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Biliary pain - causes and symptoms
contents
- Biliary pain definition and symptoms
- Pain from gallstones
- cholecystitis
- Bile problems caused by mental stress
- Diet for gallbladder pain
- treatment
- Naturopathy and home remedies for gallbladder pain
In any case, to find out the cause of the gallbladder, a doctor should be consulted. With the help of close examination, laboratory tests and imaging techniques (such as ultrasound), the patient can determine exactly whether there is bile disease. The visit to the doctor is very important, because If gallbladder inflammation is not treated in time, serious complications such as Liver abscess or intestinal obstruction occur.
Gallstones in the gallbladder are often responsible for severe pain. Image: Henrie - fotolia Biliary pain definition and symptoms
The term "bile" is colloquially commonly referred to both the gallbladder and the bile contained therein. But that is not quite true, because the bile duct system also has numerous bile ducts, some of which are finely branched within the liver, leading to the gallbladder and from there returning as liver disease from the liver. Together with the main or pelvic duct of the pancreas, this finally opens in the papilla of the duodenum ("duodenum"), which forms the connecting piece between the stomach and the jejunum.
The pear-shaped gallbladder is located on the underside of the liver and provides - as e.g. The lungs and uterus - a so-called "hollow organ" dar. The task of the gallbladder is to store the bile produced by the liver, to thicken and if necessary through the bile ducts in the duodenum give. The secretion created between meals serves on the one hand through its fat-soluble components of fat digestion. In addition, the bile supports the discharge of fat-soluble degradation products from the liver, by getting these with the liquid in the intestine and excreted ("defecation of the liver").
The gallbladder and the bile ducts are very sensitive structures, which is why even the smallest changes can lead to discomfort in this area. If the flow of bile, e.g. Blocked by gallstones, this can be massive upper abdominal pain and a number of other unpleasant consequences such. Cause sweating, nausea and vomiting. However, it is not always an organic cause of gallbladder pain. Instead, it may also be a functional disorder of the gallbladder and biliary tract. Although this causes similar or the same symptoms as a recognizable bile disease, but is based on mental stress such. pent up anger, anger or unresolved conflicts.
Pain from gallstones
Especially gallstones can cause severe pain. These are solid, crystalline deposits in the gallbladder or bile ducts, which affect up to twenty percent of all people in this country. However, the deposits often go unnoticed ("dumb stones") and lead to problems only in about every fourth case. The size of the stones can vary widely and range from a few millimeters ("semolina") to several centimeters.
The formation of gallstones can have many reasons. Most of the bile is water, plus a number of other substances, such as Cholesterol, bile acid, calcium carbonate and the bile pigment bilirubin. If these components are in a specific relationship to each other, they remain dissolved in the liquid and form a stable bile juice. However, if one of the substances is too high in concentration, it can crystallize out and gallstones are formed - which in most cases consist of cholesterol (cholesterol stones) or bilirubin pigment material (pigment stones). Sex seems to play a key role, because women are affected much more frequently than men. Other important risk factors include a high-fat diet, lack of exercise, obesity and age.
Likewise, certain diseases such as diabetes mellitus and inflammatory bowel diseases such as Crohn's disease and ulcerative colitis may have a beneficial effect on the development. Experts often talk about the so-called "6F rule" in connection with gallstones. According to this, women ("female") are over 40 years ("forty"), who have already had several children ("fertile"), overweight ("fat") and a rather Nordic type are ("fair") of Gallstones affected. In addition, there is a genetic predisposition to the disease, which is why the likelihood increases even more, if already in the family gallstones have occurred ("family").
In most cases, gallstones pose no danger, but if they reach a certain size, serious problems can arise. Because they block the gallbladder or common bile duct, an increase in pressure in this area is possible, which in turn can lead to severe gall bladder pain.
The pain known as "biliary colic" occurs in the right upper abdomen, but can also radiate into the shoulder and go along with nausea and vomiting. Patients with gallstones usually report attack-like upper abdominal pain, which can last for up to several hours, but then go away by itself. If the bile can no longer flow unhindered and accumulates accordingly, serious health consequences such as inflammation of the gallbladder or biliary tract, jaundice, liver damage or, in very rare cases, even a gallbladder tumor can occur. Therefore, the complaints should definitely be medically clarified.
cholecystitis
An acute gallbladder inflammation (cholecystitis) may be the reason for the complaints. This is a feverish disease that is usually caused by gallstones (calculus). It is also possible in rare cases, however, that it arises without gallstone (akalkulös), for example, as a result of a major abdominal surgery, a wound in the upper abdomen or inflammation of other organs (such as kidneys). Other rarer causes are infections (e.g., by Salmonella), malformations, polyps, and tumors of the gallbladder, and parasites, e.g. Roundworms are responsible for the discomfort. Typical for a disease caused by gallstones are violent, attack-like pains ("biliary colic") in the right upper abdomen, which are described by many sufferers as dull or oppressive and can last from a few minutes to several hours. Often they radiate at the same time in the shoulder and back area and are therefore experienced as hardly bearable.
Such colic often occurs after rich and fatty food, which stimulates the gall bladder to release bile acid. The stone is moved and transported into the narrow bile ducts, where it can get stuck in various places and thus cause massive pain. In addition, constipation, bloating, flatulence, nausea and vomiting, as well as the symptoms of jaundice (jaundice), e.g. Yellow eyes occur because the bile pigment bilirubin can no longer flow freely due to the obstacle and deposits in the tissue. Since this is due to lack in the small intestine, resulting in a light bowel movement or in some cases, fat stool. It is also possible a strikingly dark urine due to the "redirected" excretion of the dye via the kidneys and a strong itching by the increased concentration of bile acid in the blood and in the skin.
The congestion of bile on the way to the small intestine increases the risk of infection of the bile system with bacteria, which can spread from the site of the occlusion (usually the gallbladder) back into the gallbladder. In this case, upper abdominal pain typically persists and fever is common, often accompanied by chills, a painfully tense or hard abdominal wall, pressure pain during palpation and discomfort caused by inhalation. If the inflammation takes a chronic course, sufferers often suffer from dull, persistent pain in the right upper abdomen, which sometimes occur intermittently. Besides that, indigestion is a typical symptom.
If the symptoms described occur, then in any case a doctor should be consulted as soon as possible in order to clarify the exact cause and to avoid serious complications. An early treatment is very important, then the inflammation heals in most cases without problems and consequences. If an acute cholecystitis remains untreated, it can lead to life-threatening complications. For example, it is possible that the gall bladder tears, allowing the bile to flow into the abdominal cavity. In this case, a serious, purulent peritonitis (peritonitis) threatens, which must be treated immediately.
Gallstones. Image: Martha Kosthorst - fotolia In addition, there is a risk that the inflammation of the gallbladder passes to the liver and leads here to delineated accumulations of pus (liver abscess). It can reach the gallstones to the intestine and there, for example, a bowel obstruction ("gallstone ileus") cause possible, inter alia, a collection of pus in the gallbladder (Gall bladder emptying). Chronic inflammation that is not treated appropriately increases the risk of developing gall bladder cancer.
Bile problems caused by mental stress
"I'm getting bile up" or "I could spit venom and bile": Proverbs like this suggest that bile pain can also be triggered by physical stress or anger, intense tension and anxiety. Since no organic disease can be found in this case, medics - such as e.g. also with the irritable stomach or irritable bowel syndrome - from functional complaints. In this so-called "bile duct dyskinesia" (also called "irritable gallbladder") muscle cramps ensure that the function of the gallbladder and bile ducts is impaired and as a result the bile can no longer flow unimpeded towards the intestine.
As with a gallstone disease caused by colicky abdominal pain on the right side, which can occur both for a brief moment as well as permanently and can also be expressed in parallel in the form of shoulder punctures.
Abdominal pain due to stress. Image: gpointstudio - fotolia In addition, especially after eating greasy, luscious food and after drinking coffee or alcohol, stomach problems and indigestion, such Flatulence, fatty stools or diarrhea occur. In view of these symptoms, the irritable gallbladder often leads to a misdiagnosis at first, therefore, a thorough examination of the affected person is very important. Often, however, it is difficult to exclude other gall bladder disorders - therefore, a clear determination of the cause can only be achieved through a comprehensive blood test and imaging techniques such. Ultrasound done.
Diet for gallbladder pain
In many cases, nutrition plays a central role in case of gallbladder pain. In the case of problems, therefore, this should always be considered carefully and, if necessary, changed. This is far less serious than it may sound to many. Because while in the past bile problems often led to a radical diet, from today's point of view nothing speaks against a largely "normal" diet - provided that some important points are taken into account. Even after gallbladder surgery, there are usually no major limitations. On the other hand, during an acute biliary colic, as well as directly thereafter, food should be avoided.
Those who suffer from bile problems should generally avoid too much fat. High-fat foods can cause biliary colic and are therefore not recommended for gallstones. The background is that they cause the gallbladder to contract to release extra bile for the purpose of digestion.
It is important to find the correct measure, because a largely fat-free diet is also not recommended, since the bile juice is therefore rarely required in the gallbladder. As a result, the fluid in the gallbladder collects and concentrates, which also increases the risk of gallstones. This situation often occurs during diet or fasting, so people with an increased tendency to stone suffering should better refrain from it.
It is important to ensure a balanced, high-fiber diet, with better smaller portions instead of lavish dishes are taken. As an orientation, it can serve so much that is eaten per meal, that you feel full, but still moving. Experts recommend reducing animal fats and instead use them more often than vegetables, salads, whole grains, etc. To eat fish. In general, a high quality vegetable oil should be used in the preparation better to relieve the liver and gallbladder. Should also be dispensed hard boiled eggs, because these are particularly difficult to digest and can even trigger a colic in large quantities. Cooked differently and in smaller portions, there is usually nothing to worry about, so bile patients can occasionally eat egg-containing foods.
Frequently, even bloating foods are not well tolerated, so be careful with cabbage, legumes, salsify, onions and garlic. Here, those affected should try out themselves, which foods are problematic or where the individual limits are and accordingly shape their diet.
The right "bile eating": artichoke, zucchini ... Image: M.studio - fotolia In the case of gall-bladder problems, foods such as e.g. Soybeans, lentils, peas, zucchini, chicory and artichokes, as these are good for the health of the liver and support the bile flow. Likewise, vitamin C-rich fruit can have a positive effect, as it converts excess cholesterol into bile acid, thereby preventing gallstones. In particular, vitamin C is found in sea buckthorn berries, rose hips and black currants. Grapefruit, guava, grapefruit and strawberries are especially good.
treatment
In the case of gallbladder inflammation, the therapy is dependent on the cause or the severity of the disease. Especially when these are caused by large gallstones, surgical removal of the inflamed gallbladder is recommended for most patients (cholecystectomy). This should be done as soon as possible after the onset of symptoms to avoid complications and is usually performed minimally invasive or with the help of the so-called "keyhole surgery" (laparoscopic) under general anesthesia. However, an open surgery in which the surgeon removes the gallbladder through abdominal wall incision is today rarely used, such as in the case of an abdominal incision. a greatly increased inflammation or when suspected of having a tumor applied. In addition to the intervention usually antibiotics is also used to treat bacterial inflammation, anticonvulsant drugs can also relieve the pain.
If the patient has been suffering from the symptoms of gallbladder inflammation for more than three days, surgery will normally not be performed for safety reasons. Instead, the person also receives antibiotics and antispasmodic and analgesic drugs. In addition to relieving the gallbladder for at least one day should be completely dispensed with food and also the days on which nothing greasy or fried foods are eaten. After the acute phase of the disease subsides, however, the gallbladder should also be removed in order to remain symptom-free in the long term. The procedure is largely risk-free and most patients can leave the hospital after just a few days.
If organic causes can be excluded for bile pain, the treatment of the so-called "gallbladder irritation" (bile duct dyskinesia) is often in the learning of appropriate relaxation methods to reduce the personal stress level. Here, depending on personal taste, various relaxation methods and techniques such as e.g. Progressive muscle relaxation according to Jacobson or meditation in question, as well as enjoy traditional Asian exercises or martial arts such as Qigong and Tai Chi in recent years, an increasing popularity.
Other methods to promote relaxation, such as exercise, a walk in the fresh air or a soothing bath can often help relieve the stress-related symptoms. Nutrition also plays an important role. Oily and rich meals and alcohol should be avoided to relieve the gallbladder. Instead, a low-meat or vegetarian whole foods are recommended, and it is important to drink enough at all times. Obesity should be reduced as far as possible, as this exerts pressure on the abdominal area and can therefore increase the discomfort. It may be helpful in the food preparation certain spices such. Use turmeric, ginger and curry as they help with digestion and stimulate bile flow.
Naturopathy and home remedies for gallbladder pain
Outside of the acute stage, gall bladder problems can also be alleviated with the help of various home remedies and naturopathic procedures. From the field of herbal medicine come here, for example Celandine, yarrow, verbena and calendula, which have proven especially in a disturbed bile flow. In the case of gallstones, a tea made of peppermint, artichoke or bitter clover is also suitable. In case of gallbladder inflammation, an infusion of bearberry, chamomile or calendula may be helpful.
From the area of the Schüssler salts the salt No. 7 (magnesium phosphoricum) can help to relieve the bile pain. The Nr.10 - Natrium sulfuricum - is generally considered in naturopathy as a supportive agent for liver and bile. Homeopathy offers, among other things, the remedy Colocynthis for severe symptoms - especially if the pain radiates into the back and relax with slight movement. On the other hand, if only absolute immobilization improves the situation, homeopaths usually recommend Bryonia alba (D6 - D12). If the pain occurs as a result of excitement, anger, and rage, and the tension gets even worse during colic, Chamomilla vulgaris may be the drug of choice.
If stress is the cause (bile duct dyskinesia), it is also important to critically examine the personal stress and to develop effective strategies for mental relief. Short-term complaints as a result of internal restlessness can often be alleviated already by a warm grain pillow or a soothing tea. Chamomile or lemon balm are particularly well suited here, as well as other home remedies for abdominal pain such as vinegar wrap have proven in a cavernous gallbladder. For this, a towel in hot vinegar water (1El to one liter of water) dipped, wrung and placed on the aching stomach for about 20 minutes. In order not to "bile up" because of anger, anger or tension, herbal medicine with valerian, hops or lavender offers valuable help for "first aid".
In addition, however, should always searched for the cause of stress-related gallbladder and therefore be concerned with possibly unpleasant issues. "What makes me so upset?", "What worries I eat into myself?", "Who or what makes me so angry that I want to spit poison and bile?". A valuable support can be various methods and techniques for stress reduction, such as autogenic training, yoga or breathing exercises. Because these help the person concerned to focus on their own person and to find the inner balance again. In order to be able to work on deeper conflicts, traumas etc. and to understand the motives for one's own behavior, in some cases psychotherapeutic treatment can be very useful. (No)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)