Pain in the gallbladder most often indicates biliary dyskinesia, acute or chronic cholecystitis, cholelithiasis. Less commonly, pain syndrome occurs against the background of cholangitis, parasitic invasions, neoplasms. For the diagnosis of etiological factors, instrumental visualization is used - ultrasound, cholecystography, ERCP, scintigraphy. Laboratory techniques include bile analysis, clinical and biochemical blood tests. To stop the symptom, painkillers and antispasmodics, antibiotics, choleretic drugs are prescribed. According to the indications, surgical treatment is performed - cholecystectomy.
The appearance of pain and discomfort in the gallbladder is due to the development of cholestasis in pregnant women. Symptoms occur in the 3rd trimester of pregnancy, disappear in the first days of the postpartum period. Pain is caused by stagnation of bile in the biliary tract (BIL). In addition to pain, yellowness of the skin and mucous membranes, severe pruritus are noted. Urine becomes dark in color, and feces become gray.
Functional disorders, which include JP, are the most common cause of pain in the gallbladder in children, young and middle-aged people. The nature and duration of the pain syndrome is determined by the type of motor impairment. In the hypermotor variant, the pain sensations are cramping, strong, reminiscent of biliary colic. They appear 20-3 minutes after the end of the meal. Pain is often caused by psycho-emotional overstrain.
With the hypomotor variant of dyskinesia, aching or pulling pain in the right hypochondrium is disturbing. It begins 40-9 minutes after eating, provoked by fatty foods, drinking alcohol. In contrast to hypermotor JP, the pain syndrome is longer - up to several hours. It is accompanied by nausea, vomiting, a feeling of heaviness in the abdomen, alternating constipation and diarrhea.
With this pathology, periodic pains localized to the right in the hypochondrium are observed. They are provoked by the intake of a large amount of fatty foods, which leads to increased bile secretion and an increased load on the gallbladder. In women, the symptoms are aggravated before menstruation. In chronic cholecystitis, pain is dull or aching, not intense, combined with bitterness in the mouth, nausea, and instability of the stool.
This disease is characterized by severe cramping pain in the gallbladder area, which appear suddenly. To alleviate the condition, the person lies on his side, pulls his knees to his stomach. The pain attack is accompanied by fever, sweating, tachycardia. With the transition of inflammation to the empyema of the gallbladder, the pain reaches its maximum intensity, the body temperature rises to 40 ° C.
In the acute form of inflammation of the bile ducts, sharp, severe pains are observed in the right hypochondrium. For them, irradiation to the right shoulder, neck, interscapular region is specific. The symptom appears suddenly in combination with febrile fever and jaundice. There is no clear association of pain with dietary errors or other typical factors. At the same time, nausea and vomiting, diarrhea, and weakness occur.
Chronic cholangitis is characterized by aching pain in the projection of the gallbladder. They are felt periodically, accompanied by heaviness in the hypochondrium on the right and a feeling of fullness in the epigastrium. The pain syndrome is not intense, does not require the use of analgesics. In most cases, the pain disappears on its own after a few hours. Typically, the addition of general symptoms: prolonged subfebrile condition, increased fatigue.
Pain syndrome is the main manifestation of the disease. A typical gallstone attack is called biliary colic. It develops with the abuse of fatty foods, emotional experiences. Suddenly there is intense pain over the gallbladder and in the epigastrium. It radiates to the scapula, lower back, precordial region. Often, the pain is so strong that a person rushes about in bed, cannot find a position in which the pain subsides.
The attack lasts several hours. The pains are cramping in nature, not stopped by conventional analgesics. For cholelithiasis, an increase in body temperature is typical simultaneously with the onset of pain. Clinical symptoms are complemented by severe nausea and vomiting, stool disorders. Chills, pallor of the skin are noted.
Pain in the right hypochondrium can be a sign of giardiasis. With such a pathology, a non-intensive pain syndrome is observed. There is no connection between pain and dietary disorders or physical overexertion. The symptom is combined with unstable bowel movements, flatulence, nausea. With parasitic infections, the syndrome of intoxication is also expressed.
Symptoms of the disease occur after surgery to remove the gallbladder. For postcholecystectomy syndrome, recurrent pain attacks that develop for no apparent reason are specific. The pains have a different character - cutting, spastic, dull, aching. Soreness is accompanied by dyspeptic symptoms: belching, bitterness in the mouth, nausea, bloating. There is diarrhea with abundant fetid feces.
Benign polyps of the organ are characterized by poor symptoms. Periodically, dull pains are felt at the location of the gallbladder, which are not associated with eating. In a small number of patients, the disease is manifested by sharp pains and spasms in the area of the right hypochondrium, which are provoked by the use of fatty foods or physical exertion.
In gallbladder cancer, the pain syndrome is expressed at an advanced stage. There is a non-intense dull pain over the organ, which appears for no apparent reason. At first she worries sporadically, and then becomes constant. The clinical picture is characterized by progressive weight loss, lack of appetite, prolonged subfebrile fever.
An important role in determining the cause of the pain syndrome is played by a careful collection of anamnesis and eating habits. During a physical examination, a gastroenterologist checks for bladder symptoms that indicate an inflammatory process. Diagnostic search involves a comprehensive laboratory and instrumental examination of the biliary system. The following methods apply:
With non-intense pain, indicating a chronic process, it is permissible to confine ourselves to non-drug methods. The patient is described in detail the nutritional scheme, which involves the exclusion of animal fats, extractives, alcohol. The diet depends on the preservation of the biliary function of the bladder. Mineral waters are prescribed to increase the volume of bile. In case of acute pain attack, you should go to the hospital as soon as possible.
Drug treatment is carried out with uncomplicated forms of gallbladder disease, with no risk of organ destruction. At the initial stage, antispasmodics and analgesics are used to remove painful symptoms. Then, etiopathogenetic therapy is selected, which may include several groups of drugs:
After the elimination of acute inflammation, physiotherapeutic methods are prescribed. In chronic cholecystitis, it is advisable to use reflexology, SMT therapy, electrophoresis. The use of decoctions of medicinal plants with hepatoprotective and choleretic properties is effective. Recommended sanatorium treatment at balneological resorts.
Cholecystectomy. Gallbladder stones
In calculous cholecystitis, non-invasive stone crushing techniques are widely used. In gastroenterology, extracorporeal shock wave and contact lithotripsy are often performed. Such treatment is characterized by the absence of tissue trauma, a short rehabilitation period. Lithotripsy is required only for stones up to 2 cm in size.
With biliary colic, destructive forms of cholecystitis, surgical intervention is indicated in an urgent manner. The method of choice is laparoscopic cholecystectomy. The operation dramatically reduces mortality and the risk of complications, and is characterized by a short recovery period. In elderly and debilitated patients, surgeons prefer to use traditional cholecystectomy.