Irritable Bowel Syndrome Prognosis Treatment


Treatment of irritable bowel synd

Irritable Bowel Syndromeis closely related to stress. Therefore, in the first place, his treatment requires psychological correction, relaxation, and normalization of the diet. Drug treatment is carried out under the supervision of a doctor. Surgical treatment for irritable bowel syndrome is not shown.

Treatment of irritable bowel syndrome: 3 stages

I stage. General Activities- informing the patient about the problem at the beginning of treatment. That is, initially a capacious consultation, outlined in an accessible form - on the topic of IBS, the prognosis of the treatment of the syndrome. Sometimes psychotherapy is needed to relieve tension: the patient should realize that he does not have a serious organic disease, relax, enter the rhythm.

A diet is made, which must necessarily be accompanied by the maintenance of a food diary. For the preparation of a diet, it is first necessary to establish products that stimulate the development of symptoms of irritable bowel syndrome. This requires the maintenance of a food diary: there is no universal list of such products, each will have an individual response to a specific product.

How to keep food diary with irritable bowel syndrome?

It is necessary to write down what foods you used during the day - and on the contrary to fix what disagreeable feelings there were (or were not present at all). The sample fragment of such a food diary is presented below.

Symptom or lack of it

Diarrhea with an admixture of mucus

Bloated stomach, rubbers, gases

II stage. Symptomatic treatment- drug therapy, which is carried out depending on the type of irritable bowel syndrome (with the predominance of constipation, diarrhea, etc.) If in prevalence of IBS is diarrhea, it will be expedient to use probiotics and some representatives of serotonergic agents (5-HT antagonists receptors).

With the prevalence of constipation, the use of laxatives is recommended - they are divided according to the mechanism of action into several groups:

  1. osmotic:increase by slowing the absorption of water, the volume of intestinal contents, as a result of which receptors in the intestine become irritated. These laxatives help restore the natural urge to defecate,
  2. stimulating the motility of the large intestine- help to promote feces by the large intestine.
  3. increasing stool volume. soften the stools without irritating the large intestine, are not absorbed and are not addictive. This group of laxatives is considered optimal for prescribing IBS patients with constipation.

In the irritable bowel syndrome of a mixed type, anticholinergics, myotropic antispasmodics, can also be used.

Stage III. The use of psychotropic drugs- to reduce anxiety and pain as directed by a psychiatrist. The goal of treatment of irritable bowel syndrome is to achieve a stable remission and restore the patient's social activity.

Why does irritable bowel syndrome develop?

Methods of prevention of IBS does not exist, but it is worth talking about its nature. Irritable bowel syndrome is a complex violation, in its development, the most diverse factors are involved:

  • Stress.There is a direct relationship between stress and the development of IBS. It can be both chronic stress, and an episodic psychotraumatic situation.
  • Intestinal infection:The post-infection form of IBS is observed in 6-17% of cases of the syndrome. And up to 33% of patients who have had an acute intestinal infection subsequently notice a symptom complex inherent in IBS. Infectious pathogens, which are associated with the development of irritable bowel syndrome - shigella (most cases); Campylobacter jejuni (rarely).
  • Features of personality- above all, high anxiety, inability to distinguish between physical pain and emotional unrest; difficulties in the formulation of their feelings. Such people have an "attitude" to somatization - the ability to "carry" negative emotions into physical sensations (so-called somatic symptoms). Most patients with other digestive disorders (including IBS) suffer from depression or anxiety disorders.
  • Genetic predisposition- is of less importance than environmental factors.

... If you were diagnosed with "irritable bowel syndrome"

  1. It should be remembered that there is nothing life threatening in IBS: the presence of irritable bowel syndrome does not lead to development of malignant bowel tumors, as well as to such diseases as ulcerative colitis or Crohn's disease.
  2. Proper nutrition is a pledge of well-being. Taking meals in divided batches (4-5 times a day) will make you feel better and prevent discomfort in your stomach.
  3. You should be under the supervision of a doctor whose professional qualities you do not doubt.
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Irritable Bowel Syndrome # 8212; symptoms, treatment, diet

Irritable Bowel Syndrome # 8212; symptoms, treatment, diet

Irritable Bowel Syndromeis a violation of his functions, characterized by pain in the abdomen and violations of defecation. This disease is one of the most common and develops because of psychological or other excess effects on the intestines. Most often, irritable bowel syndrome manifests itself in women.

Despite the fact that this disease is quite common, about 75% of patients do not seek medical help. The main cause of the disease is psychoemotional disorders and overload.

Symptoms of irritable bowel syndrome

The main symptom of irritable bowel syndrome is the appearance of pain and discomfort in the abdominal cavity, stool disorders. In feces appears mucus, often in large quantities. Spasms appear almost constantly, changing their localization.

Extraintestinal symptoms can be associated not only with the organs of the gastrointestinal tract, but also with the nervous system, the psychological state. As a rule, patients experience rapid fatigue, weakness, headaches appear, decreases appetite, sleep is disturbed, there is a feeling of "lack of air urination becomes more frequent, may increase temperature.

When eating disorders, dryness and flaking of the skin, changes in its pigmentation, the appearance of pigment spots on the face, hands, legs.

There are three types of irritable bowel syndrome: with a predominance of constipation, with predominance of diarrhea, with a predominance of pain syndrome.

Diagnosis of irritable bowel syndrome

In the absence of other bowel diseases, the diagnosis can be made on the basis of typical manifestations of the disease.

Reliably diagnose irritable bowel syndrome allow "Roman criteria-II (2000)". In that case, it is possible to diagnose the disease if, during the last 12 months, not less than 12 weeks (not necessarily following one after another) there is discomfort and pain in the abdominal region, having two of three characteristics:

# 8212; pain relief after bowel movement;

# 8212; the appearance of painful sensations before changing the frequency of the stool;

# 8212; the appearance of painful sensations before changing the shape of the chair.

It should be borne in mind that in the irritable bowel syndrome, pain sensations are always associated in one way or another with the stool.

There are also signs that may indicate the presence of not only irritable bowel syndrome, but also other diseases:

# 8212; bleeding in the rectum;

# 8212; decreased body weight;

# 8212; chronic diarrhea;

# 8212; feverish conditions;

# 8212; age over 50;

# 8212; the presence of cancer or inflammatory diseases of the gastrointestinal tract in parents;

# 8212; increased pain and diarrhea at night.

The appearance of bleeding may indicate hemorrhoids, weight loss is a manifestation of depression.

Treatment of irritable bowel syndrome

In the treatment of irritable bowel syndrome, it is very important to use an integrated approach.

The diet is chosen depending on the type of disease. With the prevalence of constipation, it is necessary to add bran, food, rich in fiber, while with a prevalence of diarrhea such a diet is contraindicated. From food it is necessary to exclude caffeine, lactose, fructose, vinegar, alcoholic drinks, pepper, spices, smoked products, milk, sour-milk products.

Psychoemotional correction is an obligatory stage of treatment, during which it is necessary to carry out a complex of measures that improve the functions of the central nervous system. Here you can use both rational psychotherapy and the use of psychotropic medications. This stage of treatment is carried out by a psychoneurologist or psychotherapist.

With the prevalence of diarrhea, the use of antibacterial drugs is indicated. They can also be used for flatulence, pain. After the course of taking medications of this type, a course of taking bacterial preparations is necessary to restore the bacterial background of the intestine.

With exacerbation of diarrhea, you can use astringent medicines, herbal decoctions with this action, antacid medicines, bismuth preparations.

With the prevalence of constipation, it is necessary to introduce a diet rich in fiber in the diet to restore the lost morning reflex to defecation. In the initial stages, you can take laxatives, but only at the first time of treatment.

Prognosis for irritable bowel syndrome

The effectiveness of treatment of irritable bowel syndrome depends on the severity of disorders of the nervous system. For successful treatment it is very important to resolve conflict situations that contribute to the development of neurosis. The work capacity of the patient depends on the severity of psychoemotional disorders.

Irritable Bowel Syndrome Symptoms Treatment

Irritable Bowel Syndrome(IBS) is a functional bowel disease characterized by chronic abdominal pain, discomfort, bloating and abnormalities in the behavior of the intestine in the absence of any organic reasons.

Irritable Bowel Syndrome Symptoms, Treatment

There are histological symptoms of irritable bowel syndrome, the treatment of which corresponds to the treatment of dystrophic changes rather than inflammatory ones.
This is a stable set of functional disorders lasting at least 12 weeks over the past 12 months, manifested by pain and / or discomfort in the abdomen, which pass after defecation, are accompanied by changes in the frequency and consistency of the stool and are combined for 25% time of the disease with at least two persistent symptoms of bowel disturbance - changes in stool frequency, stool consistency, the act itself defecation (imperative urges, tenesmus, a feeling of incomplete bowel movement, additional efforts during defecation), secretion of mucus with feces, flatulence.

The assessment of a stable population is based on the diagnosis of irritable bowel syndrome symptoms. Treatment of clinical symptoms, such as lower abdominal pain in combination with impaired function of the distal departments intestines, which do not find an explanation for the currently known morphological and metabolic violations, i.e., this diagnosis is limited to the elimination of organic pathology.

The prognosis is generally favorable for the treatment of irritable bowel syndrome. Treatment of non-progressive disease, as well as chronic, recurrent, is stable. Irritable bowel syndrome, treatment of its symptoms, is not complicated by bleeding, perforation, strictures, fistulas, intestinal obstruction, malabsorption syndrome. The risk of inflammatory bowel disease and colorectal cancer in patients with irritable bowel syndrome is the same as in the general population. This determines the tactics of patient observation and the absence of the need for more frequent colonoscopy.

The prognosis of life is favorable for the treatment of irritable bowel syndrome. Symptoms, treatment the doctor himself should know well and familiarize patients with the features of the disease prognosis, which will improve their psychosocial adaptation.

Treatment programirritable bowel syndrome consists of two stages:

  • primary course;
  • subsequent basic therapy.

Implementation of the program requires a long time: the duration of the primary course of treatment for irritable bowel syndrome is at least 6 to 8 weeks of basic therapy - 1 to 3 months. The choice of the program is determined by the interaction of several factors and depends on the leading symptom (pain / flatulence, diarrhea, constipation), the severity of the syndrome irritated bowel, symptoms, treatment and influence after on the quality of life, as well as on the nature of the patient's behavior and his mental state.

Irritable bowel syndrome, symptoms. Diet therapy

Dietotherapyirritable bowel syndrome: at the first consultation with the patient discuss individual Nutrition habits, which in themselves can cause chronic symptoms of irritable syndrome intestines. Treatment to the patient is prescribed with the inclusion of a diet in which there are exceptions. A diet that does not contain caffeine, lactose, fructose, sorbitol, vinegar, alcohol, pepper, smoked products, and products that cause excessive gassing are traditionally prescribed to patients with predominant constipations. They are recommended to stick to a plant diet.

Quite often measures of psychosocial support and observance of dietary recommendations are enough: in the further they are not required prescribing drug therapy, which is certainly the most favorable variant of the course of irritable syndrome intestines.

In irritable bowel syndrome, symptoms of irritation, it follows from the treatment to exclude the simplest causesirritationsintestines, which include the chronic effects of dietary factors and drugs. Common food irritants include fatty foods, alcoholic beverages, coffee, gas-forming food and drinks, plentiful (banquet) food, changes in the usual food on business trips and travel. Among medicinal products, laxatives, antibiotics, preparations of potassium, iron, bile acids, potassium, mesoprostol etc. irritate the intestines.

Irritable bowel syndrome, symptoms. Treatment with drugs

When conducting the detection of symptoms, the treatment of irritable bowel syndrome from a doctor requires skill and patience. The key points of therapy are patient education and the use of drugs in accordance with the symptoms.
Most often, to relieve abdominal pain and reduce flatulence in irritable bowel syndrome, antispasmodics are used. Significant effectiveness in the pain syndrome is myotropic antispasmodics, selective antagonists of calcium channels - mebeverin (Duspatalin) and pinaveriium bromide. Their advantage is a selective effect on the smooth muscles of the intestine and sphincter of Oddi, as well as the absence of side effects characteristic of anticholinergic drugs.
Duspatalin has an antispasmodic effect due to a decrease in the permeability of smooth muscle cells of the intestine for Na + (Fig. 6). As a result, the entry into the cells of Ca2 + is prevented, phosphorylation of myosin becomes impossible and, as a consequence, there is no contraction of muscle cells. The second component of the mechanism of action is blockade of Ca2 + depot, restriction of K + release from the cell and prevention of development of hypotension.
Thus, Duspatalin is the normalizer of the gastrointestinal motility. Mebeverin has an antispasmodic effect that does not cause blockade of muscarinic receptors, which avoids the side effects that occur with the use of anticholinergic drugs. The drug is prescribed for 1 capsule (200 mg) 2 times a day for 20 minutes before meals. The effect of using Duspatalin manifests itself quickly (after 20-30 minutes) and lasts for 12 hours.
Pinaverium bromide exerts an antispasmodic effect by blocking the intake of Ca2 + through the calcium channels into smooth muscle cells of the intestine. The drug is also devoid of anticholinergic effects and does not affect the cardiovascular system, acts selectively as a result of low absorption (only 5-10% of it is absorbed into the bloodstream). Pinaverium bromide is prescribed for 1 tablet (50 mg) 3-4 times daily with meals.
Pain is the main target for antispasmodics, but these drugs also help with swelling and sometimes with stool disorders. It has been suggested to use calcium channel blockers (verapamil) used as antispasmodics, but unfortunately, clinical trials led to disappointing results.
With constipation, if enrichment of the diet with ballast substances is insufficient, resort to the appointment of osmotic laxatives, among which lactulose, magnesia milk and macrogol 4000 have been well established.
The treatment of cleansing enemas should be avoided whenever possible, since by mechanically exciting the parasympathetic receptor apparatus distal part of the colon, they contribute to increasing the pressure in her cavity, which can provoke spasm, pain and an increase secretion.

The most effective in IBS is complex therapy with the inclusion of all necessary means and methods, provided that each of them occupies an adequate place. In addition, an individual approach to each specific patient is also important.

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