Biliary dyskinesia is a disease in which the gallbladder does not pinch well and the bile does not remove properly from the gallbladder.
Historical Background of Biliary Dyskinesia
The biliary pain was first recognized in 1921 in the absence of gallstone. In 1924 Blalock was a doctor he find out that 138 patients out of 73 patients having cholecystitis means benign biliary disease.
One agreement was done with the Blalock paper that warn against CYC is a process in which the no definite pathology justify it .A paper was published that was Surgical Criteria for Cholecystectomy .
He recommended it in the situation when a normal presents acalculous gallbladder by identify that 49 patients go through CCY and having no proof of gallstone and 76.3 percent were asymptomatic on follow up as compared with approximately 91 percent of calculous case .
Another physiologist Graham and Cole described the cholecystography in 1927 by using the teytrabromophenolphthalein is a substance that is excreted in the biliary tree to allow radiologic exaplicate of the gallbladder and the biliary tree .
Mackey reported that 37 percent of patients completely cured from the symptoms and 33 percent reported some improvements in the symptoms while 34 percent were classified as not having satisfaction results.A operation can be done when patients have high rate of unsatisfactory for patients with history and operative findings indicative of pathologic changes.
Similarly Glenn and Mannix studied in 1956 he conclude that patients who undergo CCY for acalculous and not acutely having swollen gallbladders reporting that only 66 percent of the patients reported improvements in their symptoms and 11 percent informed that some improvements achive while 24 percent reported that no improvement occur.
Over the developing decades since Freeman with improvements in diagnosis frequently studies have found similarly high success rates compared with the history of the early 21 century.
Definition of Biliary dyskinesia
The word dyskinesia is the blend or union of two words dys and kinesia. Thedys means abnormal and kinesia means the abnormal movement of gallbladder.The gallbladder is a organ which is present at beneath the liver in the upper right part of the belly at a lower level of ribcage.
The gallbladder is presnt under the liver and it is just like small pear shape .The liver is a major organ in the body which synthesize the bile and gallbladder is another organ which store this synthesized bile and pass it to the small intestine through duct.
Bile involve in the digestion of fats particles. When we take a meal then the function of the gallbladder is to release the store bile into the small intestine that help in breakdown of large particle into small particle of food .
Epidemiology of Biliary dyskinesia
Biliary dyskinesia is mostly present in the elderly children and adults. But now a day it can be diagnosis in the hospital and it is the most reason for removal of the gallbladder. Biliary dyskinesia is may be choronic or acute and if there is inflammation of gallbladder than it is chronic .But there is no formation of stone in gallbladder.
Types of biliary dyskinesia disease
Gallstone form in the gallbladder when fatty particle or bilirubin from blood accumulate in the gallbladder and hunk the way to the bile duct and gallbladder.There size may vary from sand particle to very big size.Mny factors are of gallstone like
- High sugar level in blood like dibetes
- Older or 60 year old
- Eating medicines that having the high level of estrogen hormone
- It may be genetic disorder
- Having other liver disese
It is usually induce by the gallstone. Tumors are form in it. Its presence is notice by the having pain in the upper right portion or middle portion of the abdomen and it further induce
- High temperature or fever
- Hepatitis or jaundiance
It occur after the acute cholecystitis and in this type gallbladder reduce in size and loose the ability to store bile.It causes
- Sever abdominal pain
- Vomiting and nausea
For this treatment surgery is often recommended for chronic cholecystitis.
In this gallstone may cottage in the starting of duct and when it is sealed then no bile stayed in it. In this unique type gallbladder swollen in size.It also cause sever pain in the upper or middle portion of the abdomen.High temperature and pale colored footrest.
It is a type in which occur in the absence of gallbladder stones and gallbladder swollen in it .It is a type of chronic illness and consultant to doctor is very necessary. But symptoms of this type of illness is identical to acute cholecystitis type of gallstone.Some sever condition include in it
- Extreme physical trauma
- Heart open surgery
- Abdominal operate of any kind
- Self immune like lupus or disease of skin
- Blood infection
- Bacterial or virus infection
- Sclerosing cholangitis
Scaring is a disease in which extreme inflammation occur and bile duct is totally damaged.But in this disease symptoms are not appear regularly.But regularly showing imbalance in theupper portion of abdominal region.
It is present almost 60 to 90 percent in people but they have high quantity of ulcer colitis.In this condition there is very high chances of liver cancer but its recovery is also possible by the liver transplant.
Gallbladder cancer is not commonly occurring disease.Gallbladder cancer has many further different types .If cancer of gallbladder is very from long time then it is very difficult to treat because all the possible to treat are distinguish.Cancer of gallbladder is often cause by the gallbladder stones .
Cancer of gallbladder is often spread into liver by the moving from inner region to outer region of gallbladder than other organ .The infections of gallbladder cancer is always identical to the acute cholecystitis but it has no more symptoms like other type.
Polyps of gallbladder:
Gallbladder polyps are often tumor or outgrowth pockets that form in the gallbladder.Usually it have no symptoms .If tumor size is about 1 centimeter than removal of tumor is always recommended by the doctor.
If it is not remove after long time then it changed in to gallbladder cancer.
Gangrene of gallbladder
When insufficient blood flow occur then gangrene of gallbladder takes place.It is one of the sever type of acute cholecystitis.
Factors which involve in it are
Having high level of sugar in blood like diabetes
Dull pain in the gallbladder region of abdomen.
Signs and Symptoms of biliary dyskinesia
Abdominal pain mostly start in the region of right upper belly portion at the place where gallbladder is present.This type pain usually start after the eating meal specially eaten fatty meals like pizza etc.
The pain can be acute and chronic if pain is sudden then it is acute and if pain is recurrent or frequent for a long periode of time then it is chronic.
This is called biliary chronic . But in children nausea or vomiting and not wanting to eat are the symptoms of biliary dyskinesia. The symptoms of biliary dyskinesia are identical to regular symptoms of of any other gallbladder disease which comprise
- Intestinalgas or gas
- Swell or bloating
- Belch or Burping
- Fever and cold of body
- Concentrated urine
Many other symptoms of biliary dyskinesia Abdominal pain in the upper right portion of where gallbladder is present Low bile secretion about 31 to 42percent ,HIDA scan is used to study the secretion amount of bile.
The pain induced by biliary dyskinesia is always identical to the pain that is felts by the patients that having the gallstones.Majority patients explain it as a extensive pain go through and hindrance under the right ribs cage.
The pain is interact by the regular activities and does not let up even when the patient passes out gass and also has a bowl movement or even take excwss amount of bitter acid.
Also this type of pain is usually observed early in the morning during menstruation or after eating heavy meal. Causes Biliary dyskinesia occurs usually due to malfunctioning of muscular coordination in the gallbladder .
Doctors not yet known about the causes of of this disease but many factors play role in it like Stress is the main factor which causes the dopamine receptor malfunction which can keep the gallbladder to receive information from brain or receive proper signal from brain.
But under stress gallbladder is unable to receive proper information from brain. Other major cause is malfunction in the muscle of gallbladder.
Extensively muscle of the sphincter of oddi tight Chronic swelling Hormone secretion problems Obesity or weight gain Biliary dyskinesia is the symptoms of many other sever type disease like Hypothyrodism or insufficient secretion of thyroid gland Pancreatitis Diabetes Fibromyalgia is a disease in which muscles of gallbladder weak and also effect the muscles of gallbladder and this is common for patient having biliary dyskinesia.
Biliary dyskinesia is more common in the females as compared to the males and mostly present in the patient having age between the 41 and 60 years old.
What role of Curcumin in Gastrointestinal and Liver diseases
Billiary dyeskinesia is also called as the sphincter dyskinesia of oddi and is usually induce by the sphincteric valvular malfunction in the muscle of gallbladder. .The ecact mechanism of biliary dyskinesia almost not know.
Physiologist showed that 20mg of curcurmin given to chronic patient then results are seen that 29percent volume reduce of gallbladder that is measured by the 2h serial ultrasound.
Curcumin is very usefull in the reduction of gallbladder stones . Gallbladder disease and Hepatic infections Hydrops of gallbladder acalculouscholecystitis is not see more regularly .Maximum drops of gallbladder was distinguishby huge bloated in the absence of gallbladder stone infections inborn abnormalities.
Kwasaki is a disease in which temporary barrier of the cystic duct and increased the mucous secretion by the gallbladder during empty situation .Excess with gallbladder stone bloated and more measure of the increase of cystic duct barrier in it .
Acalculouscholecystitis commonly occurs in association with the sickness for long time like burns sepsis in stomach tauma which low water concentration in body occur .Biliary dyskinesia is completely diagnosis in the children .
The diagnosis made by the performing a gallbladder discharge fraction which is a radioisotope investigation .
An abnormal gallbladder has 40percent merit for discharge.Patient with an abnormal gallbladder removal or discharge go through the cholecystecrotomy process .This procedure is very effective in curing of 90percent of patients with many symptoms.
If there is any problem in the movement of gallbladder function is called the malfunctioning of sphinter of oddi. It has two well define divisions of malfunctioning of oddi of sphincter that are pancreatic dysfunction of sphincter of oddi and biliary dysfunction of oddi of sphincter. Usually billiary oddi of sphincter present in patient malfunction have billiard type pain on almost 3 to 5 years after processing pass through cholecystectromy.
Oddi of sphincter manometer are necessary for making a diagnosis preparing a distinguish of unusual movement of the oddi of sphincter.
By using manometric identification of the oddi of sphincter stenoisis would guide to disunion of sphincter. Sphincterotomy consequences lifelong aid of sign is more than 80 percent of sick person.Pancreatic oddi of sphincter malfunction medically introduce with reoccurring incidents of pancrease unusuall case .
Oddi of sphincter manometric of pancreatic sphinter of duct would be carry out. if having eliminate of all of the usual cause of pancrease. When stenoisis is manometrically distinguish so sick person pass through two types of biliary dyskinesia that are pancreatic and biliary sphincter of duct. .
Biliary dyskinesia has many treatment in results of consolation in excess of than 90 percent of sick person.
Diagnosis Biliary dyskinesia
Physical examination is usually not observable unless the child having symptoms.During painful situation the patient may complain of having pain in the upper right portion of the abdominal affection.
Ultrasound is a process through which you can see the gallstone which can cause the identical symptoms.No stones are present in the biliary dyskinesia .In this test a investigation is applied on the belly directly overlying the gallbladder.The ultrasound is a process which use sound waves to receive an image of the gallbladder that how many it is damaged.
HIDA scan is also known as the cholescintigraphy and it is use for the test of how well the gallbladder is empty.In this test a tracer is enter in the blood of the child .This tracer is absent in the liver and is concentrated in concentration in the gallbladder.
After the tracer is given then a injection is given to the patient it contain a medicine called cholecystokinin CCK allowed patient to eat fatty food like pizza or hamburger.Both fatty meal and CCK are signals for the pinch of gallbladder.When CCK is injected in the blood of child it induced pain in the child .
Normally when gallbladder is pinched it drop most of the bile concentration.The biliary dyskinesia is a disease in which the gallbladder is pinch only about 35 to 40 percent or less of the totally gallbladder contents.The pain occur when gallbladder contents are incomplete and inactive of gallbladder.
The trcer which is used for testing may contain a small amount of radioactive which is not extremely harmful to your child as it is cleared from body quickly and completely discharge.
Blood tests are done but in biliary dyskinesia tests are normal .Many tests are taken like check your child white blood cells count or billurubin levels and also liver function test and pancreatic enzymes functioning.
Condition that impersonator that condition Gallstones are known as the cholelithiasis and cholecystitis is known as the infection or inflammation of the gallbladder hepatitis is the infection in liver gastritis is disease in which in which the inflammation of stomach form and pancreatitis is a disease in which pancrease malfunction and inflammation take place.
An ERCP is a procedure that is use to measure the duct performance for receiving of bile from the gallbladder/.In this process doctor provide you a instrument that is endoscope that is enter through mouth and then it form a opening between the small intestine and stomach.It provide the images just like x ray .A different type of liquid is used that help in the formation of full view of image through xray.Then consult your doctor if you have sever allergic reaction by using this different type of liquid.
Treatment of Biliary dyskinesia
Surgery to remove the gallbladder stone is recommended when a child present to have symptoms of the biliary dyskinesia and the discharge fraction is low on the HIDA scan. Laparoscopic cholecystectomy is a technique which is used for the removal of the gallbladder.
This technique is frequently used and is the standard of care today.This surgery is performed very efficiently because it is performed through small take in the abdomen using a small camera and special type of tools .This type of process done very efficiently.
Risks of surgery is very costly and painful.During the open surgery large cut is taken in the abdomen .During it bile duct injury take and bile leaks from it a large amount of blood release from it and then infection take place.If complications are sever than then further surgery made.If the complication rates are low then discussed by your surgeon.
Long term outcomes If there is no guarantee that symptoms that sympyoms will resolve even after surgical removal of gallbladder .
This is because the identification is not correct and it may be difficult to tell because the cause of symptoms is from the gallbladder or may be it is due to another problem such acid high concentration in the stomach that is toxic for stomach.
It is therefore already notice that other causes of belly pain before your child under goes removal of the gallbladder.
How biliary dyeskinesia is treat
If your symptoms is pass through without passing any treatment .Then may you need of taken more following instruction or medicine if your symptoms are in drastic conditions.
Prescription about pain medicines also given to the patient.Kindly ask your doctor how to take this medicines regularly.Acetaminophen is also present in the prescription medicines for pain Avoid the other medicines that contain the acetaminophen without keeping the contact to your doctors .
If you take the high level of acetaminophen that is very toxic and it damage your liver badly.Constipation may also induce by consuming the high level of acetaminophen.Contact your doctor about how to treat constipation.
NSAIDs it is just like ibuprofen medicine and it is use for reducing the swelling of liver or stomach sever pain and chills or fever.This medicine is available on medical store and can easily purchase if doctor recommend it or not to patient.Stomach bleeding very poisonous and problems of kidney may also induce after using of high level of NSAIDs .
If you already taken the any blood thinner medicine like disprine c which keep the blood thin and if you not take it then ask your doctor that NSADIs is not toxic for you.Always follow the doctor perception and medicine taken time regularity .
It always notice that this medicine is very high potency so donot give this medicine to the children whose age is about or less 6 months if your doctor not recommend to your child.
Surgery is the last option of treatment that can be used for the discharge of gallbladder from body .The age is very important factor for the surgery because it is not take at the age of young child.
How can I do to maintain biliary dyskinesia:
Firstly we should maintain a balane weight for healthy life .If your body weight is accidently increase in amount then there are many chances of having gallbladder disease and then a sever pain may arose from it.It is necessary for a body not increase or loose body weight quickly.It also increases the chances of getting many problems of gallbladder.If you get high body weight then consult your doctor how to loose your weight and then balance it .
Always eat a variety of healthful food.Fruits low fat dairy things like milk or butter etc mutton fish etc are also consider as healthy food. If this diet is not providing you a beneficial for health then consult your doctor for special diet .
Then your doctor give you a low fat containing diet plan chart,Omega 3 fats are include in healthy food and are present in many fish types like trout salmon or tuna.Plants also provide a healthy diet like soyabeans and walnuts etc.
At the end we shuld eat that food that are necessary for healthy life and avoid fatty food that increase the symptoms of biliay dyskinesia or gallbladder.