Dyskinesia of the biliary tract of the hypotonic type. Biliary dyskinesia of hypotonic type

Biliary dyskinesia is a disease of the gastrointestinal tract, which is characterized by impaired motility of the gallbladder and the functions of its sphincters, in particular the sphincter of Oddi. As a result of these disorders, problems are found with the delivery of bile to the duodenum: its amount may be too small, not enough to digest food, or more than necessary, which negatively affects the entire gastrointestinal tract.

According to statistics, women suffer most from biliary dyskinesia. Some statistics indicate that women are 10 times more susceptible to this disease than men. Moreover, you can get dyskinesia at any age. There are also statistics that GIB in young people is characterized by excessive secretion of bile, and in older age there is an insufficiency of bile for digestion. Treatment of this disease has a positive prognosis if the patient consults a doctor at the first symptoms.

What it is?

Biliary dyskinesia is a functional disorder of the tone and motility of the gallbladder, bile ducts and their sphincters, manifested by a violation of the outflow of bile into the duodenum, accompanied by the appearance of pain in the right hypochondrium. However, there are no organic changes in these organs.

Classification

The definition of the form of dyskinesia depends on how the gallbladder contracts:

Depending on the cause of the development of the pathology in question, doctors can divide it into two types:

Causes

Speaking about the causes of dyskinesia, it is necessary to remember that the disease can be primary and secondary. Depending on this, the reasons that provoked dyskinesia will change.

The primary form of dyskinesia can be caused by the following reasons:

• inconsistency in the work of the parasympathetic and sympathetic parts of the nervous system, as a result of which the bladder itself and the sphincter of Oddi lose their tone;
• stress (acute, chronic), development of psychosomatic pathologies;
• malfunctions of the liver, as a result of which bile is produced with an altered chemical composition;
• unhealthy diet (overeating, eating too much fatty foods, untimely breakfasts, lunches and dinners);
• disturbances in the production of intestinal hormones responsible for the contractility of the gallbladder;
• not systematically eating, eating too fatty foods, overeating, insufficiently chopping food, eating in a hurry, etc.;
• allergies, as a result of which the neuromuscular apparatus of the gallbladder is in an irritated state and does not provide normal contractions of the organ;
• underweight, sedentary lifestyle, muscular dystrophy.

The causes of secondary dyskinesia may include the following:

• a history of chronic diseases of the abdominal organs - ovarian cyst, pyelonephritis, adnexitis, etc.;
• previous duodenitis, peptic ulcer, gastritis, atrophy of the mucous membrane of the gastrointestinal tract;
• helminthic infestation;
• cholelithiasis, hepatitis, cholangitis, cholecystitis;
• congenital anomalies of the biliary tract and gallbladder;
• endocrine disorders, hormonal fluctuations;
• inflammatory diseases of the gastrointestinal tract caused by pathogenic bacteria, for example, salmonella.

There are documented cases of diagnosing biliary dyskinesia against the background of a sedentary lifestyle, excess weight (stage 2-3 obesity), excessive physical activity (especially if heavy lifting is constantly occurring) and after psycho-emotional breakdowns.

Symptoms of biliary dyskinesia

The clinical picture of the described pathology is quite pronounced, so diagnosis does not present any difficulties for specialists. The main symptoms of biliary dyskinesia in adults are:

1. Dyspeptic syndrome is characterized by nausea, bitterness and dry mouth, belching with a bitter taste, bloating, unstable stools with a predominance of constipation or diarrhea, and fatty stools. Such symptoms are caused by disturbances in the digestive processes associated with insufficient or excessive flow of bile into the intestinal lumen.
2. Pain syndrome. The occurrence of pain is caused by errors in diet or stressful situations. In the hyperkinetic form of dysfunction, the patient experiences spastic pain in the right half of the abdomen under the ribs, radiating to the left half of the chest, into the shoulder blades, or becoming encircling in nature. In the hypokinetic form, the pain is bursting, pulling, with or without irradiation, intensifying or disappearing with changes in body position. The pain can disappear on its own and reappear with varying frequency - from several attacks a day to rare episodes throughout the month.
3. Astheno-vegetative syndrome is characterized by weakness, increased fatigue, a feeling of constant weakness, drowsiness or insomnia, increased levels of anxiety and other symptoms.
4. Cholestatic syndrome occurs rarely with the hypokinetic variant of dyskinesia, when bile that continues to be produced normally does not enter the intestine in the required volume, but accumulates in the gallbladder, leading to the appearance of yellowness of the skin and sclera, itching of the skin, dark urine and light feces, and enlarged liver.
5. Symptoms of neurosis - panic attacks, phobias (fears), obsessive thoughts, obsessive actions, aggression, anger, tearfulness, resentment, etc.

If a patient suffers from manifestations of hypotonic dyskinesia, then this condition is characterized by a dull and aching pain, which also manifests itself as a feeling of fullness in the area of ​​the right hypochondrium. Such pain constantly worries the patient, while his appetite noticeably decreases, the person often feels nauseous, and belching appears. There is no rise in body temperature, and a clinical blood test also does not indicate the presence of abnormalities.

If we are talking about hypertensive dyskinesia, then the pain is paroxysmal in nature. The pain is quite acute, but lasts for a short period of time. Pain may radiate to the right shoulder or shoulder blade. Especially often, such attacks occur after eating fatty foods or severe stress, both physical and emotional. Very often, patients with hypertensive dyskinesia note the manifestation of bitterness in the mouth, which most often happens in the morning.

Possible complications

As a rule, with biliary dyskinesia, patients seek help from doctors almost immediately after the first attack of pain. But many of them, having relieved the unpleasant symptoms, stop the prescribed treatment, thereby provoking the development of complications:

• duodenitis - an inflammatory process on the lining of the duodenum;
• the formation of stones in the gallbladder and its ducts – cholelithiasis;
• chronic cholecystitis – inflammation of the gallbladder that lasts more than 6 months in a row;
• atopic dermatitis is a skin disease that is a consequence of a decrease in the level of immunity;
• Chronic pancreatitis – inflammation of the pancreas for 6 months.

Biliary dyskinesia has a fairly favorable prognosis and does not shorten the patient’s life expectancy. But in the absence of proper treatment and non-compliance with the nutritionist’s recommendations, the development of the above complications is inevitable. And even these diseases are not life-threatening, but the patient’s condition will worsen significantly and eventually lead to disability.

Diagnostics

Instrumental examinations of the patient play a significant role in diagnosis. The most effective results are obtained by duodenal intubation, ultrasound, gastroduodenoscopy, and cholecystography.

1. Ultrasound examination for biliary dyskinesia is carried out in two stages. First on an empty stomach, and then again 30-40 minutes after the “test breakfast”. As a result of such procedures, the functionality of the bile ducts is analyzed.
2. Duodenal sounding is carried out using a special probe, which is placed in the duodenum. During the study, bile samples are taken for laboratory analysis. During manipulations, the work of the biliary tract, the opening of their sphincters is monitored, and the amount of bile secreted is analyzed.
3. Oral cholecystography. During the examination, the patient drinks a contrast agent. When it enters the bladder, a study of its functioning is carried out, on the basis of which it can be concluded what form of dyskinesia is manifested in the patient.
4. Gastroduodenoscopy is performed using a probe. During this procedure, the condition of the mucous membranes of the esophagus, stomach and duodenum is analyzed. If the mucous membrane of these organs is in a state of inflammation and irritation, then we can conclude that there is an excess secretion of bile acids.
5. Laboratory methods: to assess the condition of the biliary system, a biochemical blood test is used. A blood test for the lipid spectrum, or “lipidogram,” shows the content of high, low and very low density lipoproteins (HDL, LDL, VLDL), as well as cholesterol.

It is also necessary to carry out differential diagnosis of the disease with other pathologies of the gastrointestinal tract, in which similar symptoms are noted.

How to treat biliary dyskinesia?

In adults, treatment should be comprehensive, aimed at normalizing the outflow of bile and preventing its stagnation in the gallbladder.

For this purpose, the following methods are used in the treatment of biliary dyskinesia:

1. Diet (table No. 5);
2. Normalization and maintenance of work and rest regimes;
3. Reception of mineral waters;
4. Physiotherapy (electrophoresis, diadynamic currents, paraffin baths);
5. The use of closed tubes and duodenal intubation;
6. Acupuncture;
7. Massage;
8. Sanatorium-resort treatment (Truskavets, Mirgorod, Transcarpathian resorts of Ukraine);
9. Taking medications that normalize the flow of bile, relieve pain, relieve sphincter spasms and eliminate painful symptoms (enzyme, choleretic, antispasmodics);
10. Taking medications that normalize the state of the nervous system (sedatives, sedatives, tonics, etc.).

Mandatory methods of treating dyskinesia are normalizing the work and rest regime, following a diet, taking medications and using tubes. All other methods are auxiliary and can be used at will and if possible. The duration of the mandatory treatment methods for dyskinesia is 3–4 weeks. Auxiliary methods can be used for much longer, periodically repeating courses in order to prevent relapse of the disease.

Medicines

Since dyskinesia is a disease caused by a violation of nervous regulation and directly depends on the state of the psyche, before starting treatment for disorders of motor activity in the biliary tract using choleretic drugs, it is necessary to restore the patient’s mental background. If the pathology appears against the background of a depressive state, it is necessary to prescribe a course of mild antidepressants. If the disruption of the bile secretion process was caused by severe anxiety, neuroses, then it is advisable to start with antipsychotics and tranquilizers.

Such drugs can be prescribed by a psychiatrist or psychotherapist. In addition, the cause of dyskinesia is treated: correction of dysbiosis, elimination of hypovitaminosis, treatment of allergies, anthelmintic therapy.

The choice of drugs to restore the functions of bile formation and bile excretion depends on the type of dyskinesia.

• For the hypotonic type of biliary dyskinesia, Flamin, cholecystokinin, magnesium sulfate, pancreozymin are prescribed; mineral waters of high mineralization (Essentuki 17, Arzni, etc., at room temperature or slightly warmed 30-60 minutes before meals, depending on the secretion of the stomach). Herbal medicine: corn silk, immortelle flowers, chamomile, nettle leaves, rose hips, St. John's wort, oregano.
• For the hypertensive type of biliary dyskinesia, oxafenamide, nicodin, and low-mineralization mineral waters are used (Slavyanovskaya, Smirnovskaya, Essentuki 4, 20, Narzan hot or heated 5-6 times a day). For herbal medicine, chamomile flowers, peppermint, licorice root, valerian root, motherwort herb, and dill fruits are used.
• For intrahepatic cholestasis, tubes are performed (tubeless drainage of the biliary system, or “blind” probing) 1-2 times a week. Tonics, choleretics and cholekinetics are prescribed. With increased activity of the liver enzyme ALT, choleretics are not prescribed.
• For the hypokinetic type of biliary dyskinesia, sorbitol, xylitol, cholecystokinin, pancreozymin, magnesium sulfate, highly mineralized mineral waters at room temperature or slightly warmed 30-60 minutes before meals are recommended. Herbal medicine as for hypotonic type.
• For the hyperkinetic type of biliary dyskinesia, a short course of antispasmodics, potassium and magnesium preparations, and heated mineral waters of low mineralization are used 5-6 times a day. Herbal medicine: chamomile flowers, peppermint, licorice root, valerian root, motherwort herb, dill fruits.

Therapy is selected individually in each case, and for this you need to contact a specialist. A comprehensive examination will be prescribed, and after making a diagnosis, the doctor will choose the appropriate medications. Self-medication is dangerous: incorrect recognition of symptoms can only lead to worsening well-being.

Diet and proper nutrition

The basis of treatment for dyskinesia is nutrition. Only through strict adherence to the rules can the occurrence of attacks be avoided and surgical complications such as cholelithiasis and acute cholecystitis can be prevented. A diet for dyskinesia involves following general nutritional rules, however, there are points that differ significantly depending on the type of disease (hyperkinetic and hypokinetic).

For any type of dyskinesia, the following foods should be completely excluded from the diet:

• spicy, fried, fatty, smoked, sour, pickles and everything canned;
• fatty meats and fish;
• confectionery products, including chocolate, cocoa;
• pastries from butter dough;
• carbonated drinks, coffee, alcohol;
• seasonings;
• vegetables that irritate the gastrointestinal tract - garlic, onions, radishes, sorrel;
• products that increase gas formation in the intestines (legumes, rye bread, etc.);
• milk;
• marinades.

Features of nutrition in hypomotor dyskinesia. The diet should consist of foods that stimulate biliary motility:

• cream;
• eggs;
• black bread;
• sour cream;
• vegetable and butter;
• vegetables (boiled, stewed, baked);
• fruits.

Features of nutrition for hypermotor dyskinesia:

In the presence of this form of pathology, it is imperative to exclude from the daily diet foods that stimulate bile secretion and bile formation: soda, broths, fresh vegetables, fatty fermented milk and dairy products, black bread, animal fats.

For any form of dyskinesia, it is necessary to eat food 5–6 times a day in small portions (the contents of a portion should fit in two handfuls). Do not allow more than 2 hours between meals. All food and drinks should be warm or at room temperature, not cold or hot, as too high or low temperature can trigger an attack of dyskinesia. Salt must be limited, consuming no more than 3 g per day, to eliminate fluid stagnation in the tissues. Various dishes should be prepared by boiling, baking or steaming.

Mineral water

Mineral waters should be drunk regularly, 1/2 - 1 glass 20 - 30 minutes before meals, warm, choosing the required variety depending on the form of dyskinesia. Thus, for hypomotor dyskinesia, it is recommended to drink water of high mineralization (for example, Essentuki 17, Batalinskaya, Borjomi, Mashuk, etc.), and for hypermotor dyskinesia, it is recommended to drink water of low mineralization (for example, Darasun, Karachinskaya, Lipetskaya, Narzan, Smirnovskaya, etc.) .

You can and should drink mineral waters, as well as follow a diet, for a long period of time, that is, at least 3–4 months. However, if mineral waters cannot be included in complex therapy of the disease, then it is quite possible to refuse their use.

Lifestyle with dyskinesia

For a patient with biliary dyskinesia, it is very important to lead a healthy lifestyle, which includes:

• rejection of bad habits,
• moderate physical activity, without physical overload,
• rational mode of work and rest,
• a full night's sleep,

The main component of the lifestyle is a healthy diet - eliminating fatty, fried, spicy, salty, spicy foods, limiting animal products, increasing the consumption of plant products. During the period of treatment of dyskinesia, you should follow a strict diet, or treatment table No. 5.

Folk remedies

At home, treatment of dyskinesia is best done in combination with traditional methods. But before preparing and taking them, you should consult your doctor.

Infusions, decoctions, extracts and syrups of herbs are used that can activate the formation of bile and improve the motor function of the sphincters and bile ducts.

1. For the hypertonic and hyperkinetic type, mint, chamomile flowers, motherwort herb, licorice root, dill fruits, and valerian root are used.
2. In the hypotonic and hypokinetic form, rose hips, immortelle flowers, St. John's wort, corn silk, oregano, nettle leaves, and chamomile are used for herbal medicine.

Milk thistle, immortelle, tansy, dandelion leaves and root, corn silk, chicory, rose hips, fumaria, parsley, turmeric root, cumin, yarrow have a choleretic effect.

Herbal decoctions are used 20-30 minutes before meals.

Surgery

In the absence of long-awaited relief after adequate and comprehensive conservative therapy, doctors use surgical techniques. They can be:

• minimally invasive (usually using endoscopic equipment);
• radical.

In case of identified dysfunction of the sphincter of Oddi, the following is carried out:

• injections directly into this sphincter of botulinum toxin (it significantly reduces spasm and pressure, but the effect is temporary);
• balloon dilatation of this sphincter;
• placement of a special catheter-stent in the bile duct;
• endoscopic sphincterotomy (its excision together with the duodenal nipple) followed (if necessary) by surgical sphincteroplasty.

An extreme measure to combat severe hypotonic-hypokinetic variant of biliary dysfunction is cholecystectomy (complete removal of the atonic gallbladder). It is carried out laparoscopically (instead of an incision on the abdominal wall, several punctures are made for equipment and instruments) or laparotomy (with a traditional incision) by way. But the effectiveness of this serious surgical intervention is not always felt by patients. Often after this, the resumption of complaints is associated with the developed postcholecystectomy syndrome. Rarely done.

Biliary dyskinesia in children

For therapy in children, preference is given to herbal preparations. They are selected depending on the type of pathology.

So, for hypomotor dyskinesia the following are prescribed:

• medications that increase the tone of the biliary tract: magnesium sulfate, sorbitol or xylitol;
• drugs that stimulate the formation of bile: holagol, holosas, allohol, lyobil;
• “blind probes” with sorbitol or xylitol;
• herbal therapy: decoctions of dandelion, rose hips, corn silk, mint;
• mineral waters: “Essentuki 17”.

For hypermotor dyskinesia, treatment is carried out:

• herbal therapy: decoctions of St. John's wort, chamomile, stinging nettle;
• antispasmodic drugs: aminophylline, riabal;
• electrophoresis with novocaine on the gallbladder area;
• low-mineralized waters: “Slavyanovskaya”, “Smirnovskaya”.

After stopping the attack, rehabilitation is carried out in a sanatorium, where mineral waters and other physiotherapy are prescribed:

• sodium chloride baths;
• Microwave therapy;
• galvanic collar according to Shcherbak;
• for sedative purposes: pine baths, bromelectroson;
• to improve the motor activity of the biliary tract: SMT therapy, magnesium sulfate electrophoresis.
• to eliminate spasm of the biliary tract: magnetotherapy, electrophoresis of antispasmodics (no-spa, papaverine) on the area of ​​the biliary tract/

Children with dyskinesia are registered with a pediatric gastroenterologist, neurologist and pediatrician. They are scheduled for scheduled ultrasound twice a year. Also, courses of choleretic therapy are conducted every 6 months. Once or twice a year, the child is given referrals for sanatorium-resort treatment.

Prevention

To prevent the appearance and development of pathology, you should:

1. Get proper sleep and rest (sleep at least 8 hours a day);
2. Provide daily walks in the fresh air;
3. Organize proper and balanced nutrition;
4. Eliminate stress and psycho-emotional stress.

With secondary prevention (i.e., after dyskinesia has been identified), it is possible to prevent the disease by following the doctor’s recommendations and regularly undergoing preventive examinations

Biliary dyskinesia (BID)- This is a dysfunction of the gallbladder.

The gallbladder contains bile, which is secreted by the liver, then the bile is injected into the small intestine, where it breaks down fats that enter the body with food. Bile enters the intestine from the gallbladder through the common bile duct.

If bile is not cleared from the gallbladder, or cannot pass through the common bile duct, then it returns back to the gallbladder, resulting in biliary dyskinesia.

You can get dyskinesia at any age. There are also statistics that GIB in young people is characterized by excessive secretion of bile, and in older age there is an insufficiency of bile for digestion. Treatment of this disease has a positive prognosis if the patient consults a doctor at the first symptoms.

According to statistics, women suffer most from biliary dyskinesia. Some statistics indicate that women are 10 times more susceptible to this disease than men.

Causes of biliary dyskinesia

Biliary dyskinesia is formed partly due to the fault of the person himself or for independent reasons.

Poor nutrition from childhood

• lack of hot dishes;
• dry food;
• lack of vegetables and fruits;
• “starvation” diets for weight loss;
• long breaks (in childhood - violation of daily routine and nutrition);
• one-time overeating;
• fatty and fried foods with spicy sauces;
• pickles;
• fast food;
• carbonated drinks.

Stress

Prolonged stressful situations and mental trauma can cause functional disorders of the biliary tract. They occur against the background of vegetative-vascular dystonia.

Lack of movement

Any movements stimulate muscle contractions of the biliary system. The absence of this mechanism leads to stagnation of bile. We see such an example in cases of prolonged stay in bed during serious illnesses.

Diseases

Transferred viral hepatitis, infection with Giardia, worms causes a mandatory disruption of regulation.

Hormonal disbalance

The importance of the hormonal system is evidenced by the increase in the incidence of women during menopause.

Symptoms of biliary dyskinesia

Symptoms of biliary dyskinesia include various painful sensations, which differ depending on the type of disease.

With hyperkinesia of the biliary tract and hypertension of the sphincter of Oddi (excessive secretion of bile), the symptoms are as follows:

Pain in the right hypochondrium after physical and emotional stress, eating fatty, spicy, smoked foods.

Besides:

• nausea;
• vomit;
• bitterness in the mouth.

Hypokinesia of the biliary tract and hypotension of the sphincter of Oddi with bile ducts can be distinguished by the following symptoms:

• dull pain in the hypochondrium after eating;
• feeling of fullness in the right hypochondrium;
• bowel disorder.

There are also general symptoms of biliary dyskinesia, regardless of the form of the disease:

• biliary colic;
• liver enlargement;
• jaundice;
• pain on palpation in the area of ​​the gallbladder;
• feces and urine change color;
• stool disorder;
• flatulence;
• dry mouth;
• bad breath;
• chronic fatigue.

Treatment of biliary dyskinesia

In the treatment of dyskinesia, two directions are used: surgical and conservative. If there are general symptoms of the disease in the form of neurotic disorders, a consultation with a psychotherapist is necessary.

Which doctors should I contact for biliary dyskinesia?

Drug treatment

In case of dyskinesia of the hyperkinetic type, sedative drugs of the hypokinetic type are prescribed - stimulants (Eleutherococcus and pantocrine). To stimulate the secretion of bile into the duodenum, cholekinetics are prescribed, for example berberine sulfate (3 times a day, 5-10 ml before meals). For the same purpose, an alcohol tincture of barberry leaves, a tansy decoction, or a sorbitol solution can be used.

In addition to cholekinetics, choleretics (allochol, cholenzim and hologon) are used to facilitate the flow of bile into the intestines and enhance its secretion in the liver. Drinking mineral water 1 hour before meals, as well as physical therapy, have a good effect. In the case of biliary dyskinesia of the hyperkinetic type, fats and food irritants are limited.

Antispasmodics are widely used: noshpa, papaverine, etc. Anticholinergics, for example gastrocepin, are also used. To reduce the muscle tone of the sphincter of Oddi, nifedipine is prescribed 10-20 mg 3 times a day. Low-mineralized mineral waters are also recommended. Electrophoresis with novocaine, antispasmodics and magnesium sulfate has a good effect. The use of choleretic drugs is not recommended.

Additional procedures

Besides:

• acupuncture;
• diadynamic therapy;
• acupressure;
• hirudotherapy (treatment with leeches).

Surgery

If long-term conservative therapy is unsuccessful, surgical treatment is indicated. The operation must ensure the free flow of bile into the duodenum; The most suitable method should be considered the application of choledocho-duodenoanastomosis. If this is not possible, choledochotomy with submersible drainage should be used.

Folk remedies for the treatment of biliary dyskinesia

Folk remedies for the treatment of biliary dyskinesia should be used only after consultation with your doctor.

Yarrow herb, dill fruits, hop cones, celandine herb, rose hips, wormwood herb - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Dandelion root, anise fruit, tansy flowers, rose hips, yarrow herb - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Mint herb, cranberry fruits, oregano herb, St. John's wort herb, centaury herb, meadowsweet herb - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Tansy flowers, anise fruits, chamomile flowers, chicory root or herb, mint herb, St. John's wort herb, meadowsweet herb. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Hop cones, celandine herb, yarrow herb, mint herb, St. John's wort herb, chamomile flowers - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Birch buds, fireweed leaf, chicory root or herb, rose hips, corn silk, anise fruits - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Rose hips, mint herb, celandine herb, oregano herb, valerian root, dill fruits - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Birch buds, oregano herb, St. John's wort herb, immortelle flowers, Kuril tea, wormwood herb - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Chamomile flowers, calendula flowers, hop cones, dill fruits, mint herb, yarrow herb - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Mint herb, meadowsweet herb, centaury herb, oregano herb, dandelion root - equally. Preparation and use: pour 2 tablespoons of the collection into 0.5 liters of boiling water, pour it into a thermos along with the herbs, leave overnight. Take 1/3 cup 3-4 times a day. The course is 1-1.5 months.

Diet for biliary dyskinesia

A healthy and proper diet is an important part of the treatment of biliary dyskinesia. When the first signs of the disease appear, you need to reconsider your diet.

The functioning of the gallbladder depends entirely on the type and quantity of food consumed. Therefore, the dietary menu needs to be planned from products that contribute to the proper functioning of the gallbladder.

• honey, sugar and non-chocolate candies;
• teas: regular and herbal;
• bran or rye bread;
• vegetarian soups and borscht;
• boiled lean meat, preferably poultry;
• fruits and vegetables in any form;
• chicken eggs (but no more than one yolk per day, there are no restrictions on protein);
• vegetable oils and fats;
• dairy products, low-fat;
• fruit and vegetable juices;
• sweet berries;
• porridge and pasta.

Prohibited Products

• all types of sausages;
• strong tea, coffee and cocoa;
• desserts that contain refined fats;
• garlic, onions, radishes, mushrooms;
• fried foods;
• rich pastries, puff pastry and shortcrust pastry, fresh bread made from premium flour;
• chocolate products;
• hot seasonings and sauces;
• sparkling mineral water and carbonated drinks;
• broths from meat, fish, poultry;
• alcoholic drinks of all types;
• beans, beans and other legumes;
• fatty meat products (lard, red meat, liver, heart, kidneys);
• smoked products.

Basic nutrition rules

Proper nutrition is one of the effective ways to improve the condition of the gallbladder and biliary tract. Thanks to the food you eat, you can easily correct the secretion of bile. You need to eat in small portions (about 150 grams), but often (4-6 times a day). The diet for biliary dyskinesia has a fractional nature of food intake.

There should be an equal time interval between meals. Do not load your stomach before bed; it is better to drink a glass of kefir or tea. Often, just by maintaining a diet, it is possible to completely normalize the condition of the bile ducts. Remember that cholesterol leads to stagnation of bile in the bladder, which in turn leads to the formation of stones.

Therefore, it is necessary to prepare food from products that do not contain a high concentration of cholesterol. You should also remember about the body's water balance. You need to drink at least two liters of liquid per day, which can be in the form of: water, tea, juices, fresh juices, milk, etc. Preference should be given to non-carbonated drinks, preferably without sugar.

Biliary dyskinesia in children

Biliary dyskinesia in children is a functional disorder of the gastrointestinal tract, impaired outflow of bile into the duodenum, in other words, a change in the tone and motility of the biliary system, disrupting the full outflow of bile.

In order to diagnose biliary dyskinesia in children, ultrasound of the gallbladder is performed on an empty stomach and after taking a choleretic breakfast, duodenal intubation, and less often - cholecystography, hepatobiliscintigraphy.

Causes of biliary dyskinesia in children

The causes of functional diseases are mainly disorders of the regulation of the organ in which the functions are impaired. Changes in the regulation of the nervous system occur mainly due to the occurrence of stress and psycho-emotional factors and are caused by organic disorders of the central nervous system or disorders of the autonomic system. This causes the development of autonomic dysfunction.

Organic bile ducts also arise due to impaired development of internal organs, with pathological development of the gallbladder, as well as excretory ducts. JVP often accompanies diseases of other organs of the digestive system.

Symptoms of biliary dyskinesia in children

The main manifestations of biliary dyskinesia in children are pain, dyspeptic syndrome and positive cystic symptoms. The nature of the manifestations depends on the form of dysfunction.

Children with this disease complain of a painful formation in the right side, often spreading to the right shoulder blade. There are also a number of symptoms that periodically worry children. These symptoms of dyskinesia are caused by disturbances in diet, lifestyle, daily routine, nervous situation, stress, mental or physical stress, etc.

The disease manifests itself as abdominal pain, mainly in the right hypochondrium. Aching or cramping pain is accompanied by dyspeptic disorders:

• nausea;
• vomit;
• bitterness in the mouth;
• intolerance to fatty foods;
• unstable chair.

A characteristic feature is the connection of pain with neuropsychic and physical overload.

Treatment of biliary dyskinesia in children

The basis for productive treatment of children with biliary dyskinesia is dietary nutrition with limited consumption of fatty, fried, spicy, salty, sweets, and soda. It is recommended to eat fractional meals (5-6 times a day), enriching the diet with foods high in plant fiber, vitamins A, B, C, bifidobacteria and lactobacilli, and refined vegetable oils. It is necessary to regulate the child’s motor mode and create a favorable emotional background. In all cases, attention should be paid to the treatment of the underlying disease.

Children with the hyperkinetic-hypertensive type of biliary dyskinesia are prescribed sedatives (herbal preparations, novopassit, persen), antispasmodics to relieve painful attacks (papaverine, no-shpa). The basis for the treatment of hypertensive-hyerkinetic biliary dyskinesia in children are choleretics and cholespasmolytics (flamin, allochol, cholenzyme).

Psychotherapy, acupuncture, physiotherapy (paraffin baths, diathermy, inductothermy, electrophoresis with antispasmodics), massage of the cervical-collar area have proven themselves well in the treatment of biliary dyskinesia in children.

For hypotonic-hypokinetic dyskinesia of the biliary tract in children, stimulating procedures are prescribed:

• physiotherapy;
• hydrotherapy;
• massage.

Choleretic drugs with a cholinergic effect are used:

• xylitol;
• sorbitol;
• magnesium sulfate.

Herbal infusions used:

• corn silk;
• rose hip;
• calendula.

Therapeutic choleretic tubes are carried out. Of the physiotherapeutic methods used;

• galvanization;
• electrophoresis with magnesium sulfate;
• Bernard's currents.

Types of biliary dyskinesia

The main indicators of the functioning of the biliary tract are identified - muscle and sphincter tone and kinesia (outflow of bile along the ducts). Based on these two indicators, there are several options for the JVP:

• hypotonic (with decreased sphincter tone);
• hypertensive (with increased tone);
• hypokinetic (with slowing and sluggishness of bile outflow);
• hyperkinetic (with outflow activation, sudden release of portions).

In practice, doctors use a double classification, but for patients it is enough to know about the hypotonic and hypertensive types; in addition, a mixed type is also distinguished. The manifestations of different types of disease vary significantly.

Diagnosis of biliary dyskinesia

Diagnosis is based on an analysis of complaints, examination data and the results of additional research methods.

A valuable diagnostic method for this pathology is ultrasound. Ultrasound allows you to identify the nature of motor disorders of the gallbladder, diagnose anomalies of the biliary tract (kink, torsion, etc.). Very often, it is precisely these structural features of the biliary tract or gallbladder that are the direct cause of dyskinesia.

Differential diagnosis

When diagnosing, biliary dyskinesia must be differentiated from:

• cholecystitis;
• duodenitis;
• pancreatitis (hypotonic form of dyskinesia);
• peptic ulcer (hypertensive form of dyskinesia);
• adnexitis.

The hyperkinetic form of gallbladder dyskinesia must also be differentiated from:

• an attack of angina pectoris;
• myocardial infarction (abdominal form);
• intestinal obstruction;
• hepatic colic.

Prevention and prognosis of biliary dyskinesia

Prevention of primary biliary dyskinesia requires adherence to the principles of a healthy diet, timely correction of psycho-emotional disorders; prevention of secondary dyskinesia - elimination of the underlying disease.

Primary dyskinesia of the biliary tract has a favorable prognosis, however, it should be taken into account that long-term stagnation of bile in the gallbladder with hypokinetic dyskinesia contributes to the development of inflammation, as well as bile discrimination and stone formation. The course, development of complications and prognosis in patients with secondary dyskinesias depend on the course of the underlying disease.

Questions and answers on the topic "Biliary dyskinesia"

Question:Hello! I was diagnosed with gastritis and chronic gastritis (based on ultrasound and FGDS results). It constantly hurts in the left side (the pain subsides for a while and then appears again. I took a course of De-nol, Omeprazole, Itopride, but it didn’t get better, they prescribed Hofitol, Festal and Nosh-pa. Please tell me what other examination can be done?

Answer: Ultrasound and FGDS are enough. Treatment must be accompanied by a strict diet.

Question:Hello. Tell me, can JVP have any effect on weight? I mean the ratio of body weight to height. I am worried about my body weight, or rather, lack of weight. There are no deviations in symptoms. Sometimes I worry about pain in the hypochondrium when I eat fatty foods. I suffered from Botkin's disease as a child.

Answer: Hello. With any type of biliary dyskinesia, digestion is disrupted, the absorption of nutrients is impaired, and fat metabolism is especially affected. In addition, with a lack of bile, appetite decreases. As the disease continues, patients begin to slowly lose weight.

Question:Hello, I'm 31 years old. 7 years ago I was diagnosed with dyskinesia of the duodenum and biliary tract, I then underwent a course of treatment and everything still did not bother me. Now the pain has started again and is stronger in the solar plexus area, sometimes accompanied by pain in the liver area and grips the entire abdomen; sometimes, with strong spasms, the mouth fills with some kind of liquid. I take the medications that were prescribed to me then, i.e. mezim, ollochol, I also drank a decoction of calendula and a decoction of corn silk, befungin - it doesn’t help. Tell me what it is and how to treat it.

Answer: Hello, You need to do an ultrasound of the abdominal cavity and FGDS with a test for H. pylori, with the results for a consultation with a gastroenterologist. You can take Duspatalin 1 capsule 2 times a day.

Question:Hello! The child is 4 years old. Biliary dyskinesia is called into question. They did an ultrasound: the gallbladder after a test breakfast was 6.1cm* 1.4cm. V=5.3 cm3. The walls are thin 0.1 cm. The form is normal, the contents are heterogeneous. There are no stones. Contractile function 65%. Gallbladder after 40 min. after a trial breakfast 4.8*0.8,V=1.9 cm3. They didn’t do the ultrasound on an empty stomach, I didn’t understand the doctor. Is it possible to determine the diagnosis this way or not? We haven't been to the reception yet.

Answer: Hello. An ultrasound with a choleretic breakfast is done on an empty stomach, then breakfast is given and the ultrasound is watched after 15-30-45-60 minutes. More often, clinic doctors limit themselves to examination on an empty stomach and after 30 or 45 minutes.

Question:Hello! I am 23 years old, after an examination (ultrasound, tube swallowing, probing of the gallbladder) I was diagnosed with gastroduodenitis, pancreatitis, and biliary dyskinesia. I am worried about nausea, especially in the morning, poor appetite, and weakness. Please help me, what treatment will be the most effective?

Answer: Hello. It is not possible and impossible to give any recommendations abstracted from the patient and examination data. The symptoms you have are not specific; they can occur with almost any disease of the digestive system. You should discuss everything with your doctor.

Biliary dyskinesia is a functional disorder. The pathological condition leads to the fact that the volume of bile that enters the duodenum does not meet the needs of the body. To cure the pathology, you need to consult a specialist when the first symptoms of the disease appear. Therefore, we should consider in more detail what it is, what are the indirect signs, symptoms and treatment of gallbladder dyskinesia.

What is gallbladder dyskinesia? This is a functional pathology that develops when there is a violation of the coordination of the gallbladder and bile ducts, sphincters. As a result, bile is not able to be released into the intestine in the required volume for the digestion process. A distinctive feature of the disease is the absence of organic changes in the organs that are part of the biliary system.

Important! At a young age, biliary dyskinesia provokes increased bile production, while in mature patients it causes an insufficient amount.

The disorder can occur in patients regardless of age. However, the disease is more common in young women who have a thin build. Some patients note a relationship between exacerbation of biliary dyskinesia and the period of the menstrual cycle. Typically, manifestations of the disease develop 1-3 days before the onset of menstruation.

At risk for the development of biliary dyskinesia are patients who have a history of diseases of the reproductive system and people exposed to stress.

Causes

The following primary etiological factors are identified that provoke the occurrence of biliary dyskinesia:

• Systematic violation of diet over a long period of time. Gallbladder dysfunction occurs due to overeating, irregular eating, excessive consumption of fatty or spicy foods;
• Impaired coordination of neurohumoral mechanisms regulating the bile ducts;
• Physical inactivity, underdeveloped muscles;
• The presence of congenital anomalies in the development of the bile ducts and gallbladder (changes in location, high mobility, the presence of abnormal septa, atony).

Secondary causes of gallbladder disease include:

• Past viral hepatitis;
• The presence of helminths and intestinal infections;
• , gastritis, gastroduodenitis, ulcers and enteritis in the anamnesis;
• Chronic inflammation of organs located in the abdominal cavity (ovaries, kidneys, intestines, appendix);
• Hormonal imbalance due to insufficiency of the endocrine glands, pathologies of the reproductive organs, during menopause;
• Dysbiosis of intestinal microflora;
• Food allergies;
• Diabetes;
• Obesity;
• Chronic caries;
• Constant stressful situations.

Types of pathology

Modern classification involves dividing biliary dyskinesia according to etiological factors and time of onset into:

• Primary form. The pathology develops against the background of pronounced congenital biliary malformations. But in most cases, developmental anomalies can be compensated as the child grows and develops, and gallbladder dysfunction will occur against the background of provoking factors;
• Secondary form. In this case, diseases of the biliary tract occur in an adult due to the action of provoking factors and other pathologies of the digestive organs.

Important! The form of the pathology determines the specific symptoms and treatment of biliary dyskinesia.

According to the contractile activity of the muscles of the biliary tract, dystonia is divided into the following forms:

• Hypokinetic biliary dyskinesia (hypomotor type). The pathology develops against the background of sluggish contractility of the biliary system, therefore, an insufficient volume of bile is released. Hypomotor dyskinesia of the gallbladder is mainly diagnosed in patients over 40, against the background of neuroses;
• Hyperkinetic form. The pathology is characterized by excessive contractility of the ducts and gallbladder, so bile enters the duodenum in a large volume;
• Hypotonic-hyperkinetic form. Causes symptoms of hypokinetic and hyperkinetic biliary dyskinesia. The disease is characterized by uncoordinated work of the parts of the biliary system: the gallbladder may have increased contractility, and the bile ducts may have low contractility, and vice versa.

Clinical picture of the disease

Doctors identify general signs of gallbladder dyskinesia that develop in all patients, regardless of the form of the disorder:

• The occurrence of cholestatic syndrome. The condition appears against the background of insufficient bile supply, leads to itchy skin, yellowness of the mucous membranes, skin, biological fluids, stool becomes dark, the liver increases in size;
• Dyspeptic syndrome. Inadequate supply of bile provokes digestive disorders. As a result, patients experience a decrease in appetite, nausea, flatulence, belching, unpleasant odor and bitterness in the mouth. With dyskinesia of the hypokinetic type, diarrhea occurs, with a disorder of the hyperkinetic type, constipation develops;
• Asthenovegetative syndrome. Characteristic changes in the regulation of the digestive organs. Patients experience increased fatigue, disturbed sleep, excessive sweating, irritability, tachycardia, hypotension, headaches, decreased libido;
• Painful sensations. With biliary dyskinesia of the hypertensive type, pain develops in the right hypochondrium and can radiate to the right half of the body (arm, shoulder blade, collarbone). Characteristic is the development of acute, intense pain within half an hour after breaking the diet. Dystonia of the gallbladder of the hypotonic type provokes pain in the right hypochondrium. The pain syndrome has no clear localization, it is dull and aching in nature, is present for 2-14 days, and intensifies after errors in dietary nutrition.

Important! A sharp contraction of the gallbladder with hypermotor dyskinesia often leads to. The condition is characterized by the occurrence of sharp pain in the right hypochondrium, which is accompanied by the appearance of tachycardia and fear of death.

The following specific symptoms of biliary dyskinesia of the hyperkinetic type are distinguished:

• Physical and emotional stress, dietary disturbances provoke the development of pain;
• Nausea and vomiting, which relieves the condition;
• Bitterness in the mouth.

JVP of the hypokinetic type provokes the following symptoms:

• Dull pain after eating;
• Distension in the abdominal area;
• The occurrence of diarrhea.

In the mixed form, patients note the appearance of aching pain in the right hypochondrium, dry mouth, and constipation. The occurrence of a pronounced asthenovegetative syndrome is typical - patients become irritable and fatigue increases.

Diagnostic measures

In case of bile duct dyskinesia, the diagnosis is made by the attending physician based on the clinical picture of the disease, the results of laboratory and instrumental studies. Comprehensive diagnostics includes the following activities:

• Ultrasound. The procedure is carried out in two stages. The first ultrasound examination is performed on an empty stomach after a three-day diet. This is necessary to assess the size, determine echo signs of inflammation, deformations and stones in the biliary tract. Next, the patient is given choleretic products (cream, sour cream, bananas) for breakfast. After 30 minutes, the ultrasound is repeated so that the doctor assesses the speed of bile movement;
• Duodenal sounding. The method allows you to evaluate the contents of the duodenum. During the procedure, the patient on an empty stomach swallows a thin probe so that the specialist collects intestinal contents. Next, a choleretic agent is administered through a probe, and the released bile is collected for further research;
• Cholecystography and cholangiography. These contrast radiographic techniques help to examine the bile ducts and ducts;
• ERCP. The method involves the introduction of contrast through a probe into the duodenum. On x-ray, the specialist evaluates the retrograde advancement of the contrast agent;
• Cholescintigraphy. The method involves the introduction of a radioisotope into the body, which helps to assess the patency of the bile ducts;
• MRI with contrast. The examination is carried out in severe cases. The duration of the study is 40-60 minutes;
• Laboratory diagnostics. It is possible to suspect the appearance of biliary dyskinesia by blood tests for lipids, creatinine, bilirubin, uric acid, fecal analysis for helminths, and intestinal dysbiosis.

Features of therapy

Biliary dyskinesia requires complex treatment. Only with this approach is it possible to eliminate the cause of the disease and prevent the development of complications. Experts do not recommend treating gallbladder diseases exclusively with herbal infusions.

How is drug therapy administered?

For hyperkinetic biliary dyskinesia, sedative and antispasmodic drugs (Drotaverine, Papaverine) are prescribed. Nifedipine will help reduce tone.

Treatment of gallbladder dyskinesia of the hypotonic type involves the use of choleretic agents (Cholenzim, Chofitol, Allohol, Hologon). They increase the rate of bile secretion and stimulate its release into the intestines.

How to treat biliary dyskinesia? In addition to drug therapy, specialists prescribe the following procedures:

• Tubazh. The procedure involves the use of choleretic agents in a lying position with a heating pad on the right side. This allows you to cleanse the gallbladder;
• Carrying out duodenal intubation to cleanse the bile ducts;
• Performing acupressure;
• Gerudotherapy;
• Diadynamic therapy;
• Reflexology.

Surgical methods of treatment

If long-term conservative treatment of biliary dyskinesia does not bring positive results, then surgery is performed. Surgical intervention involves the use of choledochoduodenoanastomosis to ensure normal excretion of bile. Sometimes choledochotomy with submersible drainage is indicated.

Diet therapy

Treatment of hypertonic and hypotonic gallbladder dyskinesia is impossible without dietary nutrition. Only strict adherence to a diet throughout life can prevent attacks and will become an effective prevention and. Diet therapy involves split meals in small portions up to 7 times a day. It is important to eat dishes warm, boiled or steamed.

Important! The last meal should occur 2-3 hours before bedtime.

• Fast food;
• Meat broths;
• Smoked, salty, fried, fatty, spicy foods;
• Canned products;
• Millet porridge;
• Legumes and mushrooms;
• Chocolate, baked goods, ice cream;
• Carbonated and alcoholic drinks.

Hypotonic dyskinesia involves the inclusion in the diet of foods that stimulate the motility of the biliary system: baked, boiled and stewed vegetables, butter and vegetable oils, sour cream, black bread, eggs, cream. Treatment of hypermotor type dyskinesia requires the exclusion of fatty dairy products, fresh vegetables, broths, black bread and animal fats.

Folk recipes

Treatment with folk remedies makes it possible to alleviate the patient’s overall well-being and reduce the frequency of relapses. However, long-term therapy (4-5 weeks) will be required to obtain positive results.

The following herbs and medicinal plants will help cope with the hypertensive form of the disease:

• Celandine. To prepare the recipe, just mix 1 liter of plant juice with 500 ml of vodka. Seal the container tightly and place it in a dark place for 10 days. Take the composition 20 ml three times a day;
• Immortelle. Take 1 pinch of crushed flowers of the plant, pour 1 cup of boiling water, leave for a quarter of an hour. The product is taken three times a day, 20 ml;
• Lingonberry leaves. The dried leaves are crushed, poured with 1 glass of boiling water, and left for 20 minutes. The composition is taken 40 ml up to 5 times a day;
• Herbal collection. Grind the following herbs in equal quantities: mint, sage, cumin. Take a pinch of the resulting mixture, add hot water (200 ml), leave for 8 hours. The composition is taken 100 ml 20 minutes before meals.

In the treatment of hypotonic form, the following recipes are used:

• Rose hip. Pour 200 ml of boiling water over 2 tablespoons of fruit. After 8 hours, the infusion can be taken 100 ml up to 3 times a day;
• Melon seeds. The seeds must be washed and dried, ground in a coffee grinder to a powder state. Brew 1 cup of the resulting powder in 500 ml of hot milk. Eat 100 g of the mixture in the morning before meals;
• Cereals. Pour boiling water over the flakes and leave for 15 minutes. The resulting porridge is eaten for breakfast and dinner.

Biliary dyskinesia is a common functional disorder that can occur at any age under the influence of provoking factors. Therefore, it is important to follow the rules of a healthy lifestyle to prevent the disease. And if the first signs of a pathological condition occur, you should consult a specialist. Only in this case is a complete cure and elimination of unpleasant symptoms possible.

Many patients are interested in the question of what JVP means in a diagnosis and how exactly this meaning is deciphered. Dyskinesia is a disease of the gastrointestinal tract, as a result of which bile does not enter the duodenum correctly, as a result of which the digestion process is disrupted. Patients who are suspected of having dyskinesia complain of nausea, an unpleasant taste in the mouth, vomiting and pain in the right side.

The reasons why such a pathology occurs can be organic and functional. To carry out treatment, it is important to accurately determine the provoking factor, as this will avoid complications.

Main types of disease

It is important to understand exactly what the deciphering of the diagnosis of ADHD means and how exactly such a pathology manifests itself. JVP is dyskinesia. According to the classification, it can be primary and secondary and is divided according to the nature of the provoking cause and the time of development.

The primary type of bile duct occurs against the background of existing anomalies in the development of the bile ducts. The disease can develop independently or under the influence of external factors. When a congenital form of pathology occurs independently, its manifestations are observed from early childhood. However, in some cases, there may be an asymptomatic course for some time, and symptoms arise only when exposed to certain provoking factors.

Secondary dyskinesias arise as a result of the presence of diseases of the digestive system. Taking into account the characteristics of muscle contraction of the affected organ, the disease can be:

• hyperkinetic;
• hypokinetic;
• mixed.

Hyperkinetic dyskinesia is characterized by a significant amount of accumulated bile, which is released into the duodenum. The reason for its occurrence is too active contraction of the walls of the affected organ. Often such a disorder is observed in young patients.

Hypotonic GIB is characterized by the fact that the gallbladder does not function well enough, while little bile enters the digestive organs. Basically, this disorder is observed in people over 40 years of age. In addition, quite often this pathology occurs in those who are prone to neuroses.

The mixed type of the disease has signs of both of these forms of the disease. One of the organs of the biliary system works very actively, while others are sluggish. Uncoordinated functioning of organs leads to various types of disorders.

Features of the disease in children

Parents are interested, when first faced with a diagnosis of ADHD in a child, what it is and how such a disease manifests itself. Dyskinesia mainly occurs in children over 3 years of age. They are characterized by hypermotor and mixed types. In some cases, hypomotor symptoms are observed.

Dyskinesia is the most common pathology in children. The causes and basic mechanisms of its occurrence in a child are practically no different from those in an adult. In some cases, the appearance of pathology is due to the active growth of the bone and muscle systems and is temporary. However, serious disorders of the digestive system can become a provoking factor.

Doctors distinguish between organic and functional dyskinesia. Organic presupposes the presence of various types of congenital abnormalities in the development of the bile ducts, chronic allergies, systematically poor nutrition, and excessive nervous excitability. A disease of this etiology occurs in approximately 10-15% of all cases.

Functional dyskinesia is caused by concomitant pathologies and occurs much more often. In this case, the child has a history of gastrointestinal diseases, viral and bacterial infections, nervous system disorders, and helminthic infestations. Particular attention should be paid to the hereditary factor, as well as the presence of endocrine diseases.

Dyskinesia in children often manifests itself in the form of atopic dermatitis and symptoms of dysbiosis, which cannot be eliminated using traditional methods. With the development of ADHD in children, symptoms from the nervous system often appear. At the same time, the child becomes capricious, whiny, and gets tired very quickly. Schoolchildren's performance declines sharply. Also, with ADHD, children may experience increased sweating, rapid heartbeat and other symptoms.

When carrying out treatment, proper nutrition of the child is important both during the period of exacerbation and during remission. children with dyskinesia are carried out within 3 years from the time of the last exacerbation. To prevent the occurrence of such a pathology, it is imperative to monitor the child’s diet and avoid overeating. You also need to protect him from negative stressful situations and eliminate various types of violations in a timely manner.

Causes

When diagnosing VADP, absolutely every patient must know what it is and what causes this pathology, as this will make it possible to get rid of the disease much faster and more effectively. Primary dyskinesia appears under the influence of a variety of negative factors in the altered bile ducts. Among the main causes of this disease are the following:

• acute or chronic stress;
• abuse of fatty foods;
• allergies;
• taking certain medications;
• lack of weight.

Secondary VSD in adults is formed against the background of existing pathologies and diseases in humans, significantly complicating their course. Among the main diseases it is necessary to highlight the following:

• cholecystitis;
• hepatitis;
• gastritis;
• ulcer;
• pyelonephritis.

Psychosomatic factor

A psychosomatic factor can provoke the development of various kinds of diseases, including DDVP. In this case, during a medical examination, no organic or physical causes are determined that could provoke the disease. Psychosomatics is based on identifying emotional manifestations that influence the course of pathology. Among people suffering from ADHD, which developed under the influence of psychosomatic factors, it is necessary to highlight:

• touchy;
• conflict;
• evil;
• greedy people.

In addition, individuals prone to self-sacrifice may suffer from this problem. Treatment involves the use of psychotherapeutic methods, a revision of one’s life principles and positions. Lifestyle adjustments are also required. According to the principle of psychosomatics, most diseases are inherited.

People are also encouraged to learn to forgive and keep anger and irritability under control. A child suffering from psychosomatic disorders is distinguished by strict fulfillment of all given promises, punctuality, and conscientiousness. Such children are distinguished by great vulnerability and suspicion, especially towards everything new and unusual. They are often withdrawn and prone to self-accusation.

Main symptoms

When diagnosing VHD, what it is and exactly how this condition manifests itself is very important for all patients to know. With dyskinesia, the symptoms may vary somewhat, since some patients may experience a whole range of symptoms, while others may experience only part of them. Regardless of the type of this pathology, the signs characteristic of this disease appear to varying degrees.

The only difference between the hypermotor type and the hypomotor type will be the presence of certain, rather characteristic sensations. Regardless of the type of disease, it is characterized by the presence of pain, dyspeptic and cholestatic syndrome. Aching pain in the right side is almost constant and subsides a little at night. It can be significantly worse after eating food. When the hypertensive type of disease occurs, the pain syndrome is quite intense.

In a stressful situation or after even minor physical activity, the pain continues for an hour. Between attacks, a person may complain of a feeling of constant discomfort in the right side. At the same time, the patient’s general health is quite normal. The severity of pain differs somewhat depending on the form of dyskinesia.

It is mainly detected in patients in whom bile enters the duodenum in minimal quantities. An exacerbation of the disease can be distinguished by the following signs:

• stool and urine become darker than usual;
• the skin and sclera of the eyes acquire a yellowish tint;
• the liver is slightly enlarged;
• severe skin itching appears.

Cholestatic syndrome is detected in almost half of patients suffering from dyskinesia. Dyspeptic syndrome manifests itself in the form of disruption of the digestive process due to excessive or insufficient amount of bile entering the intestines. In this case, the following signs are observed:

• loss of appetite;
• bloating;
• nausea and vomiting;
• unpleasant belching after eating food;
• plaque formation on the tongue;
• constipation;
• dry mouth.

Bitterness in the mouth is often felt immediately after sleep or some time after eating food, or it can be present constantly. Nausea and vomiting are necessarily provoked by something, and often this symptom appears after consuming fatty foods or overeating. With dyskinesia, vomiting of undigested food mixed with bitter bile mainly occurs at the very peak of pain.

Asthenovegetative syndrome is the occurrence of irreversible changes in the nervous regulation of organ functioning. In this case, dyskinesia has the following manifestations:

• sleep disturbance;
• increased fatigue;
• irritability;
• excessive sweating;
• headache;
• decrease in pressure.

Before carrying out treatment, it is imperative to know what the diagnosis of VSD in an adult is and for what reason pain occurs. With hypertensive pathology, acute pain occurs in the right hypochondrium and radiates to the right side of the back, scapula, collarbone, and arm. Sometimes a painful attack is also felt in the stomach and heart. In this case, many people confuse it with an attack of angina. The intense pain lasts for about 20 minutes and may even recur several times a day. Diet errors, strong psycho-emotional and physical stress can provoke pain. After this, a feeling of heaviness appears.

Painful sensations can also be accompanied by periodic nausea and vomiting, which do not bring relief to the person. When palpating the abdomen, the pain only intensifies.

Symptoms of hypotonic type of diarrhea are associated with the fact that the painful sensations are sufficiently blurred. They are mainly localized in the right side. It is impossible to pinpoint the exact area where the attack is felt, since the discomfort spreads to the entire right side. The pain also radiates to the shoulder blade and back. It is dull, bursting in nature and lasts for a long time. In case of hypotonic type of diarrhea, increased pain occurs after consuming fatty foods.

The mixed form of the disease is characterized by prolonged pain. The pain is combined with a feeling of heaviness. In addition, there may be indirect signs of ADHD, which manifest themselves in the form of dry mouth, and constipation may also occur. Characteristic symptoms may include sudden changes in mood, constant irritability and increased fatigue.

Indirect signs of mixed-type ADHD can be characterized by the fact that the tongue becomes enlarged and you can even notice clear teeth marks on it.

Which doctor should I contact?

The attending doctor will be able to explain what kind of diagnosis this is - JVP. If characteristic signs of pathology occur, you should contact a gastroenterologist. Additionally, consultation with a surgeon, psychotherapist, infectious disease specialist, or nutritionist may be required. They prescribe a comprehensive study that will determine the characteristics of the pathology.

Many patients are interested in the question of what is the medical term and diagnosis of ADHD. This disease is recorded for all people suffering from pathology of the gallbladder and its ducts. To make a diagnosis you will need:

• taking anamnesis;
• physical examination;
• laboratory research;
• instrumental diagnostics.

Initially, the doctor collects complaints in order to clarify exactly when pain and heaviness in the abdomen appeared and what caused their occurrence. A study of the patient's medical history is also required. It is worth knowing if a person has chronic or hereditary diseases, as well as bad habits. Then the doctor conducts a physical examination, which determines the normal color of the skin or its yellowness. During palpation, pain is assessed. Tapping determines the size of the spleen and liver.

Laboratory tests include:

• blood analysis;
• urine;
• lipid profile;
• stool examination;
• markers of viral hepatitis.

A complete blood count may not detect any abnormalities. In the presence of inflammation, leukocytosis appears. A biochemical blood test will help determine the level of creatinine, uric acid, and electrolytes.

A lipidogram allows you to identify abnormalities in lipid levels. A stool examination is carried out to identify helminths. After this, the doctor prescribes an instrumental examination. When performing ultrasound diagnostics, it is possible to diagnose PVD and hepatoriamia, determine the size and shape of the affected organ. Duodenal examination helps identify signs of inflammation and the presence of stones.

Fibroesophagogastroduodenoscopy involves studying the condition of the surface of the stomach, esophagus and duodenum using an endoscope. Such a study is required if there is a suspicion of diseases of these organs and dyskinesia. Cholecystography helps determine the shape and size of the affected organ, as well as the presence of abnormalities in its development. All these methods will allow you to accurately diagnose gallbladder thyroid gland disease and prescribe subsequent treatment.

Features of treatment

If there is VADP, what it is and how to properly treat such a pathology should be explained by the attending doctor, and how to prescribe therapy after the examination. The treatment is complex and is aimed at improving the natural flow of bile to prevent its stagnation. Therapy implies:

• compliance with work and rest schedules;
• consumption of mineral water;
• diet;
• taking choleretic drugs;
• massage and acupuncture;
• taking sedative medications;
• physiotherapeutic procedures;
• sanatorium treatment.

Once a diagnosis of VSD is made, treatment should begin immediately, as this will prevent the development of complications. It will take approximately 4 weeks for the main signs of the disease to subside.

Folk remedies can be used as an additional therapy method. They can be used for a long time, repeating treatment courses if necessary. Drugs are selected depending on the type of disease.

If you have hypertensive pathology, you need to drink mineral water. Infusions of chamomile, valerian, and mint are used as herbal medicine. For the hypotonic type, the doctor prescribes medications and mineral water with a high degree of mineralization. You can also use traditional medicine with anti-inflammatory and sedative effects.

Drug therapy

When a diagnosis of ADHD is made, a specialist can tell you what it is and how to treat the disease. Drug therapy is selected only by a doctor. If the diet for any type of disease is not particularly different, then the treatment has its own certain differences.

Antispasmodics are used when treating only the hypermotor form of dyskinesia. They help reduce the tone of the biliary tract, relax the sphincters, and also prevent the outflow of bile. Drugs are often prescribed whose main active ingredient is drotaverine. For mild attacks, Papaverine may be prescribed.

Choleretic drugs are used for dyskinesia, but if there is concomitant cholelithiasis, they are contraindicated. These drugs increase the tone of the gallbladder several times and decrease it in the ducts. The drug should only be prescribed by the attending physician, since this group of drugs is very large and they contain various active ingredients.

For the hypertensive type of dyskinesia, Gepabene, which contains milk thistle extract, is mainly prescribed. In the case of a hypotonic form of the disease, Hofitol is prescribed. It contains artichoke extract. Both of these drugs are choleretic, but have different effects on the body.

The nervous system has a special influence on the regulation of gallbladder motility. That is why complex therapy necessarily includes tonic or relaxing agents. When hypertensive dyskinesia occurs, sedatives of plant origin are prescribed, as well as medications that inhibit the processes of overexcitation of the nervous system. The hypotonic type of the disease requires the use of tonics.

Diet and mineral waters

A diet for ADHD involves frequent and small meals. Your usual diet must contain foods that help remove fat from the liver - fruits and vegetables. It is necessary to limit the consumption of fatty fish, meat, eggs, and animal fats. It is necessary to completely exclude from the diet such foods as:

• fried and spicy foods;
• carbonated and cold drinks;
• legumes;
• alcohol;
• onion and garlic.

Such food can provoke a severe spasm of the bile ducts. It is important to always consume food warm and fresh. Products need to be baked or boiled. It is normal to salt food, but during an exacerbation period, salt is limited.

Dinner should be very light and no later than 2-3 hours before bedtime. In case of exacerbation of liver and gall diseases, which are accompanied by gastritis, all dishes should be consumed in pureed form, and fresh vegetables and fruits and black bread should be excluded.

During the period of remission, the diet becomes less strict, but in any case it is not recommended to abuse fatty and fried foods. If you have dyskinesia, you need to stick to a diet throughout your life.

Treatment of JVP with mineral waters is carried out only during the period of remission. In the presence of liver and biliary tract diseases, hydrocarbonate and sulfate waters are used. Before starting treatment, you need to carefully study the composition and properties of mineral water, since each of them affects the digestive organs, so some side effects may occur.

Physiotherapy

Physiotherapeutic treatment, which should be used in combination with other techniques, also has a good effect. In particular, diadynometry is used, which implies a therapeutic effect on the area of ​​the right hypochondrium with electric current of various frequencies. Electrophoresis is also used, which involves the effect of a direct electric current on the body and drugs administered with its help into the liver area.

Acupuncture or acupuncture is a treatment method in which the body is affected by introducing special needles into special points on the body. Massage, especially acupressure, has a good therapeutic effect. That is, by influencing certain places on the body, the gallbladder is affected. Many experts recommend hirudotherapy, that is, treatment with leeches affecting biologically active points - projections of the nerve endings of the corresponding organs.

Possible complications

It is important not only to understand what kind of diagnosis this is - VHD, but also what complications of the disease may occur in the event of incorrect or untimely treatment. Among the main violations it is necessary to highlight the following:

• chronic cholecystitis;
• cholangitis;
• cholelithiasis;
• gastritis;
• chronic pancreatitis;
• duodenitis.

Atopic dermatitis may also occur, which develops as a result of impaired absorption of digested food and the release of toxic substances due to inadequate flow of bile into the intestines. When dyskinesia occurs, a person may suddenly lose weight because the absorption of nutrients is impaired.

Forecast

Strict compliance with all the instructions of the treating doctor and the desire to recover will ensure that literally after several weeks of treatment, dyskinesia will no longer bother the person. The success of therapy largely depends on the normalization of work and rest schedules, resistance to stress, and a balanced diet. Modern techniques and the use of the latest drugs give very good results and allow you to return to a normal lifestyle very quickly.

Carrying out prevention

Preventive measures are very important, as they help prevent the development of the disease. Primary prevention of dyskinesia is:

• compliance with the work and rest regime;
• proper nutrition;
• eliminating stressful situations;
• timely treatment of neuroses.

A full night's sleep should be at least 8 hours and sleep should be no later than 23:00. It is important to alternate physical and mental stress, which is why when working at a computer you need to periodically take a break to perform several gymnastic exercises, as well as take walks in the fresh air.

Nutrition should be complete; it is important to limit the consumption of fatty, smoked, fried, and salty foods. It is recommended to consume as many fresh vegetables and fruits as possible.

Secondary prevention is carried out in case of dyskinesia. It consists in the earliest detection of the pathological process, for example, during regular preventive examinations. This will allow timely treatment and avoid negative consequences.

Hypokinetic biliary dyskinesia is a disease characterized by a lack of bile during food processing. The disease develops because the gallbladder did not contract in time and the required component did not enter the digestive tract. As a result of such a disorder, food is not digested normally, useful components are poorly absorbed, which means that a person’s general functioning deteriorates.

Quite often, this form of the disease is diagnosed in older people, after 40 years, when a person often experiences neuroses and succumbs to stress.

Etiology

The cause of the formation of the disease is a violation of the outflow of bile, its stagnation, deterioration of the tone and motility of the bile and ducts. The risk group of people who may develop such a pathology includes the following individuals:

• increased anxiety;
• nervous;
• with autonomic disorders – headaches, cold extremities, rapid heartbeat, disturbed sleep are noted.

Also, various early gastrointestinal diseases that have already overcome the patient - gastritis, pancreatitis, ulcers - can serve as a provoking factor.

Another reason, according to doctors, may be poor lifestyle and nutrition. Pathology can progress with overeating, frequent diet disruptions and excessive amounts of junk food.

Some patients are diagnosed with a hereditary factor that provokes the development of the disease in childhood.

Various bacteria and infections can serve as factors for the rapid development of pathology.

JVP can also occur under the influence of the following reasons:

• inflammation in the abdominal cavity and pelvis;
• vegetative-vascular dystonia;
• emotional, mental or physical stress;
• inactive way of life;
• asthenic physique;
• muscle weakness;
• chronic allergic diseases;
• osteochondrosis.

Symptoms

Hypotonic JVP develops with characteristic symptoms. Dyskinesia is divided into two forms, but each type has specific signs that help the doctor quickly identify the disease. With hypokinetic pathology, the patient experiences the following symptoms, which are provoked by strong emotional outbursts or diet violations:

• dull, aching, low-intensity pain in the right hypochondrium;
• a feeling of heaviness and expansion of the area under the rib;
• unpleasant sensations do not spread to other areas of the body;
• bitter taste in the mouth;
• nausea;
• loss of appetite;
• belching;
• bloating;
• bowel dysfunction;
• irritability;
• tearfulness;
• rapid onset of fatigue;
• profuse sweating;
• headache;
• yellow coating on the tongue.

If the disease develops in men, libido deteriorates, and in women the menstrual cycle is disrupted.

If the hypokinetic form of dyskinesia has developed to cholestasis, and this is the last stage of stagnation of bile in the bile ducts, then the patient begins to experience more severe symptoms:

• severe itching of the skin of the entire body;
• yellow tint of the skin and mucous membranes;
• darkening of urine;
• lightening of stool to a gray tint.

Diagnostics

If the above-mentioned clinical manifestations are detected, the patient should immediately consult a doctor. A gastroenterologist will help the patient cope with the identified signs. The physician must determine the cause of such symptoms, what signs were the first, and also identify risk factors. During a physical examination and questioning of the patient, the doctor determines the presence of jaundice of the skin and mucous membranes of the eyes, pain on palpation in the area under the right rib.

Laboratory examinations should be carried out to clarify the diagnosis and for the purpose of differential diagnosis:

• a blood test can show a physician an inflammatory process - leukocytosis with a neutrophil shift and an increased ESR;
• a urine test can reveal bile pigments;
• more information can be provided by a biochemical blood test, which helps determine the signs of cholestasis syndrome;
• To exclude viruses, a test for viral hepatitis is performed.

It is also necessary to conduct instrumental diagnostics:

• Ultrasound of the abdominal cavity - helps to analyze the shape and size of the gall bladder, identify the presence or absence of stones, and anomalies. It is recommended to conduct an ultrasound examination 2 times - on an empty stomach and after a light breakfast;
• duodenal intubation - the work and tone of the organ is determined, the speed of contraction of the organ and the synchronicity of the functioning of the sphincters of the bile ducts are analyzed. The doctor can diagnose lability of the gallbladder reflex, worsened rhythm of bile outflow and excessive secretion of gallbladder bile;
• esophagogastroduodenoscopy – performed to identify diseases of the stomach and small intestine;
• cholecystography - used for accurate visualization of the bile with the help of a contrast agent. Its shape, size, location and speed of contraction are analyzed;
• ERCP and hepatobiliary scintigraphy - to exclude other pathologies of the liver, pancreas and bile ducts.

Treatment

Therapy of hypokinetic type disease consists of three main methods:

• eliminating the root cause of the disease;
• treatment of cholestasis and its complications;
• restoration of normal functioning of the gallbladder.

For any problems with the gastrointestinal tract, diet therapy is very important. In case of a disease of the biliary system, doctors also prescribe to patients certain rules of nutrition and daily routine:

• the number of meals should be at least 5 times a day in small portions;
• the menu should not contain products made from animal fat;
• any fried, salted, smoked foods are prohibited;
• you need to exclude various sweets, chocolates, coffee, cocoa and soda;
• It is undesirable to consume eggs and legumes due to the increased level of gas formation;
• reduce the amount of salt;
• food should be cooked in a steam bath, in the oven or stewed;
• Observe the drinking regime and drink the required amount of fluid per day.

The diet of a person with a similar diagnosis should include the following products:

• dried bread products;
• dairy products;
• lean meat and fish products;
• vegetables;
• boiled sausage and frankfurters;
• vegetable and butter;
• sugar;
• caramel;
• paste;
• juices from fresh vegetables and fruits;
• sweet fruits and berries;
• cereals;
• light broths.

In addition to diet, the patient should also follow the correct daily routine so that the body has time to rest and recover. For this, patients are recommended the following regimen:

• sleep at least 8 hours at night;
• go to bed no later than 23:00;
• to walk outside.

In order for the treatment of the disease to be as effective as possible, doctors prescribe patients to undergo various physiotherapeutic procedures, as well as the use of medications. Doctors prescribe pills to achieve the following goals:

• normalization of bile secretion;
• eliminating pain syndrome;
• relieving spasms in the sphincter;
• reducing symptoms;
• normalization of the nervous system.

The patient’s condition can be significantly improved by using antispasmodics, enzyme preparations, choleretic, sedatives, sedatives, tonics, etc.

Physiotherapy is prescribed based on the patient’s health condition and the characteristics of the course of the disease. The patient is recommended electrophoresis, diadynamic currents, paraffin baths, acupuncture, and massages.

Often, in treating the disease, doctors use traditional methods of eliminating the disease. Such methods of treatment are especially relevant at the time of remission. Doctors advise using herbal decoctions to prevent relapses. But in moments of exacerbation, such therapy must be used extremely carefully after a doctor’s prescription. Decoctions and tinctures can be made from the following plants:

• calamus root;
• barberry;
• birch leaves;
• immortelle;
• centaury;
• coriander;
• corn silk;
• burdock;
• tansy bloom;
• sagebrush;
• Rowan;
• hop;
• chicory.

These herbs can be mixed in different proportions and combined in different ways, but before using them it is important to consult a specialist.

Complications

As a result of untimely or incorrect treatment, the patient may develop various complications - cholecystitis and cholelithiasis. Quite often, doctors manage to completely eliminate the disease, so the body is not subject to the formation of other pathologies.

Prevention

• get enough sleep;
• moderately engage in mental and physical work;
• to walk outside;
• Healthy food;
• reduce the amount of stress.

These requirements can be followed by both healthy people and patients who want to prevent relapses of dyskinesia.

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