Irritable Bowel Syndrome Symptoms and Treatment
Irritable bowel syndrome, symptoms and treatment
Of all gastroenterological diseases, irritable bowel syndrome (CPTC) occurs most often. This term is used to refer to manifestations associated with functional disorders of the colon. They contain symptoms of varying severity: abdominal pain, a feeling of raspiraniya, flatulence, diarrhea (diarrhea) and constipation with their alternation, the presence of mucus in the stool.
By definition, WA Thompson (1992), "irritable bowel syndrome # 8212; functional an intestinal disorder in which abdominal pain is combined with violations of bowel movements and intestinal transit ". Synonyms of SRTK in the literature are such definitions as spas of adjoining intestinal colitis, mucocutaneous colic, dyskinesia of the large intestine, spastic intestinal syndrome, etc.
Etiology and pathogenesis of CPTC
The basis of CPTC are various disorders of motor activity of the intestine. A major role in the development of SRTK is attributed to the characteristics of a person, which inc
Depression and other neurotic reactions are noted in about 80% of patients with SRTK, i.e. There is a strong functional connection between the central nervous system and the gastrointestinal tract (GI tract). In conditions of stress, endogenous opioids and catecholamines act on the secretory-motor functions of the gastrointestinal tract.
An important pathophysiological moment in the pathogenesis of SRTK is the appearance of so-called "habitual constipation which are formed as a result of various situations (hasty chair, bad toilet, shyness, etc.). In the pathogenesis of SRTK, the role of drugs is played, widely and uncontrolledly used population, changes in the nature of the diet (reduction of dietary fiber content), endogenous disorder. Thus, SRTK should be considered a poly-tyological disease.
Each patient can detect some leading component that caused the CPTK.
CPTK Clinic Symptoms
Sick men are more often than young people, and women are twice as likely as men. Patients complain of weakness, decreased appetite, irritability, etc.
The most characteristic signs of the disease are violation of defecation, pain in the lower abdomen and flatulence.
SRTK can occur in 3 clinical variants: with predominance of constipation and pain syndrome (spastic colitis), with chronic intermittent diarrhea; and in a mixed version, when diarrhea alternates with constipations.
At the first clinical variant constipations are accompanied by chronic spastic pains in the abdomen (more often in the area of the sigmoid colon), which decrease after defecation or the escape of gases. Cal in these patients resembles sheep, that is, has a solid consistency and the shape of round balls, small in size. Sometimes constipation is replaced for a while by mushy stool, which contains a lot of mucus. Often patients do not have the urge to defecate.
Pain in the abdomen can be localized in the mesohastrium, around the navel, to the right, to the left and to the groin. The pain worries for a long time, for several years, as a rule, is permanent, but the more it intensifies and reminds of colic. Sometimes during a bout of pain, a large amount of mucus in the form of films is released.
This indicates an increased secretion of goblet cells, the function of which is regulated by nervous mechanisms. After the act of defecation, pain, as a rule, decreases, and with nervous overstrain increases.
In the presence of a second clinical option, the leading place belongs to intermittent water type diarrhea, which lasts for several months or years. It is most pronounced in the morning or after breakfast. After three to fourfold retreat of the liquid stool, the patient's condition remains satisfactory throughout the day. The volume and weight of feces exaggerate the physiological norms (200-250 g). This fact is a differential diagnostic criterion for eliminating the diagnosis of enteritis, in which the volume of diurnal faeces is much higher.
In addition to the violation of defecation and the presence of pain, in patients with SRTK, the mandatory component is a personality change. They often become anxious, emotionally unstable. During an attack of pain, the volume of the abdomen is usually increased, but the peristalsis is not manifested.
The muscles of the abdominal wall are not strained. The painful sigmoid colon is palpable in the left lower quadrant of the abdomen.
Clinical criteria for diagnosis of CPTK:
1. Abdominal pain or discomfort in combination with an act of defecation, changes in the frequency and consistency of the stool.
2. During the whole time or several days there are:
- # 8212; Stool frequency disorder;
- # 8212; Frustration of stool decoration;
- -stair disorder (incomplete, intermittent, etc.)
- # 8212; Increased mucus in the stool;
- # 8212; Bloating (flatulence).
The diagnosis of CPTC can be determined definitively only after additional studies that eliminate the organic nature of the disease.
- - Investigation of feces for latent blood, eggs of worms, pathogenic microorganisms;
- # 8212; Colonoscopy;
- # 8212; Irrigoscopy;
- # 8212; X-ray of the stomach;
- # 8212; Ultrasonography;
- # 8212; Biopsy of the mucosa of the small or large intestine.
The diagnosis of SRTK is based on the chronic course of the disease in the absence of organic anomalies, on a clear relationship between intensity of symptoms and external, primarily emotional, as well as to exclude the presence of other diseases. For SRTK, symptoms such as anorexia, weight loss, the presence of blood in the feces, fever, night diarrhea, the recent onset of symptoms that are more characteristic of the organic pathology of the thick guts.
Treatment of SRTK
Psychotherapy plays a leading role in the treatment of patients with SRT. The patient should be convinced that the disease is firmly connected with his mental state, provide him with hygienic recommendations on the regime of work and rest. From the diet should eliminate products that cause pain, flatulence, stool. Most often these products are milk, apples, raw or canned vegetables, coffee, strong tea, etc.
To avoid constipation, patients should take a sufficient amount of fluid; develop the habit of liberating intestines at the same time; you can move more and eat foods that accelerate motor skills intestines. Offer to adhere to a diet with a high content of dietary fiber, B vitamins, and also eat vegetables, fruits, black bread with bran. Should be consumed daily 1-2 tablespoons of vegetable oil. A good effect is provided by prunes (up to 30 fruits per meal).
Of great importance is the motor activity (walking, walking up the stairs, etc.) ..
With diarrhea associated with a decrease in the tone of the colon, the symptomatic effect is promoted by drugs, which reduce the propulsive function (imodium dose to, 02 g, codeine phosphate by, 15 g three times in day). It is recommended to use enveloping agents (bismuth, calcium salts, white clay), spasmolytic herbs (peppermint, chamomile). Patients with pain syndrome and increased bowel tone are advisable to prescribe during periods of exacerbation of the disease anticholinergic preparations # 8212; selective (gastrotsepin # 8212; 25 g 3 times / day) or non-selective (metacin, platyphylline, belladonna in small doses).
At the same time, they use antispasmodics (no-shpa, halidor, papaverine, baralgin). With a decrease in the tone of the intestine, so-called gastrokinetics are effective, which increase the motility of the gastrointestinal tract (cerucal # 8212; 10 mg 4 times / day).
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Irritable Bowel Syndrome
By the term "irritable bowel syndrome physicians imply a disruption of the functioning of the colon, in no way related to its organic damage. That is, with this syndrome, no inflammatory and other pathological processes in the intestinal wall develop. However, for such a diagnosis, the patient should note disorders in the intestinal for at least 3 months, and to exclude organic pathology - to undergo a thorough examination intestinal tract.
The main cause of irritable bowel syndrome (IBS) is stress. It is with stressful situations and emotional overstrain that many patients associate the appearance of unpleasant symptoms on the part of the digestive organs. The following factors can also contribute to the development of the syndrome:
- Low-quality and irregular meals.
- Excess in the diet of heavy and fatty foods, gas-producing products and beverages, caffeine, as well as a lack of dietary fiber.
- Alcohol abuse.
- Hormonal changes. Exacerbation of pathological symptoms is especially common in women before menstruation and during it, as well as in the climacteric period.
- Gynecological diseases. In such conditions, reflex irritation of the large intestine can occur.
- Sedentary lifestyle.
Symptoms that occur with irritable bowel syndrome can be divided into two groups: intestinal and extra-intestinal. Intestinal symptoms include:
- Pain in the abdomen, which appears due to the fact that the irritated large intestine is spasmodic or overstretched by accumulated gases. The pain is localized, as a rule, in the periapical and suprapubic regions and disappears after defecation.
- Diarrhea, which usually occurs after eating in the morning.
- Constant feeling of insufficient emptying of the intestine.
- An eructation and a feeling of heaviness in the stomach.
Depending on what symptoms prevail, IBS can have different variants of the course: with predominance of diarrhea, with constipation or abdominal pain and flatulence. In addition to various intestinal disorders, IBS may be accompanied by manifestations of autonomic disorders and other extraintestinal symptoms. They include:
- Chronic headaches.
- Broken, tired, depressed.
- Chilliness of hands.
- Feeling of a "coma in the throat".
- Depressive, anxious and panic conditions.
- Violations in the genital area.
In addition, dysfunction of the bladder is often associated with IBS, which also has a psychogenic character and, as a rule, is manifested by frequent urination.
Examination of patients with suspected IBS may include:
- Inspection of the gastroenterologist.
- Blood tests (general and biochemical).
- A coprogram.
- Bacteriological analysis of feces.
- Irrigoscopy - X-ray examination of the intestine with contrasting.
- Inspection of the large intestine through the rectum with the help of special optical devices - a sigmoidoscope, a colonoscope.
- Anorectal manometry is a functional study that provides information on the tone and coordination of contractions of the rectum and anus muscles.
- Consultation of the psychotherapist.
Such a comprehensive examination is necessary to exclude organic bowel disease, since the approaches to the treatment of IBS and most diseases of the colon are radically different.
Due to the fact that many factors can contribute to the development of IBS, therapeutic measures for this pathology should be diverse, affecting both the functional state of the intestine, and the psycho-emotional sphere of the patient. The treatment regimen for patients with IBS should include:
- Rational mode of work and rest.
- Drug treatment.
- LFK training.
Dietary nutrition in IBS helps reduce gas production and normalize stools by fixing or relieving the properties of food. As for psychotherapy, its main goal is to eliminate the "provoker" of the disease, that is, reduction in the level of tension, anxiety and teaching the patient the correct pattern of behavior in stressful situations. To implement these goals, the therapist can use hypnosis, reverse biofeedback, etc. In turn, pharmacological treatment of IBS includes the appointment of the following groups of drugs:
- Anticipatory medications for diarrhea.
- Laxatives if there are constipation.
- Medicines that reduce flatulence.
- Probiotics and prebiotics.
- All kinds of phytopreparations with a soothing and antispasmodic effect.
- In severe cases - psychotropic drugs.
For people with IBS, it is very important to plan the day rationally so that there is time for a full-fledged sleep and rest, eat right, walk more and do not allow long mental overvoltage.
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Created at: 07.05.
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Irritable large intestine syndrome. Symptoms and treatment of irritable bowel syndrome
Sunday, June 07 0: 1 + in the quote book
Irritable large intestine syndrome is, above all, an overly sensitive bowel that reacts painfully to the most common life situations, such as breakfast, recruitment to work, an impending date, not to mention events such as a gala dinner, a call to the boss, a quarrel with relatives people.
Irritable Bowel Syndrome
How does the increased sensitivity of the gut? First of all, the violation of the content advancement along its logical path from top to bottom. The food lump or moves faster than normal, making pendular movements, or remains in any segment of the intestine, or even moves in the opposite direction.
Irritable bowel syndrome is a violation of motor-evacuation function, manifested by abdominal pain and / or defecation disorders. Irritable bowel syndrome develops as a result of psychological, visceral and other effects on the excessively responsive intestine.
SCHEME OF TREATMENT OF GASTROINTESTINAL TRACT DISEASES
Diagram of treatment of dysbacteriosis
It is estimated that 50% of the working time of the gastroenterologist is spent on the treatment of patients with irritable bowel syndrome. Approximately 15% of patients initially refer to a psychiatrist for a particular psychopathology that accompanies the course of IBS. 5% of patients get to doctors of other specialties - most often to gynecologists, surgeons, endocrinologists.
The true nature of irritable bowel syndrome remains unclear. Various aspects related to its nature have been studied for many years by gastroenterologists, physiologists, sociologists, psychologist experimenters, neuroscientists.
In all probability, what is now called irritable bowel syndrome has existed for a long time under a number of different names with numerous explanations and therapies. In the literature, a large number of synonyms were used to describe functional disorders of the intestine: "irritable colon syndrome" (colon irritable), functional colopathy, intestinal colic, dyskinesia of the colon, mucosal mucosa (colica mucosa), intestinal neurosis, spastic colon, functional intestinal syndrome, etc.
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However, we increasingly find the term irritable bowel syndrome in medical and colloquial languages. In our country for a long time, the term chronic spastic colitis, which also can not be recognized, successful, since the true inflammation of the mucous membrane of the colon in patients with irritable bowel syndrome is not it is noted. In general, the literature suggests a half dozen synonyms of IBS, the most expressive of which is, apparently, the term unhappy large intestine.
Sources: http://medicalit.ru/bolezni-zhkt/sindrom-razdrazhennoy-tolstoy-kishki/, http://mojkishechnik.ru/content/sindrom-razdrazhennogo-tolstogo-kishechnika, http://www.liveinternet.ru/users/5292653/post363869761
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