Chronic cholecystitis is long lasting.inflammation of the gallbladder. The main cause of the development of this disease is opportunistic microflora, represented by streptococcus, staphylococcus, Escherichia coli. Infection wipes into the gallbladder with blood, lymph, from the intestinal lumen and intrahepatic bile ducts. The development of cholecystitis also leads to a prolonged stagnation of bile in the bile ducts and in the gallbladder, changes in the physical properties and chemical composition of bile. The prolonged stagnation of bile provokes the formation of stones - chronic calculous cholecystitis develops.
Clinic of the disease is characterizedlong progressive course with periodic exacerbation of the process. The main symptom of the disease - pain, localized in the right hypochondrium. This pain is aching, often radiating to the right upper body, less often there is an irradiation of pain in the left hypochondrium.
Dyspeptic syndrome manifested by nausea,often turning into vomiting, not bringing relief. Often there is a rise in body temperature to subfebrile or even elevated numbers. The patient has a forced position on the right side or on the back. Pulse frequent, low blood pressure. A typical positive symptom of Ortner is soreness when tapping on the edge of the right costal arch.
Chronic cholecystitis, chronic symptoms, the treatment of which is different from the usual inflammation of the gallbladder, is manifested by the periodic development of attacks of biliary colic.
The diagnosis is confirmed by ultrasound, thermography, cholecystography, data from a general blood test.
Treatment of chronic cholecystitis
Если у пациента диагностирован хронический cholecystitis, treatment should be comprehensive, long and continuous. In the acute phase of the disease, inpatient treatment is indicated, and in the period of remission, outpatient treatment is indicated. Combined therapy of chronic cholecystitis includes the appointment of a diet, medication and physiotherapeutic methods of treatment.
Food features have a significantinfluence on the pathology of the digestive organs, to which chronic cholecystitis also belongs. Treatment should begin with the appointment of a diet. The diet provides an exception to the diet of fatty and fried foods, the predominant use of dairy products, vegetables and fruits, low-fat varieties of fish and meat. The patient must keep to a diet both in the remission stage and in the acute phase.
In the treatment of chronic cholecystitis are usedantibacterial drugs, antispasmodics, analgesics, choleretic agents. During the period of subsiding the exacerbation of the right hypochondrium area they apply a heating pad. At this time, the appointment of physiotherapeutic procedures is shown: paraffin or ozokerite applications, UHF, diathermy, electrophoresis. In the remission phase, the appointment of exercise therapy, spa treatment is useful.
In the event that duringinstrumental studies revealed calculous chronic cholecystitis, the treatment can be both therapeutic and surgical. In case of calculous cholecystitis, the treatment tactics depend on the size of gallstones. Small stones and sand can independently leave the gallbladder without leading to the development of complications. In this case, the treatment of calculous cholecystitis is no different from the treatment of conventional chronic cholecystitis.
In the presence of large stones, the appointment of choleretic drugs, thermal procedures in the right hypochondrium area is contraindicated.
Indications for the appointment of operationalinterventions are frequent bouts of biliary colic, obstructive jaundice, suppuration and dropsy of the gallbladder, rupture of the bladder wall with the development of biliary peritonitis.
The patient should remember that if chronic cholecystitis is detected, treatment will be effective only with the full implementation of all medical recommendations.