In total, 23 sources were found in the city and its environs, but today 16 of them are functioning. Zheleznovodsk owes its origin as a resort to the source discovered on the southern slope of Mount Zheleznaya by doctor F.M. Gaaz with the help of the Circassian prince Izmail-Bey in 1810. Subsequently, he was named Lermontovsky, in honor of the great Russian poet, who once came here for treatment and drank this water.

Lermontov pump-room in Zheleznovodsk

Although the springs originate in different places of Mount Zheleznaya, they all have a similar chemical composition: carbonic sulphate-carbonate calcium-magnesium waters with a mineralization degree of 3.0-3.7 g / l and a carbon dioxide saturation of 0.7-1.4 g / l ... Some waters contain radon, in doses sufficient for treatment. The main difference between the mineral waters of Zheleznovodsk from each other is their temperature. According to this criterion, waters are divided into three categories: cold, warm and hot.

Cold springs include waters with temperatures below 20 degrees. These are sources such as Zavadovsky, Nelyubinsky, Nezlobinsky and Gaazovsky. They are used for drinking cures and baths.

The group of warm (weak thermal) springs includes waters with a temperature of 20 to 37 degrees. These include Vladimirsky and spring # 18, as well as # 54. These waters have a low daily flow rate, therefore they are mainly used for drinking.

But the real fame was brought to the resort by hot mineral waters with temperatures ranging from 37 to 55 degrees, which include Slavyanovskiy and Smirnovskiy springs. High temperatures are uncommon for calcium waters, but these springs are a happy exception to the rule. There is no such water anymore, not only in Russia, but also in Europe.

Slavyanovskiy source

The water temperature from this spring reaches 55 degrees, which makes it the hottest water in Zheleznovodsk. The degree of mineralization is 3.4 g / l. The daily flow rate of the Slavyanovsk spring is 250 thousand liters.

The Slavyanovskiy spring is named after its discoverer, hydrogeological engineer Nikolai Nikolaevich Slavyanov, who spent almost half of his life researching and developing the mineral springs of Zheleznovodsk. Investigating the geology of Mount Zheleznaya, the scientist concluded that it was necessary to drill a deep well to obtain large volumes of mineral water. The target for drilling was the source No. 4, with a rather low production rate, by that time developed by Jules François.

When the work began, and the well reached the usual depth for the occurrence of the Zheleznovodsk mineral waters, there was no water there. But Slavyanov's calculations turned out to be correct: in April 1914, at a depth of 120.42 meters underground, an abundant spring with a water temperature of 55 degrees was discovered, with a daily flow rate of 500 thousand liters. Slavyanov proposed to name it in honor of the director of the Geological Committee F.N. Chernyshov. However, in 1916, at the initiative of the Zheleznovodsk Medical Society, it was renamed Slavyanovsky.

The water of the Slavyanovsk spring is used for drinking cures, baths and for bottling (about 40 million bottles per year). Currently, water production is carried out from two wells: No. 69 and No. 116.

Chemical composition of water:

Slavyanovsk waters normalize the excretory and secretory functions of internal organs, enhance metabolic processes and activate regeneration processes, improve the functioning of the gastrointestinal tract and biliary tract, promote the removal of sand and small stones from the urinary system, normalize the functions of the liver and pancreas. The high temperature of the water helps dissolve mucus in the stomach, reduces or neutralizes spasms, and improves blood circulation in the stomach and intestines.

Smirnovsky source

The first Smirnovsky spring is located on the eastern slope of Mount Zheleznaya in the central part of the resort park, in a covered drinking gallery. The water temperature is 37 degrees, the daily flow rate is 10 thousand liters. It is used mainly for drinking cures.

In the same gallery there is also the Smirnovsky spring # 2, discovered by Slavyanov in 1928. Its temperature is 40 degrees, the daily flow rate is up to 7 thousand liters.

The third Smirnov spring was also brought to the drinking gallery in 1828. The water temperature is 51 degrees, it is used exclusively for drinking purposes. The depth of the well is 101.5 meters.

The source was named Smirnovsky in 1898 in honor of the sixtieth anniversary of the medical practice of Semyon Alekseevich Smirnov, who from 1862 to 1871 served as director of the KMV Resorts Administration, and in 1863 founded the Russian Balneological Society.

The history of the discovery and development of the Smirnovsky source is quite interesting. Once upon a time on the eastern slope of Mount Zheleznaya there was a swampy area with hot mineral water gushing from the ground, which was called "Gryaznushka". Such an unpoetic name was explained by the large amount of silt mud around the source, which, by the way, was often used by the locals as a bathhouse. This place was quite popular among visitors, and in 1880 a two-story wooden pavilion was even built here.

In 1866, "Gryaznushka" interested Dr. Alexei Smirnov. A thorough chemical analysis of the water was done and development of the spring began soon after. It is noteworthy that during the work on clearing the land around it, at a depth of two meters, the remains of a wooden bathtub and kitchen utensils were found, which indicates the active use of this water by the highlanders who lived here.

In 1930, the famous Kislovodsk architect P.P. Eskov built the drinking gallery of the Smirnov spring, which today is an architectural monument. The graceful building, which successfully blends into the landscape, consists of two rotundas with glass facades, connected by a suite.

Chemical composition of Smirnovskaya water:

• potassium + sodium - 0.717 g / l;
• calcium - 0.279 g / l;
• chlorine - 0.316 g / l;
• magnesium - 0.51 g / l;
• iron - 0.0052 g / l;
• hydrate - 1.347 g / l;
• sulfates - 0.887 g / l;
• dry residue - 0.29 g / l;

Mineralization - 3.601 g / l, carbon dioxide - 986 g / l.

Indications for use of Slavyanovskaya and Smirnovskaya water:

Inside the Smirnovsky spring

• diseases of the digestive system (chronic gastritis, gastric ulcer and duodenal ulcer, cholecystitis, pancreatitis, gastroduodenitis, colitis, enterocolitis, chronic hepatitis, cholelithiasis, biliary dyskinesia, liver cirrhosis in the stage of compensation, cholangitis, adhesions of the abdominal region, violation metabolism, obesity);
• respiratory diseases (chronic nonspecific bronchitis, pneumonia, tracheitis, tracheobronchitis, bronchiectasis);
• urological diseases (chronic cystitis, urolithiasis, trigonitis, chronic prostatitis, sexual disorders in men);
• gynecological diseases (chronic parametritis, abnormal position of the uterus, ovarian dysfunction, uterine hypoplasia, pelvic peritoxal adhesions, chronic inflammation of the uterine appendages, genital infantilism, infertility caused by inflammatory processes);
• ENT diseases (chronic otitis media, tonsillitis, pharyngitis, laryngitis, eustachitis, rhinitis, sinusitis, adenoiditis, acoustic neuritis).

In addition, the waters of the Slavyanovsky and Smirnovsky springs can be used for the primary prevention of diseases of the gastrointestinal tract, especially in children and adolescents. Mineral water also increases the body's immunity and resistance to unfavorable environmental factors, stress and meteorological factors. Slavyanovskaya water can also be used as a means of preventing alcoholic damage to the liver and pancreas. It helps to improve metabolism and increase the strength of the target organs of alcohol - the liver and pancreas.

The chemical elements contained in these mineral waters act as follows:

• chloride in combination with carbon dioxide increases gastric secretion;
• sulfate improves the motor function of the biliary tract;
• hydro-carbonate, carbonic and phosphoric acids maintain the constancy of the active reaction of the blood and the course of intracellular processes;
• sodium regulates vital electrochemical and biochemical processes in the body;
• calcium is one of the most important elements. Its mass in the body of an adult can reach 1200 grams. It affects the condition of teeth, bones, hair and nails, as well as the state of protoplasm: its viscosity, permeability, etc. Lack of calcium ions can cause blood to clot;
• the content of iron ions in the Slavyanovsk and Smirnovsk sources helps in the treatment of anemia and increases the resistance of the bone marrow to radiation exposure.

Contraindications for use

It should be remembered that not everyone can drink the mineral water of the Smirnovsky and Slavyanovsky springs. There are also a number of contraindications:

• acute course of the disease and all chronic diseases during an exacerbation;
• diseases of the gastrointestinal tract, accompanied by vomiting, bleeding, pain syndrome or diarrhea, especially if it intensifies during the period of drinking mineral water;
• mental disorders;
• pregnancy.

It must be emphasized that a positive result from the treatment can be obtained subject to strict adherence to the recommendations of the doctor and the sanatorium regimen. The effect of drinking cure can be significantly increased when combined with mineral baths and showers, mud therapy, terrenkuro and climatotherapy.

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How to drink mineral water.

The method of drinking cure with mineral water Slavyanovskaya ...

Not for self-medication. Consult your doctor before use!

I. Chronic diseases of the digestive system:

1.1. Peptic ulcer of the stomach and duodenum in the phase of incomplete or complete remission. In the presence of an already existing gastric ulcer and duodenal ulcer, it is preferable to prescribe mineral water intake 1 month before the expected exacerbation or 2-3 months after the exacerbation.

In the exacerbation phase, the intake of mineral water is not allowed.

In the phase of complete remission of peptic ulcer disease, in the absence of periodic exacerbations, mineral water should be taken: 3-4 times a year for at least 1 month.

1.2. Gastritis with preserved, increased or decreased acid-forming function in the phase of remission and incomplete remission of the disease.

Reception of mineral water for gastritis with preserved and increased secretion is carried out one minute before meals, temperature degrees Celsius in a dose of 3 ml per 1 kg of body weight, a course of one day; with reduced acid production - minutes before meals, degrees.

1.3. Diseases of the operated stomach (dumping syndrome; hypoglycemic; small stump syndrome, etc.). In this case, the intake of mineral water is carried out as follows: temperature, time of intake of water in relation to food are the same as in peptic ulcer disease. The only difference is that mineral water is first prescribed in a dose of 1-2 ml per 1 kg of body weight, and only after a few days (that is, in the middle of the period of drinking) the dose can be increased to 3-5 ml per 1 kg of body weight.

1.4. Liver disease (any etiology). The most effective intake of mineral water for alcoholic liver damage. In this case, the temperature of the mineral water, degrees Celsius, the usual dose of ml per 1 kg of body weight, course of days. In addition, on the day of taking alcoholic beverages, it is recommended to take about 500 ml of mineral water at night in order to avoid the risk of increased thrombus formation in the vascular system caused by the action of ethanol.

1.5. Diseases of the biliary tract of any etiology. An exception is cholelithiasis with frequent and severe attacks of biliary colic. The time of taking mineral water, its temperature and dosage are the same as for peptic ulcer disease (see paragraph 1.1.)

1.6. Diseases of the pancreas - chronic pancreatitis of any etiology (including alcoholic) in the phase of complete and incomplete remission. The dose of mineral water in this case is 3-5 ml per 1 kg of body weight, the time of admission is one minute before meals, in addition to taking it before breakfast, lunch and dinner, it is mandatory to take water at night. The duration of the intake of mineral water is usual days.

II. Metabolic diseases:

2.1. In diabetes mellitus of types 1 and 2 of a compensated and subcompensated flow, it is preferable to prescribe water of a lower temperature - no more than 20 degrees Celsius. The time of taking water - minutes before meals 3 times a day, course of days.

2.2. In case of obesity, the dose of mineral water can be increased to 6-7 ml per 1 kg of body weight, but the water temperature is not less than degrees Celsius. Water should be heated in a water bath in an uncorked bottle to allow the release of carbon dioxide.

2.3. Oxaluria, phosphaturia, gout and urine acid diathesis. Mineral water intake - 4 times a day at a dose of 4-5 ml per 1 kg of body weight, temperature, degrees, duration of days.

III. Kidney and urinary tract diseases:

3.1. Pyelonephritis of various etiologies (except for tuberculosis) without severe chronic renal failure.

3.2. Pyelitis and cystitis of various etiologies in the phase of complete and incomplete remission of the disease.

3.3. Kidney stone disease without frequent and severe attacks of renal colic.

For diseases of the nephro-urological system, it is most advisable to prescribe mineral water:

4 times a day, mince before meals at a dose of 3-5 ml per 1 kg of body weight, for a day. Water temperature ° С.

Characteristics of the mineral water 'Slavyanovskaya'

Mineral water "Slavyanovskaya" complies with GOST "Drinking water" and GOST "Mineral, drinking, medicinal and medicinal-table waters". Complies with the requirements of the World Health Organization for drinking water (WHO Geneva, 1986). In accordance with GOST, natural precipitation of mineral salts is allowed.

Mineral water "Slavyanovskaya" according to GOST refers to the type of Zheleznovodskaya, characterized as carbonic, slightly mineralized (3-4 g / l) sulphate-hydrocarbonate calcium-sodium, by appointment it is a medical dining room.

Mineralization of water is determined by the total content of chemical compounds dissolved in water, the predominant form of which is ionic in water. The main ionic composition of the Slavyanovskaya mineral water is as follows:

Hydrocarbonate НСОmg / l

Sulfate SO4 + 2 90O mg / l

Chlorine Сl - 280 mg / l

Calcium Ca +2 210 mg / l

Sodium-Potassium Na + - K + 890 mg / l

Mineralization 3-4 g / l

Indications for use:

· Chronic colitis and enterocolitis;

· Chronic diseases of the urinary tract;

• peptic ulcer of the stomach and duodenum;

· Chronic diseases of the liver and biliary tract: hepatitis, cholecystitis;

Metabolic diseases: diabetes mellitus, obesity, gout, uric acid diathesis, oxaluria, phosphaturia;

How to drink Slavyanovskaya mineral water correctly

Chronic diseases of the digestive system: peptic ulcer of the stomach and duodenal ulcer in the phase of incomplete or complete remission. In the presence of an existing peptic ulcer of the stomach and duodenal ulcer, it is preferable to prescribe mineral water intake 1 month before the expected exacerbation or 2-3 months after the exacerbation. In the phase of exacerbation of the disease, the intake of mineral water is not allowed.

Pyelonephritis of various etiologies (except for tuberculosis) without severe chronic renal failure.

Pyelitis and cystitis of various etiologies in the phase of complete and incomplete remission of the disease.

Kidney stone disease without frequent and severe attacks of renal colic.

How to drink Slavic mineral water correctly

Therapeutic diet for stomach and duodenal ulcers

An ulcer is damage or a defective change on the mucous surfaces of the stomach, which is formed as a result of an imbalance between the protective functions of the body and the aggressive effects of negative factors.

As a rule, the development of gastric ulcer is caused by the harmful effects of the bacteria Helicobacter Pylori, which is present in the human body in 80% of people. Its presence does not indicate the development of gastrointestinal diseases. The bacterium begins its destructive work in tandem with secondary factors that disrupt the functioning of the stomach and lead to excessive production of hydrochloric acid and pepsin.

What is stomach ulcer

Most often, the following accompanying factors lead to the formation of peptic ulcer:

• Heredity.
• Concomitant diseases (gastritis, cholecystitis, etc.).
• Improper nutrition.
• Alcohol abuse.
• Excessive use of drugs.
• Frequent stress and depression.

Peptic ulcer is one of the most dangerous diseases for human life, which can affect not only the mucous layers of the stomach, but also the muscle tissue of the peritoneum. With such an ailment, the use of diet therapy is inevitable, because only strict nutritional restrictions in combination with a properly developed drug treatment will improve the patient's condition and avoid the progression of stomach and intestinal ailments.

Peptic ulcer and duodenal ulcer

Symptoms of stomach and duodenal ulcers

Nutrition for gastric ulcer and duodenal ulcer should be as gentle as possible. In addition to a limited diet, the patient should be limited in physical and emotional stress, and also have to forget about smoking and drinking alcoholic beverages.

During an exacerbation of peptic ulcer disease, the diet should be as thermally and chemically safe as possible, namely:

• You can not eat food, the temperature of which is below 15 and above 60 ° C.
• You can only eat liquid and puree foods.
• We will have to abandon all products that increase the secretion of gastric juice (strong alcoholic and non-alcoholic drinks, soda, fried, baked goods made from rye flour, etc.).

What diet is required for stomach and duodenal ulcers

Diet for stomach and duodenal ulcers

As we said earlier in the article, the diet for stomach and duodenal ulcers should be as light as possible in order to ensure the use of foods that increase the symptoms of intestinal and gastrointestinal diseases.

Today, the requirements for products that can be used for peptic ulcer disease are less stringent than before the moment when there was little information about the characteristics of the disease. Now it's not a secret for anyone that one of the main reasons that increases the likelihood of an exacerbation of the disease is a violation of the diet.

In 2000, 15 different tables were used to treat gastrointestinal diseases, each of which was used for a specific disease:

• From 1 to 5 diets were used for problems in the digestive system.
• Diet No. 6 was used in case of incorrect metabolic processes.
• Diet number 7 was prescribed for patients who suffer from kidney problems, etc.

Today, a slightly modified system is used, which consists of 5 variations, within each of which all dietary tables are harmoniously distributed.

Mineral waters for peptic ulcer disease

Mineral water for stomach ulcers

Of course, ulcer patients need to drink mineral water, but there are some peculiarities: you need to know the time at which it is better to drink water, as well as know what kind of water you can drink in a particular case. During remission, patients are recommended to use Borjomi, Essentuki No. 4, Slavyanovskaya, etc., which do not contain too many minerals. As a rule, doctors can prescribe drinking water three times a day.

Please note that mineral water can cause a negative reaction in the body. After 7-14 days from the moment of the 1st use of mineral water, the intensity of the pain syndrome may increase, heartburn and belching may disturb. With such a reaction, the body will have to reduce the dosage, or even refuse to drink such water for a couple of days.

There may also be individual reactions, which can be manifested by frequent vomiting and nausea, diarrhea and other unpleasant manifestations that require a visit to the doctor.

Features of the dietary diet at different stages of stomach ulcers

Of course, the permitted foods for stomach ulcers are very limited, but this does not mean that the patient will starve and lack vitamins. Today, nutritionists have developed such diet menus, adhering to which you can eat well, varied and tasty. In order to treat stomach ulcers and duodenal ulcers as efficiently as possible, it is necessary to adhere to 3 nutritional systems at different stages of disease progression (see table below).

• Slimy liquid dishes.
• Grated porridge with the addition of milk.
• Soft-boiled eggs and steamed omelet.
• Milk products.
• Lean meats and fish.
• Kissel (only ripe, non-acidic fruits can be used).
• A little butter.

• White bread croutons (no more than 100g per day).
• Groats.
• Milk soups.
• Diet meat and fish.

• Dried wheat bread.
• Galette cookies.
• First courses of grated vegetables.
• Cottage cheese.
• Not salty hard cheeses.
• Sweet fruits and berries.
• Carrot and beet juice.

1. You need to eat at least 6 times during the day.
2. Eating food should be done by the hour.
3. The portions should not be large.
4. The daily amount of food consumed should not exceed 2.5 kg.
5. The daily salt intake is up to 6g.
6. The ratio of carbohydrates, proteins and fats should be in the form of 0g.

1. The food remains fractional.
2. The number of meals is not reduced.
3. The daily intake of food should not exceed 3 kg.
4. The amount of salt should not exceed 10 grams. per day.
5. The ratio of carbohydrates, proteins and fats should be in the form of 0g.
6. The daily fluid intake should be at least 1.5 liters.

Prohibited foods and treatment with folk remedies

Treatment of stomach ulcers with folk remedies

As you can see, the list of permitted products is not too scarce, but the restrictions on some products will still remain for such products as:

• Alcohol.
• Spices and herbs.
• Spicy sauces and dressings.
• Tsibula and garlic without heat treatment.
• Raw radish and turnip.
• Tomatoes.
• Cranberry.
• Strongly brewed coffee.
• Beans and other legumes.

Please note that the following foods can be consumed, but only in limited quantities:

• Sorrel.
• Citrus fruits (in particular kiwi, oranges, lemons).
• Too fatty dairy products (fermented baked milk, sour cream, cottage cheese).

Also, the use of folk methods, especially agave and propolis, is of great benefit, but only after consulting your doctor. Propolis from stomach and duodenal ulcers began to be used by our ancestors many centuries ago. This substance has proven itself well in getting rid of stomach inflammations, and also helps to eliminate scars on mucous surfaces.

Aloe for stomach ulcers is an equally effective folk remedy that has a wound healing and antimicrobial effect, relieves pain, restores and heals damaged areas of mucous membranes and skin. But note that folk remedies for stomach ulcers and duodenal ulcers are good only in combination with properly selected medication and diet therapy. Eat right and give up bad habits, because this is the key to a healthy intestine and stomach.

Treatment of polyps in the gallbladder without surgery

The main components of conservative treatment of polyps in the gallbladder

Treatment without surgery is based on dietary nutrition and a course of taking certain medications, the action of which is aimed at improving the outflow of bile and dissolving the formed cholesterol polyps. Treatment should be carried out under the obligatory supervision of a doctor; it is also necessary to do an ultrasound of the gallbladder several times a year (preferably in the same diagnostic room).

Diet food

For all patients with pathology of the biliary tract, dietary table No. 5 is shown. The main condition is the exclusion of almost all options for fried and fatty foods. Diet number 5 is supposed to exclude from the diet:

• fresh bread of any kind, flour products from puff and butter dough;
• fried meat and fish dishes, especially fatty varieties (goose, duck, pork), as well as offal, marinades and smoked meats;
• whole milk, fatty cottage cheese, cream, spicy and fatty cheeses;
• any options for combined fats;
• pasta, as well as dishes from pearl barley, barley, wheat groats;
• legume vegetables (any types of cabbage, garlic, spinach, sorrel, radish, turnip);
• hard and sour berries and fruits (cranberries);
• all varieties of spices and spices;
• natural coffee, carbonated drinks and cocoa.

The diet of a patient with polyps in the gallbladder should include:

• dried (so-called "evening") white bread;
• baked, boiled, steamed dishes from lean meats and fish (turkey, rabbit, chicken);
• eggs in the form of an omelet or soufflé;
• any fermented milk products (fermented baked milk, yogurt, kefir, sour cream), in a limited amount of low-fat cheeses and cottage cheese;
• porridge, soufflé, buckwheat, oatmeal and rice casseroles;
• boiled or baked vegetables from potatoes, carrots, zucchini and squash;
• any options for sweet fruits and berries (cherries, cherries, plums, strawberries, blackberries, strawberries);
• tea with lemon, but not strong, herbal teas and special choleretic teas.

It is possible that some expansion of the dietary nutrition is felt and after consultation with a doctor.

Mineral water

The possibility of polyps dissolution increases when visiting the corresponding balneological resorts with mineral water springs (Essentuki and other health resorts of the Caucasus). A positive effect is noted with a sufficiently long-term use of these waters.

Choleretic drugs

These include the time-tested and well-known to everyone since the times of the USSR, the drug "Allohol", a variety of choleretic collections of medicinal herbs, the drug "Holiver". When using these drugs for several weeks (according to the scheme), there is an increase in the synthesis of bile by hepatocytes, an increase in the rate of excretion of bile along the pathways and, accordingly, a kind of "washing out" of the formed cholesterol polyps. It is important to remember that any choleretic agent should not be taken on an empty stomach, since there is a fairly pronounced stimulation of the synthesis of all digestive enzymes.

Ursodeoxycholic acid preparations

They are one of the main agents that can dissolve cholesterol polyps in the gallbladder. This organic compound reduces the concentration of cholesterol in bile by significantly inhibiting its absorption in the intestine and stomach, as well as by reducing its synthesis in the liver tissue. By participating in a number of immunological reactions, it reduces the severity of inflammatory reactions in the liver and bile ducts. By changing the activity of enzyme systems, it reduces the concentration of toxic bile acids and reduces the absorption of their fat-soluble variants.

An important feature of the use of ursodeoxycholic acid preparations is the considerable duration of the course of treatment. Without any interruption, the capsules of this drug are taken by the patient for a long time (from 6 months to 2 years). With prolonged use, a reactive increase in the activity of hepatic enzymes is possible, which must be monitored monthly and, if necessary, reduce the dose of ursodeoxycholic acid preparations.

Statins

They have an effect not so much on cholesterol polyps in the gallbladder, but on cholesterol metabolism. Various versions of the active ingredients (atorvastatin, lovastatin, simvastatin) reduce the concentration of cholesterol in the blood, thereby reducing the likelihood of its settling on the walls of the gallbladder and the possibility of progressive growth of polyps.

Folk remedies

Some supporters of alternative medicine actively advertise infusions and decoctions of the chaga mushroom as a means of dissolving polyps in the gallbladder, but there is no scientific confirmation of this assumption to date.

With timely started conservative treatment of gallbladder polyps, a complete cure is likely.

Gastroduodenitis and pregnancy

Gastroduodenitis is characterized by inflammation of the mucous membrane of the transport section of the stomach, from where the contents are pumped into the 12-pest intestine. Pathology develops against the background of an increase in the secretion of hydrochloric acid in the stomach, a decrease in the production of gastric juice, and a disruption of the endocrine system. The disease is accompanied by severe pain in the epigastric zone, severe belching with heartburn, stool disturbance, and frequent vomiting. Such symptoms are especially dangerous during pregnancy, as they can provoke a miscarriage.

The reasons for the development of gastroduodenitis during pregnancy

If a woman is sick with a chronic form of gastroduodenitis, pregnancy acts as a provocateur of an exacerbation of the disease. At this time, the body is especially weakened and susceptible to negative endogenous and exogenous factors. Primary or external causes:

• infection with a spiral bacterium Helicobacter pylori;
• eating foods that are too hot, cold, or spicy
• special eating habits in pregnant women, for example, eating incompatible foods;
• chemical poisoning with pesticides;
• low mobility and physical activity, especially in the second half of pregnancy.

Secondary or internal causes of acute pathology are:

• excess acidity;
• decreased secretion of useful mucus;
• hormonal dysfunction of the gastrointestinal tract, leading to a decrease in secretion;
• chronic diseases of the biliary tract and liver;
• endocrine pathologies;
• fluctuations in hormonal levels due to bearing a child.

Medication treatment for gastroduodenitis during pregnancy

It is forbidden to prescribe antibiotics during the period of bearing a baby.

A medical course aimed at stopping gastroduodenitis during pregnancy should be selected taking into account the maximum benefits for the mother and child. It is forbidden to prescribe antibiotics during the period of bearing a baby, since such drugs adversely affect the development and growth of the fetus. First of all, the level of acidity in the gastric juice is regulated, the main unpleasant symptoms of the disease are removed. For this, the following drugs are used:

• antacids, which raise pH and reduce heartburn
• antispasmodic, which are designed to relieve pain during exacerbation;
• prokinetic drugs that help restore the motor function of the walls of the gastrointestinal tract, thereby relieving bouts of nausea.

If acidity is reduced during gastroduodenitis, pregnant women are prescribed:

• gastric enzymes, endowed with the ability to compensate for the lack of their own enzymes, the production of which is reduced due to the low productivity of the secretory glands located in the mucous epithelium in the stomach;
• pancreatic enzymes used to normalize digestion;
• probiotics with antagonistic properties to restore the correct microflora in the gastrointestinal tract;
• combined preparations, characterized by an integrated approach to stabilize digestion.

During the period of exacerbation, bed rest is mandatory.

Herbal treatment

Due to some bans on medications prescribed to relieve inflammation in gastroduodenitis, the effect of the therapy used may be insufficient. Therefore, pregnant women are recommended methods of traditional medicine that can relieve the patient of heartburn, nausea, vomiting, epigastric pain.

Especially popular are home remedies based on healing flowers, roots and herbs, which contain a large amount of beneficial trace elements. But one should remember about the possibility of allergic reactions from the sensitive organism of a woman in position. Therefore, the selection of therapeutic components and recipes should be in consultation with a gynecologist and a doctor treating inflammation of the gastrointestinal tract.

The first glass of mint tea should be drunk in the morning on an empty stomach.

• Mint tea. 1 tablespoon of mint per liter of boiling water is steamed in a thermos. The drink is infused for 10-12 hours. Ready tea should be drunk 4 times every 24 hours. Dosage - 200 ml before meals. The first glass should be drunk in the morning on an empty stomach.
• Healing infusion of celandine. Prepared from 300 g of a plant in a liter of alcohol. The product should be infused in a dark place for 14 days. Treatment regimen:
  • the first intake - 5 drops of the drug;
  • the second -6 drops;
  • subsequent days are added drop by drop;
  • an increase in the dose is made up to 50 drops per day; Then the countdown is carried out in the reverse order, up to 5 drops.
• Tea made from a mixture of medicinal herbs. In equal quantities (1 tablespoon each), leaves of plantain, nettle, St. John's wort, chamomile flowers are mixed. 2 large spoons of the resulting collection are poured with 0.5 liters of boiling water and kept for 10-12 hours in a dark place. Tea should be drunk 150 ml 3 times in 24 aca for 30 days.
• Herbal collection. From a mixture of powdered calamus root and orange peel, centaury with wormwood, taken 50 g each, take 100 g of the collection and steam it in 0.5 liters of boiling water. The infusion is kept in a thermos for 10 hours. The product should be taken 3 times a day, 100 ml.

Other treatments

Complex therapy of gastroduodenitis in pregnant women, as in other patients, includes:

• a strict diet, developed individually;
• adherence to the food intake at a specific time;
• drug treatment program;
• physiotherapy procedures;
• the use of folk recipes according to the selected scheme.

In addition to herbal infusions, at the initial stages of the inflammatory process, pregnant women are recommended to use the following formulations:

1. 500 g of viburnum berries in 3 liters of water, kept on fire until boiling. After which the remedy is infused for a day. The next day, crushed birch mushroom is added to the tincture. Two glasses are enough. The finished mixture is kept in the refrigerator for an additional 2 days. After straining, 100 ml of aloe juice, 300 g of honey are added to the composition. The tool should be drunk 200 g 3 times at knocks before meals.
2. In the chronic form of inflammation, medicinal tea is prescribed. For its preparation, rose petals, motherwort, chamomile flowers, sage, yarrow, thyme, taken in equal quantities, are used. The mixture is poured with 1.5 liters of boiling water. Tea should be drunk during the day.
3. Blackcurrant juice diluted with water in a ratio of 1: 1. You need to drink the juice in three doses per day in small sips.

Physiotherapeutic methods for treating mucosal inflammation can be selected for pregnant women, but only after consulting a gynecologist and gastroenterologist. The duration of the course is assigned in accordance with the severity of the pathology, the state of health of the expectant mother and her baby. The main methods of physiotherapy are:

• galvanization;
• electrophoresis;
• mud treatment;
• the use of ozokerite;
• magnetotherapy.

Diet therapy in pregnant women with gastroduodenitis

The diet is developed taking into account the taste preferences of the pregnant woman and the recommendations of the attending physician. Along with the observance of the correct arrangement of dishes, you need to adhere to certain rules and diet:

1. Food intake should be fractional.
2. It is recommended to increase the number of snacks up to 7 times a day.
3. It is important to provide a full breakfast and dinner.
4. Do not transfer overnight.
5. In the first days after stopping the attack, food should be semi-liquid and warm. A good start to diet therapy will be the use of slimy cereal soups, milk porridge, cottage cheese and milk.
6. On the 4th day, it is allowed to eat boiled chicken eggs, vegetables, raw or as a stew, fruits and fruit purees.
7. After a week, you can enter boiled meat and fish, steam cutlets, porridge, mashed potatoes, hard cheese and sour cream.

With an increase in acidity during a relapse of the disease, pregnant women should drink mineral water. For these purposes "Borjomi", "Smirnovskaya", "Slavyanovskaya" are suitable. At low acidity, "Essentuki", "Mirgorodskaya", "Arzni" are recommended. You need to drink 150 ml a day between three main meals. It is advisable to do this after 2 hours.

• a ban on products that irritate the mucous membranes;
• food must be boiled or steamed;
• be sure to consume large amounts of low-fat dairy products, cauliflower and berries.

The benefits of mineral waters have been known for a long time. They have been used to cure various pathologies since ancient times. This article explains how you can use mineral water to improve your health.

The mechanism of action of mineral water

The positive effect of mineral waters on the body is due to the mechanism of their action.

Once in the esophagus, these drinks immediately irritate the nerve receptors, pushing the digestive organs through the nervous system to work actively.

Moreover, it begins in the oral cavity. Receptors react to mineral water in the mouth with increased salivation. As a result, all VT organs begin to function intensively, preparing for the upcoming food processing.

The strength of the reflex effect of mineral water is directly related to the time of contact between the water and the receptors in the oral cavity.

The longer the water is in the mouth, the stronger the motor activity of the stomach and intestines will be. These features of the mechanism of action influenced the opinion of experts who recommend drinking mineral water more slowly. They drink in sips, taking breaks between them.

There is one more rule: to activate the muscular activity of the digestive organs, they drink cold water, and for relaxation - warm water. Warm water relieves spastic contractions of the intestinal wall, reduces its tone. This must be taken into account when using mineral water as a remedy for constipation.

Mineral water for spastic constipation

If a person is faced with spastic constipation, he suffers not only from the usual consequences associated with this ailment, but also from pain.

You can get rid of unpleasant sensations with the help of correctly selected mineral water.

First, you should pay attention to the level of mineralization, medium or low (no more than 8 g / l) is suitable. Gas should not be present in large quantities. In the composition, a quantitative predominance of the following ions is desirable:

• bicarbonate (to liquefy feces and reduce the permeability of cell membranes);
• sulfate (to slow down the absorption of water in the intestines, which helps the stool to become softer);
• chlorine (also helps to stop the absorption of water in the intestines, helping to thin the feces);
• sodium (for mucus removal and anti-inflammatory action);
• magnesium (for mucus removal and anti-inflammatory action);
• calcium.

Drink mineral water on an empty stomach half an hour before meals. You need to take small sips, between each of them you should take breaks. The water should be warm. The optimum temperature is around 45 ° C. It is advisable to take these healing drinks 3 times a day. They start with half a glass, gradually come to a whole glass at a time.

To combat spastic constipation, certain types of mineral water are needed: Narzan, Essentuki No. 4, Slavyanskaya, Smirnovskaya, Moskovskaya, Uglicheskaya.

If you drink such water, brought to the right temperature, then you will surely be able to achieve bowel movements, the disappearance of pain, because the intestinal muscles will relax. The main thing is to preliminarily eliminate gases from the water. To do this, you can simply stir the drink vigorously.

Mineral water for atonic constipation

If constipation is caused by a decrease in intestinal muscle function (atony), then the approach to treatment with mineral waters should be somewhat different.

First, you need medium or high mineralization (from 8 to 20 g / l). Secondly, the following ions should prevail in the composition:

The following types of water are optimal:

• Narzan type. These are either hydrocarbonate waters, or sulphate-hydrocarbonate, magnesium-calcium, or soda-Glauber waters. These drinks can have an average mineralization of 3-4 g / l. It should be consumed cold. You can get treatment with this type of input in Kislovodsk, Zheleznovodsk.
• Like Pyatigorsk. Such waters are distinguished by a complex anionic composition, salinity can be 5 - 6 g / l. You can get treatment with these thermal waters with a sodium composition in Pyatigorsk, Zheleznovodsk (Mashuk No. 5, which contains chlorides, hydrocarbons, sulfates).
• Like "Borjomi". This type includes sodium bicarbonate waters with an alkaline composition. Mineralization can be up to 10 g / l. You can be treated with both warm and cold waters. This is a widespread type of water.
• Type "Essentuki". These are chloride-hydrocarbonate-sodium healing waters. By reaction, they are alkaline-saline. Mineralization - up to 12 g / l. Some varieties may contain components such as iodine, bromine. The source of such waters is Essentuki.
• Sodium chloride type. They contain salts in an amount of 10 g / l. They increase osmotic pressure and stimulate intestinal motility. As a result, they help to overcome atonic constipation.
• Sulphate-magnesium type. Such waters, reaching the intestines, stay there for a long time. As a result, the stool becomes softer and easier to go out. This group includes "Mirgorodskaya", "Uglichnaya".

The optimum temperature for drinking the above medicinal drinks is 18 - 24 ° C. They must be taken one and a half hours before meals at least 3 times a day. The frequency can be increased up to 4 times a day. The method of reception also has its own characteristics. Drink water as quickly as possible. The throats should be made large. This method will help to activate peristalsis and get the desired result.

In order for mineral water to be beneficial, storage conditions must be observed. Bottles give a horizontal position. They are placed in a dark place where the temperature ranges from 6 to 15 ° C.

When starting the intake of mineral water for constipation, it must be remembered that the liquid must enter the body in sufficient quantities. With insufficient water intake, the needs of the body are not met. As a result, all metabolic processes are worse.

Even constipation can be the result of a lack of water in the body. Due to lack of water, edema also develops. Do not think that they are exclusively among those who do not know the measure of drinking. If there is little moisture, then the cells become "thrifty", keeping moisture inside with all their might.

Only with the full satisfaction of the body's needs for water is it possible for all processes within organs and systems to proceed normally. Outwardly, this manifests itself in the form of healthy skin, shiny hair, strong nails. Timely stool also speaks of a sufficient amount of fluid in the body.

It must be remembered that nutrients are regularly flushed out of the body along with the exiting fluid, so it is necessary to constantly replenish their reserves.

Features of mineral waters

Not every water with a mineral composition can be considered mineral water.

It must be obtained exclusively from an officially registered underground source.

The final product must meet all the declared characteristics. Features of mineralization are the basis for dividing all waters into 3 types:

• Medicinal. Their composition of mineral substances is 10 - 15 g / l. You should not use them on your own, you need to get a doctor's prescription, drink water under the constant supervision of specialists. Too many of them are not consumed, due to the excess, salt deposition in the body may begin.
• Medical dining rooms. Mineralization from 1 g / l to 10 g / l. However, such waters are not constantly drunk. After all, their composition is quite active.
• Canteens. The amount of minerals in them is extremely low - no more than 1 g / l. Therefore, they cannot harm, you can drink them as much as you want. If you choose a composition that meets the needs of the body, with the help of such a drink, you can gradually have a beneficial effect on the body.

The tips below will help you choose the most suitable mineral water. As a basis for choice, you can take the salts that are contained in the drink in the greatest amount.

1. Bicarbonate. They have a bicarbonate content of 600 mg / l. It is forbidden to take such waters for gastritis. But if there is no such disease, then they can become an excellent source of well-being for active people and even small children. Perfect for cystitis sufferers. This group includes "Arkhyz" and "Bjni".
2. Hydrocarbonate. In the composition of minerals 1000 mg / l. Such waters will help with various diseases of the liver, kidneys, pancreas, nervous system, musculoskeletal system. A prominent representative of this group is Novoterskaya Tselebnaya.
3. Sulfate. The waters of this group of minerals contain 200 mg / l. They are recommended for adults with liver diseases, can be used for constipation. Sulphate waters are contraindicated for a growing organism. After all, sulfates interfere with the normal absorption of calcium. As a result, a person may face problems with normal bone formation. Similar problems can begin in postmenopausal individuals when calcium levels drop sharply. To prevent osteoporosis from thriving, sulfate waters are ruled out. In this group "Essentuki number 20".
4. Chloride. In such waters there are 200 mg / l of minerals. They are not recommended for people with high blood pressure. At normal pressure, it is advisable to take them with pathologies of the liver, biliary tract, intestines. The waters of this group are "Aksu", "Essentuki No. 4".
5. Sodium. The amount of minerals in the waters of this group is about 200 mg / l. They are suitable for people with a tendency to constipation. They cannot be drunk for those who are recommended a low-salt diet. It is also banned for people with high blood pressure. This variety includes "Narzan" and "Smirnovskaya".
6. Sodium chloride. These combined waters contain components of chlorine (800 mg / l) and sodium (700 mg / l). This variety has a healing effect in chronic inflammatory processes in the stomach, intestines, ulcers, pancreatitis, enteritis, colitis. Among such waters, the most common water is called "Cardamom".
7. Magnesium. They contain about 50 mg / l of magnesium. If a person knows that the slightest effect on his digestive tract can result in diarrhea, it is better for him to refuse such waters. But with constipation, this is a great helper. The waters of this variety include "Narzan" and "Erinskaya".
8. Fluorine. They contain about 1 mg / l of fluorine. These waters are useful for the prevention of osteoporosis when carrying a child. If you have to drink fluoridated water, in addition to this mineral water, then it is better to refuse the fluoride variety. This group includes "Sochinskaya", "Lazarevskaya".
9. Glandular. The amount of iron in them is also about 1 mg / l. They are drunk with anemia. If a person suffers from a peptic ulcer, then glandular waters are not recommended. In this group "Polyustrovskaya" and "Marcial".
10. Sour. Carbon dioxide anhydrides in such waters can be present in rather large quantities - over 250 mg / l. They are taken for certain diseases of the stomach, accompanied by low acidity. With an ulcer, such drinks are prohibited. Sour mineral water is "Shmakovskaya".
11. Calcium. In such drinks, the amount of calcium is 150 mg / l. It is advisable to drink them for those who do not tolerate milk. There are no serious contraindications. This variety includes "Slavyanovskaya" and "Smirnovskaya" waters.

Since almost every mineral water contains a wide range of minerals, the above classification is based on the predominance of one or another substance.

It is important to remember that bottled waters do not always meet the specifications stated on the label. Therefore, for medicinal purposes, it is better to use water directly at the resorts where these waters are obtained.

Among other tips, it is important to pay attention to the possibility of boiling. It is forbidden. You cannot cook with mineral water. When boiling, many salts precipitate, so it is not known what the cooking result will be.

Regardless of the type, mineral water should be drunk with the gases that are in its composition. If they are specially removed, then the absorption of salts will undergo changes, so it cannot be guaranteed that the desired results will be achieved.

What benefits water brings to the body, you will learn from the video:

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Holders of the patent RU 2350341:

The invention relates to medicine, namely to gastroenterology. The method includes complex spa treatment by taking drinking mineral water "Essentuki No. 4", carrying out radon baths with a concentration of 1.5 kBq / l, microclysters from herbal infusion, siphon bowel lavages with mineral water "Essentuki No. 4". Additionally, they act with a pulsed electric current from the "TINER" apparatus using a spherical single-pole electrode. The electrode is placed in a contact, labile manner and acts clockwise over the skin projection of the ascending, transverse colon and descending colon. The exposure is carried out at a frequency of 30.2 Hz, until a moderately pronounced, painless vibration under the electrode is felt. The procedure is carried out for 8-18 minutes, with an increase in duration by 1 minute with each procedure. There are 10-12 procedures per course. The method normalizes the motor-evacuation function of the large intestine, improves the quality of life of patients and increases the duration of remission. 3 tab.

The invention relates to medicine, namely to gastroenterology, and can be used in the treatment of patients suffering from irritable bowel syndrome with constipation.

In the treatment of irritable bowel syndrome with constipation, medications are used (prokinetics, antispasmodics, tranquilizers, enzyme preparations, prebiotics, probiotics that have a normalizing effect on the motor function of the colon), as well as physical factors (medicinal mineral waters, radon waters, hardware physiotherapy methods - diadynamic therapy and exposure to sinusoidal modulated currents).

A known method of treating irritable bowel syndrome with constipation using diadynamic therapy. The exposure was carried out using the devices "Tonus-1", "Tonus-2", "Endomed 982". The method of applying the electrodes was longitudinal, two-electrode. One electrode (anode) was positioned in the projection of the transverse colon over the umbilicus, and the other (cathode) - in the projection of the sigmoid colon in the left iliac region. The DN current was prescribed for 1 minute, DP - 5-10 minutes. The current strength was selected until the patient showed contraction of the muscles of the anterior abdominal wall. For a course of 10-12 procedures (Shiman A.G., Shabrov A.V., Maksimov A.V. Physiotherapy of diseases of the gastrointestinal tract. - SPb., 1999. - 209 p.). The method made it possible to achieve positive dynamics of indicators of the motor-evacuation function of the large intestine, however, this effect was not sufficiently pronounced, since diadynamic currents encounter great resistance from the surface tissues, cause electrical stimulation of the striated muscles, without penetrating deep into the abdominal cavity.

To correct motility disorders in irritable bowel syndrome with constipation, CMT therapy was also used. The procedure was carried out on the apparatus "Aplipulse-4", "Aplipulse-5", "Aplipulse-6". One water-tissue compress with an area of ​​200 cm 2 was fixed in the lumbar region, the other was sequentially moved over the region of the ascending, transverse colonic, descending parts of the colon in a variable mode of operation, type of work II, modulation frequency 20-30 Hz, modulation coefficient 75- 100%, duration of messages and pauses - 4: 6, duration for each area for 5 minutes. For a course of 10-12 procedures (Vygodner E.B. Physical factors in gastroenterology. - M .: Medicine, 1987). This method also made it possible to achieve positive dynamics of indicators of the motor-evacuation function of the large intestine; however, this effect was not sufficiently pronounced, because for a full and high-quality muscle contraction, it is necessary to use more long-term parcels and pauses between them than the "Amplipulse" devices allow, which makes the implementation of the technique even more laborious.

The closest to the proposed method is the method of complex application of radon waters (with a radon concentration of 1.5 kBq / l) and drinking mineral waters of medium mineralization of the type "Essentuki No. 4" (Efimenko N.V., Osipov Yu.S., Kaisinova A.S. New medical technology "Application of radon baths in complex spa treatment of patients with irritable bowel syndrome", registration certificate No. FS-2006/347 dated December 11, 2006 - Pyatigorsk. - 2006. - 17 p.). It has been shown that the pronounced sedative, analgesic, anti-inflammatory, desensitizing effect of radon waters and the regulating effect of drinking mineral waters of medium mineralization on the motor-evacuation function of the intestine have a positive effect on the main pathological mechanisms of IBS: psychoemotional disorders and sensory-motor dysfunction.

The problem to be solved by the claimed invention is to expand the therapeutic spectrum at the resort for patients with IBS with constipation and to increase the therapeutic efficiency of the method.

The rationale for the development of the proposed method was the data on the ability of electrical impulse therapy to restore reflex excitation of the neuromuscular apparatus of the large intestine (Bogolyubov V.M., Ponomarenko G.N. General physiotherapy. - M., St. Petersburg: SLP, 1998. - 480 p. ), as a result of which in patients there is a normalization of the motor function of the intestine, the elimination or significant weakening of inflammation, pain and flatulence. The widespread prevalence, polysymptomaticity, the risk of side effects of drug therapy dictate the need to search for new effective methods of non-drug treatment for this pathology.

In connection with the above, a method is proposed for the treatment of patients with irritable bowel syndrome with constipation with the combined use of drinking mineral waters of medium mineralization, radon baths (with a radon concentration of 1.5 kBq / l) and bioregulated electro-pulse therapy from the "TINER" apparatus to the projection of the ascending and descending sections of the large intestine.

The essence of the invention lies in the fact that patients with irritable bowel syndrome with constipation are treated with a complex spa treatment, including the intake of drinking carbonic chloride-hydrocarbonate sodium mineral water of medium mineralization (6-8 g / l) "Essentuki No. 4", radon baths with a concentration of 1, 5 kBq / l No. 10, microclysters from infusion of medicinal herbs No. 10, siphon bowel lavages with carbonic chloride-hydrocarbonate sodium mineral water of medium mineralization (6-8 g / l) "Essentuki No. 4", for a course of 4 procedures, characterized in that additionally, patients are prescribed bioregulated electroimpulse therapy from the TINER apparatus, which is carried out by a pulsed electric current of low frequency, low voltage using a spherical single-pole electrode contact, labile over the skin projection of the ascending, transverse-colonic, descending parts of the colon clockwise (in the direction of peristalsis ), with a frequency of 30.2 Hz to a feeling of moderately pronounced, b painless vibration under the electrode for 8-18 minutes (with an increase in duration by 1 minute with each procedure), 10-12 daily procedures (the second electrode (passive) is placed on the patient's hand).

The choice of the frequency of exposure (30.2 Hz) is due to the phenomena of resonance in biological systems and the optimal response of smooth muscles in response to the specified frequency. An increase in the duration of exposure with each procedure prevents the body from adapting to this physical factor, thereby increasing the effectiveness of the treatment.

The method is illustrated by the following examples.

Example 1. Patient POI, 43 years old. Diagnosis: irritable bowel syndrome with constipation. Complaints about short-term attacks of intestinal colic localized in the left lower quadrant of the abdomen, pain occurred before defecation and disappeared soon after; bloating, rumbling in the stomach, increased gas production, especially in the afternoon; stool 1-2 times a week, feces of a dense consistency in the form of a sausage with a ribbed surface with a moderate amount of mucus, while the patient noted straining during the act of defecation and a feeling of incomplete emptying after it. An objective examination revealed abdominal distension, moderate pain over its entire surface. Psychoemotional disturbances in the patient manifested themselves in the form of headaches, weakness, irritability, insomnia, feeling of weakness after a night's sleep. According to psychological testing, subclinically pronounced anxiety / depression was revealed according to the hospital scale of anxiety and depression HADS - 8.7 ± 1.5 points (the norm is 4.4 ± 1.9 points). On the Beck scale, the level of depression was 19.8 ± 1.6 points (the norm was 10.4 ± 1.6 points). According to the SAN test, a decrease in well-being was noted - 2.91 ± 0.27 points (norm 5.25 ± 0.21 points), a decrease in physical and sexual activity - 3.42 ± 0.14 points (norm 5.45 ± 0, 12 points), mood indicators were also below normal - 3.44 ± 0.16 points (normal 5.55 ± 0.19 points). According to the X-ray examination of the intestine with barium passage through the large intestine, the patient was diagnosed with hypomotor dyskinesia with hypertonicity of the large intestine and left-sided colostasis. The serotonin level in the blood serum was 114 ± 31.3 ng / ml, while the norm was 186 ± 31.3 ng / ml.

Treatment: the patient received radon baths with a concentration of 1.5 kBq / l, a temperature of 36-37 ° C, an exposure of 12 minutes, every other day, for a course of treatment 12 baths, bioregulated electro-impulse therapy from the "TINER" apparatus, low voltage using a spherical unipolar electrode contact, labile over the skin projection of the ascending, transverse-colon, descending parts of the colon clockwise (in the direction of peristalsis), with a frequency of 30.2 Hz until a feeling of moderately pronounced, painless vibration under the electrode for 8-18 minutes (with an increase in duration by 1 minute with each procedure), 12 daily procedures (the second electrode (passive) is located on the patient's hand), dietary food (diet No. 5), drinking carbonic chloride-hydrocarbonate sodium mineral water of medium mineralization "Essentuki No. 4" in the amount of 3-3 , 5 ml / kg of body weight, 30 minutes before meals, 3 times a day, warm, microclysters from herbal infusion for course No. 10 and siphon flushing intestines with mineral water "Essentuki No. 4" for a course of 4 procedures.

After taking the specified complex of treatment, the patient's frequency of defecation returned to normal (once every 1-2 days), while the patient did not complain of difficulties during the act of defecation and a feeling of incomplete emptying after it; the consistency of feces returned to normal and the amount of mucus in it decreased significantly. Pains and dyspeptic symptoms, psychoemotional disorders have significantly decreased. The indicators of anxiety and depression on the hospital HADS scale were 4.4 ± 1.5 points, the level of depression on the Beck scale decreased to normal and amounted to 10.3 ± 1.2 points. SAN indicators also normalized: health - 5.17 ± 0.22 points, activity - 5.2 ± 0.19 points and mood - 5.48 ± 0.17 points. The level of serotonin in the blood serum also returned to normal and amounted to 185 ± 32.2 ng / ml. An X-ray examination showed a positive dynamics of X-ray indicators in the patient, which was reflected in the normalization of the motor-evacuation function of the large intestine: 24 hours after taking the barium mass, X-ray examination showed the contrast in the distal colon.

After complex spa treatment with bioregulated electro-impulse therapy, the patient showed an improvement in her general condition, including a decrease in constipation and pain syndromes, a significant decrease in dyspeptic symptoms, normalization of indicators of psychological testing and motor-evacuation function of the colon. After 1 year, the patient was re-examined. The clinical condition, examination and palpation data, X-ray examination, indicators of psychological testing remained practically unchanged in comparison with the state after the course of therapy.

Summary. Thus, the patient took a course of spa treatment with bioregulated electro-pulse therapy, tolerated the procedures well, and there were no negative side effects. Remission was observed within 10-11 months.

Example 2. Patient S.B.C., 39 years old. Diagnosis: irritable bowel syndrome with constipation. On receipt of a complaint of pain in the hypogastrium, which arose before bowel movements and disappeared soon after. At the same time, the patient noted a clear connection between the occurrence of pain and psychoemotional stress. The patient also complained of headaches, weakness, irritability, feeling of weakness after a night's sleep, bloating, rumbling in the abdomen, increased gas, especially in the afternoon; stools less than 3 times a week, feces of a dense consistency in the form of a sausage with a ribbed surface with a large amount of mucus, while the patient noted straining during the act of defecation and a feeling of incomplete emptying after it. An objective examination revealed abdominal distension, moderate pain over its entire surface. According to psychological testing, subclinically pronounced anxiety / depression was revealed according to the hospital scale of anxiety and depression HADS - 6.6 ± 1.4 points (the norm is 4.4 ± 1.9 points). On the Beck scale, the level of depression was 17.3 ± 1.8 points (the norm was 10.4 ± 1.6 points). According to the SAN test, a decrease in well-being was noted - 3.22 ± 0.28 points (norm 5.25 ± 0.21 points), a decrease in physical and sexual activity - 3.86 ± 0.14 points (norm 5.45 ± 0, 12 points), mood indicators were also below normal - 3.94 ± 0.15 points (normal 5.55 ± 0.19 points). According to the X-ray examination of the intestine with the passage of barium through the colon, the patient was found to have hypomotor dyskinesia with hypotonia of the colon with diffuse colostasis, while the bowel tone was lowered, the gaustra were dilated, low. The serotonin level in the blood serum was 126 ± 27.5 ng / ml, while the norm was 186 ± 31.3 ng / ml.

Treatment: the patient was prescribed: radon baths with a concentration of 1.5 kBq / l, a temperature of 36-37 ° C, an exposure of 15 minutes, every other day, for a course of 10 baths, bioregulated electro-impulse therapy from the "TINER" apparatus, low voltage using a spherical unipolar electrode contact, labile above the skin projection of the large intestine clockwise (in the direction of peristalsis), with a frequency of 30.2 Hz until a moderately pronounced, painless vibration under the electrode within 8-15 minutes (with an increase in duration by 1 minute with each procedure), 10 daily procedures (the second electrode (passive) is placed on the patient's hand), dietary food (diet No. 5), drinking carbonic chloride-hydrocarbonate sodium mineral water of medium mineralization "Essentuki No. 4" in the amount of 3-3.5 ml / kg of body weight , 30 minutes before meals, 3 times a day, warm, microclysters from the infusion of medicinal herbs for course No. 10 and siphon washing of the intestines with mineral water Essentuki No. 4 for course 3 procedures.

After taking the specified complex of treatment, the frequency of the act of defecation in the patient returned to normal (1 time per day), complaints about difficulties with the act of defecation and the feeling of incomplete emptying after it disappeared; the consistency of feces returned to normal and the amount of mucus in it decreased significantly. Pains and dyspeptic symptoms, psychoemotional disorders have significantly decreased. The indicators of psychological testing returned to normal: the level of anxiety according to the hospital scale HADS was 4.5 ± 1.6 points, the level of depression according to the Beck scale was 10.5 ± 1.3 points, the state of health was 5.21 ± 0.21 points, and the activity was 5 , 31 ± 0.17 points and mood - 5.49 ± 0.18 points. The level of serotonin in the blood serum also returned to normal and amounted to 186 ± 31.3 ng / ml. An X-ray examination showed a positive dynamics of X-ray indicators in the patient, which was reflected in the normalization of the motor-evacuation function of the large intestine: 24 hours after the intake of the barium mass, the X-ray examination showed the contrast in the distal parts of the large intestine.

After a complex spa treatment with bioregulated electrical impulse therapy, a patient showed an improvement in his general condition, including a decrease in constipation, pain, dyspeptic syndromes, normalization of indicators of psychological testing and motor-evacuation function of the large intestine. After 1 year, the patient was re-examined. The clinical condition, examination and palpation data, X-ray examination, indicators of psychological testing remained practically unchanged in comparison with the state after the course of therapy.

Summary. Thus, patient S. B.C., 39 years old, took a course of spa treatment with bioregulated electro-impulse therapy, with good tolerability of the procedures. Remission was observed within 10 months.

According to this method, 28 patients suffering from irritable bowel syndrome with constipation were treated in the gastroenterological department of the Essentuki clinic of the branch of the Federal State Institution "Pyatigorsk State Scientific Research Institute of the Federal Health Service". The control group included 20 patients with the same diagnosis.

The patients were predominantly between the ages of 20 and 55 (91.6%) with the duration of the disease from 1 to 10 years (95.8%). Of these, there were 36 women (75%), men - 12 (25%).

The clinical picture of the disease was characterized by the presence of constipation syndrome in all patients (100%), pain - in 31 (64.5%), dyspeptic - in 40 (83.3%) and psychoemotional disorders in 44 (91.7%) patients.

The obstipation syndrome was observed in 100% of patients. The frequency of defecation in 47 (97.9%) patients was less than 3 times a week. The consistency of feces according to the Bristol scale of feces in 35 (72.9%) patients had a compacted consistency in the form of a sausage with a ribbed surface (type 3), in 9 (18.7%) - in the form of a sausage, lumpy (type 2) and in 4 (8.3%) - sausage-shaped, smooth, soft (type 4). In 34 (70.8%) subjects, there was mucus in the feces. The majority of patients (41 people - 85.4%) noted difficulties in the act of defecation of varying severity: from strong straining to massage of the abdomen with hands. The feeling of incomplete emptying after the act of defecation was observed in 31 (64.6%) patients.

Pain syndrome was observed in 30 patients (62.5%) and varied in intensity from discomfort (abdominal discomfort) to short-term attacks of intestinal colic localized in the left lower quadrant of the abdomen or hypogastrium. In 23 (47.9%) patients, pain occurred before defecation and disappeared soon after. Half of all patients (25 people - 52%) noted a clear connection between the occurrence of pain and psychoemotional stress. In 11 patients (22.9%), pain occurred after eating. 12 patients (25%) could not associate the occurrence of pain syndrome with any provoking factor. Complaints of pain in the projection of the intestines were noted by the patients only during wakefulness; they were absent during sleep. An objective examination revealed bloating, moderate pain over its entire surface; in 22 (45.8%), a spasmodic sigmoid colon was palpable.

Dyspeptic symptoms in 36 (75%) patients manifested themselves in the form of heartburn and belching, nausea - in 9 (18.5%), hypersalivation - in 7 (14.6%). 42 patients (87.5%) complained of bloating, rumbling in the abdomen, increased gas production, especially in the afternoon.

Psychoemotional disorders were observed in 44 (91.7%) patients. The assessment of their severity was carried out using generally accepted psychological tests - the hospital scale of anxiety and depression HADS, the Beck depression questionnaire and the SAN method according to the scales of Well-being, Activity, Mood. The questionnaires were filled in independently, without the intervention of medical personnel. The intensity of symptoms was ranged in points, the indicators of 15 healthy people were taken as the norm. At the same time, headaches and weakness were noted in 26 (54.2%) patients with IBS, irritability - 44 (91.7%), sleep disorders - 13 (27%). According to the data of psychological testing, somatoreactive states of the neurotic level (depression) of varying severity were noted. The data of the hospital scale of anxiety and depression HADS revealed subclinical anxiety / depression in 32 (66.7%) patients 8.7 ± 1.5 points and clinically pronounced anxiety / depression in 6 (12.5%) - 9.6 ± 1 , 8 points with a norm of 4.4 ± 1.9. Evaluation of test data in 33 (60.4%) patients according to the Beck scale averaged 19.2 ± 1.8 points, while the norm was 10.4 ± 1.6. According to the SAN test, a decrease in well-being was noted in 32 (66.7% of patients (its severity was 2.88 ± 0.25 points versus 5.25 ± 0.21 in the norm). A decrease in physical and sexual activity was noted in 36 (75%) up to 3.38 ± 0.15 points (with a norm of 5.45 ± 0.12) .Mood indicators were approximately the same level (3.45 ± 0.18 points versus 5.55 ± 0.19 in the norm) in 38 (79.2%) patients with IBS with constipation.

According to the X-ray examination of the intestine with barium passage through the colon, 46 patients (95.8%) showed violations of barium passage of varying degrees, the delay in emptying was more than 48 hours or more (normally the barium mass reaches the distal end of the colon after 24 hours, and with the act of defecation, bowel emptying occurs completely). Hypomotor dyskinesia with hypertonicity of the large intestine was observed in 29 people (60%), while in 12 (25%) of them diffuse colostasis was observed (delay of the contrast mass throughout the colon), in 4 (8.3%) - right-sided colostasis (retention of contents in the proximal intestine, mainly in the caecum, ascending gut), in 6 (12.5%) - transversal colostasis (retention of barium in the transverse colonic section during emptying of the proximal and distal sections) and in 7 (14.5%) ) - left-sided colostasis (contrast mass is retained in the sigmoid and rectum). During the study, these patients showed an increase in tone - a pronounced haustrasion, narrow, high, numerous haustras. Hypomotor dyskinesia with hypotonia of the colon was diagnosed in 17 (35.4%) patients, of which 7 (14.5%) had diffuse colostasis, 3 (6.3%) had right-sided colostasis, 3 (6.3% ) - transversal colostasis and in 4 (8.3%) - left-sided colostasis. At the same time, the intestinal tone is lowered, the gaustras are expanded, low. In 4.2% (2 patients) of cases, radiological abnormalities were not detected.

The work carried out a correlation analysis between the clinical symptoms of IBS with constipation and indicators reflecting the functional state of the colon. There was a direct relationship between the severity of psychosomatic disorders, pain syndrome and impaired intestinal motor function (r = + 0.73; r = + 0.69; P<0,001).

Determination of serotonin level in blood serum was carried out in 40 patients. It is known that 90-98% of this hormone is produced by intestinal endocrine cells. In addition, intestinal argentaffinocytes, secreting serotonin, account for 60% of all endocrine cells of the gastrointestinal tract, representing the largest endocrine factory in the body (Tepperman). Serotonin plays a key role in mediating stress-limiting effects and also has a regulatory effect on inter-hormonal interactions, the functioning of the antinociceptive system, and the analgesic effect of serotonin is hundreds of times stronger than that of morphine. In our studies, a decrease in the level of serotonin in the blood serum was revealed in 77.5% of patients to 112 ± 29.4 ng / ml, while the norm was 186 ± 31.3 ng / ml (p<0,01) (за норму были приняты показатели 15 здоровых лиц). При проведении корреляционного анализа выявлена отрицательная связь между выраженностью болевого синдрома и уровнем серотонина в сыворотке крови, т.е. чем более был выражен болевой синдром, тем ниже был показатель серотонина (r=-0,57; Р<0,001).

To determine the effectiveness of the use of bioregulated electroimpulse therapy from the "TINER" apparatus in the general complex of resort therapy, the patients were divided into 2 groups, one of which (20 people, control) received radon baths with a concentration of 1.5 kBq / l, temperature 36-37 ° With an exposure of 10-15 minutes, every other day, for a course of treatment 10 baths (I LK), another (28 people, main) additionally - bioregulated electro-impulse therapy from the "TINER" apparatus, which is carried out by a pulsed electric current of low frequency, low voltage using a spherical single-pole electrode, contact, labile over the skin projection of the ascending, transverse-colon, descending parts of the large intestine clockwise (in the direction of peristalsis), with a frequency of 30.2 Hz until a moderately pronounced, painless vibration under the electrode within 8-18 minutes (with an increase in duration by 1 minute with each procedure), 10-12 daily procedures (the second electrode (passive) is placed on the patient's arm). Both groups of patients were representative in terms of the main clinical parameters. Treatment of patients was carried out against the background of basic therapy - sanatorium-resort regime, exercise therapy, dietary nutrition (diet No. 5), drinking carbonic chloride-hydrocarbonate sodium mineral water of medium mineralization "Essentuki No. 4" in the amount of 3-3.5 ml / kg of body weight , 30 minutes before meals, 3 times a day, warm, microclysters from herbal infusion for course No. 10 and siphon bowel lavages with Essentuki No. 4 mineral water for a course of 4 procedures.

After the spa treatment, the majority of patients showed positive dynamics of the main clinical and paraclinical indicators characterizing the general state of health, the state of the psychoemotional sphere and the motor-evacuation function of the large intestine.

In patients who received complex therapy with bioregulated electroimpulse therapy from the TINER apparatus (II LK), this was reflected in the normalization of the frequency of defecation (1 time per day) in 89.3% (p<0,01) больных (табл.1). При этом жалобы на затруднения при акте дефекации и чувство неполного опорожнения после него больные не предъявляли. Отмечались также нормализация консистенции кала и значительное уменьшение количества слизи у данной группы пациентов. Прекратились или значительно уменьшились боли у 94,4% (р<0,01) больных, диспепсические явления - у 91,7% (р<0,01), психоэмоциональные нарушения - у 92,3% (р<0,01).

The improvement in the condition is also confirmed by the data of the assessment of psychoemotional indicators according to psychological tests (Table 2). Indicators of anxiety and depression on the hospital scale HADS were 4.6 ± 1.7 points, while the norm was 4.4 ± 1.9 (p<0,001). Депрессия по шкале Бека с 19,4±1,7 балла уменьшилась до нормы (10,4±1,6 балла) также у всех пациентов данной группы - 10,8±1,9 балла (р<0,001). Показатели САН нормализовались у 100% больных: самочувствие с 2,72±0,19 балла до 5,18±0,21 (р<0,001), активность с 3,40±0,17 до 5,35±0,18 (р<0,001) и настроение с 3,35±0,11 до 5,51±0,15 (р<0,001) балла.

table 2 Dynamics of psychoemotional indicators in patients with irritable bowel syndrome with constipation by level, depending on the applied medical complex
Patient group	Index	Norm	Before treatment	After treatment	Reliability P
I LC (n = 20)		4.4 ± 1.9	8.5 ± 1.3	3.3 ± 1.8	<0,001
II LK (n = 28)	Anxiety / depression on the hospital scale HADS	4.4 ± 1.9	8.9 ± 1.4	4.6 ± 1.7 *	<0,001
I LC	Wellbeing	5.25 ± 0.21	2.98 ± 0.13	4.67 ± 0.12	<0,001
(n = 20)	Activity	5.45 ± 0.12	3.37 ± 0.12	4.92 ± 0.11	<0,001
Mood	5.55 ± 0.19	3.52 ± 0.16	4.87 ± 0.12	<0,001
II Best Male	Wellbeing	5.25 ± 0.21	2.72 ± 0.19	5.18 ± 0.21 *	<0,001
(n = 28)	Activity	5.45 ± 0.12	3.40 ± 0.17	5.35 ± 0.18 *	<0,001
Mood	5.55 ± 0.19	3.35 ± 0.11	5.51 ± 0.15 *	<0,001
I LC (n = 20)	Depression on the Beck scale	10.4 ± 1.6	18.9 ± 1.9	14.5 ± 1.5	<0,001
II LK (n = 28)	Depression on the Beck scale	10.4 ± 1.6	19.4 ± 1.7	10.8 ± 1.9 *	<0,001
Note: * - R 1-2<0,001

According to X-ray examination, 92.5% (p<0,01) больных отмечалась положительная динамика рентгенологических показателей, что выразилось в нормализации моторно-эвакуаторной функции толстого кишечника (табл.3). При проведении корреляционного анализа отмечалась четкая взаимосвязь между нормализацией частоты акта дефекации (1 раз в сутки) и пассажа бария по толстой кишке: через 24 часа после приема бариевой массы при рентгенологическом исследовании контраст определялся в дистальных отделах толстой кишки (r=+0,74; р<0,001).

Table 3 Dynamics of X-ray indicators in patients with irritable bowel syndrome with constipation, depending on the applied medical complex
Index	I LC (n = 20)	II LK (n = 28)	R
abs (%)	% improvement	abs (%)	% improvement
Hypomotor dyskinesia with hypertonicity of the colon		63,6		94,1	<0,05
Hypomotor dyskinesia with colon hypotonia		57,2		90,9	<0,05
Note: the numerator is the indicators before the spa treatment; denominator - indicators after spa treatment.

The beneficial effect of complex spa therapy with the use of bioregulated electro-pulse therapy from the "TINER" apparatus is also confirmed by the data of hormonal studies. Thus, the level of serotonin in the blood serum doubled in 14 out of 16 patients (the percentage of improvement was 87.5): from 112 ± 29.4 ng / ml to 184 ± 30.5 ng / ml (p<0,01), что наиболее существенно отразилось на уменьшении болевого синдрома и улучшении психоэмоционального состояния больных СРК.

The overall effectiveness of spa therapy with the use of drinking mineral waters of medium mineralization, radon therapy and bioregulated electroimpulse therapy from the TINER apparatus was 91.3%.

In a comparative aspect, the results of treatment of this group of patients (II LC) were compared with the corresponding indicators of an identical group of patients who received only spa treatment (I LC - control). The results of the comparative assessment showed that the positive dynamics of the main indicators characterizing the pathological process (pain, dyspeptic syndromes, psychoemotional disorders) was 20-25% more pronounced in the group of patients who received additionally bioregulated electric pulse therapy from the TINER apparatus.

According to the results of an X-ray examination of the passage of barium through the colon in patients who received bioregulated electro-impulse therapy from the TINER apparatus, the indices of the motor-evacuation function of the colon at the end of the course of resort treatment were also significantly better than in patients in the control group (the percentage of improvement was 92, 5 versus 60.4 in control (p<0,05)).

The dynamics of the serotonin level also confirms the advantage of complex therapy: in 87.5% of patients with II LK, it was found to increase to normal values ​​versus 68.9% when using only mineral waters and radon baths (р<0,05).

The overall effectiveness of spa therapy was 72.4% in the first group of patients, and 91.3% in the second, p<0,01.

The proposed method of using natural and preformed therapeutic factors increases the overall effect of spa treatment by 19% and makes it possible to speed up the healing process, reduce the period of temporary disability by 2.5-3 times, reduce sick leave payments and the economic costs of the patient and the state for medicines by 3- 4 times while improving the quality of life and disease prognosis.

A method of treating patients with irritable bowel syndrome with constipation by conducting a complex spa treatment, including drinking Essentuki No. 4 mineral water, carrying out radon baths with a concentration of 1.5 kBq / l, for a course of 10 procedures, microclysters from an infusion of medicinal herbs, for a course 10 procedures, siphon bowel lavages with Essentuki No. 4 mineral water, for a course of 4 procedures, characterized in that they additionally act with a pulsed electric current from the TINER apparatus using a spherical unipolar electrode, which is placed contact, labile, clockwise above the skin with increase in duration by 1 min with each procedure, for a course of 10-12 pro procedures carried out daily.

Similar patents:

The invention relates to medicine, namely to gastroenterology

Patients who do not drink alcohol regularly and do not suffer from alcoholism should not start drinking after diagnosis. In their case, alcohol may not have played a significant role in the development of the disease, but it can still aggravate its course. In addition, many drugs used to treat irritable bowel syndrome are incompatible with alcohol. Their action can not only be neutralized, but also have a toxic effect, affecting the functioning of the liver, kidneys, and heart.

Drinking alcohol contrary to your doctor's instructions for irritable bowel syndrome can have the following consequences:

• more frequent and worse abdominal pain;
• gradual weight loss and wasting ( due to malabsorption - impaired absorption of food);
• increased frequency of episodes of constipation and diarrhea;
• overlapping the therapeutic effect of medications ( causing the illness in general to last longer);
• increased risk of infectious complications ( escherichiosis, salmonellosis and other intestinal infections);
• the risk of developing colon cancer ( with regular use).

Thus, alcohol addiction can worsen the prognosis, even though it is generally positive in irritable bowel syndrome. If possible, you should give up not only strong alcoholic drinks, but also beer ( even non-alcoholic), wine and even kvass. The fact is that they, even without causing alcohol intoxication, can contribute to fermentation processes in the intestines. This disrupts the balance of the intestinal microflora and causes flatulence ( flatulence in the intestines). In patients with irritable bowel syndrome, this symptom is especially pronounced, since due to impaired motility, gases are not excreted naturally.

In general, a single use of alcohol with this disease, of course, is not fatal. Most often, this only leads to an aggravation of the condition according to the mechanisms described above. But the wrong combination of some drugs prescribed by a doctor for the treatment of irritable bowel syndrome with alcohol can cause more serious consequences and cause urgent hospitalization ( due to poisoning). In this regard, you should be very careful and, if possible, still adhere to the diet prescribed by your doctor. When you first contact a specialist to start treatment, you should notify him if there are problems with alcohol abuse. This can initially affect the tactics of treatment.

Do you have irritable bowel syndrome during pregnancy?

Irritable bowel syndrome during pregnancy is a common problem, but not too serious. This disease is manifested by mild gastrointestinal symptoms. It is not accompanied by any irreversible pathological changes in the intestine, but is reduced only to disturbances in its work. Until now, it has not been possible to accurately determine all the mechanisms involved in the development of this syndrome. It is only known for certain that the innervation of the intestine, the state of the endocrine system and the psychoemotional background play a certain role in it.

It is the above factors that appear during pregnancy that explain the high incidence of irritable bowel syndrome. In addition, statistically, this pathology occurs most often in women of childbearing age ( from about 20 to 45 years old). In pregnant women, this syndrome is somewhat more severe than in other patients. This is due to a large number of external and internal factors that provoke frequent exacerbations.

The following factors can affect the increase in exacerbations during pregnancy:

• hormonal changes;
• mechanical squeezing of the intestine and displacement of its loops by the growing fetus;
• weakening of immunity;
• changes in diet;
• psycho-emotional stress;
• mechanical pressure on the nerve fibers that innervate the intestines;
• taking various drugs and dietary supplements.

Against the background of these changes, exacerbations become more frequent in women who have suffered from irritable bowel syndrome before. Symptoms that did not cause serious inconvenience before ( many patients do not even go to the doctor) become more pronounced. To confirm the diagnosis and prescribe symptomatic treatment, you should consult a gastroenterologist. Treatment of the underlying causes of the disease during pregnancy is not recommended ( this will be an extra risk for the fetus).

Symptomatic treatment of irritable bowel syndrome in pregnant women involves the appointment of the following drugs:

• antispasmodics and sedatives- with pain in the abdomen;
• laxatives(you can also folk remedies) - with prolonged constipation;
• fixing- with prolonged diarrhea;
• carminative- with a strong accumulation of gas in the intestine ( flatulence).

In addition, you should pay attention to lifestyle and nutrition. As mentioned above, pregnancy itself provokes an exacerbation of the disease. Therefore, you should avoid stressful situations, walk more, eat easily digestible food ( cereals, vegetables and fruits without hard plant fibers, dairy products).

Seeing a doctor at the first symptoms of the disease is mandatory. This is necessary in order to exclude more serious pathologies ( intestinal infections, adhesions of the intestines and pelvic organs, neoplasms in the abdominal cavity) that can affect the course of pregnancy. If doctors diagnose irritable bowel syndrome, then the prognosis for both the patient and the unborn child is favorable. This disease is not accompanied by serious systemic disorders, does not cause complications of pregnancy and does not threaten the fetus. Doctors continue to observe the patient according to the general scheme, periodically seeking advice from a gastroenterologist. Treatment comes down to relieving symptoms. After childbirth, the main manifestations of irritable bowel syndrome do not go away immediately and may even worsen. Usually, however, the frequency of exacerbations and the intensity of symptoms gradually decrease.

Does Irritable Bowel Syndrome Happen in Children?

Most often, irritable bowel syndrome occurs in people between 20 and 45 years old, but the disease may well develop in childhood. In these cases, the clinical manifestations will not differ much from those in adults, but with some distinctive features.

Children may experience the following symptoms of this disease:

• Stomach ache... In childhood, they are usually more frequent and more intense than in adults. This is partly because children are generally less tolerant of pain. In young children who cannot complain of pain, the symptom is manifested by anxiety, frequent crying, which increases with a change in position. Usually the pain is not well-localized, since it is caused by a spasm of the smooth muscles of the intestine, and not by local inflammation of the peritoneum.
• Digestive disorders... As in adults, they can present with prolonged periods of diarrhea ( diarrhea) or constipation ( constipation) or the alternation of these symptoms. In young children without medical care, against the background of digestive disorders, nutrients begin to be absorbed worse. Because of this, the child may lag in height and weight. In children of school age and older, this is not so noticeable due to the slower growth rates.
• Flatulence... Bloating due to flatulence is generally a common problem in young children. Their intestines are more sensitive to the food they eat. Accordingly, children with irritable bowel syndrome are forced to follow a stricter diet. More often, the syndrome occurs in infants who, for various reasons, were transferred from breastfeeding to artificial nutrition.
• Frequent urge... Children of school age and older often complain of the urge to have a bowel movement. In this case, emptying itself provides temporary relief, but the feeling of fullness in the abdomen usually does not go away.
• Discharge of mucus... Mucous discharge without blood impurities is found mainly in young children. With age, the number of such secretions decreases.

Thus, the manifestations of the disease in children are usually more intense than in adults. The diagnosis of irritable bowel syndrome is also complicated due to the wide limits of the norm for different ages. Most often, the syndrome is not correctly diagnosed by either pediatricians or gastroenterologists. With age, due to changes in the structure of growing organs, "improvement" of nervous regulation and stabilization of hormonal levels, the disease can go away by itself, without any treatment.

Differences in the manifestations of the disease and difficulties in diagnosis are explained by the following anatomical and physiological characteristics in children:

• incomplete set of digestive enzymes ( due to which not all food is normally digested in the intestines);
• gradual reproduction of microflora in the intestine ( the older the child, the closer the composition of his microflora to normal);
• greater mobility of intestinal loops than in adults;
• insufficient control of the nervous system over the intestinal muscles;
• accelerated formation of feces;
• less intense bile production ( fats are digested worse);
• food allergies are more common;
• the growth and differentiation of cells in organs is accelerated;
• the fermentation process in the intestines of young children takes place more often than in adults ( because of this, gases accumulate);
• higher sensitivity to various intestinal infections;
• weaker fixation of the mucous membrane and submucosa in the rectum.

All this explains some of the differences in the clinical picture of irritable bowel syndrome. Nevertheless, the prognosis for children with this disease always remains favorable. There are practically no complications, and the disease itself gradually goes away. Prolonged flow ( decades, until adulthood) occurs mainly when trying to self-medicate or non-compliance with the diet and other prescriptions of the attending physician. Then, over the years of digestive disorders, a variety of problems can develop. The constant stagnation of feces in the body leads to intoxication, problems with the liver, skin, heart and other internal organs.

Does stress affect Irritable Bowel Syndrome?

According to the latest research, prolonged stress is one of the most common causes of irritable bowel syndrome. The fact is that with this disease there are no morphological ( structural) tissue disorders. The appearance of symptoms of the disease is usually explained by the influence of any external factors that affect the innervation and work of smooth muscles in the intestinal walls. When interviewing patients, it is most often possible to find out that exacerbations are associated precisely with increased psycho-emotional stress.

From a medical point of view, stress is the body's response to emotional or physical stress. Normally, they allow the body to better adapt to various situations, but prolonged stress has a negative effect. First of all, this is due to the activation of the autonomic nervous system and the release of a number of hormones. It is these reactions that cause disturbances in the work of smooth muscle tissue.

As a result, due to a violation of innervation, the following problems arise:

• Muscle spasm... Spasm is a reflex muscle tension ( in this case, in the intestinal wall). Because of this, the patient may experience recurrent abdominal pain.
• Motility disorders... Intestinal motility is the set of contractions of its walls, which facilitates the passage of contents along from the stomach to the rectum. Due to the spasm, motility is impaired and the contents of the intestine are retained in certain areas. This causes a feeling of "overcrowding" in the abdomen.
• Flatulence... Delaying the content leads to an increase in fermentation processes ( especially when drinking beer, kvass, grapes and other products with a similar effect). As a result, gas accumulates in the intestines and a corresponding symptom occurs - flatulence.
• Disorders of food digestion... The nervous system not only coordinates intestinal motility, but also stimulates the secretion of digestive enzymes, regulates the absorption of nutrients and fluids. Innervation disorders can lead to alternating periods of constipation ( constipation) and diarrhea ( diarrhea).

Thus, stress has the most direct effect on bowel function. Similar effects can be noted even in healthy people who do not suffer from irritable bowel syndrome. In patients with this ailment, there are additional features in the structure of the nervous and muscular system. Because of this, the psychoemotional load causes a more lasting effect in their body. The exacerbation lasts from several days to several weeks. The stronger the load and the longer its effect, the more pronounced the symptoms of the disease will be.

In addition to stimulating the nervous system, prolonged stress can weaken the immune system. As a result, disturbances in the work of the intestines are often complicated by dysbiosis ( the composition of the intestinal microflora changes), serious intestinal infections can develop. This will aggravate the course of the disease.

To prevent irritable bowel syndrome during stress, the following measures are recommended:

• reasonable mode of work and rest;
• quitting smoking, drinking alcohol, coffee and tea in large quantities ( substances that affect the psyche and the work of the nervous system);
• playing sports or periodic gymnastic exercises;
• outdoor recreation for at least an hour a day;
• preventive use of weak sedatives ( infusion of valerian, chamomile, motherwort);
• counseling help from a psychologist ( in case of serious psycho-emotional stress).

The use of mineral water in the rehabilitation of patients with irritable bowel syndrome

Drinking mineral waters are prescribed for the rehabilitation of patients with irritable bowel syndrome as colonostimulating and colonorelaxing procedures.

Application of hydrocarbonate-sulphate sodium-magnesium waters

Therapy with hydrocarbonate-sulphate sodium-magnesium mineral waters in the rehabilitation of patients with irritable bowel syndrome refers to colonostimulating procedures. When ingested, hydrocarbonate ions inhibit AMP-dependent phosphorylation of glycolytic and lipolytic enzymes. As a result, the secretion of hydrochloric acid is reduced. Deficiency of protons inhibits the formation of pepsins, gastrin and secretin and increases intestinal motility. Sulfate ions in the intestine are practically not absorbed, but increase its motor function, providing a laxative effect. Calcium and magnesium ions enhance the contractile function of the smooth muscle elements of the intestinal walls and restore its motor activity. Naphthenes, humins, bitumens and phenols are rapidly absorbed into the bloodstream in the stomach and in the upper parts of the small intestine, activate the intestinal microflora and promote the production of antibacterial and biologically active components. They use the mineral waters of Essentuki No. 17, Batalinskaya, Lysogorskaya, Izhevskaya, Yekateringofskaya, Nizhny Karmadon, Lipetskaya and others.

Mineral water with a temperature of 20-22 ° C is drunk on an empty stomach 40 minutes before a meal, slowly, in small sips 3-4 times a day, starting with 100 ml and gradually increasing the amount of water to 250 ml per intake.

When prescribing bicarbonate-sulfate-chloride, sodium-calcium-magnesium mineral water "Novoterskaya healing" in addition to basic drug therapy for patients with irritable bowel syndrome with a predominance of diarrhea and constipation, significant changes in their condition were revealed. Water was prescribed at the rate of 5 ml per 1 kg of the patient's body weight in 3 doses 30 minutes before meals for 30 days. The choice of water temperature depended on the state of the motor-evacuation function: patients with constipation against the background of intestinal hypokinesia were prescribed cold mineral water - 18-20 ° C, and patients with diarrhea and intestinal hyperkinesia - water with a temperature of 40-50 ° C.

Application of bicarbonate-chloride sodium-calcium waters

Treatment with hydrocarbonate-chloride sodium-calcium drinking mineral waters in the rehabilitation of patients with irritable bowel syndrome refers to colonorelaxing procedures. Sodium cations, entering the interstitium and blood, restore their osmolarity, which leads to a decrease in intestinal motility. Ca 2+ ions enhance the contractile function of the smooth muscle elements of the intestinal wall. K + ions restore increased intestinal motility and evacuation function. Chloride-sodium-potassium-calcium drinking water restore osmolar and electrolyte homeostasis of the interstitium and muscle fibers of intestinal smooth muscles. Restoration of electrolyte homeostasis normalizes the excitability and contractile function of the intestinal muscles. Mineral waters Borjomi, Jermuk, Izhevskaya, Mariinskaya, Truskavetskaya, Kamenskaya,

Irritable bowel syndrome is a medical condition characterized by frequent periods of constipation and diarrhea and is usually accompanied by pain or bloating. After food is partially digested in the stomach, it is pushed through the small intestine and then through the large intestine by regular contractions of the intestinal wall muscles (peristalsis). In irritable bowel syndrome, these muscles may cramp and move food debris either too quickly (leading to diarrhea) or too slowly (causing constipation). Irritable bowel syndrome should not be confused with more serious inflammatory bowel disease.

There is no cure for irritable bowel syndrome; however, symptoms can be reduced by a combination of specific exercise and diet. Sometimes medications bring relief. Irritable bowel syndrome is more common in women than in men; symptoms may worsen during menstruation.

Causes

The cause of irritable bowel syndrome is unknown, although it is believed that it is most likely associated with a malfunction of the gastrointestinal tract, rather than a general disorder in the body.

Emotional stress can be a contributing factor.

Certain foods can cause disease outbreaks. Typical irritants include fatty foods such as bacon, poultry skin, vegetable oil, margarine and dairy products, as well as foods that cause excessive gas production, such as beans and broccoli.

This is a fairly common variant of a functional bowel disorder, which is a violation of the motor and secretory functions of the intestine in combination with an increased sensitivity of its various departments to a number of nutritional factors (allergic, temperature, mechanical, etc.), of a neuro-emotional nature. Irritable bowel syndrome is often the result of past infections, intoxications, and worms. It can arise as a consequence of previously transferred dysentery, salmonellosis, and other acute inflammatory diseases, when the causative factor has already lost its significance, inflammatory and other pathological processes have disappeared, but altered susceptibility (reactivity) of the mechanisms of regulation of intestinal activity remains. At the same time, a wide variety of influences (psychoemotional, food, physical overload, cooling, overheating, colds, etc.) can cause the manifestation of painful symptoms from the intestines.

Symptoms

Constipation, diarrhea, or alternation.

Discomfort, pain, bloating, or abdominal cramps.

Excessive gassing.

Feeling that the intestines are not completely emptied.

Nausea.

The disease often occurs at a young age, more often in women. The disease proceeds in waves and is characterized by the appearance of bouts of acute, cramping pain in the abdomen. The pain is accompanied by a frequent urge to the bottom, with the discharge of a small amount, usually loose or liquid, feces, sometimes with a large amount of mucus. Attacks of pain, often against a background of bloating and rumbling in the abdomen with mucus and diarrhea, last from 20-30 minutes to several days, being replaced in the future by normal stools and general well-being.

Short-term functional disorders of the intestines can be observed with food excesses, with alcohol abuse, including when taking dry wines, champagne, as well as soft drinks, especially cold carbonated drinks (lemonade, Pepsi-Cola). In such cases, several hours (less often minutes) after a plentiful meal, especially fatty or poorly combined (for example, milk with cucumbers and fish), there may be short-term diarrhea, rumbling and transfusion, pain throughout the abdomen. As a rule, the general condition of patients suffers little.

Functional disorders of intestinal activity in the form of constipation, diarrhea, bloating and increased gas production, short-term pain sensations can be the initial manifestation of inflammatory or other (organic) diseases. Therefore, self-medication or (even worse) indifference of patients to the onset of symptoms of the disease is a gross mistake in relation to their health. In all cases, the most correct step is to contact a local therapist or gastroenterologist, conduct, under their guidance and supervision, a set of necessary studies and receive, after the diagnosis is made, recommendations for treatment and prevention.

Diagnostics

Medical history and physical examination are required. The diagnosis is made when the possibility of other diseases, such as cancer and intestinal inflammation, is excluded.

A barium enema may be needed. Barium creates a clear x-ray image of the intestines.

To view all or part of the large intestine (colonoscopy) (rectosigmoscopy), a small, illuminated tube can be used.

Treatment

You can try eating fibrous foods. Some people find that symptoms are alleviated by eating fiber-rich foods (raw fruits and vegetables, bran, whole grain breads, and dried vegetables). Others argue that eating fibrous foods worsens symptoms.

You should eat more often and in small quantities.

Consultation with a psychologist and auto-training can help relieve stress. Regular moderate exercise can also reduce tension and ease symptoms.

The doctor may prescribe laxatives, fixatives, angispasmodics, or sedatives, or medicines to improve digestion.

Smoking can act as a trigger and should be avoided.

In the treatment program for patients with irritable bowel syndrome, individualization of nutrition is most important. In the period of exacerbation of the disease, increased frequency of diarrhea, abdominal pain, and other phenomena, it is necessary to switch to a dietary regimen according to diet No. 4c, to exclude from the diet foods and dishes that are poorly tolerated by the patient. With a tendency to diarrhea and the predominance of fermentation processes in the intestines (rumbling, bloating), it is recommended to avoid milk, milk soups and cereals. Such lactic acid products as yogurt, kefir, acidophilus and fermented baked milk should be treated individually, depending on tolerance. Spicy sauces, gravies, canned food in tomatoes, refractory fats, cold drinks, pastry products are contraindicated.

Patients with irritable bowel syndrome should study well enough the characteristics of their body in terms of the intestinal response to the nature and diet, so that conditions for an exacerbation of the process are not created. So, most of these patients do not tolerate cold, carbonated drinks, especially on an empty stomach. Therefore, you should beware of lemonade, Pepsi-Cola, water from the siphon, as well as juices and compotes immediately from the refrigerator. It is advisable to exclude strong coffee that provokes diarrhea from the diet, or to drastically reduce its use.

Many patients do not tolerate not only overeating, which causes intestinal upset, but also plentiful food. Therefore, food should be frequent, but low-volume, especially in the morning. Within 30-40 minutes after eating, patients with irritable bowel syndrome should not engage in physical labor, especially hard, so as not to cause diarrhea. It is difficult to list all the situations that each patient may face during their illness and that stimulate bowel dysfunctions. Hence, a certain conclusion suggests itself: to know all the reasons for the worsening of the course of the disease and to prevent their recurrence.

With a tendency to diarrhea, dried blueberries are recommended in the form of an infusion, a decoction (1-2 teaspoons per glass of boiling water) or in the form of blueberry jelly, as well as the fruits of bird cherry (10 g per 100 g of water, take no more than 0.5 cups 2-3 times a day). To neutralize irritating substances with diarrhea, activated charcoal or carbolene is prescribed (1-2 g twice or three times a day). However, long-term use of it is undesirable due to the possible development of enzyme deficiency of the digestive system, impairment of absorption of vitamins and mineral salts in the intestine. In order to stop or reduce diarrhea, medicinal herbs can be used with success,

The internal use of mineral waters can provide significant help in the treatment of irritable bowel syndrome at home. This provides a calming effect on disturbed intestinal motility, a decrease in irritation and increased sensitivity of its mucous membrane, and an improvement in the functional state of other digestive organs. In case of diarrhea due to increased motor function of the intestine, hot (40-45 ° C) low- and medium-mineralized waters containing HCO3 and Ca ions ("Smirnovskaya", "Slavyanovskaya", "Feodosiyskaya", "Jermuk", "Borzhomi", "Essentuki No. 4 "and others; 100 ml 3 times a day 30-90 minutes before meals, depending on the initial level of gastric secretion: with low acidity - in 30 minutes, with normal - for 40-60, with increased - for 90 min).

Small intestinal procedures in the form of therapeutic enemas are also very effective for diarrhea, especially in cases where irritable bowel syndrome is accompanied by an inflammatory process in the area of ​​the intestinal outlet (sigmoid and rectum). They are performed as follows. Half an hour after a small volume of warm cleansing enema, set very carefully, 250-350 ml of warm mineral water (such as "Essentuki No. 4" or "Essentuki No. 17", "Smirnovskaya", "Slavyanovskaya", "Jermuk", " Arzni "and others). You should try to keep this portion of water in the intestines as long as possible. The procedure often does not cause an urge, and water is completely absorbed into the intestines, providing a good anti-inflammatory effect, eliminating disorders of intestinal motor function. Medicinal enemas can be done every day for 2-3 weeks.

Prophylaxis

There is no known way to prevent irritable bowel syndrome, but symptoms can often be alleviated by dietary changes and specific exercise.

Make an appointment with your doctor if signs of irritable bowel syndrome interfere with your daily activities.

Finally, one should seriously warn against the uncontrolled use of drugs by patients, especially antibiotics, sulfonamides, enzymes and other agents. The illogicality and danger of self-medication with the listed medicines for irritable bowel syndrome, as in other forms of functional bowel diseases, is that these potent agents are intended to suppress pathogenic (pathogenic) intestinal microbes that are absent in the considered functional diseases, for the treatment of severe inflammatory phenomena intestinal mucosa and deep disorders of intracavitary and parietal digestion, which is also absent in patients with intestinal dyskinesia and irritable bowel syndrome. Moreover, not being able to affect the pathogens of the intestine, antibiotics, sulfonamines and other potent medicines show their side effects - a detrimental effect on the normal intestinal microflora, which leads to dysbiosis. As a result, fermentation processes intensify, the body's supply of vitamins deteriorates, and unfavorable influences appear. All this should convince of the danger of self-medication, the advisability of seeking advice from a doctor for choosing an individually indicated treatment.

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