Code ubb irritable bowel syndrome


Do not lie. # 8212; Do not ask

Irritable bowel syndrome (IBS), the code of the disease according to the ICD-10 classification, chronic illness of the colon and small intestine, what is it?

Syndrome with a predominance of diarrhea (characteristic signs 6). Irritable bowel syndrome is characterized by pain in the abdomen, disorders in acts of defecation. Mostly the disease develops in the large intestine, but there are cases of the development of irritable small intestine syndrome.

Excretion of mucus during defecation; sensation of bloating and overflow in the abdomen. In the world, the incidence of irritable bowel syndrome is 5-11%; among the inhabitants of the developed countries of Europe # 8212; 15-20%. Disorders of the motor function of the intestine. In women, there is an increase in the functional activity of the intestine during menstruation.

As a rule, they do not irradiate, increase after eating, decrease after bowel movement, gas leakage, do not occur at night and do not interrupt the patient's slee

p. Patients may be disturbed by frequent urge to empty their intestines, accompanied by increased gas production.

This is an x-ray study of the intestine with its preliminary filling with a contrast agent (barium suspension). It allows to reveal pathological changes along the bowels. If necessary, a biopsy of the intestine is performed to detect polyps and tumors. Patients with suspected irritable bowel syndrome should be consulted by the therapist. You can prescribe drugs that selectively affect the motor function of the intestine.

Etiology and pathogenesis

Do not absorb or metabolize in the digestive tract, do not cause structural changes in the colon and addictive, help restore the natural urge to defecate. Combined-action drugs for the treatment of patients with IBS can also include Meteopasemyl, which includes two active components # 8212; alverina citrate and simethicone.

Clinic and complications

The disease prognosis for the disease is favorable - the incidence of inflammatory bowel disease and colorectal cancer does not exceed that in the general population. These disorders cause abdominal pain, constipation, or diarrhea. Pain syndrome can be of different intensity and different nature, increasing after eating and decreasing after going to the toilet.

Constipation, periodic or permanent, can continue with irritable bowel syndrome from several days to several weeks. In the presence of irritable bowel syndrome, diarrhea or constipation may occur, with changes in the shape of the feces - in pellets, in the form of a "pencil chair" or unformulated watery.

How to distinguish IBS from other diseases?

In addition, there may be manifestations of flatulence - bloating, gas leakage. There are also signs of irritable bowel syndrome that are not related to functional disorders. By severity, the course of the syndrome is divided into mild, moderately severe and severe. The action of these factors together with functional disorders of the gastrointestinal tract causes a syndrome of spinal hyperexcitability in which the reflex response in the opening is perceived as painful.

In irritable bowel syndrome without diarrhea, it is possible to use laxatives of mild effect, so as not to increase the effect of irritant factors on the mucosa.

Patient education

Despite similar symptoms, the main difference between the syndrome and other diseases of the digestive tract is that there is no morphological basis. In patients with irritable bowel syndrome, there may be signs characteristic of neurocirculation with dystonia of different syndromes.

ICD-10 was introduced into the practice of health care throughout the RF in 1999 by the order of the Ministry of Health of Russia of 27.05.97. In women, the disease is diagnosed 2 times more often than in men. Constipation (stool less than 3 times a week). Diarrhea (stool more than 3 times a day). Up to 80% of patients complain of nausea, eructation, vomiting, pain in the right upper quadrant. During the study, the rectum is examined (up to 30 cm) with a rectoscope.

Reduction of pain and discomfort after defecation. An increase in the frequency of defecation at each episode of pain or discomfort in the abdomen. To clarify the diagnosis, mandatory: general and biochemical blood tests; analysis of feces for occult blood; sigmoidoscopy or colonoscopy.

IBS classification

Other studies are conducted when pathological changes are detected during the course of these methods. In the diet can include porridge (buckwheat and barley), prunes or dried apricots, apples baked (1-2 pieces per day). Part of the sugar can be replaced with sorbitol or xylitol.

These include, in particular, anticholinergics. Epidemiology In the world of IBS, 10-20% of the adult population suffers. The chair is decorated or serpentine, with an even and soft surface. Stressful situations The direct dependence of the onset of the disease on the presence of stressful situations in the patient's life was proved. In recent years, based on the research, a lot of information has been obtained concerning biological changes that contribute to the formation of the symptoms of the disease.

Clinical manifestations of IBS have received detailed coverage in the works of domestic and foreign scientists. Clinical forms of the disease, possible combinations of intestinal and extraintestinal symptoms, symptoms of "anxiety excluding the diagnosis of IBS, are described in the most detailed manner.

Chronic irritable bowel syndrome is characterized by alternating periods of exacerbation and calmness, but the progression of the disease is mitigated in exceptional cases.

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Navigation by records

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Code Irritable Bowel Syndrome in ICD

Among functional bowel diseases, IBS takes a leading place. In accordance with the "Roman criteria IBS is a symptom complex, in which motor and secretory disorders from the large intestine and abdominal discomfort in the absence of organic diseases. Patients with IBS should have continuous or relapsing symptoms within 3-6 months.
abdominal pain, decreasing after defecation, is accompanied by changes in frequency and consistency chair; violation of the act of defecation, flatulence (swelling), mucus secretion; feeling of incomplete emptying intestines.
Women of reproductive age suffer from this disease 2-4 times more often than men.

The exact mechanisms of IBS development remain unclear. Assume the effect of infections on the wall of the large intestine (dysbacteriosis), irritation of receptors with lactose and other sugars (usually milk intolerance). Studies show that patients with IBS severely impaired intestinal motility.
The functional nature of this syndrome is confirmed by the high frequency of combination with abnormalities in the psychoemotional sphere of patients (in 70-80%), and a third of the changes achieve obvious depression. This fact is quite understandable from a scientific point of view. In the wall of the large intestine and brain (mostly in the cortex), almost identical mirror neurotransmitters are provided, providing all the basic regulatory processes.
IBS is very often combined with neurosis, depression, hypochondria, hypochondria, carcinophobia (fear of getting cancer), deep immersion in oneself. The trigger mechanism of IBS is associated with chronic stress disorders, leading to a breakdown in the motor activity of the intestine.
Such patients develop fermental dyspepsia, constant swelling of the intestine, pain, dysbiosis, alternating constipation and diarrhea.
There are several variants of IBS: with a predominance of diarrhea, with a predominance of constipation, with a predominance of abdominal pain and flatulence. The appearance of pain is usually provoked by eating (especially dairy). Pain decreases after bowel movement.

Clinical picture
The main feature of IBS is intestinal discomfort. The pains begin with the left divisions and seize the entire abdomen, they can be girdling. Sometimes irradiate in the back, coccyx. Some patients describe pain as "whining" in one of the abdominal parts, spasms or burning. The pains are usually combined with flatulence, a feeling of raspiraniya in the stomach, rumbling, excessive gas emissions. The chair is rare, in small quantities, semi-decorated, several times a day. Diarrhea with fillings alternate.
In addition, in favor of the functional genesis of disorders are the following symptoms: variability of complaints, excessive brightness of their description patients, recurrent nature, absence of disease progression, frequent increase of disorders under the influence of stress, absence of complaints in the night time.

The criteria are permanent or recurrent symptoms, but persisting for more than 3 months: abdominal pain, upset of the chair, flatulence. Complaints are accompanied by changes in the mental and emotional sphere. The examination should include: a general and biochemical blood test, feces for dysbiosis and latent blood, feces for helminths, finger examination of the rectum, sigmoidoscopy. In more severe cases, a colonoscopy with biopsy is indicated to exclude organic pathology.

Current and forecast
With timely diagnosis and proper treatment, the prognosis is favorable. The disease is chronic with a rather low level of recovery. IBS is never accompanied by serious complications.

Completely exclude milk and often dairy products. To reduce fermentation processes, carbohydrates (porridges, potatoes, and especially flour and sweet) are limited within reasonable limits. Add protein (low-fat boiled or baked meat) to the diet. Meat ducks and goose are excluded. Exclude also gas-producing products (black bread, beans, grapes, kvass, mushrooms), marinades and pickles. With constipation, the diet has its own characteristics. Bifidoproducts, wheat bran, are added to the food. Dried apricots, cold water with honey on an empty stomach, buckwheat, seaweed are allowed.
Pharmacotherapy includes the elimination of spasms and pains (antispasmodics), swelling (defoamers), normalization of the stool (antidiarrheal or mild laxatives), intestinal flora (prebiotics). The appointment of enzyme preparations is unreasonable. Antibiotics are prescribed strictly according to indications for dysbacteriosis.

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