Intestinal dysbacteriosis symptoms treatment in adults nutrition. Herbal treatment

Overall health depends on the state of the digestive system. Any violations in gastrointestinal tract lead to imbalance throughout the body. One of the most common pathologies is intestinal dysbacteriosis in adults. It can develop due to a number of reasons. And it is very difficult to cure this disease quickly. Required A complex approach which includes a number of activities.

In order for the digestive system to function normally, it must have the right balance of microflora. Without beneficial bacteria, the normal process of digestion of food, the absorption of vitamins and trace elements is impossible. Intestinal biomass, which consists of many types of bacteria, is found in the large intestine. Their basis is aerobic lactobacilli and anaerobic bifidorbacteria.

It is the correct balance of intestinal microflora that protects a person from numerous infections, destroys and removes toxins from the body. If the balance is disturbed in the direction of pathogenic microflora, the processes of self-poisoning of the body begin, and dysbacteriosis develops. Following it, disruptions in the work of other systems and organs may occur.

Causes

It is not always possible to unambiguously answer why the balanced composition of the intestinal microflora in adults fails. There are factors that can trigger the mechanism for the development of dysbacteriosis:

• Eating disorder. This includes an unbalanced diet with a predominance of monotonous food. Insufficient fiber intake creates a deficiency of a favorable environment for beneficial microflora. The intestines are poisoned by food saturated with artificial additives, fast carbohydrates, animal fats.
• Diseases of the digestive system. A constant source of pathogenic microflora is inflammation of the gastrointestinal mucosa, improper synthesis of enzymes, intestinal obstruction, gastritis, ulcers, etc.
• Taking antibiotics. These drugs are harmful not only to pathogenic bacteria, but also to beneficial ones. Therefore, antibiotic therapy should be constantly replenished with the intake of drugs with beneficial microflora.
• Diseases of the endocrine system, which are caused by the use of hormonal agents.
• Chemotherapy and radiation therapy greatly weaken the immune system and provoke a massive reduction in beneficial bacteria.
• Postponed operations on the stomach.
• Poor hand and food hygiene through which pathogenic organisms enter the gastrointestinal tract.
• Regular stress, worries.

Important! All of these factors are the locomotives of secondary dysbacteriosis. The primary form of the disease develops only in young children.

Stages and symptoms of the disease

Dysbacteriosis develops gradually. Its 4 stages are determined, which are characterized by their own symptoms.

If timely attention is not paid to the disorder of the intestines, chronic dysbacteriosis develops. It may be accompanied by a violation of the heart rhythm, shortness of breath.

First, the patient must consult a gastroenterologist. He will prescribe a bacteriological analysis of feces. Additionally, instrumental examinations are carried out:

• Gastroscopy;
• colonoscopy;
• Irrigoscopy;
• Sigmoidoscopy.

How and what is the right way to treat?

It will not be possible to cure dysbacteriosis very quickly, especially if it is already at stages 3-4. An integrated and phased approach to treatment is needed:

• Destroy pathogenic bacteria.
• Populate the intestines with beneficial microflora.
• Normalize the balance of microflora.
• Restore bowel function.
• Carry out the correction of the immune status.

To correctly prescribe treatment, the doctor must determine which microflora prevails in the intestine, and which beneficial bacteria are in short supply in order to replenish them. That is, the treatment regimen for each patient is individual.

Medicines

Stage 1 of treatment - cleansing the intestines from pathogenic microflora. For this purpose, different groups of antibiotics (tetracyclines, cephalosporins, penicillins, etc.), antifungal agents are prescribed. Broad-spectrum antibiotics are used in case of severe intestinal malabsorption due to an excess of pathogenic bacteria, and in infections of the gastrointestinal tract. Mild cases can be treated with antimicrobials that act on bacteria in the intestinal lumen (furazolidone). The course of treatment averages 7-10 days.

Kill pathogenic flora, practically without affecting the main, intestinal antiseptics:

• Nifuroxazide;
• Intetrix;
• Enterofuril.

To cleanse the intestines of toxins accumulated after taking antibiotics, sorbents are prescribed. These remedies are also effective for diarrhea:

• Sorbex;
• Atoxil;
• Polysorb.

It is possible to improve the absorption of nutrients and the breakdown of food with the help of enzymes, choleretic drugs, and hepatoprotectors:

• Pancreatin;
• Festal;
• Hofitol;
• Gnpabene;
• Karsil etc.

The most important stage in the treatment of dysbacteriosis is the restoration of normal microflora. For this, the reception of such groups is shown. medicines:

Folk remedies

In addition to the drugs prescribed by the gastroenterologist, you can use funds traditional medicine.

• Eat 1 clove of garlic twice a day (in the morning on an empty stomach and 2 hours after dinner) for 2 weeks. Drink water or kefir. Garlic - natural antiseptic, which suppresses putrefactive processes in the intestines.
• Drink 15 drops of propolis tincture three times a day before meals. Pre-diluted with water. The course of treatment is 4-6 weeks.
• To restore the intestinal mucosa, it is useful to take a decoction of flax seeds or oats. They have an enveloping effect.
• With diarrhea, take decoctions of oak bark, pomegranate skins. They have an astringent effect.

Medicinal herbs

• Prepare a collection of herbs, (2 parts each), (1 part), (3 parts), (5 parts). Pour 1 tablespoon of the mixture with ½ liter of boiling water and simmer in a water bath for half an hour. Drink ½ cup before meals three times a day.
• Decoctions of the hay, juice have a laxative effect. These drugs are contraindicated for hemorrhoids and rectal fissures.
• To facilitate the discharge of gases and eliminate constipation, you can use a decoction, anise or.
• A decoction has an anti-inflammatory effect, (1 spoonful of raw materials per 200 ml of water).

It is impossible to cure dysbacteriosis without nutrition correction. From the 1st day of treatment, you must adhere to the rules of the therapeutic diet:

• Avoid fasting, eat every 3 hours in small portions.
• Remove fried and spicy foods from your diet.
• Exclude food that enhances fermentation processes: cabbage, sour fruits, fresh bread, pastries.
• Do not drink water while eating. You can drink food half an hour after eating it.
• Include plenty of protein foods on the menu. The meat should be lean, not fried.
• Refrain from alcoholic beverages.
• Increase the intake of fiber, which is abundant in fresh vegetables and fruits, cereals. It is useful to use sprouted grains of wheat.
• Include in the diet fresh fermented milk products containing beneficial microflora (kefir, yogurt, narine).
• Do not use products with preservatives, flavor enhancers and other chemical additives.

Prevention

Proper nutrition is the best way to prevent intestinal dysbiosis. Therefore, you need to give up harmful products, which irritate the mucous membrane, cause stagnant and putrefactive processes in the gastrointestinal tract. Do not get involved in strict diets. Refusal of many products leads to an imbalance of microflora, nutritional deficiencies and reduced immunity.

It is very important to take care of your general health. You can not self-medicate and take any medication uncontrollably. It is necessary to timely identify and treat chronic foci of inflammation that violate microbiocinosis. Compliance with the rules and norms of hygiene helps to prevent intestinal infections. Therefore, before eating, be sure to thoroughly wash your hands, vegetables, fruits.

The state of dysbacteriosis in a particular area of ​​the body is familiar to almost everyone. However, not every person is well aware of what dysbacteriosis is. Under this concept, modern medicine most often understands not a specific disease, but a consequence of some third-party factor, including a disease, as a result of which the balance of microorganisms in the intestine is disturbed.

Description

A certain set of groups of bacteria is present throughout the human body. By the way, these are not always harmful bacteria. At the same time, for each specific place, whether it be the oral cavity, intestines, throat or vagina, this set of microorganisms is different. Moreover, for each person, these combinations are often individual. Doctors call this optimal set of bacteria eubiosis, less often intestinal biocenosis, and a violation of its composition, quantity or properties - dysbacteriosis. We will understand a specific form of dysbacteriosis - a violation of the composition of the intestinal microflora, leading to a decrease in the number of beneficial bacteria that live on the intestinal walls.

Dysbacteriosis is a condition or disease (the discussion about the appropriateness of the latter term in this case has not been closed so far), which manifests itself with a fairly standard list of symptoms, depending on the complexity of the course. At the same time, the causes of this pathology of the gastrointestinal tract can radically differ from each other in various cases. Unfortunately, people are far from always well aware of intestinal dysbacteriosis, symptoms, and treatment of this disease in adults.

Causes of dysbacteriosis

Banal change of diet, change chemical composition water intake, climate change, stress, diet can lead to changes in the number of pathogenic microbes and manifestations of an imbalance in the intestinal flora. More serious conditions can also lead to this: food poisoning, indigestion due to dietary errors, the use of antibiotics or illness. intestinal tract. And the main thing in all this is that in order to get rid of the clinical symptoms of a violation of the microflora in the intestine, first of all, you need to get rid of the prerequisites for the occurrence of such a condition.

Dysbacteriosis, symptoms

Signs of intestinal dysbacteriosis are quite diverse and largely depend on the stage at which the development of the disease is. Dysbacteriosis of the large intestine is divided into four stages according to the complexity of microflora changes. Symptoms in adults for each stage have their own characteristics. Consider them for clarity in the form of a table:

Classification of dysbacteriosis according to the content of microorganisms in feces

In addition, there is another classification of the complexity of the disease, based not on the symptoms of the development of dysbacteriosis, but on the indications of laboratory studies of feces in violation of the microflora. For adults, it is divided into two groups. For clarity, we present it also in the form of a table:

Visual analysis of feces in violation of the intestinal microflora

Also, with dysbacteriosis, serious attention is paid to the nature of the pathology of the intestinal tract, which is quite simply determined by the type and color of feces, as well as by the state of the stool.

Stools with a yellowish tint indicate a large amount of undigested fiber in the feces and excess starch. Treatment of this condition must be carried out by changing the diet. Protein food (boiled meat, eggs, cottage cheese) is recommended, which should be replaced with raw vegetables, carbohydrates and milk.

Highly dark stool with strong stench shows the presence of an alkaline reaction in the intestines, as well as undigested fibrous food. In this case, meat and fats should be excluded from the diet, replacing calorie intake with boiled vegetables and sour-milk products.

Intestinal dysbacteriosis, which is accompanied by diarrhea, must be eliminated by a diet based on "soft" food. Dishes in the diet should not be either hot or cold; food, if possible, should be boiled and mashed.

Sometimes violation intestinal flora manifested by constipation. With a similar variant of bowel disease, treatment involves the inclusion in the diet of foods with a lot of fiber: apples, cabbage, carrots, apricots. Such a diet should lead to an increase in the content of beneficial flora in the intestines.

Treatment of intestinal dysbiosis in adults

If there are signs clearly indicating a violation of the balance of microflora, it is recommended to consult a doctor. Only a qualified specialist knows everything about intestinal dysbacteriosis, symptoms, treatment of this disease in adults.

Treatment of dysbacteriosis in adults primarily involves the elimination of the causes of its occurrence. This means that it is unreasonable to treat one dysbacteriosis, it is necessary to treat the disease that led to it. If the cause of the condition was the intake of antibacterial drugs, it is necessary to complete the course of antibiotic therapy, and if the diet is wrong, return to the original state of your diet. But in most cases, treatment is also required to relieve the symptoms characteristic of violations of the composition of the microflora, and to restore it. For these purposes, modern medicine recommends three types of treatment:

• diet,
• probiotic therapy,
• prebiotic therapy.

Diet for dysbacteriosis

Treatment of imbalances in the intestinal microflora, especially on initial stages, primarily implies a special diet. In most cases, it is able to completely eliminate the problem. Above, we have already considered options for changing the diet to normalize the stool, but now we will consider a number of other nutritional rules for this condition.

The diet should be as balanced as possible. It should contain sufficient amounts of proteins, fats and carbohydrates, as well as liquid. Doctors recommend drinking a glass half an hour before meals warm water. In addition, the diet should include five meals, albeit with smaller portions, as well as reducing the load on the intestines before bedtime.

It is important that the following substances are present in the products used:

• bifido- and lactobacilli, which are saturated with fermented milk products and natural butter;
• pectins and dietary fiber contained in sufficient quantities in cabbage, carrots, beets and seaweed;
• amino acids glutamine and arginine, the sources of which are chicken, beef, dairy products, fish, parsley, spinach, nuts, pumpkin seeds, wheat flour, peas.

Analyzing the above list of products, we can conclude that a diet for a disease is not a list of restrictions at all, but a tasty, healthy and balanced diet. The main thing is not to overeat, not to abuse “heavy” foods, and also to avoid eating fried, spicy and other, not the most healthy dishes during this period.

Treatment of intestinal dysbacteriosis in adults, prebiotics and probiotics

For the treatment of dysbacteriosis, prebiotic and probiotic preparations are used, which, according to assurances, do an excellent job of restoring the disturbed microflora of the intestinal tract and relieve the symptoms inherent in dysbacteriosis. Despite the similarity of names, at their core, prebiotics and probiotics are radically different drugs, and it is worth understanding what they are in more detail.

Prebiotics are substances that, when they enter the intestines, have a positive effect on the growth and activity of the beneficial microflora present there. Prebiotics are not absorbed by the organs of the gastrointestinal tract and, to put it bluntly, plain language, are food for our beneficial microflora.

Among the pharmaceutical forms of prebiotics, Lactulose, Laktitol, Hilak Forte are most often prescribed. These are only the main names of drugs, since there are dozens of their commercial names.

In addition to this, there are natural products which are prebiotics. Among them are dairy products, onions and garlic, cereals.

Now about probiotics. These drugs are a set necessary for the body human microorganisms, which, when they enter the intestine in sufficient quantities, have a positive effect on the state of the microflora. However, their use is a rather controversial issue.

The fact is that the direct introduction of microorganisms in the form of probiotics has many conventions. Some microorganisms are needed in such quantities that it is difficult to obtain them from the outside, while others are simply unrealistic to introduce in a living form. And there is not so much laboratory evidence of a real benefit from the use of probiotics.

Of the probiotics, the positive effect of which has been confirmed by studies and which are effective for symptoms of moderate dysbacteriosis, in pharmacies you can find lactobacilli and bifidobacteria (Linex, Bifiform, Bifidumbacterin, Lactobacterin), Saccharomycetes Boulardii, enterococci.

Treatment of severe dysbacteriosis

How to treat dysbacteriosis in severe forms? This requires more complex pharmaceuticals, which are divided into three conditional groups.

The first of them is antibacterial agents. They act on a certain type of conditionally pathogenic flora, stopping its growth and spread. Antibacterial drugs (intestinal antiseptics) are prescribed depending on the microorganism that caused the violation of the microflora.

It is also possible to treat dysbacteriosis with the help of bacteriophages. The principle of their action is similar to the principle of action of antibiotics. Bacteriophages are special viruses that suppress certain kind microorganisms. Like antibacterial drugs, bacteriophages are divided into groups according to the type of bacteria: Pseudomonas aeruginosa, staphylococcus, and so on.

And finally, you need to consider pharmaceutical drugs that are additionally prescribed and that eliminate the symptoms of the disease and its possible consequences.

Immunomodulators are means to improve the protective properties of the body, the intake of which, in case of violation of the intestinal microflora, has a positive effect on the process of its recovery. The use of immunomodulators should take place exclusively as directed by a doctor, and preference should be given to plant-based products: tinctures of echinacea and magnolia vine, Propolis, Dibazol.

Antihistamines. They are used to avoid the occurrence of allergic reactions that can develop against the background of the disease. The simplest of them are Cetrin, Zirtek and Claritin, which are prescribed in most cases.

Antispasmodics are drugs, the use of which is often necessary for dysbacteriosis in the event that diarrhea is observed. The most popular antispasmodic is drotaverine (No-Shpa), and Loperamide is recommended specifically for diarrhea. If constipation is observed, then special candles, liquid paraffin, Forlax are used to eliminate them.

Prevention of dysbacteriosis

Bacteria are quite tenacious creatures, and it is not so easy to bring the body to such a state that beneficial microorganisms will not settle in it (in the absence of any other diseases). To avoid disease, you just need to observe healthy lifestyle life and stick to the right balanced diet, do not abuse the "cleansing" of the body and gastrointestinal tract. Also, do not get carried away with antibacterial drugs. This type of treatment should only be carried out if antibiotics are prescribed by a doctor.

Dysbacteriosis in modern medicine

We have already noted at the beginning that dysbacteriosis as a separate disease is classified only on the territory of the former Soviet Union. Western medicine designates it solely as a condition provoked by certain prerequisites.

Discussions about the correctness of one or another designation for ordinary people are unlikely to make sense, but nevertheless we will indicate a number of interesting facts.

In the International Classification of Diseases (an official document of the World Health Organization), the diagnosis of "dysbacteriosis" does not exist. The most similar diagnosis to it is SIBO (excessive bacterial growth syndrome). It is set when more than 105 microorganisms are detected in a milliliter of aspirate taken from the small intestine.

Western medicine is quite skeptical about the analysis of feces to study the composition of the microflora. According to doctors, such a study does not allow drawing any conclusions, since the concept of “normal flora” is very vague and purely individual for each person.

In the territory former USSR, however, such a thing as intestinal dysbacteriosis is very popular. Symptoms, treatment of this disease - all this is popular topic for discussion, both among specialists and among patients. However, do not forget that this term is very actively distributed by drug manufacturers. Whether this is justified, or whether only commercial benefits are hidden under this promotion, it is difficult to judge.

Many doctors are very skeptical about the treatment of microflora disorders with the help of probiotics and bacteriophages. In their opinion, microorganisms obtained from outside have practically no chance to take root in the intestines, and bacteriophages are digested in the stomach and do not bring any benefit attributed to them.

So the only true conclusion about dysbacteriosis is the most controversial disease in modern medicine. But the symptoms, like the causes, are quite specific. There is no doubt that it is necessary to deal with its treatment, and modern methods of therapy make it possible to do this with high efficiency.

Intestinal dysbacteriosis is one of the "mysterious" pathologies. Doctors say that such a disease simply does not exist. Dysbacteriosis is not a diagnosis, but a symptom complex. But at the same time, doctors confirm that a variety of hazards, antibiotics can seriously disrupt the balance of flora in the intestines. And this is the source of formation secondary immunodeficiency. To avoid these dangerous consequences, it is more logical and easier to treat and prevent intestinal dysbiosis in a timely manner.

Characteristics of the pathology

Before determining the methods of dealing with an unpleasant condition, it is necessary to understand what “mysterious” phenomenon is hidden under the concept of intestinal dysbacteriosis (or dysbiosis).

To do this, turn to anatomy. The intestines of a healthy person are inhabited by certain bacteria - such microorganisms are normal microflora. They perform many useful functions, one of which is the support of local immunity.

As a result of some factors (taking antibiotics, malnutrition, etc.), microflora is disturbed, and immune defense is seriously reduced. As a result, pathogenic microorganisms begin to colonize the intestines. This starts the process of putrefaction in the digestive system.

Violation of the composition of the intestinal microflora (quantitative and / or qualitative) is called dysbacteriosis. You can suspect the development of pathology by the following symptoms:

• violation of the stool (patients suffer from a constant alternation of diarrhea and constipation);
• putrid smell of feces;
• increased gas formation;
• signs of decay: rumbling, bloating, belching, colic, nausea, feeling of heaviness, heartburn;
• bad breath;
• weakness, allergies;
• signs of anemia: insomnia, fatigue, irritability, drowsiness, memory impairment, pallor of the integument, brittle hair and nails, shortness of breath, discomfort in the heart.

Types of disease

Intestinal dysbiosis is always a secondary pathology that can develop against the background of external or internal environmental factors affecting the body. So, classifying dysbacteriosis according to the reasons for its occurrence, the following types of pathology are distinguished:

1. Drug. The development of dysbiosis is dictated by the use of antibiotics.
2. Non-infectious. The basis of an unpleasant phenomenon may be functional disorders of the biliary apparatus, gastrointestinal tract (GIT). Pathologies of enzyme synthesis can lead to dysbacteriosis. Sometimes the source is an allergy to the intestinal mucosa.
3. Infectious. A variety of microorganisms lead to the development of dysbacteriosis. According to the type of pathogen, the following types are distinguished:
   • fungal - Candida fungi provoke dysbacteriosis, pathology is usually accompanied by thrush, staining of the tongue in a crimson hue, the presence of a jam;
   • proteic - dictated by the growth of opportunistic microflora (proteic microorganisms), is characterized by easy flow, usually does not go beyond the intestines;
   • staphylococcal - has a severe course, characterized by a gradual spread to all body systems;
   • associative - the most severe form of pathology, it is characterized by intestinal damage by staphylococcus aureus in combination with other microbes.

Treatment regimen for dysbiosis

Dysbacteriosis is not classified as a separate disease. Therefore, it is necessary to look for the cause that launched the mechanism of microflora disturbance. Sometimes dysbiosis can hide such ailments as irritable bowel syndrome, helminthic infestations, intestinal infections, and celiac disease. Only by determining the source of the pathology, the doctor will be able to outline a treatment regimen.

Which doctor should I contact?

Most often, ailments that provoke the development of dysbacteriosis are dealt with by a gastroenterologist or an infectious disease specialist.

Treatment of intestinal dysbiosis in adult patients may begin with seeking help from a therapist.

Duration of drug therapy

How long does it take to treat dysbacteriosis? Unfortunately, this pathology implies a rather long-term therapy.

Treatment consists of several stages:

1. Removal of pathogenic microflora. At this stage, antibiotics, antiseptics and sorbents are prescribed. This treatment takes 7-10 days.
2. Intestinal colonization with normal flora. Therapy includes symbiotics, prebiotics, probiotics. In adult patients, this stage will take 2-3 weeks.
3. Feeding and support of normal microflora. To normalize the functioning of the intestines, laxatives may be prescribed (for a tendency to constipation) or antidiarrheal medicines (for a predisposition to diarrhea). Such treatment can be delayed for 10-20 days.

Thus, the therapy of dysbacteriosis can be 1-2 months. But this only applies to medications. If we talk about dieting (and this is one of the most important areas in the fight against dysbiosis), then stick to proper diet it takes about half a year.

The scheme of drug treatment

Medicines can be prescribed only by a specialist, after diagnosing the patient. Therapy most often includes such groups of medicines:

1. Antibiotics. Treatment with these drugs is justified with an advanced degree of dysbacteriosis, when it becomes necessary to destroy the pathogenic flora. Antibiotics are prescribed depending on the bacteria found in the fecal analysis. The following medications are usually recommended: Doxycycline, Cefuroxime, Erythromycin, Ceftriaxone, Ampiox, Levomycetin, Metronidazole, Furazolidone.
2. Bacteriophages. These drugs have an antibacterial effect. But, unlike the above group, they affect microorganisms selectively. For example, a staphylococcal bacteriophage is capable of destroying only staphylococcus aureus. Such preparations for the body are completely non-toxic. But they are appointed only according to the results of the analyzes received. Depending on the pathogen, the following bacteriophages can be recommended: staphylococcal, proteus, streptococcal, Pseudomonas aeruginosa, coliproteus.
3. Enterosorbents. This group of drugs is prescribed to cleanse the intestines of toxins and poisons. Enterosorbents are able to absorb all harmful substances and remove them from the gastrointestinal tract in a natural way (during defecation). For such purposes, the following medicines are recommended to patients: Activated carbon, Polysorb, Enterosgel, Smecta, Lignin.
4. Enzymes. Medicines are prescribed to eliminate the symptoms of digestive disorders. Therapy may include: Mezim, Creon, Pancreatitis, Festal, Polysim, Digestal.
5. Antifungal medicines. If yeast-like fungi are found in the tests, then the patient is prescribed: Levorin, Pimafucin, Ketokenazole, Nystatin, Fungizone, Fluconazole, Datakrin, Nicostatin.
6. Probiotics. The composition of these medicines includes living microorganisms (these are bacteria that inhabit the normal microflora). Such funds are intended for the treatment of progressive dysbacteriosis. The doctor may prescribe the following probiotics: Bifidumbacterin, Enterol, Baktisubtil, Bifidumbacterin forte, Flonivin, Bifikol, Linex, Biosorb-Bifidum.
7. Prebiotics. These are medicines that ensure the growth and reproduction of microorganisms that make up the normal flora. Effective prebiotics are: Hilak-forte, Normaza, Lactusan, Dufalac.
8. Symbiotics. This group of drugs has a complex effect. They contain both a probiotic and a prebiotic. Thus, medicines are able to saturate the intestines with beneficial bacteria and ensure their reproduction. These tasks are effectively handled by: Bifidobak, Maltodofilus.
9. Spasmolytics. With pronounced discomfort, which is spastic in nature, the patient is recommended: No-Shpa, Duspatalin.
10. Vitamins. Since dysbacteriosis is characterized by the development of hypovitaminosis, doctors must prescribe special drugs that restore all the necessary components in the body. Most often, the choice is multivitamin complexes: Decamivit, Duovit, Multitabs.
11. Drugs that normalize peristalsis. To restore the motor function of the intestine, in the presence of flatulence, constipation, diarrhea, it is usually recommended to take such drugs: Meteospasmil, Duspatalin.
12. Preparations for strengthening the immune system. Pathology is characterized by a decrease in local protection. Therefore, it is necessary to strengthen the immune system. Most often, patients are prescribed herbal remedies: tincture of propolis, magnolia vine, ginger tea.

Modern drugs for the treatment of dysbacteriosis - photo

Metronidazole eliminates pathogenic bacteria in the intestine Streptococcal bacteriophage is useful only in the fight against streptococci Polysorb cleanses the intestines from poisons, toxins Mezim improves digestion Fluconazole is effective for fungal infection Linex populates the intestines beneficial microorganisms
Hilak-forte provides reproduction of beneficial microflora No-Shpa relieves spasmodic pain Duovit protects against hypovitaminosis Meteospasmil normalizes intestinal motility

Diet Therapy

One of the most important areas in the treatment of dysbacteriosis is proper nutrition. At the same time, the diet does not at all imply severe restrictions or starvation. On the contrary, the diet should contain meals enriched with proteins, carbohydrates, vitamins, minerals, fats.

Basic principles

The diet for dysbacteriosis is based on the following rules:

• to ensure the active growth of beneficial flora, it is necessary to consume fermented milk products and foods containing vegetable fiber;
• Patients are advised to drink plenty of water. It is useful both in case of diarrhea (it compensates for the loss of fluid) and constipation (it softens the accumulation stool);
• food should not irritate the intestines. Sparing (thermally, chemically and mechanically) dishes are recommended. It is necessary to refuse to take salty, pickled foods, smoked meats. Fatty, fried foods are excluded. Taboo is imposed on too cold or hot food;
• alcohol intake should be excluded;
• food should be chewed thoroughly;
• dry food is excluded. It seriously "loads" the digestive tract;
• it is recommended to eat often. The interval between meals should be 2-2.5 hours.

Allowed products for dysbacteriosis and prohibited - table

Photo gallery: healthy dishes that help fight dysbacteriosis in adults

The diet should include dietary meat (for example, rabbit) All cereals are useful, except semolina All dairy products are good except for milk. It is allowed to eat soft-boiled eggs Pumpkin must be included in the diet Preference is given to vegetable oils

Approximate menu

The diet for a patient suffering from dysbacteriosis is selected purely individually. The doctor takes into account many factors: the causes of violations of the flora, the characteristics of the body, the age of the patient, the characteristic symptoms.

Therefore, the menu below is not a guide to action. It allows you to get acquainted with the recommended diet.

Sample set menu - table

Folk remedies

Alternative medicine has many recipes that can come to the rescue of patients suffering from dysbacteriosis. Doctors usually do not interfere with the treatment of folk remedies. But only if the patient combines medicine recipes with doctor's orders.

Folk remedies are not able to cure dysbacteriosis. After all, they perfectly relieve the symptoms, but do not eliminate the cause of the disease. Non-traditional remedies can only be an addition to drug and dietary therapy.

Garlic treatment

1. Before eating, 1 hour before, you need to eat garlic (1 clove). The product is washed down with yogurt.
2. Before going to bed, 2 hours before rest, it is recommended to consume 2-3 slices. Garlic is also washed down with curdled milk.

This treatment is designed for 2-3 days.

Potentilla therapy

Medicine preparation:

1. Dry herb cinquefoil (1 tablespoon) is poured with boiling water (200 ml).
2. The composition is boiled over low heat for about 15 minutes.
3. The mixture should be infused for 6-8 hours. It is convenient to prepare a decoction in the evening - it will infuse overnight, and in the morning the remedy can be consumed.

Take the medicine for 1/3 cup, 20 minutes before meals, three times a day. It is necessary to treat with cinquefoil for 3-5 days.

Already after the first intake of the decoction, patients notice a significant improvement.

Can dysbacteriosis be treated with enemas?

With dysbacteriosis, it is important to cleanse the intestines of toxic components that are produced by pathogenic bacteria. However, this event must be approached very responsibly.

It is strictly forbidden to put enemas without the permission of a doctor! These procedures can not only benefit, but also seriously harm the body, further disrupting the microflora or aggravating ulcerative lesions.

Well help to cope with dysbacteriosis such solutions used for enema:

1. Chamomile infusion. pharmacy grass(in accordance with the scheme given on the package) diluted with boiling water (1-2 l). The mixture is infused for 15 minutes. Then it is well filtered.
2. Soda solution. This remedy is strictly contraindicated in people with ulcerative lesions GIT. To prepare the solution, it is necessary to dissolve baking soda (50 g) in water (1 l). The mixture is heated to a temperature of 40°C.
Garlic helps restore intestinal microflora With dysbacteriosis, a decoction of Potentilla is useful
Chamomile is used for many infusions and decoctions for dysbacteriosis
Soda is used for setting enemas
Peppermint is used for many pathologies.

Features of therapy during pregnancy

The appearance of dysbacteriosis future mother- extremely unpleasant phenomenon. This condition adversely affects not only the health of the woman herself, but also provides intoxication of the fetus. In addition, severe diarrhea can tone the uterus and provoke premature delivery.

Self-treatment of dysbacteriosis for pregnant women is not only prohibited, but also very dangerous! Only a doctor can prescribe medication (especially if there is a need to take antibiotics).

Expectant mothers are allowed to be treated with preparations containing representatives of beneficial flora: Linex, Lactobacterin, Bifidumbacterin.

Prevention measures

Is it possible to protect the intestines from the reproduction of pathogenic microorganisms?

Doctors say that the following rules help to avoid the development of dysbacteriosis:

• the correct use of antibiotics. Such medicines can only be used as directed by a doctor. If there is a need for long-term treatment, the doctor will definitely include prebiotics in therapy. It should be remembered that it is the uncontrolled use of antibiotics that most often leads to the development of dysbacteriosis;
• balanced diet. To protect the intestines from violations, it is necessary to adhere to a healthy diet;
• people whose activities are directly related to hazards (for example, radiation) should introduce fermented milk products into their diet;
• timely treatment of diseases. Chronic and acute ailments (mainly pathologies of the gastrointestinal tract), which can become a source of dysbacteriosis, must be treated;
• rejection of harm. It is necessary to exclude the abuse of alcohol and addiction to tobacco. Such habits significantly reduce immune defenses.

Intestinal dysbacteriosis: complete educational program - video

People who are faced with dysbacteriosis know how unpleasant and painful this pathology is. It disrupts the rhythm of life, causes serious discomfort, and with its symptoms can bring to complete exhaustion. Therefore, treatment should be started at the first negative manifestations of dysbiosis, leaving it no chance to worsen the quality of life!

The human intestine contains over 500 different types of microbes, the total number of which reaches 10 14, which is an order of magnitude higher than the total number of cellular composition. human body. The number of microorganisms increases in the distal direction, and in the colon, 1 g of feces contains 10 11 bacteria, which is 30% of the dry residue of the intestinal contents.

Normal microbial flora of the intestine

In the jejunum of healthy people there are up to 10 5 bacteria in 1 ml of intestinal contents. The bulk of these bacteria are streptococci, staphylococci, lactic acid bacilli, and other gram-positive aerobic bacteria and mushrooms. In the distal ileum the number of microbes increases to 10 7 -10 8 , primarily due to enterococci, Escherichia coli, bacteroids and anaerobic bacteria. Recently, we found that the concentration of the parietal microflora of the jejunum is 6 orders of magnitude higher than in its cavity, and is 10 11 cells/ml. About 50% of the biomass of the parietal microflora are actinomycetes, approximately 25% are aerobic cocci (staphylococci, streptococci, enterococci and coryneform bacteria), from 20 to 30% are bifidobacteria and lactobacilli.

The number of anaerobes (petostreptococci, bacteroids, clostridia, propionobacteria) is about 10% in the small intestine and up to 20% in the large intestine. Enterobacteria account for 1% of the total microflora of the mucous membrane.

Up to 90-95% of microbes in the colon are anaerobes (bifidobacteria and bacteroids), and only 5-10% of all bacteria are strict aerobic and facultative flora (lactic and coli, enterococci, staphylococci, fungi, proteus).

Escherichia coli, enterococci, bifidobacteria and acidophilus bacilli have pronounced antagonistic properties. In the conditions of a normally functioning intestine, they are able to suppress the growth of microorganisms unusual for the normal microflora.

Square inner surface intestine is about 200 m 2 . It is reliably protected from penetration of food antigens, microbes and viruses. Important role The body's immune system plays a role in organizing this defense. About 85% of human lymphatic tissue is concentrated in the intestinal wall, where secretory IgA is produced. The intestinal microflora stimulates the immune defense. Intestinal antigens and toxins of intestinal microbes significantly increase the secretion of IgA into the intestinal lumen.

The breakdown of undigested nutrients in the large intestine is carried out by bacterial enzymes, and a variety of amines, phenols, organic acids and other compounds are formed. Toxic products of microbial metabolism (cadaverine, histamine and other amines) are excreted in the urine and normally do not affect the body. When microbes utilize indigestible carbohydrates (fiber), short-chain fatty acids are formed. They provide the cells of the intestine with energy carriers and, consequently, improve the trophism of the mucous membrane. With fiber deficiency, the permeability of the intestinal barrier may be impaired due to a deficiency of short-chain fatty acids. As a result, intestinal microbes can enter the bloodstream.

Under the influence of microbial enzymes in the distal ileum, bile acids are deconjugated and primary bile acids are converted into secondary ones. Under physiological conditions, from 80 to 95% of bile acids are reabsorbed, the rest are excreted in the faeces as bacterial metabolites. The latter contribute to the normal formation of fecal masses: they inhibit the absorption of water and thereby prevent excessive dehydration of feces.

Dysbacteriosis

The concept of intestinal dysbacteriosis includes excessive microbial contamination of the small intestine and a change in the microbial composition of the colon. Violation of microbiocenosis occurs to one degree or another in most patients with pathology of the intestines and other digestive organs. Therefore, dysbacteriosis is a bacteriological concept. It can be considered as one of the manifestations or complication of the disease, but not an independent nosological form.

The extreme degree of intestinal dysbacteriosis is the appearance of bacteria of the gastrointestinal tract in the blood (bacteremia) or even the development of sepsis.

The composition of the intestinal microflora is disturbed in diseases of the intestines and other digestive organs, treatment with antibiotics and immunosuppressants, exposure to harmful factors external environment.

Clinical manifestations of dysbacteriosis depend on the localization of dysbiotic changes.

Dysbacteriosis of the small intestine

With dysbacteriosis of the small intestine, the number of some microbes in the mucous membrane of the small intestine is increased, while others are reduced. There is an increase Eubacterium(30 times), α-streptococci (25 times), enterococci (10 times), candida (15 times), the appearance of bacteria of the genus Acinetobacter and herpes viruses. The number of most anaerobes, actinomycetes, Klebsiella and other microorganisms that are natural inhabitants of the intestine decreases from 2 to 30 times.

The cause of dysbacteriosis can be: a) excessive entry of microorganisms into the small intestine with achilia and dysfunction of the ileocecal valve; b) favorable conditions for the development of pathological microorganisms in cases of violation intestinal digestion and absorption, the development of immunodeficiency and disorders of intestinal patency.

Increased microbial proliferation in the small intestine leads to premature deconjugation of bile acids and their loss in the feces. An excess of bile acids increases colonic motility and causes diarrhea and steatorrhea, while a deficiency of bile acids leads to malabsorption fat soluble vitamins and development of gallstone disease.

Bacterial toxins and metabolites such as phenols and biogenic amines can bind vitamin B12.

Some microorganisms have a cytotoxic effect and damage the epithelium of the small intestine. This leads to a decrease in the height of the villi and a deepening of the crypts. Electron microscopy reveals degeneration of microvilli, mitochondria, and endoplasmic reticulum.

Colon dysbacteriosis

The composition of the microflora of the colon can change under the influence of various factors and adverse effects that weaken defense mechanisms organism (extreme climatic and geographical conditions, pollution of the biosphere by industrial waste and various chemicals, infectious diseases, diseases of the digestive system, malnutrition, ionizing radiation).

In the development of colon dysbacteriosis, iatrogenic factors play an important role: the use of antibiotics and sulfonamides, immunosuppressants, steroid hormones, radiotherapy, and surgical interventions. Antibacterial drugs significantly suppress not only the pathogenic microbial flora, but also the growth of normal microflora in the colon. As a result, microbes that have entered from the outside, or endogenous species resistant to drugs (staphylococci, proteus, yeast fungi, enterococci, Pseudomonas aeruginosa) multiply.

Clinical features of dysbacteriosis

Clinical manifestations of excessive growth of microorganisms in the small intestine may be completely absent, act as one of the pathogenetic factors of chronic recurrent diarrhea, and in some diseases, for example, diverticulosis of the small intestine, partial intestinal obstruction, or after surgical operations on the stomach and intestines, leading to severe diarrhea, steatorrhea and B 12 deficiency anemia.

Features clinical course disease in patients with various options dysbacteriosis of the colon, according to bacteriological analyzes of feces, in most cases cannot be established. It can be noted that patients chronic diseases intestines are more likely to become infected with acute intestinal infections compared to healthy ones. This is probably due to a decrease in their antagonistic properties of the normal intestinal microflora and, above all, the frequent absence of bifidobacteria.

Pseudomembranous colitis, which develops in some patients who have been treated with broad-spectrum antibiotics for a long time, is especially dangerous. This severe variant of dysbacteriosis is caused by toxins secreted by Pseudomonas aeruginosa. Clostridium difficile, which multiplies in the intestines when the normal microbial flora is inhibited.

The main symptom of pseudomembranous colitis is profuse watery diarrhea, the onset of which was preceded by antibiotics. Then there are cramping pains in the abdomen, body temperature rises, leukocytosis increases in the blood. The endoscopic picture of pseudomembranous colitis is characterized by the presence of plaque-like, ribbon-like and continuous "membranes", soft, but tightly soldered to the mucous membrane. Changes are most pronounced in the distal colon and rectum. The mucous membrane is edematous, but not ulcerated. Histological examination reveals subepithelial edema with round cell infiltration of the lamina propria, capillary stasis with the release of erythrocytes outside the vessels. At the stage of formation of pseudomembranes, exudative infiltrates appear under the surface epithelium of the mucous membrane. The epithelial layer rises and is absent in places; bare places of the mucous membrane are covered only with desquamated epithelium. On the late stages disease, these areas can occupy large segments of the intestine.

Very rarely, a fulminant course of pseudomembranous colitis, resembling cholera, is observed. Dehydration develops within a few hours and is fatal.

Thus, the assessment of the clinical significance of dysbiotic changes should be based primarily on clinical manifestations, and not only on the results of a study of the stool microflora.

Diagnostic methods

Diagnosis of dysbacteriosis is a complex and time-consuming task. For the diagnosis of dysbacteriosis of the small intestine, sowing of the juice of the small intestine obtained with a sterile probe is used. Colon dysbacteriosis is detected using bacteriological studies of feces.

The microbial flora produces a large amount of gases, including hydrogen. This phenomenon is used to diagnose dysbacteriosis. The concentration of hydrogen in the exhaled air on an empty stomach is directly dependent on the severity of bacterial contamination of the small intestine. In patients with bowel diseases occurring with chronic recurrent diarrhea and bacterial contamination of the small intestine, the concentration of hydrogen in the exhaled air significantly exceeds 15 ppm.

For the diagnosis of dysbacteriosis, a load of lactulose is also used. Normally, lactulose is not broken down in the small intestine and is metabolized by the microbial flora of the large intestine. As a result, the amount of hydrogen in the exhaled air increases (Fig. 1).

The most common bacteriological signs of colon dysbacteriosis are the absence of the main bacterial symbionts - bifidobacteria and a decrease in the number of lactic acid bacilli. The number of Escherichia coli, enterococci, clostridia, staphylococci, yeast-like fungi and Proteus is increasing. Pathological forms appear in some bacterial symbionts. These include hemolyzing flora, Escherichia coli with mild enzymatic properties, enteropathogenic Escherichia coli, etc.

An in-depth study of microbiocenosis showed that traditional methods do not provide true information about the state of the intestinal microflora. Of the 500 known species of microbes, only 10-20 microorganisms are usually studied for diagnostic purposes. It is important in which department - in the jejunum, ileum or large intestine - the microbial composition is studied. Therefore, the prospects for the development of clinical problems of dysbacteriosis are currently associated with the use of chemical methods for the differentiation of microorganisms, which make it possible to obtain universal information about the state of microbiocenosis. The most widely used for these purposes are gas chromatography (GC) and gas chromatography in combination with mass spectrometry (GC-MS). This method provides unique information on the composition of the monomeric chemical components of the microbial cell and metabolites. Markers of this kind can be identified and used for the detection of microorganisms. The main advantage and fundamental difference of this method from bacteriological ones is the possibility of quantitative determination of more than 170 taxa of clinically significant microorganisms in various body media. In this case, the results of the study can be obtained within a few hours.

Our studies of microbiocenosis in the blood and biopsies of the mucous membrane of the small and large intestines in patients with irritable bowel syndrome made it possible to detect deviations from the norm up to a 30-fold increase or decrease in many components. It is possible to assess changes in the intestinal microflora based on blood test data using the GC-MS-microbial markers method.

Treatment

Treatment of dysbacteriosis should be complex (scheme) and include the following activities:

• elimination of excess bacterial contamination of the small intestine;
• restoration of the normal microbial flora of the colon;
• improving intestinal digestion and absorption;
• restoration of impaired intestinal motility;
• stimulation of the reactivity of the body.

Antibacterial drugs

Antibacterial drugs are needed primarily to suppress the overgrowth of microbial flora in the small intestine. The most widely used antibiotics are from the group of tetracyclines, penicillins, cephalosporins, quinolones (tarivid, nitroxoline) and metronidazole.

However, broad-spectrum antibiotics significantly impair eubiosis in the colon. Therefore, they should be used only in diseases accompanied by disorders of absorption and intestinal motility, in which, as a rule, there is a pronounced growth of the microbial flora in the lumen of the small intestine.

Antibiotics are given orally usual doses within 7-10 days.

In diseases accompanied by colon dysbacteriosis, it is better to treat with drugs that have a minimal effect on the symbiotic microbial flora and inhibit the growth of Proteus, staphylococci, yeast fungi and other aggressive strains of microbes. These include antiseptics: intetrix, ersefuril, nitroxoline, furazolidone, etc.

In severe forms of staphylococcal dysbacteriosis, antibiotics are used: tarivid, palin, metronidazole (trichopol), as well as biseptol-480, nevigramon.

Antibacterial drugs are prescribed for 10-14 days. If fungi appear in the feces or intestinal juice, the use of nystatin or levorin is indicated.

In all patients with diarrhea associated with antibiotics, occurring with intoxication and leukocytosis, the occurrence of acute diarrhea should be associated with Cl. difficile.

In this case, stool culture is urgently done on Cl. difficile and prescribe vancomycin 125 mg orally 4 times a day; if necessary, the dose may be increased to 500 mg 4 times a day. Treatment is continued for 7-10 days. Also effective is metronidazole at a dose of 500 mg orally 2 times a day, bacitracin 25,000 IU orally 4 times a day. Bacitracin is almost not absorbed, and therefore a higher concentration of the drug can be created in the colon. With dehydration, adequate infusion therapy is used to correct the water and electrolyte balance. to bind toxin Cl. difficile use cholestyramine (Questran).

Bacterial preparations

Live cultures of normal microbial flora survive in the human intestine from 1 to 10% of the total dose and are able to some extent to perform the physiological function of normal microbial flora. Bacterial preparations can be prescribed without prior antibiotic therapy or after it. Bifidumbacterin, bifikol, lactobacterin, bactisubtil, linex, enterol, etc. are used. The course of treatment lasts 1-2 months.

Another way to eliminate dysbacteriosis is possible - the impact on the pathogenic microbial flora by the metabolic products of normal microorganisms. These drugs include hilak forte. It was created 50 years ago and is still used to treat patients with intestinal pathology. Hilak forte is a sterile concentrate of metabolic products of the normal intestinal microflora: lactic acid, lactose, amino acids and fatty acids. These substances contribute to the restoration of the biological environment in the intestine, necessary for the existence of normal microflora, and inhibit the growth of pathogenic bacteria. It is possible that metabolic products improve the trophism and function of epitheliocytes and colonocytes. 1 ml of the drug corresponds to biosynthetic active substances 100 billion normal microorganisms. Hilak forte is prescribed 40-60 drops 3 times a day for up to 4 weeks in combination with antibacterial drugs or after their use.

More recently, there have been reports of the possibility of treating acute diarrhea associated with antibiotic therapy and Cl. difficile, large doses of pre- and probiotics.

Regulators of digestion and intestinal motility

In patients with impaired abdominal digestion, Creon, pancitrate and other pancreatic enzymes are used. In order to improve the absorption function, Essentiale, Legalon or Carsil are prescribed, since they stabilize the membranes of the intestinal epithelium. Imodium (loperamide) and trimebutine (debridate) improve bowel propulsion.

Body reactivity stimulants

To increase the reactivity of the organism in debilitated patients, it is advisable to use taktivin, thymalin, thymogen, immunal, immunofan and other immunostimulating agents. The course of treatment should be an average of 4 weeks. At the same time, vitamins are prescribed.

Prevention of dysbacteriosis

Primary prevention of dysbacteriosis is a very difficult task. Its solution is associated with general preventive problems: improving the environment, rational nutrition, improving well-being and other numerous factors of the external and internal environment.

Secondary prevention involves the rational use of antibiotics and other drugs that violate eubiosis, timely and optimal treatment of diseases of the digestive system, accompanied by a violation of microbiocenosis.

It is important to note that dysbacteriosis does not have any characteristic combination possible symptoms. In other words, in two patients with this pathology, the manifestations of the disease may be dissimilar. This is due to differences in the composition of the intestinal microflora in each person, a different state of the immune system, and different dominant pathogens.

If we talk in general about the manifestations of dysbacteriosis, then in most patients its symptoms are very mild, and many do not have any manifestations of the disease or complaints at all. Asymptomatic course of dysbacteriosis is very common. In these cases, pathology can only be detected using bacteriological methods. However, in the case of an asymptomatic course, the harm to the body is minimal, and the microflora most often recovers on its own over time. Severe disorders in patients are not so common. Usually these are patients with concomitant anatomical anomalies, chronic diseases, pronounced weakening of the immune system. At severe course diseases, a variety of disorders and complications that threaten the health of the patient are possible.

In patients with intestinal dysbiosis, the following symptoms are most common:

• Chair disorders. Stool disorders in dysbacteriosis are one of the most common and characteristic symptoms. They may wear different character and will be considered separately.
• Flatulence. Flatulence is called increased gas formation, which leads to the frequent emission of gases and bloating. Against the background of flatulence, the patient may experience dull pain due to stretching of the intestinal walls. The reason for the appearance of this symptom is the predominance of bacteria in the microflora that cause decay and fermentation. Instead of the normal breakdown of food, it is fermented, during which a lot of gas is released. It accumulates in the intestinal loops and gradually comes out naturally. In patients on a diet less meat, carbonated drinks, beer and kvass), flatulence is less pronounced.
• Stomach ache. Pain in the abdomen with dysbacteriosis can appear immediately for several reasons. Firstly, this is the flatulence and stretching of the walls mentioned above. Secondly, it is a spasm of smooth muscles. It may be associated with the absorption of toxic decay products that are not released during normal microflora. Thirdly, the cause may be a primary or secondary inflammatory process. In primary dysbacteriosis, pain usually appears later than other symptoms, and in secondary it precedes them. The pain itself can also be associated with concomitant diseases that caused dysbacteriosis ( Crohn's disease, ulcerative colitis, etc.). In this case, there may be other symptoms that are not typical for dysbacteriosis. In general, abdominal pain does not appear in all patients with this disease. Most often it is absent, but many patients complain of discomfort. If pain appears, it is more often localized in the lower abdomen and is a pain or dull, "migrating" pain. In general, the nature of this symptom can be different and there is no obvious pattern.
• Slimming. Normal intestinal microflora takes an active part in the absorption of nutrients. In its absence, the so-called malabsorption syndrome develops ( malabsorption of nutrients in the intestine). So the patient can eat well and stick to different diets, but still the body will not have enough nutrients. With prolonged dysbacteriosis against the background of malabsorption syndrome, the patient begins to gradually lose weight. The more serious the violation, the faster it will become noticeable this process. Since chronic protracted dysbacteriosis is quite rare, then weight loss in patients is not so common.
• Rumbling in the stomach. Rumbling in the abdomen is due to the accumulation of gases that do not find an outlet in a natural way, as well as contractions of the intestinal muscles. Gases accumulate due to the fermentation process against the background of dysbacteriosis, and hyperactive muscle work can be explained by the absorption of various bacterial toxins. This symptom is especially characteristic of dysbacteriosis in children. In older people, dysbacteriosis often occurs with signs of paralytic ileus ( bowel muscles do not contract). Then there can be no rumbling in the stomach.
• Bad breath. Many patients go to the dentist when they experience bad breath. A thorough examination of most of them reveals dysbacteriosis ( oral cavity or intestines). Intestinal dysbacteriosis can give an unpleasant odor due to the processes of decay and fermentation caused by atypical microflora. As a result, gases are formed, some of which rises up the gastrointestinal tract. As a result, belching with an unpleasant odor or taste, or just bad breath, is possible. This symptom can appear even with minor deviations in the composition of the microflora and may be the only manifestation of the disease.

Diarrhea and constipation in intestinal dysbacteriosis

With dysbacteriosis, diarrhea has the following features:

• stool frequency is usually about 4-6 times a day ( but more in severe cases);
• diarrhea is not always accompanied by pain and pain in the abdomen;
• in most cases, the stool is not completely liquid, but simply "not formed" ( mushy);
• often the stool has a sharp unpleasant odor - the result of the processes of decay and fermentation;
• untreated diarrhea can last weeks or even months ( in this case, the patient's condition gradually worsens due to progressive dehydration);
• episodes of diarrhea may be followed by occasional constipation.

Constipation in patients with dysbacteriosis is much less common than diarrhea. They are more typical for elderly patients, since dysbacteriosis often causes deterioration of motor skills in them ( cuts) intestines. As a result, food moves more slowly through the gastrointestinal tract, water from the feces is completely absorbed. Often there are also tenesmus - painful false urges.

Is there a temperature with dysbacteriosis?

The temperature is more typical for secondary dysbacteriosis, which appeared against the background of other diseases. For example, subfebrile indicators ( 37 - 37.5 degrees) may occur in Crohn's disease or ulcerative colitis. Acute inflammatory processes in the abdominal cavity can cause a very significant increase in temperature ( 38 - 39 degrees), but they almost never occur in dysbacteriosis.

Chronic dysbacteriosis

The chronic course of dysbacteriosis is somewhat less common. At the same time, disturbances in the composition and quantity of microflora do not return to normal for a very long time ( months, years). As a rule, there are prerequisites that do not allow the normal microflora to recover. However, in most cases, this problem can still be solved with the right treatment.

At chronic course dysbacteriosis, it is important to pay attention to the presence of the following factors:

• weakened immunity;
• chronic inflammatory bowel disease;
• non-compliance with the prescribed diet;
• self-medication and unskilled treatment;
• the presence of a constant source of infection ( poor quality drinking water, etc.);
• possible bacterial resistance to prescribed antibiotics ( checked by antibiogram);
• the presence of intestinal tumors;
• chronic diseases of the liver, pancreas, stomach.

Dysbacteriosis in children

The development of microflora in the intestine is strongly influenced by several factors. First, it is the nature of the food ( mother's milk or formula). The intestine reacts differently to the food coming in the first year of life, and the limits of the norm for such children will be different. Secondly, age also affects. The older the child, the closer the composition of its microflora to the norm of an adult. Thirdly, it is necessary to take into account the possibility of anatomical and physiological abnormalities in young children, which often become the root cause of dysbacteriosis.

Normal composition of the intestinal microflora in children

The functions of normal microflora in a child's body are the same as in an adult, but play a more significant role. The child's body is growing, and it constantly needs nutrients. For example, adults have a certain "reserve" of vitamins, while young children usually do not. With dysbacteriosis in these cases, vitamin deficiency B1 - B6, B12, K, E is most noticeable. The risk of allergic reactions and various metabolic disorders also increases. As a result, the growth and development of the child is delayed. It is believed that the younger the child, the more noticeable will be the violations in dysbacteriosis.

In addition to the causes characteristic of adults, dysbacteriosis may appear in children in the following cases:

• weakened immunity due to colds, tonsillitis, etc. ( which is very common in children.);
• the presence of congenital malformations of the intestine ( diverticula, narrowing, etc.);
• the use of hormonal and antibacterial drugs without consulting a doctor;
• a tendency to food allergies or intolerance to certain substances ( gluten, lactose, etc.).

In children, the manifestations of dysbacteriosis depend on the severity of the disease:

• Compensated intestinal dysbacteriosis. The manifestations of the disease will be mild, and at first there may be no symptoms at all. In young children, rumbling in the stomach, loss of appetite, general anxiety, and poor sleep may appear. The chair usually becomes more frequent up to 2-3 times a day, but depending on the dominant pathogen, it can be 6-8 times a day ( during the reproduction of Klebsiella, the stool is also greenish in color). In the case of compensated dysbacteriosis, the symptoms of general intoxication are mild. Temperature, vomiting and severe pain may not be.
• Subcompensated intestinal dysbacteriosis. In addition to the above symptoms, signs of general intoxication and metabolic disorders may appear. The chair becomes more frequent up to 6 - 8 times a day, sometimes with blood impurities. Children who already know how to talk complain of severe abdominal pain. Blood test shows anemia ( reduced level hemoglobin), an elevated level of leukocytes ( left shift leukocytosis and eosinophilia), increased ESR ( sedimentation rate of erythrocytes) . All this indicates the reproduction of opportunistic bacteria. Sometimes they enter the bloodstream, forming infectious foci outside the intestines.
• Decompensated intestinal dysbacteriosis. The frequency of the chair is 8 - 10 times a day or more. He contains undigested food, mucus, blood impurities. There are marked deviations in the blood test. The child is pale, weak due to anemia. In a chronic course, the treatment of severe forms can take up to several months. During this period, there is a periodic increase in temperature ( up to 39 degrees or more in the presence of secondary infectious foci), clouding of consciousness, allergic rash, vomiting, severe headaches and abdominal pain, enlarged liver and spleen ( hepatosplenomegaly). In the absence of qualified treatment in young children, there is a serious risk to life.

Treatment of dysbacteriosis in children involves proper nutrition ( for every age and different states it is different), which will be explained in detail by the attending physician. To normalize the number of bifidobacteria in children on artificial nutrition mixtures of NAN 1 and 2 are recommended. For children older than six months - NAN 3 and kefir.

At persistent diarrhea antibiotics may be prescribed metronidazole, vancomycin, etc.). Bacteriophages, enzyme therapy, vitamin therapy are used. Sometimes enterosorbents are required ( enterodez, enterosgel, etc.) to absorb toxins and reduce intoxication.

Also, with dysbacteriosis in children, the following eubiotics can be used:

• lacidophilus;

It is believed that treatment is not required at all in the following cases:

• when the number of E. coli with normal enzyme activity is more than 300 ml/g;
• number of E. coli ( lactose-negative and hemolytic) less than 10% of the total;
• an increase in the number of enterococci ( more than 125% of the norm) in the absence of symptoms and complaints;
• growth of cocci hemolytic activity up to 125% of normal in the absence of symptoms;
• an increase in the number of lactobacilli and bifidobacteria.

For children, preventive treatment for dysbacteriosis is prescribed in the following cases:

• if the mother suffered from colpitis or other infections urinary tract during pregnancy and childbirth;
• exacerbation of chronic diseases in children ( amygdalitis, sinusitis, etc.);
• frequent allergies in a child;
• anemia;
• if the mother received corticosteroids during pregnancy;
• children born by caesarean section;
• children born prematurely.

Dysbacteriosis during pregnancy

In general, during pregnancy, there are the following prerequisites for the development of intestinal dysbacteriosis:

• Compression of intestinal loops. The growth of the fetus causes the intestinal loops to rise in the abdominal cavity, due to which its contents may be less likely to pass. As a result, atypical bacteria actively multiply in the formed "kinks".
• Diet change. Often, women during pregnancy try to change their diet in order to optimize the supply of nutrients to the growing fetus. However, the intestines may not be prepared for such changes. Unusually large amount of vegetable ( or, conversely, meat) food often causes dysbacteriosis.
• Hormonal changes. During pregnancy, a whole cascade of hormonal changes occurs, which, to one degree or another, affect almost all organs and systems of the body. For example, many women experience poor motor skills ( cuts) intestines, due to which its contents are worse excreted. As a result, pathogenic bacteria can develop in the intestines.
• Weakened immunity. During pregnancy, a woman's body is somewhat weakened. This is due not only to the increased intake of various nutrients ( they are consumed by both the mother's body and the fetus's body), but also by forced inactivity of the immune system. It weakens to allow the fetus to grow normally. This opens the way for pathogenic bacteria, including the prerequisites for their development in the intestines.

To prevent the appearance serious problems, pregnant women are advised to donate feces prophylactically for microbiological research. Changes in the composition of the intestinal microflora will allow you to notice the developing dysbacteriosis in time. Prescribing antibiotics during this period is not recommended ( they can harm the fetus and do not always help with dysbacteriosis). Therefore, it is important to compensate for the disorders caused by the disease ( for example, taking certain vitamins) and stimulate the growth of normal microflora. In most cases, dysbacteriosis in pregnant women is not so difficult to cure. The main thing is to contact a specialist in a timely manner for diagnosis and prescribing the right treatment. It will be individual for each patient, depending on the symptoms and test results.

What is the danger of frequent dysbacteriosis?

Also, to obtain a reliable result, patients must adhere to the following rules:

• Diet. It is advisable to start following a diet even before passing feces for analysis. For 2 - 3 days exclude beer, kvass, alcohol, lactic acid products. All of them can temporarily affect the composition of the microflora, and the results will be unreliable.
• Early stage of the disease. It is advisable to take feces for analysis in the first days after the onset of symptoms of the disease, before starting any treatment. Once antibiotics are started, many sensitive bacteria will already die, and the number of microorganisms in the sample will generally decrease. Because of this, it will be more difficult to make a correct diagnosis in the laboratory.
• Proper sampling. If possible, the analysis of feces is taken not from the toilet, but from a blank landscape sheet. It is recommended to take a sample from the middle portion, as here the largest number bacteria.
• Repeat analyses. A single analysis does not always give an objective result. Sometimes, for a more accurate diagnosis, feces are taken for analysis 2 to 3 times with an interval of several days.

In the vast majority of cases, it is the microbiological analysis of feces that makes it possible to make a final diagnosis with dysbacteriosis. It also roughly determines the stage of the disease and its severity. The resulting colonies of pathogens can be tested for sensitivity to various antibiotics ( with an antibiogram). Based on the results of this analysis, the doctor will prescribe the correct treatment.

Where to get tested for dysbacteriosis?

Treatment of dysbacteriosis

In a narrower sense, the treatment of dysbacteriosis is aimed at restoring the normal intestinal microflora. Also, in severe cases, supportive and symptomatic treatment which will improve the general condition of the patient.

The vast majority of patients with intestinal dysbiosis do not see a doctor in the early stages of the disease. In the absence of comorbidities and normal operation immune system, recovery occurs on its own, without taking any medication, and sometimes without dieting. In more severe cases, treatment is carried out on an outpatient basis ( the patient visits the doctor almost daily, but does not go to the hospital). If there are any complications or serious comorbidities are identified, the patient can be admitted to the gastroenterology department. The leading specialist will be, respectively, a gastroenterologist.

Also, the following specialists may be involved in the treatment of patients with intestinal dysbacteriosis:

• surgeon- with serious complications associated with inflammatory processes;
• family doctor/therapist– deals with the treatment of mild forms of dysbacteriosis, observes the patient for a long time;
• gynecologist- with dysbacteriosis during pregnancy;
• pediatrician/neonatologist- with dysbacteriosis in children;
• immunologist– rarely, for consultation and identification of possible causes;
• microbiologist- the main specialist who is engaged in diagnostics ( identification, classification, recommendation of antibacterial treatment) dysbacteriosis.

Drugs for dysbacteriosis

In general, the following groups of drugs can be used in the treatment of intestinal dysbacteriosis:

• Eubiotics. This group of drugs contains representatives of the normal intestinal microflora and substances that promote their growth. In other words, the restoration of normal intestinal microflora is stimulated. The choice of a specific remedy is made by the attending physician. Eubiotics linex, lactobacterin, hilak-forte, etc. are very common.
• Antibacterial drugs. Antibiotics could be the main cause of dysbacteriosis, but they are often necessary for its treatment. They are prescribed for the isolation of an abnormal dominant microorganism ( for example, with staphylococcal intestinal dysbacteriosis). Of course, in this case, antibiotics are prescribed only after an antibiogram, which shows which drug is best suited for the treatment of a particular microorganism.
• Antifungal agents. They are prescribed when an increased amount of yeast fungi is found in the intestinal contents.
• Multivitamin complexes. With dysbacteriosis, the absorption of vitamins is often disturbed, hypovitaminosis and beriberi develop. This aggravates the patient's condition. Vitamins are prescribed to make up for the deficiency, as well as to maintain the immune system, which is also important in the fight against dysbacteriosis. Vitamin complexes of various manufacturers can be used ( pikovit, duovit, vitrum, etc.). In case of severe malabsorption in the intestine, vitamins are administered intramuscularly in the form of injections.
• Antidiarrheals. These funds are prescribed to combat diarrhea - the most unpleasant symptom of dysbacteriosis. In fact, there is no cure. The drugs worsen the contractions of the intestinal muscles, improve the absorption of water. As a result, the patient goes to the toilet less often, but there is no direct effect on the intestinal microflora. Antidiarrheal drugs are a temporary solution to the problem and should not be taken for a long time. The most common are lopedium, loperamide and a number of other drugs.
• Bacteriophages. Currently, this group of drugs is rarely used. in the intestines ( often in the form of a suppository) introduce special microorganisms ( viral), which infect certain bacteria. Bacteriophages are specific and affect only a certain group of microorganisms. There are, respectively, staphylococcal bacteriophages, coliproteic bacteriophages, etc.

Diet for intestinal dysbacteriosis

Since the normal intestinal microflora is represented mainly by bacteria that decompose sugars, it will be beneficial to consume lactic acid products ( contain milk sugar– lactose). It is also important to consume enough plant fibers, which stimulate bowel contractions and normalize the mode of its emptying.

With unexpressed dysbacteriosis, the following products must be included in the diet:

• kefir;
• yogurt;
• cheeses;
• curdled milk;
• cottage cheese.

It is also important to exclude the following foods from the diet:

• carbonated drinks ( including beer and kvass);
• fried meat, tough meat, meat with blood;
• fruits that cause bloating apricots, plums, etc.);
• legumes ( may increase gas buildup and discomfort);
• cream cakes and other confectionery large quantities;
• alcoholic drinks and coffee;
• canned and pickled foods;
• spicy and salty seasonings.

In general, there are features of the diet for various types of dysbacteriosis. It depends on the type of stool disorder ( constipation or diarrhea predominates), as well as the frequency and intensity of abdominal pain. In each individual case, the attending physician can adjust the diet at his discretion.

Folk remedies for intestinal dysbacteriosis

Folk remedies to combat the symptoms of dysbacteriosis

Prevention of dysbacteriosis

In general, the following can be distinguished preventive measures to prevent intestinal dysbiosis:

• dieting;
• limited consumption of kvass and beer;
• eating fresh, quality products;
• timely treatment of chronic diseases;
• timely access to a doctor at the first signs of intestinal pathology;
• breastfeeding;
• rational and reasonable prescription of antibiotics;
• strict compliance with the prescribed antibacterial treatment by the patient.

Is it possible to drink alcohol with dysbacteriosis?

Strong alcoholic beverages in large quantities can in various conditions lead to diarrhea, dehydration, a weakened immune system, impaired motor skills ( cuts) intestines. All this does not directly affect the intestinal microflora, but creates the prerequisites for the reproduction of some pathogenic bacteria. Some varieties of wines, beer and other alcoholic beverages directly related to the fermentation process have a direct effect on the microflora. For example, brewer's yeast is separate view fungal microorganisms. Excess consumption of these drinks ( especially with pre-existing dysbacteriosis) stimulates the processes of fermentation and putrefaction in the intestines. As a result, all the symptoms of the disease will increase, and the risk of various complications will increase. That is why abstinence from alcoholic beverages is an indispensable component of the diet for patients with intestinal dysbacteriosis.