Chronic non-calculous (calculous) cholecystitis. Non-calculous (calculous) cholecystitis

Non-calculous or, as doctors also call it, acalculous cholecystitis is an inflammation of the gallbladder, which is accompanied by a violation of the biliary process. Unlike the calculous form of cholecystitis, which is accompanied by the formation of stones, the source of the development of a stoneless is an inflammatory process that affects the mucous membrane of the gallbladder. The disease can occur in both acute and chronic form.. Depending on this, the symptoms and methods of treating the pathology may differ. Not calculous cholecystitis– what is it and how to treat the disease? All this will be discussed in this article.

Non-calculous cholecystitis - what is it

The most basic reason for the development of the disease is the penetration into the cavity of the gastric bladder of an infection that enters there along with the blood. Can provoke the development of pathology infection internal organs located next to the gallbladder. For example, pathogenic microorganisms that affect the intestines can spread to the bladder. This is quite enough for the occurrence of non-calculous cholecystitis.

But, in addition to infection, there are other factors that contribute to the development of the disease:

unbalanced diet(when overeating alternates with hunger strikes);
pregnancy. During this period, the size of the uterus increases, as a result of which it compresses the internal organs, including gallbladder;
prolapse of the abdominal organs;
gallbladder deformity(congenital or acquired pathological changes, at which the size and shape of the internal organ change);
cholestasis or impaired flow of bile.

On a note! Insufficient physical activity can also lead to the development of cholecystitis. So the people who lead sedentary image life, most often encounter this disease.

According to statistics, non-calculous cholecystitis occurs in people regardless of age. But women are exposed to this pathology much more often than men (about 4 times). If treatment is not started on time, the disease can progress. In this regard, it is necessary to learn to recognize the symptoms of pathology. This will allow it to be identified early stage development.

Characteristic symptoms

The peculiarity of cholecystitis is that it develops gradually, therefore, with the definition early stage difficulties often arise. But in the process of development, the following symptoms occur:

dyspepsia, work problems digestive system;
the appearance of burning and itching in the right hypochondrium;
acute pain in the abdomen.

The clinical picture is very variable at an early stage in the development of pathology, so the symptoms may not appear simultaneously. The first signs are a slowdown metabolic processes and pain, which is often worse after drinking carbonated drinks that are too spicy, sour, or fatty foods.

Over time, the symptoms of non-calculous cholecystitis become more evident and are the same in all patients. These symptoms include:

the appearance of a rash on the skin;
muscle spasms;
bloating;
bouts of vomiting with an admixture of bile;
feeling of dryness in the mouth;
burning sensation with a taste of metal in the mouth;
when eating, a bitter taste occurs;
pain in the right side of the abdomen, which may extend to the epigastrium ( epigastric region). As a rule, pain occurs if the patient is in sitting position or immediately after a meal.

On a note! When the pathology passes into the stage of calm (remission), the patient noticeably improves his appetite. But after some time, when the symptoms of cholecystitis occur again, the appetite will deteriorate sharply.

Features of diagnostics

At the slightest suspicion of the development of non-calculous cholecystitis, you should immediately consult a doctor for an examination. The doctor will perform several diagnostic procedures:

laboratory analysis of urine and blood of the patient;
visual examination, analysis of patient complaints. As a rule, examination of the patient's oral cavity reveals a scalloped plaque on the surface of the tongue, which indicates stagnation of bile in the body;
palpation of the abdominal cavity;
Ultrasound of the gallbladder;
x-ray examination of the gallbladder with the use of a contrast agent;
duodenal sounding.

Treatment of non-calculous cholecystitis

When symptoms of pathology are detected, therapy lasting from 19 to 14 days is usually carried out in a hospital setting. Treatment consists of the following tasks:

restoration of the digestive system;
elimination of foci of inflammation and infection;
normalization of the gallbladder;
elimination of pain syndrome;
treatment possible complications that arise in the process of development of the underlying pathology;
spread prevention inflammatory process to other internal organs;
prevention of exacerbations of symptoms of the disease.

Therapy should be complex, including medication, compliance therapeutic diet and physiotherapy procedures. Let's look at each of these treatments separately.

Pharmacy preparations

Depending on the form of the disease and the severity of its course, the doctor may prescribe one or another medical preparations. Below are the most common treatments for acalculous cholecystitis.

Table. Review of drugs for the treatment of the disease.

Name of the drug, photo	Description
	A well-known medical preparation with choleretic and antispasmodic properties. Produced in the form of drops. Part this drug includes frangulomodin, magnesium salicylate, eucalyptus and mint essential oil. Used in the treatment various kinds cholecystitis, including acalculous.
	An effective drug belonging to the group of nitrofurans. It has antibacterial, anti-inflammatory and antimicrobial properties. The action of the drug is to suppress the activity of gram-negative aerobic microorganisms. It is prescribed for the treatment of inflammatory and infectious processes.
	Used as effective remedy in biliary pathology. It has choleretic, hepatoprotective, analgesic and membrane stabilizing properties. Stimulates work immune system patient.
	The composition of the drug includes dried bovine bile, hemicellulase and pancreatic enzymes. Due to the content of these components, Festal promotes the breakdown of products that include carbohydrates, proteins and fats. It is used to normalize the secretion of bile, which helps in the treatment of non-calculous cholecystitis.
	A drug in the form of a solution. It has antimicrobial, anti-inflammatory and detoxifying properties. It contains chloride, magnesium, calcium and sodium ions. The drug is used in the treatment of toxicosis, various gastroenterological diseases. Effectively manifests itself in the treatment of pneumonia. Like most strong drugs, Hemodez has several contraindications. For example, the drug should not be taken by patients suffering from cardiovascular disease, respiratory failure or allergies.
	Excellent pharmacological agent, which is part of the m-anticholinergic group. It has sedative, choleretic and antispasmodic properties. Regular use of Platifillin allows you to eliminate pain and spasmodic contractions of the gallbladder that occur with non-calculous cholecystitis. Produced in the form of a solution for injection, which is administered to the patient intramuscularly or intravenously.

As an addition to the above medicines the doctor may prescribe the intake of drugs of the enzyme group. Their task is to normalize metabolic processes in the patient's body. As a rule, the duration of the therapeutic course is approximately 14 days, but in rare cases when serious complications occur, treatment may be longer. For complex treatment, the doctor prescribes physiotherapy, due to which the contractile activity of the patient's gallbladder improves markedly.

Diet

During the entire period of treatment, the patient must comply with special diet. It should also be observed during the recovery period. The essence of the therapeutic diet is to eat food in small portions. It's about about fractional nutrition, when a person eats not 3 times a day, but 5, but in small portions. But fractional nutrition is not enough, so the patient should eliminate or at least limit the amount of food in his diet.

Prohibited products include:

sweet sparkling water;
raw fruits and vegetables;
walnuts, forest and other types of nuts;
bakery products;
chicken eggs, in particular proteins;
alcoholic drinks (wine, beer, vodka, etc.);
fried, spicy and too fatty foods.

Important! Make sure that the food you eat is always warm. Otherwise, if you regularly eat cold dishes, spasm of the sphincter of Oddi may occur ( pathological disorder sphincter, which is accompanied by a deterioration in the outflow of bile in the body). It is recommended to boil, stew or bake all dishes. This will keep maximum amount useful substances.

Add various jelly, compotes, vegetable or cereal soups, baked vegetables and protein omelettes to the menu. Depending on the individual characteristics patient, the doctor can expand the diet or, conversely, slightly reduce it. But in any case, you need to follow the recommendations of the attending physician. This is the only way to expect a quick recovery.

Surgical intervention

Development serious complications or inefficiency drug treatment compels physicians to resort to surgical operation. Patients are placed under the knife in order to remove the affected organ. You can do this in two ways: classical surgery and laparoscopy. The first method is considered more affordable financially. In this case, a small incision is made on the patient's abdomen, through which the organ is removed. Flaw this method lies in long period recovery, as the patient has to wait until the wound on the abdomen heals completely, and this is not so fast.

Laparoscopy, in contrast to the classical operation, is more modern method, in which small incisions are made in the abdominal cavity of the operated person, through which the surgeon removes the gallbladder. After operation recovery period does not last long.

Prevention measures

As with all diseases, acalculous cholecystitis is preventable. First of all, the prevention of the disease lies in proper nutrition. Make sure your diet includes only healthy foods, no fast food and stuff. Consume enough fluids, i.e. at least 1.5 liters of water per day. This is the adult norm.

Other preventive measures include:

Compliance with all these recommendations will help to avoid the development of acalculous cholecystitis. In some cases, doctors recommend including preventive measures taking hepatoprotectors, with which you can prevent the occurrence of this disease. Hepatoprotectors are medicines that protect the liver and other vital important organs human by creating a protective barrier. To the most effective hepatoprotectors include Galstena, Ursofalk, Phosphogliv and other medicines.

Video - Diagnosis and treatment of cholecystitis

The appearance and reproduction of pathobacteria in the gallbladder leads to the development of such a disease as non-calculous cholecystitis. It is accompanied by painful sensations.

It appears in acute and chronic form. The acute form is characterized by a favorable prognosis, subject to compliance with medical prescriptions.

Lack of proper treatment, non-compliance with recommendations leads to exacerbations.

Anatomy, functions of the gallbladder

WITH bottom side the liver is the gallbladder. It resembles a bag eight to fourteen centimeters long, three to five centimeters wide.

In adults, the volume is about 70 cubic meters. see Filled with bile, which comes here from the liver.

The structure distinguishes a wide bottom, body and neck. From cervical is coming cystic duct connecting the organ to the bile duct.

The walls of the body consist of the following tissues:

connective;
muscular;
epithelium.

The main purpose is to accumulate, outflow of bile. Its synthesis occurs after a person has eaten. At this time it is reduced muscle bladder, internal pressure rises, the sphincter relaxes, bile flows into the duct and enters the intestine.

Non-calculous cholecystitis

The most common diseases of the gallbladder include calculous cholecystitis, dyskinesia, cancer, polyps.

One of the pathologies associated with the occurrence of an acute inflammatory process is chronic non-calculous cholecystitis. The disease is recognized by doctors all over the world. In ICD-10, he was assigned the code K8 1.8.

The flow is characterized by acute and chronic form. It is diagnosed in 7 cases out of 1000, while women get sick more often. Sometimes cholecystitis also affects children.

Grows when sick connective tissue, scars occur. Gradually, new formations replace the tissues of the gallbladder. Peristalsis is disturbed, the ability of the walls to contract decreases. Parts of the organ become denser, the mucous membrane becomes thinner.

The resulting inflammation in about 10% of cases becomes chronic.

In order to classify pathology, several parameters are used:

Form. Mark light, moderate and severe.
Phases. In development, there is a phase of exacerbation, a decrease in the manifestation of symptoms, and remission.
The nature of the flow. It is noted monotonous, recurrent and variable.
Manifestation. The disease progresses in typical form. In rare cases, it appears atypically.

Pathology has inflammatory character, is not associated with the formation of calculi.

Symptoms

The disease manifests itself in a typical and atypical form.

Typical signs

The acute form is characterized by the appearance of severe pain on the right side under the ribs. They appear after eating, especially if a person ate a spicy dish, drank beer. Painful sensations give in the shoulder, back.

Another characteristic symptom cholecystitis - belching, accompanied by the appearance of bitterness in the mouth.

The third symptom is nausea. All three symptoms of cholecystitis of the non-calculous system usually appear after eating.

Over time, there is bloating, flatulence, skin rash, vomiting. There is a feeling of dryness and burning in the mouth.

In patients, there is an increase in irritability, a decrease in working capacity. Against the background of an acute form or exacerbation, the temperature sometimes rises.

As a rule, it does not rise above 37.5-37.7°C. There is weakness, pain in the head, anxiety, malaise, other symptoms of intoxication

IN under acute form attention is drawn to the yellow tint of the eyes, skin, constipation, diarrhea, urge to vomit.

Atypical symptoms

Approximately one third of patients are diagnosed with chronic non-calculous cholecystitis in atypical form by cardiological, intestinal and esophagalgic variant.

Manifestations of the cardiological form can be confused with heart disease. Pathology manifests itself in the later stages.

After eating or in the supine position, heart palpitations, arrhythmia, and soreness in the chest begin.

The development of an esophagalgic non-calculous type is evidenced by the occurrence of heartburn, discomfort when swallowing, pain in the abdomen.

The intestinal appearance is manifested by slight soreness in the intestinal region, rumbling, stool disorders, and bloating. It occurs due to a deficiency of bile in the intestinal tract.

Causes

The main cause of cholecystitis is the reproduction in the gallbladder of pathological bacteria: coli, proteus, enterococci, staphylococci.

It has been proven that bile is able to cope with bacteria, and the epithelium is capable of performing functions immune protection local character.

The development of the disease is associated with the involvement of a number of factors. Due to a violation of the output of bile, a decrease in peristalsis, a sluggish inflammation occurs.

When an infecting element enters this environment, the inflammatory process increases, captures the entire organ.

There are three sources of infection of non-calculous cholecystitis:

Ascending. It is caused by sphincter dysfunction, biliary dyskinesia.
descending. The infection enters the body through the blood hepatic artery, collar vein.
Lymphogenic. Caused by pneumonia gynecological diseases, appendicitis.

Diagnostics

The main symptom of acalculous cholecystitis is pain on the right that occurs after eating.

The doctor listens to the patient, writes down the medical history, provoking factors, and conducts an examination.

On possible development disease sometimes indicates white tongue. This symptom is associated with congestion bile.

Pain appears or increases on palpation. Sensations are aggravated when you press on the inhale on the bile, a slight blow on chest lateral surface of the palm, effleurage in the area of the ninth-eleventh thoracic vertebra, pressure in the area of passage of the occipital nerve.

Additionally assigned:

General formula of blood. The results indicate the presence of inflammation.
Biochemistry of blood. Pathology is indicated by an increase in bilirubin, aspartate aminotransferase, and a liver enzyme.
Analysis of urine.
duodenal sounding. Shows signs of impaired peristalsis. Protein, acids, cholesterol, bile are found in bile.
Ultrasound of internal organs. When conducting this study, signs of changes in the structure of organs, wall thickness, symptoms of a non-calculous type of inflammation are found.
Radiography with contrast.
Cholescintigraphy. During the examination, the biliary system is visualized using radiopharmaceuticals, to obtain information about the functioning of the bladder, the ability of the walls to contract, the absence of obstructions in the flow of bile, the work of the sphincters.

Treatment

In order to treat acute and chronic acalculous cholecystitis, drugs are prescribed, methods traditional medicine undergoing surgical intervention.

Outside of exacerbation, in the absence of symptoms of non-calculous cholecystitis, treatment with physiotherapeutic methods is indicated.

Drug therapy

Treatment with drugs includes painkillers, antispasmodics, drugs that improve the outflow of bile.

For cupping acute pain spasms are used antispasmodics. These are No-Shpa, Analgin, Platifillin, Papaverine.
With strong prolonged pain and the presence of signs of inflammation in the analyzes, it is indicated to use broad-spectrum antibiotics: Erythromycin, Cefantral, Ampicillin.
To eliminate signs of intoxication (vomiting, nausea), Hemodeza is administered intravenously.
Enzymes will help normalize digestion. This is Festal, Mezim Forte.
To increase the secretion of bile, Allohol, Holenztm, Ursohol are used.
Cholekinetics have a choleretic effect: Cholagol, Urolesan N.
With giardiasis, they drink Furazolidone.

IN complex therapy vitamins B, C are included. During an exacerbation, the patient is advised to observe bed rest, table number 5.

Surgery

Lack of application efficiency drug treatment non-calculous cholecystitis, the occurrence of complications is an indication for surgery.

During laparoscopy, several incisions are made through which the organ is removed. An intracavitary operation is performed. Healing after such a procedure takes a long time.

Physiotherapy

During the period when cholecystitis passes acute stage, shows the use of physiotherapy methods.

Cryotherapy helps relieve inflammation. An abdominal massage is performed. A similar effect has UHF therapy.

Spasms are eliminated by electrophoresis using antispasmodics, high-frequency magnetotherapy, paraffin applications.

To improve the flow of bile, electrical stimulation of the biliary system is prescribed. The procedure is contraindicated in case of frequent exacerbations, the presence of purulent formations, empyema, exacerbation of cholangitis.

Mud procedures are prescribed.

folk therapy

In order to improve the outflow of bile, Phytohepator decoction is indicated. The mixture contains yarrow, chamomile flowers, calendula, tansy, mint leaf.

Used to stimulate the flow of bile olive oil. A teaspoonful of it is drunk three times a day for three days.

Similar medicinal property has a black radish. Juice is squeezed out of the root crop, they drink 50 ml per day.

Treatment with wild rose decoction is shown. The dry root is crushed and boiled in a glass of water.

For the treatment of chronic non-calculous cholecystitis, a decoction of a mixture of immortelle, mint leaf, yarrow stem, wormwood, fennel grains is used. It is prepared from 10 g of the mixture, filled with two glasses of cold water.

Relieves inflammation of sage, brewed in boiling water and infused for half an hour. To prepare, take two tablespoons of the plant and 2 cups of water.

Diet

An important part of the treatment and prevention of cholecystitis is diet. It is recommended to eat up to six times a day, and the last time two hours before bedtime.

The menu is based on reducing the consumption of fatty foods rich in cholesterol. It is recommended to exclude red meat, poultry, lard, offal, egg yolk, oil.

Instead, use vegetables, rabbit meat, and lean white fish for most meals. useful carrots, bell pepper, dried fruits, melon, pumpkin.

You need to drink up to one and a half liters of liquid per day. Drink mineral water half an hour before meals. It must be without gas.

Sweets, smoked meats are forbidden, fried foods. Soda, alcohol are excluded. All vegetables, berries, fruits are consumed only in processed form.

All meals must be at room temperature. Cold dishes can provoke a contraction of the sphincter.

Foods that contain dyes and preservatives are removed from the menu.

Prevention

The main way to prevent the disease is diet. However, in addition to proper nutrition, there are measures that must be observed to prevent the development of cholecystitis and the occurrence of exacerbations.

Ignoring the symptoms of non-calculous cholecystitis in adults and delayed treatment causes the following complications:

Empyema. In the cavity of the gallbladder, pockets of accumulation of pus are formed. There is severe pain, colic, flatulence. The temperature rises.
Fistula formation. Due to rupture of the walls, bile is poured into abdominal cavity, provokes the development of abscesses, peritonitis. Skin color changes, nausea appears, internal bleeding is possible.
Hepatitis. Arises as secondary disease liver. Manifested by yellowness skin, sclera, enlargement of the liver in size, heaviness under the right ribs, fatigue.
Cholelithiasis. With prolonged non-calculous cholecystitis, stones are formed from cholesterol, bile pigments, calcium salts. Accompanied severe pain, colic.
Cholangitis. The inflammatory process covers the duct. Accompanied by fever, dull pain, nausea.
Gangrene. This complication is the least common. Manifested by tissue death, pain. In some cases, vision deteriorates up to blindness. The temperature gets very high. The disease often leads to death.

Based on the results of the diagnosis, the doctor confirms the symptoms and treatment of non-calculous cholecystitis.

Despite the fact that the disease may not manifest itself brightly, it is necessary to immediately begin to take the recommended measures. This will avoid the development of complications and exacerbations.

Useful video

Chronic non-calculous (calculous) cholecystitis- represents chronic inflammation of the gallbladder, as a rule, combined with motor-tonic disorders of the biliary system, but not accompanied by the formation of gallstones.

In foreign literature, non-calculous (acute) cholecystitis is commonly understood as severe inflammatory disease gallbladder resulting from sepsis, major surgery, severe trauma, sickle cell anemia, diabetes, prolonged fasting, or parenteral nutrition, which leads to stagnation of bile, various vasculitis (SLE, polyarteritis nodosa). Sometimes infectious agents such as salmonella or CMV can be detected (in immunocompromised patients).

The causes of chronic non-calculous cholecystitis may be opportunistic microbial flora (escherichia, streptococci, staphylococci, less often proteus, Pseudomonas aeruginosa, enterococci).

The disease is manifested by pain syndrome, disorders digestive function And common manifestations inflammatory response organism.

Epidemiology of chronic acalculous cholecystitis
The incidence of chronic acalculous cholecystitis is 6-7 cases per 1000 population. Chronic acalculous cholecystitis is much less common than it is diagnosed, especially on an outpatient basis.

According to foreign epidemiological data, chronic acalculous cholecystitis is from 5 to 10% of all cases. acute cholecystitis and has a higher mortality than calculous cholecystitis.

Women get sick more often than men by 3-4 times.

ICD-10 code
K81.8. Other forms of cholecystitis.

Diagnostics

The diagnosis of cholecystitis can be suspected when the patient complains of pain in the right hypochondrium, especially after eating fatty foods.

Diagnostic methods
- Collection of anamnesis
  When collecting anamnesis Special attention should be given to the localization of pain and its relationship with the intake of fatty foods. It is also necessary, if possible, to identify the presence of predisposing factors (factors that cause bile stasis, gallbladder dyskinesia).
- Physical examination
  In general, physical examination in chronic non-calculous cholecystitis has no specific features and does not allow us to confidently differentiate between calculous and acalculous lesions of the gallbladder without special methods research.
  - Inspection.
    Characteristic in chronic cholecystitis is the presence in patients of a furred, scalloped (with imprints of teeth) tongue, which is a reflection of stagnation in the gallbladder.
  - Palpation.
    On palpation of the abdomen, pain is noted in the projection of the gallbladder (the intersection of the outer edge of the right rectus abdominis muscle with the costal arch), aggravated by inhalation (Ker's symptom), as well as when tapping the edge of the palm along the right costal arch (Ortner's symptom). However, these symptoms are not always detected.
    
    With cervical localization of cholecystitis, sometimes with deep breath able to palpate the bottom of the enlarged gallbladder.
    
    Additional palpatory symptoms, sometimes determined in chronic non-calculous cholecystitis:
    - Murphy's symptom - careful, gentle introduction of the hand into the gallbladder area and with a deep breath, the palpating hand causes sharp pain.
    - Mussy's symptom - pain when pressing on the phrenic nerve between the legs of the sternocleidomastoid muscle on the right.
    - Mackenzie's symptom - hyperesthesia of the abdominal skin in the right hypochondrium with the most pronounced pain in the area of the gallbladder projection.
    - Chauffard's symptom - during ventrodorsal bimanual palpation, pain occurs in the area of the projection of the head of the pancreas and gallbladder (the symptom is characteristic of cholecystopancreatitis). The same symptom is described by Zakharyin.
    - Lyahovitsky's symptom - pain occurs with slight pressure on right half xiphoid process or when it is taken upward.
    - Symptom Kharitonov - pain on palpation to the right of the spinous process of the IV thoracic vertebra.
    - Yonash's symptom - pain with pressure at the site of attachment of the right trapezius muscle in the occipital region (in the area of the projection of the occipital nerve).

Non-calculous cholecystitis is a pathological condition manifested by impaired motility of the gallbladder and its tracts. It can occur in an acute form or chronic (with alternating exacerbations and remissions).

The symptoms of this disease significantly impair the quality of life of patients and cause various complications. That is why treatment is required.

For this purpose, it is applied drug therapy, surgery, and alternative treatment. It is possible to reduce the manifestations of the disease with proper nutrition.

What is this disease

This is a pathology of the gallbladder, in which the organ becomes inflamed, its motor-tonic functions are disturbed.

The difference from is that with this pathology, stones do not form in the gallbladder. That is why this condition has another name - acalculous cholecystitis.

Specialists define several types of pathology:

Chronic form. In this case, periods of exacerbations and remissions alternate.
Acute. It is characterized by severe symptoms.

Engaged in diagnosis and treatment given state gastroenterologist.

Main reasons

Most often, pathology develops if an infection enters the organ. This usually happens if there is an inflammatory process in the intestines. Then the infection of the gallbladder occurs through the lymph or blood.

Pathogenic microorganisms such as staphylococci, proteus, Escherichia coli, enterococci, streptococci cause the disease.

The disease in adults can occur against the background of other ailments of the digestive system, such as:

pancreatitis;
duodenitis;
biliary dyskinesia;
gastritis;
peptic ulcer;
hepatitis.

There are other reasons for the development of a pathological condition, due to which bile stagnates in the organ and ducts.

These include:

wall deformations;
organ prolapse;
reduced tone;
impaired flow of bile.

If the patient has an acute form of the disease, then in the presence of inflammation in the organs of the digestive system, chronic non-calculous cholecystitis begins to develop.

There are the following factors that provoke the occurrence of a pathological condition:

Diabetes mellitus can provoke the development of pathology. Install exact reason an experienced gastroenterologist can help.

Symptoms of pathology

The main symptom is pain in the right hypochondrium, usually aching in nature. Most often, this syndrome occurs if the day before there was a intake of fatty or fried foods, after experienced stress or heavy physical exertion.

The symptoms that accompany the pathology may be as follows:

frequently repeated eructation;
periodic nausea;
feeling of bitterness in the mouth;
bloating;
heartburn.

If the patient has an exacerbation of the disease or the rules have been violated diet food, then vomiting with bile may develop. Also, this condition is characterized by an increase in temperature, general weakness, sleep disorder, headache.

Non-specific signs may also appear. These include an increase in heart rate, the development of arrhythmias, intestinal colic, constipation and diarrhea.

In the presence of the above symptoms, it is important to seek help from a doctor.

Diagnostic methods

Identification of the disease specialist begins with the collection of anamnesis. It is also important to examine the patient, which is based on the tests of Murphy, Chauffard, Mussy. IN without fail the patient should go laboratory research, namely to hand over urine and a blood on the analysis.

To know accurate diagnosis you can use the following methods:

scintigraphy;
laparoscopy;
celiacography;
x-ray;
cholegraphy;
duodenal study.

Experts consider the most reliable method ultrasound diagnostics. When deciphering the results, echoes such as organ size, wall thickness, and motor function are taken into account.

Medical treatment

The choice of treatment regimen depends entirely on the form and course of the disease. If the patient has a stage of exacerbation of the pathology, then drug therapy is used in this case.

Antibiotics are mandatory to eliminate inflammation and infection in the gallbladder. May apply the following medicines this group:

Cefazolin;
Clarithrosin;
Ampiox;
Amoxiclav;
Ampicillin.

Drug treatment also includes the use of drugs of the following pharmacological groups:

The complex treatment also includes the intake of vitamins B and C.

Other measures

Auxiliary methods of therapy are physiotherapy procedures. They are best done during remission. Spa treatment is also effective.

An additional method is also probing using potassium permanganate, sorbitol and mineral water. If the motility of the organ is reduced, tubages with magnesia are used.

With an acute and severe form of the disease, surgical intervention is possible.

Proper nutrition

Diet in acute form of pathology should be based on the use of such dishes:

protein omelet;
cereals;
low-fat cottage cheese;
bran;
baked and stewed vegetables;
compote;
jelly.

With remission, the list of dishes expands slightly. Allowed to use low-fat varieties meat and fish. It is recommended to eat pumpkin, watermelon, Bell pepper, dried fruits, beets, carrots.

The patient needs to remove the following foods from the diet:

smoked meats;
marinades;
pickles;
carbonated drinks;
coffee;
fresh fruits and vegetables;
egg yolks;
confectionery;
fast food;
semi-finished products;
muffin;
spices and seasonings;
nuts;
alcoholic drinks.

Fatty foods, high-calorie fish and meat of some varieties, lard, butter are also prohibited.

The patient should eat steamed dishes, stewing and baking. They must be eaten warm.

It is important to observe the fractional nutrition: it is recommended to eat up to six times a day, but in small portions. Overeating or undereating is contraindicated.

Folk remedies

As a support and adjuvant therapy at pathological condition folk remedies are used.

To improve the process of bile secretion and relieve inflammation in the body, it is recommended to take decoctions from such medicinal plants, How:

buckthorn;
licorice;
tansy;
immortelle;
stigmas of corn;
chamomile;
marshmallow;
calendula;
sage.

They can be drunk individually, but best in collections. With exacerbations, you can take infusions peppermint, valerian, marigold, chamomile and dandelion.

It is important to remember that the use of alternative medicines must be approved by a specialist.

Prevention rules

Disease prevention measures include:

Compliance with proper nutrition.
Moderate physical activity.
Passing preventive examinations.
Personal hygiene rules.
Refusal to drink alcohol.
Establishing a drinking regimen.
Reception medicines only on doctor's orders.

If a person has a history of diseases of the digestive system, then he must adhere to all the instructions of the attending specialist.

Possible complications and prognosis

The outlook for the disease is mostly favorable. However, when advanced disease and ignoring treatment, the development of complications such as:

hepatitis;
cholelithiasis;
cholangitis in a chronic form;
empyema.

Also, with frequent exacerbations, a bag filled with pus can form in the bladder. In the future, it can break through the wall of the organ (there will be perforation), which will lead to more dangerous complications.

There are many causes of non-calculous cholecystitis. Treatment depends on the form of the course of the disease and the severity. Proper nutrition in this case, it is both an obligatory part of therapy and a measure for the prevention of pathology.

Chronic non-calculous cholecystitis is a long-term inflammatory process in the gallbladder, characterized by a violation of its motility and fibrous changes in the walls, but not accompanied by the formation of stones. The most common causes of this form of inflammation are malnutrition and infection. Acalculous cholecystitis can also occur in an acute form as a result of diabetes, prolonged starvation, extensive surgical interventions and other conditions leading to stagnation of bile.

The disease occurs with a frequency of about 7 cases per 1000 people, women get sick about 3-4 times more often than the male population. It should be noted that chronic non-calculous cholecystitis is quite common among children.

Clinical picture

The clinic of the disease is characterized by a long relapsing and progressive course, in which periods of remission and exacerbation are distinguished. For chronic non-calculous cholecystitis typical symptom is aching, Blunt pain under the right rib, sometimes in the epigastric region. Painful sensations can last for quite a long time - from several hours to weeks. The occurrence or intensification of pain is most often associated with an error in nutrition. So, an exacerbation of the disease can develop after the use a large number fatty foods, alcohol, carbonated and cold drinks, spicy dishes, eggs.

Sometimes inflammation captures the tissues around the organ, pericholecystitis develops. In this case pain syndrome becomes constant and more intense, the symptoms are aggravated by changes in body position, leaning forward. Characterized by irradiation of pain in the right subscapular region, right side neck, shoulder, lumbar region. Often there are reflex pains in the heart.

Murphy's symptom: when you press the gallbladder while inhaling, there is a sharp pain

Also, for non-calculous cholecystitis, symptoms of dyspepsia are characteristic. These include:

feeling of nausea,
bitter belching and
heartburn,
bitterness, dryness,;
change in the nature of the stool (diarrhea is replaced by constipation).

During the period of exacerbation of acalculous cholecystitis, symptoms of intoxication are possible. Patients are worried about chills, weakness, malaise, headache, sleep disorders. The temperature rarely rises above 38 degrees. If the fever reaches higher numbers, this may indicate the addition of complications (empyema of the gallbladder, cholangitis).

Important: if you have symptoms chronic cholecystitis, you should consult a gastroenterologist.

Treatment of the disease

With a pronounced exacerbation of non-calculous cholecystitis, treatment is carried out in a hospital. The goal of therapy is the relief of exacerbation, prevention and treatment of complications. Usually enough conservative therapy. Operational interventions performed in the case of frequent and severe exacerbations, with gross deformation of the gallbladder and the ineffectiveness of the use of drugs.

Diet food

Medicines

Drug treatment of chronic acalculous cholecystitis is aimed at solving the following problems:

elimination of pain syndrome;
restoration of motility and tone of the biliary tract;
suppression of the inflammatory and infectious process in the gallbladder;
normalization of impaired digestion.

Usually used for non-calculous cholecystitis antispasmodic drugs, antibiotics, agents that normalize the motility of the gallbladder and intestines. In case of severe intoxication, infusion therapy. If cholelithiasis is excluded during the examination, it is possible to use choleretic agents based on ursodeoxycholic acid.

To normalize the process of digestion are shown enzyme preparations. With exacerbations of acalculous cholecystitis, treatment takes about 2 weeks, but with the development of complications, it can be longer. After eliminating acute phenomena, the doctor may prescribe physiotherapy that will improve contractile activity gallbladder.

Herbal treatment is helpful in maintaining remission of chronic noncalculous cholecystitis.

Pharmacies sell ready-made choleretic fees which are very easy to use

To improve bile secretion and reduce the inflammatory process, decoctions of tansy, yarrow, licorice, buckthorn and other medicinal plants are used.

Important: before using any of the presented methods of treatment, you should consult your doctor.

Several recipes of traditional medicine for the treatment of acalculous cholecystitis.