Who can benefit from mineral water in the treatment of IBS? Treating irritable bowel syndrome with the right diet. Peptic ulcer of the stomach and duodenum

Treating irritable bowel syndrome with or without diarrhea is often problematic, even despite the active development of medicine and pharmacology around the world. For example, in the USA, more than 20% of the total population suffers from this pathology. With irritable bowel syndrome, symptoms and treatment are under the jurisdiction of a gastroenterologist, who should be contacted for this disease. If all people encounter periodic bowel problems and usually know what to do, then the pathology in question causes a debilitating, chronic digestive disorder, which seriously affects a person’s overall performance, his physical and psychological state.

The essence of the phenomenon

At its core, this pathology (IBS) is a chronic intestinal disorder with disruption of its functions for no apparent reason. This phenomenon is accompanied by abdominal pain, stool disturbances, and discomfort, but no inflammatory reactions or infectious lesions are detected. Even blood and stool tests do not provide informative results.

Irritable bowel disease can affect people of any age and gender. However, women suffer from this phenomenon more often (almost 2 times). The peak manifestation of pathology occurs at the age of 32–38 years. Unfortunately, up to 2/3 of all affected people do not consult a doctor, trying to cope with it on their own. In principle, this problem in the intestines extremely rarely leads to organic disorders, but it cannot be neglected, because the nervous system suffers significantly, and the body’s presence in a constant state of stress cannot pass without leaving a trace.

The pathology of irritable bowel as a disease is characterized by functional disorders in the form of deterioration of intestinal motility and susceptibility to its stimulation of a neurohumoral or mechanical nature.

In other words, under the influence of non-pathogenic factors, the intestine ceases to adequately respond to appropriate signals, which disrupts its bowel movement.

This phenomenon can develop in both the large and small intestines. The most common is irritable bowel syndrome (IBS). It is in it that the formation of feces occurs, and therefore a violation of peristalsis leads to stool disorders and problematic bowel movements. According to the nature of its manifestations, irritable bowel syndrome, like IBS in general, is divided into 3 types: predominance of abdominal pain and flatulence; IBS with diarrhea and IBS with constipation.

Etiology of the disease

The causes of irritable bowel syndrome are still not fully understood. However, medical statistics and the results of numerous studies provide a general picture of the most common etiological mechanism. Most experts believe that most often the pathology is caused by nervous stress or prolonged psychological overload.

It has been clearly established that the syndrome appears in people with increased nervous excitability against the background of psychological stress. As a rule, this factor predominates among young women.

The influence of a neurogenic factor resembles a vicious circle: stressful situations give rise to IBS, and its chronic course causes nervous disorders. They further intensify the manifestation of the symptoms of the pathology. As a result of such mutual influence, neuroses and psychopathy of various varieties often arise. Irritable bowel syndrome is rarely caused by nervous influences, but if it has already appeared, then stress can significantly aggravate the clinical picture.

In irritable bowel syndrome, the causes are associated with other endogenous and exogenous factors:

1. Increased activity of the muscles and nerve endings of the digestive tract, which causes impaired intestinal motility. In such cases, no visible disturbances are detected in the stenotic structure or the intestinal nervous system, but the regulation of intestinal motility is still disrupted.
2. Individual hypertrophied sensitivity of the body to filling and stretching of the intestine, which causes pain with small loads on the intestines, although in other people they are considered normal.
3. Hormonal factor. During periods of sudden changes in hormonal balance in the body, signs of IBS are observed. In women at the beginning and end of menstruation, they are associated with a significant increase in the level of prostaglandin in the blood.
4. One of the common etiological factors is unhealthy diet. The irritating effect is created by fatty foods with excessive calorie content and simple overeating. The risk of pathology increases when drinking strong coffee and tea, sweet mineral water with gas, and especially alcoholic beverages. In addition, it is necessary to take into account the individual intolerance of the body to certain products.
5. Hereditary predisposition quite often becomes a decisive factor in the onset of the disease.
6. Attacks of gastroenteritis can provoke chronic intestinal disorder, becoming a trigger for starting the IBS mechanism. A similar effect can be expected from dysbiosis.
7. The question of how to get rid of irritable bowel syndrome also has to be resolved with long-term use of certain medications. Antibiotics stand out especially in this area, which, in addition to pathogenic microorganisms, also destroy beneficial microflora, upsetting the balance.

Summarizing what has been said, we can characterize the etiological mechanism of IBS as follows. The small and large intestines are elements of the digestive tract, and the passage of processed food is ensured by the contractile functions of the muscular layer of the intestinal walls. When contractions slow down or become excessively active, the process of formation and excretion of feces is disrupted, and other signs of pathology appear. If muscle dysfunction persists for a long time, then we can talk about the appearance of irritable bowel syndrome. This may result in pain, diarrhea or constipation.

Symptomatic manifestations

Symptoms of irritable bowel syndrome manifest themselves in the form of functional intestinal and extraintestinal disorders. The first category, depending on the type of pathology, includes the following main symptoms: abdominal pain, diarrhea (defecation more than 3 times a day with a liquid stool consistency) or constipation (defecation less than 3 times a week). Extraintestinal manifestations include neurological, autonomic, psychopathological disorders, as well as disorders in other digestive organs.

When IBS occurs in a variant with a predominance of diarrhea, the following features of symptoms are noted. The most characteristic symptom is diarrhea, which occurs very often for various reasons. Food intake has a particularly noticeable effect. The urge to urgently defecate occurs immediately after lunch or during meals, and the symptom is most intense in the first half of the day. A person begins to suffer from the so-called “bear disease,” when diarrhea violently manifests itself under any psychological stress, emotional arousal, or fear. In addition to diarrhea, with the development of this type of IBS, other symptoms can be observed: bloating, pain in the abdomen on the sides, which intensifies with an unexpected urge to defecate and disappears after it.

Constipation-predominant syndrome, on the contrary, leads to a significant delay in bowel movements. Breaks between processes can be more than 3 days. The stool becomes dense, often taking on the appearance of small “lamb coils.” A whitish or clear mucus may be released. Prolonged stagnation of feces leads to pain along the entire length of the colon in the form of colic or aching sensations. Chronic constipation causes loss of appetite, heartburn, nausea, and an unpleasant taste in the mouth.

Finally, it is possible to develop IBS according to option 3, when abdominal pain predominates. In this case, bowel dysfunction looks like alternating diarrhea and constipation in an unpredictable pattern. The most characteristic symptom is constant pain in the abdominal area.

Finally, the following signs characterizing IBS can be identified: abdominal pain of a spastic, stabbing or aching type, becoming less intense or disappearing altogether after defecation; bowel dysfunction; inability to control the urge to defecate; constant feeling of filling of the intestines even after emptying them; flatulence and bloating; nausea; the appearance of mucous impurities in the stool. These signs are distinguished by their duration, i.e., the chronic nature of the entire phenomenon.

Prolonged disturbances in bowel movement lead to numerous disorders of extraintestinal localization. It is necessary to note the most characteristic symptoms:

1. Disorders of the neurological and autonomic type: migraine (felt by almost half of all patients), lumbar pain, sensation of a lump in the throat, chilly hands, insomnia at night and drowsiness during the day, poor quality of breathing, dysmenorrhea, dysuria of various types, impotence.
2. Psychopathological disorders: various phobias, depression, panic attacks, hypochondria, anxiety syndrome, hysteria (such disorders are observed in almost 2/3 of patients).
3. Disorder of other digestive organs: pain in the hypochondrium on the right side, vomiting, a feeling of heaviness in the epigastrium, signs of non-ulcer dyspepsia (observed in almost 85% of all victims). In addition, irritable bladder syndrome often develops.

Untreated or poorly treated IBS leads to serious problems. The apparent relative safety for health is deceptive. The psychological effects are so great that they can cause severe neurological abnormalities. Constant diarrhea exhausts the body, leads to dehydration and leaching of important microelements. Naturally, a person’s performance decreases and insomnia appears.

Disease detection methods

With irritable bowel syndrome, diagnosis faces certain difficulties in differentiating the pathology. Symptoms of IBS are similar to those of many other gastrointestinal diseases. Most often, the diagnosis of this phenomenon is made by the method of exclusion, that is, by external examination, laboratory and instrumental methods, other diseases are excluded.

It will not be possible to establish IBS directly from tests, given the absence of changes in the composition of blood, urine or feces. There is also no infectious component. Taking into account these features of the pathology, the criteria for making a diagnosis are adopted:

• discomfort and recurrent pain with irritable bowel syndrome are long-lasting, and they coincide with the period of increased frequency of urge to defecate and changes in the nature of stool;
• pain significantly decreases or disappears after bowel movement;
• pain symptoms and discomfort last for at least 5 months, and are felt for at least 3–4 days per month throughout the entire period.

It is based on the presence of these criteria that a diagnosis is made, but then it is necessary to conduct an examination to exclude other diseases. If symptoms such as disrupted bowel movements, unstable stools, abdominal pain occur, the following diagnostic procedures are performed:

• general and biochemical analysis of blood and feces;
• radiography with the introduction of a contrast agent (usually barium sulfate);
• endoscopic examinations by introducing a special endoscope through the anus - the device allows you to visually assess the condition of the colon and take a sample for biochemical analysis;
• coprogram, and, if necessary, sigmoidoscopy, irrigoscopy.
• biopsy of the intestinal walls.

When conducting research, first of all, it is necessary to differentiate irritable bowel syndrome (or small bowel) from iron deficiency anemia, deficiency of B vitamins, lactose deficiency, celiac disease, and tumor formations.

Diet for illness

Improper and excessively plentiful nutrition often provokes the syndrome in question. Taking this into account, treatment for irritable bowel syndrome begins with ensuring optimal nutrition (regime and menu). The most important thing is to organize frequent, split meals with the exclusion of foods that can have a negative effect.

The following products can be identified, which are recommended to be significantly limited, or better yet, removed from consumption altogether. The following effects of products are noted:

• stimulate the appearance of diarrhea: apples, plums, beets, foods rich in fiber;
• increase gas formation and flatulence: legumes, baked goods, cabbage, nuts, grapes;
• contribute to constipation: fried foods and fatty foods.

It should be borne in mind that quite often people experience individual intolerance to milk. It is recommended to replace whole milk with fermented milk products (kefir, yogurt, fermented baked milk). If you are at risk for celiac disease, avoid gluten-containing foods. It is better to eliminate sugary carbonated drinks and chewing gum from consumption.

• meals should be regular, without long breaks, uncontrolled fasting and overeating;
• It is recommended to drink at least 1.5–2 liters of liquid, but without caffeine (it is best to drink herbal tea);
• coffee and tea - no more than 0.5 liters per day;
• The consumption of carbonated drinks and alcoholic beverages should be avoided;
• it is recommended to introduce a limit on fresh fruit - no more than 250–300 g per day;
• To reduce gas formation, flaxseeds and oats (can be in the form of porridge) are excellent.

An alternative approach is necessary when consuming fiber-rich foods. The fact is that in case of diarrhea, such products are prohibited as diarrhea stimulants. However, for chronic constipation, dietary fiber (fiber) helps soothe an irritable bowel. The most common suppliers of dietary fiber are bran, wholemeal bread products, grains, some fruits and vegetables (plums, cabbage, zucchini, carrots, beets).

It is necessary to distinguish between types of fiber (soluble and insoluble). For dietary nutrition, you need a soluble type, which is found in oats, nuts, seeds, and pectins. You can use the pharmacy version - Nefagul powder.

Principles of pathology treatment

Questions about how to treat pathology and how to calm an irritated organ are resolved in a comprehensive manner: optimizing nutrition, eliminating psycho-emotional effects, optimizing lifestyle with increased physical activity, and administering drug therapy. Therapeutic and preventive measures are carried out for any type of IBS, but in order to cure the disease with traditional means, it is necessary to take into account the specific manifestations of the disease.

What should the treatment be?

The following remedies help cure IBS when diarrhea predominates:

1. Before meals, a drug is prescribed that can slow down motor functions. The most common drugs for irritable bowel syndrome are: Diphenoxylate, Loperamide, Imodium, Lopedium.
2. A calming effect is provided by a remedy such as Smecta.
3. Decoctions of medicinal plants are recommended: cherries, bird cherry berries, pomegranate skin, alder.
4. Sorbents can reduce gas formation: Polysorb, Polyphepan, Filtrum, Enterosgel.
5. A modern medicine for irritable bowel syndrome with diarrhea is the serotin receptor modulator drug Alosetron.

In the case of IBS with constipation, the pathology is treated with the help of drugs that can facilitate bowel movements and soften stool. The most commonly prescribed drugs are:

1. Medicines based on plantain to increase the volume of contents in the intestines: Naturolax, Mucofalk, Solgar, Metamucil, Fiberlex, Ispagol. In addition, products based on agar and artificial cellulose are used: Citrucel, Fiberal, Fibercon. Such drugs usually begin to work 9–11 hours after administration.
2. Stool softening is provided by drugs with lactulose: Duphalac, Portolac, Goodluck. Without entering the bloodstream, they can change the consistency of stool.
3. Osmotic type laxatives: Macrogol, Forlax, Lavacol, Relaxan, Exportal. These products give effect after 2-5 hours.
4. Mild laxatives: Norgalax, Guttasil, Guttalax, Slabikal, Slabilen.
5. Serotine modulators: Tegaserol, Prucalopride.
6. To create a mild laxative effect, we recommend Essentuki 17 mineral water, which contains magnesium ions.

If abdominal pain predominates in the manifestation of irritable bowel syndrome, then the following drugs are prescribed as drug therapy:

• antispasmodic drugs: No-spa, Drotaverine Hydrochloride, as well as anticholinergic drugs: Hyoscyamine, Zamifenacin, Darifenacin;
• calcium channel blockers: Spasmomen, Ditsitel;
• means for regulating intestinal motility - Debridat;
• drugs to reduce gas formation (defoamers): Espumisan, Zeolate, Polysilane.

Symptomatic therapy

With complex treatment, the most pronounced symptoms that can worsen the condition of the sick person are treated. To reduce neurological and psychopathological disorders, antidepressants are prescribed. This effect has a double effect: it eliminates the psychogenic etiological factor and prevents the development of neurogenic abnormalities as a symptom of the disease. Tricyclic antidepressants are the most commonly used. They reduce the sensitivity of brain receptors to pain and normalize the transmission of nerve regulatory impulses. Traditional drugs are: Amitriptyline, Imipramine, Northtriptyline. In addition, modern drugs are prescribed: Befol, Phenelzine, Pyrazidol.

An important role in the treatment process is given to improving the intestinal microflora and eliminating signs of dysbiosis. With the development of IBS, pathogenic microorganisms are activated and a deficiency of lactobacilli and bifidumbacteria appears. Suppression of pathogenic bacteria is carried out by probiotics: Enterol, Bactisuptil. In more severe cases of the disease, nitrofurans, fluoroquinolones, and intestinal antiseptics (Rifaximin) are prescribed. Normalization of the content of beneficial microflora is ensured with the help of eubiotics (Linex, Bifikol) and prebiotics (Lactulose, Hilak-forte).

A positive effect is observed when using folk remedies in the form of medicinal plants. The following compositions are especially noted: peppermint oil for aromatherapy; infusions and decoctions of chamomile, oak bark, caraway seeds, valerian root; infusions against constipation from licorice root, yarrow, buckthorn bark. In the fight against diarrhea, the roots of burnet, cinquefoil, plantain, blueberry, sage, and walnut are used.

IBS is a common phenomenon that people do not always have an adequate attitude towards. To exclude neurological abnormalities and other complications, this pathology must be treated with effective methods.

Irritable bowel syndrome is a disease that is 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 muscles in the intestinal wall (peristalsis). With irritable bowel syndrome, these muscles can become cramped and move food particles either too quickly (causing diarrhea) or too slowly (causing constipation). Irritable bowel syndrome should not be confused with the more serious inflammatory bowel disease.

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

Causes

The cause of irritable bowel syndrome is unknown, although it is thought to be more likely to be related to a problem with the gastrointestinal tract rather than a general problem in the body.

Emotional stress may be a contributing factor.

Some foods can cause 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 such as beans and broccoli.

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

Symptoms

Constipation, diarrhea, or alternating between them.

Discomfort, pain, bloating or cramping in the abdomen.

Excessive gas formation.

A feeling that the intestines are not completely emptied.

Nausea.

The disease often occurs at a young age, more often in women. The disease occurs in waves and is characterized by the appearance of attacks of acute, cramping pain in the abdomen. The pain is accompanied by a frequent urge to go down, with the passage of a small amount, usually unformed or liquid, feces, sometimes with a large content of mucus. Attacks of pain, often accompanied by bloating and rumbling in the abdomen with the release of mucus and diarrhea, last from 20-30 minutes to several days, later being replaced by normal stools and general good health.

Short-term functional intestinal disorders can be observed with food excesses, with alcohol abuse, including when taking dry wines, champagne, as well as soft drinks, especially cold carbonated ones (lemonade, Pepsi-Cola). In such cases, several hours (less often minutes) after a heavy 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 the intestines in the form of constipation, diarrhea, bloating and increased gas formation, short-term pain may be the initial manifestation of inflammatory or other (organic) diseases. Therefore, self-medication or (even worse) the indifferent attitude of patients to the occurrence 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 physician or gastroenterologist, conduct, under their guidance and supervision, a set of necessary studies and, after establishing a diagnosis, receive recommendations for treatment and prevention.

Diagnostics

A medical history and physical examination are necessary. The diagnosis is made when the possibility of other diseases, such as cancer and inflammation of the intestines, has been excluded.

A barium enema may be necessary. Barium creates a clear image of the intestines on x-rays.

To look at the whole colon (colonoscopy) or part of it (rectosigmoidoscopy), a small tube with a light on the end may be used.

Treatment

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

You should eat more often and in small quantities.

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

Your doctor may prescribe laxatives, restoratives, antispasmodic or sedatives, or medications 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. During the period of exacerbation of the disease, increased frequency of diarrhea, abdominal pain, and other phenomena, it is necessary to switch to a therapeutic nutrition regimen according to diet No. 4c, to exclude from the diet foods and dishes that are poorly tolerated by the patient. If you are prone to diarrhea and the prevalence of fermentation processes in the intestines (rumbling, bloating), it is recommended to avoid milk, milk soups and cereals. Lactic acid products such as yogurt, kefir, acidophilus and fermented baked milk should be treated individually, depending on tolerance. Hot sauces, gravies, canned tomato sauces, refractory fats, cold drinks, and pastry products are contraindicated.

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

Many patients do not tolerate well not only overeating, which causes intestinal upset, but also large meals. Therefore, meals should be frequent, but small, especially in the morning. For 30-40 minutes after eating, patients with irritable bowel syndrome should not engage in physical labor, especially heavy labor, so as not to cause diarrhea. It is difficult to list all the situations that every patient may encounter during his illness and that stimulate intestinal dysfunction. This suggests a certain conclusion: know all the reasons for the worsening of the disease and prevent their recurrence.

If you are prone to diarrhea, dried blueberries are recommended in the form of infusion, decoction (1-2 teaspoons per glass of boiling water) or in the form of blueberry jelly, as well as bird cherry fruits (10 g per 100 g of water, take no more than 0.5 cup 2-3 times per day). day). To neutralize corrosive substances during diarrhea, activated carbon or carbolene is prescribed (1-2 g twice or thrice a day). However, its long-term use is undesirable due to the possible development of enzyme deficiency of the digestive organs, deterioration of absorption of vitamins and mineral salts in the intestines. In order to stop or reduce diarrhea, medicinal herbs can be successfully used,

Internal use of mineral waters can provide significant assistance in treating irritable bowel syndrome at home. This provides a calming effect on impaired intestinal motility, a reduction in irritation and increased sensitivity of the intestinal mucosa, and an improvement in the functional state of other digestive organs. For diarrhea due to increased intestinal motor function, hot (40-45° C) low- and medium-mineralized waters containing HCO3 and Ca ions are prescribed (Smirnovskaya, Slavyanovskaya, Feodosiyskaya, Jermuk, Borjomi, Essentuki No. 4”, etc.; 100 ml 3 times a day 30-90 minutes before meals, depending on the initial level of gastric secretion: with low acidity - 30 minutes before, with normal acidity - 40-60 minutes before, with increased acidity - 90 minutes before 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 warm cleansing enema, delivered very carefully, 250-350 ml of warm mineral water (such as “Essentuki No. 4” or “Essentuki No. 17”, “Smirnovskaya”, “Slavyanovskaya”, “Jermuk”, “ Arzni”, etc.). You should try to keep this portion of water in the intestines as long as possible. The procedure often does not cause urge, and the water is completely absorbed into the intestines, providing a good anti-inflammatory effect and eliminating disorders of intestinal motor function. Therapeutic enemas can be done every day for 2-3 weeks.

Prevention

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

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

Finally, one should seriously warn against the uncontrolled use of medications by patients, especially antibiotics, sulfonamides, enzymes and other agents. The illogicality and danger of self-medication with the listed medications for irritable bowel syndrome, as well as for other forms of functional intestinal diseases, lies in the fact that these potent drugs are intended to suppress pathogenic (disease-causing) intestinal microbes, which 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 influence intestinal pathogens, antibiotics, sulfonylamines and other potent medications exhibit 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 adverse effects appear. All this should convince you of the dangers of self-medication and the advisability of seeking advice from a doctor to choose an individually indicated treatment.

Irritable bowel syndrome (IBS) is a complex of functional digestive disorders in the intestine, not associated with organic damage to the intestine itself, that last for more than three months. A person is considered to have irritable bowel syndrome if they are bothered by:

pain and discomfort in the abdomen (usually relieved after going to the toilet);
flatulence, rumbling;
a feeling of incomplete bowel movement or an imperative (urgent) urge to defecate;
stool disorders (constipation, diarrhea or alternation of diarrhea with constipation).
Worldwide, this disease, according to various sources, affects from 15% to 30% of the population. True, only a third of them turn to doctors for help. Irritable bowel syndrome occurs 2-4 times more often in women than in men. The peak incidence occurs at young working age - 25-40 years, and in people over 60, irritable bowel syndrome practically does not occur.

Causes of Irritable Bowel Syndrome

Intestinal dysfunction is explained by the characteristics of the patient’s body. As a rule, this disease affects people who are emotional, mentally unstable, and prone to stress. Also important:

violation of the usual diet and diet;
lack of fiber in food;
sedentary lifestyle;
gynecological diseases (can cause reflex bowel dysfunction);
hormonal disorders - menopause, premenstrual syndrome, obesity, hypothyroidism, diabetes mellitus, etc.;
suffered acute intestinal infections with subsequent dysbacteriosis.

What's happening?

Under the influence of the above factors, a change in the sensitivity of receptors in the intestinal wall occurs, and as a result, its functioning is disrupted. The cause of pain is intestinal spasms or excessive gas formation with overstretching of its walls.

You can guess if you have irritable bowel syndrome by the following signs:

pain in the abdomen around the navel or lower abdomen after eating, it usually disappears after bowel movements or passing gas;
diarrhea after eating, usually in the morning and early afternoon;
constipation;
flatulence;
feeling of incomplete bowel movement after visiting the restroom;
sometimes - belching of air, nausea, a feeling of heaviness and fullness in the stomach.
It is characteristic that all these unpleasant symptoms arise from excitement or after it, as a result of prolonged physical and nervous stress. Often, intestinal disorders are accompanied by headache, a feeling of a lump in the throat, insomnia, a feeling of lack of air, frequent urination, tinnitus, a feeling of weakness, and dry mouth.

Sanatorium-resort treatment is indicated for patients with intestinal diseases in the stage of stable clinical remission.

The main therapeutic factor in the sanatorium is the use of mineral waters. For example, for diarrhea, mineral waters with low mineralization (Essentuki No. 4, Smirnovskaya, Slavyanovskaya) are indicated. Mineral water is heated to a temperature of 40-45 ºС and thereby degassed. The amount of water consumed is calculated depending on body weight (3-4 ml per 1 kg of weight).

But in case of pathological changes in the large intestine, highly mineralized waters are indicated (“Essentuki” No. 17, “Batalinskaya”, “Morshin” at room temperature, 100 ml 3 times a day). It is recommended to drink water quickly so that it does not have time to degas.

In sanatoriums, intestinal lavages are carried out with mineral water. Such procedures are indicated for patients suffering from constipation. Intestinal lavages help remove waste, toxins, and eliminate intestinal stasis. After this procedure, normal intestinal motility is restored and constipation is eliminated. Due to the fact that fecal stones are washed away, intestinal trophism improves and the absorption of nutrients and vitamins increases. Before starting intestinal lavage with mineral waters, the patient must consult with the attending physician at the sanatorium. In some clinical situations, such procedures are contraindicated. Colon lavage should not be prescribed for nonspecific ulcerative colitis, intestinal polyposis, hemorrhoids, or cardiovascular failure.

For chronic non-ulcerative colitis, siphon intestinal lavages are also performed in sanatoriums. The doctor in the treatment room selects the temperature of the mineral water for microenemas depending on the characteristics of the patient’s intestinal motility. If the patient suffers from constipation, then warm mineral water is used, which helps to relax the intestinal wall. In case of diarrhea, the use of cold mineral water is indicated, which causes increased intestinal motility.

Sanatorium-resort treatment includes a whole range of health-improving activities. An obligatory component of the recovery course is the prescription of a particular diet. Experienced doctors select a therapeutic diet for each patient individually.

In this case, many factors are taken into account: the nature of the stool, the presence or absence of malabsorption syndrome, motility disorders, and the presence of enzymopathies. Throughout the entire stay in the sanatorium, skilled chefs will prepare not only healthy, but also tasty food, so that it will be easy for the patient to follow the necessary diet.

In the process of sanatorium-resort treatment, herbal medicine is also widely used. Healing herbs are collected in the ecologically clean surroundings of the sanatorium. Almost every specialized gastroenterological sanatorium has homeopathic doctors who can select a suitable medicinal herbal collection for the patient. For constipation, infusions and decoctions of kelp, senna, aloe, oregano, buckthorn, burdock, lemon balm, rhubarb, licorice, dill, and fennel are prescribed. For intestinal atony, buckthorn bark, marshmallow root, and flax seeds are effective. For diarrhea, doctors will select mixtures with yarrow, oak bark, birch, and blueberries. St. John's wort, bird cherry, calendula, cinquefoil, black currant, and burnet also have a fixing property. For flatulence, infusion and decoction of chamomile, mint, calendula, sage, as well as pomegranate, rose hip and strawberry juices are prescribed.

One of the fundamental and at the same time accessible methods of rehabilitation treatment in a sanatorium is physical therapy. We all know that reasonable physical activity improves health. Under the influence of physical exercise, all protective systems are activated, immunity increases, which, of course, has a beneficial effect on health. And most importantly, physical activity helps strengthen the nervous system. Thus, scientists have proven that often the cause of diarrhea or constipation is not intestinal pathology, but a disorder of nervous regulation. In such cases, therapeutic exercises become simply indispensable in the fight against the disease. In addition to affecting the nervous system, physical exercise also improves the functioning of the cardiovascular system. This, in turn, improves blood supply to the digestive organs. Activation of blood circulation in the vessels of the abdominal cavity leads to increased metabolism, an increase in the flow of nutrients and oxygen to diseased organs, which are simply vital for recovery. In addition, sports exercises strengthen the abdominal muscles, enhance intestinal motility, which leads to normal bowel movements and can serve as a preventive measure for constipation. Physical exercise improves diaphragmatic breathing, which also leads to activation of the lazy intestines.

The diaphragm is a respiratory muscle located inside the abdomen, at the border of the abdominal and thoracic cavities. If you take deep breaths, this muscle is activated and stimulates the contraction of the intestinal walls, which promotes the movement of feces.

In the process of sanatorium-resort treatment, an important role is given to the psychological rehabilitation of patients. Patients with irritable bowel syndrome, constipation, and malabsorption syndrome (malabsorption) especially need this. In this group of patients, anxiety disorders, obsessive-compulsive neuroses, and hypochondriacal disorders are noted. Each sanatorium has specialists in medical psychology and psychotherapists. For the purpose of psychological rehabilitation, hypnosis, autogenic training, and suggestive therapy are used.

In a sanatorium, you can undergo a course of necessary physical procedures. Depending on the type of disease, type of intestinal motility, age, gender, an individual course of physiotherapy is selected. For chronic constipation, ultraviolet irradiation, galvanic current, microwave therapy, and abdominal massage are indicated. To activate intestinal motility and eliminate congestion, many sanatoriums use modern and effective techniques such as reflexology, electropuncture, laser treatment of biologically active points, and electrosleep.

In the case of intestinal hypermotility, patients are prescribed electrophoresis with antispasmodics, ultraviolet irradiation, diathermy, diadynamic therapy, paraffin-ozokerite or mud applications. For hypomotility, cool water procedures, contrast baths, underwater massage showers, electrophoresis with calcium chloride, and Charcot showers are used.

If the patient has chronic diarrhea with spastic phenomena and pain, then warming compresses, paraffin or ozokerite applications, electrophoresis with antispasmodics, and inductothermy are prescribed.

At the Gorodetsky sanatorium, patients are given the opportunity to undergo a course of mud therapy. Before starting mud therapy, the patient is referred for a consultation to a sanatorium physiotherapist. Treatment with mud is indicated for inflammatory bowel diseases, moderate pain syndrome, and adhesions in the abdominal cavity. Mud is used in the form of applications to the abdominal area, as well as rectal tampons. In this case, the dirt is heated to a temperature of 42-44 ºС. Hot mud helps normalize intestinal motility and peristalsis, stimulates metabolic processes, and improves blood supply to the intestines. After completing a course of mud therapy, inflammation in the intestines decreases and the absorption of nutrients improves.

Many have probably noticed how, after strong excitement or stress, a wave of pain rolls through the stomach. It’s good if the usual no-spa is at hand - it will relieve the painful spasm. However, even without medication, when the nervous system returns to normal, the unpleasant sensations will also disappear on their own. It’s worse if, over time, abdominal pain becomes the norm.
Healthy lifestyle correspondent Lyubov Ulyanova asked Candidate of Medical Sciences, head of the department of coloproctology of the Federal State Institution “Polyclinic No. 1” of the Administration of the President of the Russian Federation Anatoly Ivanovich Vanin to explain what happens to the intestines when a person is not in a good mood.
For many years, scientists and doctors did not know how to classify a person’s condition in which he periodically experiences certain discomfort, unpleasant sensations, and incomprehensible, fleeting pain in the intestines. The malaise raised many questions, because sometimes it was difficult to even call it a disease. However, since there were more and more patients with such symptoms, about five years ago a new chapter appeared in the international classification - irritable bowel syndrome, or IBS for short.
Irritable bowel syndrome is a functional condition that most often occurs after stress, poor nutrition, or as a result of infection, when conditionally activated pathogenic microflora appears in the intestine. The main symptoms of IBS are constipation, diarrhea, mucous discharge, usually without blood, bloating, cramping pain (colic), usually in the lower abdomen.
Irritable bowel syndrome usually affects the entire intestine, starting with the stomach. The disease can be acute or chronic.
Young people, aged 25-40 years, men and women, are more likely to suffer from IBS.
Since similar symptoms are characteristic of many other diseases, in particular polyps, ulcerative colitis, cancer, Crohn's disease, differentiation of the disease is necessary. Suppose, when a person complains of bloating, we need to look for the cause, the trigger of the symptom. Sometimes endoscopic and x-ray examinations of the gastrointestinal tract are required. And if only functional changes are detected, we can talk about IBS.
First of all, this is an increased or decreased secretion of digestive juices, against the background of which fermentation and putrefactive processes occur in the gastrointestinal tract, and as a result, belching, nausea, bloating, and gas formation occur. There may also be changes in the structure of the mucous membrane: thickened folds appear or, on the contrary, its smoothness. Chronic irritable bowel syndrome is accompanied by constipation and more severe cramping pain. Although the cause of all unpleasant manifestations is usually the same - everyday stress.
Often, against the background of irritable bowel syndrome, dyskinesia and dysbiosis may occur, caused, in particular, by taking antibiotics in large doses. That is why the symptoms of IBS must be approached comprehensively.
Having resolved another, long-term syndrome, do not wait until it appears again and have a colonoscopy. Such an examination will be painless if you take 1 tablet of dicetel 3 times a day with meals for 3 days. After taking dicetel, the examination goes like clockwork.
Let me note that dicetel, as well as pancroflat, espumizan, disflotil, and meteospasmin, are good for relieving intestinal spasms in IBS. However, I still advise you to use less chemicals and use more natural preparations, herbal infusions, follow a diet, take physical therapy, and do simple exercises to train the abdominal and pelvic floor muscles. For example, the same “bicycle” is indicated for intestinal hypokinesia, and well-known relaxation exercises are indicated for the hyperkinetic type of colon motility.
If the intestines are weak, infusions of verbena, knotweed, and toadflax herbs are useful. For a glass of boiling water – 1 teaspoon, take a quarter glass three times a day before meals. And an hour and a half before meals, 2-4 times a day, you can drink a glass of cold mineral water without gas, such as “Slavyanovskaya”, “Smirnovskaya”, “Batalinskaya”. Eat more raw vegetables and fruits, as well as cold foods.
If the intestines, on the contrary, are extremely active, it will be calmed by infusions of linden flowers, chamomile, calendula, yarrow, oregano herb, lemon balm, mint, hop heads, fennel fruits, and carrot tops. Brew and take - the same. Fennel is especially effective for heavy gas formation, and lemon balm for cramps. Chamomile will relieve both. Therefore, you can use 2-3 types of herbs at the same time. From mineral waters, Borjomi and Narzan are suitable - 1-1.5 glasses each, warmed, without gas, an hour before meals, 2-3 times a day. Food should also be taken mostly warm.
Warm (37-38 degrees) general (or sitz) baths will relieve intestinal spasms just as well as medications. Especially useful With sea salt: pour 2 kg of salt with hot water, then fill the bath to the top, lie down for 20 minutes - and the pain will go away, and at the same time the nervous system will calm down. The sea bath can be replaced or alternated with pine by purchasing the appropriate concentrate at the pharmacy. It’s a good idea to wet wrap yourself at night by soaking a towel in warm water and applying it to the sore area.
And further. We must not forget that the manifestations of irritable bowel syndrome are always affected by any strong emotional situations, be it the death of a loved one, the joy of the birth of a long-awaited child, or an emergency, “burning” at work. Recently, there has been an increase in functional diseases, and in almost every third patient, symptoms of IBS are associated with social and everyday troubles. That’s why – work, rest, emotions – everything should be in moderation.

Simonova T. M., Kurbatov V. A., Sergeeva O. A.

Administration of the President of the Russian Federation Federal State Institution "Sanatorium "Oak Grove", Zheleznovodsk

Functional diseases of the gastrointestinal tract (FGID) are widespread in economically developed countries (according to some data, they affect about 70% of the population). A classic example of FBGI is irritable bowel syndrome (IBS), which is very common in medical practice. Irritable bowel syndrome is a disorder of the motor and secretory functions of the intestine, mainly the colon, without structural (organic) changes in the organ. Psychogenic factors and stress are of great importance in the occurrence of motor and secretory intestinal disorders.

We observed 25 patients with IBS who received complex sanatorium-resort treatment, including gentle or gentle-training motor regimen, therapeutic exercises, dietary nutrition, mineral water of the Slavyanovsky spring for internal (drinking) and external (in the form of baths) use, and also intestinal procedures (siphon intestinal lavages with mineral water of the same physicochemical composition as for internal use), and microenemas (with herbal decoction and oil). For drinking treatment, mineral water from the Slavyanovsky spring was used, which was prescribed 3-3.5 ml/kg body weight 40-45 minutes before meals 3 times a day. For baths, the same mineral water at a temperature of 36-370C was used as for drinking treatment, for 15 minutes 3-4 times a week. The number of baths was 10-12 per course of treatment.

The patients were predominantly aged from 20 to 55 years (92%), with a disease duration of 1 to 10 years - 24 people (96%). Of these, there were 18 (72%) women and 7 (28%) men.

The clinical picture of the disease was characterized by the presence of obstipation syndrome in all patients (100%), pain syndrome in 16 (64%), dyspeptic syndrome in 21 (84%) and psychoemotional disorders in 22 (88%). In 23 (92%) patients with obstipation syndrome, the frequency of bowel movements was less than 3 times a week. The majority of patients - 20 (80%) noted difficulties during defecation of varying degrees of severity.

Pain syndrome was observed in 60% of patients and varied in intensity from unpleasant sensations (discomfort in the abdomen) to short-term attacks of intestinal colic localized in the left lower quadrant of the abdomen or hypogastrium. In 12 patients (48%), pain occurred before defecation and disappeared soon after it. About half of the patients (52%) noted a clear connection between the occurrence of pain and psycho-emotional stress. In 6 patients (24%) pain occurred after eating. Patients with IBS noted complaints of pain in the intestinal projection only during wakefulness; they were absent during sleep. An objective examination revealed bloating of the abdomen, moderate pain over its entire surface in the majority of them, in 13 (52%) a spasmodic sigmoid colon was palpated. Dyspeptic symptoms were observed in 21 (84%) patients and were manifested mainly by heartburn and belching, nausea was detected in 5 (20%). 21 (84%) patients complained of bloating, rumbling in the abdomen, and increased gas production, especially in the afternoon.

Psychoemotional disorders were observed in 22 (88%) patients. Their severity was assessed using generally accepted psychological tests. Headaches and weakness were noted by 15 (60%), irritability - 22 (88%), impaired sleep quality - 6 (24%).

After the spa treatment, the majority of patients showed positive dynamics in the main clinical and paraclinical indicators. This was reflected in an improvement in the act of defecation (frequency of defecation at least 4 times a week) in 13 (65%) patients. Complaints of difficulty defecating and a feeling of incomplete bowel movement decreased with approximately the same frequency. Pain syndrome decreased in 12 (75%), dyspeptic symptoms - in 15 (71.4%), psycho-emotional disorders - in 14 (66.7%), headaches and weakness decreased significantly in 8 people (32%).

The overall effectiveness of spa therapy was 76%.

Thus, low-mineralized mineral water of the Slavyanovsky spring, when used internally and externally, has a beneficial effect on the clinical symptoms of irritable bowel syndrome by reducing the frequency of manifestations of the main clinical syndromes: pain, dyspeptic and obstipation.