Biliary dyskinesia.pptx

DCDD

1. Biliary Dyskinesia  

2. Learning Objectives Identify Biliary Dyskinesia Sign Symptoms. Explore Causes and Key Nutrients' Role. Discuss Treatment Options and Dietary Guidelines. Promote Multidisciplinary Care Awareness.

3. Introduction A Disorder of the Gallbladder Biliary Dyskinesia, a motility disorder affecting the gallbladder's ability to contract and relax properly, leading to digestive issues. Biliary Dyskinesia (BD) is a disorder affecting the gallbladder. It is characterized by inflammation, abnormal contraction, and emptying of the gallbladder.

4. Brief Introduction Biliary Dyskinesia is a functional disorder primarily affecting the gallbladder. It may also involve the small muscle (sphincter) where bile empties into the small intestine. Unlike mechanical blockages, it is a problem with the organ's or muscle's functioning. The gallbladder's main role is to store bile from the liver and release it into the small intestine during digestion . If the sphincter is scarred or has spasms, bile cannot flow out of the gallbladder. The bile then flows back into the gallbladder and causes pain.

5. The Anatomy and physiology of the Biliary System Biliary System Anatomy Structure Role of the gallbladder in digestion and bile absorption, Bile Flow Through the Biliary System Anatomical Variations

6. Clinical Signs and symptoms Biliary Dyskinesia (BD) is a disorder that involves abnormal gallbladder functioning, leading to various signs and symptoms. Abdominal Pain : Recurrent, intermittent pain in the upper right quadrant of the abdomen, often radiating to the back or right shoulder blade. Nausea and Vomiting : Episodes of nausea and vomiting, particularly after consuming fatty or greasy foods. Bloating and Indigestion : Complaints of bloating and indigestion after meals. Lower Abdominal Cramping : Cramping and discomfort in the lower abdomen. Dyspepsia : Experience of indigestion and discomfort in the upper abdomen. Fatty Food Intolerance : Worsening of symptoms after eating fatty or greasy foods .

7. Risk Factors The possible risk factors of biliary dyskinesia include: Advanced age Obesity Female gender Stress Gallbladder inflammation Gastrointestinal disease Hypothyroidism

8. Causes and pathophysiology of Biliary Dyskinesia The exact cause of biliary dyskinesia is unknown.   There are several risk factors that, when combined, put a person at a greater risk of developing the disorder. This includes : Previous history of gallstones Inflammation of the gallbladder A compromised immune system Being overweight or obese using specific medications such as antibiotics. persons who have a history of abdominal surgery 

9. Gallbladder Motility disorders Motility Disorders:- Hypomotility : Decreased contractility leading to sluggish gallbladder contractions.- Hypermotility: Increased contractility causing rapid and irregular contractions. Impaired Gallbladder Function and Bile Flow :- Hypomotility : Reduced bile release into the digestive tract. Hypermotility: Inadequate bile storage and controlled bile release.- Both conditions disrupt bile flow, impacting fat digestion and nutrient absorption

10. Impaired Gallbladder Function Impact on Bile Flow and Digestion. Bile's Role in Digestion:- Emulsifies fats, increasing their surface area for enzyme action.- Aids fat digestion and absorption of fat-soluble vitamins (A, D, E, K). Impact of Impaired Function:- Hypomotility : Fat malabsorption , potential nutrient deficiencies.- Hypermotility: Digestive disturbances, inadequate fat breakdown.

11. Diagnosis of Biliary Dyskinesia (BD) The following diagnostic tests or procedures may be ordered : Liver Function Test : Determines the health of your liver, gallbladder and bile ducts.  Cholecystokinin Hepatobiliary (CCK-HIDA) Scan : A small amount of radioactive dye and enzyme cholecystokinin is injected followed by a fatty meal. A nuclear medicine camera helps your doctor see how well bile is secreted from your gallbladder.  Imaging Tests : Images of your gallbladder are obtained by performing CT scan, MRI, Ultrasound, etc. Endoscopic Retrograde Cholangiography (ERCP) : is a procedure to examine bile ducts. An endoscope is inserted through the mouth into the opening between the stomach and small intestine. X-rays are taken with the help of contrast liquid. Inform the provider of any prior allergic reactions to contrast.

12. Treatment Pain Management: Prescription pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) are used to manage pain associated with Biliary Dyskinesia. Lifestyle Changes: Dietary modifications: A low-fat diet may help alleviate symptoms. Weight management and regular physical activity can be beneficial. Medications: Antispasmodics: These medications help relax the gallbladder muscles and reduce pain. Bile acid sequestrants : They may aid in binding excess bile and reducing symptoms.

13. Treatment conti .. Surgical Option - Laparoscopic Cholecystectomy: Laparoscopic cholecystectomy is a common surgical procedure for Biliary Dyskinesia. The surgery is performed under general anesthesia. Small incisions are made in the upper abdomen. A laparoscope with a camera is inserted to view the inside of the abdomen. The gallbladder is isolated, separated from the liver, and carefully removed. The incisions are closed, and the patient may experience a faster recovery compared to traditional surgery .

14. Nutritional treatment and dietary guidelines for Biliary Dyskinesia (BD) focuses on managing symptoms, supporting gallbladder function, and promoting overall digestive health. Dietary modifications can help reduce pain, improve bile flow, and enhance digestion. Here are some key aspects of nutritional management for BD:

15. Low-Fat Diet: A low-fat diet is often recommended to ease the workload on the gallbladder and reduce symptoms. Limiting the intake of fatty and greasy foods can help prevent excessive bile secretion and ease gallbladder contraction . Lean protein foods — Including lean sources of organic protein in a gallbladder diet can relieve stress. Consider chicken, turkey, grass-fed beef, bison, wild-caught fish and organic protein powder, including protein from bone broth powder. High-Fiber Foods: Including foods high in soluble fiber, such as oats, legumes, fruits, and vegetables, can aid in proper digestion and promote regular bowel movements. Fiber also binds to bile acids, helping in their elimination. Avoiding Trigger Foods : Some individuals may have specific trigger foods that worsen their symptoms. These may include spicy foods, fried foods, and processed foods. Identifying and avoiding these triggers can be beneficial. Adequate Hydration: Staying well-hydrated is essential for overall health and can help maintain proper bile consistency. Cholesterol Management: High cholesterol levels can contribute to gallbladder issues. Maintaining healthy cholesterol levels through diet and lifestyle changes is crucial. Smaller, Frequent Meals: Eating smaller, more frequent meals instead of large meals can help reduce stress on the gallbladder and promote better digestion.

16. Vitamin and Mineral Supplementation : If a deficiency in certain vitamins or minerals is identified, supplementation may be recommended. Weight Management : Maintaining a healthy weight is important for overall health and can help prevent gallbladder issues. Probiotics : Probiotics, found in fermented foods and supplements, can support gut health and aid digestion. Unrefined healthy fats (including olive or coconut oil)  . Moderate intake of unrefined healthy fats (coconut and olive oil) with medium-chain fatty acids aids digestion. Consume in small amounts (1 tbsp oil or 2 tbsp sprouted nuts/seeds) to avoid burdening the liver and gallbladder while benefiting from their anti-inflammatory properties.

17.   Use Gallbladder Herbs, Acids and Enzymes