Atoniya of intestines
Atoniya of intestines - lack of a tone of his smooth muscles owing to the organic or functional reasons. This state can develop at various diseases of internals, improper feeding with small amount of food fibers in a diet, as a result of reception of certain medicines. Diagnostics is based on holding detailed poll of the patient and detection of features of food, way of life, assessment of results of laboratory researches, carrying out an irrigoskopiya, kolonoskopiya for the purpose of an exception of organic defeat and assessment of motility of intestines. Treatment is based, first of all, on normalization of a way of life, dietotherapy, purpose of pro-kinetic means, if necessary – laxative medicines. Such complex therapy allows to reach good clinical effect, the forecast favorable.
Atoniya of intestines
Atoniya of intestines – the functional state which is characterized by sharp decrease in a tone of smooth muscles of an intestinal wall, violation of process of its depletion. Normal reductions of muscles of intestines (vermicular movement) provide advance of food weight to its final departments. Within a minute each site of a thick gut makes about fifteen peristaltic movements. At violation of a tone the vermicular movement is weakened, in hard cases – is absent. This state is followed by lengthening of intervals between acts of defecation, emergence of difficulties at depletion of intestines. Locks are extremely widespread complaint, but in most cases patients do not address the gastroenterologist for a long time, independently accept laxatives, folk remedies. However symptoms remain as it does not become clear and the state cause is not removed, and the wrong treatment only aggravates violation of a tone. Atoniya of intestines can be a symptom of other diseases therefore emergence of locks demands the obligatory address to the doctor for performing adequate diagnostics and treatment.
Intestines atoniya reasons
Both diseases of internals, and reception of certain medicines, features of a way of life can be the reasons of functional violation of a tone of intestines. A frequent etiology of decrease in a tone of intestinal muscles and development of locks is the inactive way of life. The hypodynamia leads to deterioration in an innervation of an intestinal wall therefore the quantity and force of peristaltic movements decreases. Leads to such consequences also improper feeding – the use of a large number of carbohydrate high-calorific food with insufficient intake of cellulose. The central nervous system constant stresses can be an intestines innervation cause of infringement.
Can lead reception of such medicamentous medicines as spazmolitik, morfinopodobny analgetics, antidepressants to development of an atoniya of intestines, antiulcer, antiepileptic, antatsida, some sorbents, and also the certain intestinal infections, violation of a microbiocenosis of intestines (dysbacteriosis), availability of helminths producing the substances braking a vermicular movement. Nicotine also negatively is reflected in a tone of an intestinal wall. The tone can be lowered in view of hereditary factors, at endocrine pathology (obesity, a hypothyroidism), during pregnancy, a menopause, in the presence of oncological pathology, owing to surgical interventions in an abdominal cavity and development of an adhesive disease.
Very often the atoniya of intestines of different degree of expressiveness is observed at pregnancy. It is connected both with a mechanical sdavleniye of intestines, and with the high content of progesterone, one of effects of which is relaxation of gladkomyshechny tissue of internals including intestines muscles. The tone of intestines is lowered at elderly people that is explained both by processes of physiological aging, and high frequent atherosclerotic defeat of its krovosnabzhayushchy vessels.
Intestines atoniya symptoms
Symptoms of this pathology are characterized by polymorphism and are defined by extent of violation of motility, features of nervous system of the patient, age. Signs of an atoniya of intestines are connected with a chair delay, and also with the broken digestion processes. The main symptom – locks (the slowed-down or systematically insufficient depletion of intestines). The norm is considered when defecation happens at least three times within a week and is not more often than three times a day. Respectively, locks is the frequency of defecation is more rare than three times in a week, at the same time the increased dryness, hardness of kalovy masses is characteristic. Also important diagnostic criterion is the urezheniye habitual for the person of frequency of a chair.
Atoniya of intestines is followed by such symptoms as skhvatkoobrazny abdominal pains, imperative ineffectual desires to defecation, a frequent eructation, discomfort in a stomach, nausea. Often there is a feeling of weight, an abdominal distension. Also the general symptoms are characteristic: neurovegetative violations, increased fatigue. As at violation of processes of band digestion absorption of nutrients and vitamins worsens, symptoms of hypovitaminosis are characteristic, the anemization owing to violation of digestion of iron, development of iron deficiency anemia is possible. The full atoniya of intestines leads to emergence of intestinal impassability.
Diagnostics of an atoniya of intestines
Diagnosis of this pathology is based on detection of the reason of an atoniya as the last in most cases is a symptom of any disease. The gastroenterologist carries surely out detailed inquiry of the patient, finding out features of a way of life, a food habit, the level of physical activity, the postponed diseases. Effective correction of an atoniya in the presence of its communication with a certain disease requires treatment of causal pathology.
At objective inspection the abdominal distension, weakening of peristaltic noise pays attention. All-clinical laboratory trials for the purpose of assessment of a condition of gepatobiliarny system are conducted. An obligatory method of a research is the koprogramma, and also the analysis a calla on dysbacteriosis. Existence of protozoa, helminths is estimated. The research of level of tireoidny hormones (hormones of a thyroid gland) as the hypothyroidism can be the cause of essential decrease in a tone of intestines is conducted.
The barium passage X-ray analysis allows to estimate motor function of a small intestine. For an exception of the organic reasons of damage of a large intestine can the irrigoskopiya is carried out. This method consists in a radiological research of a large intestine after retrograde introduction to it of contrast substance. It gives the chance to estimate tensile properties of an intestinal wall, a relief mucous, and also a functional state. An informative method of a research is the kolonoskopiya – the endoscopic method allowing to estimate visually an intestines condition, to exclude existence of a disease Krone, oncological pathology and other states which can be the cause of an atoniya. For the purpose of an exception of a disease of Girshprunga (the pathology which is characterized by congenital absence nervous in a muscular and submucous layer of intestines) the biopsy and a histologic research of a bioptat with carrying out the specific test for a cholinesterase is conducted.
If the held events do not find the intestines atoniya reason, carrying out consultations of the neurologist, psychologist or psychotherapist with full psychoneurological and psychological inspection as the lowered tone can have psychogenic character is expedient.
Treatment of an atoniya of intestines
Therapy of this state in gastroenterology begins with a diet. In some cases only the healthy nutrition is enough for a korrigirovaniye of frequency of defekation. At locks appoint a dietary table No. 3. It is recommended to use vegetables, fresh fruit. It is necessary to include in a daily diet products which contain antraglikozida – dried apricots, a fig, prunes. Introduction to the menu of sour-milk dishes, juice with pulp (plum, apricot), vegetable fats is obligatory. It is necessary to limit the products containing tannin (tea, bilberry, cocoa). Food has to be chemically and mechanically irritating, it is not necessary to prepare dishes in the form of puree, and also kissels.
Very important role in regulation of frequency of depletion of intestines belongs to the drinking mode. In days it is recommended to drink not less than two liters of liquid (at the accounting of absence of pathology of kidneys, cardiovascular system), it is optimum in the form of mineral waters. The correct diet is also important: the meal, maximum on volume, has to be in the morning when propulsive ability of intestines is maximum. Frequency rate of meal about 5-6 times a day is expedient.
Significantly introduction to a diet of bran improves transit of intestinal contents. Wheat bran should be filled in with boiled water and twenty minutes later to add to kefir, soups and other dishes. The mechanism of action is based that fibers from bran are not exposed to digestion, have ability plentifully to absorb water, increasing the volume of kalovy masses. Volume stimulates an intestines vermicular movement.
Sufficient level of physical activity is of great importance. Especially important it for patients who because of diseases it is long were on a bed rest (for example, after a myocardial infarction, a stroke, heavy ChMT, a spine injury, a polytrauma), and also for the persons having obesity owing to a hypodynamia.
Regulation of a way of life and food in many cases allows to achieve a positive effect without use of laxative medicines. However, unfortunately, prevalence, nonprescription availability and low cost of many means of laxative action, and also ignoring of medical recommendations leads to their mass uncontrollable independent application by patients. Introduction of medicamentous therapy has to be carried out only after the above described actions and only by the doctor.
Medicamentous therapy of an atoniya of intestines begins with application of prokinetik – medicines which raise a tone, improve motility of intestines. Cholinesterase inhibitors have this effect. Treatment usually joins also the medicines of bile-expelling action rendering the expressed irritant action on an intestinal wall.
Laxative medicines are not means of continuous therapy of an atoniya of intestines as often they are applied by patients. They are used only at the initial stages of treatment for the purpose of normalization of the broken defekatsionny reflex. Distinguish several groups of the depletive differing in the action mechanism.
Sekretorny medicines of a phytogenesis or synthetic are most often used. Their action is based on reduction of absorption of water in intestines, fluidifying of kalovy masses, and also irritation of hemoretseptor mucous. Such widespread means as medicines of leaves of Seine, a rhubarb root, castor oil concern to this group, bisakodit, sodium and others. These medicines accelerate transit of contents of intestines, and also stimulate directly defecation process. The main lack of this group is loss of electrolytes, waters at systematic application, development of the accustoming demanding correction of a dosage and also pain.
The second group of medicines of laxative action – osmotic means. The laktuloza – not soaking up biose, and also high-molecular polymers holding water concerns to this group. Being in an intestines gleam, such substances increase the osmotic pressure of kalovy masses and by that stimulate secretion in a water gut gleam. Kalovy masses becomes more liquid that promotes their best advance and stimulates motility.
The third group – means which action is based on increase in volume of kalovy masses (bran, plantain seeds, a sea cabbage, polikarbofit calcium and others). These are the only natural laxatives suitable for systematic use. They have no side effects and stimulate a vermicular movement naturally – due to mechanical action of volume of kalovy masses.
Also the means facilitating advance a calla due to the greasing effect are used: olive, almond oil, liquid paraffin. According to indications clarification of intestines is carried out: gidrokolonoterapiya or subakvalny bathtubs.
Forecast and prevention of an atoniya of intestines
This state has the favorable forecast: during the performing comprehensive examination, detection and elimination of the reason of an atoniya, correction of food and way of life (if necessary - purpose of reasonable adequate drug treatment) the intestines atoniya well gives in to therapy. The exception is made by cases of organic defeat, lack of an innervation (as at a disease of Girshprunga) and other serious illness.
Prevention of an atoniya of intestines consists in a balanced diet, since children's age, obligatory sufficient physical activities, and also timely detection and treatment of diseases which can become the reason of decrease in a tone of intestines.