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Even if a person's heart does not beat, he can still live for a long period of time, which was demonstrated to us by the Norwegian fisherman Jan Revsdal. His "motor" stopped for 4 hours after the fisherman got lost and fell asleep in the snow. Human bones are four times stronger than concrete. The meaning of dapsone pills Acholia according to the dictionary of medical terms: acholia (acholia; a- Greek chole bile) - the absence or decrease in the flow of bile into the intestines; observed with obstruction of the common bile duct, hypotonic biliary dyskinesia, or lesions of the liver parenchyma.

General information Forms Causes of development Pathogenesis Symptoms Diagnosis Treatment.

Although acholia syndrome under various names has been mentioned in the literature for a long time, there is currently no solid work on this issue as a result of a small number of observations in an individual surgeon.

Since acholia is observed with an external biliary fistula, these concepts are often identified in the literature, but it is more correct to refer to acholia those cases of bile loss in which specific pathophysiological, morphological, biochemical and clinical manifestations are observed.

The meaning of the word Acholia according to the Brockhaus and Efron dictionary: Acholia (Greek) - lack of bile, insufficient secretion of bile, occurs in feverish conditions of various kinds, in liver diseases, after severe bleeding and with a considerable duration leads to insufficient absorption of food, incessant constipation, emaciation and exhaustion.

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Acholia (acholic condition, acholic disease, fistulous disease, bile leakage, biochemical exhaustion) is a condition in which there is a partial or complete cessation of bile flow into the duodenum.

As a result of prolonged bile loss in the human body, a complex of disorders occurs associated with the cessation of the participation of bile in the process of digestion, and the subsequent violation of the functional activity of various organs and systems. Acholia is an important symptom of diseases of the biliary tract (blockage of the common bile duct, external bile fistula, etc.)

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The first case of loss of bile as a result of the formation of an external biliary fistula was described in 1670 by Thilesus, and the formation of fistulas and bile loss, which is observed in 1/3 of patients with perforation of the gallbladder, was described in 1890 by Courvoisier. The loss of bile as a result of the formation of biliary fistulas was studied by I.L. Bregadze, Yu.V. Astrozhnikov and others.

Currently, many researchers distinguish: Preaholiya, latent and explicit (chronic) acholia, depending on the stage of development of the acholia syndrome. Mild, moderate and severe acholia, depending on the severity of the disease. Acholia compensated, subcompensated or decompensated, depending on the patient's condition. According to the presence of concomitant lesions of organs and systems, hepatopathy, encephalopathy, angiopathy, etc.

The bile produced by the cells of the liver parenchyma (hepatocytes) is secreted into the bile canaliculi and then into the gradually enlarging bile ducts.

Having reached the hepatic and common bile ducts, bile is secreted directly into the duodenum or redirected within a minute or several hours through the bile duct to the gallbladder.
With the formation of a fistula, blockage (compression) of the bile ducts, or disorders of the neurohumoral mechanisms of regulation, bile does not enter the duodenum.
Since the main physiological values ​​of bile include activation of intestinal and pancreatic enzymes, a decrease in the reproduction of putrefactive bacteria, increased absorption of vitamins A, D, E, K and emulsification of fats, with acholia, the digestion and absorption of fat is disturbed (in the absence of bile, the pancreatic enzyme lipase is inactive, fats do not dissolve and do not come into contact with the lipolytic enzyme).

Enveloping food masses with undissolved fat, as a result of which proteolytic and amylolytic enzymes are not able to break down proteins and carbohydrates. Normally acidic gastric sodaRye is neutralized by bile, which maintains an alkaline environment in the duodenum that is optimal for duodenal juice enzymes. Reducing the adsorption of enzymes from the contents of the intestine by intestinal cells, as a result of which parietal digestion is disturbed. Normally, the sorption properties of the intestinal epithelium are stimulated by bile acids.

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