Bend of the gallbladder (kink, constriction): symptoms, what threatens it, what to do?

A bend in the gallbladder is an abnormal development of this organ, against the background of which there is a violation of the outflow of bile. There are several known predisposing factors leading to the formation of an acquired disease. Among them are reasons such as the course of a particular gastrointestinal disease, a wide range of liver injuries and excessive physical activity.

The disease does not have specific clinical manifestations, which is why there is a need for comprehensive diagnostics. The most characteristic symptoms can be considered an increase in abdominal volume, the appearance of discomfort in the right hypochondrium and a feeling of bitter taste in the mouth.

Treatment tactics will be individual for each patient and depend on the severity of the disease. In most cases, conservative treatment methods are sufficient, but sometimes surgery may be required.

What it is?

The gallbladder is directly involved in the digestive processes. The main function of the organ is the synthesis of bile, without which it is impossible to digest and assimilate products. If the organ is of irregular shape, digestion and fat breakdown occur with disturbances, the outflow of bile slows down or completely stops.

Experts distinguish several types of bends:

• hereditary or fixed;
• acquired or labile.

A congenital inflection of the gallbladder forms in the sixth week of gestation, at the stage when most of the child’s internal organs are formed. It is during this period that any negative impact on the female body increases the risk of congenital disorders of the biliary system and pathological deformations of the gallbladder.

Negative factors dangerous in the first trimester:

• the presence of chronic pathologies in a woman, which worsen during pregnancy;
• infections of viral origin suffered during the period up to 12 weeks;
• therapy with certain medications prescribed before week 12;
• bad habits;
• influence of unfavorable ecology.

The congenital bend of the gallbladder does not change its location, therefore it is also called fixed. With increased activity of the organ, the pathological focus changes location and shape. This pathological process is called labile inflection of the gallbladder.

Symptoms of bending of the gallbladder neck

In children with congenital inflection, symptoms are mild, and the pathology may be asymptomatic. Parents should be alert to such signs as nausea or vomiting against the background of complete health, increased fatigue of the child, sweating, aching pain in the ribs or right hypochondrium.

Nausea and vomiting may be symptoms of congenital inflection

In adults, the signs of pathology are very clear. As we have already found out, as a result of the bending of the neck of the gallbladder, bile does not exit into the duodenum, remaining inside the organ. Typically, symptoms are characterized by the following:

1. Constant heaviness in the stomach, bitter taste in the mouth, discomfort under the lower ribs on the right.
2. Increased sweating and salivation, sweating, causeless tearfulness.
3. Increased heart rate and breathing.
4. Headaches and muscle pain.
5. Grayish tint to the skin.
6. Bloating, nausea, vomiting, sharp “tearing” pain in the abdomen, radiating to the lower back or higher - to the collarbone.
7. Feces become discolored, urine becomes pale.
8. In case of necrosis of the bladder walls and the danger of peritonitis, the temperature rises greatly, severe pain occurs in the abdomen, which can deprive a person of consciousness.

If a person experiences any of these symptoms, or several in combination, they should make an appointment at the hospital immediately. If the last point applies, the patient must be taken to a medical facility as soon as possible by calling an ambulance team or using your own transport.

Classification

Due to the fact that the gallbladder consists of several sections, deformation can occur in any of them. For example, they distinguish:

• bending of the body of the gallbladder;
• a bend in the neck of this organ - this and the above form of the disease is the most common;
• deformation of the bottom of the gallbladder;
• bending of the bile duct.

One of the most dangerous locations of the bend is the area between the body and the neck of the gallbladder.

According to the etiological factor, the disease is:

• congenital – formed during intrauterine formation;
• acquired - characterized by the influence of one or more of the above reasons, and also has a clear clinical manifestation.

In addition, there are several other forms of this pathology:

• labile bend of the gallbladder - characterized by the fact that it can change its location;
• fixed bend of the gallbladder - differs from the previous one in that it is fixed in a certain place and remains motionless;
• functional bending of the gallbladder is not a threat to human life and does not cause the development of complications. This happens because it disappears on its own when the body position changes.

The bend doesn't hurt

A kink in the gallbladder cannot be the cause of pain. It appears if there is an inflammatory process in the bladder and/or motor skills (contractions) are impaired, and this, as a rule, is completely unrelated to the bend.

Yes, sometimes pronounced deformation of the gallbladder occurs. It can lead to incorrect contractions, and further down the chain: dyskinesia - inflammation - biliary sludge - stones. But even in this case, there is no need to straighten the bend.

One thing is important - to prevent stagnation of bile (cholestasis). Therefore, the doctor must find out whether everything is okay with motor skills, and if there are any problems, prescribe medications that will correct them. For example, prokinetics (itomed) are a group of drugs that improve peristalsis of all organs of the gastrointestinal tract, including the gallbladder.

It is worth noting that even with a non-standard bend, the gallbladder can work as usual. If it contracts normally and produces normal bile (not thick or thin), no treatment is required. Only periodic ultrasound monitoring is needed.

Causes

This functional state arises either due to congenital characteristics or during the patient's life. In the first case, the cause is improper formation of the internal organs of the biliary system, which occurs in the fifth week of fetal development. Here, changes in the structure of the gallbladder are often not the only problem, but are combined with other functional disorders.

Acquired pathology is caused by the following reasons:

1. Enlarged liver.
2. Obesity and excess weight.
3. Prolapse of internal organs.
4. Gallstone disease, where stones lead to twisting of the bladder.
5. Failure to comply with the prescribed diet.
6. Long-term inflammatory processes of the hepatobiliary system.
7. Excessive physical activity.
8. Physical inactivity, which is combined with poor nutrition.

There is also a labile bend, which is not congenital and changes location in the gallbladder due to the hollow structure of the organ. In addition, doctors differentiate pathologies by type of development (temporary and permanent) or localization (cervix, fundus, body, duct).

Symptoms and first signs

Characteristic clinical symptoms of gallbladder inflection are:

1. Constant bitterness in the mouth;
2. Nausea;
3. The appearance of bad breath;
4. Gray or yellowish coating on the tongue;
5. Belching;
6. Bloating and increased gas formation;
7. Heartburn;
8. Feeling of heaviness in the stomach, especially after eating;
9. Vomiting when eating fatty, fried, smoked foods;
10. Stool disorders (diarrhea followed by prolonged constipation).

When stones form in the ducts of the bladder against the background of constant stagnation of bile, the patient sometimes experiences yellowness of the skin and visible mucous membranes.

Periodically, the organ itself and the bile ducts become inflamed, as a result of which the patient develops cholangitis or cholecystitis, the symptoms of which are:

• Pain in the right hypochondrium;
• Nausea and vomiting;
• Diarrhea;
• Increase in body temperature to 38-39 degrees;
• Refusal to eat;
• Yellowness of the skin and mucous membranes;
• Attacks of biliary colic.

A bend in the gallbladder in an infant before the introduction of complementary foods may not manifest itself clinically, however, after the inclusion of adult food in the diet, constant regurgitation and stool disturbances are possible. The S-shaped bend of this organ in a young child is in most cases the main cause of a common pathology - biliary dyskinesia.

How it manifests itself

When the gallbladder is bent, the symptoms are most often explained by congestion in the bile. Then, dystrophy of the walls and a violation of the contractile function of the bladder gradually develops (Zaprudnov, A.M. Diseases of the biliary tract in children: developmental anomalies, dysfunctional disorders / A.M. Zaprudnov // Russian Bulletin of Perinatology and Pediatrics. - 2005). Signs of bending of the gallbladder (kinks, constrictions)

• — Nausea and vomiting are provoked by fatty foods or excessive physical activity. These symptoms are explained by the development of inflammation (cholecystitis).
• — Pain in the right hypochondrium associated with stretching of the bladder walls by accumulated bile. Sudden sharp pain may be caused by a stone blocking the bile duct.
• - Change in color of urine and feces. In the complete absence of bile entering the intestines, the feces become discolored and the urine darkens.
• — General intoxication (weakness, fever, headache) is an unfavorable sign, indicating a violation of the integrity of the walls and the flow of bile into the abdominal cavity (bile peritonitis).

The severity of the described symptoms depends on the degree of disruption of the outflow of bile. If the bend only partially closes the exit, the symptoms are erased and are characterized only by indigestion. If bile does not enter the intestines at all, the manifestations are bright and violent.

In children, the manifestations are exactly as violent as described here, in adults they are less pronounced. Everything depends heavily on nutrition. You will load your liver with fatty foods, alcohol, spicy foods, eat rarely but a lot, and you will feel your right side faster.

Look at your tongue! Is there a yellow coating there? Remember: after you eat, do you run to the toilet? Do you occasionally feel bitterness in your mouth?

Here are the most common signs of stagnation in adults, in addition to heaviness in the right side under the ribs, when it has not yet reached chronic pancreatitis or stones.

Complications and consequences

Needless to say, ignoring symptoms and lack of treatment in the formation or detection of pathologies, especially at the stage of their complications, can lead to serious deterioration in health.

1. If the gallbladder does not empty its contents into the stomach in a timely manner, stagnation occurs, causing stones.
2. If the functioning of the gastrointestinal tract is disrupted, this automatically leads to metabolic disorders.
3. If food is not digested properly, metabolism slows down and obesity occurs.
4. In addition, the constant pain that the patient experiences with a complex or twisted bend leads to mental disorders.
5. It will be almost impossible to lead a full life against the background of the discomfort caused by the gallbladder.

The pathology is not fatal and can be treated. Moreover, surgical operations can be avoided in most cases (only a small percentage of highly complex bends undergo surgical treatment). Physical education, diet, exercises, folk remedies, pills - all this should not just be episodes, but a well-structured complex therapy that will help get rid of the pathological bending of the gallbladder and its consequences.

Medicines of animal origin

Such medicines do not contain plant components, but are enriched with natural bile and animal enzymes.

The most common medicine in this category is “Allohol” - the drug is available as tablets and contains:

• ox bile;
• garlic and nettle extracts;
• Activated carbon.

This substance has both cholekinetic and choleretic effects. Thanks to this, it leads to the normalization of the contractile function of the affected organ and the excretion of bile.

The medicine is taken after eating, two capsules four times a day. The duration of the course of therapy can be up to two months.

Restrictions on the use of such a substance are:

• housing and communal services;
• acute course of pancreatitis, enterocolitis and hepatitis;
• liver failure;
• peptic ulcer of the duodenum or stomach;
• calculous form of cholecystitis.

It is worth noting that it is approved for use by children and during pregnancy, however, in such cases, treatment is carried out under the strict supervision of a gastroenterologist.

"Ursosan" - helps normalize cholesterol levels thanks to an active substance such as ursodeoxycholic acid. But besides this, the drug contains:

• corn starch;
• titanium dioxide and silicon;
• gelatin;
• Magnesium stearate.

Among the positive effects it is worth highlighting:

• hepatoprotective and choleretic effects;
• elimination of bile stagnation;
• prevention of stone formation;
• preventing the development of complications of the disease;
• stimulation of the immune system.

The dosage is calculated individually for each patient - on the basis that there are ten milligrams of medication per kilogram of body weight. It is worth noting that you need to drink this remedy in the evening, be sure to wash it down with plenty of liquid.

As for contraindications, they will be similar to the previous medication.

The drug "Cholenzim"

“Cholenzim” is both a choleretic and an enzyme agent aimed at stimulating bile production. The main active substance is ox bile, and in addition includes dried pancreas and the lining of the small intestine of cattle.

This substance must be taken after meals, one tablet three times a day.

List of other drugs from this category used for bending of the gallbladder:

• "Urdox";
• "Liobil";
• "Livodex";
• "Penzital";
• "Enzistal".

Diagnostics

In order to make a final diagnosis and determine the location of the pathology, instrumental examinations will be required. Before their appointment, a primary diagnosis is carried out, which includes:

• conducting a detailed survey of the patient regarding the presence and severity of characteristic symptoms;
• the clinician’s examination of the life history and medical history of not only the patient, but also his relatives - this is necessary to identify the final cause of the disease;
• performing a physical examination, which necessarily includes examination of the skin and palpation of the anterior wall of the abdominal cavity.

Laboratory tests of blood, urine and feces do not have much diagnostic value, but they may indicate the development of complications.

The basis of instrumental diagnostics is ultrasound of the abdominal cavity. This procedure is carried out in several stages:

• the first one is carried out strictly on an empty stomach;
• the second is performed thirty minutes after a choleretic breakfast, but choleretic medicinal substances can be used for such purposes. A repeated procedure will help determine the nature of the disease. If such a disease is a congenital pathology, then after breakfast or taking medications, the volume of this organ will not change. If the disease is acquired, then its size is significantly reduced, but not more than 40%

How to treat a kink in the gallbladder?

Most often, a kinked gallbladder is treated with conservative therapy.

The specialist prescribes drugs with a choleretic effect to the patient, as well as antispasmodics, which help prevent the accumulation of bile. Physiotherapy (electrophoresis with novocaine, ultrasound) is also widely used, as a result of which blood circulation and nutrition of the walls of the gallbladder are improved. This helps him restore normal functioning.

Advice. In some cases, the doctor may recommend treatment at a resort or sanatorium - this will ensure quick and easy treatment. If you have such an opportunity, it is better to follow this recommendation.

Types of bend

A healthy organ has an oval-pear-shaped shape and consists of three parts - the bottom, neck and body.

Depending on where exactly the bend occurred, there are 4 types of pathology:

• the most common disorder is the twisting of the organ between its bottom and the body;
• bending of the gallbladder in the neck or change in its size is also quite common;
• with a simultaneous combination of the two listed varieties, they speak of multiple inflection;
• finally, professional athletes or people engaged in heavy physical labor sometimes experience a temporary bending of this organ during exercise, which does not cause any discomfort and goes away on its own after some time without the use of any treatment methods.

Conservative treatment

Drug treatment is aimed, first of all, at eliminating the causes of illness. In addition, during therapy, the symptoms of both the gallbladder bend itself and the accompanying diseases: gastritis, colitis, ulcers should be relieved.

Most often, the treatment regimen for a pathological condition includes:

• Nicodin - improves bile formation and promotes the outflow of bile into the duodenum;
• Allohol, Odeston - enhance the excretory function of the liver, stimulate the motility of the biliary tract and gastrointestinal tract, eliminate putrefaction and fermentation in the intestines;
• Gepabene - a combined herbal product improves the separation of liver secretions;
• Ursosan, Hofitol - have choleretic, hypocholesterolemic and immunomodulatory effects, facilitate the breakdown of stones;
• Flamin - improves the functioning of the gallbladder, has analgesic and anti-inflammatory activity.
• medicines that improve digestion - enzymes Mezim forte, Pancreatin, Festal;
• antispasmodics - relax the smooth muscles of the bile ducts and relieve spastic pain - Papaverine, Drotaverine, No-shpa.

If the development of an inflammatory process is suspected, the patient is prescribed antibacterial drugs.

Treatment for an irregularly shaped gallbladder can take months. All medications should be taken in courses of 12–14 days. The duration of therapy and the set of medications is determined by a specialist after diagnostic measures.

To eliminate the symptoms of bending of the bile organ, the patient is prescribed physical therapy: electrophoresis with novocaine, magnetic therapy, ultrasound. The procedures provide excellent pain relief, improve the separation of liver secretions and relieve inflammation.

Treatment

Complex treatment is prescribed by a specialist and usually consists of choleretic agents, diet, exercise and traditional medicine. A bend in the neck requires long-term treatment and constant monitoring by a doctor. Treatment allows you to maintain the patient’s normal condition and well-being and block complications and symptoms of the disease.

Drugs

Most often, when the neck of the gallbladder is bent, the doctor prescribes the following remedies:

Diet - what can and cannot be eaten?

Following a special diet significantly speeds up the healing process. Gastroenterologists recommend eating every three hours, in small portions. For this pathology, table 5A is recommended. The menu should not contain spicy, salty or fatty dishes, and exclude any spices that can irritate the gallbladder and provoke inflammatory processes.

An absolute ban on sweet carbonated and tonic drinks, alcohol. Salt should be eliminated if possible. The best option is to cook without salt, and add salt to the finished dish in a plate. It is important to exclude this type of heat treatment such as frying; products can be boiled, stewed, used in a double boiler and baked.

Prohibited products:

• fatty meat and fish, as well as broths made from them;
• offal, smoked meats, lard;
• sausages and canned products;
• sweet products (especially with cream), rich pastries;
• fatty dairy products;
• legumes;
• mushrooms;
• animal fats;
• sugar, honey, chocolate, cocoa, any jam;
• citrus fruits and all dried fruits;
• spicy and overly fatty sauces.

If the organ is deformed, you can eat the following foods:

• lean varieties of meat and fish, as well as broths made from them;
• fresh vegetables, sweet fruits, dishes made from them;
• porridge, pasta;
• dairy products with a minimum percentage of fat content.

Gastroenterologists recommend drinking two liters of pure or mineral water (still). Food is taken warm. If you follow all the doctor's advice, the recovery process will go quickly.

Sample menu:

The diet for gallbladder bending should be followed in accordance with the regimen: regular frequent meals in small portions. Fasting and especially overeating are not allowed.

General recommendations

The “Table No. 5” diet is recommended if a person has an exacerbation of the disease. When the patient feels better, the diet can be made richer. In order not to worsen your condition, you just need to adhere to the following nutritional recommendations:

• it is necessary to limit the consumption of jam, honey, sugar and sweets, and also remove hot, sour and fried foods from the diet. Food is baked in the oven or boiled;
• give up confectionery and sausages until complete recovery;
• corn silk and oil have good choleretic properties and help normalize the functioning of the gallbladder;
• It is useful to eat 300 g of pumpkin daily or drink pumpkin juice;
• Gallbladder disorders are well treated with bee products. For example, pollen is taken on an empty stomach, a teaspoon and 3 times during the day, half an hour before meals;
• apple and turnip improve intestinal motility;
• It is very important to chew food thoroughly;
• Decoctions with a set of choleretic herbs - tansy, chamomile, yarrow - effectively help. To prepare it, you need to take two tablespoons of the mixture and pour a glass of boiling water over it. Drink a tablespoon of decoction three times a day;
• It is contraindicated to take medications during breastfeeding or pregnancy. An adverse reaction may include severe allergies.

Of course, it is best to initially follow proper nutrition - then you will not face the need to treat diseases of the gastrointestinal tract.

Drug treatment

This method is designed to normalize the process of bile outflow. Stagnation of bile threatens the formation of stones in the ducts. Most often, in order to prevent stagnation, drugs are prescribed that stimulate the outflow of bile. Only a specialist should prescribe choleretic tablets after a thorough examination. The use of drugs to stimulate the outflow of bile in cases where stones have already formed is extremely dangerous and can lead to blocked ducts. If stones are detected, tablets are prescribed that change the composition of bile and help get rid of them. Taking medications for a bent gallbladder should only be prescribed by a doctor, but when you need to relieve symptoms, the following medications will help.

Motilium

A remedy that can eliminate the following symptoms: vomiting, severe bloating, heaviness in the stomach, intestinal dysfunction. If symptoms characterizing disturbances in the functioning of the gallbladder appear, you should take 1 tablet. Subsequent meals should be accompanied by taking the drug 30 minutes before meals. You should limit yourself to 3 doses per day for a maximum of 3 days.

Hofitol

A universal choleretic drug based on substances of plant origin. With the help of this remedy it is possible to normalize the flow of bile in the shortest possible time. The medicine is made from the leaves of the field artichoke, a natural choleretic agent. The medicine is available in the form of tablets or solution, which you need to drink 2 tablets 3 times a day, or 3 ml of solution up to 3 times a day. The drug is not recommended for people with bile duct obstruction or serious kidney disease.

Treatment of gallbladder kinks with medications is effective and widely used by doctors. The drugs described will help cope with some symptoms, but will not get rid of the disease. Only a specialist can prescribe a course of drugs for complex treatment, based on the results of the examination.

Exercise therapy

If there is a bend, therapeutic exercises will help not only prevent further deterioration of the condition, but also improve the functioning of the gallbladder. When characteristic symptoms appear, it is recommended to perform the following exercises:

• Lying on your stomach, rest your toes on the floor and extend your arms along your body. As you exhale, you need to simultaneously raise your head, chest, arms and lower limbs (without bending your knees). Without holding your breath, hold the pose for several seconds, then return to the starting position as slowly as possible (as you exhale). Repeat 5 times.
• Lie on your back, place your arms straight behind your head, and press your lower back to the floor surface. As you exhale, raise your straight legs 20 cm and hold for at least 5 seconds, then raise your legs even higher (50 cm) and also hold this position for 5 seconds. Make sure that your breathing does not interrupt; as you exhale, slowly lower your legs. It is enough to repeat 4 times.
• Having taken the starting position, as in the first exercise, we do breathing exercises. After a deep breath, hold the air for 3 seconds, and then release it as slowly as possible, while tensing the abdominal muscles. Repeat 10 times.

It is best to conduct classes under the guidance of an experienced instructor and at the same time carefully monitor your well-being.

Purpose of therapeutic exercises

Therapeutic gymnastics for a kinked gallbladder should perform the following tasks:

• Slowing down the progression of pathological processes in the body;
• Restoring the normal functionality of the organ.

Doctors recommend regularly performing the following exercises:

• Assume a position lying on your stomach with your arms parallel along the body. When exhaling, you need to raise your body, arms, legs, stay in this position for 5 seconds and relax. It is necessary to perform 5 approaches;
• The patient needs to lie on his back, stretch his arms forward above his head and avoid bending in the neck. Raise your legs straight above your body and hold for 20–25 seconds. Perform the exercise 3–4 times;
• Perform breathing exercises in a lying position on your stomach. First you need to take a deep breath, hold your breath for 10 seconds, and then exhale slowly. Perform the exercise 10–15 times.

Before performing therapeutic exercises, it is best to consult with your doctor, since performing the exercises on your own may have the opposite effect.

Prevention

To avoid problems with gallbladder bending, people only need to follow a few simple recommendations:

• completely give up bad habits;
• lead a moderately active lifestyle;
• adhere to healthy eating rules;
• bring and maintain normal body weight;
• in the early stages of progression, eliminate pathologies that may cause the appearance of the underlying disease;
• be regularly examined by a gastroenterologist.

The prognosis of the congenital type of pathology, if all recommendations of the attending physician are followed, is favorable. An acquired disease can be complicated by the appearance of consequences, which worsens the prognosis of the disease.

When treating a gallbladder bend, do not forget:

1. Sufficient amount of clean water.
2. Take vitamin C.
3. Lecithin is necessary for this disease; it can dissolve stones or sand in the gallbladder slowly but surely.
4. Courses of any sorbents to cleanse the body on time.
5. Active lifestyle.
6. Timely treatment of all inflammatory processes in the body.

Precautionary measures:

1. Don't make sudden movements.
2. Gravity is no longer for you, so as not to cause the bubble to twist around its axis.
3. One of the most dangerous consequences of a kinked bladder is the flow of bile into the abdominal cavity.

Forecast

Pathology should not be underestimated. The bend entails disruption of the function of the bladder and ducts that remove bile into the duodenum. If this liquid does not enter the gastrointestinal tract, normal digestion will be disrupted, which can lead to various diseases of the digestive tract and liver.

With timely diagnosis and adequate treatment, the prognosis of the disease is favorable: it responds well to treatment and does not lead to the development of various complications. The prognosis of the pathology is unfavorable only when a bend in the body of the organ or an s-shaped bend is diagnosed, when the outflow of bile is completely blocked. In this case, accumulation of bile may occur, overflow of the bladder, followed by rupture of its walls and pouring of bile into the abdominal cavity. Treatment of the pathology involves surgical intervention when the gallbladder is removed.

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Herbal remedies for kinks

The main difference and at the same time advantage of choleretic drugs of this category is that they have practically no restrictions on their use and do not cause harm to the body and internal organs.

The drug "Holosas"

The most prominent representative of this group is “Holosas” - it is produced in the form of syrup and is aimed at improving metabolic processes in the liver, as well as reducing the viscosity of bile. The components of such a substance are:

• dog-rose fruit;
• sugar;
• purified water;
• various essential oils;
• vanillin;
• citric and malic acid;
• wide range of vitamin complexes.

It is best to take it thirty minutes before your main meal. For adults and adolescents, the daily norm is one teaspoon three times a day. For children from three to twelve years old - half the adult dosage.

Among the few restrictions it is worth highlighting:

• the occurrence of diabetes mellitus or cholecystitis of the calculous variety;
• complete blockage of the bile ducts;
• patient age up to three years;
• during pregnancy and lactation - take with caution.

“Flamin” is another choleretic substance of herbal composition, the main effect of which is achieved due to its active component - immortelle flowers. In addition, this medicine has a large number of therapeutic effects, including:

• choleretic and antibacterial;
• cholekinetic and anti-inflammatory;
• wound healing and pain reliever.

You should not take this substance in the following situations:

• ulcerative lesions of the stomach;
• jaundice;
• children under five years of age.

The daily norm is three tablets, it is best to drink them half an hour before a meal. The duration of the therapeutic course is set by the attending physician, as it can vary from ten to forty days.

Urolesan differs from other medications in this group in that it has a pronounced analgesic effect. In addition, it is absorbed very quickly, which makes it possible to quickly get rid of the symptoms of intestinal colic, which often worry patients with a similar diagnosis. The active substances of this choleretic agent are:

• hop cones;
• oregano and mint;
• carrot;
• fir essential oil.

Among the contraindications it is worth highlighting:

• patient age up to seven years;
• the presence of stones whose volume is more than three centimeters;
• ulcer of the duodenum or stomach;
• diarrhea and heartburn;
• diabetes.

The daily norm is one capsule before each meal. The course of treatment can vary from a week to a month.

The drug "Gepabene"

In addition to the above remedies, the group of herbal choleretic medicines includes:

• "Gepabene";
• "Karsil";
• "Convaflavin";
• "Phebihol";
• "Berberine";
• "Aristochol";
• "Hepatofalk";
• "Tanacehol."