Spastic abdominal pains

Description:

A number of different pain belongs to spastic. It is caused by a spasm of smooth muscles of internals, the digestive tract (DT), bile-excreting system, urinary tract.

Symptoms of Spastic abdominal pains:

Classical display of visceral abdominal pain — colic (Greek kulikz — an intestinal disease) — is characterized by a colicy pain in a stomach of high intensity at which rise periods of pain alternate with "light intervals". During another "fight" intensity of pain quickly increases, then there comes "plateau" — the period when expressiveness of pain is maximum on intensity (proceeds of 15 min. till several o'clock) then pain gradually abates. Between attacks pain completely is absent (Gubergrits N. B., 2010).

Kolikoobrazny pain is, as a rule, characterized by high intensity. At pain height patients are uneasy, often change position of a body, rush about or accept a forced pose, trying to find situation which will reduce sufferings.

At excessive intensity of an impulse (for example when passing a stone) or anatomic damage of body (for example infringement of a gut) there is an irradiating pain in the body parts having the general radicular innervation with the struck body (Babak O. Ya., 2006; Yakovenko E. P. and соавт., 2009).

Visceral pain is characterized by lack of accurate localization — zones of her perception are, as a rule, indistinct. At injury of a gullet, stomach, ZhP, biliary channels, a pancreas pain is localized in epigastric; at pathology thin, a caecum — mezogastralny; at damage of a large intestine, bodies of a small pelvis — hypogastric area. At the same time pain is felt closer to a stomach midline as internals have a bilateral innervation.

Abdominal pain is seldom noted as an independent symptom and often is followed by nausea, vomiting, bitterness in a mouth, heartburn, feeling of overflow in a stomach, a meteorism, a diarrhea, a lock and other symptoms. At acute visceral pain quite often note the accompanying vegetative reactions (weakness, pallor, perspiration, an asthma, etc.), fever of reflex genesis, a local muscle tension of a front abdominal wall (Baranskaya E. K., 2005; Sadovnikova I. I., 2009).

Reasons of Spastic abdominal pains:

Spastic pain most often arises in a stomach as reaction to an error in food, at a premenstrual syndrome (PMS), at chronic gastrointestinal diseases – a peptic ulcer of a stomach and a duodenum, etc. The stomach and intestines (as hollow bodies) only react to a spasm of their muscles or, on the contrary, to expansion (when, for example, gases torment).

Treatment of Spastic abdominal pains:

It is known that introduction of analgetics is contraindicated to patients with not specified diagnosis and/or signs of an acute abdomen. So, most of authors consider wrong the decision to stop acute abdominal pain at a pre-hospital stage in connection with risk of leveling of a picture of acute surgical pathology: anesthesia can complicate a diagnosyotika and make an impression of imaginary wellbeing. It is difficult to distinguish during this period an acute surgical disease from the nonsurgical reasons of an abdominal pain, poyoety at any displays of acute abdominal pain it is necessary to refrain from use of analgetics (Babak O. Ya., 2006). At the same time clinical practice demonstrates that in most cases the attack of spastic abdominal pain is followed much by the expressed pain syndrome: sufferings of the patient during this period are so painful that demand anesthesia. Thus, in the absence of need of the emergency operative measure use of analgetics is a necessary component of treatment.

Spasmolytic therapy is not followed by direct intervention in mechanisms of painful sensitivity, does not complicate diagnosis of acute surgical pathology (Ivashkin V. T. (edition), 2003). Besides, use of spasmolysants in this case is pathophysiologically reasonable. So, for the purpose of achievement of relaxation effect at the peripheral level, decrease in sokratitelny activity smooth мьшц, elimination of a spasm and recovery of normal transit use of relaxants of unstriated muscles of a GIT — cholinolytics and myotropic spasmolysants which therapeutic effect is based on intervention in mechanisms of reduction of smooth muscle cells is shown.