Syndrome of Irritation of Intestines (SII)
Syndrome of irritation of intestines – functional frustration which cornerstone violations of visceral sensitivity and physical activity of intestines, and also psychoemotional frustration are. Is followed by discomfort and the constant aching or sharp belly-ache passing after defecation, feeling of incomplete depletion of intestines. Imperative desires to defecation are characteristic, release of slime with a stake, change of frequency of a chair, consistence a calla is possible. Laboratory and tool diagnostics is directed to an exception of organic pathology of a digestive tract. Treatment of a syndrome includes a dietotherapy, psychotherapy, reception of medicamentous means.
Syndrome of Irritation of Intestines (SII)
Syndrome of the angry intestines – functional disorder of work of a large intestine, the simptomokompleks which is characterized long (before half a year) and regular (more than three days monthly) emergence of belly-ache and violation of a chair (locks or ponosa). A syndrome of the angry intestines – the functional disease, is connected with frustration of an intestinal vermicular movement and digestion of food. It is confirmed by an irregularity of complaints, a wavy current without progressing of symptomatology. A recurrence of a disease is quite often provoked by stressful situations. Losses in weight are not noted.
Among the population of the developed countries the syndrome of the angry intestines occurs at 5-11% of citizens, women suffer from it twice more often than men. It is most characteristic of age group of 20-45 years. At identification of symptomatology of SRK after 60 years it is necessary to conduct careful examination regarding organic pathologies (, polyposes, cancer of a large intestine). The syndrome of the angry intestines in this age group meets more than one and a half times less often.
Reasons of development of SRK
Now the causes and mechanisms of development of a syndrome of the angry intestines are studied insufficiently. It is revealed several factors exerting impact on a functional condition of a large intestine and promoting his irritation. Dependence of a clinical current of a syndrome of the angry intestines on psychological factors is most obviously traced that allows to assume psycho-neurogenetic mechanisms of development of a disease. It is noted that in 32-44% of cases developing of pathology was preceded by a strong psycho-emotional shock, at many sick SRK depressions, morbid depression, sleeplessness, various phobias and other neurotic frustration are noted.
Physical injuries and infectious damages of intestines (dysentery, esherikhioza, salmonellosis, etc.) in the anamnesis, a visceral giperalgeziya (hypersensitivity of intestines), the hormonal status (women are inclined to emergence of attacks of the angry intestines in the period of periods), genetic predisposition belong to the factors promoting developing of a disease (SRK is more often noted at both twins in monoovular couples, than in two-egg).
Clinical classification of a syndrome of the angry intestines is based on prevalence of these or those violations of defecation: The SRK with prevalence of a lock, a diarrhea mixed and which is not classified. Main clinical manifestations of a syndrome of the angry intestines: pain and violations of a chair (locks, diarrhea, their alternation).
Belly-ache at SRK is usually localized in the lower part of a stomach, has the stupid, aching character, but can be shown also by bad skhvatkoobrazny attacks. Morbidity amplifies after meal, after defecation are weakened, at women attacks often arise just before and during periods. The night pains disturbing a dream are uncharacteristic.
Change of nature of defecation can be as towards locks (a chair more rare than once in 3 days), and in the form of diarrhea (a frequent and liquid chair). Diarrhea usually arises in the morning and 2-5 times a day are seldom more often, at night usually does not disturb. Often alternation of the periods of a lock from ponosa takes place. Besides, patients can note increase of desires to defecation, the increased gas generation. At a syndrome of the angry intestines lump allocated per day a calla usually does not increase.
Among extra intestinal manifestations of SRK nausea, an eructation, vomiting, pain in the right podreberye, a dizuriya, headaches, weakness, a chill of fingers can be noted. Sleep disorders, breath difficulties, impossibility to lie on the left side are sometimes noted. At many patients the syndrome of the angry intestines is followed by psychoneurological frustration, sexual dysfunction.
The criteria indicating organic character of a problem include: advanced age of patients, the family anamnesis oncological complicated, fever, changes of internals at fizikalny inspection (gepato-and a splenomegaliya), identification of pathological markers at laboratory researches, not reasonable loss of body weight, clinical manifestations at night. If these signs are noted, then it is necessary to suspect any organic disease of a large intestine and to conduct comprehensive examination for its exception.
Diagnostics of SRK
Along with clinical symptomatology and data of fizikalny inspection, as diagnostic measures the laboratory and tool researches directed first of all to an exception or detection of other chronic organic pathologies of a digestive tract which can be shown by similar symptomatology are applied.
Laboratory methods of a research are presented by the general and biochemical blood test, the analysis a calla on the hidden blood, , koprogrammy, bakposevy a calla. Changes of normal indicators at laboratory diagnostics speak about the organic nature of pathological process, at SRK results of analyses are normal.
To the tool methods of diagnostics applicable at a syndrome of the angry intestines, ultrasonography of an abdominal cavity, intestines KT, radiological surveys (an irrigoskopiya, an intestines X-ray analysis), endoscopic researches (a kolonoskopiya, a rektoromanoskopiya) belong. Data of these researches also exclude organic damage of intestines, confirming the functional nature of frustration.
Treatment of SRK
Treatment of patients with a syndrome of the angry intestines is complicated in connection with insufficiently studied mechanisms of its emergence and development. Today the uniform effective scheme of treatment it is not developed. It should be noted high percent of efficiency of placebo at treatment of this pathology that speaks about considerable dependence of its current on mental sets. The significant role of a psycho-emotional factor means participation in treatment of the psychotherapist.
Dietary food, active lifestyle, influence on an emotional condition of the patient and if necessary medicinal therapy for simplification of clinical symptomatology enter a complex of therapeutic techniques at treatment of a syndrome of the angry intestines. Recommendations about dietary food differ depending on prevalence in clinic of locks and ponos, but all patients with SRK need to refuse from the products irritating a mucous membrane of intestines, promoting an excess producing gastric juice and bile, and also the rough food capable mechanically to damage an intestinal wall. At diarrheas from a diet the products containing vegetable cellulose are also removed, astringents while at prevalence of locks cereals are entered into a diet, vegetables, bread with bran are recommended and the products complicating passing of food juice are excluded.
Physical activity, walks, aerobics is recommended to patients with a syndrome of the angry intestines. Courses of physiotherapy exercises are quite often appointed. Besides, it is desirable to normalize a day regimen, to refuse the activity rich with stressful situations, to try to avoid emotional loadings and experience. Psychotherapeutic techniques are recommended.
For restoration and normalization of natural intestinal flora by the patient with a syndrome of the angry intestines medicines of intestinal bacteria are registered. In addition, medicines can be applied to pain relief (spazmolitichesky medicines), knocking over of diarrhea (loperamide) and permissions of a lock (phytogenesis depletive - a laktuloza). In case of the expressed neurologic symptoms demulcents (a valerian, a motherwort, etc.), light hypnotic drugs can be appointed. The reflexotherapy, neurosedative massage, an electrodream, relaksiruyushchy aromatic bathtubs and phytobathtubs with a valerian is shown. Tranquilizers, antidepressants, neuroleptics are appointed only according to indications after consultation with the psychiatrist.
Prevention and forecast of SRK
As preventive measures for a syndrome of the angry intestines It should be noted normalization of food and way of life (the balanced diet, regular meals, avoiding of a hypodynamia, abuse of alcohol, coffee, carbonated drinks, sharp and fat products), maintenance of a positive emotional situation, reception of medicines strictly according to indications.
The syndrome of the angry intestines does not belong to the progressing diseases, despite a long current, it is not inclined to complications. In 30% of cases treatment takes place. Sometimes passes independently in connection with change of a psychological situation and its normalization. The forecast is favorable, treatment in many respects depends on correction of the accompanying psychological manifestations.