Poor circulation in various parts of the intestines can cause urgent situations when the patient required urgent surgery. Bowel ischemia often develops on the type of chronic process, so it is important to prevent the progression of pathological changes in time to pass the necessary course of therapy.

What factors predispose to the development of intestinal ischemia

It is necessary to identify a number of factors, the presence of which experts regard as predisposing moments. Acute ischemic changes in the gut develops under the following conditions:

• infectious processes in the abdominal cavity
• inflammatory diseases of the pancreas Diabetes and pancreas - the things you need to know That occur in acute or chronic forms
• intestinal damage at various inflammatory processes
• abdominal trauma
• taking certain hormones
• presence of diseases, which increase the propensity to thrombosis

It is necessary to emphasize the importance of the cardiovascular system. If the patient noted the presence of stagnation or have different cardiac arrhythmias, it should also be attributed to the risk factors for ischemic bowel. Intestinal ischemia occurs when a person is suffering from atherosclerosis. There is a gradual formation of atherosclerotic lesions of the vessel wall, which in some circumstances is the cause of acute circulatory disorders of the intestine.

The risk group includes patients with low blood pressure Blood pressure - dangerous if his swing? . An especially negative impact on the circulation if there is concomitant diseases, such as atherosclerosis. The deposition of plaques on the walls of blood vessels of the intestine due to low numbers of blood pressure predisposes to the development of ischemia.

In which case you need to see a specialist

We must distinguish several clinical variants of the disease that are distinguished by the nature of the flow. The process of intestinal ischemia may be acute or chronic. Acute ischemia is the result of acute circulatory disorders, so the clinical picture is dominated by symptoms that indicate an urgent state. The patient develops a sudden attack of acute abdominal pain Abdominal pain: Types and Symptoms . The intensity of pain can be different.

Against the backdrop of a pronounced pain attack appear urge to defecate, with an admixture of fecal blood. It joins these symptoms nausea, vomiting and fever. This condition requires immediate assistance, so you need to see a doctor when the first symptoms of the disease. The picture of chronic intestinal ischemia is characterized by a clinical picture erased as poor circulation occurs over a long period of time. The patient appears the fear of eating, because food is a precipitating factor for the development of a twinge.

When complete cessation of blood flow to a particular area of ​​the intestine occurs dying (or necrosis). This complication is dangerous to human life, so it is important to start early treatment bowel ischemia.

Existing methods of treating ischemia

Before the start of therapy is necessary to ascertain the cause bowel ischemia, as it determines the treatment policy. Appointment inflammatory, antibiotic therapy is justified in the case of an infectious factor, inflammation in the abdominal cavity. If the basis of intestinal ischemia is concomitant cardiac pathology, the treatment is carried out in conjunction with the cardiologist. Displaying holding antiarrhythmic therapy. This phenomenon eliminates the need for heart failure Heart failure - when the heart is unable to cope with the work Normalize blood pressure (antihypertensive therapy).

If ischemia is caused by thrombus formation, it is necessary to improve the flow of drugs that prevent the formation of thrombi and expand the lumen of blood vessels. Trental bowel ischemia is assigned to improve the microcirculation and blood flow in general. With the ineffectiveness of drug therapy shows an urgent surgery that will prevent the development of intestinal necrosis. During the operation, you can delete necrotizing portion of the intestine or to create additional blood flow around it by grafting.

Lifetime therapy is indicated if in the survey were identified hereditary defect in the hemostatic system. A prerequisite is to carry out monitoring of indicators of blood coagulation system, because drugs of this pharmacological group can lead to several complications of uncontrolled reception.

Restore the narrowed lumen of the vessel can be due to angioplasty. Produce vasodilatation balloon catheter and then into the lumen of the tube set specially developed that will support the advanced vessel lumen. Possibility of angioplasty depends on the location of the damaged site, so you should conduct a comprehensive examination, including angiography, which will determine the indications for surgical treatment. If chronic intestinal ischemia has not led to the formation of necrosis, the choice is made in favor of the conservative tactics.

In some cases, patients underwent diagnostic surgery. The doctor conducting a survey of intestinal loops, reveals the presence of areas of necrosis. If these areas are identified, you can go directly to a surgery to remove dead skin and restore sites in the gut circulatory disorders.

Marina Solovyov

Cryptogenic hepatitis Hepatitis - the scourge of our time   - A hepatitis of unknown origin, which lasts more than six months. Cryptogenic hepatitis diagnosis can only be made after a thorough examination of the patient with the exception of infectious, toxic, and autoimmune causes of the disease.

How common is hepatitis, cryptogenic

Today, about 15% of chronic hepatitis are cryptogenic, that is, after the most detailed examination of the causes of their development could not be detected. With great care these patients screened for viral hepatitis, as in most cases, chronic hepatitis are viral in nature.

A feature of cryptogenic hepatitis is their penchant for continual progression and transition to cirrhosis. It is also possible the formation of a malignant tumor on the background of cryptogenic hepatitis.

Therefore, patients with cryptogenic hepatitis are under constant medical supervision, and not only on treatment, but also periodically undergo re-examination, which aims to identify the causes of the disease and its severity and activity.

The severity of disease is determined by the content of liver enzymes (ALT levels from 3 to 10 standards and norms above). The degree of activity of cryptogenic hepatitis may be minimal, low, moderate and high (calculated on a scale from 1 to 18).

Symptoms of cryptogenic hepatitis

The disease usually begins quietly with a small rise in temperature (but it may not be), general malaise, headache, joint pain Joint pain - how to understand what is going on? , Reducing appetite. Then, join pain or heaviness in the right hypochondrium. The pains are of a permanent nature, are aggravated by physical activity and errors in diet. The pain can be localized not only in the right upper quadrant, but in the upper abdomen, sometimes the patient has a feeling of heaviness in the stomach.

There are also nausea, vomiting, bitter or unpleasant taste in the mouth, bloating, stool disturbances in the form of diarrhea or constipation - all these signs are related to digestive disorders due to insufficient production of bile by the liver cells.

Sclera and the skin of the patient become jaundiced, the urine becomes dark, discolored feces, there is itching. Jaundice is a sign that does not break down bilirubin in the liver, so it increases blood levels. It increases not only the liver, but often the spleen. But there are anicteric form of the disease, they can proceed as quickly and quietly and seriously.

Throughout disease patients concerned about small (low-grade) temperature, severe weakness and fatigue - even in the absence of other symptoms, they can not do their usual work. The patient becomes irritable, often cries, his mood is constantly changing, disturbed sleep Dreams: how to understand our dreams .

In the future, there are vascular changes: a persistent redness of the palms, spider veins (telangiectasia), and petechial hemorrhages (petechiae) on the skin of the whole body, increased bleeding (nasal, uterine bleeding, and so on) from the slightest injuries generate significant bruising.

Cryptogenic hepatitis may occur long, with some necrotic liver cells and replaced by connective tissue, liver gradually loses its function cirrhosis.

Diagnosis of cryptogenic hepatitis

Cryptogenic hepatitis Diagnosis begins with an analysis of complaints of the patient, his physician examination, instrumental and laboratory research.

For laboratory tests on blood taken biochemical liver tests, are being identified bilirubin (total, direct and indirect), liver enzymes, levels of gamma-albumin and albumin. Determine as indicators of blood clotting.

From instrumental studies performed ultrasound of the abdomen (you can see an increase in volume and increased density of the liver and spleen enlargement of the inferior vena cava), magnetic resonance imaging (MRI) of the liver, a liver biopsy (a tissue taken for histological examination). If necessary in order to avoid serious diseases of the gastrointestinal tract endoscopy of the esophagus, stomach and intestines.

Treatment of cryptogenic hepatitis

During exacerbation of the disease the patient is assigned to bed rest, without exacerbation - excludes heavy exercise. The patient should always follow the diet (table number 5 - boiled low-fat diet, intake of 5-6 times a day).

Drug treatment should be comprehensive and tailored individually. It includes disintoxication therapy (intravenously saline, 5% glucose, reopoligljukin etc.), adsorbents (smectite, activated charcoal Activated carbon - old but indispensable , Polisorb, laktofiltrum). This treatment allows to excrete toxins in the urine and feces. Restoring the normal intestinal microflora (probiotics reception - bifiform, bifidumbacterin, laktobakterina etc.) restores normal intestinal digestion.

Assign also drugs are beneficial to the liver cells (hepatoprotectors) ursosan example, Essentiale, LP-52, Kars.

Cryptogenic hepatitis require constant medical supervision.

Galina Romanenko