Therapy for inflammation of the gall bladder
The therapy of a gall bladder inflammation is nowadays standard surgery. If the inflammation is mild, surgery should be performed within the first three days after the onset of symptoms. In the past, patients usually had to wait up to 6 weeks before surgery was performed, and only then when the patient was free of symptoms again.
However, studies have shown that a timely surgery brings a better outcome for the patient. Furthermore, only symptomatic gallstone carriers are operated on. Surgery is therefore necessary even in cases of proven stone disease, excluding other causes.
The gallbladder is completely removed with any stones that may be present. This is called a cholecystectomy. The operation is performed laparoscopically, as this is the gentlest procedure for the patient.
Only small abdominal incisions are needed to insert the instruments. This way, there is no large operation scar. If the gallbladder cannot be removed in this way because, for example, the stones are too large or there are too many adhesions in the abdomen, a ribcage incision must still be made.
This procedure is called open cholecystectomy. Multimorbid patients, who have a high risk of surgery, e.g.B. due to old age or certain previous illnesses, can initially be treated conservatively.
This includes the administration of antibiotics, as well as remedies against inflammation (anti-inflammatory drugs) and remedies against a spasmodic and painful contraction of the gall bladder (spasmolytics and analgesics). If possible, surgery should still follow to avoid complications of cholecystitis. Alternatively, bile can be punctured and drained using CT guidance.
This is called percutaneous drainage. Gallstones, which are the most common cause of inflammation, can be removed by various procedures. If the stone is located in the “main bile duct”, the choledochal duct, endoscopic retrograde cholangiopancreaticography, or ERCP for short, is used.
A camera tube is passed through the small intestine to the opening of the pancreatic and bile ducts. The pancreatic ducts, the gall bladder ducts and the gall bladder can be visualized by the administration of contrast medium. If gallstones are seen, they can be removed from the bile duct with the aid of a catcher basket after the papilla has been dilated.
ERCP is therefore used both for diagnosis and therapy of gallstones. However, since there is a certain risk of new stones, an operation should still follow. Contraindications for a laparoscopic removal of the gallbladder are carcinoma of the gallbladder, coagulation disorders or adhesions in the abdomen, e.g. after previous operations.
In advanced stages with tissue loss or accumulation of pus, surgery must be performed immediately and preferably in an open procedure. Stone dissolution by medication (litholysis) is achieved by oral administration of bile acid capsules over a period of 3-6 months. This procedure is only suitable for cholesterol stones.
In half of the cases, however, stones are formed again within 5 years. The stones can also be broken up with the help of extracorporeal shock waves. The procedure is also called cholelithotripsy and is only possible if the patient has less than three calcified stones, which are less than 3cm in size.
Afterwards, again, medication must be taken to dissolve them. In this case there is also a risk of new stones of about 10-15% per year. With the right diet, gallstones can often be avoided.
In the case of existing gallstones, there are also some dietary tips that can help against the symptoms. Above all, low-fat food should be avoided. In the case of gallstones, however, fats should not be completely avoided, as this can have negative effects.
If the gall bladder has already been removed, however, as little fat as possible should be taken in. In general, vegetable oils can be used for cooking instead of animal fats. In the case of dairy products, it is worth reaching for the low-fat variant of the respective product.
The gallbladder is spared. The gallbladder is also exposed to an unfavorable stimulus by eating too spicy food. In addition, several small meals spread over the day are also sensible instead of excessive full meals.
It is equally important to ensure a sufficient fluid intake. Regular drinking promotes digestion and ensures that the bile does not thicken. A strict diet or even fasting is not necessary.
This tends to thicken the bile, increase cholesterol and lead to the formation of gallstones. Gentle methods such as steaming or steam cooking can be used in the preparation of food. However, deep-frying or baking in fat should be avoided.
Of course, there are some specific globules that can be considered for gallstone complaints. These include Byronia and Chelidonium for pressure pain in the liver area. Together with podophyllum, these also help with pain that radiates further.
Mandragora and Belladonna help against cramps and colic. Ultimately, however, gallbladder complaints should not be underestimated due to the complications already described. In any case, a doctor must be consulted.
