Cholestasis: Skin itching and bile stagnation are associated. Cholestasis in pregnant women

Failures in the functioning of the liver, the formation and transmission of bile can cause intrahepatic and intravesical cholestasis (cholestatic syndrome). It is very easy to identify this pathology, which causes a lot of problems for pregnant women. It is enough to take a biochemical blood test and undergo an ultrasound of the abdominal cavity.

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When liver tissue is damaged and the oxidation of cholesterol into bile acids is impaired, this is intrahepatic cholestasis. With reduced absorption and evacuation activity of the bladder of a patient with chronic non-calculous cholecystitis, they mean “mild” intravesical cholestasis.

Without proper production of bile, the process of digestion and removal of toxic substances from the body is impossible. One of the diseases of the internal organs or an external negative effect on the body can give impetus to the development of cholestasis.

What is cholestatic syndrome?

The content of the article

The pathology caused by the improper flow of bile into the duodenum and its stagnation inside the liver is called cholestasis. The manifestation of the disease will be shown by a blood test, where indicators of a high concentration of components that should leave the organs along with bile will be visible. An excess of complex components in the liver determines the clinical picture of the disease.

Factors that cause symptoms:

the intestines contain less bile or none at all;
the amount of bile that enters the blood is higher than normal;
components of bile and its toxic metabolites affect liver cells and tubules.

In a healthy person, 80% of copper is excreted from the body with bile. Large accumulations of copper are detected by histochemical examination. The amount of copper is determined by biopsy. Copper binding protein is detected by orcein staining. Such studies provide second confirmation of the syndrome. Accumulated copper during cholestasis does not have a hepatoxic effect on the body, because the copper that enters the hepatocyte is in a non-toxic form.

Cholestasis is manifested by the liver excreting water, the basic ingredients of bile, and tubular flow decreases. With the further development of the disease, hepatocytes begin to enter the bloodstream of those components that the body of a healthy person removes. Therefore, bile is concentrated in hepatocytes, canaliculi, and damaged Kupffer cells. If such a process occurs outside the liver, then the accumulation of bile will be in the liver parenchyma and will also fill the ducts. The dysfunctions caused are reversible when the time interval of the disease is short. Over a long period of time, irreversible damage may occur, characteristic of biliary fibrosis, as well as cirrhosis.

What is bile for?

The gallbladder is a small organ that is located under the liver. Between meals, it stores bile, and during meals it contracts and dumps it into the ducts leading to the intestines. The portion of bile depends on what we eat. The gallbladder contracts best in response to fatty foods, worst of all – to proteins. This is why you cannot completely give up fats: the gall bladder stops contracting normally, bile begins to stagnate - and all this leads to inflammation (cholecystitis) and cholelithiasis. Bile must be constantly renewed, and for this you need fatty foods.

For normal functioning of the gallbladder, lipids (fats) are needed. They will bring more benefits in the morning: if you include the right fats in your breakfast, they will help the gallbladder “wake up” and contract at the right rhythm all day long.

Why does the human body need bile?

for the absorption of fats and fat-soluble vitamins A, D, E and K. If bile flow is impaired, a permanent deficiency of vitamins is possible, which persists even when taking vitamin and mineral supplements. Thus, good bile means normal vision, beautiful clean skin, strong nails and shiny hair. And also vigor and good mood.
to activate pancreatic and intestinal enzymes and complete digestion of food
to remove excess cholesterol from the body
for the removal of bilirubin, creatinine and waste hormones (estrogens)
to protect against infection and parasites (bile has powerful bactericidal properties)
to neutralize acids coming from the stomach with food and enhance intestinal motility

How to deal with diarrhea after gallbladder removal? Recommendations from doctors at Mayo Clinic, the largest private medical and research center in the world.

Forms of cholestasis

Depending on the place of development and localization of the pathology, cholestatic syndrome can be: intravesical, intrahepatic.

The first type is characterized by bile stagnation, when the extrahepatic bile ducts are blocked, and for the second type, deposits will be in the intrahepatic bile ducts and hepatocytes.

According to the manifestations of jaundice in cholestasis syndrome, there are: anicteric and icteric.

When the color of the skin changes towards yellow, the icteric form of cholestasis is identified. Anicteric cholestasis is considered a prestage of the icteric form. Sometimes the anicteric stage lasts for months; this form of the disease is difficult to treat.

Based on the criteria associated with clinical symptoms, cholestasis occurs:

acute , when symptoms appear sharply and clearly expressed;
chronic , when symptoms increase over several months, are not always noticeable and to a weak degree.

Chronic cholestasis can be complicated by the formation of pigmented stones in the biliary tract, accompanied by cholangitis.

If you monitor the destruction of cells, you can distinguish cholestasis with cytolysis and without cytolysis. Cytolysis is considered a violation of the integrity of liver cells. It can occur when exposed to hepatotropic viruses, drugs, and toxic substances.

According to the mechanism of occurrence of the syndrome, cholestasis is distinguished:

negative , when the amount of excreted bile decreases;
dissociative , with a delay in the release of certain components;
total , if the mechanism of passage of bile through the duodenum is disrupted.

Cholestasis during pregnancy

What causes intrahepatic cholestasis in pregnant women is not clear. There are a number of theories that identify the main groups of reasons:

increased sensitivity to sex hormones of liver cells due to genetic disposition;
the normal synthesis of enzymes that ensure the transport of bile from cells through the ducts is disrupted;
the synthesis of bile acids is impaired from birth due to a deficiency of certain enzymes. This disorder can cause the formation of atypical bile acids.

The main changes in pregnant women with the syndrome:

the amount of bile components in the blood is increased;
the level of secretion in the duodenum is reduced;
on the part of bile, there is an effect on hepatocytes and biliary tubules.

Symptoms of the disease in pregnant women, which begin to appear by the third trimester, are irritation and jaundice. In some patients, skin itching can be pronounced and cause a lot of inconvenience, while others tolerate it easily. Intrahepatic cholestasis leads to excoriation of the skin in pregnant women, usually on the arms, legs, and forearms. Symptoms of jaundice appear in only a tenth of women; usually these signs disappear on their own after two weeks after the baby is born. Still, you should not rely on the fact that everything will go away on its own; if you feel any changes in your health, you should consult a doctor, since all the signs can reappear due to hormonal imbalance.

Treatment of pregnant women is complicated by their piquant situation, so non-traditional treatment methods, such as oatmeal masks and chamomile decoction, are used to reduce symptoms. You can even use cold water; it relieves the condition by slowing down the blood flow, so the urge to itch decreases. It is recommended to sleep in a cool room, as well as follow a diet.

Pediatric cholestasis

The causes of childhood cholestasis may be metabolic disorders from birth, consequences of viral diseases, cardiovascular failure, malignant pancreatic tumors, parasitic lesions, genetic predisposition, sclerosing cholangitis.

The manifestation of cholestatic syndrome in children depends on the age at which the disease began and the characteristics of the body. The disease should be treated after the root cause of the disease has been eliminated. For example, if bile stagnation is caused by a malignant neoplasm, then you need to fight the tumor first, and then the symptoms of the syndrome. The child’s therapy is comprehensive: in addition to medications, vitamins A, E, D, K, as well as choleretic drugs can be prescribed.

Often, cholestasis in this group of patients cannot be cured with medications alone; then a surgical operation is performed, which is aimed at removing stones and draining blocked ducts. The danger of cholestasis is that it develops in children in a latent form. To avoid complications and severe forms of the condition, you need to start treatment in a timely manner.

Main signs of cholestasis

Cholestasis is manifested by the following symptoms:

Skin itches. A primary symptom that may appear on its own for some time. It is characteristic that it is stronger at night than during the day.
Brown or yellow formations (xanthomas) appear on the chest, back, and elbows.
Yellow symmetrical formations appear on the eyelids (xanthelasmas).
Purulent rash, scratching depending on the degree of itching.
Scratching in different areas, pustular rash.
There is a change in the color of the surfaces of the eyes, mouth, mucous membranes, and skin to a yellow color (jaundice).
Melanin levels decrease, the skin becomes dark (hyperpigmentation).
A large amount of fats is excreted along with feces, due to insufficient processing of them by the body (steatorrhea), feces are characterized by an unpleasant odor, and excrement is difficult to wash off.
The stool becomes discolored and the urine becomes dark.
Due to reduced absorption of vitamin K, which dissolves intestinal fats, bleeding increases.
Changes in metabolism due to stagnation of bile in the liver lead to a lack of vitamins (hypovitaminosis) A, D, E, and a deficiency of component A leads to night blindness - poor twilight vision, dry eyeballs, and skin.
Body weight decreases.
Stones may form in the gallbladder and ducts (cholelithiasis).

Is the flow of bile disrupted or not? Test yourself

“Man’s bile is like gold. There should be so much of it that, like gold, it can cover all the expenses of the human condition. If there is much more of it in the body than is needed, it (bile) will depreciate. If there is less of it than needed, it will be like gold in complete famine. Then you can’t buy food with it to survive…” - this is how the ancient Tibetan healers Emchi assessed the role of bile in the human body.

The gallbladder system is more than the storage and elimination of bile.

Eastern medicine traditionally considers the gallbladder and the state of bile in it in the context of its systemic energy value for humans. The gallbladder system is closely connected with the liver system as an organ that produces bile. Practical medicine of Tibet, China, India and other Eastern countries traditionally attaches great importance to the gallbladder as an energy system, respectively, in a broader form and volume than the anatomical - physiological function of this organ, which consists in the accumulation and excretion of bile.

Where is the main source of courage?

Since antediluvian times, Eastern physicians have considered the gallbladder system, together with the liver system, as “the main source of courage, determination, and, in the presence of obstacles, as a source of aggressiveness, hostility and anger.” With various manifestations of “functional failure” of the gallbladder, pathological manifestations occur.

A wide range of emotions, experiences, and behavioral characteristics can significantly distort and even have a destructive effect on the energy system of the gallbladder . It should be noted that it is the gallbladder, as a “system of activity and anger,” that can keep the entire human body in tension. Accordingly, this leads to stagnation of bile in the gallbladder , forming signs of excess energy, the so-called symptoms of “yang” .

As a rule, such symptoms lead to spasms of the bronchi with the subsequent development of bronchial asthma, to spasms of the main coronary vessels with the subsequent development of angina pectoris. The spastic state of the cerebral vessels is primarily associated with the state of excess energy in the gallbladder.

Revelations of Sole-De Moran from time immemorial.

One of the greatest apologists of oriental medicine, the Frenchman Sole-De Moran, wrote in his famous book “Ten Thousand Steps to the Top of the Mountain”: “We can safely say that, having only mastered the diagnosis and treatment of the gallbladder system (channel), you can safely take on such difficulties such as diseases of the skin, sexual sphere, joint diseases of the legs, especially the hip joints, bone pain in the lower extremities in general and pain in the bones of the feet in particular. And of course - these are all types of colds with their own peak - enfluenza (flu)."

4 main conditions for the functioning of the digestive systems.

Oriental doctors absolutely rightly believed that the quality of the digestive systems, which includes the gallbladder system, is primarily influenced by the main 4 living conditions. These are the person’s age, the quality of the current season, state of mind and nutrition. Wise Tibetan emchis like to repeat: “it is impossible to eat and drink for future use because you cannot store up bile for future use.” Fear the bile of young and old. Young as skimmed milk, you won’t live long with her. And the old one is like butter. You won’t be as full of them alone.”

Signs of impaired bile flow.

It is very important that the general symptoms of trouble in the gallbladder system are very clear and noticeable and have such manifestations as a pale, sallow face, bitterness in the mouth, pain in the right hypochondrium, pain in the right side, pain in the heart immediately after eating, pain and a feeling of constriction head and chin, the so-called “bilious hoop”, hot feet, so-called peritoneal chills, fetid sweating, swollen glands under the arms, tension in the back of the neck muscles, cervical lumbago, pain in the outer surfaces of the thighs, knee joints, outer ankles.

Symptoms of excess energy in the gallbladder system— yang symptoms— include:

Feeling of fullness in the stomach, heaviness in the head, pain on the outer thighs (strap zone), hot skin of the neck both in front and behind, night terrors, bitterness in the mouth, nausea, swelling of the neck, cheeks, chin, frequent throat diseases, difficulty falling asleep from 23 to 1 am, hot feet from 11 to 13 pm, periodic vomiting of bile on a lean stomach.

Symptoms of a deficiency in the gallbladder system— yin—symptoms include:

General loss of strength, weakness, dizziness, heavy deep sighs, unsteady (drunk) gait, the skin of the face and neck above the line of the collarbones is pale and cold, shortness of breath at rest, swelling of the feet and popliteal fossa without leaving traces of pressure, frequent inflammation of the upper and lower eyelids, jaundice of the sclera (yellow coloring of the surface of the eyeball), daytime drowsiness, night sweats.

What does this mean?

Disorders in the gallbladder system of the “yang” type - symptoms lead to the development of the following diseases:

Gastritis, gastroduodenitis, duodenopancreatitis, in childhood and adolescence lead to the development of hyperactivity syndrome, impaired psycho-emotional stability, cardioneurosis, asthenovegetative symptoms, a wide range of skin suffering (neurodermatitis, eczema, psoriasis, seasonal furunculosis, extensive juvenile acne), etc. Development " “yang” symptoms are indirect causes of disorders in the human sexual sphere and manifest themselves in early puberty, which is fraught with such manifestations as uncontrolled masturbation, and can also lead to the development of varicocele in boys and polycystic adnexa in girls.

Disorders in the gallbladder system of the “yin” type - symptoms lead to the development of diseases and functional disorders such as:

Dyskinesia of the bile ducts, extrahepatic cholangitis, cholelithiasis, cholecystitis, reflex osteochondrosis of the cervical spine, right - and bilateral cervicalgia. Biliary dyskinesia, in turn, leads to the formation of spastic-atonic colitis, which is fraught with such serious vascular suffering as varicose veins of the lower extremities, phlebitis and thrombophlebitis. Tibetan and Chinese doctors have reliably proven the close relationship between coronary heart disease and “yin” - symptoms in the gallbladder system.

How does modern medicine register a violation of the outflow of bile?

As a rule, modern medicine does not consider these symptoms as the main signs of disorders in the gallbladder, but relies on laboratory and functional diagnostic data (FGS, ultrasound and MRI) when making diagnoses. But such data can only establish the presence of a developed disease, and not its initial phase, much less the cause of its occurrence.

The only method that allows one to reliably identify the cause of the development of “yang” and “yin” symptoms in the gallbladder system is iridoscanning - a method of diagnosing the body by the state of the iris of its eyes.

We, the authors of “Dr. Kartavenko’s School of Safe Health,” have conducted a study of the body using the iridoscanning method of 845 people over the past six months. As a result of the analysis of these studies, we identified the following patterns:

bile outflow disorders accounted for 83.4% of 100% of those examined. Of these, only in 11.8% we noted changes in the gallbladder area on the iris of the eyes, corresponding to signs of hyperactivity of the gallbladder or “yang” symptoms in the gallbladder system, the remaining 71.6% correspond to signs of hypofunction or “yin” symptoms . The reliability of such data was confirmed by the clients themselves as a result of their survey during consultations.

Decide for yourself which path to choose.

And so, dear readers, now you can independently answer the question: “Is your bile flow impaired? And if the answer is affirmative, then what kind of violation exists.” But if you still want to seek the help of specialists, then you have a choice:

Or you go first to a therapist, then a lot of tests (swallow the “gut” during FGS, donate blood on an empty stomach, have an ultrasound done by another specialist, and maybe even an MRI). After two weeks of visiting offices, tiring queues, and hassle in the “You weren’t standing here” format, you will most likely receive an approximate answer. But in order to understand “What should you do with this?”, you need new trips to specialists for a prescription. And when they end with receiving prescriptions, then you are waiting for a search for medicines, alas, consisting of 97% of the chemicals that usually lie on pharmacy shelves and are very unsafe.

Or you examine the body using the iridoscanning method while at home, immediately receive recommendations for your individual safe health and can immediately begin to act.

What would you choose, dear readers? We are waiting for your comments.

We remind you that our wonderful recipe for detox soup “Weight Loss”, which is still freely available, will help you improve and normalize the flow of bile. Enjoy it for your health!

And also, a face-to-face express consultation with Professor V.V. Kartavenko. You can learn more about this and other issues of your personal health at the medical congress “Healthcare of the North Caucasus” in Kislovodsk on April 27 and 28. To do this, you need to call in advance by phone. 8 (863) 2-704-702.

And on April 26 at 12-00 in the same place (3rd floor of the Caucasus Cultural and Exhibition Complex, Shalyapin St., 7) we will hold a seminar for sanatoriums, pharmacies and health centers. For the participants of the seminar, we will conduct a personal consultation: “Look at your organs from the inside,” the cost of which is only 500 rubles, and not 3,700 rubles as usual. Pre-registration is also required for this (tel.. The number of places is limited, so call and make an appointment in advance.

With respect to you and your health, authors of “Dr. Kartavenko’s School of Safe Health” Tatyana and Victor Kartavenko

Causes of pathology

The disease can develop for various reasons. The intrahepatic form of cholestasis is manifested by a smaller flow of bile into the duodenum. This may occur due to hepatocellular pathology. If the tubules are damaged due to damage to the intrahepatic interlobular duct, then the syndrome is called canalicular, as well as extralobular ductular cholestasis, and if hepatocytes are destroyed, then hepatocellular.

Viruses, medications, alcohol, and toxic effects make it difficult for the liver to function normally. Canalicular cholestasis with hepatocellular cholestasis can be caused by any form of liver damage, as well as impaired metabolism and heart problems. The etiology of introlobular cholestasis is in the malfunction of the vacation, basolateral membranes. If the epithelium of the bile duct is damaged, patency is complicated, the composition of bile and acid metabolism are disrupted, then ductular cholestasis develops.

Intrahepatic cholestasis may appear due to factors such as ductopenia, hypoplasia of the extrahepatic and intrahepatic ducts, Alagille syndrome, infection, viruses, exposure to the drug Thiabendazole, cystic fibrosis, sarcoidosis, istiocytosis X, reactions associated with transplant rejection, cholangiocarcinoma, hepatitis, autoimmune deficiency A1- antitrypsin, cholangitis, amyloidosis, congestive liver, circulatory disorders, hepatic vein thrombosis.

Extrahepatic cholestasis begins to manifest itself when the positive effect of the main intrahepatic and extrahepatic ducts is counteracted. One of the common causes is the presence of stones in the bile ducts.

The progression of the extrahepatic form of the syndrome may be due to the presence of stones, malignant neoplasms in the ducts, damage to the duodenum, hepatic artery aneurysm, pancreatitis, malfunction of the pancreas, the appearance of cysts, hemobilia, abscess, parasitic and other infections.

Intravesical cholestasis (mild chronic) can occur in the chronic form of non-calculous cholecystitis, when the activity of the gallbladder decreases - an unbalanced composition of bile is formed.

Types of choleretic drugs

Medicines that increase the flow of bile are divided into 2 groups according to their mechanism of action - choleretics and cholekinetics.

Classification:

1. Choleretics. They increase the volume of bile secreted and the concentration of acids.

True choleretics - Allohol, Liobil. The products contain liver enzymes, animal bile, and extracts from medicinal herbs.

synthetic choleretics - Nicodin, Cyclalon. They have a choleretic effect, relieve inflammation, eliminate spasms, and fight pathogenic bacteria;
choleretics of plant origin - Cholagol, Chofitol. Contains extracts from herbs and plants. Helps improve bile movement, reduce secretion viscosity, improve liver function;
natural bile acids, often of animal origin – Cholenzyme. Active substances – crushed mucous membrane of the small intestine, pancreas, animal bile.
Hydrocholeretics. Mineral medicinal waters – Essentuki, Smirnovskaya, Slavyanskaya. Salts improve the production of bile and dilute it.

2. Cholekinetics – promotes the passage of bile into the intestines.

Cholekinetic agents. Atropine, Magnesia. They relax the bile ducts by stimulating the contractile functions of the gallbladder, eliminate congestion, and prevent their occurrence.
Cholespasmolytics. Relaxes smooth muscles, eliminates pain.
Synthetic – Drotaverine, Papaverine;
Natural – St. John's wort tincture.

Preparations to prevent the formation of gallstones with ursodeoxycholic acid - Ursosan.

The classification of drugs that have a choleretic effect is conditional; many drugs have a complex effect.

Diagnosis of intravesical and intrahepatic cholestasis

The media and the Internet should not become sources of treatment for the disease. Only special diagnostic methods reveal pathology, and competent specialists prescribe the necessary treatment.

The patient is physically (externally) examined by a doctor. At this stage, abrasions, rashes, redness, scratching, and icteric skin color may be detected.

Biochemical laboratory experiments and analysis of the concentration of serum bile acids will help diagnose the disease with greater accuracy. If the syndrome is detected, blood biochemistry will show elevated cholesterol, bilirubin, phospholipids, acids, and enzymes.

Patients continue to be evaluated to identify extrahepatic “surgical” cholestasis. It may appear at first glance to be intrahepatic in symptoms.

The next step in diagnosis will be an ultrasound of the abdominal cavity, where an enlarged gallbladder is observed and manifestations of blockage of the bile ducts are identified.

If an increase in the volume of the ducts is detected, cholangiography is prescribed, otherwise the diagnosis is indicated by the clinical picture. For example, if the presence of stones is suspected, then ERCP is performed. When this study does not detect stones, they may be referred for a liver biopsy, but before that the doctor determines the absence of an extrahepatic type.

Treatment, prevention of the syndrome

Preventive measures for bile stagnation are aimed at preventing disturbances in the function of the liver and bile ducts. Patients are recommended to walk in the fresh air, light jogging in the morning, race walking, exercises for the abdominal muscles, therapeutic massage, avoidance of harmful alcohol, overeating, and adhere to a strict diet.

The purpose of treatment depends on the form of the syndrome, the stage of the disease, aggravating factors and the characteristics of the organism. Conservative treatment algorithm:

Diet therapy, correct diet.
Etiological treatment consists of treating diseases that accompany the development of the disease.
Basic therapy - ursodeoxycholic acid (UDCA) is prescribed to reduce cholangiocytes damaged by bile acid.
Therapy aimed at reducing painful manifestations and relieving the symptom of itchy skin.
Treatment of exacerbations.

If the stage of the syndrome is advanced, then surgical intervention can be used. If treatment is not started in a timely manner, then in such forms the disease can cause irreversible consequences.

Indications for the use of drugs for the secretion of bile

General indications for taking medications with a choleretic effect:

cholecystitis;
cholangitis;
hepatitis B, C, D, pathological processes in the bile ducts of a chronic course;
cholestasis;
biliary dyskinesia;
inflection of the gallbladder;
prolonged, frequent problems with bowel movements;
after removal of the gallbladder in order to prevent the development of gallstone disease.

The need to take choleretic medications is indicated by a bitter taste, a coating on the tongue, pain, a feeling of heaviness under the right ribs, and belching. All these signs may indicate disturbances in the functioning of the biliary system and liver.

Important! General contraindications for taking medications for bile stagnation are hepatitis in the acute stage, cirrhosis, acute and subacute dystrophic liver pathologies, obstructive jaundice, erosions of the gastrointestinal tract, pancreatitis, diarrhea.

Treatment with folk remedies

After consulting with a doctor, you can resort to traditional medicine to relieve inflammatory processes:

Recipe for a drink made from birch leaves: pour a small amount of leaves into 0.5 liters of boiled water, boil for 10 minutes on fire. You can take 100 ml up to three times a day. Children, pregnant women, and people with acute liver failure should not drink.
Herbal decoction. Method of preparation: pour boiling water in equal parts of St. John's wort, corn silk, immortelle flowers, 30 minutes. boil on fire. After straining, take the decoction 25 ml up to three times a day half an hour before meals. Use is contraindicated for more than two weeks, as well as for high acidity and stomach problems.
Nettle and rosehip 10 g and 20 g, respectively, pour 200 ml of boiled water, leave for about an hour. Take twice a day for no more than two weeks. Cannot be used for thrombosis, varicose veins, or individual intolerance.
Oil remedy recipe: 1 tbsp. Mix honey with 3 drops of mint oil. Application: 3 times a day, no more than 4 weeks. Contraindications: men over 50 years old, with individual intolerance, children, pregnant women and during lactation.
Lemon oil can be added to drinks 1 drop. Use: up to 2 times a day for no more than 4 weeks. Contraindications: allergies, childhood, pregnancy.
Beet salad. Take 1 tbsp four times a day. l. Restrictions on use for stomach diseases.

Traditional methods are used only with the permission of a doctor.

Review of the best choleretic drugs

The list of good choleretic drugs is extensive. These medications quickly cope with the manifestations of diseases, have few restrictions on use and side effects. Before starting therapy, read the instructions and follow the recommended dosages.

Allohol

A medicine with choleretic and cholekinetic properties. Ingredients: extract of bile, garlic, nettle, activated carbon. The tablets enhance the process of bile formation and activate the motor and secretory functions of the gastrointestinal tract.

Additionally, Allochol has a mild laxative effect and improves the process of breaking down fatty foods.

When to take Allohol:

chronic hepatitis;
inflammatory processes in the gallbladder, bile ducts;
constipation caused by intestinal atony;
with the gallbladder removed for normal bile movement.

Dosage for adults – 2 tablets with an interval of 8 hours after meals, with an exacerbation, 1. Duration of treatment – 3-6 weeks. The break between courses is 3 months. Improvement in the condition occurs on days 5-8 of taking the medicine - pain decreases, dyspeptic disorders disappear.

Children under 7 years of age are prescribed 1 tablet in the morning, afternoon and evening. For children over 7 years old – adult dosages.

During treatment, adverse reactions rarely occur. Mostly allergic manifestations and stool disorders are observed.

Contraindications – acute form of hepatitis and pancreatitis, liver dystrophy, stones in the gall bladder or ducts, peptic ulcer of the gastrointestinal tract.

Price – 70-115 rub.

Hofitol

Plant choleretic with field artichoke leaf extract. Release form: tablets, suspension, syrup for oral administration.

A drug with hepatoprotective, choleretic effect, normalizes metabolic processes. The medicine activates the process of formation and movement of bile, prevents the development of atherosclerosis.

Indications:

nausea, bloating, discomfort in the central abdominal area;
chronic non-calculous cholecystitis, hepatitis;
slowing down the outflow of liver secretions with biliary dyskinesia;
cirrhosis;
renal failure, chronic form of nephritis.

Hofitol is prescribed as an auxiliary drug for intoxication with salts of heavy metals or alkaloids, obesity, anorexia, atherosclerosis, and urolithiasis.

Directions for use: drink three times a day before meals. Dosages – adults and children over 12 years old – 2-3 tablets. Course – 2-3 weeks. Dosage regimen for children 6-12 years old – 1-2 tablets.

Single dosages of medication in liquid form for children:

1-5 years. 10-20 drops, dissolve in 15 ml of water.
Over 6 years old. Dissolve 2-3 ml or 40-60 drops in 15 minutes of water.

The container with the suspension must be thoroughly shaken before use; the artichoke extract will settle to the bottom.

Side effects occur with long-term use of the drug in high dosages. Possible negative reactions are abdominal cramps, heartburn, upset stool, nausea. Rarely, hypersensitivity reactions occur - rash, itching, skin hyperemia.

The drug is not prescribed for individual intolerance, bile duct obstruction, cholelithiasis, or diseases of the urinary system in the acute stage. Hofitol tablets are contraindicated in children under 6 years of age.

Price – 470-580 rub.

Holosas

An effective natural remedy containing rosehip extract. It has a complex effect - improves the flow of bile, promotes the restoration of liver cells, eliminates manifestations of the inflammatory process, strengthens the immune system. Holosas reduces the permeability of small blood vessels, accelerates the regeneration process and the synthesis of hormones, and is involved in the metabolism of carbohydrates.

Indications for use:

viral hepatitis;
cholecystitis, cholangitis;
deficiency of vitamin C, P;
poisoning with drugs, alcoholic beverages;
increased physical and mental stress.

Dosage for children over 12 years of age and adults – 5 ml 2-3 times a day half an hour before meals. The average duration of therapy is 15-30 days.

The medicine should not be taken if there is intolerance to the components, cholelithiasis, and should be taken with caution if you have diabetes. The syrup is contraindicated for children under 12 years of age, pregnant and lactating women. Possible side effects are allergic manifestations, stool upset, bloating, flatulence.

Average price – 100-200 rubles.

Holenzym

Combined choleretic action tablets from the group of natural bile acids.

Practiced with:

gastrointestinal pathologies;
chronic hepatitis, cholecystitis, pancreatitis;
gastritis;
colitis;
bloating;
diarrhea of non-infectious origin.

Dosage: 1 tablet after meals at intervals of 8-24 hours.

Possible adverse reactions are caused by allergic manifestations:

sneezing;
lacrimation;
redness and swelling of the skin;
rashes.

It is strictly forbidden to take when:

acute pancreatitis or exacerbation of the chronic form of the disease;
obstructive jaundice;
hypersensitivity to components.

The price of tablets No. 50 is 250-300 rubles.

Papaverine

Synthetic antispasmodic, active ingredient – papaverine hydrochloride. The drug has a relaxing effect on smooth muscles.

Papaverine will help cope with spasms and pain due to cholecystitis and spastic colitis. The medicine is prescribed before surgical interventions on the gallbladder.

Tablet dosage regimen:

children from 1 year to 12 years – maximum single dose 200-300 mcg/kg;
adults - 0.04-0.06 g orally, dosage frequency 3-5 times a day.

Possible side effects are tachycardia, decreased blood pressure, dyspeptic disorders, drowsiness.

Contraindications:

individual intolerance;
violation of intracardiac conduction;
glaucoma;
severe forms of renal failure;
less than 6 months old.

The medicine is prescribed with caution for chronic renal failure, shock, hypothyroidism, and malfunction of the adrenal glands.

Price – 35-90 rub.

Odeston

A synthetic choleretic agent, the main ingredient is hymecromone. A complex action medicine – improves the synthesis and movement of bile, relaxes the bile ducts, analgesic, antispasmodic.

Odeston's indications:

chronic form of non-calculous cholecystitis, cholangitis, cholelithiasis;
impaired motility of the biliary tract, sphincter of Oddi;
after surgical interventions on the organs of the biliary system;
lack of appetite, problems with defecation, vomiting caused by bile hyposecretion.

Take the medicine 30 minutes before meals. Dosage regimen for adults – 1-2 tablets every 8 hours. Duration of therapy is 14-21 days.

The recommended dosage for children over 7 years old is 1 tablet 1-3 times a day. The treatment course is 2-3 weeks.

The medicine sometimes provokes the development of allergies, dyspeptic disorders, ulcers of the mucous organs of the gastrointestinal tract, migraine attacks and dizziness.

Odeston should not be taken if you have kidney or liver failure, blockage of the bile ducts, ulcerative colitis, Crohn's disease, or hemophilia. The drug is not prescribed to children under 7 years of age.

Price – 430-880 rub.

Flamin

Herbal preparation with extract of immortelle flowers. Cholekinetic, choleretic, anti-inflammatory, antimicrobial, antispasmodic.

Tablets or granules help with inflammation of the gallbladder, ducts, and liver.

Take the medicine before meals. Dosage for tablets – 1-3 times a day. Duration of treatment is 1.5-6 weeks.

Children are prescribed the drug in granules, from which a suspension is prepared.

Single dosage for children:

1-12 months – 2.5 ml;
1-3 years – 5 ml;
4-5 years – 7.5 ml;
over 5 years – 10 ml.

Course duration is 10-14 days.

Allergic reactions may occur during treatment. With hypertension, blood pressure may increase.

The medicine should not be taken if you have hypersensitivity, cholelithiasis, or obstructive jaundice.

Price – 170-300 rubles.

Magnesia

Magnesium sulfate, when taken orally, has a choleretic, laxative, and antispasmodic effect.

The medicine will help with cholangitis, cholecystitis, constipation, and gallbladder dyskinesia. The drug is effective before duodenal intubation to obtain a cystic portion of bile.

As a choleretic agent, dissolve 20-25 g of powder in 100 ml of water. Drink 15 ml solution 3 times a day before meals.

Contraindications:

hypertension;
bradycardia, AV block;
severe forms of chronic renal failure;
depression of the respiratory center.

The price of 1 sachet is 20-28 rubles.

Ursosan

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The drug contains ursodeoxycholic acid. Hepatoprotector with choleretic, immunomodulatory effects.

Indications:

uncomplicated forms of cholelithiasis;
prevention of stone formation when the gallbladder is removed;
biliary dyskinesia;
acute, chronic active hepatitis, primary biliary cirrhosis.

The Ursosan treatment regimen is selected individually, depending on the type and severity of the disease. The standard dosage is 2-5 capsules per day. The duration of therapy ranges from 2-3 months to several years.

Contraindications:

chronic hepatitis, pancreatitis;
disabled gallbladder;
acute form of cholecystitis, cholangitis;
decompensated cirrhosis of the liver;
acute infectious pathologies of the gallbladder;
renal, liver failure;
pregnancy, breastfeeding period.

Possible adverse reactions are vomiting, diarrhea, exacerbation of psoriasis, back pain, allergies, alopecia.

Price for 10 capsules – 180-190 rubles.

Proper diet

Together with drug treatment for a patient with bile stagnation, the doctor creates a proper nutrition menu. Patients exclude spicy, fried, various types of baked goods, canned goods, spices, rich meat broths, and any fatty foods from their diet. The diet is formed from dishes containing vegetables and fruits.

The patient's morning should begin with drinking medicinal mineral water; it is also recommended to consume fermented milk products daily. Eating before bed is prohibited, and during the day you need to eat in modest portions, but often (from five to seven times a day). Without strict adherence to dietary recommendations, cholestasis cannot be cured.

More than half of all food consumed must be heat-treated and served warm. You can eat oat and buckwheat porridge. Please note that you need to cook by steaming, in a slow cooker and in the oven. It is recommended to exclude cold drinks or warm them to room temperature before drinking; to do this, you can leave the drink in a warm room for a while.

What you can and cannot eat if you have bile stagnation

The diet includes rye bread, savory products, honey, and jam. Dairy products include sour cream, cheeses, and curd products (low-fat). Juices and drinks made only from sweet berries and fruits. You can also drink compotes and weak tea. You should eat a lot of greens, vegetables, fruits, and berries. Soups should be vegetable with cereals, pasta, or lean meat: rabbit, veal, chicken, turkey. It is recommended to limit vegetable fats in the diet to 50 g per day.

When dieting, it is prohibited to consume lard, animal fats, soup made from fatty meats and fish. Not all greens are allowed; green onions, sorrel leaves, and spinach should be avoided. You can't have radishes, radishes. As for drinks, alcohol, strong coffee, and any cold drinks are prohibited. Nutritionists also do not recommend canned foods (pickled vegetables, caviar, smoked foods) for consumption. Exclude from the menu confectionery pastries, chocolate, ice cream, spices, mustard, horseradish, sour varieties of fruits and berries.

For treatment, it is very useful to drink skim milk - it is a good source of calcium. When a sign of cholestasis occurs in the form of itching, you need to see a doctor for a liver examination; this symptom may appear much earlier than others; it should not be ignored, because delays often lead to liver failure. Treatment started in a timely manner can relieve symptoms and improve liver function.