How does the gallbladder work?
Bile is constantly produced by the liver and stored in the gallbladder. When eating, especially fatty foods, the bladder contracts, the sphincter of Oddi relaxes, and bile enters the intestines, helping to digest fats. With dyskinesia, this consistency is disrupted: the bladder contracts weakly or too strongly, and the sphincter opens untimely. The pressure in the bile ducts increases, which causes pain.
- Functional gallbladder disorder
- Functional disorder of the biliary sphincter of Oddi
- Functional disorder of the pancreatic sphincter of Oddi
- In domestic practice - hypomotor and hypermotor types
Causes and risk factors
The exact causes of functional disorders are not fully understood. The motility of the biliary tract is regulated by the nervous system and hormones that are released when food enters the intestines, so it is influenced by diet, stress and concomitant diseases. In children, dyskinesia is often combined with other functional digestive disorders.
- Irregular meals and long breaks between meals
- Overeating fatty foods
- Stress, anxiety disorders
- Sedentary lifestyle
- Rapid weight loss, obesity
- Hormonal changes, pregnancy
Symptoms
A typical symptom is episodes of pain in the right hypochondrium or in the pit of the stomach, which last from half an hour to several hours, do not occur every day and can radiate to the right shoulder blade. Constant aching heaviness, bitterness in the mouth and belching without attacks of pain are more often associated with other conditions - functional dyspepsia or reflux.
- Attacks of dull or arching pain in the right hypochondrium
- Pain after fatty, fried foods
- Nausea, sometimes vomiting during an attack
- Bitterness in the mouth
- Bloating and loose stools
Diagnostics
The main task is to exclude organic causes of pain. An ultrasound of the abdominal organs, blood tests for liver tests and pancreatic enzymes, and gastroscopy are performed. To assess the contractile function of the bladder, ultrasound with a test breakfast is performed, and abroad, hepatobiliary scintigraphy is performed. It is important to understand that bending or bending of the gallbladder on ultrasound is not in itself dyskinesia and does not require treatment in the absence of complaints.
- Ultrasound of the liver and gallbladder
- Ultrasound to determine the contractile function of the gallbladder
- Bilirubin, ALT, AST, GGT, alkaline phosphatase, amylase, lipase
- Gastroscopy
- According to indications - MR cholangiography
Treatment and prevention
Treatment begins with normalizing the diet: regular meals in small portions help the gallbladder to empty evenly. During attacks, the doctor may prescribe antispasmodics. When combined with functional dyspepsia or irritable bowel syndrome, these conditions are also treated. Choleretic herbs and medications should not be taken without a prescription: if there are undetected stones in the bladder, they can provoke an attack of colic. With proven severe dysfunction of the bladder with typical pain, the surgeon may recommend removal of the bladder, but the decision is made individually.
- Eat 4-5 times a day, don’t skip breakfast
- Limit fried, fatty, smoked foods
- Don't overeat at night
- Move more, walk
- Control your weight without sudden weight loss