Cholecystitis: symptoms, diagnosis and treatment

Over 25% of women and 10% of men aged 30-40 years and older have experienced pain in the right hypochondrium at least once.More attentive note that they arise after the feast, where a lot of fatty and fried food is served and the river is pouring alcohol.Some patients already at this stage may suspect the presence of cholecystitis, but often it is found accidentally when examining a person on another occasion.So, acute and chronic cholecystitis - symptoms, diagnosis, treatment methods.

Table of Contents: Causes of cholecystitis Symptoms of cholecystitis

Causes of cholecystitis

Cholecystitis is a disease that is based on the infectious process. Usually this is the case:

• , due to various causes in the gallbladder, stagnation of bile occurs;
• simultaneously with this bile undergoes changes: it increases the amount of cholesterol and decreases the content of phospholipids and bile acids;
• congestive bile is a favorable environment for the development of pathogens, and they do not slow down to begin their destructive work;
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• there is inflammation of the mucous membrane of the gallbladder, which causes the formation of stones and other troubles.

The development of cholecystitis is facilitated by factors that cause metabolic disorders:

• hemolytic anemia;
• diabetes mellitus;
• obesity;
• a meal rich in cholesterol;
• use of oral contraceptives.

Because of them, the bile composition changes.

Stasis often occurs due to anatomical features of the gallbladder, tumors, disorders in the diet, systematic abuse of alcohol.

Symptoms of cholecystitis

In direct dependence on the form of the disease there is also its symptomatology.

Acute cholecystitis

This form of the disease passes through three stages in its development, each with its own clinical picture:

1. Catarrhal cholecystitis is manifested by constant severe pain in the right hypochondrium giving to the right half of the body - a scapula,Shoulder, right side of the neck.At the beginning of the disease, the pain may be paroxysmal.Often there is vomiting of the contents of the stomach.In vomit masses, bile is almost always found.The temperature is subfebrile, the pulse is normal.
2. With phlegmonous cholecystitis, the inflammation penetrates deep into the wall of the gallbladder, affecting not only its mucosa, but also the underlying layers.The pain with this form is much more intense, intensified by changing the position of the body, breathing, coughing, straining.Vomiting is multiple, the temperature is high( 38-39 ° C).The pulse speeds up to 100 more beats per minute.The abdomen is swollen, painful when pulled out.
3. With gangrenous cholecystitis, which often occurs in the elderly, the general symptomatology comes first.The pains subside, but this is only apparent prosperity.The reason for the reduction of pain sensations is the death of nerve receptors under the influence of an infection that penetrates the entire thickness of the gallbladder wall.The patient's condition sharply becomes heavier, he becomes inhibited, sluggish.There are growing phenomena of general peritonitis - inflammation of the peritoneum, which arises from the spread of infection from the gallbladder into the abdominal cavity.The temperature is high, there is a strong tachycardia, it is sharply inflated, painful on palpation in all departments, is strained.This is an extremely dangerous form of the disease, often leading even to correct treatment to a tragic outcome.

Chronic cholecystitis

Often this form of the disease is completely asymptomatic.Only at a certain moment after a diet violation the patient develops a gallstone colic and then he is diagnosed with chronic calculous cholecystitis.

There may be no symptoms at the remission of the disease, but often a person notes some heaviness in the stomach after taking fatty, fried foods, a bitter taste in the mouth, especially after awakening, heartburn, periodic diarrhea.

During a period of exacerbation, chronic cholecystitis manifests itself with the same symptoms as acute cholecystitis.

Separately, it is worth mentioning the manifestations and treatment of chronic cholecystitis in children:

Diagnosis

In terms of diagnosing the disease, cholecystitis usually does not present a big problem.The characteristic clinical picture in most cases allows you to put the right diagnosis at the stage of questioning and examination.

Nevertheless, some laboratory and, more importantly, instrumental methods of investigation are used to clarify it:

• Ultrasound of the abdominal organs, which helps to detect inflammation in the wall of the gallbladder;
• radiography, which sometimes shows stones( unfortunately, not all);
• cholecystocholangiography, with which the doctor can detect stones that have got from the gallbladder into the bile ducts.

Treatment of cholecystitis

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The therapeutic tactics for cholecystitis directly depend on its shape.Most doctors agree that the only really radical way to fight the disease is to remove the gallbladder.By eliminating the organ that inflames, the very possibility of its disease is eliminated.Practice shows that the majority of patients after cholecystectomy( the so-called operation of gallbladder removal) can return to an absolutely full life in a relatively short time.

However, in some situations, the operation can be delayed or even eliminated.For example, in acute cholecystitis, in the absence of signs of peritonitis, the patient is prescribed conservative treatment with analgesics, antispasmodics, antibiotics, detoxification solutions, therapeutic nutrition, the application of an ice bladder to the gallbladder.Only after the complete abatement of acute phenomena the surgeon begins to consider the question of the planned removal of the gallbladder.

Please note: strongly prohibits the use of a warm warmer, as this promotes the spread of infection and the transition of the catarrhal form of the disease to heavier ones.

It usually takes 48-72 hours to see if the inflammation in the gallbladder is dying or, conversely, the situation worsens.In the case of progressing inflammation, the patient is shown emergency surgery - removal of the gallbladder.

Chronic cholecystitis is also the only treatment for cholecystectomy.Methods of percutaneous ultrasonic lithotripsy( destruction of a stone) are considered only temporary.The inflammation with their help can not be eliminated, which means that even destroying all the stones, it will not be possible to avoid the formation of new ones.

Cholecystitis can rightly be called a disease of the century.Lack of proper nutrition in most of us, the epidemic of obesity and the associated diabetes mellitus make this pathology very frequent.Treating her is not an easy task, so it's better not to bring yourself to the operating table.Restriction of fats in the diet and a healthy lifestyle will allow you to never know neither the nature of pain in the right hypochondrium, nor the nature of the surgeon operating your ill-fated gall bladder.

You will find out more about the symptoms, methods of diagnosis and treatment of cholecystitis by viewing the video review:

Volkov Gennady Gennadievich, medical reviewer, ambulance doctor.