Syndrome of the angry intestines

Description:

  The syndrome of the angry intestines is the steady set of functional frustration lasting not less than 12 weeks for the last 12 months which is shown pain and/or discomfort in a stomach which pass after defecation are followed by changes of frequency and a consistence of a chair and are combined throughout 25% of time of a disease not less than with two resistant symptoms of dysfunction of intestines - changes of frequency of a chair, consistence a calla, the act of defecation (imperative desires, tenesmus, feeling of incomplete bowel emptying, additional efforts at defecation), mucifying with a stake, a meteorism.

Symptoms of the Syndrome of the angry intestines:

The group of experts made the list of the symptoms characteristic of the syndrome of the angry intestines (SAI). Doctors often use this list known as the Roman criteria of III to distinguish SRK from other diseases of intestines. However at the people suffering from SRK it can not be observed any of these symptoms.

The probability of existence of SRK is high if symptoms began at least 6 months ago, pain or discomfort in a stomach proceed at least 3 days for 3 last months, and at least two of the following statements are true:

    * Pain decreases after defecation.
    * Pain changes depending on defecation frequency.
    * Pain changes depending on outward and a consistence of a chair.
    * Existence any of the following symptoms speaks well for the diagnosis of SRK.

Changes of a chair:

At SRK character of excrements can change over time. Two or more of the listed conditions can be observed:

    * The chair is more often (diarrhea) or is more rare (lock), than normal, that is 3 times a day are more often or are more rare 3 weekly.
    * Change of volume and consistence of a chair (firm and granulopodobny, thin, or not properly executed and watery).
    * Defecation process change. At the same time there can be strong desires to defecation or feeling of incomplete bowel emptying.
    * Abdominal distention.

Other intestinal symptoms:

Some patients complain of pain in the lower part of a stomach and the lock which is replaced by diarrhea. Others have a pain and a moderate lock, but without diarrhea. Sometimes symptoms include accumulation of gas in intestines and slime in Calais.

Abenteric symptoms:

Emergence of the symptoms which are not connected with intestines, for example is in certain cases possible:

    * Alarm or depression
    * Fatigue.
    * Headache.
    * Unpleasant smack in a mouth.
    * Dorsodynia.
    * Sleep disorders (sleeplessness) which is not caused by SRK symptoms.
    * Sexual frustration, for example, pain during sexual intercourse or decrease in sexual desire.
    * Feeling of interruptions in heart (feeling of dying down or trembling of heart).
    * Disturbance of an urination (frequent or strong desires, the complicated beginning of an urination, incomplete bladder emptying).

Symptoms often arise after food, in stressful situations or during periods.
The symptoms similar to SRK symptoms meet at many other diseases.

Reasons of the Syndrome of the angry intestines:

The origin of a syndrome of the angry intestines is not found out yet by doctors finally. At this syndrome a physical activity of a digestive tract is not carried out properly, but no deviations towards inflammatory processes or tumors in intestines are observed. Scientists consider that symptoms are connected with a problem of signaling of a brain to intestines. Such signals significantly influence the nature of physical activity of intestines.

For some people suffering from this syndrome to initiate pain and other symptoms low-quality food, a stress, hormonal changes in an organism and the use of some types of antibiotics can.

Treatment of the Syndrome of the angry intestines:

Treatment of a syndrome of the angry intestines can be divided on non-drug and medicamentous.
Non-drug treatment.
Diet. The diet allows to exclude the states imitating SRK (a lactose intolerance, fructose). To reduce gas generation and abdominal distention, and also the unpleasant feelings connected with it. But today there are no proofs that sick SRK should exclude any products from a diet completely.

Reception of vegetable fibers has identical efficiency with placebo, and their efficiency at reception by patients with complaints to an abdominal pain and a lock is not proved. The British recommendations recommend reception of fibers in number of 12 grams a day as the bigger quantity can accompany emergence of clinical symptomatology of SRK.
Psychotherapy. The psychotherapy, hypnosis, a method of the return biological communication allow to reduce alarm level, to reduce tension of the patient and more actively to involve it in medical process. At the same time the patient learns to react in a different way to a stressful factor and increases tolerance to pain.
Drug treatment at SRK is directed to symptoms which force patients to see a doctor or cause in them the greatest discomfort. Therefore treatment of SRK symptomatic and at it many groups of pharmaceutical drugs are used.

Anti-spasmodic means show short-term efficiency and do not show sufficient efficiency at long courses of reception. Are recommended for reception at patients with a meteorism and imperative desires for defecation. The analysis showed that anti-spasmodic means have bigger efficiency, than placebo. Optimum their use for reduction of an abdominal pain at SRK is considered a short course. Among drugs of this group dicyclomine (English dicyclomine) and Hyoscyaminum (English hyoscyamine) are most often used.

The funds allocated for fight against dysbacteriosis. Rather often dysbacteriosis is the reason of a syndrome of the angry intestines. Treatment of a meteorism, swelling, gripes and other symptoms of dysbacteriosis  has to work in two directions: this elimination of symptoms of swelling, and also recovery and preservation of balance of intestinal microflora. Distinguish Redugaz from the means possessing at once two of these actions. Simetikon - one of the components which are contained in structure struggles with discomfort in a stomach and  delicately exempts intestines from vials of gas, weakening their surface intention throughout intestines. The second component prebiotic Inulin helps to avoid repeated formation of gases and  recovers balance of the beneficial bacteria necessary for normal digestion. Inulin suppresses growth of bacteria which cause gas generation therefore repeated swelling does not arise. Also from pluses it is possible to note that means is issued in a convenient form in the form of chewable tablets and  has pleasant mint taste.

Antidepressants are appointed to patients with neuropathic pain. Tricyclic antidepressants allow to slow down time of transit of contents of intestines that is the advantage factor at the SRK diarrheal form.

The metaanalysis of efficiency of antidepressants showed existence of reduction of clinical symptomatology at their reception, and their big efficiency in comparison with placebo. Reception of amitriptyline is the most effective at the teenagers suffering from SRK. It is less dose of antidepressants at treatment of SRK, than at treatment of a depression. With extra care appoint antidepressants to patients who tend to locks. The published results of efficiency of other groups of antidepressants are contradictory.

Anti-diarrheal drugs. The analysis of use of loperamide for treatment of diarrhea at SRK by the standardized criteria was not carried out. But the available data showed its big efficiency, than placebo. A contraindication to use of loperamide are locks at SRK, and also the alternating locks and diarrhea at patients with SRK.

Benzodiazepines restrictedly are used at SRK because of a number of side effects. Their reception can be effective short courses, for reduction of mental reactions at patients who lead to SRK aggravation.

Blockers of serotoninovy receptors of the 3rd type allow to reduce pain in a stomach and feeling of discomfort.

Activators of serotoninovy receptors of the 4th type — are used at SRK with locks. Efficiency of a lyubiproston (drug of this group) is confirmed two placebos with the controlled researches.

Guanylate cyclase activators at sick SRK are applicable at locks. Preliminary researches show their efficiency concerning increase in frequency of a chair at sick SRK with locks.

Antibiotics allow to reduce abdominal distention, presumably due to oppression of gas-forming flora of intestines. At the same time there is no confirmation that antibiotics reduce an abdominal pain or other symptoms of SRK. Also there is no confirmation that the increased bacterial growth leads to emergence of SRK.

Alternative therapy of SRK includes reception of phytotherapeutic means, probiotics, acupuncture and addition of enzymes. The role and efficiency of alternative methods of treatment of SRK remains uncertain.