Dyskinesia of the intestine

Dyskinesia of the intestine is a functional failure of the operation of the large or small intestine, which manifests itself as a delicate problem in the form of unexpected constipation, diarrhea. Terminology indicates a violation of motility and intestinal tone.

At the same time, according to the analyzes and additional studies, no organic pathology( for example, inflammation) is detected in patients. An important link with the state of neuro-hormonal regulation of the digestive process. According to the International Statistical Classification, dyskinesia of the intestine is taken into account as a disease and encode K59.8.1.

Prevalence of

According to different observations, the disease affects between 20 and 30% of the population. Gastroenterologists believe that pathology is perhaps more common. Patients are embarrassed to see a doctor, the disease is not always recorded because of the unauthorized refusal of the examination. The maximum number of cases is detected in a group of people from 30 to 40 years.

The younger the age, the more women predominate. By the age of 50, the affection of men and women is no different. Initial signs of the disease are found in children. At 15 years, the risk of functional impairment is compared with adults. Dyskinesia of the large intestine is more common than thin.

Why does it occur?

The causes of the failure of the intestinal functions are most often hidden in the breakdown of the nervous and hormonal regulation of muscle tone. Similar conditions occur with the transferred stress( a tragic event with a loved one, problems in the family and at work, failures with business, intense study, examination session).In women, the emotional background of any event is more vivid, anxiety reaches a degree of depression.

The defeat in adolescence is associated with the inability of an adult to be aware of the difficulties, to withstand the stress on the background of vulnerable hormonal changes in the body. The factors of provocation are: any physical pain, a transferred infectious disease, malnutrition( hungry diets for girls), physical overexertion in sports.hall.

Dyskinesia of the intestine can be combined with a similar lesion of bile ducts, a violation of the psyche. Doctors psychiatrists treat such a pathology as an individual feature of a person to turn emotional instability( suspiciousness, anxiety) into a disease of internal organs.

The process of peristalsis is affected by:

• chemical composition of food entering the intestinal lumen( cellulose and vitamins intensify, high-calorie carbohydrates, fats - weaken);
• abdominal muscles - have a massaging effect by changing intra-abdominal pressure against walking background, moderate exercise.

Therefore, the quality of nutrition and motor activity of a person play an important role in the development of pathology and therapy of the disease. An attentive questioning of patients makes it possible to identify the relationship with the heredity factor, the presence of the same manifestations in relatives. It is characteristic that the elderly age symptoms of dyskinesia disappear or are transformed into organic diseases of the intestine.

Essence of violations of

The main changes in dyskinesia are the violation of the muscular fibers of the intestinal wall of perception and assimilation, which came from the nervous system or with the hormones of the pulse. Due to the presence of two muscle layers( inner annular and outer - longitudinal in the small intestine, and in the large intestine of three ribbon-like plexuses), the contents are transported gradually from the duodenum to the straight line.

The cut wave forms up to 18 pushing movements per minute. Simultaneously, in the healthy intestine there are processes of assimilation and processing of food, formation of slags in fecal masses, absorption of water. A natural activating substance is the bile delivered through the common duct.

Untimely admission or a deficiency of bile acids leads to the fact that dyskinesia of the duodenum is manifested by impaired processing of dietary masses, by reflux of contents in the opposite direction to the stomach. With the correct contractile function, the entire volume of bile and pancreatic juice passes into the small intestine.

The main regulator of peristalsis is the vegetative part of the brain. It works independently of the will of the person, and control of the contractile waves in the intestine is carried out by isolating the mediator acetylcholine substance at the ends of the nerve fibers. The motor activity is provided by the necessary "dosage" of the mediator and the susceptibility of the tissues of the intestinal wall.

There are 2 types of reactions:

• in case of congestion - sympathetic nerve impulses increase, tone increases and spasm is caused;
• if acetylcholine is low, muscles relax, the tone falls.

The intake of the activating substance goes along the fibers of the vagus nerve. Therefore, it is with his dysfunction that the mechanism of dyskinesia of the colon is associated. Sensitivity disorders and subsequent changes in the function of contractility of the muscular wall lead to impaired evacuation of the contents, accumulation of gases, instability of defecation.

Kinds of

Dyskinesia is distinguished by origin:

• primary - develops independently of other diseases of the stomach and intestines, is considered an independent violation, some authors consider it "true", confirming the mechanism of formation and denying any other changes;
• secondary - is found as a syndrome on the background of various diseases of the digestive system, is most often detected in gastroduodenitis, enteritis, colitis, pancreatitis, congenital malformations such as dolichosigma, megacolon.

The clinical classification in gastroenterology takes into account the relationship with stool frequency and stool consistency. There are 4 types of dyskinesia:

• with the advantage of constipation - of all acts of defecation more than a quarter is accompanied by a dense decorated chair, less than ¼ of the part can be attributed to diarrhea;
• with the advantage of diarrhea - more than a quarter of cases occur in diarrhea, less in constipation;
• mixed type - the above ratio is broken;
• unclassified - signs are not sufficient to establish the form of the disease.

Depending on the type of disturbance of peristalsis, the forms are distinguished:

• spastic( hypermotor) - intestine tone is in an elevated state, which causes short-term spasms, constipation or diarrhea, pains such as colic;
• atonic( hypomotor) - the fall of peristalsis promotes the accumulation of gases, feces, raspiruyuschim pains along the bowels, long constipation, reaching the acute intestinal obstruction.

For atonic forms, the intestinal symptoms of dyskinesia of the large intestine are characteristic, they are caused by poisoning of the body with unsealed slags. It is important for doctors to prescribe the optimal treatment, so it is important to divide the disorders into dyskinesia: with a disorder of the stool, severe pain syndrome, with flatulence.

Another classification provides for the principle of the origin of dysfunction:

• post-infectious disorders;
• caused by stress;
• having a clear connection with food products( the allergy mechanism is not excluded).

As the disease of

is manifested The international criterion for the presence of dyskinesia is the preservation of the symptoms for at least three days. It is customary to distinguish manifestations by nature. Intestinal:

• abdominal pains - short-term cramping or prolonged blunt, flaring, aching more often located in the left side of the abdomen, in the ileum, strengthen after eating, relieve the bowel and release gases, do not disturb at night;
• alternation of diarrhea and constipation, unstable stool( initially dense masses, then semi-liquid), the total volume is small, diarrhea begins after breakfast, there is no stool at night, false urge( tenesmus) is possible, mucus is often released;
• bloating from any food, intensified toward evening.

Symptoms expressed by other digestive disorders: at the same time the esophagus changes( belching, heartburn, swallowing difficulties), nausea, changes in the area of ​​the rectum and anal opening( cracks,hemorrhoids).

Common symptoms include nonspecific manifestations, patients complain of a headache, a feeling of suffocation, palpitation, pain in the spine, weakness, "inner trembling," nausea. Possible skin manifestations of allergy in the form of itching hives, large spots.

How is the diagnosis made?

Despite the presence of symptoms, it is difficult to make a correct diagnosis due to the absence of any specific signs. Dyskinesia of the large intestine is a presumptive diagnosis in a patient with the most typical complaints. To identify the ultimate pathology, it is necessary to exclude various diseases of the digestive system, which are accompanied by a similar symptomatology, establish a clear duration of manifestations, probable connections and mechanism of injury, the effect of the treatment.

On a more serious pathology, and not on functional disorders, indicate:

• weight loss;
• revealing the transferred inflammatory or tumoral diseases of the intestine;
• blood in feces;
• temperature increase;
• revealing the connection of symptoms in girls with menstruation;
• dependence on taking medicines;
• onset of the disease over the age of 50 years.

The hardware techniques are most appropriately assigned in the intestinal study:

• esophagogastroduodenoscopy - will exclude the pathology of the upper digestive tract;
• X-ray study of the stomach and intestines with a preliminary intake of barium suspension - a contrast agent, evenly distributed, helps to examine contours, identify ulcers, polyps, tumor-like diseases, spasmodic areas, dolichosigmus, diverticulitis;
• Irrigoscopy - is carried out by the introduction of a solution of barium in the enema, on the roentgenogram the lower sections of the large intestine, sigmoid and rectum are well contrasted;
• Colonoscopy - examination of the large intestine using an endoscopic tube injected into the rectum under anesthesia makes it possible to visually examine the lesion of the intestinal wall( ulcers, diverticulitis, inflammation);
• sigmoidoscopy - examination of the rectum excludes complications of hemorrhoids.

Laboratory techniques are needed to detect inflammation of the intestine( a large number of leukocytes, pus in the feces, red blood cells), the analysis of stool for the Gergersen reaction( latent blood) is not positive for dyskinesias.

Scraping for enterobiasis, coprogram examination - eggs of worms indicate the specificity of intestinal lesion and the symptom requires targeted treatment. In biochemical tests of blood determine the disturbed ratio of protein fractions, enzymes, hormonal active substances, indicating a certain disease of the digestive system.

Treatment of

Against the backdrop of anxious-hypothetical state of patients with dyskinesia of the intestine, always worries whether the disease is treated, whether it passes into a malignant tumor. Most often, the therapy is done on an outpatient basis, hospitalization may be needed only if it is necessary to have a follow-up, follow-up. The patient needs to get rid of unpleasant symptoms, believe in the safety of his condition and again become a socially active person.

Nutrition

Doctors start recommending diet choices depending on the preferred type of dyskinesia. Hypermotorics should temporarily exclude fresh vegetables, fruits, fiber. With propensity to constipation, on the contrary, more vegetables are recommended, prunes, dried apricots, salads from boiled beets.

To prevent allergic reaction and irritation of the intestine with any form of dyskinesia, it is necessary to switch to boiled food, refuse fried and smoked products, fatty meat and fish, baked pastry, fat, salinity, spicy seasonings, confectionery, ice cream, coffee, alcohol. Food should be organized in small portions, but often. In each case, the diet is developed individually.

Drug therapy

Patient therapy requires mild sedatives better than plant origin( tinctures of valerian and motherwort, Novopassit).It is rare for a psychiatrist to use antidepressants. With propensity to constipation laxative agents of osmotic action and stimulating motor function are recommended.

Shown as short courses:

• Regulus;
• Slabilen;
• Slabicap;
• Phytolax;
• castor oil with kefir;
• Guttalax.

Rectal suppositories with glycerin can rarely be used. When diarrhea is shown Loperamide, Smecta, probiotics with bifidobacteria. Antibacterial agents are prescribed only for secondary dyskinesia of the intestines caused by pathogenic infectious agents. The course and dosage are clearly regulated by the doctor. It is impossible to reduce or prolong the intake of drugs of this group.

To relieve pain in the abdomen, anticholinesterase drugs are used( destroying the enzyme cholinesterase, they contribute to the accumulation of the mediator acetylcholine).Spasmolytics are shown only in case of cramping pains. In cases of combination with dyskinesia of bile ducts, the doctor prescribes drugs and herbs of choleretic action that improve the composition of bile.

Physiotherapeutic methods

A significant improvement in the state can be achieved with the help of physiotherapy. The use of the method requires the obligatory elimination of latent bleeding, suspicion of a neoplasm. In sanatoriums or in the spas, you can undergo dyskinesia of the colon twice a year to take courses of sub-aqua baths( wash and clean the intestines with water with bioactive substances), oxygen fortifying procedures, the soul of Charcot.

In the physiotherapy room, it is recommended:

• exposure to electrophoresis on the abdomen, collar zone;
• diadynamic currents.

What to expect for patients?

Complete recovery can only be achieved in 10% of cases. The remaining patients should constantly maintain themselves by diet, medications. Gastroenterologists claim that the adherence of inflammatory bowel diseases, tumors against the background of therapy does not go beyond the possibility for any person of a certain age category.

When the untreated process is started, in patients with mental disorders, people constantly exposed to stress, the prognosis is unfavorable. They are at risk for further development of peptic ulcer, malignant tumors.

Doctors refer to dyskinesia of the intestine with the utmost care. Behind the manifestations may hide various rather unpleasant diseases in the preclinical stage. The examination allows them to be identified, which does not please the patient at all. Timely assistance often consists of calm and confidential conversation.