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Intestinal dysbiosis - Changes in the normal microbial composition of the intestines as a result of various factors. In violation of the normal balance of the intestinal flora is characterized by replacement of normal species composition of pathogenic flora.
Structure and function of the human intestine provide the basic mechanism of digestion of food and absorption of nutrients necessary for normal body function. After rough machining in the stomach, food moves into the small intestine, where it is transferred to nutrient blood and lymph .
In the normal state in small intestine not own microflora , Getting into the microorganisms in the intestinal tract occurs in violation of the enzymes provoked by various diseases. Hit and development in the small intestine pathogenic organisms causing the infection, which is accompanied by diarrhea , Pain, bloating, and rumbling stomach. The development of useful nonpathogenic microbes causes a swelling and discomfort.
The main part of the intestinal microflora is localized in the second division - colon . In structure the large intestine is quite different from the fine, it consists of colons - rising . transverse . downward And from blind and sigmoid . In the colon there is a final water absorption, and flora living in this department regulates important for the health of the processes.
The normal intestinal microflora is a balanced ecosystem. This property are more than 500 different species of bacteria, and is about 1, 5 kg of live bacteria. The main representatives of the intestinal flora of aerobic lactobacilli and anaerobic bifidobacteria .
Important features are the regulation of intestinal microflora metabolism bile acids and cholesterol Normalization of enzymatic digestion of proteins, carbohydrates and fats, as well as the digestion of nucleic acids, high molecular weight carbohydrates, fiber. The microorganisms in the intestinal flora increase the body's resistance to negative environmental influences. This is due to their involvement in electrolyte metabolism, synthesis of vitamins of group B, Ascorbic acid and Vitamin K As well as in the synthesis of substances having antibacterial activity.
In the qualitative composition of intestinal microflora bacteria present acting as a natural biosorbent . They contribute to the detoxification of endogenous and exogenous substrates and change the formula of toxic substances than make them harmless to humans.
In fact, a balanced intestinal ecosystem is an activator of our immune system, causing it to be on our toes and react at risk. Under the influence of microbes stimulated lymphoid apparatus , Permanent synthesis of immunoglobulins, reduced vascular permeability, penetration of toxic products.
The important functions performed by the intestinal microflora are improved synthesis histamine and amino acids In particular it is indispensable in the body tryptophan And assimilation vitamin D and calcium .
The amount and specific composition of microorganisms in the large intestine is constantly changing, while maintaining the quality ratio, in other words is stored dynamic equilibrium - the balance of the intestinal microflora . Such changes occur depending on the season, age, lifestyle, the environment and the mental state of a person. Conditionally divided into microflora resident and transient As well as non-pathogenic and conditionally pathogenic, that is useful in the composition and a small proportion. Disrupt the normal balance of intestinal bacteria overgrowth is a sharp change in the structure and the increase in the number of pathogenic bacteria leads to dysfunction and disease.
The occurrence of intestinal dysbiosis may be caused by a variety of factors, most often it is an unbalanced diet, immune deficiencies, intestinal infections, long term administration antibiotics , Hormonal and steroidal drugs. The reason may be dysbacteriosis and treatment of diseases chemotherapy and radiation therapy. In the appointment of therapy required prevention of intestinal dysbiosis.
The classification of dysbiosis are four stages of development, as well as the divided primary and secondary dysbiosis. In primary disease microflora change occurs, and further there is inflammation of the mucous membranes of the intestinal tract. Secondary dysbacteriosis usually a complication of diseases of the small or large intestine, which depends on the clinical picture and the main symptoms.
First stage intestinal dysbiosis is characterized by a slight development of pathogens and a moderate decrease in the amount of beneficial bacteria. Symptoms of intestinal dysbiosis during the first stage is usually absent.
To second stage characterized by a critical decrease in the composition of obligate flora - bifidobacteria and lactobacilli, as well as the rapid development of pathogenic microbes. Presence of the first symptoms of the disorder of the intestine.
Third stage characterized by inflammation with damage to the intestinal wall. Intestinal disorders become chronic.
Fourth Stage intestinal dysbiosis is the beginning of an acute intestinal infection. At this stage, characterized by general exhaustion, anemia. An imbalance of intestinal microflora moves toward pathogenic bacteria and fungi. Living in the gut flora is present in very small proportions.
Symptoms of intestinal dysbiosis
The clinical picture of the development of dysbiosis and the flow depends on the stage and on the microbiological embodiment disorder. Characteristic symptoms of dysbiosis is frustration of a chair . diarrhea Caused by the formation and accumulation in the intestine of a large amount of bile acids, which retard the water absorption and cause changes in the structure of the intestinal mucosa. In addition dekonyugirovannye bile acids have a laxative property, thereby causing unstable chair.
When age is characterized by frequent dysbacterioses constipation , Especially when co-morbidities such as atherosclerosis or chronic colitis . Constipation relief actions are due to the microflora of the large intestine peristalsis.
As you can see, the symptoms of dysbiosis are varied, but the main is still a flatulence . Flatulence in the colon and the intestinal wall changes lead to disruption of absorption and removal of gases. This gives rise to such symptoms as unpleasant odor and taste in the mouth, bloating, burning sensation in the area of infarction, cardiac arrhythmia. When there is a sharp increase in flatulence dyspeptic asthma Which is characterized by sudden shortness of breath and swelling, dilated pupils, and cold extremities.
A common feature is also a dysbiosis abdominal pain . Characterized by monotonous, pulling or arching pain. Generally the pain is accompanied by flatulence and intensified towards the end of the day. There may be severe and colicky abdominal pain. After the meal there is a rumbling in the stomach, gastrotsekalny reflex .
When dysbacteriosis bowel syndrome occurs gastrointestinal dyspeptic . There remains an appetite, a feeling of fullness in the epigastric region, pneumophagia , Belching and nausea. After a while there Biliary due to gut dysmotility. This condition occurs during stimulation of gut fermentation products acids. In the intestine, an excess emissions of CO2, methane, hydrogen sulfide, which further strengthens flatulence. In the fourth stage of intestinal dysbiosis may be a putrid dyspepsia. The processes of fermentation and putrefaction in the intestines leading to drastic changes in the composition of feces.
Microflora imbalance leads to violations of its basic functions, there are signs of polyhypovitaminosis . Lack of the body thiamine leads to impaired intestinal motility, there is a tendency to atony . headache , Myocardial degeneration, suffering peripheral nervous system . Patients may experience depression, irritability, excessive salivation, which is a sign of deficiency nicotinic acid . Insufficiency riboflavin shown stomatitis . dermatitis on the wings of the nose, hair loss and changes the nail plate.
Often when there is a dysbacteriosis anemia . This condition occurs due to the weakening of synthesis folic acid and cyanocobalamin . Their use as a competitive pathogenic and beneficial bacteria leads to a sharp reduction in the amount of these elements - normochromic Rarely hyperchromic anemia . Food allergies It can also act as a symptom of dysbiosis. Increased activity of the intestinal microflora leads to increased production of histamine and an allergic reaction to certain foods.
Imbalance microflora can have different symptoms of intestinal dysbiosis, it depends on the type of predominant microbe flora. The most common pathogens are representatives staphylococcus . Pseudomonas aeruginosa . Candida fungus . misogasee . aspergilus . View dysbiosis can install laboratory diagnosis, there are differences in the clinical picture of the disease.
Fungal intestinal dysbiosis is due to receive antibiotics. The use of antibiotics disrupts the balance of flora, beneficial bacteria that produce substances with a fungistatic effect die, thus giving way to the fungi that do not respond to antibiotics.
Foremost among fungal dysbacterioses is candidiasis . Reproduction yeasts Candida albicans It causes the surface of the mucous membranes. Candidiasis intestines and stomach, usually accompanied by other diseases.
In less severe clinical signs of the disease appear dysbiosis marginally. There may be slight abdominal pain, loose stools, more often than normal temperatures. In more severe course there low-grade fever That lasts long enough, headaches, excessive sweating. In the sigmoid colon felt pain, swelling, heaviness. Chair frequent, abundant with mucus.
Among fungal dysbacterioses allocated as mucormycosis and aspergillosis . These diseases in the intestinal form are much rarer than candidiasis. Often poor prognosis. Muromikoz develops as a consequence of contact with the pathogen in the intestinal tract during concomitant diseases. Aspergillosis, in turn, may occur after prolonged antibiotic therapy. The development of the disease, and acute severe. Frequent symptoms of diarrhea, changes in the intestine hemorrhagic necrotic nature.
Patients ulcerative colitis or chronic enterocolitis As well as in individuals previously undergone dysentery . salmonellosis Other acute intestinal infections may occur intestinal dysbiosis caused by Pseudomonas aeruginosa. Most Pseudomonas bacteria overgrowth occurs in patients with reduced immunity, can also be the result of food poisoning.
The morphological features distinguish catarrhal and fibro-purulent With hemorrhage, necrosis, Pseudomonas bacteria overgrowth. Symptoms of intestinal dysbiosis caused by Pseudomonas aeruginosa as a result of food toxic infection: abdominal pain, frequent repeated vomiting diarrhea with mucus. After 7-10 days can occur paralytic ileus, cardiovascular failure that lead to death. Pseudomonas bacteria overgrowth caused by excessive intake of antibacterial drugs has less pronounced pattern and a good prognosis.
Staphylococcal bacteria overgrowth bowel and develops after acute intestinal infections, an illness of the digestive system, long-term toxic effect of antibiotics paired with vitamin deficiency. In mild uncomplicated staphylococcal dysbacteriosis characterized by mild symptoms of intoxication, disturbances of appetite, weakness, and bland inflammatory process. Rising temperatures are accompanied by a fever.
At moderate and severe clinical course of dysbiosis clinical signs are more pronounced, the temperature greatly rises to 38-39 degrees, there is a fever, sweating. Intoxication is manifested by headaches, weakness, pain in the abdomen. A chair liquid up to 10 times a day, with mucus, blood and pus. In severe dehydration observed violations of the cardiovascular system.
Diagnosis of intestinal dysbiosis
The diagnosis is made by bacteria overgrowth of laboratory tests and the characteristic signs of the disease. Basic tests for suspected violation of intestinal microflora is Fecal seeding . Urine and bile dysbacteriosis, and scatological study of feces . A recent study provides an opportunity to discover iodophilic microflora , Large amounts of digested starch and intracellular tissue, which is indicative of the presence of the disease.
Diagnosis of intestinal dysbiosis by culture fecal bacteria overgrowth does not always give reliable results. The advantage of bacteriological research is the ability to cultivate a particular type of bacteria and to determine their relative proportions. Good result gives the analysis of suspected staphylococcal or intestinal fungal Bacteriosis . In addition, this method is the cheapest and most accessible of all laboratory tests. If necessary, conduct research biotapta wall of the small intestine or planting postgraduate contents of the small intestine. Due to the technical complexity of this analysis it is rarely prescribed.
More broadly in the diagnosis of intestinal dysbiosis the method polymerase chain reaction - PCR diagnostics determination of microbial species. It can be used to determine the representatives of the intestinal microflora, which are not in the intestinal lumen. Although today this method is basic, its accuracy leaves much to be desired. Informative analysis is very low, due to the limited range of bacteria that can be detected with PCR diagnostics.
For the diagnosis can be used chemical methods of research, it is Mass spektromeriya and gas-liquid chromatography . A study of the intestinal contents to determine the concentration of microbial products, which is calculated based on the composition and ratio of the intestinal microflora. A significant disadvantage of this study the cost, equipment requirements and calculations.
Fungal Bacteriosis diagnosed in the background enterocolitis and enteritis Which provoked prolonged antibiotic therapy. Symptoms of intestinal dysbiosis, particularly blood mucoid diarrhea indicate the presence of fungal infections, and laboratory analyzes confirm the diagnosis. Appointed Research scrapings of the intestinal mucosa and fecal mycelium.
The most common confirmation of the diagnosis occurs unfounded. There is no clear concept of the norm biocenosis bowel in different patients different composition of microflora, and its constant changes make it impossible to accurately calculate the ratio of quality. Complete scientific research on the subject has never been carried out. What actually is the difficulty of diagnosing dysbiosis. It is also important that the classification of diseases such diseases as intestinal dysbiosis does not exist, as there are constant discussions.
Treatment of intestinal dysbiosis
For the treatment of dysbiosis is used a number of drugs developed on the basis of micro-organisms and their products - Prebiotics and probiotics .
Assign with dysbiosis probiotics consist of live organisms that regulate intestinal microflora. An important function of such microbes is ability to survive during storage of the drug and directly intestinal ecosystem.
Appointed by several groups of probiotics. Monokompolentnye contain in their composition one species of microbes: bifidobacteria . lactobacilli or colibacteria . Polycomponent contain a combination of the main strains of bifidobacteria, lactobacilli and colibacteria. Combination products consist of symbiotic communities of the main representatives of the intestinal flora, and contain compounds stimulate the growth of normal microflora. There are also recombinant probiotics, they are composed of not only the necessary bacteria and cloned genes for the synthesis of alpha-interferon.
Prebiotics in turn is non-microbial origin drugs. Prebiotics are not digested disaccharides That stimulate the growth and activity of its own flora and inhibit the development of pathogenic micro-organisms.
Treatment of intestinal dysbiosis appointed complex, depending on the extent of the disease.
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