundice can occur simultaneously with stagnation of bile, and sometimes joins later. The main reason is a violation of the release of bilirubin. It enters the bloodstream in excess and causes yellowness of the skin.
Skin xanthoma is a flat or slightly raised yellow formation of a soft consistency above the skin. Xanthomas develop due to disorders of fat metabolism and are subcutaneous accumulations of cholesterol. Xanthomas are usually located in the region of the upper eyelid, in the folds of the palms, under the mammary glands, on the neck, chest, and back.
Discolored feces.
Deficiency of fat-soluble vitamins A, D, E, K, which is manifested by the characteristic signs of hypovitaminosis. For example, vitamin D deficiency interferes with calcium absorption in the intestines. Because of this, pain in the bones and spine appears, and the bones become more fragile, the risk of fractures increases. Vitamin K deficiency is manifested by a decrease in the level of prothrombin and increased bleeding. Vitamin E deficiency is manifested by a feeling of numbness, burning in the legs, weakness of the leg muscles. Signs of vitamin A deficiency are dry, flaky skin, blurred vision, especially in the dark (night blindness).

Effective treatment of bile stasis in the gallbladder in adults

When prescribing treatment, the doctor chooses adequate ways to deal with the cause of bile stasis. It can be both drug therapy and surgery. But first of all, an accurate diagnosis is important.

Diagnostics

If cholestasis is suspected, the doctor first conducts a visual examination, and then prescribes examinations. First of all – a general and biochemical blood test, urinalysis. With cholestasis, the level of bilirubin, alkaline phosphatase, the highly sensitive GGTP enzyme, and cholesterol increase in the blood.

Also, the doctor may prescribe a bile analysis and a coprogram (a detailed analysis of feces), as well as ultrasound of the liver and biliary tract, MRI or CT of the abdominal organs. There is an effective method for examining the biliary tract – endoscopic retrograde cholangiopancreatography (ERCP), which allows you to detect stones and narrowing of the ducts.

Preparations

Treatment of cholestasis involves treating the underlying disease that caused it. The doctor may prescribe drugs of different groups:

Hepaprotectors – to protect against damage to liver cells (for example, ursodeoxycholic acid, etc.);
Antispasmodics – to eliminate spasm of the bile ducts;
Cholagogues that stimulate the synthesis and outflow of bile (in the absence of stones in the gallbladder or in the ducts);
Antihistamines – to reduce itching;
Cholesteramine is an ion exchange resin that binds bile acids in the intestine.

Removal of stones

If bile stasis is associated with the presence of stones, they are crushed or removed. Stones are dangerous because they cause blockage of the bile ducts, because of which a person experiences very severe pain. In addition, cholelithiasis can be complicated by cholecystitis, hepatitis, peritonitis, etc.².

Surgical intervention

In case of violation of the outflow of bile (depending on the complexity of the condition), external drainage of the bile ducts, opening and even removal of the gallbladder can be performed.

Diet

Diet is an essential part of the course of treatment. For problems with the excretion of bile, table number 5 is assigned. All dishes with this diet are steamed, boiled, stewed and served only warm. Sometimes it is allowed to bake a dish, but without a greasy crust.

Be sure to drink plenty of fluids and eat fractionally: in small portions 5-6 times a day. Spicy, fried, smoked, carbonated drinks, alcohol, coffee, fatty foods, mushrooms, garlic, radishes, green onions are excluded³.

Prevention of bile stasis

To improve the outflow of bile and prevent its stagnation, you need to pay attention to your lifestyle and nutrition. Here is what is recommended for prevention:

active lifestyle, physical education;
monitor weight;
control over endocrine disorders (hypothyroidism, diabetes mellitus, impaired estrogen metabolism, which increase the activity of enzymes that enhance cholesterol synthesis and bile secretion);
timely treatment;
infectious and inflammatory diseases of the biliary tract, since the infection can provoke stagnation of bile and the formation of stones;
liver diseases, in which the level of bilirubin in bile increases;
intestinal diseases, in which the loss of bile acids with feces is possible (dysbacteriosis, enteritis, colitis);
sparing nutrition with the exception of fatty, high-calorie, cholesterol-rich foods. This is especially important with a hereditary predisposition to cholestasis and cholelithiasis. Meals should be frequent – 4-6 times a day and in small portions.

Against the background of the diet, it is recommended to consume 3-4 g of raw vegetables and fruits (carrots, celery, unsweetened and non-acidic varieties of fruits) 100-150 times a day. The diet should be enriched with dietary fiber with the addition of wheat bran, 15 g 2-3 times a day. You also need to limit the intake of easily absorbed carbohydrates (cookies, sugar, sweets).

Control your cholesterol with medication prescribed by your doctor or a low-fat diet
drink mineral waters with a choleretic effect: Essentuki-17, Jermuk, Rzhevskaya, Smirnovskaya, Slavyanovskaya. Take 20-30 minutes before meals for half a glass 3-4 times a day.