Irritable large intestine syndrome is what
Dyskinesia of the intestine (irritable bowel syndrome) is a kind of functional disease caused by impaired intestinal motility in the absence of its organic damage.
When dyskinesia of the intestine, the motor function of other parts of the gastrointestinal tract - esophagus, stomach, motor function of the small intestine is also disturbed. Therefore, the term dyskinesia of the intestine is more competent than the definition of dyskinesia or irritable bowel syndrome.
2. Etiology and pathogenesis
The causes and mechanisms of the development of this pathology have not been fully studied. However, the following factors can be considered reliably established etiologic factors:
- neuropsychological and psychoemotional stress factor;
- violation of the usual diet;
- Infectious agents and previous acute intestinal infections;
- intolerance of some food products and their effect on intestinal motility in connection with a perverted response to many nerve and humoral stimuli;
- hereditary factor;
- gynecological diseases (cause reflex
- endocrine disorders (menopause, dysmenorrhea, obesity, hypothyroidism, diabetes, etc.);
- a sedentary lifestyle and a change in the nature of nutrition with a small intake of ballast substances and plant fiber.
The pathogenetic role of endogenous opioid peptides (enkephalins) in the development of the syndrome irritated bowel, which have a significant effect on motor function and secretion through opioid receptors.
1.2. Secondary (gastrogenic, hepatogenic, pancreatogenic, allergic, medicamentous).
2. According to the clinical course.
2.1. With painless diarrhea.
2.2. With constipation (with a changeable stool).
2.3. With mucous colic.
3. By the nature of motor disorders of the intestine.
3.1. With predominance of hypermotorics (hyperkinetic).
3.2. With predominance of hypomotorics (hypokinetic).
4. Clinical picture
The clinical picture of dyskinesia of the intestine is very diverse. The most characteristic symptoms are the following:
- abdominal pain localized around the navel or lower abdomen, which may be paroxysmal or permanent, have varying intensity and duration. With dyskinesia, an important distinctive feature is the absence of pain at night;
- flatulence, accompanied by loud rumbling and often pain in the abdomen. Usually, flatulence increases in the evening or before the act of defecation. The combination of local meteorism with pain leads to the development of splenic flexure syndrome, hepatic flexion syndrome, cecal syndrome;
- symptoms of ulcer dyspepsia - a feeling of heaviness and overfilling in the epigastrium, nausea and belching of the air;
- expressed neurotic manifestations.
An overwhelming majority of patients with dyskinesia of the intestine have a disorder of stool. The most common is constipation. Coprostasis is localized most often in the sigmoid and rectum. Patients complain of a rare stool, sometimes a difficult act of defecation, a lack of a feeling of complete emptying of the bowels after defecation. The feces are fragmented, like the sheep. Constipation may be replaced by short-term diarrhea.
When diarrhea occurs, the stool is more often 3 times a day, the daily amount of feces exceeds 200 g, the feces increase the fluid content.
In rare cases, with dyskinesia of the intestine, there is a so-called mucosal colic, that is, a state where the stool on a background of stressful situations contains a significant admixture of mucus. Sometimes mucus without feces is secreted from the rectum.
5. Treatment and prevention
A complex of therapeutic measures for dyskinesia of the intestine should include dietary recommendations, medication, physical therapy, psychotherapy. There is no special diet for patients with dyskinesia. In the diet include foods containing dietary fiber (bread with bran, pure cereals, fruits and vegetables, rich in fiber).
If there is pain in the abdomen for a short time, a gentle diet is prescribed. When constipation shows mineral waters of high mineralization (Essentuki No. 15, Batalinskaya) in a cold form 1 glass 3 times a day for 30-40 minutes before meals. With diarrhea, on the contrary, it is prescribed weakly mineralized water (Slavyanovskaya, Smirnovskaya, Jermuk) in a warm form.
Drug therapy of functional bowel diseases includes psychotropic drugs and drugs that regulate intestinal motility and normalizing stools.
From psychotropic drugs use tranquilizers, antidepressants, antipsychotics. The role of psychotherapy is also great. Apply all its types, including hypnosis, abdominal variant of autogenic training, various variants of behavioral psychotherapy. With functional bowel diseases, antispasmodics and drugs normalizing intestinal motility are used. The latter include nifedipine and its analogs. Of the drugs with polytropic effect, the values of papaverine, no-spa, halidor, gastrocepin, etc., did not lose their significance.
With diarrhea, indomethacin is used and preparations that have a predominantly astringent, enveloping and adsorbing action (bismuth preparations, Almagel maalox, Gastalum). Imodium provides a good antidiarrheal effect.
As non-pharmacological agents for treating patients with functional bowel disorders, physiotherapy, acupuncture, curative microclysters with herbal infusion can be recommended.
Prevention of dyskinesia of the intestine requires a healthy lifestyle, rational nutrition, proper and harmonious upbringing, improving the methods of psychological protection.
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