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Pain in the right hypochondrium is one of the most common complaints in patients with diseases of the gallbladder and biliary tract. In recent years, in developed countries, there has been a trend towards an increase in the incidence of gallbladder diseases. According to statistics, every tenth person experiences discomfort in the upper abdomen after eating fatty, fried, salty and smoked foods, as well as after drinking alcohol or after psycho-emotional and physical exertion. The most common disease of the gallbladder and biliary tract is biliary dyskinesia.
Biliary dyskinesia is a functional disease caused by uncoordinated and untimely contraction of the gallbladder, bile ducts and sphincter of Oddi. Pain with dyskinesia is described by the term "biliary pain": it is localized in the right hypochondrium, lasts about 30 minutes, there are often repeated attacks and even at night, sometimes nausea and vomiting occur, which does not bring relief, there is a feeling of bitterness in the mouth. Traditionally, this pathology of the gallbladder was divided into hypo- and hyperkinetic types, which differed in their manifestations. The hypokinetic type is characterized by a feeling of heaviness, fullness in the right hypochondrium, often nausea, a feeling of bitterness in the mouth, bloating and stool disorders. The hyperkinetic type is usually characterized by an acute onset with an intense pain syndrome and is accompanied by the appearance of autonomic reactions: palpitations, fear, pain in the heart, numbness of the extremities, etc.
It should be noted that long-term functional disorders eventually lead to organic lesions. For example, with the hypokinetic type, a violation of the properties of bile occurs, its ability to form stones increases, which leads to the development of cholelithiasis.
To exclude organic diseases, the gastroenterologist at the reception conducts a targeted collection of complaints. For example, what is the pain associated with (eating, changing body position, defecation, and others) and this helps to eliminate more than half of the diseases.
The required minimum laboratory diagnostics includes:
- -clinical blood test,
- -blood chemistry,
- -coprogram.
According to the results of the analysis of blood and feces, it can be concluded that there are parasites in the body that are adapted to living in the biliary tract and can cause pain in the right hypochondrium.
An obligatory instrumental examination is an ultrasound examination of the abdominal organs (ultrasound), which allows to identify changes in the volume of the gallbladder, its shape and contractile function. Also, the doctor of ultrasound diagnostics excludes organic pathology of the hepatobiliary system: cholelithiasis, neoplasms of the pancreas, liver and bile ducts.
If a pathology of other organs is suspected, the gastroenterologist may prescribe additional instrumental studies.
To alleviate the condition and stop the pain syndrome, the gastroenterologist may prescribe symptomatic treatment at the first appointment, however, you need to remember that each drug has side effects and you should not take medicines on your own.
Treatment for gallbladder dyskinesia should include:
Video Biliary Dyskinesia: Symptoms and Causes You Must Know
- -diet therapy (depending on the type of dyskinesia),
- -drug therapy (antispasmodics, choleretics and cholekinetics, ursodeoxycholic acid preparations,
- -prokinetics,
- -antidepressants and others),
- -physiotherapy methods,
- -lifestyle change.