Polyp in bile treatment. Treatment of polyps in a bustling bubble without surgery by conservative methods. What is polyps

Gall Bubble 31.05.2013

Dear readers, today we will talk about the polyps in the bustle bubble. All articles in this heading leads a doctor with extensive experience of Evgeny Snegir, the author of the site for the soul http://sebulfin.com give him the word.

When conducting an ultrasound examination of one of the unexpected finds, there may be polyps in the bustling bubble. As a rule, the situation is for simple man It looks rather strange: nothing particularly bothers and suddenly some polyps there ... "In general, the polyps are scary? Will you go through? Do I need to do the operation? " - Absolutely normal questions appearing from absolutely normal manwho sorrified with such news. Let's try to figure it out in order.

So let's start with the definition. Polyps of the gallbladder are benign growth of the epithelium of the mucous membrane into the clearance of the gallbladder. All clear. Too strongly mucous membrane was injected and a benign education was formed. Benign - it means that this formation does not have signs of a malignant tumor. Now fine.

Polyps in the bustling bubble. Causes of occurrence.

And what could be the causes of polyps formation? The reasons are separated by several.

Burdened heredity. If the nearest relatives diagnosed polyps, then the risk of polyps formation is quite high.
Error in diet, leading to a violation of cholesterol and lipid exchange.
Chronic inflammation of the gallbladder mucosa (chronic cholecystitis) accompanied by bile stagnation.
Hepatitis.
Biliary dyskinesia.

Polyps in the bustling bubble. Views.

Now consider which polyps in the bustling bubble are.

According to the histological picture, the following types of polyps are distinguished:

cholesterol Polyp: the growth of the mucous bubble with cholesterol deposition, meets most often.
inflammatory polyp: the growth of granulation tissue;
adenoma: a benign tumor of iron fabric;
papilloma: a benign tumor in the form of nipple sprouts on the mucous membrane.

Polyps in the bustling bubble. Symptoms.

As we have already emphasized, most often found asymptomatic carriage Polyps. In this case, sometimes there is a small discomfort in the upper half of the abdomen or the right hypochondrium after receiving abundant fatty foods.

Pronounced clinical picture may develop if the polyp was formed in the neck of the gallbladder, which is its most narrow part. In this case, periodic intensive pains in the right hypochondrium will appear.

If the polyp size is large enough, it can even lead to blockage of bubble duct. As a result, the gallbladder is overflowing, and, therefore, it will increase and painfully pain. The attachment of infection in this case can lead to the appearance of an empiemy of the gallbladder. In addition, bile ceases to enter the intestines, which will lead to changes in the color of feces and urine.

Diagnosis of gallbladder polyps.

Polyps of the gallbladder are detected at. As we have already said that in asymptomatic flow, this is usually a random find. During the study, the doctor sees a rounded formation, intimately associated with the wall of the gallbladder and not giving an acoustic shadow.

Currently, another examination method is considered to be an endoscopic ultrasonicography. With this method on the principle of FGDS, a flexible endoscope is introduced into the twelfth intestine having an ultrasonic sensor at the end. The twelfth intersection closely arrives at the bustling bubble, so the ultrasonic picture is much clearer and representative.

Polyps in the bustling bubble. What to do? Treatment.

The problem with polyps in the bustling bubble lies in increased risks their malignation - rebirth in malignant tumor. In particular, it is characteristic of adenoma and papillomas. The risk of soligration polyps is large enough, it can reach 30%. Just think about these numbers. Every third of those who "suddenly and suddenly" diagnosed the polyp, has a chance to get a malignant tumor. This is the story.

That is why when accidental discovery of polyps in the bustling bubble, when it seems to be not bothering, the surgeons immediately offer to remove the gallbladder by gentle way - laparoscopic cholecystectomy.

Effective treatment of polyps in the bustling bubble is only surgical. No folk remedies helps to get rid of the pathological growth of the mucous membrane. Slow down - maybe. Only in order to prove it with all thoughtful doctors, you need to hold a major multicenter study confirming that taking, let's say birch buds It was possible to stop the growth of the polyp. While the patient will drink decoction of delicious birch kidneys, the polyp will continue to grow. Nobody explained him that his owner takes a miraculous medicine that should definitely stop his growth, so it is better not to resist and surrender to the world. On the contrary, he will continue to grow stronger and gradually will already be released for all the reasonable "fractions of decency."

And the rational "fractions of the decency are such." If it is determined that the polyp size is less than 5 mm, then before us, most likely, the deposition of cholesterol on the mucous bubble, which may soon be "formatted" into the cholesterol stone (about the types of stones in the bustling bubble can be found in the article.

The size of the polyps from 5 to 9 mm with a greater degree of probability tells us that we have adenaitoma of the gallbladder, which, as we have understood, may be ill-time. In this case, it is necessary to continuously monitor the growth of polyps. If the polyp has a leg, then the test ultrasound should be done once every 6 months for 2 years. Then the control is carried out once a year throughout life. If it is revealed that the polyp began to grow, then the method of choice is the removal of the gallbladder.

If the polyp is on a wide base (there is no legs), then the control of the ultrasound is carried out once every three months for 2 years (such polyps are most susceptible to discharge). Next - once a year for life. If the growth of the polyp - cholecystectomy is noted.

Polyps are greater than 1 centimeter in size - reason for serious anxiety. This can be said absolute Indication To remove the gallbladder. Something wait for a long time here is already absolutely impossible. The risk of malignancy such a polypa is directly proportional to its growth.

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Polyps in the bustling bubble. Operation.

Operational treatment is carried out by gentle way - laparoscopic cholecystectomy (on the features of the operation can be found in the article. In the preoperative period, a comprehensive examination must be completed: required analyzes blood, urine, to remove the ECG, if necessary, radiography of lungs, to obtain the conclusion of the therapist on the presence of concomitant diseases and the availability of the body to surgical intervention.

Among the many diseases digestive tractas well as liver and biliary tract special place It takes a gallbladder polyp. Treatment methods (surgery), symptoms and causes of this disease are somewhat different from those that are used, for example, with stones in a given organ. In our article, we will try to convey to readers information about what causes the formation of polyps in the bustling bubble and what consequences may entail a disease if it is not treated.

gallbladder

Polyps in the bustling bubble are education benign characterwhich consist mainly of cells of the inner epithelial layer of the organ. These neoplasms can be solid and multiple. In the event that during the examination is detected from 5 polyps, it can be about such a disease as a gallbladder polyposis. The number of which is from 1 to 3 pieces, are considered solitary. From the amount of neoplasms detected in the organ, the method of getting rid of the ailment depends.

The polyp on the mucous membrane of the gallbladder looks like its part, with the only difference that its surface is convex. Very often it has a thin "leg", which connects his body with the mucous membrane of the organ.

What are the polyps in the bustle bubble

Due to the fact that today a well-developed system of diagnosing and subsequent study of the biological materials obtained is well developed, in almost all clinics work is underway on such a matter as the classification of polyps. Such benign neoplasms, such as polyps in the bustling bubble, the causes of which will be described below, are divided into the following types:

Cholesterol - are formed with deposits in the body of a cholesterol polyp. This species The only one of all is treated with medicines.
Papilloma the walls of the gallbladder - refers to benign neoplasms. Provokes the development of this type of human papilloma virus.
Adenomatous, relating to benign neoplasms. A feature of this type of polyps is that they are not growing from the epithelium, but from iron tissue.
Inflammatory, differ from other species that constantly flow into them in the processes of inflammation of the inner shells of the neoplasm, which provokes the pathological growth of granulation tissue.

The first thing that will find out a specialist after finding polyps in the bustling bubble - types. Diagnostics, treatment and nutrition at the same time are very closely in contact with each other. After all, it is very important to use all the means in order to get as much information about the disease, assign the right treatment, and also prevent further development Ailment with a properly selected diet.

Causes of polyps

To date, there is no consensus, why the person appears in the gallbladder. The reasons for this phenomenon can be diverse. As a rule, most often those who were diagnosed with polyposis had at least one person among relatives who suffered as the same disease. All this, naturally, he pushed scientists to the idea that there is a special gene, which is responsible for the ability of the mucous membranes of the gallbladder to form polyps and other neoplasms.

There is another important factor. The causes of this education, specialists are associated with occasional inflammatory processes in the body. The fact is that this phenomenon It provokes a change in the volume of the gallbladder, as a result of which the patients have a stagnant bile. This process itself is capable of changing the integrity of the mucous membrane, not to mention the formation of polyps.

Experts celebrate another trend: in 80% of all registered cases, the disease was diagnosed in women. This made it possible to conclude that the female hormone estrogen affects the development of the polyp.

How can I suspect the presence of polyps

As a rule, such a disease, like a gallbladder polyp, the causes of which are often associated with inflammatory processes in the body, does not exhibit in any way. Specific signs of development of neoplasms are also no, but the patient has a background chronic cholecystitis And dyskinesia can appear sharp, pulling or cutting pain in the right upper part of the abdomen. Most often, such uncomfortable feelings are exacerbated after feeding. It happens in next reason: Polyp, localized within the duct or on the mucous membrane in the immediate vicinity of its mouth, can prevent the discharge of bile.

If the patient systematically uses fatty and heavy foods, symptoms such as nausea, bloating, sour burrows, burglar in mouth, weight loss on the background of normal appetite, constipation may appear in food. In addition, yellowing may be observed skin Pokrov And Scler.

Suspending the polyps in the bustling bubble, the reasons, the symptoms and the treatment of which resemble cholecystitis and other similar diseases, the specialist is important to establish the true state of affairs as soon as possible, because with a probability of approximately 40%, benign neoplasm can go to a malignant tumor.

Diagnostic methods used in suspected polyps in the bustling bubble

At the initial stage of the survey associated with complaints of patients to discomfort in the right hypochondrium, a significant role is played by collecting anamnesis. but this method It cannot fully confirm or disprove the presence of such a disease as the polyps in the bustle bubble. Symptoms, causes, treatment and diet can be installed and defined with high accuracy only after more in-depth diagnostic eventsTo which include:

Survey with the help of ultrasound, during which rounded formations can be detected in the gall bladder cavity, tightly adjacent to its wall. When changing the position of the body of the patient, such neoplasms are not shifted, in contrast to the concreters.
Endoscopic endosonography, with which is determined structural structure Benign neoplasm and place of its localization.
Magnetic resonance cholangiography - In addition to the position of the polyp and its structure, it helps to identify other pathologies of the mucous membrane of the gallbladder, as well as its ducts.
CT scan Allows S. high degree Precision determine availability combined formations In the bustling bubble and liver, as well as to establish their stage of development and the likelihood of transition from a benign stage in malignant.

How to treat gallbladder polyps

Immediately after the detection and formulation of an accurate diagnosis, conservative treatment is carried out. In the presence of cholesterol neoplasms, in most cases, it is enough to adjust the patient's nutrition, as well as assign a number of drugs. Other types of polyps in the bustling bubble, the dimensions of which do not exceed 10 mm in diameter, are observed for about two years. The patient should regularly undergo a survey using an ultrasonic apparatus, MRI or computer tomograph. In the absence of intensive growth and pain, the polyps may not be exposed to surgical removal.

If the patient is diagnosed with inflammatory polyps in the bubble bubble, first the course of special therapy is carried out, the action of which is directed only to the removal of inflammation. As a result of such treatment, the polyps may disappear independently or significantly decrease in size.

Indications for the operation

In some cases, the patient with a diagnosis of "gallbladder polyps" is immediately sent to the operation. We find out when the operational excision of the gallbladder affected by polyposis is shown:

With intensive growth of the neoplasm, in which the increase reaches 2 mm per month;
In the presence of a plurality of polyps in the bustling bubble of the patient;
In the event that the size of education is even solitary, is more than 10 mm;
If the polyps in the bustling bubble constantly cause pain in the patient;
In the presence of in the bustling bubble, in addition to polyps of other neoplasms, for example, stones;
The presence of a pronounced leg with a plurality of vessels in it;
If the patient has relatives who suffered or suffer from cancer.

Is it possible to do without surgery?

In some cases, treat the polyps in the bustling bubble, the causes of which are based on improper nutrition and caused by this factor inflammation of the body mucous membrane, a special diet and drug therapy helps. If the neoplasms do not tend to grow, operational intervention May not be required until the situation change the situation.

Power supply in the bustle bubble

The bubble bubble connection with the digestive system affects the ability to restore it if the menu is adjusted. Regardless of whether the operation was conducted or not, it was recommended to exclude the following products from the diet:

sorrel;
legumes;
fat meat;
sharp vegetables such as garlic and radish;
canned vegetables, meat and fish, as well as pickles.

Restrictions are subject to products containing a large number of fiber, essential oils and cholesterol. Diet with polyps in the gallbladder should consist mainly of boiled or cooked products: vegetables, meat and fish. In addition, it is important to include cottage cheese, compotes from fresh or dried fruits, kisins and vegetable purees.

Than dangerous disease

Very often, patients are not even suspected how dangerous polyps in the bustling bubble are. Meanwhile, even in the absence of testimony to operation, this disease affects the body not in the best way. First, the neoplasms may themselves cause inflammation of the mucous membrane due to insufficient outflow of bile from the organ, as a result of which its walls are subjected to irreversible pathological changes. Secondly, the constant increase in bilirubin in the blood caused by a toxic lesion of the brain. And thirdly, the polyps can be malingized, that is, transform into a cancer tumor. All these risks can be significantly reduced if you turn to the doctor in time and be treated in accordance with its recommendations.

Polyps are the growth of the surface epithelium of the gallbladder, can be solitary and large 1-2 cm or form a mesh of small neoplasms with a height of 1-2 mm. Polyps have a benign nature, but if they are presented, the risk of oncological rebirth of cells and development increases.

Reflect important information about polypose and body cancer The following numbers:

Oncological diseases of the gallbladder are increasingly different and range from 0.27 to 0.41% of all cancer diseases.

The gallbladder cancer is twice as often among women than among male patients.

The risk of oncology increases with age, increases, starting from 45 years, and reaches its peak in 56-70 years.

Provice the development of gallbladder cancer can transactions of biliary tract - develops in 1-5% of all cases.

Among other oncological diseases of the digestive tract, the gallbladder cancer is in fifth place after diseases such as pancreatic cancer, stomach, intestines (direct and colon)

Symptoms of polyps in the bustling bubble

Any manifestations of the disease will depend on in which location is located. The maximum unfavorable situation is its growth on the cervical bubble, or inside his duct. It creates a barrier on the way of bile in the intestine, which causes the development of such a disease in a patient as mechanical jaundice. When polypose growths are localized in other gallbladder departments, then no specific symptoms The patient does not feel.

Nevertheless, it is possible to suspect its presence in the authority in some indirect signs:

Pain. They appear in response to excessive stretching of the organ walls not by the polyp itself, but bile, which is forced by its fault. Such congestive processes lead to the fact that multiple receptors located in the serous body of the organ are constantly annoyed. In addition, pains may occur due to too frequent reduction of the walls of the gallbladder. The character of painful sensations is stupid and new. They have a property to give in the right hypochondrium, are present on a periodic basis. Military-containing drinks, fatty dishes and strong. That is why patients do not bind unpleasant sensations with polyps, relating their occurrence to other factors, for example, incorrect power.

Coloring of the skin and mucous membranes in yellow. Such a sign is the result of a mechanical jaundice, which occurs when the polyp of bile ducts occurs. Without the opportunity to exit naturally, bile begins to leak through the walls of the bubble and penetrate into the blood. The patient begins to test the skin, coverings become dry and pulled, urine darkens, can begin with bile masses and climb the temperature.

Renal colic. If the polyp has a very long leg and is located in the cervical zone of the affected organ, then when it is twisted or the clamp can develop. Most often, this happens with a pronounced reduction of the organ. When the twisted, a person is experiencing a sudden pain that has a sharp gravity character, the heartbeat increases, blood pressure is growing. In this case, the patient cannot pick up more or less comfortable postureto somewhat calm the unpleasant feeling. Exactly last sign It is a vivid indicator of hepatic colic.

Disps symptomatics. The presence of a polyp is most often indicated by symptoms. The degree of its severity varies. Characteristic manifestations Consider: bitter taste, morning nausea, vomiting after overeating. All these manifestations are explained by periodic or permanent stagnation occurring in the body. In addition, due to the polyp there is a violation of bile. Its lack of negatively affects the process of digestion, so the patient may begin to lose weight quickly.

Nevertheless, all of the above symptoms rarely force the patient to contact medical facilities, and even more so undergo an ultrasound study, during which the existing tumors can be detected.

Causes of polyps in the gallbladder

There are four reasons why polyposny growths in the bustling bubble can be developed:

Factor of heredity and abnormalities of genetic development.So, the growth and development of polypose growth is the impact of heredity. Most often, adenomatous formations and papillomas are inherited. It was established that even when identifying other relatives of other tumors, the risks of the development of the gallbladder polyps are increasing. Moreover, genetic predisposition Dyskinesia of bile ducts is a direct cause leading to the development of polyposis. However, it cannot be said that only genetic predisposition is the cause of the formation of a tumor. It grows and develops under the influence of other factors. Humidated family history in this case is an additional provocateur for disease manifestation.

Diseases of the gallbladder of inflammatory genesis.Chronic are the most common reason for which the development of the polyp occurs. In the body against the background of cholecystitis, the bile occurs, its wall is thickened and exposed to strain. The granulation bubble fabric begins to react to the inflammatory process. This reaction is manifested in the form of the growth of its cells. As a result, a person forms pseudo polyps of inflammatory genesis.

Failure of exchange processes.The most common cause of the growth of cholesterol pseudopolypes is violations of lipid metabolism. As a result, a significant amount begins to circulate in the bloodstream. Its surplus is gradually starting to postpone on the walls of the vessels, as well as in the organ - bile storage. This leads to the formation of pseudopolyams consisting of cholesterol. In addition, such formations may occur even against the background of the normal concentration of lipids in the blood, which is due to cholesterol included in the bile. When conducting an ultrasound examination, it is most often found precisely such pseudopolys. The longer a person is their carrier, the more they become. Their growth contributes to the absence of any disturbing symptoms.

Hepatobiliary diseases.Any diseases of biliary tract contribute to the impaired balance between the optimally necessary for digestion with the amount of bile and its allocated for this process. Both its disadvantage and excess breaks the food digestion process. This leads to various tractures of the gastrointestinal tract, including provoking the development of polyps.

Related diseases during gallbladder polyps

Polyps of the gallbladder can provoke pathologies in the organs nearest to it - liver and pancreas. Thus, the polyps are a potential focus for the development of infection, which give rise to the inflammatory process. It provokes cholecystitis, spasms of biliary tract, and other diseases. In addition, the inflammatory processes in the bustling bubble can contribute to the pathological growth of its mucous membranes.

What diseases are observed during gallbladder polyps?

Dyskinesia or spasms duct gallbladder. Dyskinesia, which is hypertonic, in which the tone of the gallbladder increases, is more often found in women and is usually closely related to the menstrual cycle. Hypotonic dyskinesia (insufficient intensity of the gallbladder abbreviations) is common among middle or elderly people. Dyskinesia leads to the difficulty of bile outflow, which, during chronic flow, can provoke cholecystitis or deposition of stones in a busty bubble, and in addition, it creates conditions for the formation of polyps. Also, the disease may be caused by the dysfunction of the Sphinteer Oddi separating gallways from a 12-rosewoman.

Cholelithiasis - the formation of cholesterol stones in the liver, bile ducts or a bustling bubble due to the violations of lipid metabolism. The formation of cholesterol stones in the bustling bubble begins with violation chemical composition bile - it is not enough bile acids Both phospholipids, but observed with cholesterol, fatty acids. The causes of this disease may be obesity, unbalanced diet, stagnation of bile, gallbladder infection and biliary tract. At the same time, cholesterol polyps of the gallbladder and other neoplasms of its mucous can be observed.

Acute I. chronic pancreatitis - Inflammatory disease of the pancreas, which in 65-60% of cases is observed in dyskinesia, spasms or dysfunction of the Sphinteer of Oddi, hepatic colic and biliary disease. Other reasons for pancreatitis The spread of an inflammatory process caused by an infection from the gallbladder and its duct into the pancreas, alcohol and food abuse and food that causes increased pancreatic secretion.

What are the polyps in the bustling bubble?

Cholesterol polyps - Tumor-like formations, which consist of sediments of cholesterol with calcined inclusions, develops at the beginning of the gall blade, after which it grows, forming a polyp. Are usually observed in people with violations fat Exchange for increased level Lipoproteins of low density and reduction of the concentration of HDL (lipoproteins high density). There are quite often found, they are found randomly during the examination, since their education and growth proceeds asymptomatic.

Inflammatory polyps - the cause of their formation is an inflammatory process that can develop as a result bacterial infection. On the inner shell of the gallbladder, the growth of granulomatous tissues in the form of a tumor is formed.

Adenomatous polyps - True tumors, benign, but with an increased risk of malignant rebirth. The cause of adenomatous polyps and papillomas is the growth of iron tissue, in 10% of cases they are reborn into cancer education, which causes concerns from doctors and requires constant control over their growth and immediate treatment.

Papillomas are also benign tumors, usually small sizes and characteristic paratrooped sprouts.

Diagnosis of polyps in the bustling bubble

Detection pathological expansions The bustling bubble was made possible by the development of radiology from the thirties of the twentieth century. Since modern medicine In this regard, several steps forward, and more accurate and harmless diagnostic methods are available to patients.

In most medical institutions For the diagnosis of polyps use ultrasound and endoscopic ultrasonography:

Uzi allows you to detect single or multiple gallbladder mucosa. They manifest themselves on the screen of the apparatus associated with the walls of the bubble formations of a rounded form without an acoustic shadow. When changing the position of the patient's body, the polyps are not shifted.

Ultrasonography It is a study of duodenum and gallbladder with a flexible endoscope. The device is swallowed by the patient, at its end there is an ultrasonic sensor, with which the walls of the gallbladder occurs during the presence of growths. A large role in the detection of various details is played by the operating frequency of the sensor - the higher it is higher, the details obtained. This method allows you to get a better image, respectively, and the diagnostic data is more accurate.

In addition, in some hospitals, a study is available with a tomograph that received the name of magnetic resonance cholangiography. This is the most progressive on this moment The method, thanks to which the doctor can not only see, localize and estimate the size of the neoplasm, but also identify the presence of concomitant formations arising during the malignation of the polyp. To estimate the number of contrast agent accumulated by tumor tissues, can additionally assign multi-section computed tomography.

Due to the breadth of the application of modern diagnostic methods, the statistics of cases of gallbladder polyps were compiled, which showed that about 4% of the population are their permanent carriers, of which the predominant part (60%) is a woman between the ages of 30 and above.

Answers to popular questions

Can the polyp in the bustling bubble? In 95% of cases, detected polyps are loose cholesterol formations, which makes it possible to conservative treatment. choleretic drugsTo which Ursosan and URSOFALK belong. Medicines that dilute bile contribute to the resorption of polyps of the submembraty layer of the gallbladder.

Is it possible to remove only the polyps themselves, while maintaining a functioning gallbladder? Remove the polyp, without damaging the walls of the gallbladder, it is impossible, so even if the doctor preserves the organ, its function will be broken, and the polyps will appear after a while again, possibly in more than before the operation. From this practice refused for quite a long time. Already in the 70s of the last century, they stopped performing operations that retain the gallbladder, after removing neoplasms from it. In addition, one time was a popular crushing technique (lithotripsy). However, this therapeutic technique turned out to be meaningless, since after 99% of patients had a relapse of the disease. In the future, it was helped by only surgical interference with the removal of the body. Therefore, the optimal method of treatment is the operation, namely laparoscopic cholecystectomy.

Nevertheless, the removal of the gallbladder is not single way outMost of the neoplasms are amenable to conservative treatment. From the patient, it is required to regularly undergo diagnostics twice a year to prevent the polyagnization of polyps and the beginning of the cancer process. Danger represents growing more than 10mm, which do not stop growth; If a small polyp increased over the year and has become twice as much as the initial size, it can talk about the start of malignization. The neoplasms with a wide base that have no pronounced legs are more inclined to malignant reincarnation. In case of polyps, more centimeters prescribe an operation to remove bile. In other cases, it is possible to do with choleretic drugs and the correction of the power mode, lifestyle.

Could the polype in the bustle bubble be sown? Pains for the gallbladder polyps are usually associated with the formation of cholesterol stones or are symptoms of cholecystitis. Usually, the polyps in the bustle bubble do not deliver pain.

Is it possible to visit the bath or sauna during polyps in the bustling bubble? With polyps in the gallbub, it is impossible to warm the area of \u200b\u200bthe organ, so it is not recommended to go to the bath or sauna, spend a lot of time in the sun.

What if they discovered the polyps in the bustling bubble?

In 95% of cases of neoplasms diagnosed as polyps, in fact, are cholesterol counters - loose stones that can resolve under the action of bile.

The treatment is carried out by minoroxycholic and ursodeoxycholic acid, which stimulate the mechanism of boring and improve the quality of bile, which contributes to the dissolution of cholesterol stones. A three-month treatment is prescribed, the dosage is calculated at 10 mg per 1 kg of patient weight, take in the evenings two hours after last reception Food. Treatment of bile acids combined with a diet on table №5

After the course of treatment is completed, a control ultrasound study is carried out and draw conclusions about the need for an operation. If the growth of formations slows down, their number or size decreases, then conservative treatments in this case are effective.

Treatment of polyps in the bustling bubble without surgery

First of all, it is necessary to refer to the gastroenterologist and conduct all the necessary diagnostic surveys, in order to determine the type of polyps, their size and risk of malignancy.

Cholesterol polyps are the most common type of neoplasm in the bustling bubble, with timely treatment do not represent much danger.

Cholesterol polyps are found in the form of a mesh of small inclusions of 1-2mm, common diffuse on the inner wall of the organ, or may have size up to 4 mm and in ultrasonography look like increased with smooth circuits and a wide base. Polyps are larger than 4 mm already have a thin leg.

Urozofalk, which contributes to the destruction of deposits consisting of cholesterol.

Simvastatin, contributes to a decrease in blood levels of lipoproteins and cholesterol.

Hepabenz and No-Shpa are used as auxiliary drugs, helping to relax the smooth muscles of the gallbladder. A spasm is removed from the authority, the bile has the ability to normally pass along the channels and take part in the process of digesting food.

Holyver increases the ability of the gallbladder to secrete bile and eliminates stagnant phenomena.

Ursosan allows you to eliminate cholesterol stones, with a bustling bubble that does not lose the ability to function.

Multiple cholesterol polyposis can actually be not expanding, and loose cholesterol stones, which subsequently cause painfulness in a patient. Common complaints are sensitive, nausea and pain in the right hypochondrium, symptoms of cholecystitis caused by cholesterol stones.

Treatment of cholesterol polyps can be carried out conservative in case the height of the growth is not more than 10 mm.

Surgical operation to remove polyps or the entire gallbladder is assigned only in the very extreme caseIf the neoplasms are much and they are constantly growing. In most cases, doctors are trying to preserve the body, since its absence can provoke digestive disorders and make it difficult to assimilate fat food.

Operation with polyps in the gallbladder

Oncologically tense atmosphere of modernity requires careful control over any neoplasms in the body, otherwise there is a risk of oncological rebirth of tissues. If the course of conservative treatment did not give results, or during the first diagnostics, polyps of large sizes were detected, the operation was shown.

Indications for surgical treatment of polyps:

High growth rate of polyps - from two mm per year;

New formation size from 10 mm;

A large number of expansions with a wide base without legs.

During the size of polyps less than 1 mm, the operation is not needed, but preventive inspection We are necessary every month for six months, and then every time three months. If the neoplasms do not increase in the amount, then in the future, the diagnosis is carried out every six months.

Types of operations on the bustling bubble:

VideoParoscopic Cholecystectomy (LHE) - It is considered the most gentle for the patient, uses modern technology of endoscopy.

Laparoscopic cholecystectomy - removal of the gallbladder without a cut, as with traditional cholecystectomy using tools for endoscopic operations. Considered "Gold Standard" modern surgeryBut in five percent cases, the operation is not fully managed and traditional cholecystectomy is carried out.

Traditional cholecystectomy (TCE) - By open operation, access is carried out through the upper middle section or incision on Koker in the right hypochondrium. The disadvantage of this method, in comparison with laparoscopic cholecystectomy, is its trauma - cut cuts the skin, fat fiber, white line Belly and peritone.

Endoscopic polypectomy - It is used to remove the gallbladder polyps while preserving the organ. This type Operations are carried out using a diathermic loop, which is thrown into a polypa leg and cut it off. Education without legs are removed by fragmentation. Through the loop, the electrical charge is passed to coagulate the vessels, which helps to avoid bleeding. This method is used to remove polyps in the intestine, but it is rarely used in the treatment of a gallbladder polyposis, so the consequences can be unpredictable.

Preparation for cholecystectomy

Before carrying out the operation, the patient must pass a comprehensive diagnostic examination, to avoid possible complications and choose optimal method cholecystectomy.

What kind diagnostic procedures It is necessary to conduct before surgery:

Ultrasound of the liver, gallbladder and pancreas, which allows you to identify related diseases and inflammatory processes, assess the amount of polyps, their size and type, determine the presence of stones in the liver and the bustling bubble;

CT scan (

MRI - one of the most reliable methods Studies of polyps and stones in a busty bubble, allowing you to detect adhesive processes, inflammation, the pathology of biliary tract;

Diagnosis of condition of cardiovascular and respiratory systems Using radiography and ECG, it allows you to properly assign a treatment scheme; - Serious contraindication for some methods of cholecystectomy.

Preparatory procedures necessary to the patient immediately before the operation:

Exclude from the diet products that dilute blood, to stop receiving drugs affecting blood clotting, for example, aspirin is necessary to minimize the risk of bleeding during the operation.

On the day of operation, do not eat food and liquids, even water is eliminated.

On the night before the operation, it is necessary to clean the intestines using the enema or laxative;

Immediately before the operation, carefully conduct body hygiene using an antibacterial soap.

Is it possible to live without a gallbladder?

All human bodies can be divided into vital (like brain, heart, liver, etc.) and organs, without which life is possible, but the functionality of some systems will be broken. Such organs include spleen, gallbladder, appendix and stomach. Despite the fact that a person may well live without these bodies when complying with a strict diet and restriction of loads on the body, it is not recommended to remove them without a good need.

The removal of the gallbladder is carried out only if its pathologies threaten the whole organism as a whole. So, a large amount of polyps with an accelerated growth rate and an increased risk of malignancy can lead to a gallbladder cancer with metastases in other internal organs. In this case, the removal of the gallbladder or cholecystectomy is a matter of life and death. This is an absolute reading for the operation.

There are also relative readings For surgery: when the pathology of the gallbladder does not threaten life, but its quality worsens noticeably. For example, if the polyps in the gall bladder become the cause of pain or are a hearth infection. If a person is constantly forced to be afraid of pain or potential risk malignant rebirth of polyps and cancer, it is better to make an operation. After a successful operation and rehabilitation period, the patient has a chance to return to a full-fledged life.

Rules of behavior after removal of the gallbladder

After the operation, the patient will have to slightly change the power output. The fact is that, due to the bustling bubble, the bile accumulates in the liver, and its concentration increases. In the absence of this body, digestive juice is directed directly into the intestine, and its concentration remains quite low. The removal of the gallbladder also affects the activity of enzymes - it is significantly reduced. In order for the body to be completely able to adapt to a new digestion method without the help of a remote authority, it takes about two years.

The first six months after the operation, it is necessary to very strictly monitor the power mode:

The first rule is only boiled or stolen food.

The second rule is to eat in small pieces, slowly and thoroughly chewing it. It will give liver time to activate all the necessary enzymes and inclusion in operation.

The third rule is to reduce the number of well-used foods, but increase the number of servings. Otherwise, the digestive system will not have time to cope with its functions, and nausea will appear, the severity in the intestine. Another negative consequence of violation of this rule is stagnant bile, which may occur in the ducts and after removing the bubble.

After six months of strict abstinence, fresh vegetables and fruits can be included in the diet, as well as dietary meat and fish. Although from overlooking acidic, sharp and rich foods (onions, sour berries, etc.), it is necessary to refuse for another 12-18 months.

Two years after the removal of the gallbladder, the digestive system becomes strong enough so that the patient can return to the diet's usual for him, excluding the refractory fats (heavy meat and fat), although the second and third rule is best to adhere to the whole life.

Physical activity after an operation to remove the gallbladder

Two or three months later postoperative period The patient is highly recommended to do regular hiking walks that occupy at least half an hour. This is the very first and available way Avoid stagnation of bile.

In six months, the patient can sign up to the pool or swimming in the warm season on its own independently - regular soft massage with water almost completely eliminates the danger of stagnation.

At the same time it is allowed to engage morning gymnasticsBut this does not concern the muscles of the press. The significant voltage of the muscular corset doctors is recognized as safe only a year after the operation.

Problem with microflora after cholecystectomy

Reducing the concentration of bile also affects microflora fine intestine - Microbes get the ability to breed intensively and provoke attacks, and. To stop the reproduction of conditionally pathogenic and pathogenic microflora, change the nature of the food (eliminate the diet of sweets), maintain the useful microflora with regular reception of prebiotics and food with bifi and lactobacteriums. To solve this problem, you can also contact the gastroenterologist for advice on the selection medicines, destroying intestinal microbes without harm to the body.

Diet with polyps in the bustling bubble and after removal

In diseases associated with the insufficiency of the liver and gallbladder, the doctor necessarily assigns a dietary table No. 5 or reports its basic requirements without specifying a diet, for example, simply says: "It is impossible to fried, sharp, smoked marinated", etc. In any case, the patient with the polyps in the bustling bubble needs to be known how to maintain your health, fencing itself from heavy products for the liver.

The dietary tables were invented by the founder of medical nutrition, Soviet scientist Manuel Pevzer. Despite the honorable age of research conducted for the development of diets in the 30s-50s of the 20th century, in the USSR, and then in the CIS countries, the dietary tables are appointed to this day, since their effectiveness is tested by time and does not leave doubt.

Diet No. 5 consists of products that provide a full-fledged daily portion of proteins, carbohydrates and calories with limiting fats. With use defined species Food the patient's condition may worsen because they should be excluded from the diet. Also limited to eating, unnecessarily stimulating the work of the pancreas and the secretion of the stomach itself.

The ultimate goal of the diet is not only the weakening of the chemical load on the liver, but also the early excretion of cholesterol due to the improvement of intestinal peristalticism and choleretic properties Food components.
The diet must be observed so that the optimal daily calorie intake (for an adult is 2200 to 2600 kokalorius, depending on the severity of physical labor performed regularly). In addition to caloric food, the amount of food is extremely important, as even light and liquid food taken by large portions can overload a gallbubble.

When polyps are found in the bustling bubble, which often occurs randomly with a comprehensive examination, at the first stages of the disease do not necessarily contact the doctor. The patient can adhere to this diet independently, in order not to bring the disease to the need for operational intervention and increase the efficiency of conservative treatment.

What can I eat?

Flour - bread black and white, only yesterday's baking or dried to superstar. Mostly from time to time to indulge yourself with dry cookies or biscuit. No more than two times a week, it is allowed to use well-pitched buns or oil pies in the dough;

Meat - only low-fat. If it is beef, then boiled, you can also eat tongue and ham. If the bird is dietary (chicken, turkey), it is desirable only fillets (breasts), but other fleshy parts are allowed to eat. Fish must be prepared for a pair or cooking, caviar and milk can be added only by small amounts as a flavor amplifier. When it is possible, boiled meat and fish to improve taste is allowed to be additionally baked.

Eggs to boil the schozy Use no more than one per day. It is best to prepare an omelet from it. If the omelet is big, it is necessary to separate it into parts and it is to get only one egg per day (for example, a dish of four eggs is divided into four parts and do not eat one another one per day);

Vegetables with greens can be eaten both raw and boiled. It is useful to apply vegetables in the role of garnings and full-fledged dishes, especially if it is;

Crupes boiled on water or with milk, as well as pasta;

Fruits and berries - only sweet and preferably in the composition of a jelly or compote, sour fruit Excluded from the diet. Bake and disappear fruit is not prohibited;

Molkproduks can be eaten no more than 200 g per day. It may be low-fat raw products (Cottage cheese, kefir, milk, yoghurts, unshearch cheese). It is also allowed to prepare from them casserole, dumplings, souffles, cheesecakes, fused cheese.

Vegetable oil - No more than two tablespoons per day, use exclusively as refueling in vegetable salads and other finished dishes.

Among the sweet, you should choose natural honey, jam, marshmallow, marmalade, but not more than 70 g per day;

Sauces based on milk, berries and fruits;

Drinks: Nanish rosehip, herbal fees with choleretic effect;

Among the spices to give preference to greenery (,), and.

Food is divided into small portions, the number of techniques daily at least five. It is impossible to eat a cold or very hot meal, it can provoke irritation of the intestinal mucosa. Daily use at least 1.5 liters of liquid, drink before each meal, it contributes to the yoy output, preventing it to accumulate and stagnation. Minimize the amount of salt consumed. Food as possible should be chopped before taking.

What can not eat?

Under the ban, refractory fats and products containing them - fat, lamb, pork; permissible small number butter in the diet;

Smoked, sharp, pickled, canned food;

Among the greenery and vegetables are to exclude from the diet, onions, garlic, radishes and sorrel;

All legumes;

Among dairy products is prohibited sour cream;

Baking;

Chocolate, cocoa and ice cream;

Any carbonated drinks;

Vinegar, spices and spices;

Restriction of salt intake - no more than 10 g per day;

Any alcohol.

Education: Diploma in the specialty "Therapeutic business" was obtained in the RGMU. N. I. Pirogova (2005). Graduate student in the specialty "Gastroenterology" is an educational and scientific center.

Cholesterol Polyp is a tumor formation consisting of sediments of this organic compound with calcined engines. It can grow under the mucous surface of the gallbladder.

By nature, it is not true, therefore it is referred to as a pseudopolypa. Such formations can be small and large - up to two centimeters, single or localized by groups. Their nature is benign, but they can cause serious ailments, if not treatment.

Cholesterol polyps detect the fatty metabolism suffering. With the origin of such education, it is usually no symptoms, small polyps are found in ultrasound diagnostics abdominal cavity.

The reasons for the appearance of such formations in the bustling bubble:

Failure of lipid metabolic processes. In the blood, the level of harmful cholesterol increases, the excess of which settles on the walls of the gallbladder.
Changes in bile composition due to concomitant diseases.

Because nic unpleasant sensations At first, such polyps do not deliver, they do not notice them for a long time, which contributes to the growth of formations. According to statistics, they have every twenty-fifth person, and women are over 30 years old - more than 60 percent.

Subsequently, when the polyps in the busty bubble increase in size, can manifest the following symptoms:

Painful feelings. They arise as a reaction to an excessive stretching of the walls being stuck due to the scratched polyp bile. Also stupid I. many pain may be provoked due to multiple contractions of the organ walls. They are manifested by periods, localized on the right side of the peritone.
The most sharp pain syndromes They occur after taking alcohol, fatty and fried dishes and at the time of stress. There are strong painful spasms, referred to as hepatic colic. They do not disappear when changing the posture. This happens if the polyp is twisted on the leg. Accompanying tachycardia and growth arterial pressure.
The appearance of a jaundice shade on the skin and cleaners. If the polyp has grown larger than the diameter of the gall duct, the so-called mechanical jaundice is manifested due to bile, which combines through the bubble shell. The yellowness of the skin is dry, itching, the dark color of urine, nausea and even vomiting bile. Occasionally an increase in temperature and a sharp weight loss.
Dyspepsia. There may be an unpleasant bitter taste, gentlement, belching. They also explain the bile in the bubble.

Diagnosis of the disease

How to detect cholesterol polyps?

There are several methods for studying the gallbladder:

Ultrasound procedure. It clearly shows both single cholesterol formations in the gallbladder and their groups. On the screen, they look like rounded stains with the lack of acoustic shadows and are not mixed with the change of patient's poses.
Ultrasonography. This technique uses a flexible endoscope. The patient swallows the tube with an ultrasonic sensor, it falls into duodenal gut And it can also show the state of the gallbladder. Since the distance from the sensor to the organs of the organ is less than with the usual ultrasound, the picture will be clearer. Especially if a modern device with high frequency is applied.

Here the study is carried out with the help of modern tomographs. According to this modern method The specialist will not only determine the size and localization of the polypa, but also reveals the pathological change in its cells. Due to the accuracy of this diagnosis, the most effective treatment.
Laboratory diagnostics: Biochemical blood test, Cala and urine research.

Getting rid of formations

Cholesterol polyps are quite amenable to medical therapy. First of all, it is necessary to change the power mode and establish the reception of special preparations for the appointment of a doctor who dissolve cholesterol plaques and prevent the formation of new ones. In some cases, anti-inflammatory treatment is also required.

What kind medication tools The doctor can recommend:

Name	Principle of impact	How to apply
Ursosan or URSOFALK	It dissolves cholesterol deposits in the biliary system due to active acids, which leads to the disappearance of pseudopolyam.	The number of capsules per day depends on the weight of the patient. For the average man enough two. Treatment at the first stage is carried out within three months, after the control ultrasound can be assigned a re-course.
Simvastatin	Reduces the amount of harmful cholesterol, as well as lipoproteins.	How long the treatment will last depends on the degree of the disease. Usually dodged one capsule every evening.
Holyver	Normalizes the selection of bile, improves the peristaltics of the relevant authorities. However, this drug is not prescribed if the polyp blocked the biliary paths completely.	Two tablets in front of breakfast, lunch and dinner.
But-shp.	It has a generallylabing effect on the smooth muscles of the abdominal organs, pains pain spasms.	For strong pain In the right hypochondrium, you need to drink one or two tablets.
Hepaben	Adjusts the bile secretion with hepatocytes, removes the spasms of the patient organ.	During breakfast, lunch and dinner on one capsule.

Treatment After consulting a doctor may add folk remedies. Especially useful plants with a choleretic effect: Rephetok, immortelle, rosehip.

Here are some fees that promote the disappearance of polyps:

Cocktail of healing herbs.

How to cook: take 25 grams of dried dispute and coltsfoot, as well as strawberry leaves. Add 20 grams of cornflowers, blackberry leaves, hunter and shepherd bags, 15 grams of dill and turn. Pour two spoons of a mixture of a glass of boiling water, and after half an hour filtering and adding as much tea from the rose hips.

Treatment: Drink in front of breakfast, lunch and dinner for a third of a glass in continuation of three months.

Repshok tea.

How to cook: Two teaspops of dried grass are brewed in a cup of boiling water as ordinary tea.

Treatment: Drink on the cup three times a day before full recovery.

Infusion from immortals, coriander, three-lines and mint watches.

How to cook: We mix all herbs in equal proportions, only the immortals take two times more. A tablespoon of the received collection is brewing in a half-liter thermos.

Treatment: Drink in the morning next day Anytime. Fitotherapy lasts two months.

According to doctors, if there is at least a small opportunity to preserve the gallbladder, it is necessary to do without surgery. At the same time, constant control is necessary to ensure that the polyps do not increase in size.

If they are small (up to 1 mm), then liquidation is possible with medication therapy and diet. To confirm a positive forecast, an ultrasound diagnosis is carried out in three months, after - after six months, then in a year. Polyp, which increases in size by 2 mm per year, can be a prerequisite for surgery. Provoke an increase in education can various factors, Including pregnancy.

Surgery This illness of the gallbladder can be carried out in several ways:

videoParoscopic cholecystectomy;
open laparoscopic cholecystectomy;
traditional cholecystectomy;
endoscopic polypectomy.

After surgery, you need to send remote fabrics to histological examination to check whether there are no pathological rebirths of cells into malignant.

Diet and prevention

The emergence of formations, and the more surgical intervention, suggest a certain diet. Each food is necessary for small portions every three hours during the day. We'll have to abandon hot and ice dishes, sharp spices, oily and fried, canned and fast food, as well as exotic delicacies. During the day there should be no more than tea spoons of salt, but a lot of drink is relying.

Good frost dishes cooked in a double boiler or baked. Upon completion of breakfast, lunch and dinner should not be a feeling of gravity. It is not necessary to engage in active physical activity immediately after eating.

Cholesterol gallbladder polyp is abnormally tumor educationwhich has a drop-shaped or rounded shape consists of various organic compounds with calcium particles. It occurs on the mucous membrane of the gallbladder and has a hollow structure. These formations can be both small and large, it all depends on the nature and course of the disease.

Polyps are benign tumor, however, if you do not hold timely treatmentT. negative consequences Do not make yourself wait. Let's figure it out, because of what the polyps arise on the gallbladder, how to get rid of them and what consequences can carry.

Clinical picture of the disease

The polyps are attached to the mucous membrane using a certain leg, they can also be located on a wide base and germinate into the enumeration of the organ. Cholesterol polyps in the bustling bubble are most often formed in women older than 30 years.

These neoplasms are sufficiently difficult to diagnose, since their symptoms are similar to other different diseases of the gallbladder.

There are several varieties of polyps:

Cholesterol polyps occur more often than others and can be conservative.

Causes and symptoms of polyps

The reasons for the formation of cholesterol polyps in the gall bladder are as follows:

Failure in fat exchange processes. As a result of this level poor cholesterol It grows in the blood and its excess is settled on the mucous gallbladder;
Disorders of motor and spatial coordination of biliary tract;
Amended bile composition due to pathologies and diseases.

Cholesterol polyps do not bring discomfort and painful feelings on the initial stages Development, precisely because of this, they are quite difficult to identify the progression of the disease. Over time, the polyps grow up, become more and only then bring significant changes in the usual state of the patient.

The symptoms of the disease are as follows:

The aggravation of this disease may occur when driving alcohol, non-compliance with proper nutrition and excessive physical exertion. Cases of operational intervention in the difficult stage of exacerbation.

Diagnosis and treatment of disease

As described above, detect cholesterol polyp is quite difficult. It is a poet that a comprehensive examination is carried out, which usually consists of the following hardware techniques:

Treatment of cholesterol polyps in the bustling bubble provides not only by drug interference, but also additional compliance special diet and lifestyle. Only such treatment can be considered the most efficient and rapid.

Eating is carried out in small portions every 3-4 hours;
Do not eat acute, excessively salty, sweet and sour. It should be discarded hot and cold dishes;
Limit the use of oily, fried, fast food, chips and carbonated drinks;
Drink 2-3 liters clean water a day, while limiting the consumption of tea, juices, hits and other sahane-containing liquids;
Dishes should be prepared for a couple or cook. It is best to use products in a crushed or overhead;
Should not do heavy exercise, especially in the first few hours after meals;
The use of products containing fiber will help to normalize metabolism and reduce the amount of bad fatty acids in organism;
You need to eat moderate number vegetables, fruits, nuts and bran;
You can use a paste of solid wheat varieties, but from the usual macaronium it is better to refuse;
Spend more time on fresh airIt is best to engage in hiking.
It should refuse hot dishes

The attending physician may assign one of next drugswhich are particularly effective in the treatment of cholesterol polyp gallbladder:

Ursosan. It helps dissolve cholesterol sediments on the mucous bubble;
Holyver. Contributes to the normalization of the selection of bile;
But-shp. Relieves pain in the abdominal area, and also has relaxing properties that act on smooth muscles;
Hepaben. Prevents and removes painful spasms, settles the bile secretion;
Simvastin. He contributes to the removal of lipoprotem and poor cholesterol.

The doctor can also assign some folk remedies, such as:

Infusions from coriander, immortals, mint;
Tea from repaint;
Decoration ragners, strawberry leaves, coltsfoot.

We remind you that there should be no independent treatment with this disease and take the funds below only after consulting with your attending physician. The doctor will help you choose the optimal decoctions for you and prescribe their dosage, as well as a way of cooking and receiving.

In the treatment of cholesterol polyp in the bustling bubble, operational intervention may be taken. The following surgical methods are usually used:

Holytectomy (traditional, videospairoscopic, open laparoscopic);
Endoscopic polypectomy.

Preventive measures

In order to avoid the appearance of cholesterol polyps in the bustling bubble, it is necessary to conduct preventive measuresthat will help you get rid of repeated treatment This problem.

Prevention of the disease may be carried out as follows:

Healthy, active lifestyle is extremely important, since hypodynamia contributes to the metabolic disordancy and decrease protective functions organism. In turn, this may lead to the re-occurrence of cholesterol polyps.