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November 06, 2016 00:02

Biliary colic |Symptoms and treatment of biliary colic

Biliary colic - it is one of the symptoms of gallstones.The cause of colic is becoming the stone that covers the bile duct and prevents the normal flow of bile, and colic can cause muscle spasm due to irritation of a dense cluster of stones in the body.

cause seizures could improper diet (fatty, spicy, alcohol), as well as a strong nervous or physical stress.

acalculous biliary pain that occurs in the absence of gallstones, associated with structural or functional disorders, and sometimes requires laparoscopic cholecystectomy.

ICD 10 code

According to ICD-10 Biliary colic refers to a class of diseases of the gallbladder (K-80 - hoelitiaz).

reasons biliary colic

Biliary colic can occur in the absence of gallstones, especially in young women.Up to 15% of laparoscopic cholecystectomies performed in this pathology.Common causes include the presence of microscopic stones, gallbladder dysmotility, overly sensitive biliary tract and sphincter of Oddi dysfunction, hypersensitivity adjacent duodenum, an

d possibly gallstones, which were resolved spontaneously.Some patients may develop other functional gastrointestinal disorders.

Symptoms of biliary colic

The characteristic manifestations of biliary colic include severe pain on the right side, in some cases, it may be given in the back, neck, or cover the entire abdomen.

Most often, the attack occurs at night, pain worse when breathing or if the patient lies on the left side (investment brings a prone position on the right side to shake the abdomen feet).

During an attack of colic man tormented by frequent vomiting, usually not bringing relief, the skin becomes pale, with a yellowish tinge, the stomach becomes bloated, with pressure felt a sharp pain, muscle spasm.

body temperature during attacks usually increased, feces becomes colorless hue, and urine becomes dark.

attack can last anywhere from 5-7 minutes to 2-3 days, doctors this condition refers to those that require immediate medical attention.

gall-Biliary colic is considered a major symptom of gall stone formation.Seizures occur severe pain that causes muscle spasm due to the presence of a foreign body (stone).

diagnosis of biliary colic

acalculous pain syndrome is suspected in patients with biliary colic, if the results of the survey do not reveal gallstones.The studies include ultrasound and endoscopic ultrasound.To evaluate the evacuation function of the gallbladder (ejection fraction) holestsintigrafiya performed after the introduction of cholecystokinin (avoid the use of drugs, potentially affecting the result, such as calcium channel blockers and anticholinergics).To identify the sphincter of Oddi dysfunction, performed ERCP with biliary manometry.To detect duodenal hypersensitivity performed endoscopic barostat test, but such research is carried out only in specialized centers.

Treatment of biliary colic

Laparoscopic cholecystectomy improves results when microscopic stones and possibly in violation of gallbladder motility.The ability to predict the effectiveness of treatment of such disorders laparoscopic cholecystectomy by other studies to be confirmed.

Severe pain during an attack of biliary colic removed antispasmodic drugs (usually by injection) - papaverine, no-spa, atropine.

When severe pain is used novocaine blockade.

gallbladder inflammation treatment is predominantly surgical (during surgery, the surgeon releases the bile ducts for the passage and enters the bile acids that dissolve cholesterol stones).

When pigment or calcified stones kislotorastvoryayuschaya therapy usually does not help, surgery to remove these structures should be carried out before the stones block the common bile duct.

If colic develops on the background acalculous cholecystitis, accompanied by an increase in body disruption of, the conservative treatment is given.

to improve biliary functions assigned enzyme replacement therapy.

drugs in hepatic colic

main symptoms of biliary colic is severe pain caused by spasm of the muscles, so the first thing appointed antispasmodic drugs, most often in the form of injection (Drotaverinum, no-spa, platifilin, papaverine), after removing the pain forimproving the work of the gall can be assigned cholagogue preparations, but they should be taken only after a diagnosis and consultation with a physician.

The hospital nonsteroidal anti-inflammatory drugs (metamizol, ketorolac) can be used to reduce pain.

First aid

In hepatic colic patient needs complete rest and help the doctor.Warming the stomach is not recommended, as it may worsen the disease.

You also can not use any products that are allowed to drink only non-carbonated water.

If severe pain can be given a pill No-Spa, papaverine.

emergency algorithm in hepatic colic

Before arriving ambulance should ensure the maximum comfort to the patient.

Colic is usually accompanied by frequent vomiting, so antispasmodic drugs in pill form may not have the desired effect, with strong spasms can make an injection of atropine, platifilina, shpy.

further course of treatment should only assign a specialist, in some cases require urgent surgical intervention, and sometimes helps conservative treatment, which reduces the risk of recurrence of colic.

Prevention

To reduce the risk of biliary colic is assigned to a dietary table №5.This diet includes the optimal composition of nutrients.

Patients suffering from hepatic colic should be excluded from the diet of sour vegetables, spinach, sorrel, cocoa, tea, coffee, fried food.

good means of prevention is physical activity - walking, swimming, gymnastics.

also good to help prevent attack cholagogue drugs or herbs with choleretic effect - corn silk, Agrimony, birch leaves (before taking consult with your doctor).

forecast

Prognosis depends on the cause of colic.If the attack provoked cholelithiasis, then with stones smaller than 5 mm forecasts are almost always favorable.In such a state does not require surgery, rocks out on their own.

In other cases, all leaping on the size of the stones, their character (cholesterol, calcified and so on.).

Biliary colic is a very dangerous condition that requires urgent medical assistance.The attack can last a few minutes or a few days, but in any case, such a condition requires additional diagnostics and specialist consultations.