Bend of the gallbladder neck: symptoms and treatment

How it manifests itself

When the gallbladder is bent, the symptoms are most often explained by congestion in the bile. Then, dystrophy of the walls and a violation of the contractile function of the bladder gradually develops (Zaprudnov, A.M. Diseases of the biliary tract in children: developmental anomalies, dysfunctional disorders / A.M. Zaprudnov // Russian Bulletin of Perinatology and Pediatrics. - 2005). Signs of bending of the gallbladder (kinks, constrictions)

• — Nausea and vomiting are provoked by fatty foods or excessive physical activity. These symptoms are explained by the development of inflammation (cholecystitis).
• — Pain in the right hypochondrium associated with stretching of the bladder walls by accumulated bile. Sudden sharp pain may be caused by a stone blocking the bile duct.
• - Change in color of urine and feces. In the complete absence of bile entering the intestines, the feces become discolored and the urine darkens.
• — General intoxication (weakness, fever, headache) is an unfavorable sign, indicating a violation of the integrity of the walls and the flow of bile into the abdominal cavity (bile peritonitis).

The severity of the described symptoms depends on the degree of disruption of the outflow of bile. If the bend only partially closes the exit, the symptoms are erased and are characterized only by indigestion. If bile does not enter the intestines at all, the manifestations are bright and violent.

In children, the manifestations are exactly as violent as described here, in adults they are less pronounced. Everything depends heavily on nutrition. You will load your liver with fatty foods, alcohol, spicy foods, eat rarely but a lot, and you will feel your right side faster.

Look at your tongue! Is there a yellow coating there? Remember: after you eat, do you run to the toilet? Do you occasionally feel bitterness in your mouth?

Here are the most common signs of stagnation in adults, in addition to heaviness in the right side under the ribs, when it has not yet reached chronic pancreatitis or stones.

Diagnostics

Confirming the correct diagnosis can only be done through instrumental diagnostic measures, but before prescribing them, the gastroenterologist must independently perform several manipulations. Thus, primary diagnosis includes:

• conducting a detailed survey of the patient regarding the intensity of severity and the first time of appearance of characteristic symptoms;
• studying the medical history and life history of not only the patient, but also his immediate relatives - this is required to identify etiological factors, including genetic predisposition;
• performing a physical examination. The main manipulations that the clinician performs are studying the condition of the skin and sclera, palpation of the anterior wall of the abdominal cavity, especially the area under the right ribs.

Laboratory studies of blood, urine and feces have virtually no diagnostic value. Nevertheless, they are necessary because they can indicate the development of complications of the disease.

The only instrumental method to confirm the diagnosis is ultrasound of the abdominal organs. This procedure will indicate the presence of deformation of the gallbladder.

Ultrasound of the abdominal organs

How does it affect liver function?

The bending of the gallbladder and stagnation of bile are serious factors in liver dysfunction. All bile acids are divided into hydrophilic, which protect hepatocytes, and hydrophobic, which are toxic to the liver. The gallbladder is normally designed to protect the liver from hydrophobic bile acids, accumulating them and regularly releasing them into the intestine (Ya.L. Tyuryumin, V.A. Shanturov, E.E. Tyuryumina, “The Role of the Gallbladder”//2011). With stagnation caused by bending, this process is disrupted, hydrophobic acids flow back into the bile ducts and liver and, in the literal sense, destroy the cells of this vital organ. Cholestatic hepatitis occurs. It has been proven that the function of hepatocytes is impaired after 10 days of severe stagnation of bile (I.I. Goncharik, “Hepatitis due to impaired outflow of bile, cholestatic hepatitis”). Chronic congestion, of course, damages more slowly.

Although many gastroenterologists do not agree that fatty hepatosis (diffuse changes in the liver) is somehow related to a bend (bending of the gallbladder, constrictions), in practice it is difficult not to notice: on ultrasound there are two disorders together. It’s easier to explain: retention of bile in the intrahepatic ducts, of course, prevents hepatocytes from working better and fat metabolism is disrupted.

Causes of bending in the neck area

The pathological condition can appear for various reasons, depending on the form of the disease.

The cause of a congenital anomaly of the gallbladder cannot be determined, since the organ is deformed in the womb. According to some doctors, children whose parents have a similar pathology are more at risk of developing a bent neck of the gallbladder.

The causes of the acquired type of disease may be:

1. Inadequate or untimely treatment of cholelithiasis, chronic cholecystitis. Deformation of the pyriform reservoir occurs as a result of inflammatory processes or manifests itself as a complication of a certain illness.
2. Hepatomegaly. Pathology leads to an increase in the size of the liver. Since the gallbladder and liver are located close, the neck of the gallbladder is bent.
3. Excessive physical activity. Intense and constant loads cause displacement of internal organs, which can lead to deformation of the gallbladder.
4. Liver injuries and damage.
5. The presence of adhesions in the gallbladder.
6. Prolapse of internal organs due to sudden weight loss, age-related changes, adherence to strict diets or cancer.
7. A sedentary lifestyle, prolonged exposure to an uncomfortable sitting position, and prolonged standing on your feet.
8. Obesity. The problem of excess weight also affects the internal organs; organs are pinched by the fatty layer and become displaced, which can lead to the bending of the gallbladder.
9. Inflammatory processes in the gallbladder.
10. Pregnancy. With the development of the fetus and the enlargement of the uterus, internal organs are displaced and there is strong pressure on them, as a result of which the gallbladder can become deformed.
11. Irregular and irrational nutrition, eating in large quantities immediately after a long fast. Under the influence of one or another etiological factor, bile continues to be secreted by the gallbladder, but is not excreted into the duodenum, since during fasting there is no need for the yellow substance. And when you overeat, the walls of the stomach stretch, the organ takes on an abnormal shape and compresses the gallbladder. As a result, a bend of the gallbladder appears in the neck or in the body, the outflow of bile is disrupted, stagnation of bile occurs, precipitation of its acids and the addition of a bacterial infection.

How does it affect digestion?

The main purpose of bile is the adsorption and breakdown of fats in the intestines. Due to the bending of the gallbladder into the duodenum, the flow of bile is reduced, fats are poorly broken down and are excreted in feces almost unchanged. Bile acids also activate pancreatic enzymes (pancreatic lipase), so when bile stagnates, the entire digestion process suffers, and not just lipolysis.

In addition, bile acids are needed for the absorption of fat-soluble vitamins: A, D, K, E. Their deficiency affects the functioning of all organs. If this situation persists for a long time, oxidative processes begin to predominate in the body - the main way of damaging all cells and the formation of malignant tumors.

In recent years, the influence of bile acids on many processes not related to digestion has been proven:

• - Stimulate calcium absorption (Sanyal AJ, Hirsch JI, Moore E. W. Premicellar taurocholate enhances calcium uptake from all regions of small rats. Intestine // Gastroenterology. - 1994).
• — Suppress the growth of pathogenic microflora in the small intestine. With their deficiency, dysbacteriosis and enteritis develop (Ilchenko A. A., Mechetina T. A. Bacterial overgrowth syndrome in the small intestine etiology, pathogenesis, clinical manifestations // Experimental and clinical gastroenterol. - 2009).
• - Affect the metabolism of thyroid hormones (Houten SM, Watanabe M., Auwerx J. Endocrine functions of bile acids // EMBO J. - 2006).
• - Affect the overall energy balance of the body through glucose metabolism in the liver (Ma K., Saha PK, Chan L. et al. Farnesoid X receptor is essential for normal glucose homeostasis // J. Clin. Invest. - 2006).

Protect yourself from stone formation

Stagnation of bile caused by a bend in the gallbladder triggers many negative phenomena, and the first of them is stone formation. Today, most studies associate cholelithiasis with impaired motility of the biliary tract, and not with an excess of fatty foods or cholesterol (Maksimenko V.B. Impaired concentration and motor-evacuation functions of the gallbladder in cholecystolithiasis // Russian Journal of Gastroenterol., Hepatol., coloproctol., 2006). It is the increased aggregation of bile components during stagnation that “strings” on itself the remaining mechanisms of stone formation. Even incomplete bending of the gallbladder gradually leads to a complete imbalance of health, which is explained by the numerous functions of bile that we described earlier.

It is important not to forget a simple physiological truth: bile is not produced in the bladder, it is simply collected there from the intrahepatic ducts, and it is produced by hepatocytes. Accordingly, it’s worth starting with their support.

Initially, it is important to support the liver so that the bile becomes “fluid” and the balance of bile acids and cholesterol becomes more optimal.

In the Sokolinsky System, since 2002, we have tested a dozen natural remedies and, as a result, the 3 most successful from a practical point of view are produced specifically for the Sokolinsky Center.

Liver 48 (Margali) - an ancient Megrelian herbal recipe includes a combination of herbs and sulfur in a certain proportion. You need to take it for two months in a row, 1 capsule. 2 times a day simultaneously with improving intestinal microflora (read why this is important below) and also with active plant fibers NutriDetox (more about it later, in the section on nutrition). If you wish, you can get acquainted with the results of clinical studies on how this set of herbs affects the functioning of hepatocytes according to test data.

Ziflan (export formula) is a highly concentrated immortelle extract, produced specifically for the Sokolinsky System (not sold elsewhere). This is a classic Russian natural remedy that has the property of changing the ratio of fatty acids and cholesterol in bile. It is known that it does not dissolve in water, but only in the presence of fats. Therefore, so that the bile is not excessively thick and leaves the bladder more easily, and stones do not grow, the ratio of bile acids to cholesterol should be greater than six to one. Moreover, the thickening process is reversible. If the content of bile acids in the bile returns to normal, then cholesterol will again turn into a liquid state and leave the body in the stool.

Export Ziflan is usually taken as part of our complex for stones, but the same complex is also quite applicable for prevention.

Take 1 capsule 2 times a day before or with meals

There are two important features: first, you need to alternate immortelle extract with some other remedy according to the “month/every month” scheme, and second, there is no risk that stones, even if there are any, will come, because it does not cause a sharp release like tubage and choleretic drugs.

Phytocalcule - phytocollection. This is precisely the product with which we alternate export Ziflan. The composition is fantastic! More than ten herbs, super-grinded in a special mill to almost the state of an extract. The recipe is taken from classical Russian herbal medicine. It is produced like others - especially for our center. The secret is in the quality of herbs, the ratio of ingredients, grinding. Extremely convenient to use. Simply brew 1/3 teaspoon twice a day and drink. We combine it with microflora reboot and active fiber in the diet.

It is more convenient to use in combination. As already mentioned, you can use the “Active Complex for gallstones.” Don't be scared by the name. Natural remedies are not medicines. The goal is to improve liver function and bile structure, restore self-regulation, so that you can then support it with nutrition.

Ordering as a package is always cheaper! It includes: Ziflan (export formula) + Fitocalcule + Unibacter. Special series.

The course lasts 4 months.

Treatment

If the patient has a kinked gallbladder neck, conservative therapy is usually prescribed. It consists of taking medications, following a diet, exercise therapy and traditional methods. Additionally, sanatorium treatment and physiotherapeutic procedures are indicated - electrophoresis, ultrasound therapy, hirudotherapy.

Surgery is used when gentle treatment methods have failed or when the outflow of bile is blocked and complications develop.

Drug therapy

The following medications are prescribed:

• antibiotics of the cephalosporin group - if there is a bacterial infection;
• non-steroidal anti-inflammatory, analgesics and antispasmodics - No-shpu, Baralgin, Spazgan, Spazmolgon, Ibuprofen;
• choleretic drugs - Gepabene, Ursofalk, Nikodin, Flamin, Odeston, Aristohol.

Medicines to improve immunity are indicated - tincture of echinacea, lemongrass, ginseng.

Diet for bending of the gallbladder in the cervical area

Correcting your diet is the surest way to achieve recovery from gallbladder problems. Patients should include in their diet as many vegetables and fruits, lean meats, fish, low-fat dairy products, and cereals as possible. As a basis, you need to take such cooking methods as boiling and baking in the oven. It is important to control the thorough chewing of food, mixing it with saliva to start the digestion process.

During treatment, you must strictly limit your intake of alcohol, carbonated drinks, fatty, salty and fried foods, and avoid spicy and canned foods and spices. Food should be of moderate temperature, comfortable for absorption. You should refrain from consuming hot and iced drinks and foods.

You need to eat regularly, eating a small portion every three to four hours. The main thing is to eat regularly, avoid prolonged fasting during the day and uncontrolled gluttony in the evening. The last meal should take place a couple of hours before going to bed. You should not take a bath after a meal or move actively.

Don’t forget about water balance, drinking at least one and a half liters of clean water, green tea, and herbal teas every day.

Physiotherapy

To get rid of symptoms or smooth out their manifestations, doctors prescribe:

• ultrasound;
• electrophoresis with novocaine;
• physical therapy.

Physical activity should not be intense. Sudden movements should be avoided and heavy objects should not be lifted.

The complex of therapeutic exercises includes:

• rolls - lying on your back, pull your knees to your chest;
• pulling the legs to the chest one by one;
• retraction and relaxation of the abdomen in a lying position.

All exercises are done 10 times, smoothly, without jerking. Systematic implementation of actions normalizes the outflow of bile and improves blood circulation. It is an excellent method of prevention.

Exercises

If your gallbladder is bent, you need to reconsider all your physical activity. You should avoid any sudden movements, do not lift or carry heavy objects, because such actions can cause the organ to twist around the longitudinal axis.

But physical therapy, on the contrary, will be beneficial. Below are some simple exercises that you can do on your own at home. They can significantly relieve pain associated with this disease and ensure normal functioning of the gallbladder.

But you just need to do them regularly. A single lesson will not completely correct the situation.

Simple gymnastics will help improve the flow of bile, as well as blood supply to organs. It is useful both as a treatment and as a preventative measure. The following exercises can be recommended:

• Lie on your stomach, place your arms along your torso, and place your toes on the floor. Then exhale slowly and lift your head, chest, and legs off the floor. Stay in this position for a short time and then relax again. Perform 5-6 times.
• Lie on your back, stretch your arms behind your head. Lift your legs a little off the floor and freeze for a few seconds, then raise your legs a little higher and freeze again. Try not to hold your breath during this exercise.

Why does the intestinal microflora need to be corrected?

Regarding the prevention of cholelithiasis, there is another very useful information about the use of the Sokolinsky System. This is rarely talked about; they remember only when the stones have already formed.

The fact is that today the negative impact of microflora disturbances on the risk of cholelithiasis has been well studied. Moreover, against the background of bending, it develops much faster. Therefore, when we do rebiosis (reboot of microflora) according to the “Sokolinsky System”, we “kill two birds with one stone” - and prevent the formation of stones in stagnant bile, since cholesterol returns to the liver at a higher density - less lithogenic, and the liver itself is protected by normal microflora from excess work to neutralize toxins - digestive by-products and microbial toxins.

Rebiosis takes about 4 months of taking a high-quality probiotic Unibacter. Special series + support for a sufficient amount of plant fiber NutriDetox + improvement of bile structure using Ziflan (export formula) or Phytocalcule herbal collection.

But then, you can just stick to a reasonable diet. Such a profound effect on microflora and digestion in general gives a systemic effect on the general condition.

I would not like to retell here all the information about Unibacter. A special series for rebooting microflora. So read more about it. You definitely can’t compare it to any probiotic from your local pharmacy. This is truly something special!

Nutrition when the gallbladder is bent

The main role in the prevention of cholelithiasis when the gallbladder is bent is to eat at least 3 times a day; it is especially important not to skip breakfast. In addition, it is important to limit fatty, spicy, unnatural foods and increase the amount of cereals and vegetables.

But if you don’t have time to cook vegetables twice a day, then you can protect yourself from stone formation by introducing plant fibers in a different form into your diet.

For example, it is very convenient to use Redi Fiber (vegetable powder: Jerusalem artichoke, beets, celery), which can be easily added to any fermented milk drink. This is not only a way to adjust your diet without wasting time, but also helps limit late dinners and maintain a normal weight. How much to use? This is not a medicine - it has no dosage or course. Today you drink, tomorrow you skip it... This is a normal approach. But of course there should be regularity. The anatomy will not change...

The second natural remedy, which is also produced specifically for the Sokolinsky System, is the green smoothie NutriDetox. It can help diversify the way you use active plant fibers, while you also get vitamins and minerals in sufficient quantities and in a natural version. The basis of NutriDetox is psyllium powder, spirulina, chlorella. The effect of each ingredient is written in great detail on the website. A decent and easy-to-use product developed at the Sokolinsky Center in Prague. Naturally, its benefits are not limited to the prevention of bile stagnation and stone formation. You only need 1/3 teaspoon per day.

Prevention

Special preventive measures to prevent the development of problems with such deformation of the gallbladder have not yet been developed. Despite this, people need to adhere to a few simple rules:

• completely get rid of addictions;
• eat properly and balanced;
• normalize body weight;
• introduce moderate physical activity into your lifestyle;
• avoid long periods of fasting;
• promptly treat liver diseases and other pathologies that can lead to bending of the gallbladder neck;
• undergo preventive examinations with a gastroenterologist several times a year.

The prognosis of such a disease will be individual for each patient. The congenital type of the disease often has a favorable outcome, because it rarely leads to consequences. However, this can only be achieved with timely and comprehensive therapy. An acquired disease often causes the development of complications that can be dangerous for the patient, and in some cases cause death.