How to restore intestinal absorption
5. Improve digestion and absorption in the intestine
When treating patients with chronic enteritis, it is necessary to pay attention to the functional state of other digestive organs-the stomach, the pancreas. Normalization of the functions of these organs or replacement therapy for secretory deficiency of the stomach, pancreas improves digestion in the intestine.
With secretory deficiency of the stomach are appointedgastric juice1 tablespoon per1 /2a glass of water during each meal,pepsidil -in the same dose, less often -acid-nencmorbetatsid on1-2 tablets per1 /2a glass of water during meals, to stimulate gastric secretion is usedlimonar1 tablet per day1 /2a glass of water before meals (see Ch. Treatment of chronic ga
External pancreatic insufficiency is compensated by the use of 2-3 drops of pancreatic enzyme preparations during meals:pancreatin, digestal, mezime-forte, solizima, somilase, orase, nigdadase, panzinorm, fistal, enzyme(details of these preparations - see. Ch. Treatment of chronic gastritis). It should be noted that the use of enzyme preparations containing bile (panzinorm, fesgal, enzyme, digestal), can enhance diarrhea, since bile acids increase motor function intestines.
Patients with chronic enteritis, suffering simultaneously with chronic cholecystitis with concomitant pseudomotor dyskinesia, are shown choleretic agents containing bile(holenzyme, allochol, lobil),However, when diarrhea increases, instead of them, cholagogue should be administered that does not contain bile(flamen, corn stigmas, immortelle, taschechol, oxaphenamide, nicotine, berberineand others) - for details on these preparations, Ch. Treatment of chronic cholecystitis.
In chronic enteritis, especially with a pronounced degree of disease, the secretory, motor-evacuation and absorption functions of the small intestine are significantly impaired. With reduced, but still preserved absorption capacity of the small intestine, the use of drugs stimulating the suction function is shown.
According to A. AT. Frolkis (1989), a positive effect of ephedrine (0.025-0.05 g 3 times a day), L-Dopa (levodopa) -to 100-200 mg 2-3 times a day on the sucking function of the small intestine in patients with chronic enteritis. A. AND. Parfenov (1981) recommends stimulation of absorption in the small intestine to take nitrates of prolonged action - a joint or nitronum 1 tablet 2-3 times a day for 10-15 days. The absorption function of the intestines is also stimulated by anabolic steroids (B. AT. Trusov, 1981), euphyllin (A. AT. Frolysis, 1981). The treatment of anabolic steroids will be discussed below. Treatment of chronic enteritis with euphyllinum did not receive a wide clinical spread in connection with the expressed dyspeptic phenomena at reception of a preparation inside.
In conclusion of this section, we give data on the mutual influence of medicinal products (Table. 35).
The table shows, in particular, that it is inappropriate to simultaneously take panzinorm, festal, pancreatin with bismuth preparations as an astringent for chronic enteritis. The panzinorm is inactivating colibacterin, so do not combine them.
Syndrome of impaired intestinal absorption
Syndrome of impaired intestinal absorptionis a wide range of conditions in which the assimilation of various nutrients is impaired.
The syndrome of malabsorption occurs in Crohn's disease, chronic enteritis, Whipple's disease, severe gluten enteropathy, intestinal amyloidosis, exudative hypoproteinemic enteropathy.
Symptoms of intestinal absorption
The disease is characterized by a combination of diarrhea and metabolic disorders (protein, fat, carbohydrate, vitamin, mineral, water-salt). The patient loses weight until cachexia, that is, exhaustion. Weakness, reduced efficiency and even mental disorders are noted.
Exchange disturbances lead to deficiency of vitamins, which provoke the development of osteoporosis, anemia, skin diseases. Frequent signs are trophic changes in nails, hair loss, hypoproteinemic edema, muscle atrophy and multiple organ failure.
Symptoms that are typical for the violation of electrolyte metabolism: lowering blood pressure, palpitations, dry skin and tongue, numbness of the hands, pain and weakness in the muscles, osteoporosis or osteomalacia, bone fractures, seizures and decreased sexual function.
Diagnosis of impaired suction syndrome
To diagnose the disease requires a complete blood test with the definition of total protein, protein fractions, immunoglobulins, total lipids, cholesterol, potassium, calcium, sodium, iron. Stool analysis reveals fats, starch, undigested fiber and muscle fibers.
To diagnose intolerance to disaccharides, samples with mono- and disaccharide loading are assigned, followed by determination in blood, feces, and urine.
In the diagnosis of gluten enteropathy, it is important to evaluate the result of a gluten-free diet, with suspicion of exudative hypoproteinemic enteropathy - monitoring of daily excretion of protein with feces and urine.
There are a number of respiratory diagnostic tests based on the determination in the exhaled air of the isotope content after oral or intravenous administration of special substances.
What can you do
At occurrence of a malaise, sharp reduction of weight, deterioration of a condition of a skin and hair it is recommended to address without delay for the help to the expert.
What can the doctor do?
Treatment of the syndrome of impaired absorption is complex and includes:
diet with the restriction or exclusion (depending on the severity of the disease) indigestible and irritating foods
drugs that stimulate the processes of membrane hydrolysis in the small intestine
means for correction of metabolic disorders
means, normalizing intestinal flora
Prevention of the syndrome of impaired absorption
Timely treatment of diseases of the intestine, careful compliance with the recommendations of a doctor and a sparing diet.
Before starting any preparation, consult a specialist and read the instructions for use.
How to adjust the work of the intestine - a phased process
With a decrease in the volume of useful microflora (for example, after treatment with antibiotics) begins to multiply conditionally pathogenic (capable of causing disease under certain conditions) microflora, which does not help, but interferes with digestion. This is dysbiosis. As a result of such a replacement in the intestine, depending on the prevalence of certain microorganisms, putrefactive or fermentative processes that lead to the development of bowel diseases begin.
It can be inflammation of the wall of the large intestine (colitis, including ulcerative), malabsorption some substances needed by the body, followed by a persistent violation of metabolism and immunity, and so Further. There is also a pathogenic microflora in the intestine, which can also cause disease at any time. The main signs of digestive disorders are increased gas formation (flatulence), spastic abdominal pain (intestinal colic), diarrhea, constipation or alternation.
How to adjust the work of the intestine of an adult
In order for the treatment to be effective, it is necessary to find out the cause of the disease, that is, to conduct a survey, including examining feces for dysbiosis.
Setting up the intestine, you should start by following certain rules of nutrition. At slightly expressed infringements of digestion the physiologically high-grade diet with restriction coarse fiber (bread coarsely, raw vegetables, legumes), fresh milk, spicy dishes, snacks and spices.
If constipations predominate, then a daily set of foods should contain enough protein and carbohydrates and a slightly increased amount of fat due to vegetable oils. It is recommended to use more widely dairy products, vegetables - beets, fresh carrots, tomatoes. Bread - rye or wheat from a flour of a rough grinding.
More active work of the intestine is facilitated by the introduction into the diet of dried prunes, apricots, figs, dates that are able to swell in the lumen of the intestine and stimulate its movement.
If diarrheas and bloating prevail, then the maximum mechanical and chemical shaking of the intestine, a decrease in fermentation processes in the intestine, is necessary. The diet is characterized by the restriction of carbohydrates and fats, excluding fresh milk, fiber, spices, pickles, smoked products from the diet.
Restoration of normal intestinal microflora
To suppress the reproduction of opportunistic and pathogenic microflora of the intestine, according to the results of laboratory studies, prescribe medicinal substances that depress its development. These can be antibacterial, antifungal drugs, bacteriophages (substances that can dissolve bacteria) and so on.
After the course of treatment for the suppression of harmful microflora, restore the normal intestinal microflora with the help of medicines containing colonies of normal representatives of intestinal microflora, such preparations are called probiotics. This bififor, bifidumbacterin, bifidumbacterin forte, lactobacterin, colibacterin and so on. At the same time prescribing prebiotics - drugs, which include substances that promote the reproduction of normal microflora (for example, lactusene).
The pharmaceutical industry also produces synbiotics - a combination of drugs that will contain both probiotics and prebiotics:
- bifido-tank - probiotics of bifido- and lactobacilli + prebiotics fructooligosaccharides from Jerusalem artichoke;
- maltydophilus - probiotics bacteria belonging to the normal intestinal microflora, mainly bifidobacteria and prebiotic maltodextrin - a factor that promotes the growth of normal microflora.
Take all these drugs should be in accordance with the data of laboratory studies. Some drugs are more correctly used for prophylactic purposes, others are prescribed for treatment. Of great importance is the nature of the underlying disease, which contributed to the development of dysbiosis. For example, for bacterial infections, both bifido and lactose-containing drugs are suitable, and for enterovirus infections, mostly lactose-containing probiotics.
Sources: http://www.rusmedserver.ru/med/bolp/100.html, http://www.vidal.ru/encyclopedia/gastroenterologiya/sindrom-narushennogo-vsasyvaniia-v-kishechnike, http://www.womenhealthnet.ru/gastro/8107.html
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