Strong choleretic. Effective choleretic agents

Regardless of age or gender, many people are faced with “signals” from the body about liver problems caused by cholestasis. Choleretic agents for stagnation of bile are designed to start the processes of cleansing organs of toxic “waste”, promoting the production of the hormone cholecystokinin. There are options – from medical to “grandmother’s recipes” – for coping with the disease. Take care of yourself if you:

• from time to time you feel painful symptoms in the right hypochondrium;
• you feel an unpleasant bitter taste in your mouth;
• notice yellowness of the skin;
• noticed signs of chronic fatigue.

List of the most effective choleretic agents

The best choleretic remedy for bile stagnation is compliance with a whole range of health measures. They are aimed at stimulating the functioning of the digestive organs, cleansing the liver, and normalizing the functions of the gallbladder. The combination of actions that contribute to getting rid of the disease includes:

1. Sticking to the Basics diet food.
2. Usage medical preparations, achievements traditional medicine that improve the secretion of the gallbladder.
3. Active lifestyle - it is an excellent “choleretic agent” for preventing bile stagnation.
4. Compliance with the drinking regime, inclusion of still mineral water in the therapeutic diet.
5. If you are overweight, limit the calorie content of foods to 2000 kcal per day.

Food

Congestion in the gallbladder can be prevented by adhering to the basics of dietary nutrition. The main enemies of a healthy liver are salty, spicy foods. Spices, smoked meats, baked goods and sweets are outlawed. Fractional meals up to 4-6 times a day will help. You don't have to eat large portions. Overeating is dangerous with dyskinesia of the bile ducts, causing heaviness and pain on the right side of the hypochondrium.

What are choleretic foods? They enhance the kinesthetics of the digestive tract, stimulate the release of bile into the intestines, removing stagnation and relieving spasms. However, you should not consume choleretic products in large quantities. The consequences of uncontrolled use can be the movement of stones through the bile ducts with subsequent removal of the bladder. Useful choleretic agents for bile stagnation are:

1. Vegetable oils. They stimulate the production of cholecystokinin, a hormone responsible for the formation and entry of bile into the stomach.
2. Fresh vegetable juices based on beets, carrots, cabbage; berry fruit drinks from lingonberries, cranberries; sauerkraut juice.
3. Fresh fruits, vegetables. Helps enhance gastrointestinal motility, gently cleanses the liver and intestines, preventing stagnation of bile.
4. Fiber in bran. Wheat and oatmeal, they are an excellent way to cleanse the liver, which is the first to be “under attack” during cholestasis.
5. First meal. Vegetable soups, borscht or low-fat poultry broths are indispensable dishes for dietary nutrition to prevent/treat bile stagnation.
6. Parsley, dill, cilantro, rosemary, celery, spinach, and lettuce have excellent choleretic properties.

Folk remedies

The use of choleretic compounds has been tested for many generations. Traditional medicine will help relieve the painful manifestations of cholestasis, stimulate the outflow of bile and the activity of the body's metabolic functions. Natural composition, absence of specific allergens makes folk recipes available for use during pregnancy. Medications that reduce congestion will help to avoid the development of the disease:

1. Consuming vegetable oil on an empty stomach and lemon juice. A tablespoon of flaxseed, rapeseed, olive or sunflower oil with a similar amount of lemon juice will start metabolic functions. The composition will gently cleanse the intestines and liver from stagnation of bile after a night's rest.
2. Xylitol or sorbitol. “Blind” tubage based on these substances using a heating pad in the liver area is a remedy that helps get rid of bile stagnation. The procedure should be carried out after consultation with a gastroenterologist, preferably under the supervision of a doctor.

Choleretic herbal teas

Effective means of relieving bile stagnation are teas, decoctions and infusions of herbs with choleretic properties:

1. Immortelle, tansy, angelica and corn silk perfectly cleanse the liver of toxins, while simultaneously stimulating the breakdown of food in the gastrointestinal tract.
2. Cumin and peppermint improve metabolic processes and relieve stress. These are both natural antispasmodics.
3. Pharmacy chains offer choleretic herbal preparations, known under numbers 1, 2 and 3. The main components are: immortelle, yarrow, mint, coriander, which eliminate bile stagnation.
4. Herbal collection choleretic 3 contains natural antiseptics - chamomile, calendula flowers, which prevent the development of inflammatory processes in the biliary tract, plus tansy, immortelle.

Medications

Choleretic drugs for biliary dyskinesia are represented by antispasmodics, choleretics, and cholinetics. Natural or synthetic, they are available in tablets, granules, and liquid form (ampoules). In the treatment of stagnation of bile, the scheme prescribed by the doctor as standard is as follows:

1. Taking antispasmodics with an analgesic effect from 5 days to 2 weeks.
2. Choleretics according to the instructions are taken for a long time - up to three months.
3. Cholekinetics are prescribed situationally if there is a need to stimulate the flow of bile.

Vegetable origin

Herbal choleretic drugs for bile stagnation are widely represented on the market, have a low price and are relatively safe due to their natural composition. Your doctor will help you choose a medicine by first determining the cause of bile stagnation. The purpose of the type of product depends on clinical picture diseases. You will be offered:

• alcohol tinctures: common barberry, corn silk;
• syrups (without alcohol): Holosas, Rosehip and mint;
• tablets: Febichol, Flamin, Tanacechol, Berberine;
• tea mixtures: Holaflux (Germany-England).

Animal

Choleretic drugs may have a different origin. Preparations containing extracts of animal bile and its acids can reduce the load on the pancreas, gallbladder. The substances are quickly processed by the liver, stimulate the mechanisms of food breakdown in the intestines, and make bile less viscous. These are Allohol, Cholenzym (with pancreatic enzymes), Lyobil (contains purified bovine bile), Hologon (a weak choleretic effect with increased bile formation).

Synthetic

The synthesized drugs prescribed for bile stagnation have a more pronounced nature of action. Their use requires a lower dosage than drugs of natural origin. The line is represented by Russian-made drugs: Nikodin, Oksafenamide, Polish Gimecromon, Cyqualon. In addition to choleretic, artificially created drugs have antispasmodic, anti-inflammatory, and analgesic mechanisms.

What medications are prescribed for children for bile stagnation?

1. Flamin. This anti-inflammatory, secretory, biliary drug breaks down cholesterol, dilates intestinal vessels, and relieves spasms.
2. Holagogum. Natural ingredients – turmeric, spinach, essential oils mint - safe for children's bodies. It is a stimulator of the secretory function of the gallbladder.
3. Holaflux. The herbal ingredients of the medicine act as antispasmodics, cholekinetics, and hepaprotectors of the child’s liver.

Video about choleretic herbs

Often, dysfunction of bile production is caused by an abundance of fatty, fried foods with spicy seasonings, and poor diet. Sometimes diseases are to blame - cholecystitis, pancreatitis. Seeing a doctor, making a diagnosis and prescribing treatment with choleretic drugs will help avoid complications. Do not forget about the prevention of cholestasis using herbal remedies strictly according to the instructions. After watching the video, you will learn about folk ways getting rid of bile stagnation.

Choleretic drugs are widely used to treat diseases of the biliary system. With their help, they relieve attacks of pain, eliminate stagnation of bile and alleviate the course of many organ diseases abdominal cavity. To correctly understand the purpose for which choleretic drugs are used, you need to have an idea of ​​what bile is and what role it plays in the normal functioning of the digestive system.

Bile and its functions

Bile is a biological secretion that is produced by liver cells and then sent to the gallbladder. While eating he comes out duodenum and facilitates the process of digesting food. Bile has a specific bitter taste and may have a yellow-brown or greenish color. The main functions of biological fluid are as follows:

• breakdown and digestion of fats from food;
• stimulation of digestion processes;
• ensuring complete absorption of nutrients.

Bile acids, in addition to the breakdown of fats, improve intestinal motor functions, preventing constipation, and prevent the penetration of pathogenic bacteria into the mucous membranes, which is a good prevention of intestinal infections. Bile is necessary for the body, as it helps excrete it in feces. harmful substances(cholesterol, toxins and other breakdown products).

Choleretic drugs: classification

It is difficult to provide a complete classification of choleretic drugs, since there are many such medications, and each of them has its own characteristics, various aspects of application and the mechanism of action of active substances. The main groups into which all choleretic drugs can be divided are:

1. Choleretics

The action of choleretics is aimed at increasing the production of bile by liver cells. This group of drugs in turn is represented by:

• true choleretics (contain bile acids produced from animal or plant raw materials):
• synthetic cheleretics (preparations based on chemicals obtained by organic synthesis);
• infusions of medicinal plants with a choleretic effect (activate the production of bile and help reduce its viscosity);
• hydrocholeretics (facilitate the excretion of bile, reduce its viscosity and thereby prevent the formation of stones).

1. Cholekenetics

They enhance the tone of the gallbladder and at the same time have a relaxing effect on the muscles of the bile duct, which creates ideal conditions for the outflow of bile and the prevention of stagnation. The result of their use is the release of the gallbladder from stagnant bile, its entry into the duodenum and the normalization of digestive processes.

1. Cholespasmolytics

The pharmacological action of drugs in this group is aimed at eliminating spasm of the biliary tract, dilating the ducts and facilitating the flow of bile into the intestine. Antispasmodics are prescribed in short courses; they help eliminate pain and alleviate the condition of various pathologies of the biliary system.

List of choleretic drugs

Let us list the most popular drugs representing one or a group of choleretic agents.

True choleretics. These include medications based on natural animal bile (Allohol, Lyobil, Cholenzym).

Synthetic choleretics. In addition to the choleretic effect, such drugs provide anti-inflammatory and antibacterial effects and have a positive effect on digestion (Cyqualon, Nicodin, Osalmid).

Herbal choleretic drugs. A large group, which is represented by medicines based on artichoke (Hofitol), immortelle extract (Flamin), turmeric (Febihol), rose hips (Holosas syrup), barberry (Berberis), corn silk (Insadol), etc. In addition, you can join this group include such complex medications as Holagol, Urolesan, Travochol.

Hydrocholeretics. This group includes preparations based on valerian, salicylates, as well as alkaline mineral waters (Essentuki, Borjomi).

Cholekinetics. Popular representatives are products such as Mannitol, Xylitol, Sorbitol, Cholemax, Holos, Berberine sulfate. In addition, coriander, juniper, caraway oils, lingonberry and cranberry juice, fennel and rose hips have a pronounced cholekinetic effect. Similar action exhibit medicinal herbs (calamus, dandelion, immortelle, yarrow, calendula, chamomile).

Cholespasmolytics. The list of representatives of this group includes synthetic (Papaverine, Noshpa, Drotaverine, Mebeverine, Eufillin, Besalol, Spasmolitin, Atropine) and herbal preparations (Holagol, arnica tinctures, valerian, elecampane, mint, lemon balm, calendula).

Another group of drugs are choleretic drugs with a litholytic effect, which can be conditionally classified as choleretic drugs, since they help dissolve stones formed in the gall bladder and prevent their reappearance. These are drugs such as Urdoxa, Ursosan, Ursofalk, Ursodez, etc.

Choleretic drugs for bile stagnation

To eliminate congestion in the gallbladder, drugs from the group of cholinetics are used:

• Holosas syrup,
• Flamin,
• Berberine-Gomacord

or prescribe choleretics:

• Nikodin,

Some patients are more suitable for herbal remedies based on turmeric, tansy, artichoke, barberry, etc. The medications are prescribed by the doctor, taking into account the patient’s condition and possible contraindications. It also determines the optimal dosage and duration of administration. medicines.

Choleretic drugs for biliary dyskinesia

Dyskinesia is characterized by difficulty in the outflow of bile due to spasms of the bile ducts, which do not contract and do not push out portions of biological secretions necessary for normal digestion.

The cause of this condition may be previous intestinal infections, giardiasis, hormonal and endocrine disorders, viral hepatitis, diseases of the stomach and duodenum. Biliary dyskinesia can develop in a hypokinetic or hyperkinetic type, which requires the use of certain groups of drugs. The choice of the optimal medication from the group of choleretics or cholekinetics is made by a doctor after a full examination and clarification of the diagnosis.

Choleretic drugs for inflection of the gallbladder

In medicine, it is referred to as one of the forms of dyskinesia, in which the functions of this organ are disrupted, there is stagnation of bile and a violation of its excretion, which significantly increases the risk of stone formation. The causes of the bend may be inflammatory processes in the gallbladder, sudden lifting of weights, prolapse internal organs or prolonged fasting, which is followed by a large meal.

In addition to diet and physiotherapeutic procedures, the complex treatment of inflection necessarily includes herbal and synthetic choleretic drugs:

1. Flamin,
2. Gepabene,
3. Nikodin,
4. tsikvalon
5. Cholespasmolytics (Mebeverine, Drotaverine).

The action of these drugs is aimed at relieving the pain syndrome that accompanies spasm of the biliary tract, increasing the outflow of bile, reducing the inflammatory process and eliminating congestion. The optimal treatment regimen is selected by the doctor.

Choleretic drugs after gallbladder removal

To avoid complications after surgical removal gallbladder, drugs with a choleretic effect must be prescribed. During this period, it is very important to normalize bile production and improve digestive processes. For this purpose the following is prescribed:

• antispasmodics ( no-no, Drotaverine, Mebeverine),
• choleretics (Allohol, Cholenzym),
• drugs that stimulate bile production (Cyclovalon, Osalmid).

Herbal medicine using infusions and decoctions of medicinal herbs with a choleretic effect and herbal preparations have a good effect.

Choleretic drugs for children

For children, the doctor selects the dosage of the medication and the treatment regimen individually, taking into account the age, body weight of the small patient, general condition and clinical picture of the disease. As natural hydrocholeretics, children can drink mineral waters (Borjomi, Slavyanovskaya, Essentuki), take a drug containing natural bile (Allochol).

According to indications, herbal remedies (Flamin, Holosas, Hofitol), cholekinetics based on valerian or magnesia are used. For elimination pain Cholespasmolytics are prescribed (Atropine, Platiphylline, Papaverine, Spasmonet, Drotaverine). But it is not recommended to use infusions of medicinal herbs with a choleretic effect in children (under 12 years of age), since the child’s body can react unpredictably to the wide range of active substances they contain.

The best choleretic drugs

One of the most inexpensive and frequently used drugs from the group of choleretics. The tablets are based on dried animal bile, garlic and nettle extract. Taking the drug provides a choleretic and mild laxative effect, suppresses fermentation and putrefactive processes in the intestines, stimulates the synthesis of bile acids and enhances motor and secretory function digestive organs.

At the same time, the drug should not be prescribed for peptic ulcer, acute form pancreatitis and cholecystitis, hypersensitivity to its components. Allochol can cause allergic reactions or diarrhea. The price of tablets is from 46 rubles.

Combined drug with choleretic effect. Contains digestive enzymes, dried bile and dried cattle pancreas powder. The drug normalizes the digestion process and improves the flow of bile. Prescribed for chronic cholecystitis, pancreatitis, hepatitis and other pathologies of the digestive system.

The active substances of Cholenzyme stimulate the production of bile, enhance intestinal motor function, promote complete absorption of nutrients, and normalize protein-carbohydrate metabolism. The drug is not prescribed for exacerbation of ulcerative processes, jaundice, or individual intolerance. The drug is well tolerated, but in some cases it can provoke allergic rashes, heartburn and dyspeptic disorders. The price of Cholenzym in pharmacies is from 220 rubles.

A synthetic drug with choleretic and antispasmodic effects. Its basis is the substance hymecromone. It is used for hyperkinetic biliary dyskinesia, chronic cholecystitis, cholangitis, after gall bladder surgery. The drug increases the volume of bile and promotes its discharge by relaxing the biliary tract and sphincter of Oddi. Helps eliminate bile stagnation, prevents the formation gallstones and prevents the development of cholelithiasis.

Odeston has a number of contraindications, including bile duct obstruction, renal and liver failure, blood clotting disorders, ulcerative lesions, Crohn's disease, hypersensitivity. In general, the medication is well tolerated and only in some cases causes minor digestive disorders, headache or allergic reactions. The average cost of Odeston is from 400 rubles.

Nikodin. Synthetic choleretic drug based on formaldehyde derivatives and nicotinic acid. It has a beneficial effect on liver function and, in addition to the choleretic effect, has a bactericidal and anti-inflammatory effect. Used in the treatment of gastritis, cholecystitis, cholangitis, reactive hepatitis, dyskinesia.

It is included in the complex treatment of the above pathologies along with antibiotics. There are few contraindications to the use of the medication - hypersensitivity, pregnancy and lactation. When taking the drug, pain and dyspeptic symptoms accompanying anacid gastritis may intensify, and allergic reactions sometimes develop. The average cost of the drug is from 180 rubles.

Flamin. A herbal remedy with choleretic, antispasmodic, anti-inflammatory and antibacterial effects. The medication enhances the production of bile, increases the tone of the gallbladder, while relieving spasm of the bile ducts, and reduces the viscosity of bile secretion. In addition, Flamin promotes complete absorption of nutrients, high-quality digestion of food and exhibits antibacterial activity against gram-positive microorganisms.

The tablets are based on immortelle extract and auxiliary biologically active substances. The drug is recommended for the treatment of chronic cholecystitis, cholangitis, hepatitis, biliary dyskinesia. The medication is not prescribed for ulcerative processes, jaundice and individual intolerance. Flamin is well tolerated by patients, but sometimes surges were observed when taking it. blood pressure and allergic reactions. The price of the drug is from 160 rubles.

Hofitol. Herbal medicine with choleretic and diuretic effects based on artichoke extract. Brown film-coated tablets are prescribed for chronic non-calculous cholecystitis, hypokinetic dyskinesia, chronic hepatitis and cirrhosis of the liver.

Do not use for acute inflammatory processes internal organs, the presence of gallstones, individual intolerance to components. The drug is very well tolerated, with virtually no side effects, only when taken for a long time in high doses can cause diarrhea. The price of Hofitol is from 400 rubles.

Holosas. A natural herbal choleretic agent that restores the outflow of bile, exhibits anti-inflammatory and diuretic properties, improves intestinal motility and condition immune system. It is produced in the form of a thick, sweet, dark brown syrup based on rosehip extract. Holosas is prescribed for cholecystitis, cholangitis, and hepatitis.

The natural remedy has a minimal number of contraindications, is well tolerated, but can sometimes cause heartburn and allergic reactions. Standard dose - 1 tsp. syrup half an hour before meals three times a day. Holosas exhibits a pronounced choleretic effect and helps cleanse the liver. There is a widespread belief among the population that the drug even helps to lose a couple of extra pounds. But this remedy is not suitable for diabetics because it contains sucrose. The price of syrup is from 80 rubles.

Choleretic drugs are necessary to activate bile outflow, thereby preventing the likelihood of developing pathologies of the gallbladder and liver. Stagnant processes can cause various complications, including digestive problems and stones in the bladder.

That is why timely treatment is of great importance, and it should be started immediately when the first signs appear.

Bile acid synthesis occurs in the liver. This gland produces an average of 1 liter of bile per day. After this, the secretion enters the gallbladder, in which it is concentrated and then released into the duodenum. Bile that has reached the required concentration has a yellow-brown color and a bitter taste.

Bile secretion is necessary for digestion, digestion and absorption of food, as well as for absorption useful substances and breakdown of fat cells. Bile improves intestinal motility and helps in removing toxins, waste and cholesterol from the body.

If the functionality of the gallbladder or liver is impaired, there is a risk of bile stagnation. At the same time it appears pain syndrome in the right hypochondrium, bitter taste in the mouth, yellowness of the skin, chronic fatigue, nausea and feeling of heaviness after eating food.

We should not forget that a choleretic drug should not be used if there are stones in the gallbladder. To make sure that they are absent, you should first undergo an ultrasound scan.

Choleretic drugs

In most cases, for biliary stagnation and biliary dyskinesia, the following drugs are prescribed:

• Choleretics– are responsible for increasing the concentration of bile acids in bile;
• Cholekinetics– enhance bile outflow due to improved bladder tone;
• Cholespasmolytics– have a relaxing effect on the gallbladder and bile ducts.

Choleretics

The properties of choleretics include improving liver functionality and improving the outflow of synthesized bile. This type of medicine is divided into true, synthetic, herbal and hydrocholeretics.

True choleretics are made from herbal extracts, bovine bile secretions and animal enzymes. The most commonly prescribed drugs of this type are Allohol, Hologon, Decholin and Liobil.

Synthetic choleretics (Osalmid, Odeston, Nicodin and Tsikvalon) copy the effect of natural drugs, but they contain chemically created substances. Their advantages include choleretic, anti-inflammatory, antibacterial and antispasmodic effects.

Choleretic agents of plant origin reduce the viscosity of bile secretions, improve its outflow and normalize liver functionality. This category includes many different drugs, but the most popular of them are Holosas, Flamin, Urolesan, Chofitol and Berberis.

Hydrocholeretics dilute bile with water, resulting in an increase in its volume.

The classification of choleretics is presented in the table:

Cholekinetics

Cholekinetics are drugs that have an antispasmodic effect and accelerate the release of bile acid. They restore the tone of the bladder, normalize its contraction and relax the bile ducts.

The most popular means of this group include:

Cholespasmolytics

Drugs in this group reduce the tone of the bile ducts, relieve spasms and eliminate pain. They come in both chemical and plant origin.

Drugs to prevent bile deposits

To prevent the formation of stones, medications are prescribed that contain ursodeoxycholic acid or other similar substances. This acid is considered a natural hepatoprotector, which eliminates excess cholesterol in bile secretions and reduces the production of inflammatory mediators.

In addition, the means with this active substance accelerate the dissolution of stones and prevent the appearance of new bile deposits.

Here is a list of drugs in this group:

• Ursofalk;
• Ursolite;
• Urdoxa;
• Ursoliv.

For children

If it is necessary to prescribe choleretic drugs for children, products containing natural bile are selected. Children under 12 years of age are not recommended to use herbal preparations consisting of several herbal extracts.

Before starting to use any choleretic drug, you should consult a pediatric gastroenterologist or pediatrician.

Drugs with choleretic effects that are safe for children include:

The dosage of the medication should be calculated by the doctor taking into account the disease, its severity and the child’s body weight. Children over 12 years of age may be prescribed medications prescribed to adult patients.

How to choose a drug

For each disease, different choleretic drugs are prescribed. It is recommended not to choose the medication yourself, but to consult a specialist. But still on this issue there are general recommendations, which can be relied upon when making a decision.

Dyskinesia

There are several types of biliary dyskinesia.

For the hypertensive form, the following are prescribed:

• Cholekinetics that improve the flow of bile (Sorbitol, Holosas, Magnesia);
• Cholespasmolytics that eliminate pain syndrome (No-Shpa, Drotaverine, Duspatalin, Odeston).

The course of taking antispasmodics is several days until the pain disappears, and cholekinetics - up to several weeks until bile flow improves. But choleretics and hydrocholeretics should not be taken for hypertensive dyskinesia, as the condition may worsen.

To treat the hypotonic type of this pathology, the following medications are prescribed:

• Antispasmodics from the myotropic family (Duspatalin, Odeston);
• Choleretics (Nicodin, Allohol, Tanacechol).

Cholekinetics are not recommended for this type of dyskinesia. Therapy with antispasmodics should be carried out for an average of 1 week.

Biliary stagnation

With the development of cholestasis (stagnation of bile), in most cases, dysfunction of the digestive organs develops. For the treatment of this pathology, cholekinetics (Holosas, Berberine, Flamin) and choleretics (Allohol, Nicodin, Cholenzym) are prescribed.

Cholecystitis

Before you begin treatment for cholecystitis, you should make sure there are no stones in the gallbladder. If they are detected, Ursofalk, Urdoxy and other drugs that dissolve gallstones are prescribed.

And if deposits were not detected, then the prescription of medications depends on the symptoms of the disease. If the patient has pain, antispasmodics are recommended.

Choleretics are also taken. It is better if they are of synthetic origin - Oxafenamide, Odeston, etc. In addition, in most cases, doctors prescribe antibacterial agents.

Pancreatitis

According to gastroenterologists, inflammation of the pancreas occurs after the gallbladder, so these diseases always appear together. If there are bile deposits in the bladder, the course of pancreatitis will be long and severe.

In acute forms of pancreatitis or exacerbation of chronic ones, surgical intervention is required, so treatment in these cases is selected exclusively by a doctor.

And in case of mild exacerbation of the disease, you can take:

Conclusion

Choleretic drugs are prescribed to eliminate problems with the biliary system. They are able to eliminate pain, bile stagnation and alleviate the developed disease. The form of release of such products can be different: tablets, capsules, syrups, dragees, powder, etc.

But you should not self-medicate and select medications on your own, since the wrong drug can lead to serious complications.

Judging by the fact that you are reading these lines now, victory in the fight against liver diseases is not yet on your side...

And have you already thought about surgical intervention? This is understandable, because the liver is a very important organ, and its proper functioning is the key to health and well-being. Nausea and vomiting, yellowish skin tone, bitter taste in the mouth and bad smell, dark urine and diarrhea ... All these symptoms are familiar to you firsthand.

But perhaps it is more correct to treat not the consequence, but the cause? We recommend reading the story of Olga Krichevskaya, how she cured her liver...

Biliary dyskinesia, chronic pancreatitis and cholecystitis are very common diseases in our country, even among children. They do not always manifest noticeable symptoms: most only note a lack of appetite and even nausea in the morning, heaviness in the right hypochondrium, and periodic itching of the skin. However, it turns out that all these are signs of bile stagnation. And, until thick bile begins to turn into stones, it is necessary to take choleretic drugs.

We'll talk about what they are and how they work.

Why and where do you need to drive bile?

Many people mistakenly believe that bile is formed in the gallbladder and for some reason accumulates there. This is not so: bile is produced by liver cells, from the liver it enters the gallbladder and concentrates there - excess water leaves it.

When a person eats food that contains fats, a signal about this reaches the gallbladder, and it, by contracting, removes bile through the bile ducts into the duodenum. The hole through which bile exits is located next to the hole where the pancreas releases its secretions.

Tasks of bile:

• make an emulsion from the incoming fats, which will be easier for pancreatic enzymes to reach;
• create the right conditions for the functioning of pancreatic enzymes - and without them neither proteins, nor fats, nor carbohydrates can be digested normally;
• stimulate intestinal contractions;
• ensure the absorption of fat-soluble vitamins: A, D, E, group K;
• prevents microorganisms from attaching to the intestinal walls: then they will not be able to be absorbed into the blood along with food;
• removes substances that have passed through the liver with feces: some hormones, bilirubin, cholesterol.

That is, bile is a very useful substance, and it is imperative that it is formed correctly and correctly delivered to the duodenum. This is what choleretic drugs are aimed at. But in fact, everything is not so simple.

Three different groups of drugs have been called choleretic. They affect the biliary tract in different ways, and do not simply “drive” bile along its path:

• some – choleretics – increase bile production;
• others - cholekinetics - accelerate the excretion of bile from the hepatic ducts to the duodenum;
• third - cholespasmolytics - relax the spasmodic bile ducts;
• fourth - cholelitogenic preparations of bile acids - are used to liquefy bile so that stones do not form in it. These same agents have the ability to dissolve very small stones - due to changes in the chemical properties of bile.

Each of them has its own point of application and, accordingly, its own indications. Without knowing which drug to take in this situation, you can only harm yourself. For example, relax the bile ducts that are already lacking tone. Or force the already sick liver to “strain” and produce bile (when the liver is already working as hard as it can - in order to at least neutralize dangerous toxins).

How choleretic drugs work, and on what basis one or the other is chosen, is not a mystery at all. Therefore, we tell you what, how and why.

Choleretic drugs and indications for them

To understand what type of drug is needed and when, consider how bile moves:

1. Formed in the liver cells, it enters the intrahepatic bile ducts.
2. From these ducts, bile flows by gravity first into the right or left hepatic duct (from right lobe liver - to the right, from the left, respectively, to the left). Then the bile from both of these ducts, also by gravity, is collected into the common hepatic duct. It is a tube in which there are few muscle cells.
3. From the common hepatic duct there is a branch - a “tube” (duct), which leads to the gallbladder. There are almost no muscles in it, so the bile needs to get there somehow. The force that propels it in this direction is the difference in pressure between that created by the liver (when it secreted bile) and the resistance exerted by the sphincter of Oddi. The sphincter of Oddi is a circular muscle that lies where the hepatic duct (more precisely, its continuation - the common bile duct) passes into the duodenum. That is, the sphincter of Oddi is such a faucet. When it is closed, bile flows into the cystic duct, its pressure straightens the folds lying between the bladder and the cystic duct, and accumulates in the gallbladder.
4. As the gallbladder fills, the pressure in it increases, and in the hepatic ducts, accordingly, decreases. And when the “faucet” of the sphincter of Oddi opens (this happens in response to pepsin in the gastric juice and is a signal that food has entered the gastrointestinal tract), the pressure differences become such that already prepared, concentrated bile first flows into the duodenum.
5. When the pressure in the gallbladder increases to 250-300 mm of water column, it contracts itself - then the sphincter of Oddi has to open.
6. The common bile duct also has almost no muscle fibers, so it contracts poorly.

What follows from all this in relation to drugs? Let's consider it in relation to diseases. As a result, you will understand which particular group of choleretic drugs you need. So.

Choleretic drugs for biliary dyskinesia

The word “dyskinesia” refers to a disturbance in the normal movement of bile. This diagnosis itself necessarily requires decoding, because it is unclear whether the bile will move faster or slower.

So, dyskinesia is characterized by only 2 concepts:

1. What tone do the bile ducts have? He can be:
   • normal (then there is no need to correct it);
   • increased (hypertensive dyskinesia), when bile is released quickly, which will facilitate its reflux into the stomach. In this case, drugs are needed - cholespasmolytics;
   • reduced when bile flows slowly. To correct this condition, cholekinetics are needed.
2. How the biliary tract contracts:

• at high speed - then the bile does not have time to concentrate. This can be relieved with antispasmodics;
• at normal speed;
• at a low speed, which contributes to stagnation of bile. In this case, either choleretics are needed (then more bile will be formed and it will have to be released faster), or cholekinetics - to stimulate the movements of the biliary tract.

Thus, the diagnosis for biliary dyskinesia consists of 2 parts. As a result, it may be:

• hypertonic hyperkinetic. More “strong” cholespasmolytics are needed. Usually this - synthetic drugs;
• hypertensive normokinetic. It is treated with cholespasmolytics, which do not inhibit the peristalsis of the biliary tract itself (usually herbal remedies);
• hypertensive hypokinetic. You need a drug that will relieve the spasm (otherwise the bile will not go away), and a cholekinetic agent;
• hypotonic hypokinetic. Both choleretics and cholekinetics are needed;
• hypotonic normokinetic. Usually one choleretic is enough.

If you do not determine the type of your own dyskinesia and take drugs at random, you can worsen your condition. Most often, choleretics drink it to increase bile production. Now imagine what will happen if dyskinesia is caused by a bend in the gallbladder? Or is it hypokinetic? Then the gallbladder becomes full, and then it has to contract sharply. This will be a very painful condition called biliary colic.

There is a second option: uncontrolled use of cholespasmolytics. As a result, the bile stagnates, and salts with cholesterol begin to precipitate, forming stones, or the bile becomes infected: cholecystitis occurs.

Choleretic drugs for bile stagnation

Choleretic drugs for bile stagnation are choleretics and cholekinetics. In addition, it is necessary to check the bile ducts for the presence of stones in them. If they are absent or they are small (up to 3 mm), bile acid preparations are prescribed.

When there is stagnation in the liver, which is accompanied by yellowing and itching of the skin, not only choleretic drugs are prescribed, but also drugs from other groups. In this case, treatment is generally recommended to take place in a hospital - to monitor the effectiveness of therapy and timely diagnosis complications.

Choleretic drugs for inflection of the gallbladder

The inflection of the gallbladder itself already indicates biliary dyskinesia. Most likely, it will be hypokinetic (since bile must overcome a greater obstacle to enter the gallbladder) and hypermotor. And for its treatment, cholespasmolytics, cholekinetics and bile acid preparations will be needed - for the prevention of cholelithiasis. As with “normal” dyskinesia, herbal preparations are preferable outside of exacerbation.

Dyskinesia when bending can be both hypokinetic and hypomotor. In this case, cholekinetics and, sometimes, choleretics are needed.

Choleretic agents for cholecystitis

Inflammation of the gallbladder usually requires the following medications:

• choleretics - to “dilute” infected bile with “fresh”;
• cholespasmolytics - since when the gallbladder is inflamed with cholecystitis, its spasm is inevitable;
• cholelithogenic agents in case there are no stones - to prevent their formation.

For this disease, antibiotics are also prescribed - usually 2 groups at once.

Choleretic agents for pancreatitis

Inflammation of the pancreas - pancreatitis - is accompanied by increased production of its enzymes. We remember that bile stimulates the synthesis of these substances, which means that in this case it should be released in small portions - no sudden surges. For this purpose, cholespasmolytics are prescribed for both acute and chronic pancreatitis. And to prevent the formation of stones - since bile stagnation will inevitably occur here - cholelitogenic drugs will be used.

Pancreatitis is dangerous disease, requiring complex therapy, but in no case self-medicate!

How to improve your condition after cholecystectomy

The main problem after removal of the gallbladder is the inability to concentrate bile. That is, it is more liquid and flows faster into the duodenum. However, even in such less concentrated bile, conditions remain for the formation of stones, so taking cholelithogenic drugs is mandatory.

Choleretics are contraindicated in post-cholecystectomy conditions: the liver already begins to compensatoryly produce more bile.

Antispasmodics are needed, which should be taken systematically immediately after surgery and during the first three months. This is explained by the fact that previously the gallbladder and the sphincter of Oddi worked in concert: when the bladder contracted (under the influence of hormone-like substances, gastric and pancreatic juice), the sphincter relaxed. As soon as the gallbladder was gone, the sphincter of Oddi, which is not endowed with such sensitivity, became more difficult to navigate what and when to do. In this situation, it most often spasms. It needs to be relaxed with cholespasmolytics before the spasm becomes stenosis, which will require a new operation.

The condition after surgery may also be accompanied by hypotonicity of the sphincter of Oddi, which occurs already some time after the operation. In this case, cholekinetics are prescribed.

In this condition, drugs that improve liver function, anti-inflammatory drugs and antibiotics are also prescribed.

List of choleretic drugs

Let's consider what representatives of the different groups of these drugs are. Let's start our list of choleretic drugs with the largest group - choleretics.

Choleretics

Choleretics are divided into 2 large groups:

1. True choleretics, which increase the amount of bile by increasing its formation. They, in turn, are divided into 3 groups - depending on the raw materials from which they are made - into:
   • containing bile acids (from animal bile);
   • synthetic drugs that activate the mechanisms of bile formation;
   • medicinal herbs that affect the mechanisms of bile formation.
2. Hydrocholeretics are drugs that increase the volume of the gallbladder by diluting bile with water.

In this section we will consider only drugs of animal and synthetic origin, as well as hydrocholeretics. We will consider all herbal preparations - both choleretics and cholekinetics - separately.

Hydrocholeretics include mineral waters with an alkaline pH:

• Borjomi;
• Essentuki 4 and 17;
• Jermuk;
• Naftusya;
• Slavyanovskaya.

Cholekinetics

The following synthetic drugs promote contractions of the biliary tract:

Cholespasmolytics

Cholelytics

Drugs that reduce the saturation of bile with cholesterol and, accordingly, are used to prevent the formation and dissolution of small stones are drugs based on ursodeoxycholic acid:

• Ursosan;
• Ursofalk;
• Ursodeoxycholic acid;
• Ursodez;
• Grinterol;
• Urdoxa.

The cheapest of them is Ursodeoxycholic acid: 600 rubles/50 tablets, the most expensive is Ursofalk: 915 rubles/50 tablets.

These drugs are available in the form of 250 mg capsules. Daily dose calculated depending on body weight and the presence of stones, and is 2-6 caps/day.

Ursodeoxycholic acid preparations are contraindicated in acute inflammation of the liver, gallbladder and biliary tract, during pregnancy/lactation, in the presence of calcium stones, and frequent biliary colic.

Herbal choleretic drugs

Plant choleretics

Plant cholekinetics

Berberis gommacord and its analogue, discussed in the section of plant choleretics, are complex drugs that have both an antispasmodic and an improving peristalsis of the biliary tract.

In addition, the following have a cholekinetic effect:

• almost any vegetable oil, especially olive, cumin, sunflower;
• barberry leaves;
• roots and rhizomes of calamus;
• fennel fruit;
• caraway fruits.

Herbal cholespasmolytics

These are drugs such as Cholagol, valerian tablets.

As antispasmodics of plant origin, decoctions and tinctures are prepared from various herbs, which are best purchased at the pharmacy:

• tansy;
• arnica;
• turmeric root.

What choleretic drugs can be used for children

If you can experiment with yourself on your own - at your own peril and risk, then choleretic drugs for children should be prescribed by a doctor, based on the disease and the type of contraction of the biliary tract.

The following choleretic drugs are used for children:

• “Papaverine” and “Atropine” in the form of injections, in strict dosages and only under medical supervision - from 6 months;
• “Holosas” - from 3 years;
• "Urolesan" - from 7 years;
• "Hofitol" - from 6 years;
• "Eufillin" - from 6 years;
• "Duspatalin" - from 10 years;
• "Flamin" - from 6 years old.

What drugs can be called the best?

It is very difficult to average which choleretic drugs are the best, since each organism is individual. But some patterns can still be identified.

So, among choleretics, the following work best: “Nikodin”, “Holosas”, “Urolesan”, “Tanacehol”.

It is better to choose their cholekinetics: “Magnesium sulfate” or “Sorbitol”, using them for “blind probing”.

As for cholespasmolytics, synthetic drugs all work well and act quite quickly. Optimal for the biliary tract are Buscopan and Duspatalin. “No-shpa” and “Papaverine” have a relaxing effect on all smooth muscles, without selectively affecting the bile ducts.

Impaired production and outflow of bile from the gallbladder is a problem characteristic of a number of pathologies of the liver and biliary tract. Potentially, it can cause severe dysfunction of other organs and systems - impaired twilight vision, osteoporosis, cholelithiasis, cardiovascular changes, intestinal obstruction. Choleretic agents for bile stagnation are one of the ways to correct this condition.

The general term “choleretic drugs” includes several different groups of drugs. All of them are designed to normalize bile circulation, but the indications for their use may differ slightly.

Thus, it is important to make a correct diagnosis before using any choleretic agents.

Treatment often requires a combination of drugs from different groups and additional use of antibiotics, hepatoprotectors and other agents. Only a specialist can competently develop therapeutic tactics. In some cases, with stagnation of bile, surgery is indicated.

Choleretic agents

To eliminate bile stagnation, not only medications are used. Sometimes herbal and folk remedies, as well as a special diet, can be a good help.

Foods for bile stagnation

To stimulate the production of bile and improve its circulation, a lipotropic fat dietary table No. 5 L/F has been developed. It includes low-cholesterol choleretic products:

Nutrition in case of impaired bile circulation should be subject to the following rules:

• split meals – 5-6 times a day in small portions;
• limited amount of salt and sugar;
• high fluid consumption – up to 2 liters per day;
• inclusion of large amounts of fiber.

It is also necessary to carefully monitor the individual reaction of the body. If any product causes nausea, vomiting, a bitter taste in the mouth or cramps in the right hypochondrium, it should be immediately excluded from the diet.

Choleretic herbs and preparations

Some herbs are good at stimulating the secretion and flow of bile. Choleretic herbs, like synthetic medications, can be divided into groups:

From the listed herbs, you can independently make preparations that are useful for stagnation of bile and have an antispasmodic effect.

• Mix dried St. John's wort and immortelle flowers in equal proportions. Pour 2 tablespoons of the prepared mixture into 0.5 liters of boiling water, cover and leave for 24 hours. Take 0.5 cups 1 hour after meals.
• Mix 50 grams of dried rose hips, 50 grams of corn silk, 100 grams of dry mint. Pour 1 tablespoon of the mixture into 300 ml of boiling water, boil for 5 minutes, cool and strain. Add 1 teaspoon of honey. Drink 0.5 cups 15 minutes before meals.
• Mix 2 tablespoons of valerian root, 1 tablespoon of calendula flowers, 2 tablespoons of dried barberry or rose hips, 1 tablespoon of tansy flowers. Place the finished mixture in a thermos and pour 1 liter of boiling water. Leave for a day, strain and take 0.5 cups 15 minutes before meals.

There are also ready-made pharmaceutical herbal preparations recommended for bile stagnation.

Thus, the composition of collection No. 1 includes mint, immortelle, coriander seeds and three-leaf watch. Collection No. 2 includes yarrow, immortelle, mint and coriander. Collection No. 3 consists of chamomile flowers, tansy, yarrow, calendula and mint leaves.

Folk remedies

Folk remedies for diseases of the liver and biliary tract are based on choleretic properties bee products and vegetable juices. The following compositions show good effectiveness:

• Bee honey is mixed with beebread (pollen) in a 2:1 ratio. The product is taken 1 teaspoon 5 times a day after meals.
• Juice is squeezed out of carrots, beets and cucumbers and mixed in a ratio of 4:1:4. Honey is added to the mixture to taste. Take 100 ml 15 minutes before meals.

In some cases, when bile stagnates, it may be advisable to perform tubage - cleansing the bile ducts by increasing their peristalsis. The procedure is performed like this:

• the night before, take No-Spa (2 tablets of 40 mg each) and pour mineral water“Essentuki” or “Borjomi” from a bottle into a jug;
• In the morning, heat the mineral water to 400C;
• pour regular hot water into a rubber heating pad;
• on an empty stomach, drink 5 sips of mineral water, lie down, turn on your right side, press a heating pad to your right hypochondrium and cover yourself with a blanket;
• lying down, drink warm mineral water at intervals of 5 minutes, 5 sips each;
• After drinking a total of 0.5 liters of mineral water, lie down with a heating pad for another 20 minutes.

After the procedure, frequent stools mixed with bile usually appear, the pain goes away and the bitter taste in the mouth disappears.

When treating bile stagnation with herbs and folk remedies Table No. 5 must be observed.

Herbal preparations

Today it is not difficult to purchase ready-made choleretic herbal remedies in pharmacy chains. They are available in different forms - in the form of syrups, tinctures, tablets.

A simple one is also suitable as a mild antispasmodic. pharmacy tincture valerian. However, before using even the most harmless drugs, you need to undergo medical examination to clarify the diagnosis.

Therefore, the doctor may recommend the following choleretic medications for the child:

• "Allohol";
• "Nikodin";
• "Oxafenamide".

The dosage, dosage regimen and duration of treatment with the listed drugs are individually determined by the doctor, based on the child’s weight and diagnosis.

Pregnant women are prescribed only drugs that are not capable of causing an increase in uterine tone or penetrating the placental barrier:

• "Berberis-Gommacord";
• "Hofitol";
• "Phebihol";
• "Flamin."

The use of these drugs is possible only as prescribed and after the diagnosis has been clarified. Choleretic herbs and herbs should be avoided during pregnancy.

Since unattended stagnation of bile during pregnancy and childhood can lead to dangerous consequences, any signs of it should be reported to your doctor immediately.