Felchnokamennaya disease affects 10% of the population. This figure seems simply huge if you think about it. It is cholelithiasis complicated by hepatic colic, which may require an urgent surgical operation. What is hepatic colic and how to cope with it – this professional, but accessible language will tell the doctor.
Hepatic colic arises from the obstruction of the bladder duct by concernments that are in the gallbladder. This condition is accompanied by severe and unbearable pain and a violation of the outflow of bile. Acute pain syndrome occurs due to increased intra-abdominal pressure against the background of stone obturation. Provoke this state of physical overload, non-compliance with diet or other provoking factors.
According to many years of experience as a doctor, cholelithiasis (JSB) in its prevalence is second only to diseases of the cardiovascular system and diabetes mellitus. In many patients, specialists find stones quite accidentally. About their illness, patients will be informed at the time of the onset of obvious symptoms of hepatic colic.
Who suffers from hepatic colic more often: men or women?
In the scientific world, it is commonly believed that cholelithiasis and hepatic colic are more common in women. This is due to the relationship between hormonal activity and contractility of the gallbladder. The level of hormones in women is unstable. Hormonal restructuring of the body in men does not have such an effect on the formation of concrements. Frequent pregnancy and childbirth also increase the risk of gallstones formation.
Modern women love to experiment with diets, which has a negative effect on the work of all digestive organs. Sharp restrictions of any food, prolonged starvation promote the stone formation and disrupt the process of bile secretion with a change in its chemical composition. Large intervals between meals are strictly contraindicated, especially to people who have a history of heaviness. It is noticed that on the female line LCD is transmitted more often than in the male. However, in cases of hepatic colic in men are more common, and in women, the disease often has a latent flow for a long time.
Causes of hepatic colic
At the heart of hepatic colic lies a blockage of the cystic duct, which is due to the formation of stones and a violation of the ratio of certain components of the bile, which leads to its thickening and the formation of concretions.
Most often, the symptoms of hepatic colic in women and men are due to inaccuracies in the diet. In the CLS, specialists prescribe compliance with a certain diet (table number 5), and its violation leads to spasms of the gallbladder and the advancement of stones in the duct system. Because of the increase in intravesical pressure and the violation of bile outflow, a characteristic pain syndrome appears.
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Risk factors
Risk factors for hepatic colic:
- age of the patient: the risk of symptoms of hepatic colic increases after 40 years;
- pregnancy and frequent childbirth, which are combined with hormonal changes in the body;
- female sex: women often have concrements in the gallbladder, predisposed to hepatic colic;
- chronic liver diseases: they disrupt the chemical composition of bile and its outflow, which contributes to the appearance of concrements with further recurrences of hepatic colic;
- enthusiasm for diets and prolonged starvation;
- high content in the diet of animal fats, cholesterol;
- hypodynamia: lack of necessary physical activity is a risk factor predominantly in the male population;
- overweight: obesity is accompanied by the presence of several factors contributing to the formation of stones (high cholesterol, inefficient nutrition, an abundance of animal fats in the diet).
For colic in the liver, a connection with the consumption of fatty, spicy, overly spicy food and physical stress is characteristic. At the same time, the majority of patients remain, in whom acute pain in the liver region occurs spontaneously, without the action of causative factors.
Clinical manifestations and symptoms
Symptoms of hepatic colic are referred to as an emergency, requiring first aid. It is impossible to delay with the reference to the doctor since acute pain can last up to several days, while the ducts stretch, intravesical pressure rises, acute cholecystitis and other dangerous complications may occur.
The main symptoms of hepatic colic:
- severe pain in the right upper quadrant, where the area of the gallbladder projection is located;
- nausea and vomiting of bile, which does not bring relief to the patient;
- moderate flatulence;
- possibly a rise in body temperature;
- discoloration of stool;
- darkening of urine;
- the appearance of jaundice.
Clinical manifestations of hepatic colic depend on the size and amount of gallstones, their location, the presence or absence of other diseases of the digestive system. The most severe attack occurs when the stone is blocked by a common bile duct.
Colic can last several days, and all this time the patient feels unbearable pain. Vomit contains food, have a small amount of bile. Vomiting is accompanied by bloating, a delay in urine and stool. The general condition of the patient is heavy; from the pain, he finds no place for himself. Repeated vomiting, which occurs in many patients at the end of the attack, is yellow and has an increased viscosity.
Other organs may be involved in the pathological process, including the pancreas, duodenum, intestine. This explains the variability of the symptoms of hepatic colic in different patients. The older the person, the more often the CSF proceeds without acute pain and seizures. The pain syndrome is dull and persistent.
But one common symptom of hepatic colic is the pain. It does not always localize in the right hypochondrium, it gives up in the epigastrium, in the scapula, neck, and collarbone, and questioning the presumptive diagnosis (the doctor may suspect angina pectoris). The most painful syndrome in people with small stones in the gallbladder. The attack lasts an average of 15-30 minutes, but it can go up to 6-8 hours, which usually ends with an emergency cholecystectomy.
First aid for hepatic colic
When symptoms of hepatic colic occur, first aid should be given promptly. Usually, patients who have SCI immediately understand the seriousness of the situation, when only the pain begins to increase. In this case, they use the usual medicines and often relieve the pain syndrome at home. Doing this is not recommended because of the risk of rapid complications.
The patient during the hepatic colic is in very serious condition, and he cannot provide emergency help to himself. This calls into question the correctness of the actions that the surrounding people are taking. Because of excitement or haste, they can mix up medicines, which during colic are injected only by injection.
But sometimes there are situations in which the doctor’s help is impossible to get on time. Therefore, the use of antispasmodics and pain medication can literally save a patient’s life and help him avoid an emergency operation.
In hepatic colic, non-steroidal anti-inflammatory drugs can be used in injections (ketorolac, diclofenac) for intramuscular injections. In addition, antispasmodics are prescribed, which eliminate the spasm of the vesicular ducts, which leads to their expansion and restoration of the outflow of bile. Metoclopramide is used to achieve an antiemetic effect. The drug is usually combined with several antispasmodics.
If you do not know how to relieve pain with hepatic colic, do not take any independent action. Not all people at home have the necessary drugs, and even in the form of solutions for injections. Tablet medicines will not have the expected analgesic effect. It is better to immediately call an emergency ambulance or go to the nearest hospital yourself.
With the symptoms of renal colic, treatment does not require urgent! Procrastination can result in serious health consequences, up to a lethal outcome.
Cholecystectomy with hepatic colic
The outcome of often recurrent hepatic colic is cholecystectomy – an operation to remove the gallbladder, filled with concretes. The operation is indicated for cholecystitis and other complications of CLS. Laparoscopic cholecystectomy is the best option for many patients. The operation is not accompanied by pronounced damage to the abdominal wall; it has a decent cosmetic effect and helps to significantly shorten the rehabilitation period.
Cholecystectomy is ideally carried out 5-8 months after the last attack of hepatic colic. Experts recommend that the surgery is performed if the conservative therapy is ineffective and the risk of developing dangerous complications is high. If hepatic colic occurs for the first time, expectant management is recommended, but with diet and all medical recommendations.
Diet with hepatic colic and prevention of its appearance
Compliance with diet in diseases of the gallbladder, including with cholelithiasis, allows for a high efficiency to conduct conservative treatment. Chlorin proceeds chronically, many patients for 5-10 years do not even guess about their condition and only the appearance of hepatic colic forces them to turn to specialists.
The main principle of therapeutic nutrition with a tendency toward the emergence of acute pain is the restriction of dishes that contain animal fats and increase cholesterol. It is allowed to eat a lot of fruits and vegetables, but it is strictly forbidden to fry food. You can cook food or bake. Stew is permissible, but only very rarely. If the products contain a large amount of fiber, it is better to grind them or significantly grind them. This rule applies to wiry meat.
It is recommended to abandon foods that contain oxalic acid and purines. Limit and use of salt, but not in all cases. To eat it is necessary in small portions, but not less often 5-6 times a day. Large intervals between meals are extremely negative for people with diseases of the biliary tract. The daily volume of the liquid is not less than 1.5 liters. It is better to give up carbonated drinks. Restrictions also apply to foods that increase flatulence. This does not mean that you will have to permanently abandon the legumes, cabbage, but these products are better to eat several times a week, not daily.
From meat, it is better to give preference to low-fat varieties: rabbit, veal, and poultry without skin. Necessarily included in the diet of fish. It should also be a moderate fat, cooked for a couple or boiled in a little-salted water. Refuse alcohol, as it can provoke a sudden hepatic colic. It is also not recommended to abuse strong coffee and tea, spices and seasonings.
With a reasonable approach to compliance with diet and other medical recommendations, relapses of hepatic colic will occur extremely rarely. In this case, experts recommend that the gallbladder is preserved and delayed with cholecystectomy.
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A common mistake of people with cholelithiasis is to underestimate the importance of dieting. Long-term medical experience makes it possible to state unambiguously: patients who do not eat fatty and roast, refuse alcohol and excessive physical exertion, can forget about their condition for many years and feel absolutely full and healthy people.
