Biliary dyskinesia medical therapy: Difference between revisions
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== Medical Therapy == | == Medical Therapy == | ||
* Medical therapy mostly includes of [[symptomatic treatment]] of [[abdominal pain]]: | * Medical therapy mostly includes of [[symptomatic treatment]] of [[abdominal pain]]:<ref name="pmid29132521">{{cite journal| author=Wilkins T, Agabin E, Varghese J, Talukder A| title=Gallbladder Dysfunction: Cholecystitis, Choledocholithiasis, Cholangitis, and Biliary Dyskinesia. | journal=Prim Care | year= 2017 | volume= 44 | issue= 4 | pages= 575-597 | pmid=29132521 | doi=10.1016/j.pop.2017.07.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29132521 }} </ref><ref name="pmid16678563">{{cite journal| author=Behar J, Corazziari E, Guelrud M, Hogan W, Sherman S, Toouli J| title=Functional gallbladder and sphincter of oddi disorders. | journal=Gastroenterology | year= 2006 | volume= 130 | issue= 5 | pages= 1498-509 | pmid=16678563 | doi=10.1053/j.gastro.2005.11.063 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16678563 }} </ref> | ||
**[[Opiate|Opiates]] ([[Intravenous therapy|intravenous]]) are the drug of choice, although some studies have suggested that [[Opiate|opiates]] cause [[sphincter of Oddi]] contraction. | **[[Opiate|Opiates]] ([[Intravenous therapy|intravenous]]) are the drug of choice, although some studies have suggested that [[Opiate|opiates]] cause [[sphincter of Oddi]] contraction. | ||
**[[Muscle relaxant|Muscle relaxants]] have been reported to be ineffective. | **[[Muscle relaxant|Muscle relaxants]] have been reported to be ineffective. | ||
**[[Calcium channel blocker|Calcium channel blockers (CCB)]] have been reported to be ineffective. | **[[Calcium channel blocker|Calcium channel blockers (CCB)]] have been reported to be ineffective. | ||
*** However, [[Calcium channel blocker|CCBs]] like [[nifedipine]] have been reported to have potential effect in improving the pain but [[headache]] and [[tachycardia]] are the [[Adverse effect (medicine)|adverse effects]]. | *** However, [[Calcium channel blocker|CCBs]] like [[nifedipine]] have been reported to have potential effect in improving the pain but [[headache]] and [[tachycardia]] are the [[Adverse effect (medicine)|adverse effects]].<ref name="pmid8470634">{{cite journal| author=Sand J, Nordback I, Koskinen M, Matikainen M, Lindholm TS| title=Nifedipine for suspected type II sphincter of Oddi dyskinesia. | journal=Am J Gastroenterol | year= 1993 | volume= 88 | issue= 4 | pages= 530-5 | pmid=8470634 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8470634 }} </ref> | ||
* Alternative treatments that may be effective by a [[cholagogue]] effect (increases [[bile]] discharge from the [[Bile duct|biliary system]]), or a choleretic effect (increases [[bile]] [[secretion]] from the [[liver]]) include: | * Alternative treatments that may be effective by a [[cholagogue]] effect (increases [[bile]] discharge from the [[Bile duct|biliary system]]), or a choleretic effect (increases [[bile]] [[secretion]] from the [[liver]]) include:<ref name="pmid12095476">{{cite journal| author=Toouli J| title=Biliary Dyskinesia. | journal=Curr Treat Options Gastroenterol | year= 2002 | volume= 5 | issue= 4 | pages= 285-291 | pmid=12095476 | doi=10.1007/s11938-002-0051-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12095476 }} </ref> | ||
** Artichokes | ** Artichokes | ||
** [[Greater celandine|Celandine]] | ** [[Greater celandine|Celandine]] | ||
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** St. John’s Wort | ** St. John’s Wort | ||
* Other reported effective measures in biliary dyskinesia include: | * Other reported effective measures in biliary dyskinesia include:<ref name="pmid16804961">{{cite journal| author=Bistritz L, Bain VG| title=Sphincter of Oddi dysfunction: managing the patient with chronic biliary pain. | journal=World J Gastroenterol | year= 2006 | volume= 12 | issue= 24 | pages= 3793-802 | pmid=16804961 | doi=10.3748/wjg.v12.i24.3793 | pmc=4087924 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16804961 }} </ref> | ||
**[[Smoking cessation]] | **[[Smoking cessation]] | ||
** Avoidance of fatty food | ** Avoidance of fatty food | ||
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** Lying on the right side after meals | ** Lying on the right side after meals | ||
** [[Weight loss]] | ** [[Weight loss]] | ||
** Increase in physical activity | ** Increase in physical activity | ||
==References== | ==References== | ||
Latest revision as of 14:14, 13 August 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Overview
Medical therapy mostly includes of symptomatic treatment of abdominal pain and IV opiates are the drug of choice, although some studies have suggested that opiates cause sphincter of Oddi contraction.
Medical Therapy
- Medical therapy mostly includes of symptomatic treatment of abdominal pain:[1][2]
- Opiates (intravenous) are the drug of choice, although some studies have suggested that opiates cause sphincter of Oddi contraction.
- Muscle relaxants have been reported to be ineffective.
- Calcium channel blockers (CCB) have been reported to be ineffective.
- However, CCBs like nifedipine have been reported to have potential effect in improving the pain but headache and tachycardia are the adverse effects.[3]
- Alternative treatments that may be effective by a cholagogue effect (increases bile discharge from the biliary system), or a choleretic effect (increases bile secretion from the liver) include:[4]
- Other reported effective measures in biliary dyskinesia include:[5]
- Smoking cessation
- Avoidance of fatty food
- Frequent meal consumption
- Lying on the right side after meals
- Weight loss
- Increase in physical activity
References
- ↑ Wilkins T, Agabin E, Varghese J, Talukder A (2017). "Gallbladder Dysfunction: Cholecystitis, Choledocholithiasis, Cholangitis, and Biliary Dyskinesia". Prim Care. 44 (4): 575–597. doi:10.1016/j.pop.2017.07.002. PMID 29132521.
- ↑ Behar J, Corazziari E, Guelrud M, Hogan W, Sherman S, Toouli J (2006). "Functional gallbladder and sphincter of oddi disorders". Gastroenterology. 130 (5): 1498–509. doi:10.1053/j.gastro.2005.11.063. PMID 16678563.
- ↑ Sand J, Nordback I, Koskinen M, Matikainen M, Lindholm TS (1993). "Nifedipine for suspected type II sphincter of Oddi dyskinesia". Am J Gastroenterol. 88 (4): 530–5. PMID 8470634.
- ↑ Toouli J (2002). "Biliary Dyskinesia". Curr Treat Options Gastroenterol. 5 (4): 285–291. doi:10.1007/s11938-002-0051-9. PMID 12095476.
- ↑ Bistritz L, Bain VG (2006). "Sphincter of Oddi dysfunction: managing the patient with chronic biliary pain". World J Gastroenterol. 12 (24): 3793–802. doi:10.3748/wjg.v12.i24.3793. PMC 4087924. PMID 16804961.