Hofitol and Odeston - which is better: Characteristics of drugs, Comparison with other drugs. Tablets "Odeston": reviews and comparison with analogues Which drug is better

Disorders of the gallbladder affect the entire digestive system, while the gallbladder itself may not be sick. Typical pain in the right hypochondrium, jaundice, changes in liver blood parameters often make themselves felt only with cholecystitis and cholangitis, i.e. when the inflammatory process began. Before this, dysfunction manifests itself in the form of dyspepsia, bloating and problems in nearby organs.

Bile should not only be formed in time, but also enter the intestines at the right time, which does not happen with dyskinesias. If a hypotonic type of dyskinesia is diagnosed, in which bile is retained in the ducts, then it is necessary to ensure not only its production, but also its free passage. Let's compare the popular drugs Odeston and Ursosan - which better regulates the structure and passage of bile, and which acts on the motor function of the biliary tract.

What is the difference?

Ursodeoxycholic acid (UDCA) is the main active component of capsules. It has a proven hepatoprotective effect, secondary choleretic and immunomodulatory. It is produced in small quantities normally, but if there is a metabolic disorder in the liver, the process is disrupted. Basics useful property- regulation of the qualitative composition of bile, reducing its saturation with cholesterol and preventing the appearance of cholesterol suspension, clots and stones (“sludge”). It is important to emphasize that Urososan can only be effective against small cholesterol stones over long courses of six months; for calcifications, UDCA preparations are useless.

The dosage is calculated based on body weight: the greater the weight, the more capsules you will need to take. To dissolve stones, take it once before bed, otherwise 2-3 times a day.

Choleretic antispasmodic and prokinetic based on Hymecromone. Unlike traditional agents that stimulate bile formation (), the advantage of Odeston is its selective antispasmodic effect on the muscles of the biliary tract and the duodenal sphincter. In this case, we are talking about the so-called sphincter of Oddi - a round “valve” between the intestine and the bile duct, which opens to release bile and digestive juice into the intestine when necessary. Therefore, disruption of its functioning (spasm) is often associated with symptoms similar to a deficiency of pancreatic enzymes: flatulence, diarrhea followed by constipation. Secondarily, Odeston, like Urosoan, prevents stagnation and “clumping” of cholesterol in the bile, but does not affect the dissolution of existing stones.

Since Odeston regulates the basic processes of digestion, in order to avoid disruptions, it is important to take it without skipping half an hour before meals in the same dosage.

Is it possible to take Ursosan and Odeston at the same time?

Depends on what exactly you are treating. For hypomotor dyskinesias, Odeston and Ursosan together can complement each other as an antispasmodic and choleretic, just read the different contraindications and keep in mind that the likelihood of side effects increases. It is better to get a consultation with a full-time gastroenterologist on this issue. In other cases, the feasibility of such a combination is questionable. It will not be possible to speed up the dissolution of cholesterol stones by using hymecromone, since this is a long process, and Odeston is used only for a short two-week course and is generally not intended for this.

Despite its small size, the gallbladder is a very important organ involved in the digestive process. It is a repository of bile that enters it and is discharged into the intestinal lumen. Another function of the gallbladder is the so-called reabsorption of proteins, amino acids and salts into the blood, as well as the secretion of mucus and the synthesis of the hormone anticholecystokinin. The volume of the gallbladder is approximately 50 ml.

Bile is formed in the liver, then it flows through a complex network of bile ducts into the organ, where it remains until the next meal. As soon as the ingested food reaches the duodenum, the gallbladder contracts, releasing bile and pancreatic juice into the intestine. In 24 hours, the adult human body produces up to 1 liter of bile. It contains special acids, water, vitamins A, B, C, phospholipids, amino acids, bilirubin, cholesterol, inorganic substances, mucus, proteins and other substances.

Signs of pathology

Symptoms of gallbladder diseases are quite similar, regardless of the cause of occurrence, the nature of the pathology and the pattern of development. The main sign of problems in this organ is constant aching pain in the area of ​​the right hypochondrium. The pain syndrome is not relieved by painkillers and, as a rule, appears after fried, fatty or spicy foods. If a stone comes out of the gallbladder, the pain takes on a cutting, sharp form. This process is also characterized by:

1. Increased body temperature.
2. Nausea, belching, vomiting and other signs of dyspepsia.
3. Constipation, diarrhea and other intestinal disorders.
4. Increased flatulence and bloating.
5. Loss of appetite and unreasonable weight loss.
6. Dry mouth and bitter feeling.
7. Rash on the body, accompanied by itching.
8. Yellowing of the skin.
9. The color of the urine becomes intensely yellow, and the feces may become discolored.
10. Irritability and insomnia.

Jaundice syndrome on the skin and sclera of the eyes is an obvious sign of a pathological process in the liver. In this case, there is a high risk of complications such as cirrhosis, liver failure, bleeding of internal organs, etc.

Causes

The causes of the development of pathologies in the liver and gallbladder most often are age, genetic factor, unhealthy diet, etc. In any case, this is a serious malfunction of the body and requires immediate intervention and medication.

Treatment

Today, in complex treatment and for the purpose of preventing diseases of the gallbladder and liver, specialists quite often prescribe choleretic drugs. The reason for this is the ability of this group of drugs to relieve paroxysmal pain, mitigate the course of pathology and prevent relapses. One of these drugs is, according to reviews, Odeston. It is classified as an antispasmodic with a choleretic effect.

Compound

The drug is produced in the form of tablets. Packaged in packs of up to 50 pieces. The active ingredient is hymecromone (200 mg in one tablet). Excipients include gelatin, potato starch, magnesium stearate and lauryl sulfate.

Mechanism of action

We will consider reviews of Odeston in this article. This drug belongs to the group of antispasmodics with a pronounced choleretic effect. The active ingredient of the drug helps to increase the production of bile and its release into the intestines through the bile ducts. The drug does not allow substances to linger in the gallbladder and form crystals and stones.

In addition, Odeston has a stimulating effect on the functioning of organs gastrointestinal tract. The drug reaches its peak concentration in the body three hours after administration. Instructions for use for Odeston, according to reviews, are included in each package.

The drug is quickly absorbed from the gastrointestinal tract, practically without interacting with plasma protein. The half-life process occurs in about an hour. 93 percent of the substances are excreted in the form of glucocuronate in the urine, about 1.5 percent in the form of sulfonate, and about half a percent are excreted unchanged.

Indications

Indications for taking Odeston are the following pathologies:

1. Stagnant processes that disrupt the functioning of the gallbladder.
2. Inflammatory processes in the gallbladder, not accompanied by the appearance of stones.
3. Operations performed on the bile ducts and bladder.
4. Signs of bile hyposecretion are a feeling of bitterness in the mouth, nausea, nagging pain in the hypochondrium on the right.
5. Failures in the performance of contractions by the gallbladder, ducts and sphincter of Oddi.

Before using Odeston, according to reviews, it is necessary to undergo an examination to make a correct diagnosis, as well as to exclude the presence of stones in the bile ducts and malignant neoplasms in the liver.

Contraindications

The drug is contraindicated for use in the following situations:

1. Severe renal or liver failure.
2. Blockage of the bile ducts (obstruction).
3. Peptic ulcer of the duodenum or stomach.
4. Ulcerative colitis.
5. Age under 18 years, as there is no clinical data in patients in this category.
6. Genetically determined hematological diseases.
7. Crohn's disease.
8. The presence of stones in the gallbladder more than 1 cm in diameter.
9. Intolerance to the components of the drug or hypersensitivity to them.

This is confirmed by the instructions and reviews for Odeston.

Side effects

Manifestations of individual intolerance and hypersensitivity to substances in Odeston, according to reviews, are the following symptoms:

1. From the digestive system: bloating, diarrhea, vomiting, cramps, increased flatulence, abdominal pain and bloating.
2. Allergic reactions: hives, rash, etc.
3. From the central nervous system: insomnia, headaches, irritability, etc.

If you notice the development of these symptoms while taking it, you should stop the drug and consult a specialist. In most cases, reducing the dosage of the drug helps get rid of side effects.

Overdose

There is no exact data on cases of overdose with Odeston. Reviews from patients confirm this. However, it is known that when taking abnormally large doses of the drug, severe diarrhea may develop. This phenomenon can disrupt the water-salt balance in the body, and therefore requires immediate elimination. If you accidentally take a large amount of the drug, you need to perform a gastric lavage and drink activated charcoal. Diarrhea and vomiting require treatment.

Mode of application

"Odeston" is taken internally 30 minutes before meals. The daily dose is selected based on the individual characteristics of the body and indications. The normal dosage regimen is 1-2 tablets 3 times a day. The course of therapy should last at least two weeks. Possibly more long-term use drug.

If during treatment the condition worsens, there is increased pain in the right hypochondrium, stop taking the drug and consult a doctor.

There are a lot of reviews about Odeston tablets.

There are no clinical studies for use during pregnancy. However, in order to avoid the development of intrauterine pathologies during gestation, treatment with the drug is not recommended.

There is no data on whether hymecromone can pass into breast milk; its effect on the development of the baby has not been studied. For this reason, it is recommended to stop breastfeeding during therapy.

special instructions

Odeston should not be taken simultaneously with drugs that can cause spasm of the sphincter of Oddi. When taken simultaneously with morphine, the effect of the choleretic drug weakens.

According to doctors, Odeston enhances medicinal properties indirect anticoagulants. This must be taken into account when coadministering, as dosage adjustments may be required.

If the drug is taken together with enterosorbents and antacids, its therapeutic effect is significantly reduced. For this reason, a gap of approximately 2 hours should be maintained between taking these two medications.

"Odeston" does not affect the functioning of the pancreas and the production of hydrochloric acid. The work of the central nervous system and psychomotor functions are also not influenced by the drug.

The drug has not been used in pediatrics, so it is not recommended to prescribe it to patients under 18 years of age, since safety in this case has not been proven.

The tablets are sold in pharmacies; a prescription is not required. The drug should be stored in a cool place, out of reach of children. Shelf life: 3 years. Taking expired medication is strictly prohibited. This is confirmed by the instructions and reviews for Odeston.

Analogues

No drugs with similar composition are produced. However, the pharmaceutical market offers analogues similar in therapeutic effect. These include:

• "Allohol";
• "Ursosan";
• "Hofitol";
• "Olivitin."

The main difference between Odeston and its most popular substitute today, Allohol, is its composition. If the former contains hymecromone, then in the case of the latter the active ingredients are nettle leaves, activated carbon, bile and garlic. According to reviews, analogues to Odeston are inferior.

"Ursosan" and "Odeston" are very often prescribed for complex use. They are very capable of complementing each other's properties. "Hofitol" helps replace "Odeston" during the period of prevention of relapse of diseases of the choleretic system.

You should not replace the drug with analogues yourself. Before taking any medicine, a thorough examination and consultation with a specialist is necessary. This rule applies to the duration of administration, as well as the dosage regimen. Some patients need several weeks to see positive dynamics, while others need at least a month.

Normally, bile, necessary for digestion, flows from the gallbladder and successively passes through the duodenum, liver, and intestines. If there are disturbances in the gastrointestinal tract caused by an increase in pressure in the duodenum and a malfunction of the pyloric muscle, bile begins to be thrown back into the stomach along with the duodenal contents. In this case, the person feels severe heartburn, epigastric pain and other unpleasant symptoms. Due to the accumulation of bile in the lumen of the stomach, severe irritation of its walls occurs, followed by inflammation. This condition requires immediate treatment with choleretic drugs.

Bile secretion disease can cause heartburn.

Causes of bile reflux into the stomach

To understand the reasons for the appearance of bile in the stomach, you need to understand how the digestive system works. After swallowing food, it is partially broken down in the esophagus with the help of saliva. As a result, a food bolus is formed, which enters the stomach for further digestion with hydrochloric acid. The bolus moves into the duodenum and then into the lower intestines for complete breakdown and absorption nutrients. The movement of food through the gastrointestinal tract is regulated by sphincters - valves with circular muscles. Their task is to prevent food and digestive acids from going backwards.

Failure of the locking mechanism can occur for various reasons. As a result, the valve will not close completely (it will not fit tightly). Intra-abdominal pressure may increase. This problem may be physiological in nature. For example, during pregnancy, pressure on the gastrointestinal tract is exerted by the growing fetus. Due to the entry of duodenal contents into the lumen of the stomach, a pregnant woman suffers from severe heartburn and vomiting.

Pathological filling of the stomach with bile occurs for the following reasons:

• The presence of neoplasms (hernia, tumor) or hematoma due to injury. The formations compress the duodenum, the resulting pressure pushes the burn through the sphincter back into the lumen of the stomach.
• Internal pathologies. For example, in the chronic form of duodenitis, the mucous membrane of the duodenum is in an inflamed, swollen state, so the reflux of bile acids occurs regularly.

External reasons:

• The effect of some medications. Medications may decrease the muscle tone of the pyloric sphincter. The group of such drugs includes muscle relaxants and antispasmodics.
• Poisoning. The body turns off the sphincters to empty the stomach by vomiting when poisoned by toxic substances.
• Consequences of operations. After resection of the gallbladder, the body needs some time to debug and normalize the digestive process without the organ that holds and directs bile. Another cause may be damage to the muscle fibers of the pyloric sphincter.

Heartburn and other symptoms of bile reflux

The entry of bile into the lumen of the stomach is accompanied by the following symptoms:

1. Heartburn is the main symptom. After intoxication of the stomach with bile, irritation of the mucous membrane of its walls begins, which causes a malfunction. As a result, stomach contents may back up into the esophagus.
2. Abdominal pain is intense, burning and clearly localized.
3. Nausea. It is explained by intoxication of the organ by an environment unusual for it. Nausea occurs as a defense mechanism and may result in vomiting bile.
4. Bitter taste in mouth and throat.
5. Feeling of fullness, bloating.
6. Dense yellow coating on the tongue.
7. Strong need to drink, thirst. With this symptom, the body signals the need to neutralize high acidity in the stomach.

Taking special medications

Choleretic drugs are a group of drugs that provoke the removal of bile from the body. There are 2 main categories of drugs offered:

1. preparations based on natural ingredients (extracts of corn silk, tansy, artichoke, burdock or dandelion root, immortelle, nettle);
2. artificially synthesized drugs.

According to the mechanism of action on the problem, they are distinguished:

1. Choleretics intended to enhance the secretion of bile acids and bile.
2. Cholekinetics - to accelerate the outflow of bile into the duodenum. To do this, gallbladder peristalsis is stimulated.
3. Cholespasmolytics - to relax the sphincter of Oddi and the muscles of the bile ducts, which facilitates the easy removal of bile from the body.

All choleretic drugs, regardless of release form and type, are taken 20-30 minutes before the start of a meal. The total daily dose is divided into 3-5 per day, depending on the number of snacks, since choleretic drugs should be taken before each meal. Any dose of medication is washed down with water. After half an hour, you definitely need to eat something, otherwise nausea will appear, heartburn will worsen, and diarrhea will begin.

The average duration of treatment with choleretic drugs is 3-8 weeks. To achieve stable remission, treatment should be repeated 2-4 times a year with breaks between courses of 30-60 days.

With exacerbation of pathologies accompanied by bile reflux into the stomach, the dosage of choleretic drugs is increased. For heartburn caused by reflux gastritis, reflux esophagitis, cholelithiasis, a course of treatment with choleretic drugs is prescribed for up to 8 months.

Review of choleretic drugs

The most commonly prescribed medications that improve the outflow and secretion of bile are the following:

• "Allohol" is a choleretic agent that regulates the flow of bile and activates the secretory activity of the liver. The medicine contains herbal ingredients - dried garlic, nettle, dry bile extract. The drug helps get rid of heartburn, bloating, flatulence due to poor digestion of food and its rotting. The only form of medication offered is tablets. Prescription of "Allochol" is required for diseases of the liver and gall bladder, but not at the acute stage. Contraindicated in case of hypersensitivity to components, ulcers, acute gastrointestinal pathologies.

• "Odeston" is a complex action drug, classified as a cholespasmolytic. The active substance is hymecromone. The medicine helps to cope with heartburn and accompanying symptoms, affecting the function of biliary excretion, relieving muscle spasms in the bile ducts without affecting the peristalsis of the gallbladder (this differs from products with herbal components). At the same time, the drug increases the secretion of bile acids in the liver. The medicine prevents the development of cholestasis (a disease with reduced bile secretion) and the formation of bile stagnation. Maximum effectiveness occurs after 2 hours. It exists in only one form - tablets. Taking Odeston is contraindicated for focal stomach and duodenal ulcers, granulomatous inflammation of the gastrointestinal tract, hemophilia; severe liver/kidney pathology.
• "Ursofalk" is a medicine that has cholelitholytic, hepatoprotective, and immunomodulatory effects. Additionally, the drug helps regulate the amount of cholesterol in the blood. The medicine is used over a long course, since the process of restoring the functions of the bile ducts is slow. Ursofalk rarely causes side effects, so it is well tolerated. The main active substance is ursodeoxycholic acid.
• “Hofitol” is a medicine with a herbal component composition: artichoke extract with carotene, vitamins B1 and B2, ascorbic acid normalizes metabolic processes; biologically active components (cynarin, phenolic acids) have a choleretic effect and hepatoprotective effect. "Hofitol" has a diuretic effect, accelerating the outflow of urea. The drug is contraindicated in cases of cholelithiasis, blockage of the bile ducts, and acute liver and kidney pathologies. Not prescribed for children under 6 years of age. Available in tablet form.

Gallbladder and liver diseases are quite common among the population. For their treatment, first of all, choleretic drugs are used to alleviate the course of the disease, eliminate pain and restore the functionality of organs. Among the variety of choleretic drugs, the drug Odeston can be distinguished. It quickly and effectively eliminates spasms, normalizes the formation and secretion of bile. The drug belongs to the middle price category and has a number of contraindications, so treatment is not suitable for all patients. In such cases, analogues of Odeston come to the rescue, of which there are sufficient quantities on the pharmaceutical market.

Characteristics of Odeston

The drug is produced by the Polish pharmaceutical plant Polfa in tablet form. Each tablet contains 200 mg of the active substance - hymecromone. In addition to this, the drug contains auxiliary components.

Under the influence of hymecromone, bile production is increased and its release into the intestines is improved. The substance also selectively relieves spasm of the smooth muscle muscles of the biliary tract and sphincter of Oddi. At the same time, the drug does not reduce the motility of the digestive organs and does not affect blood pressure. Thanks to the complex action of Odeston, bile stagnation decreases, its volume increases and the breakdown of fats in the intestines is normalized. The product eliminates cholestasis and prevents cholesterol crystallization.

Indications for use of the drug are:

• biliary dyskinesia;
• chronic cholangitis;
• hyperkinesia of the sphincter of Oddi;
• constipation caused by bile hyposecretion;
• noncalculous cholecystitis;
• dyspepsia and lack of appetite due to insufficient bile secretion;
• postoperative condition after interventions on the liver and gall bladder.

At standard scheme treatment Odeston should be taken 1 tablet three times a day for a 2-week course.

The use of the medicine is prohibited for:

• Crohn's disease;
• ulcerative colitis;
• intolerance to the components of the product;
• stomach and duodenal ulcers;
• obstructive gallbladder diseases;
• serious dysfunction of the liver and kidneys;
• under the age of 18;
• women with breastfeeding.

The medicine may cause the development of undesirable effects:

• allergy;
• epigastric pain;
• headache;
• flatulence;
• ulcerative lesions of the stomach;
• diarrhea.

The most popular analogues

When choosing a substitute for Odeston, you need to consult a doctor. There are many choleretic agents on the pharmaceutical market, differing both in composition and mechanism of action. However, there is no complete analogue of Odeston, which would have hymecromone as an active substance. That is why you cannot do without the help of a doctor. The doctor must choose the most appropriate drug, taking into account:

• type of disease;
• severity of symptoms;
• the presence of concomitant pathologies;
• age and characteristics of the patient’s body.

You can replace this medication with the following popular drugs:

• Allohol,
• Holyver,
• Holagol,
• Hofitol,
• Cynarix.

The cheapest and most accessible among them is Allohol.

Sometimes, to alleviate the condition, it is enough to take a course of medicinal herbs, which is even more affordable. In this case, consultation with a doctor is also required to avoid aggravation of the disease due to incorrect or insufficient treatment.

Hofitol

The drug is produced by the French pharmaceutical company Lab. Rosa-Phytopharma in the form of tablets, oral solutions and injections. The composition of the product is based on field artichoke leaf extract. In addition to it, there are additional substances, the composition and quantity of which depends on the form of the medicine.

Hofitol has not only choleretic properties. It exhibits a diuretic and hepatoprotective effect, reduces the amount of urea in the blood, normalizes metabolic processes, and promotes the removal of toxic substances from the body. Thanks to this, the list of indications for the drug is noticeably wider. The use of Hofitol is prescribed for:

• hepatitis;
• cholecystitis;
• obesity;
• fatty hepatosis;
• acetonemia;
• chronic nephritis;
• liver cirrhosis;
• intoxication of the body;
• atherosclerosis;
• chronic renal failure.

When choosing Hofitol or Odeston, you need to consider many points. Thus, Hofitol is safer for use by pregnant women. Children are allowed to use it from the age of 6. And under the supervision of a doctor, it is sometimes prescribed to smaller patients. At the same time, the choleretic properties are still more pronounced in Odeston.

Hofitol is prohibited for: acute liver pathologies, intolerance to the components of the drug, purulent inflammation of the gallbladder, liver failure, obstruction of the bile and urinary ducts.

In rare cases, while taking the drug, allergic reactions, spasms in the epigastric region, stool disturbances, and nausea may develop.

Allohol

Everyone knows this drug. It has a unique composition, thanks to which it affects most symptoms of diseases of the hepatobiliary system. The medicine consists of:

• dry bile;
• activated carbon;
• garlic and nettle extracts.

Allochol activates the secretory activity of the liver and the synthesis of bile acids, improves digestive processes, prevents the precipitation of cholesterol, exhibits anti-inflammatory properties, binds and removes toxic substances.

The drug is used as part of therapy:

• chronic cholecystitis;
• postcholecystectomy syndromes;
• cholangitis;
• hepatitis;
• to eliminate atonic constipation.

You should not use the medicine during an exacerbation of diseases of the liver and biliary tract, with individual intolerance and obstructive jaundice.

When choosing Allohol or Odeston, you need to be guided not only by the cost of the drugs, but also by their potency. In case of serious disturbances in the formation and excretion of bile, Allochol may be powerless. In addition, Odeston exhibits more pronounced antispasmodic properties.

Ursosan

The active component of this drug is ursodeoxycholic acid. This substance is found in human bile, being the most non-toxic bile acid that helps reduce cholesterol production and dissolve cholesterol stones. Based on the effects it provides, Ursosan is indicated for the formation of cholesterol stones in the gall bladder. In this case, a prerequisite for receiving therapy with the drug is the absence of changes in the functioning of the organ itself. Therefore, it is impossible to call Ursosan an equivalent replacement for Odeston. These are completely different drugs.

Gepabene

A very popular medicine used for various diseases of the liver and biliary tract. The product contains 2 active components of plant origin:

• Silymarin is an extract from milk thistle fruits, which triggers the process of restoration of liver cells and protects the organ from intoxication.
• Fumarin is an extract of medicinal fume that eliminates excessive tone of the sphincter of Oddi and stimulates the formation and excretion of bile.

The drug is included in treatment regimens:

• biliary dyskinesia;
• postcholecystectomy syndrome;
• chronic liver diseases;
• toxic hepatitis.

Gepabene is approved for use by adults and children from 6 years of age.

The use of the medicine is contraindicated during the acute period of diseases of the liver and bile ducts and in case of hypersensitivity to its components.

Gepabene exhibits a milder effect than Odeston. Therefore, it can be used not only for therapeutic but also for preventive purposes. At the same time, the medicine also has an antispasmodic effect, reducing pain.

General list of analogues

All drugs that have choleretic properties can be called analogues. Depending on the composition of the products, several groups of drugs and medicinal herbs are distinguished.

Synthetic substitutes:

• Nikodin;
• Cyclalone;
• Oxafenamide;
• Holestil.

List of drug analogues containing bile or bile acids.

Doctors call the main cause of acute cholecystitis the presence of calculi (stones) in the gallbladder, which prevent the normal outflow of bile. The chronic form of the disease develops with prolonged irritation of the bladder walls. Factors influencing the development of cholecystitis are considered infectious diseases, irregular and unbalanced diet, hereditary predisposition, sedentary lifestyle. In the absence of adequate treatment, chronic cholecystitis often develops into an acute form.

Cholecystitis requires complex therapy, carried out under the supervision of a specialist. Treatment often includes choleretic drugs prescribed to the patient to normalize the outflow of bile and prevent the formation of stones in the gallbladder. Such medications can be prescribed by a doctor only if the patient has no calcified stones in the gall bladder as a result of an ultrasound examination. Liquefing bile if stones are present is very dangerous, as they can block the bile ducts and prevent its outflow.

Ursosan - hepatoprotector for cholecystitis

Often, for people suffering from cholecystitis, doctors recommend choleretic drugs, the action of which is aimed not only at improving the outflow of bile, but also at dissolving small cholesterol gallstones. These drugs include Ursosan, a hepatoprotector based on ursodeoxycholic acid. Its dosage directly depends on the patient’s body weight; only the attending physician should select it. The following factors are contraindications to the use of the drug:

• gallbladder dysfunction;
• the presence of calcified stones in it;
• pathological changes in the liver, pancreas and kidneys;
• individual intolerance to the components included in the medicine;
• pregnancy and lactation;
• children under 5 years of age.

Side effects during treatment with Ursosan include:

• loose stools or upset stomach (common);
• urticaria, pain in the right upper abdomen, calcification of gallstones (rare).

Ursosan is intended for long-term use under medical supervision. Analogues of this medicine are drugs such as Ursofalk, Ursohol, Ukrliv, Choludexan, Urdoxa.

Herbal preparations Allohol and Chofitol

A herbal medicine for cholecystitis is Allochol, available in tablet form. The drug contains extracts of nettle and garlic, animal bile, and activated carbon. Allochol increases the secretion of bile, has a choleretic and laxative effect, and improves the functioning of the gastrointestinal tract. Indicated for non-calculous (non-stone) cholecystitis, biliary dyskinesia, chronic hepatitis, cholangitis, constipation. Contraindications to treatment with Allochol are:

• gallstones;
• acute form of pancreatitis and hepatitis;
• obstructive jaundice;
• ulcers in the stomach and duodenum.

Allochol is not used in the treatment of children under 3 years of age. Usually the drug is well tolerated by patients and does not cause side effects. Sometimes patients may experience allergic reactions and stomach upset while taking the medication. The drug must be taken as prescribed by a doctor. The course of treatment with Allochol can last up to 4 months.

An effective herbal choleretic agent, actively prescribed by doctors for cholecystitis, is Chofitol. Its main active ingredient is field artichoke leaf extract. The drug is available in the form of tablets, suspension and solution for injection in ampoules. It is used for non-calculous cholecystitis, biliary dyskinesia, acetonotomy, chronic hepatitis, nephritis and renal failure. Contraindications to the use of Chofitol for cholecystitis are:

• the presence of stones in the gallbladder;
• obstruction of the bile ducts;
• any acute liver and kidney diseases;
• individual intolerance to artichoke.

TO side effects Chophytol includes allergic reactions and stomach upset. The dosage of the drug is determined by the doctor. You need to take the medicine 20 minutes before meals. Like any choleretic drugs, Hofitol can be taken only on the recommendation of a doctor.

Hofitol was prescribed to me as a means of improving the composition of bile and promoting its outflow, since there was stagnation and the prospect of the appearance of stones if left untreated. I took Hofitol in a course of 4 weeks, three tablets three times a day every day. The result was very good, ultrasound showed significant improvements. In addition, digestion improved and stool returned to normal. I think the drug is effective.

Odeston - analogues

• lack of appetite;
• dyspepsia;
• chronic hepatitis.

What can replace Odeston?

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What is better for the liver: Livodex, Allochol, Phosphogliv, Gepabene, Ursosan or Odeston

The liver is the cornerstone of our body. If you can live without one kidney or undergo hemodialysis, then with liver failure the patient can die in a matter of hours.

To treat liver diseases, doctors prescribe various medications: Allohol, Phosphogliv, Hepabene, Livodexa, Ursosan, Odeston.

But the patient does not always strictly follow the doctor’s instructions. The patient has the right to have doubts, especially since a sea of ​​advertising information is pouring out on him from TV screens. Colleagues and acquaintances are also prescribed similar medications and share their experiences.

The question arises - which medication works better. To answer this, you need to read the annotation for the medicine.

"Livodex"

This drug is a hepatoprotector with a choleretic effect. Livodex tablets red-brown color with a dividing line.

The main active ingredient is ursodeoxycholic acid in two dosages of 150 and 300 mg.

The drug has a hepatoretector and choleretic effect, helps maintain immunity.

Indications for use of Livodex:

• symptomatic therapy for biliary cirrhosis;
• cholelithiasis with a working gallbladder;
• reflux disease;
• hepatitis;
• alcoholic cirrhosis or intoxication;
• fatty hepatosis;
• inflammatory process in the bile ducts;
• cystic fibrosis;
• impaired motility of the gallbladder and ducts;

• non-functioning gallbladder, large stones;
• cirrhosis;
• pathologies of the kidneys, pancreas;
• age up to 3 years;
• individual intolerance medicinal product;

Pregnancy is a relative contraindication. If the benefit to the mother is higher than the potential threat to the fetus, then prescribing the drug is justified.

Side effects are mainly associated with dyspeptic symptoms - nausea, vomiting, diarrhea. In rare cases, calcification of gallstones or worsening of general condition with biliary cirrhosis.

The dosage is selected individually by the attending physician, taking into account the patient’s weight, age and diagnosis. The manufacturing company is located in India.

"Ursosan"

Ursosan belongs to the same class of drugs as Livodex - hepatoprotectors. These are white capsules containing white crystalline powder inside.

The main active ingredient of Ursosan is ursodeoxycholic acid in a dosage of 250 mg. The dosage is selected individually for each patient.

If the dose of Livodex is not suitable, then Ursosan is prescribed.

Indications for use and contraindications for Ursosan are the same as for Livodexa. The only difference is that taking the drug can cause back pain, relapse of psoriasis, and hair loss from the scalp. Produces the drug "Ursosan" in the Czech Republic.

"Allohol"

This medicine has a choleretic effect. All components - animal bile, dry extracts of nettle and garlic, activated carbon in the Allochol preparation are active.

This tool provides:

• cholekinetic effect - improves the outflow of bile, increases contractions of the gallbladder;
• choleretic effect - distribution of bile secretion in even portions throughout the day.

"Allohol" is indicated for the following conditions:

• chronic hepatitis;
• initial stages of cirrhosis;
• cholangitis;
• cholecystitis;
• bile duct dyskinesia;
• constipation;
• after removal of the gallbladder.

Contraindications to taking Allohol tablets:

• individual intolerance;
• acute hepatitis;
• liver dystrophy;
• blockage of the bile duct with a stone;
• pancreatitis;
• enterocolitis;
• erosive processes in the gastrointestinal tract;
• gallstones larger than 10 mm.

"Allohol" is taken strictly after meals. Moreover, it can be a small amount - an apple, a pear, a bun. The main thing is the presence of food in the stomach. Allohol tablets stimulate the production of gastric juice. Its excess begins to irritate the gastric mucosa when taken on an empty stomach.

Pregnancy and lactation are not a contraindication for prescribing the drug.

Allohol tablets have virtually no adverse reactions. In case of overdose or improper use, they can cause dyspeptic symptoms - stool upset, nausea.

"Gepabene"

This medicine is based on the extract of milk thistle and fumifera, its effect is very similar to the previous tablets.

But "Gepabene" has a number of contraindications:

• inflammatory processes of the liver in the acute stage;
• age under 18 years;
• pregnancy.

Side effects are similar to Allohol - gastrointestinal disorders.

"Phosphogliv"

This remedy also belongs to the class of hepatoprotectors.

The main active ingredients of Phosphogliv capsules and lyophilisate are phospholipids and sodium glycyrrhizinate.

"Phosphogliv" has the following effects:

• protection of liver cells;
• anti-inflammatory effect;
• restores detoxification mechanisms in liver tissues;
• strengthens local immunity.

Indications for taking the drug "Phosphogliv":

• hepatitis;
• fatty hepatosis;
• toxic liver damage;
• cirrhosis;
• psoriasis;
• neurodermatitis;
• other skin lesions associated with liver conditions.

"Phosphogliv". Contraindications for use:

• age up to 12 years;
• pregnancy;
• breastfeeding period;
• allergic reaction to the main and auxiliary active ingredients.

Side effects of the hepatoprotector "Phosphogliv" are few. Cases of various dermatological reactions have been described - rashes, urticaria, which disappeared after discontinuation of the drug.

"Odeston"

Odeston tablets are a choleretic agent. Take this medicine half an hour before meals.

The main active ingredient is hymecromone.

Indications for the use of the drug "Odeston":

Contraindications to the use of the drug "Odeston":

• obstruction of the bile ducts;
• renal and liver failure;
• ulcerative colitis, erosion of the stomach and intestines;
• hemophilia;
• individual intolerance to the components of the drug.

Odeston tablets are not prescribed to pregnant women, children and adolescents under 18 years of age.

Side effects are standard: flatulence, nausea, diarrhea. Occasionally, Odeston causes headaches and allergic reactions.

Which drug is better?

The effect of the drug depends on a number of factors:

• patient diagnosis;
• age;
• accompanying illnesses;
• individual characteristics of the body.

Therefore, it is inappropriate to say which is better - Ursosan, Phosphogliv, Odeston or Livodex. One patient is helped by one drug, another by another, even with the same diagnosis.

The selection of a drug is the prerogative of the doctor and his patient. Therefore, you should not listen to your friends and neighbors. Trust the gastroenterologist and your own body.

Attention! Information about drugs and folk remedies treatment is presented for informational purposes only. Under no circumstances should you use the medicine or give it to your loved ones without medical advice! Self-medication and uncontrolled use of drugs are dangerous for the development of complications and side effects! At the first signs of liver disease, you should consult a doctor.

©18 Editorial staff of the portal “My Liver”.

The use of site materials is permitted only with prior approval from the editor.

Hofitol / Ursosan

The doctor prescribed hofitol or ursosan, saying that the baby’s jaundice had not yet gone away. I’m wondering, has anyone given these medications to their baby? HOW does it affect?

Otherwise, this same kind aunt prescribed us Akadetrim, and there are contraindications - CHILDREN'S AGE... somehow this aunt does not inspire confidence in me.

Prevention and treatment of vitamin D deficiency.

Prevention and treatment of rickets, rickets-like diseases, hypocalcemic tetany, osteomalacia and metabolic-based bone diseases (such as hypoparathyroidism and pseudohypoparathyroidism).

In the complex treatment of osteoporosis, including postmenopausal.

Apply the drug in a spoonful of liquid.

1 drop contains about 500 IU of vitamin D3.

Unless the doctor prescribes otherwise, the drug is used in the following dosages:

• full-term newborns from 4 weeks of life, up to 2-3 years with proper care and sufficient exposure to fresh air: ME (1 drop) per day;
• premature babies, from 4 weeks of life, twins, infants in poor living conditions: (2-3 drops) per day. IN summer time years, you can limit the dose to 500 IU (1 drop) per day.
• pregnant women: a daily dose of 500 IU of vitamin D3 for the entire period of pregnancy, or taking 1000 IU / day, starting from the 28th week of pregnancy.
• in the postmenopausal period ME (1-2 drops) per day.

Hypersensitivity to the components of the drug, especially to gasoline alcohol. Hypervitaminosis D, increased concentration of calcium in the blood (hypercalcemia), increased excretion of calcium in the urine (hypercalciuria), urolithiasis (formation of calcium oxalate stones), sarcoidosis, acute and chronic diseases of the liver and kidneys, renal failure, active form of pulmonary tuberculosis. Children up to 4 weeks of age.

With caution: state of immobilization, when taking thiazides, cardiac glycosides (especially digitalis glycosides); during pregnancy and breastfeeding.

In infants with a predisposition to early overgrowth of fontanelles (when the size of the anterior crown is small from birth).

My child had jaundice and we treated it with Ursosan. The product is good, it works almost immediately and improvements begin. Well, now we are healthy.

Mom won't miss

women on baby.ru

Our pregnancy calendar reveals to you the features of all stages of pregnancy - an extremely important, exciting and new period of your life.

We will tell you what will happen to your future baby and you in each of the forty weeks.

Ursosan or hofitol which is better

Odeston is a white tablet (sometimes with a yellowish tint) that has antispasmodic and choleretic properties.

Indications for use

• nausea,
• vomiting
• decreased appetite,
• constipation,
• cholangitis,
• non-calculous chronic cholecystitis,
• cholelithiasis,
• dyskinesia of the sphincter of Oddi and biliary tract.

In addition, Odeston is indicated for conditions after operations on the gallbladder and liver, like its analogues.

Contraindications

The drug Odeston is not prescribed for:

• renal and liver failure;
• ulcerative lesions of the stomach;
• obstruction of the gallbladder;
• ulcerative colitis;
• duodenal ulcer;
• Crohn's disease;
• lactation;
• hemophilia.

At the same time, it is better not to take Odeston if you are hypersensitive to all the components of the drug, as well as to coumarins.

Analogues

The drug Odeston has no structural analogues in terms of the active substance, however, in terms of pharmacological group, the most similar drugs are Allohol and Chophytol. These analogues have a choleretic effect, due to which they can rightfully be classified as analogues.

Allohol

Allohol is a well-known medicine produced since 1964 by the Borshchagovsky Chemical and Pharmaceutical Plant. This medicine is best used for pathological disorders of the hepatobiliary system.

A whole team of scientists worked on the creation of the drug Allochol, led by N.G. Belenky. The medicine is interesting because it has a completely unique composition.

The composition of the drug Allochol includes the following components of animal and plant origin:

• garlic powder containing a large number of antimicrobial, antithrombotic and cholesterol-lowering active biological components;
• activated carbon, which is the most common and effective enterosorbent, has the ability to adsorb toxic substances even before they are absorbed by the digestive system;
• nettle leaves, which have choleretic and hemostatic properties, reduce flatulence, enhance the activity of the digestive system, and reduce cholesterol levels in the blood;
• dry bile, which takes part in the digestive process due to the activation of pancreatic enzymes.

Allohol is an effective drug, like Odeston. Its components stimulate the synthesis of bile acid, prevent the spread of infection, reduce the likelihood of the formation of cholesterol stones, improve the secretory function of liver cells, reduce the intensity of inflammatory processes, improve the digestion process by accelerating the outflow of bile, and eliminate atonic constipation.

The drug Allohol really is a time-tested remedy, since its production was launched more than 50 years ago, and during this time it was made better and more effective. In addition, it is convenient to always carry the medicine with you.

Hofitol

Hofitol is a well-known analogue of the drug Odeston, however, it is similar to Allohol only in that it has diuretic, choleretic and hepatoprotective effects. In addition, the active substances of the drug improve the metabolism of cholesterol and lipids, the metabolism of ketone bodies by increasing the ability of hepatocides to produce coenzymes. The drug also helps reduce serum urea levels.

When using Hofitol, side effects may occur such as an allergic reaction to the components, as well as diarrhea if the drug is taken for a long time.

This medicine is contraindicated in acute diseases of the liver, kidneys, biliary and urinary tracts, cholelithiasis, bile duct obstruction, hypersensitivity to the components of the drug.

The composition of Hofitol tablets includes:

• field artichoke in the form of a dry aqueous extract;
• pregelatinized corn starch;
• talc;
• sucrose;
• gum arabic;
• gelatin;
• calcium carbonate;
• gummilk;
• disperse dye;
• magnesium stearate;
• polysorbate 80;
• rosin;
• magnesium trisilicate;
• carnauba wax.

The drug Hofitol is prescribed with extreme caution in conditions that contribute to the development of bile duct obstruction, like Odeston. If the patient experiences diarrhea, this medication should be stopped immediately and a doctor should be consulted.

During clinical trials, experts did not reveal any effect of the drug on the speed of psychomotor reaction, so it is allowed to be used by persons working as vehicle drivers.

Hofitol and Allohol are only choleretic analogues of the drug Odeston. Their effectiveness has been tested by time. All of them are commercially available, however, it is strongly recommended to consult a doctor before using them.

especially for the site Moizhivot.ru

Choleretic drugs are a specific group of medications, without which people with bile duct diseases cannot imagine a normal life. Odeston is one of the most famous representatives of his group. The drug acts quickly and very effectively. But despite its many advantages, the medication is not suitable for everyone. Fortunately, there are quite a lot of analogues of Odeston, so everyone can choose the most effective and suitable medicine for themselves.

What is better - Hofitol, Ursosan, Allochol or Odeston?

All these drugs are well-known choleretic agents, which are simply crazy popular in certain circles. Each medication has its own characteristics, so before choosing a truly effective replacement for Odeston, you will have to consult a specialist.

Odeston is an excellent choleretic agent. In addition to increasing the formation and secretion of bile, the medication can have a selective antispasmodic effect on the sphincter of Oddi and bile ducts. The active components of Odeston prevent the deposition of cholesterol crystals, but do not reduce the motility of the gastrointestinal tract and do not in any way affect blood pressure.

The main difference between one of the most popular analogues of Odeston Allochol tablets is its composition. The main active ingredient in Odeston is hymecromone. Allochol contains activated carbon, nettle leaves, garlic, and bile.

As practice has shown, Ursosan and Odeston are best taken in parallel - the drugs complement each other remarkably. And Hofitol can be a very useful substitute for Odeston during prophylaxis.

Indications for the use of all the drugs described above and their other analogues are approximately the same:

• biliary dyskinesia;
• problems associated with decreased bile secretion (frequent constipation, nausea, vomiting);
• chronic forms of cholangitis and cholecystitis;
• lack of appetite;
• simple form of cholelithiasis;
• dyspepsia;
• chronic hepatitis.

Many experts prescribe Odeston and its analogues to restore the body after operations on the gallbladder and biliary tract.

What can replace Odeston?

The choice of analogue largely depends on the characteristics of the patient’s body and, of course, the form of the disease. It often happens that drugs that are ideal for one person turn out to be completely useless for another. That is why it is advisable to select medications under the supervision of a specialist, based on the results of examinations.

The same applies to the dosage and duration of the course of taking medications. Often, a couple of weeks of taking a choleretic drug is enough for a complete recovery, but in particularly difficult cases, treatment can even extend for several months.

Among the effective analogues of Odeston tablets you can find the following medications:

Those who prefer to be treated with natural remedies choose medicines such as Bittner's herbal elixir or Demidov's elixir. Various gastrointestinal and choleretic preparations have proven themselves very well.

Of course, all these drugs have contraindications, and the most common of them look like this:

1. Odeston and its analogues are not suitable for people with bile duct obstruction.
2. It is better for pregnant women to avoid this product.
3. Medicines (for the most part) are not suitable for children under 18 years of age.

Diseases of the gallbladder and biliary tract are one of the most important medical and social problems, as there is a constant increase in incidence worldwide. From year to year, the number of operations on the biliary tract is growing, as well as the number of postoperative complications, which force repeated surgical interventions and often lead to permanent disability of the patient.

Chronic acalculous cholecystitis is considered by most authors to be the initial stage of cholelithiasis, since during the inflammatory process in the gallbladder the biochemical structure of bile changes, and the bile acquires lithogenic properties. Therefore, early detection and treatment of chronic non-calculous cholecystitis can serve as a preventive measure for the formation of gallstones.

The main role in the development of chronic acalculous cholecystitis is played by infection, which enters the gallbladder hematogenously through the hepatic artery and portal vein, lymphogenously or ascending from the intestine. Any chronic focus of infection in the body (chronic tonsillitis, chronic salpingoophoritis, sinusitis), as well as a chronic inflammatory process in the gastrointestinal tract (GIT), can be a source of infection in the bile. Bacteriological examination of bile often reveals Escherichia coli, staphylococci, enterococci, Klebsiella, clostridia, typhoid and dysentery bacteria, and Proteus. However, only 30–40% of patients have microflora in the biliary tract, since sensitization of the body and a decrease in the immunological reactivity of the macroorganism are of decisive importance in the occurrence of inflammation in the biliary tract.

The biliary tract is a complex biliary system, including the common hepatic duct, formed from the confluence of the right and left hepatic ducts, the gallbladder with the Lütkens sphincter, the common bile duct, starting from the junction of the hepatic and cystic ducts and the ampulla of the major duodenal papilla.

With each meal, the gallbladder contracts 1–2 times. Bile then enters the intestines, where it participates in digestion. The gallbladder on an empty stomach contains 30–80 ml of bile, but with stagnation its amount may increase.

In women, the gallbladder in a state of functional rest has a slightly larger volume than in men, but contracts faster. With age, the contractile function of the gallbladder decreases.

The leading role in the occurrence of dysfunctional disorders of the biliary tract belongs to psycho-emotional factors - psycho-emotional overload, stressful situations. Dysfunction of the gallbladder and sphincter of Oddi can be manifestations of neurotic conditions.

The influence of psychogenic factors on the function of the gallbladder and bile ducts is realized with the participation of cortical and subcortical formations, nerve centers of the medulla oblongata, hypothalamus, and the endocrine system.

Synchronicity disturbances in the functioning of the gallbladder and sphincter apparatus underlie dysfunctional disorders of the biliary tract and are the cause of the formation of clinical symptoms.

Disorders of the motor function of the biliary tract play a significant role in the formation of not only pain syndrome, but also dyspeptic disorders (feeling of heaviness in the epigastrium and right hypochondrium, vomiting, heartburn, belching, bitter taste in the mouth, flatulence, stool disorders). The wall of the gallbladder is easily extensible, which is due to the presence of both smooth muscle and elastic fibers in its middle shell. Thanks to this structure of the gallbladder wall, contraction occurs both throughout the organ and its individual parts.

Contraction of the smooth muscles of the gastrointestinal tract occurs when acetylcholine stimulates muscarinic receptors on the surface of the muscle cell, which is accompanied by the interaction of the Ca 2+, Na + and K + channel systems of the cell membranes. These processes determine the contraction and relaxation of smooth muscle cells and, consequently, changes in muscle tone.

The motor activity of the biliary tract is regulated with the participation of central reflexes, local (gastroduodenal) reflexes caused by mechanical stretching and exposure to food components, and humoral influences. Under the influence of these regulatory links, the gallbladder contracts and the sphincter of Oddi relaxes.

Gastrointestinal hormones occupy an important place in the regulation of the functions of the biliary system. In this case, the leading role belongs to cholecystokinin, gastrin, secretin, motilin, and glucagon.

The most important humoral stimulant, which ensures synchronous contraction of the gallbladder and relaxation of the sphincter apparatus of the biliary tract in response to food intake, is cholecystokinin. It is now known that there is a direct connection through nerve fibers between the duodenum, on the one hand, and the gallbladder and sphincter of Oddi, on the other, conducting cholinergic excitation to the nerve ganglia of the gallbladder and sphincter of Oddi.

Secretin, produced in the duodenum, stimulates the secretion of water, electrolytes and bicarbonates by the epithelium of the biliary and pancreatic ducts and potentiates the effects of cholecystokinin.

Motilin is an important hormone that regulates gastrointestinal motility. The administration of motilin causes a decrease in the volume of the gallbladder and increased contractility of the antrum of the stomach.

Neurotransmitters that cause relaxation of smooth muscle cells in the biliary tract include vasoactive intestinal peptide (VIP) and nitric oxide (NO), produced by the enzyme NO synthetase. VIP inside muscle cells stimulates an increase in the level of cyclic adenosine monophosphoric acid, and NO increases the level of cyclic guanidine monophosphoric acid. VIP and NO mutually enhance each other's production.

In the regulation of contraction of the smooth muscles of the gallbladder, norepinephrine plays a certain role, which is secreted by sympathetic postganglionic fibers and, acting presynaptically on the vagal nerve endings in the gallbladder ganglia, reduces the release of acetylcholine from the vagal nerve endings.

Currently, the term “dysfunctional disorders of the biliary tract,” according to the classification of functional disorders of the digestive organs, includes all diseases associated with impaired motility of the biliary tract, regardless of their etiology. According to the classification of functional gastrointestinal disorders, gallbladder dysfunction and sphincter of Oddi dysfunction are distinguished.

Eating large amounts of fatty and fried foods can cause spasm of the sphincter of Oddi and Lutkens, as well as disruption of the metabolism of cholesterol and bile acids, which predisposes to the development of cholecystitis.

Long-term use of anticholinergics and antispasmodics leads to dysfunction of the biliary tract, the development of hypotension and atony of the sphincter of Oddi, which contributes to the reflux of duodenal contents into the biliary tract, with the formation of “pharmacological” cholestasis, as well as duodenostasis. Therefore, in case of peptic ulcer with localization of the process in the duodenal bulb, changes in the biliary tract are often observed. In addition to motor-secretory disorders in the gallbladder and bile ducts, infections and metabolic disorders in the body, some other factors are also important in the genesis of the development of cholecystitis: genetic predisposition, occupational hazards (work with vibration, sedentary work) and repeated pregnancies.

Changes in chemical composition bile (discrimination) in the form of an increase in the concentration of bile salts can cause aseptic inflammation of the gallbladder. The importance of reflux of pancreatic juice, which is a consequence of a violation of the physiological mechanisms of the papilla of Vater with a common ampulla for the excretory ducts of the liver and pancreas, into the biliary tract in the genesis of cholecystitis has been proven. With free outflow of pancreatic juice into the duodenum, no changes in the gallbladder are detected, but if the outflow is disrupted and hypertension increases in the biliary system, stretching of the gallbladder leads to a change in the normal capillary blood flow in the bladder wall. This causes disruption of tissue metabolism, damage to cellular elements and the release of cytokinase, which converts trypsinogen into trypsin, which leads to the development of enzymatic cholecystitis.

Gallstone disease is a multifactorial and multistage disease characterized by impaired metabolism of cholesterol, bile acids and/or bilirubin with the formation of stones in the gall bladder and/or bile ducts.

In the above classification of cholelithiasis, four stages of the disease are distinguished (A. A. Ilchenko, 2002).

I, initial or pre-stone stage:

a) thick heterogeneous bile;

b) formation of biliary sludge

– with the presence of microliths;

– with the presence of putty-like bile;

– a combination of putty-like bile with microliths.

II, stage of gallstone formation:

a) by localization

– in the gallbladder;

– in the common bile duct;

– in the hepatic ducts;

b) by the number of stones

d) according to the clinical course

– with the presence of clinical symptoms:

• painful form with typical biliary colic;
• dyspeptic form;
• under the guise of other diseases.

III, stage of chronic recurrent calculous cholecystitis.

IV, stage of complications.

Thus, the mechanism of development of cholecystitis is complex, diverse, and several factors often act, leading to diseases of the biliary tract.

Pathogenetic therapy of cholecystitis aims to relieve the inflammatory process in the wall of the gallbladder, normalize the processes of bile formation and excretion, and prevent the formation of stones. Considering the important role of the nutrition factor in this process, treatment primarily involves frequent, fractional meals. Eating a small amount of food at the same hours normalizes choleresis, promotes better flow of bile into the intestines and prevents the development of cholestasis. One meal per day large quantities can lead to intense contraction of the gallbladder and the development of biliary colic. Therefore, it is advisable to eat small portions 4-5 times a day.

Due to the fact that during the inflammatory process in the gallbladder, the pH shifts to the acidic side (bile acidosis), which contributes to the loss of cholesterol in the form of crystals and a change in the ratio of bile acids towards cholesterol (cholate-cholesterol ratio), the diet should be sharply limited or exclude foods containing acidic valences. These are primarily flour and spicy dishes, meat, fish, brains, etc.

The protein content in the diet of patients with cholecystitis should correspond to the physiological norm of 80–90 g per day. Protein-rich foods - cottage cheese, milk and cheese - cause a shift in the bile reaction to the alkaline side. It should be taken into account that food poor in proteins leads to the development of fatty liver, disruption of the repair and regeneration process, disruption of the synthesis of many enzymes and hormones. All this indicates that long-term restriction of protein intake in patients with chronic cholecystitis is not justified.

Fats stimulate bile secretion, and the majority of patients do not need to limit them. However, animal fats are rich in cholesterol and should be consumed in limited quantities by patients with chronic cholecystitis. If there is insufficient flow of bile into the intestines, fats are poorly broken down, which leads to irritation of the intestinal mucosa and the appearance of diarrhea. Diets with increased amounts of fat from vegetable oil have been shown to have positive influence on the lipid complex of bile, bile formation and bile excretion. A lipotropic-fat diet with a 1:1 ratio of animal and vegetable fats is recommended. It should also be remembered that vegetable oils(corn, sunflower, olive) due to the content of unsaturated fatty acids - arachidonic, linoleic, linolenic - improve cholesterol metabolism, participate in the synthesis of prostaglandins (arachidonic acid), and affect the motility of the gallbladder. Fats increase the metabolism of fat-soluble vitamins, especially vitamin A.

Carbohydrates, especially easily digestible ones (sugar, glucose, honey, jam), which were previously recommended to increase liver glycogenization, should be limited, especially if you are overweight. It has been proven that glycogen stores are reduced only in cases of massive liver necrosis. Including large amounts of easily digestible carbohydrates can enhance lipogenesis and thereby increase the likelihood of gallstone formation. Therefore, the consumption of flour and sweet foods should be limited. The diet should be rich in plant fiber, which eliminates constipation, and this reflexively improves the emptying of the gallbladder. The diet should include carrots, pumpkin, watermelons, melons, grapes, wheat and rye bran. For oxalaturia and phosphaturia, you should limit tomatoes, sorrel, spinach, and radishes. The carbohydrate content in the first week of exacerbation of cholecystitis should be 250–300 g, from the second week it should increase to 350 g, but the proportion of simple sugars should be no more than 50–100 g per day.

Thus, with an exacerbation of chronic cholecystitis in the first week, the calorie content of food is 2000 calories; later, when the inflammatory process subsides, the calorie content can be increased to 2500 calories.

A complete vitamin composition of food is a necessary condition diet therapy for chronic cholecystitis. You should include in your diet foods containing lipotropic factors: oatmeal and buckwheat, cottage cheese, cheese, cod, soy products. Great importance has culinary food processing. During an exacerbation, a gentle version of the diet is prescribed - table No. 5a, which provides for the limitation of mechanical and chemical irritants. During the period of remission, the main dietary regimen is diet No. 5, which excludes foods rich in cholesterol and extractive substances, spicy snacks, salty, smoked and fried foods. The total calorie content of the diet corresponds to the physiological norm - 2500 calories (90 g protein, 85 g fat, 350 g carbohydrates).

The basis of drug treatment of chronic cholecystitis is anti-inflammatory therapy. Antibiotics are widely used to suppress infection in the biliary tract. The choice of antibacterial drug depends on individual tolerance and the sensitivity of the bile microflora to the antibiotic. The most effective are antimicrobial drugs of the fluoroquinolone group - norfloxacin (nolicin, norbactin, girablok) 0.4 g 2 times a day, ofloxacin (tarivid, zanocin) 0.2 g 2 times a day, ciprofloxacin (tsiprobay, ciprolet, tsifran) 0.5 g 2 times a day, levofloxacin (Tavanic, Lefoccin) 0.5 g 2 times a day; macrolides - erythromycin 0.25 g 4 times a day, azithromycin (sumamed, azitrox, azitral) 0.5 g once a day, clarithromycin (clacid, clubax, klerimed) 0.5 g 2 times a day, roxithromycin (rulide, roxide, roxolid) 0.1 g 2 times a day, midecamycin (macropen) 0.4 g 2 times a day and semisynthetic tetracyclines - doxacycline (vibramycin, Unidox Solutab, Medomycin) 0.1 g 2 times per day, metacycline 0.15 g 4 times a day. You can use semi-synthetic penicillins: ampicillin 0.5 g 4 times a day, oxacillin 0.5 g 4 times a day, ampiox 0.5 g 4 times a day - although they are less active. In severe cases - cephalosporins (ketocef, cephobid, claforan, cefepime, rocephin). The preferred route of administration of the antibiotic is the usual therapeutic dose, the course of treatment is 7–8 days, it is possible to repeat the course with other antibiotics after 3–4 days. Correction of antibacterial therapy is carried out after obtaining a culture of bile for microflora and determining its sensitivity to the antibiotic.

If the bile microflora is not sensitive to antibiotics or is allergic to them, co-trimaxazole (Biseptol, Bactrim) is recommended, 2 tablets 2 times a day, although its effectiveness is significantly lower than that of antibiotics, and the adverse effect on the liver is higher. A good effect is achieved by using nitrofuran drugs - furazolidone, furadonin, and metronidozole (0.5 g 3 times a day for 7-10 days).

In case of severe pain syndrome, in order to reduce spasm of the sphincter of Oddi and sphincter of Lutkens, and in case of hypermotor type gallbladder dysfunction, antispasmodics are indicated. There are several groups of antispasmodics, differing in their mechanism of action.

Both selective (methacin, gastrocepin) and non-selective M-cholinergic blockers (buscopan, platifillin) are used as antispasmodics. However, when taking this group of drugs, a number of side effects may occur (dry mouth, urinary retention, visual disturbances, tachycardia, constipation). The combination of the rather low effectiveness of this group of drugs with a wide range of side effects limits the use of this group of drugs.

Direct-acting antispasmodics, such as papaverine, drotaverine (no-spa), are effective in relieving spasms. However, they are not characterized by selectivity of action, since they affect all tissues where smooth muscles are present, including the vascular wall, and cause vasodilation.

Mebeverine hydrochloride (duspatalin), which also has a direct myotropic effect, has a significantly more pronounced antispastic activity, but it has a number of advantages over other antispasmodics. It almost selectively relaxes the smooth muscles of the digestive tract, does not affect the smooth muscle wall of blood vessels and does not have the systemic effects characteristic of anticholinergics. According to the mechanism of action, duspatalin is a sodium channel blocker. The drug has a prolonged effect and should be taken no more than 2 times a day in the form of 200 mg capsules.

Pinaveria bromide (dicetel) is a myotropic antispasmodic. The main mechanism of its action is the selective blockade of calcium channels located in the smooth muscle cells of the intestine, bile ducts and peripheral nerve endings. Dicetel is prescribed 100 mg 3 times a day for pain.

A drug that has a selective antispasmodic effect on the sphincter of Oddi and the sphincter of the gallbladder is hymecromone (odeston). This drug combines antispasmodic and choleretic properties, ensuring harmonious emptying of intra- and extrahepatic bile ducts. Odeston does not have a direct choleretic effect, but it facilitates the flow of bile into the digestive tract, thereby enhancing the enterohepatic recirculation of bile acids. The advantage of odeston is that it has virtually no effect on other smooth muscles, in particular circulatory system and intestinal muscles. Odeston is used 200–400 mg 3 times a day 30 minutes before meals.

All antispasmodics are prescribed for a course of 2–3 weeks.

In the future, they can be used if necessary or in repeated courses. For acute pain syndrome, drugs can be used once or in short courses.

In the relief of pain, a special role is given to drugs that affect visceral sensitivity and nociceptive mechanisms. Currently, the possibility of prescribing antidepressants, 5-HT3 receptor antagonists, k-opioid receptor agonists, and somatostatin analogs for pain of this origin is being discussed.

Antidepressants (amitriptyline, mianserin, etc.) are used in medium doses, the duration of their use should be at least 4–6 weeks.

In case of gallbladder dysfunction caused by hypomotor dyskinesia, prokinetics are used to increase contractile function for 10–14 days: domperidone (Motilium, Motonium, Motilak) or metoclopramide (Cerucal) 10 mg 3 times a day 20 minutes before meals.

The prescription of choleretic drugs requires a differentiated approach depending on the presence of inflammation and the type of dysfunction. They are indicated only after the inflammatory process has subsided. All choleretic drugs are divided into two large groups: choleretics - drugs that stimulate bile formation, and cholagoga - drugs that stimulate bile secretion.

Choleretics include drugs that increase the secretion of bile and stimulate the formation of bile acids (true choleretics), which are divided into:

• for drugs containing bile acids - decholin, allochol, cholenzyme, hologon;
• herbal preparations - hofitol, tanacechol, holagol, livamine (liv.52), hepabene, hepatofalk, silymar;
• drugs that increase bile secretion due to the water component (hydrocholeretics) - mineral water.

The second group of drugs that stimulate bile secretion include:

• cholekinetics - drugs that cause an increase in the tone of the sphincters of the biliary tract and gallbladder - magnesium sulfate, Carlsbad salt, sorbitol, xylitol, holagogum, olimetin, rovachol, preparations containing oil solutions - pumpkinol;
• drugs that cause relaxation of the biliary tract (cholespasmolytics) - platifillin, no-spa, duspatalin, odeston, dicetel.

Drugs of these groups should be prescribed differentially, depending on the type of dyskinesia accompanying chronic cholecystitis.

During the period of exacerbation of chronic acalculous cholecystitis, physiotherapeutic procedures are indicated: electrophoresis with antispasmodics for hypermotor type dysfunctions and with magnesium sulfate for hypomotor dysfunction. Diathermy, inductothermy, paraffin, ozokerite, and UHF therapy are prescribed for the gallbladder area. Recently, works have appeared on the effectiveness of laser therapy for chronic acalculous cholecystitis. During the period of the onset of remission, physical therapy can be used to help empty the gallbladder.

In the treatment of chronic acalculous cholecystitis, treatment with medicinal herbs - herbal medicine, which allows prolonging the therapeutic effect of medications, is becoming increasingly important. Medicinal plants are also divided into two groups: choleretics and cholekinetics, although many of them have both effects. The first group includes: immortelle flowers (flamin), corn silk, peppermint, tansy, barberry fruits, elecampane root, centaury herb, dandelion root, yarrow, black radish juice.

The second group includes: hawthorn flowers, valerian root, dandelion root, fruits and bark of common barberry, herb, blue cornflower flowers, calendula, wild chicory root, rose hips, caraway seed, dill seed, tansy, sandy immortelle, lavender, lemon balm. Medicinal plants are used in the form of infusions and decoctions. Collections of choleretic herbs with different mechanisms of action are widely used.

Infusions and decoctions of herbs are used half a glass 30 minutes before meals 2-3 times a day, long-term, for several months (2-3 months). It is advisable to prepare them daily or for 2 days. It is necessary to observe the principle of gradually expanding the spectrum and adding herbs to the collections (but no more than 5 herbs), taking into account the individual tolerance of individual herbs and concomitant diseases. Herbal medicine courses must be repeated 3-4 times a year.

Mineral waters have long been widely used in the treatment of chronic cholecystitis, since most of them have choleretic and cholekinetic effects, affect the chemistry of bile, increasing the cholate-cholesterol ratio. Oral use of mineral waters can be combined with intraduodenal lavage, as well as blind probing (tubage without a probe). Tubage is carried out in the morning on an empty stomach. The patient sips over 40–50 minutes 0.5 liters of degassed warm mineral water (Essentuki, Smirnovskaya, Slavyanovskaya) with the addition of 15–20 g of xylitol or 1/3 teaspoon of Karlovy Vary salt. For cholecystitis with hypomotor dysfunction of the gallbladder, the patient is recommended to moderate physical activity 1–1.5 hours before meals. Bottled mineral waters are widely used. It is also recommended to stay at the following resorts: Essentuki, Zheleznovodsk, Krainka, Monino, Dorokhovo, Karlovy Vary, etc. When prescribing mineral waters, the state of the secretory function of the stomach is taken into account. In addition, balneological factors have a beneficial effect on the state of the nervous system and the neurohumoral regulatory mechanisms of bile secretion.

The presence of biliary sludge in the gallbladder as a pre-stone stage of cholelithiasis requires correction in the treatment of patients with chronic cholecystitis. Appointed medicines, enhancing choleresis, cholecystokinetics, as well as preparations of ursodeoxycholic and chenodeoxycholic acids: ursofalk, ursosan - at the rate of 10 mg/kg body weight once at night or henofalk, lithopalk at the rate of 15 mg/kg body weight once at night. The duration of litholytic therapy is 3 months, after which ultrasound examination (ultrasound) is performed.

Treatment of cholelithiasis at the stage of formed stones requires different approach to the management of patients. The only non-invasive treatment method is oral litholytic therapy with bile acid preparations.

Litholytic therapy is carried out when there are contraindications to surgical treatment and when the patient refuses surgery. However, there are certain contraindications to the prescription of litholytic therapy: pigmented and mixed stones, the diameter of the stones is more than 10–15 mm, the number of stones occupying more than 1/3 of the gallbladder, impaired contractile function of the gallbladder, the presence of active hepatitis, biliary cirrhosis and peptic ulcer in the stage exacerbations. Ursodeoxycholic or chenodeoxycholic acid is prescribed at a dose of 15 mg/kg of the patient’s body weight in two doses (morning and night). It is possible to combine these drugs in half the dose each (8 mg/kg body weight). Therapy is carried out for a long time - for 1 year or longer. Ultrasound is performed every 3 months. If there is no effect after 6 months, treatment is stopped, about which the patient must be warned in advance. Side effects of therapy in the form of diarrhea and a transient increase in aminotransferases are possible, and therefore it is necessary to monitor the biochemical profile of the blood every 3 months.

With successful therapy, drugs are subsequently prescribed that enhance choleresis and normalize the motor-evacuation function of the gallbladder and biliary tract. In order to prevent relapses of cholelithiasis after 1.5–2 years, repeated courses of bile acid preparations in half doses are recommended for 2–3 months.

Other non-surgical treatment options include extracorporeal shock wave lithotripsy and contact endoscopic lithotripsy.

Thus, by eliminating the factors that cause the development of chronic cholecystitis, and adopting the principle of therapeutic rational nutrition, pharmacological agents, herbal medicine, spa treatment, it is possible to influence the complex pathogenetic mechanisms of the development of chronic acalculous cholecystitis and prevent the development of cholelithiasis. Sanitation of chronic foci of infection and treatment of underlying diseases are mandatory components of therapy and help prevent the development of chronic cholecystitis or its exacerbation. However, taking into account the variety of factors and complex mechanisms of development of biliary tract pathology, treatment, which requires patience from both the doctor and the patient, should be long-term, prolonged (drug therapy, herbal medicine, mineral waters) and carried out consistently.

Literature

1. Belousov A. S., Vodolagin V. D., Zhakov V. P. Diagnosis, differential diagnosis and treatment of diseases of the digestive system. M.: Medicine, 2002. 424 p.
2. Ilchenko A. A. Gallstone disease. M.: Anacharsis, 2004. 200 p.
3. Kalinin A.V. Functional disorders of the biliary tract and their treatment//Clinical perspectives of gastroenterology, hepatology. 2002. No. 3. P. 25–34.
4. Leuschner U. Practical guide to diseases of the biliary tract. M.: GEOTAR-MED, 2001. 264 p.
5. Loranskaya I. D., Mosharova E. V. Biliary dysfunctions: diagnosis, treatment: tutorial. M., 2004. 20 p.
6. Shulpekova Yu. O., Drapkina O. M., Ivashkin V. T. Abdominal pain syndrome // Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2002. T. 12. No. 4. P. 8–15.
7. Yakovenko E. P., Agafonova N. A., Kalnov S. B. Odeston in the treatment of diseases of the biliary tract // Practitioner. 2001. No. 19. pp. 33–35.
8. Drossman D. A. The functional gastrointestinal disorders. Second edition. 2000. 764 pp.

I. D. Loranskaya, Doctor of Medical Sciences, Professor

L. G. Rakitskaya, Candidate of Medical Sciences, Associate Professor

E. V. Malakhova, Candidate of Medical Sciences

L. D. Mamedova, Candidate of Medical Sciences, Associate Professor

What is Hofitol prescribed for, indications for use

This drug is prescribed for diseases of the liver and gall bladder, namely: for jaundice, for pancreatitis, for choletasis, for cholecystitis, for bending of the gall bladder, for hepatitis, for gastritis, for gastroduodeitis, for giardiasis (from giardia), for removed gall bladder, from edema during early pregnancy with toxicosis, for infants, for constipation, for heartburn, for polyhydramnios (as a diuretic).

The good thing about the drug is that it contains natural extracts and is widely used for use by pregnant women. It can also be taken for prophylaxis, for many years, when the disease is chronic.

Compound

• Release form: tablets, ampoules and solution and syrup (suspension).
• The tablet contains 0.2 g artichoke extract. There are 60 tablets in a package.
• Ampoule – 0.1g.
• Solution – 1g.
• At home, tablets and solution are used. Ampoules are designed for injection.
• Manufacturer France. Shelf life - 3 years.

Hofitol analogues are cheap

There are quite a large number of cheaper analogues of hofitol. These are Flamin, Ursosan, Odeston, Ursofalk, Holosas, Galstena, Legalon, Cholenzym. These medications are similar in their effects, but have different compositions. The doctor should decide which substitute to purchase.

The cheapest, similar to the drug hofitol, are allochol and holosas. It is very good to take in combination with drugs such as Karsil, Hepabene, Essentiale, Liv, since the liver is closely connected with the bile ducts and it has bile ducts.

The cost of hofitol is from 300 rubles, and allohol from 22 rubles. There is no cheaper analogue for Allochol. Although the active ingredient is the same. Prices in Novorossiysk and Novosibirsk do not differ from the market average. Before replacing, consult your doctor.

Allohol or hofitol, which is better?

When changing the drug, you should definitely consult your doctor. Allochol has the same active ingredient – ​​artichoke. But in addition to cleaning the bile ducts, it will also improve the functioning of the gastrointestinal tract, eliminate constipation and relieve nausea. This is a very good, natural, choleretic method.

These medications also have different additional substances. Allochol also contains garlic and nettle extract, as well as animal bile. And it costs less.

Instructions for use of hofitol tablets

• Children over 12 years of age and adults are prescribed 1-2 tons 3 times a day.
• In more early age(but not less than 6 years) 1 tablet 3 times a day.
• The course of treatment is 2-3 weeks. As prescribed by doctors, it can be used longer. Take the drug before meals.
• How many minutes does it take to start working? - In 30.

During pregnancy

Can be used in early pregnancy to prevent gestosis if nausea is present. But only after consulting a doctor. The medicine is widely used in gynecological practice. Studies on use during breastfeeding (lactation) have not been conducted. When taking any drug, there may be 1% in breast milk. Therefore, it is unknown how it will affect children.

Why is it prescribed for newborns?

Newborns often suffer from jaundice. This is not a disease. After 1-2 weeks (up to a month) everything goes away. Hofitol reduces bilirubin in the blood. The doctor determines how to use it for a newborn. But, as a rule, it is 5-10 drops, diluted in 5 ml of boiled water. It must be diluted, as the drops contain alcohol.

How to give syrup to children, dosage

As you know, hofitol can be given to children and infants. The dose for infants is calculated depending on the weight of the child.

Children from one to five years old take a drop diluted in 15 ml of water. From 6 to 12 years, drops diluted with water.

There is also hofitol syrup. Some people call it children's hofitol because it is sweetish. It can be given to children from 6 years old, 1 tsp. before meals. It cannot be given at an earlier age, as the syrup contains additional substances.