- This is a condition caused by a violation of the intestinal microflora associated with a change in the species composition of bacteria. With dysbacteriosis, the number of beneficial bifidus and lactobacilli is reduced, and the number of pathogenic (pathogenic) microorganisms increases. Pathology accompanies many diseases of the digestive system, prolonged or uncontrolled use of antibiotics, immunosuppressants, exposure to harmful environmental factors. Manifested by constipation, diarrhea, poor appetite, sleep, abdominal pain, skin rashes. In especially severe cases, bacteria of the gastrointestinal tract can be found in the blood, which threatens the development of sepsis.

General information

(dysbiosis) of the intestine is a disease characterized by a pathological change in the composition of the normal intestinal flora, contributing to disruption of the functioning of the intestine.

Causes

Intestinal dysbacteriosis is almost never a primary pathology, but develops as a result of certain violations of the functioning of organs or systems, or under the influence of taking drugs and substances that negatively affect microorganisms.

• Iatrogenic intestinal dysbacteriosis occurs as a result of taking drugs that suppress the vital activity of microorganisms (antibiotics, sulfanilamide drugs, hormonal agents, cytostatics, etc.). Also, dysbacteriosis can be the result of surgery.
• Improper nutrition, lack of necessary components in the diet, its imbalance, the presence of various kinds of chemical additives that contribute to the suppression of flora, disruptions in diet, a sharp change in the nature of the diet.
• Psychological stresses of various kinds.
• Infectious diseases of the intestine.
• Other diseases of the digestive organs (pancreatitis, hepatitis, gastritis, etc.).
• Immune disorders, endocrine diseases, metabolic disorders.
• Violation of biorhythms, acclimatization.
• Violation of intestinal motility.

Pathogenesis

The intestines of an adult normally contain about 2-3 kg of various microorganisms (about 500 species). These are symbionite bacteria that are directly involved in the act of digestion. In a healthy body, the qualitative and quantitative individual composition of the microflora is in a state of physiological balance - normobiocenosis (eubiosis). With changes in the composition of the intestinal flora, this balance is destroyed, which negatively affects the ability of the intestine to digest.

The normal functions of the intestines are:

1. trophic function - providing the body with nutrients;
2. energy function - supply of ATP, energy supply of the intestinal epithelium;
3. peristaltic function - chemical regulation of peristalsis;
4. regenerative function - participation in cell differentiation during the renewal of the epithelial lining of the intestine;
5. participation in maintaining the ionic balance;
6. the formation of a gas composition in the intestine;
7. participation in biochemical processes in the intestine - deactivation of poisons, activation of drugs, the formation of biologically active substances, neurotransmitters, signal markers, etc.;
8. protective function - participation in local immunity, production of immunoglobulin, cytoprotection, ensuring the resistance of the epithelium to pathogenic and carcinogenic factors, the capture of viruses, reading the genomes of pathological microorganisms;
9. participation in the metabolism of proteins, fats, bile acids and many other important components of nutrition, the synthesis of B vitamins, pantothenic acid;
10. maintaining the constancy of the physico-chemical environment of the intestine.

Symptoms of dysbacteriosis

• Dyspeptic syndrome - diarrhea (sometimes - alternating constipation and diarrhea), flatulence, bloating, belching and an unpleasant aftertaste in the mouth, rumbling in the intestines.
• Many people (especially children) who suffer from intestinal dysbacteriosis have allergic reactions to food that were not typical before. Reactions can be either of a conventional allergic nature (urticaria, pruritus, bronchospasm, angioedema), or intestinal (loose foamy stools, severe abdominal pain, nausea up to vomiting, lowering blood pressure).
• Malabsorption syndrome - malabsorption in the intestines of various essential nutrients is manifested by a lack of metabolic substrates - protein-energy deficiency, various hypovitaminosis, primarily, as a rule, in the group of vitamins B, anemia, ionic balance disorders, calcium deficiency, etc.
• Intoxication of the body - weakness, lack of appetite, subfebrile condition, headaches.
• Reduced immunity - an increase in infectious diseases (ARI, SARS, herpes), fungal diseases.

Diagnostics

Diagnosis of intestinal dysbacteriosis in clinical gastroenterology begins with the identification of characteristic dyspeptic disorders based on complaints, and a physical examination is performed. When diagnosing, as a rule, the symptoms of dysbacteriosis appear against the background of a primary pathology, or one is present in the anamnesis. Be sure to pay attention to the treatment that has taken place with drugs that suppress the microflora.

The most specific method for laboratory diagnosis of intestinal dysbacteriosis is an analysis for dysbacteriosis and stool culture. Small intestine dysbacteriosis is diagnosed by bacteriological examination of a scraping or aspirate of the jejunum, but due to the complexity of this technique, this technique is used only in cases where other diagnostic criteria are doubtful. Indirect signs of intestinal dysbacteriosis can be demonstrated by a coprogram, biochemistry of feces, gas-liquid analysis.

Treatment of dysbacteriosis

Treatment is carried out by a gastroenterologist and involves therapy in several areas - pathogenetic treatment (eradication of the cause of the disease), correction of the resulting pathological state of digestion, removal of acute symptoms of the disease, strengthening of protective properties and restoration of normal biocenosis in the intestine.

• Pathogenetic therapy is aimed at the primary pathology, and also includes measures to restore the motor functions of the intestine, relieve the inflammation that has arisen, and carry out enzyme replacement therapy.
• Patients with intestinal dysbacteriosis are shown diet No. 4 (modifications depending on the condition), which contributes to the normalization of intestinal activity, a decrease in the activity of putrefactive processes. Nutrition should be carefully balanced in terms of nutrient composition and energy component. Be sure to maintain a balance in the content of proteins, fats, carbohydrates, supply the body with vitamins and trace elements, a sufficient amount of liquid. It is necessary to pay attention to the diet, its compliance with biorhythms.
• Inclusion in the diet of foods containing dietary fiber, live bacterial cultures.
• Correction of the composition of the microflora using selective non-absorbable antibacterial drugs (rifaximin), intestinal antiseptics (nifuroxazide), drugs containing antagonist cultures of pathogenic intestinal flora, bacteriophages.
• Immunomodulators are used to restore immunity (echinacea preparations, nucleic acids, etc.).

Restoration of normal microflora is carried out using:

• probiotics (preparations containing live cultures of essential microorganisms);
• prebiotics (substances that promote the growth and reproduction of beneficial flora);
• synbiotics (complex preparations containing both the microorganisms themselves and the components necessary for their development).

Forecast and prevention

With timely treatment, the prognosis is favorable. Prevention of intestinal dysbacteriosis for healthy people implies proper nutrition in compliance with the regimen, the presence in the diet of products containing beneficial microorganisms (sour-milk products, substances containing bifidus and acidophilus bacteria, food and drinks based on sourdough). A balanced diet is required in terms of the composition of the substances necessary for the body, vitamins and trace elements.

For infants, the optimal prevention of dysbacteriosis is breastfeeding, which forms the normobiocenosis and immunity of the child. Breast milk has the optimal composition of prebiotics for the development of a healthy intestinal microflora.

Since intestinal dysbacteriosis most often occurs as a result of the use of antibacterial drugs, in such cases, the prevention of this disease is the rational prescription of pharmacological agents, an integrated approach to the treatment of infections - the appointment of drugs according to the antibiograms, a certain degree of resistance of a pathogen to antibiotics, parallel administration drugs for the correction of intestinal biocenosis.

With long-term antibiotic treatment, it is imperative to include in therapy a special diet containing foods rich in beneficial bacteria, antifungal and immunostimulating, as well as antihistamine therapy.

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

A banal change in diet, a change in the chemical composition of water consumed, 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 diseases of the 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:

Stage	Symptoms of dysbacteriosis	Solutions and possible consequences
First stage	At this stage of dysbiosis, symptoms are practically not observed. Possible manifestation of non-systemic rumbling in the abdomen.	Dysbacteriosis of the large intestine of the first stage occurs by changing the mode of eating or the type of water consumed. Elimination of the cause leads to self-normalization of the microflora.
Second stage	In the second stage of dysbacteriosis, symptoms include constipation or diarrhea, decreased appetite, bad taste in the mouth, nausea, and vomiting.	When the intestinal microflora is disturbed, such symptoms occur due to a significant change in the composition of microbes, which is provoked by antibiotics or mild food poisoning.
Third stage	There are pains in the intestines, intestinal absorption is disturbed and undigested food comes out with feces, the symptoms characteristic of dysbacteriosis of the second stage intensify.	Intestinal dysbacteriosis at this stage leads to the development of inflammation of the mucous membranes of the intestinal walls, disorders of intestinal motility and the digestive process. Medical intervention is required to avoid serious consequences.
Fourth stage	Symptoms of dysbacteriosis of the fourth stage include signs characteristic of the previous stages. In addition, insomnia, apathy, and depression increase.	With an almost complete change in the composition of the intestinal microflora, anemia and vitamin deficiency develop. If qualified treatment is not carried out, then intestinal dysbacteriosis of the fourth stage can lead not only to digestive disorders, but also to serious infectious diseases.

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:

Age	Stage	Laboratory indicators
Up to 50 years old	1 stage	Underestimated to 10 5 -10 6 or overestimated to 10 9 -10 10 indicator of typical Escherichia, underestimated to 10 5 -10 6 indicator of lactobacilli and underestimated to 10 6 -10 7 indicator of bifidobacteria.
	2 stage	Overestimated to 10 5 -10 7 indicator of opportunistic bacteria, underestimated to 10 7 indicator of bifidobacteria and up to 10 5 lactobacilli.
	3 stage	The indicator of opportunistic microorganisms exceeds 10 7 , the indicator of lactobacilli is reduced to 10 5 , bifidobacteria - to 10 7 .
After 50 years	1 stage	The indicator of typical Escherichia went beyond 10 5 -10 10 , the indicator of lactobacilli decreased to 10 4 -10 5 , bifidobacteria - to 10 6 -10 7 .
	2 stage	The increase in the indicator of conditionally pathogenic microorganisms rises to 10 5 -10 7 , the indicator of lactobacilli decreases to 10 4 , bifidobacteria - up to 10 6 .
	3 stage	The indicator of conditionally pathogenic microorganisms exceeds 10 6 -10 7 , the indicator of lactobacilli is reduced to 10 4 , bifidobacteria - to 10 6 .

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.

Very dark stools with a strong stench show 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 a violation of the intestinal flora is 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 in the initial stages, primarily involves 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 of warm water half an hour before meals. In addition, the diet should include five meals, albeit with smaller portions, as well as reducing intestinal stress.

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, in very simple terms, they 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, there are natural products that are prebiotics. Among them are dairy products, onions and garlic, cereals.

Now about probiotics. These drugs are a set of microorganisms necessary for the human body, which, when ingested 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 pharmaceutical preparations, which are divided into three conditional groups.

The first of these 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 types of 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 for improving the protective properties of the body, the use 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 the disease, you just need to follow a healthy lifestyle and adhere to a correct, 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 this or that designation for ordinary people are unlikely to make sense, but nevertheless we will designate 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.

On the territory of the former USSR, however, such a concept as intestinal dysbacteriosis is very popular. Symptoms, treatment of this disease - all this is a 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.

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

What is dysbacteriosis?

The term itself dysbacteriosis"involves an imbalance in the normal balance among the different types of bacteria in the body. Some authors also refer to this condition as dysbiosis. In principle, these terms are synonymous. Dysbacteriosis as a whole is, rather, not an independent disease, but a syndrome that is characteristic of certain pathologies and disorders in the body. It can cause any symptoms and manifestations, and sometimes seriously worsen the general condition of the patient. But the isolation of dysbacteriosis as an independent disease is difficult due to very vague and conditional diagnostic criteria.

In the vast majority of cases, dysbacteriosis is understood as intestinal dysbacteriosis. It is in the intestinal lumen that the largest number of various microorganisms live, which together represent a complex biosystem. The intestinal microflora normally performs many useful functions for the body. With dysbacteriosis, this process is disrupted.

Thus, in medical practice, intestinal dysbacteriosis is of the greatest importance. Other types of this syndrome are less common, less well studied and do not have such clinical significance. In other words, dysbacteriosis of other organs and parts of the body usually does not pose a serious threat to health.

Along with intestinal dysbacteriosis, the following types of this syndrome are distinguished:

• vaginal dysbacteriosis;
• oral dysbacteriosis;
• skin dysbiosis.

The above species also have some clinical significance. They will be discussed separately.

Intestinal dysbacteriosis

Intestinal dysbacteriosis is a very common problem in the world. This syndrome occurs in more than 75% of patients with various diseases of the gastrointestinal tract ( gastrointestinal tract). It occurs with almost equal frequency in men and women. Intestinal dysbiosis can also occur at any age ( including in infants). To better understand what exactly this problem is, one must first understand the normal composition and function of the intestinal microflora.

The intestinal microflora is a collection of various microorganisms that inhabit the lumen of the small and large intestines. Their number in an adult is very large. According to some reports, the total weight of microorganisms in the human intestine exceeds 2 kg. Of course, such a large number of microbes cannot but affect the host organism ( macroorganism).

All microorganisms that make up the normal intestinal microflora can be divided into two large groups:

• obligate microflora. Obligate ( obligatory) are called microorganisms that are always present in the intestine. They make up approximately 95 - 98% of all microorganisms. Due to the peculiarities of life, these microbes take part in the digestion of food, partly stimulate the intestines and perform other useful functions. Obligate microflora does not cause any pathological processes. On the contrary, it prevents the reproduction of pathogenic bacteria on the principle of competition. The species and quantitative composition of the obligate microflora is relatively constant. Part of it is excreted naturally during defecation ( bowel movements), but is compensated by the division of the remaining microorganisms.
• Facultative microflora. This group also includes a fairly large number of microorganisms that live in the intestines of healthy people. However, the species and quantitative composition of the facultative microflora is not constant. This may depend on lifestyle and nutrition, the region where a person lives, etc. Some opportunistic microorganisms also belong to the facultative microflora. They can lead to the development of various diseases and disorders if they accumulate too much. This partly explains a number of symptoms that appear in humans with dysbacteriosis. The facultative microflora makes up only a few percent of the total number of intestinal microorganisms and does not perform the useful functions that the obligate microflora performs.

In general, more than 500 species of various microorganisms live in the intestines of a healthy person. From a medical point of view, it makes no sense to single out each of them. Most microorganisms are grouped according to their main biochemical characteristics. When conducting analyzes, the number of representatives of a particular group is estimated, and some of the most common representatives are also distinguished.

Normal microflora in the intestines of a healthy person performs the following useful functions:

• Creation of a specific environment in the intestine. In the stomach, an acidic environment is created by special glands that produce hydrochloric acid. In the small intestine, the alkaline reaction of the environment ( pH) are produced in part by microorganisms. In the large intestine, pH is normally 5.3 - 5.8. This prevents the multiplication of many dangerous microbes. Once here, they do not survive and do not lead to the development of diseases. In addition, an optimal environment is needed for biochemical processes ( digestion and absorption of food, the formation of feces).
• Digestion of food. Many representatives of the obligate intestinal microflora ( lactobacilli, bifidobacteria, etc.) have enzymes that can aid in the digestion of food. In particular, they saponify fats, promote the fermentation of carbohydrates, and help break down fiber.
• Assimilation of vitamins. Some representatives of the intestinal microflora not only improve the absorption of vitamins, but also produce them themselves. First of all, this applies to vitamins K and some B vitamins. Also, without intestinal microflora, the body absorbs nicotinic acid and folic acid worse. In smaller quantities, ascorbic acid and other substances important for the body can also be formed.
• Intestinal contractions. The vital activity of the intestinal microflora partly stimulates the contraction of smooth muscle fibers in the intestinal wall. As a result, the intestines contract better ( peristalsis improves), food is well digested, and undigested residues are removed in time.
• Detoxification. It has been proven that the substances that are released ( are secreted) bifidobacteria and lactobacilli block and break down some toxins that can enter the body with food. It also neutralizes toxic substances that pathogenic microbes produce. All these toxins are not absorbed and do not enter the bloodstream.
• cholesterol metabolism. With bile, a significant amount of bile acids and cholesterol enters the intestine. They are necessary for the digestion of fats, but if reabsorbed, they can harm the body. Some bacteria in the process of life convert cholesterol into other compounds ( sterol - coprostanol, etc.), which are not reabsorbed by mucosal cells.
• Synthesis of biologically active substances. The intestinal microflora is also able to produce a number of substances that play an auxiliary role in the work of many body systems. They affect the functioning of the hematopoietic, cardiovascular and digestive systems.
• Strengthening immunity. The vital activity of bifidobacteria and lactobacilli stimulates many mechanisms associated with the functioning of the immune system. In particular, such important substances for the body as cytokines, immunoglobulins, interferon, etc. are better isolated. As a result, the immune defense of the body as a whole improves, and it becomes more resistant not only to intestinal diseases, but also to other infectious diseases.

As mentioned above, the number and species composition of the intestinal microflora are relatively constant. They can vary within certain limits, but a serious imbalance leads to the fact that the above processes cease to proceed normally. This condition is called dysbacteriosis.

In general, in the organs of the gastrointestinal tract, microorganisms are distributed as follows:

• Oral cavity. This department is in contact with the environment most often, and the number of bacteria here is normally up to 10 billion in 1 ml of liquid. The specific and quantitative composition is due to the bactericidal action of saliva and its biochemical properties. The most typical are Neisseria, streptococci, staphylococci, micrococci, lactobacilli, diphtheroids, etc.
• Stomach. Here the microflora is relatively poor due to the extremely acidic environment ( pH is normal 1.5 - 2.0), which kills most of the bacteria coming from the oral cavity. However, some microorganisms survive under these conditions. Normally, from 1 ml of liquid in the stomach, from 100 to 10 million microorganisms can be isolated. The most typical for the stomach are lactobacilli and bifidobacteria in small quantities, yeast fungi, bacteroids. Also, in the acidic environment of the stomach, a common pathogenic ( pathogenic) bacterium Helicobacter pylori.
• Duodenum. The alkaline environment of this department is better suited for bacteria. Here, the number of microorganisms varies greatly even during the day ( varies depending on food intake). On average, it ranges from 10 to 100 thousand microorganisms per 1 ml. Of the bacteria, the most characteristic are lactobacilli and bifidobacteria, fecal streptococcus, yeast.
• Small intestine. The number of microorganisms here can vary over a very wide range - from 1000 to 100 million in 1 ml or more. Not many opportunistic species live here ( they are more characteristic of the large intestine). The most typical in this section of the gastrointestinal tract are enterobacteria, streptococci, clostridia, staphylococci. There are also significant numbers of lactobacilli and bifidobacteria.
• Colon. In this section of the gastrointestinal tract, the microflora is the richest. The number of microorganisms per 1 ml is more than 100 billion, and their diversity is very large. Anaerobic microbes dominate, which do not need oxygen for reproduction. A large number of opportunistic species live here. The most typical representatives in a healthy person are lactobacilli and bifidobacteria, peptococci, clostridia, E. coli, enterobacteria, etc.

When we talk about intestinal dysbacteriosis, we usually mean serious changes in the species composition or number of microorganisms that inhabit the large and small intestine. However, disturbances at other levels of the gastrointestinal tract ( stomach and even mouth) may also have some effect on the intestinal microflora. With food, for example, many microorganisms pass from one department to another.

An unequivocal statement of such a diagnosis as intestinal dysbacteriosis is a very difficult task. The fact is that many studies conducted in this area have yielded mixed results. In European countries and the United States, dysbacteriosis is not diagnosed as a separate independent disease, since there are no clear criteria and limits of the norm. In the post-Soviet space, dysbacteriosis can be considered both a syndrome and a separate pathology. However, the criteria for making this diagnosis differ depending on the country, national standards, methods of analysis. The table below shows one of the most relevant templates, which indicates the main intestinal microorganisms and the rate of their content in the intestine. The norm is measured in the so-called colony-forming units per 1 g ( cfu/g). This means that when sown on a nutrient medium, each bacterium will grow its own colony. By the number of these colonies, one can approximately judge the number of microorganisms in the intestine.

The main representatives of the intestinal microflora

Representative of the intestinal microflora	Normal content in the intestines ( cfu/g)
bifidobacteria
lactobacilli
Peptococci and Peptostreptococci
Bacteroids
Escherichia
Hemolytic Staphylococci + Plasmacoagulating Staphylococci
Staphylococcus epidermidis and coagulase-negative (does not cause plasma clotting on analysis)
Streptococci (all groups)
Clostridia
eubacteria
Mushrooms from the yeast family
Conditionally pathogenic enterobacteria, including gram-negative rods

In principle, single deviations from the above standards cannot be regarded as dysbacteriosis. The intestinal microflora is a rather individual indicator, and some people have some deviations after past illnesses or due to other factors. Therefore, the results of the tests performed to make a diagnosis will not only be compared with normal values, but also compared with the clinical picture. In other words, the decision of whether a patient has dysbacteriosis is largely subjective. The doctor will definitely consider the possible causes of this disease, as well as its manifestations.

Causes of intestinal dysbacteriosis

There are many reasons that can affect the qualitative and quantitative composition of the intestinal microflora. In general, they can be divided into two large groups. The first is factors related to the internal environment of the body. This includes some diseases, features of the immune system, some special conditions of the body ( e.g. pregnancy in women). The second group is somewhat more common. These are factors that affect the body from the outside. This may include the use of certain medications, changes in diet or lifestyle. In practice, dysbacteriosis is almost always the result of a combination of several possible factors. In the vast majority of cases, the main cause that led to intestinal dysbacteriosis cannot be found. Therefore, if the disease is not of a protracted nature, but is manifested only by general symptoms, doctors most often do not look for the cause. A complete and accurate diagnosis is important in the case of recurring or prolonged episodes of dysbacteriosis, as well as in severe cases of the disease.

The change in the composition of the intestinal microflora during antibiotic therapy occurs for the following reasons:

• Many patients and some doctors do not consider it necessary to do an antibiogram in order to select the most effective antibiotic. Most of the agents used have a fairly wide spectrum of action and affect not only the pathogen that must be destroyed, but also representatives of the normal microflora.
• Among more than 500 representatives of the intestinal microflora there are bacteria that are sensitive to a variety of antibiotics. Therefore, theoretically, any antibacterial drug can become a direct or indirect cause of dysbacteriosis. In practice, the wider the spectrum of the drug, the more serious the consequences for the intestines.
• Some infections require long-term antibiotic treatment. For example, patients with tuberculosis take antibiotics for at least 3 months, and sometimes for several years without a break. Of course, during this time, drugs destroy a significant part of the intestinal microflora, causing chronic dysbacteriosis.
• Dysbacteriosis can be caused by the introduction of antibiotics in any way. Its risk is highest with oral ( in tablets and capsules) reception, as the medicine enters directly into the intestines. However, when administered intravenously or intramuscularly, the active substance through the blood still affects the intestinal microflora ( albeit in smaller doses), so dysbacteriosis is not excluded.
• Many patients and doctors do not attach importance to drugs that should be prescribed in parallel with antibiotics. These are antifungal agents and agents for protecting the intestinal microflora. In most cases, such prophylaxis will prevent dysbacteriosis in a timely manner.
• Often disease-causing microbes are more resistant to antibiotics than the normal intestinal flora. Receive mode violation ( the patient forgot to take the drug on time) or dosage may cause the pathogen to survive and the normal intestinal flora to die. As a result, the course of antibiotic therapy will be delayed, and dysbacteriosis will be more pronounced.

In most patients, signs of intestinal dysbiosis appear 1 to 2 weeks after the start of antibiotic treatment. In the first days of the course, the antibiotic destroys sensitive microflora ( selectively some species), then there is a reproduction of species that are not sensitive to this drug. The result is an imbalance. If there is an overgrowth of opportunistic bacteria, then the manifestations of dysbacteriosis can be very serious.

According to statistics, the most likely development of dysbacteriosis after a course of treatment with the following antibiotics:

• sulfa drugs;
• synthomycin;
• polymyxin;

However, the sensitivity to the antibiotic in each case is individual, therefore, not every patient will develop dysbacteriosis after a course of treatment with these drugs. The risk increases in the presence of other factors ( chronic diseases of the gastrointestinal tract, beriberi, weakened immunity, etc.). Theoretically, a course of any antibiotic lasting at least 3-5 days can cause dysbacteriosis.

In addition to the actual dysbacteriosis, there is another serious problem. Bacteria resistant ( sustainable) to the drug used, not only give excess growth, but also become even more resistant. In other words, patients who are frequently treated with antibiotics have strains of opportunistic intestinal bacteria that are resistant to the most commonly used antibiotics. If such strain ( colony-forming species) causes disease, it will be difficult to find an antibiotic to which it is sensitive.

Thus, antibiotic therapy should always be prescribed with an eye to the possible side effect in the form of dysbacteriosis. It is advisable to do an antibiogram in order to choose the most “highly specialized” antibiotic that will quickly destroy the causative agent of the disease and will not affect the intestinal microflora. Unfortunately, doctors do not always have the opportunity to make such an analysis, and patients do not always have the financial opportunity to purchase the safest and most effective drug. Perhaps this explains the high prevalence of dysbacteriosis after antibiotic therapy.

Classification of dysbacteriosis

The classification of intestinal dysbacteriosis is very conditional, since there are no clear boundaries of the norm for this syndrome. In addition, for each person, to one degree or another, there are individual indicators of the composition and amount of microflora. The clinical manifestations of the disease also create difficulties. They are weakly related to laboratory data. In some patients, the analysis does not reveal serious abnormalities, but the symptoms may indicate dysbacteriosis. At the same time, pronounced deviations in the analyzes do not always mean a serious condition of the patient. Many at the same time feel good and even refuse any treatment. Therefore, from a practical point of view, any classification of intestinal dysbacteriosis has no serious basis.

By type of pathogen, intestinal dysbacteriosis can be divided into the following groups:

• staphylococcal;
• clostridial ( usually dominated by the bacterium Clostridium difficile);
• protein ( genus Enterobacteriaceae);
• Klebsiella ( dominated by Klebsiella);
• bacteroid;
• candidiasis ( dominated by fungi of the genus Candida);
• mixed.

In this case, the type of dysbacteriosis is determined according to the microorganism that most intensively colonized the intestinal lumen. The number of its colonies when sown on nutrient media will be the largest. In some cases, there is a dependence of symptoms on the type of pathogen. Some of them cause abdominal pain, while others have blood impurities in the feces. However, a strict pattern is still not observed.

Also, dysbacteriosis can be divided according to the degree of severity. This indicator is estimated by a microbiologist after analyzing cultures that have grown on nutrient media. The criterion will be the number of colonies, respectively.

According to the severity, the following types of dysbacteriosis are distinguished:

• Mild dysbacteriosis. The growth of normal E. coli is somewhat reduced, and colonies of opportunistic bacteria occupy no more than a quarter of a Petri dish ( a special container with a nutrient medium where microbes are inoculated).
• Moderately expressed dysbacteriosis. A visible decrease in the growth of Escherichia coli, colonies of opportunistic bacteria occupy half of the Petri dish.
• Pronounced dysbacteriosis. The growth of Escherichia coli is greatly reduced, and colonies of opportunistic bacteria occupy ¾ of the Petri dish.
• Pronounced dysbacteriosis. E. coli practically does not grow, and the entire surface of the nutrient medium is occupied by colonies of conditionally pathogenic microorganisms ( staphylococcus, proteus, candida, lactose-negative escherichia, etc.).
• Normal intestinal microflora. Colonies of Escherichia coli grow abundantly, and colonies of opportunistic microorganisms rarely appear on the medium.

Stages of dysbacteriosis

The development of intestinal dysbacteriosis takes some time, so some researchers distinguish several stages of this disease. In the first stages of the disease, there is usually a decrease in the number of normal non-pathogenic microorganisms that make up the bulk of the intestinal microflora. Further, the growth of conditionally pathogenic microorganisms begins, which, having lost competition, actively colonize the intestinal lumen. Some bacteria have been observed to grow earlier than others. They are satisfied with minor changes in the chemical and biological state of the environment. Others actively grow only when the disease is advanced, since their growth and reproduction in general are slower.

Based on the quantitative and qualitative composition of the intestinal microflora, the following stages of dysbacteriosis can be distinguished:

• First stage. There is a decrease in the number of lactobacilli and bifidobacteria, which normally inhibit the growth of other microorganisms. At this stage, it is not yet possible to isolate other dominant representatives of the microflora.
• Second stage. At this stage, colibacilli are predominantly isolated ( E. coli and others.). Among them there are also species with atypical enzymatic activity. Each type of bacteria has its own set of enzymes that can be detected during microbiological analysis.
• Third stage. At this stage, the results of microbiological research can be the most diverse. The intestine is colonized by a mixed microflora, consisting mainly of opportunistic microbes.
• Fourth stage. In the absence of treatment, a pronounced growth of bacteria of the genus Proteus begins ( Proteus) and Pseudomonas ( Pseudomonas aeruginosa).

In most cases, the patient's condition gradually worsens according to the stages of the disease. Each next type of microbes that colonize the intestines cope with the functions of normal microflora worse and worse. However, there is still no clear distinction in terms of symptoms and clinical manifestations.

• Primary dysbacteriosis. With primary dysbacteriosis in a healthy person, due to the influence of external factors, the intestinal microflora begins to change. This leads to the multiplication of opportunistic bacteria that can damage the cells of the mucous membrane and cause an inflammatory process. Thus, in primary dysbacteriosis, qualitative and quantitative disturbances in the microflora precede inflammation as such.
• Secondary dysbacteriosis. Such dysbacteriosis is spoken of in intestinal infections, after some autoimmune processes, after surgery. The inflammatory process in the intestine occurs first due to the influence of various factors ( aggressive pathogenic bacteria, own antibodies, injuries, etc.). Against the background of inflammation, the habitat of normal microorganisms changes, and secondary dysbacteriosis develops.

The need for such a division is due to the fact that the superficial inflammatory process in the intestinal mucosa and changes in the composition of the microflora occur approximately simultaneously in the vast majority of patients. These are interrelated processes, but determining their sequence is sometimes important for a correct diagnosis.

Due to the low practical value of classifying dysbiosis, most Western medical schools and laboratories do not have any criteria. When formulating a diagnosis, they simply do not indicate the stage, since this does not greatly affect the patient's treatment process. Some laboratories and clinics have their own criteria, which generally coincide with the above classifications.

Before use, you should consult with a specialist.

This article describes what dysbacteriosis is, its features, symptoms and causes. The disease differs in types and stages, which are characterized by certain signs. The article contains detailed information about the treatment.

Brief description of the disease

Intestinal dysbacteriosis is a common phenomenon that some doctors consider a disease, while others consider it just a dysfunction resulting from a different pathology or a certain lifestyle. In both cases, we are talking about a violation of the intestinal microflora, which has unpleasant symptoms and is fraught with various complications and consequences.

Normal microflora

Intestinal biocenosis is a variety of microbes in the large intestine, which are present in certain quantities in every healthy person and are the norm. Microorganisms perform many important functions. Bacteria for the intestines are the usual "inhabitants".

Their total weight in this organ in an adult is approximately two to three kilograms. The number of species of microorganisms reaches five hundred. The vast majority of microbes "live" in the colon. The minimum falls on other departments. All intestinal microorganisms are conditionally divided into beneficial bacteria and pathogenic. The first group includes:

• bifidobacteria;
• lactobacilli;
• coli.

Pathogenic flora includes:

• peptococci;
• mushrooms Candida;
• staphylococci;
• clostridia.

There are relatively few harmful (or facultative) bacteria. In a healthy person, they “sit quietly”, because immunity does not allow them to “stick out”. Their presence in this state is normal and necessary for a certain balance of power.

Microbial diversity is extremely important for the body, since it performs protective functions, synthesizes vitamins, lowers cholesterol, helps processed food to be absorbed into the intestinal wall, and at the same time activates metabolic processes.

The essence of dysbacteriosis

Dysbacteriosis is the antonym of normbiocenosis. With it, the balance of microflora is disturbed. Beneficial bacteria become less, their activity decreases. Putrefactive bacteria (opportunistic pathogens), on the contrary, multiply rapidly, suppressing their "neighbors".

Extremely unhealthy processes begin.

Deficiency of lactobacilli and other beneficial microorganisms leads to indigestion, reduced immunity, slowing down metabolic processes. The body lacks nutrients, weakens, becomes vulnerable.

Sometimes you can hear the term stomach dysbacteriosis. It is erroneous, since there are not so many microorganisms in the digestive organ that could play a significant role. It is also wrong to look for differences and similarities between dysbiosis, dysbacteriosis. In this case, we are talking about the same thing.

What causes dysbiosis

The imbalance of microflora is always caused by certain factors. The pathogenic process does not start on its own. The causes of dysbacteriosis, in which beneficial microorganisms die, can be:

Dysbacteriosis can be cured only by knowing what provoked it. The factors listed above result in:

Often, severe dysbacteriosis occurs in people who have made a flight from one climatic zone to another. In a short travel time, the body does not have time to rebuild without consequences. In such cases, it is not necessary to treat dysbacteriosis with serious drugs. After adaptation of the body, the normal microflora will be restored. If the signs are pronounced, you can provide first aid in the form of symptomatic treatment.

Varieties of dysfunction

There are such types of dysbacteriosis as acute and chronic. The first occurs in most cases. With adequate treatment, the microflora is restored in a few weeks, all symptoms disappear.

The chronic type is much less common. It develops when it is not possible to defeat dysbacteriosis for months, and sometimes for years. As a rule, recovery is hindered by certain factors. For example, a severe incurable disease, constant stress or alcoholism. Chronic dysbiosis leads to serious consequences for the body.

There is also a classification of pathology according to the type of pathogen. There are fungal dysbacteriosis, proteus, staphylococcal type and associative. Proteus has the easiest and safest course. The most complex type is considered to be associative.

A warning! It is difficult to determine which type is taking place by one symptom. A quality check is required.

Stages of dysbacteriosis

Like most dysfunctions, dysbacteriosis has several stages. They depend on the manifestations of the disease, as well as treatment. The development of pathology occurs in stages:

1. Dysbacteriosis 1 degree. A decrease in the number of Escherichia coli (escherichia) is recorded. Bifidobacteria and lactobacilli are present in full composition.
2. Dysbacteriosis 2 degrees. The number of Escherichia is significantly reduced. There is a slight deficiency of bifidobacteria. The number of pathogenic microorganisms is growing.
3. Dysbacteriosis 3 degrees. Bifidobacteria and lactobacilli are much less than necessary. Pathogenic flora provokes malfunctions in the intestines.
4. Dysbacteriosis 4 degrees. Bifidoflora killed. Almost complete absence of lactobacilli. The intestine is exposed to serious destructive processes.

It is easiest to fix the problem at the very beginning. Normalization of the intestinal microflora in the later stages will take a lot of time and effort. In this case, the disease will have time to cause significant damage to the body.

Advice! At the first clinical manifestations, you should consult a doctor.

Symptomatic picture

The imbalance of microflora may not make itself felt for a long time. Symptoms of dysbacteriosis in adults are often absent in the first stages, appearing only when everything is already quite running. And this is the trick of the disease. In addition, the signs of dysbacteriosis are identical to the manifestations of many other pathologies. None of them are specific.

Dysbiosis is characterized by:

1. Bad breath. Sometimes this is the only sign of dysbacteriosis. It is explained by putrefactive processes occurring in the intestines.
2. Diarrhea is a common symptom of dysbiosis. It can occur four to six times a day, or even more often. Dangerous dehydration. Regular diarrhea is a sure sign that something is wrong with the intestines. Feces can be frothy and difficult to flush from the toilet
3. Constipation is less common than diarrhea. Usually they suffer from elderly patients who have significantly slowed down intestinal motility.
4. Unstable stool alternates with constipation and diarrhea. The bowel movements can be very offensive. Sometimes there is an unusual color of feces.
5. Rumbling in the abdomen is heard more often in the initial stages. Indicates problems in the intestines. Over time, flatulence intensifies, a person is literally bursting with gases, his stomach increases. There is frequent belching of air.
6. Pain is localized in the intestines. The stomach hurts especially badly with constipation, with severe flatulence due to stretching of the intestinal walls. The discomfort is aggravated by pressure.
7. Nausea, vomiting, internal discomfort, bad taste in the mouth. These signs, which are typical for many diseases of the gastrointestinal tract, can also appear with dysbacteriosis. Sometimes there is heartburn.
8. With dysbiosis, food is poorly absorbed, the body receives less "building materials", which often leads to weight loss.
9. Deficiency of nutrients in advanced stages is manifested by symptoms such as apathy, drowsiness, depression. A person almost constantly feels a general weakness. It does not go away even after a night's rest. The patient wakes up tired.
10. Dysbacteriosis is rarely accompanied by an increase in temperature. Such a symptom can make itself felt if there is a strong intoxication of the body. Fever is possible with severe exacerbations of chronic dysbiosis.
11. Sometimes after eating familiar foods, allergic reactions can occur. Namely - a rash, hyperemia of the skin, itching. Such reactions are explained by a decrease in the protective properties of the body due to disturbed microflora.

Vitamin deficiency resulting from dysbacteriosis can be manifested by brittle nails, dull hair, as well as pallor and dry skin, jams in the corners of the lips. The more serious the stage, the more pronounced the symptoms, which indicate not only a disturbed microflora, but also a general deterioration in health.

Diagnostic measures

An accurate diagnosis of dysbacteriosis can only be made by a professional doctor, who should be contacted at the first alarming symptoms. At the initial stage of the survey will be carried out:

• conversation with the patient;
• collection of anamnesis;
• visual inspection with palpation.

However, only on the basis of data obtained as a result of these actions, a treatment regimen for dysbacteriosis cannot be developed. Be sure to need laboratory research methods that will refute or confirm the presence of a problem, determine the type of pathogen, the stage of the disease.

To date, the main method for diagnosing dysbacteriosis remains bacteriological analysis of feces. Although it is not perfect (it is expensive, takes a lot of time, does not exclude errors), but there is no better method yet.

It is important to properly prepare for the analysis, to collect the material correctly. A few days before the procedure, it is necessary to exclude from the diet everything that can affect the microflora. These are dairy products:

• fermented baked milk;
• kefir;
• sour cream;
• kvass;
• any alcohol (especially beer);
• antibiotics.

When collecting material, it is advisable to take an average portion of feces, and not from the toilet, but from a clean piece of paper. Place the piece in a special sterile flask. Deliver to the laboratory no later than two hours after collection.

Attention! Sometimes you have to take an analysis for dysbacteriosis several times. This is due to the fact that during the collection of material or during the study, errors are made that affect the result.

To diagnose diseases that have become the cause or consequence of dysbacteriosis, other research methods are used. This is a blood test, ultrasound, MRI, CT. Sometimes an x-ray with contrast is prescribed to determine the condition of the intestine. It complements the results of microbiological analysis of microflora.

Features of treatment

Normalizing the situation with dysbiosis in most cases is not so easy. Comprehensive treatment is needed, aimed not only at eliminating the symptoms, but also at eliminating the causes. Its main tasks are:

• inhibition of the growth of the number of pathogenic microorganisms;
• stimulation of the reproduction of beneficial bacteria;
• boosting immunity.

Today in pharmacies there are quite inexpensive, but effective drugs for dysbacteriosis. Their use greatly facilitates the fight against the sore. However, even the best remedies for dysbacteriosis will not help if you do not adjust the diet, do not lead a healthy lifestyle. Poor quality food, bad habits will aggravate the situation.

In some cases, treatment of intestinal dysbiosis in adults is not required. The microflora, disturbed after stress, a series of holidays or climate change, is restored by itself. Treatment of dysbacteriosis after antibiotics may be limited to preparations based on live bacteria.

Complex therapy is required. It takes not one or two days, but several weeks. As a rule, drugs for dysbacteriosis can be taken at home. Only occasionally are hospital conditions required.

Medical therapy

In the treatment of dysbacteriosis, drugs to improve microflora play an important role. These are products containing live bacteria. Their common name is probiotics. In cases where a large number of pathogenic organisms have been sown, treatment should begin with their elimination. Otherwise, beneficial bacteria will have nowhere to settle. Therefore, it is necessary to drink antibiotics from dysbacteriosis. Recommended medications include:

1. Furazolidone is a monoamine oxidase inhibitor. It is considered a powerful antimicrobial agent. Activates the immune system.
2. Metronidazole has an antiprotozoal and antimicrobial effect. Widely used for abdominal infections.
3. Levomycetin is considered a broad-spectrum antibiotic. It is especially effective in detecting enterococci.

If a fungal type of dysbacteriosis is diagnosed, patients are prescribed a yeast-fighting drug, Candida Fluconazole. It is not an antibiotic, but is considered an antifungal agent.

Doctors try to use all antibacterial drugs very carefully, preferring intestinal antiseptics. They eliminate the pathogenic flora, while not touching the healthy one. The new generation of intestinal antiseptics include:

• Dependal-M;
• Sumetrolim;
• Enterosediv;
• Ercefuril;
• Intetrix.

Another drug widely used for dysbacteriosis is Enterofuril. After therapy with antibiotics and antiseptics, the free space is populated by beneficial bacteria contained in probiotics. For example, live lactobacilli for the intestines are found in Lactobacterin.

Bifidobacteria - in Bifidumbacterin. Both of these drugs are monopreparations in tablets for the restoration of intestinal microflora. Although there are other forms of release of these drugs. In particular, candles with lactobacilli and bifidobacteria.

Along with monocomponent preparations, polycomponent preparations with different types of bacteria can also be prescribed. Effective agents from this group include, for example, Bifiform. There are also combined probiotics containing beneficial and pathogenic organisms - Acipol, Bifiliz. To stimulate the growth of healthy bacteria, Linex is used. Bilaminolact, Ecoflor have a similar effect.

Activated charcoal is prescribed to remove toxins from the body. It should be used to a limited extent. The means of this action also include Polyphepan, Polysorb. Prebiotics are relevant for dysbacteriosis, stimulating the growth of healthy microflora. These substances are found in food. Special drugs may be prescribed - Hilak Forte, Duphalac (syrups) or Bactistatin capsules.

Treatment of dysbacteriosis should be complex. It is aimed at eliminating the root cause, which often becomes a gastrointestinal disease. The drugs used depend on the specific pathology. It can be:

1. Omez has a pronounced antiulcer effect.
2. Mezim is an enzyme agent. It is prescribed for serious digestive disorders.
3. Pancreatin is used in diseases of the pancreas. Helps improve food digestion.
4. De-nol is indispensable for gastritis. It has an astringent and enveloping effect.

If signs of dysbacteriosis are pronounced, symptomatic treatment may be required. So, for example, diarrhea is eliminated by Loperamide. This drug normalizes the stool, but has absolutely no effect on the intestinal microflora. Pain is relieved with analgesics. Constipation is treated with laxatives.

Important! Symptomatic treatment is not able to eliminate the cause, therefore it is carried out exclusively in the course of complex therapy.

Diet and folk remedies for dysbiosis

Nutrition in dysbacteriosis plays an important role. Recovery largely depends on it. The purpose of the diet is to protect the intestines from negative influences (mechanical, thermal). Food should be steamed, stewed or boiled. It should be taken according to the schedule - often, but little by little. You can eat:

• low-fat varieties of fish, meat;
• vegetables, fruits, berries that have undergone heat treatment (except grapes, bananas, sweet apples);
• greenery;
• cereals;
• nuts;
• legumes.

Diet for intestinal dysbacteriosis in adults excludes:

• fatty;
• roast;
• food full of preservatives;
• acute;
• fast food;
• ice cream;
• condensed milk;
• most products that provoke flatulence;
• semolina and rice porridge;
• soda;
• alcohol.

Folk remedies for dysbacteriosis are often based on food. For example, it is proposed to use raspberry, blueberry, pomegranate, cranberry, strawberry juices as antiseptics. Dill, cumin have a carminative effect, on the basis of which decoctions and infusions are prepared. To get rid of dysbacteriosis, it is recommended to eat more garlic and Jerusalem artichoke.

Herbal medicine is widely used. For example, with diarrhea, fixing decoctions of their oak bark are prepared. Mint, calendula, St. John's wort help to stop the pain syndrome. They fight constipation with enemas based on a decoction of chamomile.

Dysbacteriosis in children

Dysbacteriosis in a child is more common than in an adult. Especially when it comes to breasts. The development of pathology is facilitated by an unformed digestive system, the almost complete absence of one's own immunity. Higher risk of infection in artificial babies.

Dysbacteriosis manifests itself in children with frequent loose stools or, conversely, its long absence; restlessness, sleep problems, loss of appetite, prolonged crying. Such babies can be severely underweight. Symptoms of intestinal dysbacteriosis in children are not always pronounced. The deviation can be manifested only by a slight rumbling in the stomach. And you should not ignore this sign, because the situation can worsen.

Treatment of intestinal dysbiosis in children depends on the age of the young patient. Artificial babies are transferred to special mixtures, kefir is introduced into the diet. If the baby's nutrition is mother's milk, then the mother is advised to reconsider her menu. Most often, the reasons are in his errors.

Older children, as well as babies suffering from serious dysbacteriosis, may be prescribed antibiotics, preparations containing enzymes. But in any case, it is necessary to adjust the nutrition.

Important! Pay special attention to ensure that the child's body receives enough vitamins.

So, dysbacteriosis is not an independent disease, but a consequence of another pathology or an unhealthy lifestyle. If you care about prevention, the intestines need to be protected. Eat normally, do not abuse alcohol, try not to take antibiotics unless absolutely necessary, wash your hands before eating, treat all diseases in a timely manner, undergo regular medical examinations, and avoid outbreaks of epidemics. For young children, the best preventive measure is breastfeeding.

If dysbacteriosis nevertheless made itself felt, it is necessary to start its treatment immediately. The chronic form is fraught with such serious complications as secondary intestinal infections, diverticulitis, enterocolitis, sepsis, peritonitis.
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The body with it constantly lacks the necessary substances, which leads to a deterioration in the general condition - both physical and moral. Acute dysbacteriosis can lead to dehydration. This is especially true and dangerous for young children, who may even die.

The disease cannot be ignored. With a competent approach, dysbacteriosis is successfully treated, the prognosis is favorable.

Bloating, rumbling in the abdomen, impaired stool - almost every person is familiar with these symptoms. However, not everyone knows that this is a manifestation of dysbacteriosis. The attitude to dysbacteriosis in people is twofold: someone does not perceive this disease as a serious problem, and someone believes that dysbacteriosis is a dangerous disease that requires immediate treatment. Modern medicine considers dysbacteriosis not as a specific disease, but as a consequence of any pathology or an unhealthy lifestyle, as a result of which the balance of microorganisms in the intestine is disturbed.

What is intestinal dysbiosis

Intestinal dysbacteriosis is a clinical and laboratory syndrome characterized by a qualitative and/or quantitative change in the composition of the normal intestinal microflora, leading to gastrointestinal disorders.

Digestion is a complex process in which bacteria play an important role.

On the mucous membrane of a healthy intestine, a huge number of microorganisms peacefully colonize - both beneficial and potentially dangerous, their total weight is 2-3 kg.

Among them are:

• beneficial bacteria- bifidobacteria, lactobacilli, colibacilli. These microorganisms contribute to the absorption of nutrients, create conditions for normal digestion, and prevent the reproduction of pathogenic microorganisms.
• potentially pathogenic microorganisms- enterococci, staphylococci, fungi, some protozoa. Under certain conditions, there is an increase in the number of microorganisms that inhibit the functions of beneficial bacteria, leading to the development of diseases.

“According to Tibetan ideas, indigestion causes a heat disease (excessive penetration of Yang energy into hollow organs) or a cold disease (disturbance of the Yin constitutions Wind or Mucus), which depletes the “fire” of the stomach. The warmth of the stomach, which contributes to the proper digestion of food, is lost if hypothermia of the body occurs regularly, foods with cooling properties are systematically consumed, passion for diets, fasting, and the diet is not observed. Physical inactivity, stress are also provocative factors.”

Tibetan medicine doctor, reflexologist, hirudotherapist, phytotherapist, physiotherapist, neurologist

Causes of digestive disorders

Dysbacteriosis is provoked by:

• taking antibiotics;
• long-term treatment with hormonal, steroidal and non-steroidal anti-inflammatory drugs and the like;
• chemotherapy;
• diseases of the digestive tract (gastritis, pancreatitis, colitis, cholecystitis, etc.);
• some chronic diseases in the acute stage;
• allergic reactions;
• age-related deterioration in the functioning of the gastrointestinal tract;
• alcohol abuse;
• immunodeficiency states;
• change in diet;
• climate change;
• transferred operations on the digestive organs.

Symptoms of intestinal dysbiosis in adults and children

The symptomatology of this disease can be extremely diverse, it depends on the location and degree of development of dysbacteriosis.

There are the following stages of dysbacteriosis:

1 stage

Symptoms are practically absent, pathology can only be determined by the results of laboratory tests, indicating a slight increase in the number of pathogenic bacilli.

2 stage

At this stage, the patient is disturbed by a violation of the stool (constipation or diarrhea), loss of appetite, nausea, vomiting. In the analyzes, there is a decrease in beneficial microflora, the rapid reproduction of pathogenic flora.

3 stage

A significant growth of pathogenic microflora provokes inflammatory processes in the intestine. Symptoms are more pronounced: pain in the intestines, constipation and diarrhea become chronic, intestinal absorption processes are disturbed and undigested food comes out with feces.

4 stage

Pathogenic microflora prevails, beneficial bacteria are practically replaced by harmful microbes. Pain, violation of the chair persist. Quick fatigue, insomnia, apathy, depression join.

Diagnosis of dysbacteriosis

Laboratory research methods

• General blood analysis
• coprogram (fecal analysis)

Instrumental research methods

• Ultrasound of the abdominal organs

Diagnosis of dysbacteriosis in the Naran clinic, in addition to laboratory methods, includes a thorough questioning of the patient, examination, and pulse diagnosis.

At the consultation, the doctor clarifies what kind of lifestyle the patient leads, what food preferences, frequency of meals, and also finds out what diseases he had, what therapy he took. The doctor asks in detail about the patient's complaints, which worries how long ago certain symptoms appeared.

After a detailed survey, the doctor develops a clear picture of the possible causes of the disease.

The doctor of Tibetan medicine attaches great importance to the general examination of the patient: examination of the tongue, skin, mucous membranes, palpation of the abdomen are very informative in terms of diagnosing the disease.

The study of the pulse is the main diagnostic method in Tibetan medicine, which allows to identify the state of the three main vital principles of the human body:

1. "wind" (nervous system)
2. bile (digestive system)
3. "mucus" (lymphatic and endocrine system).

and determine the place of origin of the disease even without symptoms. Pulse diagnostics is distinguished by a very high accuracy in determining the disease. Timely detection of the onset of the disease allows you to avoid serious problems.

Treatment of intestinal dysbiosis

The modern approach to the treatment of dysbacteriosis consists mainly in taking medications (antibiotics, pro- and prebiotics) and prescribing a diet.

Treatment at the Naran clinic is aimed at eliminating the causes that contribute to the development of dysbacteriosis. Tibetan medicine considers the body as a whole, the treatment of which requires an integrated approach.

In Tibetan medicine, there are 3 methods of treatment:

1. Lifestyle Correction
2. Power correction

   Nutrition for dysbacteriosis should correspond to the natural "dosha" of the patient, because with its help it is possible to strengthen or, on the contrary, pacify the digestive "fire". It is better if the food is light, but satisfying.

3. Phytotherapy

   Ecologically clean herbs, which are part of herbal teas, suppress the activity of pathogens in the intestines and gently contribute to the restoration of healthy microflora. Specially selected Tibetan and Baikal plants have proven to be an excellent remedy for dysbacteriosis, they are also indispensable in the treatment of other diseases of the gastrointestinal tract: they normalize metabolism, improve digestion, increase immunity, stop the inflammatory process and remove toxins and toxins accumulated in the intestines.

In addition, with a diagnosis of dysbacteriosis, treatment will be aimed at eliminating concomitant diseases of the gastrointestinal tract and comprehensively improving the entire digestive system, including the stomach, pancreas, liver, biliary tract, small and large intestines.

Food should be steamed or boiled, it is necessary to exclude the use of fried, fatty, smoked, salty foods.

Limit sweets, mushrooms, confectionery, meat products, canned foods, white bread and eggs in the diet.

Add more fresh vegetables and fruits, dairy products, cereals to the diet.

Quit drinking alcohol and smoking cigarettes completely.