Dyskinesia code according to ICD. Extragenital pathology in obstetrics: Diseases of the biliary system in pregnant women. Features of the treatment of dyspnea in children

Various types of biliary dyskinesia cause serious harm, since the functionality of the affected gallbladder is seriously impaired. Biliary dysfunction is another name for pathology. In ICD-10, this disease is coded K82.8. JVP is a prominent representative of psychosomatic diseases.

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Etiology and pathogenesis of the disease

In the process of breakdown and absorption of food, bile plays a significant role, which ensures stable functioning of the gastrointestinal tract. This biological fluid contains enzymes that the body needs to process food entering the stomach. The liver produces bile around the clock. In the process of processing food, the liver biological fluid first moves into the gallbladder (vesica fellea). It then moves to the duodenum (duodenum) if food arrives.

In patients with GIB, bile outflow deteriorates. The biological fluid stagnates in the bladder and does not enter the duodenum in the required quantity. This leads to serious digestive problems. Women and people with unstable mental health are more likely than others to develop biliary dyskinesia. Statistics show that up to 40% of people in our country suffer from this disease.

Causal factors of pathology:

1. Prolonged stressful situations and constant conflicts are the main causes of DV. Intense psycho-emotional experiences negatively affect the functioning of the gallbladder.
2. Difficulties in the professional sphere and family problems, as a rule, provoke the development of jvp. Impaired bile secretion causes all sorts of changes in the functioning of the entire gastrointestinal tract.
3. Food allergies. Development of gallstone disease, cholecystitis in the body.

The triggering mechanism for the development of primary forms of JP is:

dysfunction of the endocrine glands;
metabolic disorders in diabetes mellitus;
hormonal imbalance;
eating food in freeze-dried or canned form;
intoxication with thyroid hormones;
excess fat deposits;
chronic food intoxication;
recurrent diseases of the ENT organs;
damage to the food tract by worms;
sedentary lifestyle;
genetic predisposition;
allergic dermatitis;
a number of endocrine diseases;
food allergies;
psychogenic disorders;
autonomic dysfunction;
poor nutrition.

Provoking factors of secondary VSD:

features of the child’s constitution;
menopause period;
irregular meals;
protozoal invasion - giardiasis;
invasive infections;
appendicitis;
recurrent viral hepatitis;
stomach ulcer;
lack of physical activity - physical inactivity;
consumption of hot spices;
chronic gastritis;
gallbladder pathology.

Features of biliary dysfunction

Disturbance of normal motility of the gallbladder is a heterogeneous disease.

Classification of JP

In gastroenterology, there are 2 types of the disease. The type of pathology depends on the properties of the nervous organization of the digestive tract of a particular patient.

Hyperfunction of vesica fellea:

1. Increased contractile function occurs - hypertonicity of this organ. A hyperkinetic type of pathology develops.
2. Vesica fellea with such biliary dyskinesia always reacts violently to the flow of food into the gastrointestinal tract. Sharp contractions of the vesica fellea occur, and a portion of biological fluid is released under strong pressure.

Hypofunction of the bile storage organ:

1. When the biliary system is characterized by low contractile activity, a hypokinetic form of pathology is formed. This type of biliary dyskinesia occurs much more often in patients. The situation with this pathology is completely different.
2. The wall of the vesica fellea contracts poorly, since due to the pathological process the gallbladder becomes atonic and relaxed. It stretches easily. The bubble has an abnormally large volume.

Young people are more likely to experience a hyperkinetic form of dyskinesia. Gallbladder pathology of the hypokinetic type is typical for patients over 40 years of age.

Typical external manifestations of the disease:

1. Hepatic colic - pain in the right hypochondrium, which can greatly interfere with a person’s quality of life. The patient cannot fully perform his activities.
2. In the hypokinetic form of the pathology, the pain is aching or dull. There is an intense, repulsive odor from the mouth. Characterized by poor appetite, a feeling of bitterness in the mouth, a painful sensation in the stomach, and involuntary swallowing of air.
3. With the hyperkinetic form of the disease, a short-term pain syndrome occurs. Hepatic colic is acute, paroxysmal in nature. Attacks of diarrhea or constipation and bloating occur constantly.
4. Patients with biliary dysfunction are characterized by attacks of tearfulness, chronic fatigue, and lack of strength. These are indirect signs of pathology. Characterized by sleep disturbance. Periodic headaches, sweating, and palpitations are noted. Women's menstrual cycles are often disrupted. Sexual activity of men decreases. Temporary relief occurs when the attack ends.

Possible complications

If treatment is not started in a timely manner, ADHD may be accompanied by the occurrence of inflammatory processes. Violation of the outflow of bile leads to damage to the bile ducts, hepatitis, reactive pancreatitis, inflammation of the bile ducts - cholangitis. Patients with ADHD are at risk of developing cholelithiasis. The rate of stone formation depends on the properties of bile. Timely treatment will help to avoid complications of VAVP.

Diagnostic procedures

Considering the variety of causative factors of the disease, for a reliable diagnosis it is possible to conduct a comprehensive examination and consult specialists of various profiles. The state of the nervous system is examined. Foci of chronic infection are identified. In the clinical laboratory, biochemical blood tests and other necessary studies are carried out. Using ultrasound and functional equipment, specialists determine the correct diagnosis. Ultrasound, echo signs, contrast cholecystography make it possible to identify the type of dyskinetic disorders.

Therapeutic measures

As a rule, a specialist prescribes a special regime. It consists of psychotherapeutic measures, certain requirements that relate to fluid intake, frequency and quality of nutrition. With biliary dyskinesia, it is often enough to organize the correct diet so that the gallbladder is cleared of bile.

If necessary, the psychotherapist prescribes a course of treatment using modern medications: antipsychotics, antidepressants, tranquilizers. In order to free the bladder from bile, duodenal intubation procedures using a double probe are prescribed. Contractions of the gallbladder are stimulated by the closed tube technique.

Each type of disease requires different medications. Cyclalon tablets effectively relieve pain. The use of heat on the liver area and the use of antispasmodics make it possible to easily relieve colic with hyperkinetic type dyskinesia. The size of the liver in hypomotor biliary dyskinesia after taking cholekinetic drugs may normalize or decrease. A specialist may prescribe Cholenzym tablets - a means for the outflow of bile. The dosage regimen is determined by the attending physician.

It is impossible to completely cure biliary dyskinesia, since this disease is associated with the nervous organization of the gastrointestinal tract. However, in 80% of patients, drug correction of VSD and compliance with the regimen prescribed by the doctor allow the disease to be transferred to a stage of deep remission. When, despite proper treatment, complaints persist, it makes sense to consult a psychotherapist. Because very often depression is a manifestation of problems with the digestive tract.

In some cases, a patient with biliary dyskinesia requires drug treatment. The specialist prescribes the necessary medications. In other situations, the patient requires surgical intervention to improve the outflow of biological fluid. The doctor makes a decision regarding drug treatment, taking into account the severity of the pain syndrome. In severe cases, gallbladder resection is necessary.

Only in very severe cases of biliary dyskinesia is it worth contacting high-level gastroenterological hospitals that have sufficient equipment. Here, doctors, using a special algorithm, identify the need to consult a surgeon. Modern drugs for the effective treatment of biliary dyskinesia permanently eliminate the symptoms of biliary dysfunction.

To ensure that the bladder is well emptied of bile, it is important to eat properly. For biliary dyskinesia, diet therapy is prescribed within the framework of dietary table No. 5. In a patient with hypokinetic type GIB, the contractility of the gallbladder is reduced, so he requires food with good choleretic properties. Vegetable oil should be included in the diet of adults. Olive oil has the strongest choleretic effect.

The patient needs juices, bran, egg yolks, fresh fruits. It is important to consume more vegetable fats. Drinking mineral waters as prescribed by a doctor gives good results. It is important to pay attention to the water regime. If patients do not drink enough fluids, this seriously affects the efficiency of muscle contractions of the digestive tract.

Water must be drunk in a certain mode. You need to take 2-3 sips every 20 minutes. Hypertonicity of the gallbladder is well relieved by wheat and buckwheat porridge. Limiting fatty foods and spicy foods is necessary for patients with hyperkinetic dyskinesia. A proper diet is the best prevention of the disease.

At the first symptoms of the disease, you should contact a qualified gastroenterologist.

JVP should be treated only under the supervision of a specialist. If necessary, the doctor will refer the patient to specialized specialists: endocrinologist, hepatologist, nutritionist, psychotherapist, neurologist, psychologist. Timely, qualified assistance is a quick path to recovery.

JVP (biliary dyskinesia) is a disease that develops due to dysfunction of the organ, biliary dyskinesia (ICD-10 disease code - K83.9). The consequence of this is the improper secretion of bile into the duodenum during digestion. Dyskinesia of the gallbladder is included in the group of diseases of the digestive system. If suspicious symptoms appear, you should contact a specialist as soon as possible. Any disease can lead to serious complications. Timely and correctly selected drug therapy (Ursofalk, Ursosan, Allochol) will help cure adult patients and avoid the consequences of the disease (exacerbation of the disease, disruption of other organs). To treat the disease, doctors often use homeopathy and folk remedies (for example, valerian, flaxseed oil, celandine, peppermint).

Definition

Dyskinesia is a disease that is part of a group of ailments of the digestive system. The disease leads to destabilization of the ducts, as a result of which bile does not penetrate into the intestine in the amount necessary for proper digestion. Thus, there is a disruption in the functioning of the duodenum and the digestive system as a whole. The sphincter of Oddi regulates the flow of bile directly from the liver through the bile tract into the duodenum. The work of the Sphincter of Oddi affects the activity of the bladder as a whole.

Classification

Each type of disease is characterized by corresponding symptoms. The disease can develop in two forms:

hypomotor (corresponds to the hypokinetic process);
hypermotor (corresponds to the hyperkinetic process).

If an insufficient amount of bile penetrates into the duodenum, the disease is called hypokinesia. When there is excess bile, the disease is classified as hyperkinesia.

Etiology of the disease

Doctors list the main reasons for system failure as the consumption of large quantities of spicy and fatty foods, pickles, fried foods, smoked foods, and alcoholic beverages. In addition, excessive irritability often leads to the appearance of the disease.

Biliary dyskinesia can appear after severe stress, which results in spasms in the gallbladder. In turn, this provokes the release of bile directly into the duodenum. In such cases, pancreatitis is possible, which can lead to diabetes.

Symptoms

Manifest in the form of attacks in the abdominal region, hypochondrium (on the right side).

JVP is characterized by a number of symptoms, including painful sensations (can be dull and sharp), which can manifest themselves in the form of attacks in the abdominal region, hypochondrium (on the right side). The pain often radiates to the shoulder. In addition, unpleasant sensations occur near the navel. There are other symptoms of biliary dyskinesia: bitterness in the mouth, gagging.

In addition to the main symptoms (pain in the hypochondrium, nausea), with the development of this gallbladder disease, neuroses are possible: nervousness, tearfulness, decreased body tone, the patient's sleep is disturbed, mood changes sharply, possible increased heart rate, increased sweating. Therapy for this disease in Tibet, among other therapeutic methods, involves restoring the nervous system.

Due to the characteristics of disorders in the gallbladder, 2 types are distinguished: hyperkinetic, hypokinetic. Each type of disease (hypotonic, hypermotor, hypomotor form) is characterized by different manifestations. Thus, dyskinesia of the biliary system of the atonic type is determined by the presence of aching painful sensations that do not have a specific localization.

The spastic type of disorder of the biliary process is characterized by sharp, stabbing pain on the right side. In addition, this type of disease manifests itself in the form of pain that radiates to the shoulder blade or shoulder. Gallbladder dyskinesia is the most common disease of the digestive system. This disease is the main cause of cholestasis, the formation of stones in the tract and gall bladder.

Survey

To establish the type of dyskinesia, it is necessary to conduct an ultrasound of the abdominal area and a number of other studies. Specialists prescribe laboratory blood tests. To determine changes in shortening pathways (the neuromotor unit can be high or low), the patient is referred to a special probing procedure or ultrasound. Before the study, you should eat choleretic food. Using a comprehensive examination, doctors determine the type of disease (hypotonic) that has affected the biliary tract. Biliary dyskinesia during pregnancy requires particularly careful diagnosis.

Treatment

It is important to take into account that therapeutic methods are determined depending on the causes of the disease. The type of bile duct disease (for example, hypotonic) is also taken into account. Treatment of biliary dyskinesia should take into account that such pathologies relate to ailments characterized by pain in the patient (psychosomatics).

Therefore, treatment involves the use of psychotherapeutic methods. However, such treatment can only be prescribed by a psychotherapist. Patients often consider the illness to be somatic, and rarely seek help from a doctor who deals with psychosomatics. If the patient complains of depression and a depressed state, he is prescribed tranquilizers, antipsychotics and other drugs.

In the future, treatment of biliary dyskinesia is determined by the form of the disease. In particular, with the hypokinetic type of the disease, the patient needs to switch to a dietary diet, including dishes that have a choleretic effect and contain minerals.

During therapy, doctors prescribe waters that contain minerals. You should drink water daily (3 glasses per day) 30 minutes before meals. In addition, massage is effective for illness. Physical exercise has a beneficial effect on the patient’s body. Experts recommend therapy in sanatoriums.

In some cases, the patient should be prescribed sounding - such procedures will help remove secretions from the bile. The patient will be helped by normalizing his diet, rest, and eliminating certain foods. Sometimes doctors prescribe Ursofalk, Ursosan, Allohol. Doctors often prescribe homeopathy to patients as auxiliary medications.

Folk remedies in the treatment of biliary dyskinesia

Doctors advise using some natural remedies, for example, decoctions of medicinal herbs. As part of the treatment of dyskinesia, it is allowed to use decoctions of St. John's wort, peppermint, coriander, celandine, immortelle, valerian, and anise. It is recommended to drink grapefruit juice before meals.

There are other remedies, for example, milk thistle, the powder of which contains silymarin (a hepatoprotector that improves the functioning of the liver and the pathways that remove bile). A good choleretic effect is achieved by taking medicines from flaxseed, immortelle, calendula and other plants. Herbal decoctions should be taken half an hour before eating.

Vegetable oil (linseed or olive) mixed with lemon juice has a positive effect on the digestive system. It should be taken half a glass before meals. Flaxseed is also often used. In terms of the presence of Omega-3, it is flaxseed that is ahead of other plant foods.

Disease prognosis

If the patient adheres to the prescribed recommendations, then after just 1-2 weeks the health condition will noticeably improve. The development and treatment of ADHD are not least influenced by the patient’s diet and his resistance to stress.

There are many methods (for example, homeopathy), drugs (Ursofalk, Ursosan, Allohol) that effectively affect the patient’s body.

Gastroenterologists and therapists often use the ICD 10 code DZHVP to register and record this pathology. The diagnosis is confirmed using instrumental and laboratory research methods to detect disturbances in the outflow of bile from the gallbladder.

Treatment of this pathological condition should be comprehensive and include mandatory correction of the diet.

Pathologies of the biliary tract in ICD 10

The International Classification of Diseases, 10th revision, includes nosological units, each of which has its own code. Biliary dyskinesia according to ICD 10 is coded K82.8.0 and belongs to the section “Other specified diseases of the gallbladder.”

The following unfavorable factors may be the cause of the development of pathology::

errors in diet;
sphincter of Oddi dysfunction;
disorder of the innervation of the gallbladder;
hereditary predisposition to cholelithiasis.

A child may develop dyskinesia due to the immaturity of the nervous regulation of the gastrointestinal tract; with age (if the correct diet is followed), the disease regresses. The most significant symptoms of this pathological condition are nausea, a feeling of bitterness in the mouth, heaviness in the right hypochondrium, and sometimes vomiting. Violations can occur in a hypomotor or hypermotor type, which affects the characteristics of the clinical picture. In ICD 10, gastrointestinal tract diseases are included in the same section as other diseases of the digestive system, since against the background of this pathology other inflammatory and functional diseases of the gastrointestinal tract may appear.

Routes of transmission of Giardia in children and adults:

through water;
with contaminated food;
contact-household.

Provoking factors that increase the likelihood of developing giardiasis in children:

reduced function of the immune homeostasis system;
there are pathologies of the biliary system of a congenital nature;
the function of enzymatic activity in the gastrointestinal tract is impaired;
low body weight.

The mechanism of pathology development

Cysts of the pathogen are very stable. Even the aggressiveness of the acidic environment of the stomach cannot destroy them. Therefore, when they enter the mouth, they easily penetrate through the esophagus into the stomach, and then into the duodenum. At this point, each cyst turns into two vegetative forms. Protozoa attach to the walls of the duodenum and upper small intestine. These are the favorite habitats of adults.

The causative agent of the disease penetrates the tissue of the intestinal wall, causing the development of a local inflammatory reaction.
Atrophic changes appear on the intestinal mucosa. The epithelium is damaged. The result is the appearance of malabsorption syndrome, that is, a chronic digestive disorder occurs, which is manifested by impaired absorption and transport of nutrients.
Due to the pathology of absorption of a number of vital substances, elements, vitamins, the process of synthesis of intestinal secretion enzymes changes, which aggravates the condition.
Pathology of the biliary tract develops.
Adequate production of immunoglobulin A is disrupted, resulting in a decrease in the body's defenses.
Chronic giardiasis in children, against the background of which immunity is reduced, leads to the development of pathologies of all organs of the digestive tract. The process is aggravated by a large number of toxic substances formed as a result of the breakdown of the vital activity of pathogens. Chronic intoxication of the body appears.

Classification

As such, there is no official international classification of the disease in children. The authors divide the pathology depending on the severity of the course (acute form, subacute and chronic) and identify groups of complications (stomach and intestinal disorders, extraintestinal signs of Giardia infection, arthritis, manifestations of the skin and visual analyzer).

There are a significant number of classifications by Russian scientists and specialists, but none of them fully consider infection of the body with Giardia as an infectious disease. Modern infectious disease doctors adhere to the following classification. Depending on the symptoms, a typical and atypical form is distinguished. The second is divided into carriers without symptoms and those with blurred clinical signs.

Clinical form of the disease associated with damage to the gastrointestinal tract:

interstitial – expressed in inflammatory processes of the duodenum and upper parts of the small intestine;
pancreatobiliary – mainly affects the functioning of the liver and biliary system;
gastric – symptoms of gastric damage predominate;
combined.

Symptoms affect not only the gastrointestinal tract, but can also affect other systems and organs. Separately, the following syndromes are distinguished, against the background of which certain clinical manifestations predominate: intoxication-allergic, dermatological, asthenoneurotic, anemic. There is also a mixed variant, in which manifestations of pathology of the stomach and intestines are combined with the clinical picture of damage to other organs and systems.

Depending on the severity of the course and duration of symptoms, there is an acute form of the disease, which lasts up to 30 days, subacute - from 30 to 90 days, and chronic - more than 90 days. There is also a classification for complications of giardiasis. Complications can be specific (urticaria, Quincke's edema, arthritis, damage to the visual analyzer) and non-specific (the addition of other diseases that complicate the course of the pathological process, and insufficiency of protein metabolism).

Symptoms

The first symptoms of giardiasis in children appear within 1–3 weeks after the cysts enter the body. This period is called incubation. It is believed that the more pathogen cysts enter the body against the background of reduced immunity, the brighter the clinical picture of the disease will be. Acute manifestations more often occur in patients of preschool age who were infected from family members or in children's groups. As a rule, the diagnosis of giardiasis is not made because the doctor thinks about an intestinal infection.

Parents complain of an increase in body temperature to 39 ° C and the appearance of small pinpoint rashes on the skin. The rash is similar to that which occurs with rubella. Diarrhea with mucus, symptoms of dehydration, nausea, vomiting, decreased appetite, insomnia, and flatulence appear. A clear clinical picture lasts for two to three days. This should prompt the doctor to think about acute giardiasis, since the manifestations of intestinal infection will be longer lasting.

The chronic form can be erased (in half of the patients) and have no manifestations at all (in a quarter of the patients). Vivid clinical signs occur only in 15–30% of cases. If the infection becomes chronic in children, frequent relapses occur.

Manifestations of chronic giardiasis are:

the appearance of a white coating on the tongue;
flatulence, feeling of bloating;
pain on palpation of the liver area and the area near the navel;
hepatomegaly (increase in liver size);
pain on palpation of the gallbladder points.

In principle, all clinical manifestations do not have specificity, that is, they can be characteristic of most diseases of the gastrointestinal tract and the hepatobiliary system itself, therefore it is important to detect Giardia in a child in a timely manner using laboratory diagnostic methods.

Intestinal form

Giardiasis is characterized by damage to the intestines, which means that dyspeptic manifestations occur more often than others. The intestinal form is manifested by pain in the abdomen, increasing with palpation, pain on the right under the ribs, nausea and vomiting, bloating, belching, and lack of appetite. Patients complain of headache. Parents may notice the appearance of nervous tics, poor sleep, and irritability. In adolescents, a concomitant diagnosis of vegetative-vascular dystonia is made due to frequent pressure surges.

Patients of preschool age develop diarrhea, which lasts for 2-3 days, then constipation may occur. Lumps of undigested food are detected in the stool. In the chronic course of the intestinal form of giardiasis, doctors note:

steatorrhea;
signs of malabsorption syndrome;
retardation in physical development;
weight loss;
skin rashes in the form of dermatitis and allergic reactions.

The appearance of Giardia in infants and older children is accompanied by characteristic changes in the skin, which are the basis for prescribing specific examinations. Patients have a high pallor of the face, which contradicts the hemoglobin numbers in a general blood test, the color of the skin is usually uneven (some areas have a more yellow tint), the skin is dry with the periodic formation of nodules and papules.

The color of the palms and feet is specific. At first it takes on a brick tint, and then becomes orange. The condition of the skin and around the mouth changes. Inflammation of the red border of the lips appears, cracks, jams, etc. appear. The changes even affect the hair. Hair becomes weak, brittle, and sometimes changes color.

Hepatobiliary form

Manifested by the occurrence of lamblia in the liver in children. Dyskinesia of the gallbladder is characteristic, against the background of which there is a violation of the outflow of bile. Later, inflammation of the stomach and duodenum occurs. The long course of the disease in the hepatobiliary form provokes inflammatory reactions from the pancreas and liver. Patients complain of symptoms similar to those during the development of the intestinal form of giardiasis.

Asthenoneurotic form

Characteristic symptoms:

headache;
irritability;
sleep disturbance;
chronic fatigue;
emotional lability;
pain in the heart area.

Toxic-allergic form

Parents of patients complain about the high propensity of children to allergic reactions and the stubborn persistence of manifestations. Strong medications are used to treat conditions because the body may not respond to most medications. In 30% of patients, a complete blood count shows a high level of eosinophils. This occurs due to allergic reactions to toxic substances released during the life of worms and protozoa.

Damage to the heart and blood vessels

This form of giardiasis is characterized by pain in the chest, heart, and joints. Patients complain of constant fatigue.

Diagnostics

Diagnosis of giardiasis in children is carried out in the following cases:

diarrhea of unknown nature;
chronic gastrointestinal pathologies;
prolonged nausea not accompanied by other clinical signs;
a sharp decrease in body weight;
a combination of depressive mood with gastrointestinal disorders;
skin manifestations (dermatitis, urticaria, eczema, neurodermatitis);
state of immunodeficiency;
inflammation of the bronchi and bronchial asthma;
allergic reactions of general and local type of unknown origin;
maintaining a high level of eosinophils in the blood for a long time;
prolonged increase in temperature to low-grade levels of unknown etiology;
contact with a patient who has giardiasis, or a carrier.

There are conditions under which testing for the presence of a disease is mandatory. The list of contingent includes children attending kindergarten, as well as schoolchildren from grades 1 to 4. Diagnostics should be carried out annually: at the beginning of team formation and after summer vacation. It is also mandatory to examine personnel working in school and preschool educational institutions before hiring and annually.

This also includes children and adolescents who are enrolled in schools, orphanages, boarding schools, sanatoriums and health camps. Research is carried out at the time of admission and annually. Food industry workers, sanitation workers, persons who have been in contact with a patient or carrier, as well as patients undergoing inpatient or outpatient treatment (as indicated) are subject to mandatory examination.

You can identify Giardia in a child and check whether the person is contagious using the following methods:

examination of feces for the presence of pathogen cysts;
detection of cysts in the liquid fraction of feces collected by scraping;
diagnosis of the contents of the duodenum;
conducting a PCR study to detect pathogen DNA in stool and biopsy of the duodenal mucosa;
The ELISA method allows you to determine the presence of antigens to pathogens.

What is the danger of Giardia in children?

Some complications of giardiasis occur in 100% of clinical cases, others - in 50%. But, as a rule, all children suffer in one way or another from concomitant pathologies, since giardiasis provokes a sharp decrease in the activity of the body’s defenses. What can a child’s body suffer from? Intestinal dysbiosis occurs in almost every sick child, and in every second child, a slowdown in the process of physical development is confirmed.

In 100% of cases, patients suffer from vitamin deficiency in the body. Most children suffer from colds for 3 or more months in a row and suffer from a long-term chronic cough. This is precisely what explains the need to register not only with an infectious disease specialist, but also with an allergist, neurologist, pulmonologist and gastroenterologist.

Principles of treatment

You can read more about the treatment of giardiasis in children in this article.

Diet

Medicines

Experts recommend treating giardiasis in three stages. The first is preparatory and lasts up to 14 days. Drugs that improve the flow of bile, enterosorbents, vitamins, enzymes, antihistamines, and probiotics are prescribed.

In the recovery period of treatment (third) the following are prescribed:

pre- and probiotics;
vitamins and vitamin complexes;
herbal medicines that support the functioning of the hepatobiliary system;
adaptogens.

Evaluating the effectiveness of activities

During therapy, periodic assessment of the effectiveness of the measures taken is necessary. During treatment, body temperature, pressure and blood pressure, respiratory rate and the condition of stool are monitored. If your baby suffers from vomiting and frequent diarrhea, it is important to control his body weight. This is especially true for children in the first year of life.

Once every 7–10 days, blood is taken (capillary and venous) for testing. How to determine whether a patient has been cured or not? A three-time determination of the presence of Giardia is carried out in a stool analysis or a PCR analysis, or clarification of the presence of antigens to the causative agents of the disease.

What is hepatic colic: symptoms, causes and treatments

Sharp pain in the right side, exhausting in its intensity for several hours or even days - this is how hepatic colic manifests itself. It most often occurs unexpectedly, after a pleasant feast or necessary work in the house or on a personal plot that requires the use of physical force.

Typically, such attacks require urgent intervention by an ambulance team. Such pain may be the first signal of a disturbance in the process of bile outflow and developing cholelithiasis.

Symptoms of the disease

In anticipation of biliary colic, you can notice some warning signs:

Occasional nausea.
Weak aching pain under the right lower rib.
Bitter taste.
Belching with an unpleasant odor.

If you ignore these symptoms, the progressive disease will manifest itself in more severe ways:

During an examination by a doctor, pain appears when pressing or tapping in the area of the lower ribs, collarbone and gall bladder. Palpation reveals an enlarged liver.

With such symptoms, the patient needs urgent assistance from medical professionals.

Causes

The following reasons can provoke a painful attack:

Stomach ulcer.
Dysfunction of the gallbladder.
Colitis.
Appendicitis.
An abundance of fatty foods and a love of spicy seasonings.
Excessive food consumption.
Frequent consumption of alcoholic beverages.
Age indicator. Attacks of biliary colic most often appear after 40 years.
Excess body weight.
Psychological stress.
Women are likely to experience colic in the last months of pregnancy or in the early postpartum period. Increased blood circulation during the menstrual cycle can also be accompanied by a painful attack.

Where are the pains based?

It is difficult to determine the exact location of the source of pain during colic. A feeling of intense burning and painful distension can spread along the right side of the body from the abdominal cavity to the shoulder and can be felt even in the back.

When you try to palpate the liver, its increased size and painfulness of the tense gallbladder are determined.

Which doctor should I contact?

An acute attack of hepatic colic is relieved with the help of a called medical team.

If there are no indications for hospitalization, then the patient must independently and without delay seek advice from a therapist. The doctor, having familiarized himself with the medical history and symptoms, will refer you to a specialized specialist - a gastroenterologist. Based on the test results, effective treatment will be prescribed.

Diagnostic methods

After an examination by a doctor and a medical history, diagnosing hepatic colic is usually not difficult due to the characteristic symptoms.

To establish the main cause of bile stagnation, additional diagnostic studies are performed.

Blood analysis

A general blood test can reveal the presence of inflammatory processes. To do this, pay attention to the number of leukocytes and the ESR indicator.

A biochemical blood test is prescribed to determine the level of bilirubin, which can confirm the presence of pathologies in the gallbladder.

Hemotest

In the Hemotest medical laboratory, a comprehensive biochemical blood test is performed, including the study of a complete list of liver enzymes. As a result of such research, the picture of the functioning of the liver, gallbladder and pancreas becomes clearer.

In this laboratory you can undergo a full examination, including ultrasound and general blood tests.

Other tests

To more accurately determine the disease, the use of ultrasound examination of the gallbladder is effective. If there is a suspicion of biliary dyskinesia, then an ultrasound is performed after the patient has consumed raw chicken yolks, which makes it possible to determine the degree of contraction of the gallbladder.

If necessary, radiography and computed tomography may be used.

Urgent help during a seizure

During a painful attack of colic, an ambulance must be called. Arriving doctors will be able to assess the complexity of the situation on the spot and if it is necessary to hospitalize the patient, after first reducing pain. The following drugs are often used:

Painkillers. Usually these are injections of Ketorol, Baralgin or Diclofenac.
Antispasmodics reduce spasm of the bile ducts. For example, no-shpa, Spasmol.
Diphenhydramine enhances the effect of antispasmodics.
Antiemetics and solutions to restore water balance.

Differences in symptoms and diagnosis between men and women

Symptoms of biliary colic are almost the same in both men and women.

Men often contribute to the onset of an attack through heavy physical work and abusing alcoholic beverages.

Women, according to statistics, suffer more from gallstone disease. Biliary colic often accompanies women over 40 who have given birth repeatedly. Exacerbations are observed while taking hormonal contraceptives, during the menstrual cycle, as well as in the last trimester of pregnancy. Therefore, when diagnosing colic, you need to make sure there are no gynecological diseases.

Treatment options

Patients with acute manifestations of biliary colic are treated under the supervision of a doctor in the gastroenterology department. After stopping the attack, such patients are prescribed drug therapy aimed at eliminating the primary cause and relieving symptoms.

An additional purpose will be to adhere to a strict diet. During an attack, the patient is even advised to fast during the day.

The standard treatment method in difficult situations is surgery.

Traditional medicine can be used as auxiliary and supportive measures. But such treatment will be effective if the disease is mild or in remission.

During the recovery period, warming and other physiotherapy procedures are used.

Medication

Traditional medicine can only help as an adjuvant. In severe cases, these remedies will not have a particularly effective effect.

A decoction of immortelle and chamomile flowers, infused for 30 minutes in boiling water, will help relieve spasms and reduce inflammation. You need to drink 100 ml before meals three times a day for two weeks.
Grated carrots mixed with a spoonful of honey can remove Giardia and cure cholecystitis. This paste must be eaten every day for a month.
But onion juice with honey (in equal parts) can dissolve stones and improve the flow of bile. Drink one tablespoon of juice three times a day before meals.

Other methods

If drug therapy does not alleviate the pain symptoms after a few hours, surgery must be resorted to.

To eliminate the cause of colic, laparoscopy, stone removal using shock wave lithotripsy, or a radical method—removal of the gallbladder—can be used.

Urgent pain relief for hepatic colic

What to do before the doctor arrives and how to relieve pain when medical care is delayed? At home, you can ease the course of an attack if you remember the algorithm of actions for first aid to a patient.

Don't hesitate to call an ambulance.
Place the patient on his right side and ensure complete rest.
Avoid any movement or massage of the sore spot.
No food other than water is allowed
If there is no doubt that this is hepatic colic, you can place a warm heating pad under the liver area.
To relieve pain, you need to give the patient an intramuscular injection of Baralgin or any antispasmodic, for example No-shpa. Taking nitroglycerin tablets will ease the situation.

In any case, you should consult a doctor as soon as possible.

Proper nutrition

In order for the treatment to bring a positive result, you must adhere to a strict diet. You will have to limit the consumption of the following products:

Smoked and sausage products.
Vegetables without heat treatment.
Spicy vegetables and seasonings.
Bean dishes.
Meat and fish products high in fat.
Fried dishes.
Wheat baked goods.

Alcoholic drinks and strong coffee.

You can eat without fear:

First courses with vegetable or chicken broth.
White poultry meat.
Boiled or baked fish.
Porridge and cereal side dishes.
Boiled vegetables.
Baked goods made from oatmeal or bran.
Weak tea, jelly and compotes.

Prevention

To avoid relapses, it is worth using simple preventive measures. It’s a good idea to learn to react calmly to stressful situations.

Bad habits such as smoking and drinking alcohol should be replaced with healthy ones: playing sports and long walks.

Compliance with the diet and regular visits to the doctor should continue regardless of the duration of remission.

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ICD 10

ICD is a system of classification of various diseases and pathologies.

Since its adoption by the world community at the beginning of the 20th century, it has gone through 10 revisions, so the current edition is called ICD 10. For the convenience of automating the processing of diseases, they are encrypted with codes, knowing the principle of their formation, it is easy to find any disease. Thus, all diseases of the digestive system begin with the letter “K”. The next two digits identify a specific organ or group of organs. For example, liver diseases begin with combinations of K70–K77. Further, depending on the cause, cirrhosis may have a code starting with K70 (alcoholic liver disease) and K74 (fibrosis and cirrhosis of the liver).

With the introduction of ICD 10 into the system of medical institutions, the registration of sick leave began to be carried out according to new rules, when instead of the name of the disease, the corresponding code is written. This simplifies statistical accounting and allows the use of computer technology to process data sets both in general and for various types of diseases. Such statistics are necessary for analyzing morbidity on a regional and national scale, when developing new drugs, determining their production volumes, etc. To understand what a person is sick with, it is enough to compare the entry on the sick leave certificate with the latest edition of the classifier.

Classification of cirrhosis

Cirrhosis is a chronic liver disease characterized by liver failure due to tissue degeneration. This disease tends to progress and differs from other liver diseases in its irreversibility. The most common causes of cirrhosis are alcohol (35–41%) and hepatitis C (19–25%). According to ICD 10, cirrhosis is divided into:

K70.3 – alcoholic;
K74.3 – primary biliary;
K74.4 – secondary biliary;
K74.5 – biliary, unspecified;
K74.6 – different and unspecified.

Alcoholic cirrhosis

Liver cirrhosis caused by alcohol is coded K70.3 in ICD 10. It was specially identified as a group of individual diseases, the main cause of which is ethanol, the damaging effect of which does not depend on the type of drinks and is determined only by its quantity in them. Therefore, a large amount of beer will cause the same harm as a smaller amount of vodka. The disease is characterized by the death of liver tissue, which transforms into scar tissue in the form of small nodes, while its correct structure is disrupted and the lobules are destroyed. The disease leads to the fact that the organ ceases to function normally and the body is poisoned by decay products.

Primary biliary cirrhosis

Primary biliary cirrhosis is an immune-related liver disease. According to ICD 10 it has code K74.3. The causes of the autoimmune disease have not been established. When it occurs, the immune system begins to fight the liver’s own bile duct cells, damaging them. Bile begins to stagnate, which leads to further destruction of organ tissue. Most often, this disease affects women, mainly 40–60 years old. The disease is manifested by skin itching, which at times intensifies, leading to bleeding scratching. This cirrhosis, like most other types of disease, reduces performance and causes depressed mood and lack of appetite.

Secondary biliary cirrhosis

Secondary biliary cirrhosis occurs due to exposure to bile, which, having accumulated in the organ, cannot leave it. According to ICD 10 it has code K74.4. The cause of obstruction of the bile ducts may be stones or the consequences of surgery. This disease requires surgical intervention to eliminate the causes of obstruction. Delay will lead to continued destructive effects of bile enzymes on liver tissue and the development of the disease. Men suffer from this type of disease twice as often, usually at the age of 25-50 years, although it also occurs in children. The development of the disease most often takes from 3 months to 5 years, depending on the degree of obstruction.

Biliary cirrhosis, unspecified

The word "biliary" comes from the Latin "bilis", which means bile. Therefore, cirrhosis associated with inflammatory processes in the bile ducts, stagnation of bile in them and its effect on liver tissue is called biliary. If it does not have the distinctive features of primary or secondary, then it is classified according to ICD 10 as biliary unspecified cirrhosis. The cause of these types of disease can be various infections and microorganisms that cause inflammation of the intrahepatic bile ducts. In the 10th edition of the classifier, this disease has code K74.5.

Other and unspecified cirrhosis

Diseases that, in terms of etiology and clinical characteristics, do not coincide with those previously listed are assigned a general code K74.6 according to ICD 10. Adding new numbers to it allows for their further classification. So, in the 10th edition of the classifier, unspecified cirrhosis was assigned the code K74.60, and the other - K74.69. The latter, in turn, can be:

cryptogenic;
micronodular;
macronodular;
mixed type;
postnecrotic;
portal.