Dyskinesia of the gallbladder is a violation of filling or contraction of the organ. As a result of such pathology the outflow of bile worsens. This is a functional pathological disorder that can lead to digestive disorders.
Characteristics of the disease
Dyskinesia of the gallbladder is 1/8 of all diseases of this organ.
Equally common in both adults and children. Women suffer from ailment 10 times more often than men. This is due to a specific hormonal background. Especially often, pathology is found in girls with asthenic physique.
In modern medicine, the ailment was first described in 1903-1909.Surgeons operated on a patient who complained of severe pain in the right hypochondrium. Having opened the peritoneum, they did not find stones and inflammatory process. Therefore, it was decided to continue the study of the disease.
Causes of pathology
Primary disease is caused by anomalies in the development of the gallbladder and SCW.Often the premise is the doubling or narrowing of the bladder and ducts, the appearance of scars and constrictions.
The cause may be the problem of the motor activity of smooth muscle cells and a decrease in their sensitivity to certain enzymes.
Secondary disease is formed on the background:
- Hormonal changes. These include taking hormonal contraceptives.
- Somatic diseases. It can be cirrhosis of the liver, diabetes mellitus.
- Bile duct problems. For example, cholecystitis, stricture.
Usually the problem arises from the increased pressure in the biliary tract, which is combined with a decrease in the contractile function of the gallbladder walls. With this process, there is no sufficient emptying, the bile ceases to enter the duodenum in the right amount.
Symptoms of dyskinesia of the gallbladder and bile duct
The manifestation of the disease depends on the age and degree of disruption of the motor function of this part of the body.
Symptoms in adults
Symptoms depend on the form of the pathology. With a hyperkinetic type, pain in the right hypochondrium is noted. It has a sharp, coelike character. It gives mainly to the shoulder blade and shoulder. It can be provoked by physical stress, stress.
Painful sensations are accompanied by vomiting, separation of a large amount of urine, diarrhea. On a background of an attack irritability, headaches, a sweating can be noted.
When hypotonic the pain is focused in the hypochondrium to the right, does not give to other parts of the body.
Pain is dull, aching. Patients describe it as the severity or stretching of the area under the rib. Such sensations are caused by strong emotions or errors in the diet. In addition, there is bitterness in the mouth, nausea, a decrease in appetite, belching.
Both types can cause bad breath, yellow plaque on the tongue. In women, there may be a violation of the menstrual cycle, and in men, a decrease in the libido.
Signs in children
Symptoms of the disease in children are similar with the course of the disease in an adult. Vomiting usually occurs because of a severe pain attack.
In addition to pain in the area of the liver, they can give to any other, delivering even greater discomfort. A rapid pulse is usually seen during a period of severe pain.
Clinic of exacerbation
During the exacerbation the disease is accompanied by a cholestatic syndrome. Pathology affects the biliary tract and liver. Therefore, the skin becomes yellowish. It is possible to change the color of urine and feces. Itching of the skin is possible.
During the period of exacerbation there is a feeling of chronic fatigue, severe headaches. Almost always there is bloating, the appearance of bitterness in the mouth, vomiting. The patient becomes irritable, the quality of sleep worsens.
When pregnant
An important role in the development of dyskinesia bile ducts is the psychological state of women. Sometimes the disease occurs not only against the background of a dramatically changing hormonal background, but also after the transferred stresses.
Violation may occur due to constitutional features of the woman. Another common cause is the pressure of the growing uterus on all organs of the digestive tract. Therefore, the disease often occurs in the third trimester.
Pain is usually aching, not very intense. In the early stages of pregnancy, the disease is often taken for toxicosis. Some future mothers develop a picture of a vegetative crisis. There is pain in the heart, tachycardia, dyspnea. The remaining symptoms are the same as those of other adults. There are three main types:
- hypomotor,
- hypermotor,
- mixed.
Hypomotor
With this type of tone and motor skills are reduced. The prevalent number of patients with this type of woman.
Symptoms become less acute after eating and taking cholagogue funds, but do not think that the disease will pass by itself.
The sensation of bitterness usually appears in the morning. Chronic pain on the right of the blunt and violent character leads to a change in human behavior.
Hyper-motor
Usually found in persons with vagotonia. It is characterized by the appearance of acute and severe pain. Its origin is associated not so much with errors as with psycho-emotional overstrain. Pain is the result of a sudden increase in pressure in the gallbladder.
Most patients report increased irritability fatigue, mood swings. Outside the period of exacerbation, palpation shows a slight soreness in the area of the gallbladder projection.
Mixed form of
In this case, symptoms appear in both forms. They can be expressed in different degrees. Usually dullness of taste sensations occurs, the feces become colorless, and urine dark.
If there is a marked violation of the outflow of bile, the yellowness of the skin appears. With congestion of bile, bilirubin is absorbed into the blood and spread throughout the body, settling on the mucous membranes and skin.
Complications
The disease occurs against a background of various gastrointestinal diseases, but the pathology itself, if untreated, can lead to the development of cholecystitis, cholangitis.
Diagnosis
The main task in the study is to determine the type of the disease and identify co-morbidities. Ultrasound is mandatory.
In dyskinesia, this study can show an increase or decrease in the size of the gallbladder, the presence of moving or fixed focal formations, the expansion of the common bile duct.
Laboratory investigations are also conducted. These include a general blood test. At the primary form it is not changed. But in the presence of an inflammatory process, the ESR is significantly increased. Biochemical blood test, too, with the primary form is not changed, but with a secondary increase in bilirubin indicates a stagnant bile.
X-ray methods include:
- cholecystography,
- cholangiography,
- duodenal sounding,
Methods of treatment of DZHVP in adults and children
Patients usually receive the necessary medical care in the department of gastroenterology.
The main rule of treatment is compliance with the diet. Medication depends on the type of dyskinesia.
Usually, during long-term course of the disease, the administration of bile-containing drugs is prescribed. Surgical treatment of this disease is recognized as ineffective.
Do they release from the army?
With such a diagnosis completely from the army can not be freed. The disease refers to item "B", which provides for the "B-3" shelf-life category.
It is not a restriction for military service. But if frequent exacerbations, a person lies in hospitals, there is a violation or concomitant illnesses, then the question is decided by the medical commission individually. A record can be made that the recruit is of limited duration.
Prevention
In order for the problem not to appear, you need:
- It is a good idea to sleep at least 8 hours a day.
- Alternate mental and physical labor.
- Walking in the fresh air.
- To eat fully, adding to your diet more plant foods, cereals.
Forecast
The prognosis for this disease is favorable, since it has no effect on life expectancy. However, in the presence of secondary diseases, the prognosis depends on their severity.