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Diseases of the liver and gallbladder in a child

Diseases of the liver and gallbladder in a child

The liver is a kind of laboratory that filters and purifies blood, accumulates glucose as a source of energy in the form of glycogen, and produces bile, which is needed for the digestion and absorption of fat.

Already from the 4th week of pregnancy, the future baby’s liver begins to synthesize proteins necessary for its normal growth and development. On the 12th week of intrauterine development, bile secretion is noted.

By the time the baby is born, the liver becomes one of the largest organs. It accounts for 5% of body weight (in an adult, this figure is only 2%), and it takes up almost half of the abdominal cell volume of a newborn.

This is due to the fact that during intrauterine development, the liver performs a hematopoietic function, and after the baby is born, it produces bile, actively synthesizes proteins, carbohydrates and fats, regulates metabolism. There are a lot of blood and lymphatic vessels in it, along the bile ducts the bile produced in the liver enters the gallbladder and accumulates there.

As you can see, the liver, gallbladder and biliary tract are closely linked. The disease of one organ leads to changes in another: in children in 95% of cases, malfunction of the liver occurs due to stagnation of bile in the gallbladder.

The earlier such violations are recognized, the lower the risk of negative consequences of the disease.

It is about the most common ailment of the gallbladder – biliary dyskinesia, that is, a violation of coordinated contractions of the gallbladder and sphincter muscles, which ensure the passage of bile from the gallbladder into the duodenum.

Normally, bile is synthesized by the liver, from where it enters the gallbladder. There, she “waits” for food to be eaten from the stomach into the duodenum. As soon as this occurs, the gallbladder, contracting, releases into the intestinal lumen a portion of bile, which promotes the breakdown of fats into fatty acids.

These acids are “understandable” by the body and can be absorbed. If this motor function of the gallbladder and bile ducts is disturbed, but there are no organic lesions, they speak of biliary dyskinesia.

The causes of this disease are many. Among them – intestinal infections, allergies, eating disorders, diseases of the stomach and duodenum, abnormal development of the gallbladder and bile ducts.

There are 2 forms of dyskinesia: hypotonic and hypertensive. The first in children most often makes itself felt by nausea, a feeling of heaviness in the epigastric region, aching, dull, almost constant non-intensive pain in the right hypochondrium.

Sometimes the pain gives to the right shoulder, shoulder blade. Such symptoms manifest themselves after errors in diet, physical exertion or emotional stress.

The pain is usually short, easily relieved by antispasmodic drugs.

During an attack, the baby becomes restless, he becomes sick, vomiting, heart palpitations and headache may occur, the tongue is often coated with a gray-yellow bloom. The child complains of a bitter feeling in the mouth.

Between the attacks, the baby feels good, although from time to time, after drinking carbonated drinks or having something cold, he complains about short cramps in his stomach and often around the navel.

With hypertonic dysfunction, the gallbladder due to excessive sphincter activity is too quickly emptied. The main symptom is a sudden pain in the right hypochondrium.

Often it occurs in response to physical activity: running, lifting weights.

Diseases of the liver and gallbladder in a child

An accurate diagnosis can only be made by a gastroenterologist. He will schedule stool tests for digestibility and urine for diastasis to see how irritated the pancreas is. Ultrasound of the gallbladder is also done to determine its shape, size, to identify deformities and stones in the gallbladder and bile ducts.

The study is conducted in the morning on an empty stomach, then the child is offered to eat a provocative breakfast, such as a glass of sour cream. After 45 minutes, another study is conducted, during which they evaluate how the gallbladder contracted.

Duodenal intubation allows to study 5 fractions (phases) of biliary excretion. Since bile is examined at 5-minute intervals, it allows to assess the tone and motility of various parts of the biliary system and muscles of the bile duct and gall bladder.

To get rid of attacks, it is sometimes enough to follow a diet. The diet excludes fatty meats and fish, fried, smoked, salted, pickles, canned goods, pastry and puff pastry. Eating should be gradually 4-5 times a day at the same time.

Medications that are prescribed only by a doctor help to relieve pain and improve the flow of bile.

If stones form in the gallbladder or bile ducts, they are talking about gallstone disease. Her development contribute to diseases of the gastrointestinal tract. And in 75–95% of cases it turns out that the parents of the baby or his siblings face similar problems.

An unhealthy diet can provoke an illness when carbohydrates and fats predominate in a child’s diet, and fruits and vegetables rich in dietary fiber and trace elements are not enough. Anomalies of the development of the biliary system are also contributing.

Up to 7 years, cholelithiasis (ICD) often “visits” boys, at 7–9 years old, the ratio between boys and girls is evened out, and by 10–12 years this disease is 2 times more often defined in girls. In adolescence, the prevalence of girls becomes apparent and is close to that of adults: 3 girls with JCB per 1 boy with the same diagnosis.

About half of the children do not even suspect about stones in the gall bladder. If they are discovered, then by chance.

The rest of the “carriers” of stones complains of acute or dull pains in the abdomen or in the navel, difficulty and painful digestion, heaviness in the stomach, feeling of bitterness in the mouth, belching with air. Parents should also pay attention to symptoms such as flatulence, unstable stool. During or immediately after eating, the baby may have an urge to have a bowel movement.

At the same time, the child’s appetite does not change.

Ultrasound of the gallbladder, which is prescribed by a gastroenterologist, makes it possible to determine 90–95% of stones, their number, localization, mobility and size, to identify the features of the shape and position of the gallbladder. But with the help of this study, it is difficult to detect stones in the bile ducts inside the liver, so a child may be assigned a magnetic resonance cholangiopancreatography – a safe and highly effective diagnostic method that makes it possible to “see” the intrahepatic stones.
For diseases of the liver and gallbladder, only a doctor should prescribe drugs. In no case can you independently treat the child with homeopathic remedies or dietary supplements.

This can worsen the course of the disease and lead to serious complications.

To get rid of gallstones, the doctor may recommend drugs that promote their dissolution. It is necessary to take medicine for a long time, parents should be patient and strictly follow the instructions of the doctor.

Only then is success possible.

Children under the age of 12 may also be recommended surgery as cholecystectomy (removal of the gallbladder). The operation is performed laparoscopically.

Diseases of the liver and gallbladder in a child

Stagnation of bile in the gallbladder (cholestasis) can cause liver disease. Most often, congenital hypoplasia of the bile ducts or jaundice of newborns leads to it. Liver problems are also suspected when jaundice appears in the crumbs older than 2 weeks.

The alarming symptom is discolored stools. Normally, bilirubin contained in bile enters from the gallbladder into the intestine, where it turns into stercobilin pigment, which dyes brown in feces. With cholestasis, bile, stagnating in the gallbladder, does not enter the intestine, and the child’s feces will be discolored.

Jaundice develops due to the fact that bilirubin, a yellow-brown pigment, enters the bloodstream from the bile accumulated in the gallbladder. Other signs of liver damage are an increase in it, disturbances in the blood coagulation system (many clotting factors are synthesized in the liver).

In this case, a thorough examination is necessary. To determine the level of bilirubin, biochemical blood test is taken, the size of the liver and spleen helps to determine the ultrasound. Tactics of treatment is chosen individually.

For example, in case of atresia of the bile ducts, surgery is indicated, in other cases, drug therapy is possible. Preparations are prescribed only by a doctor, he also determines the scheme of their reception, which must be strictly followed.

Animal fats are excluded from the diet, which are replaced by vegetable fats, as well as fried, salty, spicy dishes and foods.

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