Restoration of intestinal motility with drugs, exercises and folk remedies. Increased intestinal peristalsis Treatment of intestinal dyskinesia

14.7.4. MOTOR FUNCTION OF THE SMALL INTESTINE

The motor activity of the small intestine ensures further mechanical processing of chyme, its grinding, mixing with alkaline digestive secrets, moving along the intestine in the distal direction, changing the layer of chyme near the mucous membrane, and increasing intracavitary pressure. In addition, the strictly coordinated contractile activity of the muscles of the small intestine determines the duration of retention of contents in each of its sections, which is optimal for the digestion of food substrates with the formation of the required amount of nutrients and their transport into the blood and lymph. Thus, the motor function of the small intestine increases the efficiency of cavitary and parietal digestion and promotes the absorption of nutrients.

The ability of smooth muscle cells to automatize underlies all types of contractions of the small intestine.

The main types of motility of the small intestine are as follows.

Rhythmic segmentation manifests itself in the form of simultaneous contractions of the circular muscles in several neighboring sections of the intestine, dividing it into segments, due to which the chyme moves a short distance in both directions from the places of narrowing of the intestinal lumen. With the next contraction of the circular muscles, each segment is divided into two parts, and the previously contracted sections of the intestine are relaxed. The content of each new segment of the intestine consists of the chyme of the two halves of the former segments. Due to rhythmic segmentation, chyme mixing and its slight displacement in the distal direction are provided.

pendulum contractions arise as a result of rhythmic contractions mainly of the longitudinal muscle layer with the participation of circular muscles, leading to the movement of the chyme back and forth. They provide mixing of intestinal contents and its weak translational

progress in the distal direction. The frequency of pendulum contractions and rhythmic segmentation in the same area of ​​the intestine is the same. The alternation of rhythmic segmentation and pendulum contractions promotes thorough mixing of the chyme.

peristaltic contractions are contractions of circular muscles that spread in waves along the intestine, preceded by a wave of relaxation. They ensure the promotion of the contents of the intestine in the proximodistal direction. The peristaltic wave occurs as a result of the narrowing of the intestinal lumen during the contraction of the circular muscles above the lump of chyme and the expansion of the intestinal cavity during the contraction of the muscles of the longitudinal layer below the lump. The resulting proximodistal pressure gradient is the direct cause of the movement of chyme through the intestines.

Peristaltic contractions can be different in strength and speed of distribution. Sufficiently strong peristaltic contractions move the chyme in the distal direction over long distances. Such peristaltic movements are called propulsive. The speed of propagation of peristaltic waves in the small intestine in a healthy person is usually 1-2 cm / s. In the proximal parts of the small intestine, it is higher than in its middle part, and in the terminal part of the ileum, with rapid peristalsis, it reaches 7-21 cm/s. This type of peristaltic contractions is observed at the end of the digestive period.

Peristaltic waves can occur in any part of the small intestine. Most often they begin in the duodenum at the time of evacuation of gastric chyme. At the same time, several such wave-like contractions pass through the intestines, which give the movements of the intestine a resemblance to the movement of a worm. Hence their name - worm-like, or peristaltic, contractions.

tonic contractions may have a local character or move through the intestine at low speed. Rhythmic and peristaltic waves are superimposed on tonic waves. Basal pressure in the cavity of the small intestine is determined not only by the tone of its muscular wall, but also by intra-abdominal pressure and in humans is 8-9 cm of water. The value of intracavitary pressure in the intestine increases significantly with

appearance of peristalsis. Tonic contractions underlie the motor activity of smooth muscle sphincters.

Micromovements of the intestinal villi contribute to the mixing of chyme. The frequency of rhythmic contractions of the villi decreases from the proximal to the distal parts of the small intestine. The intestinal hormone vallikin, produced in the mucous membrane of the small intestine, has a stimulating effect on their motor activity.

14.7.5. REGULATION OF THE MOTOR ACTIVITY OF THE SMALL INTESTINE

Motility of the small intestine is regulated by myogenic, nervous and humoral mechanisms.

A. Myogenic mechanism of regulation. The motor activity of the small intestine is based on the properties of smooth muscle cells to contract spontaneously and respond with contraction to stretching.

Spontaneous activity of smooth muscles, which manifests itself in the form of rhythmic generation of slow electrical waves, bursts of action potentials, and phase contractions of the small intestine in the absence of external stimuli, is provided by the myogenic mechanism. The frequency of generation of slow electrical waves is constant for each area of ​​the small intestine and depends on the level of metabolism. A local decrease in temperature in the area of ​​the pacemaker leads to a decrease in the frequency of generation of slow waves and rhythmic contractions of the smooth muscles of the small intestine and the rate of their propagation. Separation of the pacemaker from the underlying segments of the intestine by complete transection of the intestine or only the longitudinal muscle layer while maintaining the external nerves reduces the frequency of contractions of the intestine distal to the transection by 20-30%.

The contractile response of smooth muscles to stretch also belongs to the myogenic mechanisms of regulation of the motility of the small intestine. The contraction of the muscles of the longitudinal muscular layer of the intestine provides a stretch of the circular muscles, sufficient to cause their contraction.

B. Intramural nervous mechanisms of regulation. The motor activity of the small intestine is regulated by the enteric nervous system - a complex of microganglionic formations, including a complete set of neurons (sensory, endogenous)

cilators, interneurons, tonic and efferent neurons), giving it the features of true autonomy (A.D. Nozdrachev). The enteric nervous system has a descending inhibitory tonic effect on the myogenic rhythm of the smooth muscle of the intestine. The endogenous oscillator of the intraganglionic ensemble is cholinergic, it causes excitation of the efferent peptidergic neuron, at the endings of which inhibitory mediators VIP, ATP are released, causes hyperpolarization of the smooth muscle cell membrane, which leads to a decrease in the amplitude of slow electrical waves, cessation of the generation of peak potentials and inhibition of motor bowel activity. The enteric system, based on incoming sensory information received from receptors, programs and coordinates the motor activity of the small intestine.

The irritant that triggers and maintains bowel movements is the stretching of its wall. Local irritation of the intestine after transection of extraorganic nerves causes myenteric reflex, manifested in muscle contraction above and their relaxation below the site of irritation. The reflex arc of the myenteric reflex closes in the intramural ganglia. Even more pronounced "mucous" local reflex, arising from the action of mechanical and chemical stimuli on the intestinal mucosa, manifested in the contraction of the circular muscles proximal to the chyme and their relaxation distal to the intestinal contents. Excitation of stretch receptors or chemoreceptors located in the mucosa is transmitted through sensory neurons of the submucosal plexus to interneurons of the intermuscular plexus, which leads to excitation of the cholinergic motor neuron and contraction of the circular muscles of the proximal portion of the intestine and activation of the peptidergic inhibitory neuron (mediators ATP, VIP) , causing relaxation of the distally located circular muscles.

B. Central influences. In the regulation of motor activity of the intestine, an important role is played by the cerebral cortex, the structures of the limbic system, and the hypothalamus.

Electrical stimulation of the anterior sigmoid gyrus of the cortex stimulates the motility of the small intestine, and the orbital gyrus, on the contrary, inhibits it. Irritation of the anterior cingulate gyrus (limbic cortex) and amygdala complex

causes both inhibitory and stimulatory effects, depending on the initial functional state of the small intestine. Irritation of the nuclei of the anterior and middle sections of the hypothalamus mainly stimulates, and the posterior - inhibits the motility of the small intestine. However, in general, the effect of the central nervous system on the motility of the small intestine is predominantly inhibitory (Yu.M. Galperin).

The effects of the central nervous system on the motility of the small intestine are realized with the help of sympathetic (adrenergic), parasympathetic (cholinergic) and, apparently, serotonergic nerve fibers. Excitation of the parasympathetic fibers of the vagus nerves has a predominantly stimulating effect on the motility of the small intestine due to the release of acetylcholine in their endings. However, inhibitory effects may also occur. The mechanism of the inhibitory effect of the vagus nerve on intestinal motility is not well understood. It is believed that its implementation is carried out through the activation of M-cholinergic receptors of sympathetic terminals and the release of catecholamines by them. The inhibitory effect is better detected against the background of strong bowel contractions. Excitation of the sympathetic fibers of the splanchnic nerves has a depressing effect on the motor activity of the small intestine (Fig. 14.14, A). Evidence has been obtained that the celiac nerves contain serotonergic fibers, the excitation of which stimulates the motility of the small intestine (Fig. 14.14, B).

Reflex zones and reflexes. The basic law of reflex regulation of the motor activity of the gastrointestinal tract has a universal character. Its action is clearly manifested in the example of reflex regulation of the motility of the small intestine in the form of motor and inhibitory reflexes of the intestine.

To motor reflexes intestines include esophago-intestinal, gastrointestinal and intestinal reflexes.

Esophageal-intestinal motor reflex occurs when the mechanoreceptors of the esophagus are stimulated against the background of rest or weak contractions of the small intestine and manifests itself in the form of an increase in its tone and amplitude of peristaltic waves. The reflex arc of this reflex closes in the medulla oblongata, and efferent excitatory influences on the motility of the small intestine are transmitted through the vagus nerves.

Gastrointestinal motor reflexes (gastroduodenal, gastrojejunal and gastric

stroleal) are observed when the mechanoreceptors of the stomach are irritated or when it is filled with food, which leads to the appearance or strengthening of the existing contractions of the small intestine. Excitation to the small intestine during irritation of the stomach is transmitted in two ways: along the wall of the digestive tract - with the help of local reflexes that close in the ganglia of the enteric nervous system; reflex - through the vagus nerves, with the closure of the reflex arc in the central nervous system.

Intestinal the motor reflex occurs with adequate mechanical and chemical stimulation of the small intestine and is manifested by increased contractions of the underlying sections of the intestine. Excitation from the proximal to the distal parts of the intestine is transmitted with the help of local reflexes (Fig. 14.15), which close in the intramural ganglia, as well as central reflexes that realize their stimulating effect on intestinal motility through the vagus nerves.

To inhibitory reflexes intestines include reflex inhibition (relaxation) of the upper sections of the small intestine during meals; intestinal inhibitory reflex and rectoenteric reflex.

Reflex inhibition of the motility of the small intestine during the act of eating is manifested by a decrease in the tone and amplitude of peristaltic contractions of the proximal intestine, followed by an increase in its motor activity. This phenomenon has been named perceptual inhibition(receptive relaxation) of the intestine. Affe-

small intestine with chyme inhibits the entry into its cavity of the following portions from the proximal parts and enhances the motor-evacuation activity of this and downstream segments of the intestine. When, as a result of hydrolysis, absorption and promotion of chyme, its amount in this segment decreases, the inhibitory effect on the overlying parts of the intestine decreases. As a result, the motility of the proximal sections of the intestine increases and the chyme moves down the intestine, entering the segment of the intestine that is freed from the contents, where the processes of hydrolytic breakdown of nutrients and absorption of their digestion products into the blood and lymph continue.

G. Humoral regulation. Motilin, gastrin, CCK, histamine, serotonin, substance P, bradykinin, vasopressin and oxytocin, acting on myocytes and neurons of the enteric nervous system, increase, while secretin, VIP, GIP inhibit the motility of the small intestine.

The reflex path of the reflex arc of this reflex begins with the receptors of the root of the tongue and pharynx, and the efferent link is represented by adrenergic fibers of the celiac nerve.

Intestinal the inhibitory reflex is caused by strong irritation of the mechano-receptors of any part of the gastrointestinal tract, which leads to a weakening of the motor activity of other parts, including the small intestine, with the exception of the ileocecal sphincter. The closure of the reflex occurs in the spinal cord below Th V |. The most important role in the implementation of this reflex belongs to the adrenergic fibers of the celiac nerve.

rectal-intestinal the reflex occurs as a result of irritation of the mechanoreceptors of the rectum and the sphincters of its ampulla. It is manifested by inhibition of the motility of the small and large intestine. The closure of this reflex occurs in the spinal cord. The transmission of inhibitory influences from the rectum to the motor activity of the small intestine is carried out through adrenergic fibers of the celiac nerves.

The motor and inhibitory reflexes of the intestine that occur during digestion provide the optimal rate of digestion of nutrients and absorption of hydrolysis products in each section of the small intestine. Overflow of any department

The digestive system is one of the main mechanisms in human life. But at the same time, her organs are the first to begin to lose their functions. An important point in the work of the gastrointestinal tract is intestinal peristalsis. It can be strong or weak, but in any case, when violated, it causes a lot of discomfort.

Peristalsis is the contraction of the muscles of the intestine, aimed at moving food masses through the body.

What is peristalsis?

Intestinal peristalsis is understood as wave-like contractions of the intestinal walls, which help to push the mass of feces to the anus. It is one of several motor activities that take place in the intestines. It is thanks to the correct contractions that normal digestive processes are realized, during which all the necessary trace elements are absorbed, and what is not absorbed leaves the body.

In order to maintain the normal functioning of the gastrointestinal tract for a long time, you need to monitor the diet, introduce physical activity and eliminate bad habits. In addition, it is necessary to treat systemic diseases that affect the performance of the organ in time. If these conditions are not implemented, then peristalsis can be increased or, conversely, reduced, which is far from being the norm.

Peristalsis begins to be realized after the stomach has been filled with food. The norm is the case when 10-12 contractions per minute occur in the duodenum, 9-12 in the small intestine, 3 contractions in the large intestine, and no more than 3 in the rectum. If the patient has malfunctions in peristaltic activity, they may constipation or diarrhea occur.

Reasons for violation

In adults

Peristaltic activity can be impaired due to a number of factors. Sometimes the violation occurs due to a genetic factor or due to another disease, after which the side effects began. A special risk group includes patients who:

• constantly there are stressful situations that overload the work of the nervous system;
• improper diet and diet (this includes fasting or overeating, neglecting a full meal, eating heavy foods that are difficult to digest);
• practically no physical activity;

• there was a long-term use of painkillers;
• dysbacteriosis, various infections are observed on an ongoing basis (it is precisely because of the emerging toxins that peristalsis decreases);
• there are tumor formations, due to which malfunctions in the nervous system occur;
• there are bad habits (drugs and alcohol strongly affect the central nervous system, the tone of organs decreases);
• found helminthiasis;
• previous surgical interventions in the gastrointestinal tract were performed;
• there are failures in the psyche (people who are in a state of strong mental stress);
• there are various diseases of the endocrine system.

It must be remembered that not in all cases the disease is a factor for the appearance of atonitis. Such phenomena can be observed due to stressful situations, during which an adult patient has a feeling of anxiety and panic, affecting the activity of peristalsis. In any case, the lack of treatment will not lead to anything good.

In children

Poor peristalsis can be observed not only in mature patients, but also in children. Many believe that such a phenomenon as atonitis will go away on its own and does not need treatment. But this opinion is erroneous, because the baby's general condition worsens and intoxication begins. What are the causes of sluggish peristalsis in childhood?

• A decrease in peristaltic activity may occur due to a hereditary factor that appears even when a woman is pregnant or breastfeeding.
• Atony is typical for young patients who are experiencing stressful situations.
• Peristalsis worsens if the child's diet is changed. For example, this happens when a baby is weaned.
• The syndrome can occur in cases where little water enters the child's body.

Massage will help to get rid of an unpleasant symptom. In addition, the doctor prescribes special glycerin suppositories, which cause the natural release of stool masses from the body, improving the process of peristalsis.

In the elderly

When an older person moves little or has previously experienced surgery, they may experience constipation. The use of chamomile enemas, frequent walks in the fresh air, and the introduction of dairy products into the diet will help to cope with this. An important point is the presence in the menu of well-ground products that cause an increase in peristaltic activity.

During pregnancy

A problem such as constipation causes some discomfort in a pregnant woman. A similar symptom appears due to the fact that during this period of life in the body of the expectant mother, a special type of hormone, progesterone, begins to be produced. Due to its action, peristaltic activity decreases, as a result of which undigested food is more than expected in the intestines. In addition, the full digestive tract puts pressure on the growing uterus, in which the fetus matures. Such interaction of organs is considered normal, because they have a common innervation.

A balanced diet and the right regimen will help to cope with such a problem. To maintain health, a pregnant woman should refuse fatty, heavy foods (hamburgers, etc.). The expectant mother needs to drink more fluids. In order to avoid stagnation of blood in the small pelvis, you need to walk more often in the air, minimize sitting. If such recommendations do not give a result, you need to go for a consultation with a doctor who will prescribe a medicine. Pregnancy is a temporary phenomenon, and when the baby is born, the body will begin to recover.

Symptoms

There are several symptoms by which you can determine the presence of weakened peristalsis. First of all, the main symptom is constipation. They occur when the patient has not gone to the toilet for 48 hours or more. At the same time, there are pain in the abdomen and uncomfortable feelings due to bloating. Pain can constantly occur due to the appearance of stressful situations, overstrain or sudden physical exertion. As a result, the patient turns pale, weakness occurs, and the general condition of the body worsens. If a person has atonitis for more than 3 days, the temperature and pressure indicators rise. At the same time, a person can reject food without having an interest in it. In most cases, this type of constipation is accompanied by drowsiness. Sometimes the patient gains weight, develops an allergy, or the skin is affected.

Enhanced peristalsis

Peristalsis can be not only weakened, but also increased. Excessively active peristalsis is observed when the intestinal walls begin to contract faster, while the stool becomes more frequent up to 8 times a day. As a result, dehydration of the body occurs, salts and useful trace elements are lost. There are several factors due to which the activity of intestinal motility is increased. First of all, these are intestinal diseases, such as acute intestinal infections, dysbacteriosis, oncological diseases of the digestive organs, exacerbations of chronic ailments. In addition, the appearance of diarrhea may indicate that harmful food has entered the body, which has a detrimental effect. This is a kind of protective function. As a result of this, the patient has an increase in gas formation, flatulence begins. The patient may notice small white lumps in the feces - these are compounds of certain trace elements with fatty acids. Violent peristalsis is accompanied by pain in the abdomen, and mucus may appear in the feces.

To start therapeutic measures, you need to look at the reasons why accelerated peristalsis. To treat violent intestinal motility, the doctor prescribes drugs that will help reduce its activity. To stimulate a decrease in the tone of the processes, the doctor may prescribe absorbent drugs that bind harmful substances and stimulate the intestines.

Diagnostics

Violation of intestinal motility has pronounced signs, with the appearance of which you need to urgently consult a doctor. This may be a proctologist or gastroenterologist who will establish an accurate diagnosis, while establishing the factors of occurrence and prescribing a treatment complex. In no case should you self-medicate, because this will only worsen the situation.

First of all, the doctor conducts a survey of the patient, during which the signs that disturb the person are determined. To establish the exact causes of the weakening of intestinal motility, the doctor takes feces for analysis, performs a colonoscopy, x-rays. The patient's lifestyle and birth diseases are clarified.

Movements of the small intestine, as well as the entire gastrointestinal tract, can be divided into mixing contractions and translational (propulsive) contractions. To a large extent, this division is artificial, since all essential movements of the small intestine cause both mixing and promotion to some extent. The usual classification of these processes is as follows.

When the part small intestine stretched by chyme, stretching of the intestinal wall causes local concentric contractions located at intervals along the intestine and lasting a fraction of a minute. The contractions divide the small intestine into separate segments that form a chain of "sausages". When one row of contractile segments relaxes, a new row always appears behind it, but contractions at this time occur already in other areas between the previous places of contractions. Segmental contractions “chop” the chyme 2-3 times per minute, stimulating the progressive mixing of food with the secrets of the small intestine.

Maximum segmental frequency contractions in the small intestine is determined by the frequency of occurrence of electrical slow waves of the intestinal wall. Since the frequency in the duodenum and proximal jejunum is usually no more than 12 contractions per minute, the maximum frequency of segmental contractions in these areas is also about 12 contractions per minute, but this occurs only under extreme conditions of irritation. In the terminal ileum, the maximum frequency is usually 8-9 beats per minute.

Segmental contractions become extremely weak when the excitatory activity of the enteric nervous system is blocked by atropine. So, even if slow waves in smooth muscle themselves cause segmental contractions, these contractions are ineffective without prior excitation, which comes mainly from the intermuscular nerve plexus.

Chyme moves along the small intestine due to peristaltic waves in any part of the small intestine. The waves move towards the anus at an average speed of 0.5-2.0 cm/sec, faster in the proximal intestine and slower in the distal. Usually they are very weak and fade after passing only 3-5 cm, rarely - more than 10 cm.

Chyme promotion forward is very slow, so slow in fact that the effective movement through the small intestine averages 1 cm / min. This means that it takes 3-5 hours for the chyme to pass from the pylorus to the ileocecal valve.

Control peristalsis nerve and hormonal signals. The peristaltic activity of the small intestine increases significantly after eating. This is partly due to the fact that chyme, entering the duodenum, stretches its wall, and also as a result of the so-called gastroenteric reflex, which occurs when the stomach is stretched and is carried mainly by the intermuscular plexus from the stomach down the wall of the small intestine.

In addition to nerve signals that can affect peristalsis, it is also affected by several hormonal factors: CCK gastrin, insulin, motilin and serotonin. Each of them increases intestinal motility and is secreted during different phases of food processing. In contrast to these hormones, secretin and glucagon inhibit the motility of the small intestine. The physiological role of each of these hormones is still controversial.

tasks peristaltic waves in the small intestine is not only the movement of chyme towards the ileocecal valve, but also the distribution of chyme over the surface of the intestinal mucosa. As soon as the contents from the stomach enter the intestines and peristalsis occurs, the chyme is immediately distributed throughout the intestines.

This process is enhanced when extra portion of chyme enters the duodenum. When the ileocecal valve is reached, the passage of the chyme is sometimes blocked for several hours until the person begins to take other food. At this time, the gastroileal reflex increases peristalsis in the ileum and causes the remaining chyme to pass through the ileocecal valve into the caecum of the large intestine.

segmental movements, although lasting about a few seconds, usually extend about 1 cm in the anal direction and at this time help to move food down the intestines. The difference between segmentation and peristaltic movements is not so significant.

Intestinal peristalsis is a systematic contraction of the smooth muscles of an organ that allows food to move through the gastrointestinal tract and ultimately remove undigested residues from the body.

Motility is also necessary for efficient digestion: thanks to the contraction of internal muscles, enzymes of the gallbladder and pancreas are delivered to the hollow organs.

The proper functioning of the totality of all systems of the human body is directly related to the health of the intestines. The state of the digestive tract depends on the immunity of a person, his well-being and performance. Often, malfunctions in the digestive tract become the basis for the development of other diseases.

In a normal state, a hollow organ contracts systematically. Muscle fibers line the inner walls in two layers: in the first they are located longitudinally, in the second - annularly.

The amplitude of the wave-like movement of the muscles varies depending on the area of ​​​​the intestine: the small intestine contracts both at a slow and at a fast pace. In addition, several cuts can be made simultaneously in this department.

The food bolus moves much more slowly through the large intestine. The intensity of the peristaltic impulse increases several times a day at the time of the urge to empty.

The frequency of contractions is considered normal: for the duodenum - 1-12 per minute, for the straight line - 9-12, for the thick - 3-4 and 6-12, for the straight line - 3.

What happens if the motor activity of the intestine increases or, on the contrary, decreases? The process of passage of the food bolus through the intestinal tube is complicated, as a result of which digestion suffers: useful substances from incoming food are absorbed more slowly and not in the proper amount, undigested food stagnates in the body, releasing toxic toxins.

Violation of motor function leads to the development of a number of diseases that manifest themselves as intestinal disorders in the form of diarrhea or constipation, increased gas formation, abdominal pain, inflammation of the mucous membrane, and ulcerative damage to the walls of internal organs.

Factors contributing to the development of pathology

The main reasons for the weakening of motor function are:

• malnutrition, the use of large amounts of simple carbohydrates, high-calorie foods;
• eating disorders: long intervals between meals, overeating;
• insufficient amount of liquid consumed; dehydration;
• low level of physical activity;
• chronic diseases of the liver, gallbladder, pancreas;
• infection of the body;
• malignant neoplasms in the intestine;
• complications after surgery on the abdominal organs;
• chronic fatigue syndrome, constant stress, depression;
• side effects of medications;
• heredity and features of old age;
• bad habits: smoking, alcohol abuse, drug addiction.

Weak peristalsis, most often the result of malnutrition, leads to constipation. Snacking on the go, junk food (fast food, sweets, flour products, coffee, carbonated drinks) cause digestive disorders.

Constant fermentation and rotting of undigested and unextracted food leads to intoxication: a detrimental effect is first on nearby organs - the kidneys, liver - then other systems are affected by harmful substances.

A high level of slagging, the formation of fecal stones adversely affect the condition of the mucosa. Persistent constipation contributes to the development of hemorrhoids, the formation of polyps in the intestine, which can degenerate into cancerous tumors.

Less common is another variant of peristalsis dysfunction - an increase in muscle contractions. Strengthen the motor activity of the digestive organs can be factors such as:

• the use of products that irritate the mucous membrane: sour, spicy dishes;
• oncology;
• dysbacteriosis;
• chronic infectious diseases;
• psychoneurological disorders;
• taking certain medications (such as antibiotics).

In this case, the patient is tormented by severe pain, diarrhea: the stool is very liquid, foamy. Frequent diarrhea leads to dehydration. Therefore, with increased motor skills, especially in children, it is urgent to consult a doctor.

Symptoms of intestinal peristalsis

Signs that indicate dysfunction of the digestive tract are:

• pains that have varying degrees of severity - from imperceptible discomfort to sharp spasms. Pain is reduced after going to the toilet, passing gases. They can also subside at night, and with a meal (over a morning cup of coffee or strong tea) they intensify again. Negative emotions can provoke an increase in pain;
• difficult bowel movements (constipation). Over time, constipation becomes chronic. Emptying the bowels naturally becomes almost impossible;
• feeling of heaviness in the lower abdomen;
• bloating, increased gas formation;
• bad breath;
• loss of appetite due to weight gain;
• pallor of the skin;
• signs of general malaise: lethargy, fatigue, fatigue, headaches, insomnia, irritability;
• dizziness: with anemia that has developed as a result of a lack of useful substances;
• signs of poisoning: allergies, deterioration of the skin and hair.

Dysfunction, characterized by an increase in contractile movements of smooth muscles, is accompanied by:

• acute pain in the intestines;
• frequent diarrhea with mucus or blood particles;
• flatulence, bloating;
• lack of relief after defecation, false urge to empty;
• there are signs of dehydration: dry mouth, weakness, drowsiness, chills, increased heart rate, reduced immunity.

These symptoms are warning signs that should not be ignored. To prevent serious consequences, it is necessary to contact the clinic, where specialists, based on the results of tests and studies, will be able to determine the exact diagnosis and prescribe effective therapy.

Diagnostics

During the examination and palpation, swelling, pain with pressure on the abdomen already manifests itself.

An effective laboratory test will be a coprogram - an analysis of feces for the presence of blood, pathogenic microflora.

Among the instrumental methods, the most informative are:

• endoscopy - examination of the intestine with optics;
• colonoscopy - using a special tube with a probe inserted into the anus, the doctor will assess the degree of patency of the organ, the condition of the mucosa, take a sample of the material for histological analysis;
• irrigoscopy - X-ray with the simultaneous introduction of a contrast suspension;
• Ultrasound of the pelvic organs and MRI are performed in difficult situations.

Treatment of disorders of intestinal motility

To restore the functioning of the digestive organs, an integrated approach is used, which includes changes in nutrition, exercise. In the case of chronic constipation, stool fossilization, drug therapy is indicated.

Medicines

First of all, it is necessary to clean the digestive tract from stagnant feces. For this purpose, laxatives are prescribed (Guttalax, Phenolphthalein, Dufalac), presented on the pharmaceutical market in various forms - in the form of tablets, drops, rectal suppositories.

Natural laxatives are rhubarb roots, licorice, buckthorn bark, senna leaves. Regulax is classified as a plant-based preparation.

Epsom salts and Glauber's salts are considered to be potent agents used when emptying is impossible. They act on the entire intestine, producing the desired effect within a couple of hours after ingestion.

Softens the food lump, facilitates its advancement to the anus castor oil. The effect is usually observed after a few hours.

You should not get carried away with laxatives: they are addictive, the digestive organs can “unlearn” how to work independently, without external stimuli.

Prozerin, Vasopressin, Aceclidin have a strengthening effect on the muscles of the intestine. They increase motor activity, stimulating the passage of food through the digestive tract.

Digestion is assisted by Mezim, Festal, Creon, which are not recommended to be taken for longer than 10 days.

To correct psychosomatic disorders, sedatives and antidepressants are prescribed.

All drugs, their dosage and treatment regimen are prescribed by a specialist. Replacement of the drug or early termination of its administration is possible only after a second examination. Independent use of any pharmaceuticals is prohibited!

Physiotherapy

An active lifestyle helps to restore the motility of internal organs. Running, swimming, hiking, horseback riding, abdominal pumping exercises will bring the intestines back to normal.

For unusual physical activity for you, first consult with an exercise therapy specialist!

A set of exercises to strengthen motor skills:

1. from a prone position (you can lie in bed immediately after waking up. It is important that the surface is not too soft!) Raise the body;
2. lying on your back, raise your legs bent at the knees at an angle of 90 degrees and perform the “cycling” exercise;
3. Remaining in the same position, grab your bent knees with your hands and pull them to your chest;
4. lower your bent legs to your feet and raise your pelvis;
5. in a kneeling position with an emphasis on the palms, alternately take your legs back;
6. from a kneeling position with an emphasis on the elbows, alternately sit on the right and left buttocks;
7. from a standing position, slow squats with abduction of the pelvis back;
8. jumping with or without a rope (in the absence of pathologies of the pelvic organs).

Abdominal exercises should be avoided to reduce intestinal motility. In this case, stretching is suitable.

Daily massage of the abdomen will also stimulate the digestive tract.

It has a beneficial effect on the body and a contrast shower or dousing with cold water, followed by intensive rubbing with a terry towel.

A necessary and effective method of treating the disease is to follow a diet based on the inclusion of vegetable fiber in the diet and reduce the consumption of high-calorie carbohydrate foods.

Basic rules for impaired dysfunction:

• it is better to eat more than 3 times a day (4-5) in small portions. Food must be chewed thoroughly;
• drink enough liquid (at the rate of 30 ml per 1 kg of body weight in the absence of kidney problems). Get in the habit of drinking a glass of water at room temperature in the morning: this method will help the intestines get to work;
• exclude from the menu foods rich in simple carbohydrates (sweets, especially chocolate, flour, fast food), starch (potatoes, rice, semolina), as well as irritating mucous membranes (carbonated drinks, fatty and fried foods, pickles, smoked meats, canned foods, sour fruit);
• use butter, boiled eggs, legumes with caution, which increase gas formation;
• you will have to limit the intake of strong tea and coffee, hot drinks;
• to enhance motor skills, fresh vegetables (cabbage, carrots, beets) and fruits (green apples, apricots, plums), bran, cereals, flax seeds, cereals from oatmeal and buckwheat, greens, berries are shown;
• for cooking, use vegetable oils (preferably cold-pressed): olive, linseed;
• freshly squeezed juices are useful (especially carrot, cabbage and beet, as well as berries), compotes, fermented milk products, dried fruits;
• if possible, eat more seafood, seaweed.

• pureed soups;
• cereals from barley, rice, semolina;
• lean meats, eggs;
• vegetable purees;
• astringent fruits and berries (quince, pear, bird cherry, chokeberry).

In any case, you will have to give up cigarettes and alcohol.

Traditional medicine

Non-traditional methods can effectively complement the main treatment: cleanse the slagged intestines, restore its motor function, stimulate the healing of damaged tissues and get rid of pathogenic bacteria.

Before using folk remedies, you need to consult a specialist!

Recipes for constipation:

• bran, fiber, which can be eaten separately or added to various dishes (salads, soups, cereals, jelly) 1-2 tablespoons a day;
• beetroot salad with prunes or garlic;
• mixture of prunes and dried apricots. Twist 400 grams of pitted dried fruits in a meat grinder, adding 2 tbsp. propolis tinctures, senna leaves (1 pack) and 200 ml of fresh, not candied honey. All ingredients must be mixed thoroughly. Take 2 tsp. at night with water at room temperature;
• a decoction of buckthorn bark is drunk instead of tea;
• crushed plantain seeds: 1 tsp each before eating.

Disease prevention

Any disease is easier to prevent than to cure. Therefore, the implementation of the following recommendations will be a significant contribution to the health of your intestines:

• stick to the basics of a balanced diet: the diet should be varied, including vegetable fiber and protein. Do not allow yourself to overeat, excessive passion for sweets, flour products, smoked, salty and fatty foods;
• keep your body in good shape: do morning exercises, walk in the fresh air, ride a bike and ski, swim in open water or a pool;
• observe the mode of work and rest: sleep 7-9 hours, avoid psychological overstrain and negative emotions;
• regularly visit a gastroenterologist (1-2 times a year) for preventive examinations and timely detection of abnormalities in the gastrointestinal tract.

Taking care of your body will help you avoid a lot of trouble. Be healthy!

Peristalsis (ancient Greek περισταλτικός - embracing and compressing) - a wave-like contraction of the walls of hollow tubular organs (esophagus, stomach, intestines), contributing to the promotion of their contents to the outlets.

Physiology of motility of smooth muscle organs

Most of the organs in which the process of peristaltic contractions occurs have two layers of smooth muscles in their walls, in one of them the muscle fibers are located longitudinally, in the other - circularly.

Coordinated contractions of these muscles form a peristaltic wave. Smooth muscles, unlike striated muscles, contract relatively slowly. Their contractions are involuntary, that is, they cannot be controlled by consciousness.

For example, the muscles of the organs of the digestive tube are smooth, with the exception of the "input" (striated muscles are present up to the upper third of the esophagus) and "output" (the external sphincter of the anus).

Therefore, after the beginning of the sip and before the act of defecation, all processes associated with the promotion of food, including peristalsis, are not controlled by consciousness.

The frequencies of peristaltic waves are different in different organs (departments). They are set by special pacemakers - clusters of nerve cells, among which the interstitial cells of Cajal play a dominant role. Pacemakers generate slow waves of transmembrane potentials. Slow waves do not cause muscle contractions, but create a potential in the muscles close to the activation threshold.

When slow waves of action potentials appear on the plateau, the muscle fiber contracts.

Pacemakers thus determine the frequencies of peristaltic waves (as well as other phase contractions).

They are the following in a healthy person (in cycles per minute): in the stomach - 2-4, in the duodenum - 10-12, in the jejunum - 9-12, in the ileum - 6-8, in the large intestine - about 0, 6, as well as 3-4 and 6-12, in the rectum - about 3, in the sphincter of Oddi - 3-6.

Peristalsis of the gastrointestinal tract

The peristalsis of the hollow organs of the human gastrointestinal tract (GIT) plays an important role in the process of digestion and the movement of food from the upper to the lower sections.

At the same time, peristaltic contractions are not the only type of motor activity in most of these organs. For each of them, the role of peristalsis and its contribution to the overall motor activity are different.

Peristaltic contraction for the digestive organs is understood as synchronized contractions of the organ wall, spreading from its "input" to "output" and moving in the same direction to some extent digested food.

For tubular organs (that is, all organs of the digestive tube except the stomach), it is assumed that peristaltic contractions completely or almost completely block the lumen of the organ.

Peristalsis of the esophagus

The difference between the esophagus and other organs of the gastrointestinal tract is that it does not have to perform any "processing" of food, but only has to deliver it from the oral cavity (pharynx) to the stomach. Therefore, for the esophagus, peristalsis is the main type of motor activity.

It is also important that the muscles of the upper 1/3 of the esophagus are striated, the physiology of the motility of this area is somewhat different than that of the smooth muscle of the lower 2/3 of the esophagus, stomach and intestines.

Peristalsis of swallowing

Esophageal manometry. Four primary peristaltic waves are seen with "wet" pharynxes

Distinguish between primary and secondary peristalsis of the esophagus.

Primary occurs immediately after the passage of a lump of food (bolus) of the upper esophageal sphincter. Secondary is a reaction to the stretching of the bolus wall of the esophagus. The speed of the peristaltic wave in the esophagus is about 3-5 cm per second.

At rest, the pressure in the esophagus is about 10 cm of water. Art. Tonic tension in the upper and lower esophageal sphincters, "locking" the esophagus on both sides - 20-30 cm of water. Art. The primary peristaltic wave that occurs during swallowing creates a pressure of about 70-90 cm of water. Art., varying from 30 to 140 cm of water. Art.

The speed of peristalsis of the pharynx is 2-4 cm per second. With an average length of the esophagus of 23-30 cm, the peristaltic wave passes through it in 6-10 seconds.

A feature of the peristalsis of swallowing is the suppression of the peristaltic wave of the previous sip by the next sip, if the previous sip did not pass through the area of ​​​​striated muscles.

Frequent repeated sips completely inhibit esophageal motility and relax the lower esophageal sphincter. Only slow sips and the release of the esophagus from the previous bolus of food create the conditions for normal peristalsis.

"Cleansing" peristalsis

In addition, a peristaltic wave may occur in the esophagus, which is not associated with the act of swallowing.

It is called cleansing or sentinel and is a reaction to irritation of the esophagus by foreign bodies, food debris, or stomach contents thrown into the esophagus by gastroesophageal reflux. It is noticeably smaller than the peristaltic wave associated with the act of swallowing.

Peristalsis of the stomach

Unlike the esophagus, the motor function of the stomach is not only to move food from the lower esophageal sphincter into the duodenum, but also to deposit, mix and grind it.

In the interdigestive period, when the stomach is not filled with food, its contractions are small and are mainly represented by a migrating motor complex, including periodically repeating peristaltic movements.

After eating, three types of motor activity occur in the stomach: systolic contractions of the pyloric part, a decrease in the size of the cavity of the fundus and body of the stomach, and peristaltic waves.

In the first hour after eating, peristaltic contractions are not large, the propagation speed of such a wave is about 1 cm per second, the duration of each wave is about 1.5 seconds. Then these waves increase, their amplitude and speed of propagation in the antrum of the stomach increase. The pressure in the stomach rises, the pyloric sphincter opens, and part of the chyme is pushed into the duodenum.

Peristalsis of the small intestine

The motor activity of the small intestine is very diverse and peristalsis, playing an important (but not predominant) role, is only one of the types of contractions of the small intestine.

Peristalsis of the small intestine when stimulated with food

During the period stimulated by food, several types of peristaltic waves propagate in the small intestine, which differ in the speed of passage through the intestine. There are very slow, slow, fast and rapid peristaltic waves.

As a rule, peristaltic waves occur in the duodenum, but can appear in both the jejunum and the ileum. At the same time, several waves move along the intestine.

Peristaltic waves move along the intestine at a speed of 0.1-0.3 cm / s, in the duodenum their speed is greater, in the jejunum - less, and in the ileum - even less. The speed of the rapid (propulsive) wave is 7-21 cm / s.

During the period when the small intestine is filled with food, in addition to peristaltic waves moving towards the large intestine, retrograde peristalsis is sometimes observed - peristaltic waves propagating towards the stomach (not considered physiological).

In addition, an important role in the digestive process in the small intestine is occupied by motor skills aimed at mixing the digested food (chyme) - rhythmic segmentation and pendulum contractions.

Peristalsis of the small intestine in the interdigestive period

In the interdigestive period, the motility of the small intestine is determined by the so-called migrating motor complexes, which include peristaltic waves, which perform the function of cleansing the intestinal epithelium from food debris, digestive juices, bacteria, etc.

Colon peristalsis

In the colon, the period of digestion of food is longer than in other parts of the gastrointestinal tract. The time occupied by peristaltic contractions, in relation to motor activity aimed at mixing the contents of the intestine, is noticeably less than in the previous sections of the gastrointestinal tract.

In the colon only 3-4 times a day there are strong propulsive peristaltic contractions that move the contents of the intestine in the caudal direction (towards the "exit"). Such contractions occur, among other things, after filling the empty stomach with food, which causes, through the mechanism of the gastrocolic reflex, the peristalsis of the colon and other intestines.

Peristalsis of the sphincter of Oddi and biliary tract

Peristalsis in the sphincter of Oddi is the main form of its motor activity. Their frequency is normal - 3-6 cycles per minute, amplitude - 50-70 mm Hg. Art. In addition to peristaltic waves propagating towards the duodenum, retrograde peristaltic contractions occur in the sphincter of Oddi and are considered physiological.