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Thus, the digestion of proteins and carbohydrates is disturbed, and the concentration of absorption products decreases. Since fat-soluble vitamins (A, D, E, K) are practically not absorbed, hypovitaminosis develops in patients (for example, in a significant number of cases, blood clotting decreases as a result of vitamin K deficiency in patients). Insufficient digestion and absorption of fats leads to the development of steatorrhea (excess fat in the stool). As a result, up to 70-80% of dietary fats are excreted from the body.
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In the absence of bile, the excitability of the intestinal receptors is also disturbed and its peristalsis is disturbed. In combination with the absence of a bactericidal effect of bile in patients, the processes of fermentation and putrefaction in the intestine increase, flatulence increases, and intoxication of the body develops. With a prolonged lack of bile and developing insufficient digestion of food, patients experience incessant constipation, emaciation and exhaustion. In some cases, delirium occurs, occasionally coma develops.
With prolonged loss of bile (from 2 months), the wrists thicken in patients, gait is disturbed, pain in the hands appears, kyphoscoleosis and severe osteoporosis develop, the nails become brittle, the skin peels off, and the teeth are destroyed. As a result of beriberi, impotence, amenorrhea or menorrhagia also develops.
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In the presence of a fistula, its canal is probed, methods using dyes are used.
Treatment should be aimed at eliminating the cause of the disease and restoring bile flow. First of all, conditions are created for an unhindered outflow of bile, and in the presence of an inflammatory focus in fistulas, it is delimited from the free abdominal cavity.