The concept of biliary dyskinesia
Dyskinesia of biliary tract are oftenoccurring diseases. Women suffer 10 times more often than men. Dyskinesia of the gallbladder and biliary tract sphincters is incomplete, excessive or untimely contraction of the muscles of the gallbladder or biliary tract sphincters, which leads to disruption of normal outflow of bile.
The reduction of the gall bladder is under thethe hormone cholecystokinin, which is isolated duodenal mucosa cells. Isolation occurs under the action of cholecystokinin food. When food enters the duodenum, cholecystokinin is released, gallbladder contracts and the sphincter of Oddi relaxes. Bile is released into the duodenum. This entire process depends on the condition and muscle tone of the gall bladder, sphincter, and the nature of food.
Options biliary dyskinesia
The causes of biliary dyskinesia hitherto not completely understood. According to allocate origin:
- secondary dyskinesia of the gallbladder and biliary tract
Primary dyskinesia occurs due toviolation of neuromuscular regulation of motor activity of the gallbladder and biliary tract sphincters. It is believed that this type of dyskinesia occurs in asthenic physique of patients with neurotic or psycho-emotional disorders. Such patients except for the diagnosis of biliary dyskinesia, often establishes the diagnosis of neuro dystonia or vascular dysfunction. Causes of dyskinesias are endocrine diseases, such as thyroid disease, gonads, menopause.
Secondary dyskinesia of the gallbladder andbiliary tract occurs in patients with other diseases of the gastrointestinal tract (chronic gastritis, duodenitis, enteritis, colitis). Very often dyskinesias occur in diseases of the duodenum, when in connection with damage to the mucous membrane cells of the duodenum, they disrupted the release of cholecystokinin. Secondary dyskinesias arise in patients with cholelithiasis and chronic cholecystitis.
By the nature of violations of motor function Biliary dyskinesia is divided into:
Hypertonic-hyperkinetic dyskinesiararer. It is typical for people with excitable nervous system, asthenic physique, combined with neuroses. Mostly the young age of the patients. It is believed that hypertonic dyskinesia promotes food with lots of spices, condiments, spicy dishes.
Hypertonic-hyperkinetic dyskinesiagall bladder causes pain. Pain appear in the gallbladder, right upper quadrant. Pain is given in the right half of the chest, the right shoulder blade, collarbone, shoulder, neck or right half of the mandible. Pain intensity can be varied. Most pains are strong enough. The duration of pain to half an hour. Provokes pain attack intake of fatty or spicy food, psycho-emotional stress.
Hypotonic-hypokinetic dyskinesia of the gallbladder and biliary tract is more common and occurs mainly in those who lead a sedentary lifestyle, are overweight.
The cause of hypotension biliary tractmay be a chronic inflammatory disease of the mucous membranes of the stomach or duodenum. More common in older people. The pain in this type of dyskinesias slightly pronounced. They are usually dull, aching, accompanied by a feeling of fullness in the right epigastric region. Patients more likely to develop digestive disorders, since hypotension gallbladder bile into the intestine is slowed down.
With digestion in the intestine occurs flawbile acid, which is manifested by malabsorption of fat, vitamins, cholesterol, calcium salts. Patients after a meal, especially with overeating, nausea, flatulence, violations of the chair. Often develop constipation due to lack of stimulating action of bile acids in the intestinal muscles. But sometimes there are diarrhea, which are called gipoholicheskaya diarrhea. This condition is also caused by lack of bile acids in the intestine.
Eating Disorders contribute to obesity,metabolic disorders that manifest the development of polyarthritis, kidney stones. In the long process in the gall bladder and ducts can form stones or develop inflammation.
Diagnosis of the disease
Diagnosis of dyskinesia of the gallbladder andBiliary carried out using duodenal intubation. In hypertensive form of a dyskinesia bile stimulator introduction (magnesium sulfate) often causes pain attack and a fraction of the gallbladder bile is released quickly or intermittently phase reduction of the gall bladder can be reduced. At hypokinetic dyskinesia of the bile from the gall bladder flows through a large amount of time after stimulation, the secretion of bile is slow. Work is also cholecystography and intravenous cholegraphy, radioholetsistografiya. These studies reveal changes in the filling and emptying of the gallbladder, and to rule out other diseases of the biliary tract and gallbladder.