Original Dr. Dragon from Chelsea98.com Hui Zhou Million Dragon's Great Health
Gallstones are the most common biliary disease,
The prevalence rate in countries around the world is about 5%-25%;
Among them, the western population, women and the elderly have a higher prevalence;
With the improvement of living standards, the incidence of gallbladder stones is still rising;
The age at which gallstones are susceptible is older than middle-aged, and younger people also tend to increase. Occasionally, the same happens in newborns and toddlers;
In terms of gender, in Europe and America, there are 1.5 to 3 times more women than men;
Japan is predominantly male, but young women are about 1.5 times that of young men;
The incidence of gallbladder stones in China is 10%-15%, of which asymptomatic gallbladder stones account for 50%-70%. The incidence has doubled compared with 10 years ago, and it is more common in women;
People who are thin may also suffer from gallstones, but they are generally common in people who like to eat fatty foods. Cholesterol system stones have this tendency.
It was learned at the Hepatobiliary and Pancreatic Forum held in Beijing in 2015 that gallbladder cancer is on the rise in China. Experts point out that gallbladder cancer is a highly malignant tumor. It is almost always at an advanced stage after the onset of symptoms, and has lost the opportunity for a radical cure. Its formation is related to many factors, including gallbladder stones, chronic gallbladder inflammation, gallbladder adenoma polyps, biliary parasite infections, etc. Among them, gallbladder stones and gallbladder polyps are the most common risk factors. Therefore, it must be treated in an early and timely manner to achieve better results.
The main risk factors for cholesterol stones are: Female, pregnancy, high consumption of estrogen, increasing age, race (the incidence of Native American Indians is higher, while the incidence of black Americans and people from China, Japan, India and Thailand is lower), genetics, obesity, high Triglyceride levels, low HDL levels, sudden weight loss, high-energy diet, refined carbohydrate diet, lack of exercise, liver cirrhosis, Crohn’s disease, and gallbladder contraction disorders (such as after gastrectomy or after vagus nerve resection).
(1) Causes of gallstones
Gallstones are gallbladder stones, also known as cholelithiasis (gallstones, choleliths), which are crystals deposited in the gallbladder. The bile ducts or gallbladder produce gallstones and cause severe abdominal pain, jaundice, fever and other symptoms. The so-called gallstones are changes in the composition of bile (digestive juice excreted from the liver), and then stones are caused by its composition. The stones in the gallbladder are called "gallbladder stones" and the stones in the bile duct are called "biliary stones". Both of them have individual characteristics in terms of formation, composition, and symptoms.
The main components of gallstones are cholesterol and bilirubin (bile pigment) in bile. In addition, there are still calcium and fatty acids as the main components. Gallstones are distinguished according to their main components, including cholesterol stone, bilirubinite, calcium stone, fatty acid stone and others. From a therapeutic point of view, it can be divided into two types: cholesterol system stones and bilirubin system stones. Most gallstones are one of the two. The properties and symptoms of calcium stone are similar to cholesterol and fatty acid stones. Other gallstones are similar to bilirubinite.
Causes of gallstones:
1. The combined effect of multiple genes; 2. Bacterial infection; 3. Schistosoma infection; 4. Overeating; 5. High-fat/low-fat diet; 6. Cholecystitis; 7. Incorrect lifestyle (such as dieting); 8. Other theories: The more famous ones are the theory of metabolic disorders, the theory of cholestasis and biliary tract (cholestosis), the theory of biliary inflammation, the theory of infection, and the theory of autonomic disorders. In fact, it is caused by a combination of the above-mentioned various reasons. Hemolysis, chronic bacterial or parasitic infections are often considered to be the main risk factors for bile pigment stones, but the above three factors can often be avoided through health management measures.
The most important thing is the changes in bile composition caused by the above-mentioned various reasons. Cholesterol is saturated in the bile, and if a certain change occurs, it immediately crystallizes into gallstones. Bile will change, and most of it is a decrease in bile acids that have the ability to dissolve cholesterol. For example, the gallbladder causes inflammation, the bile acid in the bile is absorbed by the gallbladder wall, but the cholesterol is not absorbed, making the ratio of cholesterol and bile acid increase, and finally gallstones are produced. In addition, the dissolution of cholesterol, fatty acids in bile are also closely related to lecithin.
Certain bacteria (such as E. coli) can cause the decomposition of water-soluble bilirubin in the bile, and the free bilirubin after the decomposition will form a precipitate with calcium ions to form a stone. Bile stasis in the biliary tract can also cause changes in bile components. Sympathetic nerves and parasympathetic nerves cause biliary tension and dyskinesia, and living conditions (such as those who sit and work all day, those who have the habit of corsets, and those who are prone to constipation) also have an impact. Women during pregnancy and postpartum are also prone to gallstones. This is because cholesterol in the blood and bile increases, and as the fetus grows, the bile duct is compressed and causes bile stasis. Abnormal hormone levels are also one of the reasons.
(2) Symptoms of gallstones
Before the onset of severe pain, swelling, nausea, and vomiting of the upper abdomen occur. People with several episodes can predict it in advance. In the acute phase, Murphy's sign may occur, with sudden upper abdomen pain, often to the right side. The strongest point of pain is in the upper right abdomen. Patients often hold their right abdomen and bend down due to severe pain, which is extremely painful. The pain will spread from the upper abdomen to the right chest, right back, right shoulder and other places outside the biliary tract. Pancreatitis also has dissipated pain, which is characterized by dissipating to the left back and left shoulder.
During the attack, the patient sweats, feels cold and trembling, and sometimes has a fever. In addition, it causes intense vomiting, and it becomes more comfortable after vomiting something with yellow bile. After the onset of colic, there will be slight jaundice, making the stools grayish white and the urine thick brown. This is because gallstones are blocked in the bile ducts and bile cannot flow into the intestines. The underside of the right ribs will also be tense and stiff, and you will feel pain when pressing with your hands, and you can also feel the swollen gallbladder. During the intermittent period after calming down, there are usually no severe symptoms. I only feel pressure on the left back, pain in the right ribs, and slight swelling of the upper abdomen. Some patients also have abnormal bowel movements or constipation, but some people have no such symptoms.
When the attack of gallstones lasts for a long time, is caused repeatedly, and causes inflammation, it often causes various troublesome complications. When there is the possibility of other diseases, surgery should be performed to remove gallstones. Complications include cholecystitis, cholangitis, and subsequent perforation of the gallbladder, biliary peritonitis, liver abscess, pancreatitis, and sepsis. Small gallstones will be excreted into the intestines through the bile duct and excreted with feces, but bold stones over 2 cm cannot be excreted. If you want to discharge it into the intestine, the gallbladder and the intestine will be blocked, and a perforation (biliary fistula) will be formed at the place, and discharge from the perforation to the intestine. When gallstones pass through the intestine, they are often infarcted in the narrow part, especially the small intestine between the large intestine and the valve between the large intestine, which leads to intestinal occlusion. In this case, surgery should be performed quickly. Repeated biliary inflammation or obliterative jaundice can cause liver disorders.The stimulation of gallstones is also considered to be one of the causes of gallbladder cancer and cholangiocarcinoma.
During and shortly after the onset of gallstone colic, when jaundice and high fever occur, keep quiet and pay attention to diet. Avoid eating irritants, fats, and indigestibles. And within a few days after the attack, rest more. If you take a bath outside of the attack, it will not harm your body. Can only do a certain degree of sports, but such as golf, baseball, judo and other sports that require rapid abdominal twisting, should be avoided as much as possible. If women with gallstones become pregnant, they will only have them after giving birth. But surprisingly, many women have lived through it safely, so don't worry too much. If there are no symptoms for two months after the operation, you can live a normal life.
(3) Diet therapy for gallstones
Fatty diet can promote the secretion and excretion of bile, cause gallbladder contraction or increase the internal pressure of the gallbladder, and easily induce biliary colic. Therefore, diet should pay attention to:
(1) Eat more light and vegetable foods, such as fermented soy products, fermented milk products, whole wheat flour, eggs, spinach, celery, tomatoes, carrots, potatoes, etc.; (2) Avoid eating high cholesterol and irritating Sexual food, as well as alcohol and strong condiments;
(3) In order to get the necessary nutrition, lean pork, liver, chicken and duck can be eaten;
(4) Pay attention to supplementing fat-soluble vitamins, such as vitamin A, vitamin D, vitamin E, and vitamin K.
Excessive intake of refined rice noodle sugar, unhealthy fat, overeating, irregular life, constipation, overwork, etc. are the inducements for gallstones. People who sit and work all the year round or who have the habit of corsets, the flow of bile in the body will become worse, and eventually gallstones will form. It is best to stretch your limbs frequently and do exercises to reduce the burden on your abdomen.
About skipping breakfast causes stones: Under the condition of eating breakfast normally, the gallbladder shrinks and cholesterol is discharged with the bile, the cholesterol saturation in the bile remaining in the gallbladder will be reduced, and the formation of stones will not be easy. And if you don’t eat breakfast, the fasting time is too long, and the bile storage time in the gallbladder is too long, resulting in over-saturation of cholesterol in the bile, which will cause cholesterol deposition and gradually form stones. If you wake up late, try to eat breakfast within 1 hour after you wake up, and don't let your stomach empty for too long. Boshilong reminds: For people who detoxify and lose weight, you can use 300ml of lemonade and 300ml of light salt water to make a low nutrient density breakfast. The organic acid in it can accelerate the digestion of stones and will not cause stone problems.
About tea: The rich oxalic acid in tea is a high risk factor for calcium oxalate stones (a kind of kidney stones). The cause of gallstones is different from that of kidney stones. Tea contains biochemical components that are closely related to human health. Drinking tea not only has pharmacological effects such as refreshing and refreshing, clearing heat and relieving heat, reducing fire and improving eyesight, stopping dysentery and dehumidification, but tea can cause increased gastric and duodenal secretions and promote The contraction of the gallbladder increases the obstruction of bile drainage, which can induce biliary colic. It is recommended that patients with gallstones can drink a little tea in moderation, but not too strong. Scented tea and light green tea can generally be drunk, while teas like Tieguanyin or Dahongpao, which are very stimulating, and strong tea are definitely not allowed, otherwise it may affect bile. This causes various fluctuations, which may further stimulate the growth of the stones. People with heavy tea drinking habits and patients with calcium oxalate stones can also choose the low oxalate instant tea products currently on the market to replace ordinary tea drinks.
(4) Nutritional therapy for gallstones
In addition to western medicine and diet,Some functional nutrients also have better prevention and relief effects, Such as probiotics, digestive enzymes, aloe vera powder and vitamin C, followed by antioxidants, which are also very effective, such as seal oil, grape seed extract, astaxanthin, coenzyme Q10 and so on. Lycopene can reduce the body's caloric intake and reduce fat accumulation. However, it is best not to use curcumin (antioxidant), curcumin will stimulate the contraction of the gallbladder, people with gallstones should use it with caution. Seal oil contains a variety of unsaturated fatty acids, as well as squalene and vitamin E. Among them, EPA, DPA, and DHA are particularly rich. In particular, seal oil contains higher DPA, which is 10 times more effective than EPA in repairing damaged blood vessels. . EPA and DHA can reduce the content of triacylglycerol and cholesterol in the blood, which can effectively prevent the occurrence of gallstones. Dietary fiber powder not only contains a set of soluble and insoluble cellulose, but also contains nutrients that are beneficial to intestinal microbes and digestion. It is especially suitable for being sensitive to insoluble fiber but needs to increase fiber intake and hope to improve blood lipid and blood sugar level. People; can reduce the amount of bile acid reabsorption, change the speed of food digestion and secretion of digestive tract secretions, can prevent gallstones. In the same way, before using these nutrients, you must pay attention to detoxification and use antioxidants to relieve various factors that affect the accumulation of calcium ions in the blood.
(5) Diet therapy after cholecystectomy
Usually, the diameter of gallstones exceeding 3 cm is regarded as the standard for gallbladder surgery. After cholecystectomy, the gallbladder has lost its function of concentrating and storing bile, so when the bile has not been concentrated enters the small intestine. The concentration of bile acids in the patient's intestinal tract cannot reach the critical micelle concentration. The content of bile salts is also reduced by half compared with normal people; if they eat more fat in their food, it will cause fat indigestion. But after a period of time, the body of these patients will gradually adapt to this situation, which takes about 2-3 months.
Studies have found that after cholecystectomy, bile that cannot be stored enters the intestine and is broken down by intestinal bacteria to produce carcinogenic "secondary bile acid", which increases the risk of intestinal cancer. Therefore, Boshilong reminds: After cholecystectomy, patients must strengthen their dietary balance in their usual daily diet, eat more fresh fruits and vegetables, supplement appropriate amounts of seal oil, digestive enzymes, probiotics, and antioxidants to prevent bowel cancer.
The specific method is as follows:
(1)Removal of the gallbladder1-2Within days, The function of the patient's entire digestive system will be affected to a certain extent, so it should be strictly fasted. At this time, intravenous drip can be used to supplement various nutrients. From the 3rd day after the operation, the patient can eat some liquid diet according to the specific situation, such as rice soup, kefir yogurt, lotus root powder, fruit juice and so on. Then gradually change to eat millet gruel, oatmeal, tofu soup, jujube puree rice paste, and white fungus soup.
(2)After cholecystectomy4Within a weekPatients should reduce the intake of fatty foods, fasting high-fat foods and fried foods. After the gallbladder is removed, the human body will lose the function of regulating the excretion of bile into the intestine, and the ability to digest fat will be correspondingly weakened. It is impossible to digest a large amount of fatty food in a short time. Therefore, these patients are ingesting fat Symptoms such as abdominal distension, diarrhea and indigestion often occur after food. Eat low-fat semi-liquid food or low-fat soft rice, such as various porridges, whole-wheat noodles, fermented soy products, egg whites, yogurt and lean meats, vegetables and fruits with less fiber; you should also avoid eating them or try your best Eat less fatty meat, animal offal, egg yolks, and fried foods. It is also inappropriate to eat all kinds of high-fat and high-calorie "fast foods". When cooking food, use animal oil as little as possible. Dishes should be steamed, stewed, and cold. Mainly, avoid eating spicy and irritating food, especially drinking alcohol, in order to reduce the adverse stimulation of the biliary tract. During this period, supplementing the digestive enzymes of the capsules has a very significant effect.
(3)Cholecystectomy1Patients after monthsAfter several weeks of adaptation, the common bile duct connecting the liver and the small intestine will gradually expand and expand, which can replace the function of the gallbladder to store bile. If there is no obvious abnormality in the digestive function of the patient at this time, the nutrition can be gradually strengthened. Generally, ordinary diets such as lean meat, aquatic products, fermented milk products and fermented soy products can be eaten. You can also eat more seaweed, mushrooms and other foods. , To supplement the lack of protein in the body. In general, the patient's diet during this period should be light, but it is not necessary to excessively limit the intake of fat, because a certain amount of fat in the intestine is to stimulate the secretion of bile and expand the volume of the common bile duct and maintain the bile duct. Necessary for fluency. In addition, eating high-fiber and vitamin-rich foods is also very beneficial to the recovery of patients after cholecystectomy.
(4)Cholecystectomy3-6Months of patients can appropriately increase the number of meals. However, it should be noted that each meal should not be eaten more, because eating less and more meals can reduce the burden on the digestive system and help patients recover after surgery. In addition, during this period, it is best for patients to eat some vinegar or apple cider vinegar every day, because vinegar will not only enhance the digestive function of the stomach, but also regulate the pH in the intestines, which is conducive to the effect of bile. Drinking light tea regularly and eating more fresh fruits and vegetables can also help the digestion and absorption of food.
- The patient within six months after cholecystectomy, There are often irregular, loose stools and even diarrhea. This kind of performance is serious for specific patients. If you eat more fatty foods, the symptoms of diarrhea are more obvious. In medicine, this condition is called "fatty diarrhea." After the gallbladder is removed, the body loses the storage and concentration function of the gallbladder. Temporarily not concentrated bile enters the small intestine, and the concentration of bile acid in the intestine decreases. If the fat content in the food consumed at this stage is too high, it will cause fat indigestion. After a period of time, the body will gradually adapt and compensate. The process will take about 3-6 months, and most of them will gradually disappear or lessen within half a year. Digestive enzymes and probiotics have a significant effect on improving these symptoms.
Therefore, during this period of time for the body to adapt to the taste, the intake of fat must be particularly restricted, especially not eating too much animal fat at a time: such as fatty meat, butter, cheese, etc. Control foods with high cholesterol, eat less foods with high cholesterol such as animal organs, crab roe, fish roe, and scaleless sea fish (such as eel). During this period of time, it is best to eat less walnut cakes, cakes with more oil and other foods. You can eat less and more meals. One meal is not too full. The food is a low-fat diet, such as millet porridge, oatmeal, whole-wheat noodles, fermented soy products, egg whites, fermented milk products, low-fat lean meats, vegetables and fruits, etc., and stew, steam, and cook are better.
The symptoms of indigestion will last for about half a year. Later, according to the body's response to fatty foods, gradually increase some fatty foods until the normal amount before surgery. If you have bloating or discomfort or diarrhea, reduce it as appropriate or stop eating fatty foods for a few days. As time goes by, the common bile duct gradually expands, which will partially replace the role of the gallbladder, the symptoms of indigestion will gradually alleviate, and the diet will gradually become normal.
(6) Acupoint Therapy
(1)Gallbladder point, This is an odd acupuncture point outside the meridian, on the outer side of the lower leg, when the anterior and inferior depression of the fibula is 1-2 inches straight down. Whether gallstones or cholecystitis, one of its main pathological mechanisms is liver and gallbladder stasis and heat. The stasis and heat of the liver and gallbladder gather and grow there, causing various symptoms. At this time, it is necessary to clear away heat and remove blood stasis. The gallbladder point is a point specifically for gallbladder diseases. Long-term rubbing of this point is effective for cholecystitis, gallstones, biliary polyps and other diseases. If moxibustion is more effective.
(2)Danshu Point: Danshu point is on our back, below the spinous process of the 10th thoracic vertebra, 1.5 inches away from the side. There is a bladder meridian on our back. There are many acupoints on the bladder meridian, which are directly connected with the viscera and are an important position for the infusion of the viscera's Qi machine. It happens that the gallbladder has a point in the bladder meridian, which is the Danshu point. This acupuncture point has a powerful function of clearing liver and gallbladder heat, soothing liver and stomach, and regulating qi.
(3)Sun Moon Cave: The position of Riyue acupoint is relatively hidden, in our upper abdomen, straight below the nipple, the seventh intercostal space, four inches from the front midline. The deep part of this acupuncture point is where the liver, gallbladder, spleen and stomach reside, as well as the acupoints and mou points of the Gallbladder Meridian of Foot Shaoyang, which are related to the Shaoyang Channel, Taiyin Channel and Yang Wei Channel. It is just behind the liver and gallbladder, it is a shortcut to directly clear the liver and gallbladder heat, sooth the liver and relieve the gallbladder, regulate the qi and relieve pain.
(4)Yanglingquan: It is the joint point of the Gallbladder Meridian, on the outer side of the lower leg, when the fibula is in the anterior and inferior depression. Yanglingquan has the functions of clearing liver and gallbladder damp-heat, stagnation of liver qi, and strengthening liver and gallbladder fire. It is the main acupoint for liver and gallbladder health care treatment. Massage this acupoint during acute attack of cholecystitis and gallstones, which has immediate analgesic effect. Long-term regular massage of Yanglingquan can effectively reduce the number of attacks and reduce the frequency of disease, thereby playing the role of preventing and treating cholecystitis, gallstones and gallbladder polyps.
(5)Qiuxu Cave: It is the original point of the Gallbladder Meridian, in the depression in front of the tip of the lateral malleolus. Clear the liver and improve eyesight, clear the meridians and activate collaterals It can relieve ankle and joint diseases, and is suitable for sprains, heel pain, sciatica, ankle pain, poor blood circulation of the foot muscles, and calf cramps. It is also effective for improving shoulder and neck stiffness, pain, chest pain, dizziness and other diseases. In addition, if you feel severe pain when pressing this point, it means you may have gallstones. If you press this point frequently, you can slightly relieve the pain caused by gallstones.
The main reason for the formation of stones is the problem of diet and lifestyle. It is recommended that you drink more water, eat more fresh vegetables and fruits, walk more, and stay at home less. If you have stones, don't be afraid, follow the advice of nutritionists and health managers.
No matter what part of the stone is affected, the best treatment commonly used is drinking water + diet therapy + functional nutrients + exercise + acupoints. A healthy lifestyle is the first way to prevent stones. Preventive diet therapy is mainly to drink lemonade, tartary buckwheat tea, apple cider vinegar, drink less carbohydrates, reduce refined rice noodle sugar, reduce western fast food and barbecued fried food, and eliminate the generation of stones from the source.
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