Gastroenterologist, Gastroenterology Journal

Question: doctor. I have to you this question. Six months ago I removed the abscess appendicitis (perhaps this is irrelevant to the problem.) Somewhere after 2 months started intestinal disorders. In the stomach constantly urchit, bloating. Persistent pain after eating. And the more you sing, the more. Pain in different places and different character (usually sharp, cutting). That the stomach, then the right. . directly under the seam, then the lower abdomen. Pass themselves. But pressing constantly have any painful areas. And. A chair is often in the form of small dense balls. This is about something said? What do you suggest? Call to gastroenterologist or try to drink bakpreparaty, Omez and Motilium (I made this appointment gastroenterologist last time). Thank you very much!

Answer: 23 years. Irritable Bowel Syndrome often manifests (ie, begins to appear clearly) just after abdominal surgery or after severe food poisoning. See the corresponding subheading.

Question: this kind of question: the problem is that somewhere before about a year ago, in 3-4 years because of the tight employment at work ate nenarmirovannym schedule (ie, eating when they received!), well, in addition to all chewing gum on an empty stomach. in consequence of that was a constant gassing. . . ie constantly feel the air in the stomach and wanting to emit gases. . . a very unpleasant situation. . . was at the doctors (a few), looking stomach, checked in different ways. . . told that nothing is surprisingly not only increased acidity in the stomach. . . prescribed each in its own pile of drugs, but no outcome. . . noticed that the hand must necessarily normalized schedule feeding. . all done. . . eat from the time very clearly. . . for lunch as it should be and the first and second, but to no avail. . . can anyone else knows a way out of the situation? do not live in the most progressive place, and therefore do not know. . whether the doctors pingyang to misunderstand the essence of the problem, Toli that. . although pingyang in any event no sense. . . can anyone else encountered such a case and knows what's all the same may be about? Thanks in advance for any kind of information!

Answer: Not just anybody, but the mass of young people have such a problem: http://doktor. ru/qa/15430/qa. html? id = 83802.

Question: Consult please, what happening to me? "I had IBS years 5. That is, gas, pain, etc. In the survey of any organic abnormalities. Already accustomed to live with this thing, and especially do not download it yourself. There is only one problem, which would like to solve what some drugs. . . By the nature of work and communication has to take alcohol (beer or vodka) on Friday and Saturday. As a result, on Sunday, a small gas and sometimes diarrhea, and on Monday the sharp impulses in more after eating and gas, Tuesday and Wednesday all day gases by Friday to normal digestion, even the CMB disappears, but you have to drink again and everything is new. Little easier situation smectic + Hollin. Perhaps there are some medications that after drinking then I was not tortured gases and urge the outlet to the toilet after meals? Or it is not IBS, and from the pancreas or liver problems? I know better than to engage with alcohol, but there is no possibility. Thanks in advance for the answer.

Answer: I do not see evidence for the generous assistance, try to find out yourself. CMB – biopsychosocial disease and you amplify the impact of a pathogenic social factors.

Question: doctor! Sorry, my terminology beforehand. My child 3 years, we are plagued by constant constipation. At exactly 1 year we have experienced intensive care – a child raised acute enterocolitis, one year almost exclusively breast-fed, after the hospital moved to the main food. Not shit for 3-4 days in the summer of 2,6 years was to leave the rectum, and so at intervals, when not pokakaet approx. 4 days, I began to follow, Duphalac give every day for about 3 teaspoons – but it's nothing, no response, began to use the mini-enema "mikrolaks" – he was shit, went addictive, and now for us pokakat stress – it requires an enema, I fill them a little water and do "Dummy" – he cocoa. We eat dried apricots, give fruit svekol. juice and grow. Oil = 2 tea spoon. It should be noted that my Sashulka, of course, bad eating vegetables, soups cook already at a water – cabbage, potatoes, carrots. . . Kashi eat in the morning. The main question – how do you think is better to lie to us in the hospital to exclude anomly related kishecheikom?? (Let there be some liquid in the intestines), or try to adjust in other ways. The baby mobile, runs, jumps, up to 2 years old cocoa standing, running, running, and on you. . . Thank you for not denied )))

Answer: Radiocontrast study intestinal useful only for identifying the causes _ustranimyh_. And so are only Hirschsprung's disease. This is a rare anomaly (1 case per 5000 live births). Being a doctor for adults, I'm not experienced with it.

Question: ZdravstuyteYa already asked you a question about Irritable Bowel some time ago. I am concerned about abdominal bloating and pain at night. I think pain associated with gases in the intestine, as when the stomach is not swollen then no pain. Very tired because of this. Can IBS so to emerge? Also, diarrhea 3-4 times a day and sometimes more. Escaping smectite, mebeverin + Hilak forte help (it is interesting that in combination, individually weak. Hilakam Though you to think about bad judging by your answers). All of the drugs give a temporary effect. He did kolonoskiyu 3 years ago – they found nothing. I read that dairy products can irritate the intestine (not even because of lactose and milk proteins due) – milk, I just can not stand, but did not notice the bright reaction to cheese, cottage cheese and yogurt. Although everywhere they rekomenduyuyut excluded from IBS, which was hard for me, because it ate their whole life. Fruits, vegetables, bad bear, eating at a minimum. It is not clear how pitatsya to cope with IBS? (Pro flatulence in your links is written that he was connected with bakteriyamib which multiply in the undigested food. It's clear to me. Voprosb pitatsya how to make it and enough vitamins and calories and keep food to digest. I think this question is difficult to solve.) I eat 3-4 times a day and fresh vegetables, fruits hardly eat. It is difficult to determine which is annoying. Maybe recommend something? Should I just exclude dairy products (gritting teeth). How to get better if you can not have a lot of food (and appetite is good especially after sports work out) – get indigestion. (64 kg/177 cm). Can fermentopathy and what should be further obsledovatsya (although the UK is quite difficult here, doctors are reluctant to the survey)? Sorry if the question asked many times, your system is somehow bad work. . . . .

Answer: Continuing http://doktor. ru/qa/14071/qa. html? id = 63517 and http://doktor. ru/qa/14490/qa. html? id = 74877. Body weight you are normal, so that digestion goes, energy and nutrients get enough. You can take a multivitamin. Symptoms in IBS often change, and dietary restrictions and medications given transient effect. Hence there is no ready-made regimens. We must get out somehow independently or interact with a permanent doctor. Examined is not necessary, because there is no malabsorption syndrome.

Question: Dear doctor, I ask the Board about his condition. I am 39 years old, over 15 suffer quite badly in the past year, more intensive, high gas formation, incomplete bowel movement, diarrhea. symptoms are so intense, that became unbearable work surrounded by people. 12 years have seen a gastroenterologist, is put IBS dolihosigma, lack Bauhin flaps, dysbiosis, xp gastroduodenitis dzhvp, hypothyroidism. Uzi liver, gall without pathology, colonoscopy (examination of the full after the first failure) – catarrhal sigmoid, dolihosigma. Biochemical tests were normal. Periodically assigned course-Intetriks, enterol, bifiform that if they make it easy to position, it is very low. Symptoms removes only loperamide. In general deterioration are a few times a month, quite unnecessarily, have kept a strict diet of vegetables and fruits do not use for years – just oatmeal, potatoes, meat, fish, white bread. Even the cheese had to be deleted, without causing the discomfort. How valid is my treatment? Can something in principle, improve the quality of life? Are there, in your opinion, the need for full-time consultation with specialists from leading clinics? Thank you very much in advance.

Answer: Unfortunately, only a highly individual approach, and even then not always, improves the quality of life in principle. Of course, you must be sure that it was not aggravated by gluten enteropathy, lactose intolerance. Recommendations of the leading clinics "seem to be very sad. Here are quoting a message from the November 9, 2003 itself can try the original scheme proposed by the Moscow Research Institute of Gastroenterology. The originality lies in the fact that: 1) it is distinctive, very different from the known relevant foreign materials, 2) has the nature of practical recommendations for local health workers, despite the lack of information about effectiveness, and 3) advised to apply well-defined commercial products, ie . a lobbyist shade. This scheme is not, of course, secret, and has been published in the professional print and web in 2002 and 2003. I quote it verbatim. "TREATMENT UNDER standards developed in TSNIIG (2003). I. In IBS with diarrhea predominance is recommended that mechanically and chemically smooth diet (# 4 in). Of the drugs prescribed: a) motor controllers: loperamide 0,002 g, 2 tablets 1 once a day under the tongue, to stabilize the stool (1-3 days or more), b) smectic. 1 sachet 3 times daily before meals to design a chair, c) one of probiotics: bifiform 1-2 capsules, 2 times a day 2 weeks; laktobakterin 5 doses 2 times, 4 weeks; lineks 1-2 capsules 3 times a day, 4 weeks, d) prebiotic Hilak Forte. 60 drops 3 times a day, 4 weeks. II. In IBS with constipation predominance designate : a) food additives (wheat bran, flax seed), b) Mukofalk. 1-2 teaspoons of the night, 2 weeks or macrogol 4000 on 10-20 g (1-2 bags) at night, 2 weeks, c) 15-30 ml of lactulose. III. In IBS with predominance of pain used mebeverin 0,2 g, 2 times per day, 2 weeks; Meteospazmil. 1 capsule 2-3 times per day, 2 weeks or pinaveriya bromide 0.05 g 3 times day, 2 weeks. The course of treatment in the hospital continues for 2 weeks. If you do not achieve remission – additional examination, consultation and treatment at the clinic of neurosis. "Help: lactulose = Duphalac. ; Macrogol = Forlaks. ; Mebeverin = Dyuspatalin. ; Pinaveriya bromide = Ditsetel. . It seems to be ridiculously simple: two weeks in the hospital, the walls are treated, "issued" with the improvement, and then two weeks swallow these OTC brands of tools at home, then stop the drug and go to a psychiatrist. As said Stanislaw Jerzy Lec, in fact, is not so, as in reality. Of course, everything is much more complicated and effective assistance impossible without some knowledge of medicine. P. S. Diet N4v differs little from the intestinal dietary N 4b (see http://doktor. Ru/qa/14941/qa. Html? Id = 60159). A) food can bake and serve in uncomminuted form. B) are resolved with good endurance (which is absent in the CMB): cabbage, green peas, young beans, beets and leaf lettuce, tangerines, oranges, watermelons and grapes without skin, sweet fruit and berry juices. B) You can eat sausage soaked herring, lean ham and finely chopped noodles.

Question: doctor. Disturbing IBS for 3 years already. But the symptoms were weaker than before, gone these wild oschyuscheniya. The truth remains a loud rumbling, mutable chair and poor tolerance of milk, which sometimes disappears, especially in the summer on vacation. Previously, I was also troubled by stomach: unpleasant oschyuscheniya stomach during a meal, could not sleep on his stomach, was constantly hungry (as they say "not in the horse food"). I read that stomach problems occur in giperotvetstvennyh people with a sense of guilt. Liquidated all the stimuli and the stomach does not bother already 3 months. Now we have to deal with the bowel. I read that AT & Training can be cured. The only thing that I do not like in AT, is something that must be dealt with 3 times a day, that is, there is some sort of a relationship as I think. I have been doing physical exercise at home, or rather physical training without weights: pull-ups, push-ups, abdominal exercises, etc. I wanted to ask you what you think about self-hypnosis? There, too, comes first nat. relaxation, but instead of words do you do visualization, will it have the effect of treatment? I have a book of Michael Shoyfeta "hypnosis". Weigh 65 kg with an increase in 180. Thank you.

Answer: All recommend this book or series of articles to its founding: http://www. aif. ru/health/436/15_01. php.

Question: I am 21 years old. I have a problem-constant gassing. Granted, many are there and I know that is associated with food (solid all that you do not eat), but I like some strange turns, not to eat or not eat anything for a day or still gases, there are always strong, so extent that not even withstand the day (always looking for a toilet or closed position). Noticed as well that more gas is formed when you drink any liquid in the toilet in a small (by the way I go very often, there oschuenie not fully emptying and discomfort in the groin area) when you go inside, too, feel it all begins. Make and receive for many pills, nothing helps! Uzi showed constriction of the gall bladder (cholecystitis written), colonoscopy revealed chronic colitis and bauginit, gastroscopy showed nothing, everything is normal, basic courses ropival caps that advertise-Espumizan, Enterosgel, and such as dyuspatalin, enzistal, Buscopan, mukofalk. . . Nothing helped. I hope you will help me. Maybe all should turn to the urologist!? Although everyone says that these things are not linked. . . . . Do not know.

Answer: Excuse me, but I think that you are under 21 years old and all these problems are age character. Engage in active sports. Research statistics show that per day in healthy people through the rectum is allocated from 200 to 2000 ml of gas (about 600 ml) of 13.6 plus / minus 6 passages.

Question: Thank you very much for your reply (http://doktor. ru/qa/14490/qa. html? id = 87867). Tell me, please, the results of my tests below say something about the suspicion of celiac disease? Antibodies to tissue transglutaminase IgG 10. 84 (Rule 0-9. 99) Antibodies to tissue transglutaminase IgA 0. 10 (Rule 0-9. 99) antibodies to gliadin IgA 0. 5 (rate of up to 25) antibodies to gliadin IgG 2 (rule 25)

Answer: The suspicion must be removed, only one border crossing with standard deviations of parameters. Those or other serologic evidence of intolerance to gluten (a blood test for antibodies) are found in 3-4% of healthy population.

Question: For several days, worried about feeling pressure in the lower left ribs. Moreover, if I look at them, I see as a protrusion of the chest in this place more than the right. And if I stand almost no concern discomfort, the same lying on his back. More worried about in the morning, if prvy to lie on his side and if hungry. Other symptoms: belching food or air, and sometimes an unpleasant taste (not bitter, not sour – just weird), white patches on the tongue, the chair is not always issued, and sometimes several times a day, unstable in general, potashnivaet sometimes, rumbling in the stomach is rarely, swelling, too. After eating, it becomes easier, appetite is normal and common condition is normal. Tests (blood, feces, urine) in normal, ultrasound showed only steatosis and bending gall, no stones, fibrogastroduodenoscopy – chronic superficial gastritis. The diagnosis of the doctor: chronic colitis, chronic cholecystitis, chronic pancreatitis. From pancreatitis treated with (omez, amoxicillin, Almagel, an antibiotic, pancreatin) – nocturnal symptoms were nausea, from hepatotoxicity (Liv 52, gepabene, hilak forte), too, but then came a feeling in the left hypochondrium. Do you think that this might be? I suppose colitis, but wondering why the left ribs stick out? What could be the cause? Can back (spine) to give such symptoms as a reaction on the part of the digestive tract, because all the abdominal organs in accordance with surveys of apparently healthy?

Answer: 26 years. Suppose somatoform neurosis. Diseases diagnoses that you reward, incurable, and in this age of men at the same time do not occur.