Infectious diseases of the digestive system message. Diseases of the gastrointestinal tract: symptoms of various pathologies of the human digestive system

The digestive system performs the function of processing food, separating proteins, carbohydrates, minerals and other essential substances, and also ensures their absorption into the bloodstream. Consider the most common diseases of the digestive system.

The digestive organs include:

• esophagus;
• liver;
• gallbladder;
• stomach;
• pancreas;
• intestines.

Interruptions in the normal functioning of these organs can cause serious consequences for human life. The efficiency of the gastrointestinal tract is closely related to the environment and most diseases are largely dependent on the effects of external factors (viruses, bacteria, etc.).

Remember! To avoid diseases of the gastrointestinal tract, you should not abuse food and drinks. Changes in the digestive process also cause emotional stress.

Abdominal pain can occur anywhere in the digestive tract, from the mouth to the intestines. Sometimes the pain indicates a minor problem, such as overeating. In other cases, it may be a signal that a serious illness has begun that requires treatment.

This is difficult or painful digestion. May occur against the background of physical or emotional overload. It can be caused by gastritis, an ulcer, or inflammation of the gallbladder.

The main symptoms of dyspepsia: a feeling of heaviness in the stomach, gases, constipation, diarrhea, nausea. These uncomfortable manifestations may be accompanied by headaches or dizziness. Treatment is prescribed depending on the specific cause of the disease and includes taking medications, introducing a special diet.

Heartburn

Heartburn occurs due to insufficient closure of the sphincter. In this case, stomach acid can be thrown into the esophagus and cause irritation.

There are a number of factors that contribute to heartburn. This is overweight, which causes squeezing of the abdomen, fatty or spicy foods, alcoholic beverages, caffeine, mint, chocolate, nicotine, citrus juices and tomato. The habit of lying down after eating also contributes to the occurrence of heartburn.

Acute abdominal pain is a symptom of various disorders of its functions. Often they occur due to infections, obstruction, eating foods that irritate the walls of the digestive tract.

The problem of the occurrence of colic in an infant is not well understood, although it is believed that they are caused by increased production of gases due to digestive disorders. Renal colic occurs when stones are passed from the ureter to the bladder. Symptoms of colic are sometimes confused with appendicitis and peritonitis.

From a medical point of view, it is considered that with constipation, the defecation process occurs less than 3 times a week. Constipation is not a disease, but a symptom of a disease. It may appear when:

• insufficient fluid intake;
• malnutrition;
• lack of regularity of the defecation process;
• in old age;
• lack of physical activity;
• pregnancy.

Also, constipation can cause various diseases such as cancer, hormonal disorders, heart disease or kidney failure. In addition, constipation can occur after taking certain medications.

Note! By itself, it is not dangerous, but if it continues for a long time, it can lead to hemorrhoids or anal fissures.

Diarrhea

Diarrhea is a violation of the rhythm of the intestine, accompanying loose stools. The process is the cause of infections, viral or bacterial. It can occur when taking toxic substances that irritate the intestines or during emotional stress.

Hernias

A hernia is a prolapse of an organ or part of it through the wall of a cavity. The classification depends on their structure or localization.

1. Inguinal hernia - prolapse of part of the intestine through the abdominal wall into the groin area.
2. A diaphragmatic hernia or hernia of the esophagus is a hole in the diaphragm through which the intestines can enter the chest cavity.
3. Umbilical hernia - penetration of the intestine through the abdominal wall under the skin of the navel.

Usually hernias occur due to excessive load on weakened walls. An inguinal hernia can occur, for example, when coughing or defecation. It causes moderate pain. Intra-abdominal hernias are very painful. Some hernias can be reduced by applying light pressure to the prolapsed part of the intestine. It is advisable to provide such assistance to the elderly. Surgery is recommended for young patients.

Should know! If a hernia is incarcerated, an emergency surgical operation is necessary, as this can lead to gangrene in a few hours. The operation is performed to strengthen the cavity of the walls by suturing.

Gastritis is an acute or chronic inflammation of the stomach lining.

1. Acute gastritis causes erosion of the surface cells of the mucous membrane, nodular formations, and sometimes bleeding of the walls of the stomach.
2. Chronic gastritis occurs with the gradual transformation of the mucous membrane into fibrous tissue. The disease is accompanied by a decrease in the rate of gastric emptying and weight loss.

The most common cause of gastritis is smoking, drinking alcohol, stimulating drinks (tea, coffee), excessive secretion of hydrochloric acid into the gastric juice, and various infections, including syphilis, tuberculosis, and some fungal infections.

Recently, scientists have found that Helicobacter pylori bacteria are present in the mucous membrane of the stomach and duodenum in 80% of patients with gastritis and peptic ulcer (gastric and duodenal ulcers). This discovery was revolutionary in the treatment of such diseases to the point that the use of antibiotics became one of the main directions.

Remember! Of no small importance in the occurrence of gastritis is psychological stress.

A spastic process in which episodes of constipation and diarrhea alternate, accompanied by severe abdominal pain and other symptoms of unknown causes, is called irritable bowel syndrome. In some cases, this is due to a malfunction of the smooth muscles of the colon. This disease affects up to 30% of patients seeking advice on gastroenterology.

Often the manifestations of diarrhea are associated with stressful situations. In some cases, such a disease may begin after an infectious disease. Equally important is proper nutrition. Some patients have improved well-being after the introduction of fiber into the diet. Others claim relief comes from cutting back on carbs and white bread.

Enteritis

Inflammatory bowel disease - enteritis. May present with abdominal pain, tingling, fever, loss of appetite, nausea, and diarrhea. Chronic enteritis can be caused by serious conditions that require surgery.

Acute enteritis is less severe, but in the elderly and children it can cause dehydration up to a threat to their lives. Enteritis can be caused by chemical irritants, allergies, or emotional stress. But the most common cause is infection (viral or bacterial).

Appendicitis is an acute inflammation of the appendix of the intestine. Which is a tube 1-2 cm in diameter and from 5 to 15 cm in length. It is located, as a rule, in the lower right square of the abdomen. Its removal does not cause a pathological change. The most common cause of appendicitis is an infection. Without treatment, the wall of the process collapses and the contents of the intestine spill into the abdominal cavity, causing peritonitis.

Appendicitis is more common in young people. But it can appear at any age. Its typical symptoms are abdominal pain (especially in the right lower part), fever, nausea, vomiting, constipation or diarrhea.

Know! The treatment for appendicitis is to remove it.

ulcers

Ulcers can occur in the stomach or in the small intestine (duodenum). In addition to pain, ulcers can lead to complications such as bleeding due to erosion of blood vessels. Thinning of the walls of the stomach or intestines or inflammation in the area of ​​the ulcer causes peritonitis and obstruction of the gastrointestinal tract.

The immediate cause of peptic ulcer disease is the destruction of the mucous membrane of the stomach or intestines under the influence of hydrochloric acid, which is present in the digestive juice of the stomach.

Interesting! It is believed that Helicobacter pylori plays an important role in the occurrence of stomach or duodenal ulcers. A connection has also been established for its appearance due to an excess amount of hydrochloric acid, genetic predisposition, smoking abuse, and psychological stress.

Depending on the cause of the ulcer, appropriate treatment is applied. These may be drugs that block the production of hydrochloric acid. Helicobacter pylori is treated with antibiotics. Alcohol and caffeine should be avoided during treatment. Although the diet is not of paramount importance. In severe cases, surgery is necessary.

Pancreatitis

This inflammation of the pancreas occurs if the enzymes are not removed from it, but they are activated directly in this gland. Inflammation can be sudden (acute) or progressive (chronic).

1. Acute pancreatitis, as a rule, means only an "attack", after which the pancreas returns to its normal state.
2. In severe form, acute pancreatitis can endanger the patient's life.
3. The chronic form gradually damages the pancreas and its functions, leading to organ fibrosis.

Pancreatitis can be caused by alcoholism or a high intake of fatty foods. The main symptom is pain in the upper abdomen, spreading to the back and lower back, nausea, vomiting, a feeling of pain even with a light touch on the stomach. Often such an attack ends in 2-3 days, but in 20% the disease evolves, causing hypotension, respiratory and renal failure. In this case, part of the pancreas dies.

Chronic pancreatitis is characterized by recurrent abdominal pain. Diabetes mellitus can provoke the disease. 80% of cases are caused by gallstones. Also affect the occurrence of this disease:

• kidney failure;
• hypercalcemia;
• the presence of a tumor;
• abdominal trauma;
• cystic fibrosis;
• stings of a wasp, bee, scorpion, etc.;
• some medicines;
• infections.

Treatment for pancreatitis depends on the severity. In 90% of patients with acute pancreatitis, the disease resolves without complications. In other cases, the disease is delayed, turning into a chronic form. If the condition does not improve within the first hours or days, then, as a rule, the patient is transferred to intensive care.

Cholecystitis

Cholecystitis is an inflammation of the walls of the gallbladder. In this case, micro- and macroscopic changes occur, which develop from simple inflammation to the suppuration phase.

Symptoms can be varied (abdominal pain, nausea, fever, chills, yellowing of the skin, etc.). Attacks usually last for two or three days, but if not treated, they will continue. The onset of cholecystitis can be sudden or gradual.

There are several reasons that can cause or worsen cholecystitis. This is the presence of stones in the gallbladder, infection in the bile duct, tumors in the liver or pancreas, decreased blood circulation in the gallbladder.

diverticulitis

A group of disorders of the functions of the large intestine in which there is inflammation of the small pockets of the mucosa (inner lining of the intestine). These sacs are called diverticula. When diverticula do not have complications, it is called asymptomatic diverticulosis. But if this causes spasms in the intestines and other symptoms, this disease is called diverticulitis.

Diverticulitis occurs when a bowel movement is blocked and the colon becomes inflamed. Symptoms of diverticulitis: soreness and fever. In severe cases, abscesses, intestinal obstruction occur.

Sometimes the walls of the large intestine fuse with the small intestine or vagina. This is due to the formation of fistulas. In severe cases, intestinal contents enter the abdominal cavity, which causes peritonitis.

Chronic liver disease that leads to irreversible destruction of liver cells. Cirrhosis is the final stage of many diseases that affect the liver. Its main consequences are the failure of liver functions and an increase in blood pressure in the vein that carries blood from the stomach and gastrointestinal tract to the liver.

Note! Alcohol and hepatitis B are thought to be the main cause of cirrhosis of the liver. In countries with low alcohol consumption (eg Islamic countries), the prevalence of liver cirrhosis is much lower.

The digestive tract is a vital system in the body. Diseases of this system are usually the result of external factors such as nutrition and infections. From this we can conclude that in most cases it is the result of our own inattention and ignoring a healthy diet and hygiene rules.

Many do not pay attention to the symptoms of diseases of the digestive system that have appeared. This leads to the fact that at first they simply bring inconvenience, but over time they turn into serious diseases that are very difficult to cure.

Treatment of gastritis and stomach ulcers is carried out in a complex manner with the use of medications, diet and traditional medicine. These diseases are the most common types of inflammatory conditions of the mucosa ...

Gastritis is an inflammatory disease of the gastric mucosa, in which its severe irritation occurs, erosion occurs, which can eventually lead to an ulcer. There are several different types...

Gastritis is a fairly common disease in modern times. Now an active and fast-paced lifestyle prevails, which does not always allow you to eat rationally and regularly. As a result...

Gastritis - an inflammatory disease of the gastric mucosa - is an extremely common pathology today, which can cause many unpleasant symptoms and lead to other disorders ...

Causes of diseases of the digestive system

Each disease of the digestive system has its own specific causes, but among them are those that are characteristic of most diseases of the digestive system. All these reasons can be divided into external and internal.

The main ones are, of course, external reasons. These, first of all, include food, liquids, medicines:

Unbalanced diet (lack or excess of proteins, fats, carbohydrates) irregular meals (every day at different times), frequent consumption of “aggressive” ingredients (spicy, salty, hot, etc.), the quality of the products themselves (various additives such as preservatives) - all these are the main causes of diseases of the stomach and intestines and often the only cause of such digestive disorders as constipation, diarrhea, increased gas formation and other digestive disorders.

From liquids, first of all, diseases of the digestive system can cause alcohol and its surrogates, carbonated and other drinks containing preservatives and dyes.

And, of course, drugs. Almost all of them, to one degree or another, have a negative effect on the gastric mucosa.

Also, external causes of diseases of the digestive system include microorganisms (viruses, bacteria and protozoa that cause specific and non-specific diseases), worms (flukes, tapeworms, roundworms), which come mainly with food or water.

Smoking, an independent cause of diseases of the stomach and intestines, is rare, but it, together with insufficient oral hygiene, causes diseases of the oral cavity (gingivitis, stomatitis, periodontal disease, lip cancer).

More external causes of diseases of the stomach and intestines include frequent stress, negative emotions, worries for any reason.

The internal causes of diseases of the digestive system include genetic ones - this is a predisposition (that is, the presence of a disease of the digestive system in previous generations), intrauterine development disorders (mutations in the genetic apparatus), autoimmune (when the body for one reason or another begins to attack its organs).

The main symptom in diseases of the digestive system is pain along the digestive tract. This symptom is present in almost every disease of the stomach or intestines, but depending on the disease it will have one or another character. By localization, pain can occur in the right (cholecystitis) or left hypochondrium, girdle (pancreatitis), without specific localization, along the esophagus, often the pain can radiate (give) between the shoulder blades (inflammation of the esophagus), to the region of the heart, etc. Pain can be constant aching or, conversely, at some point very strong (perforation of a stomach ulcer), and eventually disappear, appear on palpation, tapping (cholecystitis). May be associated with meals or not, or when taking a particular food (for example, fatty as in chronic pancreatitis or cholecystitis), or, conversely, when taking some food to pass (for example, dairy in hyperacid gastritis), or occur when you do not eat anything (gastric ulcer). In diseases of the rectum, pain may occur during the act of defecation.

In diseases of the stomach, a symptom such as dyspepsia is often encountered. It can be divided into upper and lower. The upper symptoms include heartburn (a burning sensation behind the sternum or in the upper abdomen with gastritis), belching (sour in stomach diseases, bitter in gallbladder damage), nausea, vomiting (peptic ulcer), a feeling of fullness and pressure in the epigastric areas (with disorders of the evacuation function of the stomach), dysphagia (swallowing disorders in diseases of the esophagus), anorexia (loss of appetite).

Lower dyspepsia includes a feeling of fullness and fullness in the abdomen, flatulence (excessive accumulation of gases in the intestines in violation of the digestive processes), diarrhea (infectious diseases), constipation (irritable bowel syndrome).

Other symptoms include a change in the color of the stool (discoloration in hepatitis, melena - tarry stools in gastric bleeding, "raspberry jelly" in amoebiasis, green in salmonellosis, scarlet blood in the feces).

There are also various changes on the skin, as manifestations of symptoms of various diseases of the digestive system (rash - infectious diseases, spider veins and skin color changes in liver diseases).

Diagnosis of diseases of the digestive system

Prevention of diseases of the stomach and intestines.

The main and most important prevention of diseases of the digestive system, and not only them, is maintaining a healthy lifestyle. This includes the rejection of bad habits (smoking, alcohol, etc.), regular physical education, exclusion of physical inactivity (lead a mobile lifestyle), adherence to work and rest regimes, good sleep, and more. It is very important to have a complete, balanced, regular diet, which ensures the intake of the necessary substances (proteins, fats, carbohydrates, minerals, trace elements, vitamins), monitoring the body mass index.

Also, preventive measures include annual medical examinations, even if nothing bothers you. After 40 years, it is recommended to conduct an ultrasound examination of the abdominal organs and esophagogastroduodenoscopy annually. And in no case should you start the disease, if symptoms appear, consult a doctor, and not self-medicate or only traditional medicine.

Compliance with these measures will help to avoid or timely identify and promptly begin treatment of diseases not only of the digestive system, but of the body as a whole.

Nutrition in diseases of the stomach and intestines.

Nutrition for diseases of the digestive system should be special. In this regard, in our country, at one time, the Russian Academy of Medical Sciences developed special diets that are suitable not only for diseases of the digestive system, but also for other systems too (diets are indicated in articles on the treatment of certain diseases). A specially selected diet is necessary in the treatment of diseases of the digestive system and is the key to successful treatment.

If normal enteral nutrition is not possible, parenteral nutrition is prescribed, that is, when the substances necessary for the body enter the blood immediately, bypassing the digestive system. Indications for the appointment of this food are: complete esophageal dysphagia, intestinal obstruction, acute pancreatitis and a number of other diseases. The main ingredients of parenteral nutrition are amino acids (polyamine, aminofusin), fats (lipofundin), carbohydrates (glucose solutions). Electrolytes and vitamins are also introduced, taking into account the daily needs of the body.

Diseases of the digestive system include:

Diseases of the oral cavity, salivary glands and jaws
Diseases of the esophagus, stomach and duodenum
Diseases of the appendix [vermiform appendix]
Hernias
Noninfectious enteritis and colitis
Other bowel diseases
Diseases of the peritoneum
Liver disease
Diseases of the gallbladder, biliary tract and pancreas
Other diseases of the digestive system

More about diseases of the digestive system:

List of articles in category Diseases of the digestive system

Alcoholic hepatitis
Liver amyloidosis
Anal fissure 🎥
Ascites 🎥
Achalasia cardia 🎥
Crohn's disease 🎥
Gastritis 🎥
Gastroduodenitis 🎥
Gastroesophageal reflux disease (GERD) 🎥
Liver hemangioma
Hernia of the anterior abdominal wall 🎥
Diverticulosis and intestinal diverticulitis
Esophageal diverticula 🎥
Intestinal dysbiosis 🎥
Biliary dyskinesia 🎥
Duodenitis 🎥
Gallstone disease (cholelithiasis, gallstones) 🎥
Gum disease: gingivitis, periodontitis (inflammation of the gums), periodontal disease

Even young children are familiar with disorders of the digestive system. Adults face this problem quite often. Violation of the gastrointestinal tract may be associated with overeating or eating stale foods. Unfortunately, no one is immune from digestive disorders. In some cases, they are associated with the development of gastrointestinal diseases. Digestive problems are indicated by symptoms such as abdominal pain, nausea, and changes in stool. Such manifestations are associated with both acute inflammatory processes and chronic diseases. If you experience symptoms of gastrointestinal disorders, you should consult a doctor.

How is the digestive process carried out normally?

As you know, the digestive system consists of many interconnected organs. It begins in the oral cavity and passes through the entire body, ending in the anus. Normally, all stages of the digestion process are carried out sequentially. First, food enters the mouth. There it is crushed with the help of teeth. In addition, there is an enzyme in the mouth - salivary amylase, which is involved in the breakdown of food. As a result, a lump of crushed products is formed - chyme. It passes through the esophagus and enters the stomach cavity. Here the chyme is treated with hydrochloric acid. The result is the breakdown of proteins, carbohydrates and fats. The pancreas produces enzymes that enter the lumen of the duodenum. They provide further splitting of organic substances.

The work of the digestive system is not only in grinding the food eaten. Thanks to the organs of the gastrointestinal tract, useful substances penetrate into the bloodstream. The absorption of amino acids, fats and glucose occurs in the small intestine. From there, nutrients enter the vascular system and are carried throughout the body. The large intestine absorbs fluid and vitamins. There is also the formation of fecal masses. Intestinal peristalsis contributes to their promotion and excretion.

Digestive problems: causes of disorders

Violation of any stage of the digestive process leads to the development of disorders. It can develop for various reasons. In most cases, the penetration of bacterial or viral agents leads to disruption of the digestive tract. Pathogens begin to multiply rapidly and damage the mucous membrane of the digestive tract. This, in turn, leads to an inflammatory response. As a result, the digestion process slows down or is disturbed. Causes of gastrointestinal disorders include:

To find out for what reason the disorder arose, it is necessary to be examined. Laboratory and instrumental diagnostic procedures will help determine the source of the pathology.

Causes of Digestive Disorders in Children

In childhood, digestive problems are common. They may be related to various factors. Among them are hereditary anomalies, improper feeding, helminthic invasions, infectious pathologies, etc. In some cases, urgent surgical care is required to fix the problem. Causes of indigestion in children include:

1. Hereditary disorders of the exocrine glands - cystic fibrosis.
2. Anomalies in the development of the digestive tract.
3. Spasm or stenosis of the pyloric stomach.
4. Feeding a young child excessively thick food.
5. Poisoning from stale or spoiled food.
6. Infection with various pathogenic bacteria that enter the gastrointestinal tract with food.
7. Worm infestations.

Only a doctor can find out: why there was a problem with digestion in children. Some pathologies can be fatal, so they require urgent medical attention.

Varieties of diseases of the digestive system

Diseases of the digestive system are classified according to the cause of occurrence, the source of the development of the pathological condition, the methods of necessary treatment. There are surgical and therapeutic pathologies of the gastrointestinal tract. In the first case, recovery can only be achieved with the help of surgery. Therapeutic diseases are treated with medications.

Surgical pathologies of the digestive system include:

Therapeutic diseases of the digestive system are acute and chronic inflammatory processes in the stomach and intestines and poisoning. Injuries can belong to both groups, depending on the severity and nature of the lesion.

Digestive problems: symptoms

Pathologies of the digestive system can be manifested by a syndrome of gastric or intestinal dyspepsia, pain in the abdomen and changes in the nature of the stool. In some cases, phenomena of intoxication of the body are observed. Symptoms of stomach pathologies include: pain in the epigastric region, nausea and vomiting after eating. Similar clinical manifestations are observed in cholecystitis. The difference is that patients with inflammation of the gallbladder complain of pain in the right upper abdomen and a bitter taste in the mouth. characterized by a change in the consistency of the stool (diarrhea, less often - constipation) and flatulence. Unpleasant sensations can be in the navel, in the right or left side of the abdomen.

In acute surgical pathologies, the intensity of pain is stronger, there is a delay in gas discharge, an increase in body temperature. Often patients are forced to lie down or take a forced position to alleviate the condition.

Diagnosis of diseases of the gastrointestinal tract

Diagnosis of pathologies of the digestive system is based on clinical data and additional studies. First of all, patients must pass a general blood and urine test. If inflammatory is suspected, it is necessary to determine the level of indicators such as bilirubin, ALT and AST, amylase. You should also take a feces for analysis.

Instrumental studies include radiography, abdominal ultrasound and FGDS. In some cases, additional diagnostics are required.

Which doctor should be consulted?

What to do if there are problems with digestion, which doctor will help? Gastrointestinal diseases are treated by a gastroenterologist. However, before making an appointment with him, it is worth undergoing an examination, which is prescribed by a therapist or pediatrician. If acute abdominal pain occurs, emergency care should be called to exclude surgical pathologies that require immediate surgical intervention.

Treatment of pathologies of the digestive system

Surgical treatment consists in eliminating intestinal obstruction, removing calculi, tumor formations, suturing an ulcer, etc.

Prevention of digestive disorders

To prevent digestive problems from recurring, it is necessary to follow preventive measures. These include:

1. Dieting.
2. Careful food processing.
3. Hand washing.
4. Quit smoking and alcohol.

If you experience discomfort in the abdomen, stool disorders or nausea, you should undergo an examination and find out the cause of the problem.

The state of our health depends not only on what kind of food we eat, but also on the work of those organs that digest this food and bring it to every cell of our body.

The digestive system begins with the mouth, followed by the pharynx, then the esophagus, and finally the foundation of the digestive system, the gastrointestinal tract.

Oral cavity is the first section of the digestive system, therefore, the entire further process of digestion depends on how well and correctly all the processes for the initial processing of food proceed in it. It is in the oral cavity that the taste of food is determined, here it is chewed and moistened with saliva.

Pharynx follows the oral cavity and is a funnel-shaped canal lined with a mucous membrane. It crosses the respiratory and digestive tracts, the activity of which should be clearly regulated by the body (it is not for nothing that they say that when a person chokes, the food got “in the wrong throat”).

Esophagus is a cylindrical tube located between the pharynx and stomach. Through it, food enters the stomach. The esophagus, like the pharynx, is lined with a mucous membrane, which contains special glands that produce a secret that moisturizes food during its passage through the esophagus to the stomach. The total length of the esophagus is about 25 cm. At rest, the esophagus has a folded shape, but it has the ability to lengthen.

Stomach- one of the main components of the digestive tract. The size of the stomach depends on its fullness and ranges from about 1 to 1.5 liters. It performs a number of important functions, which include: directly digestive, protective, excretory. In addition, processes associated with the formation of hemoglobin occur in the stomach. It is lined with a mucous membrane, which contains a mass of digestive glands that secrete gastric juice. Here, the food mass is saturated with gastric juice and crushed, more precisely, an intensive process of its digestion begins.

The main components of gastric juice are: enzymes, hydrochloric acid and mucus. In the stomach, solid food that has entered it can stay up to 5 hours, liquid - up to 2 hours. The components of gastric juice chemically process food entering the stomach, turning it into a partially digested semi-liquid mass, which then enters the duodenum.

Duodenum represents the upper, or first, part of the small intestine. The length of this part of the small intestine is equal to the length of twelve fingers put together (hence its name). It connects directly to the stomach. Here, in the duodenum, bile from the gallbladder and pancreatic juice enter. In the walls of the duodenum there are also a fairly large number of glands that produce an alkaline secret rich in mucus that protects the duodenum from the effects of acidic gastric juice entering it.

Small intestine, in addition to the duodenum, it also combines the lean and ileum. The small intestine as a whole is about 5–6 m long. Almost all the main processes of digestion (digestion and absorption of food) take place in the small intestine. On the inside of the small intestine there are finger-like outgrowths, due to which its surface is significantly increased. In humans, the process of digestion ends in the small intestine, which is also lined with a mucous membrane, very rich in glands that secrete intestinal juice, which includes a fairly large number of enzymes. Intestinal juice enzymes complete the process of breaking down proteins, fats and carbohydrates. The mass in the small intestine is stirred by peristalsis. Food slurry slowly moves through the small intestine, in small portions getting into the large intestine.

Colon about twice as thick as thin. It consists of the cecum with appendix, colon and rectum. Here, in the large intestine, the accumulation of undigested food residues occurs, and digestion processes are practically absent. There are two main processes in the large intestine: absorption of water and formation of feces. The rectum serves as a place of accumulation of feces, which are removed from the body during defecation.

Appendix, as we have already said, it is part of the large intestine and is a short and thin process of the caecum about 7-10 cm long. Its functions, as well as the causes of its inflammation, are still not clearly understood by doctors. According to modern data and the opinion of some scientists, the appendix, in the wall of which there are many lymphoid nodules, is one of the organs of the immune system.

But the digestive system, no matter how properly arranged its individual organs, could not work without certain substances - enzymes that are produced in the body by special glands. The triggers for the digestive system are digestive enzymes, which are proteins that break down large food molecules into smaller ones. The activity of enzymes in our body during the process of digestion is directed to substances such as proteins, fats and carbohydrates, while minerals, water and vitamins are absorbed almost unchanged.

For the breakdown of each group of substances, there are specific enzymes: for proteins - proteases, for fats - lipases, for carbohydrates - carbohydrases. The main glands that produce digestive enzymes are those of the oral cavity (salivary glands), the glands of the stomach and small intestine, the pancreas, and the liver. The main role in this is played by the pancreas, which produces not only digestive enzymes, but also hormones, such as insulin and glucagon, which are involved in the regulation of protein, carbohydrate and lipid metabolism.

There are a lot of cells that produce digestive enzymes in the pancreas. They form special clusters, from which small excretory ducts depart; secreted pancreatic juice moves along them, which is a kind of cocktail of various enzymes.

Of no small importance are the glands of the small intestine, in which most of the food is digested.

Diseases of the digestive system

Disorders of the digestive system bring a lot of trouble to a person. Diseases of the digestive system, as a rule, are reflected in other systems, causing a chain reaction. Digestive disorders occur as a result of hereditary or congenital diseases; pathogens that enter the body; malnutrition (eating poor-quality or far from healthy products for the body, eating disorders, etc.); psychosomatic reactions.

The most common causes of diseases of the gastrointestinal tract are infectious agents, as well as malnutrition. For example, gastrointestinal diseases are often caused by bacteria: salmonella, staphylococci, shigella, which enter the body with poor-quality food. Pathogens such as amoeba, worms (roundworms, tapeworms, pinworms) enter the gastrointestinal tract with uncleaned, poorly processed foods, contaminated drinking water or through dirt.

In recent years, diseases of the digestive system, which are based on improper, unbalanced nutrition, have become more frequent. Excessive consumption of fatty, sweet, starchy foods leads to an overload of the digestive system. In addition, food eaten on the run is poorly chewed, and therefore poorly absorbed by the body.

A few words should be said about the stresses that abound in our lives, especially in megacities. Our mental, or rather, psycho-emotional state has a direct impact on the work of all organs and systems of the body. So, for example, a stressful situation at work, a scandal at home can cause pain in the abdomen, the resumption of peptic ulcer. It should not be forgotten that many people react to professional and personal problems with ailments of the gastrointestinal system.

Gastritis(from gr. gaster- stomach) - inflammation of the gastric mucosa; is acute and chronic. Acute gastritis develops as a result of excessive consumption of alcoholic beverages or other products that irritate or corrode the mucous membrane. It is accompanied by sharp pains in the stomach, vomiting, and sometimes a slight increase in temperature. Acute gastritis is characterized by a feeling of fullness in the stomach, in addition, there are diarrhea or constipation, bloating.

Chronic gastritis does not develop immediately (unlike acute gastritis): for a certain time, processes occur that lead to disruption of the cells of the gastric mucosa, the secretion of gastric juice, and motor activity. Often chronic gastritis occurs in heavy smokers. In recent years, data have appeared confirming the infectious nature of gastritis. Helicobacter pylori is the cause of chronic gastritis.

Chronic gastritis, which is essentially an inflammatory disease, bears little resemblance to the usual types of inflammation. In chronic gastritis, the normal restoration of mucosal cells is disrupted, which leads to its thinning, and, accordingly, disruption of the production of gastric juice. Chronic gastritis, in turn, is divided into gastritis with high and low acidity. Both forms are accompanied by pain in the abdomen. With gastritis with high acidity, belching with a sour taste, heartburn, nausea, and an unpleasant taste in the mouth are noted. With gastritis with low acidity, nausea, vomiting, a feeling of rapid satiety, and flatulence often occur. People suffering from gastritis with low acidity tend to lose weight, they develop dry skin, hair loss and brittle nails.

Gastroduodenitis(from gr. gaster- stomach, duodenum- duodenum) most often has a chronic form. This disease affects the duodenum, the mucous membrane of which becomes inflamed, which leads to pain in the stomach and duodenum, bitter belching. With chronic gastroduodenitis in a person, 2-3 hours after eating, a state of lethargy, general malaise, weakness, sweating, rumbling in the abdomen, dizziness may occur. These symptoms are associated with disruption of the sensory nerve endings located in the inflamed duodenal mucosa.

Diarrhea (diarrhea)(from gr. diarrhoea- expire) is a disorder of bowel function, accompanied by frequent emptying, in which the feces have a soft or liquid consistency. Diarrhea can not be attributed to diseases, most often it is a symptom of any disease. Diarrhea can also develop with intestinal infections, inflammatory diseases of the intestines and pancreas, intolerance to any type of food, disturbances in the intestinal flora, intestinal overload, as well as when taking antibiotics or abuse of laxatives. Excessive alcohol consumption can also lead to intestinal upset. Severe or long-lasting diarrhea can lead to dehydration.

There are several types, or types, of diarrhea. Diarrhea is acute, which occurs in stressful situations, fear, excitement (the so-called "bear disease") or intolerance to any food. This diarrhea does not last long, it is harmless and often goes away on its own. "Travel" diarrhea can last from several hours to several days. Travelers and tourists suffer from it, especially during their stay in Southern Europe, Africa, Asia and Latin America. The cause of this disease is a change in climate, food, the use of cold drinks and ice cream. In chronic diarrhea, loose stools recur over time. The causes of this disease may be inflammatory processes occurring in the large or small intestine, some types of products. Infectious diarrhea is caused by bacteria and viruses that can enter the human body through food or drink. With this disease, spasms, fever, and fever are often noted. Such diarrhea is often observed in dysentery, cholera, typhoid fever.

Dysbacteriosis- a syndrome characterized by a violation of the mobile balance of the microflora that inhabits the intestines. With dysbacteriosis in the intestine, the number of putrefactive or fermentative bacteria increases, mainly Candida. Conditionally pathogenic microorganisms begin to multiply actively.

With dysbacteriosis, appetite decreases; may have an unpleasant taste in the mouth, nausea, flatulence, diarrhea or constipation; feces have a sharp putrefactive or sour smell; signs of general intoxication are often noted. It is believed that the cause of dysbacteriosis is, first of all, a violation of the digestive processes, as well as a long and uncontrolled intake of antibiotics that suppress the normal microflora.

Dyskinesia of the digestive tract- a functional disease manifested by a violation of the tone and peristalsis of the digestive organs with smooth muscles (esophagus, stomach, biliary tract, intestines). The disease is accompanied by symptoms such as belching, regurgitation of gastric contents after a heavy meal, when the torso is tilted and in the supine position. In addition, there is chest pain associated with swallowing, as well as a feeling of heaviness in the stomach, brief abdominal pain.

Constipation- This is a condition in which bowel movement occurs rarely or feces is a very dense solid mass in the form of small balls. As a rule, in people suffering from constipation, the process of defecation is very difficult and is accompanied by painful phenomena. Constipation is acute and chronic.

Acute constipation occurs when a person is temporarily unable to have a bowel movement every day. Such a phenomenon is noted, for example, when changing the place of residence (especially if climatic and, accordingly, nutritional conditions change significantly), as well as in certain diseases. The main symptoms of acute constipation are a feeling of fullness in the stomach and intestines, bloating or mild nausea.

If a person for a long time cannot normally empty his intestines daily, then in this case they speak of chronic constipation. Chronic constipation is characterized by a feeling of fullness in the stomach, loss of appetite, pain in the abdomen and back, headaches, fatigue and lethargy. The skin takes on an earthy gray, unhealthy hue, and a skin rash may occur on the back and face. The cause of chronic constipation can also be malnutrition, leading to intestinal overload; psycho-emotional state; alcohol abuse. Often constipation occurs in women during pregnancy.

Heartburn is not a characteristic disease, it can most likely be attributed to certain physiological conditions. It is often the result of eating too much or hastily, in which fatty or sugary foods are dominant. Heartburn can be an accompanying symptom with irritation of the stomach and intestines, peptic ulcer. With heartburn, there are unpleasant painful sensations, usually of a burning nature, that occur in the retrosternal region, going in the direction from the stomach to the throat. Heartburn is usually accompanied by a bitter or sour taste in the mouth.

Colitis(from gr. kolon colon) is an inflammatory disease of the colon. With colitis, severe intestinal spasms and pain in the intestinal region often occur, accompanied by diarrhea, sometimes mixed with blood and mucus. Colitis can be acute, but most often its chronic form develops. The causes of this disease are: prolonged stress, disorders of the immune system, eating unbalanced food, changing the place of residence (especially if there is a sharp change in climatic conditions). In addition, colitis can develop as a result of infection of the body by amoebas or any bacteria. Then they talk about infectious colitis.

Pancreatitis(from gr. pancreas- pancreas) - inflammation of the pancreas; is acute and chronic. Acute pancreatitis usually develops suddenly and is characterized by severe pain in the upper abdomen and back, which can often be accompanied by the development of shock. In chronic pancreatitis, the symptoms of the disease are not clearly expressed: there are no severe pains, but the development of diabetes mellitus may be the result of chronic pancreatitis. The causes of this disease are not fully understood, but many experts consider the presence of stones in the gallbladder as such, as well as alcohol abuse.

Esophagitis(from gr. oisophagos- esophagus) - inflammation of the esophagus, in which there is heartburn, the flow of bitterness from the esophagus into the oral cavity, and in some cases even difficulty swallowing, sometimes accompanied by pain. Due to the entry of gastric contents into the respiratory tract, hoarseness and a barking cough may appear in the morning. Esophagitis complications include bleeding, narrowing of the esophagus, and ulceration of the esophagus.

The causes of esophagitis can be divided into two groups: external and internal. External causes include the ingestion of a sharp object, such as a fish bone, into the esophagus; a burn of the mucous membrane of the esophagus (for example, as a result of acid entering it), which is then complicated by inflammation. Internal causes include disturbances in the functioning of the stomach, which are associated with the processes of the flow of protective mechanisms, increased pressure in the abdominal cavity, and high acidity of gastric juice. In certain situations, the stomach begins to work so that its juice enters the esophagus, resulting in inflammatory processes, because the mucosa of the esophagus is much more sensitive to acid than the stomach.

Enteritis(from gr. enteron- intestines) - inflammation of the small intestine, often causing diarrhea and vomiting in a person. Sometimes the patient has a significant loss of fluid. Basically, enteritis is infectious in nature as a result of certain viruses or bacteria entering the human body. In addition, the cause of enteritis may be radiation exposure (X-rays or radioactive isotopes).

Peptic ulcer of the duodenum- an ulcer resulting from the action of acid and pepsin on the mucous membrane. This disease, as a rule, develops against the background of increased acidity of gastric juice. The main symptom of the disease is pain in the upper abdomen, most often occurring in a person before eating (on an empty stomach). The pain may subside spontaneously and not bother a person for several weeks or even months, but then it can occur with a vengeance. Sometimes the pain is accompanied by vomiting, weakness.

Stomach ulcer develops under the action of acid, pepsin and bile on the mucous membrane of the stomach wall. The secretion of acid in the stomach does not increase. The main symptoms of stomach ulcers are vomiting and pain in the upper abdomen shortly after eating; often a complication such as gastric bleeding can develop.

Allowed and prohibited foods for gastrointestinal diseases

Information on permitted and prohibited foods for diseases of the gastrointestinal tract is given in Table. one.

Table 1

Chapter 2

Diseases of the digestive system are the third most common after diseases of the cardiovascular and respiratory systems. Methods for diagnosing these diseases are constantly being improved. In recent years, such examination methods as ultrasound examination (ultrasound) of the abdominal cavity, as well as fibrogastroscopy, colonoscopy, scanning, X-ray methods, and organ biopsy have been introduced into clinical practice.

Diseases of the gastrointestinal tract include all diseases of the stomach and duodenum (gastritis, colitis, etc.), diseases of the intestines (thick and thin), diseases of the liver, gallbladder, pancreas.

Chronic gastritis

Chronic gastritis is the most common disease of the digestive system. In many countries, more than 90% of the population suffers from gastritis, but even in European countries, such as Finland or Sweden, chronic gastritis is observed in 60% of the population. Recently, the disease has significantly "rejuvenated". Even at the age of 5–6 years, cases of chronic gastritis have been reported.

This disease is characterized by damage to the gastric mucosa (Fig. 2), in which the glands that produce hydrochloric acid, pepsin, and mucus suffer. With gastritis, the processes of cell regeneration worsen, and as a result, the function of the stomach is disturbed. These disorders can be of two types: elevated levels of hydrochloric acid (chronic gastritis with increased secretory activity) and low levels of hydrochloric acid (chronic gastritis with reduced secretory activity).

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The causes of chronic gastritis are varied. The most common are caused by malnutrition: malnutrition, overeating, irregular meals, eating rough, spicy foods, alcohol. These factors, although they certainly play a large role in the development of chronic gastritis, are not its root cause. Are there many people who eat absolutely right in the conditions of modern life? How many people consume high-quality natural products? But not everyone suffers from chronic gastritis.

As shown by studies of recent years, made in the largest institutions in Europe and America, the root cause of the disease may be immune disorders in the body (production of antibodies to mucous membrane cells). The cause of the disease can be special acid-resistant bacteria that can live in a very acidic environment of the stomach. Experts also consider hereditary predisposition to the disease to be an important factor.

For the diagnosis of chronic gastritis, fibrogastroscopy, examination of gastric juice, X-ray examination of the stomach are used. With fibrogastroscopy, a thin probe is inserted into the stomach, with the help of which the mucous membrane of the stomach and duodenum is examined.

In chronic gastritis with increased secretory activity, patients are concerned about stomach pain that occurs on an empty stomach, and sometimes at night, heartburn, belching, and a tendency to constipation. This gastritis is considered a pre-ulcerative condition, and the principles of its treatment are the same as for peptic ulcer disease.

If chronic gastritis with reduced secretory activity is observed, then it is not pain that bothers, but a feeling of fullness in the stomach, heaviness after eating, nausea, and sometimes diarrhea. In the treatment of this type of gastritis, gastric juice, acidin-pepsin, and abomin are recommended. It is advisable to use highly mineralized waters ("Slavyanskaya", "Smirnovskaya", "Arzni", "Essentuki", etc.) in a cool form, with gas. Instead, you can use decoctions of medicinal herbs: plantain, chamomile, St. John's wort, calendula flowers, mint, wormwood.

To restore the gastric mucosa, multivitamins, pentoxyl, riboxyl, sea buckthorn are recommended. Invaluable in chronic gastritis are therapeutic nutrition, cleansing diets, massage of the abdomen. Chronic gastritis is dangerous because it contributes to the development of other diseases of the digestive system, including stomach cancer. Therefore, it is necessary to use all possible means for the treatment of this disease.

Peptic ulcer of the stomach and duodenum

Peptic ulcer of the stomach and duodenum is a chronic disease characterized by the formation of ulcerative defects of the mucosa (Fig. 3).

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A stomach ulcer is formed for several reasons: due to increased production of hydrochloric acid, which causes inflammation of the mucosa and the formation of an ulcer, or due to the loss of the ability of the gastric mucosa to defend itself against aggressive gastric juice. Factors of aggression are called factors of the first group, factors of protection - factors of the second group.

Aggression factors include: an excess of hydrochloric acid and pepsin (an increased number of specialized stomach cells that produce these substances), accelerated gastric motility, that is, the rapid advancement of food that has not had time to undergo sufficient processing from the stomach to the duodenum; bile acids and pancreatic enzymes that can enter the stomach, as well as other causes. Therefore, an exacerbation of peptic ulcer can be provoked by conditions that affect factors of aggression: alcohol, smoking, eating disorders, bacteria that cause chronic gastritis.

Protective factors include mucus produced in the stomach, the ability to regenerate mucosal cells, sufficient blood flow, the alkaline component of pancreatic juice, etc. Protective factors weaken in chronic gastritis, stress, beriberi, and chronic diseases. An imbalance between the factors of aggression and defense leads to the formation of an ulcer.

Peptic ulcer is diagnosed using fibrogastroduodenoscopy with a biopsy (pinching off) of a piece of mucosa near the ulcer for examination. Only the tumor nature of the ulcer is excluded.

Peptic ulcer has, as a rule, a chronic course, that is, periods of exacerbation are replaced by periods of remission, during which a peptic ulcer is not detected (small scars remain at the site of the ulcer). Peptic ulcer is characterized by seasonal exacerbations: in autumn and spring. It used to be that peptic ulcer disease is a disease more characteristic of young men. However, it is now increasingly occurring in women.

Clinical manifestations of peptic ulcer of the stomach and duodenum are not the same. For gastric ulcer, pain in the epigastric region is typical 20–30 minutes after eating, while with duodenal ulcer, pain appears on an empty stomach, at night, and, on the contrary, subsides when eating. Peptic ulcer may be accompanied by heartburn, nausea. Sometimes, because the ulcer bleeds, black stools appear. The nature of the pain may also change: sharp dagger pains or constant, persistent, not relieved by drugs. The appearance of liquid black stools and vomiting may indicate complications of peptic ulcer. Properly organized nutrition plays a leading role in the treatment of peptic ulcer, taking into account the stage of the disease, the acidity of the gastric contents, as well as the season of the year.

Drug treatment of peptic ulcer involves the impact of both aggression factors and defense factors. In the first case, drugs are used that reduce the secretion of hydrochloric acid and reduce gastric motility. These are gastrocepin, metacin (contraindicated in glaucoma, as it can cause dry mouth), atropine (contraindicated in glaucoma, because it causes blurred vision, dry mouth, palpitations). This group also includes drugs of a different mechanism of action: cimetidine, tagamet, histodil, ranitidine.

The drugs that reduce the aggressiveness of gastric contents also include antacids that neutralize high acidity: almagel, vikalin, vikair, phosphalugel, magnesium oxide (burnt magnesia), Bourget mixture. The intake of these drugs must be timed to the moment when food, which also has an alkalizing effect, leaves the stomach and free hydrochloric acid can again act on the mucous membrane. That is, it is important to take medications strictly 1.5–2 hours after meals and at night. In the treatment of peptic ulcers, a combination of antacids with one of the above drugs is usually used. For example, almagel and metacin, vikalin and cimetidine, etc.

Means that affect protective factors include drugs such as denol, venter, sucralfate. They create a protective film over the ulcer that prevents the action of gastric juice, and in addition, they have an antacid effect. These drugs can be used alone or combined with the cimetidine and gastrocepin group. Oxyspheriscarbon, solcoseryl, gastrofarm, vinylin, sea buckthorn oil, biogastron, B vitamins, ascorbic acid, methyluracil have always been considered traditional agents that affect ulcer healing. But all of them are not independent, but additional methods of treatment.

Recently, given that microorganisms can be the cause of peptic ulcer, antibacterial agents are used in the treatment: ampicillin, trichopolum, etc. They are combined with drugs of the listed groups.

The duration of ulcer healing is on average 6-8 weeks. Treatment of patients is carried out in a hospital, then at home under the supervision of a doctor. The patient undergoes fibrogastroscopic control at certain intervals. After the acute stage of peptic ulcer has passed, a therapeutic massage is prescribed, which is then replaced by a preventive one.

Gallbladder diseases

Often patients complain of pain in the liver, but in most cases this is due to the pathology of the gallbladder and biliary tract (Fig. 4). These diseases are divided into metabolic (cholelithiasis), inflammatory (cholecystitis), functional (dyskinesia). Dyskinesia passes without inflammatory processes, but with a violation of the motility of the gallbladder. Dyskinesias are observed most often, mainly in young people.

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The gallbladder collects bile from the liver, where it is formed, and in the process of digestion, it contracts to secrete bile, which is necessary for the breakdown of fats. With dyskinesia, there is a violation of the regulation of the gallbladder. The bubble either contracts very poorly (it is in a relaxed state) and bile constantly flows out of it (hypotonic form of dyskinesia), or, conversely, the bladder is spasmodic, contracted, does not secrete bile (hypertonic form of dyskinesia).

In the hypotonic form of the disease, patients often experience aching, dull, prolonged (for several hours, and sometimes days) pain and a feeling of heaviness in the right hypochondrium, which occurs after nervous stress, overwork, as a result of irregular nutrition. With this form of the disease, choleretic agents are indicated that promote the release of bile and contraction of the gallbladder, otherwise the bile will stagnate, which will lead to the formation of stones.

Agents such as xylitol, sorbitol and magnesium sulfate are good to use when performing blind probing (tubage), which is indicated for patients with a hypotonic form of gallbladder dyskinesia and is performed during an exacerbation 2-3 times a week. In the morning, on an empty stomach, they take a solution of magnesia, Karlovy Vary salt or other means: xylitol, sorbitol, two yolks, a glass of mineral water, etc. For 30–40 minutes, the patient lies on his right side with a heating pad. With this form of dyskinesia, highly mineralized waters are shown, applied cold, with gas (30-40 minutes before meals).

Some herbs have a choleretic effect. Peppermint (leaves), shamrock, chamomile (flowers), hawthorn, centaury (grass), thyme, celandine, rhubarb (rhizome), dandelion (root) are used in the treatment.

The nature of nutrition is also very important, since food can contribute to both the formation and excretion of bile. First of all, meals should be regular, frequent (5-6 times a day), preferably at the same time, with the last dose just before bedtime. This contributes to the regular emptying of the biliary tract and eliminates the stagnation of bile. Alcoholic drinks, carbonated water, smoked, fatty, spicy, fried foods and seasonings are excluded from the diet, as they can cause cramps. Dishes and broths 2-3 days old are not recommended, freshly cooked food is shown in a warm form. It should be noted that these are not temporary restrictions, but long-term recommendations.

The diet takes into account the influence of individual nutrients on the normalization of the motor function of the biliary tract. So, with hypertensive dyskinesia, products that stimulate the contraction of the gallbladder should be sharply limited: animal fats, vegetable oils, rich fish, mushroom, meat broths. With hypotension of the gallbladder with impaired bile secretion, patients usually tolerate weak meat broths, fish soup, cream, sour cream, vegetable oil, soft-boiled eggs. Vegetable oil should be consumed in a teaspoon 2-3 times a day half an hour before meals for 2-3 weeks, as it stimulates the production of cholecystokinin.

To prevent constipation, dishes that promote bowel movement are also recommended (carrots, pumpkin, zucchini, greens, watermelons, melons, fruits, raisins, prunes, dried apricots, oranges, honey). Bran has a pronounced effect on the motility of the biliary tract. One tablespoon is brewed with boiling water and added to various side dishes in the form of gruel. The dose of bran is increased until the stool normalizes. Nutrition should be complete, with a sufficient content of proteins, fats, carbohydrates, as well as enriched with dietary fiber, vitamins. Animal fats and sweets limit.

In the hypotonic form of gallbladder dyskinesia, massage and physiotherapy exercises are shown that affect the tone of the gallbladder; special massaging and morning exercises, including exercises for the muscles of the body and abdominals in a standing position, sitting, lying on the right side. Also important are sports, sufficient sleep, and in some cases, the treatment of neurotic disorders.

The hypertensive variant of gallbladder dyskinesia is characterized by acute paroxysmal pain in the right hypochondrium, radiating to the right shoulder blade, shoulder, neck and arising after stress, with irregular nutrition, the use of foods that cause spasm of the gallbladder (wine, coffee, chocolate, ice cream, lemonade).

For the treatment of this variant of dyskinesia, choleretic agents that promote the formation of bile (choleretics) and antispasmodics are used. Choleretics include allochol, cholenzym, oxaphenamide, flamin, tsikvalon, etc. Antispasmodics include noshpa, halidor, papaverine, metacin. Tubazhi with this form of dyskinesia should be carried out carefully, with the same means, but taking two tablets of noshpa, halidor or other antispasmodics 20 minutes before the procedure. Mineral waters of weak mineralization are used warm, without gas, 30 minutes before meals. Meals should be frequent, regular, at the same time. In addition, choleretic herbs are recommended in the form of heat before meals.

Diagnosis of dyskinesias is carried out using ultrasound, cholecystography (X-ray examination after taking special radiopaque tablets) and duodenal sounding. Untimely treatment of gallbladder dyskinesia contributes to the development of cholecystitis and gallstone disease.

Cholecystitis is an inflammatory disease of the gallbladder resulting from its infection. Clinical manifestations resemble gallbladder dyskinesia: the appearance of pain after taking fatty, fried foods, spicy snacks, eggs, wine, beer, as well as during exercise, shaking. Signs of inflammation may also appear: fever, weakness, decreased performance, bitterness in the mouth, nausea, sometimes vomiting, diarrhea.

For diagnosis, the same methods are used (with the exception of probing) in combination with a blood test. Acute cholecystitis, which occurs with severe pain, is subject to treatment in surgical clinics; exacerbations of chronic cholecystitis are treated therapeutically, inpatient or outpatient. For treatment, antibacterial agents are necessarily used: tetracycline, ampicillin, oletethrin, etc., as well as antispasmodics.

In the first days of exacerbation, it is better not to resort to choleretic drugs. In the future, cholagogues are used depending on the type of dyskinesia, which is always present with cholecystitis.

Nutrition in cholecystitis is important. Patients with chronic cholecystitis must follow a diet constantly. Recommended frequent, fractional meals with the exception of fatty, fried, salty and smoked foods, strong broths, beer, wine, syrups, egg yolks. Strict adherence to time intervals in food intake and frequent meals contribute to a better outflow of bile, and vice versa, long breaks in food cause stagnation of bile in the bladder. It is forbidden to eat abundantly at night, as this disrupts the rhythm of bile secretion and causes a spasm of the biliary tract.

Exacerbation of cholecystitis contributes to the stagnation of bile and the formation of stones, that is, the occurrence of cholelithiasis. Dyskinesia of the gallbladder, obesity, aggravated heredity, frequent pregnancies, malnutrition and certain diseases (diabetes mellitus, gout, etc.) also predispose to this.

The presence of gallstones can sometimes be asymptomatic. Often, against the background of complete well-being, attacks of hepatic colic occur: acute pain in the right hypochondrium with the same irradiation as with cholecystitis: nausea, vomiting, not bringing relief; fever, jaundice. Attacks are often provoked by the intake of rich, fatty foods, physical activity. Treatment of gallstone disease, depending on the course (uncomplicated and complicated), is carried out in therapeutic or surgical hospitals.

Recently, more and more operations are performed to remove the gallbladder (cholecystectomy) through special probes without opening the abdominal cavity. With frequent severe exacerbations of cholelithiasis, one should not delay with surgical treatment, since it will still be necessary to operate, but only during the period of exacerbation, which may complicate the operation. Conservative treatment, including diet therapy, offers the same methods as in the treatment of cholecystitis.

In recent years, special medicines have appeared to dissolve gallstones - henofalk, urofalk. But such treatment should be carried out under the supervision of a doctor, as it has its own indications: the stones should be small, the bile ducts should be well passable, in addition, there should be no serious concomitant diseases.

Liver disease

The liver is a unique organ. Neither the heart, nor the lungs, nor the kidneys can compare with it in terms of the volume and complexity of the work performed. Attempts to fully reproduce all the processes occurring in the liver have not yet been implemented: this would require an extremely complex structure, a whole building stuffed with various devices.

The liver is a participant in all metabolic processes in the body. About a thousand chemical reactions take place in one liver cell. More than a thousand samples have been proposed for the study of various liver functions. Liver diseases are also quite diverse. The following are the most common ones.

Chronic hepatitis is a chronic inflammatory disease. The most common cause of its occurrence are viral and alcoholic liver damage. Less commonly, chronic hepatitis is of toxic, including medicinal, origin. Approximately 20% of all chronic hepatitis are viral. They mainly develop after acute hepatitis.

Acute hepatitis is caused by the hepatitis A virus (the most favorable form, ending in recovery, in which chronic hepatitis rarely develops; infection occurs through dirty hands).

The B virus is transmitted through blood from sick people (through blood transfusions, injections, through dental and surgical instruments), it causes acute hepatitis B, which can turn into chronic hepatitis. In recent years, two more viruses have been isolated - C and D, which can also lead to the development of chronic hepatitis.

Penetrating into the liver cells, the virus begins to multiply and causes destruction (necrosis) of the liver tissue. The body begins to resist this intervention and mobilizes the forces of immunity. With hepatitis A, these forces are sufficient, and the virus is eventually expelled, while with other types, the process is delayed and becomes chronic. Chronic hepatitis can proceed in different ways, sometimes completely asymptomatic. A person, being a carrier of the virus, poses a danger to others, therefore, injections and other medical procedures should be performed with separate instruments, and doctors should always be warned about the virus.

With a calm benign passage of the disease, patients have a slight weakness, increased fatigue, dull moderate pain in the right hypochondrium, a slight enlargement of the liver, sometimes nausea, bitterness in the mouth. Such hepatitis is treated on an outpatient basis and does not require much effort. However, in this case, to establish a diagnosis, the patient must undergo an appropriate examination (blood, urine, ultrasound of the liver or scan is performed). First of all, all kinds of stresses on the liver should be eliminated: physical activity, alcohol consumption (excluded in any form), vaccination, sun exposure and medication.

The use of drugs should be minimal, since almost all drugs are metabolized in the liver, and if in a healthy body it becomes a kind of target for drugs, then a diseased liver is a doubly target.

In chronic hepatitis, the use of hepatoprotectors that strengthen the membranes of liver cells is indicated - Karsil, Legalon, Catergen. Used drugs that normalize the metabolism in the liver: lipoic acid, lapamide, Essentiale. One-month courses of treatment with the indicated means are carried out (with interruptions). Perhaps the use of B vitamins, enzyme preparations that do not contain bile acids. In some cases, no medical treatment is required.

In the event that chronic hepatitis proceeds aggressively (active chronic hepatitis), the clinical manifestations are distinct: weakness increases, jaundice appears, itching of the skin, and the liver enlarges. There are changes in other organs: bloating, diarrhea, etc. These forms of the disease are treated in hospitals with the use of hormonal agents, cytostatics, antiviral drugs. After discharge, it is recommended to conduct supportive courses, which have already been discussed.

In chronic hepatitis, special attention is paid to nutrition. In addition to alcohol, all smoked foods, canned food, including homemade, with vinegar are excluded (only boiled ones are allowed); refractory fats (goose, duck). For therapeutic purposes, in order to exclude the exacerbation of the disease, massage is prescribed for a month, 5-6 sessions with a break of three days, then monthly 10-12-day courses throughout the year.

Cirrhosis of the liver is a severe damage to the liver with the development of connective tissue in it, which disrupts the structure and function of this organ. Cirrhosis can develop as a result of active forms of chronic hepatitis and alcoholic liver damage (Fig. 5). Along with signs of damage to the liver tissue (necrosis and inflammation, as in chronic hepatitis), there is a rapid growth of connective tissue nodes. As a result, the liver loses its functions and liver failure develops: there are signs of poisoning of the body, and especially the nervous system, with toxic substances that the liver in a healthy state should neutralize. Protein synthesis is also disturbed (edema, weight loss appear), pressure in the vessels of the liver increases due to compression by their nodes (fluid accumulates in the abdomen, the spleen enlarges).

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Patients with cirrhosis during the period of exacerbation are treated in hospitals. At home, they should continue taking diuretics (usually veroshpiron or triampur in combination with furosemide), potassium preparations to reduce pressure in the liver vessels, drugs from the group of anaprilin and obzidan. In addition, the use of hepatoprotectors is shown.

The diet has the same features as in chronic hepatitis, but due to the stage of liver failure, it is necessary to limit protein in food (liver failure will increase), as well as salt and liquid (with edema and fluid accumulation in the abdomen).

Comprehensive continuous treatment of cirrhosis creates good prerequisites for increasing life expectancy. The achievements of modern science have made it possible to find approaches to the impact on the main causes of chronic hepatitis and cirrhosis of the liver - viruses. These are antiviral drugs and antiviral vaccines that can be vaccinated in all newborns. In addition, in some cases, liver transplantation is used, which was first performed in the 1960s. A part of the liver is taken from the donor, most often a close relative, and transplanted to the patient. Recently, the number of such operations has increased significantly, as modern transplantation gives a good result.

In addition to drug treatment, massage of internal organs, shiatsu and reflexology are prescribed. Patients are advised to be outdoors more often and follow a strict diet.

Diseases of the pancreas

Using the example of diseases of the pancreas, one can trace how often one disease causes another. For example, gallstone disease can contribute to the development of inflammation of the pancreas - pancreatitis. The output duct of the pancreas and the bile duct are located nearby (see Fig. 4) and with inflammation, stones in the gallbladder, when pressure rises in it, bile can be thrown into the pancreas.

The pancreas can produce very strong enzymes that break down proteins, fats, carbohydrates during digestion. In contact with bile, pancreatic enzymes are activated and can digest the tissue of the gland itself. Alcohol has the same effect. Therefore, patients with pathology of the biliary tract and alcohol abusers may develop pancreatitis, manifested by acute pain in the epigastric region, which are girdle in nature, radiate the entire back, often accompanied by indomitable vomiting.

With attacks of pancreatitis, it is necessary to call an ambulance, and, as a rule, such patients are treated in a hospital. Sometimes you have to resort to surgery, the outcome of which is ambiguous. Pancreatitis usually manifests itself in a chronic form: periods of exacerbations are replaced by remissions. Over time, the pancreas becomes sclerotic, as areas of inflammation are replaced by connective tissue.

Then the main symptom of the disease becomes a violation of digestion: due to the lack of enzymes, there is no breakdown and absorption of proteins, fats, carbohydrates; diarrhea appears, weakness, weight loss, beriberi develop. In addition, the pancreas produces insulin, which promotes the utilization of sugar in the body, therefore, if the pancreas function is impaired, the patient may develop diabetes mellitus, the first signs of which are constant thirst, dry mouth, itchy skin, and large amounts of urine.

In the treatment of patients with pancreatitis, diet is of paramount importance, since the slightest violation can often lead to an exacerbation of the disease. In acute pancreatitis, the best medicine is fasting for 3-5 days with the intake of alkaline mineral waters such as Borjomi (without gas and slightly warmed up), as well as rosehip broth. Nutrition for pancreatic disease is only slightly different from nutrition for chronic gastritis. The volume of protein products slightly increases, but the content of fats (mainly due to the consumption of vegetable oils) and carbohydrates decreases (sugar is recommended no more than 30–40 g per day). At the same time, some sweet dishes are prepared using xylitol.

Since hydrochloric acid of gastric juice is also a stimulant of pancreatic secretion, it is necessary to limit foods and dishes that increase the secretion of gastric juice. Excluded food that causes fermentation in the intestines and bloating, as well as stimulating the secretion of bile, rich in dietary fiber (legumes, nuts, mushrooms, dried fruits, most raw vegetables and fruits); besides this, food is salty, sour, spicy and smoked, cold. Meat and fish broths rich in extractive substances, refractory fats and fat breakdown products formed during frying are also excluded from the diet.

The total amount of fat in dishes is significantly limited (up to 50–70 g), but the protein content, in accordance with the data of modern nutrition, rises to 110–120 g due to low-fat meat, fish, dairy products, and egg protein. But the attending physicians of most patients still recommend adhering to the norm of 70–90 g of protein, due to the fact that the pancreas is involved in the digestion of fats, proteins, and carbohydrates, and this function is impaired in pancreatitis. The same applies to carbohydrates, especially easily digestible ones, since not only the process of carbohydrate digestion is disturbed, but also the synthesis of insulin. You should mainly use boiled or steamed dishes of minced meat and fish, as well as soufflés, jelly, mousses, puddings, jelly, regular fasting for 1-3 days, as well as cleansing diets, will be of great benefit.

Usually, treatment with one drug is carried out within a month. These drugs improve digestion, but they should not be used constantly, as they can suppress the already reduced function of the pancreas. Antispasmodics and vitamins are also shown. With the development of diabetes, appropriate therapy is carried out. Also, the patient is prescribed baths with herbs and rubbing, therapeutic massage and mandatory walks in the fresh air.

Bowel disease

The intestines are made up of the small intestine and the large intestine, which have different functions. The small intestine breaks down and absorbs proteins, fats, and carbohydrates. The large intestine absorbs water and electrolytes and forms feces.

The causes leading to intestinal diseases are different: bacteria, viruses, worms, radiation, allergies, hereditary diseases. All this affects the intestinal mucosa (Fig. 6) and causes the so-called organic diseases: enteritis (small intestine) and colitis (large intestine). However, functional bowel diseases are much more common - dyskinesias, in which the mucosa does not change, but only the function of the intestine, mainly motor, suffers.

Rice. 6

The causes of these diseases are primarily nervous factors (the nervous system regulates the activity of the intestine), malnutrition (excess protein or carbohydrate food), and intestinal dysbacteriosis. Dysbacteriosis is a violation of the normal composition of the intestinal microflora. In a healthy person, beneficial bacteria live in the colon, which are involved in the synthesis of B vitamins, the digestion of fiber, and also protect the mucosa from pathogenic microorganisms. With infection or long-term antibiotic treatment, these bacteria die, and others take their place, causing putrefactive or fermentative dyspepsia, which disrupts bowel function.

The causes of bowel disease are different, and the reactions to damage are the same - primarily a violation of the stool. It is believed that a person can have a chair several times a day, and only 3-4 times a week. The stool should be formed, without pathological impurities (blood, mucus, pus), and the act of defecation should not bring pain. The main thing, some gastroenterologists believe, is not the frequency of stools, but a change in its usual nature. Although most doctors are of the opinion that a chair less than 1 time per day already indicates incipient constipation.

For diseases of the small intestine, the appearance of diarrhea is characteristic - copious mushy stools 2-3 times a day with an unpleasant fetid odor, covered with a film of fat (poorly washed off). There is bloating, vague pain around the navel. With organic diseases of the small intestine (enteritis), there are also violations of the absorption of proteins, fats, carbohydrates, vitamins. As a result, weight loss gradually develops, edema, blurred vision, impaired skin sensitivity, etc. Functional diseases of the colon (colon dyskinesia) are also mainly manifested by stool disorders: diarrhea, which is replaced by constipation. Bowel movements with diarrhea have a watery appearance, not abundant (less than 200 g per day). Frequent bowel movements - up to 5-10 times or more, there may be false urge to defecate. In the case of an organic disease of the colon (ulcerative colitis, etc.), pathological impurities in the feces, temperature, weakness, damage to other organs: skin, joints, liver, etc. may appear.

Organic bowel diseases are treated in a hospital, where salazopreparations (salazodimethoxine, salazolpyridazine, salofalk), hormones are used, proteins, saline solutions, etc. are infused. The diagnosis is established after an X-ray and functional examination, in some cases after a biopsy of the intestine.

Dyskinesias are treated on an outpatient basis. The diet should be complete, containing a sufficient amount of proteins, fats, carbohydrates. Constipation is facilitated by such foods as hard-boiled eggs, semolina and rice porridge, white bread, cocoa, coffee, strong broths, red wines. Cold vegetable fruit juices, mineral water or just a glass of cold boiled water are recommended on an empty stomach. Useful in the morning vegetable salads (carrots, radishes, swedes, pumpkins), seasoned with sunflower oil, sour cream, mayonnaise.

With diarrhea, on the contrary, black bread, fresh vegetables and fruits, seaweed, prunes, walnuts, sardines, mayonnaise, sour cream are excluded. Food should be warm, mechanically processed, well chewed. Often, patients with bowel disease have a bad effect on milk. But pain, flatulence and diarrhea can also be observed in healthy people after taking milk. In this case, it should be replaced with sour-milk products.

In case of chronic inflammation of the small intestine (enteritis) or large intestine (colitis), accompanied by bloating and pain in the abdomen, diarrhea, weight loss, disruption of the normal intestinal microflora, it is necessary first of all to establish bowel function. For this, products and dishes containing astringent tannins are used (decoctions and jelly from dry blueberries and raspberries, bird cherry berries, pears, dogwood, quince, juice and decoction of pomegranate peel, viburnum juice, blackthorn fruits and juice, strong tea, etc.) . An infusion of dill seeds reduces gas formation in the intestines, thereby reducing pain. The diet includes dishes that envelop the intestinal mucosa - decoctions of cereals, especially rice, pureed cereals, mucous soups. Drinks and food must be used only in a warm form; dishes with a temperature below room temperature, carbonated drinks and all foods that increase intestinal motility are prohibited.

Since the intestinal microflora is disturbed, it is imperative to use sour-milk drinks, a small amount of well-mashed fruits, berries, and vegetables. Apple, vegetable and fruit diets are effective with normal tolerance. Due to the fact that with diarrhea there is a significant loss of protein, vitamins and minerals, they should be slightly more than usual in the diet, mainly due to boiled meat and fish, cottage cheese, egg dishes, as well as food enrichment with synthetic multivitamin products.

Of the drugs for diarrhea, antibacterial ones are used, since intestinal dyskinesia contributes to the development of dysbacteriosis, which exacerbates functional disorders. It is advisable to start with the following drugs: enteroseptol, intestopan, mexase, mexaform. They do not affect the normal microflora, but pathogenic bacteria are sensitive to them. These drugs are taken 1-2 tablets 3-4 times a day, the course is no more than 5-7 days, it can be repeated after 7-10 days. A contraindication to the appointment of these funds is damage to the optic nerve, dysfunction of the thyroid gland, allergy to iodine and bromine.

If the above is ineffective, agents such as furadonin, furazolidone, 5-NOC or sulfonamides (biseptol, sulgin, fthalazol) are used. Last resort to antibiotics: levomycetin, tetracycline, oletethrin, etc.

After 1-2 short courses of antibacterial agents, treatment is carried out with biological preparations containing a culture of beneficial bacteria: bifidum-bacterin, colibacterin, lactobacterin, bifikol, bactisubtil. Improve digestion and enzyme preparations, as well as vitamins.

To eliminate diarrhea, imodium, powders with calcium, bismuth, white clay, blueberries, bird cherry, pomegranate bark are recommended. For constipation, it is better not to start with laxatives, as you can get used to them, but try to correct the situation with a diet. With the ineffectiveness of the latter, bisacodyl and a gentle massage of the abdomen are prescribed. Isafenin is also often used. These drugs increase the secretion of intestinal juice without affecting the motility of the intestine, and are recommended especially for static constipation, accompanied by pain in the abdomen.

The next group of drugs enhances intestinal motility and is indicated for atonic constipation, which often develops in elderly sedentary people. These are senade, senadexin, rhubarb root, ramnil, buckthorn bark, phenolphthalein (purgen), fennel fruits, cumin, jostera.

You can use such a laxative collection: buckthorn bark, nettle leaves, yarrow grass or senna leaves, joster fruits, anise fruits, licorice roots. These fees are used in the form of infusions of 1/4-1/2 cup at night. To reduce the viscosity of feces, oils are used: vaseline (necessarily on an empty stomach), castor oil, glycerin suppositories. Salt laxatives reduce the absorption of water from the intestines: xylitol, sorbitol, Glauber's salt, Karlovy Vary salt. Sometimes constipation is associated with a violation of the act of defecation due to anal fissures, hemorrhoids. In this case, candles with belladonna, novocaine are shown.

The doctor Kurennov P. M. in his "Therapist" advises the following remedies for hemorrhoids: ice candles, the use of a sitz bath with cold water for 3-5 minutes, anti-hemorrhoid tea. Ice candles are made independently. Water is poured into paper cylindrical tubes and frozen. Before entering the anus, the tube is lowered into warm water to remove roughness, or lubricated with petroleum jelly. At first, ice candles are introduced for half a minute, then every 5 days, half a minute is added. Anti-hemorrhoid tea is prepared from kidney grass (highlander bird or knotweed). It is brewed like regular tea and drunk several times a day. Irrigation of the anus with cold water for 2-3 minutes 3-4 times a day also helps well until it feels numb.

For bowel diseases, massage is also used and physiotherapy exercises are recommended.