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

Noncalculous 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 acalculous cholecystitis is an inflammatory process that affects the mucous membrane of the gallbladder. The disease can occur in both acute and chronic forms. 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.

Noncalculous cholecystitis - what is it?

The most basic reason for the development of the disease is the penetration of infection into the cavity of the gastric bladder, which enters there along with the blood. Can provoke the development of pathology infectious lesion internal organs located next to the gallbladder. For example, pathogenic microorganisms that affect the intestines can spread to the bladder. This is quite enough to cause 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 abdominal organs;
gallbladder deformity(congenital or acquired pathological changes, in which the size and shape of the internal organ change);
cholestasis or obstruction of bile flow.

On a note! Insufficient physical activity can also cause the development of cholecystitis. Therefore 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 in time, the disease may progress. In this regard, it is necessary to learn to recognize the symptoms of pathology. This will allow us to identify it further early stage development.

Characteristic symptoms

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

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

The clinical picture varies greatly at the early stage of development of the pathology, so symptoms may not appear simultaneously. The first signs include slowing down metabolic processes and pain, which often intensifies after drinking carbonated drinks that are too hot, sour or fatty foods.

Over time, the symptoms of non-calculous cholecystitis become more obvious and appear equally in all patients. These symptoms include:

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

On a note! When the pathology enters the stage of calm (remission), the patient's appetite noticeably improves. But after some time, when the symptoms of cholecystitis occur again, your appetite will sharply worsen.

Diagnostic features

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

laboratory analysis of the patient’s urine and blood;
visual examination, analysis of patient complaints. As a rule, examination of the patient’s oral cavity reveals 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 using a contrast agent;
duodenal sounding.

Treatment of non-calculous cholecystitis

If symptoms of pathology are identified, therapy lasting from 19 to 14 days is usually carried out in a hospital setting. Treatment consists of performing 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 during the development of the underlying pathology;
prevention of spread inflammatory process to other internal organs;
prevention of exacerbations of disease symptoms.

Therapy should be comprehensive, including medication, compliance therapeutic diet, as well as physiotherapeutic procedures. Let's look at each of these treatment methods separately.

Pharmacy drugs

Depending on the form of the disease and the severity of its course, the doctor may prescribe certain medical supplies. Below are the most common remedies for the treatment of acalculous cholecystitis.

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

Name of the drug, photo	Description
	A well-known medical drug that has choleretic and antispasmodic properties. Produced in the form of drops. Part this drug includes frangulomodine, magnesium salicylate, eucalyptus and mint essential oil. Used in treatment various types 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. Prescribed for the treatment of inflammatory and infectious processes.
	Used as effective means with bilinary pathology. It has choleretic, hepatoprotective, analgesic and membrane-stabilizing properties. Stimulates work immune system patient.
	The drug contains 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. Used to normalize bile secretion, which helps in the treatment of non-calculous cholecystitis.
	A drug produced in the form of a solution. It has antimicrobial, anti-inflammatory and detoxifying properties. It contains chlorine, magnesium, calcium and sodium ions. The drug is used in the treatment of toxicosis and various gastroenterological diseases. It is effective in treating pneumonia. Like most potent drugs, Hemodez has several contraindications. For example, the drug should not be taken by patients suffering from cardiovascular diseases, respiratory failure or allergies.
	Excellent pharmacological agent, part of the group of m-anticholinergic drugs. It has sedative, choleretic and antispasmodic properties. Regular use of Platiphylline eliminates pain and spasmodic contractions of the gallbladder that occur with non-calculous cholecystitis. Available in the form of an injection solution, which is administered to the patient intramuscularly or intravenously.

In addition to the above medicines The doctor may prescribe enzyme medications. 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 in rare cases When serious complications occur, treatment may take longer. For complex treatment, the doctor prescribes physical therapy, due to which the contractile activity of the patient’s gallbladder noticeably improves.

Diet

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

Prohibited products include:

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

Important! Make sure that the food you eat is warm. Otherwise, if you regularly eat cold foods, a 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 save maximum amount useful substances.

Add a variety of 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, reduce it slightly. But in any case, you need to follow the recommendations of your doctor. This is the only way to count on a quick recovery.

Surgical intervention

Development serious complications or inefficiency drug treatment forces doctors to resort to surgery. Patients are put under the knife to remove the affected organ. You can do this in two ways: classical surgery and laparoscopy. The first method is considered more financially accessible. In this case, a small incision is made on the patient’s abdomen, through which the organ is removed. Flaw this method is long period recovery, since the patient is forced to wait until the wound on the abdomen heals completely, and this is not so fast.

Laparoscopy, unlike classical surgery, is more modern method, in which small incisions are made in the abdominal cavity of the person being operated on, through which the surgeon removes the gallbladder. After operation recovery period doesn't last long.

Prevention measures

As with all diseases, acalculous cholecystitis can be prevented. First of all, disease prevention involves proper nutrition. Make sure your diet includes only healthy foods, no fast food or anything like that. Consume sufficient quantity liquids, that is, 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 avoid the development of acalculous cholecystitis. In some cases, doctors recommend including on the list preventive measures taking hepatoprotectors, which can help prevent the occurrence of this disease. Hepatoprotectors are medications that protect the liver and other vital important organs person by creating a protective barrier. To the very effective hepatoprotectors include Galstena, Ursofalk, Phosphogliv and other drugs.

Video - Diagnosis and treatment of cholecystitis

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

Manifests itself in acute and chronic forms. The acute form is characterized by a favorable prognosis, provided that medical prescriptions are followed.

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

Anatomy, functions of the gallbladder

WITH bottom side The liver contains the gallbladder. It resembles a bag eight to fourteen centimeters long and three to five centimeters wide.

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

The structure includes a wide bottom, body and neck. From cervix goes cystic duct, connecting the organ with the bile duct.

The walls of the organ consist of the following tissues:

connecting;
muscular;
epithelium.

The main purpose is the accumulation and outflow of bile. Its synthesis occurs after a person has eaten. At this time it is decreasing muscle bladder, internal pressure increases, the sphincter relaxes, bile flows into the duct and enters the intestines.

Non-calculous cholecystitis

The most common diseases of the gallbladder include calculous cholecystitis, dyskinesia, cancer, and 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 it is assigned code K8 1.8.

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

Grows when sick connective tissue, scars appear. Gradually, new formations replace gallbladder tissue. Peristalsis is disrupted, and the ability of the walls to contract decreases. Areas of the organ become denser, the mucous membrane becomes thinner.

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

To classify pathology, several parameters are used:

Form. Marked as mild, moderate and severe.
Phases. In development, there is a phase of exacerbation, reduction of symptoms, and remission.
The nature of the current. It is noted to be monotonous, recurrent and variable.
Manifestation. The disease occurs in typical form. In rare cases, it appears atypically.

Pathology has inflammatory nature, is not associated with the formation of stones.

Symptoms

The disease manifests itself in typical and atypical forms.

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 has eaten a spicy dish or drank beer. Painful sensations sent to 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, bloating, flatulence, skin rash, and vomiting appear. There is a feeling of dryness and burning in the mouth.

Patients experience an increase in irritability and a decrease in performance. 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. Weakness, headaches, anxiety, malaise, and other symptoms of intoxication appear

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

Atypical symptoms

Approximately a third of patients are diagnosed with chronic non-calculous cholecystitis in atypical form according to cardiological, intestinal and esophageal variants.

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

After eating or lying down, rapid heartbeat, arrhythmia, and pain in the chest begin.

The development of the esophageal non-calculous type is indicated by the occurrence of heartburn, discomfort when swallowing, and pain in the abdominal area.

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

Causes

The main cause of cholecystitis is considered to be the proliferation of pathological bacteria in the gallbladder: 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 defense of a local nature.

The development of the disease is associated with the involvement of a number of factors. Due to impaired bile output and decreased peristalsis, low-grade inflammation occurs.

When an infectious element enters this environment, the inflammatory process increases and affects the entire organ.

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

Rising. Caused by sphincter dysfunction, biliary dyskinesia.
Descending. The infection enters the organ 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 side that occurs after eating.

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

On possible development diseases sometimes indicate white tongue. The appearance of this symptom is associated with stagnation bile.

On palpation, pain appears or intensifies. The sensations intensify when you press the gall while inhaling, or lightly hit the chest lateral surface of the palm, tapping in the area of the ninth-eleventh thoracic vertebra, pressure in the area of the occipital nerve.

Additionally assigned:

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

Treatment

For the treatment of acute and chronic acalculous cholecystitis, medications and methods are prescribed traditional medicine, surgery is performed.

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, and agents that improve the flow of bile.

For cupping acute pain, spasms, antispasmodics are used. These are No-Shpa, Analgin, Platyfillin, Papaverine.
With strong long-term pain and the presence of signs of inflammation in the analysis, it is recommended to use broad-spectrum antibiotics: Erythromycin, Cefantral, Ampicillin.
To eliminate signs of intoxication (vomiting, nausea), Hemodesa is prescribed intravenously.
Enzymes will help normalize digestion. This is Festal, Mezim Forte.
To increase bile secretion, Allohol, Cholenztm, Ursohol are used.
Cholekinetics have a choleretic effect: Holagol, Urolesan N.
For giardiasis, take Furazolidone.

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

Surgery

Lack of effectiveness drug treatment non-calculous cholecystitis, the occurrence of complications serves as 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, the use of physiotherapy methods is shown.

Cryotherapy can relieve inflammation. An abdominal massage is performed. UHF therapy has a similar effect.

Spasms are eliminated using electrophoresis using antispasmodics, high-frequency magnetic therapy, and paraffin baths.

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

Mud treatments are prescribed.

Traditional therapy

In order to improve the outflow of bile, taking a decoction of Phytogepator is indicated. The mixture contains yarrow, chamomile flowers, calendula, tansy, mint leaves.

Used to stimulate bile flow olive oil. Drink a teaspoon three times a day for three days.

Similar medicinal properties black radish has. Squeeze the juice from the root vegetable and drink 50 ml per day.

Treatment with rosehip decoction is indicated. The dry root is crushed and boiled in a glass of water.

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

Sage, brewed in boiling water and infused for half an hour, relieves inflammation. To prepare, take two spoons of the plant and 2 glasses 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, with 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, for most dishes use vegetables, rabbit meat, and white lean fish. Carrots are useful 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 should be without gas.

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

All dishes must be at room temperature. Cold foods can trigger sphincter contraction.

Products 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 followed to prevent the development of cholecystitis and exacerbations.

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

Empyema. Foci of pus accumulation form in the cavity of the gallbladder. Severe pain, colic, and flatulence occur. The temperature rises.
Fistula formation. Due to the rupture of the walls, bile is poured into abdominal cavity, provokes the development of abscesses and peritonitis. Skin color changes, nausea appears, and internal bleeding is possible.
Hepatitis. Appears as secondary disease liver. Appears yellowish skin, sclera, enlarged liver, heaviness under the right ribs, fatigue.
Cholelithiasis. With prolonged noncalculous cholecystitis, stones are formed from cholesterol, bile pigments, and 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 and pain. In some cases, vision deteriorates to the point of blindness. The temperature becomes very high. The disease often leads to death.

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

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

Useful video

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

In foreign literature, noncalculous (acute) cholecystitis is usually understood as severe inflammatory disease gallbladder resulting from sepsis, major surgery, severe trauma, sickle cell disease, 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 (in immunocompromised patients) can be detected.

The causes of chronic non-calculous cholecystitis may be opportunistic microbial flora (Escherichia, streptococci, staphylococci, less commonly Proteus, Pseudomonas aeruginosa, enterococci).

The disease manifests itself as pain, disturbances digestive function And general manifestations inflammatory reaction body.

Epidemiology of chronic acalculous cholecystitis
The incidence of chronic acalculous cholecystitis is 6-7 cases per 1000 population. Chronic acalculous cholecystitis occurs much less frequently than is diagnosed, especially in outpatient settings.

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

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

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

Diagnostics

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

Diagnostic methods
- History taking
  When collecting anamnesis Special attention attention should be paid to the localization of pain and its connection with the intake of fatty foods. It is also necessary, if possible, to identify the presence of predisposing factors (factors causing bile stasis, gallbladder dyskinesia).
- Physical examination
  In general, physical examination for chronic non-calculous cholecystitis does not have specific features and does not allow one to confidently differentiate calculous and acalculous lesions of the gallbladder without special methods research.
  - Inspection.
    A characteristic feature of chronic cholecystitis is the presence of a coated, scalloped (with teeth imprints) tongue in patients, which is a reflection of stagnation in the gallbladder.
  - Palpation.
    When palpating the abdomen, there is pain in the projection of the gallbladder (the intersection of the outer edge of the right rectus abdominis muscle with the costal arch), which intensifies with inspiration (Kehr'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 it is possible to palpate the bottom of the enlarged gallbladder.
    
    Additional palpation symptoms, sometimes identified in chronic non-calculous cholecystitis:
    - Murphy's symptom - careful, gentle insertion of the hand into the gallbladder area and, with a deep breath, the palpating hand causes sharp pain.
    - Mussi's symptom is pain when pressing on the phrenic nerve between the legs of the sternocleidomastoid muscle on the right.
    - McKenzie's symptom is hyperesthesia of the skin of the abdomen in the right hypochondrium with the most severe pain in the area of the projection of the gallbladder.
    - Shoffard's symptom - during ventrodorsal bimanual palpation, pain occurs in the projection area of the head of the pancreas and gallbladder (a symptom characteristic of cholecystopancreatitis). The same symptom was described by Zakharyin.
    - Lyakhovitsky's symptom - pain occurs with slight pressure on the right half xiphoid process or when retracting it upward.
    - Kharitonov's symptom is pain on palpation to the right of the spinous process of the IV thoracic vertebra.
    - Jonash's symptom is pain when pressing at the insertion of the right trapezius muscle in the occipital region (in the area of the projection of the occipital nerve).

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

The symptoms of this disease significantly worsen the quality of life of patients and cause various complications. This is why mandatory treatment is required.

For this purpose it is used drug therapy, surgery, and alternative treatment. The manifestations of the disease can be reduced by following proper nutrition.

What kind of illness is this

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

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

Experts identify several types of pathology:

Chronic form. In this case, periods of exacerbations and remissions alternate.
Spicy. Characterized by severe symptoms.

Engaged in diagnosis and treatment this 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 infection of the gallbladder occurs through lymph or blood.

The disease is caused by pathogenic microorganisms such as staphylococci, Proteus, Escherichia coli, enterococci, streptococci.

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

pancreatitis;
duodenitis;
bile duct dyskinesia;
gastritis;
peptic ulcer;
hepatitis.

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

These include:

wall deformations;
organ prolapse;
decreased tone;
impaired outflow 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.

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

Diabetes mellitus can provoke the development of pathology. Install exact reason An experienced gastroenterologist will 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 you consumed fatty or fried food, after experiencing stress or heavy physical activity.

Symptoms that accompany the pathology may be the following:

frequent belching;
periodic nausea;
a feeling of bitterness in the mouth;
bloating;
heartburn.

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

Nonspecific signs may also appear. These include increased heart rate, development of arrhythmia, intestinal colic, constipation and diarrhea.

If you have the symptoms described above, it is important to seek help from a doctor.

Diagnostic methods

A specialist begins identifying a disease by collecting an anamnesis. It is also important to examine the patient, which is based on the Murphy, Shoffard, and Mussi tests. IN mandatory the patient should undergo laboratory research, namely, donate urine and blood for analysis.

To know accurate diagnosis you can use the following methods:

scintigraphy;
laparoscopy;
celiacography;
X-ray;
cholegraphy;
duodenal examination.

Experts believe that the most reliable method is ultrasound diagnostics. When interpreting the results, echo signs such as organ size, wall thickness, and motor function are taken into account.

Drug treatment

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

Antibiotics are prescribed to eliminate inflammation and infection in the gallbladder. Can be applied the following medications this group:

Cefazolin;
Clarithrosin;
Ampiox;
Amoxiclav;
Ampicillin.

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

Complex treatment also includes taking vitamins B and C.

Other measures

Physiotherapeutic procedures are considered auxiliary methods of therapy. They are best carried out during remission. Spa treatment is also effective.

An additional method is also probing using potassium permanganate, sorbitol and mineral water. If organ motility is reduced, tubes with magnesium are used.

In acute and severe forms of the disease, surgical intervention is possible.

Proper nutrition

The diet for acute pathology should be based on the consumption of the following dishes:

egg white omelette;
porridge;
low-fat cottage cheese;
bran;
baked and stewed vegetables;
compote;
jelly.

During 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;
baked goods;
spices and seasonings;
nuts;
alcoholic drinks.

Fatty foods, high-calorie fish and certain types of meat, lard, and oil are also prohibited.

The patient should eat dishes prepared by steaming, stewing and baking. They must be eaten warm.

It is important to keep your meals divided: it is recommended to eat up to six times a day, but in small portions. Overeating or undereating is contraindicated.

Folk remedies

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

To improve the process of bile secretion and relieve inflammatory processes in the organ, it is recommended to take decoctions of such medicinal plants, How:

buckthorn;
licorice;
tansy;
immortelle;
corn silk;
chamomile;
marshmallow;
calendula;
sage.

They can be drunk separately, but are best in collections. During exacerbations, you can take infusions peppermint, valerian, calendula, 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:

Maintaining proper nutrition.
Moderate physical activity.
Passing preventive examinations.
Rules of personal hygiene.
Refusal to drink alcohol.
Establishing a drinking regime.
Reception medicines only as prescribed by a doctor.

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

Possible complications and prognosis

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

hepatitis;
cholelithiasis;
cholangitis in chronic form;
empyema.

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

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

Chronic noncalculous cholecystitis is a long-term inflammatory process in the gallbladder, characterized by impaired 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 poor nutrition and infection. Acalculous cholecystitis can also occur in acute form as a result of diabetes mellitus, prolonged fasting, 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 are affected approximately 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 clinical picture 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 errors in nutrition. Thus, an exacerbation of the disease may develop after consuming large quantity fatty foods, alcohol intake, carbonated and cold drinks, spicy dishes, eggs.

Sometimes inflammation affects the tissue around the organ, and pericholecystitis develops. In this case pain syndrome becomes constant and more intense, symptoms intensify with changes in body position and bending forward. Irradiation of pain to the right subscapular region is characteristic, right side neck, shoulder, lumbar region. Reflex pain in the heart often occurs.

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

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

feeling of nausea,
bitter belching and
heartburn,
bitterness, dryness, ;
change in the nature of 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 complications (empyema of the gallbladder, cholangitis).

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

Treatment of the disease

In case of severe exacerbation of non-calculous cholecystitis, treatment is carried out in a hospital. The goal of therapy is to relieve exacerbations, prevent and treat complications. Usually enough conservative therapy. Surgical interventions performed in case of frequent and severe exacerbations, severe deformation of the gallbladder and ineffective use of medications.

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 antispasmodics, antibiotics, agents that normalize the motility of the gallbladder and intestines. In case of severe intoxication, carry out infusion therapy. If cholelithiasis is excluded during the examination, it is possible to use choleretic drugs based on ursodeoxycholic acid.

To normalize the digestion process enzyme preparations. For exacerbations of acalculous cholecystitis, treatment takes about 2 weeks, but with the development of complications it can be longer. After acute symptoms have been eliminated, the doctor may prescribe physiotherapy that will improve contractile activity gallbladder.

To maintain remission of chronic non-calculous cholecystitis, treatment with herbal remedies is useful.

Pharmacies sell ready-made choleretic fees, which are very convenient 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 treatment methods, you should consult your doctor.

Several traditional medicine recipes for the treatment of acalculous cholecystitis.