Proctology

Intestinal Dysbiosis

Intestinal Dysbiosis

Dysbacteriosis – change of structure and quantitative ratios microflora normally inhabiting hollow bodies, communicating with the environment (e.g., the upper respiratory tract, intestines), and human skin.

With the activity of the microflora associated physiological status of the body condition and its nonspecific protective forces. Representatives of the so-called normal microflora, usually living in the gut, upper respiratory tract and on the skin of a person, due to the strong antagonistic activity protect these organs from penetration and rapid propagation of pathogenic and conditionally pathogenic microorganisms, and perform several other functions.

Intestinal dysbiosis is a large and still poorly understood problem of modern Coloproctology. As you know, the newborn gastrointestinal tract is sterile, and within a few hours after birth begins its colonization by strains of streptococci, Escherichia coli etc. in a day in the intestines it is already possible to detect anaerobic lactobacilli and enterococci, and about the 10th day, multiply intensively Bacteroides, and on average a month is established and stable at the same time, individual microbial cenosis. In the stomach, the proximal part of the small intestine in the jejunum and colon flora is very poor, while in the distal ileum, especially in the area of the ileocecal valve, the composition of the microflora varies, and the number of germs increases dramatically. In the colon there are 17 families, 45 genera and about 500 species of resident microflora.

The term “Dysbiosis” is invited to share in the “syndrome colonic dysbiosis” and separately “syndrome of intestinal dysbiosis”, and is almost important to know that various violations of the balance of the microbial flora of the intestine can lead to the exacerbation of colitis.

When dysbiosis may disappear some representatives of normal microflora (bifidobacteria, lactic acid and Escherichia coli etc.) and appear for rarely occurring microorganisms (fungi of the genus Candida, Staphylococcus, Proteus, Pseudomonas aeruginosa, etc.). There are varying degrees of marked local inflammation, and with a sharp weakening of the body resistance can develop generalized form of endogenous infection until sepsis. Dysbiosis is an important link in the pathogenesis of number of diseases of the digestive system, respiratory tract and skin, affecting the course and outcome of the disease and often require special treatment.

Causes

The causes of dysbiosis may be a few: it’s Hypo – and achlorhydria of the stomach (especially in case of violation of evacuation from it), is the leading loop syndrome after gastric resection for Billroth-2, jejunum and duodenal diverticula, blind loop syndrome with thin-colonic anastomosis the end-to-side, bowel obstruction, chronic pancreatitis, immunodeficiencies, thoughtless and uncontrolled use of antibiotics leading to death of a considerable part of representatives of normal microflora, sensitive to the drug, and multiplication of resistant to it of the microflora, including pathogenic and opportunistic, eating disorders, alcohol etc.

Symptoms, clinical course

Clinical syndrome of a dysbacteriosis develops of the 4 major symptoms – diarrhea, steatorrhea, weight loss and anemia.

Diagnostics

First of all, it is necessary to perform endoscopic or x-ray examination of the entire colon, in order not to miss polyps, polyps or cancer of this localization. Neoplastic processes, often affecting the large intestine, can occur, including abdominal pain, unstable stool (alternating constipation and diarrhea), bloating, weight loss, anemia – symptoms, seems to indicate the presence of dysbiosis.

Usually for the diagnosis of dysbiosis perform stool cultures on the flora. For a more accurate diagnosis can be used other methods: aspiration of the contents of jejunum; respiratory test with carbon; the test determining the level of 5% hydroxyindoleacetic acid (5% HIAA) in urine; glucose hydrogen breath test; D-kelasnya and-kelasnya tests for special investigations and determination of the severity of malabsorption related to the hypoproteinemia.

Dysbiosis and irritable bowel syndrome clinically similar and often occur together. In any case, the study of microbial cenosis of the colon in patients with irritable bowel syndrome is necessary, in the absence of conditions for a qualified bacteriological analysis of feces should be treated with the bacterial preparations.

Treatment

Goiter is often associated with impaired intestinal motility, irritable bowel syndrome, psycho-emotional disorders, so in many cases, the treatment of dysbacteriosis must be complex. Important components of treatment are:

  • strict adherence to diet;
  • normalization of the motility of the digestive tube – in normal colon reduced of 1 per minute and duration of the waves of peristalsis 40-50 seconds, and in violation of this rhythm (dyskinesia, disritmia) there is a slowdown or frequency reductions, which is clinically manifested, respectively, in constipation or diarrhea;
  • normalization of intestinal flora bacterial drugs and the elimination of possible intestinal stasis. Antibiotic therapy in many cases only aggravates a dysbacteriosis, although the appointment of tetracycline and other antibiotics, of course, strictly under the control of the sensitivity to them sown flora is widely accepted. The effectiveness of treatment is evidenced by the cessation of diarrhea;
  • functional food – good effect gives the use of antispasmodics and preparations of osmotic action;
  • consultation with a therapist – dysbiosis and irritable bowel syndrome is found in 10-20% of adults and is clearly seen in his relationship with the psycho-emotional sphere, i.e. with the characteristics of the individual: 75% of patients identified fatigue, depression, anorexia, kantserofobiey, etc. it Should be remembered that the examination of such patients, it is first necessary to exclude organic lesions of the digestive tract is to perform the proximal and distal endoscopy, preferably with a biopsy, to perform microbial cenosis of the intestine and the coprogram.

Prevention of dysbiosis

Prevention of dysbiosis is to explain the exaggerated and uncontrolled use of any antibacterial drugs, and application of bacterial preparations during and after treatment with antibacterial drugs, restorative therapies and nutrition for debilitated patients.

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