EFFECTIVENESS OF TONIC THERAPEUTIC EXERCISES IN BILIARY TRACT MOTILITY DISORDERS OF HYPOTONIC-HIPOKINETIC TYPE
DOI:
https://doi.org/10.32782/health-2023.3.19Keywords:
therapeutic gymnastics, biliary dyskinesia, chronic cholecystitisAbstract
The aim of the study was to analyze the effect of tonic therapeutic gymnastics on the course of dyskinesia of the hypotonic-hypokinetic type of the gallbladder and other biliary tract. Materials and methods: The study was conducted on the basis of the outpatient department of the Rivne City Hospital of the Rivne City Council. It involved 28 patients with a clinically confirmed diagnosis of non-calcific chronic cholecystitis in remission, biliary dyskinesia of the hypotonic type. Half of the tested patients (control group n=14) were treated with standard treatment, and the other half (main group n=14), in addition, were engaged in our proposed course of therapeutic exercises aimed at increasing the tone of the gallbladder and accelerating the passage of bile through the biliary tract. During the experiment, three parameters were tested: the effect of the therapeutic tonic exercises proposed by us on the clinical course of the disease; the degree of emptying the gallbladder after the use of choleretic agents; the volume of a single release of gallbladder bile. Two test measurements were made – at the beginning of the experiment and after 6 months of treatment. Results. The final summarizing results indicate a significant positive effect of targeted therapeutic tonic exercises on the course of the underlying disease, namely: the frequency of pain attacks after eating and at night decreased by 34 and 24 ± 2% in patients of the main group, respectively, compared to the control group; dyspeptic phenomena – nausea/ vomiting and flatulence/stool disorders by 18 and 28 ± 2%, respectively. In addition, the contractile capacity of the gallbladder increased by 5 ± 0.2%, and the volume of bile secretion decreased by 13 ± 2%. Conclusions. The use of tonic therapeutic gymnastics in dyskinesia of hypotonic-hypokinetic type significantly improves the contractile function of the gallbladder and ducts, which is manifested by improvement of clinical symptoms and reduction of bile stasis in the hepatobiliary system.
References
Di Ciaula A, Wang DQ, Portincasa P. An update on the pathogenesis of cholesterol gallstone disease. Curr Opin Gastroenterol 2018;34:71–80. doi: 10.1097/MOG.0000000000000423 [in English].
Shabanzadeh DM. New determinants for gallstone disease? Dan Med J 2018;65:B5436 [in English].
Di Ciaula A, Portincasa P. Recent advances in understanding and managing cholesterol gallstones. F1000Res 2018;7:F1000 Faculty Rev-1529. doi: 10.12688/f1000research.15505 [in English].
Kim Y, Lee E. The association between elderly people’s sedentary behaviors and their health-related quality of life: focusing on comparing the young-old and the old-old. Health Qual Life Outcomes 2019;17:131. doi: 10.1186/s12955-019-1191-0 [in English].
Di Ciaula A, Garruti G, Wang DQ, Portincasa P. Cholecystectomy and risk of metabolic syndrome. Eur J Intern Med 2018;53:3–11. doi: 10.1016/j.ejim.2018.04.019 [in English].
Di Ciaula A, Wang DQ, Portincasa P. An update on the pathogenesis of cholesterol gallstone disease. Curr Opin Gastroenterol 2018;34:71–80. doi: 10.1097/MOG.0000000000000423 [in English].
Gudsoorkar VS, Oglat A, Jain A, Raza A, Quigley EMM. Systematic review with meta-analysis: cholecystectomy for biliary dyskinesia-what can the gallbladder ejection fraction tell us? Aliment Pharmacol Ther. 2019; 49: 654–663 [in English].
Portincasa P, van Erpecum KJ, Di Ciaula A, Wang DQ. The physical presence of gallstone modulates ex vivo cholesterol crystallization pathways of human bile. Gastroenterol Rep (Oxf) 2019;7:32–41. doi: 10.1093/gastro/goy044 [in English].
Di Ciaula A, Wang DQ, Portincasa P. Cholesterol cholelithiasis: part of a systemic metabolic disease, prone to primary prevention. Expert Rev Gastroenterol Hepatol 2019;13:157–171. doi: 10.1080/17474124.2019.1549988 [in English].
Cairo SB, Aranda A, Bartz-Kurycki M, Baxter KJ, Bonasso P, Dassinger M, et al. Variability in perioperative evaluation and resource utilization in pediatric patients with suspected biliary dyskinesia: a multi-institutional retrospective cohort study. J Pediatr Surg. (2019) 54:1118–22. doi: 10.1016/j.jpedsurg.2019.02.049 [in English].
Krishna YT, Griffin KL, Gates RL. Pediatric biliary dyskinesia: evaluating predictive factors for successful treatment of biliary dyskinesia with laparoscopic cholecystectomy. Am Surg. (2018) 84:1401–1405 [in English].
Gudsoorkar VS, Oglat A, Jain A, Raza A, Quigley EMM. Systematic review with meta-analysis: cholecystectomy for biliary dyskinesia- what can the gallbladder ejection fraction tell us? Aliment Pharmacol Ther. (2019) 49:654–663. doi: 10.1111/apt.15128 [in English].
Deacy AD, Friesen CA, Staggs VS, Schurman JV. Evaluation of clinical outcomes in an interdisciplinary abdominal pain clinic: a retrospective, exploratory review. World J Gastroenterol. (2019) 25:3079–90. doi: 10.3748/wjg.v25.i24.3079 [in English].
B Biomed GB, Carroll G, Mathe A, Horvat J, Foster P, Walker MM, et al. Evidence for local and systemic immune activation in functional dyspepsia and the irritable bowel syndrome: a systematic review. Am J Gastroenterol. (2019) 114:429–36. doi: 10.1038/s41395-018-0377-0 [in English].
Du L, Chen B, Kim JJ, Chen X, Dai N. Micro-inflammation in functional dyspepsia: a systematic review and metaanalysis. Neurogastroenterol Motil. (2018) 30:e13304. doi: 10.1111/nmo.13304 [in English].
