Activated charcoal at rm. What are the drugs for irritable bowel syndrome and when is it appropriate to take them

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Irritable bowel syndrome (IBS) is a complex disorder of the digestive tract, is a functional disorder (there are no irreversible changes in the organ). Women suffer 2 times more often than men, the disease affects people aged 20-45 years.

Causes

IBS can occur for the following reasons:

According to the characteristics of the chair, the following types of IBS are distinguished:

• IBS with a predominance of constipation: solid stools make up 25%, diarrhea is less than 25% of the total number of bowel movements;
• IBS with a predominance of loose stools: diarrhea more than 25%, solid stools less than 25%;
• Mixed IBS: hard and liquid stools account for more than 25%;
• Unclassified IBS: data do not fit the options above.

Symptoms

The main symptoms of IBS include:

In addition to the "intestinal" symptoms, with physical and emotional overstrain, a person may experience the following signs:

• Insomnia;
• Feeling of a lump in the throat;
• Lack of air;
• Headache;
• Noise in ears;
• Lethargy, weakness;
• Polyuria (frequent urination).

Diagnosis of the disease

The diagnosis of "irritable bowel syndrome" is made on the basis of the patient's complaints, anamnesis (heredity, diet, lifestyle), on examination (bloating, smooth muscle spasm), according to the results of laboratory tests.

Diagnostic studies:

• Clinical blood test for leukocytosis, accelerated ESR, anemia (reduced number of red blood cells);
• Feces for occult blood;
• Coprogram - a study of feces for color, the presence of impurities in it of blood, mucus, undigested food fragments;
• - endoscopic examination of the rectum: assess the condition of the mucosa of the organ;
• Irrigoscopy - X-ray examination with a contrast agent. The patient drinks a barium suspension, then a series of images are taken to assess the efficiency of the intestines, stagnation of feces.

Methods of treatment of IBS

Medical treatment:

• Analgesics - to relieve pain: analgin, ketanol, solpadein fast. Ketanol, 1-2 capsules 2-3 times a day;
• Antispasmodics - to relieve spasm of smooth muscles: spasmolgon, dicyclomine, sparex. Sparex 200 mg, 1 tablet 2 times a day;
• Antidiarrheal - with loose stools: diara, lopedium, imodium. Diara, an initial dose of 2 tablets, then 1 tablet after each bowel movement, the maximum daily dosage is 16 mg (8 tablets);
• Laxatives for constipation: citrucel, Gutasil, Metamucil. Citrucel, 1 capsule twice a day;
• Antidepressants - to relieve depression: imipramine, fluoxetine, amitriptyline. Amitriptyline, 1 tablet 3 times a day;
• Probiotics - to restore the natural intestinal microflora: acipol, bifidumbacterin, lactobacterin. Lactobacterin, 5 doses per day;
• Enterosorbents - remove toxic substances from the body: polyphepan, activated carbon, smectite. Activated charcoal, 1-2 tablets 4 times a day;
• Enzymatic agents - to improve digestion: creon, mezim, penzital. Mezim, 1-2 tablets 2-3 times a day;
• Intestinal antiseptics: intetrix, furazolidone. Intetrix, 2 capsules in the morning and 2 capsules at bedtime.

Physiotherapy procedures:

Psychological methods:

• Conversational treatment: identifying problems, eliminating them, suppressing anxiety; relaxation (relaxation) of the body occurs;
• Hypnotherapy (hypnosis treatment): hypnosis helps to reduce pain and discomfort at a subconscious level.

A patient with irritable bowel syndrome needs to perform regular dosed physical activity, take walks in the fresh air.

Physical activity has a positive effect on the activity of the nervous system, increases the body's resistance to stressful situations.

Diet

The diet for IBS depends on the prevalence of symptoms (diarrhea or constipation). Meals should be fractional, minimal portions, at least 6 times a day at one set time. Preference should be given to products that contain coarse fiber (fiber) - whole grains, bran.

For IBS with constipation, the following foods should be included:

• Raw vegetables and fruits;
• Sweets (honey, jam);
• Lactic acid products (kefir, sour cream, cottage cheese);
• Butter, vegetable oil;
• Rye bread, with bran;
• Meat fish;
• Soups cold;
• Cereals, cereals;
• Rosehip broth, green tea, vegetable and fruit juices.

Prohibited Products:

Carbonated and alcoholic drinks.

ethnoscience

In the treatment of IBS, the following traditional medicine recipes are used:

Complications

IBS is not capable of causing serious complications and diseases, but can lead to the development of psycho-emotional disorders(depression, irritability, anxiety).

It can have a negative impact on some aspects of a person's life: public (attendance at work, social events), private (relationships with family, sexual partner).

Thanks

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

General information

irritable bowel syndrome or IBS is a functional disorder intestines. Functional disorders are characterized by the absence of laboratory evidence of the disease, although the patient feels unwell. The disease was described in the middle of the nineteenth century, but in those days it was called mucous colitis . Further, the names changed many times and only by the end of the eighties of the twentieth century was the term " irritable bowel syndrome».

In total, almost twenty-two million inhabitants of the planet suffer from this disease, which is 20% of the adult population. Representatives of the weaker sex aged from thirty to forty years are more susceptible to the disease. Unfortunately, the vast majority of patients do not even resort to the services of doctors, despite the fact that the disease not only worsens the digestion of food, but also significantly reduces the patient's quality of life. In patients, sexual desire decreases, working capacity decreases, people stop enjoying life.

Causes

There is no single cause for IBS. The disease develops under the influence of a combination of several factors, the main of which are:

• Eating under stress
• Illiterate diet composition, too high levels of caffeine, alcohol, fatty foods ( fatty foods greatly stimulate intestinal motility), sodas,
• Lack of fiber in the diet
• Gluttony.

The psyche and development of IBS

Stress was added to this list only at the beginning of the twenty-first century, and now it is considered almost the main cause of the development of the disease.
It is known that people with IBS are more likely to suffer from depression, experiencing various fears ( in particular the fear of getting cancer). In such patients, increased production of substances ( endogenous opioids), which affect the activity of substances that trigger the process of digestion: the production of gastric juices, the motor and secretory functions of the intestine.
It is noted that the most complex forms of IBS are observed in people who have experienced situations on the verge of life and death, sexual violence, physical violence, as well as those who have mental disorders. Even the death of one of the parents in childhood or the divorce of the parents later can cause the development of irritable bowel syndrome in an adult.

In a number of individuals, the motor function is somewhat changed, which is the impetus for the development of the syndrome.
According to doctors, with this syndrome, pain is localized in the wall of the large intestine. In the tissues of this organ, there are many nerve endings that are sensitive to "stress hormones", including adrenaline. Pain leads to the fact that intestinal motility increases, with increased gas formation, even a slight stretching of the intestine causes pain, since the receptors are already “excited”. The reaction to pain can be just the opposite - that is, the patient has constipation. Both the small intestine and the large intestine are spasmodic.

Signs of the disease

The disease is chronic. Signs of it may appear after the age of twenty and, with greater or lesser intensity, pursue a person all his life. For some people, the symptoms of IBS go away completely.
According to the clinical picture, there are three types of irritable bowel syndrome:

• The main symptom is diarrhea
• The main symptom is constipation,
• The main symptom is increased gas formation and pain in the epigastrium.

In this case, often in the same patient, symptoms can replace each other.
The most common symptom of the syndrome in all cases is an unpleasant feeling in the stomach, pain and a change in the frequency of bowel movements. In addition, the quality of faeces also changes. They can be either very solid or semi-liquid. In addition, patients note ineffective urge to defecate, a feeling of incomplete bowel cleansing, too strong attempts during bowel movements, the presence of mucus in the stool, and copious gas.
Very often, IBS is combined with ailments such as GERD (gastroesophageal reflux disease), muscle pain, migraine-like pain, manager's syndrome, spinal pain, and depressed mood.
According to some studies, about sixty percent of patients with the syndrome are mentally unstable individuals with a predominance of anxiety.

Symptoms with predominant diarrhea

• Pain immediately upon waking in the morning. The intensity of pain can be different, but the time of occurrence is constant.
• The pain appears during meals, often before dinner.
• Persistent diarrhea, sensation of incomplete emptying of the intestines.
• Increased gas formation in the morning.
• Panic attacks and urge to defecate during difficult situations.
• predisposition to dysbacteriosis.
• Discomfort when lying on the left side.
• Urinary dysfunction.
• Migraine pains.
• Feeling of lack of oxygen.
• Sensation of a foreign object in the throat during swallowing.
• Sometimes predisposition to candidiasis.

Constipation-predominant symptoms

• Difficulty with bowel movements in 25% of cases or more,
• Hard or squishy ( sheep) feces in 25% of cases and more often,
• Sensation of congestion during bowel movements in 25% or more of cases,
• Help hands with a bowel movement of 25% or more often or three times a week.

Diagnostics

According to the Rome criteria ( criteria adopted in 1988 by the International Group for the Study of Functional Pathology of the Gastrointestinal Tract) IBS is diagnosed if, in the absence of laboratory changes, the patient has pain or discomfort in the stomach area for twelve months in a row, which disappear after a bowel movement. And also, at least twice a week, a combination of several of the following disorders is observed: mucus in the feces, bloating, impaired stool consistency, difficulty with defecation.

Treatment of patients with a predominance of constipation

In the event that a change in diet does not have an effect, osmotic laxatives are prescribed: milk of magnesia, lactulose, macrogol.
If these drugs are not effective, prokinetics are prescribed, in particular cisapride 5 - 10 milligrams three times - four times a day.
Do not take saline laxatives that provoke pain.
If pain is combined with constipation, the use of anxiolytics and tricyclic antidepressants may intensify pain, constipation, and gas.

As an addition to drug treatment, physiotherapy exercises, hypnotherapy, and physiotherapy are indicated. Even schools and group classes for patients with IBS are practiced abroad.

Irritable bowel syndrome in children

According to some reports, 14% of school-age children from time to time find themselves with symptoms characteristic of irritable bowel syndrome.
Although the disease is very widespread, its diagnosis is difficult. After all, the criteria for diagnosing have not yet been fully defined. A group of scientists from Institute of Pediatrics, Obstetrics and Gynecology at the Academy of Medical Sciences of Ukraine developed a method for determining IBS in children and adolescents.

First of all, the doctor interviews the sick baby in detail. If the baby is still very young and cannot explain his feelings, parents should carefully observe him.

Symptoms to watch out for parents:

• The child is capricious, often cries,
• Sits on the pot for a long time
• He has unstable defecation: either constipation or diarrhea.

In the event that stomach pain or discomfort is combined with indigestion for six months or longer, and over the past 12 weeks these symptoms have been observed more than three times a month, the child is prescribed tests that exclude the possibility of another disease ( urinalysis, blood test, coprogram, stool culture).
If there are signs of another disease ( anxiety symptoms), the baby can be sent to the hospital for a thorough examination.

In the absence of signs of other diseases, the child is prescribed treatment that takes into account the specifics of his illness. At the end of the first course of treatment, its effectiveness is determined.

The treatment of IBS in children is based on the same principles as in adults. This is primarily a correction of nutrition and the use of drugs.
When pain and swelling worsen, you should not give your child raw foods ( only boiled or stewed).
With diarrhea, food should be in a mushy semi-liquid form. You should give up raw fruits and vegetables, milk.

Medicines for IBS in children

For constipation:

• Drugs that increase the amount of feces and improve their movement through the intestines: psyllium seeds, lactulose,
• Prokinetics, for example, domperidone,
• Preparations of hemicellulose and bile,
• probiotics, prebiotics,
• If necessary and after consulting a psychotherapist, special preparations for the correction of the mental state.

For diarrhea:

• Astringent preparations, sorption and enveloping: for example, smecta. If their use does not give an effect - loperamide. His children are not prescribed for a long time, only until the condition is relieved,
• probiotics, prebiotics,
• Enzyme preparations: mezim, festal, pancreatin,
• If necessary, drugs for the correction of the psycho-emotional state.

In combined form:

• Selective antispasmodics, such as duspatalin,
• Drugs to reduce gas formation, for example, simethicone,
• probiotics and prebiotics,
• enzyme preparations,
• After a doctor's appointment, psychotherapeutic drugs.

A very important measure in the treatment of IBS in children is to strengthen the body. It is necessary to organize outdoor games, long walks in the fresh air.
The nutrition of the baby must be organized clearly by the hour. Portions should not be large, the multiplicity - 5 - 6 times a day. After a night's sleep, it is helpful to give your baby juice at room temperature. In order for the intestines to work clearly, you should adhere to the daily routine.

Therapeutic nutrition for IBS

The main requirement for the nutrition of a patient with irritable bowel syndrome is a good assimilation of the products included in the diet. It should be made taking into account the tastes and habits of the patient, as well as the body's reaction to products.

Diet for pain and constipation

The diet as a whole should be consistent with the diet №3 .
The diet should contain all the necessary nutrients: proteins, carbohydrates and lipids ( give preference to vegetable). You should completely abandon food that provokes the processes of fermentation and putrefaction in the intestines, as well as food with a large amount of extractives, essential oils and cholesterol. Increase the level of vegetable fiber by introducing more buckwheat, millet, barley. The nutritional value of the diet is from 2500 to 2800 kcal. per day.

• Cereal or bran bread, rye bread,
• Fresh dairy products, cottage cheese and sour cream,
• Vegetable and butter oils,
• Fish and meat prepared in various ways,
• hard-boiled chicken eggs,
• The cereals listed above
• Raw fruits and vegetables,
• Jam, honey, compote,
• Sauces and condiments.

Not recommended:

• Chocolate, cocoa, coffee, strong tea,
• porridge
• muffin,
• cream soups,
• Kissel.

It is advisable to take food not very hot.

Diet for diarrhea

If the condition worsens, there should be more proteins in the food and completely abandon animal fats, as well as food that is not tolerated by the patient's body. It is forbidden to use prunes, beets, honey, carrots, raw vegetables and fruits that have a laxative effect.
Those who suffer from increased gas formation should give up peas, beans, beans, cabbage, reduce the amount of grape and apple juice, nuts, bananas, beer, raisins in the diet. Increased gas formation can be caused by sorbitol, which is sometimes included in medicines and diet foods, as well as fructose, which comes from berries and fruits. You should eat 4 to 6 times a day. Before going to bed, it is advisable not to overeat.

Those people who do not tolerate milk and dairy products ( lactase deficiency), you should abandon these products completely or reduce their share in the diet as much as possible.
With an exacerbation of the disease, you should adhere to a dietary table. №46 .

• Three-day fermented milk products, fresh cottage cheese,
• Butter limit,
• Eggs limit,
• A decoction of oats and rice,
• Meat in small quantities
• Salt, sugar and sweets in small quantities.

Not recommended:

• Spices, pickles, seasonings, spicy dishes,
• Fruits vegetables,
• Rye bread,
• Fresh dairy products, milk,
• Fatty meat and fish
• Cold drinks,
• Muffin.

Food and drinks should be consumed hot.
Often, patients with IBS are generally afraid to eat anything and try to cut down on the range of products as much as possible. But this is wrong. On the contrary, the diet should be diversified as much as possible, taking into account the peculiarities of the digestive tract of each patient. Since the lack of certain substances, such as magnesium, zinc, omega-3 and omega-6 fatty acids, lead to a deterioration in the condition of the intestinal mucosa.

A lot of controversy in the scientific world is about how to use plant fibers in clinical nutrition. The studies that have been conducted so far give rather conflicting results. But doctors are unanimous in one thing: in the diet of patients with IBS with constipation, there should be an abundance of coarse fiber, which enhances peristalsis. And in the diet of people suffering from diarrhea, on the contrary, there should be a lot of water-soluble fiber ( pectins).

So, for constipation, it is recommended to introduce bran, pumpkin, beets, cabbage, carrots, seaweed, mushrooms, apples, oatmeal and buckwheat into the diet. Dietary fiber creates favorable conditions in the intestines for the reproduction of beneficial microflora and the production of butyric and propionic acids by microbes, which are favorable for the intestinal mucosa.

How else to alleviate the condition with IBS?

1. Eat clearly according to the schedule, do not rush, chew food very carefully.
2. Make friends with sports and physical education. This will reduce the manifestations of the disease, improve the emotional state.
3. The act of defecation should take place when the body requires it. You should not try to force yourself to defecate, just as it is harmful to postpone this event if the need is felt.
4. In the process of defecation, you should not strain too much. Everything should happen calmly and naturally. Haste is also not needed here.
5. It is advisable to keep a food diary. This will help identify foods that cause deterioration and eliminate them from the diet. In a food diary, you should write down absolutely everything eaten per day. At the same time, it is necessary to record in the diary the deterioration or the appearance of symptoms of the disease. You can visit the consultation of a nutritionist who will help you competently draw up a diet.
6. With IBS, it is desirable to avoid surgical interventions, if possible. According to some data, it is patients with IBS who are more likely to be prescribed surgery to remove the gallbladder or appendix, which could have been avoided.

Alternative treatment

Plants that are used in the treatment of irritable bowel syndrome most often:
For constipation: root

Bloating and increased gas formation is a common symptom that accompanies various digestive pathologies. Activated charcoal for flatulence will help eliminate the problem if the increased formation of gases is not considered a consequence of significant violations of the intestinal tract, but is provoked by overeating or malnutrition.

Activated charcoal is a strong natural sorbent that has detoxifying and antidiarrheal qualities. The tool stops the absorption of poisonous and toxic elements that enter the body with medications and food products, and speeds up their elimination from the body. In addition, activated carbon perfectly absorbs gases due to its porous surface.

Coal, which is intended for medical purposes, is a microporous element obtained during the processing of charcoal or coal coke. Coal, which has undergone special processing, is determined by its absorbent qualities, does not irritate the mucous membrane of the digestive tract and helps to get rid of intoxication of the body and other unpleasant symptoms that accompany diseases of the digestive system.

Coal with increased gas formation has an absorbent surface. Therapy with this tool includes detoxification and enterosorbent actions. The drug is considered an antidote. It simply adsorbs toxins from the body before they are absorbed. For this reason, charcoal should be taken as soon as the first signs appear.

Activated charcoal in gas formation has a good effect. The agent absorbs excess gases into the porous surface. Excess air is expelled through the intestines or belching. The drug does not do any harm at all, it is not absorbed into the blood and does not develop side effects. For this reason, the main effect of the drug occurs in the intestinal tract.

When is activated charcoal used?

Due to the fact that this drug is considered an excellent sorbent, it is used for any diseases of the digestive system, which are accompanied by increased formation of gases. Therapy of flatulence with coal is possible due to the focus of its effect, which consists in binding and eliminating gases and toxins from the body.

The most common disorders that are accompanied by the accumulation of gases in the intestinal tract are:

• Dysbacteriosis. With such a disease, coal helps to rid the body of many pathogenic bacteria that are located in the human gastrointestinal tract and give gases a fetid odor due to their activity.
• Chronic course of pancreatitis. This disease is always a factor for excess gas formation, it causes powerful flatulence after eating, so you need to use the tablets 30 minutes before eating.
• SRK. With such a violation, coal removes gases that have accumulated precisely in the human intestinal tract due to stool disorders (constipation or diarrhea).
• The inflammatory process of the lining of a healthy intestinal tract can cause gas formation, which is often accompanied by diarrhea or constipation.
• Activated charcoal is used for bloating and when it is provoked by a lack of enzymes that create intolerance to a particular nutrient component. In particular, it is lactose, which is found in dairy products.
• Obstruction of the intestinal tract due to the formation of a tumor there or the growth of polyps, which are a mechanical barrier to the removal of gases.

Mistakenly, many believe that the use of cheap coal for gas formation is irrational, and prefers treatment with more expensive drugs. All doctors advise using activated charcoal when such a delicate difficulty appears.

Dosage

With flatulence and dyspeptic disorders, the agent is used 3-4 times a day, 250-750 mg for 3-7 days. One tablet contains 250 mg. You need to use it every day before meals for an hour. Accurate dosing provides a tangible effect gradually. The therapy has a beneficial effect. In this embodiment, the agent does not overload the body and does not create secondary consequences.

You need to use the tool with short breaks. The maximum rate must be no more than 7 days. Then a break is made, which should be equal to 5-7 days. In the opposite case, hypovitaminosis can be traced in a person. In this case, you will need to additionally take various complex vitamins. In addition to drug therapy, it is required to pay attention to physical activity and selected nutrition.

Before taking the drug must be crushed. The resulting coal powder must be diluted in distilled water. Such therapy has better absorption. With worse absorption of the tablet, it is possible not to crush it, but to chew and drink it with warm water. At the moment, coal is produced in gelatin capsules. This form of coal acts much more slowly. For such a medicine, it takes time for the gelatin to dissolve. For this reason, the action will not be swift, but slowed down.

The maximum dosage for one person should be no more than 3-4 tablets (that is, 250-750 mg). Signs of an overdose are expressed as dehydration and exhaustion. At the same time, there is a violation of the absorption of vitamins and nutrients. A person can feel weakness, concentration, weight loss. There is a constant desire to sleep.

Note! When expressing signs of an overdose, the use of the drug must be canceled.

How to use

Many pathologies of the gastrointestinal tract are considered an indication for the use of enterosorbent. Among them are food poisoning, alcohol intoxication, drug overdose. The tool is used to eliminate side effects during antibiotic therapy, to eliminate toxic elements, salts of heavy metals, allergens and other harmful components.

As part of complex treatment, coal is prescribed in the treatment of many diseases of the gastrointestinal tract, which are accompanied by flatulence and bloating (cholecystitis, pancreatitis, gastritis, hepatitis, colitis), as well as in situations where such a symptom is provoked by the physiological causes listed above. .

The use of this tool alleviates the condition with alcohol withdrawal, allergies, metabolic disorders, as well as during radiation treatment and chemotherapy. To reduce the formation of gases in the intestinal tract, the intake of coal is prescribed before the implementation of endoscopic and radiological procedures.

Instruction

Flatulence, triggered by excess gas inside the digestive system, causes bloating and other unpleasant symptoms. Therefore, the use of coal, which absorbs gases, allows you to normalize your well-being and eliminate unpleasant feelings.

To achieve a good action, you need to find out how to take coal if there is flatulence. It is required to accurately calculate the dosage of the agent. If the dose is small, then it will not be possible to remove the swelling. As a rule, the dosage when consuming coal must be calculated taking into account the body weight of a person.

It is necessary to use the drug at the rate of 1 tablet per 10 kg of weight. If the body weight is 73 kg, then the dose is rounded up. It turns out that you need to use 8 tablets of coal.

This dosage should be taken three times a day for 3 days. Longer use of the drug is not recommended. It is optimal to get advice from a doctor before taking the medicine, who will help in calculating the dosage and tell you how to drink coal with gas formation.

The therapy must be short, otherwise, with prolonged use of coal, along with toxins, it will also remove useful elements that guarantee balance in the microflora of the digestive system. Because of this, dysbacteriosis or a lack of vitamins is formed. When there is a need for longer treatment, the doctor additionally prescribes vitamin complexes.

Before using coal, it needs to be crushed, pour the powder into a small amount of cold boiled water, mix and drink immediately. In this form, the drug provides the ultimate absorption effect. You need to use coal one and a half hours before eating a meal.

activated charcoal during pregnancy

The period of pregnancy inevitably causes compression of the intestinal tract due to the enlarging uterus. Gases accumulate in the intestines, fermentation and putrefactive processes are often formed. For this reason, a woman may complain of flatulence.

It is necessary to highlight the fact that the use of any medication during pregnancy is undesirable. Activated charcoal often causes constipation, which leads to increased uterine tone. It is allowed to use the sorbent only after the appointment of a gynecologist. In this case, it is necessary to observe the recommended dose:

1. It is required to adjust the size of the medication by subtracting the weight of the woman, fetus and amniotic fluid from the total mass.
2. Further, the usual calculation scheme is used. But it is worth remembering that you need to reduce the number of tablets that are used at a time by 1 piece. For example, if the body weight of a pregnant woman is 69 kg, then according to the instructions, you need to drink 7 tablets of coal. From this amount you need to subtract one tablet.

If the stomach swells constantly and activated charcoal does not eliminate the symptoms within 3 days, then the frequency of use or the number of tablets should not be increased. It is necessary to consult with a gynecologist.

Contraindications

There are few contraindications for the use of this drug. It is contraindicated for use in ulcers and bleeding from the digestive system, with ulcerative colitis, with personal susceptibility to the components of the drug. In other embodiments, therapy with a sorbent can be carried out, since it is safe for health. It is allowed to be used for the treatment of adults and children.

Side effects from the use of activated charcoal

Activated charcoal may cause side effects in certain patients. These actions include:

• feeling of nausea;
• Constipation;
• Skin rashes;
• Feeling of heaviness in the chest;
• Dysbacteriosis.

If side effects occur, it is necessary to seek advice from doctors, and also stop taking the drug before the consultation.

According to a World Health Organization (WHO) working group, irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain is combined with impaired bowel function and defecation. The prevalence of IBS among the population is 14-48%.

In women, this pathology is observed 2-4 times more often than in men. Although the disease often begins in youth, the peak of seeking medical attention for this disease is between the ages of 35-50 years. Every year in the United States, the cost of diagnosis and visits to a doctor for IBS is $ 3 billion, and the cost of treatment is $ 2 billion. Patients with IBS have a significantly reduced ability to work, sleep, sexual activity are disturbed, and other disorders that interfere with normal life are observed.

IBS - a mystery?

Until now, the true causes of IBS, unfortunately, have not been established. It is believed that IBS occurs due to motor and sensory disorders of the intestine. An important role is played by disorders of the normal function of the central nervous system (CNS).

Patients have abnormal intestinal motility, violations of secretion processes in the intestine, changes in visceral sensitivity. In IBS, both the small and large intestines show increased reactivity in the form of intestinal spasm, slowing or speeding up motility to various stimuli, including drugs and even food.

E.P. Yakovenko et al. (1998) believes that in addition to the above factors, a disturbed microbial composition in the lumen of the small and large intestine plays a significant role in this disease.

The waste products of microorganisms support the irritated state of the intestine, contribute to the violation of the hydrolysis of sugars, fats, proteins. Intraintestinal pH may decrease, causing inactivation of digestive enzymes and leading to relative enzyme deficiency.

At the same time, changes in the sensitivity and motility of the intestine can occur under the influence of the central nervous system, including its higher sections. Patients are prone to depression, anxiety, cancerophobia, they often react more actively to stress.

Borderline neuropsychiatric disorders are found in 75% of patients with IBS. However, one can also assume an inverse relationship: such personality changes are not a cause, but a consequence of long-term disorders of the gastrointestinal tract (GIT).

Endogenous opioids (enkephalins, endorphins) and catecholamines are secreted both in the gastrointestinal tract and in the brain. They can influence through a change in the exchange of mediators (acetylcholine, serotonin, gastrin, etc.) on intestinal motility and secretion.

IBS is often considered as a psychosomatic disease, in which stressful situations act as trigger factors, followed by the inclusion of nervous, neuromuscular and hormonal chain reactions that determine the individual type of human motor skills.

Thus, in the pathogenesis of IBS, the leading importance is given to the following factors: psychological, impaired motor skills and visceral sensitivity, changes in the chemical composition of intestinal contents.

How to recognize IBS

For the diagnosis of this still largely mysterious disease, the so-called Roman criteria are used.

The following symptoms persist or recur for at least 3 months.

Abdominal pain and/or discomfort that improves with a bowel movement depends on changes in stool frequency or consistency.
Combination of two or more of the following symptoms that bother for at least 25% of the time when the patient experiences any complaints:

• change in stool frequency (more than 3 times a day or less than 3 times a week);
• change in the consistency of the stool (fragmented, dense, liquid, watery);
• change in the act of defecation (the need for prolonged straining, urgent urges, a feeling of incomplete emptying of the intestine);
• secretion of mucus during bowel movements;
• accumulation of gases in the intestines and a feeling of fullness in the abdomen.

The diagnosis of IBS is established by exclusion. A general blood test, urine test, fecal occult blood test, scatological examination are carried out, daily fat loss with feces is determined, the microbiological composition of feces is determined, abdominal ultrasound, colonoscopy, gynecological examination, with concomitant gastric dyspepsia - FGS.

It is advisable to consult the patient with a psychiatrist. In accordance with the recommendations of the international meeting of experts (Rome, 1998), IBS with pain and flatulence, IBS with diarrhea, IBS with constipation are distinguished.

Principles of treatment of IBS

The main condition for successful therapy is the establishment of a trusting relationship with the patient. He definitely needs to explain the functional nature of the disease, and also warn that the manifestations of the syndrome can persist for many months and even years without progression; under the influence of treatment, symptoms can be weakened.

The patient's attention should be focused on the fact that the disease does not turn into cancer and that it is associated with hypersensitivity of the intestine to the usual environmental factors. The duration of such a discussion with the patient should be at least 15 minutes.

Together with the patient, an individual plan of measures is drawn up to achieve remission of the disease, and possibly a complete cure.

It was not possible to prove the role of dietary nutrition in controlled trials, however, the influence of dietary factors on the nature of the stool (diarrhea, constipation) seems to be quite significant. It is necessary to limit the intake of fatty and gas-producing foods, alcohol, caffeine, and sometimes excessive amounts of fiber.

With constipation, you should still try to increase the amount of ballast substances - dietary fiber (DF) in the diet.

Sources of HP: cereals, root crops (beets, carrots, pumpkin), fruits, cereals (buckwheat, oatmeal). Black bread, dried fruits, especially prunes, dried apricots have the most pronounced laxative effect. Traditionally, with constipation, the amount of vegetables and fruits in the diet should be at least 500-700 g daily.

With swelling and pain, they should first be taken boiled, stewed and baked. As the pain subsides, a combination of raw and boiled, stewed, baked vegetables and fruits is individually selected. At the same time, it should be said that the opinion on the therapeutic effect of dietary fiber in IBS is ambiguous.

With constipation, defecation can be disturbed not only due to a change in the consistency of feces and a slowdown in the motility of the entire colon, but also due to disorders in the coordination of contractions of the pelvic floor muscles.

With diarrhea, milk, raw vegetables and fruits are excluded, it is possible to use a small amount (100-200 g) of boiled or stewed carrots, zucchini, baked apples. It is allowed to eat beef, chicken, rabbit, fish, eggs, sour-milk products, including cottage cheese, cheese, white bread, cereals.

With severe diarrhea, wipe the food. As the state of health improves, the amount and composition of vegetables and fruits is determined by the patient individually.

Pharmacotherapy of IBS

Drug treatment of IBS is carried out according to the recommendations for the diagnosis and treatment of IBS, approved at the V Russian Gastroenterological Week (Moscow, 1999).

Constipation and poor tolerance to products containing ballast substances (PV). Swelling laxatives are used: mucofalk is a preparation from the shells of psyllium seeds. It is able to retain water, thereby increasing the volume of the stool and it becomes soft.

Unlike other laxatives, these drugs do not irritate the intestines. Mucofalk is taken before breakfast (1-2 packets), washed down with a significant amount of water, if necessary, the drug is taken in the evening. For constipation resistant to mucofalk, it is combined with lactulose or cisapride.

Osmotic laxatives: lactulose, magnesium sulfate, citrate and magnesium hydroxide, forlax, etc.

Forlax forms hydrogen bonds with water molecules in the intestinal lumen, increases the amount of fluid in the chyme, stimulates mechanoreceptors, improves intestinal motility.

The evacuation reflex is restored and the act of defecation is optimized (due to the normal volume and consistency of chyme). The drug is not absorbed or metabolized, it is taken 1-2 packets 1-2 times a day. The laxative effect develops 24-48 hours after ingestion.

Lactulose is taken 30 ml 1-2 times a day, magnesium sulfate - 10-30 g in 1/2 glass of water, citrate and magnesium hydroxide - 3-5 g per dose.

It is possible to use laxatives that soften feces: vaseline, almond oil, liquid paraffin, although their laxative effect is somewhat less pronounced.

Laxatives - irritants (with antiresorption-secretory mechanism of action): guttalax, bisacodyl, anthranoids. These drugs inhibit the absorption of water and electrolytes in the small and large intestine, thereby increasing the flow of water into the intestinal lumen.

This increases the volume of intestinal contents and reduces the time it takes to pass through the colon. They also stimulate the contractile activity of the colon.

Guttalax is prescribed 5-15 drops, bisacodyl - 2-3 tablets per day or 1 suppository rectally. These two drugs are among the most commonly prescribed, probably due to the predictability of their action.

Anthranoids: preparations of senna, aloe, buckthorn bark, rhubarb root. Currently, they are prescribed less frequently, due to the fact that their use is accompanied by pain, especially at first. However, this is typical of all "irritants" in the first 3-6 receptions. With prolonged use of senna preparations, the formation of melanosis of the mucous membrane of the colon and damage to the intermuscular nerve plexuses is possible.

Means that activate the motility of the gastrointestinal tract: these drugs are isolated into an independent group of prokinetics. They have a laxative effect and significantly reduce bloating. These include cisapride (Coordinax, Peristil), which is prescribed 3 times a day 15 minutes before meals and at night, or 20 mg 2 times a day.

Diarrhea. Drugs are prescribed that slow down the movement of contents through the intestines. First of all, it is loperamide (imodium, vero-loperamide). Dosing schedule: 2-4 mg 1-2 times a day.

Astringents: calcium carbonate (1.5-3 g 1-3 times a day), aluminum hydroxide (1 g 1-2 times a day), smecta (1-2 packets 3-4 times a day).

IBS with pain syndrome

Antispasmodics:

1. calcium channel blockers: spasmomen (40 mg 3 times a day) or dicetel (50 mg 3 times a day);
2. anticholinergics: buscopan (10 mg 3 times a day);
3. motility regulators: debridet (table 1-2 3 times a day).

The drug acts on the enkephalinergic system of the intestine, as a result of which the pain syndrome decreases. Possessing an affinity for suppression and excitation receptors, it has a stimulating effect in hypomotility and an antispasmodic effect in hyperkinesia.

Often, the pain syndrome is associated not so much with spasm (and antispasmodics in this case will be ineffective), but with distension of the intestine with gas, and therefore, in a number of patients, the pain disappears after the appointment of drugs that reduce bloating.

Flatulence, flatulence often disturb patients with IBS and as independent symptoms. The causes of excess gas accumulation in the intestines are complex. An important role is played by excessive swallowing of air. This occurs with hasty eating, insufficient chewing of food and talking while eating. A significant amount of gas is produced in the small and large intestine.

In the large intestine, gas is formed as a result of the enzymatic action of intestinal bacteria on organic substances that are not absorbed in the small intestine. More often these are carbohydrates that are not hydrolyzed by amylases, in this case CO2 is formed.

Hydrogen sulfide is a product of the transformation of amino acids by anaerobes. During the day, 20 liters of gas are formed in the intestines. It is mostly reabsorbed through the intestinal wall. Nitrogen and hydrogen sulfide are not absorbed and are excreted through the rectum. During the day, 600 ml of gases are released through the rectum, individual differences are possible in the range of 200-2000 ml.

The unpleasant smell of gases is associated with the presence of trace amounts of skatol, hydrogen sulfide, mercaptan. They are formed in the large intestine as a result of the action of microflora on protein substrates undigested in the small intestine. Accumulating substances form foam in the intestine: a dispersed system consisting of gas bubbles and liquid. This system obeys the laws of surface tension.

The more the processes of normal digestion and absorption of food ingredients are disturbed, the more gases are formed and the conditions for the formation of a stable foam are facilitated. Foam, covering the surface of the intestinal mucosa with a thin layer, makes it difficult for parietal digestion, reduces the activity of enzymes, and reduces the reabsorption of gases.

Patients with IBS most often have alimentary, dysbiotic, dynamic and psychogenic flatulence. Treatment is aimed at eliminating the causes of flatulence.

Effective adsorbents and defoamers. It can be activated carbon, white clay, aluminum hydroxide, bismuth preparations. The best defoamer is simethicone (espumizan). It is a high molecular weight silicon-based polymer. He is prescribed 40 mg 3 times a day.

IBS with bacterial overgrowth in the small intestine and colon dysbiosis. First, antibacterial drugs are prescribed: intetrix (1-2 caps. 3 times a day), or furazolidone (0.1 g 3 times a day), or ersefuril (1 caps. 3-4 times a day), or metronidazole (0, 25 g 3 times a day), sulgin (0.5 g 4 times a day), enterol 1-2 packets 2 times a day. One of these funds is prescribed, as a rule, for 5-7 days, it is possible to conduct two consecutive courses with various drugs.

Then you can prescribe a probiotic - a bacterial preparation: bifiform (1-2 capsules 2 times a day), or colibacterin, bifidum-bacterin, lactobacterin (5 biodoses 1-3 times a day immediately after meals for 2-6 weeks). At the same time, you can prescribe a prebiotic: hilak-forte (a product of the metabolism of normal microorganisms of the intestinal flora, 50-60 drops 3 times a day).

Against the background of intestinal dysbacteriosis, a relative deficiency of digestive enzymes can be observed. In this regard, enzyme preparations may be prescribed. In IBS with constipation, it is more expedient to prescribe enzyme preparations containing bile and / or hemicellulase: panzinorm, festal, digestal, enzistal, etc. They are prescribed 1 table. in the morning, 2 tab. at lunch and 3 tab. in the evening.

In IBS with diarrhea, enzymes containing pancreatin are used (pancitrate, creon, licrease, mezim-forte). In general, the following indicative treatment regimens are recommended for IBS with gut bacterial overgrowth syndrome:

• 1st week: ersefuril and / or metronidazole + enzyme preparation + drugs that normalize motor disorders;
• 2nd week: hilak-forte + bifi-form + enzyme preparation + drugs that normalize motor disorders;
• 3rd week: hilak-forte + bifi-form.

With depression, increased anxiety, asthenia, carcinophobia, anxiolytics and antidepressants can be prescribed. As a rule, they are appointed after consultation with a psychiatrist. The most effective are tricyclic antidepressants: amitriptyline (1-2 tablets), lerivon 1-2 tablets, or serotonin reuptake inhibitors: fluoxetine (framex) - 40 mg / day.

In addition to stopping the actual symptoms of depression, they have a neuromodulatory and analgesic effect. Eglonil (25-50 mg 2 times a day) contributes to the relief of pronounced vegetative disorders.

Despite a sufficient set of drugs used to treat IBS, the effectiveness of treatment is often assessed as insufficient. A search is underway for new drugs to treat this disease.

A great achievement is new enzyme preparations. One of them is pepphysis. The effectiveness of the drug pepfiz (Ranbaxy Laboratories Ltd.) in patients with IBS was studied.

Pepfiz contains in 1 tablet: papain 84 mg, fungal diastase 30 mg, simethicone 27.5 mg and excipients - sodium bicarbonate, potassium bicarbonate, citric acid, fumaric acid, sodium saccharin, sodium carbonate, sodium lauryl sulfate, sunset yellow and orange dye flavoring.

Pharmacological properties: digestive enzymes papain and fungal diastasis facilitate digestion and absorption of proteins and carbohydrates in the body. Simethicone is a "foaming agent" that reduces the amount of gas in the intestines.

Pepfiz is indicated for any violations of the exocrine function of the pancreas (chronic pancreatitis), proximal small intestine and liver diseases, with non-ulcer dyspepsia syndrome, with flatulence, increased gas formation in the postoperative period, a feeling of stomach fullness or flatulence due to unusual food, overeating, use alcohol, coffee, nicotine.

Dosing regimen: 1 tab. 2-3 times a day after meals. Contents of 1 tab. before use, dissolve in 1/2 tbsp. water. Side effects of the drug were not found. 1 tablet of pepfiz contains 419 mg of sodium, and therefore it should be prescribed with caution in hypertension, kidney and liver diseases. The drug is contraindicated in case of individual intolerance.

The type of charcoal used for medicinal purposes is quite different from other types of charcoal found in barbecues and artists' tools.

A medicinal or activated type of charcoal is used to treat a number of conditions, from treating cases of poisoning to relieving digestive problems, a common side effect of which is bloating.

Activated charcoal for bloating should be prescribed to the patient exclusively by the attending physician, taking into account the individual characteristics of the body of a particular person.

Drinking activated charcoal tablets on your own without consulting a doctor is highly undesirable.

general information

Activated charcoal, which can be found in powder, liquid, or tablet form, is a natural substance used to absorb toxins from the body.

It was originally used in poison control centers to remove ingested poisons. Activated charcoal tablets are a safe and easy-to-use home remedy for a wide variety of ailments or health problems.

The above remedy is a fine black powder that is highly absorbent with the ability to limit the toxicity of almost any chemical that enters the digestive tract.

Liquid and powder forms of this remedy are most commonly used in case of poisoning, while tablets are usually used to relieve common health problems such as digestive difficulties.

Such charcoal is made from natural materials such as coconut shell, wood, peat and bamboo.

It is heated to such a temperature until it becomes porous. This helps it act like a sponge and absorb chemicals.

It is important to note that the product should be purchased at pharmacies and health food stores. They, unlike conventional charcoal, are edible and safe for internal use.

Chemicals found in processed foods, pesticides on fruits and vegetables, bacteria and acids that cause indigestion are known to cause indigestion.

Activated charcoal binds to these sources in the sick person's stomach and intestines, removing them and reducing the symptoms they cause.

The beneficial properties of activated charcoal are not limited to a calming effect. It can be used in a wide variety of ways.

In particular, with the help of this product, you can even whiten your teeth. It can also be used to deeply cleanse the skin and add volume to the hair.

Although activated charcoal tablets can have a huge positive effect on the body, you should make sure that they are used safely. For this purpose, prior to their use, it is necessary to consult with your doctor.

Coal from bloating

With its ability to absorb most poisons, activated charcoal can be very effective at absorbing the less harmful acids and gases that build up in the intestines.

The fact is that these substances can cause dyspepsia, acid reflux and bloating. The remedy is able to absorb these gases and reduce gastric distension to more acceptable volumes.

The drug is tasteless and odorless, so there is no unpleasant sensation when it is used or after taking it during bloating.

If there is bloating and flatulence, it is advisable to take two to three tablets three times a day. However, before using coal during bloating, you should read the instructions on the package for the drug.

As you know, due to its absorbent nature, the drug can absorb both essential nutrients in the intestines and harmful toxins.

Therefore, when bloating, it is imperative to be careful when using it and always follow the directions for use and dosage.

Some signs that this remedy is having an adverse effect on the human body are constipation, vomiting, stomach pain, and diarrhea.

To be sure of the effectiveness of activated charcoal, it is worth discussing the medication regimen, the course of the gastrointestinal disease and possible allergic reactions with your doctor before starting to use the above remedy.

It is worth noting that, according to recent studies, activated charcoal helps with symptoms caused by irritable bowel syndrome, reflux, and various other stomach ailments, such as ulcers.

Activated charcoal tablets bind to toxins in fats and in the digestive tract, helping foods to be digested properly while also trying to break down those extra toxins.

This effect of taking charcoal is especially beneficial for the lower intestines and for relieving the symptoms of increased gas production from bloating.

Because charcoal binds to acids that cause indigestion, reflux, and bloating, a person can quickly find a positive result in a less bloated belly.

Doctors who find activated charcoal tablets useful in therapy recommend using them only as needed.

One of the risk factors with the frequent use of this remedy is that it is not completely known how the internal organs that perform the main functions in the body will react.

To avoid possible negative consequences for the body after taking charcoal, it is more advisable to maintain a high level of kidney and liver health and maintain healthy eating habits.

It is also worth focusing on the scheme of taking the above medication. Some people take it after meals to relieve bloating, or even before meals, and claim to see positive results.

The problem with using activated charcoal at mealtimes is that it can absorb nutrients that any body really needs.

To avoid this, medical experts recommend taking the tablets between meals, ideally 2 hours before and after meals. Since no studies have been conducted on this subject at the moment, there is no clear answer as to when is the best time to take the remedy.

It is for this reason that many experts advise experimenting with different time intervals of charcoal use to determine the greatest effectiveness.

You must carefully follow the instructions on the packaging with the product regarding the dosage. Exceeding the norm and taking too many charcoal tablets can lead to diarrhea.

If the stool has a black tint after using the remedy, do not worry, because this means that the coal leaves the body after passing through the gastrointestinal tract.

It is undesirable to use the drug to remove poison from the body. In this case, it is best to consult a doctor if the poison has entered the body or there is a possibility of an overdose from drugs.

As previously noted, activated charcoal can absorb active ingredients from other medications, making them ineffective, so it is recommended not to take it while taking other medications.

People of any age category are allowed to take coal, however, only by correctly calculating the dosage and taking into account all the existing contraindications.

If there is any discomfort during therapy with this drug, it is recommended to urgently stop taking the medication and make a visit to a medical specialist in the field of gastroenterology.

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