- Which organs of the right hypochondrium are important for proper nutrition?
- Causes of pain in the right upper quadrant after eating
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In the practice of the gastroenterologist, patients often complain of pain in the right upper quadrant after eating. The condition is not clear for people with a healthy stomach. They believe that the pain under the ribs, generally speaking, is not related to digestion. Mistaken opinion is refuted by inspection.
Of course, possible causes may be rib diseases, shingles (herpes zoster), diseases of the lower-thoracic vertebrae with radicular syndrome, neuralgia. These reasons are not exactly related to food, do not depend on the time of eating. There are many diseases of organs located in the hypochondrium on the right, reacting to the quality and diet.
Which organs of the right hypochondrium are important for proper nutrition?
Directly in the subcostal zone are the right lobe of the liver, the gallbladder with outgoing tracts, the bend of the transverse colon. The liver produces bile and transports it for storage in the gallbladder. The quantity and quality of bile depends on the incoming "order" from the stomach, determined by the composition of the food, drinks.
Overloading with fatty and fried meat dishes, alcohol, spicy seasonings causes increased functioning. Sometimes even with a single overeating of pain in the right hypochondrium after a meal indicate the failure of the synthesis, the inability to produce sufficient amounts for cleavage. With a regular habit of eating only meat, spicy dishes such a reaction is inevitable.
The liver works around the clock, getting rid of its harmful toxic substances by its enzymes, including trying to translate into a non-toxic form the alcohol taken, carcinogenic substances. It loses its functions when the cells become inflamed with hepatitis, fatty degeneration or are replaced with scar tissue. Are formed areas of cirrhosis, unable to work.
The lack of vitamins in food leads to a disruption in the synthesis of liver enzyme systems. And the lack of proper support for carbohydrates because of hungry diets causes the loss of the glycogen depot, which is forced to split up to glucose for energy production.
The addiction to spicy food contributes to the disruption of the motor muscle of the muscular wall of the bladder and the pathways. Called spastic contraction or stagnation of bile. This explains why there are pains associated with eating.
Particular importance is attached to the concentration of salts in the bile. The influence of food products on precipitation is proved, followed by gluing and formation of calculus stones.
Delayed bile secretion is the cause of inflammation and the introduction of pathogenic microorganisms into an organ devoid of local immunity. Thus, cholecystitis is formed.
We can not fail to note the role of nearby organs (the head of the pancreas, the bulb of the duodenum), which, in inflammation, ulcerous process, tumors give irradiation to the right hypochondrium
Causes of pain in the right upper quadrant after eating
Without additional diagnosis, the disease of neighboring organs is difficult to distinguish from local problems. Let's consider variants of the reasons of pains in hypochondrium on the right on characteristic signs.
Pain in cholecystitis
At the beginning of the disease, a functional failure of the ejection of bile occurs. It is possible to increase or decrease motility. Then the infection in the gall bladder comes from the liver with hepatitis, pancreas, intestines.
Pathogenic pathogens are delivered by lymph or blood from palatine tonsils, maxillary cavity, carious teeth, urinary system organs, inflamed appendages in women, prostate in men with chronic inflammation. Possible reaction to the introduction of worms and lamblia.
With calculous (stone) cholecystitis bile duct stagnation is important. If it is not, then additional factors are important. Among the provocators of gallbladder inflammation, the habit of fatty foods, drinking alcohol, fried or spicy snacks, a weak physical load.
Pain in the right upper quadrant appears two hours after eating and can be very intense cramping (with an acute form of the disease) with nausea, vomiting of bile, high fever. Irradiation is observed in the right scapula, shoulder, collarbone, waist.
In the interictal period, the pain is blunt, drawing character (can be replaced by a feeling of heaviness after eating). A man complains of constant bitterness in his mouth, nausea, loss of appetite. Often the pain passes from the right hypochondrium to the solar plexus and is felt by the base and closer to the navel.
Calculous cholecystitis is accompanied by yellowing of the skin and sclera after a bout of pain. In the absence of treatment, the inflamed wall becomes inflamed and the cholecystitis becomes phlegmonous and gangrenous. The pain becomes dull, there is a high fever, chills, growing weakness. Necrosis of the tissues of the bladder leads to the disappearance of pains against the background of a severe general condition.
Pain with cholangitis
The conditionally pathogenic intestinal flora in the bile ducts causes their inflammation (cholangitis). To distinguish it from cholecystitis is almost impossible, since the infection spreads rapidly to the gallbladder.
Characteristic spastic pain (hepatic colic) after taking fatty and fried foods. Inflammation causes overlap in the output of bile and stagnation in the bladder. The patients have jaundice, skin itching against a background of high body temperature. Prolonged course of cholecystitis and cholangitis leads to biliary cirrhosis of the liver, renal and hepatic insufficiency.
Pain with a stone in the gallbladder
Gallstone disease is associated with cholecystitis: inflammation creates the conditions for the formation of stones in the bladder and ducts.
Stones differ in size, nature of the surface, are able to move around
An attack of pain in the right hypochondrium appears after fatty food, alcohol. The pain is sharp, very intense. Irradiates into the right side, shoulder blade, shoulder, collarbone, into the epigastric zone. At the same time the patient is shivering, tears bitterness. The attack lasts several minutes or hours. Afterwards, there is a strong general weakness, aching pain in the area of the gallbladder.
Hepatic pain after eating
Pain in the right upper quadrant, depending on liver disease, is provoked by fatty foods and fried foods, the intake of alcohol-containing beverages (including beer), carbonated water, spicy condiments.
Hepatitis - inflammatory diseases of nature, toxic and autoimmune lesions. The most common viral hepatitis. Characteristic latent latent stage of the disease, in which the patient notes:
- temporary nausea;
- lack of appetite;
- intolerance to the smell of food.
In the clinical stage, dull pains appear in the hypochondrium to the right in response to swelling and stretching of the liver capsule. Violation of the outflow of bile causes the entry of its components into the blood. As a result, jaundice of the skin, sclera, mucous membranes, itching of the skin, dark urine and grayish feces, unstable stools are manifested. The temperature does not happen high, but weakness is expressed, a headache.
With fatty liver disease, resulting from chronic alcoholism or prolonged intoxication, hepatocytes lose fats and die off. Gradually, the liver is turned off from digestion. There is dull pain after eating and outside it, soreness on palpation of the liver, an increase in the organ, increased fatigue.
Pain in peptic ulcer disease
Pain in the hypochondrium to the right can give an ulcer, localized in the area of the bulb of the duodenum. The earliest disease is often bulbitis - an inflammation of this zone.
Ulcers can be different in size, depth, nature of the edges
Patients describe cutting pain 1.5-2 hours after eating or at night on an empty stomach. Immediately after eating, there are eructations, nausea, vomiting, bloating, excessive sweating, and weakness.
Less often pain in the right hypochondrium is disturbed when the ulcer is located in the pyloric part of the stomach. The appearance of the dagger character of pain indicates the perforation of the wall and the release of the contents into the cavity of the peritoneum.
Pain in pancreatitis
In the right hypochondrium spreads pain in pancreatitis, cancer of the head of the pancreas. For the pain syndrome is typical pronounced intensity, pulsating nature, the phenomenon of "girdling" with nausea, vomiting bile, diarrhea. Patients quickly lose weight due to impaired absorption of the main nutritional components of food.
Pain in Gilbert's syndrome
The disease is also called "constitutional hepatic dysfunction, family non-hemolytic jaundice." Pathology is congenital, inherited. The high content of bilirubin is constantly detected in the blood, which causes a slight icterus of the skin.
Patients have increased sensitivity to fatty and spicy dishes. After eating, they have dull-colored pains on the right side of the epigastrium and in the hypochondrium, eructations, nausea and vomiting of bitterness. In addition to this symptomatology, concern:
- feeling of bitterness in the mouth;
- stool disorders.
In patients with non-hemolytic icterus, a constant icteric sclera
Upon examination, the doctor checks the tongue, the color of the sclera, the condition of the lymph nodes. Palpation of the abdomen allows you to identify the most painful areas, augmentation of the liver, a dense or soft edge, a tuberous surface with cirrhosis, an enlarged gallbladder.
Laboratory research includes:
- general and biochemical analyzes - confirm the inflammatory process, the phase of the disease, the degree of disruption of functions, the composition of enzymes allow us to identify the role of the pancreas and liver;
- In viral hepatitis, immunological tests are performed to identify a specific type of virus;
- in the urine, examine glucose, protein. bilirubin, diastase;
- the analysis of a feces on a gliwic invasion, ljamblii is checked;
- by probing the contents of the duodenum are obtained, the composition of bile is examined, the elements of inflammation are revealed in cholecystitis;
- ultrasound examination is a common technique, it allows to determine the size of organs, the presence of stones in the bladder and strokes, to reveal a form disorder in cicatricial changes.
When necessary, contrast radiography of the gallbladder, fluoroscopy of the stomach and duodenum is used. Fibrogastroscopic method allows you to examine the lower parts of the stomach and the bulb of the duodenum, to establish the localization of the ulcer.
The treatment plan for each disease is made by a doctor after a general examination. One can not find one healing remedy for pain in the right hypochondrium. Serious efforts of the patient in observance of a regimen and a diet will be required.
- stop heavy exercise, just walk, do gymnastics in the morning, you can do yoga, Pilates, visit the pool;
- with excess weight arrange for unloading days;
- Learn how to manage the state after the excitement or take light vegetable soothing drugs;
- very closely monitor the contraindications specified in the instructions when it is necessary to treat different means.
The diet will have to support a lifetime. It is necessary to exclude from the consumed products:
- alcoholic drinks regardless of the fortress, carbonated water, strong tea and coffee, all fatty meat products, sour cream and mayonnaise, fatty cottage cheese;
- canned food;
- fried and smoked dishes from meat, fish, vegetables;
- fatty confectionery with cream;
- beans, fresh and sour cabbage, radish;
- chocolate, candy.
Curd in the diet is necessary, but in a low-fat form
Use in nutrition:
- meat of chicken, turkey, low-fat beef;
- Soups and broths should not be rich;
- dairy and vegetable soups;
- porridge with a restriction of butter;
- boiled or braised potatoes with vegetables;
- kefir and low-fat cottage cheese;
- vegetable oils;
Medications and Surgery
The removal of the pain syndrome is achieved in each specific case in different ways. With an ulcer in the stomach or duodenum, enveloping agents are prescribed (Almagel-A, Gastal), for anti-Helicobacter therapy - a course of eradication with antibiotics, as agents stimulating motility, drugs depending on the type of acidity (antispasmodics or prokinetics).
Treatment of the pancreas will require in the early days of hunger, then gradually expanding the diet. It is necessary to assign enzymes, vitamins for compensation, restore absorption processes in the intestine.
Diseases of the liver are treated with antiviral drugs with immunomodulators (hepatitis), large doses of vitamins, choleretic agents, corticosteroids, hepatoprotectors. Patients have to use methods of detoxification with the appearance of signs of cirrhosis and liver failure (plasmapheresis, hemodialysis).
In diseases of the gallbladder, it is important to find out the cause. To eliminate inflammation, antibacterial agents are prescribed. With stones trying to soften and split them into smaller ones, although this is only partially achieved.
Existing means that affect the biliary apparatus, are reduced to choleretics (enhance the synthesis of bile) and cholekinetics (act on the musculature of the gallbladder and ducts). Therefore, one can not use the advice of friends on their own and take their medications. Each patient has a different type of disorder.
Considerable help is provided by the methods of physiotherapeutic treatment, they are appointed by a specialist doctor in the absence of signs of tumor growth and bleeding
The decision on an operative decision is taken urgently in case of an emergency condition, dangerous for life:
- phlegmonous and gangrenous gallbladder should be removed as soon as possible;
- ulcer with persistent pains excise and stitch the stomach with an intestinal loop;
- Malignant tumors may require the complete removal of the organ or its significant part surrounding the lymph nodes with subsequent chemotherapy and irradiation.
In the treatment of Gilbert syndrome used: cholagogue, hepatoprotectors, enterosorbents. The destruction of excess bilirubin is achieved by phototherapy with blue lamps. Pain in the right upper quadrant can not be treated in a single way. Optimal therapy is selected after examination and revealing the cause. The best thing a patient can do is to consult a doctor in a timely manner.