Odeston or allohol which is better. Odeston: instructions and indications for use What is the difference between ursosan and odeston

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Odeston is a selective antispasmodic, the main active ingredient in which is hymecromon. This drug is produced by a Polish pharmaceutical company and is used as part of the complex therapy of liver diseases. The only dosage form is tablets.

The drug is prescribed in the presence of such pathologies (pathological conditions):

• acalculous cholecystitis (in chronic form);
• cholangitis (nonspecific inflammatory lesion of the bile ducts);
• biliary dyskinesia and sphincter of Oddi dysfunction of the hyperkinetic type;
• the occurrence of nausea, vomiting, constipation and other unpleasant manifestations that develop against the background of reduced bile secretion;
• cholelithiasis;
• also prescribed in the postoperative period.

The drug is prohibited for use if the patient has such pathologies (and other reasons):

• Crohn's disease (pathology of the gastrointestinal tract, in which the development of a granulomatous inflammatory process is observed);
• hemophilia (a disease associated with a violation of the process of blood clotting);
• obstruction of the bile ducts;
• renal/liver failure;
• peptic ulcer of the stomach and duodenum;
• chronic pathology of the colon, characterized by immune inflammation of its mucous membrane (ulcerative colitis);
• hypersensitivity.

Use during pregnancy and lactation is not desirable, but in some cases the drug is still prescribed. The drug is contraindicated for children.

Possible side effects:

• pain in the abdomen (abdominal);
• diarrhea;
• ulceration (ulceration) of the mucosa;
• flatulence;
• allergy;
• headache.

The approximate price of the drug is from 383 to 819 rubles. Patients respond positively to the drug Odeston, they note the following: efficiency, affordable price, safety.

The drug Odeston has analogues that differ in price: some are cheaper, others are more expensive. The most famous analogues of Odeston are Allohol, Hofitol, Gepabene, Ursosan.

Allochol

Allohol is a Russian cheap analogue of the Odeston preparation, containing in its composition the following components: dry bile, activated carbon, dried garlic, nettle leaves.

The drug is produced exclusively in the form of tablets and is prescribed in cases where the closest analogue of Odeston is needed, since these two drugs have almost the same list of indications for use. The essential difference between them is the composition: Odeston is a synthetic drug, and Allochol consists of natural ingredients.

Contraindications to the use of this cheap analogue:

• hypersensitivity;
• ulcerative lesions of the stomach or duodenum;
• jaundice (obstructive);
• hepatitis (in acute form);
• liver dystrophy (acute or subacute).

Side effects can manifest themselves in the form of allergic reactions and diarrhea (the list of adverse reactions is insignificant, so the drug can be considered relatively safe).

The approximate price is 15-59 rubles (much cheaper than Odeston). Reviews about Allochol are mostly positive. Patients note such advantages of this analogue: safe composition (herbal components), price, effectiveness, but decide: Odeston or Allohol which is better only the attending physician can.

Hofitol

Hofitol is an expensive French analogue (substitute) for Odeston, in which the main active ingredient is the field artichoke. Indications for use are almost similar, but there are some differences: Hofitol is prescribed for renal failure and nephritis, hepatitis and cirrhosis, while Odeston is not prescribed.

Hofitol, an analogue of Odeston, is contraindicated in such cases:

• if the patient has gallstone disease;
• patients with obstruction of the bile ducts;
• patients diagnosed with acute diseases of the urinary and biliary tract, liver and kidneys;
• if the patient has intolerance to the components that make up the drug Hofitol.

Possible side effects from the use of this cheap analogue are diarrhea and various kinds of allergic reactions (rarely observed, but if they occur, you should contact your doctor to replace the drug).

This drug is produced in the following forms:

• injection;
• oral solution;
• pills.

The approximate price is from 346 to 803 rubles. Patients note its effectiveness in complex treatment, availability and natural composition. The advantages of this analogue drug are a variety of forms of release, fewer side effects (safety), the disadvantage is the price (Hofitol is an expensive analogue of Odeston), so if you need a cheaper option, then Hofitol is not a suitable option for replacement. Only the attending physician can decide that Odeston or Hofitol is better.

Gepabene

Gepabene is a German cheap analogue of Odeston, containing in its composition not synthetic, but plant components. Produced exclusively in the form of capsules. This drug is prescribed for such diseases (indications for the use of the drug are): hepatitis, pathological disorders of the motility of the biliary tract.

The drug is contraindicated in pediatric patients, people with intolerance to the components that make up the drug and if the patient has inflammatory diseases of the biliary tract and liver (during an exacerbation). Pregnant women and breastfeeding women are prescribed Gepabene in exceptional cases.

Possible side effects from the use of an analogue are the occurrence of allergic reactions, a laxative effect and an increase in diuresis.

The approximate price for this analogue of Odeston is 488 rubles (cheaper than Odeston). Patients note its effectiveness, availability and safety (herbal medicine).
Ursosan

Ursosan is an expensive Czech analogue of Odeston, whose active ingredient is ursodeoxycholic acid. This expensive analogue is produced in the form of capsules and tablets.

The drug is used to treat cholelithiasis (in an uncomplicated form), gastroesophageal reflux disease and reflux gastritis (biliary), hepatitis (chronic), fatty liver, biliary dyskinesia, structural changes and impaired liver function due to systematic long-term use alcoholic drinks.

Instructions for use states that the drug is contraindicated if the patient has stones in the biliary tract, hypersensitivity, with a non-functioning gallbladder, malfunction of the pancreas and other organs, cirrhosis, infectious and inflammatory diseases of the biliary tract, occurring in acute form.

There are also some special instructions: careful (and exclusively for the intended purpose) use of this analogue for children under 3 years old, pregnant and lactating.

Possible side effects include the following: calcification of gallstones, nausea and vomiting, allergic reactions, frequent loose stools, abdominal pain, and a transient increase in liver enzymes (transaminases).

The approximate price of the drug is from 187 to 1820 rubles. Reviews about this analogue of Odeston are mostly positive, patients note its effectiveness, safety, and a wide spectrum of action.

Odeston has cheap analogues, the price of which is much lower (or slightly higher), prescribed by specialists in order to defeat liver diseases, pathologies of the biliary tract and kidneys (Ursosan).

The main active ingredient that is part of Odeston (hymecromon) has a number of some advantages (its pharmacological properties):

• promotes increased production of bile;
• stimulates the outflow and excretion of bile;
• eliminates spasms in the bile ducts;
• reduces bile retention in the gallbladder and its ducts;
• used to prevent the crystallization of cholesterol deposits (since such a process can cause the formation of stones).

You can use inexpensive analogues of Odeston only as prescribed by the attending physician, since these drugs have different active components in their composition and, accordingly, differ somewhat in indications, contraindications and the number of adverse reactions. It is also necessary to understand that cheap analogues are not always high-quality substitutes, so in no case should you self-medicate.

The main cause of acute cholecystitis is called the presence of calculi (stones) in the gallbladder, which prevent the normal outflow of bile. The chronic form of the disease develops with prolonged irritation of the bladder walls. Factors influencing the development of cholecystitis are infectious diseases, irregular and unbalanced nutrition, hereditary predisposition, sedentary lifestyle. In the absence of adequate treatment, chronic cholecystitis often becomes acute.

With cholecystitis, complex therapy is required, carried out under the supervision of a specialist. The treatment often includes choleretic drugs prescribed to the patient to normalize the outflow of bile and prevent the formation of stones in the gallbladder. Such drugs can be prescribed by a doctor only if the patient did not find calcified stones in the gallbladder as a result of an ultrasound examination. It is very dangerous to liquefy bile if stones are present, as they can clog the bile ducts and prevent its outflow.

Ursosan - hepatoprotector for cholecystitis

Often, people suffering from cholecystitis, doctors recommend choleretic drugs, the action of which is aimed not only at improving the outflow of bile, but also at dissolving small cholesterol gallstones. Ursosan is a hepatoprotector based on ursodeoxycholic acid. Its dosage directly depends on the patient's body weight, only the attending physician should select it. Contraindications to the use of the drug are the following factors:

• non-functioning of the gallbladder;
• the presence of calcified stones in it;
• pathological changes in the liver, pancreas and kidneys;
• individual intolerance to the components that make up the drug;
• pregnancy and lactation;
• children's age up to 5 years.

Among the side effects in the treatment of Ursosan include:

• loose stools or upset stomach (often);
• urticaria, pain in the right upper part of the abdominal cavity, calcification of gallstones (rarely).

Ursosan is intended for long-term use under medical supervision. Analogues of this medication are drugs such as Ursofalk, Ursohol, Ukrliv, Choludexan, Urdox.

Herbal preparations Allochol and Hofitol

A herbal remedy for cholecystitis is Allohol, produced in tablet form. The composition of the drug includes extracts of nettle and garlic, animal bile, activated charcoal. Allochol enhances the secretion of bile, has a choleretic and laxative effect, improves the functioning of the digestive tract. It is indicated for non-calculous (non-stone) cholecystitis, biliary dyskinesia, chronic hepatitis, cholangitis, constipation. Contraindications to treatment with Allochol are:

• stones in the gallbladder;
• acute form of pancreatitis and hepatitis;
• obstructive jaundice;
• ulcers in the stomach and duodenum.

Allochol is not used in the treatment of children under 3 years of age. Usually the drug is well tolerated by patients and does not give side effects. Sometimes patients may experience allergic reactions and indigestion while taking the medication. The drug must be taken as prescribed by a doctor. The course of treatment with Allohol can last up to 4 months.

Hofitol is an effective herbal choleretic agent actively prescribed by doctors for cholecystitis. Its main active ingredient is an extract of the leaves of the field artichoke. The drug is available in the form of tablets, suspensions and injections in ampoules. It is used for non-calculous cholecystitis, biliary dyskinesia, acetonotomy, chronic hepatitis, nephritis and renal failure. Contraindications to the use of Hofitol for cholecystitis are:

• the presence of stones in the gallbladder;
• obstruction of the bile ducts;
• any diseases of the liver and kidneys in an acute form;
• individual intolerance to the artichoke.

Side effects of Hofitol include allergic reactions and indigestion. The dosage of the drug is determined by the doctor. You need to take the medicine 20 minutes before meals. Like any choleretic drugs, Hofitol can be drunk only on the recommendation of a doctor.

Hofitol was prescribed to me as a means of improving the composition of bile and facilitating its outflow, since there was stagnation and the prospect of the appearance of stones if left untreated. Hofitol took a course of 4 weeks, every day three tablets three times a day. The result was very good, ultrasound showed significant improvements. In addition, digestion improved and the stool returned to normal. The drug is effective.

Odeston - analogues

• lack of appetite;
• dyspepsia;
• chronic hepatitis.

What can replace Odeston?

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Which is better for the liver: Livodex, Allochol, Phosphogliv, Gepabene, Ursosan or Odeston

The liver is the cornerstone of our body. If you can live without one kidney or undergo hemodialysis, then with liver failure, the patient can die in a matter of hours.

For the treatment of liver diseases, doctors prescribe various drugs: Allohol, Phosphogliv, Gepabene, Livodex, Ursosan, Odeston.

But the patient does not always clearly follow the doctor's prescription. The patient has the right to doubt, especially since a sea of ​​advertising information pours out on him from the TV screens. Colleagues and acquaintances are also prescribed similar drugs and they share their experiences.

The question creeps in - which of the medicines works better. To answer it, you need to read the annotation to the drug.

"Livodex"

This drug belongs to hepatoprotectors with a choleretic effect. Tablets "Livodex" red-brown color with a dividing line.

The main active ingredient is ursodeoxycholic acid in two dosages of 150 and 300 mg.

The drug has a hepatorotic and choleretic effect, helps to maintain immunity.

Indications for the appointment of "Livodex":

• symptomatic therapy for biliary cirrhosis;
• cholelithiasis with a working gallbladder;
• reflux disease;
• hepatitis;
• alcoholic cirrhosis or intoxication;
• fatty hepatosis;
• inflammatory process in the bile ducts;
• cystic fibrosis;
• impaired motility of the gallbladder and ducts;

• non-functioning gallbladder, large stones;
• cirrhosis;
• pathology of the kidneys, pancreas;
• age up to 3 years;
• individual intolerance to the drug;

Pregnancy is a relative contraindication. If the benefit to the mother is higher than the potential threat to the fetus, then the drug is justified.

Side effects are mainly associated with dyspeptic symptoms - nausea, vomiting, diarrhea. In rare cases, calcification of stones in the gallbladder or worsening of the general condition with biliary cirrhosis occurs.

The dosage is selected individually by the attending physician, taking into account the weight, age and diagnosis of the patient. The manufacturing company is located in India.

"Ursosan"

Ursosan belongs to the same class of medicines as Livodex - hepatoprotectors. These are white capsules with a white crystalline powder inside.

The main active ingredient of Ursosan is ursodeoxycholic acid at a dosage of 250 mg. The dosage is selected individually for each patient.

If Livodex is not suitable for the dose, then Ursosan is prescribed.

Indications for admission and contraindications for Ursosan are the same as for Livodex. The only difference is that taking the drug can cause back pain, recurrence of psoriasis, hair loss from the head. Produces the drug "Ursosan" in the Czech Republic.

"Allohol"

This drug has a choleretic effect. All components - animal bile, dry extracts of nettle and garlic, activated charcoal in the preparation "Allochol" are active.

This remedy provides:

• cholekinetic action - improvement of the outflow of bile, increases the contraction of the gallbladder;
• choleretic effect - the distribution of bile secretion in uniform portions throughout the day.

"Allohol" is shown in such conditions:

• chronic hepatitis;
• initial stages of cirrhosis;
• cholangitis;
• cholecystitis;
• biliary dyskinesia;
• constipation;
• after removal of the gallbladder.

Contraindications to taking Allohol tablets:

• individual intolerance;
• acute hepatitis;
• liver dystrophy;
• blockage of the bile duct by a stone;
• pancreatitis;
• enterocolitis;
• erosive processes in the gastrointestinal tract;
• gallstones larger than 10 mm.

"Allohol" is taken strictly after meals. Moreover, it can be a small amount - an apple, a pear, a bun. The main thing is the presence of food in the stomach. Tablets "Allochol" stimulate the production of gastric juice. Its excess begins to irritate the gastric mucosa, when taken on an empty stomach.

Pregnancy and lactation is not a contraindication for prescribing the drug.

Tablets "Allochol" practically do not give adverse reactions. In case of an overdose or improper intake, they can cause dyspeptic symptoms - stool upset, nausea.

"Gepabene"

This drug is based on the extract of milk thistle and fumes officinalis, in action it is very similar to the previous tablets.

But "Gepabene" has a number of contraindications:

• inflammatory processes of the liver in the acute stage;
• age up to 18 years;
• pregnancy.

Side effects are similar to "Allohol" - disorders of the gastrointestinal tract.

Phosphogliv

This tool also belongs to the class of hepatoprotectors.

The main active ingredient of Phosphogliv capsules and lyophilisate is phospholipids and sodium glycyrrhizinate.

Phosphogliv has the following effect:

• protection of liver cells;
• anti-inflammatory effect;
• restores detoxification mechanisms in liver tissues;
• strengthens local immunity.

Indications for taking the drug "Phosphogliv":

• hepatitis;
• fatty hepatosis;
• toxic liver damage;
• cirrhosis;
• psoriasis;
• neurodermatitis;
• other skin lesions associated with the state of the liver.

"Phosphogliv". Contraindications to the appointment:

• age up to 12 years;
• pregnancy;
• the period of breastfeeding;
• allergic reaction to the main and auxiliary active substances.

Side effects of the hepatoprotector "Phosphogliv" are few. Cases of various dermatological reactions are described - rashes, urticaria, which disappeared after discontinuation of the drug.

"Odeston"

Tablets "Odeston" is a choleretic agent. Take this medicine half an hour before meals.

The main active ingredient is Hymecromone.

Indications for the appointment of the drug "Odeston":

Contraindications to the appointment of the drug "Odeston":

• obstruction of the bile ducts;
• renal and liver failure;
• ulcerative colitis, erosion of the stomach and intestines;
• hemophilia;
• individual intolerance to the components of the drug.

Odeston tablets are not prescribed for pregnant women, children and adolescents under 18 years of age.

Side effects are standard: flatulence, nausea, diarrhea. Occasionally, "Odeston" causes headaches and allergic reactions.

What drug is better?

The effect of the drug depends on a lot of factors:

• the patient's diagnosis;
• age;
• accompanying illnesses;
• individual characteristics of the body.

Therefore, it is inappropriate to say which is better - Ursosan, Phosphogliv, Odeston or Livodex. One patient helps one drug, the second - another, even with the same diagnosis.

The selection of a drug is the prerogative of the doctor and his patient. Therefore, do not listen to friends and neighbors. Trust the gastroenterologist and your own body.

Attention! Information about drugs and folk remedies is provided for informational purposes only. In no case should you use the medicine or give it to your loved ones without medical advice! Self-medication and uncontrolled intake of drugs is dangerous for the development of complications and side effects! At the first sign of liver disease, you should consult a doctor.

©18 The editors of the portal "My Liver".

The use of site materials is permitted only with prior agreement with the editors.

Hofitol / Ursosan

the doctor prescribed hofitol or ursosan, saying that the baby's jaundice has not gone away yet. So I think, has anyone given these drugs to their baby? How does it affect?

And then this same kind aunt prescribed academy for us, and there in contraindications - CHILD AGE ... something this aunt does not inspire confidence in me.

Prevention and treatment of vitamin D deficiency.

Prevention and treatment of rickets, rickets-like diseases, hypocalcemic tetany, osteomalacia and metabolic-based bone diseases (such as hypoparathyroidism and pseudohypoparathyroidism).

In the complex treatment of osteoporosis, including postmenopausal.

The drug is used in a spoonful of liquid.

1 drop contains about 500 IU of vitamin D3.

Unless the doctor prescribes otherwise, the drug is used in the following dosages:

• full-term newborns from 4 weeks of life, up to 2-3 years with proper care and sufficient exposure to fresh air: ME (1-drop) per day;
• premature babies, from 4 weeks of life, twins, babies in poor living conditions: (2-3 drops) per day. In the summer, you can limit the dose to 500 ME (1 drop) per day.
• pregnant women: 500 IU of vitamin D3 daily for the duration of pregnancy, or 1000 IU/day from 28 weeks of gestation.
• in the postmenopausal periodME (1-2 drops) per day.

Hypersensitivity to the components of the drug, especially to gasoline alcohol. Hypervitaminosis D, increased blood calcium concentration (hypercalcemia), increased excretion of calcium in the urine (hypercalciuria), urolithiasis (formation of calcium oxalate stones), sarcoidosis, acute and chronic diseases of the liver and kidneys, kidney failure, active form of pulmonary tuberculosis. Children's age up to 4 weeks of life.

With caution: a state of immobilization, when taking thiazides, cardiac glycosides (especially digitalis glycosides); during pregnancy and breastfeeding.

In infants with a predisposition to early overgrowth of fontanelles (when small sizes of the anterior crown are established from birth).

My child had jaundice and we treated it with ursosan. The tool is good, it works almost immediately and improvements begin. Well, now we are healthy.

Mom won't miss

women on baby.ru

Our pregnancy calendar reveals to you the features of all stages of pregnancy - an unusually important, exciting and new period of your life.

We will tell you what will happen to your future baby and you in each of the forty weeks.

Ursosan or hofitol which is better

Odeston - white tablets (sometimes with a yellowish tint), which have antispasmodic and choleretic properties.

Indications for use

• nausea,
• vomiting,
• loss of appetite,
• constipation
• cholangitis,
• non-calculous chronic cholecystitis,
• cholelithiasis,
• sphincter of Oddi discenia and biliary tract.

In addition, Odeston is indicated for conditions after operations on the gallbladder and liver, like its counterparts.

Contraindications

The drug Odeston is not prescribed for:

• renal and hepatic insufficiency;
• ulcerative lesions of the stomach;
• obstruction of the gallbladder;
• ulcerative colitis;
• duodenal ulcer;
• Crohn's disease;
• lactation;
• hemophilia.

At the same time, it is better not to take Odeston in case of hypersensitivity to all components of the drug, as well as to coumarins.

Analogues

The drug Odeston has no structural analogues for the active substance, however, according to the pharmacological group, drugs such as Allochol and Hofitol are the most similar. These analogues have a choleretic effect, due to which they can rightfully be referred to as analogues.

Allochol

Allohol is a well-known drug that has been produced since 1964 by the Borshchagovsky Chemical and Pharmaceutical Plant. This medicine is best used for pathological disorders of the hepatobiliary system.

A whole team of scientists worked on the creation of the drug Allochol, led by N.G. Belenky. The medicine is interesting because it has a completely unique composition.

Allohol contains the following components of animal and vegetable origin:

• garlic powder containing a large amount of antimicrobial, antithrombotic and cholesterinemic active biological components;
• activated carbon, which is the most common and effective enterosorbent, which has the ability to adsorb toxic substances even before they are absorbed by the digestive system;
• nettle leaves, which have choleretic and hemostatic properties, reduce flatulence, enhance the activity of the digestive system, reduce blood cholesterol levels;
• dry bile, which takes part in the digestive process due to the activation of pancreatic enzymes.

Allochol is an effective drug, like Odeston. Its components stimulate the synthesis of bile acid, prevent the spread of infection, reduce the likelihood of the formation of cholesterol stones, improve the secretory function of liver cells, reduce the intensity of inflammatory processes, improve the digestion process by accelerating the outflow of bile, and eliminate atonic constipation.

The drug Allochol is indeed a time-tested remedy, since its release was launched more than 50 years ago, and during this time it has been made better and more effective. In addition, it is convenient to always carry the medicine with you.

Hofitol

Hofitol is a well-known analogue of the drug Odeston, however, it is similar to Allochol only in that it has diuretic, choleretic and hepatoprotective effects. In addition, the active substances of the drug improve the metabolism of cholesterol and lipids, the metabolism of ketone bodies by increasing the ability of hepatocides to produce coenzymes. The drug also helps to reduce the level of urea in the blood serum.

When using Hofitol, side effects such as an allergic reaction to the components, as well as diarrhea, can be observed if the drug has been taken for a long time.

This medicine is contraindicated in acute diseases of the liver, kidneys, biliary and urinary tract, cholelithiasis, obstruction of the biliary tract, hypersensitivity to the components of the drug.

The composition of Hofitol tablets includes:

• field artichoke in the form of a dry aqueous extract;
• pregelatinized corn starch;
• talc;
• sucrose;
• gum arabic;
• gelatin;
• calcium carbonate;
• gummilac;
• disperse dye;
• magnesium stearate;
• polysorbate 80;
• rosin;
• magnesium trisilicate;
• carnauba wax.

The drug Hofitol is prescribed with extreme caution in conditions that contribute to the development of biliary tract obstruction, like Odeston. If the patient has diarrhea, this medicine should be stopped immediately and a doctor should be consulted.

In the course of clinical trials, experts did not reveal any effect of the drug on the speed of psychomotor response, so it is allowed to be used by people working as drivers of vehicles.

Hofitol and Allochol are only choleretic analogues of Odeston. Their effectiveness has been tested by time. All of them are freely available, however, before using them, it is strongly recommended to consult a doctor.

especially for Moizhivot.ru

Cholagogue drugs are a specific group of medicines, without which people with diseases of the biliary tract cannot imagine a normal life. Odeston is one of the most famous representatives of his group. The drug works quickly and very effectively. But despite its many advantages, the drug is not suitable for everyone. Fortunately, there are quite a few analogues of Odeston, so everyone can choose the most effective and suitable medicine for themselves.

Which is better - Hofitol, Ursosan, Allohol or Odeston?

All these drugs are well-known cholagogues, which in certain circles are simply crazy popular. Each of the medicines has its own characteristics, so before choosing a truly effective replacement for Odeston, you will have to consult a specialist.

Odeston is a great choleretic agent. In addition to increasing the formation and secretion of bile, the drug can have a selective antispasmodic effect on the sphincter of Oddi and the bile ducts. The active components of Odeston prevent the precipitation of cholesterol crystals, while not reducing the peristalsis of the gastrointestinal tract and in no way affect blood pressure.

The main difference between one of the most popular analogues of Odeston Allochola tablets is in the composition. The main active ingredient in Odeston is Hymecromon. Allohol contains activated charcoal, nettle leaves, garlic, and bile.

As practice has shown, Ursosan and Odeston are best taken in parallel - the drugs complement each other remarkably. And Hofitol, by the way, can be replaced by Odeston for the period of prophylaxis.

Indications for the use of all the above drugs and their other analogues are approximately the same:

• biliary dyskinesia;
• problems associated with a decrease in bile secretion (frequent constipation, nausea, vomiting);
• chronic forms of cholangitis and cholecystitis;
• lack of appetite;
• a simple form of gallstone disease;
• dyspepsia;
• chronic hepatitis.

Many experts prescribe Odeston and its analogues to restore the body after operations on the gallbladder and biliary tract.

What can replace Odeston?

The choice of analogue largely depends on the characteristics of the patient's body and, of course, the form of the disease. It often happens that drugs that are ideal for one person are completely useless for another. That is why the selection of medicines is desirable to be carried out under the supervision of a specialist, based on the results of examinations.

The same applies to the dosage and duration of the course of medication. Often, a couple of weeks of taking a choleretic agent is enough for a complete recovery, but in especially difficult cases, treatment can even stretch for several months.

Among the effective analogues of Odeston tablets, you can find the following medicines:

Those who prefer to be treated with natural remedies choose medicines such as Bittner's herbal elixir or Demidov's elixir. Various gastrointestinal and choleretic preparations have proven themselves very well.

Of course, all these drugs have contraindications and the most common of them look like this:

1. Odeston and its analogues are not suitable for people with bile duct obstruction.
2. It is better to refuse funds for pregnant women.
3. Medicines (for the most part) are not suitable for children under 18 years of age.

Diseases of the gallbladder and biliary tract are one of the most important medical and social problems, as there is a constant increase in the incidence worldwide. From year to year, the number of operations on the biliary tract is growing, as well as the number of postoperative complications, which make it necessary to resort to repeated surgical interventions and often lead to permanent disability of the patient.

Chronic acalculous cholecystitis is considered by most authors as the initial stage of cholelithiasis, since during the inflammatory process in the gallbladder the biochemical structure of bile changes, and bile acquires lithogenic properties. Therefore, early detection and treatment of chronic non-calculous cholecystitis can serve as a prevention of gallstone formation.

The main role in the development of chronic acalculous cholecystitis is played by an infection that enters the gallbladder by the hematogenous route through the hepatic artery and portal vein, by the lymphogenous route, or by the ascending route from the intestine. Any chronic focus of infection in the body (chronic tonsillitis, chronic salpingo-oophoritis, sinusitis), as well as a chronic inflammatory process in the gastrointestinal tract (GIT), can be a source of infection in the bile. Bacteriological examination of bile often reveals Escherichia coli, staphylococci, enterococci, Klebsiella, clostridia, typhoid and dysentery bacteria, and Proteus. However, only in 30–40% of patients, the microflora in the biliary tract is detected, since sensitization of the body and a decrease in the immunological reactivity of the macroorganism are of decisive importance in the occurrence of inflammation in the biliary tract.

The biliary tract is a complex system of bile excretion, including the common hepatic duct, formed from the confluence of the right and left hepatic ducts, the gallbladder with the Lutkens sphincter, the common bile duct, starting from the junction of the hepatic and cystic ducts, and the ampulla of the major duodenal papilla.

With each meal, the gallbladder contracts 1-2 times. In this case, bile enters the intestines, where it participates in digestion. The gallbladder on an empty stomach contains 30-80 ml of bile, but with stagnation, its amount may increase.

In women, the gallbladder in a state of functional rest has a slightly larger volume than in men, but it contracts faster. With age, the contractile function of the gallbladder decreases.

The leading role in the occurrence of dysfunctional disorders of the biliary tract belongs to psycho-emotional factors - psycho-emotional overload, stressful situations. Dysfunctions of the gallbladder and sphincter of Oddi may be manifestations of neurotic conditions.

The influence of psychogenic factors on the function of the gallbladder and biliary tract is realized with the participation of cortical and subcortical formations, nerve centers of the medulla oblongata, hypothalamus, and the endocrine system.

Synchronicity disorders in the work of the gallbladder and sphincter apparatus underlie dysfunctional disorders of the biliary tract and are the cause of the formation of clinical symptoms.

Disturbances in the motor function of the biliary tract play a significant role in the formation of not only pain, but also dyspeptic disorders (feeling of heaviness in the epigastrium and right hypochondrium, vomiting, heartburn, belching, bitter taste in the mouth, flatulence, stool disorders). The wall of the gallbladder is easily extensible, which is due to the presence of both smooth muscle and elastic fibers in its middle membrane. Due to the similar structure of the gallbladder wall, both the entire organ and its individual parts contract.

The contraction of the smooth muscles of the gastrointestinal tract occurs when acetylcholine stimulates muscarinic receptors on the surface of the muscle cell, which is accompanied by the interaction of the Ca 2+ , Na + and K + channels of the cell membranes. These processes determine the contraction and relaxation of smooth muscle cells and, consequently, changes in muscle tone.

The motor activity of the biliary tract is regulated with the participation of central reflexes, local (gastroduodenal) reflexes caused by mechanical stretching and exposure to food components, and humoral influences. Under the influence of these regulatory links, the gallbladder contracts, and the sphincter of Oddi relaxes.

An important place in the regulation of the functions of the biliary system is occupied by gastrointestinal hormones. In this case, the leading role belongs to cholecystokinin, gastrin, secretin, motilin, glucagon.

Cholecystokinin is the most important humoral stimulator that provides synchronous contraction of the gallbladder and relaxation of the sphincter apparatus of the biliary tract in response to food intake. It is now known that there is a direct connection through the nerve fibers between the duodenum, on the one hand, and the gallbladder and the sphincter of Oddi, on the other, conducting cholinergic excitation to the nerve ganglia of the gallbladder and the sphincter of Oddi.

Secretin produced in the duodenum stimulates the secretion of water, electrolytes and bicarbonates by the epithelium of the biliary and pancreatic ducts and potentiates the effects of cholecystokinin.

Motilin is an important hormone that regulates gastrointestinal motility. The introduction of motilin causes a decrease in the volume of the gallbladder and an increase in the contractility of the antrum of the stomach.

Neurotransmitters that cause relaxation of the smooth muscle cells of the biliary tract include vasoactive intestinal peptide (VIP) and nitric oxide (NO), produced by the enzyme NO synthetase. VIP inside muscle cells stimulates an increase in the level of cyclic adenosine monophosphoric acid, and NO - increases the level of cyclic guanidine monophosphoric acid. VIP and NO mutually reinforce each other's production.

Norepinephrine, which is secreted by sympathetic postganglionic fibers and, acting presynaptically on the vagal nerve endings in the gallbladder ganglia, plays a certain role in the regulation of contraction of the smooth muscles of the gallbladder, reduces the release of acetylcholine from the vagal nerve endings.

Currently, the term "dysfunctional disorders of the biliary tract", according to the classification of functional disorders of the digestive system, includes all diseases associated with impaired motility of the biliary tract, regardless of their etiology. According to the classification of functional disorders of the gastrointestinal tract, gallbladder dysfunction and dysfunction of the sphincter of Oddi are distinguished.

Eating a large amount of fatty and fried foods can cause spasm of the sphincter of Oddi and Lutkens, as well as a violation of the metabolism of cholesterol and bile acids, which predisposes to the development of cholecystitis.

To dysfunction of the biliary tract, the development of hypotension and atony of the sphincter of Oddi, contributing to the reflux of the contents of the duodenum into the biliary tract, leads to long-term use of anticholinergics and antispasmodics with the formation of "pharmacological" cholestasis, as well as duodenostasis. Therefore, in case of peptic ulcer with localization of the process in the duodenal bulb, changes in the biliary tract are often observed. In addition to motor-secretory disorders in the system of the gallbladder and biliary tract, infections and metabolic disorders in the body, some other factors are also important in the genesis of the development of cholecystitis: genetic predisposition, occupational hazards (work with vibration, sedentary work) and repeated pregnancies.

Changes in the chemical composition of bile (dyskrinia) in the form of an increase in the concentration of bile salts can cause aseptic inflammation of the gallbladder. The significance of reflux of pancreatic juice, which is a consequence of a violation of the physiological mechanisms of the Vater papilla with a common ampoule for the excretory ducts of the liver and pancreas, into the bile ducts in the genesis of cholecystitis has been proven. With a free outflow of pancreatic juice into the duodenum, no changes in the gallbladder are detected, but if the outflow is disturbed and hypertension in the biliary system increases, the stretching of the gallbladder leads to a change in the normal capillary blood flow in the bladder wall. This causes a violation of tissue metabolism, damage to cellular elements and the release of cytokinase, which converts trypsinogen into trypsin, which leads to the development of enzymatic cholecystitis.

Cholelithiasis is a multifactorial and multistage disease characterized by impaired metabolism of cholesterol, bile acids and/or bilirubin with the formation of stones in the gallbladder and/or bile ducts.

In the above classification of cholelithiasis, four stages of the disease are distinguished (A. A. Ilchenko, 2002).

I, initial or prestone stage:

a) thick heterogeneous bile;

b) formation of biliary sludge

– with the presence of microliths;

- with the presence of putty bile;

- a combination of putty-like bile with microliths.

II, stage of gallstone formation:

a) by localization

- in the gallbladder;

- in the common bile duct;

- in the hepatic ducts;

b) by the number of stones

d) according to the clinical course

- with the presence of clinical symptoms:

• pain form with typical biliary colic;
• dyspeptic form;
• under the guise of other diseases.

III, stage of chronic recurrent calculous cholecystitis.

IV, stage of complications.

Thus, the mechanism of development of cholecystitis is complex, diverse, often there are several factors that lead to biliary tract disease.

Pathogenetic therapy of cholecystitis sets itself the task of removing the inflammatory process in the wall of the gallbladder, normalizing the processes of bile formation and bile secretion, and preventing the formation of stones. Given the important role of the nutrition factor in this process, treatment involves, first of all, frequent, fractional meals. Reception of a small amount of food at the same hours normalizes choleresis, promotes a better outflow of bile into the intestines and prevents the development of cholestasis. A single meal in large quantities can lead to intense contraction of the gallbladder and the development of biliary colic. Therefore, it is advisable to recognize the food in small portions 4-5 times a day.

Due to the fact that during the inflammatory process in the gallbladder, the pH shifts to the acid side (bile acidosis), which contributes to the precipitation of cholesterol in the form of crystals and a change in the ratio of bile acids towards cholesterol (cholate-cholesterol coefficient), diet should be sharply limited or eliminate foods containing acidic valences. These are primarily flour, spicy dishes, meat, fish, brains, etc.

The content of proteins in the diet of patients with cholecystitis should correspond to the physiological norm of 80–90 g per day. Protein-rich foods - cottage cheese, milk and cheese - cause a shift in the bile reaction to the alkaline side. It should be borne in mind that food poor in proteins leads to the development of fatty degeneration of the liver, disruption of the repair and regeneration process, disruption of the synthesis of many enzymes and hormones. All this indicates that a long-term restriction of protein intake in patients with chronic cholecystitis is not justified.

Fats stimulate bile secretion, and the majority of patients do not need to limit them. However, animal fats are rich in cholesterol and should be consumed in limited amounts by patients with chronic cholecystitis. With insufficient flow of bile into the intestines, fats are poorly broken down, which leads to irritation of the intestinal mucosa and the appearance of diarrhea. It has been shown that diets with an increased amount of fat due to vegetable oil have a positive effect on the bile lipid complex, bile formation and bile secretion. A lipotropic-fatty diet with a 1:1 ratio of animal and vegetable fats is recommended. It should also be remembered that vegetable oils (corn, sunflower, olive) due to their content of unsaturated fatty acids - arachidonic, linoleic, linolenic - improve cholesterol metabolism, participate in the synthesis of prostaglandins (arachidonic acid), affect gallbladder motility. Fats increase the metabolism of fat-soluble vitamins, especially vitamin A.

Carbohydrates, especially easily digestible ones (sugar, glucose, honey, jam), which were previously recommended to increase liver glycogenization, should be limited, especially with overweight. It has been proven that glycogen stores decrease only with massive liver necrosis. Including high amounts of easily digestible carbohydrates can enhance lipogenesis and thereby increase the likelihood of gallstone formation. Therefore, the use of flour and sweet foods should be limited. The diet should be rich in vegetable fiber, which eliminates constipation, and this reflexively improves the emptying of the gallbladder. The diet should include carrots, pumpkins, watermelons, melons, grapes, wheat and rye bran. With oxalaturia and phosphaturia, tomatoes, sorrel, spinach, and radishes should be limited. The content of carbohydrates in the first week of exacerbation of cholecystitis should be 250–300 g, from the second week it should increase to 350 g, but the proportion of simple sugars should be no more than 50–100 g per day.

Thus, with an exacerbation of chronic cholecystitis in the first week, the calorie content of food is 2000 calories, later, when the inflammatory process subsides, the calorie content can be increased to 2500 calories.

A complete vitamin composition of food is a necessary condition for the diet therapy of chronic cholecystitis. Foods containing lipotropic factors should be included in the diet: oatmeal and buckwheat, cottage cheese, cheese, cod, soy products. Food preparation is of great importance. During the period of exacerbation, a sparing version of the diet is prescribed - table No. 5a, which provides for the limitation of mechanical and chemical stimuli. During the period of remission, the main dietary regimen is diet number 5, which excludes foods rich in cholesterol and extractives, spicy snacks, salty, smoked and fried foods. The total calorie content of the diet corresponds to the physiological norm - 2500 calories (90 g of protein, 85 g of fat, 350 g of carbohydrates).

The basis of drug treatment of chronic cholecystitis is anti-inflammatory therapy. Antibiotics are widely used to suppress infection in the biliary tract. The choice of an antibacterial drug depends on individual tolerance and on the sensitivity of the bile microflora to the antibiotic. The most effective are antimicrobial drugs of the fluoroquinolone group - norfloxacin (nolicin, norbactin, girablok) 0.4 g 2 times a day, ofloxacin (tarivid, zanotsin) 0.2 g 2 times a day, ciprofloxacin (ciprobay, ciprolet, tsifran) 0.5 g 2 times a day, levofloxacin (tavanic, lefoktsin) 0.5 g 2 times a day; macrolides - erythromycin 0.25 g 4 times a day, azithromycin (Sumamed, Azitrox, Azitral) 0.5 g 1 time per day, clarithromycin (Klacid, Klabaks, Clerimed) 0.5 g 2 times a day, roxithromycin (rulid, roxide, roxolid) 0.1 g 2 times a day, midecamycin (macropen) 0.4 g 2 times a day and semi-synthetic tetracyclines - doxacycline (vibramycin, unidox solutab, medomycin) 0.1 g 2 times per day, metacycline 0.15 g 4 times a day. You can use semi-synthetic penicillins: ampicillin 0.5 g 4 times a day, oxacillin 0.5 g 4 times a day, ampioks 0.5 g 4 times a day - although they are less active. In severe cases, cephalosporins (ketocef, cefobid, klaforan, cefepime, rocefin). The oral route of taking the antibiotic is preferable, the usual therapeutic doses, the course of treatment is 7-8 days, it is possible to repeat the course with other antibiotics after 3-4 days. Correction of antibiotic therapy is carried out after receiving a bile culture on the microflora and determining its sensitivity to the antibiotic.

In the absence of sensitivity of the bile microflora to antibiotics or the presence of an allergy to them, co-trimaxosole (biseptol, bactrim) 2 tablets 2 times a day is recommended, although its effectiveness is much lower than that of antibiotics, and the adverse effect on the liver is higher. A good effect is the use of nitrofuran drugs - furazolidone, furadonin, as well as metronidazole (0.5 g 3 times a day for 7-10 days).

With a pronounced pain syndrome, in order to reduce the spasm of the sphincter of Oddi and the sphincter of Lutkens, with dysfunctions of the gallbladder in the hypermotor type, antispasmodics are indicated. There are several groups of antispasmodics that differ in their mechanism of action.

As antispasmodics, both selective (methacin, gastrocepin) and non-selective M-anticholinergics (buscopan, platifillin) are used. However, when taking this group of drugs, a number of side effects can be observed (dry mouth, urinary retention, visual disturbances, tachycardia, constipation). The combination of rather low efficacy of this group of drugs with a wide range of side effects limits the use of this group of drugs.

Direct-acting antispasmodics, such as papaverine, drotaverine (no-shpa), are effective for stopping spasms. However, they are not characterized by selectivity of action, since they affect all tissues where smooth muscles are present, including the vascular wall, and cause vasodilation.

Mebeverine hydrochloride (Duspatalin) has a much more pronounced antispastic activity, which also has a direct myotropic effect, but it has a number of advantages over other antispasmodics. It almost selectively relaxes the smooth muscles of the digestive tract, does not affect the smooth muscle wall of blood vessels and does not have systemic effects characteristic of anticholinergics. According to the mechanism of action, duspatalin is a sodium channel blocker. The drug has a prolonged action, and it should be taken no more than 2 times a day in the form of capsules of 200 mg.

Myotropic antispasmodics include pinaverium bromide (dicetel). The main mechanism of its action is the selective blockade of calcium channels located in the smooth muscle cells of the intestine, biliary tract and peripheral nerve endings. Dicetel is prescribed 100 mg 3 times a day for pain.

Hymecromone (odeston) is a drug that has a selective antispasmodic effect on the sphincter of Oddi and the sphincter of the gallbladder. This drug combines antispasmodic and choleretic properties, ensures harmonious emptying of the intra- and extrahepatic biliary tract. Odeston does not have a direct choleretic effect, but facilitates the flow of bile into the digestive tract, thereby enhancing enterohepatic recirculation of bile acids. The advantage of Odeston is that it has practically no effect on other smooth muscles, in particular the circulatory system and intestinal muscles. Applied odeston 200-400 mg 3 times a day 30 minutes before meals.

All antispasmodics are prescribed in a course of 2-3 weeks.

In the future, they can be used if necessary or repeated courses. In acute pain syndrome, drugs can be used one-time or in short courses.

In the relief of pain, a special role is given to drugs that affect visceral sensitivity and nociceptive mechanisms. Currently, the possibility of prescribing antidepressants, 5-HT3 receptor antagonists, k-opioid receptor agonists, and somatostatin analogues for pain of this genesis is being discussed.

Antidepressants (amitriptyline, mianserin, etc.) are used in medium doses, the duration of their intake should be at least 4-6 weeks.

In case of gallbladder dysfunction caused by hypomotor dyskinesia, prokinetics are used to increase contractile function for 10-14 days: domperidone (motilium, motonium, motilac) or metoclopramide (cerucal) 10 mg 3 times a day 20 minutes before meals.

The appointment of choleretic agents requires a differentiated approach depending on the presence of inflammation and the type of dysfunction. They are shown only after the inflammatory process subsides. All choleretic drugs are divided into two large groups: choleretics - drugs that stimulate bile formation, and cholagogue - drugs that stimulate bile secretion.

Choleretics include drugs that increase the secretion of bile and stimulate the formation of bile acids (true choleretics), which are divided into:

• on preparations containing bile acids - decholine, allochol, cholenzym, hologon;
• herbal preparations - hofitol, tanacechol, cholagol, livamine (liv.52), hepabene, hepatofalk, silimar;
• drugs that increase the secretion of bile due to the water component (hydrocholeretics) - mineral waters.

The second group of drugs that stimulate bile secretion include:

• cholekinetics - agents that cause an increase in the tone of the sphincters of the biliary tract and gallbladder - magnesium sulfate, Karlovy Vary salt, sorbitol, xylitol, cholagogum, olimetin, rovachol, preparations containing oil solutions - tykveol;
• drugs that cause relaxation of the biliary tract (cholespasmolytics) - platifillin, no-shpa, duspatalin, odeston, ditsetel.

The drugs of these groups should be prescribed differentially, depending on the type of dyskinesia that accompanies chronic cholecystitis.

In the period of exacerbation of chronic acalculous cholecystitis, physiotherapeutic procedures are indicated: electrophoresis with antispasmodics for dysfunctions of the hypermotor type and with magnesium sulfate for hypomotor dysfunction. Diathermy, inductothermy, paraffin, ozocerite, UHF therapy on the gallbladder area are prescribed. Recently, there have been works devoted to the effectiveness of laser therapy for chronic acalculous cholecystitis. During the onset of remission, physiotherapy exercises can be used to help empty the gallbladder.

In the treatment of chronic acalculous cholecystitis, herbal treatment is becoming increasingly important - herbal medicine, which allows you to prolong the therapeutic effect of medications. Medicinal plants are also divided into two groups: choleretics and cholekinetics, although many of them have both effects. The first group includes: flowers of immortelle sandy (flamin), corn stigmas, peppermint, tansy, common barberry fruits, elecampane root, centaury herb, dandelion root, common yarrow, black radish juice.

The second group includes: hawthorn flowers, valerian root, dandelion root, fruits and bark of the common barberry, grass of the pharmacy smoke, blue cornflower flowers, calendula, wild chicory root, rose hips, cumin seed, dill seed, tansy, sandy immortelle, lavender, Melissa officinalis. Medicinal plants are used in the form of infusions and decoctions. Choleretic herbs with different mechanisms of action are widely used.

Infusions and decoctions of herbs are used half a glass 30 minutes before meals 2-3 times a day, for a long time, for several months (2-3 months). It is advisable to cook them daily or for 2 days. It is necessary to follow the principle of gradual expansion of the spectrum and the addition of herbs to the collections (but not more than 5 herbs), taking into account the individual tolerance of individual herbs and concomitant diseases. Phytotherapy courses should be repeated 3-4 times a year.

Mineral waters have long been widely used in the treatment of chronic cholecystitis, since most of them have a choleretic and cholekinetic effect, affect the chemistry of bile, increasing the cholate-cholesterol coefficient. Oral application of mineral waters can be combined with intraduodenal lavage, as well as blind probing (tubage without a probe). Tubage is carried out in the morning on an empty stomach. The patient drinks in sips for 40–50 minutes 0.5 l of degassed warm mineral water (Essentuki, Smirnovskaya, Slavyanovskaya) with the addition of 15–20 g of xylitol or 1/3 teaspoon of Karlovy Vary salt. In cholecystitis with hypomotor dysfunction of the gallbladder, the patient is recommended moderate physical activity 1-1.5 hours before meals. Bottled mineral waters are widely used. It is also shown to stay at the resorts: Essentuki, Zheleznovodsk, Krainka, Monino, Dorohovo, Karlovy Vary, etc. When prescribing mineral waters, the state of the secretory function of the stomach is taken into account. In addition, balneological factors have a positive effect on the state of the nervous system and neuro-humoral regulatory mechanisms of bile secretion.

The presence of biliary sludge in the gallbladder as a pre-stone stage of cholelithiasis requires correction in the treatment of patients with chronic cholecystitis. Drugs are prescribed that increase choleresis, cholecystokinetics, as well as drugs of ursodeoxycholic and chenodeoxycholic acids: ursofalk, ursosan - at the rate of 10 mg / kg of body weight once at night or chenofalk, lithofalk at the rate of 15 mg / kg of body weight once at night. The duration of litholytic therapy is 3 months, after which an ultrasound examination (ultrasound) is performed.

Treatment of cholelithiasis at the stage of formed stones requires a different approach to the management of patients. The only non-invasive treatment is oral litholytic therapy with bile acids.

Litholytic therapy is carried out with contraindications to surgical treatment and if the patient refuses surgery. However, there are certain contraindications to the appointment of litholytic therapy: pigmented and mixed stones, the diameter of the stones is more than 10–15 mm, the number of stones occupying more than 1/3 of the gallbladder, impaired contractile function of the gallbladder, the presence of active hepatitis, biliary cirrhosis and peptic ulcer in the stage exacerbations. Ursodeoxycholic or chenodeoxycholic acid is prescribed at a dose of 15 mg/kg of the patient's body weight for two doses (morning and night). Perhaps a combination of these drugs in a half dose each (8 mg / kg of body weight). Therapy is carried out for a long time - for 1 year or longer. Ultrasound is performed every 3 months. If there is no effect after 6 months, treatment is stopped, about which the patient must be warned in advance. Possible side effects of therapy in the form of diarrhea and a transient increase in aminotransferases, and therefore it is necessary to control the biochemical blood profile every 3 months.

With successful therapy, drugs are prescribed in the future that increase choleresis and normalize the motor-evacuation function of the gallbladder and biliary tract. In order to prevent recurrence of cholelithiasis after 1.5–2 years, repeated courses of bile acid preparations in half doses are recommended for 2–3 months.

Other non-surgical treatments include extracorporeal shock wave lithotripsy and contact endoscopic lithotripsy.

Thus, by eliminating the factors that cause the development of chronic cholecystitis, and adopting the principle of therapeutic rational nutrition, pharmacological agents, herbal medicine, sanatorium treatment, it is possible to influence the complex pathogenetic mechanisms of the development of chronic acalculous cholecystitis and prevent the development of cholelithiasis. Sanitation of chronic foci of infection, treatment of underlying diseases are essential components of therapy and can prevent the development of chronic cholecystitis or its exacerbation. However, given the variety of factors and complex mechanisms for the development of biliary tract pathology, treatment that requires patience from both the doctor and the patient should be long-term, prolonged (drug therapy, herbal medicine, mineral waters) and carried out sequentially.

Literature

1. Belousov AS, Vodolagin VD, Zhakov VP Diagnosis, differential diagnosis and treatment of diseases of the digestive system. Moscow: Medicine, 2002. 424 p.
2. Ilchenko A. A. Gallstone disease. M.: Anacharsis, 2004. 200 p.
3. Kalinin AV Functional disorders of the biliary tract and their treatment//Clinical perspectives of gastroenterology, hepatology. 2002. No. 3. S. 25–34.
4. Leishner U. A practical guide to diseases of the biliary tract. M.: GEOTAR-MED, 2001. 264 p.
5. Loranskaya I. D., Mosharova E. V. Biliary dysfunctions: diagnosis, treatment: textbook. M., 2004. 20 p.
6. Shulpekova Yu. O., Drapkina O. M., Ivashkin V. T. Abdominal pain syndrome//Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2002. V. 12. No. 4. S. 8–15.
7. Yakovenko E. P., Agafonova N. A., Kalnov S. B. Odeston in the treatment of diseases of the biliary tract // Practitioner. 2001. No. 19. S. 33–35.
8. Drossman D. A. The functional gastrointestinal disorders. second edition. 2000. 764 p.

I. D. Loranskaya, Doctor of Medical Sciences, Professor

L. G. Rakitskaya, Candidate of Medical Sciences, Associate Professor

E. V. Malakhova, Candidate of Medical Sciences

L. D. Mamedova, Candidate of Medical Sciences, Associate Professor

Hofitol from what is prescribed, indications for use

This drug is prescribed for diseases of the liver and gallbladder, namely: for jaundice, for pancreatitis, for choletasis, for cholecystitis, for bending of the gallbladder, for hepatitis, for gastritis, for gastroduodeitis, for giardiasis (from giardia), with a remote gallbladder, from edema during early pregnancy with toxicosis, for infants, with constipation, from heartburn, with polyhydramnios (as a diuretic).

The drug is good because it contains natural extracts and is widely used for pregnant women. It can also be taken for prevention, for many years, when the disease is chronic.

Compound

• Release form: tablets, ampoules and solution and syrup (suspension).
• The tablet contains artichoke extract 0.2g. The package contains 60 tablets.
• Ampoule - 0.1g.
• Solution - 1g.
• At home, tablets and solution are used. Ampoules are designed for injection.
• Manufacturer France. Shelf life - 3 years.

Hofitol analogues are cheap

There are quite a lot of cheaper analogs of hofitol. These are Flamin, Ursosan, Odeston, Ursofalk, Holosas, Galstena, Legalon, Cholenzim. These drugs are similar in their action, but have a different composition. Which substitute to buy should be decided by the doctor.

The cheapest, similar to the drug hofitol, are allochol and holosas. It is very good to take in combination with drugs such as Karsil, Hepabene, Essentiale, Liv, since the liver is closely connected with the bile and it has bile ducts.

The cost of hofitol is from 300 rubles, and allohol from 22 rubles. There is no analogue cheaper than allochol. Although the active ingredient is the same. Prices in Novorossiysk and Novosibirsk do not differ from the market average. Before replacing, consult your doctor.

Allohol or hofitol which is better?

When changing the drug, be sure to consult a doctor. Allochol has the same active ingredient - artichoke. But in addition to cleaning the biliary tract, it will also improve the functioning of the gastrointestinal tract, eliminate constipation and relieve nausea. This is a very good, natural, choleretic way.

Also, these drugs have different additional substances. Allochol also contains an extract of garlic and nettle, as well as animal bile. And it costs less.

Instructions for use hofitol tablets

• Children over 12 years old and adults are prescribed 1-2 tons 3 times a day.
• At an earlier age (but not less than 6 years) 1 tablet 3 times a day.
• The course of treatment is 2-3 weeks. According to the doctor's prescription, it can be used for longer. Drink the drug before meals.
• After how many minutes does it start to work? - After 30.

During pregnancy

Can be used in early pregnancy to prevent preeclampsia if nausea is present. But only after consulting a doctor. The drug is widely used in gynecological practice. Studies on the use of breastfeeding (lactation) have not been conducted. When taking any drug in breast milk can be 1%. Therefore, it is not known how it will affect babies.

Why is it prescribed for newborns?

Newborns often suffer from jaundice. This is not a disease. After 1-2 weeks (up to a month) everything passes. Hofitol reduces bilirubin in the blood. How to apply to a newborn is determined by the doctor. But, as a rule, it is 5-10 drops diluted in 5 ml of boiled water. It is necessary to dilute, as the drops contain alcohol.

Syrup for children how to give, dosage

As you know, hofitol can be given to children and infants. The dose for infants is calculated depending on the weight of the child.

Children from one to five years old take a drop diluted in 15 ml of water. From 6 to 12 years old drops, diluted with water.

There is also hofitol syrup. Some call children's hofitol, as it is sweetish. It can be given to children from 6 years of age, 1 tsp. before meals. At an earlier age, you can not give, as the syrup contains additional substances.

Instructions for use of the drug Odeston says that it is intended to eliminate symptoms that relate to bile stasis. This is heaviness and pain in the right side, bitterness in the mouth, nausea. Odeston stops the stagnation of bile, promotes the crystallization of cholesterol and the formation of gallstones, regulating bile.

The drug Odeston is produced at Pabyanitsky Pharmaceutical Plant Polfa AO.

Release form and composition

The drug Odeston 200 mg is available in the form of round tablets of a light shade, or there may be flat cylindrical tablets with one-sided engraving "Ch".

On sale, the medicine is available in plates or in plastic jars of 50 tablets.

One tablet of the drug contains 200 mg of hymecromon and special substances: starch, gelatin, sodium lauryl sulfate and magnesium stearate.

Indications for use

The drug Odeston is used in the treatment of such diseases:

• violations of contractions of the gallbladder and its ducts;
• non-calculous chronic cholecystitis, cholangitis, cholelithiasis;
• during the rehabilitation period after intervention on the gallbladder and biliary tract;
• with a decrease in appetite, nausea, constipation, vomiting (against the background of bile hyposecretion).

Mode of application

Must be taken inside 30-40 minutes before meals. Adult dosage of 200-400 mg (up to 800 mg) 3 times a day for 2-3 weeks. Children's dosage 200-600 mg / day for 1-3 doses.

Side effects

Side effects when taking the drug Odeston may be:

• various allergic reactions;
• diarrhea;
• abdominal pain;
• ulceration of the gastrointestinal mucosa;
• severe headaches.

Contraindications

It is forbidden to take the drug for people who:
shennaya hypersensitivity

Overdose

In case of an overdose, an increase in unwanted effects may be noticeable.

According to statistics, there are no factors that relate to cases of Odeston overdose in humans.

Alcohol compatibility

Doctors say that it is undesirable to drink alcoholic beverages with any medication. Alcohol is processed by the liver, which receives a load from the disease and from the effects of drugs. Drinking alcohol can lead to unwanted results. No exception and the drug Odeston.

Which is better: allohol, ursosan, duspatalin, hepabene, flamen or odeston

Name of the drug	Price	Best before date	During pregnancy	Dosage, mg
Allochol (50 pcs)	41.2 UAH/77 RUB	4 years	By appointment	100
Ursosan	865.86 UAH/1729 RUB	4 years	Allowed	250
Duspatalin (30 pcs)	119.14 UAH/558 RUB	5 years	Forbidden	200
Gepabene	150.36 UAH/274 RUB	3 years	By doctor's prescription	275
Flamin (30 pcs)	86.65 UAH/198 RUB	5 years	By appointment	50
Odeston (50 pcs)	470 UAH/611 RUB	3 years	prohibited	200

Odeston during pregnancy

Pregnant women can take the drug Odeston only in exceptional cases. If the doctor has analyzed the ratio of benefits to the mother and the risk to the fetus and can say that it cannot be done without its use. Clinical trials on pregnant women have not been conducted.

Storage conditions

Store the drug at a temperature not higher than 25 °C. Avoid contact between children and the drug.

Price

Analogues

Before replacing Odeston with any analogue, consult a doctor. It may be that it is impossible to replace the drug with an analogue.

The drug has several substitutes that are identical in composition.

is a herbal medicine. Its base is an extract from the field artichoke. The medicine not only solves choleretic problems, but also restores liver cells and has a mild diuretic effect.

The drug expresses a choleretic effect, normalizes the production of bile and prevents the formation of stones.

Despite its small size, the gallbladder is a very important organ involved in the digestive process. It is a repository of bile that enters it and is excreted into the intestinal lumen. Another function of the gallbladder is the so-called reverse absorption of proteins, amino acids and salts into the blood, as well as the secretion of mucus and the synthesis of the hormone anticholecystokinin. The volume of the gallbladder is approximately 50 ml.

The formation of bile occurs in the liver, then it enters through a complex network of bile ducts into the organ, where it remains until the next meal. Once ingested food reaches the duodenum, the gallbladder contracts, expelling bile and pancreatic juice into the intestines. In 24 hours, up to 1 liter of bile is produced in an adult human body. It consists of special acids, water, vitamins A, B, C, phospholipids, amino acids, bilirubin, cholesterol, inorganic substances, mucus, proteins and other substances.

Signs of pathology

The symptoms of gallbladder diseases are quite similar, regardless of the cause of the appearance, the nature of the pathology and the pattern of development. The main symptom of problems in this organ is a constant aching pain in the right hypochondrium. The pain syndrome is not relieved by painkillers and, as a rule, appears after fried, fatty or spicy foods. If a stone comes out of the gallbladder, the pain becomes a cutting, sharp form. This process is also characterized by:

1. Increase in body temperature.
2. Nausea, belching, vomiting and other signs of dyspepsia.
3. Constipation, diarrhea and other intestinal disorders.
4. Increased flatulence and bloating.
5. Loss of appetite and unreasonable weight loss.
6. Dry mouth and feeling of bitterness.
7. Rash on the body, accompanied by itching.
8. Yellowing of the skin.
9. The color of the urine becomes intensely yellow, and the feces may become discolored.
10. Irritability and insomnia.

Icteric syndrome on the skin and sclera of the eyes is an obvious sign of a pathological process in the liver. In this case, there is a high risk of complications such as cirrhosis, liver failure, bleeding of internal organs, etc.

Causes

The reasons for the development of pathologies in the liver and gallbladder are most often age, genetic factor, malnutrition, etc. In any case, this is a serious malfunction of the body and requires immediate intervention and prescription of medication.

Treatment

To date, in the complex treatment and in order to prevent diseases of the gallbladder and liver, specialists quite often prescribe choleretic drugs. The reason for this is the ability of this group of drugs to relieve paroxysmal pain, mitigate the course of the pathology and prevent relapses. One of these drugs is, according to reviews, Odeston. It is classified as an antispasmodic with a choleretic effect.

Compound

The drug is produced in the form of tablets. Packed in packs of up to 50 pieces. The active ingredient is Hymecromon (200 mg per tablet). Excipients include gelatin, potato starch, magnesium stearate and lauryl sulfate.

Mechanism of action

We will consider reviews about Odeston in this article. This drug belongs to the group of antispasmodics with a pronounced choleretic effect. The active substance of the drug increases the production of bile and its release into the intestine through the bile ducts. The drug does not allow substances to linger in the gallbladder and form crystals and stones.

In addition, "Odeston" has a stimulating effect on the functioning of the organs of the gastrointestinal tract. The drug reaches its peak concentration in the body three hours after ingestion. Instructions for use for "Odeston", according to reviews, are available in each package.

The drug is rapidly absorbed from the gastrointestinal tract, practically without coming into contact with plasma protein. The half-life process occurs in about an hour. 93 percent of the substances are excreted in the form of glucocuronate in the urine, about 1.5 percent in the form of sulfonate, and about half a percent is excreted unchanged.

Indications

Indications for taking "Odeston" are the following pathologies:

1. Stagnant processes that disrupt the gallbladder.
2. Inflammatory processes in the gallbladder, not accompanied by the appearance of stones.
3. Operations performed on the bile ducts and bladder.
4. Signs of bile hyposecretion - a feeling of bitterness in the mouth, nausea, pulling pains in the hypochondrium on the right.
5. Failures in the execution of contractions by the gallbladder, ducts and sphincter of Oddi.

Before using Odeston, according to reviews, it is necessary to undergo an examination to make the correct diagnosis, as well as to exclude the presence of stones in the bile ducts, malignant neoplasms in the liver.

Contraindications

The drug is contraindicated in the following situations:

1. Severe renal or hepatic failure.
2. Blockage of the bile ducts (obstruction).
3. Peptic ulcer of the duodenum or stomach.
4. Ulcerative colitis.
5. Age under 18 years, as there are no clinical data in patients of this category.
6. Genetically determined hematological diseases.
7. Crohn's disease.
8. The presence of stones in the gallbladder more than 1 cm in diameter.
9. Intolerance to the components of the drug or hypersensitivity to them.

This is confirmed by instructions and reviews for Odeston.

Side effects

Manifestations of individual intolerance and hypersensitivity to substances in the composition of "Odeston", according to reviews, are the following symptoms:

1. From the digestive system: bloating, diarrhea, vomiting, cramps, increased flatulence, abdominal pain and bloating.
2. Allergic reactions: urticaria, rash, etc.
3. From the side of the central nervous system: insomnia, headaches, irritability, etc.

If you notice the development of these symptoms while taking it, you should stop the drug and consult a specialist. In most cases, reducing the dosage of the drug helps to get rid of side effects.

Overdose

There is no exact data on cases of overdose with Odeston. Patient reviews confirm this. However, it is known that when taking abnormally large doses of the drug, severe diarrhea may develop. This phenomenon can disrupt the water-salt balance in the body, and therefore requires immediate elimination. If you accidentally took a large amount of the drug, then you need to perform a gastric lavage and drink activated charcoal. Diarrhea and vomiting require treatment.

Mode of application

"Odeston" is taken inside 30 minutes before meals. The daily dose is selected based on the individual characteristics of the body and indications. The normal dosage regimen is 1-2 tablets 3 times a day. The course of therapy should have a duration of at least two weeks. Perhaps a longer use of the drug.

If during treatment the condition worsens, there is an increase in pain in the right hypochondrium, stop taking the drug and consult a doctor.

Reviews of tablets "Odeston" are available in large numbers.

There are no clinical studies for use during pregnancy. However, in order to avoid the development of intrauterine pathologies during the gestation period, it is not recommended to be treated with the drug.

There is no data on whether hymecromon can pass into breast milk, its effect on the development of the baby has not been studied. For this reason, it is recommended to stop breastfeeding during therapy.

special instructions

"Odeston" should not be taken simultaneously with drugs that can cause spasm of the sphincter of Oddi. When taken simultaneously with morphine, the effect of the choleretic drug weakens.

According to doctors, Odeston enhances the healing properties of indirect anticoagulants. This must be taken into account when prescribing at the same time, as dosage adjustment may be required.

If the drug is taken in conjunction with enterosorbents and antacids, its therapeutic effect is significantly reduced. For this reason, a break of approximately 2 hours should be observed between taking these two drugs.

"Odeston" does not affect the functioning of the pancreas and the production of hydrochloric acid. The work of the central nervous system and psychomotor functions are also not affected by the drug.

The drug has not been used in pediatrics, therefore it is not recommended to prescribe it to patients under 18 years of age, since safety in this case has not been proven.

Tablets are sold in pharmacies, a prescription is not required. Keep the drug in a cool place out of the reach of children. Shelf life 3 years. It is strictly forbidden to take an expired drug. This is confirmed by instructions and reviews for Odeston.

Analogues

Preparations similar in composition are not produced. However, the pharmaceutical market presents analogues similar in therapeutic effect. These include:

• "Allohole";
• "Ursosan";
• "Hofitol";
• "Olivitin".

The main difference between "Odeston" and its most popular substitute "Allochol" today is the composition. If the former contains hymecromon, then in the case of the latter, the active ingredients are nettle leaves, activated charcoal, bile and garlic. According to reviews, the analogues of "Odeston" are inferior.

"Ursosan" and "Odeston" are very often prescribed for a complex reception. They are very good at complementing each other's properties. "Hofitol" helps to replace "Odeston" in the period of prevention of recurrence of diseases of the choleretic system.

It is not worth replacing the drug with analogues on your own. Before taking any drug, a thorough examination and consultation of a specialist is necessary. This rule also applies to the duration of administration, as well as to the dosing regimen. For some patients, several weeks are enough to get positive dynamics, for others it takes at least a month.

Cholagogue drugs are a specific group of medicines, without which people with diseases of the biliary tract cannot imagine a normal life. Odeston is one of the most famous representatives of his group. The drug works quickly and very effectively. But despite its many advantages, the drug is not suitable for everyone. Fortunately, there are quite a few analogues of Odeston, so everyone can choose the most effective and suitable medicine for themselves.

Which is better - Hofitol, Ursosan, Allohol or Odeston?

All these drugs are well-known cholagogues, which in certain circles are simply crazy popular. Each of the medicines has its own characteristics, so before choosing a truly effective replacement for Odeston, you will have to consult a specialist.

Odeston is a great choleretic agent. In addition to increasing the formation and secretion of bile, the drug can have a selective antispasmodic effect on the sphincter of Oddi and the bile ducts. The active components of Odeston prevent the precipitation of cholesterol crystals, while not reducing the peristalsis of the gastrointestinal tract and in no way affect blood pressure.

The main difference between one of the most popular analogues of Odeston tablets is in the composition. The main active ingredient in Odeston is Hymecromon. Allohol contains activated charcoal, nettle leaves, garlic, and bile.

As practice has shown, Ursosan and Odeston are best taken in parallel - the drugs complement each other remarkably. And Hofitol, by the way, can be replaced by Odeston for the period of prophylaxis.

Indications for the use of all the above drugs and their other analogues are approximately the same:

• problems associated with a decrease in bile secretion (frequent constipation, nausea, vomiting);
• chronic forms of cholangitis and cholecystitis;
• lack of appetite;
• a simple form of gallstone disease;
• dyspepsia;
• chronic hepatitis.

Many experts prescribe Odeston and its analogues to restore the body after operations on the gallbladder and biliary tract.

What can replace Odeston?

The choice of analogue largely depends on the characteristics of the patient's body and, of course, the form of the disease. It often happens that drugs that are ideal for one person are completely useless for another. That is why the selection of medicines is desirable to be carried out under the supervision of a specialist, based on the results of examinations.

The same applies to the dosage and duration of the course of medication. Often, a couple of weeks of taking a choleretic agent is enough for a complete recovery, but in especially difficult cases, treatment can even stretch for several months.

Among the effective analogues of Odeston tablets, you can find the following medicines:

• Holos;
• Urosliv;
• Livodex;
• Vitanorm;
• Cavehol;
• Urosan;
• Febihol;
• Olimentin;
• Cynarix;
• Urso 100;
• Oxaphenamide;
• Gepabene;
• Urolesan;
• Cavehol;
• Tykveol;
• Urodox;
• Ursodez;
• Holosas;
• Rompharm;
• Hepatofalk;
• Sibektan;
• Flamin;
• Cynarix.

Those who prefer to be treated with natural remedies choose medicines such as Bittner's herbal elixir or Demidov's elixir. Various gastrointestinal and choleretic preparations have proven themselves very well.

Of course, all these drugs have contraindications and the most common of them look like this:

1. Odeston and its analogues are not suitable for people with bile duct obstruction.
2. It is better to refuse funds for pregnant women.
3. Medicines (for the most part) are not suitable for children under 18 years of age.