Cholecystitis and cholelithiasis

Author: Song Xiaoyu / Country: Mainland China
Publisher:
Publish Date: 2006-06-01
Features: What is cholecystitis? Cholecystitis includes acute and chronic cholecystitis. Acute cholecystitis is a common and frequently occurring disease of the biliary system. Due to anatomical characteristics of the gallbladder, as well as factors such as gallbladder duct obstruction, bacterial invasion, bile retention, and gallbladder wall ischemia, acute cholecystitis occurs. Acute cholecystitis is a common surgical acute abdominal disease and a common complication of gallstones, with about 90% of patients having gallstones. Acute cholecystitis is more common in middle-aged women, with a male-to-female ratio of 1:(1.2–2). Elderly patients (over 60 years old) with acute cholecystitis have a significantly higher mortality rate due to the risk of complications such as cholecystic suppurative infection, gangrene, perforation, and acute cholangitis-related pancreatitis. Chronic cholecystitis includes chronic calculous cholecystitis and chronic non-calculous cholecystitis. In patients with recurrent cholecystitis, about 70% have gallstones, and the patients are mostly middle-aged or older, with a higher prevalence in women. Due to repeated inflammation, the gallbladder wall may thicken, showing fibrous tissue hyperplasia and chronic inflammatory cell infiltration, with varying degrees of mucosal atrophy, leading to reduced concentration and contraction function. In severe cases, the normal tissue structure of the gallbladder wall may be largely destroyed, followed by fibrous scar tissue hyperplasia, resulting in complete loss of gallbladder function. The symptoms of chronic cholecystitis are generally not obvious or atypical and are often overlooked. However, during acute episodes, the clinical symptoms are significant and should not be ignored.
P1 How should cholecystic disease be prevented?
Lifestyle Prevention:
In terms of dietary habits, it is advisable to eat at regular intervals and avoid overeating. Strictly control the intake of fat and cholesterol-containing foods, such as fatty meat, fried foods, and animal organs. Ensure an adequate supply of vitamins, especially foods rich in vitamin A, B vitamins, vitamin C, and vitamin E. Vitamin A helps in the growth and maintenance of biliary epithelial cells, aids in the repair of diseased bile ducts, and has a preventive effect on cholecystitis and gallstones. B vitamins promote bile secretion, aid digestion, and improve symptoms of biliary infection and cholelithiasis. Vitamin C enhances antibody formation in the body, improves the phagocytic function of white blood cells, and has detoxifying effects. Experimental studies suggest that a deficiency in vitamin E can lead to the formation of gallstones. Choose foods high in dietary fiber, such as leafy vegetables, radishes, coarse grains, beans, fruits, mushrooms, wood ear mushrooms, and enoki mushrooms. Dietary fiber increases bile excretion, inhibits cholesterol absorption, lowers blood lipids, normalizes cholesterol metabolism, and reduces the risk of gallstone formation. It is recommended to drink plenty of water, with an ideal daily intake of about 1,500 mL, to dilute bile, promote bile excretion, prevent bile stasis, and facilitate anti-inflammatory, stone expulsion, and prevention of stone recurrence, which are beneficial for the recovery of biliary diseases.
Eating small, frequent meals is a principle of traditional Chinese medicine for maintaining health and preventing illness. As early as the Tang Dynasty, Sun Simiao noted, "Eat frequently but in small amounts." Small meals reduce the burden on the digestive system, while frequent meals stimulate bile secretion, maintain bile duct patency, facilitate the drainage of inflammatory substances in the bile duct, and alleviate and improve pain. The ideal number of meals per day is 4–5, following the principle of "a hearty breakfast, a moderate lunch, and a light dinner." Dietary habits should be light, but this does not mean avoiding flavor. It means avoiding overly rich or greasy foods. In particular, excessive sweetness should be avoided, as it can promote damp-heat and lead to obesity. Avoid spicy foods. Fatty foods can promote the release of cholecystokinin, enhancing gallbladder contraction. If the Oddi sphincter does not relax promptly, bile flow may be obstructed, causing discomfort. During acute episodes, fatty foods should be avoided, and a high-carbohydrate liquid diet should be adopted. Foods high in cholesterol, such as brain, liver, kidneys, fish eggs, and egg yolks, should be consumed in moderation, whether during an episode of cholelithiasis or during the asymptomatic period. Regardless of whether there is biliary obstruction or during the asymptomatic period, vegetable oils have a choleretic effect and need not be restricted.
P105–106