Typically, patients rely on the efficiency of their recommended surgery (especially planning).But some of them made operative intervention entails no relief and new problems that require long-term medical treatment and diet therapy.A good example is postcholecystectomical syndrome.
In this article, let's talk about what this syndrome, as it is classified, we will discuss treatment and recommended diet. Content
wise nature prudently bestowedevery organ of our body's specific functions, so the artificial removal of virtually any organ does not go quite so completely.The gallbladder stores the image of the liver bile, concentrating it, and then throw in the bile ducts as needed.
postcholecystectomical syndrome called the condition that has developed as a result of the removal of the gallbladder (cholecystectomy).It occurs in about a quarter
Among the pathological conditions that make up the essence of postcholecystectomy syndrome, doctors are three groups.They differ in the type of causal relationships with surgical intervention (cholecystectomy).
The first group includes those patients with postcholecystectomic syndrome whose disease can not be associated with the operation, so the actions of surgeons and eliminate the true cause of the ailment.These diseases simply were not diagnosed in time because:
culprit of postcholecystectomy syndrome in patients in the second group is a very surgical removal of diseased gallbladder.It is held in either insufficient (e.g., in the ducts remained undetected stones), or arranged in other operational errors.They may be:
Often in such cases, the extent of surgical manipulation does not match the pathological process.For example, in complicated cholelithiasis cholecystectomy, surgeons are limited to the standard rather than the more serious and extensive interventions.
The basis of the formation of postcholecystectomy syndrome in patients belonging to the third group are emerging motor disorders:
postcholecystectomy syndrome Clinical manifestations directly related to his causes.But most often caused or enhanced existing prior to surgical procedures:
therapeutic measures aimed at combating postcholecystectomic syndrome, should be comprehensive and individually selected (depending on the cause of the condition).These may include:
Even in the case of a favorable postoperative course all patients after the removal of the gall bladder must be health food.For 1.5-2 months, they have to stick to the diet, the appropriate table №5a (by Pevsner).If the patient is suspected or diagnosed postcholecystectomical syndrome, then it is more suitable diet №5sch.
is somewhat different in chemical composition, since it contains 90 to 100 g protein, less fat quota (50 - 60 g), excluding not only animals refractory fats and vegetable oils.Limitation of vegetable oils suitable for reducing biliary excretion.The carbohydrate content has been reduced to 250 - 300 grams through the elimination of sugar and sugary foods (for the prevention and control, and excessive flatulence).The daily energy consumption of this diet is also low (2000 - 2100 kcal).Therefore, in the case of low-weight patients need additional introduction of protein products or special enteral treatment of mixtures sold in pharmacies (nutrikon, Diso, Peptamen, Supro-760, and others.).
There are recommended every 4 hours, so the frequency of administration permitted the food will contribute to a more uniform load on the digestive system and more orderly evacuation of bile from the stomach (almost 80% of the operated patients have an abnormal reflux of bile from the duodenum into the stomach, called duodenogastric reflux).
from the diet to be eliminated or substantially reduced the amount of products with high cholesterol (pork, mutton fat dairy products, egg yolk, etc.)., Since the operation does not change the chemical composition of bile.From it can still form new rocks (especially in the first year after surgery).The remaining fat should be distributed evenly on all meals and mix them with other foods.This measure can prevent pain and diarrhea.In order to prevent excessive gassing to watch out for products with roughage (fresh vegetables, berries, fruits, bran, etc.).
permitted food (boiled meat, thermally processed fruits and vegetables) should certainly be wiped, lean fish can be served whole or in chopped form.Patients are recommended vegetable purees, various soufflés, soups and pureed jelly.Wheat bread slightly dried.Cold dishes that can provoke spastic processes (cramps) and cause diarrhea, are excluded.
should be remembered that as a result of the operation may vary individual tolerability.So, there is a negative reaction to the raw milk, cocoa, ice cream, chocolate, spicy food (pickles etc.), Vegetables with lots of essential oils (green onions, radishes, garlic, radish, and others.) In the form of pain, diarrhea,nausea, bloating.
duration of treatment is determined individually №5sch diet (to subside pain and dyspepsia).
In the case of the predominance of stagnation of bile in the remaining bile duct is more justified the appointment of lipotropic fat diet №5 l / w.It is characterized by a high fat quota (up to 110 g), the share of vegetable fats should account for 50%.The diet is sure to include products with lipotropic properties (egg whites, lean meat, fish, cheese), vegetable oils, and wheat bran to facilitate disposal of "excess" fat in the body.The food is boiled or baked, rubbing it optional.Oils are added to the ready-made meals.
composition and duration of drug therapy depends on the severity of symptoms and the survey data, specifying the reason postcholecystectomy syndrome.Drug treatment may consist of:
If postcholecystectomical syndrome due to surgical mistakes, in some cases require repeated surgery.It can be both radical surgery with opening the abdomen and internal audit bodies and in less serious endoscopic manipulations (for example, in endoscopic sphincterotomy dissected sphincter of Oddi).
In this video you can see the "instructions for use" of the gallbladder.Elena Malysheva and her colleagues tell what this body that it is harmful and what is useful: