Hypotonic biliary syndrome

　　Pathologically, there is gallbladder dilatation and disappearance of the gallbladder neck, which is mainly due to disorders of autonomic nervous function, decreased vagal nerve function, and reduced secretion of cholecystokinin. It can also be caused by mental factors, but it can also be secondary to the lesions of adjacent organs, such as papillitis, duodenitis, bulb ulcer, duodenal parasites such as Giardia lamblia, Strongyloides stercoralis infection, etc., leading to the occurrence of this disease. In addition, abnormal bile secretion pressure and abnormal resistance of the Oddi sphincter are important factors in determining biliary function.

　　This disease is prone to complications such as biliary dysfunction syndrome, anorexia, and dyspepsia. Hypotonic bile ducts lead to delayed gallbladder emptying, directly affecting the storage and excretion of bile. The gallbladder's dynamic regulation is influenced by exogenous nerves, endogenous nerves, gastrointestinal peptides, and gastrointestinal function. They interact with each other, and the mechanism and their effects on functional dyspepsia and anorexia require further study. 5-HT, this important neurotransmitter of the enteric nervous system, exerts both excitatory and inhibitory effects in different receptor subtypes at different sites in the gastrointestinal tract. Similarly, 5-HT receptors are also distributed on the neurons of the gallbladder visceral nervous system. It can be seen that biliary motor disorders can also affect gastrointestinal motility, leading to complications of functional dyspepsia and anorexia.

　　Oral gallbladder imaging or B-ultrasound can show an enlarged gallbladder, poor gallbladder contraction function after a fatty meal, and only when excluding organic biliary diseases (such as gallstones, biliary roundworm disease, biliary infection, etc.) can this syndrome be considered.

　　More common in women, discomfort or pain in the upper right abdomen, nausea, vomiting, indigestion, and aversion to greasy foods, occasionally jaundice and tenderness in the upper right abdomen.

　　Adjust life routine to ensure regular meal times, have a peaceful and pleasant mood during meals, chew food slowly, take a short nap after lunch, get enough sleep, regular physical exercise, reduce or avoid emotional fluctuations. The fat content can be general, but if high-fat foods can alleviate symptoms, they can also be eaten.

　　
At the time of diagnosis, in addition to relying on clinical manifestations, auxiliary examinations are also needed. This disease can be found by oral gallbladder imaging or B-ultrasound, which shows an enlarged gallbladder. This disease seriously affects the daily life of patients, so it should be actively prevented.

　　1. Foods that are good for the body in low biliary tone syndrome

　　Easily digestible foods, and some anti-inflammatory and choleretic foods, such as mushrooms.

　　2. Foods to avoid in low biliary tone syndrome

　　Avoid eating spicy foods or strong seasonings.

　　1. Drug Treatment

　　Mild patients can be treated with sedatives and anticholinergic drugs, such as diazepam (Valium), atropine, anisodamine (654-2), etc., which may be effective; amyl nitrite and nitroglycerin also have a relaxing effect on smooth muscles, thus they can relieve sphincter spasm and play a role, but they can have systemic adverse reactions, and after long-term use, they can develop drug resistance and fail to play a role; glucagon, cholecystokinin, and bombesin may all be effective, but due to their high cost, inconvenience of use, and possible allergic reactions, their widespread use is limited.

　　2. Surgical Treatment

　　Most patients experience varying degrees of relief of clinical symptoms after general treatment and drug therapy. If the symptoms of the patient cannot be relieved after conservative treatment, endoscopic sphincterotomy or surgical treatment should be considered.