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

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

1 Reasons for this violation

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

This condition may be due to severe physical exertion or emotional stress. These factors provoke an increased production of adrenaline, which in turn brings all the muscles and blood vessels into a state of extreme tension, so spasms occur. They are the main prerequisite for stagnant bile processes in the liver ducts. From here, sharp burning pains appear, with which a person is sometimes not able to cope on his own.

The presence of a stone in the gallbladder is not the only cause of hepatic colic. modern medicine highlights a number additional factors contributing to the development of such a disorder. Among them, the most common reasons are:

• severe stretching of the gallbladder or its ducts;
• spasm of smooth muscles;
• irritation of the bladder with stones;
• abuse of fatty or spicy foods;
• the use of alcoholic beverages;
• deviation from diet and daily routine.

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

1. "Silent" zone. This includes the bottom and body. If the inflammatory process is absent, then pain does not occur.
2. Moderately sensitive area. It includes the body, funnel and neck. When the stone touches this place, the outflow of bile is difficult. A person begins to feel mild tolerable pain, which eventually disappears.
3. flow zone. The stones are in the channels and completely block the path. Bile stagnates, and this causes sharp strong discomfort. This state lasts until the calculus moves away and opens the ducts.

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

2 How does this violation manifest itself?

Each disease is characterized by a specific clinical picture. Is no exception and biliary colic, its symptoms are not very diverse, but are expressed, as a rule, brightly and sharply. Modern medicine indicates such signs of this disorder:

1. Strong pains. They cover the right side of the abdomen, sometimes affecting the right shoulder blade and collarbone. Attacks begin mainly at night, and have a duration of several hours or more. When the pain covers the entire abdomen, it is difficult for the patient to lie on the right side and it is painful to move. It's already extreme case when to call an ambulance.
2. Inclination to vomit. The patient may be constantly nauseated. He vomits, but the result does not appear. Cleansing the stomach does not bring any improvement in well-being.
3. Skin disorders. The body is covered with cold sweat, excessive moisture introduces dysfunction into the normal functioning of all systems. The skin becomes white or yellow. Outwardly, symptoms of jaundice may be noticeable.
4. Bloating abdominal cavity. When feeling the abdomen, there may be slight swelling and muscle tension. If you tap on the rib with your palm, then there will be a feeling of pain and discomfort in the right hypochondrium.
5. Increased body temperature, especially if there are inflammatory processes.
6. Significant darkening of urine and lightening of feces.

Among other manifestations, one can observe the rapidity of the pulse. Wherein arterial pressure remains within the normal range. When an attack begins, the pain develops gradually. It takes 15 to 60 minutes on average. When the pains reach their climax, they can last for up to six hours. IN medical practice there are cases when the attack lasted more than one day, but this happens very rarely and only in extremely advanced cases. In some patients, hepatic colic does not recur more than once. This means that it was provoked by side factors: stress, physical activity.

At the first signs of hepatic colic, it is necessary to understand its causes. Diagnosis must be made by a healthcare professional after all required examinations, procedures, and necessary analyzes. Based on the results obtained, the root cause of the seizures will be identified, to which the therapeutic complex will be directed.

3 How to treat this disease

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

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

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

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

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

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

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

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

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

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

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

Pain (very intense) can be constant and cramping.

An attack of hepatic colic

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

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

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

As the pain subsides, it is possible to feel an enlarged painful liver, and sometimes a stretched gallbladder.

From additional symptoms note hyperesthesia of the skin in the right hypochondrium, phrenicus symptom (soreness with pressure in the region of the legs of the right sternocleidomastoid muscle), Ortner's symptom (sharp pain when tapping along the right costal arch).

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

Diagnosis. characteristic of uncomplicated renal colic considered fast reverse development all painful manifestations after the subsidence of the pain attack.

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

Emergency care: hepatic colic, what to do

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

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

These activities can be carried out only if the patient knows that he has cholelithiasis.

If hepatic colic (an attack of gallstone disease) happened for the first time, call a doctor.

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

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

Pain relief: drugs and medicines

Emergency care by an ambulance paramedic.

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

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

Treatment of hepatic colic at home

Consider folk method treatment of biliary colic, a diet for cholelithiasis, how to relieve hepatic colic and pain at home.

A patient suffering from hepatic colic is recommended:

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

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

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

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

1. common juniper fruit - 3 parts,
2. sage herbs officinalis - 3 parts,
3. peppermint herbs - 3 parts,
4. creeping thyme herbs - 2 parts,
5. wormwood herbs - 1 part.

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

Prevention

To prevent recurring attacks of biliary colic is necessary.

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

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

Drink 10 glasses at once very hot tea within 15 minutes. This greatly softens the stones, turns them into sand and makes it easier to exit.

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

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

Option 2. Gather and dry spring birch leaf penny size. Pour 2 tablespoons of a dry leaf with a glass of boiling water, boil over low heat until the volume is reduced by half, when it cools down - strain. Take 1 dessert spoon three times daily before meals. The course of treatment is 3 months. Good for small stones. When the stones come out, pain, nausea, cramps can be observed.

Infusion of birch leaves drink 3 cups daily.

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

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

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

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

Infusion of grass geranium meadow. Pour 2 teaspoons of herb into 2 cups of cold boiled water, insist 8 hours. Drink in sips throughout the day. The tool is used as a dissolving stones in the kidneys and liver.

Medical treatment of hepatic colic

The treatment of the disease may be conservative And surgical.

Conservative treatment is as follows:

1. Application alkali salts, mineral waters in order to facilitate the evacuation of bile from the gallbladder and its dilution (Carlsbad salt, burnt magnesia, Essentuki-20 and other mineral waters).
2. Compliance with a diet with restriction of products containing cholesterol, fats and animal proteins.
3. Regulation of meals; patients should be advised to eat moderately, regularly, and often, as eating is a natural means of facilitating the outflow of bile.
4. Appointment of thermal procedures: heating pads, diathermy, compresses, etc.
5. If there is no doubt about the correctness of the diagnosis, then the patient is prescribed antispasmodics and painkillers (0.5–1 ml of a 0.1% solution of Atropine, 1–2 ml of a 2% solution of Papaverine, 1 ml of a 0.2% solution Platifillin, 1-2 ml of a 1% solution of Promedol or 1 ml of a 2% solution of Pantopon).

With non-stopping hepatic colic, hospitalization is carried out in a surgical hospital.

Related videos

Hepatic colic: an attack of the gallbladder, what to do

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

Stones in the gallbladder: symptoms of biliary colic

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

This disease is also widely known under the name "cholelithiasis", and you can often find its name in the form of such an abbreviation "GSD".

Gallstone disease does not occur without characteristic causes. If stones form in the gallbladder or its pathways, this means that cholesterol and bilirubin metabolism has been disturbed in the body. Due to a metabolic disorder of these substances, the outflow of bile is difficult, bile stagnates, and stones form from it.

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

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

Gallbladder: treatment in a safe way

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

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

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

In 2 minutes, I have to tell you how to quickly rid yourself of the state of heartburn, nausea, from the state of impending soreness. That is, from such unpleasant sensations that are associated with bloating of the stomach, with a feeling of nausea.

Literally a few days ago on our website www.doktor-kartavenko.ru we posted an article called "Violation of the outflow of bile and the secret point of Genghis Khan."

Located in such a convenient place for each person: the landmarks are the intersection of the first wrist groove and the base thumb. It is precisely in such a place that the wonderful, for a long time"Closed" point of Genghis Khan.

Why is she wonderful? It is remarkable and characteristic that it can be used almost constantly. Are you in the subway, are you in a long traffic jam, are you in front of the computer, do you experience discomfort in front of some stressful situation, or you are called “on the carpet” or a few seconds before the exam ... In a word, you experience the sensations that we talked about. This is nausea, heartburn, a feeling of bloated stomach.

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

Hepatic colic occurs due to the development of pathologies in the gallbladder. Most often, symptoms develop due to clogging of the organ ducts with dense formations. Colic occurs more frequently in women than in men due to hormonal disruptions(pregnancy, menstruation, birth control).

Pain in the right hypochondrium can be caused by diseases of the gallbladder. Due to a malfunction of the organ, stones and mucous plugs can form in it, which can move and block the ducts of the bladder, which leads to stagnation of bile and an increase in the pressure of the organ from the inside. This provokes the appearance of severe, unbearable pain.

Also, the symptom may occur due to the following reasons:

1. The development of a tumor and inflammatory processes (inside the organ or outside) can lead to clamping of the bile ducts.
2. Their permeability may be impaired cholesterol plaques and thrombi.
3. Changes in the tone and motor ability of the ducts can lead to their bending.

Factors that can lead to changes in the gallbladder and diseases:

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

Symptoms

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

Further, unbearable pains already arise, which are cramping, sharp and bursting in nature. They don't shrink in any position. They can be localized in the right side, in the region of the stomach, and also give to the shoulder, neck, shoulder blades. Sometimes the pain may cover the region of the heart.

The pain symptom may be accompanied by bloating with nausea and the release of vomit, with bile impurities. After the stomach is empty of food, there is no feeling of relief. If the gallbladder is severely damaged, vomiting may be permanent.

In addition, the number of heartbeats increases (the pressure remains normal), the skin becomes pale, may have a yellow tint. Maybe slight increase temperature. A change in the color of the stool to a lighter color, and the urine, on the contrary, becomes darker.

In this state, a woman can stay from 10 minutes to 8 hours. Depends on what triggered the attack. If the pain does not recede for more than a day, it is necessary to call emergency care, an urgent operation may be required.

Urgent Care. How to quickly stop an attack at home

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

When a woman knows exactly what caused the pain. Then it is necessary to put injections that relieve spasms and the inflammatory process. It can be combined with tablets. Medicines are prescribed by a therapist or gastroenterologist. The first remedies that come across can cause a deterioration in the condition.

Diagnostics

Hepatic colic (symptoms in women are pronounced) require the use of painkillers, as well as complete diagnosis for prescribing treatment. It is necessary to find out what caused the symptom, and what method of treatment the pathology lends itself to.

Diagnostic method	What is produced for?	Notes
Primary examination and collection of verbal data	The therapist learns from the words when the first symptoms appeared, what preceded this, as well as the duration and characteristics of the pain. With the help of palpation, an increase in the size of the liver can be determined. It is also assessed whether there is yellowness of the skin	If relatives have problems with the gallbladder, this should be told at the examination. And also about what measures were taken to eliminate pain. Did the medicine help or not, and for how long
General and biochemical analysis blood	Erythrocyte sedimentation rate determines the presence of inflammatory process in organism. As well as the presence of bile pigments	Blood test does not complete picture diseases. It is possible to identify inflammation, and whether it is associated with the gallbladder
Urine analysis	The urine may contain bile pigment. What will indicate a violation of the work of the body	Analysis is not always effective
ultrasound	The state of the liver and gallbladder is determined. If the latter contains stones, then their location, size and number are determined. You can see if there is an inflammatory process, narrowing of the ducts, tumors.	Ultrasound data is often sufficient for further treatment. The procedure takes up to 15 minutes and is safe
MRI and CT	Often done before surgery. For a more accurate location of stones and determining the condition of the ducts in the gallbladder	During the procedure, the woman must remain still, otherwise the results may be distorted.
Cholecystography	The procedure is performed using a contrast fluid and x-rays. This method allows you to determine the location of the tumor, stones and the inflammatory process with the highest accuracy.	For the patient, the procedure is not very convenient, since the introduction and removal of the fiberscope through the oral cavity causes quite unpleasant sensations.

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

Drugs for hepatic colic

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

1. Drugs that help relieve pain:

2. Means for relieving spasms:

• papaverine;
• platifillin;
• no-shpa;
• mebeverine.

3. Medicines that weaken the sensitivity of the body:

• diphenhydramine;
• morphine.

4. Anti-inflammatory drugs:

To speed up the removal of bile from the bladder, allochol is prescribed. At severe pain funds are recommended to be administered intramuscularly so as not to load the gallbladder. If drug therapy will not give results and the pain symptom is not stopped, it will be prescribed surgical treatment. Often the gallbladder is removed.

Folk remedies

Hepatic colic is only amenable to drug treatment and under the guidance of a gastroenterologist. When the symptoms are stopped, then you can take medicines combine with the use of folk recipes.

Among women, the most popular means are:

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

Other methods of pain relief

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

Also, the attack can be removed with a massage. Only an experienced massage therapist can carry out the procedure. It is forbidden to do it on your own, as you can disrupt the patency of the ducts. With proper conduct, the patency improves, and the attack of pain recedes.

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

Medications help relieve pain when it appears in acute form. If the attacks are weak, then you can remove the pain with folk recipes. To prevent the onset of symptoms, the gastroenterologist prescribes strict adherence to the diet, until full recovery. With proper adherence to it, pain rarely occurs.

Diet

Hepatic colic (symptoms in women are more likely to occur due to a violation of the diet) can be made less if you follow the diet prescribed by your doctor. On the first day of the attack, eating is undesirable. Otherwise, the products may cause a repeated pain symptom. In a day, the digestive tract will have time to recover. Further observance of the medical menu is obligatory.

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

It is also necessary to monitor the amount of proteins, fats and carbohydrates consumed. If there is excess weight, then it can be assigned low calorie diet. A large number of fat cells can provoke re-development seizures.

Food should be divided into small portions, be warm.

With hepatic colic, you can not eat fried, smoked and spicy dishes.

With hepatic colic use fried foods Absolutely forbidden!

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

Allowed and prohibited products

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

Products table:

Allowed	Forbidden	Conditionally permitted
Compotes and jelly are cooked on xylitol or sorbitol. Tea can only be sweetened with these same sweeteners	Margarine, fat, lard	Oil of vegetable and animal origin
Rye bread or yesterday's white	White cabbage, turnip, sorrel, mushrooms	Vegetables only in baked and boiled form
Boiled meat, fish and liver (lean)	Citrus, pomegranate, grapes	Apples, bananas, berries
Vegetable and chicken broths	Confectionery, jam, chocolate	Honey
Porridge, crumbly. Cook with water or low fat milk	Strong tea, juices, coffee	Juices, diluted only
Soups with cereals	Fatty meat and fish, sausages
Biscuit and oatmeal cookies	Use spices and pepper
Steamed omelet eggs	Alcoholic products
Dairy products with low fat content

A more complete list of products should be checked with a gastroenterologist. Since if there are chronic diseases digestive tract or other diseases, then the list of allowed products will be reduced.

Complications

Hepatic colic (symptoms in women, this main feature apply for medical assistance) with incorrect or untimely treatment, they are dangerous for the development of complications. Treatment that will take yet more time and the development of chronic diseases.

Common pathologies due to hepatic colic:

Forecast

With timely access to a gastroenterologist, taking medications and following a diet, the treatment prognosis is positive. It is important that if the treatment does not bring changes in the condition, you should not adjust the treatment yourself (change drugs or increase the dose of drugs), all adjustments can only be made by a specialist.

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

Article formatting: Mila Fridan

Video about hepatic colic

What can be done with hepatic colic:

Hepatic colic is the most common clinical form cholelithiasis (75% of patients). It is manifested by sudden onset and usually recurring intense pain attacks.

Among the most characteristic main manifestations that occur in connection with the formation of stones in the gallbladder is biliary colic. Its occurrence, according to the corresponding medical statistics, is noted with a certain frequency in every tenth patient with cholelithiasis, mainly in male patients. Women, on the other hand, suffer from hepatic colic much less frequently; it appears in them with approximately half the frequency of recorded cases.

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

ICD-10 code

R10.4 Other and unspecified abdominal pain

Causes of hepatic colic

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

Different zones of the gallbladder and bile ducts are characterized by an unequal pain reaction to the presence of a calculus. Usually there are three zones:

• the bottom and body of the gallbladder is a “silent” zone (the presence of a stone in it does not give pain in the absence of inflammation of the mucosa);
• zone of moderate sensitivity - the funnel, the neck of the gallbladder and the adjacent part of the body of the gallbladder (moving into this zone, the stone causes a violation of the outflow of bile; contraction of the gallbladder is accompanied by moderate pain);
• zone of acute pain (duct zone) - the presence of calculi in the ducts causes their spasm, accompanied by wall ischemia, impaired bile outflow, stretching of the overlying sections of the duct, hyperperistalsis, which causes severe pain and increased spasm (vicious circle) that continues until the calculus, clot mucus or administration of antispasmodics. It is not recommended to administer true opioid receptor agonists (morphine, fentan, promedol, etc.), which can aggravate the pain syndrome (sphincter spasm is possible).

Symptoms of hepatic colic

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

Acute hepatic colic

Acute hepatic colic occurs mainly against the background of the fact that cholelithiasis occurs. To a lesser extent, biliary dyskinesia is capable of provoking its appearance. The fundamental factor in the development of the prerequisites for the appearance of acute hepatic colic is the blockage of the outflow of bile from the gallbladder by the stones formed in it. Because of this, the amount of bile increases to a large extent, which is why the gallbladder begins to stretch in that part of it that is above such an obstacle, which creates the impossibility of a free outflow from this organ.

Excessive consumption can lead to acute hepatic colic. a large number food, especially if it is too fatty, excessive use of hot spices, spices in food, intemperance in relation to alcoholic beverages. In addition to appear pain symptoms of this kind are capable as a result of too intense physical tension body.

The following symptoms are characteristic of acute hepatic colic. It may be preceded by the appearance of nausea, a feeling of heaviness in the pit of the stomach or in the region of the right hypochondrium. In these parts of the body, sudden appearance pain that is acute. Pain in addition to this can take place in the right shoulder and shoulder blade, and spread to the neck. In some cases, the localization of the pain syndrome, extending from the hypochondrium, completely covers the abdomen.

Pain in acute hepatic colic is very intense, it can be permanent or manifest in the form of contractions.

The duration of the attack can be equal to a few minutes or hours, and continue for a time exceeding a whole day. In acute hepatic colic, patients, as a rule, come into a state of extreme excitement, turn pale, sweat and are very restless, trying to find the position of the body in which relief can come.

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

An attack of hepatic colic

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

Due to the fact that with the course of the pathological process of formation of stones in the gallbladder congestion become more and more pronounced, pain symptoms are characterized by an ever-increasing intensity. They appear against the background of the fact that the lumen of the common duct turns out to be a clogged stone or is significantly narrowed due to spasm. This leads to an excessive accumulation of bile inside the gallbladder, which increases in size, stretches and this process is accompanied by pain. Attacks of hepatic colic can also occur when stones move in the bile ducts.

An attack of hepatic colic from the very first moment as soon as it appears, signals that cholelithiasis, if it has so far been present in a person asymptomatically and in no way manifesting itself, its presence has not been established, now it is completely clear and with all certainty makes itself known. It is with an attack of hepatic colic that the development of all kinds of complications of this disease basically begins.

Hepatic colic during pregnancy

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

An unplanned and ill-conceived approach to organizing the diet of a woman preparing to become a mother can also lead to the appearance of hepatic colic during pregnancy. In this case, it is necessary to consult a doctor in order to optimize the diet. You should avoid eating those foods and dishes that can adversely affect the normal functioning of the liver. It is advisable to refrain from everything spicy, fried, to exclude all kinds of smoked meats from your menu.

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

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

Emergency care for hepatic colic

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

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

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

In the area where the gallbladder is located, it is recommended to hold a heating pad. It shouldn't be too full. big amount of water so as not to expose the peritoneal wall to significant pressure. When there is such a possibility, a patient with hepatic colic can be placed in a bath with water of a sufficiently high temperature for 10-15 minutes.

If hepatic colic is accompanied by the appearance of heat in the patient, he is shivering, and fever persists for more than one day, are prescribed antimicrobials, for example, the introduction of 500,000 streptomycin twice a day. Alternatively, you can also consider 1.0 sulfadimesine with a 4-hour interval.

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

First aid for hepatic colic

Before taking any independent measures to help with hepatic colic, it must be taken into account that if the pain is protracted and does not stop after 5 to 6 hours, this requires an immediate appeal to a medical specialist. This situation means that the disease automatically goes into the category of surgical. That is, it becomes such that the control of a person's condition, diagnosis and treatment should be entrusted to the surgeon. Since often the only effective treatment method can be only surgery. Thus, if hepatic colic does not go away for a long time, such a patient needs to be hospitalized.

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

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

It should be noted that the use of a heating pad is not always justified. It is expedient only in that situation, if for certain and unambiguously you can be sure that it is hepatic, biliary colic that is taking place, despite the fact that there is no acute cholecystitis. And only a doctor is competent in this matter.

So, having done the above, be sure to make a call to the medical emergency. Especially if the attack happened for the first time. With this, all first aid for hepatic colic is exhausted, and the matter of further treatment should be transferred to the hands of doctors.

How to remove hepatic colic?

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

This can be achieved using pharmacological preparations possessing antispasmodic properties. In particular, the use of drotaverine, no-shpy, papaverine, platyfilin is justified. In especially severe cases, it may be necessary to administer them intramuscularly, as well as intravenously.

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

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

Useful when hepatic colic occurs, drinking can become mineral water, from which all gases have previously been released.

In addition, allochol tablets in an amount of 2 to 3 pieces are also capable of helping to cope with hepatic colic.

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

Painkiller for hepatic colic

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

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

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

If attacks of hepatic colic have occurred before and the patient has previously sought medical help for this, it makes sense to use those specific painkillers that are among the doctor's prescriptions to relieve pain.

Without a prescription, pain relievers available for use are rectal suppositories with papaverine, as well as those containing belladonna extract. However, it should be noted that one should resort to their help no earlier than after consulting a doctor. Since they, in particular, are contraindicated in case of glaucoma.

If the pain is not too pronounced, the use of atropine solution 0.1% from 5 to 10 drops per tablespoon is indicated. cold water. Atropine belongs to the list of prescription drugs.

The possibility of using a warming compress or a non-hot heating pad in the area of ​​the upper abdomen is not excluded from the number of permissible measures. But, putting a heating pad should be taken into account, if after a 5-10-minute period of time there is no improvement from the heat, it must be removed.

An anesthetic for hepatic colic can bring relief to a certain extent to the patient's condition, but we should not forget that such pain is a symptom associated with impaired functioning of the gallbladder and impaired bile outflow processes in the hepatic duct. And this calls for the need to treat the underlying disease in the first place.

Nutrition for hepatic colic

Hepatic colic is closely related to diseases of the liver and biliary tract. Nutrition for hepatic colic should therefore be organized based on general recommendations regarding the principles on which it is necessary to build a diet and choose a menu for these diseases.

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

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

Not the last role in terms of how you can achieve the greatest sparing of the digestive tract is the method of cooking. In this regard, culinary processing by boiling, food in pureed or chopped form is optimal. better digestion assimilation in to a large extent promotes food intake in small quantities through short intervals time. This principle of fractional nutrition improves intestinal motility, and in addition produces a remarkable choleretic effect.

Normalization of the outflow of bile also occurs due to the content in the diet of products whose composition is rich dietary fiber. Thanks to this, in stool cholesterol is rapidly excreted.

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

Diet for hepatic colic

Diseases of the liver and biliary tract, if excluded birth defects heredity, the consequences of acute infections, metabolic disorders with the formation of stones in the gallbladder, arise and pass into chronic form often against the background of excessive consumption of alcoholic beverages and an irrationally organized diet. Provoke violations of the functioning of the liver and gallbladder in a state of systematic irregular food intake, an unbalanced menu, which lacks sufficient proteins and essential vitamins.

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

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

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

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

When adhering to a diet for hepatic colic, one should not abuse fatty and spicy foods, refrain from smoked meats and pickles, exclude foods with great content cholesterol. A reasonable approach to the use of alcoholic beverages is also important.

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

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

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

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

Causes

The group of causes of hepatic colic includes:

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

The provoking factor of hepatic colic can be:

1. alcohol abuse;
2. starvation;
3. a sharp decrease in body weight due to a serious illness or a strict diet;
4. the use of fatty, fried foods and spicy spices. After eating, the gallbladder begins to contract, thereby moving the stones into the ducts. The pathogenesis of the onset of pain is represented by hypertension, which develops as a result of obstruction of the lumen of the excretory tract and impaired bile flow;
5. parenteral nutrition;
6. severe psycho-emotional stress;
7. Start menstrual cycle(due to change hormonal level in the bloodstream).

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

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

Symptoms of hepatic colic

Clinically, gallbladder colic is manifested by symptoms such as:

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

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

Features of manifestation in men and women

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

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

Diagnostics

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

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

The pathology of the biliary tract is indicated by the appearance of soreness in the area of ​​​​the right hypochondrium after errors in the diet, heavy exercise or drinking alcohol.

Also, the patient may be disturbed by non-specific signs of digestive dysfunction, such as nausea, bitterness in oral cavity, bloating and heaviness in the gastric region.

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

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

With cholecystography contrast agent is administered intravenously. Thus, the specialist visualizes a "disabled" bubble, which confirms the presence of obstruction in the ducts.

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

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

Emergency care for biliary colic

To quickly stop a pain attack, you need to know the cause of its occurrence. The patient is hospitalized in a gastroenterological hospital. urgent medical complex allows you to remove the spasm of the ducts, after which the bile outflow is restored and stops hurting in the area of ​​​​the right hypochondrium.

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

• complete physical rest;
• hunger for a day, after which the nutritious diet should correspond to diet No. 5;
• first aid for biliary colic is antispasmodics (papaverine, drotaverine). If you are concerned about nausea and frequent vomiting, it is recommended to additionally introduce metoclopramide;
• analgesic drug, for example, ketorolac, baralgin.

If colic persists for more than six hours, consideration should be given to surgical intervention.

The operational method is also used in case of occurrence frequent seizures pain. Treatment is to remove the gallbladder. For this, it can be used laparoscopic method or laparotomy (with complicated course).

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

Usually surgery with successful drug relief an attack is carried out in a month. If colic no longer recurs, the doctor adopts expectant management.

It is impossible to treat an attack at home due to high risk development of jaundice and sharp deterioration general condition. No folk recipe can quickly provide effective help and reduce pain.

If the patient has repeated bouts of colic, before the ambulance arrives, you can take antispasmodic drugs on your own and apply a warm heating pad to the hepatic region. However, this method is strictly prohibited for cholecystitis.

Possible Complications

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

1. discoloration of feces;
2. itching;
3. dark urine;
4. yellowness of the skin and mucous membranes. Its severity can reach an orange tint.

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

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

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

1. obstruction of the duct with a large calculus;
2. spasm of the biliary tract;
3. malnutrition in the wall on which the stone exerts pressure;
4. tissue necrosis;
5. violation of the integrity of the wall;
6. penetration of bile into the abdominal cavity.

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

Basic principles of diet number 5:

1. complete rejection of alcoholic beverages, including low alcohol;
2. exclusion of fatty milk, meat and fish products;
3. a ban on spicy seasonings, marinades, smoked meats, pickles and canned food;
4. rejection of fresh muffins, cream products and chocolate;
5. exclusion of coffee;
6. a ban on legumes, mushrooms, and products with oxalic acid.

The diet should consist of:

• low-fat foods;
• vegetables;
• yesterday's muffin;
• various cereals from buckwheat, oatmeal, pasta or rice;
• egg whites;
• soups, low-fat broths;
• biscuit cookies.

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

Dishes should have a puree-like consistency. Cooking is carried out with the help of steam, by boiling or baking.

After surgery, only liquid is allowed on the first day. Then the diet gradually expands due to grated dishes. Assuming normal flow postoperative period the patient is transferred to diet number 5, which must be observed for life.

Prevention

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

• early diagnosis of diseases of the digestive system;
• proper nutrition;
• dosed physical activity;
• refusal of alcohol;
• normalization of body weight;
• exclusion of long periods of hunger.

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