Hepatic colic first aid algorithm. Who suffers from hepatic colic more often: men or women? How to treat this disease

Hepatic colic is one of the clinical forms of cholelithiasis. The attacks occur spontaneously and are accompanied by severe sharp pain in the right hypochondrium. They are repeated, and their intensity only grows. Hepatic colic may accompany urolithiasis, being the main symptom this violation. This manifestation of the formation of gallstones is more typical for men than for women. Seizures occur in every tenth male representative who is ill urolithiasis. In women, such attacks occur half as often. If the pain does not go away for more than two hours and becomes more severe, you need to urgently call ambulance, since untimely measures threaten human health.

1 Reasons for this violation

The development of hepatic colic is associated with many factors. But the main prerequisite is gallstones. This provokes stagnant processes. As a rule, this phenomenon is accompanied by severe pain, which is repeated with clear frequency, but occurs spontaneously. The pain is localized in the lower abdomen on the right, and can radiate to the right shoulder blade and right collarbone.

This condition may be a consequence of undergoing heavy physical activity or emotional stress. These factors provoke increased production of adrenaline, which in turn puts all muscles and blood vessels in a state of extreme tension, causing spasms to occur. They are the main prerequisite for stagnant bile processes in the liver ducts. This results in sharp, burning pains that a person is sometimes unable to cope with on his own.

The presence of a stone in the gall bladder is not the only cause of hepatic colic. Modern medicine highlights a row additional factors that contribute to the development of such a disorder. Among them, the most common reasons are:

severe distension of the gallbladder or its ducts;
smooth muscle spasm;
irritation of the bladder with stones;
abuse of fatty or spicy foods;
drinking alcohol;
deviation from diet and daily routine.

Depending on which zone of the gallbladder the calculus is located in, the corresponding nature of pain appears. Biliary colic is concentrated in three areas:

"Mute" zone. This includes the bottom and body. If there is no inflammatory process, then pain does not occur.
Moderately sensitive area. It includes the body, funnel and neck. When a stone touches this place, the outflow of bile becomes difficult. The person begins to feel mild tolerable pain, which passes over time.
Flow zone. The stones are in the channels and completely block the path. The bile stagnates, and this causes sharp, strong discomfort. This condition lasts until the stone moves away and opens the ducts.

Hepatic colic - dangerous violation, which can lead to disastrous consequences. At the first signs of an attack, it is better to immediately consult a doctor to avoid complications of the disease. The doctor will identify the cause of hepatic colic and prescribe therapy.

2 How does this violation manifest itself?

Each disease is characterized by a specific clinical picture. Biliary colic is no exception; its symptoms are not very varied, but are usually expressed clearly and acutely. Modern medicine indicates the following signs of this disorder:

Severe pain. They cover the right side of the abdomen, sometimes affecting the right shoulder blade and collarbone. The attacks begin mainly at night and last several hours or more. When the pain covers the entire abdomen, it is difficult for the patient to lie on the right side and it is painful to move. It's already extreme case when you need to call an ambulance.
Urge to vomit. The patient may feel nauseous all the time. He vomits, but the result does not appear. Cleansing the stomach does not bring any improvement in well-being.
Skin disorders. The body becomes covered in cold sweat, excess moisture introduces dysfunction into the normal functioning of all systems. The skin takes on a white or yellow tint. Symptoms of jaundice may be visible externally.
Bloating abdominal cavity. When you feel your abdomen, you may experience slight swelling and muscle tension. If you tap on the rib with your palm, you will feel a feeling of pain and discomfort in the right hypochondrium.
Increased body temperature, especially if there are inflammatory processes.
Significant darkening of urine and lightening of stool.

Among other manifestations, you can observe increased heart rate. Wherein arterial pressure remains within normal limits. When an attack begins, the pain develops gradually. This takes from 15 to 60 minutes on average. When the pain reaches its peak, it can last for six hours. IN medical practice There are cases when an attack lasted more than one day, but this happens very rarely and only in extremely advanced cases. In some patients, hepatic colic does not recur more than once. This means that it was provoked by side factors: stress, physical activity.

At the first signs of hepatic colic, it is necessary to understand its causes. The diagnosis must be made by a medical professional after all required examinations, procedures and tests have been completed. necessary tests. Based on the results obtained, the root cause of the attacks will be identified, to which the therapeutic complex will be directed.

3 How to treat this disease

The course of therapy is prescribed only by a doctor. But there are times when there is an urgent need to take action and provide first aid for hepatic colic yourself at home. This is not always justified or effective, but it will help alleviate the condition until the doctor arrives. The patient must be provided bed rest and proper care. You should also take painkillers or powders, and you can turn to medications that relieve spasms. In addition, a heating pad is used to relieve pain symptoms. But this does not always help, since the heating pad only acts externally.

If the pain does not go away for more than six hours and grows stronger, then there can be no talk of independent measures.

Unprofessional actions may be inappropriate and will only harm the patient. Thus, patients are urgently hospitalized and treatment continues surgically.

If the diagnosis sounds like acute colic, emergency care has other parameters. The patient is also hospitalized. Next, examinations are carried out, and only after this doctors decide how the therapy will be carried out.

Hepatic colic can also be treated at home. If the patient has an attack only once, then therapy is aimed at preventing repeated phenomenon. It is very important to adhere to the diet prescribed by your doctor, spend enough time fresh air and flatly refuse bad habits. Proper nutrition, regular exercise and a healthy lifestyle are the key successful treatment and prevention of recurrent attacks.

Bubble or biliary tract above the obstacle. The code is provided to indicate hepatic (biliary) colic in ICD-10: K80.2.

Today we will talk about the symptoms and treatment of hepatic colic in women and men, how to provide emergency first aid for an attack of pain at home.

Provoking factors in the occurrence of an attack are negative emotions, rich food, consumption of fats, spices, hot seasonings, alcoholic drinks, physical activity, driving on bad road, as well as work in an inclined position.

Sometimes the precursors of an attack are nausea, a feeling of heaviness in the right hypochondrium or in the epigastric region; often these precursors indicate the inflammatory nature of the disease.

In women, colic often coincides with menstruation or occurs after childbirth.

Sharp sharp pain, as a rule, occurs suddenly, often at night, is localized in the right hypochondrium (sometimes in the epigastric region), often radiates to right shoulder and shoulder blade, neck, sometimes spreads from the right hypochondrium to the entire abdomen. Less commonly, the pain radiates to the left, to the region of the heart, provoking an attack of angina.

The pain (very intense) can be constant and cramping.

Attack of hepatic colic

An attack of biliary colic may be accompanied by repeated vomiting, which does not bring relief.

The duration of a painful attack is from several minutes to several hours, in some patients up to 2 days. Usually the patient is agitated, moaning, pale, covered in sweat, trying to find comfortable position.

Sometimes the attack is less acute. During a painful attack, the stomach is swollen, the abdominal wall is tense, the patient spares the stomach when breathing. Palpation of the right hypochondrium is sharply painful, muscle protection makes it difficult.

After the pain subsides, it is possible to palpate the enlarged, painful liver, and sometimes a distended gallbladder.

From additional symptoms Skin hyperesthesia in the right hypochondrium, phrenicus symptom (pain when pressing in the area of the legs of the right sternocleidomastoid muscle), Ortner's symptom (sharp pain when tapping along the right costal arch) are noted.

Often, hepatic colic is accompanied by a rapid and significant rise in temperature; the fever does not last long. Leukocytosis in colic is insignificant.

Diagnosis. Characteristic for uncomplicated renal colic considered fast reverse development all painful manifestations after the pain attack subsides.

Hepatic colic may be the beginning of the development of acute cholecystitis.

Emergency care: hepatic colic, what to do

The first pre-hospital emergency aid for an attack of biliary colic at home to relieve pain consists of the following algorithm:

Place the patient on the right side on a heating pad, give 1–2 tablets No-shpy(drotaverine).

These measures can only be carried out if the patient knows that he has gallstone disease.

If hepatic colic (an attack of cholelithiasis) occurs for the first time, call a doctor.

Among the circumstances that provoke the appearance of colic, great importance has a fatty and heavy dinner, drinking alcoholic beverages. Hypothermia, fatigue, shaking and riding, heavy physical work, sharp emotions, etc.

Colic can result in the passage of a stone into the intestines, and sometimes it is possible to find a stone in the stool 1-3 days after the attack.

Pain relief: drugs and medications

Emergency care by an ambulance paramedic.

If there is no doubt about the correctness of the diagnosis, antispasmodics and painkillers are prescribed (0.5-1 ml of 0.1% atropine solution, 1-2 ml of 2% papaverine solution, 1 ml of 0.2% platyphylline solution, 1-2 ml of 1% promedol solution or 1 ml of 2% pantopon solution).

Hospitalization. If hepatic colic cannot be stopped, hospitalization in a surgical hospital.

Treatment of hepatic colic at home

Let's consider folk method treatment of biliary colic, diet for cholelithiasis, how to relieve hepatic colic and pain at home.

A patient suffering from hepatic colic is recommended to:

maintain bed rest;
organize fractional meals (eat in small portions, but often);
exclude from the diet foods containing a lot of cholesterol: egg yolk, brains, liver, caviar, fatty meat, fatty fish, etc.;
stop drinking alcohol;
regularly visit the Russian steam bath;

Accept vodka tincture birch buds: take 10 grams of birch buds, mash them well in a mortar and pour 100 ml of vodka, leave for several days; strain; drink one teaspoon three times a day a quarter of an hour before meals.

Take an infusion of flowers sandy immortelle: pour one tablespoon of dried flowers into 250 ml of boiling water and leave in a sealed container for about half an hour, strain; drink the infusion in several doses throughout the day.

During an attack, do an enema with an infusion of flowers. chamomile: pour one tablespoon of dried flowers with a glass of boiling water and leave for 15–20 minutes, strain; inject 100–200 ml of warm infusion into the rectum; After the enema, it is recommended to take a warm bath (15–20 minutes), then go to bed.

common juniper fruits – 3 parts,
Salvia officinalis herbs – 3 parts,
peppermint herb - 3 parts,
creeping thyme herb - 2 parts,
wormwood herb – 1 part.

Pour one tablespoon of the mixture into two glasses of water, cook at low boil for 1 minute, then leave for an hour, strain; drink half a glass eight to nine times a day, then, if there is improvement, reduce the dose to five and three times a day.

Prevention

To prevent frequently recurring attacks of biliary colic it is necessary.

Beet syrup. Take a few beets, peel, cut and cook them long time until the broth thickens and becomes like syrup. Take this decoction ¼ cup three times a day before meals. Healers recommend drinking this syrup for a long time, then the dissolution of gallstones will occur gradually and painlessly.

Infusion of horseradish in milk. Grate 4 tablespoons of horseradish, mix with a glass of milk, heat until almost boiling (but do not boil) and leave in a warm place for 10 minutes. Then strain, squeeze out the grounds and drink a little of everything throughout the day.

Drink 10 glasses at once very hot tea within 15 minutes. This greatly softens the stones, turning them into sand and making it easier to get out.

Decoction of dandelion roots. Pour a teaspoon of crushed roots into 1 glass of water and boil for 20 minutes. Drink one fourth of a glass 4 times a day.

Birch leaf decoction Option 1. Pour a glass of boiling water over a tablespoon with the top of birch leaves, boil for 20 minutes, leave for 1 hour, strain. Drink a glass of decoction for a long time, 2 times a day, half an hour before meals.

Option 2. Collect and dry spring birch leaf the size of a penny. Pour 2 tablespoons of dry leaf into a glass of boiling water, boil over low heat until the volume is reduced by half, when it cools, strain. Take 1 dessert spoon three times a day before meals. The course of treatment is 3 months. Good for small stones. When stones pass, pain, nausea, and stinging may occur.

Infusion of birch leaves drink 3 cups daily.

Olive oil. Take the oil half an hour before meals, starting with half a teaspoon and working up to half a glass. Treatment lasts 2–3 weeks.

Infusion of corn silk. A tablespoon of stigmas per 600 ml of boiling water. Brew, infuse and drink one quarter glass 3-4 times a day.

Red rowan. Forest (unsweetened) rowan should be eaten for a month and a half - with anything: with bread, tea, sugar - for stones in the liver and ducts. During the day, eat 2 glasses of fresh rowan.

Infusion of immortelle flowers. Pour a tablespoon of flowers with a glass of boiling water, leave for 1 hour, strain. Take one third of a glass three times a day.

Infusion of meadow geranium herb. Pour 2 teaspoons of herbs into 2 cups of cold boiled water, leave for 8 hours. Sip throughout the day. The product is used as a dissolving stones in the kidneys and liver.

Medical treatment of hepatic colic

Treatment of the disease can be conservative And surgical.

Conservative treatment is as follows:

Application alkaline salts, mineral waters to facilitate the evacuation of bile from the gallbladder and its dilution (Carlsbad salt, burnt magnesia, “Essentuki-20” and other mineral waters).
Following a diet limiting foods containing cholesterol, fats and animal proteins.
Regulation of food intake; Patients should be advised to eat moderately, regularly and often, since food intake is a natural means of promoting the outflow of bile.
Purpose of thermal procedures: heating pads, diathermy, compresses, etc.
If there is no doubt about the correctness of the diagnosis, then the patient is prescribed antispasmodics and painkillers (0.5–1 ml of 0.1% solution of Atropine, 1–2 ml of 2% solution of Papaverine, 1 ml of 0.2% solution Platiphylline, 1–2 ml of 1% solution of Promedol or 1 ml of 2% solution of Pantopon).

In case of intractable hepatic colic, hospitalization is carried out in a surgical hospital.

Video on the topic

Hepatic colic: gallbladder attack, what to do

What is biliary or hepatic colic? Biliary colic, sometimes called a gallbladder attack, is a condition in which a gallstone temporarily blocks the bile ducts, causing severe pain in the right upper quadrant. This video describes the pathophysiology, manifestations and symptoms, as well as treatment of biliary colic.

Gallstones: symptoms of biliary colic

Gallstone disease is a disease characterized by the formation of stones in the gall bladder. The main symptoms of the disease are pain and biliary colic.

This disease is also widely known as “cholelithiasis”, and you can often find its name in the form of the abbreviation “Cholelithiasis”.

Gallstone disease does not occur without characteristic reasons. If stones form in the gallbladder or its ducts, this means that cholesterol and bilirubin metabolism in the body has been disrupted. Due to metabolic disorders of these substances, the outflow of bile becomes difficult, bile stagnates, and stones form from it.

Accordingly, gallstones may have different composition: They may consist of bilirubin, cholesterol, and potassium salts. As a rule, stones form in the gall bladder, and a person may not feel them for quite a long time, even his entire life. However, if suddenly the stones move and move from their place, then this process will not go unnoticed. A person will experience symptoms that are described in the article below, after which there will be an urgent need to stop the attack and treat the disease.

It is worth noting that gallstone disease often affects females. Thus, among patients who applied for medical care in this situation, it was noted that the majority of women aged 45 years and above were overweight.

Gallbladder: treatment in a safe way

Treat your gallbladder in another simple and safe way at home.

My name is Viktor Vladilenovich Kartavenko. I'm a professor, doctor medical sciences, I am one of the authors of the “School safe health Dr. Kartavenko."

Today we will talk to you about the problems and conditions of the gallbladder and safe folk ways treatment of those very unpleasant sensations associated with the gallbladder.

In 2 minutes, I must tell you how to quickly rid yourself of the condition of heartburn, nausea, and the condition of an impending sore throat. That is, from such unpleasant sensations that are associated with bloating of the stomach, with a feeling of nausea.

Just a few days ago on our website www.doktor-kartavenko.ru we published an article called “Impaired outflow of bile and the secret point of Genghis Khan.”

Located in such a convenient place for each person: the landmarks are the intersection of the first radiocarpal groove and the base thumb. This is exactly the place where the wonderful one is located, for a long time"closed" point of Genghis Khan.

What's so special about her? The remarkable and characteristic thing is that it can be used almost constantly. Are you on the subway, are you in a long traffic jam, are you in front of a computer, do you experience discomfort before doing something? stressful situation, or you are called “on the carpet” or a few seconds before the exam... In a word, you experience the sensations that we talked about. This is nausea, heartburn, a feeling of a bloated stomach.

But this point will help cope with these problems associated with the condition of the gallbladder and is simple and safe means traditional treatment gallbladder colic.

Hepatic colic occurs due to the development of pathologies in the gallbladder. Most often, symptoms develop due to blockage of the ducts of the organ by dense formations. Women experience colic more often than men, this is due to hormonal imbalances(pregnancy, menstruation, taking birth control pills).

Painful sensations in the right hypochondrium can be caused by diseases of the gallbladder. Due to disruption of the functioning of the organ, stones and mucus plugs can form in it, which can move and block the ducts of the bladder, which entails stagnation of bile and an increase in the pressure of the organ from the inside. This provokes the appearance of severe, unbearable pain.

Symptoms may also occur due to the following reasons:

The development of tumors and inflammatory processes (inside or outside the organ) can lead to compression of the bile ducts.
Their patency may be impaired cholesterol plaques and blood clots.
Changes in the tone and motor ability of the ducts can lead to their bending.

The following factors can lead to changes in the gallbladder and diseases:

If one of your immediate relatives has gallbladder disease accompanied by hepatic colic, then the woman will have a predisposition to the disease.

Symptoms

Hepatic colic (symptoms in women most often occur during sleep or complete rest) sometimes appear after intense physical activity. Before the main symptoms appear, there is discomfort in the right side, and a feeling of bitterness.

Then unbearable pain occurs, which is cramping, sharp and bursting in nature. They do not decrease in any position. They can be localized in the right side, in the stomach area, and also extend to the shoulder, neck, and shoulder blades. Sometimes the pain may involve the heart area.

The painful symptom may be accompanied by bloating with nausea and vomit mixed with bile. After emptying the stomach of food, there is no feeling of relief. If the gallbladder is severely damaged, vomiting may be constant.

Additionally, the number of heart contractions increases (pressure remains normal), the skin becomes pale and may have a yellow tint. Maybe slight increase temperature. Change in color of stool to a lighter color, and urine, on the contrary, becomes darker.

A woman can stay in this state from 10 minutes to 8 hours. Depends on what triggered the attack. If the pain does not subside for more than a day, it is necessary to call emergency help; emergency surgery may be required.

Urgent Care. How to quickly stop an attack at home

When symptoms appear for the first time, you should immediately call emergency help. Do not take painkillers or apply heat to your side. Because of the pills, doctors will not be able to fully clarify the picture of the disease. And a heating pad can cause a worsening of the condition if the attack was caused by inflammation or infection.

When a woman knows exactly what caused the pain. Then it is necessary to give injections that relieve spasms and inflammation. Can be used in combination with tablet medications. Medicines are prescribed by a therapist or gastroenterologist. The first available remedies can cause the condition to worsen.

Diagnostics

Hepatic colic (symptoms in women are pronounced) require the use of painkillers, as well as full diagnostics to prescribe treatment. It is necessary to find out what caused the symptom and what method of treatment the pathology can be treated with.

Diagnostic method	What is it produced for?	Notes
Initial examination and collection of verbal data	The therapist will learn from words when the first symptoms appeared, what preceded it, as well as the duration and characteristics of the pain. With the help of palpation, you can determine an increase in the size of the liver. It is also assessed whether there is yellowness of the skin	If relatives have problems with the gallbladder, this should be discussed during the examination. And also about what measures were taken to eliminate pain. Did the medicine help or not, and for how long?
General and biochemical analysis blood	The erythrocyte sedimentation rate determines the presence of inflammatory process in organism. As well as the presence of bile pigments	Blood test does not show full picture diseases. Inflammation can be detected and is it related to the gallbladder?
Urine analysis	Urine may contain bile pigment. What will indicate a malfunction of the organ?	Analysis is not always effective
Ultrasound	The condition of the liver and gall bladder is determined. If the latter contains stones, then their location, size and quantity are determined. You can see if there is an inflammatory process, narrowing of the ducts, or tumors.	Ultrasound data is often sufficient to further prescribe treatment. The procedure takes up to 15 minutes and is safe
MRI and CT	Most often done before surgery. To more accurately locate stones and determine the condition of the ducts in the gallbladder	During the procedure, the woman must remain motionless, otherwise the results may be distorted.
Cholecystography	The procedure is performed using contrast fluid and X-rays. This method allows you to determine the location of the tumor, stones and inflammatory process with the highest accuracy.	For the patient, the procedure is not entirely convenient, since insertion and removal of the fiberscope through the oral cavity causes quite unpleasant sensations

After collecting all the information, the gastroenterologist can determine whether surgery is required or drug treatment is possible. Medicines and diet therapy are prescribed.

Drugs for hepatic colic

Hepatic colic is always accompanied by severe pain. First of all, it is necessary to relieve the pain symptom and eliminate the cause of its occurrence. After diagnosis, the gastroenterologist prescribes a course of medications:

1. Drugs that help relieve pain:

2. Remedies for relieving spasms:

papaverine;
platiphylline;
no-shpa;
mebeverine.

3. Medicines that weaken the body’s sensitivity:

diphenhydramine;
morphine

4. Anti-inflammatory drugs:

To speed up the removal of bile from the bladder, allochol is prescribed. At severe pain It is recommended to administer the drug intramuscularly so as not to burden the gallbladder. If drug therapy will not produce results and the pain symptom is not relieved, will be prescribed surgical treatment. Often the gallbladder is removed.

Folk remedies

Hepatic colic can only be treated drug treatment and under the guidance of a gastroenterologist. When the symptoms are relieved, you can take medicines combine with the use of folk recipes.

Among women, the following products are more popular:

Folk remedies are often used to prevent the development of the disease. If they are used during treatment, then the dose and course should first be obtained from a gastroenterologist. Since even herbal decoctions can have a cumulative effect and cause harm to the body over time.

Other methods of pain relief

To eliminate the pain syndrome, but only after examination by a therapist and finding out the cause of the pain, it is allowed, in case of severe pain, to apply heat to the liver area (a heating pad with warm water). But if there is a fever, the procedure is contraindicated.

An attack can also be relieved with massage. Only an experienced massage therapist can perform the procedure. It is prohibited to do it yourself, as it can disrupt the patency of the ducts. When carried out correctly, patency improves and the attack of pain subsides.

If medications, massages and ethnoscience do not bring changes, then the gastroenterologist prescribes surgery. When the cause of pain is in stones and they big size, then the gallbladder is removed. When the formations are of medium size, they are surgically crushed to the state of sand (the ducts are first expanded) and they are removed from the organ.

Medicines help relieve pain when it appears in acute form. If the attacks are mild, then you can relieve the pain with folk recipes. To prevent the onset of symptoms, the gastroenterologist prescribes strict adherence to the diet, until full recovery. When followed properly, pain rarely occurs.

Diet

Hepatic colic (symptoms in women more often occur due to poor diet) can be reduced by following a diet prescribed by a doctor. On the first day of the attack, eating is not advisable. Otherwise, the products may cause repeated pain symptoms. Within a day, the digestive tract will have time to recover. Next, it is necessary to follow the treatment menu.

A woman should consume at least 1.5 liters per day clean water. The amount of salt consumed in dishes should not exceed more than 10 g per day. The menu should contain products that provide a complete supply of all necessary nutrients.

It is also necessary to monitor the amount of proteins, fats and carbohydrates consumed. If you are overweight, you may be prescribed low calorie diet. A large number of fat cells can cause re-development seizures.

Food should be divided into small portions and kept warm.

If you have liver colic, you should not eat fried, smoked or spicy foods.

For hepatic colic use fried foods Absolutely forbidden!

Vegetables, fruits and meat products can be boiled, baked or steamed. In the first week, it is better to eat liquid foods so as not to overload the digestive tract and additionally use enzymes (but only if they are prescribed by a gastroenterologist). The woman can create the menu herself. During the treatment period, hunger strikes and weight loss diets are prohibited, without consulting a specialist.

Permitted and prohibited products

When compiling weekly menu the patient needs to know which foods are allowed to be included in the diet and which are prohibited. There are also conditionally approved products. That is, they can be consumed in limited quantities and with special preparation.

Products table:

Allowed	Prohibited	Conditionally permitted
Compotes and jelly are cooked with xylitol or sorbitol. Tea can be sweetened only with the same sweeteners	Margarine, fat, lard	Vegetable and animal oils
Rye bread or yesterday's white bread	White cabbage, turnip, sorrel, mushrooms	Vegetables only baked and boiled
Boiled meat, fish and liver (low-fat)	Citrus fruits, pomegranate, grapes	Apples, bananas, berries
Vegetable and chicken broths	Confectionery, jam, chocolate	Honey
Porridge, crumbly. Cook with water or low-fat milk	Strong tea, juices, coffee	Juices, only diluted
Cereal soups	Fatty meat and fish, sausages
Biscuits and oatmeal cookies	Use spices and pepper
Steamed omelet eggs	Alcohol products
Low fat dairy products

A more complete list of products should be checked with a gastroenterologist. Because if you have chronic diseases digestive tract or other diseases, the list of permitted products will be reduced.

Complications

Liver colic (symptoms in women, this is main feature apply for medical assistance) if treated incorrectly or untimely, they are dangerous for the development of complications. Treatment that will take more longer time and the development of chronic diseases is possible.

Common pathologies due to hepatic colic:

Forecast

If you consult a gastroenterologist in a timely manner, take medications and follow a diet, the treatment prognosis is positive. It is important that if the treatment does not bring changes in the condition, you should not adjust the treatment yourself (change medications or increase the dose of medications); all adjustments can only be made by a specialist.

Liver colic, according to statistics of the most common diseases, is in 3rd place. The symptoms of the disease are pronounced; when they first appear, you should immediately go to the hospital; self-treatment is prohibited. In women, the disease can also be provoked by hormonal imbalances caused by pregnancy or taking hormonal drugs.

Article format: Mila Friedan

Video about hepatic colic

What you can do for hepatic colic:

Hepatic colic is the most common clinical form cholelithiasis (75% of patients). It manifests itself as sudden and usually periodically recurring intense pain attacks.

Among the most characteristic main manifestations that occur in connection with the formation of gallstones is hepatic colic. Its occurrence, as stated by the corresponding medical statistics, is observed with a certain frequency in every tenth patient with cholelithiasis, mainly in male patients. Women suffer from hepatic colic much less frequently; it occurs in them with approximately half the frequency of recorded cases.

Hepatic colic occurs due to the fact that the stones present in the gallbladder create an obstacle to the processes of normal outflow of bile. Accompanied by this pathological phenomenon V human body acute pain that occurs in the area where the gallbladder is located, namely with right side under the costal arch. The localization of pain syndrome in hepatic colic also involves right shoulder blade, and in addition to this, pain may sometimes be felt under the right collarbone. Pain in hepatic colic is acute burning character, and can be provoked as physical activity great intensity, and act as a consequence of strong emotional stress. Due to heavy physical exertion or an excited psycho-emotional state, the content of the hormone adrenaline in the blood increases, the excess of which leads to spasms in the muscle tissue, as well as vascular spasms. This provokes stagnation of bile in the hepatic ducts, which in turn causes pain characteristic of hepatic colic.

ICD-10 code

R10.4 Other and unspecified abdominal pain

Causes of hepatic colic

An attack of hepatic colic can be provoked by an error in diet or physical activity, however, in many patients it is not possible to identify provoking factors, and the pain may begin during night sleep. The mechanism of hepatic colic is complex and not fully understood. Most often, an attack of colic is caused by a violation of the outflow of bile from the gallbladder (GB) (spasm of the cystic duct, obstruction with a stone, a lump of mucus) or a violation of the discharge of bile along the common bile duct (CBD) (spasm of the sphincter of Oddi, obstruction with a stone, a lump of mucus, passage stone according to the CBD).

Different areas of the gallbladder and bile ducts are characterized by different pain reactions to the presence of a stone. Typically there are three zones:

the bottom and body of the gallbladder are a “silent” zone (the presence of a stone in it does not cause pain in the absence of inflammation of the mucous membrane);
zone of moderate sensitivity - the funnel, the neck of the gallbladder and the adjacent part of the body of the gallbladder (moving into this zone, the stone causes a disruption in the outflow of bile; contraction of the gallbladder is accompanied by moderate pain);
zone of severe pain (duct zone) - the presence of stones in the ducts causes their spasm, accompanied by ischemia of the wall, impaired outflow of bile, stretching of the overlying sections of the duct, hyperperistalsis, which causes sharp pain and increased spasm (vicious circle), continuing until the stone or clot leaves mucus or administration of antispasmodics. It is not recommended to administer true opiate receptor agonists (morphine, fentant, promedol, etc.), which can increase pain (possible sphincter spasm).

Symptoms of hepatic colic

The following clinical symptoms are characteristic of hepatic colic: the attack occurs suddenly, can last for hours, rarely more than a day. The pain is acute, paroxysmal in nature, vaguely localized in the right hypochondrium and epigastrium - visceral pain(occurs with spasm, stretching, swelling of organs). Irradiation of pain to the back or shoulder blade is caused by irritation of the endings of the branches spinal nerves, taking part in the innervation of the hepatoduodenal ligament along bile ducts. The noted symptoms may be associated with the presence of choledocholithiasis, cholangitis, ductal hypertension - the so-called choledochial colic. The attack may be accompanied by reflex vomiting, which does not bring relief. The pulse may increase, but blood pressure does not change significantly. There is no increase in temperature, chills, or leukocytosis, since there is no inflammatory process (unlike an attack of acute cholecystitis). The pain usually increases within 15-60 minutes, and then remains almost constant from 1 to 6 hours. Subsequently, a gradual subsidence of the pain is noted, but a sudden cessation is also possible. An attack of pain lasting more than 6 hours may indicate possible development acute cholecystitis. Between attacks of hepatic colic, the patient feels quite well. 30% of patients do not experience repeated attacks.

Acute hepatic colic

Acute hepatic colic occurs mainly against the background of gallstone disease. To a slightly lesser extent, biliary dyskinesia can provoke its appearance. The fundamental factor in the development of the prerequisites for the appearance of acute hepatic colic is the blockage of the bile outflow tract from the gallbladder by stones formed in it. Because of this, the amount of bile increases significantly, causing the gallbladder to begin to stretch in that part of it that is located above such an obstacle, which creates the impossibility of free outflow from this organ.

Excessive consumption can lead to acute hepatic colic. large quantity food, especially if it is too fatty, excessive use of hot seasonings and spices in food, intemperance in relation to alcoholic drinks. Also appear pain symptoms of this kind are capable as a consequence of too intense physical stress bodies.

The following symptoms are characteristic of acute hepatic colic. It may be preceded by nausea, a feeling of heaviness in the stomach or in the right hypochondrium. In these areas of the body it is noted sudden appearance acute pain. In addition, pain may occur in the right shoulder and shoulder blade, and spread to the neck. In some cases, the localization of the pain syndrome, extending from the hypochondrium, completely covers the abdomen.

The pain in acute hepatic colic is very intense, it can be constant or manifest itself in the form of contractions.

The duration of an attack can be several minutes or hours, or last for more than a whole day. With acute hepatic colic, patients, as a rule, become extremely agitated, turn pale, become covered in sweat and are very restless, trying to find a body position in which relief can occur.

Acute hepatic colic calls for the need to immediately take appropriate therapeutic measures to help the patient cope with such a critical condition.

Attack of hepatic colic

An attack of hepatic colic occurs against the background of cholelithiasis and is also called biliary or gallstone colic. Attacks of hepatic colic are mainly observed at that stage of the disease with the formation of gallstones, at which undeniable clinical manifestations this disease. The previous two stages are predominantly characterized by an asymptomatic course and absence of pain. For cholelithiasis, when it reaches its third stage in the process of developing pathological progress, it is characterized by the alternation of rather long periods during which the disease practically does not manifest itself at all, with episodic attacks of hepatic colic. Over the course of a long time, all symptoms can be reduced to nothing more than a feeling of heaviness in the right hypochondrium, minor discomfort after eating and the appearance of a bitter taste in the mouth. And sometimes even such manifestations may not be observed. But such a lull in the course of the disease is only for the time being, and sooner or later, one way or another, one must expect the occurrence of an attack of hepatic colic.

Due to the fact that during the pathological process of formation of stones in the gall bladder congestion become more and more pronounced, pain symptoms become increasingly intense. They appear against the background of the fact that the lumen of the common duct is blocked by a stone or is significantly narrowed due to spasm. This leads to excessive accumulation of bile inside the gallbladder, which increases in size, stretches, and this process is accompanied by pain. Attacks of hepatic colic can also occur when stones move in the biliary tract.

An attack of hepatic colic, from the very first moment as soon as it appears, signals that cholelithiasis, if it was still present in a person asymptomatically and without manifesting itself in any way, its presence was not established, is now completely clear and with all certainty makes itself felt. It is with an attack of hepatic colic that the development of all kinds of complications of this disease basically begins.

Liver colic during pregnancy

Hepatic colic during pregnancy may be due to the fact that the pregnant woman had any chronic diseases or dysfunction before she began to bear the child. internal organs associated with the processes of bile outflow. Among the causes of hepatic colic in this regard, one can name in particular cholelithiasis and biliary dyskinesia. Liver colic in this case occurs as a consequence of exacerbation of such diseases during pregnancy.

An unplanned and ill-considered approach to organizing the diet of a woman preparing to become a mother can also lead to the appearance of hepatic colic during pregnancy. In this case, you need to consult a doctor to optimize your diet. You should avoid eating foods and dishes that can negatively affect the normal functioning of the liver. It is advisable to refrain from anything spicy or fried, and exclude all kinds of smoked foods from your menu.

When a woman suffers from hepatic colic during pregnancy, she often finds it difficult to find a body position in which it becomes possible to reduce the intensity of pain. The pain of hepatic colic during pregnancy is very sharp and aching and may be accompanied by fever, nausea and vomiting. In order to cope with hepatic colic during pregnancy, it is not recommended to take any pharmacological painkillers since their use will not benefit the functions of the liver.

The best way to combat hepatic colic during pregnancy is perhaps barefoot walking, which stimulates the feet, and this in turn has a beneficial effect on relaxing the muscles of the gallbladder and bile ducts. To relieve spasms, taking antispasmodic drugs is also justified.

Emergency care for hepatic colic

Emergency care for hepatic colic involves, on the one hand, the use of means that help reduce the severity of the pain syndrome, and on the other, ensuring the restoration of the patency of the bile duct by relieving tension in its muscles.

A high degree of effectiveness as an antispasmodic drug is shown by the use of nitroglycerin in alcohol solution or in the form of tablets. The patient needs to take either one tablet or a solution in the amount of 2 drops. Sometimes this measure is not enough. In this case, it is necessary to administer platiphylline subcutaneously in a 0.2 percent solution of 2 ml or from 2 to 3 milliliters of papaverine solution at a concentration of 2%. An alternative may be the subcutaneous injection of a 0.1 percent atropine solution, 1 milliliter. This drug can be used in combination with each of the two above. Good results in terms of relieving spasms, they are achieved by using Arpenal, which must be injected under the skin in a 1-milliliter dose of a 2% solution.

To relieve pain, an injection of 1.0 aspirin or analgin is given into the similar dose. Allowed reuse of these drugs at 4-hour intervals.

It is recommended to keep a heating pad in the area where the gallbladder is located. It should not be filled too much big amount water so as not to subject the peritoneal wall to significant pressure. When there is such a possibility, a patient with hepatic colic can be placed in a bath with water at a sufficiently high temperature for 10-15 minutes.

If hepatic colic is accompanied by a fever in the patient, he is shivering, and elevated temperature persists for more than one day, prescribed antimicrobial agents, for example, administration of 500,000 streptomycin twice a day. As an option, 1.0 sulfadimezine with a 4-hour interval can also be considered.

As you can see, emergency care for hepatic colic has two main directions: therapeutic effects. The essence medical events in connection with it, it is to eliminate the spasm in the bile duct that prevents the normal outflow of bile, as well as to reduce the intensity of pain symptoms associated with its excess content in the gallbladder.

First aid for hepatic colic

Before taking any independent measures to help with hepatic colic, it is necessary to take into account that if the pain is protracted and does not stop after 5 to 6 hours, this requires immediate contact with a medical specialist. This situation means that the disease automatically becomes surgical. That is, it becomes such that monitoring a person’s condition, conducting diagnostics and treatment should be entrusted to the surgeon. Since often the only effective treatment method can only be surgical intervention. Thus, if hepatic colic does not go away for a long time, such a patient needs hospitalization.

As for how you can help alleviate suffering during an attack, there are a number of practical recommendations what should it be first aid with hepatic colic.

The minimum program in this case assumes, first of all, that such a patient needs to be provided with bed rest. Next, he is asked to take painkillers (1-2), a couple of papaverine or no-shpa tablets, and validol under the tongue.

It should be noted that using a heating pad is not always justified. It is only advisable in a situation where you can be sure and unambiguously that it is hepatic, biliary colic that is occurring, despite the fact that there is no acute cholecystitis. And only a doctor is competent in this matter.

So, having done the above, you should definitely call a medical emergency. Especially if the attack happened for the first time. This exhausts all pre-medical care for hepatic colic, and the matter of further treatment should be transferred to the hands of doctors.

How to relieve hepatic colic?

When an attack of acute pain in the area of the liver and gallbladder occurs, the question of what needs to be done in this case and how to relieve hepatic colic becomes especially relevant? Since this phenomenon is most directly caused by the appearance of stagnant processes, in order to alleviate the condition of a patient with hepatic colic, the primary measure is a series of actions aimed at ensuring the free outflow of bile in the hepatic ducts and gallbladder.

It seems possible to achieve this using pharmacological drugs possessing antispasmodic properties. In particular, the use of drotaverine, no-shpa, papaverine, and platiphylline is justified. In especially severe cases, it may be necessary to administer them intramuscularly, as well as intravenously.

Among the measures that are advisable for hepatic colic is the use of a heating pad, which is applied to the right side. Here, however, it is necessary to take into account that resorting to such a measure is allowed only if there is complete confidence that this is not an acute attack of appendicitis.

Another way that can help normalize the processes of bile outflow is to completely abstain from food during that temporary period until all the food in the body is completely digested.

Drinking a drink may be helpful when hepatic colic occurs. mineral water, from which all gases have been previously released.

In addition, allochol tablets in an amount of 2 to 3 pieces can also help cope with hepatic colic.

Thus, although there are a sufficient number of various means and ways to relieve hepatic colic, nevertheless, if, as a result of their use, it is not possible to relieve pain for more than half an hour from the onset of the attack, this requires immediately calling an ambulance. But even if you successfully relieve hepatic colic on your own, you should not postpone your visit medical specialist, who will be able to outline the range of possible causes leading to its appearance and subsequently establish an accurate diagnosis.

Pain reliever for hepatic colic

So, what remedies will help cope with sudden acute burning pain in the liver and what can be used as an effective pain reliever for hepatic colic?

In case of an attack different to a large extent severity, the use of painkillers and antispasmodics is carried out through injections, as well as intravenous administration. And the appointment and implementation of such manipulations can only be performed by a medical specialist. As for what should be done until the ambulance team arrives, there are a number of specific recommendations that, if followed, can help alleviate the patient’s suffering.

It is often possible to successfully reduce the severity of pain in hepatic colic with the help of nitroglycerin, a tablet of which must be placed under the tongue. As alternative way After taking this drug, a few drops (2-3) may appear on a piece of refined sugar.

If there have been attacks of hepatic colic before and the patient has previously sought medical help for this, it makes sense to use the specific painkillers prescribed by the doctor to relieve pain.

Non-prescription pain relievers available for use are rectal suppositories with papaverine, as well as those containing belladonna extract. It should be noted, however, that you should resort to their help no earlier than after consulting a doctor. Since they are, in particular, contraindicated in patients with glaucoma.

If the pain is not too pronounced, it is recommended to take atropine solution 0.1% from 5 to 10 drops per tablespoon cold water. Atropine is a prescription drug.

Among the acceptable measures, the possibility of using a warm compress or a non-hot heating pad in the upper abdomen is also not excluded. But, having put the heating pad on, you need to take into account that if after a 5-10-minute period of time there is no improvement from the heat, it must be removed.

An anesthetic for hepatic colic can bring some relief to the patient’s condition, but we should not forget that such pain is a symptom accompanying dysfunction of the gallbladder and disruption of the processes of bile outflow in the hepatic duct. And this calls for the need to treat the underlying disease first.

Nutrition for hepatic colic

Hepatic colic is closely related to diseases of the liver and biliary tract. Nutrition for hepatic colic should thus be organized based on general recommendations regarding the principles on which one should build a food intake regimen and choose a menu for these diseases.

The diet when hepatic colic occurs should include: sufficient quantity full-fledged easily digestible protein. The fundamental factor on the basis of which the required content and quality of fats is calculated is the general condition of the patient in each specific case. In order for the diet to acquire properties that contribute to the activation of choleretic processes, when such a need exists, it is necessary to include in it an increased amount of fats of plant origin.

Regarding the extent to which carbohydrates should be included in the diet, there is a rule according to which they should not be in excess of the amount regulated by the physiological norm. If the patient has overweight body, in which case carbohydrates may be present in the diet in reduced quantities.

Not the least important role in terms of how to achieve the greatest sparing of the digestive tract is played by the method of cooking. In this regard, culinary processing by boiling, food in pureed or chopped form is optimal. Better digestion absorption in to a large extent promotes eating in small quantities through short periods time. This principle of fractional nutrition ensures improved intestinal motility, and in addition produces a remarkable choleretic effect.

Normalization of the outflow of bile also occurs due to the content in the diet of foods whose composition is rich dietary fiber. Thanks to this, in the composition feces Cholesterol is intensively removed.

Nutrition for hepatic colic, as obviously, has the main goal of promoting the normalization and leading to an optimal state of the functioning of the gastrointestinal tract, liver, gallbladder and bile ducts. As a result, the likelihood of occurrence of characteristic acute attacks pain.

Diet for hepatic colic

Diseases of the liver and biliary tract, if excluded birth defects heredity, the consequences of acute infections, metabolic disorders with the formation of gallstones, arise and develop into chronic form often against the background of excessive consumption of alcoholic beverages and an irrationally organized diet. Problems in the functioning of the liver and gallbladder can be provoked by systematically irregular food intake, an unbalanced menu that does not contain sufficient proteins and essential vitamins.

The diet for hepatic colic, after pain symptoms have been successfully relieved, should be based on the principle of reducing the possibility of such attacks in the future as soon as possible. During the first few weeks after hepatic colic, you should avoid eating meat and fats of animal origin, as well as eggs. Boiled fish can be a suitable replacement for these products. vegetable oil, cottage cheese. You can diversify the menu by adding an increased amount of boiled vegetables to it.

In the future, by strictly adhering to certain dietary requirements, it becomes possible to minimize the likelihood that hepatic colic will occur.

As a rule, diet No. 5 is taken as a basis for diseases of the liver and biliary tract. In accordance with it, the energy value of dishes should be calculated based on physiological standards, and it is recommended to avoid overeating. Physiological norm proteins – 1 gram to one kilogram of body weight, which is optimal. Moreover, about half of their total amount should be represented by proteins of animal origin: meat, poultry, fish, dairy products, eggs.

The diet is compiled in the ratio of two-thirds animal fats to one-third vegetable fats of the total daily norm 70-80 grams.

When adhering to a diet for hepatic colic, you should not abuse fatty and spicy foods, refrain from smoked meats and pickles, and exclude foods with high content cholesterol. A sensible approach to drinking alcohol is also important.

The diet for hepatic colic is chosen on the basis of medical recommendations and prescriptions, taking into account the stage at which the main disease has reached in its course and based on general condition patient.

Hepatic colic, therefore, has as its prerequisites the presence of certain factors of pathogenic properties, and its occurrence occurs solely on their basis. In the absence of health problems and normal functioning it does not appear in the liver and gall bladder.

In 75% of cases, biliary colic is the first sign of cholelithiasis (the process of stone formation in the bladder).

The intensity of pain depends on the size of the stone, its shape, and location. It is maximum when the stone is localized in the ductal system. With gallstone disease, the risk and frequency of pain attacks increases with age.

Causes

The group of causes of hepatic colic includes:

biliary dyskinesia;
presence of stones;
giardiasis;
inflammation of the ducts;
congenital anomalies of the structure of the biliary tract.

The triggering factor for hepatic colic can be:

alcohol abuse;
starvation;
a sharp decrease in body weight due to serious illness or adherence to a strict diet;
eating fatty, fried foods and spicy seasonings. After eating, the gallbladder begins to contract, thereby pushing stones into the ducts. The pathogenesis of pain is represented by hypertension, which develops as a result of obstruction of the lumen of the excretory tract and disruption of bile outflow;
parenteral nutrition;
severe psycho-emotional stress;
Start menstrual cycle(due to change hormonal levels in the bloodstream).

The underlying pathology may be liver disease of infectious or toxic origin, obesity, diabetes or hemolysis of red blood cells. In 30% of cases, biliary colic occurs at night.

The main task of diagnosis is to distinguish the pathological condition from an attack of calculous cholecystitis, in which the pain syndrome is caused by the inflammatory process.

Symptoms of hepatic colic

Clinically, gallbladder colic is manifested by symptoms such as:

dyspeptic disorders. The patient is concerned about flatulence, nausea and frequent vomiting bile, which does not bring relief. The involvement of the pancreas in the pathological process is indicated by its indomitable nature;
acute pain is the main symptom of the pathology. It is localized in the area of the right hypochondrium (bladder projection) or epigastrium, extends to right hand, shoulder region and scapula. The pain may be stabbing or tearing. The patient cannot find a comfortable position to reduce its intensity;
yellowness of the skin as a sign of bile stagnation;

If an attack of biliary colic lasts more than a day, acute cholecystitis should be suspected. It is characterized by hyperthermia above 38 degrees. Sometimes painful sensations may spread to the left side of the chest, resembling an angina attack.

Features of manifestation in men and women

If we compare the clinical picture of biliary colic in opposite sexes, there are no definite differences. One has only to note that in women, pregnancy can provoke colic, which is associated with displacement of internal organs due to an enlarged uterus.

In turn, a man is more difficult to tolerate dietary restrictions, so he more often violates medical recommendations on diet therapy. As a result, both an attack of colic and inflammation of the gallbladder can occur. In addition, alcohol plays an important role, the abuse of which is more common among men.

Diagnostics

To correctly diagnose the disease and prevent the recurrence of pain, it is necessary to carefully study the anamnesis and conduct additional examination. First, the doctor asks the patient about the clinical symptoms that bother him, as well as the characteristics of their appearance and progression.

Particular importance should be given to information about past illnesses, chronic pathology, the presence of similar attacks before, as well as the nature of nutrition and alcohol abuse. With cholelithiasis, episodes of colic gradually become more frequent, longer and more intense.

Pathology of the biliary tract is indicated by the appearance of pain in the area of the right hypochondrium after errors in diet, heavy exercise or drinking alcohol.

The patient may also be bothered by nonspecific signs of digestive dysfunction, such as nausea, bitterness in oral cavity, bloating and heaviness in the gastric area.

During a physical examination, the doctor focuses on a slight yellowness of the skin and mucous membranes, which indicates stagnation of bile. To reduce pain, the patient lies down on the couch and takes a position with the chest knees. When trying to palpate the abdomen, tension in the abdominal wall is noted as a protective reflex.

To confirm the diagnosis, an ultrasound examination is prescribed, which allows you to examine the hepatobiliary tract (biliary tract, liver). The doctor detects stones, notes an increase in the size of the bladder and stretching of the walls.

With cholecystography contrast agent administered intravenously. Thus, the specialist visualizes a “disabled” bladder, which confirms the presence of obstruction in the ducts.

During laboratory diagnostics an increased ESR and an increase in leukocytes are detected. After an attack, bile pigments can be detected in the urine, which indicates the development of jaundice. Sometimes there is an increase in amylase.

Differential diagnosis should be carried out with acute acalculous cholecystitis, renal colic, intestinal spasm, inflammation of the pancreas, appendicitis and ulcerative lesion stomach.

Emergency care for biliary colic

To quickly stop a pain attack, you need to know the cause of its occurrence. The patient is hospitalized in the gastroenterology hospital. Urgent medical complex allows you to relieve spasm of the ducts, after which the bile outflow is restored and the pain in the area of the right hypochondrium ceases.

Hospitalization is mandatory for all patients with biliary colic, as the attack can recur at any time. So, the doctor prescribes:

complete physical rest;
fast for a day, after which the nutritional diet should correspond to diet No. 5;
First aid for biliary colic is antispasmodics (papaverine, drotaverine). If nausea and frequent vomiting bother you, it is recommended to additionally administer metoclopramide;
analgesic drug, for example, ketorolac, baralgin.

If colic continues for more than six hours, treatment is considered. surgical intervention.

The surgical method is also used in case of frequent attacks pain. Treatment consists of removing the gallbladder. For this it can be used laparoscopic method or laparotomy (for complicated cases).

In most cases, preference is given to laparoscopy, as it can significantly reduce the rehabilitation period due to the low traumatic nature of the operation. In addition, the technique has a good cosmetic result, and relapses are less common. Your doctor may also recommend crushing stones using extracorporeal shock wave lithotripsy.

Usually surgical intervention if successful drug relief the attack is carried out after a month. If colic does not recur, the doctor takes a wait-and-see approach.

It is impossible to treat an attack at home because high risk development of jaundice and sharp deterioration general condition. Not a single folk recipe can quickly provide effective help and reduce pain.

If the patient has repeated attacks of colic, before the ambulance arrives, you can independently take antispasmodic drugs and apply a warm heating pad to the liver area. However, this method is strictly prohibited for cholecystitis.

Possible complications

With complete obstruction of the lumen of the biliary tract, a large calculus develops obstructive jaundice. Clinically it manifests itself:

discoloration of stool;
itching;
darkening of urine;
yellowness of the skin and mucous membranes. Its severity can reach an orange tint.

Laboratory tests reveal an increase in the level of total bilirubin and its direct fraction in the blood. Bile pigments are detected in the urine. By using ultrasound examination it is possible to visualize the calculus and assess the degree of damage to the bladder and ductal system.

After surgical removal stone, bile outflow is restored, and signs of jaundice regress.

Another complication is peritonitis. The mechanism of its development is as follows:

obstruction of the duct with a large stone;
spasm of the biliary tract;
disruption of nutrition in the wall on which pressure is exerted by the stone;
tissue necrosis;
violation of the integrity of the wall;
penetration of bile into the abdominal cavity.

Regardless of choice therapeutic tactics conservative or surgical method, an integral part of therapy is a dietary regimen. This diet nutrition allows you to reduce the load on the hepatobiliary tract and facilitate bile outflow. In turn, this prevents changes in the composition of bile and the process of stone formation.

Basic principles of diet No. 5:

complete abstinence from alcoholic beverages, including low-alcohol ones;
exclusion of fatty milk, meat and fish products;
a ban on hot seasonings, marinades, smoked foods, pickles and canned food;
refusal of fresh baked goods, cream products and chocolate;
exclusion of coffee;
a ban on legumes, mushrooms, and products with oxalic acid.

The diet should consist of:

low-fat foods;
vegetables;
yesterday's baking;
various porridges from buckwheat, oatmeal, pasta or rice;
egg whites;
soups, low-fat broths;
biscuits.

Every day you need to drink at least two liters of weak green tea, still mineral water, jelly or diluted juice. The amount of salt per day is limited to 7 grams. Meals should be fractional, small portions. Therefore, it is recommended to eat every two hours. This makes it possible to regulate bile flow and prevent stagnation.

Dishes should have a puree-like consistency. Cooking is carried out using steam, by boiling or baking.

After surgery, only liquid is allowed on the first day. Then the diet gradually expands to include pureed foods. Assuming normal flow postoperative period the patient is transferred to diet No. 5, which must be followed for life.

Prevention

At timely provision help, the prognosis is favorable. Preventive actions help prevent the process of stone formation in the biliary tract and reduce the risk of colic. These include:

early diagnosis of diseases of the digestive system;
proper nutrition;
dosed physical activity;
giving up alcohol;
normalization of body weight;
avoiding long periods of hunger.

The recommendations listed are quite simple and do not require effort to follow. They make it possible not only to normalize bile flow, but also to improve the functioning of the entire digestive system.