Cholecystitis chronic

Inflammation of the gallbladder develops gradually, rarely after acute cholecystitis. In the presence of stones, they speak of chronic calculous cholecystitis, in their absence - a chronic, effeminate cholecystitis. Often occurs against the background of other chronic diseases of the gastrointestinal tract: gastritis, pancreatitis, hepatitis. Women often suffer.
Complaints of dull aching pain or discomfort in the right upper quadrant, epigastric region, sometimes under the right scapula, nausea, bitterness in the mouth, bloating. The appearance of these sensations, as a rule, is associated with the consumption of fatty, fried foods, smoked products, sometimes diarrhea begins after it. When palpation of the abdomen is determined by soreness in the right hypochondrium, less often enlarged liver, also painful. With an acute exacerbation of a lot of similar to the clinic of acute cholecystitis: the pains are of the nature of hepatic colic, the temperature can rise to subfebrile digits. Jaundice appears only in the complicated course: plugging of the common bile duct with stone, mucus, cholangitis, hepatitis, less often pancreatitis. Chronic cholecystitis is often accompanied by dyskinesia - a violation of the motor function of the bladder and bile ducts. With dyskinesia, the hypomotor type decreases the volume of the contracted bladder, slows down its emptying with subsequent stagnation of bile, along the hypermotor type, on the contrary, the contractile function is accelerated, which is manifested by paroxysmal pains of the aching or cramping character. Dyskinesia of bile ducts even in the absence of chronic cholecystitis affect the patient's well-being.
The diagnosis is made on the basis of the clinic, ultrasound of the abdominal cavity, cholecystography, analysis of duodenal contents.
Diet N 5, completely excluding fatty and fried foods, preferably the predominance of plant foods. Recommended mineral water from sources: Essentuki, Jermuk, Zheleznovodsk, Borjomi, Izhevsk. Bottles with mineral water are opened in advance to remove gases and heated in a water bath-pan with water. In the period of exacerbation, antibiotics of a broad spectrum of action in the average therapeutic doses are prescribed by the doctor. With pain - antispasmodics (papaverine, no-spa, atropine, preparations of belladonna). Cholagogue agents that stimulate the secretion of bile by liver cells are taken 20-30 minutes before meals: chologon, allochol, cholenzyme, lobil, holosas, flamin, corn stigma extract. A group of drugs that increase the tone of the gallbladder and reduce the tonic stress of the ducts and sphincter: natural Karlovy Vary salt, sorbitol, xylitol, mannitol (they are preliminarily dissolved in 50100 ml of warm water), cholago, cholecystokinin (pancreosimin). If the liver is involved in the process, then the vitamins of group B, ascorbic acid, carp, essential oil are added to the medicines. Sanatorium treatment is indicated in the absence of exacerbation, cirrhosis of the liver, disconnected gallbladder.