Dysbacteriosis of the intestine
- Normal microflora
- Causes of dysbiosis
- Symptoms of dysbiosis
- Diagnosis of dysbiosis
- Treatment of dysbiosis
- Drug therapy
- Prevention of dysbiosis
Intestinal dysbacteriosis (synonym - dysbiosis) is called laboratory-clinical syndrome, in which there are persistent shifts in the qualitative and / or quantitative composition of microorganisms living in the intestine. Violations of microbial relationships can be accompanied by digestive, immune, metabolic disorders.
It should be noted that in practical medicine the generally accepted term "dysbacteriosis" reflects a picture of the microbial landscape of the extremely large intestine. A microbial shifts in the small intestine is termed "a syndrome of excess bacterial growth."
The question of the prevalence of dysbiosis causes heated discussions among specialists. Some believe that it is present in almost 90% of patients of the gastroenterological profile. Others persistently deny its existence.
This kind of attention to tiny inhabitants of the human intestine is explained by the fact that these microorganisms have a very positive effect on health. They have many beneficial functions. So, a useful microflora:
- synthesizes vitamins (especially group B), antitumor substances, enzymes for the breakdown of proteins and sugars;
- protect the intestinal mucosa from infectious agents, allergens, an excess of opportunistic microbes;
- activates immunity:
- neutralizes toxins and harmful products of metabolism;
- lowers cholesterol;
- stimulates the absorption of the necessary substances (water, iron, calcium, gases, vitamins E, D);
- produces short-chain fatty acids, which ensure the integrity of the large intestine mucosa.
In addition to useful microbes (bifidobacteria, lactobacilli, etc.), opportunistic microorganisms (klebsiella, proteus, staphylococcus, atypical escherichia, serrations, enterobacter, yeast-like fungi, etc.) live in the gut. In a healthy person, their number is strictly limited, so they do not harm in any way. But with the fall of immunity, after intestinal infections, stress, etc. these insidious bacteria and fungi are activated, begin to multiply and have an adverse effect, leading to clinical symptoms.
Causes of dysbiosis
There are a huge number of factors that can cause changes in the composition of normal intestinal microflora. Some of them are easily eliminated, others lie in the unhealthy way of life of the ordinary inhabitants of megacities, and to get rid of the third, years of regular treatment are required.
By the appearance of intestinal dysbiosis may be required:
- reception of some medicines (antibiotics, laxatives, immunosuppressants, hormones, psychotropic, secretolitics, adsorbents, antitumor agents, tuberculostatics, etc.);
- infectious diseases of different origin (bacterial, fungal, parasitic, viral diseases);
- malnutrition (foods with preservatives, dyes, stabilizers, nutrition with a lack of fiber, with excess proteins or digestible sugars, prolonged fasting, prolonged artificial feeding through the veins, alcohol abuse);
- presence of any diseases of the digestive organs (peptic ulcer, chronic cholecystitis , Crohn's disease, cirrhosis , celiac disease, pancreatitis , etc.);
- congenital defects or postoperative disorders between the digestive organs (absence of a damper between the colon and small intestine, condition after removal of part or whole stomach, areas of the intestine, gallbladder, etc.);
- prolonged psychoemotional overstrain;
- allergic diseases;
- excessive physical loads;
- environmental problems (fertilization of soils with chemicals, pollution of water and air with industrial emissions, melioration, etc.);
- a sharp change in climatic and geographic conditions.
Symptoms of dysbiosis
Dysbacteriosis of the intestine does not have special characteristic symptoms. Its manifestations are identical to the clinical picture of many other gastroenterological ailments. So, patients can be bothered by:
- diarrhea (a liquid or mushy stool, which is often foamy and poorly washed off the walls of the toilet);
- unstable stool (persistent constipation changes diarrhea and vice versa);
- change in the smell of stool (it becomes extremely putrid or sour);
- enhanced gas formation (gases are fetid and odorless, sonorous and no);
- bloating of different intensity (it is more pronounced in the evenings, can worsen after some products);
- abdominal pain without permanent localization (often associated with bloating, after disappearing of accumulated gases they disappear or significantly decrease):
- allergic rashes;
- burning, discomfort and itching in the anus (due to the constant irritation of the mucosa with liquid feces, which contains many aggressive organic acids);
- increased fatigue;
- signs of lack of vitamins and / or minerals (seizures, lip cracks, dry flaky skin, brittle nails, hair loss, neurological disorders, tongue edema, insomnia, depression, etc.).
In some patients, dysbacteriosis is not manifested in any way, but is detected exclusively by the results of bacteriological and other studies. In such cases, much depends on the level of expertise of a particular laboratory.
Diagnosis of dysbiosis
Although scientists have developed a lot of techniques that confirm dysbacteriosis, doctors actively use only one - sowing feces (bacteriological study) for dysbiosis. Unfortunately, this method, expensive for a patient's pocket, has a number of significant drawbacks. He estimates a limited number of species of microflora (no more than 15, when in the intestine is detected more than 500) of the large intestine. The research itself is labor intensive, therefore it takes at least 10 days. Not all doctors, sending the patient to this analysis, intelligibly explain the rules of his collection and subsequent transportation.
To increase the objectivity of the diagnostic study, the stool collected by the sterile instrument should be sent to the same sterile dishes. Now in pharmacies for this you can buy a special hermetically-sealed jars, the caps of which are equipped with a spatula. Then the stool should be sent to the laboratory within the next 2 hours. If this is not possible, then you can put it in the refrigerator, but only for 6 hours. In addition, the patient should not use any means containing live microbes. Otherwise, they will be sown, and the real microbial landscape will be distorted.
In addition to feces, it is possible to send aspirates from the jejunum to the bacteriological examination, pieces of small intestinal mucosa (they are taken with endoscopic procedures), scrapings.
In addition to crops for the diagnosis of dysbiosis in some clinical and scientific centers apply:
- coprogram (the detection of iodophilic flora during examination of the stool under a microscope indirectly indicates the presence of dysbiosis);
- respiratory tests (hydrogen, with C-14-D-xylose, with C-14 glycocholate) assess the intestinal flora;
- biochemical tests of feces (there is an increase in enterokinase, alkaline phosphatase);
- the content of scatol and indole in urine;
- chromatography of blood, stool, small intestinal fluid (registers substances associated with the vital activity of the flora);
- molecular tests (PCR).
Practitioners use several classifications of dysbiosis.
Most of them are based on quantitative characteristics. Depending on the results of inoculation, the dysbacteriosis can vary from mild (I) to severe (III-IV) degree. Sometimes the diagnosis indicates the type of microorganisms, which causes dysbiosis, and the degree of compensation.
Treatment of dysbiosis
Undoubtedly, the main medical measures for intestinal dysbiosis should be directed to the underlying disease, which is the cause of changes in the microbial landscape. Otherwise, all efforts will be ineffective, and short-term improvement will be replaced by the resumption of symptoms.
Along with this, correction of existing microflora disorders should be carried out. This task will help to solve:
- diet therapy;
- drug treatment;
Patients are strongly advised to remove from the diet or significantly limit all those products that adversely affect useful intestinal bacteria. They, as a rule, are stuffed with preservatives, emulsifiers, taste enhancers and other "chemistry". These include:
- all industrial canned goods (fish, vegetable, meat, fruit);
- condensed milk;
- ice cream;
- carbonated drinks manufactured by industry (Coca-Cola, etc.);
- crackers with flavoring;
- most lozenges;
- some ready-to-cook seasonings;
- Soups, mashed potatoes, vermicelli of fast cooking, etc.
In addition, it is necessary to eliminate beverages and products that promote gas generation:
- white porridge (from mango, rice);
- White bread;
- whole milk;
- sweet apples;
- gas-containing drinks (including mineral waters, sparkling wines), etc.
Such patients should eat more foods rich in fiber. It is a kind of food for useful microorganisms, promotes their reproduction and resistance to negative influences. Therefore, it is desirable that patients necessarily include in their meals a sufficient amount:
- fruits (peaches, plums, apples, citrus fruits, etc.);
- greens (dill, celery, watercress and lr.);
- berries (strawberries, sweet cherries, etc.);
- melons (watermelon, pumpkin, squash, etc.);
- vegetables (turnips, all kinds of cabbage, beets, carrots, etc.);
- cereals (rye, buckwheat, millet, corn, oats, etc.);
- bread with whole-grain corn and / or bran;
- non-canned juices with pulp.
Some plants contain phytoncides - substances that have antibacterial action, and organic acids that adversely affect the representatives of the excess conditionally pathogenic flora. They are horseradish, laurel, cloves, peppers, onions, cranberries, garlic, mountain ash, apricot, cumin, cranberry, barberry, black currant, lemon, sea kale.
Beneficial effects may not be pasteurized sour-milk products with live microflora (bifido- and / or lactobacilli) and the absence of flavor additives (bifid, etc.). They are already sold in pharmacies and grocery stores. They can be made and at home using special starter cultures ("Narine", "Evita", etc.). Such products are referred to as functional nutrition, which improves individual functions and the general state of the human body.
Medicines should be prescribed strictly individually, taking into account the age, existing diseases and the results of the survey performed, and not blindly.
If the patient is sown with excess opportunistic bacteria and / or fungi, then they must first be eliminated. If at this stage, first to start taking funds with living beneficial microorganisms, then they will simply have nowhere to settle, because all vacant "houses" are occupied. As a result, an expensive medication transit through the intestines, without having absolutely no effect. Therefore, you should first conduct a course:
- antibacterial agents (intetriks, furazolidone, enterofuril, biseptol, metronidazole, neviramone, etc.);
- bacteriophages (intestibacteriophage, staphylococcus bacteriophage, pyobacteriophage, coliprotein bacteriophage, etc.);
- antibiotics (fluoroquinolones, cephalosporins, penicillins, macrolides, aminoglycosides, etc.);
- antifungal agents (pimafucin, amphotericin M, nystatin, etc.);
- probiotics (sporobacterin, enterol, cerebiogen, bactisubtil, etc.).
Usually, one of the listed groups is selected. In more serious situations, several drug courses from different groups may be needed. The most optimal tactic is based on the choice of a particular drug based on the result of the assessment of the sensitivity of bacteria sown from the feces of the patient to different drugs. Most often doctors recommend the most harmless bacteriophages and antibacterial synthetic drugs. The duration of one course is about a week.
Self-medication is best not to get involved, as all these medicines have significant side effects. And their uncontrolled chaotic use leads to the formation of the strongest resistance in microbes (resistance), which seriously complicates further treatment.
After the destruction of unnecessary flora, or immediately (if only the deficit of representatives of any useful microflora is detected in patients), one should start taking medications with bifido-, colibac- and lactobacilli (probiotics).
When there is a shortage of bifidobacteria, patients are recommended bifinorm, biovestin, bifilong, bifidumbacterin, liquid or dry, euflorin B, bifiform and others.
Deficiency of lactobacillus compensates for normoflora, acylactate, biobactone, acipol, gastropharm, lactobacillus, lactoflora, lactobacterins, liquid or dry, laminolact, etc.
If a decrease in the growth of both lacto- and bifidobacteria is detected, then eco flore, linex, maltidophylus, bion-3, florin-forte, bilaminolactate, polibacterin, etc. can be recommended.
Coliform deficiency disorders are treated with colibacterin, bifikol, bioflora.
Duration of treatment doctors set individually, but the shortest course should be up to 3 weeks.
When purchasing a probiotic, it is necessary to familiarize yourself with its instructions, which set out the temperature conditions for its storage. Many drugs remain active only when they are in the refrigerator.
During the same period, prebiotics can be added to the treatment - the means of stimulating the growth and activity of one's own microflora of the body. They do not collapse when used together with antibiotics, improve intestinal motility, reduce the formation of gases, strengthen immunity. Such means are:
- calcium pantothenate;
- para-aminobenzoic acid;
Essential prebiotic activity can also have all kinds of biological supplements (BAA), which are filled with pharmacies. Such nutritional supplements should contain dietary fiber, oligosaccharides (galactooligosaccharides, fructo-oligosaccharides, lactulose), microbial and plant extracts, antioxidants, lectins, polysaccharides (chitosan, inulin, pectins, etc.), enzymes, unsaturated fatty acids.
Healing properties of plants can be used in complex treatment. In the case of dysbiosis, reasonably selected fees can:
- eliminate unwanted microorganisms;
- reduce gassing;
- reduce spastic contraction of the bowel;
- normalize the stool;
- activate immune processes.
Antimicrobial properties are found in oregano, celandine, juniper, sage, gravel (rhizome), thyme, birch (leaves), blackberries (leaves), St. John's wort, turn, eucalyptus, cinquefoil, Pacific banana. They eliminate harmful bacteria, thanks to the content of essential oils, tannin, phenolic compounds.
Fungistatic and fungicidal plants will help to combat fungi and fungicidal plants: alder (aroot), ayr (rhizome), peppermint, triple leaf violet, medicinal veronica, cowberry, birch buds, black currant (leaves).
Fermentation processes and associated gas formation can reduce chamomile, raspberry, dog rose, sage, mint, barberry, calendula, strawberry, dogwood, oats stems.
Spasmolytic and at the same time carminative effect is possessed by phytocoenoses with dill, anise, coriander, fennel, cumin, marshmallow, thistle, immortelle, angelica.
Strengthening of the stool is promoted by rhizomes of gravel and blood-grouses, oak bark, bird cherry (fruit), snake mountaineer, bramble (fruits), blueberries (fruits), horse sorrel (rhizome). Laxative phytogens contain linseed, bramble (flowers), buckthorn (bark), senna (leaves), sea cabbage (leaves), jaoster (fruits), golden yew, blackberry (fruits), dodder,
Immunomodulating effect can be provided by nettles, cornflower blue (flowers), mother-and-stepmother, birdwort, St. John's wort, smooth-billed gerbil, elephant (rhizome).
Herbal preparations should be taken or given in enemas in the form of broths and infusions. Begin with a small amount (since phytogens can provoke an allergy), then, provided adequate tolerance, the daily volume is increased to a glass. It is drunk for three meals.
Prevention of dysbiosis
Preventive measures, as a rule, are aimed at eliminating the causes of dysbiosis. Therefore, they are:
- rational antibiotic therapy (many doctors advise, together with antibiotics, to take prebiotics);
- adequate nutrition;
- timely detection and therapy of digestive ailments;
- epidemiological measures in infectious outbreaks;
- normalization of the rest regime, psychoemotional loads and labor;
- breastfeeding, etc.
- Dysbacteriosis of the intestine in adults: symptoms, treatment
- Bloating: causes and treatment
- Increased gas production in the intestine
- Irritable Bowel Syndrome (IBS)