Modern treatment of irritable bowel syndrome


Too sensitive intestines can greatly spoil your life. It is much easier to treat such a disease than to diagnose it. Irritable Bowel Syndrome (IBS) is a chronic disease.

It causes unpleasant symptoms in the digestive tract, for example, various kinds of abdominal pain: tingling in the stomach or painful twisting sensations, spasms in the intestines, swelling, constipation or diarrhea.

The real torture is the constant visit to the toilet. And it happens most often when we are experiencing great stress or other strong emotions, including positive ones. Problems with emptying are due to the fact that the intestines, instead of contracting rhythmically, sometimes work too fast, and sometimes the rhythm slowly.

It is not known exactly what is causing this disease. It is not caused by bacteria or viruses, nor is it related to the structure of the digestive tract. In addition, the emerging symptoms can be different in different patients and can often be similar to manifestations of serious gastroenterological dise

ases, including cancer. Treatment of IBS is the gastroenterologist, to which the therapist will send you.

Patients suffering from IBS should follow a diet that is specifically designed to take into account the symptoms. For example, if constipation occurs during IBS, raw vegetables and fruits rich in fiber should be included in the diet: apples, carrots, kohlrabi and cereal products.

In case the patient suffers from a stomach disorder, a diet based on rice and pasta is suitable. Vegetables should be cooked for a couple, and the meat and fish boil. Patients are recommended to eat 5-7 times a day (every 2 hours), but in small portions Overeating always increases unpleasant symptoms in the digestive system. It should limit the use of black coffee, carbonated drinks and alcohol, as these drinks irritate the intestines.

You should drink plenty of still mineral water - at least two and a half liters a day. It should also avoid the sharp dishes and products that cause gas formation and bloating (cabbage, beans). Supplement the daily diet can be probiotic drugs that help to regulate the digestive process.

A contrast shower will strengthen the capillaries and help get rid of the pain. With nervous overloads, take homeopathic remedies that relieve stress, or drink a decoction of herbs: 2-3 sips after eating during the day (1 liter of water 1 tablespoon of dog rose, 1 teaspoon of immortelle, leaves of cranberries, flowers of claws).

Do a stomach massage: tilt the torso forward in a deep breath, hold your breath and play with your stomach, relaxing and straining it, then exhale (repeat 5 times). Such a massage will improve the tone of the intestines, relax the muscles.

Be sure to engage in auto-training: close your eyes, try to relax, tune in a positive way, then strain the muscles and relax them. During the day, watch your posture, periodically ask yourself the following questions: what is my expression now, how my muscles are, what I think. If you are tense, your face is unhappy, and you think about the problems, try to change all these three points: relax, smile, think about the good.

Irritable Bowel Syndrome

Irritable bowel syndrome is a functional pathology of the intestines of a psychosomatic nature. In other words, bowel dysfunction has no direct connection with pathological processes in the intestinal tube or gastrointestinal tract in general, and the etiological roots of the disease go into the psycho-emotional state of the patient, the destabilization of which leads to a failure in the transmission of impulses from the head brain intestines.

Irritable bowel syndrome in women of the age group from thirty to forty years is more frequent manifestation than in other demographic strata, although both men and children of both sexes. The first signs of irritable bowel syndrome are pains with more or less severity and dependence on defecation. The pain syndrome can have a different character and pass or weaken after defecation, as well as be accompanied by constipation or diarrhea, or with a stapular disorder of the stool with its subsequent fastening. Irritable bowel syndrome is very rare in the elderly, so if available similar symptoms need to undergo a more complete examination that would exclude diverticulosis of the thick intestines. chronic enteritis exacerbation of Crohn's disease.

Some symptoms of irritable bowel syndrome have a variable character - bloating and a feeling of not completely emptying the last defecation, diarrhea and constipation, nausea and discomfort in the abdomen. In addition, pain in irritable bowel syndrome can be both acute, stitching and aching blunt. Patients complain of severe fatigue, frequent headaches, depression and insomnia, frequent and strong urination, discomfort during intercourse, and even heart abnormalities.

Among the causes of irritable bowel syndrome, the first and leading role is played by psychosomatics, emotional background and the general state of the nervous system of the patient, but in addition to psychosomatic Factors of the onset of the disease also note the dependence on changes in the hormonal background, genetic predisposition, the adoption of certain medications, including antibiotics (for one and the same kind of antibiotic each person has his own reaction, in order to determine the level of antibiotic exposure to organisms do research - antibioticogram).

Syndrome of irritated large intestine is difficult to diagnose, because during the disease of pathological processes in the intestine, its mucosa, etc. not happening. In most cases, the diagnosis of irritable bowel syndrome is made on the basis of a detailed history and exclusion of other intestinal diseases. A complete examination is carried out, including laboratory blood tests, instrumental studies intestines and esophagus, for the purpose of checking for chronic esophagitis (inflammation of the esophagus) and acute erosive gastritis. because these diseases can also give painful feelings, giving into the abdominal cavity and the chest area, as well as to exclude the diagnosis of the esophagus of Barrett. Provided that no deviations are detected, the doctor makes the conclusion that the patient's condition is caused by the clinic of irritable bowel syndrome.

Irritable bowel syndrome in children proceeds according to the same scenario as in older people, and requires immediate consultation of a neurologist, because, violations of absorbability of nutrients, due to diarrhea can lead to avitaminosis, a malfunction in metabolism and other unpleasant consequences. In addition, the presence of irritable bowel syndrome clearly indicates a functioning disorder nervous system, a state of constant stress, which in turn can give other serious complications.

Functional treatment of irritable bowel syndrome is prescribed depending on the presence of symptoms of the disease. In irritable bowel syndrome with diarrhea, binding binders, products with a high content of starch and a reduced fat content are prescribed. Medicamental treatment of irritable bowel syndrome with constipation, involves the appointment of laxatives to ease defecation. With strong flatulence and pronounced pain syndrome, irritable bowel syndrome can be treated with antibacterial drugs. Treatment of irritable bowel syndrome during pregnancy involves exclusively diet therapy or cautious The use of herbal preparations under the close supervision of a gastroenterologist and midwife gynecologist. The use of laxatives during pregnancy is extremely undesirable, since it can provoke premature labor of the uterus, which in turn represents a threat to abortion the kid.

Diet in irritable bowel syndrome is made by a doctor based on the symptoms (frustration, constipation, flatulence, etc.). In IBS with predominance constipation, recommended the use of wheat bran (in order to increase dietary fiber in the diet) prunes, beets, fermented milk products in the evening time. Nutrition in irritable bowel syndrome with a predominance of diarrhea, involves the use of products fastening and disinfection action: blueberries, bird cherries, boiled rice without butter, boiled potatoes, strong tea, both black and green. The menu in irritable bowel syndrome with pain and methorism excludes consumption of carbonated drinks, chocolate and coffee, fried and excessively fatty foods.

Treatment of chronic irritable bowel syndrome in Israel involves not only a functional solution to the problem with the help of diet and medicine, but also to eliminate the cause of the disorder - a stressful psycho-emotional state. With the help of qualified psychologists, the patient is helped to solve his internal problems causing stressful situations, which leads to stabilization of mental processes, reduction of nervous tension and guarantee of non-return of psychosomatic syndrome of irritated intestines

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Modern approaches to the treatment of irritable bowel syndrome

Author: А.А. Sheptulin,Ph.D. Professor, First Moscow State Medical University. I.M. Sechenov, Moscow

IBS is the most common gastroenterological disease. Among the population of developed countries, it meets an average of 15-20%. IBS is detected in 28% of all patients who seek gastroenterology. The choice of drugs in IBS is determined by the clinical variant of the disease. The only class of drugs, the effectiveness of which is confirmed for the treatment of pain in IBS, are antispasmodics. The meta-analyzes carried out have shown that the effectiveness of antispasmodics in the treatment of IBS patients is 53-61%.

Irritable Bowel Syndrome (IBS) in accordance with Roman Criteria III (2005) is defined as a complex of functional disorders, including recurrent pains or discomfort in the abdomen, marked for at least 3 days during the month for the last 3 months (with a total duration of clinical symptoms of at least 6 months) and Combined with two of the following three symptoms: pain decreases after the act of defecation; pain accompanied by a change in stool frequency; pain accompanied by a change in consistency chair. Distinguish the following clinical variants of IBS: with constipation, diarrhea, mixed (with alternating constipation and diarrhea) and unclassifiable. Changes in the consistency of stool, established according to the Bristol scale, are the main feature of a variant of IBS: 1 and 2 items of this scale (hard, cloddy feces in the form of nuts) are characteristic for the variant of IBS with constipation, 6 and 7 points (mucous or watery stool) - for the variant of IBS with diarrhea [8].
Take-away 1. IBS is detected in 28% of all patients seeking gastroenterology, and in 8-12% of patients seeking general practitioners.

IBS is the most common gastroenterological disease. Among the population of developed countries, it meets an average of 15-20%. IBS is detected in 28% of all patients seeking gastroenterology, and 8-12% of patients seeking general practitioners [3].

An important place in the pathogenesis of IBS is occupied by various violations of the motor function of the intestine, contractile activity of smooth muscle fibers of the intestinal wall, considered the main cause of pain in of patients with IBS. In patients with IBS, there is an increased sensitivity of the intestinal wall to stretching (visceral hypersensitivity), which can lead to a decrease in the threshold of pain sensitivity (visceral hyperalgesia). A modulating role in this may be played by the altered activity of the central nervous system. Thus, when the rectum is stretched, non-limbic structures are activated in the IBS patients, and the prefrontal cortex zone responsible for depressive reactions is activated.

The transferred intestinal infection (the so-called post-infection IBS), psychoemotional stress, physical or sexual trauma, transferred by the patient (especially in childhood or adolescence), can contribute to the occurrence of violations of intestinal motility and increased visceral sensitivity. The clinical picture of IBS is nonspecific, therefore, when diagnosing, it is necessary to exclude a wide range of organic diseases: tumors of the colon and rectum, chronic inflammatory intestinal diseases (ulcerative colitis and Crohn's disease), microscopic (collagen and lymphocytic) colitis, diverticular bowel disease, disaccharidase insufficiency, celiac disease, etc. [2]. When examining patients, attention should be paid to the presence of symptoms of anxiety, detection who makes the diagnosis of IBS is unlikely and requires the search for a serious organic disease nature. Symptoms of anxiety include the appearance of the first symptoms of IBS in old age, fever, an admixture of fresh blood in the feces (haemathece), the onset intestinal disorders at night, unexplained weight loss, progressive course of the disease, anemia, leukocytosis, increased ESR, steatorrhea and polyphecal [1].

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