Combination of functional dyspepsia syndrome and irritable bowel syndrome
The aim of publication. To demonstrate features of diagnostics and adjustment of treatment in the patient with combined functional disorder, by the example of clinical case.Original positions. Patient М., 36 years old, female, has referred to the clinic with multiple complaints, such as postprandial...
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Gastro LLC
2011-06-01
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| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
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| Online Access: | https://www.gastro-j.ru/jour/article/view/1442 |
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| author | V. T. Ivashkin Ye. A. Poluektova |
| author_facet | V. T. Ivashkin Ye. A. Poluektova |
| author_sort | V. T. Ivashkin |
| collection | DOAJ |
| description | The aim of publication. To demonstrate features of diagnostics and adjustment of treatment in the patient with combined functional disorder, by the example of clinical case.Original positions. Patient М., 36 years old, female, has referred to the clinic with multiple complaints, such as postprandial feeling of heaviness and epigastric pain, bile vomiting, pain in the right hypochondrium, developing without any obvious cause, poorly localized aching abdominal pain in the afternoon, intensified at the evening time, meteorism, frequent bowel movements, up to 3 times per day (night-time diarrhea was absent), loose stool with admixture of mucus. Patient complained of weakness, drowsiness, dizziness, attacks of subfebrile fever, accompanied by bone aching, frequent painless micturition. Patient felt sick for the first at the age of 7, deteriorations in state of health were directly related to events (or risk of events), requiring mobilization of inner forces – study at school and institute, intrafamily conflicts, individual activity, etc. Patient was investigated repeatedly. Differential diagnostics was carried out between organic disease of gastro-intestinal tract, i.e. gastroduodenal erosions or ulcers, celiac disease, inflammatory bowel diseases, functional disorders. Treatment, that was carried out brought incomplete and inconsistent effect. At admission during physical examination no significant deviations from normal values were revealed except for increased skin sensitivity at palpation of all regions of abdomen. On the basis of complaints, data of past history and physical examination the diagnosis: functional dyspepsia syndrome and irritable bowel syndrome with diarrhea was established. Treatment by trimedat, that modifies nervous reactivity at the level of intestinal wall and spinal cord synapses, was prescribed. It was possible to achieve significant improvement in the state of health on the background of therapy. However, the overall prognosis for this patient is unfavorable. Prescription of pharmacological agents can hardly result in complete cure, as presence of almost constant complaints has «secondary psychologic benefit» for this patient.Conclusion. The factor determining quite low efficacy of pharmacotherapy at combined functional disorders is the personality features of the patient, that determine relationship with society, and development of symptoms as the adaptive mechanism protecting from necessity to be socially active. |
| format | Article |
| id | doaj-art-ce6d77ee93864b88be30cfcf4fb33fc8 |
| institution | Kabale University |
| issn | 1382-4376 2658-6673 |
| language | Russian |
| publishDate | 2011-06-01 |
| publisher | Gastro LLC |
| record_format | Article |
| series | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| spelling | doaj-art-ce6d77ee93864b88be30cfcf4fb33fc82025-02-10T16:14:31ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732011-06-012147581976Combination of functional dyspepsia syndrome and irritable bowel syndromeV. T. IvashkinYe. A. PoluektovaThe aim of publication. To demonstrate features of diagnostics and adjustment of treatment in the patient with combined functional disorder, by the example of clinical case.Original positions. Patient М., 36 years old, female, has referred to the clinic with multiple complaints, such as postprandial feeling of heaviness and epigastric pain, bile vomiting, pain in the right hypochondrium, developing without any obvious cause, poorly localized aching abdominal pain in the afternoon, intensified at the evening time, meteorism, frequent bowel movements, up to 3 times per day (night-time diarrhea was absent), loose stool with admixture of mucus. Patient complained of weakness, drowsiness, dizziness, attacks of subfebrile fever, accompanied by bone aching, frequent painless micturition. Patient felt sick for the first at the age of 7, deteriorations in state of health were directly related to events (or risk of events), requiring mobilization of inner forces – study at school and institute, intrafamily conflicts, individual activity, etc. Patient was investigated repeatedly. Differential diagnostics was carried out between organic disease of gastro-intestinal tract, i.e. gastroduodenal erosions or ulcers, celiac disease, inflammatory bowel diseases, functional disorders. Treatment, that was carried out brought incomplete and inconsistent effect. At admission during physical examination no significant deviations from normal values were revealed except for increased skin sensitivity at palpation of all regions of abdomen. On the basis of complaints, data of past history and physical examination the diagnosis: functional dyspepsia syndrome and irritable bowel syndrome with diarrhea was established. Treatment by trimedat, that modifies nervous reactivity at the level of intestinal wall and spinal cord synapses, was prescribed. It was possible to achieve significant improvement in the state of health on the background of therapy. However, the overall prognosis for this patient is unfavorable. Prescription of pharmacological agents can hardly result in complete cure, as presence of almost constant complaints has «secondary psychologic benefit» for this patient.Conclusion. The factor determining quite low efficacy of pharmacotherapy at combined functional disorders is the personality features of the patient, that determine relationship with society, and development of symptoms as the adaptive mechanism protecting from necessity to be socially active.https://www.gastro-j.ru/jour/article/view/1442functional disorderirritable bowel syndromefunctional dyspepsia syndrome |
| spellingShingle | V. T. Ivashkin Ye. A. Poluektova Combination of functional dyspepsia syndrome and irritable bowel syndrome Российский журнал гастроэнтерологии, гепатологии, колопроктологии functional disorder irritable bowel syndrome functional dyspepsia syndrome |
| title | Combination of functional dyspepsia syndrome and irritable bowel syndrome |
| title_full | Combination of functional dyspepsia syndrome and irritable bowel syndrome |
| title_fullStr | Combination of functional dyspepsia syndrome and irritable bowel syndrome |
| title_full_unstemmed | Combination of functional dyspepsia syndrome and irritable bowel syndrome |
| title_short | Combination of functional dyspepsia syndrome and irritable bowel syndrome |
| title_sort | combination of functional dyspepsia syndrome and irritable bowel syndrome |
| topic | functional disorder irritable bowel syndrome functional dyspepsia syndrome |
| url | https://www.gastro-j.ru/jour/article/view/1442 |
| work_keys_str_mv | AT vtivashkin combinationoffunctionaldyspepsiasyndromeandirritablebowelsyndrome AT yeapoluektova combinationoffunctionaldyspepsiasyndromeandirritablebowelsyndrome |