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Syndrome of the angry intestines
The syndrome of the angry intestines is a state which is defined as the functional disorder of intestines having biopsychosocial character. Interaction of two different mechanisms is considered a basis of display of this illness. This psychosocial action and sensoromotorny dysfunction of which problems with a physical activity and visceral sensitivity of intestines are characteristic. To provide high-quality treatment of this state, implementation of special approach to diagnosis, the differential diagnosis, and also providing the correct course of therapy of a disease is required.
Prevalence of a syndrome of the angry intestines
Most often suffer from this illness at working-age: these are people from 25 to 40 years. At the same time existence of symptoms of this illness at people who already crossed a sixty-year boundary forces specialists to doubt the similar diagnosis.
Syndrome of the angry intestines — an illness which high frequency takes place in many countries. However about two thirds of people who complain of symptoms of this illness do not address for the qualified treatment at all. The illness equally often occurs at representatives of both floors.
Symptoms of a syndrome of the angry intestines
It is necessary to understand existence of constant set of functional frustration which continue not less than twelve weeks for the last year as a syndrome of the angry intestines. They are expressed by pain and feeling of a certain discomfort in a stomach. At a syndrome of the angry intestines at the patient abdominal pain takes place. Its intensity can be as not really high (pain quite tolerant and non-constant), and especially intensive (pain is sometimes intolerable, reminds intestinal colic). Very often pain is shown after acceptance of food, there is abdominal distention, the peristaltics amplifies. After defecation and a passage of flatus pain often abates. At the night of the patient it mainly does not disturb.
Besides, the person in parallel has a change of a consistence and frequency of a chair. Throughout 25% of time of an illness these signs are followed not less than two constant symptoms of disturbance of functioning of intestines. The speech in this case goes about a meteorism, availability of slime in Calais, defecation process changes (existence of tenezm, imperative desires, feelings of incomplete bowel emptying, need of efforts at the act of defecation).
Also manifestation of some other signs is characteristic of the person with a syndrome of the angry intestines. So, its complaints are often changeable and have recurrent character; progressing of a disease is not observed, the person does not grow thin, at it anemia, fever does not develop, however under the influence of a stressful situation frustration can be aggravated.
Besides, existence of communication of this syndrome with other disorders of functional character, for example, with a syndrome of a vegetative adynamy, a syndrome of the angry stomach, neurosises, a syndrome of the angry bladder and other states is possible.
Chronic disease with recurrence, however, without progressing is characteristic of a syndrome of the angry intestines. As a rule, the disease does not provoke serious complications. As a result, it is about the favorable forecast. However it should be noted that this illness significantly influences quality of human life, lowering its working capacity, worsening a dream, rest, sexual life.
Today this illness is considered an illness, eurysynusic among people. But in view of an illegibility of its symptoms very often patients do not address specialists at all, thereby, aggravating a state.
Diagnosis of a syndrome of the angry intestines
It is accepted to define three different types of course of a syndrome of the angry intestines, depending on a symptom which prevails. This disease at which the meteorism and an abdominal pain prevails; a disease with the prevailing locks; a syndrome of the angry intestines at which diarrhea prevails.
In the course of establishment of the diagnosis initially the specialist has to exclude the most often common causes on which there is an irritation of intestines. This, first of all, chronic action of improper feeding, reception of medicamentous drugs. Among foodstuff which influences intestines as irritants it should be noted alcohol, fat dishes, coffee, products from which gases are formed. Also negatively too plentiful acceptance of food can influence functions of intestines during banquets, changes of usual approach to food because of trips and travel. Among medicines intestines purgatives, iron preparations, potassium, bile acids, antibiotics, etc. often irritate.
Besides, symptoms of a syndrome of the angry intestines are shown at women at certain physical states – during the period before periods, at pregnancy, during a climax.
Symptoms of this disease are shown also after the strong tension of intellectual and emotional character, nervousness, a fright. However at normalization of a mental condition of the person they disappear.
Therefore the specialist has to conduct detailed survey of the patient and estimate existence of resistant set of clinical symptoms. In rate it is about pains in the bottom of a stomach which are combined with disturbances of functioning of distal departments of intestines and cannot be explained with disturbances of morphological or metabolic character. Therefore, organic pathology is excluded.
As symptoms on which the doctor has to pay special attention when determining disease, it should be noted disturbance of transit and the act of defecation. So, as pathology it is necessary to consider a chair which occurs more than three times a day or less than three weekly. As a rule, at a syndrome of the angry intestines diarrhea arises in the first half of day more often after the person has breakfast. About a half of patients at the same time note that at Calais there is a slime. At the same time diarrhea at night, presence of blood in Calais, sharp loss of weight of the person excludes the diagnosis "a syndrome of the angry intestines".
At the address to the doctor patients, the rule, state complaints which can be carried to three groups conditionally.
First, disorders of neurologic and vegetative character take place: a bad dream or drowsiness, migraine, feeling of a lump in a throat, impotence, a dysmenorrhea, etc. Such a state are characteristic approximately of a half of patients.
About eighty percent of patients state complaints to symptoms of diseases of digestive organs: they show nausea and vomiting, an eructation, feeling of pain in right hypochondrium, etc.
Rather small amount of patients (15 — 30%) complain of psychopathological frustration – uneasiness, a depression, hysteria, phobias, panic attacks other.
In the presence of such complaints and, respectively, the suspicion to the patient appoints carrying out a kolonoskopiya and rektoromanoskopiya to a syndrome of the angry intestines. Such researches allow to exclude many morphological and metabolic disturbances. Sometimes for an exception of other diseases also carrying out a biopsy of a mucous membrane is appointed.
In general diagnosis given diseases is rather difficult process therefore it is carried out, as a rule, step by step.
So, at the first stage the doctor defines the preliminary diagnosis. Further it is important to allocate a symptom which dominates and to define, thus, what clinical phase of an illness. The third stage of diagnosis — the differential diagnosis. Further the doctor appoints carrying out a number of analyses: clinical and biochemical blood analysis, koprologichesky research ultrasonography of bodies of a small pelvis and abdominal cavity, kolonoskopiya and irrigoskopiya.
After carrying out all researches to the patient the therapy course calculated, at least, for six weeks is appointed. After that the attending physician repeatedly estimates the established diagnosis. So, if treatment gives due effect, then it is about the final diagnosis. If such effect is absent, then there is a need of carrying out additional researches.
Treatment of a syndrome of the angry intestines
Generally the program of therapy of a disease is made by two composing. Initially attending physician appoints primary course of treatment, and at the second stage basic therapy is carried out.
The patient has to be adjusted on long-term therapy. So, primary course lasts about 6-8 weeks, the second stage can take about three months. The doctor defines remedies, being guided by weight of an illness, its main symptom, a mental condition of the patient.
It is important for high-quality and effective treatment that the patient adhered to some dietary principles of food. So, its diet should not contain caffeine, fructose, lactose, alcoholic beverages, spicy food, vinegar, sorbitol. Also those products which provoke the high level of gas generation are excluded. Besides, diarrhea is often provoked by tobacco smoking. So it is desirable to get rid of this addiction. To people at whom locks prevail the vegetable diet will be the most optimum method of food. It is important to include cellulose in an everyday diet, to drink enough liquid. A lot of celluloses contain fruit, some vegetables, chop off wheat. At the same time it is necessary to eat always in an appropriate situation, not to hurry, accepting food. Sometimes the patient recommend to eat special additives which contain cellulose.
Thus, the patient has to realize that the special diet which has to be observed in each case does not exist. However it is possible to control manifestations of a syndrome of the angry intestines, having excluded from a diet that food which provokes emergence of symptoms – diarrheas, locks, etc.
In certain cases rendering psychosocial support and a diet are an efficient method of treatment of a syndrome of the angry intestines, and the subsequent drug treatment is not required at all.
At primary course of treatment in more hard cases emphasis is placed on elimination of symptoms of an illness, and also on check of correctness of primary diagnosis. In the course of the subsequent basic treatment drugs are selected depending on what symptom at the patient prevails. The drugs having anti-spasmodic, anti-diarrheal or laxative action are generally used. Sometimes effective are also small doses of tricyclic antidepressants. Some specialists practice purpose of probiotics, that is drugs which contain useful microorganisms.
Often at this stage use also physical therapy methods, special physiotherapy exercises, etc. An important role is played also by use of psychotherapy, the weakening methods.
However the most important principle of treatment of a syndrome of the angry intestines is use of an individual approach. The only scheme of therapy of this illness does not exist.
Besides, at treatment of a syndrome of the angry intestines some national methods of therapy are applied. So, by means of use of oil of a peppermint it is possible to remove intestinal spasms quickly. Besides, for treatment it is possible to prepare the grass collecting consisting of identical parts of a valerian, a St. John's Wort, yarrow, a camomile, mint. These herbs need to be filled in with boiled water and to insist on an extent of night. It is necessary to use infusion in the small portions several times a day. Also traditional medicine offers use of other herbs for preparation of broths and infusions. Effectively the glycyrrhiza root, flax seeds, a burnet root, buckthorn bark, bird cherry fruits, a leaf of bilberry, a grass and seeds of fennel, caraway seeds seeds influence a condition of patients.
Prevention of a syndrome of the angry intestines
Prevention of a disease is directed to the prevention of manifestation of its symptoms. It is, first of all, the correct approach to food. Depending on dominance of symptoms (a lock, diarrhea) it is necessary to adhere to the principles of food described above.
The everyday drinking mode is important: the use in a day not less than six glasses of water will help to normalize a condition of intestines. However water should not be drunk during acceptance of food.
Besides, it is necessary to lead a quiet life, to warn whenever possible stressful situations, to constantly show physical activity. Can improve a state at emergence of problems with functions of intestines even the elementary walk on fresh air lasting not less than thirty minutes. However it is necessary to walk every day.
Regular high-quality rest, ability to fully relax and recover emotional balance is necessary.
At reception of any medicines it is important to watch a condition of work of intestines. If its disturbance takes place, it is necessary to talk to the doctor about a possibility of replacement of drug.
Section: Gastroenterology