Functional disorder

This name to denote different disturbances, developing in the late period after operations on the stomach, primarily after the resection or intervention after a vagotomy.

The frequency of these violations is an average of 10-15%, and their nature and severity to some extent depend on the type produced by the operation: some symptoms develop only after resection or vagotomy, while others may only take place after both types of operations.

Generally accepted classification of disorders associated with gastric surgery, does not currently exist. The most common classification is basically contain postgastrorezektsionnoy division of pathology at the functional disturbances and organic lesions. Meanwhile, a division of postoperative disorders is arbitrary, since there are always the pathophysiological changes after surgery, which, through violations of the functional states lead to an organic lesion of the gastrointestinal tract. It later sold some clinical symptoms, we can say that the pathogenesis of disorders after surgery for peptic ulcer disease is complex and not always fit into the concept of "functional disorder" or "organic lesions.

Dumping syndrome - the most common functional disorder after gastric operations. The current literature is the most common term used to describe a complex symptom, occurring shortly after eating.

Pathogenesis of dumping syndrome is complicated. Anatomic and functional brand viagra defects introduced by any surgical intervention on the stomach and lead to a number of pathophysiological disturbances not only in the digestive system, but throughout the body. Fast food mass evacuation of the operated stomach, the rapid passage of the small intestine, followed by inadequate osmotic and reflex influences, joining violation of humoral regulation, activation of the sympathetic-adrenal system, as well as existing neuro-psychiatric disorders - all these individual pathogenetic links simtomokompleksa complex.

Diagnosis. The clinical picture of dumping syndrome is very characteristic: it will soon be after eating severe weakness, sweating, headache, and often patients notice palpitations and marked muscle weakness, the emergence of an uncontrollable desire to go to bed, often after eating a headache in the stomach cutting nature, increased peristalsis that is accompanied by profuse diarrhea.

Objective changes, konstatiruemye with dumping syndrome is also plentiful.
Among them, increased heart rate, changes in blood pressure, a fall of bcc, the change of peripheral blood flow and EEG. For a special study is often possible to ascertain vegetative-vascular and neuro-psychiatric disorders.

All of the above symptoms with some degree of schematization can be divided into three groups:

1. vasomotor,
2. intestinal,
3. Neuropsychiatric, the severity of which depends on the severity of dumping syndrome.

The diagnosis of dumping syndrome is based on a detailed clinical and psycho-neurological examination of patients. X-ray study also allows us to obtain a series of data: the rapid emptying of the stomach, the accelerated passage of the small intestine, and also expressed dystonic and diskineticheskih disorder.

Treatment. Conservative treatment of dumping syndrome to be complex. Its basis is diet therapy, often high-energy food fractional portions of the restriction of carbohydrates and fluid, full of vitamin nutrition. The mistake is to assign patients antiulcer dietary regimes that may exacerbate the manifestation of the syndrome.

Means of bracing therapy is recommended infusion of glucose with insulin, blood transfusions, parenteral vitamin therapy. In some cases, the appropriate designation Panzinorm, Festal, etc., especially when symptomatic insufficiency of exocrine pancreatic function.

Sedation neyroplegikami shown in patients with severe Neuropsychiatric disorders. Appointment of agents to facilitate slow evacuation from the stomach and reduce the motility of the small intestine, has a pathogenic orientation (drugs atropine, ganglioplegic, procaine blockade). Focused conservative therapy is effective only when mild dumping syndrome. Severe manifestations of syndrome is an indication for surgical treatment. The main idea of surgical intervention in the dumping syndrome that developed after resection of the stomach, is to slow down gastric emptying of the stump and the restoration of passage through the duodenum. The most common operations currently used, is reconstructive gastroeyunoduodenoplastika. Effectiveness of existing treatments dumping syndrome depends largely on the severity of the suffering.

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topical ointment