Intestinal dysbiosis

Intestinal dysbiosis – change of normal bacterial structure of intestines owing to action of various factors. At disturbance of normal balance of flora of intestines substitution of normal species composition pathogenic flora is characteristic.

The structure and functions of intestines of the person provide the main mechanism of digestion of food and digestion of nutrients necessary for normal work of an organism. After rough processing in a stomach the food moves to a small intestine where there is a transfer of nutrients to blood and a lymph.

At a normality in a small intestine there is no own microflora, hit of microorganisms in this department of an intestinal path happens at disturbance of functions of the enzymes provoked by various diseases. Hit and development in a small intestine of pathogenic microflora causes an infection which is followed by diarrhea, pains, swelling and rumbling of a stomach. Development of useful nonpathogenic microbes causes only swelling and discomfort.

The main part of intestinal microflora is localized in the second department – a large intestine. On the structure the large intestine strongly differs from thin, it consists of the colons — ascending, cross, descending, and also of a blind and sigmoid gut. In a large intestine there is a final absorption of water, and the microflora living in this department regulates processes, important for health.

Normal the intestinal microflora represents the balanced ecosystem. In this complex there are more than 500 species of various bacteria, and these are about 1,5 kg of live bacteria. Main representatives of indestinal flora aerobic lactobacilli and anaerobic bifidobacteria.

Important functions of intestinal microflora are regulation of an exchange of bile acids and cholesterol, normalization of zymolysis of proteins, carbohydrates and fats, and also digestion of nucleic acids, high-molecular carbohydrates, celluloses. Microorganisms as a part of indestinal flora increase resistance of an organism to negative influences of environment. It comes thanks to their participation in an electrolytic exchange, synthesis of vitamins from group B, the ascorbic acid and vitamin K, and also in synthesis of substances having antibacterial activity.

At qualitative structure of intestinal microflora there are bacteria which are carrying out a role of a natural biosorbent. They promote a detoxication of endogenous and exogenous substrates and change of a formula of toxic agents, than do them harmless to the person.

Дисбактериоз кишечникаIn fact, the balanced ecosystem of intestines is the activator of our immune system, forcing it to be in a tone and to react at danger. Under the influence of microbes the lymphoid device is stimulated, continuous synthesis of immunoglobulins is provided, permeability of vessels for penetration of toxic products decreases.

Important functions which are carried out by intestinal microflora are improvement of synthesis of a histamine and amino acids, in particular it is irreplaceable tryptophane in an organism, and also digestion of vitamin D and salts of calcium.

The quantity and species composition of microorganisms in a large intestine is constantly changed, at the same time keeping a qualitative ratio, in other words the dynamic equilibrium – balance of intestinal microflora remains. Such changes happen depending on a season, age, way of life, environment and a mental condition of the person. Conditionally the microflora is divided on resident and tranzitorny, and also on nonpathogenic and conditionally pathogenic, that is useful in small structure and a ratio. Disturbance of normal balance is also an intestinal dysbiosis, sharp change of structure and increase in quantity of pathogenic microbes leads to disturbance of functions and development of diseases.

Developing of an intestinal dysbiosis can be caused by various factors, most often this unbalanced food, immunodeficiency, intestinal infections, long reception of antibiotics, hormonal and nonsteroid drugs. Also treatment of diseases himio-and radiation therapy can be the cause of dysbacteriosis. At purpose of therapy prevention of an intestinal dysbiosis is obligatory.

In classification of dysbacteriosis distinguish four stages of development, and also subdivide primary and secondary dysbacteriosis. At primary disease there is a change of microflora, and further there is an inflammatory process of mucous membranes of an intestinal path. Secondary dysbacteriosis, as a rule, is complication of diseases of a small or large intestine what the clinical picture and the main symptoms depends on.

The first stage of an intestinal dysbiosis is characterized by insignificant development of pathogenic flora and moderate reduction of volume of beneficial bacteria. Intestinal dysbiosis symptoms at the first stage, as a rule, are absent.

Critical decrease in structure of obligate flora – bifidobacteria and lactobacilli, and also prompt development of pathogenic microbes is characteristic of the second stage. There are first symptoms of disturbance of work of intestines.

The third stage differs in inflammatory process with defeat of walls of intestines. Intestinal frustration gain chronic character.

The fourth stage of an intestinal dysbiosis is the beginning of acute intestinal infection. At this stage the general exhaustion, anemia is characteristic. The imbalance of intestinal microflora is displaced towards pathogenic microbes and mushrooms. The useful flora in intestines is present at very small ratios.

Intestinal dysbiosis symptoms

Дисбактериоз кишечникаThe clinical picture of development and the course of dysbacteriosis depends both on a stage, and on microbiological option of frustration. Characteristic symptoms of dysbacteriosis it frustration of a chair, the diarrhea caused by education and accumulation in intestines of a large amount of bile acids which detain absorption of water and cause changes in structure of a mucous membrane of intestines. Besides dekonjyugirovanny bile acids have aperient property, thereby provoking an unstable chair.

At age dysbacterioses frequent locks are characteristic, in particular at an associated disease such as atherosclerosis or chronic colitis. Locks arise owing to ease of action of microflora on a peristaltics of a large intestine.

As you see, symptoms of dysbacteriosis are various, but the basic nevertheless is the meteorism. And changes in a wall of intestines lead the increased gas generation in a large intestine to disturbance of absorption and removal of gases. From there are such signs as an unpleasant smell and taste in a mouth, swelling, burnings in a myocardium, disturbances of a cordial rhythm. At sharp increase of a meteorism there is dispepsichesky asthma which is characterized by a sharp otdyshka and swelling, expansion of pupils and a cold snap of extremities.

Frequent symptom of dysbacteriosis is also the abdominal pain. The monotonous, pulling or arching pains are characteristic. Generally pain is followed by a meteorism and amplifies by the end of day. Also the strong kolikoobrazny abdominal pain can be observed. After meal there is an abdominal murmur, a gastroceccal reflex.

At an intestinal dysbiosis there is a syndrome of gastrointestinal dyspepsia. Appetite remains, there is a feeling of completeness in an anticardium, an aerophagia, an eructation and nausea. After a while there is a diskeniziya owing to disturbance of motility of guts. This state arises at irritation of guts products of fermentation of acids. In intestines excess of CO2 gases, methane, hydrogen sulfide is formed that even more strengthens a meteorism. At the fourth stage of an intestinal dysbiosis putrefactive dyspepsia can be observed. Processes of fermentation and rotting in intestines lead to strong changes in structure a calla.

The imbalance of microflora leads to disturbances of its main functions, there are polyhypovitaminosis signs. The lack of an organism of thiamin leads to disturbances of motility of intestines, there is a tendency to an atony, a headache, myocardium dystrophy, the peripheral nervous system suffers. At patients depression, irritability, the increased salivation can be observed that is signs of deficit of niacin. Insufficiency of Riboflavinum is shown by stomatitises, dermatitis on nose wings, a hair loss and changes of nail plates.

Quite often at dysbacteriosis anemia is observed. Such state arises owing to weakening of synthesis of folic acid and cyanocobalamine. Their competitive use by both pathogenic, and beneficial bacteria leads to sharp decrease in quantity of these elements – normokhromny, is more rare than hyperchromic anemia. Food allergy can act as a dysbacteriosis symptom too. A superactivity of intestinal microflora leads to the increased development of a histamine and there is an allergic reaction to some foodstuff.

The imbalance of microflora can have different symptoms of an intestinal dysbiosis, it depends on a species of the microbe prevailing in flora. The most frequent representatives of pathogenic flora are staphylococcus, a pyocyanic stick, mushrooms Candida, misogasy, aspergilus. The type of dysbacteriosis can be established by laboratory diagnosis, differences and in a clinical picture of disease are observed.

The fungal intestinal dysbiosis arises owing to reception of antibacterial drugs. Use of antibiotics breaks the balance of flora, beneficial bacteria producing substances with fungistatic effect perish, thereby giving way to mushrooms which do not react to antibiotics.

Дисбактериоз кишечникаOn the first place among fungal dysbacterioses there is a candidiasis. Reproduction of drozhzhepodobny mushrooms of Candida albicans causes superficial damage of mucous membranes. The candidiasis of intestines and stomach, as a rule, accompanies other diseases.

At the easy course of a disease clinical signs of dysbacteriosis are shown in an insignificant measure. Insignificant abdominal pains, a liquid chair, temperature most often normal can be observed. At heavier current there is subfebrile temperature which keeps long enough, headaches, the increased perspiration develop. In the field of a sigmoid gut pains, swelling, weight are felt. The chair is frequent, plentiful with slime impurity.

Also the mucoromycosis and an aspergillosis are distinguished from fungal dysbacterioses. These diseases in an intestinal form meet much less often than a candidiasis. The forecast of a disease is more often adverse. Muromikoz develops in a consequence of hit of the activator in the intestinal highway at associated diseases. An aspergillosis in turn can arise after a long antibioticotherapia. Development and course of a disease acute, heavy. Frequent symptoms diarrhea, changes in intestines of hemorrhagic and necrotic character.

At patients with ulcer colitis or chronic a coloenteritis, and also at persons earlier had dysentery, salmonellosis and other acute intestinal infections can arise the intestinal dysbiosis caused by a pyocyanic stick. More often pyocyanic dysbacteriosis arises at patients with reduced immunity, can also be a consequence of food poisoning.

On morphological features distinguish catarral and fibropurulent, with hemorrhages, the centers of necroses, pyocyanic dysbacteriosis. The intestinal dysbiosis symptoms caused by a pyocyanic stick owing to food toxicoinfection: abdominal pains, the frequent repeating vomitings, a liquid chair with slime. In 7-10 days there can be paralytic Ilheus, cardiovascular insufficiency which lead to a lethal outcome. The pyocyanic dysbacteriosis caused by excessive reception of antibacterial drugs has less expressed picture and the good forecast.

The staphylococcal intestinal dysbiosis also develops after acute intestinal infections, the postponed diseases of bodies of the alimentary system, long toxic action of antibiotics with couple with a vitamin deficiency. At the easy uncomplicated course of staphylococcal dysbacteriosis insignificant symptoms of intoxication, appetite disturbance, weakness, and also slight inflammatory process are characteristic. Temperature increase is followed by a fever.

At an average and the heavy clinical course of dysbacteriosis clinical signs are more expressed, temperature strongly increases, to 38-39 degrees, the fever, perspiration is observed. Intoxication is shown by headaches, weakness, abdominal pains. A chair liquid to 10 times a day, with impurity of slime, blood and pus. At a heavy current disturbance dehydration from cardiovascular system is observed.

Diagnosis of an intestinal dysbiosis

Дисбактериоз кишечникаThe diagnosis dysbacteriosis is made on the basis of laboratory researches and characteristic symptoms of a disease. The main analyses at suspicion on disturbance of microflora intestines are crops a calla, urine and bile on dysbacteriosis, and also koprologichesky research a calla. The last research gives the chance to find yodofilny microflora, large amounts of intracellular starch and the digested cellulose, as is an indicator of existence of a disease.

Diagnosis of an intestinal dysbiosis by a crops method a calla on dysbacteriosis not always yields reliable result. Advantage of bacteriological research is an opportunity to cultivate a specific species of microbes and to define their quantitative ratio. The good result is yielded by such analysis at suspicion on a staphylococcal or fungal bacteriosis of intestines. Besides this method the cheapest and available among all laboratory researches. If necessary conduct researches of a biotapt of a wall of a small intestine or crops of the graduate student of contents of a small bowel. Because of technical complexity of such analysis it is appointed extremely seldom.

More widely in diagnosis of an intestinal dysbiosis the method of polimerazny chain reactionPTsR-diagnosis of definition of species of microorganisms is applied. With its help it is possible to define representatives of intestinal microflora who are not in an intestines gleam. And though today this method is the basic, its accuracy leaves much to be desired. Informational content of the analysis very low that is connected with a limited circle of microbes which can be revealed with PTsR-diagnosis.

Chemical methods of research can be applied to diagnosis, it is mass spektromeriya and gas-liquid chromatography. Research of contents of intestines for determination of concentration of waste products of microbes is conducted on the basis of what the structure and a ratio of intestinal microflora is calculated. Essential minus of such research its cost, requirements to the equipment and calculations.

The fungal bacteriosis is diagnosed against a coloenteritis and enteritis which are provoked by long antibacterial therapy. Intestinal dysbiosis symptoms, in particular krovavo indicate a mucous diarrhea existence of mycoses, and laboratory analyses confirm the diagnosis. Researches of scrapings mucous intestines and the analysis a calla are appointed to a mycelium.

Most often confirmation of the diagnosis happens unreasonably. There is no accurate concept of norm of a biocenosis of intestines, different patients have a structure of microflora different, and its continuous changes do not give the chance to precisely calculate a qualitative ratio. Full scientific researches in on this matter were never conducted. In what actually difficulty of diagnosing of dysbacteriosis also is. Also the fact that in classification of diseases of such disease as the intestinal dysbiosis does not exist about what constantly there are discussions is important.

Treatment of an intestinal dysbiosis

Дисбактериоз кишечникаFor treatment of dysbacteriosis a number of drugs of the developed on the basis of microorganisms and their products – prebiotics and a probiotics is used.

The probiotics appointed at dysbacteriosis consists of live microorganisms which regulate intestinal microflora. Important function of such microbes is ability to a survival, as at drug storage, and directly in an intestines ecosystem.

Several groups of probiotics are appointed. Monokompolentnye contain one species of microbes in the structure: bifidobacteria, lactobacilli or colibacillus. Multicomponent contain combinations of the main strains bifido-, lakto-and a colibacillus. The combined drugs consist of symbiotic communities of the main representatives of indestinal flora, and also contain the connections stimulating growth of normal microflora. There is also recombinant probiotics, they incorporate not only necessary bacteria, but also the cloned genes for alpha interferon synthesis.

Prebiotics in turn it is drugs of not microbic origin. Not digested disaccharides which stimulate growth and activity of own flora belong to prebiotics and slow down development of pathogenic microorganisms.

Treatment of an intestinal dysbiosis is appointed in a complex depending on disease degree. As dysbacteriosis develops under the influence of many factors, it is important to remove the cause of its development, otherwise reception of probiotics will not give a positive effect. Elimination of the centers of an infection and chronic diseases the main task in treatment of dysbacteriosis.

Prevention of an intestinal dysbiosis

For prevention of development of dysbacteriosis at antibacterial therapy complexes of probiotics and prebiotics, vitamins, fermental drugs are appointed. An important point is treatment of diseases of the alimentary system and obesity. The healthy balanced nutrition and active lifestyle strengthen immunity and prevent disturbances of balance of intestines.

Section: Gastroenterology