Spinal nerve roots. Treatment of the spinal roots

A stone of organic origin, formed in the body of some ruminants, most often in bezoar goats, consists of magnesia, oxalic acid and phosphate of lime. The habitat of bezoar goats is the middle and highlands of the Central Asian region. The flora here is specific - rosehip, sumac, prickly almond, wild pistachio, i.e. very dense and tenacious shrubs.

Naturally, animals are forced to literally wade through thorns while moving along the slopes. A lot of hair remains on the bushes - not only from bezoar goats, but also from other animals grazing in this area. Goats swallow tufts of hair along with their food. They accumulate on tangles swallowed by animals. mineral salts, the main composition of which is calcium hydrogen phosphate.

These stones are found in the stomachs of seals, walruses and some cetaceans. IN auditory organs fish also find “ear stones,” or osteoliths, consisting of calcium carbonate crystals. The word bezoar probably comes from the Chaldean "bel" - lord and "zaar" - poison. The stone is bluish-gray or earthy in color with a blackish and reddish tint, not very hard, greasy to the touch, and has a bitter taste when crushed.

The stone has the ability to intensively absorb arsenic compounds and therefore was considered a strong antidote and was highly valued by princes. If a bezoar stone is briefly dipped into wine containing arsenic, it will remove it from the liquid and in return release harmless phosphate. healing properties This nondescript gray-blue stone was considered precious for many centuries.

IN medieval Europe The bezoar was a rare, expensive and very desirable acquisition not only for doctors, pharmacists and alchemists. Secular dignitaries, princes of the church, nobles and cardinals, kings and popes sought to obtain it. The ongoing struggle for power forced them to live in constant anticipation of an assassination attempt. And the most common method of settling scores was poisoning.

belief healing properties the bezoar was deep and unshakable. Lawrence Catelan wrote a whole book about him, in which he spoke with delight:

“Providence has not given mankind a more magnificent, more powerful and effective means against poisons The disease virus tends to the stone, like heliotrope turns to the sun, like a palm tree to a palm tree, like a remora** reaches to a ship, and an orb*** to the wind.”

The bezoar was usually worn around the neck, but it could be soaked in wine for a couple of hours until the wine absorbed miraculous power stone

Patriarch Nikon had the handle of his staff crowned with a bezoar stone (the so-called bezui stone), which he dipped into the bowl before drinking any drink. And the king’s bride drank vodka infused with bezui stone.

The bezoar stone was constantly worn by Queen Elizabeth I of England. The Shah of Persia sent many of these stones to Napoleon. Either the emperor was in a bad mood, or he was driven by a desire to humiliate the Persian envoy, but the great reformer ordered stones to be thrown into the fireplace. Thirty years later, the appropriateness of such an act already seemed doubtful. May 5, 1821 on the island of St. Helena after a severe and painful illness Former French Emperor Napoleon Bonaparte died as a result of poisoning.

Alexander Dumas the father, known not only as a popular and prolific writer, but also as an experimental cook, was also interested in the bezoar, and even tried to create a safety sauce based on the stone.

The bezoar from East India was considered the most valuable. Travelers said that the peasants there discovered bezoars in the following way: both hands were placed on the belly of a goat, from which they hoped to find a stone. After this, with strong pressure from both sides, the stone was squeezed into the middle of the stomach.

The price of a bezoar, like a diamond, rapidly increased in accordance with its weight. There were 5-6 small stones per ounce (about 30 grams). And they cost from 5 to 18 francs. A bezoar that weighed a whole ounce already cost 100 francs. For a stone weighing 4 ounces they willingly gave 2000 francs. When making a purchase, one had to be very careful, because the tempting price also gave rise to falsifications. Dough of a certain quality was mixed with tree resin, after which small bezoars were brought to a large size using this mixture. The deception could be discerned in this way: the stone was weighed and then lowered into warm water. If his color did not change and he did not lose weight, everything was without deception.

According to Dr. Valentini, even more valuable than the bezoar was a stone found in a certain breed of pig from Malacca. It came into circulation under the name Piedra del Porco (pork stone), or Lapis Malacensis (Malacca stone). And in our time, among the bezoars there is one: on its frame there is an image of a small pig. The Dutch East India Company laid its paw on the valuable export item and sold the stones for 135-175 Dutch florins apiece. The dealer was already asking 400-600 florins for them. It was possible to rent a stone, but for every 24 hours one gold piece had to be paid as rent. After all, bezoar cured gout, colic, obesity and even jaundice.

Unfortunately, the bezoar has not yet been included in any mineralogical anthology in the world, and in vain. Even the great scientist al-Biruni, the author of the “Collection of Information for the Knowledge of Jewels,” exclaims: “I swear on my life, this is the most noble of all the precious stones that are kept in treasuries, for it is useful for life, not they!”

This healing stone The ancient Armenian physician A. Amasiatsi also attached great importance, claiming that the more valuable stone is the one that turns green when rubbed. He believed that a bezoar saves its owner from poisons, helps with all types of animal bites, eliminating their harmful effects:“If you grind it with fennel juice and lubricate the site of a snake bite, it will help and immediately soothe the pain.” “If you give a stone weighing 12 barley grains to eat, it will help with heart weakness. And it gives strength to a person. And its dose per reception is 1 dank (0.091 g). And the one who eats half a danka of it every day is saved from all evil and poisons. The bezoar is also useful for hot body conditions, because it acts due to its inherent properties, and not nature. And know that the nature of this medicine is very hot."

In ancient Russian medical books, a “beluga” stone is described, which was found on the sides of the holes through which the fish spews eggs. It was used for difficult childbirth, childhood illnesses, illnesses Bladder and ureters. Sometimes similar stones were found in the bladder of a dead boar. “Boar” stone was valued even more than “beluga” stone.

Perhaps the most valuable type of bezoar is the “pigeon” stone, which is formed in the stomach of a pigeon. According to A. Amasiatsi, the medicine made from the stone helps with uterine cancer. "He is one of the best medicines for cancer. It's been tested."

Among magicians, the bezoar is considered one of effective means attracting love. To do this, it must be dried and ground into a fine powder. Then find a red apple, cut out a piece the size of a bean, near the stem, remove the seeds, fill the void with the resulting powder and insert the cut piece in place. After this, wrap it in finger-width peeled apple peels. The sacrament is best performed on April 15 at 6 am. In addition, blood taken from ring finger left hand, you need to write the name of your beloved person and the word “Abuenop”, and your beloved should not know about this: you should not show her the cut finger. Then you need to let your beloved eat a quarter of the apple. But you can leave the apple in a warm place to dry, and then turn it into powder and put it in your loved one’s dress.

Few people know that organic stones can form in the stomach. There is such a thing medical concept- bezoar of the stomach. Pathology is more common in women and children, who tend to predominate in the diet certain products nutritionists who have the habit of sucking their own hair. Symptoms appear as the bezoar enlarges in the form of acute attacks pain. Severe complication is considered to be a blockage and complete obstruction in the intestines. The reference methods for diagnosing the problem are x-rays and endoscopy.

The essence of pathology

A bezoar is a rock-like organic body with different shapes, consistency and size, formed as a result of incorrect nutrition and wrong image life.

A bezoar is formed from an accumulation of hair, bone particles, large hardened pieces of food and other undigested elements. Gradually accumulating in the stomach, they are grouped into a sphere, which gradually increases in volume. If you do not intervene in time and start treatment, the overgrown stone will provoke complete dysfunction of the digestive system.

The growth rate of the gastric bezoar depends on the substances from which it is formed, the type and characteristics of physiology individual person. The sphere can form in a few days or grow for decades. The consistency of the formations is also different. Bezoars can be soft, loose or hard, stone-like. There are single or multiple formations that are colored brown or green color with a sharp unpleasant smell. The size of gastric tumors varies - from small to impressive (weighing a kilogram or more). Rare cases have been recorded when a bezoar filled the entire lumen of the stomach, representing a cast of the organ.

Main types

Trichobezoars form when hair enters the stomach.

By physical characteristics There are the following types of stomach bezoars:

• trichobezoars;
• pharmacobezoars;
• phytobezoars;
• other types: shellacobesoars, pixobesoars, pseudobezoars, polybezoars, etc.

The peculiarity of the formation is the main component - hair, which enters the stomach in large quantities. This problem most often occurs in people with mental disorders or those suffering from addiction in the form of biting and sucking hair. Trichobezoar appears at hairdressers-stylists. It is not uncommon for problems to be diagnosed in children with schizophrenia.

After exposure to large quantities of hairy particles and their processing gastric juice, the lump becomes sticky. Due to this, food masses quickly stick to it. A dense calculus gradually forms. If the problem is not detected in time, the bezoar, without being digested, will begin to move into the intestines, which can cause blockage of the evacuation section of the stomach and pain.

The mass of such formations can reach 4 kg or more.

Phytobezoars

They are among the most common agglomerates in the stomach - 70% of all recorded cases. The reason for their formation is considered to be a decrease in the secretory activity of the stomach. The process of removing contents from the organ further into the intestines is disrupted, which causes pain. The main provocateur is poor quality chewing of food while eating. The composition of phytobezoars is formed from particles of wild persimmon, grapes, plums, figs, bird cherry, which are enriched with coarse plant fibers and have a dense skin. Unripe persimmons containing a large amount of astringent components and resins can start the rapid process of creating a bezoar. The size is from 1 mm to tens of centimeters.

Pharmacobezoars

Having undergone gastric surgery - possible reasons appearance.

Gastric agglomerates, which contain particles of insoluble drugs, in particular sucralfate and gel-like aluminum hydroxide. They differ in consistency consistency. Particles can also be found in the compressed clot undigested food. At risk are people with various pathologies that require constant drug treatment.

Other types

Other types of bezoars are even less common. These include:

• pixobesoars - agglomerated from particles of resin or pitch;
• sebobezoars - formed due to the habit of eating fatty foods animal origin;
• shellac-bezoars are the result of long-term intoxication with polishes and nitro-varnish (the problem is typical for workers in the construction and repair industry);
• lactobezoars - found in children artificial feeding low-quality mixture with lactose and casein.

Causes of stones in the stomach

The rarity of the development of pathology in the stomach does not exclude the risk of its occurrence. The fact is that there are many provoking factors, which together can lead to the problem of stone formation in the stomach. The main reason is a violation of motor function, which is responsible for evacuation food bolus from the stomach to the intestines. Typical provoking diseases - complications diabetes mellitus(diabetic gastroparesis, partial gastric paralysis).

The following provoking factors are no less important:

• weakening of the secretion of gastric glands, decreased acidity;
• colonization of the intestines and stomach with pathogenic microflora (yeast-like fungi);
• increased mucus viscosity.

People at risk are:

• those who chew food poorly and abuse coarse and fatty foods;
• those who have undergone gastric surgery (partial resection, vagotomy) and have not undergone follow-up examinations.

Typical signs

Vomiting after a meal - typical signs diseases.

The main risk is that a bezoar can remain in the stomach without manifesting itself for a period of time. for long years. But under certain circumstances, some symptoms appear that allow you to suspect something is wrong. The clinical picture of the disease depends on foreign bodies, weight, nature, etiology, localization, and time spent in the stomach. In children it manifests as swelling, pain or hypoproteinemia. Symptoms develop against the background of metabolic disorders due to the growth and filling of the stomach lumen with bezoar.

Characteristic signs of the presence of agglomerate in the organ are as follows:

• dull pain that intensifies as food is consumed (pain goes away after 1.5 hours);
• instant satiation with a small amount of food;
• heaviness in the epigastrium;
• constant nausea;
• vomiting after meals;
• belching with a strong, foul odor.

Large bezoars in the stomach appear more pronounced in the form of:

• increased incidence of acute respiratory viral infections and acute respiratory infections against the background of decreased immunity;
• exacerbation of other chronic pathologies;
• severe loss of body weight;
• rapid fatigue, loss of performance;
• general weakness;
• brittle nails, crumbling tooth enamel due to vitamin deficiency;
• unhealthy complexion.

If the bezoar is pinched in the outlet zone of the stomach, it appears acute symptoms, characterized by cramping pain with repeated, debilitating vomiting.

A bezoar (stomach calculus, or stone) is a foreign body formed as a result of the accumulation in the stomach cavity of particles of different origin (coarse plant fibers, hair) that are unable to be digested.

Gastric stones take several weeks to decades to form. The diameter of bezoars can reach from several millimeters to 20-25 cm. There are cases when the calculus was almost completely filled internal cavity stomach.

This is a rare pathology; V medical literature Only a few hundred cases of this disease have been described.

Bezoars - stomach stones

Causes and risk factors

In most cases, bezoars are formed from tightly compressed coarse plant fibers (fruit seeds, fiber, peel). Such stones are green in color and round in shape, and have an unpleasant odor. They are detected in people whose diet contains large quantities of foods plant origin: first of all, nuts, sunflower seeds, grapes, dates, figs, plums, persimmons. Factors predisposing to the formation of bezoars of plant origin:

• poor chewing of food bolus;
• decreased secretion of gastric juice;
• impaired gastric motility (as a result of which food is retained in its cavity);
• gastric candidiasis;
• previous operations on the stomach (gastric resection, vagotomy with pyloroplasty);
• high viscosity of the mucus that is part of the gastric juice.

Much less common are bezoars, consisting of a lump of hair with inclusions of food particles and mucus. Such stones are usually found in people with mental disorders who pull out and bite their hair, in in rare cases– for those who professionally process hair (for example, hairdressers).

Small bezoars can leave the patient's body along with vomit or feces.

Other reasons for the formation of bezoars may be:

• ingestion of plasticine, chewing gum;
• accumulation of insoluble residues in the stomach cavity medicines, including activated carbon;
• ingestion of blood during esophageal bleeding due to portal hypertension;
• ingestion of polish, BF glue, nitro varnish;
• eating food that has not passed heat treatment beef, lamb or goat lard.

In the first weeks of life, in premature babies who are bottle-fed with high-calorie formulas containing lactose and casein, stones called lactobesoars can also form in the stomach cavity.

Types of disease

Depending on the composition, bezoars come in the following types:

• trichobezoars (from hair);
• hemobezoars (from blood clots);
• phytobezoars (from plant fibers);
• shellac bezoars (from toxic substances);
• lactobezoars (from casein and lactose);
• pixobesoars (from resinous substances);
• sebobezoars (from fat);
• anthracobezoars (from drug residues);
• mixed bezoars.

Symptoms

The clinical picture is determined by the size of the bezoar. If the calculus is light in weight and has a small diameter, there are usually no symptoms or slight heaviness in the epigastrium.

Bezoars of middle and big size are manifested by the following symptoms:

• quick feeling of satiety;
• stomach pain that gets worse after eating;
• belching;
• nausea, vomiting;
• sensation of a rolling ball in the stomach;
• general malaise, increased fatigue;
• weight loss

Diagnostics

Basic methods for diagnosing a bezoar:

1. X-ray of the stomach with barium sulfate contrast. The pictures show defects in the filling of the stomach round shape with clear edges.
2. Gastrofibroscopy. The method allows you to estimate the size of the bezoar and determine its composition.

Sometimes a large bezoar in thin people can be detected by palpation of the abdomen.

Required differential diagnosis with stomach tumors.

In most cases, bezoars are formed from tightly compressed coarse plant fibers (fruit seeds, fiber, peel).

Treatment

Small bezoars can leave the patient's body along with vomit or feces. To remove phytobezoars, patients are prescribed to take a 10% sodium bicarbonate solution orally, and then undergo an abdominal massage. After several procedures, the stone disintegrates into small parts, which are then removed naturally. To break down lactobezoars and hemobezoars, repeat gastric lavages are performed. To speed up the removal of stone particles from digestive tract patients may be prescribed prokinetics - medications, improving the motor function of the stomach and intestines.

If conservative treatment ineffective (as well as for other types of bezoars), they resort to removal using a fiber gastroscope. A stone of significant size is pre-crushed by subjecting it to laser or ultrasound.

Very hard and large bezoars are removed surgically during open surgery(gastrotomy). If the stone blocks the outlet of the stomach, emergency surgery is indicated.

Possible complications and consequences

Most frequent complications bezoars:

• stone damage to the gastric mucosa with further formation in this place of the ulcerative defect;
• formation of bedsores of the stomach wall, which can cause perforation;
• bezoar penetration into the lumen duodenum, provoking the development of high mechanical intestinal obstruction.

Forecast

The prognosis is favorable. After removal of stones using conservative or surgical methods complete recovery occurs.

The diameter of bezoars can reach from several millimeters to 20-25 cm. There are cases when the calculus almost completely filled the internal cavity of the stomach.

Prevention

Prevention of bezoar formation includes the following measures:

• getting rid of the habit of biting your hair;
• active treatment of mental disorders;
• coarse limitation plant food in the diet;
• refusal to ingest drugs that cannot be digested in the stomach.

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