Symptoms and treatment of cholecystitis

  Cholecystitis is a common surgical emergency abdominal disease, second only to acute appendicitis in incidence, generally occurring in middle-aged people. This is because people in middle age, work pressure, mental tension, the body is also gaining weight and so on, these factors will lead to an increase will have different degrees of neuromodulation and metabolic disorders, affecting the normal contraction and diastole of the gallbladder, so that the excretion of bile is not smooth, resulting in fat metabolism disorders, cholesterol deposition, easy to form gallstones, easily induced cholecystitis. The treatment of cholecystitis is based on Chinese medicine, so this aspect is regulated by the Chinese medicine practitioner’s prescription. Chronic cholecystitis generally manifests as abdominal distension, epigastric or right upper abdominal discomfort, persistent right upper abdominal or right scapular discomfort, and also indigestion symptoms such as stomach burning-heat, nausea, belching, acid reflux.  I. Chronic cholecystitis Chronic cholecystitis symptoms and signs are not typical. Most of the symptoms are biliary dyspepsia, aversion to fatty foods, epigastric distention, belching, stomach burning, etc., similar to ulcer disease or chronic appendicitis; sometimes due to stone obstruction of the gallbladder ducts, can be an acute attack, but when the stones move, the obstruction is lifted, that is, rapid improvement. On physical examination, there may be mild pressure pain or percussion pain in the gallbladder area; if the gallbladder is waterlogged, a round, smooth cystic mass can often be found.  Many patients with acute cholecystitis develop in the middle of the night after a greasy dinner, because a high-fat diet can make the gallbladder strengthen contraction, and lying down is easy for small gallstones to slide into and embed the gallbladder duct. The main manifestations are persistent pain in the right upper abdomen with paroxysmal intensification, which may radiate to the right shoulder and back; often accompanied by fever, nausea and vomiting, but chills are rare and jaundice is mild. Abdominal examination reveals right upper abdominal fullness, abdominal muscle tension, marked pressure pain and rebound pain in the gallbladder area.  Cholecystitis is a more common disease with a high incidence. According to its clinical manifestations and clinical course, it can be subdivided into two types, acute and chronic, often in combination with cholelithiasis. Acute cholecystitis with severe pain or colic in the right upper abdomen, mostly caused by stones or parasites embedded in the neck of the gallbladder, is often sudden and very intense, or presents a colic-like pain. In non-obstructive acute cholecystitis of the gallbladder duct, the pain in the right upper abdomen is generally not severe, but mostly persistent and distending.  The most common cause of acute cholecystitis is the sudden obstruction of stones in the gallbladder or an embedded cystic duct. In addition, during the aging process, the gallbladder wall gradually becomes hypertrophic or atrophic, and the contraction function decreases, resulting in bile stagnation, concentration and formation of bile salts; the end of the common bile duct and the sphincter of Oddi become relaxed, making it easy for retrograde infection to occur; systemic atherosclerosis and increased blood viscosity can aggravate gallbladder artery ischemia. After obstruction of the cystic duct or gallbladder neck, the stagnant bile in the gallbladder concentrates and forms bile acid salts, which stimulates the gallbladder mucosa and causes chemical cholecystitis (early stage); at the same time, bile retention increases the pressure in the gallbladder, and the swollen gallbladder firstly affects the venous and lymphatic reflux of the gallbladder wall, and the gallbladder becomes congested and edematous. The ischemic gallbladder is prone to secondary bacterial infection, aggravating the process of cholecystitis and eventually complicating gallbladder gangrene or perforation. In case of obstruction of the cystic duct without blood circulation disorders and bacterial infection of the gallbladder wall, gallbladder effusion develops. Recent studies have shown that phospholipase A can be released from the damaged gallbladder mucosal epithelium due to bile stagnation or stone impaction, causing the hydrolysis of lecithin in bile to lysolecithin, the latter in turn causing changes in the integrity of the mucosal epithelium causing acute cholecystitis.  Fourth, the treatment 1, bile bad in the attack period should be bed and temporary fasting, so that the gallbladder to get sufficient rest to be able to move to solve the discomfort. Supplementary nutrition by intravenous, or give complete gastrointestinal nutrition.  2, bad bile can be appropriate to participate in some physical activities to enhance physical fitness, but not in excess, because of excessive activity, related keywords: ankylosing spondylitis, consumption, the need to supplement high-energy food, which will greatly increase – increase the burden on the gallbladder.  3, avoid over – excessive exertion and often stay up late, because over – excessive fatigue is on the induced bile bad common cause.  4, take time to the countryside to dig some with the root of the tree Rong bitter vegetables, simply wash, boil water and boil soup, with brown sugar.  5, maintain a good state of mind Five, cholecystitis in the diet to pay attention to Less high-fat food pork, beef, mutton, cream, butter, fried food (especially hamburger eggs), animal offal, roe, and more oil pastries, etc., are high-fat food, cholecystitis patients should eat as little as possible such food. It stimulates the gallbladder to contract and secrete a large amount of bile. As a result, strong contraction of the gallbladder occurs, which causes an acute attack of cholecystitis.