Chronic cholecystitis: symptoms and treatment
Chronic cholecystitis is an inflammatory disease that affects the gallbladder. Its progression is promoted by pathological activity of conditionally pathogenic microorganisms. More often pathology is diagnosed in patients older than 40 years. More susceptible to chronic cholecystitis of the fair sex. The code for the ICD-10 is K81.1.
The gall bladder is a hollow organ. The main function of this element is the accumulation of bile. This secret during the digestion of food plays a very large role:
- is involved in the process of fission of fats
- destroys microbes that, along with food, enter the digestive tract.
Because of infection, the destruction of the walls of the bubble occurs. As a consequence, the ability to accumulate bile in full is significantly reduced. This adversely affects the work of the entire digestive tract.
The main reason for the progression of chronic cholecystitis is the pathological activity of infectious agents. Also, the development of pathology due to infection of the bladder with fungi, viruses and helminths is not excluded.
Factors that increase the risk of progression of pathology:
- tumors of benign and malignant nature, localized on a number of located organs
- congenital gallbladder defects
- traumatic gallbladder injury of varying severity;
- metabolic disorder
- eating disorder;
- Inadequate diet;
- circulatory disorders in the gallbladder area
This disorder is characterized by a chronic course, as well as a tendency to alternate relapses and remissions. The severity of chronic cholecystitis is determined clinically by the number of exacerbations during one year.
There are two types of ailment:
- chronic non-calculous cholecystitis. It is also called stoneless. The inflammatory process affects the walls of the organ, but no stone formation is observed
- chronic calculous cholecystitis. As a result of the progression of this type of disease, specific concretions (stones) are formed.
It is worth noting that it is the stoneless pathology that is diagnosed in patients most often. Pathology progresses with the penetration of infectious agents into the bladder and the stagnation of bile. As a consequence, the walls of the organ undergo destruction. With the progression of the stone-free appearance of the disease, development of pancreatitis, hepatitis, pericholecystitis is possible.
A distinctive feature of chronic calculous cholecystitis is the formation of concrements. This pathological process is preceded by stasis of bile. This secretion includes various acids, pigments, minerals and lipids. If under the influence of various unfavorable endogenous and exogenous factors there will be a change in the ratio of these substances, then the incoming cholesterol will precipitate and crystallize.
Chronic calculous cholecystitis is more dangerous than non-calculous, as almost always it is accompanied by a malfunctioning organ.
The main symptom of the progression of chronic cholecystitis (both stoneless and calculous) is the appearance of pain syndrome in the right part of the abdomen. Pain can be paroxysmal or prolonged. She can irradiate to the shoulder and shoulder blade. Along with pain syndrome, the following signs of pathology arise:
- the patient observes a bitter taste in the mouth
- nausea and vomiting
- Abdominal pain. It is worth noting that sometimes the patient can not name a clear localization of pain;
In periods between exacerbations, the patient sometimes experiences dull or aching pain in the right side of the abdomen. It is worth noting that during an exacerbation the symptoms of chronic cholecystitis are very similar to those of an acute form of a disease.
Usually chronic cholecystitis manifests itself as an independent nosological unit (primary type). But also the pathology can progress after earlier transferred acute cholecystitis. After an acute type of pathology, the work of the organ is significantly impaired. This element becomes denser and can not fully accumulate bile.
Symptoms of the disease manifest gradually. Pathology usually occurs over a long period of time. If at the appearance of the first symptoms immediately go to the doctor and hold a full treatment of chronic cholecystitis, then you can achieve a long-term remission.
Clinicians identify 4 pathology variants that differ in symptoms and course:
- arthritic. The main symptom is the joint pain syndrome
- cardiac. A distinctive feature is arrhythmia
- Neurasthenic. It is manifested by vegetative dystonia, insomnia
- Subfebrile. Characteristic symptoms are an increase in temperature to 38 degrees, an intoxication syndrome.
If you suspect a progression of stone-free or calculous chronic cholecystitis, you should go to a medical institution for diagnosis. The most informative methods are:
- Ultrasonography of the gallbladder
- duodenal sounding.
Non-stone type therapy
Treatment of chronic cholecystitis without a stone form should be only complex:
- taking antibiotics;
- diet therapy;
- herbal medicine
- use of antispasmodics
- use of funds that improve the outflow of bile
Treatment of pathology is carried out only in stationary conditions (especially during the period of exacerbation). If you strictly adhere to the doctor’s recommendations, the signs of pathology disappear after a few days from the beginning of therapy.
Treatment of a calculable species
Treatment with conservative methods does not bring the desired effect. The main method of treatment of cholecystitis of this type is cholecystectomy (removal of the organ together with the formed stones).
With this pathology, a fractional diet is recommended. It is best if the patient takes food at the same time. It is also important to consume enough fluids.
The diet for chronic cholecystitis is prescribed for each patient strictly individually, taking into account the severity of the course of his pathology, as well as the characteristics of his body. Diet is made by a dietician. The diet for chronic pancreatitis involves the use of such foods:
- bakery products
- dairy products
- white meat
- Vegetables and fruits.
Diet for cholecystitis excludes the use of the following foods:
- fried foods
- puff pastry
- spicy or salty cheese
- fizzy drinks;
- pickled vegetables
- Smoked products
- Ice cream.