Strong choleretic medicine. Choleretic drugs for stagnation of bile

Important! Before taking choleretic drugs, you need to make sure that there are no stones in the gallbladder. This can be done with the help of ultrasound, ultrasound.

Medications for stagnation of bile

To eliminate the stagnation of bile, drugs with different composition and mechanism of action are used. In order to choose the right one, you should consult with your doctor.

There are certain rules for taking almost all choleretic drugs:

• Regardless of the form in which the drugs are released, they are taken before eating no earlier than an hour, washed down with non-carbonated water;
• The daily dose is divided into 2 - 4 doses. It depends on how many times a day the patient eats;
• Eating food after taking such funds is a prerequisite. If the patient remains hungry, he may experience nausea or indigestion;
• Preparations of this group are taken in long courses according to the instructions from 21 to 60 days.
• Then you need a break for 30 - 60 days and, if necessary, you can continue treatment. 2 - 4 courses of admission are allowed per year.

Choleretics

Choleretics are drugs that help the liver increase bile production. They can do this in different ways, depending on the composition:

• True choleretics. They contain bile acids made from extracts of animal or plant origin. As a basis for these drugs, natural bile, intestinal mucosal tissue of animals, their liver or pancreas can be used. In addition to this, extracts of medicinal herbs are used. These drugs include: Allohol, Cholenzim, Liobil, Hologon;

• Synthetic choleretics. They contain compounds obtained by organic synthesis. In addition to the fact that such drugs are choleretic, they have antispasmodic, antibacterial and anti-inflammatory effects. Medicines of this group have a positive effect on digestion, eliminate and suppress fermentation in the intestines. These drugs include: Nicodin, Osalmid, Tsikvalon.
• Medicinal plants that have a choleretic effect. They reduce the viscosity of bile, increase its production and have a positive effect on liver function. These remedies include: Hofitol (artichoke extract), Flamin (immortelle extract), Insadol (corn stigma extract), Febihol (turmeric extract), Berberis-Gommakord (barberry extract), Holosas (rosehip extract). Complex preparations include: Urolesan, Holagol, Travohol.

cholekinetics

Cholekinetics, acting on the gallbladder, increase its tone, at the same time, relaxing the bile ducts. This contributes to the fact that bile is excreted faster. The group of cholekinetics includes drugs such as: Magnesia, Sorbitol, Manit, Xylitol, Flamin, Holosas.

Hydrocholeretics

The action of hydrocholeretics is based on their ability to increase the amount of bile due to the fact that its viscosity decreases. In this case, the amount of water in its composition increases, and it is more quickly excreted into the duodenum.

Such means include mineral waters with alkali: Essentuki, Polyana Kvasova, Borjomi. Also hydrocholeretics are salicylates and drugs based on valerian.

Depending on the pharmacological action, cholespasmolytics include drugs from various groups. But the purpose of their reception is the same - to eliminate spasms of the gallbladder and expand the bile ducts. This helps bile to quickly evacuate into the duodenum. Preparations of this series are taken to relieve pain.

Cholinospasmolytics are divided as follows:

• Synthetic cholenospasmolytics:, Papaverine, Euffilin, Mebeverine;
• Cholinolytics: Platifillin, Bellalgin, Besalol;
• Cholenospasmolytics of plant origin: tinctures of arnica, valerian, elecampane, St. John's wort, lemon balm.

How to get rid of the disease with the help of Allochol

The most popular choleretic agent for stagnation of bile is Allochol. It consists of dry bile, garlic powder, crushed nettle and activated charcoal. A successful combination of components allows for a quick cleansing of the gallbladder. In addition, the medicine helps to improve the functioning of the entire digestive system.

In addition to the fact that Allochol is an effective choleretic agent for stagnation of bile, it also has an affordable price.

Allochol must be taken 1 or 2 tablets at least 3 times a day for a month. In order to get rid of stagnation of bile, it can be used according to the following scheme:
1. 1st day 1 tablet three times;
2. From the 2nd to the 5th - 2 tablets three times;
3. 6th - 3 tablets three times;
4. 7th - 3 tablets three times;
5. From the 8th to the 10th - 2 tablets three times;
6. 11th - 1 tablet three times.

Such cleaning is best done under the supervision of a doctor. If you feel worse, you must stop taking Allohol.

Traditional medicine methods

In addition to drugs that help get rid of the problem, there are folk methods that allow you to quickly and effectively solve the issue of bile stasis. In most cases, the basis of home-made products are medicinal plants.

Choleretic plants include:

• Birch buds;
• Burdock roots;
• Calamus rhizomes;
• Corn silk;
• Artichoke leaves;
• Rowan fruits;
• Wormwood grass;
• Orthosiphon leaves.

On the video Vitaly Ostrovsky - ALL ABOUT THE GALL BLADDER! , Dyskinesia w. P.! THREE HERBS FOR GALE!

Choleretic juices

Effective choleretic agents for stagnation of bile are juices. For the treatment of the disease use:

• Dandelion juice. To prepare the product, a freshly harvested plant is used along with the roots. It is used as a bile secretion stimulant. It also helps to effectively remove bile. With stagnation of bile, take 20 ml of fresh juice 2 times a day. It will take 30 days to get rid of the disease;
• Rowan juice. In order to prepare juice, ripe fruits are used, collected after the first frost. It is an effective diuretic. It is used 20 ml 3 times a day. Treatment must be continued for 21 days;

• Turnip juice garden. The intake of juice from this root vegetable stimulates the contractile function of the bile ducts and is indicated for narrowing of the bile ducts. It is taken 25 ml up to 3 times a day. Treatment should be continued until the patient's condition improves. It is not recommended to use turnip juice for peptic ulcer;
• Radish juice. It enhances the formation of bile and quickly removes it from the gallbladder to the intestines, and improves the functioning of the stomach with low acidity. Take this medicine 25 ml up to 3 times a day. You should not get carried away with such treatment with, and with high acidity;
• Pear juice. Used to improve bile production. It must be consumed 100 ml in the morning and evening. The period of application is not limited.

How to prepare juices for treatment

In order to preserve all the beneficial substances, medicinal juices should be prepared immediately before use. Raw materials must be thoroughly washed, dried with a paper towel. Juice can be squeezed using a juicer, or, after grinding the raw materials in a meat grinder, squeeze through gauze.

In the event that it is not possible to prepare fresh juice or it is necessary to store it for a certain period, 70% medical alcohol can be used as a preservative, which is added in a ratio of 1:5. The finished product should be stored in a cool place.

Decoctions that increase bile production

In the event that bile is produced in insufficient quantities, the following folk methods are used:

• St. John's wort, celandine, knotweed, dandelion root and anise fruits are mixed, 2 parts of corn stigmas are added. Half a liter of water is poured into 5 g of the collection and boiled over low heat for 5 minutes. After the broth has cooled, it is filtered. For a day, you need to drink 300 ml of the drug, divided into 3 doses;
• A mixture is prepared from 2 parts of immortelle flowers and St. John's wort. A liter of water should be poured with 15 g of the collection and left for 10 hours. Then the product is put on fire and boiled for 7 minutes. Use it in 100 ml one hour after eating. It is necessary to drink 400 ml of broth per day. Continue treatment for 21 days. If there is a need to continue treatment, then the break should be at least a week. Ready broth to store in a cold place;

• Mix 1 part each of corn stigmas, nettle, milk thistle seeds and knotweed herb. 400 ml of cold water is poured into 5 g of dry raw materials and allowed to brew for at least 6 hours. Then the decoction is boiled for 5 minutes. Cool it in a sealed container and strain. Take 300 - 400 ml per day, divided into several doses. Treatment continues for fourteen days.

Infusions for spasms of the gallbladder

If bile stasis occurs due to spasms of the gallbladder, then in this case, decoctions and infusions prepared from the following medicinal preparations are used:

• Mix in the same proportion the grass of celandine, peppermint leaves and cinquefoil. Pour 250 ml of boiling water over 2 g of the collection and allow to cool slightly. The infusion should be used hot, twice a day for 2 weeks;
• Prepare a mixture of 2 tablespoons of valerian root, mint leaves and St. John's wort. Add 1 tablespoon herb wormwood and hop cones. Pour 3 g of the collection with three hundred milliliters of boiling water and leave for a quarter of an hour. Strain and take orally 100 ml three times a day;
• Mix hop cones, nettle leaves, immortelle and wormwood herb. 2 g of the collection is poured into 200 ml of boiling water and placed in a thermos. Let it brew for at least 2 hours. Filter and take 50 ml before each meal.
• In the same proportion, corn stigmas are mixed with sandy immortelle flowers. 3 g of dry raw materials are poured into 300 ml of boiling water and allowed to brew for 2 hours. The resulting infusion should be drunk during the day, divided into three doses.

Decoctions for impaired function of the gallbladder and ducts

With stagnation of bile as a result of dysfunction of the gallbladder or bile ducts, the following remedies are used:

• A mixture is prepared from coriander fruits, 2 parts of mint leaves, 3 parts of three-leaf watch leaves and 4 parts of sandy immortelle. For 200 ml of boiling water, add 2 g of the mixture and boil for 10 minutes. After cooling the broth, it should be filtered. Take 40 minutes before meals in the morning and evening. At a time you need to drink 100 ml.
• Mix gentian root, fennel fruit and three-leaf leaves 1 part each, add dandelion root, barberry leaves and mint 2 parts each. Boil 3 g of the collection in 300 ml of water for 7 minutes. Let it brew for 40 minutes. After this, strain the infusion and take 3 tablespoons three times a day before eating;

A choleretic agent for stagnation of bile is an infusion of sandy immortelle. To prepare this folk remedy, 10 g of flowers are poured into 200 ml of water and insisted under the lid for an hour. Take half an hour before meals according to the following scheme:
1. On the 1st day 1 time 70 ml;
2. In the 2nd - 2 times 70 ml;
3. On the 3rd - 3 times 70 ml;
4. On the 4th - 3 times 100 ml;
5. On the 5th - 2 times 100 ml;
6. On the 6th - 1 time 100 ml.

If necessary, after a week break, the course is repeated.

Tyubazh

Tubage is a washing of the gallbladder and bile ducts. Three days before the procedure, you must refuse fatty and fried foods. Preference should be given to vegetable food, steamed or boiled.

The procedure is carried out in the morning. To do this, take one of the following solutions:

• 500 ml of non-carbonated mineral water (Essentuki, Borjomi). Its temperature should be about 40 degrees;
• 250 ml hot water to which 1 tablespoon of sulfate powder is added;
• 200 ml of water, in which a tablespoon of Sorbitol dissolves;
• 2 tablespoons of Holosas and a glass of mineral water.

After that, they lie on their right side, applying a warm heating pad to the hypochondrium. It is necessary to lie down for 2 hours, during this period the gallbladder is cleared. The procedure is considered effective if, after this time, bowel movement occurs. In this case, small colic may occur.

Important! Such a procedure can be carried out only as prescribed by a doctor, no more than once every six months.

Oils

With stagnation of bile, vegetable oils of the first pressing are the most effective: olive, sunflower, linseed. They must be consumed daily, on an empty stomach in a tablespoon or dessert spoon, and after half an hour start breakfast. In this case, they will help not only get rid of stagnation of bile, but also improve digestion.

As a strong choleretic agent for stagnation of bile, you can use self-prepared flax oil, which contains a large amount of nutrients and vitamins. To prepare it, 100 g of flax seeds are crushed with a coffee grinder and placed in an 850 g jar, then it is filled to the top with refined olive or sunflower oil. The remedy must be infused for a week in a dark place.

You need to take this oil in a tablespoon, daily in the morning on an empty stomach. Continue treatment until the symptoms of the disease are relieved. If side effects appear in the form of, or abdominal pain, the amount of oil must be reduced.

An effective remedy that allows you to quickly get rid of the disease is natural ground coffee. Every day in the morning you need to drink a cup of this drink without sugar and eat a small piece (on the tip of a knife) of butter.

Milk thistle for treatment

Milk thistle is one of the most famous and effective choleretic agents that are used in both folk and traditional medicine. In order to successfully cope with the disease, you can use meal, which is easy to purchase at any pharmacy. It is a powder that remains after pressing the oil. It will take 400 g for the course of treatment. It is taken daily three times a day for half an hour before meals. A teaspoon of the powder is swallowed and washed down with water.

To make your own meal, milk thistle seeds are ground with a coffee grinder just before ingestion and ingested before each meal.

In order to prepare milk thistle oil, the seeds are crushed, placed in a glass container and poured with extra virgin olive oil. Let it brew for a week in a dark place and take a dessert spoon once a day before meals.

In order to prepare a choleretic decoction, a tablespoon of the seed is poured into 250 ml of water and boiled over low heat for 5 minutes. After that, let it brew for an hour, filter and consume 100 ml 2 times a day before meals.

Treatment of bile stasis in childhood

Gallbladder problems can occur not only in adults, but also in children. In order to get rid of cholestasis, various choleretic agents are used. The safest choleretic agents for cholestasis, bile stasis for children:

• Allochol;
• Nicodin;
• Flamin;
• Febihol;
• Holosas;
• Hofitol;
• Valerian;
• sulfate.

A safe remedy for the treatment of children with cholestasis.

The dosage of all these choleretic drugs for children should be calculated by the doctor, according to the instructions, based on the weight and age of the child. It is also necessary to introduce natural juices and alkaline mineral waters into the child's diet.

Important! Infusions and decoctions of choleretic herbs, as well as alternative methods for the treatment of children with cholestasis, whose age is less than 12 years, should be used with caution and only under the supervision of a physician, since they can cause unwanted side reactions.

Contraindications

Despite the benefits of taking choleretic drugs for cholestasis, it must be remembered that there are contraindications for their use:

1. The presence of large stones in the gallbladder or bile ducts. When taking choleretic drugs, they can budge, clog the bile ducts and cause hepatic colic. They can also cause an inflammatory process. In such cases, surgical intervention is indicated;
2. Peptic ulcer in the acute stage;
3. Individual intolerance to the components of the drug;
4. Spicy .

The most effective means

When people get cholestasis, they ask themselves: what is the best, most effective remedy for bile stasis? There is no single answer in this case. Allohol is suitable for some people, teas based on medicinal herbs are suitable for others. It depends on the individual characteristics of the body, and therefore it is necessary to contact specialists, gastroenterologists, for a personal consultation or appointment.

It is possible to verify the effectiveness of one or another choleretic agent for cholestasis only after the full course of treatment with the chosen drug or method has been completed.

Biliary dyskinesia, chronic pancreatitis and cholecystitis are very common diseases in our country, even among children. They are not always manifested by noticeable symptoms: most note only a lack of appetite and even nausea in the morning, heaviness in the right hypochondrium, and occasional itching of the skin. However, it turns out that all these are signs of bile stasis. And, until the thick bile began to turn into stones, it is necessary to take choleretic drugs.

We'll talk about what they are and how they work.

Why and where to drive bile

Many people mistakenly believe that bile is formed in the gallbladder and accumulates there for some reason. This is not so: bile is produced by liver cells, from the liver it enters the gallbladder and is concentrated there - excess water leaves it.

When a person eats food that contains fats, a signal about this reaches the gallbladder, and it, contracting, removes bile through the bile ducts into the duodenum. The hole through which bile exits is located next to the hole where the pancreas excretes its secret.

The tasks of bile:

• make an emulsion from the incoming fats, to which it will be easier for pancreatic enzymes to reach;
• create the right conditions for the work of pancreatic enzymes - and without them, neither proteins, nor fats, nor carbohydrates can be digested normally;
• stimulate bowel contractions;
• ensure the absorption of fat-soluble vitamins: A, D, E, group K;
• prevents microorganisms from attaching to the intestinal walls: then they will not be able to be absorbed into the blood along with food;
• removes with feces substances that have passed through the liver: some hormones, bilirubin, cholesterol.

That is, bile is a very useful substance, and it is imperative that it is properly formed and correctly delivered to the duodenum. This is what choleretic drugs are aimed at. But in fact, everything is not so simple.

Cholagogue called 3 different groups of drugs. They affect the biliary tract in different ways, and do not just “drive” bile along its path:

• some - choleretics - increase the production of bile;
• others - cholekinetics - accelerate the excretion of bile from the hepatic ducts to the duodenum 12;
• the third - cholespasmolytics - relax the spasmodic bile ducts;
• the fourth - cholelithogenic preparations of bile acids - are used to thin the bile so that stones do not form in it. These same agents have the ability to dissolve very small stones - due to a change in the chemical properties of bile.

Each of them has its own point of application and, accordingly, its own readings. Not knowing which drug to take in this situation, you can only harm yourself. For example, to relax the bile ducts that do not already have a tone. Or force an already diseased liver to “tighten up” and produce bile (when the liver is already working hard to at least neutralize dangerous toxins).

How choleretic drugs work, on what basis one or the other is chosen is not a secret at all. Therefore, we tell - what, how and why.

Choleretic drugs and indications for them

To understand what type of drug is needed and when, consider how bile moves:

1. Formed in the liver cells, it enters the intrahepatic bile ducts.
2. From these ducts, bile by gravity first enters the right or left hepatic duct (from the right lobe of the liver to the right, from the left, respectively, to the left). Then the bile from both of these ducts, also by gravity, is collected in the common hepatic duct. It is a tube in which there are few muscle cells.
3. From the common hepatic duct there is a branch - a "tubule" (duct), which leads to the gallbladder. There are almost no muscles in it, so bile needs to get there somehow. The force that propels it in this direction is the difference in pressure between that created by the liver (when it secreted bile) and the resistance that the sphincter of Oddi provides. The sphincter of Oddi is a circular muscle that lies where the hepatic duct (more precisely, its continuation - the common bile duct) passes into the duodenum 12. That is, the sphincter of Oddi is such a crane. When it is closed, bile flows into the tubule of the cystic duct, with its pressure spreads the folds that lie between the bladder and cystic duct, and accumulates in the gallbladder.
4. As the gallbladder fills, the pressure in it increases, and in the hepatic ducts, respectively, decreases. And when the “faucet” of the sphincter of Oddi opens (this happens in response to pepsin of gastric juice and is a signal that food has entered the gastrointestinal tract), pressure differences become such that already prepared, concentrated bile first enters the duodenum.
5. With an increase in pressure in the gallbladder to 250-300 mm of water column, it contracts itself - then the sphincter of Oddi has to open.
6. The common bile duct also has almost no muscle fibers, so it contracts poorly.

What follows from all this in relation to drugs? Let's look at diseases. As a result, you will understand which group of choleretics you need. So.

Cholagogue drugs for biliary dyskinesia

The word "dyskinesia" refers to a violation of the normal movement of bile. This diagnosis itself necessarily requires deciphering, because it is not clear whether bile will move faster or slower.

So, dyskinesia is characterized by only 2 concepts:

1. What is the tone of the biliary tract. He can be:
   • normal (then it is not necessary to correct it);
   • elevated (hypertonic dyskinesia), when bile will be ejected quickly, which will contribute to its reflux into the stomach. In this case, drugs are needed - cholespasmolytics;
   • lowered when bile will go slowly. To correct this condition, cholekinetics are needed.
2. How the bile ducts are reduced:

• at a high speed - then the bile does not have time to concentrate. This is removed by antispasmodics;
• at normal speed;
• at a low rate, which contributes to the stagnation of bile. At the same time, either choleretics are needed (then more bile will be formed and it will have to be released faster), or cholekinetics - to stimulate the movements of the biliary tract.

Thus, the diagnosis for biliary dyskinesia consists of 2 parts. As a result, it may be:

• hypertonic hyperkinetic. More "strong" cholespasmolytics are needed. Usually these are synthetic drugs;
• hypertonic normokinetic. It is treated with cholespasmolytics, which do not inhibit the very peristalsis of the biliary tract (usually these are herbal remedies);
• hypertonic hypokinetic. We need a drug that will relieve spasm (otherwise the bile will not pass), and a cholekinetic;
• hypotonic hypokinetic. We need both choleretics and cholekinetics;
• hypotonic normokinetic. Usually one choleretic is enough.

If you do not determine the type of your own dyskinesia and drink drugs at random, you can worsen your own condition. Most often, it is choleretics who drink it - to increase the production of bile. Now imagine what will happen if dyskinesia is caused by an inflection of the gallbladder? Or is it hypokinetic? Then the gallbladder will overflow, and then it has to contract sharply. This will be a very painful condition called biliary colic.

There is a second option: uncontrolled intake of cholespasmolytics. As a result, bile stagnates, and salts with cholesterol begin to precipitate in it, forming stones, or infection of bile occurs: cholecystitis occurs.

Cholagogue preparations for stagnation of bile

Choleretic drugs for stagnation of bile are choleretics and cholekinetics. In addition, it is necessary to check the bile ducts for the presence of stones in them. If they are not present or they are small (up to 3 mm), bile acid preparations are prescribed.

With stagnation in the liver, which is accompanied by yellowing and itching of the skin, not only choleretic drugs are prescribed, but also drugs from other groups. In this case, treatment is generally recommended to take place in a hospital - to monitor the effectiveness of therapy and timely diagnosis of complications.

Cholagogue preparations for inflection of the gallbladder

By itself, the inflection of the gallbladder already indicates biliary dyskinesia. Most likely, it will be hypokinetic (since bile must overcome a greater obstacle to enter the gallbladder) and hypermotor. And for its treatment, cholespasmolytics, cholekinetics and bile acid preparations will be needed to prevent gallstone disease. As with "normal" dyskinesia, herbal preparations are preferred without exacerbation.

Dyskinesia with inflection can be both hypokinetic and hypomotor. In this case, cholekinetics and, sometimes, choleretics are needed.

Choleretic agents for cholecystitis

Inflammation of the gallbladder usually requires the appointment of such drugs:

• choleretics - to "dilute" the infected bile "fresh";
• cholespasmolytics - since with inflammation of the gallbladder with cholecystitis, its spasm is inevitable;
• cholelithogenic agents in case there are no stones - to prevent their formation.

In this disease, antibiotics are also prescribed - usually 2 groups at once.

Cholagogues for pancreatitis

Inflammation of the pancreas - pancreatitis - is accompanied by increased production of its enzymes. We remember that bile stimulates the synthesis of these substances, which means that in this case it should be released in small portions - no sudden emissions. For this, both acute and chronic pancreatitis are prescribed cholespasmolytics. And to prevent the formation of stones - since stagnation of bile will inevitably occur here - cholelithogenic drugs will be used.

Pancreatitis is a dangerous disease that requires complex therapy, but by no means self-treatment!

How to improve the condition after cholecystectomy

The main problem after removal of the gallbladder is the impossibility of concentrating bile. That is, it is more liquid and drains faster into the duodenum. However, even in such a less concentrated bile, there are conditions for the formation of stones, so taking cholelithogenic drugs is mandatory.

Choleretics in a state after cholecystectomy are contraindicated: the liver already begins to produce more bile compensatoryly.

Antispasmodics are needed, which immediately after the operation and during the first three months should be taken systematically. This is due to the fact that before the gallbladder and the sphincter of Oddi worked in concert: when the bladder contracted (under the influence of hormone-like substances, gastric and pancreatic juice), the sphincter relaxed. As soon as the gallbladder was gone, it became more difficult for the sphincter of Oddi, which is not endowed with such sensitivity, to navigate what and when to do. In this situation, he most often spasms. It needs to be relaxed with cholespasmolytics until the spasm becomes a stenosis, due to which a new operation will be required.

The condition after surgery may also be accompanied by hypotonicity of the sphincter of Oddi, which happens already after a time after surgery. In this case, cholekinetics are prescribed.

In this condition, drugs are also prescribed that improve liver function, anti-inflammatory drugs and antibiotics.

List of choleretic drugs

Consider what are the representatives of various groups of these drugs. Let's start our list of choleretic drugs with the largest group - choleretics.

Choleretics

Choleretics are divided into 2 large groups:

1. True choleretics, which increase the amount of bile by increasing its formation. They, in turn, are divided into 3 groups - depending on the raw materials from which they are made - into:
   • containing bile acids (from animal bile);
   • synthetic drugs that activate the mechanisms of bile formation;
   • medicinal herbs that affect the mechanisms of bile formation.
2. Hydrocholeretics - drugs that increase the volume of the gallbladder - by diluting bile with water.

In this section, we will consider only drugs of animal and synthetic origin, as well as hydrocholeretics. All herbal preparations - both choleretics and cholekinetics - we will consider separately.

Allochol Compound: natural bile, nettle, activated charcoal, garlic Analogues- based on bile: Medical canned bile (emulsion), Cholenzym (contains pancreatic enzymes and bile), Festal (complete analogue of Cholenzym) Contraindications: Allergy to components, acute hepatitis, for cholenzim / festal - acute pancreatitis, obstructive jaundice, acute gastroenterocolitis, liver dystrophy - acute and chronic Prices: Allohol: 10 tabs - 10 r, 50 tabs - 60 r, Medical bile (emulsion) 250 ml - 250 r, Cholenzim 50 tabs - 220 r, Festal 40 tabs - 220 r

Odeston Compound: hymecromon (synthetic drug) Analogues: Cholesteel, Holonerton (at the moment they are under re-registration) Contraindications: blockage of the biliary tract, Crohn's disease, increased bleeding, including hemophilia, liver failure, stomach ulcers, intestines, lactation Prices: 20 tabs - 360 r, 100 tabs - 750 r

Nicodin Compound: synthetic substance hydroxymethylnicotinamide Analogues: Bilizarin, Holamid, Felosan, Isohol (currently not available in pharmacies) Contraindications: blockage of the bile ducts, gastritis with extremely low acidity, allergy to the drug Prices: drug under re-registration

Hydrocholeretics include mineral waters with an alkaline pH:

• Borjomi;
• Essentuki 4 and 17;
• Jermuk;
• Naftusya;
• Slavyanovskaya.

cholekinetics

The following synthetic drugs contribute to contractions of the biliary tract:

Magnesium sulfate (powder) Compound: magnesium Analogues: Other magnesium preparations are not used as cholagogues. How to use: Dissolve the sachet in 1 liter of water, take 1 tbsp * 3 r / day Contraindications: Allergy, inflammation in the intestines, cholelithiasis, pregnancy, blockage of the bile ducts Prices: 25 g - 30 r

Sorbitol Compound: Analogues: No How to use: Dissolve 1 tablespoon of the drug in a glass of warm water, drink, put a warm heating pad under your right side, lie down for 30 minutes with it Contraindications: ascites, irritable bowel syndrome, allergy, colitis. Be careful with diabetes Prices: powder 350 g - 90 r

Cholespasmolytics

Bellalgin Compound: belladonna extract, metamizole, soda, benzocaine Analogues:(according to belladonna extract) - Atropine How to use: Strictly prescribed by a doctor due to the abundance of side effects. 1 tab * 2-3 r / day, before meals Contraindications: tachycardia, pregnancy, allergy, angle-closure glaucoma, liver or kidney failure, hematopoietic disorder Prices: Bellagin 10 tab - 60 r, Atropine is sold as a solution for subcutaneous injections

Metacin Compound: Metocinium iodide Analogues: No How to use: 2-3r / day, 1-2 tab. before meals Contraindications: heart disease, reflux of gastric contents into the esophagus, diaphragmatic hernia, intestinal atony, prostate hyperplasia, gastrointestinal obstruction, liver or kidney failure Prices: 10 tabs - 180 r

Platifillin Compound: platifillina hydrotartrate Analogues: — How to use: subcutaneous injection Contraindications: atherosclerosis, heart disease, arrhythmias (especially tachycardia type), diaphragmatic hernia, ulcerative colitis, intestinal atony, gastrointestinal bleeding Prices: 10 amp - 70 r

Papazol Compound: papaverine hydrochloride, bendazole Analogues: Papaverine - suppositories, Papaverine - injections, Dibazol - tablets and injections How to use: 1tab 2-3r/day Contraindications: hypotension, AV conduction disorder, allergy, old age Prices: 10 tablets - 10 r

Drotaverine Compound: Analogues: No-shpa How to use: 1-2 tabs*2-3r/day Contraindications Key words: glaucoma, atherosclerosis of heart vessels, allergy Prices: Drotaverine from different manufacturers No. 20 from 15 to 70 r, No-shpa No. 24 - 110 r

Duspatalin Compound: mebeverine Analogues: Mebeverin, Meverin - on re-registration How to use: 1 caps*2r/day Contraindications: allergies, pregnancy, children under 10 years old Prices: 30 tabs - 510 r, 50 tabs - 600 r

Eufillin Compound: aminophylline Analogues: Aminophylline - on re-registration How to use: 1 tab*3r/day Contraindications: acute myocardial infarction, arrhythmia, allergy, cardiomyopathy, exacerbation of peptic ulcer, children under 6 years old, epilepsy, hyperthyroidism Prices: 30 tabs - 20 r

halidor Compound: benziklan Analogues: No How to use: 1 tab*3r/day Contraindications: acute myocardial infarction, AV blockade, allergy, children under 18, epilepsy, hyperthyroidism Prices: 50 tabs - 550 r

Buscopan Compound: hyoscine Analogues: No Contraindications: allergy, urolithiasis, cerebral atherosclerosis, porphyria, hypertension, myasthenia gravis, glaucoma, spastic paralysis Prices: 380 r - 20 tabs, 360 r - 10 candles

Cholelytics

Drugs that reduce the saturation of bile with cholesterol and, accordingly, are used to prevent the formation and dissolution of small stones are drugs based on ursodeoxycholic acid:

• Ursosan;
• Ursofalk;
• Ursodeoxycholic acid;
• Ursodez;
• Grinterol;
• Urdox.

The cheapest of them is Ursodeoxycholic acid: 600 r/50 tab, the most expensive is Ursofalk: 915 r/50 tab.

These drugs are available in the form of 250 mg capsules. The daily dose is calculated depending on body weight and the presence of stones, and is 2-6 caps / day.

Ursodeoxycholic acid preparations are contraindicated in acute inflammation of the liver, gallbladder and biliary tract, during pregnancy / feeding, in the presence of calcium stones, frequent biliary colic.

Herbal choleretic preparations

Herbal choleretics

Flamin Compound: Analogues: sand immortelle herb How to use: 30 minutes before meals for 1t * 3r / day Contraindications: stones more than 1 cm, allergy, children under 3 years old, obstructive jaundice Prices: tablets No. 30 - 180 r, granules for suspension No. 20 - 280 r

Tanacehol Compound: tansy extract Analogues: tansy flowers for preparing a decoction, tansy flowers in granules of 1.5 g How to use: 20 minutes before meals 1-2t * 3r / day Contraindications: allergy Prices: 30 tabs - 50 r

Berberis-homaccord Compound: homeopathic drops based on barberry Analogues: Berberis vulgaris granules How to use: 10 drops * 3r / day 20 minutes before meals or an hour after it Contraindications: pregnancy Prices: Gommakord 550 r, Berberis granules 140 r/10 g

Holosas Compound: extract in syrup Analogues: Rosehip Syrup Dietary Supplement, Rosehip Fruit CLS, Rosehip with Vitamin C Syrup How to use: 1 tsp * 2-3r / day Contraindications: allergy, cholelithiasis Prices: 300 g - 120 r, Rosehip syrup dietary supplement 250 ml - 50 r, wild rose fruit KLS - 20 pcs 2 g each - 70 r, Rosehip with vitamin C 150 ml - 130 r

Hofitol Compound: artichoke extract Analogues: Artichoke Extract How to use: 2-3 tons * 3r / day before meals Contraindications: cholelithiasis, acute diseases of the kidneys, liver, bile and urinary tract Prices: 60 tabs - 300 r, solution 120 ml - 400 r, Artichoke Extract 20 tabs - 170 r

Urolesan Compound: complex of choleretic herbs Analogues: Holagol - on re-registration How to use: drops - 8 cap. for sugar*3r/day Contraindications: stones more than 3 mm in diameter, allergy. For diabetes, drip into water, not sugar or use capsules Prices: drops 25 ml - 310 r, capsules No. 40 - 350 r

Valerian tablets Compound: valerian extract Analogues: valerian tincture How to use: 1-2 tabs*3-4r/day Contraindications: intolerance Prices: from 25 r/50 tab to 450 r/25 tab

Herbal cholekinetics

Berberis-hommacord and its analogue, discussed in the section of herbal choleretics, are complex drugs that have both an antispasmodic and an effect that improves biliary motility.

In addition, the cholekinetic effect is exerted by:

• almost any vegetable oil, especially olive, cumin, sunflower;
• barberry leaves;
• roots and rhizomes of calamus;
• fennel fruit;
• cumin fruits.

Herbal cholespasmolytics

These are drugs such as Cholagol, valerian tablets.

As antispasmodics of plant origin, decoctions and tinctures are prepared from various herbs, which are best bought at a pharmacy:

• tansy;
• arnica;
• turmeric root.

What choleretic drugs can be used for children

If you can experiment with yourself on your own - at your own peril and risk, then a doctor should prescribe choleretic drugs for children, based on the disease and the type of contraction of the biliary tract.

For children, the following choleretic drugs are used:

• "Papaverine" and "Atropine" in the form of injections, in strict dosages and only under medical supervision - from 6 months;
• "Holosas" - from 3 years;
• "Urolesan" - from 7 years old;
• "Hofitol" - from 6 years;
• "Eufillin" - from 6 years;
• "Duspatalin" - from 10 years old;
• "Flamin" - from 6 years old.

What drugs can be called the best

It is very difficult to average which choleretic drugs are the best, since each organism is individual. But some patterns can still be identified.

So, among choleretics, the following work best: "Nikodin", "Holosas", "Urolesan", "Tanatsehol".

It is better to choose their cholekinetics: "Magnesium sulfate" or "Sorbitol", using them for "blind probing".

As for cholespasmolytics, synthetic drugs all work well and act quite quickly. Optimal for the biliary tract are "Buscopan" and "Duspatalin". "No-shpa" and "Papaverine" have a relaxing effect on all smooth muscles, without a selective effect on the bile ducts.

Thanks

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Currently choleretic drugs in the complex treatment and prevention of various diseases of the liver and gallbladder are widely used in the clinical practice of a gastroenterologist. This is due to the effects of choleretic drugs that relieve pain attacks, alleviate the course of the disease, and also prevent the deterioration or the appearance of a new pathology provoked by decompensation of an existing disorder.

To understand why choleretic drugs are needed, you should know what bile is, what its physiological functions are, and how it moves in the digestive system. Bile is a biological fluid produced by liver cells and stored in the gallbladder. The liquid has a bitter taste, a specific odor and, depending on the prescription of production, can be colored yellow, brown or greenish. Bile performs the following physiological functions in the human body:

• Emulsification and digestion of dietary fats;
• Activation of enzymes of the small intestine and pancreas, necessary for the complete digestion of food;
• Provides complete absorption of fat - soluble vitamins , calcium and cholesterol .

Activation of the enzymes of the small intestine and pancreas is due to the fact that bile neutralizes the effect of pepsin, which came in place with the food bolus from the stomach. After neutralization of pepsin, the necessary conditions are created for the functioning of the enzymes of the small intestine and pancreas.

Emulsification of fats is carried out by bile acids contained in bile, which also improve intestinal motility, stimulate the formation of protective mucus and prevent the attachment of bacteria and proteins to the mucous membrane. Due to these effects, bile prevents constipation and intestinal infections. In addition, bile is necessary for the excretion of substances such as cholesterol, bilirubin, glutathione and steroid hormones from the human body along with feces.

Bile is synthesized by the liver cells and enters the gallbladder through special ducts. Then from the gallbladder, also through the duct system, it enters the duodenum, where it performs its physiological functions. That is, the gallbladder is a kind of reservoir for the temporary storage of bile from the moment it is produced until the food bolus enters the duodenum.

Classification of choleretic drugs

Currently, an anatomical-therapeutic-chemical classification of choleretic agents is used, which takes into account both the chemical structure of the drug used, its therapeutic effects, and the anatomical structures affected by the drug. Such an integrated approach makes it possible to create the most complete classification that reflects various aspects of the use, therapeutic effects and absorption, distribution and excretion of drugs from the human body.

So, today choleretic drugs are classified into the following groups and subgroups:

1. Choleretics(drugs that increase the production of bile by liver cells):

True choleretics that increase the production of bile due to the active synthesis of bile acids:

• Choleretics containing bile acids and made on the basis of plant or animal raw materials (for example, animal bile, plant extracts, etc.);
• Synthetic choleretics, which are chemicals obtained by organic synthesis and have the property of increasing bile production;
• Medicinal herbs with a choleretic effect (used in the form of infusions, decoctions, etc.).

Hydrocholeretics, which are substances that increase the volume of bile by diluting it light and increasing the percentage of water in it.

2. cholekinetics(means that improve the outflow of bile by increasing the tone of the gallbladder and simultaneously relaxing the bile ducts).

3. Cholespasmolytics (means that improve the outflow of bile by relaxing the muscles of the gallbladder and biliary tract):

• anticholinergics;
• Synthetic antispasmodics;
• Antispasmodics made on the basis of vegetable raw materials.

4. Drugs to reduce the bile lithogenicity index (remedies prevent the formation of stones in the gallbladder and contribute to the dissolution of existing ones):

• Preparations containing bile acids - ursodeoxycholic or chenodeoxycholic;
• Preparations containing highly active solvents of organic compounds of a lipid nature, for example, methyl tert-butyl ether.

True choleretics, containing bile acids as active components, are drugs, mainly made on the basis of animal raw materials. Most often, natural bile, extracts of the liver or pancreas, as well as tissues of the mucous membrane of the small intestine of healthy animals are used as raw materials. That is why choleretic drugs of this group are often called means of animal origin. In addition to animal raw materials, many complex preparations may include extracts of medicinal herbs that have the necessary choleretic effect.

Synthetic choleretics are preparations that contain as active substances only compounds obtained in the course of organic synthesis. The drugs of this group, in addition to the choleretic action, also have the following therapeutic effects: antispasmodic (reduce pain in diseases of the biliary tract and gallbladder), hypolipidemic (reduce the concentration of cholesterol in the blood), antibacterial (destroy pathogenic bacteria that provoke inflammatory diseases of the biliary tract) and anti-inflammatory (stop inflammation present in the biliary tract). In addition, synthetic choleretics suppress the processes of putrefaction and fermentation in the intestines, thereby eliminating bloating, stool instability and other dyspeptic phenomena.

Medicinal herbs with choleretic action improve liver function, increase bile secretion, while reducing its viscosity. Herbs also increase the concentration of cholates in bile. Along with the choleretic effect, medicinal herbs also have a cholekinetic effect, that is, on the one hand, they increase the secretion of bile, and on the other, they improve its excretion, due to which a complex therapeutic effect on the human body is achieved. Herbal preparations are also able to have anti-inflammatory, antimicrobial and diuretic effects. Due to the content of only various herbs as active substances, preparations of this group are often called herbal choleretic agents.

Hydrocholeretics increase the volume of bile due to its dilution and decrease in viscosity, achieved by increasing the content of the water fraction in it. In such a situation, the excretion of bile is facilitated and the formation of stones is prevented.

cholekinetics are means that increase the tone of the gallbladder and at the same time relax the muscles of the bile duct. To understand the significance of the effect of cholekinetics, it is necessary to know that the gallbladder is connected to the duodenum by the bile duct, through which bile flows from one organ to another. Accordingly, with an increased tone of the bile duct, it narrows, which interferes with the progress of bile. And with a low tone of the gallbladder, it simply does not "push" bile into the duct. Thus, an increase in the tone of the gallbladder and relaxation of the duct create ideal conditions for the outflow of bile, since the first is intensively reduced, pushing the contents out of itself and not allowing it to stagnate, and the second has a wide enough lumen to skip the entire volume within a short period of time. The resulting effect of cholekinetics is the release of the gallbladder and the flow of bile into the duodenum, resulting in improved digestion and elimination of stagnation.

Cholespasmolytics are divided into several groups depending on the characteristics of their pharmacological action, but the resulting effects are the same for everyone. Cholespasmolytics eliminate spasm and expand the biliary tract, facilitating the excretion of bile into the intestine. These drugs are usually used in short courses to relieve pain in various diseases of the gallbladder and biliary tract.

Drugs to reduce the lithogenicity of bile, strictly speaking, are designed to dissolve existing gallstones and prevent the formation of new ones. Since these drugs have a choleretic effect, they are classified with a certain degree of convention as a choleretic group.

Each group and subgroup includes certain drugs that have a number of properties and clinical effects used in various pathologies of the biliary tract and liver. In the next section, we give a list of choleretic drugs belonging to each group and subgroup.

Cholagogue drugs - lists

Below, for ease of orientation and selection, we present a list of choleretic drugs by classification groups. At the same time, we will first indicate the international name of the active substance, and next to or in brackets a number of commercial names under which the drug can be produced.

True choleretics

True choleretics containing bile components include the following drugs:

• Preparations containing components of the natural bile of animals - Allohol, Cholenzim, Vigeratin, Liobil;
• Dehydrocholic acid - Hologon;
• Sodium salt of dehydrocholic acid - Decholin, Biliton, Supracol, Holamine, Holomin.

Synthetic choleretics

Synthetic choleretics are the following drugs:

• Hydroxymethylnicotinamide (Nicodin, Bilamid, Bilizarin, Bilocid, Cholamid, Coloton, Felosan, Isochol, Niciform);
• Hymecromon (Odeston, Holonerton, Holestil);
• Osalmid (Oxafenamide, Osalmid, Auxobil, Drenamid, Driol, Enidran, Salmidochol);
• Cyclovalone (Cyclovalone, Benevo, Cyclovalone, Divanil, Divanone, Flavugal, Vanilone).

Herbal choleretics

Herbal choleretics are as follows:

• Immortelle flower extract (Flamin);
• Extract of corn stigmas (Peridol, Insadol);
• Tansy extract (Tanacehol, Tanaflon, Sibektan, Solaren);
• Turmeric extract (Konvaflavin, Febihol);
• Sumpia leaf extract (Flacumin);
• Barberry leaf and root extract (Berberine sulfate, Berberis-Homaccord, Berberis plus);
• Rose hip extract (Holosas, Holemaks, Holos);
• Hemp datiski extract (Datiscan);
• Volodushka extract (Pekvokrin);
• Artichoke extract (Hofitol, Holebil);
• Preparations containing a complex of herbs with a choleretic effect (Cholagol, Cholagogum, Travohol, choleretic preparations No. 2 and 3, Urolesan, Phytohepatol No. 2 and 3).

Hydrocholeretics

Hydrocholeretics are the following drugs:

• Alkaline mineral waters (Naftusya, Borjomi, Narzan, Essentuki 17, Essentuki 4, Arzni, Smirnovskaya, Slavyanovskaya, Izhevskaya, Jermuk, etc.);
• Salicylates (sodium salicylate);
• Valerian preparations (alcoholic infusion of valerian, valerian tablets, Valerianahel, etc.).

cholekinetics

Cholekinetics are the following drugs:

• Magnesium sulfate (Magnesia, Cormagnesin);
• Sorbitol (Sorbitol);
• Mannitol (Mannitol, Mannitol);
• Xylitol;
• Barberry leaf and root extract (Berberine sulfate, Berberis-Homaccord, Berberis plus);
• Immortelle flower extract (Flamin);
• Rosehip fruit extract (Holosas, Holemaks, Holos).

Cholespasmolytics

Cholespasmolytics are the following choleretic drugs:
1. Anticholinergics:

• Bellalgin;
• Belloid;
• Besalol;
• Metacin;
• Platifillin;
• Spasmolitin;
• Fubromegan.

2. Synthetic cholespasmolytics:

• Papaverine (Papaverine, Papaverine Bufus, Papazol);
• Drotaverin (Bioshpa, Nora-Drotaverin, Droverin, No-Shpa, Nosh-Bra, Ple-Spa, Spazmol, Spazmonet, Spazoverin, Spakovin);
• Aminophylline (Aminophyllin-Eskom, Eufillin);
• Mebeverin (Duspatalin).

3. Herbal cholespasmolytics:

• Arnica tincture;
• Valerian tincture;
• Elecampane tincture;
• Hypericum tincture;
• Mint tincture;
• Melissa tincture;
• Tincture of calendula flowers;
• Convaflavin (turmeric root);
• Cholagol (extracts of various herbs).

Choleretic with litholytic action

Choleretic with litholytic action are as follows:
1. Ursodeoxycholic or chenodeoxycholic acids - Livodex, Urdox, Urso 100, Ursodez, Ursodex, Uroliv, Ursolit, Ursor C, Ursosan, Ursofalk, Choludexan, Exhol;
2. Methyl tert-butyl ether.

Choleretic herbal preparations

Choleretic herbal preparations are presented in finished dosage forms (tablets, tinctures or powders for oral solution) or dried crushed parts of plants with the necessary properties.

Currently, the domestic pharmaceutical market has the following choleretic herbal preparations in finished forms:

• Berberis-Homaccord;
• Berberis plus;
• Berberine sulfate;
• Datiscan;
• Insadol;
• Peridol;
• Convaflavin;
• Pekvokrin;
• Sibektan;
• Solaren;
• Tanaflon;
• Tanacehol;
• Travohol;
• Urolesan;
• Febihol;
• Phytogepatol No. 2 and 3;
• Flacumin;
• Flamin;
• Holagogum;
• Cholagol;
• Holebil;
• Cholemax;
• Holos;
• Holosas;
• Hofitol.

In addition, the following medicinal herbs have a choleretic effect (choleretic):

• Birch buds;
• Turmeric root;
• Calamus rhizome;
• Roots and leaves of barberry;
• Burdock roots;
• Dandelion roots;
• chicory root;
• Corn silk;
• Artichoke leaves;
• Volodya leaves;
• nettle leaves;
• Peppermint leaves and oil;
• Orthosiphon leaves;
• parsley leaves;
• Skumpia leaves;
• Leaves and flowers of tansy;
• fir oil;
• Terpene oil Rose hips;
• coriander fruit;
• Rowan fruits;
• Carrot seeds;
• Horseradish root juice;
• Grass mountaineer bird;
• Danish grass;
• Herb oregano;
• Herb centaury;
• Lily of the valley grass;
• Artemisia grass;
• Immortelle flowers;
• Cornflower flowers;
• Tatar flowers.

The following products and medicinal herbs have a cholekinetic effect:

• Calamus rhizomes;
• Dandelion roots;
• Rhubarb roots;
• leaves of barberry;
• Cowberry leaves;
• Watch leaves;
• Coriander oil;
• Juniper oil;
• Cumin oil;
• Olive oil;
• Coriander fruits;
• Juniper fruits;
• Cumin fruits;
• fennel fruit;
• Dog-rose fruit;
• Sunflower oil;
• Cowberry juice;
• Grass mountaineer bird;
• Herb oregano;
• Shepherd's purse grass;
• thyme herb;
• Yarrow herb;
• Immortelle flowers;
• Cornflower flowers;
• Marigold flowers;
• Chamomile flowers.

Modern choleretic drugs

Modern choleretic drugs are represented by a group of synthetic choleretics and combined herbal and animal remedies. Synthetic choleretics include preparations containing nikodin, hymecromone, osalmid or tsikvalon as active substances. Synthetic choleretics compared to natural ones (for example, Allochol, Holenzim, Liobil, etc.) are better tolerated, do not cause unstable stools, and also have a number of additional positive therapeutic effects, such as antispasmodic, lipid-lowering, antibacterial and anti-inflammatory.

In addition, modern choleretic drugs include dehydrocholic acid (Hologon, Decholin) and ursodeoxycholic acid (Livodex, Urdox, Urso 100, Ursodez, Ursodex, Uroliv, Ursor, Ursor C, Ursosan, Ursofalk, Choludexan, Exhol). Also a modern drug is the cholespasmolytic Duspatalin.

Among the choleretic herbal and animal preparations, the following are modern:

• Berberis-Homaccord;
• Vigeratin;
• Insadol;
• Convaflavin;
• Pekvokrin;
• Peridol;
• Sibektan;
• Solaren;
• Tanacehol;
• Tanaflon;
• Urolesan N;
• Febihol;
• Holagogum;
• Cholagol;
• Holaflux;
• Holosas.

Choleretic drugs - indications for use

A common indication for the use of choleretic drugs is the pathology of the gallbladder, biliary tract or liver. However, in order to select the optimal drug, it is necessary to know the indications for the use of each group of choleretic agents. Within the groups, there are slight differences between the drugs, which, however, do not affect their indications for use, which remain the same. Thus, for clinical orientation in choleretic preparations, it is necessary to know the indications for the use of each classification group, which we will consider below.

Choleretics

Indications for the use of choleretics are the same for all three subgroups of this group of choleretic agents. This means that both synthetic choleretics (for example, Tsikvalon, Nicodin, Oxafenamide, etc.), and preparations containing natural bile components (for example, Allochol, Liobil, Decholin, Cholenzim, Hologon, etc.), and herbal remedies (for example, Convaflavin, Holosas, Flacumin, etc.) have the same indications for use. So, choleretics are indicated for use in the following conditions or diseases:

• Chronic inflammatory diseases of the liver (for example, hepatitis, steatosis, etc.);
• Chronic inflammatory diseases of the biliary tract (cholangitis, cholecystitis, etc.);
• Habitual constipation, provoked by a violation of the outflow of bile.

Choleretics, depending on the characteristics of the course, diseases can be used in combination with antibiotics, painkillers, antispasmodics and laxatives.

In addition, with insufficient bile secretion, choleretics containing components of natural bile of animals can be used as replacement therapy drugs.

Among choleretics, the most "hard" are drugs containing bile components, so they are the worst tolerated and often provoke stool disorders. Synthetic choleretics have a milder effect, but in terms of the spectrum of positive therapeutic effects, they are significantly inferior to drugs containing bile components. In addition, synthetic choleretics do not improve the properties of bile, as natural preparations and products containing medicinal herbs. But synthetic choleretics, in addition to choleretic properties, have the following therapeutic effects:

• Antispasmodic effect (eliminate spasm and pain in the biliary tract) is expressed in osalmid and gimecromon;
• Lipid-lowering effect (reduce the concentration of cholesterol in the blood due to its excretion from the body) is expressed in osalmid;
• Antibacterial effect expressed in Nicodin;
• Anti-inflammatory effect expressed in tsikvalon;
• Suppression of decay and fermentation in the intestines - the effect is pronounced in nicodine.

These therapeutic effects must be taken into account when choosing the optimal drug. For example, if a person has a pronounced pain component, then he needs a choleretic drug with an antispasmodic effect. That is, he needs to choose a drug containing osalmid or gimecromon. If diseases of the biliary tract and gallbladder are combined with atherosclerosis, hypertension and high blood cholesterol, then a drug containing osalmid should be chosen. With pronounced inflammatory changes in the wall of the gallbladder or biliary tract, it is necessary to choose drugs with tsikvalon.

Herbal choleretics have a milder effect compared to synthetic and natural preparations containing bile components. In addition, they have a complex positive effect on the organs of the gallbladder, ducts and liver, due to which their very high efficiency is achieved. That is why at present, in the absence of allergies or intolerance to herbal components, it is recommended to use preparations containing herbal components as choleretics.

Hydrocholeretics

Indications for the use of hydrocholeretics, in principle, do not differ from those for choleretics. However, drugs in this group are almost never used on their own. They are usually used in combination with other choleretic agents, mainly choleretics and cholekinetics, to enhance the therapeutic effect.

cholekinetics

Indications for the use of cholekinetics are as follows:

• Biliary dyskinesia of hypotonic form;
• Atony of the gallbladder with stagnation of bile, combined with dyskinesia;
• Chronic cholecystitis;
• chronic hepatitis;
• Gastritis with low or zero acidity (hypoacid or anacid) of gastric juice;
• Preparation for duodenal sounding.

Cholekinetics cause an increase in the tone of the gallbladder and relaxation of the sphincter of Oddi, so they are prescribed mainly for the hypotonic form of biliary dyskinesia. Indications for their use are atony of the gallbladder with bile stasis in dyskinesia, chronic cholecystitis, chronic hepatitis, in anacid and severe hypoacid conditions. They are also used during duodenal sounding.

Cholespasmolytics

Indications for the use of cholespasmolytics are as follows:

• Biliary dyskinesia of hyperkinetic form;
• Moderate pain syndrome accompanying diseases of the biliary tract and gallbladder.

Basically, cholespasmolytics are used to relieve moderate pain on an outpatient basis or at home.

Indications for the use of choleretic drugs with litholytic action

Indications for the use of choleretic drugs with litholytic action are as follows:

• Dissolution of small stones in the gallbladder and prevention of the formation of new ones;
• Dissolution of fragments of stones formed after the procedure of ultrasonic crushing;
• Complex treatment of cholelithiasis;
• Reflux gastritis or reflux esophagitis, provoked by the reflux of bile acids into the stomach or esophagus;
• Acute hepatitis;
• Toxic damage to the liver by poisons, alcohol, drugs, etc.;
• Compensated biliary cirrhosis of the liver;
• Primary cholangitis;
• Atresia of the intrahepatic biliary tract;
• Stagnation of bile on the background of parenteral nutrition;
• Biliary dyskinesia;
• Complex treatment of chronic opisthorchiasis;
• Prevention of liver damage against the background of the use of cytostatics or oral contraceptives.

Taking choleretic drugs - a brief instruction

All choleretic drugs, regardless of the form of release, must be taken 20 to 30 minutes before meals. Moreover, the total daily dosage is divided equally into 3-5 doses, depending on how many times a day a person eats. It is recommended to take choleretic drugs before each meal. The preparations must be washed down with a sufficient amount of water and be sure to eat something half an hour after taking. If a person does not eat anything after taking a choleretic drug, then he will experience nausea, diarrhea and general well-being will worsen.

Usually, choleretic drugs are taken in long-term (up to 3-8 weeks) courses 2-4 times a year, with intervals of at least 1-2 months between them. Such courses of the use of choleretic drugs are prophylactic and should be carried out during the entire period of time while the disease persists. With exacerbation of diseases of the biliary tract, liver and gallbladder, choleretic drugs are used as part of complex therapy in large dosages.

Ursodeoxycholic acid preparations for the treatment of reflux gastritis and reflux esophagitis, as well as the dissolution of gallstones, must be taken continuously for 6 to 8 months.

Cholagogue preparations for children

In children, the following choleretic drugs can be used:

• Choleretics containing components of natural bile - Allochol;
• Synthetic choleretics - Nicodin, Oxafenamide, Osalmid;
• Choleretics containing medicinal herbs - Flamin, Febihol, Holosas, Cholemax, Holos, Hofitol;
• Cholekinetics - Valerian, Valerianahel, Magnesia, Cormagnesin, magnesium sulfate;
• Cholinolytics (cholespasmolytics) - Atropine, Metacin, Platifillin, Papaverin, Papazol, Drotaverin, No-Shpa, Bioshpa, Nora-Drotaverin, Nosh-Bra, Ple-Spa, Spazmol, Spazmonet, Spazoverin, Spakovin Eufillin.

The dosage of the above choleretic drugs is calculated individually by body weight, based on the ratio indicated in the instructions for each specific drug.

In addition, children can drink alkaline mineral waters (Borjomi, Essentuki 17, Essentuki 4, Jermuk, Slavyanovskaya, etc.) as natural hydrocholeretics. It is recommended not to use medicinal herbs with a choleretic effect in children under 12 years of age, since prepared infusions and decoctions contain a wide range of active substances and it is simply impossible to predict the reaction of a child's body to all of them.

Cholagogue drugs during pregnancy

Pregnant women can take only those choleretic drugs that do not provoke contractile activity of the uterus and do not penetrate the placenta to the fetus, and also do not cause a pronounced deterioration in the condition. The following choleretic drugs are absolutely safe during pregnancy:

• Holenzim;
• Holosas;
• Cholemax;
• Holos;
• Valerian;
• Magnesia (magnesium sulfate);
• Cormagnesin;
• Atropine;
• Metacin;
• Papaverine (Papazol);
• Drotaverin (No-Shpa, Bioshpa, Nora-Drotaverin, Nosh-Bra, Ple-Spa, Spazmol, Spazmonet, Spazoverin, Spakovin).

In addition, there is a group of choleretic drugs that can be taken during pregnancy under the supervision of a doctor and only as directed. These drugs are theoretically safe for pregnant women, but experimental clinical studies have not been conducted for obvious ethical reasons. Therefore, the instructions usually write that the drugs can be used during pregnancy, but only under the supervision of a doctor. These choleretics include the following:

• Odeston;
• Holonerton;
• Cholestil;
• Flamin;
• Febihol;
• Berberis-Gommakord;
• Hofitol;
• Eufillin.

It is better not to use medicinal herbs with a choleretic effect during pregnancy, since their infusions and decoctions contain a large number of active substances, the effects of each of which cannot be assessed in advance and with high accuracy. If necessary, you can choose ready-made dosage forms based on herbs, for example, Holosas, Cholemax, Cholenzim, etc.

Dosages, rules of administration and duration of therapy with choleretic drugs in pregnant women are exactly the same as usual.

The use of choleretic drugs for certain diseases

Biliary dyskinesia (BDB)

The choice of drugs depends on the form of biliary dyskinesia. Yes, at hypertensive type of biliary dyskinesia (ZHVP) shows the following choleretic drugs:

• Cholespasmolytics of any type (for example, No-Shpa, Papaverine, Platifillin, Metacin, Duspatalin, Odeston, etc.), which reduce pain;
• Cholekinetics (for example, Magnesia, Cormagnesin, Berberine-Gommakord, Holosas, Cholemax, Holos, Sorbitol, Mannitol, Flamin, etc.).

The general scheme of therapy is usually as follows - cholespasmolytics are used in short courses to eliminate pain, after which a long-term intake of cholekinetics begins. Cholespasmolytics can also be used episodically as needed. With a hypertensive type of dyskinesia of the biliary tract, choleretic drugs from the group of choleretics and hydrocholeretics, for example, Allochol, mineral waters, etc., cannot be used.

With dyskinesia of the biliary tract by hypotonic type the following choleretic drugs are shown:

• Any choleretics (for example, Allohol, Liobil, Nicodin, Tsikvalon, Cholagogum, Cholagol, Flacumin, Konvaflavin, Febihol, Sibektan, Tanacehol, etc.);
• Hydrocholeretics (alkaline mineral waters, etc.);
• Antispasmodics of myotropic action (Duspatalin, Odeston).

Choleretics are used in long courses of 4 to 10 weeks, and antispasmodics in short cycles of 7 to 14 days. Alkaline mineral waters can be drunk constantly. Cholekinetics in the hypotonic form of biliary dyskinesia are usually not used.

Cholagogue preparations for stagnation of bile

In this case, to eliminate congestion, the most effective and optimal are their choleretic groups of cholekinetics, for example, Kormagnesin, Berberine-Gommakord, Holosas, Mannitol, Flamin, etc.

Cholecystitis

Choleretic drugs for cholecystitis are used at any stage of the disease. In the presence of stones in the gallbladder with cholecystitis, only products containing ursodeoxycholic acid as an active substance can be used as choleretic drugs (for example, Livodex, Urdox, Urso 100, Ursodex, Ursodex, Uroliv, Ursolit, Ursor C, Ursosan, Ursofalk, Choludexan , Exhol).

With non-stone cholecystitis, it is necessary to take choleretics from any group. Among synthetic choleretics, choleretic ones containing oxafenamide and hymecromone or cyclovalone as active substances are optimal. When using oxafenamide or hymecromon, it is not necessary to additionally take cholespasmolytics (No-Shpa, Papaverine, etc.), since these synthetic choleretics have an antispasmodic effect. And against the background of the use of cyclovalon, it is not necessary to take additional antibacterial drugs, since this choleretic has a pronounced antimicrobial effect. When using choleretics containing bile components or medicinal herbs (for example, Allochol, Liobil, Sibektan, Tanacehol, etc.), it is necessary to additionally take cholespasmolytics or antibacterial drugs.

In addition to any choleretics for non-stone cholecystitis, it is necessary to take cholekinetics (Magnesia, Cormagnesin, Berberine-Gommacord, Holosas, Cholemax, Holos, Sorbitol, Mannitol, Flamin, etc.), which will facilitate the release of bile into the duodenum from the gallbladder.

There are very few negative reviews about choleretic drugs and they are usually due to the ineffectiveness of a particular drug in this particular case. The absence of a clinical effect causes disappointment in a person, from which he concludes that the drug is ineffective, and leaves a negative review about it.

However, choleretic drugs are very effective if taken correctly and as directed, taking into account the properties of each drug. Therefore, a negative review of any drug is not a reflection of its inefficiency, but of the wrong choice of medicine.

Cholagogue drugs - prices

Prices for choleretic drugs are very variable and range from 50 to 500 rubles per pack. The cost of the drug depends on the manufacturer (imported drugs are more expensive than domestic ones) and its composition. The cheapest are preparations containing components of natural bile and medicinal herbs. The most expensive are synthetic choleretics, cholespasmolytics and ursodeoxycholic acid preparations. That is, there are groups of drugs with a relatively expensive and cheap cost. However, since in each case choleretic drugs from a certain group are shown, it is impossible to replace them with drugs from another, cheaper classification subgroup. You can only choose the cheapest drug from the same group. This principle of substitution should always be used when choosing a choleretic drug.

Cooking choleretic salad Marco Polo - video

Before use, you should consult with a specialist.

Violation of the production and outflow of bile from the gallbladder is a problem characteristic of a number of pathologies of the liver and biliary tract. Potentially, it can cause severe dysfunctions of other organs and systems - impaired twilight vision, osteoporosis, cholelithiasis, cardiovascular changes, intestinal obstruction. Cholagogue drugs for stagnation of bile is one of the ways to correct this condition.

Under the general term "choleretic agents" several different groups of drugs are combined. All of them are designed to normalize the circulation of bile, but the indications for their use may vary slightly.

Drug group	Mechanism of action	Indications
Choleretics	Increase the production of bile in the liver cells.	hepatitis; cholecystitis; steatosis; dyskinesia of the biliary tract; cholangitis; constipation caused by congestion of bile.
Hydrocholeretics	Increase the volume of bile by diluting it with water.	Indications are similar to choleretics.
cholekinetics	Tone up the gallbladder, causing bile to enter the small intestine faster.	atony of the gallbladder; hypomotor dyskinesia; chronic hepatitis and cholecystitis; hypoacid gastritis.
Cholespasmolytics	Improve the excretion of bile by relieving spasm of the bile ducts.	hyperkinetic form of biliary tract dyskinesia; cholelithiasis; pain and spasms in diseases of the liver and biliary tract.
Drugs against the formation of gallstones	Dissolve stones in the bile ducts and bladder and prevent the formation of new ones.	cholelithiasis; liver intoxication; acute hepatitis; primary cholangitis; biliary atresia; prevention of the appearance of stones in dyskinesia of the biliary tract; stagnation with parenteral (intravenous) nutrition.

Thus, before using any choleretic agents, it is important to make a correct diagnosis.

Treatment often requires a combination of drugs from different groups and additional intake of antibiotics, hepatoprotectors and other drugs. Only a specialist can competently develop a therapeutic tactic. In some cases, with stagnation of bile, a surgical operation is indicated.

Cholagogue

To eliminate stagnation of bile, not only medications are used. Sometimes herbal and folk remedies, as well as a special diet, can be a good help.

Foods for stagnant bile

To stimulate the production of bile and improve its circulation, a lipotropic-fat dietary table No. 5 L/F has been developed. It includes low-cholesterol choleretic products:

Products and dishes	Can be consumed	Cannot be consumed
Soups	Cereals, vegetable broths, dairy.	Dishes on strong broths from fish, mushrooms, meat.
Meat dishes	Steam products from minced meat of lean varieties. Cooked meat.	Sausage, fatty pork, any fried meat, smoked meats, canned food.
Fish dishes	Boiled, baked lean fish. Soufflé, quenelles, steamed cutlets.	Fried, salted or smoked fish of any kind. Fatty fish (herring, mackerel, sturgeon).
side dishes	Boiled cereals. Baked or boiled vegetables.	Canned peas, corn. Pickles, marinades, home preservation. Salads and cuts of mushrooms, fresh cabbage, radish, swede.
Eggs	Protein omelettes, eggnog or boiled soft-boiled, no more than 1 egg per day.	Fried or boiled.
Sweet dishes	Fresh ripe fruits and berries of sweet taste, dried fruits, honey, mousses, jelly.	Confectionery, ice cream, nuts, chocolate.
The drinks	Tea, coffee, compotes, fruit decoctions, fresh juices, mineral water.	Alcohol, cocoa, carbonated drinks.
Fats	Melted butter. Vegetable oils.	Lard, margarine, combined fat, lard.

Nutrition in violation of the circulation of bile should be subject to the following rules:

• fractional meals - 5-6 times a day in small portions;
• limited amount of salt and sugar;
• high fluid intake - up to 2 liters per day;
• the inclusion of a large amount of fiber.

It is also necessary to carefully monitor the individual reaction of the body. If any food causes nausea, vomiting, a bitter taste in the mouth, or cramps in the right hypochondrium, it should be immediately eliminated from the diet.

Cholagogue herbs and fees

Some herbs are good for stimulating the secretion and flow of bile. Cholagogue herbs, as well as synthetic drugs, can be divided into groups:

Of the listed herbs, you can independently make fees that are useful for bile stasis and have an antispasmodic effect.

• St. John's wort and immortelle flowers are mixed in equal proportions. 2 tablespoons of the prepared collection pour 0.5 liters of boiling water, wrap and leave for a day. Take 1 hour after eating 0.5 cup.
• Mix 50 grams of dry rose hips, 50 grams of corn stigmas, 100 grams of dry mint. Pour 1 tablespoon of the collection with 300 ml of boiling water, boil for 5 minutes, cool and strain. Add 1 teaspoon of honey. Drink 0.5 cup 15 minutes before meals.
• Mix 2 tablespoons of valerian root, 1 tablespoon of calendula flowers, 2 tablespoons of dried barberry or rose hips, 1 tablespoon of tansy flowers. Put the finished collection in a thermos and pour 1 liter of boiling water. Infuse for a day, strain and take 0.5 cups 15 minutes before meals.

There are also ready-made pharmaceutical herbal preparations recommended for stagnation of bile.

So, collection No. 1 includes mint, immortelle, coriander seeds and a three-leaf watch. Collection number 2 includes yarrow, immortelle, mint and coriander. Collection No. 3 consists of chamomile flowers, tansy, yarrow, calendula and mint leaves.

Folk remedies

Folk remedies for diseases of the liver and biliary tract are based on the choleretic properties of bee products and vegetable juices. The following compositions show good efficiency:

• Bee honey is mixed with pollen (pollen) in a ratio of 2:1. The remedy is taken 1 teaspoon 5 times a day after meals.
• Juice is squeezed out of carrots, beets and cucumbers, mixed in a ratio of 4:1:4. Honey is added to the mixture to taste. Taken 100 ml 15 minutes before meals.

In some cases, with stagnation of bile, it may be appropriate to carry out tubage - cleansing the biliary tract by increasing their peristalsis. The procedure is performed like this:

• on the eve of the night, take the drug "No-shpa" (2 tablets of 40 mg) and pour the mineral water "Essentuki" or "Borjomi" from the bottle into a jug;
• in the morning, heat the mineral water to 400C;
• pour ordinary hot water into a rubber heating pad;
• drink 5 sips of mineral water on an empty stomach, lie down, turn on your right side, press a heating pad to your right hypochondrium and cover yourself with a blanket;
• lying down, drink warm mineral water with an interval of 5 minutes, 5 sips;
• after drinking a total of 0.5 liters of mineral water, lie down with a heating pad for another 20 minutes.

After the procedure, frequent stools with an admixture of bile usually appear, the pain disappears and the taste of bitterness in the mouth disappears.

When treating bile stasis with herbs and folk remedies, table number 5 must be observed.

Herbal preparations

In pharmacy chains today it is not difficult to purchase ready-made choleretic agents of plant origin. They are available in different forms - in the form of syrups, tinctures, tablets.

Name of the drug	Group and release form	Mode of application	Contraindications
"Holagol"	Choleretic and cholespasmolytic in the form of drops	10 drops per sugar cube 30 minutes before meals	acute inflammation of the liver; pregnancy and lactation; age up to 12 years.
"Holosas"	Cholekinetic Syrup	1 teaspoon 30 minutes before meals	cholelithiasis; pregnancy and lactation; age up to 12 years; diabetes.
"Convaflavin"	Cholespasmolytic in the form of tablets	2 tablets of 10 mg 3 times a day before meals	individual intolerance.
"Tanatsekhol"	Choleretic in the form of tablets	2 tablets of 50 mg 3 times a day before meals	erosive gastroduodenitis; cholelithiasis; ulcerative lesions of the gastrointestinal tract.
"Hofitol"	Choleretic and cholekinetic in the form of tablets or suspension	1 tablet 200 mg 3 times a day before meals 1 teaspoon suspension 3 times a day before meals	cholelithiasis; obstruction of the bile ducts; age up to 12 years.

As a light antispasmodic, a simple pharmacy tincture of valerian is also suitable. However, before using even the most harmless drugs, you need to undergo a medical examination to clarify the diagnosis.

Therefore, for a child, the doctor may advise the following medicinal choleretic drugs:

• "Allohole";
• "Nicodin";
• "Oxaphenamide".

The dosage, regimen and duration of treatment with the listed drugs is individually determined by the doctor, based on the weight of the child and the diagnosis.

Pregnant women are prescribed only drugs that are not able to provoke an increase in the tone of the uterus or penetrate the placental barrier:

• "Berberis-Gommakord";
• "Hofitol";
• "Febihol";
• "Flamin".

The use of these drugs is possible only for the intended purpose and after clarification of the diagnosis. From choleretic herbs and fees during pregnancy should be abandoned.

Since the stagnation of bile during pregnancy and childhood, left unattended, can lead to dangerous consequences, any signs of it should be reported to the doctor immediately.

Content

Cholestasis, or impaired bile flow, causes congestion in the gallbladder. This active substance is involved in the process of digestion, improves intestinal motility. When it malfunctions, unpleasant symptoms occur. Cholagogue drugs that normalize the function of the biliary system will help to cope with them.

Causes and symptoms of cholestasis

Many factors influence the functioning of the gallbladder. The causes of cholestasis are:

1. Increased nervousness - due to stress, muscles spasm.
2. Instability of the emotional background - slows down the function of digestion.
3. Consumption of foods rich in cholesterol - bile simply cannot cope with its processing.
4. Unbalanced nutrition - the liver is loaded.
5. Low motor activity - tissue hypoxia occurs.
6. Taking certain medications - worsen the activity of bile outflow.
7. Weak abdominal muscles - the gallbladder is not in its place.
8. Inflection of the gallbladder - can be congenital or acquired due to diseases of the kidneys, liver, muscle hypermobility, eating disorders, strong physical exertion, obesity, alcohol abuse, omission of organs. The condition is characterized by a decrease in the synthesis and deterioration of the excretion of bile, threatens the development of stones and polyps.

It is possible to suspect a violation of the biliary function by specific symptoms:

• constipation, diarrhea;
• loss of appetite;
• vomiting, nausea, heartburn, belching with air, bitterness in the mouth;
• dull pain in the right side, radiating to the collarbone, spine, neck;
• bloating and heaviness after eating;
• increased sweating;
• bad breath;
• yellowing of the skin and sclera;
• skin itching;
• dark urine, light stool.

Choleretics with bile stasis

This group of drugs improves the functional abilities of the liver, increases the volume of bile. Means are indicated for cholestasis, constipation, steatosis, liver hepatitis, chronic inflammation or biliary dyskinesia. Cholagogue drugs for stagnation of bile are divided into groups:

1. True - extract of natural bile from animals, plant extracts.
2. Artificial - the components are chemically derived, have antibacterial, antiphlogistic (against inflammation), antispasmodic effects.
3. Vegetable with choleretic action - reduce the viscosity of the bile secretion, activate its secretion and release. At the same time act on the liver.
4. Medicines to reduce the index of supersaturation of bile with cholesterol - additionally serve as a preventive measure for the formation of stones or dissolve existing stones.

True choleretics

Preparations for diluting bile from the group of true choleretics stimulate the production of secretions due to the action of active ingredients. The latter are obtained from natural bile, liver tissues, intestinal mucosa, pancreas of animals.

Name	Active substance	Mode of application	Side effects	Contraindications	Price, rubles
	Bile, garlic, activated charcoal	On an empty stomach 15-30 minutes before meals, 1-2 tablets 3-4 times daily for 3-4 weeks.	Diarrhea, allergies.	Calculous cholecystitis, jaundice, hepatitis, liver dystrophy, pancreatitis, stomach ulcer.	17 for 10 tablets
	Dehydrocholic acid	1 pc. three times a day.	Allergies, nausea, vomiting, diarrhea, heartburn	Age up to 12 years, acute inflammatory liver disease, impaired renal function, pregnancy, lactation.	100 for 20 pcs.
	Freeze-dried bovine liver	1 tablet three times a day after meals for a course of 2 months.	Heartburn, allergies, diarrhea.	Jaundice, pancreatitis.	120 for 15 pcs.

Synthetic choleretics

The basis of the composition of the preparations are chemical compounds obtained by organic synthesis. They have choleretic, antibacterial, antispasmodic, anti-inflammatory effects. Preparations have a positive effect on the digestion process, eliminate flatulence, fermentation.

Name	Active substance	Mode of application	Side effects	Contraindications	Price, rubles
Oxaphenamide		1-2 tablets three times daily for 15-20 days.	Diarrhea, allergies.	Hepatitis, hepatosis, liver cirrhosis, jaundice, stomach ulcer.	150 for 50 pcs.
	Hydroxymethylnicotinamide	500-1000 mg 3-4 times a day for a course of 10-14 days.	Abdominal pain, indigestion.	Antacid gastritis, intolerance to the components of the composition.	120 for 10 pcs.
tsikvalon	cyclovalon	300-400 mg daily in 3-4 doses for 3-4 weeks.	Bitterness in the mouth, feeling of pressure in the abdomen.	Hepatitis, cirrhosis, jaundice, gastric ulcer, blockage of the bile ducts.	35 for 10 pcs.

Herbal preparations with choleretic effect

The composition of the medicines includes herbal extracts with a choleretic effect. They cause liquefaction of bile, stimulate its production, positively affect the functioning of the liver.

Name	Active substance	Mode of application	Side effects	Contraindications	Price, rubles
	immortelle extract	Half an hour before meals, 1-2 tablets 2-3 times daily for 10-40 days.	High blood pressure, allergies.	cholelithiasis, jaundice.	150 for 30 tablets
	Artichoke extract	2-3 tablets three times a day for 2-3 weeks.	Allergy, diarrhea.	Gallstone disease, obstruction of the bile ducts, acute liver disease.	335 for 60 tablets
Urolesan (combination drug)	Oils of fir, mint, castor oil, extracts of carrots, hops, oregano.	8-10 drops on sugar three times a day.	Dyspepsia, skin rash, dizziness, hypotension.	Heartburn, nausea, diarrhea, age under 18.	290 for 25 ml

Hydrocholeretics

The group includes alkaline mineral waters, salicylates, valerian. They increase the secretion of bile by reducing its viscosity, increase the amount of water secreted. Bile stagnates less, quickly enters the duodenum. Every day they take Borjomi, Slavyanovskaya, Essentuki No. 7 water in an amount of up to 1.5 liters, observe the treatment table No. 5. Treatment with hydrocholeretics alone is not carried out, it is combined with other medications.

Cholespasmolytics

The drugs of the group are aimed at reducing the tone, spasms in the gallbladder, bile ducts. Means facilitate the excretion of bile into the intestines, are indicated for stagnation of the secret. They are prescribed for immediate help with cholelithiasis, hepatic colic, cholangitis, cholestasis, cirrhosis, painful spasms against the background of tumor growth.

The drugs are divided into:

• vegetable - contain extracts of mint, St. John's wort, lemon balm, calendula, arnica, elecampane;
• artificial - derived synthetically, contain papaverine, aminophylline, drotaverine;
• anticholinergics - block or weaken the effect of acetylcholine, contain atropine, besalol.

Name	Active substance	Mode of application	Side effects	Contraindications	Price, rubles
	Turmeric pigments, frangulaemodin, magnesium salicylate, peppermint and eucalyptus oils.	5-10 drops on a piece of sugar three times a day.	Bronchospasm, belching, diarrhea.	Biliary tract obstruction, active ulcer, hemorrhagic diathesis, age up to 16 years.	200 for 10 ml
Duspatalin	mebeverine	20 minutes before meals, 200 mg twice daily.	Urticaria, exanthema.	Age up to 18 years.	675 for 50 tablets
Spasmolitin	Adifenine	After meals, 50-100 mg 3-4 times a day for a course of 3-4 weeks.	Nausea, vomiting, heartburn, allergies.	Angle-closure glaucoma.	60 for 10 pcs.

cholekinetics

The choleretic agents of the group restore the function of contraction of the bile ducts, increase the tone of the bladder, and prevent the process of decay. These include magnesium sulfate (magnesia), Platifillin, Febihol, Decholin. They are indicated for chronic cholecystitis, hepatitis, gastritis, before duodenal sounding.

Name	Active substance	Mode of application	Side effects	Contraindications	Price, rubles
Berberis	Berberis vulgaris, citrullus colocynths, veratrum album.	Half an hour before or one hour after meals, 10 drops in 30 ml of water three times a day.	Allergic reactions.	Age up to 18 years.	580 for 30 ml
Mannitol	Mannitol, xylitol.	Intravenously, 50-100 g per day.	Muscle weakness, convulsions, tachycardia.	Dehydration, heart failure, kidney failure, pregnancy.	95 for 400 ml
Holosas syrup	Rosehip extract	One teaspoon 2-3 times a day half an hour before meals.	Allergy, heartburn.	Intolerance to the components of the composition.

Choleretic with litholytic action

To dissolve stones and prevent their formation, special means are used. Cholagogue preparations with an inflection of the gallbladder have a litholytic effect, support liver function, and relieve pain.

Name	Active substance	Mode of application	Side effects	Contraindications	Price, rubles
Gepabene	Extracts of fumes, milk thistle.	During meals, one capsule three times a day.	Allergy, diarrhea, increased diuresis.	Acute liver disease, under 18 years of age.	440 for 30 capsules
	Hymecromon	Half an hour before meals, 200-400 mg three times a day for a course of 2 months.	Diarrhea, flatulence, headache.	Ulcerative colitis, Crohn's disease, bile duct obstruction, hemophilia, age under 18 years.	810 for 100 tablets
Ursofalk	Ursodeoxycholic acid	10 mg per 1 kg of body weight per day.	Diarrhea, nausea, allergies.	Blockage of the bile ducts, acute inflammation.	205 for 10 capsules or 1200 for 125 ml suspension

Cholagogue preparations for children

The choice of drugs for the treatment of a child must be approached carefully. You can buy drugs only after consulting a pediatrician. More often appointed:

1. Herbal choleretics - Holaflux in the form of tea or capsules, Flamin (assigned to children over 5 years old) in the format of ointment, tablets, tea, suspension. They are indicated for the chronic form of cholecystitis, dyskinesia of the gallbladder and ducts. The composition includes herbal ingredients that facilitate the outflow of bile. Means have practically no side effects.
2. True choleretics - Allochol improves the outflow of secretions, normalizes liver function, contains dry animal bile. The drug is prescribed for babies older than a month, ½-1 tablet 2-3 times a day.
3. Combined remedies - Cholenzyme, containing enzymes and improving digestion. The composition includes dry animal bile and herbs, it is prescribed for children over 12 years old in a tablet three times a day. For children from 3 years old, the dosage is calculated individually. The course of treatment lasts no longer than 9 weeks.
4. Cholekinetics - Barberine in tablet format is prescribed from 5 years. This is an effective choleretic and antispasmodic agent, it is contraindicated in case of allergy to barberry.
5. Litholitics - Odeston, shown to children over 10 years old. The preparation of plant origin increases the synthesis and excretion of bile, prevents the processes of crystallization of cholesterol.

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