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Gallstones, causes of formation, treatment. Treatment of gallstones without surgery

To understand how to get rid of stones in gallbladder, need to get general idea about the disease. The presence of a stone in the gallbladder or biliary tract means the development of gallstone disease. More often this happens due to improper metabolism or stagnation of bile.

Gallstones are made up of cholesterol crystals or bilirubin salts. The formations are common, occurring in every tenth person, even more often in old age. There are various shapes and sizes ranging from fine bile sludge and pebbles measuring 2 cm (20 mm) to huge stones with a diameter of 16 cm (160 mm) or more.

Metabolic disorders and quality composition bile with a predominance of calcium, bile pigments or cholesterol.
Cholecystitis.
Biliary dyskinesia.
Stagnation of bile due to various pathologies(large duodenal papilla, biliary tract).

Predisposing factors include:

Belonging to the female gender.
Excessive body weight.
Frequent pregnancies.
Estrogen therapy.
Genetic predisposition.
Not proper nutrition With a large number fat
Exhausting diets.
Certain diseases (hemolysis, diabetes, liver cirrhosis, Crohn's disease and others).
Laparotomy surgical operations.

Clinical course

Quite often the disease is asymptomatic. Gradually, with the accumulation of stones, the following symptoms begin to bother patients:

Cramping pain in the epigastrium on the right, varying in intensity.
Sensation of bitterness on the tongue.
Nausea, vomiting, belching.
Hyperthermia.
Yellow discoloration of the skin and sclera.

Manifestations of biliary colic

This condition often accompanies gallstones. Colic is characterized by intense unbearable pain on the right side. The pain is preceded by an error in diet or shaking.

The pain is so severe that the patient cannot find a comfortable position. Colic may be accompanied by vomiting, if inflammation develops in the gallbladder, and high fever occurs.

Diagnostics

The doctor is obliged to conduct diagnostic measures determine the severity of the condition in full, excluding other pathologies. As a rule, patients consult a doctor after an attack of hepatic colic; the pain causes considerable discomfort and is prone to recurrence.

It is important that the doctor collect a complete history and find out how the disease began, how it progressed, what medications helped, the nature of the attacks, and trace the connection of the disease with nutrition. Then an examination is carried out and the symptoms of calculous (cholelithiasis) cholecystitis are identified - Kera, Murphy, Ortner-Grekov and others. The color of the bile lining and sclera is assessed, and jaundice begins from there.

After the consultation, instrumental diagnostics gallstones:

Ultrasound examination - in the vast majority of cases reveals a cystic calculus.
Abdominal X-ray:

A survey radiograph is aimed at identifying a calculus with a large amount of calcium in its composition.
A study with the introduction of contrast into the gallbladder - allows you to find stones that are not visible on standard x-rays.

CT and MRI can distinguish even small stones in the gall bladder and are used for differential diagnosis.
Endoscopic retrograde cholangiopancreatography helps assess the condition bile ducts, detect stones and voluminous neoplasms.

Conducted laboratory diagnostics– the level of bilirubin and inflammatory markers (CRP, ESR, leukocytosis and others) is determined in the blood.

Treatment

Patients who do not know where to turn for gallstone disease should make an appointment with a gastroenterologist. The doctor will conduct full examination and determine further treatment steps. Self-medication is strictly prohibited as it can cause harm. For example, the use of choleretic drugs in the presence of stones leads to complications.

If the stones are small (up to 3 cm), there are few formations, it is permissible to try conservative therapy. This includes resorption of stones through the administration of special medications, external shock wave lithotripsy, percutaneous transhepatic cholelitholysis and others.

Drug dissolution of stones

For this method of therapy, drugs containing ursodeoxycholic and chenodeoxycholic acids are used. The substances dissolve stones containing excess cholesterol. Typically, the method is used when the stones are small (4-16 mm). When choosing a method, the contractility of the gallbladder should remain normal.

Medicines are used over a long course from six months to two years under the supervision of a doctor. In most cases, the method helps, but the disease can reappear. To prevent relapse, you will need to continue taking medications in small dosages.

External shock wave lithotripsy

The method is designed to break up a large stone in the gall bladder into many small ones, often used in combination with the previous method. The first step is to crush large stones. The second is medicinal dissolution of the resulting small fragments.

Shock wave lithotripsy is fraught with many dangers; the procedure can clog the bile duct or damage the gallbladder. There is a need for surgical intervention.

Percutaneous transhepatic cholelitholysis

A rare minimally invasive method of therapy. It involves catheterization of the gallbladder through the skin and liver tissue. An agent (methyl butyl ether) is injected through the catheter, resolving a calculus of any origin.

Surgical treatment

When conservative treatment contraindicated or ineffective, a decision must be made surgical intervention. Often carried out endoscopic operations through a small laparoscopic opening. The interventions are minimally invasive, do not leave large scars, are relatively inexpensive and are less likely to be complicated by hernias.

Perhaps either the entire bladder with a calculus. More often the organ is removed, metabolic disorders do not disappear, and stones can appear again. If the stone is large, for other indications (adhesions, obesity, pregnancy), an open laparotomy operation is performed.

Postcholecystectomy syndrome

The operation helps most patients; rarely (two out of ten cases) there are consequences of treatment or residual effects, which did not disappear after surgery, are united under the name postcholecystectomy syndrome. These include:

Lesions of the biliary tract not related to the gallbladder (disorders in the sphincter of Oddi, common bile duct stone).
Postoperative complications (adhesions, hernias, damage to the bile ducts, the formation of stones in the stump of the bladder, and others).
Diseases that arose under the influence of gallstones, but were not stopped after surgery (biliary pancreatitis, hepatitis).

Properly selected treatment brings relief from the disease, it is necessary to seek medical care.

Diet

If a person has a tendency towards formation or formations arose but were removed, it is extremely important to adhere to special diet. You need to eat often (6 times a day) in small portions. With such a diet, the release of bile through duodenal papilla, the secret does not stagnate. If the portion is too large, the motility of the gallbladder increases, which in the presence of a calculus can lead to inflammation.

The diet is supposed to be balanced, filled nutrients, vitamins and microelements. It is recommended to consume low-fat varieties of meat and seafood, low-fat dairy products, cereals, especially oatmeal and buckwheat, plant foods(fruits, vegetables, herbs, dried fruits), compotes, juices, mineral waters. It is not recommended to consume fatty, fried, spicy foods, foods with increased content caffeine, smoked meats, canned food, garlic, cucumbers, beans.

Prevention

If predisposing factors are identified, you will have to follow the rules:

News correct mode and diet (described in the article).
Support normal weight body through exercise and diet.
Taking medications that improve metabolic processes in bile.
Timely seeking medical help when the first symptoms of the disease occur.
Do not self-medicate, do not take choleretic drugs on your own. In case of severe pain, you can take a tablet of no-shpa or a similar antispasmodic.

Complications

In case of incorrect or untimely treatment the following complications arise:

Cholecystitis – inflammatory disease gallbladder.
Biliary colic.
Inflammation of the bile ducts.
Biliary peritonitis - occurs due to rupture of the bladder with the flow of bile into the abdominal cavity. Extremely dangerous.
Biliary pancreatitis - appears due to increased pressure in the bile ducts and bile entering the pancreatic ducts and damage to the ducts and pancreatic cells.
Septic complications in case of infection.
Malignant tumors that arise due to permanent damage to the walls of the bladder.

Gallstone disease is the formation of stones in the gallbladder, called stones. In most patients, it initially occurs in hidden form. Often the disease is complicated by inflammation of the gallbladder, bile duct or pancreatitis.

Gallstones are cholesterol, pigment and mixed. The reasons for their appearance are as follows:

unhealthy diet (excessive consumption of animal fats);
disorders of the thyroid or pancreas;
injuries;
infectious diseases of the gallbladder;
sedentary lifestyle;
bile stagnation;
violation metabolic processes;
helminthiases;
cirrhosis;
elderly age of the patient.

At the beginning of the disease, a feeling of fullness appears in the right side under the ribs, bitterness in the mouth in the morning, and indigestion.

If a stone blocks the bile ducts or causes spasm of the biliary tract, an attack of hepatic colic occurs. It is typical for her sharp pain, With right side in the hypochondrium extending into the shoulder or scapula. It may be accompanied by nausea and vomiting and fever.

Traditional medicine recipes

Before you start treating cholelithiasis with medications traditional medicine must be carried out ultrasound examination and consult your doctor.

If there are moving stones in the gall bladder, treatment with choleretic preparations can provoke their movement and temporary blockage of the biliary tract and pancreatic duct, which will lead to an attack of hepatic colic.

Herbs

In order to remove small stones and sand from the gallbladder, infusions and decoctions are used medicinal herbs. They must be taken within long period. Choleretic herbs include:

rhizomes of snakeweed, a tablespoon, pour half a liter of water and simmer in a steam bath for 10 minutes. The decoction should be drunk one day before;
shepherd's purse grass, 3 g, is poured with three hundred milliliters of water and boiled for 5 minutes. Drink 100 ml three times a day;
Creeping wheatgrass rhizomes, 1 g, pour 100 ml of water and boil for half an hour. Take 20 ml four times a day.

Separately, it is necessary to remember that effective remedy for crushing gallstones, like madder. A teaspoon of rhizomes and roots is poured with two hundred milliliters of cold boiled water, leave for at least eight hours, filter.

The remainder is poured with boiling water and after standing for 10 minutes, filtered. The infusions are mixed and taken a day, divided into four times.

Herbal infusions

In what cases is it used?	Collection	Method of preparation and use
Used as a choleretic and sedative if the disease proceeds without complications. Can also be used for constipation as a laxative.	Buckthorn, marshmallow, mint leaves, sage 20 g each and caraway fruit 10 g.	Three grams of the collection should be poured with two hundred milliliters of boiling water and left under the lid until cooled. Strain and drink in small sips. If the patient has no problems with stool, you need to drink 1 glass of the drug per day; for chronic constipation, the dose is increased to 2. Treatment is continued for about 2 weeks.
Increases the amount of bile and promotes its excretion. Taken for cholelithiasis without exacerbation.	Take buckthorn, immortelle, fennel, mint and motherwort in equal proportions.	Boil six grams of the mixture in half a liter of water for 5 minutes. After it cools down, strain. Drink half the broth in the morning and evening, half an hour before meals. Treatment should be continued for 21 days.
Used in the presence of small stones and sand in the gallbladder. It is a choleretic agent, has mild laxative and anti-inflammatory properties.	Take one part each of mint, wormwood, dandelion root, and buckthorn. Two parts of immortelle, and four parts of madder rhizomes.	Two grams of the collection are boiled in one hundred milliliters of boiling water for five minutes. Strain immediately and consume in small sips. This decoction should be used three times a day, 30 minutes before eating, for four weeks. Then you need to take a two-week break and resume treatment.
The collection is used for exacerbation of cholecystitis. It has anti-inflammatory and mild analgesic effects.	Take equal quantities of immortelle, buckthorn, dandelion, yarrow and mint.	Infuse three grams of the collection in two hundred milliliters of boiling water for an hour. Strain and drink in small sips. The drug should be taken before meals, until the symptoms of the disease disappear.
The product is used for stagnation of bile.	5 g dandelion root 5 g of field steelhead root 5 g mint leaves 5 g buckthorn bark.	For an hour, four grams of raw material are infused under a lid in half a liter of boiling water. You can add no large number honey Take a glass three times a day, before meals. Treatment is continued for a week.
The product helps get rid of bile stagnation, has analgesic and anti-inflammatory properties.	Mix equal amounts of birch leaves, St. John's wort, mint, rose hips and add half the dose of kidney tea.	Simmer in a steam bath for ten minutes, four grams of the mixture in three hundred milliliters of water. After this, let it brew for four hours, filter, and drink one hundred milliliters in the morning and evening 30 minutes before eating. Thus, you need to be treated for ten days.
Used as cholagogue with stones in the gall bladder.	10 g immortelle flowers 5 g celandine herb 5 g mint leaves.	Two grams of raw materials are infused in two hundred milliliters of boiling water. After cooling, filter and divide into two portions. Treatment is continued for a week.

Juices

Berry and vegetable juices are used to treat gallstone disease. Prepare them immediately before use:

barberry juice. 20 ml of the product are pre-dissolved in 100 ml of water and drunk half an hour before meals twice a day;
carrot juice. A tablespoon of juice is mixed with the same amount of honey. Take before meals up to five times a day;
lingonberry juice. 60 ml is mixed with 100 ml of water and taken twice a day half an hour before meals;
juice white cabbage. Take 100 ml three times a day before meals;
strawberry juice Drink 100 ml three times a day half an hour before meals.

Other ways

The first method of getting rid of gallstones was described by Dr. P.M. Kurennov back in 1975. He recommends using Provence oil ( olive oil high quality) 500 ml and lemon juice in the same amount.

The last solid meal should be at least 12 hours before the procedure (liquids do not count). In the evening, no later than 19 o'clock, you need to drink 4 tablespoons of oil and wash it down with a spoon of juice. Repeat every quarter of an hour until the product runs out.

In order to control the removal of stones from the body, the doctor recommended washing the stool through a strainer. When washed, stones look like soft rubber. This method is not recommended if the stones reach large sizes.

You will learn the symptoms, causes and treatment of gallstones from the video.

Diet for cholecystitis

The basis of treating the disease is proper nutrition. Food should be boiled, baked or steamed. You need to use it in small portions at least 4 times a day.

The following should be excluded from the diet:

meat fatty varieties: pork, lamb, goose, duck, offal;
legumes;
sour fruits and vegetables;
baked goods, fresh baked goods;
chocolate and ice cream;
radishes, spinach;
onions and garlic;
marinades, smoked meats, canned food.
fatty fish;
spicy and hot sauces;
carbonated drinks;
alcohol.

The temperature of food should be moderate, because too hot or cold foods can trigger an attack of hepatic colic. The menu should contain a large number raw vegetables and fruits.

For cholecystitis, the diet should consist of the following products:

lean meat: rabbit, turkey, chicken;
lean fish;
vegetables and fruits;
porridge: buckwheat, rice, oatmeal;
low-fat fermented milk products;
sweet fruits and berries.

Use of medications

If sufficiently large stones have already formed in the gallbladder, then you can get rid of them only with the help of surgical intervention.

Choleretic drugs are used as a prophylaxis if the bile is viscous. The most often recommended is taking ursodizoxycholic acid drugs (Ursosana, Ursofalka).

They help dissolve cholesterol stones. The course of treatment usually ranges from 6 months to 2 years.

To change the thickness of bile and prevent gallstone disease, drugs such as Gepabene, Allochol, Karsil are used.

In order to avoid the appearance of gallstones, you must adhere to the following rules:

It is worth limiting the consumption of food containing animal proteins, fats and sugar;
the diet should contain a large amount of vegetables and fruits containing vitamin C;
You should not skip breakfast, meals should be regular;
in order to improve digestion you need to drink bitter drinks;
it is necessary to lead an active lifestyle and exercise;
If the skin and sclera of the eyes become yellow, you should immediately consult a doctor.

If you have symptoms of gallstone disease, do not start self-treatment. Even the use of traditional medicine requires supervision by a specialist.

If, during the treatment process, severe pain in the hypochondrium appears, fever and bouts of vomiting, you should immediately seek medical help.

Recipe beet composition To dissolve stones you will learn from this video.

Gallstones are formed due to metabolic problems in the body. They are the cause of cholelithiasis. Stones formed in the organ can be located anywhere - both in the bladder itself and in its ducts, and even in the liver, while their shape and size vary from very small (sand) to very large.

The appearance of stones often causes irritation of the organ mucosa, resulting in the development of a disease such as.

Gallstones are formed mainly from cholesterol crystals, but for the time being they do not bother a person - biliary colic is a consequence of blockage of one of the duct stones.

Most often, women aged forty and older suffer from this pathology. Men, on the other hand, experience the disease 6–8 times less often, but why this happens is not fully understood.

Symptoms

For a long time, gallstones do not make themselves felt and people find out about their presence randomly during an examination or when they begin to move through the ducts and even block them.

The main signs of gallstones depend on the location of the stone - the manifestation of cholelithiasis will be associated with the size and shape of the latter. The symptoms that all patients with gallstones experience are as follows:

pain under the rib on the right side (paroxysmal, stabbing);
nausea;
bitter taste in the mouth;
flatulence and other intestinal problems;
belching air;
development .

Sometimes symptoms such as fever and chills are also noted - this can occur when the stone begins to move through the ducts. However, most often, an increase in temperature indicates the addition of an infection and the development of cholecystitis, the symptoms of which are characteristic of the inflammatory process.

Predisposing factors causing hepatic colic, are stressful conditions and physical overexertion, eating spicy, fatty and fried foods, overuse alcohol.

The first symptoms of the disease are a deterioration in general well-being and pain, which, although localized under the ribs on the right side, radiates to other parts of the body. The pain develops due to the fact that the stone in the gallbladder, starting to come out, irritates and stretches the walls of the ducts. Or pain syndrome may be caused by overstretching of the bladder due to the accumulation of bile in it.

Note that the symptoms in case of blockage of the ducts are as follows: sclera and skin the person becomes yellow, the person feels heaviness on the right under the ribs, vomiting appears mixed with bile, which does not bring relief. This condition is extremely dangerous, as it can lead to seizures and a critical increase in temperature.

Usually the attack ends after the stone hits the small intestine. To improve the patient's condition, lay him on his right side and apply a heating pad. But sometimes the size of the stone is such that it cannot pass through the ducts and gets stuck in them - in this case, removal of stones from the gallbladder is carried out by surgical extraction.

Reasons

Normally, stones should not form in healthy body. However, there are predisposing factors that influence the disruption of metabolic processes and become the causes of the formation of stones in the gall bladder.

Excessive consumption of foods rich in cholesterol is main reason development of housing and communal services. From here comes the second predisposing factor - due to a disruption in the nutritional process. Also, causes such as disorders in the liver, long-term use of drugs can cause a disturbance in the composition of bile with the formation of sediment in the form of solid particles, which subsequently form stones. oral contraception, and some pathologies of internal organs.

The formation of stones occurs against the background of a decrease in the ability of the gallbladder walls to contract, which, in turn, also depends on the complete objective reasons. For example, the reasons for the decline contractile function consist in the presence of pathologies such as flatulence and others. If operations were performed on the organ, this can also cause a disruption in its performance.

Other reasons are physical inactivity and poor nutrition. And during pregnancy, there may be an additional load on the gallbladder, as a result of which its transport function is disrupted.

Mechanical obstacles to the outflow of bile also cause the appearance of stones. In particular, this can occur with various tumors, in the presence of adhesions and cysts, with severe swelling the walls of the bladder and even due to birth defect– bending of the duct.

Call cholelithiasis There may also be reasons such as infections that enter the organ through the bloodstream or lymph flow from other systems of the body. Any infection that penetrates the gallbladder causes its inflammation, after which inflammation of its ducts develops. This leads to the development of cholecystitis and, against which cholelithiasis often develops.

Today, doctors distinguish two types of stone formation in this organ:

primary, in which gallstones form over a long period of time and for a long time do not make themselves known;
secondary, when the formation of stones occurs due to development stagnation in the gallbladder.

Features of treatment

The diagnosis of cholelithiasis is made based on examination data. Patients are advised to do this, but if it is difficult to determine the presence and location of stones using ultrasound, cholecystography or retrograde cholangiopancreatography is performed.

Treatment of pathology directly depends on the size and number of stones in the organ and their location. It can be either conservative or surgical. Timely conservative treatment makes it possible to preserve the integrity of the organ and ducts and consists of such procedures as:

dissolution of stones by taking certain medications;
crushing using ultrasound.

Also in some cases, percutaneous cholelitholysis and minimally invasive methods of stone removal are indicated. Sometimes treatment involves surgery - cholecystectomy. Important Diet also plays a role in treating gallstones. Treatment with traditional methods has also proven itself well.

Drug treatment consists of treatment with drugs such as Henofalk and Ursosan - they allow you to dissolve stones and painlessly remove them from the body.

Drug treatment is indicated only in cases where the stones are small in size and when the functioning of the organ itself is not impaired. A method such as crushing gallstones using ultrasound or laser can be used when large stones need to be broken into small pieces that can independently move through the bile ducts into the intestines. It usually takes several sessions to destroy the stones, but this method is used in cases where a person has several large stones in the gallbladder that cannot be dissolved by taking medications.

Percutaneous cholelitholysis is rarely used and the procedure involves administering a substance that dissolves stones through a special catheter. Much more often, stones are removed from the gallbladder through small incisions (laparoscopy).

The most common operation for patients with cholelithiasis is cholecystectomy, which involves a large-scale operation to remove the organ. This procedure should be used in cases where other methods are unable to solve the problem, or when the entire organ is filled with large stones.

Treatment of this pathology is also associated with the need to adhere to a certain diet. The diet for gallstones includes the following recommendations:

eat food up to six times a day in small portions;
increase consumption of foods rich in magnesium;
increase the amount of animal protein in the diet.

In addition, the diet for gallstones recommends completely avoiding foods such as sausages and smoked meats, pickles and preserves, legumes and butter, and also eliminating some vegetables (cucumbers, eggplants, radishes). It is not recommended to consume coffee, alcohol and organ meats.

The diet for gallstones allows you to eat fish and white meat, cereals (oatmeal and buckwheat are especially useful), cottage cheese and low-fat milk, fruits and vegetables that do not irritate the gastrointestinal mucosa, as well as drink mineral water and natural juices.

Traditional medicine methods

Treatment of this disease is carried out and folk remedies. In particular, the dissolution of stones is carried out by drinking a glass hot water with the juice of one lemon squeezed into it. In this case, slow dissolution occurs, so you need to use this recipe for a long time.

Other juice mixtures are also used for a long time:

carrots, cucumbers and beets;
carrots, celery and parsley juice.

There are other folk remedies to get rid of the disease. For example, you can treat an illness with raisins, which are mixed with holosas and mineral water Borjomi. Or tincture of pine nuts.

Note that folk remedies can remove those stones from the gallbladder that are small in size, provided that there are only a few of them. It is dangerous to “expel” large stones, as this can lead not only to blockage of the ducts, but also to their rupture.

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Gallbladder 05/11/2013

Dear readers, today we will talk about whether it is possible to treat gallstones without surgery and get rid of them. Probably, when people are faced with this problem, the first question that arises is precisely this: “How to avoid surgery to remove the gallbladder, is it possible to do something”? I give the floor to doctor Evgeniy Snegir, who runs this column.

When a diagnosis of cholelithiasis is made and the surgeon insists on laparoscopic cholecystectomy , then all patients always have the same question in their heads: is it possible? Treatment of gallstones without surgery? We will try to answer this question reasonably.

At the beginning of the conversation, we will pay attention to theoretical concepts.

So, briefly. The gallbladder is a reservoir for collecting bile produced in the liver. Bile is necessary for digestion; it helps to emulsify food fats in order to make their absorption process convenient. If there are disturbances in the chemical composition of bile, it increases lithogenicity– ability to form stones. Salts bile acids gallstones begin to precipitate and form in the gall bladder.

Types of gallstones.

According to their chemical composition, due to the predominance of one or another component, stones can be cholesterol, bilirubin, calcareous and mixed. For common man without medical education this information, without much detail, is quite sufficient to understand mechanism of formation of gallstones .

A radical way to help a person once and for all is to remove the altered gallbladder with stones, i.e. execute cholecystectomy , which we have already discussed in detail in the article. If the operation is not performed and the gallbladder is left in place, then in this case the stones themselves will have to be removed from the gallbladder in some way. This is also quite understandable. In this case, the stones must either be dissolved completely or crushed into fine particles so that they can get from the gallbladder through the bile ducts into the duodenum and beyond in a natural way leave the body with feces. This is the situation.

Dissolution of gallstones.

Let's focus on the first method treatment of gallstone disease without surgery - dissolving stones . To begin with, let us immediately note that using medicines Only cholesterol stones will be dissolved. If they contain calcium ions, and the majority of such options exist, then it will no longer be possible to dissolve the stones.

How to determine the composition of gallstones?

The following methods will help us in this matter.

The simplest is X-ray ( oral cholecystography ). Have a drink radiocontrast agent, take an x-ray. Cholesterol stones are X-ray negative – we won’t see them in the image. But all stones, regardless of their composition, are clearly visible. Those. if the doctor sees stones during an ultrasound, but x-ray If there are no stones, then we can safely conclude that the gallstones are cholesterol.
A more unpleasant way for the patient - duodenal intubation(probing of the duodenum to obtain different types bile). The patient swallows a special probe with olive. The end of the probe will be located in the duodenum, and the bile we collect will flow through the probe. The method allows you to accurately determine chemical composition bile from the bladder and draw a conclusion about the nature of the stones formed.

So, if we understand that our stones are exclusively cholesterol, their size is not very large, and the duration of the disease is short, then theoretically we can try to dissolve them - take medications for this. The most effective is ursodeoxycholic acid (a drug Ursosan) and chenodeoxycholic acid (drug Henofalk ).

But there is one very important circumstance here. Even if these medications help and it is possible to dissolve the stones, no one can guarantee that these stones will not form again. And once again you will have to take medications and try to dissolve the newly formed stones. Given enough high cost drugs and the lack of a guaranteed recovery result, it is very doubtful to recommend this method as the main one in the treatment of cholelithiasis.

A variation of this method is percutaneous transhepatic cholelitholysis , when a stone-dissolving drug is injected directly into the bladder itself through a catheter inserted through the skin and liver tissue. The method allows you to dissolve not only cholesterol stones, but also all other types of stones. But again, no one can guarantee that stones will not form again. So what, now you have to constantly “clean the bubble”? Let me note to my dear readers that the gallbladder is not the interior of a car, “mine, I don’t want it,” everything is more complicated in the body.

Well, dissolving stones is not a rewarding idea, then maybe try to crush them? They crush kidney stones and it actually helps? Of course, we will consider this method.

Crushing stones in the gall bladder.

Invented for crushing gallstones extracorporeal shock wave lithotripsy . The essence of the method is to generate shock waves in the lumen of the gallbladder and focus them on the stones, due to which crushing is achieved - dividing the stones into small fragments measuring 4-8 mm.

If, after crushing kidney stones, small fragments can leave the body on their own through urinary tract, then in the case of the biliary tract everything is much more complicated. The diameter of the bile ducts is narrow; at the place where the common bile duct flows into the duodenum there is a special valve, which can be a serious obstacle to the passage of stones. Therefore, after crushing gallstones, their small fragments still have to be dissolved.

In addition, the method also has its contraindications - it is not used for pronounced violations blood clotting, acute inflammation gallbladder ( acute cholecystitis), with cardiac arrhythmias. It will not help with calcified and bilirubin stones if there are a lot of stones and their size is more than 3 cm.

Moreover, this method dangerous for the development of complications. No one can guarantee that perforation (rupture) of the altered wall of the gallbladder with fragments of stones, blockage of the lumen of the bile ducts with small fragments will not occur with the development obstructive jaundice. Again, where is the guarantee that stones will not form again later? And once again you will have to go “split up”, wait possible complications and horror.

Thus, we understand again: of course, you can take risks, but no one will give any guarantees.

From here we come to a logical conclusion. The most in a reliable way is operative - simply remove the altered gallbladder with stones, go through rehabilitation period and forget about this problem. That is why, when stones are detected in the gall bladder, surgeons advise removing the gall bladder in a way that is gentle on the body - performing a laparoscopic cholecystectomy.

201 comments

Answer

Elena
26 Mar 2018 at 20:26

Answer

Vasily
18 Mar 2018 at 23:31

Answer

Nastya
18 Mar 2018 at 10:03

Every tenth inhabitant of our planet is diagnosed with gallstones. They differ in size. Sometimes there is only one stone in the bubble, but most often there are several, and different shapes. This pathology, as a rule, are discovered at the next preventive examination. In this case, the question arises: “Gallstone in the gall bladder - should it be removed or not?” It is not possible to give a definite answer to this. The pathology may not manifest itself for a long time, but it is not recommended to start it. The stone can injure the walls of the organ, and inflammation can spread to other areas. In this article we will talk in more detail about the causes of this pathology and the treatment methods offered by modern medicine.

General information

The gallbladder is a small reservoir of liquid contents that is located next to the liver. The latter continuously produces bile. It constantly accumulates in a bladder, which, when emptied, throws it into the duodenum. Bile promotes active digestion of food. It consists of quite complex chemicals, as well as from cholesterol and bilirubin. Over a long period of time, cholesterol gradually begins to precipitate and then be deposited on the so-called protein frameworks. This process entails the formation of microscopic stones, which over time can increase in size and merge with each other. In this case, we are usually talking about cholelithiasis.

The formation of a stone in the gallbladder is a fairly long process, taking from 5 to approximately 20 years. Experts distinguish the following types:

Cholesterol. Are different rounded shape and small diameter up to 18 mm.
Calcareous. They contain a lot of calcium and are extremely rare.
Mixed. Characterized by a layered structure.

The type of stones depends primarily on the person’s diet. For example, in Europe, 90% of all diagnosed gallstones differ in cholesterol nature. In Japan, until 1945, calcareous forms predominated. However, over time and as the Japanese switched to a “Western” diet, the proportion of cholesterol stones began to increase.

It is noteworthy that on the African continent this kind of pathology is confirmed extremely rarely, which cannot be said about our country. On the territory of Russia, 12 out of 100 people are diagnosed annually, 600 thousand people; in the USA these figures are much higher. In America, about 1.2 million people undergo surgery every year.

Reasons

IN normal conditions absolutely healthy people Bile in the bladder is in a liquid state and does not contribute to the formation of stones. However, experts call a whole series factors that influence changes in its initial properties. As a result, stones are formed.

Inflammation of the wall of the pouch.
Metabolic disorders due to physical inactivity, stagnation of bile, ailments of an infectious nature.
Hereditary predisposition.
Liver diseases.
Food. Due to the consumption of cholesterol-containing foods, the concentration of this substance gradually increases and stones form.
Diet. Fasting often causes the development of gallstone disease.
Changes to hormonal level. An excess of female sex hormones is usually observed during pregnancy and the use of oral contraceptives.
Age. The body of older people quite often cannot cope with the load on the liver, which entails the formation of pathology.
Stress.
Drinking alcoholic beverages.

What symptoms indicate a gallstone?

How to relieve an attack of pain? What medications should I take for this? Before understanding these issues, it is necessary to tell what signs indicate the formation of stones.

Many people with this pathology often do not even suspect it. Symptoms most often appear several years after the onset of its formation.

Biliary colic appears suddenly. The pain is constant in nature and is localized mainly in the area of the right hypochondrium. The duration of the spasms can range from 15 minutes to approximately four hours. If after this time the pain does not go away, inflammation of the gallbladder can be suspected.

Patients also note the presence of a pronounced dyspeptic syndrome (problems with stool, nausea, bloating). Some people have a fever. This symptom most often indicates the addition of a secondary bacterial infection.

Survey plan

If you have been diagnosed with a gallstone, only qualified specialist. When primary symptoms It is recommended to consult a gastroenterologist. Diagnosis of this pathology involves a conversation with a doctor, studying the patient’s specific complaints, and collecting an anamnesis.

If gallstones are suspected, mandatory apply instrumental methods diagnostics It is usually not possible to examine the pathology using the most ordinary x-ray. Patients are recommended cholecystography, which uses x-rays along with a contrast agent.

Even more accessible method Ultrasound examination is considered diagnostic. It allows you to identify stones, determine their size and shape, as well as mobility.

What to do if a pathology is detected?

If a gallstone has been diagnosed, treatment methods should be comprehensive. Modern medicine depending on the nature of the pathology and severity inflammatory process offers several approaches to therapy:

Diet (principles of proper nutrition).
Lifestyle correction (normalization of sleep and rest patterns, physical activity).
Conservative therapy.
Non-operative stone removal.
Surgical intervention (if, for example, the gallstone is 32 mm).

What to do first? All patients, without exception, with this diagnosis are recommended to reconsider their usual lifestyle. It is necessary to give up everything bad habits(smoking, alcohol abuse) and try to adhere to the right image life. Patients should increase motor activity to enhance the burning of fats in the body and the removal of cholesterol. For these purposes, it is not at all necessary to go to the gym and do serious exercises. It is quite enough to take a walk after work, attend yoga or exercise classes.

Let's talk about nutrition

Bile and cholesterol are intrinsically linked. This is explained by the fact that an excess of these substances can provoke the formation of gallstones. 80% of cholesterol is constantly produced by the liver. The remainder comes with food. Cholesterol is extremely important for the synthesis of sex hormones, normal digestion and absorption of vitamins. However, its excess leads to heart attacks. By controlling cholesterol levels with diet, you can avoid the occurrence of pathologies such as gallstones.

The diet for this disease is based on reducing the intake of animal fats and excessively high-calorie foods. As practice shows, vegetarians practically do not have to face such a problem. Patients with this diagnosis are advised to abstain from foods of animal origin. high content fat (pork, rich broths, fried meats, etc.). Smoked meats, canned foods, and lard are also prohibited. The diet should be varied with vegetables and fruits, lean meat and fish are allowed in small quantities, as well as lactic acid products. The best breakfast counts oatmeal on water with fresh berries or cottage cheese, you can bake it for lunch chicken fillet under vegetables, and make it light for dinner vegetable salad with fish cutlets. Dishes are steamed or stewed.

It is recommended to take food in small portions, but often (4-5 times a day). All those who take a break between meals of more than 14 hours have increased likelihood development of this type of pathology. In addition, the risk group includes women who are constantly losing weight and those who like to refuse a full breakfast. Absence regular meals leads to a deficiency of certain acids in the gastrointestinal tract. Excess cholesterol is not broken down and falls out, that is, a stone is formed in the gall bladder.

The diet suggests complete failure from alcohol and coffee. Just half a cup of this stimulating drink a day provokes unnecessary and even useless contraction of the bladder.

As for the fair sex, those ladies who daily include citrus fruits, grains and legumes in their diet are less at risk of developing pathology.

Conservative treatment

Diet alone is usually not enough to resolve gallstones. How to dissolve it medicinally? Therapeutic treatment, first of all, should be aimed at reducing unpleasant symptoms. Here we're talking about about the so-called biliary colic. Accompanying her severe pain caused by intense muscle spasm in the area where the stone is located. In this case, a vicious circle is often observed. The spasm provokes severe pain discomfort. Pain, through a neuro-reflex effect on all surrounding tissues, only intensifies the spasm. In this case, therapy should simultaneously pursue two goals: relieving spasm and eliminating pain.

Experts prescribe various antispasmodic drugs to reduce the pain discomfort that accompanies gallstones. Only the doctor decides how to treat the pathology and what dosage of the drug to choose. As a rule, an attack is relieved by an injection of Papaverine or Dibazol. At acute attacks biliary colic is recommended intramuscular injection“No-shpy” or “Eufillina”. Of course, any of these medications has its contraindications, so the choice of one or another drug is made only after examining the patient.

Antispasmodics are often administered simultaneously with painkillers. “Baralgin” is particularly effective.

If it is not possible to reduce symptoms with the help of the above medications, more strong remedies in combination (“Tramal” + “Atropine”).

Very often, due to nausea, the patient cannot take the medicine. In this type of situation, drugs are administered using an enema. As a rule, a combination of Eufillin, Analgin and belladonna is used.

Drug therapy is also actively used to dissolve gallstones. How to display it in this case? The calculus can be literally dissolved with the help of ursodeoxycholic acids (Ursosan, Ursohol, Ursofalk) and chenodeoxycholic acids (Chenohol, Henofalk, Henodiol).

Who is this treatment suitable for? First of all, stones in the gallbladder should be of a cholesterol nature, their size should be no more than 15 mm, and the contractility of the bladder should be normal. The course of treatment usually lasts from 6 to approximately 24 months. During this time, patients are advised to avoid medications that promote stone formation and interfere with the normal absorption of drug components (for example, antacids).

Removing stones without surgery

For this, shock wave lithotripsy is used - a technique in which a specialist uses ultrasound or a laser to “break” a stone in the gall bladder. Surgery to remove a stone is not suitable for all patients. It is recommended only if the number of stones does not exceed three, they differ in cholesterol nature. Due to the fact that the procedure involves direct physical impact, it is not suitable for patients with bleeding disorders.

A total of no more than seven therapy sessions are required. The stones fragment to particles of about 3 mm, and then pass out on their own along with the bile. In practice, this treatment is usually combined with drug therapy. Among the common side effects include the following: development of the inflammatory process.

A laser can also be used to remove gallstones. Laser removal surgery is carried out on the same principle as ultrasound. However, with this procedure there is a fairly high probability of burning the mucous membrane. That is why its help is resorted to only in exceptional cases.

Surgical intervention

Surgery is different high efficiency with a problem such as a gallstone. The operation to remove an existing stone can be carried out in two ways:

Open cholecystectomy. This classic procedure, which is recommended for large stones. During the operation, the doctor makes an incision in the abdominal cavity, then removes the gallbladder and, if necessary, drains it. Drainage involves the installation of special plastic tubes for blood outflow, biological fluids and wound exudate. A couple of days after surgery, the tubes are removed.
Laparoscopy is now actively used in many areas of medicine. One has to resort to its help in case of such pathology as a stone in the gall bladder. The operation to remove stones is characterized by its low-traumatic nature. Initially, the surgeon makes several punctures, through one of them the carbon dioxide directly into the abdominal cavity itself. This is necessary so that the abdomen increases in size, and in the resulting space it is easier to carry out manipulations. After this, the laparoscope itself is inserted directly through the trocar. It is a tube with a camera at the end. An optical cable with a light source can be connected to it. This device allows you to view organs from the inside, since the image from the laparoscope is displayed on a computer screen. Micromanipulators are inserted through the remaining trocars to perform the operation itself.

Today, when choosing from the options proposed above, experts most often give preference to the second. Laparoscopy is recommended if the stone in the gall bladder is 2 cm. An operation of this kind has many advantages. These include the following: fast recovery, absence postoperative scars, slight blood loss.