Gallstones : Causes and symptoms of

Gallstone disease (GSD) - a disease in which the formation of stones (stones) in the gallbladder and bile ducts.

disease is extremely widespread in all continents, in 80% of asymptomatic, most common in women aged 20 years and older, and after 70 years meets every third.

main causes and mechanism of development of gallstones

Currently accepted that the basis for the formation of gallstones is a violation of the colloidal composition of bile, leading to a change in bilirubin ratio, cholesterol and calcium loss of the sediment in the form of flakes, of whichsubsequently formed stones (calculi).

most common following types of gallstones:

  • cholesterol stones, they are more often single, the size of 5 to 35mm, oval and yellowish,
  • pigment (bilirubin) stones, they are more likely to be multiple, small size, krugllyor crescent shape with uneven surface, green-brown or black,
  • mixed stones can have a different shape, size and color can be layered and most of all - multiple.

There are many factors tha

t contribute to the formation of gallstones.The most common ones are:

  • Inflammatory processes in the biliary tract.In the composition of bile stones are pieces of epithelium of the gallbladder, proteins and calcium salts of inflammatory exudate, edema appears when the bladder wall.Violation
  • composition bile in hemolytic jaundice and other kinds leads to an increase in cholesterol and its reduction of bile acids (normally it is 1:15, and in GSD 1: 6), which leads to the precipitation of cholesterol.
  • Stagnation of bile (cholestasis).It is observed in biliary dyskinesia, irregular and unbalanced diet, flatulence, constipation, with an increase in intra-abdominal pressure (such as pregnancy), and reflex influences from other organs (eg, coronary heart disease), when wearing tight clothing, adhesive diseaseand t.d.Zastoy leads to thickening of bile, as well as to the development of the inflammatory process, often accompanied by the addition of

infection The main clinical manifestations of gallstone disease.

Very often a person first becomes aware of the presence of his CL only when the liver (bile) colic - an attack is extremely severe pain in the right upper quadrant.Sometimes this is preceded by nausea, hiccups, vomiting of bile, discomfort in the abdomen, arising after a fatty, fried, spicy food, and alcohol.Provoke colic can bumpy ride, exercise, emotional distress, cooling.

duration pain attack is different - from several minutes to several days.It is characterized by irradiation (output) this pain: under the right shoulder blade and collarbone in his right shoulder and neck, at least in the lower back and left side of the chest.Analgesics do not remove these pains, but sometimes there comes a relief after administration (reception) antispasmodics, expanding the bile ducts (shpy, spazgama).Biliary colic can occur not only when the blockage of the bile duct stone, and while passing through it "sand" and bile clots, mucus, pus and blood clots.

During colic may experience an increase temperaturytela, delayed stool, temporary urinary retention and the appearance (reflexively) attack stenokardii.Palpatsiya belly at this time is very painful, and the abdominal muscles are tense.If colic lasts more than a day the patient is mild jaundice of the sclera and the skin appears itchy skin, discolored feces and dark urine.If you are restoring patency of the bile duct, jaundice disappears and the pain becomes less intense, dull, and accompanied by a pronounced flatulence.

flow CL is different: sometimes attacks are rare, and cramps are brief and are not accompanied by severe pain.In other patients with frequent attacks or are rare, but so intense that the patient prefers to be operated at once, so as not to feel in the future of such torment, and to prevent the development of complications.

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