Conservative

Hypoglycemic syndrome - a characteristic syndrome that develops in 2-3 hours after ingestion, which is based on sharp fluctuations in blood sugar followed by hypoglycemia to subnormal numbers. Some authors call this state "late dumping syndrome," as if to emphasize this difference from the time of development of symptoms of "early" dumping syndrome.

Etiopathogenesis of the syndrome is associated with impaired function of the insular apparatus of the pancreas, when in response to the initial hyperglycemia hyperinsulinemia occurs reflex nature.

Diagnosis. Clinically hypoglycemic syndrome is acute developing feelings of weakness, dizziness, sudden hunger, sucking patients note pain in the epigastric region, sweating, trembling, palpitations. Also lowered blood pressure and slowed heart rate. Blood sugar level at this time falls to low numbers (75-50 mg%). All of these effects usually disappear after taking small amounts of food, especially carbohydrate.

Afferent loop syndrome - a chronic pain may develop after stomach resection Billroth-2, when a one-way off intestine and violated his motor-evacuation function.

Pathogenesis syndrome complicated. It is based on violation of the evacuation of the contents of the afferent loop and its reflux into the stomach, causing what may be the mechanical moments of (her inflection, adhesions), and violation of motor function of the afferent loop due to denervation and changes in the normal anatomic relationships.

Diagnosis. Patients complain of a feeling of heaviness and brand viagra sometimes a pain in the epigastric region and right upper quadrant, which intensified soon after ingestion. The intensity of pain increases, and they soon completed copious bilious vomiting, followed by a relief.

Of the objective data can be noted a significant asymmetry of the abdomen due to bulging of the right upper quadrant, which vanishes after a heavy vomiting, mild jaundice of sclera, the fall in body weight.

Laboratory findings may indicate liver dysfunction and certain manifestations of so-called syndrome of the cecum. X-ray examination can also help in diagnosis.

Treatment. Possibilities of conservative therapy are limited. Clinical manifestations of syndrome decrease slightly after the appointment of a diet, gastric lavage, anti-inflammatory therapy. Pronounced afferent loop syndrome with frequent and abundant vomiting is an indication for surgical intervention.

Reflux gastritis - a pathological syndrome that develops in patients as a result of continuous casting of duodenal contents into the stomach or his worship, and due to the damaging effect of bile acids, lizoletsitina contained in gastric juice on the gastric mucosa.

Diagnosis. For the clinic reflux gastritis is characterized by a triad of symptoms: epigastric pain, regurgitation and vomiting of bile, loss of body weight. Pain, constant or persistent, is aching, burning in nature, localized in the epigastrium or upper abdomen, worse after eating or antacids. Vomiting, frequent, irregular, does not bring relief, there is a sudden, at any time of day, sometimes even at night. In the presence of bile vomit, in addition, patients often complain of a feeling of bitterness in the mouth. With the progression of the disease develops hypo-or achlorhydria, iron-deficiency anemia, patients lose weight.

Methods of functional diagnosis of duodenogastric reflux and reflux gastritis can be divided into qualitative and quantitative. The first group includes visual inspection of vomit aspiriruemogo gastric contents in the presence of bile; endoscopic diagnosis of reflux gastritis, based on the detection of bile in the stomach and the macroscopic characteristics of its mucosa. Quantitative methods include x-ray, determines the presence and extent of duodenogastric reflux; determining the concentration of bile acids, bilirubin in the gastric juice by biochemical methods; ionomanometricheskie, radioisotope and other methods of diagnosis of reflux. Morphologic study of the gastric mucosa of gastritis register now.

Treatment. Conservative treatment: diet therapy, the purpose of cholestyramine, antacids, drugs normalize the motility of the stomach and duodenum, reparants, vitamin therapy.

safety
long time
Review CNS
multivitamin
tactics