Inflammation of the gallbladder

definition

The pear-shaped Gallbladder (lat: vesica biliaris or cholecystis) is with about 10cm length and 4cm width In comparison, it is a rather small organ in the human body, but it can do so in the event of a disease strongest pain cause. The gallbladder is protected in an indentation at the bottom of the liver in the right upper half of the abdomen approximately at the level of the last rib.

They can be found in your immediate neighborhood liver, of the stomach and the Duodenum. The term bile for the gallbladder is incorrect, as only bile is contained in the gallbladder liquid referred to as. However, the bile itself is not produced in the gallbladder, but in the liver, which carries the bile through many smaller bile ducts and a large bile duct into the gallbladder, where it is then stored until it is needed.

This intermediate storage plays a role especially between meals, as the bile is used Digestion of food is needed and bile produced between meals can be accumulated and stored until the next meal. That way stand roughly at every meal 50ml bile to disposal.

In addition, the Bile Water is withdrawn from the bile so that the stored bile is more concentrated than the bile that comes directly from the liver. Concentration gives you more, among other things Bile acids and Cholesterol present in the same amount of bile.
The bile gets along with the fluid after eating pancreas through a common passage into the Duodenum, the first part of the intestine directly connected to the stomach.

There the bile serves the Digestion of fatsby breaking down fats into small fat droplets so that the fat splits up Enzymes can work well. In addition, the bile can transport waste materials out of the body that cannot be passed through other organs like the body kidney can be transported away if, for example, they are not soluble in water or urine.

These include, for example Breakdown products of drugs or Bilirubin, a breakdown product of old blood cells that gives bile its yellowish-brownish color. Since the production of bile is a very energy-consuming process for the body, part of the bile in the last part of the small intestine is absorbed back into the body and recycled so that the fluid does not always have to be produced from scratch.

root cause

The most common form of inflammation of the Gallbladder (lat: cholecystitis) arises as a result of a Gallstone disease (=Cholelithiasis). Other causes can rarely be identified and are usually found in patients after major operations or accidents or with the most serious illnesses such as Tumors, hepatitis or Poisoning.

In order to save space, a large part of the water it contains is withdrawn from the bile in the gallbladder, which is enormous Thicken the liquid has the consequence. Due to the enormous dehydration, if the composition of the liquid changes, the components can precipitate Gallstones arise.

Since mostly the Cholesterol percentage Is out of balance, cholesterol stones are usually formed. However, these do not always cause discomfort and the stones can be an incidental finding during one Ultrasound examination getting discovered. They only become painful when they clog the bile duct and a Biliary colic arises. The body then tries similarly to one renal colic move this stone through wave-like muscle movements towards the exit Duodenum to transport.

Due to the backlog of secretions in the gallbladder, the highly concentrated and sometimes very aggressive components like the Bile acids ignite and a gallstone disease arises Inflammation of the gallbladder. The normal ones Gut inhabitants like E. coli or enterococci or Proteus can work their way up through the bile ducts and the biliary block to the gallbladder and themselves implant in the gallbladder and multiply. The inflammation can be intensified by the rising intestinal germs. A doctor can usually quickly determine whether gallstones or other drainage disorders are the cause using his examination methods.

Symptoms

The symptoms of gallstones and biliary colic are usually very impressive and are expressed in persistent strongest wavy, that means increasing and decreasing Pain in the upper right half of the abdomen.

This pain is accompanied by nausea and Vomit. If the gallbladder is already inflamed, a typical one develops severe pain when pressing on the gallbladder or even at rest in this same region and it occurs not infrequently fever as a sign of inflammation. The pain can also often radiate into the left shoulder.

Because the bile mainly after eating is released, the gallbladder is more active at this point than between meals and the gallbladder occurs strongest complaints thus also after eating. The patients do not report any fatty foods to be able to consume more.

If the bile builds up back into the liver, that too can happen Bilirubin with its yellowish color no longer excreted in the bile can and remains in the body. If the amount exceeds a certain limit value in the body it is as yellowish color of the skin, the so-called Jaundiceto recognize (=Jaundice). Due to the lack of fat digestion in food, the fat remains in the intestines and stool. This then becomes shiny from the fat and changes its color to grayish, since the brownish color is caused by the bilirubin that has remained in the body due to the blockage of the bile duct.

diagnosis

Biliary colic is usually easy to diagnose due to the typical increasing and decreasing pain. Only renal colic on the right side would cause pain similar to that of gallbladder inflammation or gallstones. The pain when pressing the bile region under the costal arch during the physical examination suggests inflammation of the gallbladder.

To confirm this, doctors usually do an ultrasound examination (=Sonography) carried out. Stones and a gallbladder wall that has thickened due to the inflammation are usually easy to see on the screen during an ultrasound examination and ensure the correct diagnosis. Signs of inflammation can also be found in the blood. Important markers here are the so-called sedimentation rate and CRP. Liver values ​​provide information about whether the bile congestion is already reaching into the liver. In cases that are still unclear, the doctor can also examine the bile duct and gall bladder with an examination similar to a gastroscopy, with the difference that a camera is used instead of an ultrasound head. This examination is called endosonography.

In unclear cases, an MRI of the liver can also be performed. The MRI of the liver also includes the gallbladder in the imaging, so inflammation in the gallbladder can also be identified by the MRI.
Read more about this at: MRI of the gallbladder and ultrasound of the abdomen

therapy

The treatment of choice for inflammation of the gallbladder is its surgical removal within a few days (=Cholecystectomy).

Surgery during inflammation is performed only in exceptional cases. Instead, the time is brought forward a few days later when the inflammation has subsided, as fewer complications then occur. The operation usually no longer takes place through a large incision on the abdomen but rather through several small incisions through which thin instruments and a camera are inserted. This type of surgery is called laparoscopy, and gallbladder removal is called cholecystectomy.

Read more about gallbladder removal here.

Until the operation, the patients are treated with painkillers and also receive medication that relaxes the muscles of the bile ducts and so the colic subside.
Very rarely surgery is not possible for patients and they are treated without surgery. However, this type of treatment is associated with high complications such as gallbladder rupture or death (lat: necrosis) and should therefore remain the exception, since bile in the abdomen can quickly cause a life-threatening clinical picture, the so-called peritonitis (lat. peritonitis, peritoneum= Peritoneum). It is therefore important to avoid this incident at all times.

If only smaller stones are the cause of the complaints, there is the so-called ERCP (=endoscopic retrograde cholangiopancreatography). Similar to a gastroscopy, a tube is pushed into the duodenum and the biliary tract and stones can even be removed directly with a small tool.

The heat pillows used to alleviate biliary colic should no longer be used in the case of gallbladder inflammation with or without fever, since inflammation alone means overheating that should not be increased. From the area of ​​medicinal plants, earth smoke, caraway, fennel or even goose foxwort are suitable for biliary colic. Marigold, chamomile, devil's claw or bearberry can also relieve inflammation. The herbs are recommended primarily as tea and can often be purchased as a finished product.

If gallstones are present, medicinal plants that promote the flow of bile should be avoided, since the gallbladder is already irritated and no additional aggressive bile should be added.

forecast

After the gallbladder has been removed, the affected person is considered cured. However, the prognosis worsens with an accompanying one Inflammation of the pancreas (lat: pancreatitis: Pancreas = pancreas) or one Rupture of the gallbladder (lat: rupture) with subsequent life-threatening Peritonitis (lat: peritonitis).

After the removal, those affected face an almost normal life. Only at large, high-fat meals could complaints occur, otherwise can normal whole food should be consumed and only foods that actually cause problems should be avoided stomach pain or diarrhea prepare. Only in rare cases occurs after the removal of the gallbladder the so-called Postcholecystectomy-syndrome on which one with frequent abdominal pain and Diarrhea goes hand in hand and causes severe discomfort for those affected.

prophylaxis

A prophylaxis inflammation of the gallbladder is only possible to the extent that one of the Prevents the formation of gallstones. This is through a Nutrition rich in fruit, vegetables and whole grains quite possible. Furthermore applies Obesity and very fatty food as a risk factor and in reverse Weight reduction such as exercise as protective and risk-reducing.

Fat should not be avoided entirely, but eaten in moderation and Vegetable fats should be preferred to animal fats, this one easier to digest are. Boiled eggs in particular contain a large amount of fat and Cholesterol levels and should rarely be on the menu.

Smaller meals lead to one more uniform need for bile and prevent prolonged concentration in the gallbladder with an increased risk of gallstones forming. There is also air in the intestines, so Flatulence Should increase the pressure on the gallbladder, such foods as bloating Cabbage or legumes should be avoided if it can provoke gallbladder pain.

From the field of Medicinal plants are suitable artichoke, Chicory, dandelion or also the Milk thistle to increase the biliary function. The bile production are also stimulating Field mint, Wild garlic, artichoke, mugwort, tarragon, nutmeg, sage, radish, Black cumin or also the Chicory.

Risk factors

In principle, anyone of any gender and any age can be affected by gallstones and gallbladder inflammation. Next diet-related risk factors and bad lifestyle habits there is still the so-called 5F rule from the English usage to describe the risk factors for the development of gallstones. You designated

1.) Female = women
2.) Fertile = fertile: high Estrogen levels increase the risk of gallstones
3.) Fat means being overweight
4.) Fourty, that means over 40 years
5.) Fair = blonde.