An injection in the arm to stimulate the intestines. Prevention and elimination of intestinal paresis in postoperative patients. Affecting the small intestine
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Intestinal peristalsis- This is a rhythmic contraction of the intestinal walls, during which the food bolus moves through the gastrointestinal tract. Proper contraction helps normalize digestion, absorb nutrients and remove toxins from the body.
These are medicinal laxatives that enhance intestinal motility and the passage of feces. They can be divided into several groups:
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Contraindications
Before using the above groups of drugs, you must consult with a gastroenterologist and therapist, since only after diagnosis is their use considered possible.
Contraindications to their use will be:
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Possible side effects
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The above side effects do not always occur, more often in people who abuse laxatives for a long time. To prevent such unpleasant symptoms, it is necessary to take breaks between courses of medication.
Other methods of enhancing peristalsis
The use of drug therapy is advisable with an integrated approach to. So, to ensure a better therapeutic effect, in addition to medications, the following is used:
- Diet. Exclusion from the diet of fatty, smoked, fried foods. You need to drink up to 2 liters of clean water per day (excluding soups, compotes, etc.), eat several vegetables or fruits, ideally a few more nuts and prunes (see). The daily diet should include porridge with water and foods high in plant fiber. In the morning, half an hour before breakfast, you need to drink a glass of cool water; a glass of fresh kefir an hour before bed also gives good results.
- Physiotherapy. This includes the “Bicycle” exercise, squats, self-massage of the abdomen, and playing sports.
- Cold and hot shower.
- Avoiding stress.
- Rejection of bad habits.
These are medicinal laxatives that enhance intestinal motility and the passage of feces. They can be divided into several groups:
- Medicines that increase stool volume. These drugs are taken with water and help soften stool. Representatives are Mucofalk, Glycerin, Vaseline oil.
- Prokinetics. They exert their effect through the release of acetylcholine. The main advantage is that their long-term use has virtually no negative side effects. This group includes Ganaton, Itomed.
- Osmotic laxatives. Drugs such as Duphalac, Portalac have a good osmotic effect, retain water well, and are the drugs of choice for pregnant women and children. Osmotic laxatives also include salt-based drugs. The mechanism of action of saline laxatives is based on improving the permeability of the intestinal walls, due to which a large amount of water enters the intestinal lumen, thereby causing the urge to defecate. Representatives: Glauber's salt (sodium sulfate), Magnesium citrate.
- Softening drugs or plasticizers are actively used in postpartum women or people who have undergone surgery. They are prescribed to patients who need to minimize the load on the anterior abdominal wall. However, their long-term use is not recommended due to the removal of large amounts of electrolytes from the body. Representatives: Lanolin, various oils, wax.
Contraindications
Before using the above groups of drugs, you must consult with a gastroenterologist and therapist, since only after diagnosis is their use considered possible.
Contraindications to their use will be:
- Oncology of the gastrointestinal tract, in particular the intestines. Laxatives and any other medications that improve peristalsis may not only not solve the problem, but also aggravate it. If the intestinal cavity is completely or partially closed by a tumor or polyp, then a sharp increase in pressure due to stimulation of motility can cause acute intestinal obstruction, intestinal volvulus, or perforation of the formation.
- Ulcerative defects of the gastrointestinal tract.
- Threatening bleeding.
- Intestinal obstruction.
- Inflammatory diseases of the gastrointestinal tract in the acute stage.
- Allergic reaction to the components of the drug.
- Acute surgical pathology.
- Pregnancy and lactation period. This contraindication is relative, since the use of lactulose-based laxatives (Duphalac) can be prescribed to pregnant women and even infants.
Possible side effects
- allergy;
- frequent diarrhea, which contributes to the leaching of necessary elements from the gastrointestinal tract (K, Na, Mg, etc.);
- disruption of nutrient absorption processes;
- inflammation of the intestinal walls;
- intestinal obstruction;
- dyspepsia: nausea, vomiting, belching;
- perianal itching.
The above side effects do not always occur, more often in people who abuse laxatives for a long time. To prevent such unpleasant symptoms, it is necessary to take breaks between courses of medication.
Other methods of enhancing peristalsis
The use of drug therapy is advisable with an integrated approach to the treatment of constipation. So, to ensure a better therapeutic effect, in addition to medications, the following is used:
- Diet. Exclusion from the diet of fatty, smoked, fried foods. You need to drink up to 2 liters of clean water per day (excluding soups, compotes, etc.), eat several vegetables or fruits, ideally a few more nuts and prunes (see Foods that enhance intestinal motility). The daily diet should include bran, water-based cereals, and foods high in plant fiber. In the morning, half an hour before breakfast, you need to drink a glass of cool water; a glass of fresh kefir an hour before bed also gives good results.
- Physiotherapy. This includes the “Bicycle” exercise, squats, self-massage of the abdomen, and playing sports.
- Cold and hot shower.
- Avoiding stress.
- Rejection of bad habits.
How to improve intestinal motility - recovery and treatment
Statistics show that a large part of the population of developed countries suffers from diseases associated with the gastrointestinal tract. It is the digestive system that is one of the first to begin to lose its functions, which entails the development of all kinds of pathologies and diseases. Even in ancient times, doctors advised changing lifestyle and diet in order to cope with illnesses.
Good health and performance of the body at any age depends on the proper functioning of the intestines. Any disruptions in the functioning of the digestive system immediately affect a person’s well-being and become a prerequisite for weakened immunity and the development of unwanted pathologies. Let's take a closer look at what happens to the body when intestinal motility is disrupted (dyskinesia), how to deal with this condition and restore the normal functioning of the digestive tract.
What is peristalsis?
Intestinal peristalsis is a wave-like contraction of the walls of a hollow tubular organ, promoting the movement of a bolus of food from its upper sections to the outlet openings. Peristalsis of the gastrointestinal tract plays a vital role in the digestion process, helping to move digested food from the upper to the lower intestines.
The process of peristaltic movements involves smooth muscles located in the intestinal walls in two layers. In one layer the muscle fibers are arranged longitudinally, in the other - circularly. The coordinated movements of these muscles create a peristaltic wave, the frequency of which will be different in different parts.
Thus, several types of peristaltic waves propagate in the small intestine, which differ from each other in the speed of passage through the intestine and can be very slow, slow, fast and rapid. In this case, several peristaltic waves can simultaneously pass along the small intestine.
In the large intestine, digested food moves more slowly than in other parts of the intestine, and accordingly the speed of the peristaltic wave will be slower. But several times a day, strong contractions occur in the intestine, pushing its contents towards the anus.
Peristaltic movements in the colon occur under the influence of a reflex after food fills the stomach. Normally, the frequency of peristaltic waves is: in the duodenum - contractions per minute, in the small intestine - 9-12, in the colon - 3-4 or 6-12, in the rectum - about 3.
This condition causes the development of many gastrointestinal diseases, which manifest themselves as stool disorders (constipation, diarrhea), inflammatory processes, the formation of ulcers and polyps. To prevent such sad consequences, you need to know about the risk factors that cause intestinal dysfunction.
Causes leading to impaired peristalsis
Weak intestinal motility can be caused by a number of provoking factors:
- Unbalanced diet with a predominance of low-calorie foods in the diet
- Chronically diseases of the intestines and internal organs (liver, pancreas, gall bladder)
- Benign and malignant intestinal tumors
- Surgical operations on the abdominal organs
- Insufficiently active lifestyle (physical inactivity)
- Age factor
- Genetic predisposition
- Disturbances in the functioning of the central nervous system, prolonged stress
- Taking medications that affect intestinal motility
Errors in nutrition are the main cause of constipation. Many are accustomed to satisfying their hunger with quick snacks, preferring a sandwich with sausage or fast food products combined with carbonated drinks or strong coffee to a full lunch. As a result of consuming floury and starchy foods containing excess fat and sugar, fermentation and putrefaction processes begin in the intestines.
Toxic substances penetrate through the walls of the large intestine into the abdominal cavity, poisoning the surrounding organs (liver, kidneys). By the age of 40, the intestines become heavily polluted, so-called fecal stones begin to form, the passage of which through the digestive tract causes damage to its mucous membrane. Lack of peristalsis leads to persistent constipation, stagnation of blood in the pelvic organs, the development of hemorrhoids, the formation of polyps and tumors.
For the normal functioning of the intestines and the vital activity of beneficial microorganisms, a slightly acidic environment and a sufficient amount of dietary fiber are necessary, which can be obtained by eating vegetables, fruits, cereals, and fermented milk products.
Proper functioning of the intestines largely depends on lifestyle. The onset of many gastrointestinal diseases is provoked by sedentary work, lack of movement and adequate physical activity. To enhance intestinal motility, it is necessary to carry out a set of daily exercises, including morning exercises and warm-up at work. Long walks in the fresh air will be of great benefit.
In old age, intestinal motility disorders are caused by the progression of concomitant diseases, hormonal causes, muscle atrophy and decreased muscle tone. In old age, atonic type constipation predominates, the development of which is associated with impaired innervation of the nerve nodes responsible for the motility of the gastrointestinal tract and age-related tissue hypoxia.
Symptoms
Disturbances of intestinal motility (dyskinesia) are manifested by a wide variety of symptoms:
- Frequent abdominal pain of different localization. The intensity of the pain syndrome can range from slight discomfort to acute spasms and increase or decrease depending on the time of day. For example, pain disappears after bowel movements or passing gas, they can subside in the afternoon and completely disappear during sleep, then renewing during breakfast, after drinking drinks containing caffeine (coffee, strong tea). Painful sensations can intensify with emotional turmoil and stress.
- Flatulence, bloating. Increased gas formation often accompanies the process of digesting food.
- Stool disorders. Characterized by persistent constipation, which can be replaced by diarrhea. Over time, constipation becomes chronic, and it is possible to achieve bowel movement only with the help of laxatives or cleansing enemas.
- Weight gain. Many patients, as the process of digestion and assimilation of food is disrupted, begin to gain extra pounds.
- Deterioration of general condition, weakness, irritability, insomnia.
- An increase in symptoms of intoxication of the body, the development of allergic reactions, damage to the skin (acne, rash, pustules).
If such unfavorable symptoms occur, you must rush to see a doctor for diagnosis and timely treatment of the pathological condition of the intestine.
Diagnostics
Diagnosing intestinal motility disorders only on the basis of patient complaints is quite difficult, since the symptoms of dyskinesia are similar to the clinical picture of many gastrointestinal diseases. The doctor needs to rule out intestinal pathologies such as colitis, diverticula, polyps of the rectum and colon, tumors.
For this purpose, a complex of studies is carried out, including scatology, stool examination for occult blood and dysbacteriosis, and hardware examinations (endoscopy and irrigoscopy). An important examination method is colonoscopy with biopsy (tissue sampling for histological examination). Diagnostic measures will make it possible to clarify the cause that causes malfunctions in the digestive tract and will help to understand how to restore intestinal motility.
Improvement and strengthening of intestinal motility
Treatment of intestinal motility involves an integrated approach, including the prescription of medications, nutritional adjustments and special exercises. Good results are achieved by using traditional medicine: decoctions and infusions of medicinal herbs, preparing mixtures that enhance peristalsis.
Treatment with medications:
In the treatment of intestinal motility disorders, drugs that have a stimulating effect, enhance motility and increase intestinal muscle tone (prozerin, aceclidine and vasopressin) are successfully used. All prescriptions must be made by a doctor, and medications must be taken under his supervision.
To enhance the contractile function of the intestines, laxatives are used. With their help, intestinal emptying is accelerated by enhancing peristalsis. Currently, there are a large number of different laxatives, their use will be determined by the need to influence certain parts of the intestine. All laxatives can be divided into several main groups:
- Laxatives that act on the entire intestine. These are Epsom and Glauber's salts; they are considered the most powerful and fastest-acting remedies. When taken, the osmotic pressure in the intestinal lumen increases, which prevents the absorption of the liquid part of the chyme and leads to increased peristalsis. The effect after administration occurs within 1-2 hours and promotes rapid emptying in case of acute constipation.
- Laxatives acting on the small intestine. These products include castor oil. Its intake facilitates the movement of contents through the intestines, increases its motility and speeds up the process of bowel movements. The effect after taking a laxative occurs within 2-6 hours and may be accompanied by moderate cramping abdominal pain.
- Laxatives affecting the large intestine. Such drugs can be herbal or synthetic. Herbal preparations are based on medicinal herbs and plants: roots of rhubarb, buckthorn, licorice, senna leaves and are available in the form of powders, tinctures, dry extracts, suppositories or drops. Their effect is manifested in increasing the tone of the colon and restoring the act of defecation. Such a modern preparation as Regulax contains senna leaves and fruits, plum and fig puree, paraffin, and kafiol. It is well tolerated and used for intestinal atony caused by stress, physical inactivity and poor diet.
Synthetic drugs include Phenolphthalein, Bisacodyl, Guttalax. These products are available in the form of tablets, rectal suppositories, and drops. Under their influence, intestinal motility increases, they effectively help with constipation and intestinal atony that develops after surgical operations. But these drugs can become addictive, and their use can be accompanied by allergic reactions and intestinal colic.
Proper nutrition to improve intestinal motility
Nutritional adjustments are of great importance in the treatment of impaired intestinal motility. This will allow for the normal functioning of the digestive system and cleanse the intestines of toxins. All food products, according to their effect on intestinal motility, can be divided into two large groups:
- Hot drinks (tea, coffee, cocoa)
- Red grape wines
- Fresh white bread, pastries (cookies, muffins, pies, pastries, cakes)
- Chocolate
- Berry jelly with potato starch
- Porridge (barley, rice, semolina), rice broth
- Any pureed soups, vegetable purees
- Meat dishes, eggs, butter
- Fruits: pear, quince and compotes from them
- Berries: chokeberry, bird cherry
Promoting increased intestinal motility:
- Cold drinks: berry and fruit juices and compotes, kvass, white grape wines, mineral waters
- Fresh fermented milk products: kefir, sour cream, yogurt, curdled milk
- Ice cream (preferably fruit)
- Vegetables high in fiber: cabbage (fresh and pickled), radishes, turnips, radishes, carrots, beets. Watermelons, melons, cucumbers, tomatoes, legumes, and onions have a good cleansing effect.
- Berries and fruits: sour apples, apricots, plums, ripe persimmons. From berries - grapes, gooseberries, strawberries, blueberries, raspberries
- Dried fruits: dried apricots, raisins, figs, prunes
- Porridge: oatmeal, buckwheat, barley
- Vegetable oils: sunflower, corn, olive, flaxseed
- Wheat bran, bran bread
- Sea kale, seafood
- Greens, nuts
Vegetables are best consumed raw. Their ratio to thermally processed food should be 3:1. A good effect for enhancing intestinal motility is provided by drinking freshly squeezed juices: carrot, cabbage, beetroot and eating salads from these vegetables seasoned with vegetable oil.
Try not to allow long breaks between meals; the best option would be 5-6 meals a day in small portions. You need to carefully monitor your daily diet and exclude fried and fatty foods, smoked foods, canned food, flour dishes, baked goods, and sweets from the menu.
You should eat more greens, grains, cereals, raw vegetables and fruits, and make salads daily with the addition of vegetable oil. Drinking fermented milk drinks has a good effect; a glass of kefir at night is especially useful.
In the morning, before breakfast, you need to drink a glass of water, this will enhance intestinal motility and promote bowel movement. Follow the drinking regime; you should drink at least 1.5 liters of liquid per day.
Treatment with folk remedies
To restore intestinal motility, you can use proven folk recipes.
- Laxative mixture. To prepare it you will need: one tablespoon of sprouted wheat grains, two apples, two tablespoons of oatmeal, one tablespoon each of honey and chopped nuts, ½ lemon. Apples must be grated on a coarse grater and combined with the rest of the ingredients, add two tablespoons of warm water and juice from half a lemon. Mix the mixture thoroughly and take throughout the day without restrictions.
- Dried fruit mixture. You will need 400g of prunes and pitted dried apricots. Dried fruits are passed through a meat grinder and two tablespoons of propolis, a pack of medicinal herb senna and 200 ml of liquid natural honey are added to them. The mixture is thoroughly mixed and taken two teaspoons at night, washed down with warm water.
- Buckthorn decoction. A tablespoon of buckthorn bark is brewed with 500 ml of boiling water, infused and drunk as tea.
- Plantain seeds. In the intestines, the seeds of this plant swell, helping to form feces and facilitate easy bowel movements. Plantain seeds should be ground in a coffee grinder and taken one teaspoon before meals.
- Wheat bran. Take 1-2 tablespoons with water. They contribute to the formation of a sufficient volume of feces and effectively cleanse the intestines.
In addition to these measures, one should not forget about physical activity. Try to move more, take long walks in the fresh air. Do active sports, run, swim, exercise.
A set of exercises to restore peristalsis
Sports such as running, horse riding, swimming, and tennis will help normalize peristalsis. Daily abdominal massage, dousing with cold water and a set of exercises that can be performed at home will help. These activities will help strengthen the abdominal muscles and enhance intestinal motility:
- The exercise is performed from the “lying on your back” position. The legs are raised and movements are made as if riding a bicycle. At the same time, the abdominal muscles are toned, and blood flow in the pelvic area increases.
- From the starting position “lying on your back,” grab your legs bent at the knees and press them tightly to your stomach, remaining in this position for several seconds. This exercise stimulates the intestines and promotes the release of gases.
- Take the starting position “kneeling”. The legs are alternately straightened and pulled back, while bending in the back. Exercise strengthens muscles and eliminates congestion in the pelvic organs.
- Take the starting position “kneeling” with emphasis on the elbows and palms, head lowered. Alternately squat on the buttocks, first lowering to the left side, then to the right. Exercise helps restore peristalsis and release gases.
- Let's pump up the press. This exercise can be performed in the morning without getting out of bed and slowly raising the upper body 10 to 20 times.
- Squats. It is better to perform them at the final stage of charging and try to do each squat as slowly as possible.
- Jumping in place. Active jumping will help stimulate intestinal function. You can use a jump rope to perform jumps.
A doctor must prescribe a set of treatment measures. The patient’s task is to strictly follow the recommendations, correct nutrition and increase physical activity. This will restore normal intestinal functions and ensure full recovery.
7 modern drugs to normalize intestinal motility
Eating homogeneous food, physical inactivity, stress, and various diseases often cause intestinal motility disorders such as hypotonicity. In this case, intestinal function slows down or stops completely, causing the development of constipation. To restore its function, it is usually enough to adhere to an appropriate diet and remove the source of stress. But in some cases, medication is still necessary.
Drugs that improve intestinal motility
Drugs for regulating intestinal motility
- Lactiol (Exportal) is the safest laxative, similar in action to lactulose, but is considered more stable in its action and is better accepted by patients;
- Lactulose (Duphalac and Normaze, Prelax) is a mild laxative that restores intestinal motility and its microflora. It is considered safe, therefore it is prescribed to children and even pregnant women;
- Mucofalk is a herbal preparation based on the shells of plantain seeds. It helps normalize the activity of the colon mucosa and does not have an irritating effect. It is also approved for use by pregnant women;
- Linaclotide is a new selective enterokinetic that has virtually no side effects in therapeutic doses. The drug is used only 1 time per day. Due to its effectiveness and relative safety, it may soon become a leader in the treatment of intestinal hypotension and constipation;
- Prucalopride (Rezolor) is a highly effective selective enterokinetic, used for the treatment of chronic constipation. Stimulates the motility of the large intestine, increases the frequency of bowel movements. The drug is quite safe, but is not recommended for pregnant women and breastfeeding;
- Domperidone (Motilium, Motilak) is the most commonly prescribed prokinetic agent at the moment, because has significantly fewer side effects compared to metoclopromide, cisapride, etc. Provides improvement in gastric motility, as well as other parts of the gastrointestinal tract;
- Itopride (Ganaton, Itomed) is a new prokinetic agent, considered promising and recommended for use in the initial stages of illness, because has a dual mechanism of action. Side effects are less pronounced than with domperidone.
Review of drugs for the treatment of constipation
Constipation is the name given to systematically insufficient, difficult, and delayed bowel movements. According to statistics, this problem occurs in 10% of the population of various age groups. Constipation can occur for various reasons, and its clinical manifestations are also varied. Treatment of this condition requires an exclusively individual approach from the doctor and includes a whole range of measures: a special diet, changes in the patient’s lifestyle and lifestyle, and drug therapy. This article will discuss medications that can be used by doctors to treat constipation.
Classification of drugs used to treat constipation
Drugs used to correct this condition have different mechanisms of action, depending on which they are combined into the following pharmacological groups:
- prokinetics: drugs that enhance peristalsis of the gastrointestinal tract;
- drugs that regulate intestinal motility;
- laxatives;
- myotropic antispasmodics;
- drugs for correcting the intestinal microbial environment.
Drugs that enhance peristalsis of the gastrointestinal tract, or prokinetics
This group includes several well-known drugs: domperidone (Motoricum), mosapride (Mosid), metoclopramide (Cerucal) and itopride hydrochloride (Primer), but only one of them, the last one, is usually used to treat constipation.
Itopride hydrochloride (Ganaton, Zirid, Itomed, Primer)
Since this drug acts not only on the upper parts of the digestive tract, but also on the intestines, enhancing its peristalsis, it is widely used to treat constipation. Its mechanism of action is due to the blockade of special receptors - D2-dopaminergic, as well as stimulation of the synthesis of the hormones motillin and somatostatin.
Itopride is well and quickly absorbed from the digestive tract, its maximum concentration in the blood is observed within minutes after the first dose. Actively distributed in tissues, penetrates into breast milk. Penetrates through the blood-brain barrier in small quantities. The half-life of the drug is 6 hours. It is excreted from the body mainly in urine.
It is not an independent treatment for constipation, but is used as part of complex therapy for this condition.
Available in the form of tablets containing 50 mg of active substance.
Itopride is contraindicated in case of individual intolerance to it by the patient's body, in case of gastrointestinal bleeding, obstruction (blockage of the lumen) of the intestine or perforation (perforation) of its wall. It is also not recommended to take the drug during pregnancy and breastfeeding.
While taking this medicine, the following undesirable effects may develop:
- allergic reactions (skin rash with or without itching, anaphylaxis);
- changes in the general blood test: decrease in the level of leukocytes (leukopenia) and platelets (thrombopenia);
- in a biochemical blood test - increased levels of liver transaminases, alkaline phosphatase and bilirubin;
- headache, dizziness, tremor;
- gynecomastia, hyperprolactinemia;
- increased salivation, nausea, vomiting, abdominal pain, jaundice, diarrhea, constipation.
Drugs that regulate intestinal motility
Medicines in this group act on type 4 serotonin receptors and are their agonists. One of the effects of serotonin is its participation in the regulation of intestinal secretion, visceral sensitivity and intestinal motility, and type 4 serotonin receptors help maintain normal functions of the gastrointestinal tract. Among drugs that have a similar effect, a special role belongs to the drug tegaserod (Fractal).
Tegaserod (Fractal)
This substance is a partial agonist of type 4 serotonin receptors, that is, by combining with them, it causes their physiological response. As a result, the production of digestive juices is activated, the tone and motility of the gastrointestinal tract are improved: the transit time of food through the intestines is reduced, and tension during defecation is also reduced. The number of bowel movements increases, the consistency of stool becomes softer, and pain and discomfort in the abdominal area decreases.
When taken orally, it is only partially absorbed. The maximum concentration in the blood is observed 1 hour after a single dose. Excreted in urine and feces.
Available in the form of 6 mg tablets.
It is recommended to take 1 tablet orally before meals, twice a day for 1-1.5 months. An improvement in the patient's condition is noted already at the end of the first week of regular use of the drug and continues for another 3 months after its discontinuation.
Fractal is not used in children under 18 years of age, in case of a history of intestinal obstruction, adhesive disease, severe impairment of liver and kidney function, or clinically significant diseases of the gallbladder.
While taking the drug, side effects occasionally appear, such as:
- dizziness, headache, migraine attacks, sleep disorders, depression;
- nausea, vomiting, belching, increased appetite, abdominal pain, false urge to defecate, diarrhea, exacerbation of cholecystitis, partial intestinal obstruction;
- attacks of bronchial asthma;
- decreased blood pressure, arrhythmias, angina pectoris;
- frequent urination, pain in the kidney area, the appearance of albumin protein in the urine;
- increased menstrual bleeding, threat of miscarriage, ovarian cyst;
- increased levels of liver transaminases, creatine phosphokinase, and bilirubin in the blood;
- allergic reactions: skin itching, rashes, angioedema;
- pain in the back, legs, joints, leg cramps, increased risk of developing breast tumors.
There is no data regarding the safety of taking tegaserod in such categories of patients as pregnant and breastfeeding women, therefore it is not recommended for them to take this drug.
Laxatives
Drugs in this group are also classified depending on their mechanism of action.
1. Drugs that increase the volume of intestinal contents. This is a group of drugs that absorb large amounts of water, as a result of which the bowel movements become very voluminous and softer, intestinal motility is activated and the speed of passage of feces through it increases.
Such drugs include:
- Wheat bran. Before use, they must be steamed with boiling water and taken 3-6 tablespoons per day. You can simply add it to food. Intestinal bloating often develops when taking bran.
- Plantain seed preparations. Actively bind water. During treatment, it is necessary to consume increased volumes of fluid to prevent the development of intestinal obstruction. The most well-known preparations of plantain seeds are Mucofalk (take 1 sachet 2-3 times a day with 1/2 glass of water; the course of treatment is 4-6 weeks) and Defenorm (the recommended dose is 1-2 capsules twice a day for 1 -1.5 months or more).
- Sea kale also has properties of this group of substances. It is recommended to use it for constipation as desired.
2. Laxatives, softening stool. Drugs in this group promote the evacuation of hard stool, softening it. These include mineral and vegetable oils. Due to the possibility of impaired absorption of fat-soluble vitamins, decreased rectal sensitivity and the likelihood of spontaneous leakage of intestinal contents from the anus, these drugs are not taken for a long time, but are prescribed only for a short period. Can be taken orally or used in the form of oil enemas.
- Olive oil. It is recommended to take poml (about 3-4 tablespoons). For the purpose of performing an enema, use a ml of oil.
- Vaseline oil. The dosages are the same.
3. Osmotic laxatives. They retain water in the intestines, increasing its content in stool, which speeds up and improves the process of defecation. As a rule, they are not used for long-term treatment of constipation, but are used before X-ray or endoscopic examination of the colon for the purpose of thorough, complete bowel emptying for better visualization of changes in the examined organ.
- Magnesium sulfate. The recommended dose is ml.
- Fleet Phospho-soda. It is used according to the scheme described in detail in the instructions for use.
- Fortrans. It is used on the eve of the examination according to the scheme described in the instructions.
- Forlax. Unlike the drugs described above, it is used for the symptomatic treatment of constipation. The recommended single dose is 1-2 sachets, the frequency of administration is 2 times a day. The effect occurs 1-2 days after the 1st dose of the drug.
4. Non-absorbable (non-absorbable) di- and polysaccharides. The main drugs in this group are lactulose-based drugs. They have the properties of an osmotic laxative (that is, they retain water in the intestines) in combination with prebiotic properties (that is, they “feed” beneficial intestinal bacteria). Safe. Can be prescribed for a long period. Used in pregnant women.
Lactulose (Normaze, Duphalac, Lactulax, Lactuvit, Normolak) is a synthetic disaccharide that is not absorbed by the intestinal wall. After ingestion, it reaches the ileum unchanged, and is broken down by intestinal microflora to form acids, which leads to acidification of the intestinal contents and an increase in osmotic pressure, which means an increase in the mass of feces and stimulation of intestinal motility. Also, during the processing of the drug by bacteria, an excess amount of gas is formed, which leads to bloating. It is recommended to take 1-3 tablespoons (15-45 ml) before meals three times a day. The duration of treatment is 1-1.5 months.
5. Contact or irritant laxatives. Drugs in this group are characterized by a rapid (after 6-10 hours) onset of effect and elimination of the painful sensation of a full intestine. The mechanism of their action is due to irritation of specific receptors of the intestinal mucosa, provoking propulsive contractions of the muscles of the colon. Also, contact laxatives increase intestinal secretion and reduce the absorption of fluid from the intestinal cavity into the blood.
Due to their positive properties, these drugs are widely used by patients for self-medication, but it is not recommended to get carried away with them: their metabolic products have a damaging effect on the intestinal epithelium, which over time will lead to disturbances in the processes of absorption and secretion, and will also worsen intestinal motility. Because of these negative effects, you should not take stimulant laxatives for long periods of time. In addition, with long-term use, tolerance to the treatment may develop, as well as cramping abdominal pain and false urge to defecate.
- Senna preparations: Senade, Senadexin, Glaxenna. Use 1-3 tablets twice a day, no more than 14 days in a row.
- Sodium picosulfate – Guttalax, Picolax. It has a milder effect than senna preparations. It is recommended to take it drops or 1-2 tablets once a day.
- Bisacodyl. It is recommended to use 1 suppository into the rectum once a day (preferably at night).
Myotropic antispasmodics
Once in the body, these drugs trigger a number of mechanisms, as a result of which muscle fiber contractions decrease. They are used as part of the complex treatment of constipation, since the latter is usually accompanied by pain in the lower abdomen.
The most well-known drugs in this class are mebeverine and otilonium bromide.
Mebeverine (Duspatalin, Meverin, Mebsin retard)
Eliminates spasms of intestinal smooth muscles without affecting its peristalsis (does not reduce the tone of the muscles of the gastrointestinal tract). It is recommended to take the drug 1 tablet (135 mg) three times a day or 1 capsule (200 mg) twice a day for 2-4 weeks. It is preferable to take one minute before meals.
During pregnancy and breastfeeding, treatment with mebeverine should not be done, since no studies have been conducted on it in these categories of patients.
Otilonium bromide (Spasmomen)
It has a pronounced antispastic effect on the smooth muscles of the digestive tract.
Use with caution during pregnancy and breastfeeding.
Preparations for correcting the intestinal microbial environment, or bacterial preparations
They are not used independently to treat constipation, but in combination with drugs that improve intestinal motility, their use is completely advisable.
These medications increase the amount of beneficial microflora in the intestines, which improves digestion processes and helps to activate the motor function of the colon. When combining the use of bacterial preparations with dietary fiber, which are prebiotics, the effectiveness of the treatment will be much higher.
Take probiotics in courses of 2-4 weeks.
- Lactovit forte – take 4 capsules per day in 2 divided doses 40 minutes before meals;
- Lactobacterin - it is recommended to take 5 tablets or 2-3 ampoules of the drug three times a day;
- Bifiform – 2-4 capsules per day in 1-2 doses;
- Extralact – take 1 capsule 3 times a day half an hour before meals;
- Bifidumbacterin - the recommended daily dose is 15 doses, the frequency of administration is 3 times.
Microclysters
Separately, it is worth mentioning the drugs used in this dosage form. The most famous among them is docusate sodium (Norgalax).
When introduced into the rectum, the active substance helps soften stool and initiates the bowel movement reflex. The effect is observed within 5-20 minutes after administration.
As a rule, it is used in preparation for endoscopy of the lower parts of the colon and in the event that the postpartum woman does not have a bowel movement for 3 days.
Using a special cannula tube, the gel is injected into the rectum. If necessary, the procedure is repeated every other day.
The use of this drug is contraindicated in case of exacerbation of hemorrhoids, hemorrhagic colitis and proctitis, in case of anal fissures.
So, the modern pharmacological industry offers a huge number of drugs that will help the patient cope with such a delicate problem as constipation, but we draw your attention to the fact that only a doctor should prescribe them!
Which doctor should I contact?
If you have persistent constipation, you should consult a gastroenterologist, since this symptom can be a manifestation of severe intestinal diseases, even cancer. If constipation is caused by poor diet, a nutritionist can help by adjusting the foods you eat. In some cases, constipation is associated with diseases of the endocrine system, in particular hypothyroidism, then it is necessary to treat the underlying disease by an endocrinologist. If a pregnant woman has constipation, she should consult with her obstetrician-gynecologist and therapist. Before and after surgical interventions on the intestines, a surgeon or proctologist will prescribe laxatives.
The third group of drugs stimulates intestinal motility. Indications for them are limited to atonic constipation, especially in elderly people and in the presence of moderately severe megadolichocolon. Therefore, spastic constipation as a variant of functional intestinal dyspepsia is a contraindication to the use of these drugs.
Prozerin for the treatment of constipation
For persistent atonic constipation, it is sometimes recommended to use proserin orally 0.015 g 2 - 3 times a day or 1 ml of a 0.05% solution under the skin. Its effect begins after 20 minutes, manifesting itself in increased peristalsis and subsequent bowel movement. The drug is contraindicated in cases of severe atherosclerosis, angina pectoris, bronchial asthma, and epilepsy. During treatment, special caution is necessary, since hypersensitivity to proserin may cause complications - increased salivation, diarrhea, colicky abdominal pain. These signs indicate an increase in vagal tone and determine the replacement of the drug with belladonna and its derivatives.
Dulcolax for the treatment of constipation
Along with prozerin, the drug dulcolax (Germany) has a parasympathomimetic but contact effect. Dulcolax gives a mild laxative effect for various forms of constipation, irritating only the superficial layer of the colon. When 2 tablets are taken orally at night, the effect appears after 8-10 hours, and after administration in a suppository - after 30-40 minutes. Dulcolax is also available under other names: bisacodyl (Poland), Videx (Hungary), perilax (Germany), nopolax (Yugoslavia). Pursenide, regulax and kafiol are also effective.
For persons suffering from spastic constipation, it is advisable to limit the use of irritating substances - both plant (buckthorn bark, joster fruit, senna leaf, sabur or aloe) and chemical (phenolphthalein). But in some cases, with persistent constipation and the absence of effect from other therapeutic agents, it is necessary to prescribe medicinal plants for a short time.
With prolonged use of these laxatives, melanosis (black staining) may develop, which is morphologically manifested by the accumulation of brown pigment in the muscular layer of the intestinal mucosa. Rectoscopy reveals darkening of the rectal mucosa, which acquires a silver-black color. When the drug is discontinued or the dose of laxatives is reduced, the normal color of the mucous membrane is completely restored.
Saline laxatives
Unlike drugs containing anthraquinone, saline laxatives have an effect throughout the intestine, causing an increase in the volume of intestinal contents and its dilution due to changes in intracavitary osmotic pressure and accumulation of water.
The most well-known remedy in this group is sodium sulfate (Glauber's salt): 15 - 30 g of it is taken in a quarter glass of water and washed down with 1 glass of water. Consume cold on an empty stomach.
Carlsbad salt, natural or artificial, is also used as a laxative, 1 tablespoon per 0.5 glass of water on an empty stomach.
It must be emphasized that laxatives, although they promote bowel movement during spastic or atonic constipation, can ultimately only strengthen them. Therefore, it is better to avoid laxatives if possible. Of course, sometimes the use of laxatives is justified, for example, for situational constipation, i.e., occurring during long trips, forced stay in bed, as well as in preparation for various medical tests or operations.
The invention relates to medicine and is intended to stimulate the intestines in the postoperative period. Blood is taken from a peripheral vein at the rate of 2 ml/kg body weight. Irradiate with ultraviolet rays with a length of 254 nm in the Isolda MD-73M apparatus. The reinfusion is subjected to oxygenation for 1 hour. The oxygen flow rate in the oxygenator is 10 l/min. The reinfusion process is carried out into the portal vein through a catheter installed in the recanalized umbilical vein during surgery. Sessions of ultraviolet irradiation and oxygenation of autologous blood in extracorporeal conditions with reinfusion into the portal vein are carried out once a day for 2 days. Sessions begin 2-3 days after surgery. The method allows you to restore intestinal motility and dramatically reduce endogenous intoxication. 2 tables, 8 ill.
The invention relates to medicine, mainly to abdominal surgery, and can be used to restore intestinal motility after operations on the abdominal organs. Restoring intestinal motility after operations on the abdominal organs is one of the difficult problems of abdominal surgery. The timely appearance of intestinal peristalsis indicates a favorable course of the postoperative period and, as a rule, in most cases serves as a good prognostic sign. When its recovery is delayed, the patients’ condition becomes significantly worse, endogenous intoxication increases, and liver function worsens. In addition, bloating in these cases makes it difficult for the heart and lungs to function adequately. Developing intestinal paresis contributes to overstretching of its walls with gases, and the processes of fermentation and decay in the chyme contribute to a sharp increase in intoxication, as well as the penetration of microbes through the intestinal wall into the peritoneal cavity with the development of peritonitis or the entry of microbes into the circulatory system, including the portal system of the liver (B P. Petrov, I. A. Eryukhin "Intestinal obstruction". - M.: Medicine. - 1989. - P. 11, 29-35; V. S. Savelyev et al. "The influence of probe decompression on portal and systemic bacteremia in patients with peritonitis." - Khir. - 1993. - N 10. - P. 25-29). All this necessitates careful monitoring of the process of restoration of intestinal motor activity after operations on the gastrointestinal tract, and also forces the use of its stimulation in case of delays in the restoration of peristalsis. Currently, the following methods are known to stimulate intestinal motility in the postoperative period: a - medications; b - novocaine blockades (perinephric, intrapelvic, round ligament of the liver, etc.); c - epidural anesthesia; d - external decompression of the upper digestive tract (stomach, small intestine), which is most often combined with enteral tube feeding with saline nutritional mixtures (saline enteral solution, Ringer's solution, etc.); d - electrical stimulation; e - oxygen barotherapy; g - detoxification by extracorporeal methods; h - correction of water-electrolyte shifts in the body; and - exposure to sound waves (V.P. Petrov, I.A. Eryukhin “Intestinal obstruction.” - M.: Medicine. - 1989. - P. 70-74). Thus, the “Method for the treatment of postoperative intestinal paresis” is described (a.c. N 1197645, cl. A 61 N 1/36, publ. Bulletin N 46, 1985), providing for the introduction of a medicinal mixture through a microirrigator into the retroperitoneal tissue during and after surgery, as well as “Method of electrical stimulation of motor activity of the gastrointestinal tract” (a.s. N 430861, class A 61 N 1 /36, published bulletin N 21, 1974) and “Method of treatment of postoperative paresis of the gastrointestinal tract” (a.c. N 1243737, class A 61 N 1/36, published bulletin N 26, 1986) based on stimulation of the intestines with pulsed current. Currently, stimulation of the gastrointestinal tract is most often carried out against the background of external decompression of the upper digestive tract, including nasointestinal. In particular, the “Method of restoring the motor-evacuation function of the intestine in the postoperative period” is described (a. c. 1560231, class A 61 N 1/36, publ. bulletin N 16, 1990), according to which patients with acute intestinal obstruction or peritonitis, a special probe is inserted over the entire length of the small intestine and, at the same time, 20-24 hours after the operation, electrical stimulation is carried out with multiple electrodes located on the probe. Also known is the “Method of electrical stimulation of the gastrointestinal tract in the postoperative period” (patent N 2001401, class A 61 N 1/36, published bulletin N 37-38, 1993), which provides for external decompression of the stomach with enteral tube feeding in the postoperative period and conducting electrical stimulation of the intestine with a half-sinusoidal current when a state of electrophysiological readiness of the small intestine to perceive these electrical impulses occurs. At the same time, in the pathogenesis of postoperative intestinal paresis, vascular spasm and microcirculation disorders play an important role, as a result of which the blood supply to the small intestine and liver is sharply reduced. In this case, hypoxia in these organs reaches the most pronounced value (V.P. Petrov, I.A. Eryukhin “Intestinal obstruction.” - M.: Medicine. - 1989. - P. 33-34; V.A. Popov “Peritonitis ". - L.: Medicine. - 1985. - P. 24-25). This causes severe metabolic changes in the liver, small intestine and the body as a whole. Therefore, corrective effects on these links in the pathogenesis of postoperative intestinal paresis will be important in restoring intestinal motility. In this regard, ultraviolet irradiation of autologous blood, which has a complex of therapeutic effects on the body, as well as oxygenation of portal blood deserves attention. As is known, ultraviolet irradiation of blood has a detoxifying, vasodilating, anti-inflammatory, antioxidant effect, improves microcirculation, rheological properties of blood and its oxygen saturation, activates respiratory enzymes, specific protection factors, stimulates regeneration (I. G. Dutkiewicz et al. "Changes in the hemostatic potential of blood after autohemotransfusion with UV irradiation." - In the collection: The mechanism of influence of blood irradiated with ultraviolet rays on the human and animal body. - L.: Science. - 1986. - P. 97-103; A.E. Gromov et al. "The influence of reinfusion of autologous blood irradiated with UV rays on the rheological properties of blood." - In the same place, p. 207-211; V.V. Levanovich, D. M. Vorypin "Autotransfusion of ultraviolet irradiation of blood in the treatment of purulent peritonitis in children. - Vestn. Skhir. - 1986. - N 7. - P. 7-10; V.I. Rotar et al. "The influence of ultraviolet irradiation of blood on its oxygen transport function. - Wedge. hir. - 1990. - N 3. - P. 29-30). The method described by A.P. was taken as a prototype of the proposed technical solution. Vlasov and I.G. Rumyantsev in the article “Methods of increasing the tolerance of intestinal anastomosis to circulatory hypoxia”, published in the collection “Efferent methods in medicine” - Part 1. - Izhevsk. - 1992. - S. 24-25. The essence of the method, taken as a prototype, is that in order to increase the tolerance of the intestinal anastomosis to circulatory hypoxia during intestinal surgery and in the postoperative period, extracorporeal ultraviolet irradiation of autologous blood is carried out every other day with its reinfusion into a peripheral vein. A more rapid elimination of oxygen deficiency in the intestine and improved wound healing along the anastomotic suture line were noted, which was important for increasing the tolerance of the intestinal anastomosis to motor activity and chyme passage. This method has a number of disadvantages: 1 - an unexpressed therapeutic effect on the intestines to restore its motor activity, since after reinfusion, the blood irradiated with ultraviolet rays is diluted in the vascular bed; 2 - weaker detoxification effect, reducing the effectiveness of restoration of intestinal motility; 3 - low blood oxygenation in the portal system, delaying the restoration of liver and small intestine functions. These disadvantages are eliminated in the proposed method of stimulating intestinal motility. Its essence is that in order to increase the efficiency and reliability of the method of stimulating intestinal motility, blood is taken from a peripheral vein at the rate of 2 ml/kg, subjected to ultraviolet irradiation and oxygenation in extracorporeal conditions, and then returned to the body intraportally through a catheter placed in during the operation into the portal vein through the recanalized umbilical vein. Detailed description of the method and examples of its practical implementation. In severely ill patients, during surgery on the abdominal organs, the umbilical vein is recanalized with the insertion of a special catheter into its lumen. To do this (Fig. 1), on the round ligament 1 of the liver 8 at a distance of 4-5 cm from the anterior abdominal wall, the peritoneum 2 with a length of 3 cm is longitudinally dissected. In the fatty tissue of this ligament, an obliterated umbilical vein 3 is found in the form of a cord with a diameter of 5-9 mm. The umbilical vein 3 is taken onto a ligature-holder 4. Then the index finger 5 of the left hand, covered with a gauze napkin 6, is placed under the umbilical vein 3. Using a scalpel in the transverse direction in the projection 7 of the index finger 5, the anterior wall of the umbilical vein 3 is dissected to the obliterated lumen. A mosquito-type clamp is passed along the obliterated lumen of the umbilical vein 3 towards the liver 8 in order to enter the proximal end of the umbilical vein 3 and lift its anterior wall. Two mosquito-type clamps (Fig. 2) 9 grasp the free edges of the raised anterior wall of the umbilical vein 3 for retention. Then, using a uterine probe 10 with an olive diameter of 2-3 mm, they enter the obliterated lumen 11 of the umbilical vein 3 towards the liver 8 to a depth of 12-13 cm. Overcoming the obstacle by “falling through” the uterine probe 10 and its free movement in depth to 1-1.5 cm indicates about its passage into the lumen of the portal vein. This is confirmed by the appearance of blood from the recanalized lumen 11 of the umbilical vein 3 when the uterine probe 10 is removed. A special umbilical catheter 12, for example N 8 or 10 (TU 25-1961.032-87), pre-washed with a weak solution of heparin, is inserted into the recanalized lumen 11 of the umbilical vein 3. and immediately, for example, Ringer's solution or a weak heparin solution of 3-4 ml is injected into the umbilical catheter 12 with a syringe to prevent thrombosis. An additional ligature 13 is used to tie the umbilical vein 3 in the transverse direction to fix the umbilical catheter 12 in it (Fig. 3). Another ligature 14 is passed around the umbilical vein 3, but it is not tied, and the ends are brought out to the anterior abdominal wall through the laparotomy wound and fixed on a gauze ball in a loose state. Mosquito clamps 9 are removed. The peritoneum of 2 round ligaments 1 is sutured with separate sutures. The outer part of the umbilical catheter 12 is brought out onto the anterior abdominal wall (Fig. 4) through the surgical wound and fixed to the skin with separate ligatures 16. In the postoperative period, glucose-electrolyte solutions, blood substitutes, vitamins are administered intraportally through the umbilical catheter 12, and donor blood and its preparations are transfused. . By the 2-4th day after surgery, when obvious signs of postoperative intestinal paresis appear (bloating, failure of gases through the rectum, regurgitation or vomiting, or passage of copious stagnant contents through a nasogastric tube, absence of intestinal peristalsis sounds during auscultation of the abdomen), the patient needs to stimulate intestinal motility. For this purpose (Fig. 5), a peripheral vein 17, for example the ulnar vein, is punctured from the patient, and using an infusion system 18, a low-flow blood oxygenator 19 is sequentially connected to it, for example, a membrane dialyzer of the DIP-02-02 type adapted for these purposes, then a device for ultraviolet irradiation of autologous blood 20, for example "Isolde MD-73M", and at the end a bottle 21 for collecting blood containing a stabilizer, for example "Glyugitsir", to prevent its clotting. Using the roller pump of the Isolda MD-73M apparatus 20, blood is taken from the peripheral vein 17 at the rate of 2 ml/kg and irradiated with ultraviolet rays with a wavelength of 254 nm. Oxygen is not connected to the low-flow blood oxygenator 19 during blood sampling from the peripheral vein 17. Then (Fig. 6) the blood collected in the bottle 21 is placed on a stand and, using the same infusion system 18 and roller pump, is returned to the portal vein by connecting the cannula 22, through which blood was taken from the peripheral vein 17, to the umbilical catheter 12. At the same time, through low-flow oxygenator 19 begins to supply oxygen gas at a flow rate of 10 l/min continuously for 1 hour, which is necessary to complete the reinfusion of autologous blood. In this case, the blood from bottle 21, passing through the Isolda MD-73M apparatus 20, is re-exposed to ultraviolet irradiation, and then oxygenated when passing through a low-flow oxygenator 19. Sessions of ultraviolet irradiation of autologous blood, followed by oxygenation and reinfusion into the portal vein, are carried out daily for the next 2 day. Already after the first session of ultraviolet irradiation of autologous blood with additional oxygenation, after 18-20 hours the patient begins to show signs of restoration of intestinal motility: vomiting disappears, and when auscultating the abdomen, intestinal sounds of peristalsis are heard. After the second session, gases begin to pass through the rectum, bloating disappears, and independent stool appears. Endogenous intoxication is sharply reduced. After this, the catheter 12 is removed from the umbilical vein 3 (Fig. 4). To do this, the skin around the umbilical catheter 12 is treated with an antiseptic solution, for example 1% iodonate. Using sterile scissors, the umbilical catheter 12 is released from the fixing ligatures 16 on the anterior abdominal wall. The ligature 14 brought to the front wall is pulled at both ends to slightly lift the umbilical vein 3 anteriorly. The umbilical catheter 12 is grabbed with tweezers and removed out with the ligature 14 in a tense state in order to clamp the lumen and prevent reverse blood flow through the recanalized umbilical vein 3 into the abdominal cavity. Then the ligature 14, without relaxing, is tied on a gauze ball 15, placed on the skin in the area of the sutured surgical wound, and left in this state for three days (the time required for thrombosis and fixation of blood clots in the recanalized umbilical vein). After three days, the skin in the area of the sutured surgical wound is treated with an antiseptic solution, for example 1% iodonate, and a gauze ball 15 is slightly lifted above the skin with tweezers, one of the ends of the ligature 14 is found and, with sterile scissors, it is crossed directly above the skin, in the area that appears from subcutaneous tissue. After this, the ligature 14 is removed from the abdominal cavity by its second end. The inventive method is illustrated by the following clinical examples. 1. B-noy N-o, 16 years old (case history N 3271), was admitted to the surgical department of Rostov Emergency Hospital No. 1 with a diagnosis of gangrenous-perforated appendicitis, diffuse peritonitis. The patient underwent emergency surgery - laparatomy, appendectomy, lavage of the abdominal cavity with its drainage, catheterization of the umbilical vein. In the postoperative period, the patient's condition is serious. By the second day after the operation, the phenomena of endogenous intoxication and intestinal paresis were increasing: pulse 118 per minute, blood pressure 110/70 mm Hg, copious stagnant discharge was discharged through the nasogastric tube, there was bloating, non-discharge of gases, absence of intestinal sounds of intestinal peristalsis upon auscultation of the abdomen. In the blood test, leukocytes are 9.910 9 /l, the blood formula is: band neutrophils - 30%, segmented neutrophils - 59%, lymphocytes - 7%. In this regard, the patient underwent a session of extracorporeal ultraviolet irradiation of autologous blood, followed by its oxygenation and reinfusion into the portal vein according to the described method. The oxygen tension in the blood reinfused into the umbilical vein was 310 mm Hg. The study of volumetric blood flow in the vessels of the splanchnic bed using Doppler ultrasound indicated an increase in the level of blood supply (Table 1). The next day (18 hours after the first session), the patient’s condition improved: auscultation of the abdomen revealed intestinal sounds of peristalsis. The electroenterogram (Fig. 7, pos. B) showed an increase in the amplitude of the waves compared to the state before reinfusion of ultraviolet irradiated and oxygenated blood (Fig. 7, pos. A). The patient underwent a repeated session of ultraviolet irradiation of blood with its oxygenation and intraportal reinfusion. By the next day (the fourth after the operation), the patient had well-defined intestinal motility, gases passed through the rectum, and bloating disappeared. The electroenterogram (Fig. 7, pos. B) showed normal wave amplitude. In the general blood test: leukocytes 6.610 9 /l, band neutrophils - 12%, segmented neutrophils - 58%, lymphocytes - 24.5%, monocytes - 5.5%. On the fifth day after the operation, food intake by mouth was allowed, and an active motor regimen was prescribed. A day later the patient began to have independent stool. The postoperative period proceeded without complications. The patient was discharged from the hospital in satisfactory condition. 2. B-noy 3-n, 62 years old (case history N 2882), was admitted to the surgical department of Emergency Hospital No. 1 in Rostov-on-Don due to venous thrombosis of the vessels of the mesentery of the small intestine, dynamic intestinal obstruction. An emergency operation was performed after preoperative infusion preparation - laparatomy, cecostomy with intubation of the small intestine, catheterization of the umbilical vein. By the third day after the operation, the patient's condition had deteriorated significantly, the symptoms of endotoxicosis and intestinal paresis were increasing: bloating, discharge of copious stagnant discharge through the nasogastric tube; intestinal peristalsis was not detected during auscultation of the abdomen. Pulse 112 per minute, blood pressure 140/60 mm Hg. In the general blood test, leukocytes are 9.010 9 /l, leukocyte formula: band neutrophils - 33%, segmented neutrophils - 47%, lymphocytes - 17%, monocytes - 7%, ESR 48 mm/h. Blood urea rose to 13.6 mmol/l. To stimulate intestinal motility, a session of extracorporeal ultraviolet irradiation of blood was performed with its oxygenation and subsequent reinfusion into the portal vein according to the proposed method. Doppler ultrasound examination of splanchnic blood flow showed a significant increase in the blood supply to the liver and small intestine (Table 2). 20 hours after the first session, the patient began to hear intestinal motility. The electroenterogram performed (Fig. 8, pos. B) revealed an increase in the amplitude of the waves compared to the previous study before the session of stimulation of intestinal motility (Fig. 8, pos. A). Ultraviolet irradiation of blood with its oxygenation in extracorporeal conditions and reinfusion into the portal vein was repeated. The next day (20 hours after the second session), good intestinal motility was determined by auscultation, there was no bloated abdomen, gases and loose stools passed through the cecostomy. The electroenterogram revealed normal wave amplitude (Fig. 8, item B). The patient's condition improved significantly: pulse 88/min, blood pressure 140/80 mm Hg. In the general blood test, the shift of the leukocyte formula to the left sharply decreased: band neutrophils - 15%, segmented neutrophils - 57%, lymphocytes - 20%, monocytes - 6%. Blood urea decreased to 8.6 mmol/l. During further treatment, the patient's condition continued to improve. He was discharged from the hospital in satisfactory condition with good motor-evacuation bowel function. The proposed method of stimulating intestinal motility in the postoperative period was tested on four patients. Intestinal motility was restored in all. No negative consequences of intraportal reinfusion of ultraviolet irradiated and additionally oxygenated autologous blood were noted. Thus, compared to the prototype, the proposed method has the following advantages: 1 - a pronounced effect on the blood flow in the small intestine and the saturation of the blood flowing from it with oxygen, leading to the restoration of peristalsis in the next 18-20 hours after 1-2 sessions of the proposed treatment; 2 - significant reduction of endogenous intoxication, promoting the restoration of intestinal motility; 3 - improving the blood supply to the liver and the saturation of the blood flowing to it with oxygen, increasing its protective functions.
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How to improve intestinal motility: products, drugs and traditional medicine
Most people who have crossed the thirty-year threshold are faced with such a problem as dyskinesia, otherwise - poor intestinal motility. This problem brings a lot of inconvenience and therefore people are increasingly wondering how to improve intestinal motility? We will tell you about this in the article.
The concept of peristalsis
The intestine is the largest organ of the gastrointestinal tract, in which the final processing of food products, their neutralization and absorption of useful minerals into the blood occurs. If peristalsis (motility) is impaired, then all these processes are inhibited. This process causes harm to the body and inconvenience to the person.
Symptoms of intoxication and decreased intestinal motility include:
- frequent headaches;
- constant feeling of fatigue;
- heaviness and pain in the abdomen;
- loss of appetite;
- a person gains weight, although he eats the same as usual, or even less;
- the appearance of a rash on the face, possibly on the body;
- sleep problems;
- bloating, flatulence, which worsens after eating;
- changes in stool, there are fewer of them, they take on a denser shape;
- frequent and painful constipation, which can in rare cases be replaced by bouts of diarrhea;
- general malaise and even fever.
Neither an adult nor a child will be happy with such symptoms of intestinal arrest. Therefore, you need to force your intestines to work on their own, or seek help from a doctor.
Moreover, the second option will be much better, because Absolutely any disease can cause poor motor skills, or the normal functional state of the body. But to figure out what exactly caused the intestinal stoppage can only be done by conducting an examination and passing tests.
Causes of weak peristalsis
Many factors influence intestinal function, and now we will try to find out which of them slow down and even completely stop peristalsis, and which can stimulate intestinal motility.
Causes, slowing down peristalsis:
- Not balanced diet when the diet is dominated by foods with high calorie content, foods of artificial origin (fast foods with a lot of spices and sauces and foods with added chemicals - chips, crackers), lack of regularity of meals, its speed (eating a sandwich on the way to the office).
- Treatment with antibiotics or other drugs that reduce the balance of intestinal microflora.
- Diseases of the gastrointestinal tract all departments, including the stomach, liver, gall bladder.
- Tumors in the intestine, both small and large.
- Behavior of surgical intervention on the intestine.
- Inactive lifestyle, constant sedentary work, frequent climate change.
- Predisposition to constipation, its chronic course.
- Frequent stress, negative experiences.
- Disturbance in the functioning of nerves, improper innervation of the intestinal walls.
Factors enhancing intestinal motility:
- Constant walking and exercise.
- Maintaining a balanced diet.
- Compliance with the drinking regime is very important for constipation in order to soften the masses and improve their passage through the intestines.
- Using intestinal stimulation - massages and morning warm-ups.
- Normalization of lifestyle, regular and sufficient sleep, adherence to a schedule.
- Undergoing constant annual medical examination and timely treatment of intestinal diseases.
If your life mostly or even completely consists of items on the first list, then do not be surprised that intestinal motility weakens.
But if peristalsis is already impaired for some reason, then there are means to improve intestinal motility in adults and children.
How to improve peristalsis?
Restoring intestinal function and enhancing peristalsis is possible only by using several types of treatment simultaneously, namely:
- Folk remedies. This is the first thing that is better to try than to swallow advertised pills, which can only cause harm if the diagnosis is not established.
- Drugs that stimulate bowel function can also be purchased at the pharmacy, but before doing so, you should consult a doctor so that he can select them for you individually and also prescribe the required dosage.
- An excellent way to enhance peristalsis is gymnastics. It helps increase blood flow to the intestines, as well as the pelvic organs, thereby helping to move feces forward through the intestines. Helps strengthen the walls of the large and small intestines.
- You can increase peristalsis by following a certain diet. Her main rule- We eat and drink everything that is healthy, we don’t even try anything that is not healthy.
Improving peristalsis will largely depend on how the person himself feels about solving his problem.
In this case, the intestines did not work, do not work, and will not work. But for those who want to normalize the functioning of their intestines, we will tell you in more detail about each point in the treatment of weak peristalsis.
How to strengthen intestinal motility
The smooth functioning of the human intestines is not only the key to good health, but also to the health of the entire body. Stable gastrointestinal motility depends on many detailed factors, for example, proper nutrition, the absence of bad habits and regular cleansing. However, when intestinal problems appear, a number of measures should be immediately taken to normalize its activity.
How can you increase intestinal motility in adults and children?
Disruption of intestinal motility can cause constipation in the patient with the release of rather dense feces in the form of a thin ribbon or sheep feces. This indicates stool dehydration due to a lack of water in your body. In order for the intestines to function smoothly, it is necessary, first of all, to regulate the water balance and its metabolism in the body. At the same time, it should be taken into account that you need not only to drink enough water every day, but also to be able to retain it in the intestines so that its peristalsis is always complete.
What drugs will increase intestinal motility?
To enhance the contractile functions of the intestines, laxatives are used. With their help, peristalsis is enhanced and bowel emptying is accelerated. Today there are a huge number of different laxative drugs that affect different parts of the intestines. There are medications for peristalsis:
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acting on the entire intestine.
to the small intestine.
on the large intestine.
Such drugs can be of either synthetic or natural origin.
Products that enhance intestinal motility
First, carefully monitor your daily diet. The intestines are very susceptible to toxins that are constantly formed from leftover food that has not been digested. Minimize, and preferably completely eliminate fatty and oil-fried dishes from your menu, and together with them – canned food, smoked meats, refined sugar, baked goods, alcohol and carbonated drinks. Eat cereals, greens, nuts, rolled oats, bran, vegetables, and fruits every day. Make it a healthy habit to drink a glass of kefir on the eve of sleep.
To enhance peristalsis, food should be chewed very thoroughly, ideally until it turns into a liquid pulp. You should never drink solid food with water, and you should also not do this with other liquid foods (juices, compotes, tea). You can drink liquids no earlier than an hour after a meal. It is much healthier and correct to drink water before meals than after.
Drink plenty of plain mineral water (still). During the day, the total amount of liquid you consume (including soups and teas) should be at least eight glasses.
How to use folk remedies to increase intestinal motility?
You will need the following two sets of components:
- dried apricots, honey, hay grass, prunes, propolis tincture (20%);
- rose hips, beets, raisins, orange peels, lemon, black currants, cranberries, lingonberries, blueberries, prunes, vegetable oil, dried apricots, salt, honey.
Take 400 grams of dried apricots and the same amount of prunes, remove the seeds from the latter. Grind the components using a meat grinder, and then add a pack of this hay to the mixture, along with 2 tablespoons of 20% propolis tincture and an incomplete glass (200 g) of liquid honey (necessarily natural). Mix everything. Peristalsis will improve if you take a couple of teaspoons for dinner during the evening meal, washing it down with tea or warm water.
Strengthen peristalsis for intestinal problems with beetroot balm. The preparation method is the same as for any other similar product and storage is also quite simple - in a closed container in the refrigerator. To prepare it, take:
- 2 kg beets;
- 1 tsp rosehip;
- a small amount of orange peels,
- lemon wedge along with zest,
- strengthens the intestines with a mixture of lingonberries, black currants, blueberries, cranberries (about 5 tablespoons in total) - frozen berries can be used.
- a quarter cup of raisins,
- strengthen motor skills prunes and dried apricots - 10 pieces each,
- 4 tablespoons vegetable oil (unrefined),
- a teaspoon of salt,
- a tablespoon of fresh honey.
What exercises will help strengthen bowel function in old age?
To increase peristalsis, you should perform regular exercises to improve bowel function. Each exercise is repeated 10–15 times.
The starting position for this exercise to improve bowel function (i.p.) is lying on your back with your legs raised straight. Perform leg movements as when riding a bicycle. The exercise trains the muscles of the thighs and abdominals, and stimulates blood flow in the abdominal cavity.
I. p. – lying on your back. The leg bent at the knee (or both legs) is clasped with the arms and pressed tightly to the stomach, then returned to the i. n. Exercise stimulates intestinal motility, activates blood circulation in the abdominal cavity, and promotes the release of gases during flatulence.
I. p. – lying on your back. The leg is bent at the knee and they try to touch it to the floor on the opposite side, without lifting the shoulder girdle from the floor. Then do the same with the other leg. Exercise strengthens the muscles of the back and lower back, and also stimulates intestinal motility.
I. p. – standing on your knees, resting on your palms or elbows, head bowed. Squat on your buttocks alternately to the left and right. Exercise stimulates the intestines and promotes the release of gases during flatulence.
I. p. – as in exercise 4. Alternately straighten and stretch your legs back, arching your back. Exercise develops the muscles of the buttocks and back, and in case of problems with peristalsis, it helps to improve the outflow of blood from the pelvic organs.