Symptoms of intestinal dysbiosis in children and adults, diagnosis. How to treat dysbiosis in adults Dysbiosis of the body
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Dysbacteriosis is a condition caused by a violation of the intestinal microflora associated with a change in the species composition of bacteria. The number of beneficial bifidobacteria and lactobacilli is reduced, and the number of pathogenic (disease-causing) microorganisms increases. Intestinal dysbiosis is not an independent disease. Often it turns out to be a consequence of other ailments (sometimes quite formidable). According to statistics, it occurs in 90% of adults.
Learn more about what kind of disease this is - intestinal dysbiosis - what the first signs and symptoms are, as well as how to properly treat it in adults and children with diet and medications.
What is dysbiosis?
Gut dysbiosis (also dysbiosis) - This is a state of microbial imbalance on or within the body. With dysbacteriosis, the ratio of beneficial and opportunistic microorganisms is disturbed, for example, in the intestines or in the reproductive organs.
The adult intestine normally contains about 2-3 kg of various microorganisms(about 500 species). 60% of all microorganisms are settled in the gastrointestinal tract.
Microorganisms help digest food, synthesize vitamins, remove toxins and carcinogens, and break down all unnecessary elements. The main representatives of the intestinal flora are aerobic lactobacilli and anaerobic bifidobacteria.
In the human body, three types of bacteria take part in the digestion of food:
- beneficial (bifidobacteria, lactobacilli). They maintain the ratio of other bacteria in the stomach, prevent the development of allergic diseases, weakened immunity and many other negative effects on the human body. They also control the number of harmful bacteria;
- neutral. They live in a certain place. They do not bring any particular benefit or harm;
- harmful (candida fungus, staphylococcus, streptococcus). They provoke various diseases and disruptions in the gastrointestinal tract.
Causes
The number of each type of bacteria that lives in the intestines is controlled by the laws of natural selection: those that multiply greatly do not find food for themselves, and the excess ones die, or other bacteria create unbearable living conditions for them. But there are situations in which the normal balance changes.
The reasons for the suppression of normal intestinal flora during dysbacteriosis may be the following factors:
Sometimes almost completely healthy people can suffer from dysbiosis. In this case, the reason should be sought in the characteristics of the profession, or in seasonal changes in nutrition.
Kinds
Depending on the cause of its occurrence, intestinal dysbiosis syndrome in modern medicine is divided into several types.
- Dysbacteriosis that occurs in healthy people:
- Professional (violations occur due to harmful professional activities)
- Age-related (flora is disrupted due to aging of the body)
- Nutritional (associated with poor nutrition)
- Seasonal (flora changes depending on the time of year, mainly in cold weather).
By severity:
- light;
- medium-heavy;
- heavy.
With the flow:
- acute (up to 30 days);
- prolonged (up to 4 months): with clinical manifestations (continuous or recurrent) and without clinical manifestations;
- chronic (more than 4 months): with clinical manifestations (continuous or recurrent) and without clinical manifestations.
Dysbacteriosis of the small intestine
Dysbacteriosis of the small intestine begins to manifest itself when it is over-contaminated. In this case, the microbial composition changes, which provokes disruption of the normal functioning of the gastrointestinal tract. The pain is localized in the navel area.
Dysbacteriosis of the large intestine
Colon dysbiosis is an extremely common pathology that disrupts the microflora simultaneously in the stomach, duodenum, and intestines. The disease can be long-lasting, take a more severe form and disrupt a person’s normal lifestyle.
Symptoms of intestinal dysbiosis
The clinical picture of the development and course of dysbiosis depends on both the stage and the microbiological variant of the disorder.
Characteristic signs of dysbiosis in adults:
- Stool disorders. Stool disorders due to dysbacteriosis are one of the most common and characteristic symptoms. Most often it manifests itself in the form of loose stools (diarrhea). With age-related (in older people) dysbiosis, constipation most often develops, which is caused by a decrease in intestinal motility (due to a lack of normal flora).
- With pronounced processes of decay and fermentation, which are observed in only 25% of patients, the composition, shape and color of feces are disrupted. It becomes foamy, liquid, acquires a light color and a sour odor. You may experience a burning sensation in the anus.
- change in the smell of feces (it becomes sharply putrid or sour);
- increased gas formation (gases can be smelly or odorless, sonorous or not);
- bloating of varying intensity (it is more pronounced in the evenings, and may worsen after certain foods);
- Dyspeptic disorders: nausea, vomiting, belching, loss of appetite, are the result of impaired digestion;
- The intestines do not empty completely.
- Rotten taste, belching.
Symptoms that appear during dysbacteriosis may not be observed in everyone, this is individual characteristics. About half of those suffering from this disorder experience nothing other than loose stools or constipation.
With dysbacteriosis, digestion suffers the most. Since food in the intestines is first broken down by bacteria, and only then absorbed into the blood. Without the help of microorganisms, the body cannot absorb many nutrients. Therefore, nausea, vomiting, and loose stools appear.
Stages of dysbiosis in adults
There are the following stages of the disease:
Stage 1 |
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2 |
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3 |
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4 |
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With intestinal dysbiosis, other symptoms and manifestations are possible, but they will most likely relate to complications of the disease or to an exacerbation of concomitant pathologies. These symptoms are not directly related to a violation of the intestinal microflora. For example, signs of hypovitaminosis and vitamin deficiency are possible. The lack of vitamin is due to the fact that it is not absorbed normally in the intestines.
Diagnostics
With intestinal dysbiosis, symptoms such as enterocolitis, inflammation of the large and small intestines are observed. The doctor’s task is to make a correct diagnosis, excluding the above pathologies of the digestive organs.
It is difficult to diagnose dysbiosis without tests. The symptoms of the disease are very similar to the symptoms of other diseases. To make a diagnosis, the doctor needs to have diagnostic results. After collecting the patient’s complaints and palpation, the specialist prescribes 2-3 necessary procedures.
The following will help you make an accurate diagnosis:
- Stool analysis. The most specific method for laboratory diagnosis of intestinal dysbiosis is stool analysis and culture.
- Clinical blood test - shows the presence of inflammation and possible bleeding in the intestines. With severe dysbacteriosis, a decrease in the level of hemoglobin in the blood is noted.
- Colonoscopy. Allows you to assess the condition of a section of intestine up to one meter long.
- Ultrasound examination of the abdominal cavity. It can be used to detect concomitant pathologies.
- Fibroesophagogastroduodenoscopy. It consists of examining the mucous membrane of the stomach, esophagus and duodenum, which is carried out using an endoscope.
- X-ray of the intestines. To detect pathological changes, a contrast agent is used during the procedure.
Treatment of dysbiosis in adults
With a mild degree of imbalance in the intestinal microflora, it may be sufficient to eliminate these causes through a balanced diet, taking prebiotics or probiotics. In case of severe disorders, dietary nutrition is also indicated simultaneously with complex antimicrobial therapy.
How to treat intestinal dysbiosis? Treatment activities consist of:
- elimination of excessive bacterial contamination of the small intestine;
- restoration of normal microbial flora of the colon;
- improvement of intestinal digestion and absorption;
- restoration of impaired intestinal motility;
- stimulating the body's reactivity.
Medications
To treat dysbiosis, drugs are used that help restore normal intestinal flora. Typically, a product from one of the following groups is selected:
- Antibacterial drugs are necessary primarily to suppress the excessive growth of microbial flora in the small intestine. The most widely used antibiotics are from the group of tetracyclines, penicillins, cephalosporins, quinolones (tarivid, nitroxoline) and metronidazole.
- Bacteriophages (intestibacteriophage, staphylococcal bacteriophage, pyobacteriophage, coliproteus bacteriophage, etc.);
- Antibiotics (fluoroquinolones, cephalosporins, penicillins, macrolides, aminoglycosides, etc.);
- Probiotics for dysbacteriosis (sporobacterin, enterol, cereobiogen, bactisubtil, etc.).
- Antifungal agents. Prescribed when an increased amount of yeast is detected in the intestinal contents.
- Enzymes are prescribed in case of severe digestive disorders. Mezim tablets, 1 tablet 3 times a day, before meals. In order to improve the absorption function, Essentiale, Legalon or Karsil are prescribed, since they stabilize the membranes of the intestinal epithelium. Propulsive bowel function is improved by imodium (loperamide) and trimebutine (debridate).
- Sorbents are prescribed for severe signs of intoxication. Activated carbon is prescribed 5-7 tablets at a time, for 5 days.
Prescribe medications for dysbiosis, determine their dosage and duration of use only a doctor can. Self-medication risks complications.
During long-term treatment with antibiotics, be sure to include in the therapy a special diet containing foods rich in beneficial bacteria, antifungal and immunostimulating, as well as antihistamine therapy.
Treatment of intestinal dysbiosis is prescribed comprehensively depending on the degree of the disease. Since the disease develops under the influence of many factors, it is important to eliminate the cause of its development, otherwise taking probiotics will not have a positive effect. Elimination of foci of infection and chronic diseases is the main task in treatment.
Diet and proper nutrition
There is no special diet for each person, you just need to follow some rules, avoid unwashed fruits, low-quality foods and eat food every three hours in small portions. It is important to eat hot liquid food every day: soup, broth.
Basic principles of proper nutrition for dysbiosis:
- eating regularly at the same time;
- eating warm food (within 25-40 degrees) and avoiding too cold or hot food;
- avoiding aggressive and spicy foods;
- chewing food thoroughly;
- eating food frequently (every two and a half hours) and in small portions;
- drink plenty of fluids, but not during meals (so as not to interfere with the digestion of food).
When following a diet, you are allowed to eat the following foods:
- white or rye bread – not fresh, but yesterday’s bread;
- crackers;
- soups in low-fat broths with pureed cereals and vegetables;
- boiled, steamed or stewed meat dishes;
- lean meats;
- lean fish, boiled, steamed, stewed or fried without breading;
- vegetables (excluding cabbage, legumes and mushrooms) boiled, baked or steamed;
- fruits and berries in jelly, compote, puree or mousse;
- baked or raw grated apples;
- low-fat dairy products;
- butter in small quantities;
- sauces without spices;
- all drinks except alcoholic, carbonated, kvass and fruit drinks.
Along with the diet, patients may be prescribed probiotics and prebiotics. These drugs improve intestinal function and restore healthy flora.
Folk remedies
Traditional medicine, if proven remedies are used correctly, can improve the condition and alleviate the symptoms of the disease. But it can only be used as a supplement to the main treatment prescribed by a doctor.
The following are allowed as folk treatment:
- plants that give an antiseptic effect: pomegranate and rosehip juice diluted with water, strawberries, raspberries;
- mint extract, chamomile tea, and St. John's wort infusions provide an analgesic effect;
- have an astringent effect, anti-inflammatory blueberries, bird cherry, beets.
Traditional methods include the use of the following means:
- Oak bark . A decoction of oak bark has an astringent effect and helps with diarrhea, which often accompanies dysbacteriosis. A tablespoon of raw material, poured with 250 ml of boiling water, is simmered over low heat for a quarter of an hour. The liquid is cooled, filtered and taken half a glass up to 3 times a day.
- Garlic . It contains antibacterial compounds that destroy pathogenic microflora and prevent the development of putrefactive processes. To prepare the medicine, you need to crush a clove of garlic in a mortar and pour a glass of low-fat kefir over it. Drink 2 glasses of the resulting drink every day.
- A healthy and tasty cure for dysbiosis is a mixture of sunflower seeds, pumpkin seeds and walnut kernels. Well-dried ingredients must be ground in a coffee grinder and taken 2 tablespoons of the resulting powder daily, washed down with warm water.
- Serum. Sold in stores or left over after making homemade cottage cheese. The heated whey is drunk in the morning on an empty stomach for a month, 1 glass.
- If digesting food is accompanied by bloating. Pour 4 tablespoons of dill seeds into a glass of hot water, leave for 2 hours, then strain and drink every 2 hours throughout the day.
- Based on propolis honey: A teaspoon of this honey should be diluted in a glass of warm water or rosehip decoction and taken 2 times a day after meals for 1.5 months.
- The simplest herbal decoction options– this is eucalyptus and mint. To prepare the first 3 tbsp. dry eucalyptus is poured with 500 ml of boiling water. For the second recipe, use 2 times less boiling water – 250 ml. Eucalyptus decoction is drunk a quarter of a glass 3 times a day, and mint decoction is drunk of 3 quarters of a glass 4 times a day. The course of treatment lasts 14 days.
Treatment exclusively with herbs is possible only in cases of mild dysbacteriosis. In other cases, traditional methods are only an addition to the main treatment prescribed by a specialist.
Prevention
Preventive measures include following recommendations for proper nutrition, hygiene and sanitary processing of products.
Basic preventive measures for adults are as follows:
- healthy eating;
- taking antibiotics only as prescribed by a doctor;
- timely treatment of diseases of the digestive system.
To get rid of dysbiosis and prevent further relapses, it is most effective to use an integrated approach. At the first symptoms, be sure to seek help from a gastroenterologist. Be healthy and always watch your lifestyle!
Disputes continue among scientists:
- “If intestinal dysbiosis is not a disease, then why fight it?”
- “Treatment of dysbiosis is necessary especially in childhood, since it causes disruption of intestinal function with subsequent reflection on the entire body.”
- “Any healthy person needs to strengthen and support beneficial intestinal microorganisms.”
Practitioners who see suspicious manifestations of an unclear nature in the stomach and intestines after exposure to certain factors have to take these opinions into account. The worst thing is when they appear in an adult patient or child during recovery from respiratory and infectious diseases.
What is dysbiosis?
Dysbacteriosis is indeed not the name of a disease, but a term denoting an imbalance in the quantitative composition of bacteria. The disease, unlike intestinal dysbiosis, has typical damage to the structures of the wall of the afferent vessels, nerve plexuses, and neighboring lymph nodes.
The intestinal flora is 95% filled with bifidobacteria and lactobacilli. They provide:
- final breakdown of nutrients and the possibility of their absorption into the bloodstream;
- cleaning of waste, gases, rotting products;
- accelerated removal of harmful components;
- the production of certain enzymes for biochemical processes;
- synthesis of vitamins;
- production of immune cells for local protection.
Violation of the composition of beneficial microorganisms and the growth of opportunistic flora, the appearance of clearly pathogenic bacteria occurs under the influence of various reasons on the body. Symptoms of dysbiosis intensify as the intestinal flora deteriorates. A person appears:
- alternating diarrhea and constipation;
- constant bloating due to the accumulation of gases and fermentation processes;
- aching pain along the intestines, sometimes colic;
- in feces - undigested pieces of food, mucus, blood;
- loss of appetite, weight loss, underweight in infants;
- frequent allergic reactions, diathesis in children;
- dense plaque on the tongue, teeth;
- bad breath;
- joint pain;
- bleeding gums;
- slight increase in temperature;
- thinning and hair loss;
- increased brittleness of nails;
- areas of peeling on the skin;
- frequent colds due to decreased immunity, exacerbation of chronic diseases.
Proponents of treating intestinal dysbiosis as a pathological change in microflora have created an approximate classification according to causative factors. It is proposed to distinguish the following types of dysbacteriosis:
- Medicinal - caused by irrational use of medications, their negative properties, or excess dosage.
- Non-infectious - the main changes occur under the influence of dysfunction of the biliary system, stomach, intestines or the entire gastrointestinal tract (GIT). Allergic changes are allowed.
- Infectious - the “culprits” are microorganisms.
They are divided according to the type of pathogen and the characteristics of the clinic:
- for Proteus - mild course, symptoms are tolerated satisfactorily, go away gradually on their own;
- staphylococcal - the predominance of intestinal symptoms causes a severe course, gradually spreading to other organs;
- fungal - caused by Candida fungi, marks appear on the lips, the tongue turns crimson, spreads to the vagina in women (thrush), it is difficult and takes a long time to treat;
- associative - the most complex form, caused by a combination of staphylococci with other microorganisms.
The classification is not the only one; it does not include social and nutritional factors.
The role of proper nutrition
To get rid of dysbiosis, it is not enough to take expensive medications. Treatment begins with organizing a regimen and changing the quality of nutrition. With the correct selection of products and gentle decongestion of the gastrointestinal tract, the intestinal microflora is capable of independent recovery. This requires time and patience.
In this regime, you should stick to eating every 3-4 hours in small portions, but regularly. Any “starvation” diets or drastic restrictive measures are contraindicated. But you should make sure that your diet does not include fast food, snacks on the go, fatty cakes, sweets, fried and smoked foods.
For taste, you can add raisins and dried fruits to the porridge.
You will have to refuse:
- from carbonated drinks, coffee, alcohol;
- hot sauces, pepper, mustard, ketchup;
- fatty meat, lard;
- pickles from vegetables and mushrooms;
- canned foods;
- fresh vegetables, berries, fruits;
- onions and garlic, radishes, sorrel.
All dishes should be eaten boiled or stewed. For meat products, minced chicken and beef are suitable. Steamed cutlets, meatballs, and meatballs are recommended. You can cook any kind of porridge, but use water and no sugar. Preference for fermented milk products (kefir, yogurt, yogurt, whey), cottage cheese.
For a baby who is bottle-fed, nutritional formulas based on kefir are selected. Soft-boiled eggs and steamed eggs are allowed. You can drink green tea, rosehip decoction, berry jelly, dried fruit compote.
What medications help in treatment
The treatment regimen for dysbiosis requires compliance with certain stages in the use of medications. It is necessary to restore the microflora gradually, using complex treatment along with proper nutrition.
Stage 1
The patient is prescribed prebiotics to create favorable conditions for the existence of beneficial microorganisms in the intestines. Drugs in this group do not require absorption.
They are able to make the life of pathogenic microflora impossible, strengthen local immune cells, and activate the development of beneficial microorganisms. In cases of mild dysbiosis, nothing more is required.
Drugs at this stage include Duphalac, Lactusan. A combined prebiotic and enterosorbent Lactofiltrum is used. It simultaneously removes toxins. As symptomatic drugs, antispasmodics are prescribed for cramping abdominal pain, choleretic drugs against the background of tract dyskinesia, and multivitamin complexes.
Stage 2
Treating intestinal dysbiosis in adults after preparing and cleansing the intestinal mucosa continues with probiotics. These are preparations containing the necessary bacteria. There are many options for choosing the right drug. In pharmacotherapy, they are usually divided into generations as new drugs are produced.
The first generation consists of drugs with one strain of microorganisms. These are Bifidumbacterin, Lactobacterin, Colibacterin. The second generation is formed from antagonist drugs containing flora that can fight pathogenic bacteria and at the same time support digestion. Includes: Baktistatin, Biosporin, Sporobacterin.
The third generation includes multicomponent drugs. They include several strains of bacteria + dietary supplements. Representatives: Linex, Acipol, Bifiliz, Atsilakt, Bifiform.
The fourth generation is synthesized only from bifidobacteria. It turned out that the first generation drugs were strengthened: Florin Forte, Probifor, Bifidumbacterin Forte.
Main content: lactobacilli
All probiotics differ in the bacterial composition of the main component:
- bifidobacteria - contain Bifidumbacterin (forte or powder), Bificol, Bifiliz, Bifiform, Biovestin, Lifepack, Probifor, Probiotics;
- lactobacilli - included in Linex, Lactobacterin, Acilact, Acipol, Biobakton, Gastrofarm;
- colibacteria - contained in Colibacterin, Bioflora, Bifikol;
- enterococci - included in Linex, Bifiform;
- yeast-like fungi - found in Biosporin, Baktisporin, Enterol, Baktisubtil, Sporobacterin.
The drugs come to the Russian Federation from different countries, so they differ in price. Produced specifically for children in the form of a suspension or soluble powder.
Liquid probiotics are indicated for infants, especially those born prematurely, after acute respiratory viral infections with diarrhea and stunted growth. Pediatricians choose from the group:
- Bifidumbacterin Forte;
- Linux;
- Biphilis;
- Lactobacterin;
- Probifor.
You should not try to choose the drug yourself. It has been found that probiotics can have negative effects. Studies of expensive imported products have shown that the activity of microorganisms corresponds to only 20% of the declared one. In addition, bacteria do not establish themselves in the intestines for a long time.
Microbiologists believe that people living in Russia are more adapted to local strains. Therefore, domestic drugs are more useful for the treatment of dysbiosis.
Synbiotics are the newest drugs for restoring intestinal flora. They are created from a combination of probiotic and prebiotic.
Both products help maintain the activity of microorganisms, feed beneficial bacteria, protect and stimulate their reproduction. Lb17 is considered one of the best drugs today. it contains more than 70 components: 17 types of living bacteria, extract of algae, vegetables, mushrooms, medicinal herbs, fruits, grains.
The drug is quite expensive, since it is synthesized by natural fermentation over a period of three years. Comes from Canada. Multidophilus plus is an American drug that includes three strains of lactobacilli, bifidobacteria, and maltodextrin. Indicated for the treatment of adults.
Intetrix, in addition to being antimicrobial, has antifungal activity and does not affect normal intestinal flora
Drugs of different groups
An intestinal antiseptic is a type of antibiotic that suppresses pathogenic flora (Enterofuril, Intetrix). Bacteriophages are viruses that, when multiplied, destroy certain types of intestinal bacteria. They are prescribed in addition to antiseptics.
Intesti-bacteriophage is a soluble agent, administered orally or as an enema. Effectively fights pathogenic flora (enterococci, dysentery bacteria, salmonella).
In practice, a streptococcal bacteriophage is used, which destroys only streptococci.
Recovery duration
How long does it take to treat dysbiosis? The duration of therapy aimed at normalizing the intestinal microflora depends on the degree of disturbances and the stages of the course of treatment. It will take 7–10 days to remove the pathogenic microflora that plagues dysbiosis in adults; this is the minimum time for using antibacterial drugs, sorbents and antiseptics.
In order to “populate” the intestines with the necessary flora, restoration of intestinal microflora in an adult patient requires two to three weeks of use of a combination of prebiotics and probiotics to “feed and support” the renewed microflora.
To activate the functioning of the intestines, laxative medications are prescribed (for constipation) or antidiarrheal medications (if diarrhea is a concern). It takes 10–20 days for motor skills to stabilize. Therefore, the entire treatment of intestinal dysbiosis with medications may take up to two months. Additionally, you will have to follow a diet for six months.
How to restore the microflora of the stomach?
Certain bacteria live on the gastric mucosa. They partially penetrate from the oral cavity along with saliva. The main composition of the gastric microflora:
- bacteroides,
- veillonella,
- lactobacilli,
- streptococci,
- staphylococci,
- micrococci.
All microorganisms protect the stomach wall from the penetration of pathogenic bacteria only under conditions of normal secretion of gastric juice. With increased or decreased acidity, part of the flora dies. Then the stomach becomes defenseless for other microorganisms that can cause gastritis.
Restoring the gastric microflora requires, first of all, normalizing acidity. When conditions are created, the microflora grows independently. The following is used in treatment:
- diet depending on the acidity state;
- eubiotics and probiotics - with lactobacilli;
- drugs like Omeprazole to normalize acid secretion;
- prostaglandin E (Cytotec, Misoprostol);
- herbal remedies (aloe, sea buckthorn oil);
- stimulants for mucosal restoration (Actovegin, Solcoseryl).
The drug is used to normalize the acidity of gastric juice
How to restore intestinal microflora using traditional methods?
In herbal medicine, some diseases are treated with folk remedies to support medications. It is impossible to avoid taking special medications for dysbiosis. But some healers offer their own regimens that include the most useful products with properties in therapy.
Prebiotic products:
- chicory (raw root);
- wheat bran;
- asparagus;
- dried apricots, prunes;
- fruits (apples, citrus fruits, bananas);
- berries (black and red currants, strawberries, plums).
Probiotic products:
- flaxseed, oil;
- corn;
- figs;
- grape;
- sauerkraut;
- herbal intestinal antiseptics:
- onion and garlic;
- cardamom;
- ginger root;
- dill and fennel (greens, seeds);
- walnuts and almonds;
- fruits of rowan, blueberry.
Doctors believe that the whey contains all the substances that help restore the microflora of the stomach and intestines; you need to drink it warm, in small sips
It is recommended to prepare decoctions from herbal remedies and add them to the menu. You should consult your doctor about the composition. Many people may experience allergic reactions, so during treatment you need to monitor the appearance of swelling and itchy rashes on the skin.
Some of the products offered are quite aggressive. For example, onions and garlic. They are allowed to be used only if the patient does not have stomach diseases (gastritis, ulcers). It is recommended to prepare whey yourself from kefir by heating and straining the curd. Honey lovers are allowed to add a teaspoon to a glass of decoction or whey.
Symptoms of intestinal dysbiosis lead patients to gradual anemia, vitamin deficiency, weight loss, and can become a trigger for various diseases. Therefore, it is recommended to begin treatment against the background of a disruption in diet or medication. Patient restoration of the functional state of the intestine will prevent other pathologies.
Intestinal dysbiosis is a disease accompanied by an imbalance in the ratio of beneficial and harmful bacteria.
The intestines of a healthy person are inhabited by an innumerable mass of microbes, 90% of which are representatives of obligate flora (healthy), 5-10% are facultative (conditionally pathogenic). Lactobacilli, bifidobacteria, anaerobic propionobacteria, Escherichia are involved in digestion, metabolism, protect against allergies, entry and uncontrolled reproduction of pathogenic organisms in the gastrointestinal tract.
Elements of conditionally pathogenic flora (fungi, fusobacteria, gram-negative bacilli, staphylococci, streptococci) do not cause diseases provided that a person has strong immunity. Under certain circumstances, the number of obligate flora decreases and the growth of pathogenic organisms in the intestines increases.
What it is?
Intestinal dysbiosis is a change in the intestinal microflora, which leads to deterioration of absorption and the development of pathologies throughout the body. The normal amount of beneficial bacteria in the intestines, the correct ratio of their content as a percentage is called normal flora. It maintains homeostasis in the body.
Normal microflora
This focus on the tiny inhabitants of the human intestine is explained by the fact that these microorganisms have an extremely positive effect on health. They have many beneficial functions. So, beneficial microflora:
- protect the intestinal mucosa from infectious agents, allergens, and excess opportunistic microbes;
- synthesizes vitamins (especially group B), antitumor substances, enzymes for the breakdown of proteins and sugars;
- neutralizes toxins and harmful metabolic products;
- reduces cholesterol;
- activates immunity:
- produces short-chain fatty acids, which ensure the integrity of the colonic mucosa;
- stimulates the absorption of necessary substances (water, iron, calcium, gases, vitamins E, D).
In addition to beneficial microbes (bifidobacteria, lactobacilli, etc.), opportunistic microorganisms (Klebsiella, Proteus, staphylococci, atypical Escherichia, Serracia, Enterobacter, yeast-like fungi, etc.) live in the intestine. In a healthy person, their number is strictly limited, so they do no harm. But when immunity drops, after intestinal infections, stress, etc. these insidious bacteria and fungi are activated, begin to multiply and have adverse effects, leading to clinical symptoms.
Causes
Dysbacteriosis does not necessarily develop in people with health problems. Quite often, the problem can appear in adults and children who have never previously experienced any problems with the digestive system.
The main reasons for the development of dysbiosis may be the following:
- Incorrect use of certain medications;
- Sudden change in food type;
- Eating poor quality food;
- Lack of fortified and fermented milk foods in the diet;
- Recent intestinal infections;
- Frequent use of antibiotics;
- Insufficient protection of the immune system;
- Having acute or chronic diseases - gastritis, pancreatitis, etc.
At the initial stages of development, dysbiosis may practically not make itself known. A person may only occasionally suffer from minor abdominal pain, bloating, and rare stool disorders.
Main signs
The first signs of intestinal dysbiosis in adults:
- Abdominal pain;
- Feeling of heaviness;
- Bloating;
- Flatulence;
- Diarrhea alternating with constipation;
- Feeling of increased discomfort.
Symptoms directly depend on the degree of neglect of the disease.
Symptoms of intestinal dysbiosis
In adults, the symptoms of dysbiosis are varied in their manifestation and severity. The severity of their manifestations depends on conditions such as age, lifestyle, immune system, and stage of development. In one person, a week of antibiotic therapy will cause only a slight disruption of the intestinal microflora, while in another it will cause severe symptoms of dysbiosis.
- Stage 1 of dysbiosis is characterized by a slight imbalance of normal and pathogenic bacteria. This condition may be due to a short course of taking antibacterial drugs or a change in usual food and water. At this stage, symptoms are mild and may be limited to minor intestinal upset. After completing antimicrobial treatment or getting used to new nutritional conditions, the balance of intestinal microflora is restored independently.
- At stage 2, the intestines cease to produce sufficient quantities of enzymes necessary for normal digestion of food. The result of this may be a fermentation process characterized by bloating, bitterness in the mouth, pain, flatulence, constipation or diarrhea. These symptoms may indicate the development of other diseases of the gastrointestinal tract, but most often indicate progressive dysbiosis.
- Stage 3 requires medical intervention, since pathogenic flora, affecting the intestinal walls in large quantities, causes inflammation. Symptoms become more pronounced, the patient experiences nausea and vomiting, undigested food fragments can be seen in the stool, patients complain of severe abdominal pain, and body temperature may rise.
- At stage 4, pathogens almost completely displace the beneficial intestinal microflora. In this case, the mechanism of absorption of nutrients is disrupted, which leads to the development of vitamin deficiency and anemia. In addition, toxins formed as a result of incomplete digestion of food and the activity of pathogenic microflora, entering the blood, cause severe allergic reactions. The previously described symptoms may include rash, eczema, hives, asthma, chronic fatigue, insomnia and problems concentrating. Lack of timely treatment threatens the development of severe intestinal infections.
It must be remembered that it is easiest to eliminate dysbiosis in its initial stages. If you discover a list of suspicious symptoms that do not go away within a couple of days, you should contact a gastroenterologist.
Chronic dysbacteriosis
Chronic dysbacteriosis is somewhat less common. At the same time, disturbances in the composition and quantity of microflora do not return to normal for a very long time (months, years). As a rule, there are prerequisites that do not allow normal microflora to recover. However, in most cases, this problem can still be solved with proper treatment.
In the chronic course of dysbacteriosis, it is important to pay attention to the presence of the following factors:
- self-medication and unqualified treatment;
- weakened immune system;
- chronic inflammatory bowel diseases;
- non-compliance with the prescribed diet;
- presence of intestinal tumors;
- the presence of a constant source of infection (poor quality drinking water, etc.);
- possible resistance of bacteria to prescribed antibiotics (checked by antibiogram);
- chronic diseases of the liver, pancreas, stomach.
In the presence of the above factors, the prerequisites are created for changes in the composition of the intestinal microflora. If these factors are not eliminated, treatment in most cases will not have the desired effect. The disease takes a chronic course.
Diagnostics
In order to determine the presence and nature of dysbiosis, it is necessary to find out which microbes populate the intestines and in what quantity. Today, two main diagnostic methods are practiced:
- The method for examining microflora metabolites is based on determining the substances (volatile fatty acids) that microbes secrete during their development. This method is highly sensitive and easy to determine microbes and allows you to get results within a few hours. In addition, it is not as expensive as bacteriological.
- Bacteriological research. With the bacteriological method, depending on the specialization of the laboratory, from 14 to 25 species of bacteria are determined (this is only 10% of all microorganisms). Alas, you will receive the result of this analysis only after 7 days; on average, this is the time it takes for bacteria to grow in special nutrient media and be identified. In addition, the quality of the results of this analysis also depends on compliance with delivery times and the quality of the material; there are also difficulties in cultivating certain types of bacteria.
It must be remembered that the composition of the intestinal microflora is individual for each person. It depends on age, food consumed, and even the time of year. Therefore, making a diagnosis based solely on tests is a mistake. Additional examination is needed to determine the cause of dysbiosis.
Complications
The most serious consequences can be caused by the following complications of dysbacteriosis:
Considering the lack of vitamins and weakened immunity that occur with dysbiosis, there is a risk of other complications that are not directly related to disorders of the intestinal microflora. In general, we can say that dysbiosis is not a dangerous disease, but you still shouldn’t start the disease.
Treatment of intestinal dysbiosis
In case of confirmed intestinal dysbacteriosis, planned treatment is carried out using drugs that restore normal intestinal flora and correct other disorders in the body (using enzymes, sorbents, vitamins).
Groups of drugs prescribed for intestinal dysbiosis in adults:
- Sorbents are prescribed for severe signs of intoxication. Activated carbon is prescribed 5-7 tablets at a time, for 5 days.
- Prebiotics - have a bifidogenic property, i.e. contribute to the stimulation and growth and reproduction of microbes that are part of the normal intestinal flora. Representatives of this group include: Hilak-forte, Duphalac. Hilak-forte is prescribed 40-60 drops 3 times a day.
- Antibacterial drugs are used for the 4th degree of intestinal dysbiosis, to destroy pathogenic flora. The most commonly used antibiotics are: tetracyclines (Doxycycline), cephalosporins (Cefuroxime, Ceftriaxone), penicillins (Ampiox), nitroimidazoles: Metronidazole, prescribed 500 mg 3 times a day, after meals.
- Symbiotics (Bifidobak, Maltodophilus) are combined preparations (prebiotic + probiotic), i.e. simultaneously stimulate the growth of normal flora and replace the missing number of microbes in the intestines. Bifidobac is prescribed 1 capsule 3 times a day, with meals.
- Bacteriophages. To eliminate the symptoms of dysbiosis, you can take medications containing viruses that attack a specific type of bacteria. They are combined with antibacterial treatment or used as an alternative therapy.
- Enzymes are prescribed in case of severe digestive disorders. Mezim tablets, 1 tablet 3 times a day, before meals.
- Antifungal drugs (Levorin) are prescribed if there are yeast-like fungi such as Candida in the stool. Levorin is prescribed 500 thousand units 2-4 times a day.
- Multivitamins: Duovit, 1 tablet 1 time per day.
The dosage, duration of treatment and group of drugs are prescribed by the attending physician, depending on the degree of dysbacteriosis. Below are the dosages of drugs for adults; for children, the dosage depends on the weight and age of the child.
Probiotics
Probiotics (eubiotics) are preparations containing live microorganisms (i.e. bacteria of normal intestinal flora), they are used to treat grade 2-4 dysbacteriosis.
- 1st generation drugs: Bifidumbacterin, Lifepack probiotics. They are liquid concentrates of lactobacilli and bifidobacteria and are not stored for long (about 3 months). This group of drugs is unstable under the influence of gastric juice or enzymes of the gastrointestinal tract, which leads to their rapid destruction and the intake of insufficient concentrations, the main disadvantage of 1st generation probiotics. Bifidumbacterin is prescribed orally, 5 doses of the drug 2-3 times a day, 20 minutes before meals;
- 2nd generation drugs: Baktisubtil, Flonivin, Enterol. They contain spores of bacteria of normal intestinal flora, which in the patient’s intestines secrete enzymes for the digestion of proteins, fats and carbohydrates, stimulate the growth of bacteria of normal intestinal flora, and also suppress the growth of putrefactive flora. Subtil is prescribed 1 capsule 3 times a day, 1 hour before meals;
- 3rd generation drugs: Bifikol, Linex. They consist of several types of bacteria from the normal intestinal flora, and therefore are highly effective compared to the previous 2 generations of probiotics. Linex is prescribed 2 capsules 3 times a day;
- 4th generation drugs: Bifidumbacterin forte, Biosorb-Bifidum. This group of drugs consists of bacteria of normal intestinal flora in combination with an enterosorbent (with activated carbon or others). Enterosorbent is necessary to protect microorganisms when passing through the stomach, it actively protects them from inactivation by gastric juice or enzymes of the gastrointestinal tract. Bifidumbacterin forte is prescribed 5 doses 2-3 times a day, before meals.
Treatment of intestinal dysbiosis is prescribed comprehensively depending on the degree of the disease. Since dysbiosis develops under the influence of many factors, it is important to eliminate the cause of its development, otherwise taking probiotics will not have a positive effect. Elimination of foci of infection and chronic diseases is the main task in the treatment of dysbiosis.
Diet for dysbiosis
How to treat intestinal dysbiosis? With a mild degree of imbalance in the intestinal microflora, it may be sufficient to eliminate these causes through a balanced diet, taking prebiotics or probiotics.
In case of severe disorders, dietary nutrition is also indicated simultaneously with complex antimicrobial therapy. Basic Rules:
- Products are steamed, boiled, baked, stewed. No frying!
- Drink plenty of fluids, mostly clean water. For diarrhea, it helps against dehydration, and for constipation, it softens clotted stool.
- The food is balanced, rich in foods containing proteins, carbohydrates, vegetable fats, minerals, vitamins necessary for the full functioning of the body.
- Remove foods that irritate the gastrointestinal tract, have a laxative or fixative effect.
- Avoid products that cause gas formation, fermentation, and rotting.
- Remove sauces, hot spices, smoked meats, marinades, and strong alcohol. No fast food, semi-finished products, dry food, on the go. Rich broths, confectionery, baked goods, whole milk, strong tea are prohibited.
- Eat foods that create favorable conditions for the growth of beneficial bacteria. They place emphasis on fermented milk products (kefir, yogurt, acidophilus milk), and foods rich in plant fiber.
- They refuse fresh vegetables and fruits. Any heat treatment is preferred. Baked apples are an excellent dessert, rich in vitamins and healthy elements.
- Eat food regularly, every 2.5-3 hours in small portions. Long intervals between meals should not be allowed.
- The temperature of the food should be pleasant and warm. You can't eat hot, it's too cold.
Diet is an important condition for the successful treatment of dysbiosis in adults and children. Food consumption is not limited, its composition is changed. A balanced diet and properly prepared food will help restore the lack of vitamins, increase hemoglobin, normalize digestion, and ensure complete excretion of bile.
Can the patient do without treatment?
Cases of independent voluntary disposal of minor disturbances in the intestinal microflora are recorded quite often in medical practice. But most of these examples are associated with disorders due to emotional shocks or rapid acclimatization.
Please note that dysbiosis can stop progressing only in the first phase of its development. This is the big problem, because during this period it is almost impossible to notice characteristic changes in the intestinal microflora. And if the patient already has pronounced symptoms of the disease, then he needs medical help, since we are talking about a seriously advanced process.
Prevention
The most important method of prevention is timely and rational antibacterial therapy. In this way, the patient can protect himself from the symptoms of dysbiosis and the development of the disease.
A common case of dysbacteriosis is long-term use of antibiotics. To prevent the disease, it is recommended to take the following measures:
- eat fermented milk products;
- start using antifungal drugs;
- take probiotics, multi-enzymes and multivitamins.
The complex of drugs must be prescribed by a doctor; it is not recommended to use any medications on your own.
Intestinal dysbiosis is a pathological condition of the body in which there is a change in the quantitative and qualitative composition of the intestinal microflora with a possible change in the area. Symptoms of dysbacteriosis in adults: stool disorder, dyspeptic symptoms, pain along the intestines and a disturbance in the general condition of the patient.
In the human intestine there are over 500 different types of microbes, the total number of which reaches 1014, which is an order of magnitude higher than the total number of cellular composition of the human body. The number of microorganisms increases in the distal direction, and in the colon 1 g of feces contains 1011 bacteria, which constitutes 30% of the dry residue of the intestinal contents.
The concept of intestinal dysbiosis includes excessive microbial contamination of the small intestine and changes in the microbial composition of the large intestine. Disruption of microbiocenosis occurs to one degree or another in most patients with pathologies of the intestines and other digestive organs. Therefore, dysbiosis is a bacteriological concept. It can be considered as one of the manifestations or complication of the disease, but not an independent nosological form.
Classification and degrees
Depending on the severity of changes in the intestinal microbiota, the disease is divided into four degrees or phases, which determine the symptoms and treatment of intestinal dysbiosis.
Degrees of dysbacteriosis:
- The first degree is characterized by initial changes and is often called the latent phase. It is characterized by a predominance of anaerobic microorganisms. The number of lactobacilli and bifidobacteria decreases slightly, structural changes affect no more than a fifth of E. coli, and opportunistic flora begins to multiply.
- The starting phase, in which the number of aerobes and anaerobes is approximately equal. There is inhibition of the development of normal flora with the development of opportunistic strains of microorganisms, which is accompanied by the appearance of symptoms.
- Aggressive microbial association phase. The flora becomes aerobic, E. coli undergo structural and functional changes. Hemolytic coccal flora, Proteus and other pathogenic flora appear.
- Associated dysbacteriosis phase. Aerobes predominate in the intestinal microflora; morphologically complete E. coli are practically not detected. Normal flora is replaced by pathogenic strains of microorganisms.
A similar classification was proposed by I.N. Blokhina. It is actively used by clinicians in their practice to determine one of three degrees of changes in the intestinal microflora and subsequent treatment of intestinal dysbiosis with varying amounts of drug therapy.
Depending on the severity of the clinical picture, the following are distinguished:
- Compensated intestinal dysbiosis. The patient has changes in laboratory tests, but there are no symptoms of the disease.
- Subcompensated intestinal dysbiosis. Symptoms of the disease appear. Their severity is often moderate. Local symptoms of the pathological process prevail over the general ones and are always corrected by the basic treatment regimen.
- Decompensated intestinal dysbiosis. The clinical picture is manifested by a severe disorder of the patient’s general condition with pronounced local symptoms. A secondary infection is often observed due to significant suppression of local immune defense. Such patients should be treated in a hospital.
Causes
The number of each type of bacteria that lives in the intestines is controlled by the laws of natural selection: those that multiply greatly do not find food for themselves, and the excess ones die, or other bacteria create unbearable living conditions for them. But there are situations in which the normal balance changes.
Sometimes almost completely healthy people can suffer from dysbiosis. In this case, the reason should be sought in the characteristics of the profession, or in seasonal changes in nutrition.
Symptoms
Intestinal dysbiosis in adults does not have any specific characteristic symptoms. Its manifestations are identical to the clinical picture of many other gastroenterological ailments. Thus, patients may be concerned about:
- Abnormal stool. Most often it manifests itself in the form of loose stools (diarrhea), which develops as a result of increased formation of bile acids and increased intestinal motility, inhibiting the absorption of water. Later, the stool becomes unpleasant, putrid odor, mixed with blood or mucus; With age-related (in older people) dysbiosis, constipation most often develops, which is caused by a decrease in intestinal motility (due to a lack of normal flora).
- Bloating, due to increased formation of gases in the large intestine. The accumulation of gases develops as a result of impaired absorption and excretion of gases by the altered intestinal wall. A swollen intestine may be accompanied by rumbling and cause unpleasant sensations in the abdominal cavity in the form of pain.
- Cramping pain associated with an increase in pressure in the intestines, after the passage of gas or stool, it decreases. With dysbacteriosis of the small intestine, pain occurs around the navel; if the large intestine suffers, the pain is localized in the iliac region (lower abdomen on the right);
- Dyspeptic disorders: nausea, vomiting, belching, loss of appetite are the result of impaired digestion;
- Allergic reactions, in the form of itchy skin and rashes, develop after consuming foods that usually do not cause allergies, and are the result of insufficient antiallergic action, disturbed intestinal flora.
- Symptoms of intoxication: there may be a slight increase in temperature up to 38 0 C, headaches, general fatigue, sleep disturbance, are the result of the accumulation of metabolic products (metabolism) in the body;
- Symptoms characterizing vitamin deficiency: dry skin, seizures around the mouth, pale skin, stomatitis, changes in hair and nails and others.
What is the danger?
Dysbacteriosis itself is not a dangerous disease that could pose a threat to the patient’s life. Most often, this is simply a temporary functional disorder that causes certain symptoms and manifestations, and, as a result, discomfort in the patient’s life. However, severe cases of dysbiosis can pose a certain danger. There are also complications of dysbiosis that must be taken into account. To prevent their development, patients are advised to promptly seek qualified medical help.
Considering the lack of vitamins and weakened immunity that occur with dysbiosis, there is a risk of other complications that are not directly related to disorders of the intestinal microflora. In general, we can say that dysbiosis is not a dangerous disease, but you still shouldn’t start the disease.
Diagnostics
In order to determine the presence and nature of dysbiosis, it is necessary to find out which microbes populate the intestines and in what quantity. Today, two main diagnostic methods are practiced:
- Bacteriological research. With the bacteriological method, depending on the specialization of the laboratory, from 14 to 25 species of bacteria are determined (this is only 10% of all microorganisms). Alas, you will receive the result of this analysis only after 7 days; on average, this is the time it takes for bacteria to grow in special nutrient media and be identified. In addition, the quality of the results of this analysis also depends on compliance with delivery times and the quality of the material; there are also difficulties in cultivating certain types of bacteria.
- The method for examining microflora metabolites is based on determining the substances (volatile fatty acids) that microbes secrete during their development. This method is highly sensitive and easy to determine microbes and allows you to get results within a few hours. In addition, it is not as expensive as bacteriological.
It must be remembered that the composition of the intestinal microflora is individual for each person. It depends on age, food consumed, and even the time of year. Therefore, making a diagnosis based solely on tests is a mistake. Additional examination is needed to determine the cause of dysbiosis.
Treatment of dysbiosis
In adults, treatment of dysbiosis should be comprehensive (scheme) and include the following measures:
- elimination of excessive bacterial contamination of the small intestine;
- restoration of normal microbial flora of the colon;
- improvement of intestinal digestion and absorption;
- restoration of impaired intestinal motility;
- stimulating the body's reactivity.
The vast majority of patients with intestinal dysbiosis do not see a doctor in the early stages of the disease. In the absence of concomitant diseases and normal functioning of the immune system, recovery occurs on its own, without taking any medications, and sometimes without following a diet. In more severe cases, treatment is carried out on an outpatient basis (the patient visits the doctor almost every day, but does not go to the hospital). If there are any complications or serious concomitant pathologies are identified, the patient may be admitted to the gastroenterology department. The leading specialist will, accordingly, be a gastroenterologist.
On average, treatment of dysbiosis lasts several weeks. During this time, the patient still experiences the main symptoms of the disease that bothered him before treatment (diarrhea, flatulence, etc.). However, they gradually pass. It is almost impossible to cure intestinal dysbiosis completely in 1–2 days, since bacteria grow quite slowly, and the disease will not go away until the intestines are colonized by representatives of normal microflora.
What medications help with dysbiosis?
For intestinal dysbiosis, a fairly wide range of drugs can be used that pursue different goals as part of complex treatment. Drug treatment should be prescribed by a specialist after conducting the necessary tests. Self-medication is dangerous, as the situation can worsen greatly. For example, taking the wrong antibiotics can kill the remnants of normal microflora and accelerate the proliferation of pathogenic bacteria.
In general, the following groups of drugs can be used in the treatment of intestinal dysbiosis:
- Eubiotics. This group of drugs contains representatives of normal intestinal microflora and substances that promote their growth. In other words, the restoration of normal intestinal microflora is stimulated. The choice of a specific remedy is made by the attending physician. Eubiotics Linex, Lactobacterin, Hilak-Forte, etc. are very common.
- Antibacterial drugs. Antibiotics could be the main cause of dysbiosis, but they are also often necessary for its treatment. They are prescribed when an abnormal dominant microorganism is isolated ( for example, with staphylococcal intestinal dysbiosis). Of course, in this case, antibiotics are prescribed only after an antibiogram, which shows which drug is best suited to treat a particular microorganism.
- Antidiarrheals. These drugs are prescribed to combat diarrhea, the most unpleasant symptom of dysbiosis. In fact, there is no treatment. The drugs impair contractions of the intestinal muscles and improve water absorption. As a result, the patient goes to the toilet less often, but there is no direct effect on the intestinal microflora. Antidiarrheals are a temporary solution and should not be taken for a long time. The most common are lopedium, loperamide and a number of other drugs.
- Multivitamin complexes. With dysbacteriosis, the absorption of vitamins is often impaired, and hypovitaminosis and vitamin deficiency develop. This aggravates the patient's condition. Vitamins are prescribed to compensate for deficiencies, as well as to maintain the immune system, which is also important in the fight against dysbiosis. Vitamin complexes from various manufacturers can be used ( picovit, duovit, vitrum, etc.). In case of severe malabsorption in the intestine, vitamins are administered intramuscularly in the form of injections.
- Bacteriophages. Currently, this group of drugs is rarely used. Into the intestines ( often in the form of a suppository) introduce special microorganisms ( viral) that infect certain bacteria. Bacteriophages are specific and infect only a certain group of microorganisms. There are, respectively, staphylococcal bacteriophages, coliproteus bacteriophages, etc.
- Antifungal agents. Prescribed when an increased amount of yeast is detected in the intestinal contents.
If necessary, antiallergic, anti-inflammatory and other groups of drugs can also be prescribed. They will be aimed at combating the corresponding complications and will not directly affect the intestinal microflora.
Use of antibiotics
The use of antibacterial drugs must be carried out according to strict indications. Strictly speaking, antibiotic treatment is absolutely recommended only if there is a threat of bacteria from the intestines entering the blood and the development of sepsis. In this case, blood culture is performed to ensure sterility, and specific antibacterial drugs are selected based on the identified microorganisms. In other conditions, treatment of dysbiosis should begin with intestinal antiseptics. These are drugs such as nitroxoline, furazolidone and others.
They act more gently, do not cause damage to normal microflora, but at the same time significantly reduce the number of pathogenic microorganisms. Antiseptics are prescribed for 10-14 days. If there is no effect, the use of antibiotics is recommended. If stool analysis reveals signs of dysbiosis, but there are no external manifestations, then antibiotics and antiseptics are generally contraindicated. In this case, our task will be to preserve normal flora and use drugs that stimulate its growth.
Use of prebiotics
The modern pharmacological industry is very rich in drugs that help establish the balance of intestinal microflora. These drugs include probiotics and prebiotics, which contain either living microorganisms themselves or their metabolic products.
To stimulate the natural growth of beneficial bacteria, gastroenterologists prescribe prebiotics - these are substances that enter the body along with food of non-microbial origin; they are not digested, but are designed to stimulate the development of normal microflora, since they serve as a nutrient medium for obligate, beneficial flora.
Prebiotics not only help improve the metabolic activity of natural microflora, but also suppress the proliferation of pathogenic bacteria, the body does not reject them. Unlike probiotics, they do not require special storage conditions or special packaging. Prebiotics include:
- Indigestible disaccharides are Lactulose (Normaze, Duphalac, Goodluck, Prelax, Lactusan), Lactitol (Exportal), gastrointestinal transit prebiotic (contains fructooligosaccharides, artichoke, lemon and green tea extracts), lactic acids - Hilak forte.
- These substances are found in natural products: cereals - corn, chicory, onions and garlic, as well as dairy products.
Bacteriophages
These are special viruses that act on a specific type of bacteria; they can be used as an independent treatment or in combination with other antimicrobial therapy, used in the form of enemas or for oral administration. The following bacteriophages are currently produced: Proteus, Staphylococcus, Coliproteus and Pseudomonas aeruginosa.
Nutrition for dysbiosis - what can and cannot be eaten?
Even if the patient takes all prescribed medications in a timely manner and in the exact dosage, it will be impossible to achieve positive results without nutritional correction. No one claims that you will need to exclude most foods and limit yourself to the pleasure of eating your favorite delicacies, but some nutritional rules for dysbiosis will need to be followed. And by the way, the diet period lasts exactly as long as the symptoms of the disease in question are present.
In case of intestinal dysbiosis, nutrition should be “structured” according to the following rules:
- You should not drink tea or coffee immediately after eating food - it is better to wait 20-30 minutes;
- Spicy and fatty foods must be excluded from the menu;
- You should not drink water directly during meals (many people drink food with food) - this can cause “dilution” of gastric juice, which will delay the processing of food in the stomach;
- You definitely need to eat protein foods, and in large quantities. But keep in mind that meat can only be included in the diet of lean varieties and boiled or steamed;
- It’s better to completely give up bread and any pastries in general, but if this is impossible, then you should give preference to dried (yesterday’s) bread;
- alcohol is excluded during the diet. In some cases, when it is impossible to ignore the consumption of alcoholic beverages, it is advisable to drink vodka, liqueur or cognac in small quantities, but not champagne, wine and beer;
- The daily menu should contain a lot of vegetables and fruits, and in their raw form they “work” better in the intestines;
- It is imperative to introduce sprouted wheat grains into the diet - they not only help restore normal intestinal microflora, but also have a beneficial effect on the functionality of the whole body;
- do not exclude milk and lactic acid products from your diet - kefir, cottage cheese, milk and other derivatives can replenish the amount of beneficial bifidobacteria and lactobacilli in the intestinal microflora.
Patients are strongly advised to remove from the diet or significantly limit all those foods that negatively affect beneficial intestinal bacteria. They are usually loaded with preservatives, emulsifiers, flavor enhancers and other “chemicals”. These include:
- all industrial canned food (fish, vegetables, meat, fruit);
- condensed milk;
- ice cream;
- industrially produced carbonated drinks (Coca-Cola, etc.);
- chips;
- flavored crackers;
- most candies;
- some ready-made seasoning mixtures;
- soups, purees, instant noodles, etc.
In addition, it is necessary to eliminate drinks and foods that contribute to gas formation:
- white porridge (from semolina, rice);
- baked goods;
- White bread;
- whole milk;
- sweets;
- grape;
- turnip;
- bananas;
- sweet apples;
- carbonated drinks (including mineral waters, sparkling wines), etc.
Such patients should eat more foods rich in fiber. It is a kind of food for beneficial microorganisms, promotes their reproduction and resistance to negative influences. Therefore, it is advisable that patients include in their diet a sufficient amount of:
- fruits (peaches, plums, apples, citrus fruits, etc.);
- greens (dill, celery, watercress, etc.);
- berries (strawberries, cherries, etc.);
- melons (watermelon, pumpkin, squash, etc.);
- vegetables (turnips, all types of cabbage, beets, carrots, etc.);
- nuts;
- grains (rye, buckwheat, millet, corn, oats, etc.);
- bread with whole grains and/or bran;
- legumes;
- uncanned juices with pulp.
You shouldn’t focus on your nutrition and build some complex meal plans - just don’t feel hungry and sit down at the table every 3 hours (at least!).
Prevention
Prevention of intestinal dysbiosis includes the following recommendations:
- Avoid stress;
- Get enough sleep, do not refuse proper rest;
- Do not leave diseases of the gastrointestinal tract, especially infectious ones, to chance, so that they do not become chronic;
- In case of colds, also consult a doctor in a timely manner;
- Stop drinking alcohol and smoking;
- Avoid spontaneous prescription and use of medications, especially antibacterial or hormonal drugs;
- If antibiotics are used, support the intestinal microflora by simultaneously taking prebiotics;
- Try to eat foods enriched with vitamins and microelements;
- Avoid hypothermia;
- Follow the rules of personal hygiene.
Dysbacteriosis in modern medicine
We already noted at the beginning that dysbiosis is classified as a separate disease only in the territory of the former Soviet Union. Western medicine refers to it exclusively as a condition provoked by certain preconditions.
Discussions about the correctness of this or that designation for ordinary people hardly make sense, but we will still outline a number of interesting facts regarding dysbiosis:
- In the International Classification of Diseases (an official document of the World Health Organization), the diagnosis of “dysbacteriosis” does not exist. The most similar diagnosis to it is SIBO (bacterial overgrowth syndrome). It is diagnosed when more than 105 microorganisms are detected in a milliliter of aspirate taken from the small intestine.
- Western medicine is quite skeptical about stool analysis to study intestinal microflora. According to doctors, such a study does not allow us to draw any conclusions, since the concept of “normal intestinal microflora” is very vague and purely individual for each person.
- In the territory of the former USSR, the concept of dysbiosis is very actively disseminated by drug manufacturers. Whether this is justified or whether there is only commercial gain hidden behind this promotion is difficult to judge.
- Many doctors are very skeptical about the use of probiotics and bacteriophages for impaired intestinal microflora. In their opinion, microorganisms obtained from outside have practically no chance of taking root in the intestines, and bacteriophages are digested in the stomach and do not bring any benefit attributed to them.
So the only correct conclusion about dysbiosis is that it is the most controversial disease in modern medicine. But the symptoms, as well as the causes, are quite specific and can be eliminated absolutely effectively.
Normally, the gastrointestinal tract is home to a mass of bacteria that perform a wide variety of useful functions: they break down plant fiber, synthesize group B, inhibit the proliferation of pathogenic microorganisms, etc. With dysbacteriosis, a change occurs in the qualitative and quantitative composition of the intestinal microflora - a population of beneficial bifidobacteria and lactobacilli decreases significantly, and the number of pathogenic microorganisms increases.
Causes of intestinal dysbiosis
Symptoms of intestinal dysbiosis
Symptoms and manifestations are usually associated with the disease or condition that caused the dysbiosis and are nonspecific:
What can you do
Treatment of dysbiosis is a long process. Therefore, your main task is to scrupulously follow the doctor’s prescriptions.
What can a doctor do?
As a rule, the diagnosis and treatment of dysbacteriosis is carried out. To make a diagnosis, a certain clinical picture is required, as well as the results of the following tests: coprogram (general stool analysis) and microbiological stool culture. But to prescribe competent treatment, it is necessary not only to establish the presence of dysbiosis, but also to identify its cause. Each specific case may require a different set of additional studies.
Medicines used for dysbiosis are divided into probiotics and prebiotics.
Probiotics contain live microorganisms - lactic acid bacteria, often bifidobacteria or lactobacilli, which are normal inhabitants of the intestines of a healthy person. Prebiotics are substances that create an environment for the growth of beneficial bacteria. In most cases, to treat dysbiosis, it is enough to repopulate the intestines with healthy microflora. And she herself will defeat pathogenic microorganisms. Sometimes it is necessary to use antibiotics to combat pathogenic flora. Treatment is carried out for at least 4-6 weeks with subsequent monitoring of the effectiveness of therapy.
Prevention
Of no small importance for the prevention of dysbacteriosis is a rational diet and a balanced composition of food. When prescribing antibiotics, it is recommended to use drugs that support the growth and development of normal microflora in parallel. Expectant mothers should know that breastfeeding protects babies from dysbacteriosis from birth.