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BURSITIS

 Bursitis is an illness charicterized by inflammation of small articular sacks (Bursae). It is accompanied by secretion and accumulation in their cavities of  (liquid) exudate.

Symptoms and diagnostics of bursitis

    pain in joints (is more often knee or elbow);

    hypostasis and reddening round a joint;

    restriction of movements;

    temperature increase in a joint.

Diagnostics methods:

    surgeon examination;

    radiography of a sick joint;

    joint ultrasonography;

    puncture of  of an articular sack followed by bacteriological research of the received liquid.

Diseases with similar symptoms: arthritis, deforming osteoarthrosis.

Course of the disease

There are two types of bursitis: acute and chronic.

Acute bursitis develops suddenly – in 2-3 days. As a rule, the patient wakes up and finds reddening, hypostasis and pain in a joint. It usually happens after intensive strain of a joint or after an acute infectious disease. Within several days symptoms accumulate, then gradually decrease. In the absence of treatment bursitis can pass to a chronic stage.

Chronic bursitis develops gradually, for several months. It can be a consequence of acute bursitis or other inflammatory diseases of bones and joints (arthritis, gout).

Round a joint appears a limited soft swelling , skin over the joint and function of the extremity isn't changed. Chronic process can become acute which leads increase in the amount of liquid in thecavities of an articular sack.

Complicationsof Bursitis:
Chronic bursitis can lead to cicatrical adhesions in a joint and to decrease in joint mobility.

Unfavorable issue of sharp bursitis can take place if it is complicated by arthritis, osteomyelitis, fistulas, sepsis.

Causes and prevention


Bursitis can be caused by infection getting into an articular sack, mechanical
overstrain of a joint  capsule as the result of its deformation or overload.

Bursitis can develop at:

     injuries of a joint;
    overstraining of joints;
    calcium adjournment in sinews;
    infections;
    various arthritises (inflammations of joints);
    gout;
    sharp increase in physical activity.


Bursitis prevention:
     treat infectious diseases in due time;
    dose out loading in sports activities;
    correction of joints deformations, especially joints of feet.


Treatment
Bursitis treatment must be carried out by a traumatologist-orthopedist and a surgeon . It is necessary to consult the doctor at the first symptoms of the disease. Treatment of acute bursitis is carried out in policlinic. Hospitalization can be necessary at development of chronic bursitis . During sharp pains it is necessary to follow these four rules:


    the injured joint should be immobilized (for this purpose it is possible to use
    bandages and other clamps);
    cold -  the sore point needs to be massaged from time to time with a package with
    ice (through fabric);
    compression by means of elastic bandage reduces pain;
    is desirable to hold the injured joint raised with the help of pillows.


Treatment purpose: fight against infection, prevention of complications, decrease in frequency of
aggravations. Are prescribed: antibiotics, anti-inflammatory and anesthetizing medications. Dosages and the mode of drug intake should be defined by the attending physician depending on the general condition of the patient and the features of the course of the disease. Also physiotherapy, shock and wave therapy can be applied.

If chronic bursitis is not giving in to conservative treatment, operation on the inflamed articular sack, removal of adhesions and washing with antiseptic solutions is carried out.




       BILIARY DYSKINESIA



This disease is the result of  motility disorders of gall bladder and bilious channel which leads to change in bile production and its stagnation. Bile and its components begin to circulate incorrectly in  liver and  intestines. It leads to decrease in activity of digestive enzymes that in turn interferes with the normal absorption of many vital substances, first of all fat-soluble vitamins.

Diskinesia can be of two typess: hyperkinetic and hypokinetic.
 In the first case the gall bladder tone rises, sphincters are contracted, and bile can't get to duodenal gut. In the  case of hypokinetic dyskinesia gall bladder and bilious ways, on the contrary, are relaxed and bile outflow is slowed down.

Diet

People suffering from this disease need a diet. Besides, it is one of the main components of treatment.  It is necessary to keep to a diet not less than half  half a year so that there was noticeable improvement .


Meals should be taken 4-5 times a day by small portions.

Excluded: all broths (meat, chicken, mushroom, fish); fried, fat and hot dishes; refractory fats (pork, mutton, duck, goose); smoked and salty products; nuts, mushrooms, peas, bean, black bread (because of a rough cellulose containing in them); pungent vegetables - turnip, radish, onions, garlic, a garden radish; from cereals - millet (it has dense cellular covers which badly digested); fresh pastry, coffee, cocoa, chocolate (digestion of these products forces to strain fermental systems too much); aerated drinks, ice-cream, chewing gum.

Treatment.

Diet normalization, correct alternation of work and rest, normalization of functions of the central nervous system have great value. The last often needs prescription of sedative medications, tranquilizers and sleeping pills. Treatment should be regular and, as a rule, it takes a long time.

At hyperkinetic type of biliary dyskinesia the great value has keeping to a diet with exclusion of fried and stewed dishes, spices, marinades, pickles, pork, beef and mutton fats, smoked products, meat and fish broths, and also alcoholic drinks. Take meals 4-5 times a day in small portions. To relieve pains spasmolytics (no-spa, atropine, papaverine, etc.) and sedative therapy (infusions of  valerian, motherwort, etc.) are used. Heat (hot-water bottles, paraffin) and UHF are applied to gall bladder area  for the purpose of relaxation of its muscles. Sanatorium treatment at mud resorts is recommended.  Infusions of following herbs can be taken half an hour before meals: St. John's-wort, dog-rose, mint, immortelle.

At hypokinetic type of a dyskinesia the diet is similar to mentioned above, but it is a little expanded: meat and fish broths are permitted. The use of vegetable oil is recommended. Cholecystokinetics are used to stimulate the retractive function of gall bladder (25 % solution of magnesium sulfate, 10% solutions of xylite or sorbite 50-100 ml., 2-3 times/day, half an hour before meals). Herbs infusions: dandelion, sweet flag, barberry, yarrow.