What does fermentative dyspepsia mean? What symptoms are observed, how to treat, nutrition

Dyspepsia: what is it? Symptoms and treatment of dyspepsia

In therapeutic practice, the most common case of visiting a doctor is dyspepsia: what is it from the point of view of etiology, what causes the symptoms - questions that in some cases will require very serious differential diagnosis.

After all, dyspepsia is a disorder characterized by a non-specific symptom complex of discomfort in the gastrointestinal tract. In the series “dyspepsia: what it is - symptoms - treatment”, a special problem is the stage of searching for the sources of symptoms, which is complicated by the fact that many patients ignore the manifestations of gastrointestinal discomfort.

Only every tenth patient with dyspepsia seeks medical help. However, one cannot lightly “brush it off” if dyspepsia is discovered: what is it - the result of an error in the diet, or perhaps the symptoms of a malignant neoplasm - sometimes not just the return of comfortable digestion, but also the patient’s life depends on finding out the reasons.

Causes

Symptoms of dyspepsia can occur in anyone and at any age. If the disease is not treated, a chronic form may develop. There are several main reasons that provoke the development of functional dyspepsia:

• psycho-emotional stress (pathology of neurotic origin develops);
• taking certain groups of medications (antibiotics, antitumor drugs, hormonal drugs);
• errors in nutrition, consumption of large amounts of nutrients (carbohydrates, proteins and fats). This is the main reason for the development of putrefactive, fatty and fermentative dyspepsia;
• intoxication of the body due to household poisoning, viral infections and purulent diseases;
• increased secretion of hydrochloric acid;
• motility disorders of the gastrointestinal tract.

The main causes of functional dyspepsia include psychological trauma and stress.

Types of dyspepsia

Nutritional or functional dyspepsia is of the following types:

1. Putrid dyspepsia. Occurs with excessive consumption of protein products, especially those that require a long time to digest. Toxic substances formed during the breakdown of proteins cause intoxication of the patient's body. This mainly applies to red meats (lamb, pork, beef) and their derivatives (sausages and other meat products), the abuse of which stimulates the development of putrefactive intestinal microflora.
2. Fatty (soapy) dyspepsia. Caused by eating too much refractory fats, such as lamb and lard and their derivatives.
3. Fermentative dyspepsia. It is caused by the predominance in the diet of foods high in carbohydrates that cause fermentation (sweet and flour products, honey, fruits, peas, cabbage, legumes, etc.), as well as fermentation products (kvass, mash, pickled vegetables, etc.). At the same time, fermentative microflora develops in the intestines.

Dyspepsia, which is a consequence of enzyme deficiency, is of the following types:

1. Pancreatogenic (lack of pancreatic enzymes);
2. Gastrogenic (caused by disruption of the secretory function of the stomach);
3. Enterogenous (disturbed secretion of intestinal juice);
4. Hepatogenic (liver origin);
5. Cholecystogenic (caused by impaired bile secretion);
6. Mixed dyspepsia.

These include

1.
Enterosorbents (enterosgel, activated carbon, polysorb, lactofiltrum).
The function of this group of drugs is the sorption of gases and toxic substances in the intestines. 2.
Defoamers (espumisan, dimethicone, bobotik).
The action of these drugs is based on a change in the surface-active resistance of gases and they are destroyed. 3.
Digestive enzymes (mezim, pancretin).
Digestive enzymes facilitate the digestion of food without additional gas formation. These drugs are especially helpful for enzyme deficiency. 4.
Probiotics.
Lacto and bifidobacteria contained in probiotics create conditions in the intestines for the complete breakdown of food and prevent fermentation processes. 5.
Prebiotics (lactulose, lignin). They create conditions for the growth of normal intestinal microflora and have sorption properties.

Do not self-medicate; before taking medications, it is better to consult a doctor.

To prevent bloating for any reason, increased gas formation is a diet. The diet for bloating should be gentle. The amount of coarse fiber, baked goods, sauces, starchy foods, and fried heavy foods is limited. Meals should be fractional, 5-6 times a day. Following these recommendations prevents bloating and makes digestion comfortable.

Symptoms of different types of dyspepsia

Symptoms of dyspepsia can manifest themselves in different ways, since they directly depend on the specific type of pathology. However, all types and subtypes of dyspepsia are characterized by a number of similar symptoms:

1. Unpleasant sensations in the epigastric region (upper abdomen): a feeling of heaviness, fullness, sometimes pain of varying intensity;
2. Nausea;
3. Belching. Single belchings may not be a sign of a disorder, but constant ones indicate dyspepsia;
4. Heartburn. A burning sensation in the epigastric and retrosternal region that occurs when aggressive gastric contents enter the esophagus, which should not normally occur;
5. Flatulence. A feeling of fullness in the abdomen caused by increased gas formation in the intestines, as well as increased gas production;
6. Stool disorder. A characteristic symptom of dyspepsia is irregular bowel movements, usually frequent.

Symptoms of fermentative dyspepsia:

• bloating in the lower abdomen, and excessive gas;
• frequent bowel movements (loose, foamy stools, light in color and sour odor).

Symptoms of organic (enzymatic) dyspepsia:

• rumbling and transfusion in the abdomen;
• frequent passing of gas;
• nausea without vomiting;
• unpleasant taste in the mouth;
• frequent bowel movements (loose stools);
• the presence of food residues in the stool;
• fatigue and weakness;
• headaches and poor sleep.

Symptoms of putrefactive dyspepsia:

• signs of intoxication;
• nausea and vomiting (see also - how to get rid of nausea);
• headaches, dizziness;
• weakness and malaise;
• frequent loose stools (stools are dark and have a strong odor).

Symptoms of fatty dyspepsia:

• noticeable pain 30 minutes after eating;
• feeling of heaviness in the stomach and fullness;
• belching and flatulence;
• copious stools (stools are whitish and greasy).

Diagnosis of dyspepsia

In order to identify a patient with dyspepsia of one type or another, comprehensive measures are taken. You will need to consult doctors such as a gastroenterologist, an infectious disease specialist and a therapist. Depending on the symptoms of the disease, the following procedures may be prescribed:

• Ultrasound examination makes it possible to identify chronic pancreatitis and gallstone disease.
• Esophagogastroduodenoscopy - allows you to detect reflux esophagitis, gastric ulcers, stomach tumors and other organic diseases.
• X-ray examination.
• Electrogastroenterography - allows you to identify gastroduodenal motility disorders.
• Clinical blood test.
• Blood chemistry.
• General stool analysis, stool occult blood test.
• Stomach scintigraphy helps detect gastroparesis.
• Antroduodenal manometry - allows you to examine the motility of the stomach and duodenum.
• Esophagomanometry - which allows you to evaluate the contractile activity of the esophagus, the coordination of its peristalsis with the work of the lower and upper esophageal sphincters (LES and UES)
• Daily pH-metry allows you to exclude gastroesophageal reflux disease.
• Determination of infection of the gastric mucosa by the bacterium Helicobacter pylori.

How can fermentative dyspepsia be identified?

After examining the patient, the doctor usually prescribes the following:

1. Fibroesophagogastroduodenoscopy (FGDS). The endoscope is carefully inserted into the stomach, passing the esophagus and duodenum. The mucous membrane is examined for lesions, and it is possible to take cells for a more detailed examination. These instrumental examination methods will help to identify their nature and exclude the possibility of oncological development.
2. Contrast radiography. A special solution (barium) is injected into the stomach, after which an x-ray is taken and the condition of the mucous membrane is assessed.
3. Ultrasound examination of organs. It is necessary to exclude the presence of tumors and gallstones. This analysis makes it possible to see how efficiently the process of food digestion occurs, whether there are harmful microorganisms in the body, and whether other diseases develop.
4. Functional dyspepsia (which includes the fermentative form) can be designated only if organic changes do not occur in the functioning of the digestive system. This type of disease must last for at least 3 months without interruption. In this case, the doctor must clarify how the process of defecation occurs in relation to diets.

Treatment of dyspepsia

Treatment of patients with dyspepsia should be comprehensive and include not only the prescription of medications, but also measures to normalize lifestyle, diet and diet.

Functional dyspepsia

Treatment of functional dyspepsia is general. The patient is advised to exclude salty, spicy and fatty foods from the diet. Eat small portions, but often (from 6 times a day). If necessary, you can additionally assign:

• Antacids (Gaviscon, Almagel);
• H+-pump inhibitors (Omeprazole, Rabeprazole, Lansoprazole);
• Sedatives (Phenazepam, Adaptol, Grandaxin).

Fermentative dyspepsia

• For fermentative dyspepsia, treatment should begin with a diet low in carbohydrate foods. It is allowed to eat high-protein dishes (boiled meat, meat broth, butter, steamed chicken), it is necessary to reduce the amount of bread, potatoes, vegetables and fruits, baked goods, and cereals.
• Adsorbent substances (Smecta, Polysorb, Neosmectin), probiotics (Acipol, Laktofiltrum, Bifiform, Bifikol) and enzyme preparations for dyspepsia (Creon, Pancreatin) are used. As you recover, carbohydrate-containing foods are gradually introduced into the diet, but in limited quantities. The menu and allowed dishes are determined depending on the cause of the development of this syndrome.

Putrid dyspepsia

• Therapy is carried out similarly to the fermentation form. First of all, the patient is recommended to eat a diet that excludes protein (all types of meat and fish, dairy products, eggs, etc.). You should also use sorbents and probiotics. As a rule, enzyme preparations are not used during the treatment process. The need for antibiotic therapy is determined by the doctor.

Intestinal dyspepsia. First of all, it is necessary to treat the underlying disease:

• Intestinal infections - antibiotics;
• Food toxins – elimination of general intoxication and use of local local detoxicants (Enterodes, Polysorb MP);
• Crohn's disease - prescription of hormonal therapy.

If you have any of these conditions, you should not eat foods high in fiber. It is important to take sorbents (Smecta, Smectin, activated carbon, etc.), which are quite effective in eliminating the syndrome. To reduce pain, it is possible to prescribe antispasmodics (Drotaverine, Kellin, etc.).

Gastric dyspepsia

To eliminate this syndrome, the underlying disease should be treated. Depending on this, medical tactics will change. If the cause of dyspepsia is gastritis or peptic ulcer, the following therapeutic measures are recommended:

• If the role of Helicobacter is proven, the doctor prescribes complex antimicrobial therapy, which necessarily includes 2 antibiotics;
• A diet excluding fatty, salty and spicy foods. You should also not eat foods enriched with fiber (rye bread, fruits, vegetables, juices, etc.), as they can increase pain;
• It is possible to prescribe medications that create a protective membrane for the gastric mucosa (De-Nol, Sucralfate, etc.).
• Acidity should be normalized to treat dyspepsia. Increased secretion of hydrochloric acid can be eliminated with “H+-pump inhibitors” (Omeprazole, Rabeprazole, Lansoprazole) and antacids (Gaviscon, Almagel). With low acidity, you can stimulate acid-forming cells with Pentaglucide or plantain juice;

The discovery of an open ulcer or tumor is often an indication for surgery. If a patient has a hormonal disease, treatment can only be determined by an endocrinologist.

Intestinal dyspepsia syndrome in children

Children suffer from dyspepsia in the first years of life

Most often, simple dyspepsia is observed in children in the first years of life. The pathology can be acute or manifest against a background of anxiety, regurgitation, loss of appetite, and frequent urge to defecate.

After a few days, stool can be up to 7 times a day. It acquires a heterogeneous color, liquid consistency, and mucus may appear in the stool. Dyspepsia in children can be manifested by the following symptoms:

• bloating;
• regurgitation;
• frequent passage of gases;
• vomiting;
• intestinal colic;
• decreased appetite.

The duration of simple dyspepsia is from 2 to 7 days. As a result of the disease, stomatitis, thrush, and diaper rash may occur.

Weak children may develop a toxic form of dyspepsia. Symptoms:

• frequent vomiting;
• fever;
• frequent bowel movements (up to 20 times a day).

Severe diarrhea and vomiting contribute to the loss of fluid from the child’s body, which causes dehydration, retraction of the large fontanel, decreased tissue turgor, and rapid loss of body weight.

In addition, dryness of the mucous membranes and skin occurs, decreased reflexes, and possible formation of convulsions. The danger of this pathology lies in the possible development of impaired consciousness, coma.

In children of the older age category with FD the following appear:

• abdominal pain (usually immediately after a meal);
• nausea;
• belching;
• fast saturation;
• heartburn;
• feeling of fullness in the stomach;
• alternating diarrhea with constipation.

Digestive disorders in children often develop due to stress.

Folk remedies

In folk medicine, there are many recipes that are used for stomach dyspepsia. But before starting such treatment, you need to visit a doctor.

The most effective recipes:

1. Fennel. To prepare the medicine, you need to take 10 g of fennel berries, pour 200 ml of boiling water and heat until boiling (over low heat for about 15 minutes). Then cool the broth, strain and add boiled water to it so that the result is the original volume. The entire amount of the medicine should be drunk throughout the day in small portions.
2. Cumin/marjoram. Prepare a healing drink: place crushed cumin and marjoram seeds in 200 ml of boiling water and leave for 15 minutes. This remedy should be taken twice a day at a dose of 100 ml per dose.
3. Grind the roots of elecampane. Take 1 teaspoon of raw material and pour 200 ml of cold boiled water. Do not heat or boil! The medicine is infused for 8 hours, then filtered and taken 1/3 cup three times a day before meals. Duration of treatment – ​​2 weeks.
4. Prepare 375 g aloe, 625 g honey and 675 ml red wine. Wash and finely chop the aloe leaves, mix with the rest of the ingredients. You need to take the medicine 1 teaspoon before meals - this is the dosage for the first 5 doses. In the future, it is recommended to take 2 teaspoons twice a day before meals. The duration of treatment with this medicine is a minimum of 2 weeks, the maximum period of use is 2 months.

You cannot decide on the treatment of gastric dyspepsia using traditional methods on your own. Only after consulting a doctor can you be sure that it is safe to use homemade decoctions/infusions.