Biliary dyskinesia : symptoms, treatment , causes of dyskinesia of the bile ducts in children and adults

Contents:

  • little about the anatomy and physiology
  • What dyskinesia, its types
  • reasons
  • disease Signs
  • disease diagnosis
  • Treatment
    • Dietotherapy
    • Drug therapy
    • treatment folk methods
    • Complementary therapies
  • Complications of biliary dyskinesia
  • prevention of the disease and its prognosis
  • dyskinesia in children
  • treatment in children

dyskinesia is not called curvature or bend of the gallbladder or leadingfrom his ways, as it considers most.The term comes from the Greek word "kinesis" meaning "movement" and "dis-" prefix means "breach."Thus, biliary dyskinesia - a condition which interferes with the tone or motility system supporting the bile from the liver into the duodenum.It causes pain in the right upper quadrant, the problem with a chair, sometimes - and the bitterness in the mouth, but when examining any damage these organs were observed.

Dyskinesia most commonly occurs in people with malformations biliary organs with love to an unbalanced diet, as well as in indivi

duals who are often exposed to various stressful situations.There are other reasons for this condition.The most affected by this disease are women.Treatment of psoriasis is aimed at addressing the symptoms, as well - especially if bile duct have a slow motion speed or poor contractility - to prevent stone formation.

little about the anatomy and physiology

Bile - a fluid is brownish-yellow color, necessary for digestion.Its main function - falling food fats separate from each other, increasing their surface area.Then their processes well lipase enzyme, whereby the blood components are absorbed fats - fatty acids.Additionally, bile affect the absorption of proteins and carbohydrates.Under the influence of this substance produced by the liver to ¾ of, and in the ¼ - liver passages, normally works the small intestine: in it there are processes of absorption of nutrients, as well as division and death of her own cells.

To all of the above processes were correct, bile must have a normal concentration.He engaged in this gall bladder which "gives" vessels of excess water.If the bile is not retained in the bladder, it gets into the intestines in a diluted form and annoys him, causing diarrhea.In the case of excessively long stay in the gall bladder, it arrives too concentrated, it is also not helpful.

bile formed in the liver.Further, it should by bile ducts to reach the gallbladder, and from it to get into the 12-duodenum.Traffic Secrets provided the difference in pressure in the biliary tract, which is caused by the work of circular muscles - sphincters.For example, the sphincter, which transmits the bile in the gallbladder, is closed - it flows from the liver.Further, it opens and the secret flows into a bubble, which was nearly empty, and in which the pressure was lower than in the channel.When the 12-duodenum is supplied fatty foods, the gallbladder, which is a body equipped with muscles is reduced.In this neck of the bladder sphincter to open, and the one that begins the entrance to the 12-duodenum, is closed, and opens it at the close of the first.Acronyms biliary tract regulate the sympathetic nervous system and some substances produced in the stomach and the pancreas.

What dyskinesia, its types

examined the anatomy can explain the disease in more detail.So dyskinesia is a condition:

  • if sphincters (one or more), located in the biliary ducts, do not relax time;
  • or, conversely, despite the ingestion, do not want to relax the sphincter;
  • if there is a strong contraction of the gallbladder;
  • if the gallbladder or the ducts are reduced very sluggish, reducing the rate of outflow of bile.

Depending on violations of motor function and tone of dyskinesia may be:

  • hypertension: increased sphincter tone;
  • hypotonic: the tone, on the contrary, decreased;
  • hypokinetic: biliary tract movement slowed down, the bile is thrown out slowly;
  • hyperkinetic: active flow of bile, its portion of the emitted sharply.

usually increased tone combined with enhanced motility, forming a hypertonic-hyperkinetic (or spastic) type of dyskinesia.The same is true in the reverse situation: when a weak motility weakened tone of the biliary tract - hypotonic-hypokinetic (atonic) type.It happens, and mixed type.

spasmodic dyskinesia characterized to improve the tone of the parasympathetic division.Atonic same type of disease develops when the prevalence of the influence of the sympathetic part of the autonomic nervous system.

Causes

to violations of tone or movement bile ducts lead such reasons:

  • Congenital malformations of the bile ducts and gall bladder:
    • doubling of the bile ducts;
    • congenital weakness of the bladder wall;
    • intrahepatic gall bladder;
    • inflection of the gallbladder;
    • divided by a partition gall bladder;
    • valves in the bile duct;
    • additional gall bladder;
    • movable bubble;
    • abnormally positioned bladder.

All these diseases cause dyskinesia called "primary."Next, list the diseases acquired (occurring in their lifetime), which may cause secondary biliary dyskinesia.


  • Eating habits: long periods of starvation, abandonment of vegetable fats or, on the contrary, the use of large amounts of fat, smoked and spicy food.
  • Constant stress or stressful situations.
  • Borne pancreatitis or other inflammatory pathology of the gastrointestinal tract or the female organs.
  • Chronic cholecystitis.
  • cardiopsychoneurosis when disrupted the normal control sequence biliary tract contractions.
  • Always there are pockets of infection in the body (caries, chronic tonsillitis).
  • Diseases of endocrine organs: obesity, diabetes, thyrotoxicosis.
  • Food Allergies.
  • Borne Viral Hepatitis.
  • parasitic diseases.
  • Giardiasis in which flagellate protozoa colonize the gallbladder.
  • menopause period, when disturbed regulation of contractility of the biliary tract.
  • Dysbacteriosis.
  • Transferred intestinal infections.

Symptoms of the disease

Biliary dyskinesia symptoms vary depending on the type of disease: Is it hyperkinetic or hypokinetic.

The main difference between the basic types of the disease are pain in dyskinesias:

Characteristics pain Hyperkinetic type hypotonic type
Localization in the right upper quadrant in hypochondrium right
Character Acute, colicky dull, aching, not intensive.It may be described as a heaviness or tension area under the edge
Where gives in right shoulder blade and shoulder felt just under the rib
What provoked exercise, stress, after a fatty meal strong emotions,errors in diet
What other symptoms of pain accompanied

nausea, vomiting, a division of a large amount of urine, constipation / diarrhea.

Against the background of the attack can be: irritability, sweating, blood pressure, headaches

bitter taste in the mouth, nausea, decreased appetite, belching air, a sense of "bloating" of the abdomen, constipation / diarrhea
The eliminated preparation "no-spa", "Buscopan" Passes own
between outside attack Nothing bothers may appear only brief pain in the right upper quadrant, "the stomach", near the navel disease reversibly alter personalityman: he becomes whiny, irritable, gets tired quickly, marked mood swings.Outside the attack did not hurt

Both types of psoriasis can cause other symptoms:

  • irritability;
  • sweating;
  • periodic headaches;
  • halitosis;
  • bloating;
  • reduce appetite;
  • bitter taste in the mouth;
  • yellow coating on the tongue;
  • reduce libido in men;
  • some women - menstrual disorders.

extreme manifestation of hyperkinetic variant is biliary colic.It manifests sudden severe pain under the right rib, which is accompanied by heart palpitations, panic attacks, numbness of extremities.

maximum manifestation hypokinetic dyskinesia is cholestasis - stagnation of bile in the biliary tract.This is indicated by the following symptoms:

  • severe itching all over the skin;
  • yellowing of the skin and whites of the eyes;
  • dark urine;
  • feces becomes pale yellow or grayish color.

Diagnostics

symptoms alone are not sufficient for the diagnosis, because these same symptoms may occur with more severe liver disease.Secondly, it is necessary to establish the cause (for example, malformations of bile ducts), which has caused the disease to eliminate it afterwards.

Biliary dyskinesia - a condition in which the structure of these bodies is not broken.That is, the diagnosis is made on the fact of violation of contraction or tone on the way from the liver to 12-duodenum.How to see it?

US

completing ultrasound gallbladder choleretic breakfast.First, after observing a three-day diet, performed "normal" abdominal ultrasound.With the help of estimated volumes, dimensions, distortion, abnormal bile ducts, are examined for gallstones.Then a person takes food that should cause the release of 12 duodenal intestine, bile (which may be 100 grams of cream or fat sour cream, fat yogurt, chocolate or a couple bananas), and the doctor looks, in what sequence and how the movement of bile.

Duodenal intubation

By estimating portions of the contents of 12 duodenal ulcer.To do this, we conducted a study entitled "duodenal intubation": a man need to swallow a thin tube from which to achieve them 12 duodenal ulcer, and will receive its contents.Research carried out on an empty stomach.Initially, the probe prepared from normal colon contents portion, which is composed of bile fluid isolated to pancreatic juice and the 12 most duodenum.Further, in the probe introduced choleretic drug - magnesium sulfate.The gall bladder is reduced and bile enters the intestine contained therein.It can also take on the study.Through time here drains bile is earlier in the intrahepatic bile ducts.It is also taken for analysis.For the diagnosis of dyskinesia is important to the time that elapses from the moment of introduction choleretic until a second and then a third portion.It is also important, and the contents of various lipids in the last two portions.

Cholecystography

With the help of X-ray contrasting methods - holetsistografii (examined extrahepatic bile ducts) and cholangiography (conducted inspection intrahepatic bile ducts).In the first case, the person needs to take a radiopaque substance through the mouth, then an X-ray will show how the contrast reaches the gallbladder as he comes out of it, in what sequence occurs contraction and relaxation of the sphincter.The second method involves the injection: a radiopaque dye is injected directly into the bile ducts, and after the radiologist watches his progress on the biliary ways.

ERCP

When performing ERCP (endoscopic retrograde cholangiopancreatography), when the 12-duodenum introduced probe with an optical fiber and through him directly in the bile duct injected contrast material, retrograde (that is, opposite to normal flow) whose promotion inspected by X-ray.

Holestsintigrafiya

By radiological research - holestsintigrafii in which the organism is introduced radioisotope preparation and in the light of the special emission occurs visualization as it travels to the liver, released into the bile ducts, is sent into the gallbladder, and then reaches the duodenum 12.

Magnetic resonance cholangiography

In severe cases, shows the execution of magnetic resonance cholangiography - non-invasive method of investigation when the body is introduced contrast agent, and its path is observed in magnetic resonance imaging.To carry out such a diagnosis a person will need about 40-50 minutes to be in the unit cell, observing the stillness.

Blood tests for bilirubin lipids and its fractions, fecal bacteria overgrowth, helminth eggs and coprogram - methods to determine the safety of biliary tract function, and eliminate the possible cause of the disease - worms.The diagnosis for these tests is not put.


Treatment Treatment of biliary dyskinesia consists of:

  • diet therapy: it is different in hypo-and hyperkinetic forms of pathology;
  • reception decoctions or infusions of various herbs: he assigned a gastroenterologist with the type of the disease, is an integral part of treatment;
  • drug therapy: assigned courses, aimed at arresting the attack, preventing their occurrence in the future, as well as for the prevention of complications.

Dietotherapy

Nutrition for dyskinesia - the basic "kit" treatment.Only he, with strict compliance with the rules, to avoid attacks and carry out prevention of surgical complications such as acute cholecystitis and cholelithiasis.

Diet for dyskinesia contains general food regulations, but there are moments when radically different hypokinetic and hyperkinetic options.

General rules

Eating is necessary so that the gallbladder is emptied completely, but it did not arise pain attacks.To do this:

  • eat slowly 4-5 times a day;
  • Eat small meals;
  • observe the 3-4 hour intervals between meals;
  • dine for 2-3 hours while at night eats meat;
  • morning and evening, eat low-fat dairy products;
  • Avoid taking cold or too hot food;
  • not reheat food in the animal or trans-fats: margarine, pork, goose or mutton.
Eliminate completely Exclude only during exacerbations can have
  • broths;
  • sausage;
  • fast food;
  • chips;
  • millet porridge;
  • salted nuts;
  • fried foods;
  • fatty meats and fish;
  • canned;
  • fish broth;
  • baking;
  • legumes;
  • mushrooms;
  • fat of any animal or bird;
  • chocolate;
  • ice cream;
  • spicy dishes;
  • cold drinks with gas;
  • alcohol;
  • gum.
  • onions;
  • pepper;
  • mustard;
  • mushroom broth;
  • salty foods;
  • radishes and radish;
  • sorrel;
  • hot sauces;
  • horseradish;
  • rye bread.