Ce este si cum se trateaza colica biliara?

Colica biliara este o durere puternica in zona mijlocie-superioara dreapta a abdomenului. Apare in momentul in care o piatra biliara blocheaza conducta biliara, tubul care in mod normal dreneaza bila din vezica biliara catre intestinul subtire.

Durerea dispare in cazul in care piatra patrunde in intestinul subtire si deblocheaza conducta. Tratamentul obisnuit pentru calculi biliari cronici cu durere este eliminarea vezicii biliare. Acest organ nu este esential pentru sanatatea digestiva.

Cauza

Colicile biliare isi fac aparitia atunci cand vezica biliara se contracta si determina o piatra biliara sa blocheze temporar canalul care dreneaza vezica biliara. Calculii biliari sunt mase dure care iau nastere in vezica biliara.

Pot fi mici si numerosie, sau mari si putini. Chisturile biliare apar datorita dezechilibrelor chimice ale vezicii biliare sau a golirii rare sau incomplete a vezicii biliare. Presiunea crescuta a vezicii biliare provoaca durerea si disconfortul, acestea fiind senzatii asociate colicilor biliare.

Ce este bila?

Bilele si enzimele digestive sunt transportate de catre canalele biliare de la ficat, vezica biliara si pancreas, la intestinul subtire. Bilele indeparteaza deseurile din ficat si ajuta la digerarea grasimilor.

O portiune a bilei este depozitata in vezica biliara. Mancarea unei mese face contractia vezicii biliare sau se strecoara spre interior. Aceasta goleste continutul vezicii biliare in intestinul subtire.

Simptome

O persoana cu colici biliare, de obicei se plange de o durere sau o senzatie de presiune in partea superioara a abdomenului. Aceasta durere poate fi in centrul abdomenului superior chiar sub piept, sau in partea superioara dreapta a abdomenului, in apropierea vezicii biliare si a ficatului.

La unii oameni, durerea abdominala se raspandeste spre omoplatul drept. Multe persoane au, de asemenea, greata si varsaturi.

Deoarece simptomele colicilor biliare sunt, de obicei, declansate de cererea sistemului digestiv de bila, acestea sunt mai ales frecvente dupa mesele grase. Simptomele pot aparea de asemenea, atunci cand o persoana care a postit rupe repede postul si mananca o masa foarte mare.

Cea mai grava durere a colicilor biliare dureaza in majoritatea cazurilor, intre 30 de minute si pana la o ora, dar poate continua la o intensitate mai mica timp de cateva ore. Durerea se opreste in momentul in care piatra biliara se desprinde de canalul biliar si trece in intestin.

Factori de risc

Unii oameni sunt mai susceptibili sa aiba calculi biliari decat altii, bazandu-se pe factori diferiti.

  • Sex: Femeile au sanse mai mari sa dezvolte calculi biliari comparativ cu barbatii. Acest lucru se datoreaza faptului ca estrogenul, hormonul sexual feminin, poate face calculi biliari mai probabili.
  • Ereditate: Un istoric familial de calculi biliari cu siguranta poate creste riscul de probleme ale vezicii biliare.

  • Varsta: Aalculii biliari sunt mai frecventi la persoanele mai mari de 40 de ani.
  • Greutate corporala: Persoanele supraponderale sau obeze pot avea mai mult colesterol in bila, ceea ce ajuta la formarea pietrelor. Pierderea rapida in greutate si postul cresc de asemenea, cantitatea de colesterol din bila.

Diagnostic

Dupa ce va descrieti simptomele, medicul dumneavoastra va efectua un examen fizic, acordand o atentie deosebita portiunii din dreapta sus a abdomenului (zona ficatului si a vezicii biliare).

Ecografia, aceeasi procedura nedureroasa folosita pentru a produce imagini cu bebelusi in pantecele mamicilor, poate fi utilizata pentru a produce imagini cu abdomenul, astfel incat medicul dumneavoastra sa poata cauta calculi biliari.

De asemenea, pot fi efectuate teste de sange, mai ales daca aveti febra sau daca durerea dvs. persista.  In unele cazuri, medicul dumneavoastra poate comanda tomografie computerizata (scanare CT), imagistica prin rezonanta magnetica (RMN) sau alte teste de diagnostic.

Durata preconizata

Majoritatea episoadelor de colici biliare trec dupa 1 pana la 5 ore. Dupa trecerea durerii cele mai intense, abdomenul poate continua sa sa va doara usor timp de aproximativ 24 de ore.

Tratament

La inceput, medicul dumneavoastra va poate prescrie medicamente pentru durere si va poate incuraja sa mancati o dieta fara grasimi. Daca primul episod de colica biliara este deosebit de sever sau daca episoadele de colica continua sa fie reconstituite, de obicei este recomandata o interventie chirurgicala pentru indepartarea vezicii biliare (colecistectomie).

Aceasta procedura se poate face prin incizii mici, folosind un instrument numit laparoscop. Procedura necesita de obicei doar o scurta sedere in spital, iar unele persoane pot parasi spitalul in aceeasi zi.

Este cel mai utilizat tratament la persoanele cu probleme de calculi biliari durerosi, deoarece este foarte eficient si sigur, fara complicatii in mai mult de 90 la suta din cazuri.

Daca interventia chirurgicala nu poate fi facuta si simptomele colicilor biliare sunt de durata, se poate utiliza medicamente care dizolva calculii biliari. Cu toate acestea, acest medicament este scump si poate dura luni sau ani de munca.

De asemenea, doar pietre mici se vor dizolva. Rareori, medicatia pentru dizolvarea calculilor biliari este combinata cu o procedura numita litotripsie cu unda de soc, care foloseste undele de soc orientate cu atentie pentru a sparge calculii biliari. Cu toate acestea, la multe persoane tratate cu medicamente sau litotripsie, calculii biliari tind sa se formeze din nou in cativa ani.

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