Gallbladder distension

　　Gallbladder distension is caused by the accumulation of bile in the gallbladder. If the bile ducts function normally, under the action of the liver and gallbladder, bile is discharged into the intestines through the bile ducts to assist in the digestion and absorption of food. If gallbladder Qi is stagnant due to factors such as dietary preferences, excessive worry and anger, external damp-heat, deficiency and exhaustion, or gallstones, or if it transforms into fire, and the bile fails to descend, gallbladder distension can occur.

　　1. Qi depression in the gallbladder, irritability, sudden anger, emotional disturbances, maladjustment of the liver's function of discharge, affecting the gallbladder, causing Qi stagnation, or stagnation transforming into fire, leading to abnormal free flow and descent of bile, stagnation in the gallbladder, and ultimately resulting in cholecystoconstriction.

　　2. Damp-heat accumulation, preference for rich and greasy foods, overeating, can lead to dampness and heat accumulation over time, or external invasion of pathogenic heat, or infection with dampness transformed into heat internally, or invasion of dampness and heat internally, leading to accumulation in the gallbladder. Qi stagnation and bile stagnation lead to distension and pain. Pain and distension occur in the right rib, leading to cholecystoconstriction.

　　3. Gallstone blockage, with long-term damp-heat accumulation, cooks the bile, collects into stones, blocks the bile duct, causes Qi depression in the gallbladder, and the bile flow is not normal. Stasis leads to distension, and blockage leads to pain, forming cholecystoconstriction.

　　4. Those caused by blood stasis blockage in the bile duct have the same mechanism as gallstone blockage.

　　The pathogenesis of cholecystoconstriction disease mainly involves Qi stasis, damp-heat, gallstones, and blood stasis leading to Qi depression in the gallbladder, and the loss of free flow of bile. The disease location is in the gallbladder, closely related to the liver and stomach. Over time, if not cured, recurrent attacks will damage the healthy Qi, causing the healthy Qi to become increasingly weak. Additionally, with the persistence of pathogenic factors, phlegm and damp-heat will damage the spleen and stomach, leading to insufficient production of vital substances, and the healthy Qi will become even weaker. Finally, it can lead to symptoms of either liver and kidney Yin deficiency or spleen and kidney Yang deficiency, with deficiency of healthy Qi and excess of pathogenic factors.

　　Cholecystoconstriction is a common disease in liver and gallbladder diseases. Its clinical manifestations are similar to those of chronic cholecystitis, chronic cholangitis, and cholelithiasis in Western medicine. Below, taking choledocholithiasis as an example, we introduce the complications of cholecystoconstriction:

　　The common complications of choledocholithiasis include varying degrees of cholangitis and bacterial infection of the bile ducts. Next, there are cholelithiasis-induced pancreatitis, liver abscess, sepsis, and biliary ileus. It is rare for the compression of gallstones to cause ulcers in the mucosa of the common bile duct, leading to stricture. In China, it is occasionally seen that the compression of gallstones can cause ulcers, necrosis, and bleeding in the bile duct mucosa, while in Western countries, patients with choledocholithiasis rarely experience biliary hemorrhage. In addition, patients with choledocholithiasis who have long-term recurrent cholangitis and jaundice may further develop into biliary cirrhosis.

　　Cholecystoconstriction mainly manifests as distension and pain in the right rib, which can also be accompanied by stabbing pain, burning pain, or even hidden pain in chronic cases. It often presents with symptoms such as distension and fullness in the epigastrium, nausea, bitter taste in the mouth, belching, and a tendency to sigh, which are related to the reversal of Qi in the gallbladder and stomach. Severe cases may also be accompanied by symptoms such as alternating chills and fever, vomiting, severe distension and pain in the right rib, and pain radiating to the shoulders and back. This disease generally has a slow onset, often recurs, and stops and starts intermittently. Some cases may have an acute onset. Recurrences are often triggered by factors such as overeating greasy foods, anger, and fatigue. The age group most prone to this condition is over 40 years old.

　　Actively treat diseases of the liver and gallbladder such as pain in the ribs, jaundice, and worm diseases. The course of treatment should be sufficient, eliminating all pathogenic factors, and after the disease is cured, attention should be paid to adjustment and care, which are important measures for preventing cholecystoconstriction. Patients should pay attention to adjusting their mind and spirit in their daily life, maintaining a tranquil and pleasant psychological state; regulating work and rest, doing both activities appropriately to ensure the smooth flow of Qi and blood; and adjusting their diet, favoring foods that clear phlegm, eating more vegetables and fruits such as radishes, bitter melon, finger citron, and apples, which are beneficial for promoting bile excretion and removing dampness. It is advisable to avoid overeating and consuming rich and greasy foods, as well as excessive alcohol consumption, seeking coolness, and drinking cold drinks. Pay attention to staying warm.

　　Patients with gallbladder distension should undergo duodenal drainage, ultrasound examination, abdominal X-ray film, Cr, and other physical and chemical examinations.

　　1. Duodenal drainage:Duodenal drainage is a method of draining duodenal juice and bile out of the body using a duodenal drainage tube. This procedure can assist in diagnosing gallbladder and bile duct inflammation, obstruction, calculi, and abnormal bile duct motility, and can also assist in the diagnosis of liver and bile parasitic diseases, such as Opisthorchis viverrini (liver fluke) and Giardia lamblia disease, etc. In addition, it can also determine the pancreatic enzymes in duodenal juice to understand the function of the pancreas. The duodenal drainage itself also has a therapeutic effect on biliary infections.

　　2. Ultrasound examination:Ultrasound examination is a type of ultrasonic examination, a non-surgical diagnostic examination, a new discipline, and has become an indispensable diagnostic method in modern clinical medicine.

　　In addition to general treatment, patients with gallbladder distension can also relieve symptoms through dietary therapy.

　　1. Eat more foods rich in vitamin A, B vitamins, and vitamin C, such as oranges, apples, tomatoes, and other fruits and vegetables.

　　2. To protect the function of the digestive system, use beets, myrtle, yam, Job's tears, radish, etc.

　　3. Eat more foods beneficial for bile secretion, such as buckwheat, Job's tears, mushroom heads, dregs of tofu, chrysanthemum, sea cucumber, figs, sesame, sea buckthorn, etc.

　　4. Eat more light and nutritious foods, such as fish, lean meat, protein, tofu, etc., and carbohydrates such as rice and noodles.

　　The Western medicine treatment for gallbladder distension is mainly conservative treatment. For patients with mild symptoms and those who do not affect normal life, non-surgical treatment can be chosen, such as low-fat diet, long-term oral administration of bile-promoting drugs such as anti-inflammatory bile tablets, bear bile capsules, and bile-active substances, and antispasmodic drugs of the belladonna type can be used for symptomatic treatment when abdominal pain occurs. For patients with severe symptoms or recurrent attacks of gallbladder colic, accompanied by gallstones, surgical treatment can be chosen.