Chronic cholecystitis - treatment and symptomatology of the disease
Chronic cholecystitis is a prolongedinflammation of the gallbladder. The main cause of the development of this disease is a conditionally pathogenic microflora, represented by streptococcus, staphylococcus, E. coli. Infection droops into the gallbladder with a current of blood, lymph, from the lumen of the intestine and intracoolal bile ducts. To the development of cholecystitis also results in prolonged congestion of bile in the biliary tract and in the gall bladder, a change in the physical properties and chemical composition of the bile. Prolonged stagnation of bile provokes the formation of stones - develops chronic calculous cholecystitis.
Clinical picture
Clinic of the disease is characterized bya continuous progressive course with periodic exacerbation of the process. The main symptom of the disease is pain localized in the right hypochondrium. This aching pain, often giving to the upper right side of the body, rarely radiates the pain in the left hypochondrium.
Dyspeptic syndrome manifests itself with nausea,often turning into vomiting, not bringing relief. Often there is an increase in body temperature to subfebrile or even elevated figures. The patient takes a forced position on the right side or on the back. Pulse is frequent, low blood pressure. Typical positive symptom Ortner - soreness when tapping along the edge of the right costal arch.
Calculous chronic cholecystitis, the symptoms whose treatment is different from the usual inflammation of the gallbladder, is manifested by the periodic development of attacks of hepatic colic.
The diagnosis is confirmed by ultrasound, thermography, cholecystography, general blood test data.
Treatment of chronic cholecystitis
If the patient is diagnosed with chroniccholecystitis, treatment should be comprehensive, continuous and continuous. In the acute phase of the disease, inpatient treatment is shown, in the period of remission - outpatient. Complex therapy of chronic cholecystitis includes the appointment of diet, medications and physiotherapy methods of treatment.
Features of nutrition have a significantinfluence on the pathology of the digestive system, to which the chronic cholecystitis belongs. Treatment should begin with the appointment of a diet. The diet provides for the exclusion from the diet of fatty and fried foods, the predominant use of dairy products, vegetables and fruits, low-fat varieties of fish and meat. The patient should adhere to a diet both in a stage of remission, and in a phase of an exacerbation.
In the treatment of chronic cholecystitis usedantibacterial drugs, antispasmodics, analgesics, cholagogue. During the period when the exacerbation subsides, a heating pad is applied to the area of the right hypochondrium. At this time, the appointment of physiotherapeutic procedures is indicated: paraffin or ozocerite applications, UHF, diathermy, electrophoresis. In the phase of remission, it is useful to prescribe exercise therapy, sanatorium and spa treatment.
In the event that, wheninstrumental studies revealed calculous chronic cholecystitis, the treatment can be both therapeutic and surgical. With calculous cholecystitis treatment tactics depend on the size of the stones in the gallbladder. Small stones and sand can independently leave the gallbladder, without leading to the development of complications. In this case, the treatment of calculous cholecystitis does not differ from the treatment of usual chronic cholecystitis.
In the presence of large stones, the administration of choleretic preparations and thermal procedures to the right hypochondrium region is counter-indicative.
Indications for the appointment of an operationalinterventions are frequent attacks of hepatic colic, mechanical jaundice, suppuration and edema of the gallbladder, rupture of the wall of the bladder with the development of biliary peritonitis.
The patient should remember that if chronic cholecystitis is detected, the treatment will be effective only if all the medical recommendations are fully implemented.
