Irritable Bowel Syndrome (Irritable Bowel Syndrome, Colon Dyskine-Zia, Mucosal Colic, Chronic Spastic Colitis)

Disorders of the motor and secretory functions of the intestine in the absence of organic changes in the organs. The disease is more common in women aged 20-40 years.

Etiology, pathogenesis. Neuropsychological factors (personality type, mental status - anxiety, depression, etc.), dietary habits (refusal of a full breakfast, haste in eating, insufficient amount of fiber in the diet), gynecological diseases (dysmenorrhea) play a role in the development of the disease. etc. Concomitant dysbiosis has a certain significance in maintaining intestinal dysfunction.

Symptoms, course. Characterized by cramping or dull, bursting pain in the abdomen (as a rule, they intensify after eating, before defecation and decrease after defecation), constipation (stool less than 3 times a week), diarrhea (loose stools more than 3 times a day, light, often with an admixture of mucus), alternating constipation and diarrhea is possible. “Sheep” feces, flatulence, a feeling of bloating, fullness, rumbling and other dyspeptic disorders are often observed.

A distinctive sign of irritable bowel syndrome is the absence of any complaints at night. Signs of vegetative dystonia are often observed: headache, paresthesia, palpitations, sensation of a lump in the throat, feeling of incomplete inspiration, frequent urination, etc. Upon examination, spastically contracted painful descending (sometimes ascending and colon) colon may be detected.

An endoscopic examination does not reveal any changes in the colon, but air insufflation can be painful. X-ray examination may reveal diffuse or segmental narrowing of the intestinal lumen, uneven passage of barium sulfate suspension through the intestine. Additional studies are necessary to exclude organic diseases of the digestive system (intestinal tumors, ulcerative colitis, Crohn's disease, helminthiasis, polyposis, diverticulosis, tuberculosis).

The presence of blood in the stool, severe weight loss, anemia, and increased ESR make the diagnosis of irritable bowel syndrome unlikely. The course of the disease is undulating, with periods of remissions and relapses, but not progressive.

Treatment: diet therapy, psychotherapy.

Symptomatic treatment of constipation is carried out (increasing fiber in the diet, a sufficient amount of fluid, lactulose 30-60 ml per day, or guta laque 10-12 drops before bedtime, or for laque 2 sachets per day in combination with bisacodyl 1-3 tablets per day before sleep), diarrhea (smecta 1 packet 3 times a day after meals, loperamide 2 mg 2 times a day or more), spastic pain - antispasmodics, anticholinergics (no-spa, gastrocepin, buscopan). When intestinal tone decreases, domperidone (Motilium 10 mg 3 times a day), cisapride (Coordinax 20 mg 2 times a day), Debridate (1 tablet 3 times a day) are used. Treatment of concomitant dysbacteriosis is indicated (antimicrobial agents - ersefuril, intet-rix, metronidazole, bacterial agents - bifidobacterin, lactobacterin, etc., as well as hilak forte). According to indications, psychotropic drugs are used (tricyclic antidepressants - amitriptyline, etc., selective serotonin reuptake inhibitors - fluoxetine, etc.).