What is cholecystitis. Treatment of cholecystitis in adults

Cholecystitis is an inflammatory lesion of the mucous membrane of the gallbladder. Chronic calculous cholecystitis is increasingly common in pathology statistics - inflammation with the presence of one or more stones in the lumen of the gallbladder. But the stoneless form of the disease causes no less suffering.

Causes of cholecystitis

Patients are mainly interested in the practical side of the disease - how to cure the disease and what to eat with cholecystitis. But it is recommended to know the causes and mechanisms of the development of the pathology so that it can be prevented.

The most frequent provocateurs of inflammatory changes in the mucous membrane of the gallbladder:

disturbance (difficulty) or complete absence of outflow of bile from the bladder (it is because of it that signs of cholecystitis attack appear in women and men);
pathological microflora in the organ cavity;
deterioration of blood supply to the gallbladder wall;
erosion of the mucous membrane of the gallbladder by pancreatic juice when it enters the lumen of the bladder.

The following forms of pathology are distinguished according to the clinical course:

sharp;
chronic;
exacerbation of chronic (in fact, signs of acute cholecystitis are observed).

All types of cholecystitis can occur in the presence of gallstones (from 1 to 50-60). The smallest concretions are sometimes called sand.

Acute cholecystitis occurs:

catarrhal;
phlegmonous (with the formation of purulent content);
gangrenous (with irreversible changes in the gallbladder wall that lead to its death.

Its most frequent reasons:

the presence of stones in the biliary tract - hepatic, cystic and common bile duct (the treatment of cholecystitis in adults depends on the presence of calculi). Also, a calculus can get stuck in the pharyngeal papilla (in the place where the choledochus flows into the duodenum) and thereby contribute to stagnation of bile in the biliary tract, although they themselves remain passable;
tumors;
strings (connective tissue bridges) in the abdominal cavity;
strictures (narrowing) and scars of the biliary tract.

Clinical symptoms

Chronic cholecystitis in the stage of remission (subsidence of symptoms) can be manifested by periodic painful sensations in the abdomen on the right under the rib. They are mainly associated with nutritional deficiencies in noncalculous cholecystitis and its calculous form.

If you continue to ignore diet food, the following symptoms are added:

nausea;
vomiting with an admixture of bile;
eructations with the taste of bile.

Pains during exacerbation of chronic cholecystitis become more intense.

Similar symptoms are characteristic of the acute form of cholecystitis - clinical signs will be more pronounced. At the same time, an increase in body temperature is also observed - in some cases it is significant (up to 39.2-39.5 degrees Celsius).

If a calculus, which is located in the gallbladder from the very beginning, has moved, stuck at the exit from the bladder or further in the duct, it will prevent the exit of bile into the duodenum. In this case, hepatic colic (severe pain syndrome) and mechanical jaundice develop. Painful and dyspeptic symptoms are joined by yellowing of the skin, eye sclera and visible mucous membranes. It is also characteristic:

faeces become colorless (due to the absence of bile pigments);
due to the dark color of the urine, it looks like beer.

It is necessary to know the nuances of symptoms of various forms of inflammation of the gallbladder, because it depends on how to treat cholecystitis.

Diagnostic methods

Abdominal pain, nausea and vomiting can also occur with other diseases of the digestive tract, so for an accurate diagnosis of cholecystitis, additional examination methods should be used. The most informative:

Ultrasound of the liver, gallbladder and bile ducts - will help to detect thickening of the inflamed wall of the gallbladder and calculi in the lumen of the bladder (if present);
cholecystocholangiography - a contrast agent is injected into the bile ducts and an X-ray is taken;
biochemical blood analysis - laboratory signs of acute cholecystitis are an increase in the amount of bilirubin, alkaline phosphatase and some globulins.

Diet for cholecystitis and drug treatment

Chronic cholecystitis in remission can be treated on an outpatient basis. The main purpose is to follow a diet. Diet for cholecystitis means, first of all, the exclusion of spicy, fried, salty food from the diet. The use of carbonated drinks is also prohibited.

At the same time, the following are allowed: poultry and beef, lean fish and seafood, fresh vegetables (not sour) and fruits, as well as greens.

With signs of acute cholecystitis and exacerbation of its chronic form, the patient should be hospitalized in a hospital.

Cholecystitis treatment methods:

conservative;
operational.

Conservative therapy is based on the following goals:

hunger;
nasogastric tube;
medical treatment.

Drugs for non-calculous cholecystitis or its calculous form are administered intramuscularly, intravenously as a jet or intravenously as a drip. Appoint:

antibiotics;
saline infusion solutions;
freshly frozen plasma;
spasmolytics.

If acute phlegmonous or gangrenous cholecystitis is detected, the treatment tactic consists in emergency surgical intervention - cholecystectomy (removal of the gall bladder). The operation is performed after preparing the patient - administration of infusion solutions.

If there are stones in the gallbladder, the treatment of cholecystitis in adults is to remove the gallbladder. The prognosis will be more favorable if such an operation is performed in a planned manner, and not in an urgent (urgent) manner, with the addition of an infection and an increase in acute phenomena from the side of the gallbladder.

At the stage of remission, sanatorium-resort treatment is recommended. You can learn more about it on the website of our clinic https://dobrobut.com.

Related services:
Gastroenterologist consultation
Videogastroduodenoscopy