Gastritis

Gastritis is an inflammatory lesion of the gastric mucosa, which occurs with a change in its structure and disruption of the functions of the stomach.

There are two types of gastritis:

Acute gastritis;

Chronic gastritis.

Acute gastritis

Acute gastritis is an acute inflammation of the gastric mucosa caused by a single exposure to strong irritants.

Depending on the depth and severity of damage to the stomach, three forms of acute gastritis are distinguished:

Simple (catarrhal) gastritis;

Toxic-chemical (corrosive) gastritis;

Phlegmonous (purulent) gastritis.

Complications: bleeding in the area of ​​erosions, impaired evacuation of gastric contents, dehydration, liver abscess, peritonitis, sepsis.

Helicobacter pylori infection is the most common cause of acute gastritis;

Other bacterial infections (H. heilmanii, streptococci, staphylococci, Proteus species, Clostridium species, Escherichia coli);

Cytomegalovirus infection;

Fungal infection: candidiasis, histoplasmosis, phycomycosis;

Exposure to drugs and other chemicals: nonsteroidal anti-inflammatory drugs (acetylsalicylic acid, ibuprofen, naproxen), antibiotics, sulfonamides, glucocorticoid hormones (prednisolone, metypred);

Alcohol abuse;

Acute stress;

Food allergies;

Food poisoning;

Consumption (accidentally or intentionally) of acids, alkalis and other toxic substances;

Bile reflux from the duodenum into the stomach;

Acute gastritis is indicated by severe burning pain in the stomach, belching, heaviness in the stomach, nausea, vomiting, weakness, and dizziness. Some patients vomit brown or bloody contents.

Acute gastritis is treated by a gastroenterologist.

General examination of the patient:

Laboratory diagnostics:

General blood test;

Biochemical blood test;

General urine test;

Coprogram;

Instrumental diagnostics:

Endoscopy and histological examination of biopsy samples obtained during endoscopy;

X-ray of the stomach with barium suspension;

Computed tomography and plain radiography of the abdominal organs;

Basics. First of all, it is necessary to eliminate the cause that caused acute gastritis: tobacco, alcohol, irritating drugs. For acute gastritis of a specific etiology, appropriate treatment is carried out - anti-Helicobacter, antifungal, anti-tuberculosis therapy.

In the first 12-24 hours, fasting is indicated, then a gentle diet is prescribed. In case of food or chemical poisoning, gastric lavage is performed.

Treatment of acute phlegmonous gastritis is carried out surgically: in this case, gastrotomy, gastrectomy or gastrectomy may be indicated.

Additional. Helps alleviate acute gastritis and accelerate the disease:

Enterosorbents: hydrolytic lignin, activated carbon, etc.;

Antispasmodics for severe pain;

Antibiotics;

H2-histamine receptor blockers - to reduce the production of hydrochloric acid;

Antacids;

Gastroprotectors.

What can you do?

Diet. After the condition improves, you must adhere to a special gentle diet for at least 3 months. Food should be consumed boiled or steamed.

Chronic gastritis

Chronic gastritis is a long-term, recurrent inflammatory lesion of the gastric mucosa, which occurs with a change in its structure and disruption of the functions of the stomach.

Chronic gastritis is divided into types:

With high acidity;

With low acidity;

With normal acidity.

Depending on the type of irritants that cause the disease, there are several types of chronic gastritis:

type A (autoimmune) – fundic gastritis. The inflammation is caused by an autoimmune reaction to antibodies to stomach cells;

type B (bacterial) – antral gastritis. The inflammation is caused by the bacteria Helicobacter pylori. This type of gastritis accounts for up to 90% of all cases of chronic gastritis;

type C (chemical) - develops as a result of the reflux of bile and lysolecithin into the stomach during duodenogastric reflux or as a result of taking certain classes of drugs.

Complications: gastritis damages the gastric mucosa, which, if not properly treated, can lead to peptic ulcers, bleeding, and even degeneration of the disease into stomach cancer. With gastritis with low acidity, the absorption of vitamin B12 is impaired, which leads to the development of B12-dependent anemia. Dangerous complications include peptic ulcer and gastric adenocarcinoma.

Risk factors leading to the development of acute gastritis:

Dietary disorders;

Smoking and alcoholism;

Long-term use of medications;

Chronic stress;

Duodenogastric reflux;

Chronic infectious diseases;

Metabolic disorders.

What symptoms indicate acute gastritis?

The presence of chronic gastritis can be indicated by heaviness and a feeling of pressure, fullness in the epigastric region that appears or worsens during meals or shortly after eating, belching, nausea, an unpleasant taste in the mouth, heartburn, bloating and upset stool.

Which specialist should I contact?

If you experience symptoms of chronic gastritis, you should consult a gastroenterologist.

What diagnostics should the doctor carry out?

General examination of the patient:

palpation in the epigastric region.

Laboratory diagnostics:

General blood test;

Biochemical blood test;

Determination of the levels of pepsinogen I and pepsinogen II and their ratio in blood serum;

Determination of gastrin level in blood serum;

Determination of vitamin B12 level in blood serum;

General urine test;

Fecal occult blood test;

Determination of antibodies to Helicobacter pylori;

Bacteriological culture of stool.

Instrumental diagnostics:

Esophagogastroduodenoscopy with targeted biopsy;

Ultrasound of the liver, biliary tract, pancreas;

Intragastric pH-metry;

Electrogastroenterography;

Breath test for Heliobacter;

Manometry of the upper gastrointestinal tract.

What treatment is necessary for acute gastritis?

Basics. In the treatment of chronic gastritis the following is used:

Antacids to relieve heartburn;

Antiulcer drugs;

Antibacterial drugs.

Additional. Preparations to protect the gastric mucosa, enzyme preparations, antibiotics.

Physiotherapy: balneotherapy: galvanization of the stomach area, electrophoresis of medicinal substances (platiphylline, papaverine), ultraviolet irradiation, SMT therapy, EHF therapy.

Spa treatment: Borjomi, Essentuki, Zheleznovodsk, Arsan-Kapal, Arzni, Archman, Ayak-Kalkan, Berezovsky mineral waters, Birshtonas, Goryachy Klyuch, Goryachinsk, Darasun, Jabal-Abad, Jermuk, Druskininkai, Java, Izhevsk mineral waters, Isti-Su, Issyk-Ata, Kashin, Kislovodsk, Krainka, Krasnousolsk, Lipetsk, Mardakan, Medvezhya, Morshin, Mirgorod, Nalchik, Odessa, Polyana, Pyatigorsk, Sernovodsk-Caucasian, Staraya Russa, Sairme, Talaya, Truskavets, Tashkent Mineral Waters, Ust-Kachka , Uchum, Feodosia, Khilovo, Chartak, Yumatovo, Shivanda, Shira, Shambary, Shmakovka, Yamarovka, Anapa, Birshtonas, Evpatoria, Yeisk, Karachi, Kemeri, Kuyalnik, Liepaja, Moltaevo, Muyaldy, Naftalan, Pärnu, Sadgorod, Saki, Slavyansk .

What can you do?

Diet. For successful treatment of chronic gastritis, it is necessary to adhere to a special diet for the entire period.

The main portion of the diet should be foods that are weak secretion stimulants: cottage cheese, milk, omelet, boiled lean meat and fish, mashed potatoes, mashed soups, semolina and rice porridge, sweet fruit puree, dried bread, still alkaline water.

It is necessary to exclude from the diet foods that contribute to mechanical irritation of the gastric mucosa: foods rich in coarse plant fiber (radish, turnip, beans, unripe fruits, gooseberries, grapes, raisins, currants, dates, wholemeal bread), as well as cartilage and stringy meat.

For gastritis with high acidity, exclude acidic foods from your diet: kefir, cranberries, citrus fruits, sauerkraut. For gastritis with low acidity, on the contrary, it is worth including these products in the diet.

Too hot and cold food irritates the stomach. Avoid drinking ice cream, iced drinks, very hot drinks and soups.

Small meals are recommended, 5–6 times a day, since a large volume of food administered at one meal contributes to mechanical irritation of the gastric mucosa. It is necessary to develop and strictly observe a diet - you need to eat at certain hours.

Physical activity. Active physical exercise increases the production of hydrochloric acid and enzymes. On the other hand, when performing certain physical exercises (general developmental and breathing exercises, relaxation exercises) at a slow pace, with monotonous movements, the increased secretory activity of the stomach decreases. At the same time, try not to involve the abdominal muscles.

It is useful to massage the abdomen: circular strokes in a clockwise direction.

Pancreatitis

Pancreatitis is inflammation of the pancreas.

With pancreatitis, enzymes secreted by the pancreas cannot enter the duodenum and begin the digestion process in the pancreas itself.

According to the nature of the flow, they are distinguished:

Acute pancreatitis,

Acute recurrent pancreatitis,

Chronic pancreatitis,

Exacerbation of chronic pancreatitis.

Based on the nature of the damage to the gland, the following forms of pancreatitis are distinguished:

Edematous form – without the formation of islands of necrosis;

Destructive form – with areas of pancreatic tissue necrosis:

– small focal pancreatic necrosis;

– medium-focal pancreatic necrosis;

– large-focal pancreatic necrosis;

– total-subtotal pancreatic necrosis.

Acute pancreatitis

Acute pancreatitis is a rapidly developing inflammation of the pancreas.

There are two stages of acute pancreatitis:

Mild acute pancreatitis, occurring with minimal organ dysfunction and rapid recovery.

Severe (destructive) acute pancreatitis, occurring with impaired organ function and local complications (acute fluid accumulations, pancreatic necrosis, acute false cyst, pancreatic abscess).

Complications: intestinal obstruction, bleeding, peritonitis, septic shock.

Risk factors leading to the development of pancreatitis:

Alcohol abuse – 50% of cases;

Gallstone disease – 20% of cases;

Abdominal injury;

Long-term use of certain medications;

Diseases of the duodenum;

Infectious diseases;

Heredity;

Prolonged contact with insecticides and chemical fertilizers.

What symptoms indicate acute pancreatitis?

Clear signs of acute pancreatitis are severe, increasing pain in the epigastric region, frequent painful vomiting, diarrhea and bloating. The pain decreases when lying on the stomach. Bluish spots may appear on the left side wall of the abdomen, sometimes with a yellowish tint.

Which specialist should I contact?

It is necessary to consult a gastroenterologist. But in case of severe pain and uncontrollable vomiting, you should contact an emergency medical service.

What diagnostics should the doctor carry out?

General examination of the patient:

Palpation of the abdomen;

Blood pressure measurement;

Listening to the abdomen with a stethoscope;

Laboratory diagnostics:

General blood test;

General urine test;

Biochemical blood test;

Determination of cholesterol and triglycerides.

Instrumental diagnostics:

Gastroscopy;

Radiography;

Computed or magnetic resonance imaging;

Electrocardiography;

Angiography of the pancreas;

CT-guided puncture biopsy;

Laparoscopic examination.

What treatment is needed for acute pancreatitis?

General. Fasting for 2-4 days is a mandatory recommendation for acute pancreatitis. Cold on the stomach is indicated. In some cases, a nasogastric tube is installed to remove gastric contents. Drug treatment of acute pancreatitis includes:

Antispasmodics for pain relief;

Drugs that reduce the secretion of pancreatic enzymes;

Plasmapheresis for detoxification of the body;

Antibiotics.

In severe cases, surgical intervention is necessary:

Installation of drainages and peritoneal lavage dialysis - allows you to quickly remove toxins and thereby reduce the toxic effects on the liver, kidneys, heart, lungs and other organs and tissues;

Pancreatic resection;

Lawson's operation.

Additional. If symptoms are present, antiemetic drugs are prescribed; if hemoglobin levels drop, a blood transfusion is required.

Physiotherapy: electrophoresis of novocaine, papaverine or drotaverine on the area of ​​projection of the pancreas, diadynamic currents on the area of ​​the left hypochondrium, ultrasonic influence on the pancreas, low-frequency alternating magnetic field, mud therapy, balneotherapy: drinking warm sodium bicarbonate waters.

What can you do?

It is important to understand that acute pancreatitis is prone to relapses, and further exacerbations will further destroy the pancreas, an irreplaceable organ in our body. Therefore, the rehabilitation period is very important. Do not violate doctor's orders!

Diet. For 2–3 months, you must adhere to a diet high in protein and low in fat and carbohydrates. Steamed and boiled food is recommended. The food temperature should not be too hot or cold. It is better to avoid products containing a rough texture. It is recommended to consume the products pureed.

Meals should be 5-6 times a day in small portions. Develop a diet - meals should be at the same time every day.

Chronic pancreatitis

Chronic pancreatitis is a constant inflammation of the pancreas, leading to changes in its structure.

Chronic pancreatitis is divided into:

Primary – an independent disease;

Post-traumatic, arising from trauma;

Secondary, which is a complication of another disease.

Based on the nature of changes in the pancreas, there are three main types of chronic pancreatitis:

Chronic calcific pancreatitis - with the formation of plugs rich in protein and calcium;

Chronic obstructive pancreatitis;

Chronic parenchymal-fibrous (inflammatory) pancreatitis.

Complications: subhepatic jaundice, erosive esophagitis, chronic duodenal obstruction, pancreatic ascites, pancreatic cancer, peritonitis, sepsis.

Risk factors leading to the development of chronic pancreatitis:

Alcohol abuse;

Gallstone disease;

Cirrhosis;

Abuse of fatty, fried foods;

Viral diseases;

Endoscopic operations;

Abdominal injuries;

Long-term use of certain types of medications;

Smoking.

What symptoms indicate chronic pancreatitis?

The most common signs of chronic pancreatitis are periodic attacks of pain in the epigastric region or left hypochondrium and weight loss. Sometimes the pain radiates to the back. Most often, pain occurs after a heavy meal.

In chronic pancreatitis, so-called “bloody tears” often form under the skin of the abdomen - convex formations with a diameter of 1-3 mm of a purple color.

Which specialist should I contact?

A gastroenterologist treats chronic pancreatitis.

What diagnostics should the doctor carry out?

General examination of the patient:

Palpation of the abdomen;

Examination of the tongue and skin.

Laboratory diagnostics:

General blood test;

General urine test;

Biochemical blood test;

Coprogram;

Secretin-pancreozymin test;

LUNDT test;

Bentyramine test;

Fecal elastase-1 test;

Glucose tolerance test.

Instrumental diagnostics:

Ultrasound examination of the abdominal organs;

X-ray of the abdominal organs;

Gastroscopy;

C-breathing tests;

Computed tomography or magnetic resonance imaging of the pancreas;

Endoscopic retrograde cholangiopancreatography;

Endoscopic ultrasonography;

Angiography of the pancreas.

What treatment is needed for chronic pancreatitis?

Basics. Treatment of chronic pancreatitis depends on the phase of the disease.

For exacerbations of pancreatitis, the following is prescribed:

Antispasmodics for pain relief;

Close-focus radiation therapy – for persistent pain;

Antacids;

Antisecretory drugs;

Enzyme preparations;

Antibiotics;

Psychotropic drugs – in case of neuropsychic disorders.

During the silent period of the disease, the following is used:

Enzyme preparations;

Antisecretory drugs;

Insulin therapy – for endocrine pancreatic insufficiency.

When the patient's condition worsens in severe cases of chronic pancreatitis, the need for surgical treatment arises. Indications for the operation are:

Forming pseudocyst;

Obstruction of the pancreatic duct;

Doubts about the correctness of the diagnosis - to exclude pancreatic cancer;

Pancreatic fistula;

Severe pain that cannot be eliminated even with narcotic analgesics.

Physiotherapy: electrophoresis with novocaine, ultrasound therapy, SMT therapy, diadynamic currents to the left hypochondrium, balneotherapy: drinking warm calcium bicarbonate and magnesium waters, carbon dioxide, sodium chloride, radon, pine baths, mud applications, galvanic mud procedures.

Spa treatment: Essentuki, Borjomi, Zheleznovodsk, Truskavets, Narzan, Dzhemruk, Karmadon, Morshin, Pyatigorsk, sanatoriums in Belarus.

What can you do?

When diagnosed with chronic pancreatitis, successful treatment requires changes in lifestyle: giving up alcohol and smoking, following a diet, and regularly taking prescribed medications.

Diet. The diet should be rich in foods containing a lot of protein. The amount of fat and carbohydrates should be reduced.

Meals should be 5-6 times a day in small portions. Develop a food routine - eat at the same time every day. The calorie content of the diet should not exceed 3,000 kcal.

Physical activity. Take walks daily. In the morning, it is useful to bend and twist your torso to improve blood circulation in the pancreas area.

Breathing exercises are also useful:

Exhale, hold your breath. Gently, pull your stomach in for three seconds. Inhale and relax your abdominal muscles.

Lying on your back, slowly inhale air through your nose, sticking out your stomach. Hold your breath for three seconds. Then relax your abdominal muscles.

Duodenitis

Duodenitis is an inflammatory disease of the mucous membrane of the duodenum.

Duodenitis has the following classification:

Acute duodenitis:

– acute catarrhal duodenitis;

– acute erosive-ulcerative duodenitis;

– acute phlegmonous duodenitis.

Chronic duodenitis:

– primary chronic duodenitis;

– secondary chronic duodenitis.

According to the location of the lesion, they are distinguished:

Chronic duodenitis, mainly bulbitis, of acidopeptic origin;

Chronic duodenitis, combined with atrophic gastritis or enteritis;

Chronic duodenitis that developed against the background of duodenostasis;

Local duodenitis – papillitis, peripapillary diverticulitis.

According to the endoscopic picture there are:

Superficial chronic duodenitis;

Atrophic chronic duodenitis;

Interstitial chronic duodenitis;

Erosive-ulcerative chronic duodenitis.

Complications: duodenal hormonal insufficiency, intestinal bleeding, perforation of the intestinal wall, acute pancreatitis.

Risk factors leading to the development of duodenitis:

Irregular meals;

Spicy, fried, sour and too hot food;

Abuse of alcohol and coffee;

Food allergies;

Food poisoning;

Stress, diseases of the nervous system;

Helicobacter Pylori infection;

Diseases of the digestive system;

Toxic effects.

What symptoms indicate duodenitis?

In acute duodenitis, diffuse pain appears in the upper abdomen, nausea, vomiting, and pain when pressing on the abdomen. Characterized by general weakness, fatigue, and increased body temperature.

Chronic duodenitis is manifested by nausea, vomiting, heartburn, belching with a sour aftertaste, constipation, and fatigue. With chronic duodenitis, the pain becomes dull, aching in the right hypochondrium. Characteristic is a decrease in pain when turning on the left side, in the knee-elbow position, or in the squatting position.

In women, children under 12 years of age and men over 45 years of age, chronic duodenitis can occur without pain or with mild symptoms.

Which specialist should I contact?

A gastroenterologist treats acute duodenitis.

What diagnostics should the doctor carry out?

General examination of the patient:

Palpation in the epigastric region.

Laboratory diagnostics:

General blood test;

Biochemical blood test;

General urine test;

Fecal occult blood test;

Coprogram;

Bacteriological culture of stool.

Instrumental diagnostics:

Ultrasound examination;

X-ray of the stomach and duodenum;

Fibrogastroduodenoscopy with biopsy;

pH-metry;

Antroduodenal manometry - study of pressure in the stomach, duodenum and jejunum;

Impedance measurement of the esophagus;

Breath test for Helicobacter.

What treatment is necessary for duodenitis?

Basics. Treatment depends on the form of the disease.

Acute duodenitis. For catarrhal and erosive-ulcerative duodenitis, fasting and bed rest are prescribed for 1–2 days, the stomach is washed with a solution of potassium permanganate, and antacids and antispasmodics are used.

For phlegmonous duodenitis, treatment is carried out with antibiotics and surgical methods.

Chronic duodenitis:

Antibiotics – for Helicobacter pylori infection;

Drugs that reduce the secretion of hydrochloric acid;

Antacids;

Enveloping drugs;

Enzyme preparations;

Choleretic drugs;

Duodenal intubation with duodenal lavage.

Surgical treatment is prescribed only in severe cases.

Physiotherapy: electrophoresis of novocaine and platiphylline, SMT therapy, paraffin baths, diathermy, pine, oxygen and pearl baths, drinking sodium bicarbonate mineral waters.

Spa treatment: Dorokhovo, Druskininkai, Borjomi, Essentuki, Zheleznovodsk, Jermuk, Izhevsk mineral waters, Kashin, Kislovodsk, Krasnousolsk, Lipetsk, Morshin, Nalchik, Odessa, Pyatigorsk, Sernovodsk-Caucasian, Staraya Russa, Truskavets, Anapa, Evpatoria, Kuyalnik, Saki.

What can you do?

Physical activity. For duodenitis, moderate physical activity is recommended - walking, swimming.

Outside of exacerbations, do morning exercises at a slow pace. Include abdominal exercises and breathing exercises.

Peptic ulcer

Peptic ulcer disease is a chronic disease, the leading manifestation of which is the formation of ulcers in the stomach and/or duodenum.

Peptic ulcer disease can be acute or chronic.

There are several stages of peptic ulcer disease:

Fresh ulcer;

Beginning of epithelization of the ulcerative defect;

Healing of an ulcerative defect of the mucous membrane with preserved duodenitis;

Clinical and endoscopic remission.

There is the following classification of peptic ulcer:

Gastric ulcer;

Duodenal ulcer;

Peptic ulcer of unspecified etiology;

Peptic gastrojunal ulcer after gastric resection.

Complications: bleeding, perforation of the ulcer, stenosis of the gastric outlet, peritonitis, development of the ulcer into a malignant neoplasm.

Risk factors leading to the development of peptic ulcer:

Helicobacter pylory infection;

Frequent stress, depression;

Taking non-steroidal anti-inflammatory drugs;

Irregular diet and eating habits;

Abuse of spicy and fried foods;

Gastritis with increased secretion;

Diabetes mellitus;

Smoking;

Alcohol abuse;

Heredity.

What symptoms indicate a peptic ulcer?

Peptic ulcer disease is manifested by severe pain in the upper abdomen, occurring 3-4 hours after eating. The pain can radiate under the shoulder blade, in the lower back, or chest. Pain also often occurs on an empty stomach and at night. Peptic ulcer disease is characterized by heartburn, sour belching, vomiting without previous nausea, frequent constipation, and changes in appetite.

Which specialist should I contact?

A gastroenterologist treats peptic ulcers.

What diagnostics should the doctor carry out?

General examination of the patient:

Palpation of the abdomen.

Laboratory diagnostics:

General blood test;

General urine test;

Coprogram;

Fecal occult blood test;

Biochemical blood test;

PCR diagnostics of Helicobacter.

Instrumental diagnostics:

Breath test for Helicobacter;

Daily pH-metry;

Endoscopic examination of the stomach and duodenum with examination of the obtained biopsy samples;

X-ray examination of the abdominal organs;

Gastroduodenoscopy.

What treatment is necessary for peptic ulcer disease?

Basics. First of all, when Helicobacter pylori is detected, treatment is aimed at destroying this causative agent of peptic ulcer disease. For this we use:

Antibiotics of various groups;

5-nitroimidazole derivatives: metronidazole and tinidazole;

Furazolidone;

Drugs that regulate gastrointestinal motility - metoclopramide, domperidone.

Additional. The following medications are used in the treatment of peptic ulcers:

Antacids;

Antisecretory antiulcer agents;

Gastroprotective agents;

Enzyme preparations.

Physiotherapy: galvanization and medicinal electrophoresis on the abdominal area, DMV therapy, SMV therapy, magnetic therapy, inductothermy, amplipulse therapy, microwave therapy, UHF therapy, electrophoresis, hyperbaric oxygenation, acupuncture, electrosleep therapy, application of ozokerite, peat mud, paraffin applications.

Spa treatment: Borjomi, Essentuki, Zheleznovodsk, Jermuk, Druskininkai, Kislovodsk, Pyatigorsk, Berezovsky mineral waters, Truskavets, Saki.

What can you do?

Stop smoking and drinking alcohol.

Diet. Meals should be frequent, 4–6 times a day, in small portions. It is worth removing foods that irritate the stomach from your diet: meat and fish broths, canned food, smoked foods, marinades and pickles, soft white bread, carbonated water, coffee.

Physical activity. The development of peptic ulcers is often provoked by stress and depression, and physical activity helps combat the negative influence of these factors. Therefore, during the remission phase, physical exercise will be very useful.

During the period of scarring of the ulcer, exercises involving the abdominal muscles are contraindicated.

Gastroesophageal reflux disease

Gastroesophageal reflux disease is a chronic relapsing disease caused by spontaneous, regularly repeated reflux of stomach or duodenal contents into the esophagus, leading to damage to the lower esophagus.

Gastroesophageal reflux disease is divided into two types:

Gastroesophageal reflux disease with esophagitis - detected by endoscopic examination;

Gastroesophageal reflux disease without esophagitis is not detected by endoscopic examination.

Complications: narrowing of the esophagus, erosions and ulcers of the esophagus, accompanied by bleeding, adenocarcinoma of the esophagus.

Risk factors leading to the development of gastroesophageal reflux disease:

Frequent consumption of fatty foods, alcohol, coffee, carbonated drinks;

Overweight;

Taking certain medications (nitrates, antidepressants, beta-blockers, hormones, calcium channel blockers, anticholinergics);

Hiatal hernia;

Pregnancy.

What symptoms indicate gastroesophageal reflux disease?

Typical symptoms of gastroesophageal reflux disease are: heartburn, sour belching, which often occur after eating, when bending the body forward or at night. Gastroesophageal reflux disease is also accompanied by nausea, vomiting, bad breath, excessive salivation during sleep, and substernal pain that radiates to the interscapular region, neck, lower jaw, and left half of the chest.

The likelihood of having gastroesophageal reflux disease is high if you experience heartburn at least twice a week.

Which specialist should I contact?

A gastroenterologist treats gastroesophageal reflux disease.

What diagnostics should the doctor carry out?

Laboratory diagnostics:

General blood test;

General urine test;

Biochemical blood test;

Determination of serum iron level;

Fecal occult blood test;

Bernstein test;

Alkaline test;

Rabeprazole test.

Instrumental diagnostics:

Daily monitoring of pH in the lower third of the esophagus;

X-ray examination of the esophagus;

Endoscopic examination of the esophagus;

Manometric examination of the esophageal sphincters;

Scintigraphy of the esophagus;

Impedance measurement of the esophagus;

Computed tomography of the gastrointestinal tract.

What treatment is needed for gastroesophageal reflux disease?

Basics. Treatment of gastroesophageal reflux disease helps relieve symptoms of the disease. For this purpose the following is prescribed:

Antacids and gastroprotectors that neutralize the effect of hydrochloric acid;

Histamine H-blockers to reduce the production of hydrochloric acid;

Proton pump inhibitors - they are more effective than histamine H2 receptor blockers and have fewer side effects;

Prokinetics are substances that stimulate gastrointestinal motility.

Physiotherapy: interference therapy, galvanization, drug electrophoresis of antispasmodics, transcranial electroanalgesia, electrosleep therapy, local cryotherapy, low-intensity UHF therapy, infrared laser therapy, low-intensity UHF therapy, low-frequency magnetic therapy, galvanization of the brain and collar area; balneotherapy: iodine-bromine, nitrogen and pine baths, sodium chloride baths, sodium-calcium mineral waters.

Spa treatment: Kislovodsk, Pyatigorsk, Essentuki, Zheleznovodsk, sanatoriums of the Leningrad region, sanatoriums of Belarus.

What can you do?

Diet. When eating for gastroesophageal reflux disease, adhere to the following rules:

The last meal should be no later than 2 hours before bedtime.

Meals should be divided: 3-4 times a day, in small portions.

Eliminate spicy, hot and very cold foods from your diet.

Don't drink carbonated drinks.

Reduce your fat intake.

Limit or eliminate consumption of coffee, chocolate, green onions and garlic, tomatoes and citrus fruits.

After eating, do not lie down for 2 hours.

Stop smoking and drinking alcohol;

Reduce your normal caloric intake by 10-15% if you are overweight.

Household rules:

Raise the head end of the bed by 15 cm.

Avoid work that requires bending or lifting heavy objects.

Avoid stress and exercise on the abdominal muscles.

Do not wear tight clothes, belts, belts.

Intestinal dysbiosis

Intestinal dysbiosis is a violation of the relationship between different types of microorganisms in the intestine.

Intestinal dysbiosis according to the types of reasons that caused the disease is divided into:

Dysbacteriosis in practically healthy individuals;

Dysbacteriosis accompanying various diseases of the digestive system;

Dysbacteriosis in other diseases;

Drug dysbacteriosis;

Stress dysbacteriosis.

Complications: allergies, bronchial asthma, atopic dermatitis, gastritis, duodenitis, duodenal ulcer, caries, cholelithiasis, decreased effect of hormonal contraception.

Risk factors leading to the development of intestinal dysbiosis:

Unbalanced diet;

Age-related changes in the properties of microflora;

Allergic reactions;

Long-term use of certain medications (antibiotics, hormones, cytostatics);

Frequent respiratory viral infections;

Functional or inflammatory diseases of the digestive system;

Acute and chronic gastrointestinal infections;

Urogenital infections;

Oncological diseases;

Immunodeficiencies.

What symptoms indicate intestinal dysbiosis?

The main symptoms of intestinal dysbiosis are: belching, bloating, nausea, vomiting, decreased or lack of appetite, metallic taste in the mouth, constipation, diarrhea, a feeling of incomplete bowel movement after defecation. In some cases, dull, aching or cramping pain appears in the abdomen.

Also, the presence of intestinal dysbiosis is indicated by cracks in the corners of the lips, dry and itchy skin, rash, weakness and fatigue.

Which specialist should I contact?

A gastroenterologist treats intestinal dysbiosis.

What diagnostics should the doctor carry out?

General examination of the patient:

Examination of the skin and tongue;

Laboratory diagnostics:

General blood test;

General urine test;

Biochemical blood test;

Stool culture for dysbacteriosis;

Coprogram;

Biochemical examination of stool;

Gas-liquid chromatography of feces;

PRC diagnostics;

Hydrogen breath test with glucose or lactulose;

Breath test with C-14-glycocholate, C-14-D-xylose.

Instrumental diagnostics:

Gastroscopy.

What treatment is necessary for intestinal dysbiosis?

Basics. Therapy for dysbiosis has two goals:

1. Suppression of excess opportunistic microflora, for which the following are used:

Antibiotics;

Intestinal antiseptics;

Bacteriophages are viruses that can penetrate a bacterial cell, multiply in it and cause its destruction;

Probiotics;

Herbal antiseptics.

2. Restoration of intestinal microflora by implantation of live bacterial preparations:

Probiotics;

Prebiotics;

Probiotics are substances that contain cultures of living microbes characteristic of the normal microflora of the human intestine.

Prebiotics are substances that create an environment for the growth and reproduction of beneficial bacteria.

Symbiotics are complex preparations that include pre- and probiotics.

Additional. Intestinal dysbiosis may also require symptomatic treatment. Depending on the problem that arises, the following is prescribed:

Antispasmodics;

Antidiarrheals;

Laxatives;

Adsorbents;

Polyenzymes;

Immunomodulators;

Antihistamines;

Drugs for the correction of metabolic disorders;

Multivitamins;

Antioxidants;

Defoamers.

Physiotherapy: intestinal lavage.

Spa treatment: Pyatigorsk, Morshin.

What can you do?

Diet. Diet therapy is one of the main components of the treatment of intestinal dysbiosis. The diet should contain:

Products rich in dietary fiber: bran, buckwheat, barley, oatmeal, almonds, dried fruits, herbs, seaweed;

Natural products additionally enriched with any functional ingredient or group of ingredients;

Fermented milk products: yoghurt, kefir, cottage cheese, matsoni, etc.

From the diet you should exclude spicy, smoked, pickled foods, onions, garlic, fatty foods, fried foods, alcohol, foods that cause bloating: legumes, cabbage.

Colitis

Colitis is an inflammatory disease of the mucous membrane of the large intestine.

According to the course, acute and chronic colitis are distinguished.

Colitis is classified according to the cause of its occurrence:

Ulcerative;

Infectious;

Ischemic;

Toxic;

Radiation.

Colitis is classified according to location:

Pancolitis - all parts of the colon are affected;

Typhlitis - inflammation of the mucous membrane of the cecum;

Transversitis - inflammation of the mucous membrane of the transverse colon;

Sigmoiditis – inflammation of the mucous membrane of the sigmoid colon;

Proctitis is inflammation of the rectal mucosa.

Complications: acute toxic dilatation of the colon, perforation of the colon, hypovitaminosis, anemia, endocrine disorders, ulcerative esophagitis, lesions of the tongue and gums, lesions of the iris, conjunctivitis, blepharitis, polyarthritis, spondylitis, colonic obstruction, perianal abscess, anal fissures, paraproctitis, phlegmon tissue of the pararectal space, rectal and rectovaginal fistulas.

Risk factors leading to the development of colitis:

Taking medications;

Intoxication;

Poor nutrition;

Allergic reactions;

Chronic diseases of the digestive system;

Removal of appendicitis;

Pathologies of the nervous system.

What symptoms indicate colitis?

In acute colitis, there are sharp pains in the abdomen, painful and frequent urge to defecate, rumbling and bloating, diarrhea or alternating diarrhea with constipation, stools may contain blood and mucus. General malaise, weakness, loss of appetite appears. Sometimes nausea and vomiting occur.

With chronic colitis, there are sensations of fullness in the stomach and heaviness in the abdominal cavity, a feeling of squeezing, cramping pain, which is accompanied by the urge to defecate, flatulence and stool disorders. Feces are foul-smelling, often mixed with blood and mucus.

With ulcerative colitis, general symptoms may include rectal bleeding or bloody purulent discharge.

Chronic colitis over a long period of time leads to weight loss, weakness and loss of strength, dry skin and mucous membranes, cracks in the corners of the lips, and visual disturbances.

Which specialist should I contact?

Colitis is treated by a gastroenterologist or coloproctologist.

What diagnostics should the doctor carry out?

General examination of the patient:

Palpation of the abdominal area;

Finger examination;

Anoscopy.

Laboratory diagnostics:

General blood test;

Biochemical blood test;

General urine test;

Fecal occult blood test;

Fecal analysis for helminth eggs;

Coprogram;

Coagulogram;

Bacteriological culture of stool.

Instrumental diagnostics:

Sigmoidoscopy or colonoscopy;

X-ray of the intestines with barium;

Irrigoscopy is an X-ray examination of the intestine with its preliminary filling with a contrast agent;

Selective mesenteric angiography.

What treatment is needed for colitis?

Basics. Depending on the cause of the disease, the following treatment for acute and chronic colitis is used:

Antimicrobial drugs – for infectious colitis;

Vascular drugs: antiplatelet agents, thrombolytics, antispasmodics - for ischemic colitis;

Saline laxatives – for toxic colitis.

For chronic colitis the following are used:

Antispasmodics;

Regulators of intestinal motility;

Antidiarrheals;

Anti-inflammatory drugs;

Glucocorticoid hormones.

Surgical treatment is used only in extreme cases: with severe ulcerative colitis, progressive colon ischemia, gangrenous colitis.

Additional. Vitamins C, B2, B6, B12, broad-spectrum antibiotics, microenemas - chamomile, tannin, protarhead, from a suspension of bismuth nitrate, with peloidin, astringents and enveloping agents, sedatives, intestinal adsorbents, immunomodulators, prebiotics and probiotics.

Physiotherapy: electrophoresis, diadynamic therapy, inductothermy, UHF therapy, SMV therapy, UHF therapy, amplipulse therapy, magnetic therapy, galvanic collar, local and general ultraviolet irradiation, paraffin applications of the abdominal area, segmental massage, abdominal massage, paraffin and ozokerite applications, mud therapy: mud applications, mud electrophoresis, balneotherapy: drinking sodium chloride waters, subaqueous baths.

Spa treatment: Essentuki, Zheleznovodsk, Borjomi, Arsan-Kapal, Arzni, Archman, Ayak-Kalkan, Berezovsky mineral waters, Birshtonas, Goryachy Klyuch, Goryachinsk, Darasun, Jabal-Abad, Jermuk, Druskininkai, Java, Izhevsk mineral waters, Isti-Su, Issyk-Ata, Kashin, Kislovodsk, Krainka, Krasnousolsk, Lipetsk, Mardakan, Medvezhya, Morshin, Mirgorod, Nalchik, Odessa, Polyana, Pyatigorsk, Sernovodsk-Caucasian, Staraya Russa, Sairme, Talaya, Truskavets, Tashkent Mineral Waters, Ust-Kachka , Uchum, Feodosia, Khilovo, Chartak, Yumatovo, Shivanda, Shira, Shambary, Shmakovka, Yamarovka, Anapa, Birshtonas, Evpatoria, Yeisk, Karachi, Kemeri, Kuyalnik, Liepaja, Moltaevo, Muyaldy, Naftalan, Saki, Slavyansk.

What can you do?

Physical activity. For chronic colitis, physical exercise is beneficial. There are special complexes of exercise therapy and breathing exercises for this disease. Depending on the form of colitis, different exercises are needed, so before engaging in exercise therapy, be sure to consult with your doctor.

Swimming, walking, and exercises for the abdominal muscles are useful for constipation.

Irritable bowel syndrome

Irritable bowel syndrome is a disease with various forms of functional disorders of motility, absorption and secretion, mainly of the colon.

Under the influence of various factors, the sensitivity of receptors in the intestinal wall changes, causing its functioning to be disrupted.

Depending on the leading symptom, there are three variants of the course of irritable bowel syndrome:

With predominant abdominal pain and flatulence;

With predominant diarrhea;

With predominant constipation.

Complications: Irritable bowel syndrome has no serious complications and does not affect life expectancy.

Risk factors leading to the development of irritable bowel syndrome:

Stress and depression;

Neuroses;

Violation of the usual diet and diet;

Lack of fiber in food;

Sedentary lifestyle;

Hormonal disorders;

Alcohol abuse.

What symptoms indicate irritable bowel syndrome?

Abdominal pain that noticeably decreases or goes away after defecation, diarrhea after eating, usually in the morning and early afternoon, an uncontrollable urge to have a bowel movement, a feeling of incomplete bowel movement after bowel movement, constipation, bloating, mucus in the stool. The occurrence of these symptoms often occurs against a background of stress, nervous tension, and excitement.

You can suspect irritable bowel syndrome if its main symptoms: constipation, diarrhea or flatulence bother you at least once every 4 days.

Which specialist should I contact?

Irritable bowel syndrome is treated by a gastroenterologist. At the same time, a visit to a psychotherapist or neurologist is required.

What diagnostics should the doctor carry out?

Before making a diagnosis of irritable bowel syndrome, it is necessary to exclude other, more serious, diseases of the digestive system.

General examination of the patient:

Palpation of the abdominal area.

Laboratory diagnostics:

General blood test;

General urine test;

Biochemical blood test with mandatory determination of electrolytes and protein spectrum;

Examination of stool for dysbacteriosis;

Immunogram.

Test for thyroid hormones.

Instrumental diagnostics:

Ultrasound of the abdominal cavity and pelvis;

Gastroscopy;

Irrigoscopy;

Sigmoidoscopy;

Anorectal manometry;

Colonoscopy.

What treatment is needed for irritable bowel syndrome?

Basics. Treatment for irritable bowel syndrome is selected based on which symptoms most often bother the patient. Use:

Drugs that block intestinal spasms are dicyclomine or goiscyamine;

Antidepressants;

Antidiarrheal drugs;

Type 3 serotonin receptor blockers – reduce abdominal pain and discomfort;

Activators of type 4 serotonin receptors (with a tendency to constipation);

Activators of guanylate cyclase (if prone to constipation);

Antibiotics.

Additional. A course of therapy is carried out by a psychotherapist to eliminate stress factors and normalize the emotional state.

Physiotherapy: acupuncture, cryomassage of the abdomen, general massage and massage of the cervical-collar area, paraffin, ozokerite or mud applications on the stomach, taking warm low-mineralized mineral waters.

Sanatorium-resort treatment: Essentuki, Pyatigorsk, Zheleznovodsk, Narzan, Borjomi, Jermuk, Karmadon.

What can you do?

Diet. For constipation, add fiber-rich foods to your diet: vegetables, fruits, bran. If you have diarrhea, on the contrary, you should limit these foods.

Keep a food diary and note in it when you have intestinal problems - this will help identify provoking foods.

Eliminate foods that irritate the intestines from your diet: spicy, smoked, salty, sour, vinegar, alcohol, coffee. Also, do not eat foods that stimulate gas formation, such as cabbage, peas, beans, potatoes, grapes, milk, kvass.

Add foods that have an anti-stress effect to your diet: almonds, turkey, bell peppers, greens.

Physical activity. Physical exercise helps normalize intestinal motility and promotes the production of the hormone endorphin, which improves the condition of the nervous system. Walking in the fresh air, jogging, and rhythmic gymnastics are very useful.

If you are prone to constipation, abdominal exercises are useful.

Gallstone disease

Gallstone disease is the formation of hard deposits of cholesterol or calcium salts in the gallbladder or nearby bile ducts.

Every fifth woman and every tenth man have gallstones.

Gallstone disease is divided into three stages:

The initial physicochemical stage is characterized by changes in the composition of bile, without the formation of stones. It occurs without symptoms.

The stage of stone formation is also asymptomatic, but with instrumental diagnostic methods it is possible to detect stones in the gallbladder.

The stage of clinical manifestations is characterized by the development of acute or chronic calculous cholecystitis.

Based on their chemical composition, the following types of stones are distinguished:

Cholesterol – cholesterol content 70% or higher;

Bilirubin black pigment - consist predominantly of calcium bilirubinate without cholesterol;

Bilirubin brown pigment - consist mainly of calcium bilirubinate with an admixture of cholesterol.

All stones can also be non-calcified or calcified.

Complications: obstruction of the cystic or common bile duct by a stone, acute cholecystitis and cholangitis, herniation of a stone into the lumen of the major duodenal papilla, acute biliary pancreatitis, chronic cholecystitis, perforation of the gallbladder, sepsis.

Risk factors leading to the development of gallstone disease:

Metabolic syndrome;

Pregnancy;

Rapid weight loss;

Taking estrogen-containing drugs;

Hereditary predisposition.

These factors relate to the risk of developing cholesterol stones. Diseases accompanied by hemolysis, portal hypertension in liver cirrhosis, and bile duct cysts are prone to the formation of bilirubin black and brown stones.

What symptoms indicate gallstone disease?

5–10 years from the onset of development, gallstone disease practically does not produce symptoms. As stones form, jaundice and attacks of sudden severe pain may occur - biliary (liver) colic, caused by the movement of the stone along the bile ducts.

All other symptoms are caused by concomitant diseases. The pain is cutting, stabbing in nature, and can radiate to the lower back, right shoulder blade, right forearm. In some cases, the pain radiates to the sternum, causing pain in the heart, arrhythmia and difficulty breathing.

Which specialist should I contact?

If you suspect you have gallstone disease, consult a gastroenterologist.

What diagnostics should the doctor carry out?

General examination of the patient:

Examination of the skin and sclera;

Palpation of the abdomen;

Percussion of the abdomen.

Laboratory diagnostics:

General blood test;

General urine test;

Biochemical blood test.

Instrumental diagnostics:

Survey radiography of the abdominal organs;

Computed tomography;

HIDA scintigraphy;

Endoscopic cholangiopancreatography;

Magnetic resonance cholangiopancreatography;

Endoscopic ultrasonography;

Cholecystography.

What treatment is necessary for gallstone disease?

Basics. For gallstone disease, treatment is primarily aimed at removing stones. This can be done in two ways:

Chenotherapy is carried out using drugs chenodeoxycholic and ursodeoxycholic acids, which prevent the crystallization of cholesterol, suppressing its production in the liver and reducing the concentration of cholesterol in the bile, which contributes to the gradual dissolution of stones. This method is suitable if gallstones in size do not exceed 1.5 cm. The duration of gene therapy is from 6 to 24 months with continuous use.

Minimally invasive treatment methods - extracorporeal shock wave lithotripsy helps to destroy stones using a shock wave. This procedure is used to crush stones and prepare them for subsequent gene therapy.

Surgical treatment is cholecystectomy, i.e. removal of the gallbladder. Laparoscopic cholecystectomy is more gentle than open cholecystectomy.

Spa treatment: Essentuki, Zheleznovodsk, Pyatigorsk, Truskavets, Borjomi, Belokurikha, Morshin. If there are stones in the gall bladder with a diameter of more than 0.3 cm, sanatorium treatment is contraindicated.

What can you do?

Diet. Treatment of gallstone disease will be ineffective without following a certain low-cholesterol diet.

A high calorie diet, abuse of flour products, deficiency of vegetable oils and low fiber content in the diet contribute to the formation of stones.

For gallstone disease, foods high in magnesium are beneficial. Magnesium salts have antispasmodic and anti-inflammatory effects, contract the gallbladder, and enhance intestinal motility.

It is also necessary to consume as many fiber-rich foods as possible. Fiber helps remove cholesterol from the body.

Physical activity. Outside of exacerbations of gallstone disease, physical therapy exercises are vital. They have a tonic effect on the biliary tract and gallbladder, increase the outflow of bile, and also improve blood circulation in the abdominal cavity. Exercises for the abdominal muscles will be effective in this regard. The following exercises are also recommended:

Exercise 1

Feet shoulder-width apart, raise your arms to chest level and clasp them together. Do twists in the lower back in different directions without moving your pelvis. Rotate as much as your flexibility allows.

Exercise 2

Get on all fours. As you inhale, arch your back. As you exhale, bend at the waist and look up. Repeat slowly 10 times.

Exercise 3

Lie on your back. As you inhale, round your stomach; as you exhale, draw your stomach in. Try not to move your chest as you perform the exercise.

How to live after gallbladder removal?

The liver produces bile and sends it to the gallbladder, where it accumulates and thickens and concentrates. Then, from the gallbladder, during the digestion process, the required amount of bile is thrown into the duodenum.

After removal of the gallbladder, bile begins to flow into the duodenum directly from the liver through the hepatic and common bile ducts. Therefore, the bile is less concentrated, which affects the motility of the duodenum and disrupts digestion. In addition, such liquid bile protects the duodenum less well from microbes, which leads to their proliferation and the occurrence of dysbacteriosis.

If certain rules are not followed after removal of the gallbladder, complications may develop.

Complications: cholangitis, duodenitis, esophagitis, colitis.

Diet. Since bile, after removal of the gallbladder, begins to enter the duodenum in a less concentrated form, and also due to the lack of a reservoir for its storage, it is necessary to rebuild the nutritional system.

Firstly, you should not take long breaks between meals. If you do not eat regularly, bile will begin to accumulate in the bile ducts and stretch them. Stagnation of bile in the liver can cause the formation of stones in it. Eat 6-7 times a day. It is necessary to adapt the body to life without a gallbladder, so it is recommended that you eat food every day at the same hours for at least the first 4 months after surgery.

Secondly, you need to eat in small portions, since weakly concentrated bile will not be able to cope with the digestion of large volumes of food.

Thirdly, after removal of the gallbladder, the amount of enzymes in the bile that facilitate the digestion of fats decreases. Therefore, refractory fats of animal origin should be completely excluded from the food of such patients: beef and lamb fat, lard.

Fourthly, after removal of the gallbladder, all food is prepared either by steaming, or by boiling or stewing.

From the 3rd day, mashed boiled vegetables, pureed meat and fish, grated porridge, protein omelet, pureed soups with a weak broth, and jelly are introduced into the diet.

From the 5th day, white bread baked yesterday, biscuits, crackers are added - these products cannot be consumed dry.

From the 6th day, fermented milk products are added.

From the 8th day and for 1.5–2 months, all food is consumed pureed, steamed or boiled. Do not eat hot or cold foods; food should only be eaten warm. The diet includes: herring pre-soaked in milk, fish and lean meat - in the form of meatballs, meatballs and steamed cutlets, zucchini and carrots, vegetable purees, milk porridge, cottage cheese, protein omelet, vegetarian soups, jelly, non-acidic juices, compote dried fruits

From 2 months and throughout life:

Sometimes constipation or diarrhea, as well as flatulence, may occur after gallbladder removal. This is due to the increased proliferation of microbes in the duodenum. If you have such complaints, eliminate sweets from your diet and consume probiotic products daily: kefir or yogurt with bifidobacteria and lactobacilli. Also avoid caffeinated drinks such as tea and coffee, which can make diarrhea worse. If unpleasant symptoms do not disappear, consult a gastroenterologist who can select medications to treat dysbiosis.

Physical activity. After removal of the gallbladder, your main task is to avoid stagnation of bile in the liver and bile ducts. Daily therapeutic exercises will help you with this. Two months after surgery, daily walking for 30-40 minutes is recommended.

In the first 6 months after surgery, exercises related to abdominal tension are prohibited: bending, lifting the legs and body from a lying position. Also avoid heavy lifting, digging beds, or dragging heavy objects.

Physiotherapy: ozone therapy, mineral water tubes, drinking mineral waters.

Fatty liver hepatosis

Fatty liver hepatosis (fatty degeneration, steatosis) is a liver disease in which fat accumulates in the liver cells.

Fatty liver hepatosis is the most common type of hepatosis.

Complications: steatohepatitis, cholecystitis, cholelithiasis, liver cirrhosis.

Risk factors leading to the development of fatty liver hepatosis:

Overweight;

Abuse of fatty foods, fast food;

Alcohol abuse;

Diabetes mellitus type 2;

Itsenko-Cushing syndrome;

Thyroid diseases;

Taking certain medications: tetracycline antibiotics, hormonal drugs, antidepressants;

Exposure to toxic chemicals;

Sedentary lifestyle;

Age over 45 years;

Female gender.

What symptoms indicate fatty liver hepatosis?

With fatty liver hepatosis, periodic nausea, flatulence, weakness and dizziness, headaches, and fatigue during physical activity may appear. Sometimes there is heaviness or dull aching pain in the right hypochondrium.

In 60% of cases, fatty liver hepatosis is asymptomatic for many years.

Which specialist should I contact?

The treatment of fatty liver hepatosis is carried out by a gastroenterologist.

What diagnostics should the doctor carry out?

General examination of the patient:

Palpation of the liver area.

Laboratory diagnostics:

General blood test;

General urine test;

Biochemical blood test;

Serological blood test.

Instrumental diagnostics:

Ultrasound examination of the liver;

Magnetic resonance imaging of the liver using phase contrast;

Liver elastography;

What treatment is necessary for fatty liver hepatosis?

Basics. First of all, it is necessary to eliminate the cause of the disease: lose weight, change eating habits, stop taking medications that damage the liver. For fatty liver hepatosis the following are prescribed:

Hepatoprotectors – stabilize and protect liver cell membranes;

Insulin sensitizers are drugs that increase the sensitivity of cells to insulin;

Ursodeoxycholic acid is a drug that minimizes the toxicity of bile acids and has antioxidant properties.

In most cases, with appropriate treatment, fatty liver disease is completely reversible.

What can you do?

Success in treating fatty liver disease largely depends on you.

The main reason for the development of fatty hepatosis is physical inactivity and overeating, which leads to excess weight.

Reduce weight to normal, but gradually - no more than 500 g per week;

Eliminate foods rich in carbohydrates and fats;

Eat foods rich in dietary fiber;

Add green beans and Jerusalem artichoke to your diet - these foods help lower blood sugar levels;

Drink at least 2 liters of water per day;

Walk as much as possible;

Do 40-50 minutes of moderate intensity exercise every day: exercise bike, walking, elliptical trainer, swimming.

Cirrhosis

Liver cirrhosis is a progressive liver disease characterized by the irreversible replacement of normal liver cells by connective tissue.

Depending on changes in liver tissue, cirrhosis is classified into:

Small nodular or micronodular cirrhosis of the liver - the diameter of the nodes is from 1 to 3 mm;

Large nodular or macronodular cirrhosis of the liver – the diameter of the nodes is more than 3 mm;

Incomplete septal cirrhosis of the liver – there are no regenerative nodes;

Mixed cirrhosis of the liver - different sizes of nodes.

Depending on the causes of the disease, the following forms of cirrhosis are distinguished:

Viral;

Alcoholic;

Drug;

Secondary biliary;

Congenital – for some congenital diseases;

Congestive – with circulatory failure;

Budd-Chiari disease and syndrome;

Metabolic and nutritional, in the following conditions: small intestinal bypass, obesity, severe forms of diabetes mellitus;

Liver cirrhosis of unknown etiology.

There are several stages of disease development:

Compensation stage – there are no symptoms of the disease; during diagnosis, varicose veins of the esophagus and stomach can be identified;

Subcompensation stage – the first symptoms appear, pain appears;

Stage of decompensation - liver failure appears. This stage of liver cirrhosis is life-threatening for the patient.

Complications: bleeding from dilated veins of the esophagus and stomach, jaundice, liver failure, hepatic coma, thrombosis in the portal vein system, liver cancer, hepatorenal syndrome, pneumonia, peritonitis, sepsis.

Risk factors leading to the development of liver cirrhosis:

Alcohol abuse;

Hepatitis: viral (B, C, delta, G) and autoimmune;

Metabolic disorders;

Chemical toxic substances;

Long-term use of certain medications;

Diseases of the biliary tract: cirrhosis of the liver develops 3–18 months after obstruction of the bile duct;

Long-term venous congestion of the liver: constrictive pericarditis, veno-occlusive disease, heart failure.

What symptoms indicate liver cirrhosis?

The first signs of liver cirrhosis are dull pain in the right hypochondrium, nosebleeds, weakness, increased fatigue, decreased performance and appetite, bloating, diarrhea and constipation, itching, dry skin, and increased body temperature. In the later stages of the disease, the following are observed: a yellow tint of the sclera of the eyes and skin, redness of the palms, swelling of the legs, enlargement of the abdomen due to the accumulation of fluid in its cavity, the appearance of numerous spider veins, deformation of the terminal phalanges of the fingers like “drumsticks”, enlarged milk glands in men.

Which specialist should I contact?

A gastroenterologist treats liver cirrhosis.

What diagnostics should the doctor carry out?

General examination of the patient:

Examination of the sclera of the eyes and skin for the presence of jaundice;

Palpation of the liver area;

Examine the patient for the presence of edema.

Laboratory diagnostics:

General blood test;

General urine test;

Biochemical blood test;

Coagulogram;

Determination of antibodies to chronic hepatitis viruses;

Determination of the concentration of immunoglobulins IgA, IgM, IgG in blood serum;

Determination of alpha-fetoprotein;

Study of iron metabolism indicators;

Determination of alpha-1-antitrypsin activity.

Instrumental diagnostics:

Ultrasound examination of the abdominal cavity;

Computed tomography of the abdominal cavity;

Esophagogastroduodenoscopy;

Radionuclide liver scan;

Ultrasound-guided liver biopsy.

Patients with liver cirrhosis should undergo blood tests every 3 years and undergo esophagogastroduodenoscopy every 2 years.

What treatment is needed for liver cirrhosis?

Basics. The main goal of treating liver cirrhosis is to slow the progression of the disease. For this purpose, specific therapy is performed for diseases that cause cirrhosis of the liver. For example, for hepatitis, interferon therapy is performed.

In some cases, surgery is necessary:

Mesenteric-caval anastomosis or splenorenal anastomosis - for portal hypertension;

Laparoscopic cholecystectomy – removal of the gallbladder, performed for hepatitis;

Sclerotherapy of dilated veins of the esophagus and stomach - for bleeding from varicose veins;

Liver transplantation.

Additional. Treatment of symptoms of liver cirrhosis is also used:

Antihypertensive drugs and beta-blockers for portal hypertension;

Enzyme preparations for digestive disorders;

Zinc sulfate to prevent its deficiency in the body;

Antihistamines for itchy skin.

Physiotherapy: Physiotherapy is contraindicated for liver cirrhosis.

What can you do?

Completely avoid alcohol and medications that cause liver damage.

Drugs that should not be taken for liver cirrhosis: indomethacin, ibuprofen, isoniazid, valproic acid, erythromycin, amoxicillin, ketoconazole, chlorpromazine, ezetimibe, aminoglycosides.

Diet. To improve intestinal motility and bile outflow, split meals are needed - 5-6 times a day in small portions. Eating foods rich in fiber will help remove excess cholesterol. Fried, fatty, smoked, spicy and highly salted foods are excluded. Recommended cooking methods: boiling, steaming, stewing.

Rules for swelling of the legs and accumulation of fluid in the abdominal cavity - ascites:

Eat more foods rich in potassium - dried apricots, raisins, prunes, potatoes, celery;

Limit your intake of table salt to 0.5 g per day, liquids to no more than 1.5 liters per day;

Eliminate foods containing baking soda from your diet: cakes, biscuits, cakes, pastries and regular bread;

Measure your body weight and abdominal volume daily;

Monitor the amount of liquid you take in and excrete when urinating.

Physical activity. During the course of the disease without complications, walking and swimming are useful.

Lifting weights and exercising the abdominal muscles can cause bleeding from varices in the esophagus and stomach. Therefore, these loads are contraindicated in liver cirrhosis.

If you experience sudden vomiting that looks like “coffee grounds” and loose stools that look like “raspberry jelly,” accompanied by severe weakness and dizziness, call an ambulance immediately.

Hepatitis

Hepatitis is an inflammation of the liver, mainly caused by a viral infection.

There is the following classification of hepatitis:

Infectious hepatitis:

hepatitis A;

hepatitis B;

hepatitis C;

hepatitis D;

hepatitis E;

hepatitis F;

hepatitis G;

hepatitis as a component of: yellow fever, cytomegalovirus infection, rubella, mumps, Epstein-Barr virus infection, herpes, Lassa fever, AIDS;

bacterial hepatitis: with leptospirosis, syphilis;

toxic hepatitis:

alcoholic hepatitis;

drug-induced hepatitis;

hepatitis due to poisoning by various chemicals;

radiation hepatitis;

Hepatitis as a consequence of autoimmune diseases.

Complications: biliary dyskinesia, liver cirrhosis, polyarthrosis, hemorrhagic syndrome, liver cancer, hepatic coma.

Hepatitis can be acute or chronic. In this book we will look at the most common types of hepatitis - hepatitis A, B and C.

Hepatitis A (Botkin's disease)

The virus spreads through the fecal-oral route, through unwashed hands: infection can occur through food, water, dishes, toys and other objects contaminated with feces.

What symptoms indicate hepatitis A?

After contracting the virus, symptoms appear within 1–6 weeks.

Initially, symptoms of general intoxication characteristic of a common acute respiratory viral infection appear: an increase in body temperature to 37.5–38 ° C, a feeling of weakness and malaise, sleep disturbances, loss of appetite, nausea and vomiting, chills, muscle pain. Then darkening of urine, jaundice, and discoloration of feces are noted. As a rule, during this period the initial symptoms disappear: fever, chills, nausea. Abdominal pain and itching throughout the body may occur. In some cases, hepatitis A may be asymptomatic.

Which specialist should I contact?

Hepatitis A is treated by a hepatologist or infectious disease specialist. Observation by a gastroenterologist is also necessary.

What diagnostics should the doctor carry out?

General examination of the patient:

Palpation of the liver area;

Laboratory diagnostics:

General blood test;

Biochemical blood test;

General urine test;

Enzyme immunoassay for the presence of IgM class antibodies in the blood.

Instrumental diagnostics:

What treatment is needed for hepatitis A?

With hepatitis A, the patient is hospitalized. There is no specific treatment for hepatitis A. Intravenous drip administration of drugs that relieve intoxication, intravenous drip administration of glucose, and vitamin therapy are used. In most cases, the disease does not require serious treatment. After a few months, patients recover completely.

There are vaccines against hepatitis A. Vaccination is recommended before traveling to countries with high rates of this disease: African countries, including Egypt and Tunisia, Turkey, Central Asia, India and Southeast Asia, some countries in South America and the Caribbean.

Hepatitis in

The hepatitis B virus is transmitted through biological fluids - blood, saliva, and sexual contact. Infection can occur during medical procedures, during manicures, pedicures, piercings and tattoos, dental procedures, and when using someone else's toothbrush. Infection with hepatitis B through blood transfusion is unlikely, as careful monitoring of the quality of blood for transfusions is now ensured. Drug addicts who use one syringe for several people are at risk. The hepatitis B virus remains active in dried blood for more than a week, so you can become infected with this virus by simply stepping on a needle or blade with traces of blood while walking barefoot on the ground.

What symptoms indicate hepatitis B?

Symptoms appear 2 to 6 weeks after contracting the virus.

The symptoms of hepatitis B are similar to those of hepatitis A, but are often more severe. In some cases, the disease is asymptomatic without jaundice and is manifested only by weakness and fatigue.

With chronic hepatitis, in addition to the main symptoms, bleeding gums, spider veins, weight loss, and enlarged liver and spleen appear.

Chronic hepatitis B leads to the gradual death of liver cells and the growth of connective tissue cells in place of the dead cells - liver cirrhosis.

Which specialist should I contact?

Hepatitis B is treated by a hepatologist or infectious disease specialist. Observation by a gastroenterologist is also necessary.

What diagnostics should the doctor carry out?

General examination of the patient:

Palpation of the liver area;

Examination of the eyes and skin for the presence of jaundice.

Laboratory diagnostics:

General blood test;

Biochemical blood test;

General urine test;

Enzyme immunoassay for antibodies to the HBs antigen of the hepatitis B virus.

Instrumental diagnostics:

In some cases, an ultrasound examination of the liver may be required.

What treatment is needed for hepatitis B?

Basics. The following are used in the treatment of hepatitis B:

Interferon preparations;

Nucleoside analogues;

Detoxification drugs.

For chronic hepatitis B, treatment can last from 6 months to several years.

Additional. Hormones, hepatoprotectors, immunomodulators, vitamins.

Hepatitis C

Hepatitis C is one of the most severe forms of the disease, the consequences of which are cirrhosis, liver cancer and death.

The hepatitis C virus is transmitted in the same way as the hepatitis B virus: through contaminated syringe needles, during medical procedures, during the provision of dental services, during acupuncture, piercing, tattooing, manicure and pedicure. Infection through sexual contact is unlikely, but possible.

What symptoms indicate hepatitis C?

Unlike hepatitis B, with this type of disease, fever and jaundice rarely appear. Hepatitis C is characterized by joint pain, general weakness, fatigue, mental depression, and digestive disorders. Due to the fact that the symptoms of this type of hepatitis are similar to many other diseases, and are even perceived by the patient as a temporary general malaise, hepatitis C is often detected in the later stages.

Which specialist should I contact?

Hepatitis C is treated by a hepatologist or infectious disease specialist. Observation by a gastroenterologist is also necessary.

What diagnostics should the doctor carry out?

General examination of the patient:

palpation of the liver area;

examination of the eyes and skin for the presence of jaundice.

Laboratory diagnostics:

general blood test;

biochemical blood test;

general urinalysis;

analysis for Anti-HCV-total;

polymerase chain reaction.

Instrumental diagnostics:

in some cases, an ultrasound examination of the liver may be required;

liver biopsy.

Basics. The main point of treatment for hepatitis C is combination antiviral therapy: interferon-alpha and ribavirin drugs. Recently, protease inhibitors have been used to treat hepatitis C.

During treatment, blood parameters are monitored, treatment is carried out until the parameters are completely normalized.

Additional– hepatoprotectors, immunomodulators, vitamins.

What can you do?

Diet. For all types of hepatitis, you must adhere to a strict diet during treatment and for at least 6 months after recovery. Small meals 5–6 times a day are recommended. Food is steamed or boiled. Before consumption, food is wiped.

Physical activity. In case of hepatitis, intense physical activity is contraindicated: active sports games, running, aerobics. Lifting heavy objects is also prohibited. Low intensity exercise is recommended: walking, therapeutic exercises, stretching exercises.

Spa treatment for chronic hepatitis: Pyatigorsk, Essentuki, Truskavets, Zheleznovodsk, Mirgorod, Arzni.

Digestive diseases- this group of diseases occupies one of the leading places among diseases of internal organs. The fact is that the digestive system is constantly influenced by various environmental factors - the nature of nutrition, working and living conditions.

In addition to structural changes in the organs of the digestive system, functional disorders may also occur. The internal digestive organs include the esophagus, stomach, intestines, liver, and pancreas. The bile ducts are also involved in digestion.

Digestive diseases are widespread. Most often, these are various inflammatory processes associated with the presence of infection or disruption of the endocrine glands. Any of these diseases in the acute stage requires immediate treatment, since when it becomes chronic, surgical intervention may be required.

Digestive diseases

Diseases of the digestive tract are distinguished by the diversity of their clinical and morphological signs.

They include independent primary diseases, which are studied by a science called gastroenterology, as well as other secondary ones, which are a manifestation of a number of diseases of an infectious and non-infectious nature, acquired or hereditary origin.

These diseases may be based on various general pathological processes, such as alteration, inflammation, hyper- and dysplastic processes, autoimmune disorders and, finally, tumors.

Descriptions of diseases of the digestive system

Causes of digestive diseases

The causes of digestive system disorders are:

Diseases of the digestive system can be caused by exogenous, endogenous, as well as genetic factors.

Exogenous

These primary causes of the disease include:

• eating dry food,
• eating very hot foods,
• abuse of various spices and spices,
• excessive alcohol consumption,
• smoking,
• consumption of poor quality food,
• lack of diet,
• hasty eating,
• defects of the human masticatory apparatus,
• uncontrolled use of medications,
• unfavorable environmental conditions.

Diseases caused by exogenous factors include gastritis and enteritis, colitis, gastric and duodenal ulcers, cholelithiasis, as well as dyskinesia and cirrhosis of the liver.

Endogenous

Secondary (or endogenous) causes of gastrointestinal diseases are diseases such as diabetes and anemia, obesity and hypovitaminosis, various kidney and lung diseases, and stress. Diseases provoked by endogenous factors are hepatitis and cholecystitis, pancreatitis and enterobiasis.

Genetic

This group includes genetic factors, as well as developmental anomalies, including malformations of the esophagus and benign tumors (both esophagus and stomach), diagnosed abnormal development of the pancreas (for example, cystic fibrosis of the pancreas itself), as well as congenital hypoplasia of the pancreas .

It should be noted that most often gastrointestinal diseases arise from a combination of both endogenous and exogenous factors.

Symptoms of digestive diseases

Symptoms of diseases of the digestive system are varied, but the main signs of the presence of the disease are always present:

• nausea;
• frequent change of stool;
• belching;
• vomit;
• flatulence;
• loss of appetite;
• fatigue;
• weight loss;
• abdominal pain of various locations;
• insomnia.

The remaining characteristic symptoms are different and depend on the type of disease. In many cases, digestive diseases are accompanied by rashes on the skin.

Diagnosis of diseases of the digestive system

Initially, if the development of diseases of the digestive system is suspected, the doctor must conduct a thorough examination of the patient. During the examination, palpation, percussion, and auscultation are practiced. It is necessary to ask in detail about the complaints and study the anamnesis.

As a rule, for diseases of this type, the patient is prescribed laboratory tests:

• general and biochemical blood tests,
• conducting a general urine test,
• stool analysis.

Radiation research methods are also widely used in the diagnostic process. An informative method is ultrasound examination of the abdominal organs, radiography, fluoroscopy with the use of contrast agents, CT, MRI.

Depending on the disease, procedures may also be prescribed to assess the condition of the internal organs of the digestive system and at the same time obtain material for a biopsy:

• colonoscopy,
• esophagogastroduodenoscopy,
• sigmoidoscopy,
• laparoscopy.

To examine the stomach, it is practiced to use functional tests that provide detailed information about the acid secretion of the stomach, its motor function, as well as the condition of the pancreas and small intestine.

Treatment of diseases of the digestive system

The treatment method is determined after diagnosis. For infectious and inflammatory pathologies, antibacterial therapy is required. The following medications are used: Ciprofloxacin, Cefazolin, Metranidazole.

To treat enzyme deficiency, the drugs “Mezim” and “Pancreatin” are used. Anti-inflammatory and antisecretory agents are also used. Surgical treatment consists of eliminating intestinal obstruction, removing stones, tumor formations, suturing an ulcer, etc.

Nutrition for diseases of the digestive system

Nutrition for diseases of the digestive system must 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 of other systems (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 regular enteral nutrition is not possible, parenteral nutrition is prescribed, that is, when the substances necessary for the body enter directly into the blood, bypassing the digestive system. Indications for the use of this diet 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 body's daily needs.

Prevention of digestive diseases

The main and most important prevention of diseases of the digestive system, and not only them, is maintaining a healthy lifestyle.

This includes giving up bad habits (smoking, alcohol, etc.), regular physical exercise, avoiding physical inactivity (lead an active lifestyle), adherence to work and rest schedules, adequate sleep, and more.

It is very important to have a complete, balanced, regular diet, which ensures that the body receives the necessary substances (proteins, fats, carbohydrates, minerals, trace elements, vitamins), and monitoring the body mass index.

Preventative measures also include annual medical examinations, even if there is no concern. After 40 years, it is recommended to conduct an annual ultrasound examination of the abdominal organs and esophagogastroduodenoscopy.

And in no case should the disease be allowed to progress; if symptoms appear, consult a doctor, and not self-medicate or only traditional medicine.

Questions and answers on the topic "Diseases of the digestive system"

Question:I eat, go to bed and a bitterness appears in my throat and mouth.

Answer: Bitterness in the mouth and throat is considered a manifestation of many diseases of various types: from otolaryngological and dental pathologies to disorders of the digestive tract. The most likely cause of the feeling of bitterness in the throat is a disruption in the functioning of the biliary tract. You need a face-to-face consultation with a doctor for examination.

Question:Hello! I am 52 years old. Somewhere in 2000, I was examined by a doctor, diagnosed with gastritis and hiatal hernia, pancreatitis, cholecystitis, in general, a whole bunch of diseases. There were stones in the gall bladder. She took various medications, herbal decoctions, and then stopped her treatment. But for many years I have been tormented by heartburn, there are pains in the stomach and liver. I take various medications for heartburn, and for a year, after every meal, I feel heaviness in my stomach and after a while I constantly feel sleepy and have frequent heartburn again. I almost always save myself only with antacids. Please tell me why I start to feel sleepy after eating and whether frequent use of Rennie and Almagel A is harmful?

Answer: First of all, you need to decide on gallstones. If they are present, all your problems will only get worse. An examination by a gastroenterologist is necessary.

Gastroenterology

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Gastroenterology– a special discipline that studies the structure, physiology and pathology of the digestive system, as well as issues of prevention, diagnosis and treatment of diseases of the digestive system. Within gastroenterology there are narrower sections: for example, liver and gall bladder diseases are studied by hepatology, pathology of the large intestine and pararectal space - proctology. The normal functioning of the gastrointestinal tract is greatly influenced by the state of the endocrine system, oral cavity, and the presence of infectious agents in the body.

The digestive system includes a collection of many organs and glands that provide the nutrients the body needs for development and functioning. It permeates almost the entire body, starting with the oral cavity and ending with the rectum. Therefore, the pathology of even one of the digestive organs entails a disorder in the functioning of the digestive system as a whole. Modern ecology, stress, new foods and additives, as well as medications cause the occurrence or exacerbation of diseases of the gastrointestinal tract.

Ulcers of the stomach and duodenum, cholelithiasis, ulcerative colitis. A serious problem in modern society is intestinal dysbiosis, which occurs in the vast majority of people, including newborns.

Diseases of the stomach, pancreas, and intestines are often the root cause of many skin and metabolic diseases. The symptoms of diseases of the digestive system are very diverse and depend on the affected organ. Common manifestations include loss of appetite, abdominal pain, belching, heartburn, nausea, vomiting, flatulence, stool disorder, weakness, weight loss.

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

The digestive system begins with the oral cavity, followed by the pharynx, then the esophagus, and finally the core 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 of initial food processing 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 mucous membrane. The respiratory and digestive tracts intersect in it, the activity of which must be clearly regulated by the body (it’s not for nothing that they say when a person chokes that food has gone “down the wrong throat”).

Esophagus It 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 in which there are special glands that produce a secretion that moistens food as it passes through the esophagus into the stomach. The total length of the esophagus is about 25 cm. In a calm state, 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 approximately 1 to 1.5 liters. It performs a number of important functions, which include: direct 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, or rather, the intensive process of its digestion begins.

The main components of gastric juice are: enzymes, hydrochloric acid and mucus. Solid food that enters the stomach can remain in it for up to 5 hours, liquid for 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 folded together (hence its name). It connects directly to the stomach. Here, in the duodenum, bile from the gallbladder and pancreatic juice enter. The walls of the duodenum also contain a fairly large number of glands that produce an alkaline secretion rich in mucus, which protects the duodenum from the effects of acidic gastric juice entering it.

Small intestine, In addition to the duodenum, it also unites the jejunum and ileum. The small intestine as a whole is approximately 5–6 m long. Almost all basic digestive processes (digestion of food and its absorption) take place in the small intestine. On the inside of the small intestine there are finger-like projections, due to which its surface increases significantly. In humans, the digestive process ends in the small intestine, which is also lined with a mucous membrane very rich in glands that secrete intestinal juice, which contains a fairly large number of enzymes. Enzymes in intestinal juice complete the process of breaking down proteins, fats and carbohydrates. The mass located in the small intestine is mixed due to peristalsis. The food gruel slowly moves through the small intestine, entering the large intestine in small portions.

Colon about twice as thick as a thin one. It consists of the cecum with a vermiform appendix, the colon and rectum. Here, in the large intestine, the remains of undigested food accumulate, and digestion processes are practically absent. Two main processes occur in the large intestine: the absorption of water and the formation of feces. The rectum serves as a place for the 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 extension of the cecum, about 7-10 cm long. Its functions, as well as the causes of its inflammation, are still not clearly clear to 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 correctly its individual organs are structured, could not work without certain substances - enzymes, which are produced in the body by special glands. The triggering mechanisms 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 digestion process is aimed at substances such as proteins, fats and carbohydrates, and minerals, water and vitamins are absorbed almost unchanged.

To break down 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 the glands 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 quite a lot of cells that produce digestive enzymes in the pancreas. They form special clusters from which small excretory ducts extend; Secreted pancreatic juice moves along them, which is a kind of cocktail of different enzymes.

The glands of the small intestine, where most of the food is digested, are also important.

Digestive system diseases

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

The most common causes of gastrointestinal diseases are infectious pathogens, as well as poor nutrition. For example, gastrointestinal diseases are often caused by bacteria: salmonella, staphylococcus, shigella, which enter the body with poor-quality food. Pathogens such as amoebas, 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, flour foods leads to overload of the digestive system. In addition, food eaten while running 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 more precisely, psycho-emotional state has a direct impact on the functioning of all organs and systems of the body. For example, a stressful situation at work or a scandal at home can cause abdominal pain and the recurrence of a peptic ulcer. We should not forget 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; can be acute or chronic. Acute gastritis develops as a result of excessive consumption of alcoholic beverages or other foods that irritate or corrode the mucous membrane. It is accompanied by sharp pain 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 is diarrhea or constipation, and bloating.

Chronic gastritis does not develop immediately (unlike acute gastritis): over a certain period of time, processes occur that lead to disruption of the cells of the gastric mucosa, the secretion of gastric juice, and motor activity. Chronic gastritis often occurs in heavy smokers. In recent years, evidence has emerged confirming the infectious nature of gastritis. The cause of chronic gastritis is called Helicobacter.

Chronic gastritis, which is essentially an inflammatory disease, bears little resemblance to the usual types of inflammation. In chronic gastritis, the normal restoration of cells in the mucous membrane 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 abdominal pain. 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 experience 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, and bitter belching. With chronic gastroduodenitis, a person may experience a state of lethargy, general malaise, weakness, sweating, rumbling in the stomach, and dizziness 2-3 hours after eating. These symptoms are associated with disruption of the sensory nerve endings located in the inflamed mucous membrane of the duodenum.

Diarrhea (diarrhea)(from gr. diarrheo- expire) is a disorder of intestinal function, accompanied by frequent bowel movements, in which the stool has a soft or liquid consistency. Diarrhea cannot be classified as a disease; most often it is a symptom of some 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 abusing 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. Acute diarrhea, which occurs in stressful situations, fear, excitement (the so-called “bear disease”) or with intolerance to any food. This type of diarrhea does not last long, is harmless and often goes away on its own. Road diarrhea can last from several hours to several days. It affects travelers and tourists, especially during their stay in Southern Europe, Africa, Asia and Latin America. The cause of this disease is a change in climate, food, consumption of cold drinks and ice cream. With chronic diarrhea, loose stools are repeated over a long period of time. The causes of this disease may be inflammatory processes occurring in the large or small intestine, or certain types of foods. 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 observed. Such diarrhea is often observed with dysentery, cholera, and typhoid fever.

Dysbacteriosis– a syndrome characterized by a violation of the mobile balance of the microflora populating the intestines. With dysbacteriosis in the intestine, the number of putrefactive or fermentative bacteria increases, mainly Candida. Opportunistic microorganisms begin to actively multiply.

With dysbacteriosis, appetite decreases; there may be an unpleasant taste in the mouth, nausea, flatulence, diarrhea or constipation; feces have a sharp putrid or sour odor; signs of general intoxication are often observed. It is believed that the cause of dysbacteriosis is, first of all, a disruption of the digestive processes, as well as prolonged and uncontrolled use of antibiotics that suppress normal microflora.

Dyskinesia of the digestive tract– a functional disease, manifested by a violation of the tone and peristalsis of the digestive organs that have 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 bending over and in a lying position. In addition, there is chest pain associated with swallowing, as well as a feeling of heaviness in the stomach, brief abdominal pain.

Constipation is a condition in which bowel movements are rare or the stool 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 accompanied by painful phenomena. Constipation can be acute or chronic.

Acute constipation occurs when a person is temporarily unable to have a bowel movement every day. This phenomenon is observed, for example, when changing place of residence (especially if climatic and, accordingly, food conditions change significantly), as well as with 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 cannot empty his or her bowels normally every day for a long time, then in this case they speak of chronic constipation. Chronic constipation is characterized by a feeling of fullness in the stomach, loss of appetite, abdominal and back pain, headaches, fatigue and lethargy. The skin takes on an unhealthy, earthy-gray hue, and a skin rash may appear on the back and face. Chronic constipation can also be caused by poor nutrition, leading to intestinal overload; psycho-emotional state; alcohol abuse. Constipation is often observed in women during pregnancy.

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

Colitis(from gr. kolon- colon) - inflammatory disease of the colon. With colitis, severe intestinal spasms and pain in the intestinal area often occur, accompanied by diarrhea, sometimes mixed with blood and mucus. Colitis can have an acute form, but most often its chronic form develops. The causes of this disease are: prolonged stress, disorders of the immune system, consumption of unbalanced food, change of 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 with amoebas or any bacteria. Then they talk about infectious colitis.

Pancreatitis(from gr. pancreas– pancreas) – inflammation of the pancreas; can be acute or 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 is no severe pain, but the result of chronic pancreatitis can be the development of diabetes mellitus. The causes of this disease are not fully understood, but many experts consider the presence of gallstones, as well as alcohol abuse, as such.

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 gastric contents entering the respiratory tract, hoarseness and a barking cough may appear in the morning. Complications of esophagitis include bleeding, narrowing of the esophageal canal, and ulceration of the esophagus.

The causes of esophagitis can be divided into two groups: external and internal. External causes include the entry of a sharp object into the esophagus, such as a fish bone; 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 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 esophageal mucosa 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 humans. Sometimes the patient experiences significant fluid loss. Basically, enteritis is infectious in nature as a result of the entry of certain viruses or bacteria into the human body. In addition, enteritis can be caused by radiation exposure (X-rays or radioactive isotopes).

Duodenal ulcer– an ulcer resulting from the action of acid and pepsin on the mucous membrane. This disease usually 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 and weakness.

Gastric ulcer develops under the influence of acid, pepsin and bile on the mucous membrane of the stomach wall. At the same time, acid secretion in the stomach does not increase. The main symptoms of a stomach ulcer are vomiting and pain in the upper abdomen soon after eating; Often a complication such as gastric bleeding can develop.

Allowed and prohibited foods for gastrointestinal diseases

Information on permitted and prohibited products for diseases of the gastrointestinal tract is given in table. 1.

Table 1