Update: October 2018
Probably in the world it is impossible to find a person who would be intestinal
discomfort never broke the usual rhythm of life. Diarrhea, constipation,
intestinal colic or bloating at least once in everyone’s life. But
not everyone knows that the cause of such misunderstandings may not be
intestinal infections or organic diseases of the gastrointestinal
Approximately 30% of cases are guilty of similar symptoms.
become functional disorders that relate to violations
motor function of the small or large intestine. In this case, speech
идет о синдроме раздраженного intestines (СРК). What is it,
How to recognize and treat this disease?
What is irritable bowel?
When there is no infection in the intestinal wall (bacterial,
viral, fungal) or immune inflammation when it is not
affected by protozoa or not populated by worms, free from
tumors and anatomical abnormalities, but humans periodically
disturbed stool and pain syndrome – this is a syndrome
раздраженного intestines. Симптомы синдрома раздраженного intestines
also not accompanied by any changes in blood tests and
Most often this pathology affects people after 20 years, 40%
patients aged 35-50 years. The prevalence of the syndrome – 15-25%
women and 5-18% of men. Moreover, 60% of patients do not seek
medical care, 12% go to therapists, 28% – to
Why does IBS occur?
There is no single universal reason for the development of
синдром раздраженного intestines.
It is noticed that pathology occurs with increased excitability
nervous system on the background of chronic stress (therefore, more often sick
young and women). A vicious circle occurs when
неблагоприятный эмоциональный фон вызывает раздражение intestines, а
the disease itself drives the patient into a depression, against which
other organs and systems begin to suffer. In some patients with
IBS during the examination at the psychoneurologist revealed psychopathy,
Doctors jokingly call IBS – “irritable head syndrome”,
since in addition to the main symptoms, there are often signs
disorders of the autonomic and central nervous system.
- Расстройство моторики intestines
Also among the causes of the syndrome revealed disorders
моторики intestines и сдвиги в передаче мышцам кишки нервных
impulses that make the intestines shrink. Wherein
any abnormalities in the intestinal wall or in the nerve apparatus of the intestine
no, but there is a periodic deregulation of contractions and
- Patients also have an increased sensitivity to
overfilling and distention of the bowel. Increased and painful
- There is also a certain relationship with the hormonal background. So y
women, the last day of the cycle and the first days of menstruation can
combined with diarrhea and intestinal pains against a background of temporary
increase in the blood of prostaglandin E.
- Unusual, over-fat or high-calorie foods also
may cause intestinal disorder symptoms. Of drinks
alcohol, coffee, tea and sweet
- Hereditary predisposition is also not discarded.
accounts: the syndrome is more common in people whose parents suffered
- Intestinal infections are the trigger of IBS in 30%
- Dysbacteriosis and lack of ballast substances in the diet are also
lead to the development of irritable bowel syndrome.
Читайте также по теме: СРК можно вылечить
Symptoms and signs of IBS
По своим проявлениям, симптомам синдром раздраженного intestines
not much different from typical intestinal disorders. For today
distinguish several of its options.
Option in which among the symptoms in the first place diarrhea
- Wherein наблюдаются выраженные позывы к испражнению сразу
after or even while eating, and this pattern is repeated
several times a day. More typical for this morning hours and
the first half of the day.
- Sometimes loose stools occur with strong emotional
excitement or worries, fears. In the people, this state
known as “bear disease”, because it is the brown inhabitants of the forest
react by involuntary stool to fear or danger.
- Also with this variant of IBS, bloating is observed, pain in
the side of the abdomen below the navel, which precede the sudden
urge and decrease after relief.
Option with a predominance of constipation
All the same bloating and pain along the colon, but
accompanied by delayed stool for more than 3 days. Pain may occur
in the form of intestinal colic or have a long aching nature,
несколько стихает после опорожнения intestines. Chair often changes
form, becomes more dense in the form of “sheep’s feces” and has
impurity of clear or white mucus.
Disorders of the stool may also cause frustration.
digestion in the form of anorexia, nausea, heartburn, unpleasant
taste in mouth.
The third option is the alternation of diarrhea and constipation.
The option of IBS, in which the leading become abdominal pain and
the alternation of constipation or diarrhea is the third type
Таким образом, для синдрома раздраженного intestines характерны
- Stitching, aching, or cramping abdominal pain, discomfort,
which decrease or disappear after emptying the bowel
- Stool disorders (diarrhea, constipation, or alternation)
- Feeling impossible to contain the urge to stool
- Feeling of incomplete bowel emptying
- Bloating, flatulence (causes)
- Mucus secretion during bowel movements
How to diagnose IBS
As with this pathology no significant changes
can not be found either in tests or during x-rays or biopsies, then doctors
at a conference in Rome agreed that:
Признаками синдрома раздраженного intestines будут считаться:
pain or discomfort in the intestines if they annoy the patient though
within 3 days a month for the last 6 months and
combined with improvement after a bowel movement, started simultaneously with
changing the frequency or shape and appearance of the chair.
Auxiliary features are:
- abnormal stool frequency – feces less than 3 times a week
(запор) или чаще 3 раз за сутки (diarrhea)
- reshaping stools: rough hard or foamy
- abnormal defecation: straining or urgent urge to
Due to the fact that the main symptoms of irritable syndrome
intestines не специфичны, очень важно исключить другие, более
serious diseases and bowel lesions before putting up
diagnosis of IBS. Therefore, patients with complaints of stool instability,
pain and bloating in the stomach is prescribed:
- general and biochemical blood tests
- if necessary, a sigmoidoscopy is performed and
- according to the testimony performed biopsy of the intestinal wall
Almost 90% of patients after going to the doctor and examination
adapt to their condition, independently cope with
symptoms and consider themselves healthy people. But 10% зацикливаются,
considering themselves hopelessly ill, they turn to all specialists,
insist on numerous studies and therapeutic activities
not bringing them relief, which convinces them even more
pathology and this condition of patients often leads to their
Symptoms that should be alarming because they are not peculiar
irritable bowel syndrome:
- if the disease started in old age
- if symptoms progress
- if acute symptoms appear – IBS is not acute;
- symptoms appear at night
- weight loss, loss of appetite
- bleeding from the anus
- diarrhea with pain
- steatorrhea (fat in feces)
- high body temperature
- fructose intolerance and lactose intolerance (see lactase
deficiency), gluten intolerance (see symptoms
- наличие воспалительных заболеваний или рака intestines у
The following conditions and diseases are necessarily included in
differential diagnostic search because some have
Physiological conditions of women
|The effects of drugs and food irritants:
Fright, excitement, lasting intellectual overstrain, but
Give a typical clinical picture of IBS
Органические заболевания intestines
Notйроэндокринные опухоли ЖКТ
Usually occur under the mask of pain or diarrhea form of IBS
Notкоторые симптомы схожи с диарейной формой СРК
Лечение синдрома раздраженного intestines
Раз уж проявления синдрома раздраженного intestines достаточно
diverse, but there are no painful changes in the intestine itself,
treatment for the most part will be reduced to suppressing the prevailing
symptoms of pathology.
But, прежде, чем браться за лекарственные средства, стоит
recall the teachings of Academician Pavlov and his theory of duties
unhealthy central nervous system in all ailments. If a
the popularity of this theory today and has faded away, it’s just not in
case of IBS. Here academic research is fully
confirmed by practical medicine that has proven beneficial
impact on the course of IBS of various activities that normalize
psycho-emotional state of patients.
Therefore, if a person suffering from irritable syndrome
intestines, alone unable to cope with chronic
stress, trouble at work or in the family, then he should
seek qualified psychological help. If
The case has already gone far, and there is a phobic disorder,
caused by fear of pain, involuntary bowel movements or
somatized depression, you will have to fight primarily with
this, referring to psychiatrists and neuropathologists.
In milder cases, before starting medication.
- redefine lifestyle
- adjust power mode
- give up alcohol and tobacco
- walk and do more physical work
This set of simple activities helps balance the nervous
system and relieves the intestines from unnecessary influence too
Medical nutrition for IBS is not required, or rather, it is inappropriate
to focus on cooking some special dishes and counting
calories and nutritional value eaten. It is more important to establish a regular
food in moderate portions in a relaxed atmosphere. Still makes sense
limit products that provoke:
- diarrhea – products that increase motility in diarrhea – apples,
plums, fiber, beets
- gassing – baking, beans, cabbage, grapes,
- constipation – fat and fried with constipation
In case of intolerance to milk sugar, milk is replaced by kefir,
ryazhenka and yogurt, with celiac disease exclude products with gluten
(see the list of gluten-containing products). Reduce consumption
sweet soda and chewing gum. Recommended by prophylactic courses
take drugs that normalize the intestinal flora (Linex,
Bifidumbacterin, see the full list of probiotics, analogs of Linex),
as dysbiosis in the intestine may increase the manifestations of IBS.
Treatment of IBS with diarrhea
If the stool cannot be adjusted, the pain and intestinal
discomfort is seasoned with frequent bowel movements, the urge for which can
arise wherever and whenever, it’s time to get serious
treatment. But, при этом стоит помнить, что под маской поноса
many intestinal infections are hidden (see symptoms of foodborne
poisoning) therefore diagnose irritable syndrome
intestines, подбирать лечение и препараты лучше доверить грамотному
a gastroenterologist. This will save unnecessary problems and unnecessary
Constantly taking medication for IBS is impossible and dangerous.
Medicines are prescribed only for periods of exacerbations when the condition
The patient suffers:
- Before meals, it is possible to prescribe Diphenoxylate,
Loperamide (Imodium 180-250 rub, Diara 100 rub, Lopedium 30 rub,
Loperamide 20 rub.) Up to 2-3 times per day. These funds are essential
замедляют моторику intestines (см. лекарства от поноса).
- Smecta gives a good effect (instruction)
- From herbal remedies – pomegranate peel, sweet cherry, fruits
bird cherry, alder – in the form of decoctions
- As well as sorbents – Polysorb, Polyphepan, Filtrum STI,
- Even with this variant of CPK, a serotonin modulator is used.
If there is constipation
- Preferred means for IBS, increasing volume
intestinal contents: based on the plantain flea (Naturolax,
Mukofalk 350 rub., Solgar Psillium 1200 rub, Metamucil, Fayberleks
150 rub., Ispagol 250 rub), agar, kelp and synthetic
pulp (Citrucel, Polycarbophil, Fiber, Fibercon) act
10 hours from the reception.
- Lactulose – when the variant with stool delays is the gold standard,
polyatomic alcohol remains for patients of any age
лактулоза (Дюфалак, Butрмазе, Ромфалак, Портолак, Гудлак). Not
absorbed in the intestine and without irritating its mucous membrane, the drug decides
problems with the chair.
- Polyethylene glycol – other drugs from the group of osmotic
laxatives have a similar effect and start working
in 3-6 hours (Macrogol, Forlaks 200 rub, Fortrans 500 rub,
Lavacol 200 rub., Tranzil, Osmogol, Relaxax) and lactiol
- Emollient laxatives – herbal and mineral oil,
Butргалакс, Пикосульфат натрия (Гуттасил, Лаксигал 350 руб,
Guttalaks drops 300 rubles, Regulax Picosulfate 150 rubles. Slabikap,
Slabilen drops of 100 rubles).
- Effective and serotonin modulators Tegaserod,
- Weaken mineral water with magnesium ions – Essentuki number 17 and
Read more about all drugs for constipation in the article.
Laxatives for constipation.
From pain and cramps
кие средства (Гиосциамин, Дарифенацин и
Zamifenacin) are used along with classic antispasmodics
(But-шпой и Гидрохлоридом Дротаверина).
- Calcium channel blockers (Spasmomenon, Dicytel) and regulator
Debridd motility reduce pain.
- Antifoaming agents (Espumizan, Dimethicone, Zeolat, Polysilan)
break gas bubbles. Since pain is often the result
stretching the intestine with gases, then the remedies for metorism can also
help with IBS.
Antidepressants for IBS
That stool disorders and recurring episodes of pain in
abdomen for IBS – often the result is deeply hidden
psychological problems – has been known for a long time. In turn himself
синдром раздраженного intestines способен вогнать в депрессивное
condition even quite balanced person Therefore, increasingly
for the treatment of this disease is used tricyclic
The mechanism of action of these drugs in this case
comes down to suppressing the excessive influence of the cortex on the perception of pain,
as well as the normalization of the supply of nerve impulses from the brain and
spinal cord to the intestines, which reduces its uneven
contractions resulting in pain and impaired stool.
- Traditionally, the appointment of amitriptyline, doxepin, nortriptyline,
- For today предпочтение отдается ингибиторам
: Бефол, Пиразидол, Фенелзин, Моклобемид более
мягко действующим при психо-соматическ
IBS and dysbiosis
Течение синдрома раздраженного intestines может утяжелиться
concomitant dysbacteriosis of the gastrointestinal tract. Wherein избыточный рост
pathogens and a lack of lacto-and
bifidobacterium contribute to the weighting of pain, swelling and
stool disorders. Therefore, it makes sense to stay on the treatment
First you need to suppress harmful bacteria:
- For this traditionally used derivatives of nitrofurans:
Furasolidone, Enterofuril, Stop-diar. The course continues from 5
up to 7 days.
- In milder forms, probiotics with antibacterial agents are used.
action Enterol, Baktisuptil, bacteriophages.
- According to the testimony may use fluoroquinolones
(Ciprofloxacin, Cefloxacin), Metronidazole (Trichopol), intestinal
antiseptic Intrix, intestinal antimicrobial drug
Rifaximin (Alpha Normix).
Enterosorbents are used in the complex therapy:
Лактофильтрум, Фильтрум, Enterosgel
Then comes the turn of eubiotics (drugs containing different
combinations of lacto, bifidobacteria, enterococci and Escherichia coli)
and prebiotics that create the conditions for the supply of beneficial microbes.
- In the first group, Linex, Premadophilus,
Бифидумбактерин, Butрмофлорин, Бификол (см. все пробиотики, список).
The course of eubiotics should be at least 4 weeks.
- Of the second group, prebiotics are most often used –
Lactulose and Hilak-forte.
Народное лечение синдрома раздраженного intestines
In folk medicine, the treatment of intestinal disorders takes
significant place. Previously, this way they tried to get rid of
any intestinal discomfort, without discerning what was his
the real reason. Since the basis of IBS are transient
functional impairment, it is quite possible
possibly. The main thing is to know when to stop.
- The most effective ways is aromatherapy with
using peppermint oil, which soothes the intestines and
relieves the person from spasms.
- Inside it is customary to take infusions and decoctions of chamomile, oak bark.
From spastic pain save fennel seeds, dill water, mint,
chamomile, cumin seeds and anise drops, valerian root.
- For constipation, buckthorn bark, licorice root,
yarrow (see how to get rid of constipation in home
дкий стул прекращает корни лапчатки, змеевика и
burnet, plantain, blueberries, sage and walnut leaves
Еще один интересный способ нормализовать работу intestines – это
special therapeutic exercises forcing the intestines to work in
correct mode. It is important that the classes have a sufficient flow.
fresh air. It soothes the central nervous system and
reduces its effect on the internal organs. Effective various
stretch marks for the spine (yoga, pilates) walking at an average pace and
bicycle. Swedish scientists from the University of Gettenberg in
more than half of patients with IBS can significantly reduce
symptoms of the disease, devoting to moderate physical exertion from
half an hour to 60 minutes a day for 3-5 days a week.
It is a great way to calm the nervous system and intestines without
positive attitude to achieve results. Wherein групповые
classes have a greater therapeutic effect than individual
Таким образом, при лечении синдрома раздраженного intestines не
so important is the set of medicines that relieve the leading symptoms, as
a measured rhythm of life, a philosophical attitude to everyday storms and
a positive attitude for recovery, which is not only
желательно, но и possibly.