The network of neurons in the gut is so extensive that it is often called the “second brain” or the enteric nervous system. It consists of interconnected nerve ganglia in the intestinal wall and contains more than 100,000,000 neurons1, which exceeds the number in the spinal cord.
The enteric nervous system, like the brain, uses about 30 biologically active chemicals to transmit information between cells; 90% of the body's serotonin is located in the intestines2. Serotonin is one of the chemical messengers through which nerve cells “communicate” with each other; it serves as a “transmitter” in the interaction between the intestines and the brain, as well as a regulator of intestinal motility. Thus, the intestinal and central nervous systems are similar in structure and function and are in constant interaction1.
Nervous system of the intestine - why is it needed?
The “second brain” is not the birthplace of conscious thought or decision making. Philosophy and poetry are left to the brain, but the function of the enteric nervous system is no less important. It has long been known to control digestion1. The breakdown of food, the absorption of nutrients, and the removal of undigested particles require proper rhythmic muscle contractions that move food evenly down the gastrointestinal tract. And the nervous system regulates complex intestinal motility.
The intestinal system is connected through the vagus nerve to the brain. Most of the vagus nerve fibers carry information from the gut to the brain1. This means that everyday emotional states can affect the gut. When your stomach cramps or “bear sickness” takes you by surprise, this may be an example of the manifestation of such a physiological reaction to acute stress.
Peristalsis of the fallopian tubes [edit | edit code ]
The fallopian tubes are hollow tubular anatomical structures 10-12 cm long. The muscular lining of the fallopian tubes consists of two layers of smooth muscle: the inner - circular and the outer - longitudinal. The lining of the fallopian tube has the ability to perform peristaltic contractions directed from the ampulla of the fallopian tube to the uterus. The magnitude of peristalsis is greater at the time of ovulation and at the beginning of the luteal phase of the menstrual cycle. Thanks to peristalsis of the fallopian tubes (and vibrations of the cilia of epithelial cells), the egg moves along the fallopian tube towards the uterus. [8]
How does chronic stress affect the immune system (and gut)?
With prolonged stress, the situation changes: there is a prolonged release of chemical signal transmitters in the brain structures (hypothalamus and pituitary gland), as well as the release of cortisol by the adrenal glands. This causes suppression of the immune system and disruption of the function of one of its important components - T-cells (T-lymphocytes)3. They secrete fewer biologically active substances and as a result, not only a decrease in immunity occurs, but also a violation of the motility of the stomach and intestines. This type of response is similar to the changes that occur during chronic infections3. Also, with chronic stress, the brain sends constant messages to organs, including the intestines, that something has gone wrong.
Treatment of peristalsis disorders
Treatment of gastric motility must necessarily be comprehensive, which, in addition to medications that improve peristalsis, is carried out with mandatory adherence to a diet in the diet.
Diet
For successful treatment, a necessary condition is adherence to the daily regimen:
- eating 5-6 times a day with short intervals between them;
- small portions, one-time consumption of food products in a volume of no more than 200 grams;
- stop eating three hours before bedtime;
- steaming or stewing food;
- dishes in the diet are presented in the form of pureed soups, slimy porridges, chopped dietary meat of chicken, turkey, rabbit;
- exclude the consumption of certain foods, such as peas, beans, lentils, cabbage, grapes, raisins, which contribute to increased gas formation in the stomach;
- daily consumption of fermented milk products;
- water ration consumption is about 1.5-2 liters of liquid.
After clarifying the diagnosis and establishing the cause of disturbances in the motor function of the stomach, medications are prescribed to improve the motility of the digestive organ.
Why does the intestine become irritable?
Irritable bowel is the result of abnormal movements of the muscle walls of the gastrointestinal tract, increased sensitivity to pain, and complex interactions between the brain and the gastrointestinal tract.
The main risk factors for this condition are stress; unhealthy diet (abuse of fast food, alcohol), excessive bacterial growth in the small intestine, previous viral or bacterial intestinal infections (infectious gastroenteritis), smoking, and a sedentary lifestyle also play a role.
The term “irritable bowel” refers to a functional disorder (improper bowel function) that results in a range of symptoms. They can vary in severity, from almost imperceptible to significant. Worldwide, 15% of people suffer from this problem, and 25% of them are severe, with symptoms that interfere with daily life9.
The most common symptoms are cramping or stabbing pain in the abdomen (they usually decrease after going to the toilet and intensify before eating), excessive gas formation, bloating, changes in the shape of the stool, alternating periods of diarrhea and constipation. These signs often intensify against a background of anxiety.
Impaired bowel movement
⇐ PreviousPage 11 of 12Next ⇒The motor activity of the small intestine ensures the mixing of food contents with digestive secretions, the advancement of chyme and an increase in intraintestinal pressure, which facilitates the filtration of certain components into the blood and lymph.
Disorders of intestinal motor function are manifested in the acceleration or deceleration of peristalsis and the alternation of these processes, as well as in the disruption of rhythmic segmentation, which occurs due to the predominantly circular layer of muscles and
pendulum-like contractions that ensure the interaction of the longitudinal and circular layers of muscles. Normally, several peristaltic waves move simultaneously along the length of the intestine. In cases of intestinal motor activity disorders, antiperistaltic contractions are observed when the wave of movement goes in the opposite (oral) direction. Tonic contractions can have a very low speed and sometimes do not spread, which causes a narrowing of the intestinal lumen over a large area.
Motor activity of the intestines is excited through parasympathetic nerve fibers. The important role of the cerebral cortex in the regulation of motor skills is proven by the fact that motor skills are enhanced even when thinking about tasty food, and with a negative attitude towards food, on the contrary, they are inhibited. With fear, violent intestinal peristalsis (“nervous diarrhea”) is sometimes observed. The motility of the small intestine depends on the physical and chemical properties of chyme. Thus, rough foods (brown bread, vegetables) and fats increase its activity. A number of humoral substances also influence intestinal motility, acting directly on muscle fibers and through receptors on neurons of the intramural nerve ganglia. Thus, increased motility of the small intestine is observed with an increase in the level of vasopressin, bradykinin, serotonin, histamine, cholinomimetics, cholecystokinin - pancreozymin and peptides (motilin, gastrin). Usually the basic empirical rhythm is constant - about 8 contractions per minute. However, in a number of cases it is more frequent, for example with thyrotoxicosis.
Inhibition of intestinal motor activity occurs under the influence of sympathetic fibers. Motor activity decreases during fasting. In humans, after 24-36 hours of fasting, it is 34% of the original.
The motor function of the small intestine plays an important role in the efficiency of absorption of nutrients from its lumen. Thanks to the contractile function of the intestine, mixing and movement of contents into the intestinal cavity occurs, which does not allow the formation of a high concentration of hydrolysis products in one parietal layer, creating a diffusion barrier. It has been proven under experimental conditions that with a high rate of transit of chyme through the intestine, its absorption capacity decreases. For example, this happens when coarse fiber products are included in the diet. The blood glucose level becomes 2 times less than with a diet without coarse fiber.
Acceleration of peristalsis. As a result of accelerated peristalsis, food gruel moves through the intestines faster and diarrhea .
Diarrhea can be acute (does not exceed 2-3 weeks) and chronic (lasts 4-6 weeks or more), infectious and non-infectious, inflammatory and non-inflammatory. According to the mechanism of development, the following types of diarrhea are distinguished: hypersecretory (hyperexudative) and hyperosmolar, hypo- and hyperkinetic.
Hypersecretory type of diarrhea
characterized by increased secretion of water and electrolytes into the intestinal lumen. This is due to the effect on the intestinal mucosa of bacterial endotoxins (cholera, intestinal infections), bile and fatty acids, glucagon, prostaglandins and a number of laxatives (bisacodyl, castor oil, phenolphthalein). The pathogenesis of bacterial diarrhea is due to two mechanisms: bacterial invasion of the mucous membrane and hypersecretion caused by enterotoxins. Hypersecretory diarrhea is also observed with an increase in hydrostatic pressure due to damage to the intestinal lymphatic system (with lymphectasis, intestinal amyloidosis, lymphoma, Whipple's disease) and right ventricular heart failure. With this type of diarrhea, stools are usually large and watery.
Very severe diarrhea
(so-called
watery diarrhea) may be caused by excess production of vasoactive intestinal polypeptide, which is normally found in the gastrointestinal tract, mainly in the wall of the small intestine.
It suppresses the secretion of hydrochloric acid, stimulates intestinal and pancreatic secretions, and increases the concentration of cAMP in the small intestinal mucosa. Vasoactive intestinal polypeptide (VIP) is produced by some tumors - ganglioneuroblastomas (more often in children) and islet tissue adenomas (not α- and not β-cell) of the pancreas - VIPomas (Werner-Morrison syndrome - “pancreatic cholera”). By acting on specific receptors of the intestinal epithelium, VIP activates adenylate cyclase and increases the level of cAMP. This causes an increase in the secretion of water and electrolytes, as a result of which profuse watery diarrhea develops (the osmotic density of the stool is close to the osmotic density of plasma). Dehydration occurs (more than 3 liters per day are lost, sometimes up to 20 liters), hypokalemia progresses (increased loss of potassium in stool), metabolic acidosis, cachexia (in the absence of steatorrhea). Due to the influence of VIP on vascular tone, some patients experience hot flashes (a feeling of heat for 2-3 minutes) with a purple coloration of the face and upper half of the body, while another part develops diabetes mellitus. An increased level of circulating VIP is detected, but this indicator has a high percentage of false-positive and false-negative results. Chronic diarrhea can be a manifestation of other endocrine tumors that produce secretion stimulants. For example, in thyroid carcinoma, diarrhea is caused by increased secretion of calcitonin and other peptides.
Diarrhea in cholera is associated with excessive cAMP production. Vibrio cholerae toxin (cholerogen), in combination with a specific receptor c1m1-ganglioside, activates adenyl cyclase, which catalyzes the formation of cAMP. Severe watery diarrhea develops. It should be noted that with cholera, the intestinal mucosa remains normal and its absorption capacity is preserved. This creates the basis for oral rehydration with solutions containing simple sugars and sodium chloride (the former stimulate the absorption of the latter).
For hyperosmolar type of diarrhea
there is a decrease in the absorption of water and electrolytes. This type of diarrhea is observed in cases of malabsorption, which is observed with celiac disease, ischemic disease of the small intestine, congenital malabsorption defects, chronic pancreatitis, pancreatic cancer, deficiency of bile acids (for example, obstructive jaundice), insufficient time of contact of chyme with the intestinal wall ( during resection of the small intestine, enteroanastomosis), etc. Polyfecal matter and steatorrhea are noted. Thus, with resection of the ileum and some diseases of the small intestine (for example, Crohn's disease), diarrhea may occur due to impaired absorption of bile acids and free fatty acids, which stimulate fluid secretion in the colon. In mild cases, only the absorption of bile acids is inhibited. In especially severe cases (resection of more than 100 cm of the terminal ileum), the absorption of both bile acids and salts is impaired, which, in turn, leads to impaired digestion and absorption of fatty acids. The latter, entering the large intestine, cause diarrhea. For other forms
steatorrhea, for example in pancreatogenic insufficiency, unabsorbed triacylglycerols reach the colon, where they are hydrolyzed by microorganisms to fatty acids, which also causes diarrhea.
Hypo- and hyperkinetic types of diarrhea
caused by stimulation: neurogenic, for example in irritable bowel syndrome, diabetic enteropathy; hormonal (serotonin, secretin, pancreozymin); pharmacological (laxatives - isophenine, phenolphthalein). It is possible to slow down the transit of intestinal contents with scleroderma and cecal syndrome. The stool is usually liquid or pasty, not abundant.
Slowing down peristalsis. When peristalsis slows down, the movement of food chyme through the intestines is inhibited, and constipation (obstipatio).
With constipation, the intervals between bowel movements increase compared to the individual physiological norm or the intestines are systematically insufficiently emptied. The frequency of stool is very variable and can change depending on the habit of emptying the intestines after a certain time, the nature of the diet, climatic and other factors. Most people have stool once a day, some - 2 times, and a much smaller percentage (7%) - 3 times a day or more. Typically, chronic delay of bowel movement for more than 48 hours is considered constipation.
The terminal section of the alimentary tract, carrying out the absorption of water and mineral salts, takes part in the regulation of water-salt metabolism. The main functions of the colon (formation, promotion, retention and ejection of feces) are realized through the interaction of the following components of motility - the tone of the intestinal wall, peristaltic waves of varying strength and length, their coordination and discoordination. The motor activity of the colon is influenced by nervous, endocrine, physical and nutritional factors. In addition, the participation in the regulation of microflora motility and the emotional and mental sphere of a person is characteristic.
The classification of A.V. most fully takes into account etiological and pathogenetic factors. Frolkis, which produces constipation: 1) nutritional; 2) neurogenic (dyskinetic, reflex), due to suppression of the urge to defecate, with organic diseases of the central nervous system; 3) hypodynamic; 4) due to inflammatory bowel diseases; 5) proctogenic; 6) mechanical
chesical; 7) due to abnormalities in the development of the colon; toxic; 9) medications; 10) endocrine; 11) due to disturbances in water-electrolyte metabolism.
Constipation can be a manifestation of mechanical obstructions in the intestines: volvulus of the sigmoid colon, diverticulitis, intussusception, hernia, tumor, scars, fecal stones, etc. Proctogenic constipation is distinguished, i.e. caused by pathological processes in the anal region of the rectum (hemorrhoids, anal fissures and perianal abscesses). They are associated with suppression of the urge to defecate due to severe pain and with spasm of the anal sphincter, which mechanically prevents the release of feces. So-called senile constipation associated with intestinal atony is possible. Disturbances in intestinal motility may also be associated with endocrine pathology. Constipation of endocrine origin includes intestinal dyskinesia in women during pregnancy, after childbirth, and during menopause. Thus, during pregnancy and after childbirth, relative hypotension of the intestinal muscles is observed, caused by hormonal changes in the woman’s body. Chronic constipation develops with hypothyroidism, which is associated with a characteristic slowdown in intestinal transit. A similar situation occurs with hypercalcemia.
Based on the nature of movement disorders, hyper- and hypokinetic constipation are distinguished. Hyperkinetic constipation occurs when spasm of the intestinal wall impedes the movement of food chyme through the intestines. Spasm often develops in areas of the intestine where increased contractions take place (Vali's sphincter, the transition of the cecum to the ascending and colon, etc.). The hyperkinetic type of constipation is possible due to poisoning with mercury, lead, sublimate, and when taking medications (iron, calcium, tranquilizers, ganglion blockers, etc.). This type of constipation may develop under the influence of emotions and psychotic states (psychogenic constipation). They arise as a reaction to unfavorable conditions for bowel movement, i.e. Negative emotions, for example, when it is necessary to perform an act of defecation in an unhygienic environment, can lead to its involuntary suppression. With repeated “inhibitions” of defecation, the urge disappears and habitual constipation develops. This type of constipation can occur under the influence of other psychogenic factors (mental stress, depression,
schizophrenia, drug addiction), and may also be associated with the influence of viscero-visceral reflexes from the stomach, pancreas, biliary tract, etc.
Changes in the volume of intestinal contents, the composition of the intestinal microflora, and gastrointestinal reflux disorder can lead to a weakening of propulsive motility, i.e. to the development of hypokinetic constipation. Quite often, constipation is caused by poor nutrition, intake of easily digestible, low-fiber foods (mechanically and chemically sparing diets). The use of chemically purified, completely water-soluble products used in space flights causes a decrease in stool frequency to once every 5-7 days, and nutritional constipation occurs. During the summer, when a lot of fruits and vegetables are consumed, the incidence of constipation decreases. The role of dietary fiber in stimulating bowel movements has been proven. Bran increases the daily amount of feces and accelerates intestinal transit. Constipation is aggravated by dry eating (drying of feces), a lack of calcium and potassium salts in the diet, and excessive digestion of food masses in the stomach, for example, with hyperchlorhydria. In addition, insufficient and untimely food intake leads to disruption of gastrointestinal reflux, stimulating large peristaltic waves. Therefore, people who neglect breakfast and eat irregularly often suffer from constipation. Hypokinetic constipation also occurs in the absence of physical exercise (with physical inactivity).
Primary motor disorders of the anorectal region and pelvic floor include congenital disorders of intestinal motility with Hirschsprung's disease, mobile cecum and sigmoid colon, and congenital splanchnoptosis. With Hirschsprung's disease, there is an anomaly in the development of the large intestine, characterized by chronic stagnation of intestinal contents, expansion of the colon with hypertrophy of its wall. The essence of the disease lies in the complete absence or deficiency of intramural nerve ganglia. Thus, ganglion cells of the Auerbach plexus are completely absent in the internal anal sphincter, rectum and sigmoid colon. The affected area of the intestine is narrowed, does not peristalt, the intestinal contents above the lesion site stagnate, and the overlying sections of the colon expand (megacolon). The intestinal wall hypertrophies, as peristalsis increases due to the need
the need to overcome the narrowed non-peristaltic area. It was found that in this area the concentrations of VIP and substance P, which normally stimulate intestinal motility, are sharply reduced. With a long affected area, the picture of intestinal obstruction increases. There is usually no stool for 3-7 days, in rare cases it is independent, for the most part - only after an enema.
Intestinal obstruction (ileus)
- obstruction of intestinal patency due to disruption of its functions or mechanical obstruction.
Intestinal obstruction can be congenital, which is caused by improper development of the intestinal tube in the prenatal period, or acquired. Acquired intestinal obstruction according to its pathogenesis is divided into mechanical, dynamic and thromboembolic.
Mechanical obstruction is associated with mechanical closure of the intestinal lumen by a tumor, fecal stones (coprostasis), helminths, foreign bodies, or due to compression of the intestine from the outside by a tumor or scar. Mechanical obstruction develops with intestinal volvulus, intussusception, strangulation of an intestinal loop in the hernial opening, or with adhesions in the abdominal cavity. The following causes are distinguished: 1) extraintestinal compression of the intestine, for example with abdominal adhesions, hernias (external and internal); 2) internal compression of the intestine (diverticulosis, cancer, regional enteritis, or Crohn's disease); 3) obstruction, for example, gallstones or intussusception.
Most often, the causes of obstruction of the small intestine are abdominal adhesions and external hernias, and the causes of obstruction of the large intestine are cancer, diverticulitis (sigmoid colon) and volvulus. Mechanical obstruction can be obstructive and strangulating. With obstructive obstruction, the intestinal lumen is closed, but blood circulation in its wall is initially not impaired; with strangulation, along with obstruction of the intestinal lumen, compression of the vessels and nerves of the mesentery occurs, which causes an extremely severe clinical picture. A rapid disruption of the nutrition of the intestinal wall leads to its necrosis. With mixed obstruction, along with blocking the intestinal lumen, gradual compression of its mesentery occurs with disruption of the blood supply to the intestinal wall.
Dynamic obstruction occurs during spasm (spastic), which can be observed in case of heavy salt poisoning
metals, diseases of the biliary tract and other abdominal organs or paralysis of the intestinal muscles (paralytic), when intestinal motility sharply weakens until it stops completely. This occurs during severe long-term abdominal surgeries and injuries.
Thromboembolic (hemostatic) intestinal obstruction develops as a result of circulatory disorders in the intestinal wall due to thrombosis (embolism) or paralysis of its vessels. Thrombosis or embolism of the intestinal arteries can be a manifestation of severe atherosclerosis, heart failure, and can complicate atrial fibrillation, implantation of artificial heart valves, or severe heart defects. Involvement of large intestinal arterial vessels in the process is also possible with systemic vasculitis.
The pathogenesis of intestinal obstruction is complex. Distension of the intestine occurs when gases and liquid contents accumulate in it proximal to the obstructed segment. The fluid accumulated in the intestine consists of saliva, gastric juice, bile and pancreatic enzymes. In the first 12-24 hours of obstruction, the motor activity of the intestine decreases, the transport of sodium and, consequently, water from the lumen of the dilated intestine into the blood slows down. After 24 hours, sodium and water accumulate in the intestinal lumen, which is accompanied by its distension and loss of fluid. Intestinal pressure increases, vomiting occurs. Strangulation occurs (blood circulation is sharply disrupted) due to pronounced stretching of the intestine proximal to the site of occlusion. Intramural blood flow is reduced so much that intestinal necrosis occurs. If its blood supply is disrupted, pathogenic bacterial flora multiplies rapidly with the subsequent development of peritonitis. A high position of the diaphragm due to intestinal bloating causes impaired pulmonary ventilation with the development of atelectasis in the lungs. The outflow of blood in the inferior vena cava system is disrupted. The loss of fluid and electrolytes by body tissues can be pronounced. As a result, dehydration and blood thickening quickly occur. The content of chlorides in the blood decreases, which, together with water, pass into the abdominal cavity, and the content of ammonia, urea and other decay products that form in the intestines and are absorbed into the blood increases. Severe intestinal autointoxication develops. Increasing hypovolemia leads to the development of acute renal failure
accuracy, shock and death of the patient. With complete obstruction, gases and feces do not pass away. Blood in the stool is rarely detected, only sometimes with the invagination form of occlusion. Fecal vomiting is possible, more often with obstruction of the small intestine than the large intestine.
There is pseudo-intestinal obstruction, which is based on severe motility disorders, which contributes to intestinal distension, abdominal pain, nausea and even vomiting. Pseudo-obstruction can be primary or secondary. In primary, or idiopathic, pseudo-obstruction, the disturbance of intestinal motility is caused by an abnormality of the sympathetic innervation or its muscular layer, and the patient does not have any systemic disease. In case of secondary pseudo-obstruction, expansion of the large and/or small intestine is associated with the involvement of the muscular layer in the process, for example, in autoimmune diseases (dermatomyositis, scleroderma, amyloidosis) or the autonomic visceral nervous system in endocrine diseases - diabetes mellitus, myxedema. Secondary pseudo-obstruction can develop in chronic diseases of the nervous system (Parkinson's disease, cerebrovascular disease), and can also be associated with the side effects of a number of medications (calcium antagonists, anticholinergics, β -blockers, psychotropic drugs, etc.).
Defecation disorders. May occur in the following situations:
1) with severe mental shocks (fear, fright), the influence of the cerebral cortex on the spinal center of defecation falls out, and in this case defecation occurs involuntarily (reflexively);
2) in case of damage n. pelvici, n. hypogastrici
defecation is disrupted because the function of the muscles involved in this act is disrupted;
3) during inflammatory processes in the rectum (with proctitis of any etiology), the sensitivity of its receptors increases and a false urge to defecate (tenesmus) occurs;
4) with injuries to the lumbosacral spinal cord, due to the shutdown of the defecation center, fecal incontinence occurs or there is no urge to defecate. In addition, due to disruption of the abdominal muscles, rectal emptying may be incomplete and constipation may occur;
5) with a decrease in muscle tone and physical activity in elderly, bedridden patients, the act of defecation is disrupted, a feeling of fullness of the rectum appears, the urge to defecate, constipation or paradoxical diarrhea develops (when liquid feces passes through distal fecal stones).
Flatulence (accumulation of gases in the intestines, bloating). A large amount of gases pass through the digestive tract of healthy people every day. Gases enter the intestines along with the inhaled air and partially diffuse from the blood. A certain amount of gases is formed in the intestines as a result of enzymatic processes and the activity of intestinal microflora. On average, about 500 cm3 of gases are formed per day. However, this may be exacerbated by aerophagia or increased gas production by intestinal bacteria. Gas formation increases with malabsorption syndrome, especially when eating foods such as beans, peas, cauliflower and cabbage, which are characterized by a high content of indigestible polysaccharides. When gases are retained in the intestines under conditions of fermentation and decay, the amount of carbon dioxide, methane, and hydrogen sulfide increases. In this case, blood circulation in the intestinal wall is disrupted, its mechano- and chemoreceptors are overstimulated. A number of reflex changes may occur: inhibition of diuresis, instability of blood pressure. Due to the high position of the diaphragm, breathing is impaired. The secretion of the digestive glands is inhibited, intestinal hypotension increases, which further aggravates flatulence. A “vicious circle” is created.
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How to avoid making a mistake with a diagnosis?
It is often difficult to distinguish “irritable bowel” from other more serious bowel diseases, such as inflammatory bowel diseases. The two conditions have similar symptoms, but they are different problems and the treatment will be different.
Diagnosis is usually made using a thorough history, laboratory and endoscopic tests. The Rome Criteria4 may also help, stating that functional impairment is most likely to occur if there is recurrent abdominal pain. It must occur on average at least once a week for the past three months and be accompanied by two or more additional symptoms: must be associated with bowel movements (going to the toilet), a change in the frequency of bowel movements, or a change in the shape or appearance of the stool.
There are several alarming symptoms that you need to pay attention to that do not occur with “irritable bowel”: this is an increase in body temperature, the appearance of blood in the stool, unmotivated weight loss, the appearance of symptoms at night, and constant severe abdominal pain. If they appear, you should consult a gastroenterologist or therapist.
How is IBS treated?
There is no etiological treatment for this condition, but there are many treatment options that can reduce or eliminate symptoms. Treatment includes dietary changes, lifestyle changes, and prescription medications.
Changes in diet and composition are the first treatments that should be recommended for the treatment of irritable bowel syndrome. In particular, there are several types of foods that often cause characteristic symptoms and signs. They should be avoided.
Why do you need yoga and the Fodmap diet?
Given the complex relationship between the gut and brain and the significant role of stress, a holistic approach is needed to treat irritable bowel disease. Of course, you need to reduce your stress levels. For example, through physical exercise, including yoga. In addition to increasing flexibility, asanas help establish a more conscious connection with the body. Muscles and ligaments send signals to the brain, causing the production of endorphins. This leads not only to muscle relaxation, but also to stabilization of the emotional background. Meditation works in a similar way. They help reduce tension in the striated and smooth muscles of the intestines and relieve general tension.
Another way to improve irritable bowel conditions is to a low FODMAP5 diet
The name comes from the first letters of the foods that should be avoided: F ermentable (fermentable or fermentable), O ligosaccharides (oligosaccharides), D isaccharides (disaccharides), Monosaccharides (monosaccharides) and P olyols (polyols).
The diet was developed in Australia and involves reducing the amount of various natural sugars and artificial sweeteners. These substances have the property of retaining water and are fermented by bacteria, during this process large amounts of methane and carbon dioxide are released, which leads to flatulence and abdominal pain. Diet means a decrease in diet:
- oligosaccharides: products based on wheat, rye, barley (bread, pastries, cereals), red beans and soybeans, peas, beets. Fruits such as peaches, persimmons, nectarines, as well as dried fruits (especially prunes), watermelons;
- disaccharides: products containing lactose, such as milk;
- monosaccharides: apples, pears, mangoes, cherries, high fructose fruit juices, corn syrup, honey;
- polyols: mushrooms, cauliflower, green peas.
The place of these products in the diet is occupied by citrus fruits, melon, passion fruit, berries, vegetables (carrots, cucumbers, cabbage, pumpkin), cereals (buckwheat, sorghum, quinoa), nuts, lean meat, fish, poultry, eggs, lactose-free, almond or rice milk, hard cheese, feta, cottage cheese.
According to a recent study, 86% of people reported improvement in their irritable bowel symptoms with the diet5. Their pain and bloating decreased, and constipation/diarrhea began to bother them less.
Physiology of motility of smooth muscle organs [edit | edit code ]
Most organs in which the process of peristaltic contractions occurs have two layers of smooth muscle in their walls, in one of them the muscle fibers are located longitudinally, in the other - circularly. The coordinated contractions of these muscles form a peristaltic wave. Smooth muscles, unlike striated muscles, contract relatively slowly. Their contractions are involuntary, that is, they cannot be controlled by consciousness. For example, the muscles of the digestive tube organs are smooth, with the exception of the “input” (striated muscles are present up to the upper third of the esophagus) and the “output” (external sphincter of the anus). Therefore, after the start of swallowing and before the act of defecation, all processes associated with the movement of food, including peristalsis, are not controlled by consciousness.
The frequencies of peristaltic waves are different in different organs (departments). They are set by special pacemakers - clusters of nerve cells, among which the leading role is played by the interstitial cells of Cajal. Pacemakers generate slow waves of transmembrane potentials. Slow waves do not cause muscle contractions, but create a potential in the muscles close to the activation threshold. When slow waves of action potentials occur on a plateau, the muscle fiber contracts.
Pacemakers thus determine the frequencies of peristaltic waves (as well as other phasic contractions). In a healthy person they are as follows (in cycles per minute): in the stomach - 2-4, in the duodenum - 10-12, in the jejunum - 9-12, in the ileum - 6-8, in the colon - about 0, 6 [1], as well as 3-4 and 6-12 [2], in the rectum - about 3, in the sphincter of Oddi - 3-6 [3].
The key to success is comprehensive treatment
To achieve results with irritable bowel, medication support is necessary. Therefore, it is advisable to take drugs that relieve spasms and coordinate the work of intestinal smooth muscles. It is important that the medicine is selective, that is, it acts specifically in the intestines, without affecting other systems of the body.
Duspatalin® 135 mg works , developed specifically for the treatment of irritable bowel 6. Duspatalin® 135 mg begins to act within 15 minutes7, helping to relieve pain and spasms. When taken over a course of 28 days8, Duspatalin® fights a complex of symptoms, eliminating pain and normalizing intestinal function.
Working only in the intestines, it acts directly on smooth muscle cells, therefore it has no systemic side effects and can be used indefinitely. The effect of the drug lasts 6 months8.
The brain and the gut are inextricably linked, and when there is a problem in the gut, it affects the functioning of the entire body. If irritable bowel disease is interfering with your life, then this is the time to think about doing yoga, a special diet, and taking medications designed specifically to treat it. Such as Duspatalin® 135 mg . With it, your intestines are calm.
Registration number RUS237535, November 05, 2021.
Increased intestinal motility
Peristalsis is nothing more than the working process of the digestive system, expressed in the promotion of food processed by the stomach due to muscle contractions of the wave-like nature of the gastrointestinal tract. During the process of digestion, a lump of food substance moves from the beginning of the upper regions of the esophagus to the anus.
Peristaltic movements are based on the moments of contraction of two-layer smooth muscles located in muscle fibers. In one of the layers it is longitudinal, in the other, circular, which forms the desired peristaltic wave.
The intensity of wave-like contractions differs depending on the part of the organ.
For example, in the small intestine there are several types of peristaltic movements, ranging from very slow muscle contractions to fast, and in some cases, even rapid rates.
The slowest site of peristalsis is the large intestine. Here the rate of muscle contractions is low, and only several times a day in the work of the organ there are moments of strong rhythmic contractions, forcing the substance to be pushed towards the anus.
The mechanism of accelerated intestinal motility
Malfunctions in the form of an accelerated rate of contractions of the intestinal muscles can occur for various reasons: characteristics of the properties of food products, malfunctions of the central nervous system, diseases of the gastrointestinal tract. Also, the reason for the acceleration of peristalsis can be the formation of a soapy environment, as a result of the combination of potassium with magnesium salts, the presence of fatty acids and other enzymes.
The rate at which digested food moves is directly dependent on the state of the receptors. The more irritated they are by the factors that are involved in this, the faster and more rhythmic the contraction of the intestinal muscles.
In some cases, a high level of peristalsis is achieved artificially to treat the gastrointestinal tract. For this purpose, a complex approach is used: a special food diet and therapeutic and preventive exercises, which force the peristalsis mechanism to work in the required mode.
What strengthens it?
The main reason for the increased work of peristalsis is the presence of fermentation in the gastrointestinal tract; it is this factor that explains the appearance of bloating, seething, gurgling, rumbling, pain in the stomach, increased flatulence, and diarrhea. An increase in the frequency of contractions of the muscles of the gastrointestinal tract affects the work of peristalsis, accelerating its work. What can provoke speed and intensification of peristalsis:
In some cases, stress or nervous tension can also provoke the intensity of muscle contractions of the gastrointestinal tract, in particular the colon and intestines.
The same reaction can be caused by plant foods in combination with other products, as a kind of protective reaction of the body, helping the body cope with the elimination of difficult-to-digest foods and toxic substances.
Symptoms of increased peristalsis
Increased peristalsis of the gastrointestinal tract is expressed in the following symptoms:
- Presence of pain in the gastrointestinal tract. Malfunctions of the intestines can be expressed in varying degrees of pain, which can manifest themselves both in the area where the organ is located and more widely. This symptom is explained by an increase in the intensity of muscle contractions, and this type of symptom can manifest itself as a result of organ diseases, food characteristics, or as a consequence of stressful situations.
- Flatulence, bloating. An increase in the speed of peristalsis can cause bloating and accumulation of gases in the abdomen.
- Fast weight gain. Digestive dysfunction as a result of weight gain is one of the symptoms of increased peristalsis.
- Frequent diarrhea. This type of symptom can manifest itself against the background of various diseases of the gastrointestinal tract.
- Bad feeling. Increased peristalsis can negatively affect the general condition in the form of weakness, fever, sweating, and malaise.
How to slow down intestinal motility
Before starting treatment for the consequences of accelerated peristalsis, it is necessary to find out the reason why this type of failure occurred.
In some cases, it is more advisable to use medications that help eliminate substances that irritate the organs.
This will normalize the work and facilitate the removal of material that can provoke inflammatory processes, reduce the frequency of stools and organize high-quality digestion of food.
In cases where the use of medicinal substances is contraindicated, experts advise using recipes taken from traditional medicine. There are a lot of different products of both industrial and plant origin, which in combination, or separately, inhibit and reduce the work of peristalsis.
Drugs
When choosing the drugs needed to slow down the contractions of the muscles of the gastrointestinal tract, experts advise paying attention first of all to the method of influence. Here it is important to accurately determine the category of medications that inhibit peristalsis:
- Enterosorbents. The simplest, most affordable and most effective is still activated carbon. When consumed, this drug neutralizes and absorbs harmful and toxic microorganisms, which are then eliminated from the body naturally. You can also note: Polysorb, Enterosgel, Polyphepan, Carbopect, Atoxil, Polifan, Neosmectin and of course Smecta.
- Pribiotics. Medicines of this type are created on the basis of special microflora containing a composition of bacteria useful in their properties. The principle of action of pribiotics is to organize the microflora necessary for normal digestion in the gastrointestinal tract, by settling the necessary bacteria, which ensure the stability of peristalsis after a certain period of time. Probiotic preparations: Bifidumbacterin, Linex, Bifiform, Lactobacterin, Baktistatin, Norbactin, Acylact and others.
- Antibacterial and antimicrobial drugs. This type of treatment involves the use of antibiotics that suppress the work of bacteria and microbes, this is especially important in cases where the presence of E. coli and other harmful microorganisms in the body is accurately diagnosed. For example: Levomycetin, Metronidazole, Alpha Normix, Enterofuril, Intetrix, Intestopan.
- Drugs that slow down peristalsis. This type of medication is designed to calm muscle contractions, especially in the colon, which in turn reduces the frequency of diarrhea. The same medications are used for chronic diarrhea or irritable bowel syndrome - Imodium, Loperamide, Stoperan, Loflatil, Lopedium.
Sources
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More: https://www.aboutibs.org/facts-about-ibs/statistics.html https://www.medicalnewstoday.com/articles/37063.php https://www.emedicinehealth.com/irritablebowelsyndrome/articleem htm#howdoyouknowifyouhaveibs-tests https://www.news-medical.net/health/Irritable-Bowel-Syndrome-(IBS)-and-Stress-Response.aspx https://s3.gi.org/patients/cgp/ pdf/ibs.pdf https://www.sciencedaily.com/releases/2017/06/170620122901.htm https://www.scientificamerican.com/article/gut-second-brain/
