Failure digestive syndrome

Failure digestive syndrome - a syndrome characterized by digestive disorders in the gastrointestinal tract. There are violations predominantly cavity digestion (dyspepsia) and membrane digestion, as well as mixed forms of the syndrome of digestive disease.

Dyspepsia. Etiology, pathogenesis. Indigestion is caused by uncompensated failure of the secretory function of the stomach, exocrine function of the pancreas, biliary excretion, due to various reasons, violation of passage of chyme through the gastrointestinal tract (stasis, stagnation as a result of stenosis or compression of the intestine or rapid acceleration due to increased peristalsis); are important intestinal infections, goiter, nutritional disorders (excessive food load, mainly protein, fat or carbohydrate diet, drinking large amounts of beverages fermentation). Dyspepsia may be functional, but more often is a result of diseases of the digestive system. It is characterized by incomplete splitting of nutrients, active multiplication of bacterial flora in the gut with settling her in the proximal small intestine, the development of dysbiosis, more active than normal, the participation of bacteria in the enzymatic digestion of food with formation of a number of toxic products (ammonia, indole, low molecular weight fatty acids, etc..), causing irritation of the intestinal mucosa, increased motility and symptoms of intoxication because of their absorption into the blood and receipts.

Dyspepsia is observed in gastric achlorhydria and ahilii, long decompensated pyloric stenosis, atrophic gastritis, gastric cancer. Characterized by a feeling of heaviness, pressure or fullness in the epigas-central region after eating, frequent belching air, food, often sour or rotten unpleasant smell, unpleasant taste in the mouth, nausea, decreased appetite. Ahilicheskie frequent diarrhea, flatulence.

Dyspepsia is observed in intestinal failure of exocrine pancreatic function, chronic inflammatory diseases of the small intestine, and so on. D. It is characterized by feelings of bloating, rumbling and transfusion in the intestine, copious gas, diarrhea, putrid or sour smell of stool (constipation rarely). To study characteristic coprological steatorrhea, amylorrhea, kreatoreya, kitarinoreya. When X-ray marked the accelerated passage of barium suspension through the small intestine. Research exocrine pancreatic function, aspiration enterobiopsiya, definition enterokinase and alkaline phosphatase in the intestinal juice, allow to specify the cause of intestinal dyspepsia. Research glycemic curve with oral starch load and radioisotope study trioleatglitserinom, sunflower or olive oil make it possible to assess the degree of impairment of the digestive cavity. It is important to study the intestinal microflora (see. Dysbacteriosis).

Treatment. The first treatment of major diseases. Symptomatic therapy: diarrhea -dieta №4 for 2-5 days and then №46; additional enzymes (pancreatin, abomin, Festal, etc..), binding agents, carbol.

Lack of membrane digestion occurs in chronic diseases of the small intestine, accompanied by degenerative, inflammatory and sclerotic changes of the mucous membrane, disruption of the structure of the villi and microvilli and decreased their number, impaired intestinal peristalsis (enteritis, sprue, intestinal lipodystrophy, exudative enteropathy and so on.). The symptoms are the same as in dyspepsia syndrome and intestinal insufficiency suction. Diagnosis is established by determining the activity of enzymes (amylase, lipase) consistent with their desorption Homogenous-dinates mucosal pieces obtained by needle biopsy of the small intestine mucosa. The method of studying the glycemic curve after oral di- and monosaccharides loads allows differentiation syndrome wall digestion insufficiency of intestinal lesions associated with impaired absorption processes intestinal wall nutrient degradation products, and acceptance of polysaccharides (starch) - the syndrome of deficiency of digestive cavity. Aspiration biopsy reveals atrophic changes in the mucosa of the small intestine (indirect sign).

Treatment. Carry out the treatment of the underlying disease, syndrome suction failure. Symptomatic therapy - enzyme (abomin, Festal, etc...), And astringents (Tanalbin et al.) Drugs inside.