the Dysbacteriosis is very widespread phenomenon: meets, approximately in 90 % of cases among adults, and among children - in 95 %.

V a stomach and a duodenal gut usually there is no microflora, or is available poor, mainly, gramme-positive. The distalnee department of a digestive path, the more richly it is populated with microflora. In norm in intestines the intestinal stick, putrefactive bacteria, anaerobnye and aerobic laktobatsilly, enterokokki, drozhzhepodobnye fungi co-exist in an optimum parity. This status sometimes name eubioz.

intestines Dysbacteriosis is the status proceeding more or less long time which can disappear at corresponding correction or to be transformed to heavier form. In other cases the dysbacteriosis initially proceeds with various semiology and without corresponding treatment can accept long progressing techenie.

V intestines of the person is over 500 various kinds of the microbes which total reaches 1014, that 10 times more an aggregate number of cellular structure of a human body. The quantity of microorganisms increases in distalnom a direction, and in a thick gut in 1 g kala 1011 bacteria that makes 30 % of the dry rest intestinal soderzhimogo.

V concept of a dysbacteriosis of intestines contain enters superfluous microbic obsemenenie a thin gut and change of microbic structure of a thick gut. Infringement mikrobiotsenoza occurs to some extent at the majority of patients to a pathology of intestines and other bodies of digestion. Hence, the dysbacteriosis is bacteriological concept. It can be considered as one of displays or disease complication, but not independent nozologicheskaja the form. Krajnej degree of a dysbacteriosis of intestines is occurrence of bacteria of a gastroenteric path in blood (bakteriemija) or even development sepsisa. Sostav intestines microflorae is broken at illnesses of intestines and other bodies of digestion, treatment by antibiotics and immunodepressantami, influences of harmful factors of an environment. Klinicheskie dysbacteriosis displays depend on localisation disbioticheskih izmenenij.

the Dysbacteriosis of a thin gut

Pri a dysbacteriosis of a thin gut number of one microbes in a mucous membrane of a thin gut is increased, and others is reduced. Increase Eubacterium (in 30 times) is marked?-Streptococci (in 25 times), enterokokkov (in 10 times), kandid (in 15 times), occurrence of bacteria of sort Acinetobacter and herpes viruses. The quantity of the majority anaerobov, aktinomitsetov, klebsiell and other microorganisms which are natural inhabitants of intestines decreases from 2 to 30 times.

Prichinoj a dysbacteriosis can be: superfluous receipt of microorganisms in a thin gut at ahilii and function infringement ileotsekalnogo the valve; favorable conditions for development of pathological microorganisms in cases of infringement of intestinal digestion and vsasyvanija, developments of an immunodeficiency and infringements of passableness of intestines.

Povyshennaja proliferatsija microbes in a thin gut leads premature dekonjugatsii bilious acids and their loss with kalom. Surplus of bilious acids strengthens a motility of a thick gut and calls a diarrhoeia and steatoreju, and deficiency of bilious acids leads to infringement vsasyvanija fat-soluble vitamins and to development zhelchnokamennoj to illness. Bacterial toxins and metabolity, for example phenols and biogene aminy, can connect vitamin В12. Some microorganisms possess cytotoxic action and hurt epitely a thin gut. It conducts to reduction of height of fibers and deepening kript. At electronic microscopy the degeneration of microfibers comes to light, mitohondry and endoplazmaticheskoj seti.

the Dysbacteriosis of a thick gut

Sostav microflorae of a thick gut can vary under the influence of various factors and the adverse influences weakening protective mechanisms of an organism (extreme klimatogeograficheskie conditions, pollution of biosphere by industrial wastes and various chemical substances, infectious diseases, illnesses of bodies of digestion, the defective food, ionising radiation).

V development of a dysbacteriosis of a thick gut the big role play jatrogennye factors: application of antibiotics and sulfanilamidov, immunodepressantov, steroid hormones, rentgenoterapija, surgical interventions. Antibacterial preparations considerably suppress not only pathogenic microbic flora, but also growth of normal microflora in a thick gut. The microbes which have got from the outside, or endogennye the kinds steady against medical products (stafilokokki, protej, barmy mushrooms, enterokokki, sinegnojnaja a stick) as a result breed.

dysbacteriosis Treatment

dysbacteriosis Treatment should be complex (scheme) and include sledujushchie actions:

• elimination superfluous bacterial obsemenenija a thin gut;
• restoration of normal microbic flora of a thick gut;
• improvement of intestinal digestion and vsasyvanija;
• restoration of the broken motility of intestines;
• stimulation of reactance of an organism.

Antibacterial preparations

Antibacterial preparations are necessary first of all for suppression izbytochnogo growth of microbic flora in a thin gut. Are most widely applied antibiotiki from group tetratsiklinov, penicillin, tsefalosporiny, hinolony (tarivid, nitroksolin) and metronidazole.

However antibiotics of a wide spectrum of action substantially break eubioz in a thick gut. Therefore they should be applied only at diseases, soprovozhdajushchihsja by infringements vsasyvanija and intestines motility, at which as pravilo, the expressed growth of microbic flora in a gleam of a thin gut is marked.

Antibiotics appoint inside in usual doses within 7-10 days.

At the diseases accompanied by a dysbacteriosis of a thick gut, treatment luchshe to spend preparations which make the minimum impact on simbiontnuju microbic flora and suppress growth proteja, stafilokokkov, barmy gribov and others aggressive shtammov microbes. Antiseptics concerns them: intetriks, ersefuril, nitroksolin, furazolidon, etc.

At heavy forms of a staphylococcal dysbacteriosis apply antibiotics: tarivid, palin, metronidazole (trihopol), and also biseptol-480, nevigramon.

Antibacterial preparations appoint within 10-14 days. In a case pojavlenija in kale or intestinal juice of mushrooms application of nystatin or levorina is shown.

At all patients with a diarrhoeia, assotsiirovannoj with the antibiotics, proceeding with intoksikatsiej and lejkotsitozom, occurrence of a sharp diarrhoeia should be connected with Cl. difficile .

In this case urgently do crops kala on Cl. difficile also appoint vankomitsin on 125 mg in 4 times a day; if necessary the dose can be uvelichena to 500 mg 4 times a day. Treatment continue within 7-10 days. Effektiven also metronidazole in a dose of 500 mg in 2 times a day, batsitratsin on 25 000 ME in 4 times a day. Batsitratsin it is not soaked up almost in this connection v the thick gut can create higher concentration of a preparation. At obezvozhivanii apply adequate infuzionnuju therapy to correction vodno-elektrolitnogo balance. For toxin linkage Cl. difficile ispolzujut holestiramin (kvestran).

Bacterial preparations

Live cultures of normal microbic flora survive in intestines of the person from 1 do 10 % from the general dose and are capable to carry out in any measure physiologica l funktsiju normal microbic flora. Bacterial preparations can be appointed without predvaritelnoj antibacterial therapy or after it. Apply bifidumbakterin, bifikol, laktobakterin, bakt isubtil, lineks, enterol, etc. the Course lechenija lasts 1-2 months.

one more way of elimination of a dysbacteriosis - influence on pathogenic mikrobnuju flora products of a metabolism of normal microorganisms Is possible. To such preparatam concerns hilak forte. It is created 50 years ago and till now primenjaetsja for treatment of patients with intestines pathology. Hilak forte represents soboj a sterile concentrate of products of a metabolism of normal microflora kishechnika: dairy acid, lactose, amino acids and fat acids. These substances sposobstvujut to restoration in intestines of the biological environment necessary for sushchestvovanija of normal microflora, also suppress growth of pathogenic bacteria. Vozmozhno, metabolism products improve trofiku and function epiteliotsitov and kolonotsitov. 1 ml of a preparation corresponds to biosynthetic active substances 100 billion normal microorganisms. Hilak till 40-60 the thaw 3 raza in day for the term up to 4 weeks in a combination to preparations antibacterial dejstvija or after their application forte appoints.

there were messages on possibility of treatment of a sharp diarrhoeia, assotsiirovannoj with antibacterial therapy and Cl. difficile , big dozami pre - and probiotikov.

Regulators of digestion and intestines motility

At patients with infringement polostnogo digestion apply kreon, pantsitrat and drugie pancreatic enzymes. For the purpose of function improvement vsasyvanija appoint essentsiale, legalon or karsil, since. They stabilise membranes intestinal epitelija. propulsivnuju intestines function improve imodium (loperamid) and trimebutin (debridat).

Stimulators of reactance of an organism

For increase of reactance of an organism by the weakened patient it is expedient primenjat taktivin, timalin, timogen, immunal, immunofan and others immunostimulirujushchie means. Course of treatment should average 4 weeks. Odnovremenno vitamins are appointed.

dysbacteriosis Preventive maintenance

Primary preventive maintenance of a dysbacteriosis represents very much a challenge. It reshenie it is connected with the general preventive problems: ecology improvement, ratsionalnym a food, improvement of well-being and other numerous faktorami the external and internal environment.

Secondary preventive maintenance assumes rational application of antibiotics and drugih the medicines breaking eubioz, timely and optimum treatment boleznej the bodies of digestion accompanied by infringement mikrobiotsenoza.