How is cholecystitis treated? How to treat cholecystitis

Cholecystitis is caused by long-term dampness and heat in the liver and gallbladder, chronic diseases need to be carefully recuperated, they are the best doctors, the diet must be well controlled, high cholesterol and high fat, you have to try not to eat or eat less including (wine, chili, fatty meat, animal offal, fish roe, egg yolk, milk, etc.); Another is personal emotion, gallbladder is the positive organ, the most can not be angry, some patients are angry inevitably, so this is also very important, and the other is not to stay up late, from 23 to 3 o'clock in the morning, respectively, the active period of liver and gallbladder (this is why cholecystitis patients have severe pain at night)) So try to fall asleep before 23 o'clock!

There is a small method of dietary therapy recommended to you, that is, to cook soup with wild bitter cabbage and drink, drink it three times a day, add an appropriate amount of brown sugar before drinking, and insist on it for about a month, the symptoms of cholecystitis can be relieved or disappeared without any ***, and the effect is quite good.

The ** of cholecystitis mainly includes conservative and surgical, minimally invasive**. If you are a patient with chronic cholecystitis that does not affect your life, you can be advised to take medications**, common drugs are gallstone retone tablets, anti-inflammatory choleretic tablets, etc. However, if the disease is reversed and it is an advanced patient, timely surgery is required.

Symptoms of cholecystitis in middle-aged and elderly people and related common sense.

Cholecystitis is divided into:

1) Many patients with acute cholecystitis develop their illness in the middle of the night after eating a greasy dinner, because a high-fat diet can strengthen the contraction of the gallbladder, and lying flat is easy for small gallstones to slip into and incarcerate the cystic duct. The main manifestations are persistent pain and paroxysmal exacerbation in the right upper quadrant, which can radiate to the back of the right shoulder; It is often accompanied by fever, nausea and vomiting, but chills are rare and jaundice is mild. Abdominal examination revealed that the right upper quadrant was full, and the abdominal muscles in the gallbladder region were tense, markedly tender, and rebound tender.

2) Symptoms and signs of chronic cholecystitis are atypical. Most of the manifestations are biliary dyspepsia, aversion to greasy food, epigastric distention, belching, heartburn, etc., which are similar to ulcer disease or chronic appendicitis; Sometimes the cystic duct is obstructed by a stone, which can be acute, but it improves rapidly when the stone moves and the obstruction is relieved. On physical examination, there may be mild tenderness or percussion pain in the gallbladder area; If there is fluid in the gallbladder, a round, smooth cystic mass is often palpable.

Cholecystitis is divided into acute cholecystitis and chronic cholecystitis, the classic of acute cholecystitis, is cholecystectomy, but for the initial symptoms are relatively mild, you can consider using non-surgical ** first, control inflammation and symptoms, and then elective surgery after the disease is controlled**, for more severe acute purulent, or gangrenous cholecystitis or gallbladder perforation, surgery should be carried out in time**. However, adequate preoperative preparations must be made, including correction of water-electrolyte and acid-base balance, as well as the application of antibacterial drugs, etc., non-surgical ** methods are still effective for most, about 80% of patients with early acute cholecystitis, the method mainly includes fasting, antispasmodic, analgesic, antibacterial drug application, as well as correction of water and electrolyte acid-base balance, as well as systemic support**. At present, it is believed that the early operation of the patient does not increase the mortality and complication rate of the operation, but the time required for hospitalization and recovery work is relatively short, but the early operation is not equal to emergency surgery, but the patient is admitted to the hospital after a period of non-surgical ** and preoperative preparation, and the application of ultrasound and examination to further confirm the diagnosis, and the time of onset of the disease, no more than 72 hours under the premise of surgery.

Chronic cholecystitis is mainly based on elective surgery, the first choice is laparoscopic cholecystectomy, in the case of unclear anatomy of the gallbladder and bile ducts, as well as bleeding or bile leakage, and can not be satisfactorily controlled, should be timely transferred to laparotomy, for comorbidities that may increase the risk of surgery, should be corrected in time, such as cardiovascular disease, liver cirrhosis and so on. Patients should be followed up with regular ultrasonography, and if the gallbladder wall is found to be thickened beyond 5 mm, or if there is a localized irregular bulge, the gallbladder should be removed with surgery as soon as possible.

There are two types of cholecystitis: acute and chronic. There are generally three methods for acute cholecystitis**: 1. Internal medicine**

General**, rest, fasting, and intravenous replenishment of nutrient solutions, water, and electrolytes; Antispasmodic and analgesic: Atropine, nitroglycerin, and demerol can be used to relieve spasm and pain of the ODDI sphincter. 2. Antibacterial**:

The choice of susceptible antibiotic can be based on culture and susceptibility testing, and ampicillin or cephalosporin is often used. 3. Surgery**: At present, there are still differences in the most appropriate time for surgery, but surgery is still suitable for all acute cholecystitis, and all cases with onset of disease after 72 hours should be operated on as soon as possible.

There are generally two methods for chronic cholecystitis: 1. Internal medicine**: low-fat diet, oral magnesium sulfate choleretic, ursodeoxycholic acid can be used; People with parasitic infections should be dewormed**.

2. Surgery: For chronic cholecystitis with symptoms and chronic stones, cholecystitis resection should be the main treatment; This type of removal is controversial for gallbladders with only dyspepsia symptoms and no stones in the gallbladder.

Expert tips: the best method of cholecystitis should be determined according to the specific situation of the patient, whether the cholecystitis patient is acute or chronic, whether it is accompanied by stones, whether the patient has other complications, whether it is allergic to drugs, and the specific method should also be analyzed for specific problems.

**Cholecystitis requires a combination of medical drugs** and surgery to determine the optimal ** plan according to the patient's condition and comprehensive situation. If surgery is chosen**, laparoscopic cholecystectomy is commonly used.

Patients with cholecystitis often experience abdominal pain and gastrointestinal symptoms such as nausea and vomiting, and it is recommended that patients with cholecystitis can take relevant symptomatic measures**. For example, antiemetic and analgesic measures may be given, and antibiotics may be given if necessary**. If the patient's symptoms do not improve after taking medication**, it is recommended that the patient can go to the hospital to take intravenous antibiotics** under the guidance of a doctor, and eat a lighter diet.

If you have cholecystitis, you need to see a doctor and take medication as recommended by your doctor. Usually pay attention not to get angry, don't get tired, eat less foods high in protein, and eat lightly.

Symptoms of cholecystitis generally include severe pain in the upper right abdomen, accompanied by nausea, vomiting, and increased body temperature. Cholecystitis is generally treated with drugs**, first for analgesia, and some painkillers, such as nitroglycerin. Antibacterial and anti-inflammatory** are also required, and the drug selection is aminocarcillin, clindamycin, cephalosporin, etc.

Assist in taking some choleretic drugs, such as magnesium sulfate and bile acid tablets. If the disease is severe, surgery** is required to remove the inflamed gallbladder. In life, we should pay attention to food hygiene, it is not easy to eat too much, exercise moderately, and do not squeeze the abdomen.

Cholecystitis, whether acute or chronic, is recommended to be surgically removed, which is also the best way to cholecystitis. Of course, most patients are afraid of surgery and still refuse surgery.

The principle of non-surgical ** can only be symptomatic**. If bed rest, fasting, and severe abdominal distension are required, a gastric tube is required, water is fasted, support, fluids, electrolyte replenishment, and acid-base balance is regulated**.

**Measures have the following aspects Dietary adjustment: The onset of cholecystitis is related to diet and obesity, and regular, low-fat, low-calorie diets are recommended, and quantitative and regular eating methods are advocated. Antispasmodic and analgesic:

It is used for biliary colic during acute attacks of chronic cholecystitis. Intramuscular injection of atropine and promethazine can be used; The analgesic meperidine is injected intramuscularly, which is used in combination with antispasmodics to enhance analgesia. Choleretic**:

Azimide and ursodeoxycholic acid are commonly used. The application of compound azinamide helps to improve the symptoms of biliary dyspepsia, so as to increase the concentration of pancreatic enzymes in the digestive tract and enhance digestion; Ursodeoxycholic acid is a hydrophilic dihydroxycholic acid, which has the mechanism of action of expanding the bile acid pool, promoting bile secretion, regulating immunity, and cell protection. Surgery**:

Indications: Pain without relief or reversal, affecting life and work; gradual thickening of the gallbladder wall up to 4 mm or more; Gallstones are increasing and enlarging year by year, combined with hypofunction or disorder of the gallbladder; The gallbladder wall is ceramic-like.

Drugs**.

Antispasmodic painkillers.

For patients with acute cholecystitis, sudden abdominal pain or chronic cholecystitis, meperidine can be used for pain relief, and meperidine can be used in moderation for severe pain, but meperidine is used for addiction and cannot be used repeatedly.

In order to avoid the occurrence of infection, antibiotics should be treated with ampicillin, metronidazole, and second- and third-generation cephalosporins**.

Choleretic drugs. It can be taken orally with anti-inflammatory choleretic tablets, choleretic tablets, bile acid tablets, etc.

Surgery**:Cholecystectomy.

Laparoscopic cholecystectomy is preferred, but conventional or small incision cholecystectomy may also be used. Suitable for those who have onset within 48 to 72 hours; Those who are ineffective or worsened by non-surgery**; Patients with complications such as gallbladder perforation, diffuse peritonitis, complicated by acute purulent cholangitis, acute necrotizing pancreatitis, etc.

For patients with simple gallbladder inflammation, the first method is generally conservative. If the patient is suffering from chronic cholecystitis attacks, it is more likely that the patient has swelling pain and discomfort in the right upper abdomen and back after eating fatty foods or high-protein diets, and this swelling pain and discomfort is generally mild. If the patient is an acute cholecystitis attack, the general patient has more severe pain and discomfort, and generally cannot tolerate it, at this time, it is generally necessary for the patient to actively consider intravenous infusion of cephalosporin antibiotics, as well as metronidazole, tinidazole and other drugs to actively reduce inflammation**.

In addition, if the patient has gallbladder inflammation and gallstones, it is recommended that laparoscopic cholecystectomy or cholelithotomy be considered as early as possible**. In addition, for some patients with gallbladder inflammation for more than half a year, if the patient is conservative and the effect is not good, further laparoscopic cholecystectomy surgery should also be considered.

Cholecystitis, as a very common benign disease of the biliary system, does not matter the best way. Depending on the severity of cholecystitis and the frequency of attacks, different methods are used. Generally speaking, for chronic cholecystitis, that is, gallbladder stones and gallbladder polyps caused by gallbladder mucosal instrumental injury, anti-inflammatory choleretic tablets are generally used to increase the secretion of bile acids, so as to make the bile unobstructed, avoid causing biliary cholestasis or biliary tract infection, and can effectively control the symptoms.

In terms of traditional Chinese medicine, you can choose Depu de Li bile beam tea to help reduce inflammation in the gallbladder.

If acute cholecystitis occurs, usually secondary to bacterial infection, cephalosporin antibiotics are usually added to control bacterial growth and reduce symptoms of cholecystitis in addition to oral anti-inflammatory choleretic tablets to increase bile acid secretion. If the above-mentioned ** later reversal** causes gallbladder contractile dysfunction, then laparoscopic cholecystectomy is usually required to obtain **.

Symptoms of cholecystitis in middle-aged and elderly people and related common sense.

Cholecystitis is mainly based on the degree of gallbladder inflammation, whether it is combined with stones, whether there are gallbladder polyps, so comprehensively judged, if mild cholecystitis, can be controlled by diet, through drugs, choleretic drugs, can achieve relief, but if there are gallbladder polyps, or gallbladder stones are relatively large, more than one centimeter, advocate or surgery**, if there are gallbladder stones, if there are more gallstones, cholecystitis it stones have no symptoms, If there are asymptomatic gallstones, if the stones are relatively small, they can be observed first, but if there are symptomatic gallstones, surgery can usually be done.

When acute cholecystitis occurs, if there are no other complications, consider fasting water, antispasmodic and analgesic, intravenous nutritional support, anti-infection**, etc., and ask a surgeon to assess whether surgery is needed after the condition is relieved**.

If the condition is critically ill and does not go into remission, or if concomitant purulent cholecystitis or gangrenose perforated cholecystitis is identified, emergency surgery should be considered as soon as possible**.

If it is a patient with mild cholecystitis, you can take some anti-inflammatory choleretic tablets, which can control the patient's condition and avoid aggravation of the condition.

Initiatives are proposed. 1. Patients with cholecystitis will have many adverse symptoms, and it is necessary to choose the appropriate method, most patients use drugs, acute cholecystitis is mostly antispasmodic and analgesic drugs, and choleretic drugs can also be taken for patients with chronic cholecystitis.

2. Patients with cholecystitis can also use Chinese patent medicines**, such as taking golden gallbladder tablets, liver clearing and gallbladder oral liquid, etc., which can be effectively relieved.

Precautions. If the patient has cholecystitis, surgery is required** to prevent the condition from getting worse.