Contents
Cholecystitis is an inflammation of the gallbladder, accompanied by a violation of the outflow of bile. Gallstone disease, gallbladder dyskinesia, pathogenic bacteria and viruses, Giardia and roundworms can provoke such inflammation.
Treatment depends on the phase of the disease and is aimed at restoring normal gallbladder function and reducing inflammation. If treatment is not started on time, the inflammatory process will spread to adjacent organs.
Our expert will tell you more about the most recommended and effective methods of treating cholecystitis: therapeutic rational nutrition, pharmacological agents, herbal medicine, physiotherapy, spa treatment and special physical education. These methods can help prevent the development of gallstones.
diet therapy
This is the first and easiest method for correcting exacerbations of cholecystitis. The basic rules of nutrition for cholecystitis are as follows:
- fractional meals 5-6 times a day and unlimited fluid intake;
- obligatory breakfast and a light dinner 2-3 hours before bedtime.
Such a diet normalizes the outflow of bile and leads to normal cholesterol metabolism.
The main diet is dietary table number 5.
| Excluded: | Allowed: | Limited: |
| fried food | oatmeal and buckwheat porridge | pulse |
| butter | wheat and rye bread (yesterday’s) | salt |
| smoked meats | lean meat | fresh fruits |
| fish and mushroom broths | steam cutlets | sweets |
| fat | boiled fish | cabbage |
| fat meat | cereal soups, dairy | vegetable oil |
| sausages | broths are not strong | sweet pastries |
| egg yolks | cabbage soup vegetarian, borscht | |
| pickled foods | cottage cheese, kefir, mild cheese | |
| alcoholic beverages | boiled and baked vegetables | |
| strong tea and coffee | cracker | |
| ice cream | vegetable juices | |
| chocolate | compotes, jelly, rosehip broth | |
| confectionery | ||
| spices |
Dishes are steamed, boiled or baked. Food is recommended to be taken warm.
The therapeutic diet is not a panacea for cholecystitis, and only in combination with physiotherapy and drug treatment, it normalizes the functioning of all digestive organs and the liver.
Medicines for cholecystitis
Only after an accurate diagnosis is established, the gastroenterologist recommends complex drug treatment. Taking medication relieves pain and eliminates the symptoms of the disease.
Antispasmodics
This group of drugs helps to relax the spasmodic smooth muscles of the digestive system.
To eliminate biliary dyskinesia and spastic pains, reduce dyspeptic manifestations, the following are prescribed: Duspatalin, Neobutin, Spareks, Trimedat, Odeston.
Antispasmodics are taken 30-40 minutes before meals and drunk in a course of 14-21 days.
Antibiotics
The basis of drug treatment of chronic cholecystitis is anti-inflammatory therapy. To achieve the best effect, antibiotics are combined with the use of pre- and probiotics.
Which antibiotic the doctor prescribes depends on the cause of the disease and the clinical manifestations.
More often, gastroenterologists prescribe: Cefixime, Ceftriaxone, Amoxicillin, Clarithromycin.
The course of antibiotic therapy lasts from 10 to 14 days.
Cholagogue
The appointment of choleretic agents requires an individual approach, depending on the presence of inflammation and the type of dysfunction. This group of drugs is indicated only after the inflammatory process has subsided and in the absence of gallstones.
Choleretic drugs enhance the formation of bile and promote its release into the intestinal lumen, increase the enzymatic activity of gastric juice.
Allochol, Cholenzim, Hofitol, Flamin, Karsil, Tykveol, Odeston, Magnesium sulfate – help the gallbladder and improve the neutralizing function of the liver.
Enzymatic
Enzyme therapy is aimed at improving digestion and is selected individually. Enzyme preparations, which include bile components, are necessary for hypomotor biliary dyskinesia.
Festal, Enzistal, Normoenzyme – taking these drugs normalizes the processes of digestion and absorption of proteins and fats. Bile acids increase the contractile function of the gallbladder with its hypotension, improve the process of emulsification of fats, increase pancreatic secretion.
Hepatoprotectors
Medicines containing ursodeoxycholic acid are the most commonly prescribed by gastroenterologists for chronic diseases of the liver and gallbladder in adults and children.
In preparations Ursosan, Ursofalk, Ursodez. Urdoksa, Grinterol – ursodeoxycholic acid has a beneficial effect on liver function, which allows it to be successfully used in patients with various liver diseases and congestion in the gallbladder. Ursodeoxycholic acid also has a significant immunomodulatory effect.
Treatment is carried out under medical supervision. The duration of therapy ranges from 1 month to 12 months or more.
Spa treatment and balneotherapy
Sanatorium treatment is an important stage in the rehabilitation of patients with diseases of the digestive system.
The effect of treatment outside the stage of exacerbation at the resort is higher than in the hospital. Natural healing factors (climatotherapy, mineral waters, baths, mud therapy, healthy nutrition and physical education) have a positive effect on the functional state of the nervous system and bile secretion mechanisms, help restore immunity, normalize metabolism, and have an anti-inflammatory effect.
Balneotherapy – treatment with mineral waters – a proven and effective method that corrects disorders of the digestive system.
When prescribing mineral waters, it is necessary to take into account the state of the secretory function of the stomach. Bottled mineral waters are also successfully used – Essentuki, Slavyanovskaya, Smirnovskaya, Nagutskaya, Stelmas, Psyzh and others.
Rinse the cup with hot water, then pour 1/3 cup of mineral water and slowly take it warm 25-40 minutes before eating.
On the recommendation of a gastroenterologist, tubage can be performed with mineral water with the addition of 20–25 g of xylitol or 1/2 teaspoon of Karlovy Vary salt. Mineral water is drunk in courses of 15-30 days.
Phytotherapy
Herbal medicine for chronic acalculous cholecystitis can enhance the therapeutic effect of medications.
Medicinal plants are used in the form of infusions and decoctions, which gently, safely, naturally improve bile secretion, have a beneficial effect in inflammatory diseases of the liver and gallbladder.
Valuable action in cholecystitis have:
- sand immortelle flowers,
- corn silk,
- peppermint herb,
- tansy flowers,
- elecampane root,
- centaury herb,
- dandelion root,
- yarrow herb,
- wild chicory root,
- dog-rose fruit,
- cumin seed,
- fennel seed,
- herb melissa officinalis.
Freshly prepared infusions and decoctions are used ½ cup 30-40 minutes before meals. It is advisable to repeat herbal medicine courses 3 times a year, the duration of one course is from 30 days.
For the duration of herbal medicine for diseases of the gallbladder, for the best effect, it is recommended to give up coffee and strong tea.
Special physical education
During the onset of remission, physiotherapy exercises can be used to help empty the gallbladder.
Gallbladder exercises naturally unload the organ and help bile pass into the intestines. The main secret of success is regular exercise. It is important to pay attention to proper breathing, as it helps to relax muscle tone and improve blood circulation to tissues.
Physiotherapy
During the period of exacerbation of chronic acalculous cholecystitis, physiotherapeutic procedures are indicated:
- diathermy,
- electrophoresis with antispasmodics, with magnesium sulfate.
- inductothermy,
- paraffin + ozokerite,
- UHF therapy.
Recently, there have been works devoted to the effectiveness of laser therapy for chronic acalculous cholecystitis.
Remote lithotripsy
Remote shock wave lithotripsy can grind soft and small (up to 2,0 cm) stones. The procedure is practically painless, does not require anesthesia, you do not have to walk with drains and worry about the healing of endoscopic or standard incisions.
For patients who have undergone this procedure, the availability of surgical care should remain available for several months, since fragments of the broken stone can take a long time to come out. With large stones, with pathological changes in the gallbladder itself, the doctor recommends removing the gallbladder.
Surgery for cholecystitis
The only indication for performing an emergency operation in the next few hours from the moment the patient enters the hospital is diffuse biliary peritonitis.
The main part of patients is operated on in a planned manner after the subsidence of acute inflammatory phenomena. Because each subsequent attack can cause the development of acute cholecystitis with severe complications from the liver and pancreas.
Currently, most operations are performed endoscopically and are much easier to tolerate by patients. This minimally invasive technique has significantly reduced mortality and the number of postoperative complications.
Popular questions and answers
Our expert Elena Nilova, relying on more than thirty years of experience in medicine, answered the most common questions.
Why does cholecystitis occur?
● violation of the outflow of bile with damage to the mucous membrane of the bladder,
● inversion of the gallbladder and bending of its neck,
● reflux of pancreatic enzymes,
● infringement of the stone in the bladder neck.
Acute inflammation of the gallbladder occurs when an infection enters the gallbladder (Escherichia and Pseudomonas aeruginosa, staphylococcus, enterococcus, etc.).
How to stop an attack of cholecystitis before the ambulance arrives?
Is it possible to treat cholecystitis with folk remedies?
Alternative recipes can be used as an adjuvant therapy and only on the advice and under the supervision of a doctor.
Can cholecystitis be permanently cured?
And if there is a genetic predisposition, then you will have to be attentive to the state of the gastrointestinal tract all the time.
How to avoid inflammation of the gallbladder?
Be sure to lead an active lifestyle, regularly undergo medical examinations, and avoid stressful situations.
It seems that these rules are easy to follow. But worldwide there is a steady increase in the number of diseases of the gastrointestinal tract. And every year the number of operations on the gallbladder and the number of postoperative complications is growing. The correct assessment of clinical symptoms, the use of modern diagnostics and the appointment of complex treatment can prevent the development of pathological processes in the digestive organs.
Sources:
- Saifutdinov R.G., Trifonova E.V., Ryzhkova O.V. Improving the conservative management of patients with stones of the hepato-biliary system, 2010
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