Intestinal hyperpneumatosis (pneumatosis) is a pathological process that is characterized by the formation of air cysts in the intestinal wall. The disease is manifested by cramping diffuse pains and a feeling of fullness in the abdomen. In this case, frequent stool disorders, belching, nausea, vomiting occur. A set of diagnostic measures includes a consultation with a gastroenterologist, an overview x-ray of the abdominal cavity, colonoscopy, and irrigoscopy.
Depending on what symptoms prevail in this condition, with hyperpneumatosis, carminative, laxative, antispasmodic or antidiarrheal medications are prescribed, diet food with limited use of products that cause excessive gas formation.
General information about the disease
Intestinal hyperpneumatosis is a rather rare disease of the digestive system, in which gases penetrate from the intestinal cavity into the thickness of its walls and form air cavities in them. In most cases, this pathological process is localized in the subserous or submucous layer of the jejunum or colon. The disease can occur in people of all ages, but it mainly occurs in the elderly and infants due to frequent disorders of the digestive system and reduced physical activity.
The sizes of air cysts in diameter vary from 0.5 to 5 cm. According to the prevalence of the process, hyperpneumatosis is divided into diffuse and limited, which affects only one area of the intestine. The diffuse form is characterized by the uniform distribution of pathological formations along the entire length of the intestinal tract.
Frequent questions of patients: “Is there intestinal hyperpneumatosis without structural changes?”, “How to treat the disease?” A disease never goes away without structural changes, since air cysts disrupt the structure of the intestinal walls, after which more serious organic lesions can develop.
Causes of occurrence
This disease rarely acts as an independent pathology. It most often develops against the background of a primary lesion of the digestive tract. The main cause of intestinal hyperpneumatosis is the excessive formation and prolonged presence of gases in it, which is observed due to the following pathological conditions:
- Tumors of the gastrointestinal tract. As a result of the development of benign and malignant neoplasms in the intestine, a blockage or narrowing of its lumen occurs, which contributes to the development of intestinal obstruction, excessive accumulation of gases and their penetration into the intestinal walls.
- Various intestinal infections. In case of severe infectious lesions of the intestines (cholera, dysentery, food toxicoinfection, salmonellosis), excessive gas formation is the result of fermentation and the formation of gaseous substances by pathogenic microorganisms.
- Other diseases of the digestive system. They can be atony, intestinal pathologies of inflammatory genesis (enterocolitis, colitis, Crohn's disease), the presence of adhesions, in particular between intestinal loops, which contributes to the violation of gas utilization and the development of hyperpneumatosis.
- Unhealthy Lifestyle. Frequent nervous disorders, adynamia, the use of an excess volume of products that provoke excessive gas formation (bread, cabbage, legumes, etc.) can lead to digestive disorders, flatulence and the formation of air cavities in the intestinal wall.
Pathogenesis
The mechanism of formation of air cysts in the intestine has not been fully studied to date, however, there are three main theories for the development of intestinal hyperpneumosis: infectious, pulmonary, and mechanical.
According to pulmonary theory, pneumatosis results from chronic lung pathologies (COPD, bronchial asthma). Due to constant long-term cough, microscopic tears of the alveoli occur, pneumomediastinum develops, which contributes to the spread of air in the retroperitoneal space. From there, free gas begins to diffuse into the intestinal wall and accumulate under the serous membranes.
According to the infectious theory of the origin of this disease, the gases released by bacteria penetrate the inflamed intestinal walls and begin to merge with the formation of large blisters.
In the field of gastroenterology, the mechanical theory of the development of severe intestinal hyperpneumatosis has earned the most recognition. According to this concept, air cysts in the intestine arise due to the primary pathology of the digestive system (enterocolitis, tumor, stenosis), and also as a result of congenital defects of the intestinal lymphatic and blood vessels. Against the background of gastrointestinal diseases, regular traumatization and gradual thinning of the intestine internal cover occur. Gas under the influence of intra-intestinal pressure penetrates through microdefects, after which it passes into the submucosal lymphatic vessels, and then it spreads with the help of peristalsis along the submucosal layer of the intestine.
Inside, air cysts are lined with a layer of epithelial cells. They can contain different gases: oxygen, nitrogen, hydrogen, carbon dioxide, argon, etc.
Intestinal hyperpneumatosis in a child
In most cases, pneumonia in children appears with the development of infectious pathologies. Somewhat less often - as a result of intestinal obstruction, which forms against the background of tumors in the intestine and after surgical interventions. In addition, in children this disease can be caused by a lack of physical activity. In infancy, children have a lack of maturity of the digestive system, as a result of which they often have flatulence. Intestinal hyperpneumatosis in a child has an extremely negative effect on motor functions. With excessive formation of gases in a child, treatment is carried out with the help of gas suppressants and long courses of massage.
The children's body has the property of rapidly recovering due to the speed of cell regeneration processes. With timely diagnosis of this disease, absolute recovery is possible without going into a chronic form.
The clinical picture of this pathological process
Symptoms of intestinal hyperpneumatosis depend on the number of gas cavities and the degree of spread. Patients most often complain of a constant feeling of discomfort and excessive heaviness in the abdomen, impaired gas discharge (flatulence). In addition, periodic abdominal cramping pains that do not have a clear localization often occur.
The formation of air cysts in the intestine leads to inhibition of peristalsis and the development of constipation. A prolonged absence of stool is replaced by diarrhea, in which mucus is observed in the stool. The patient has belching with an unpleasant odor, vomiting, nausea. Diffuse spread of the disease leads to a significant deterioration in the general condition of the patient: pallor of the skin, increasing weakness, lowering of blood pressure are noted, the frequency of heart contractions increases compensatory.
What is intestinal hyperpneumatosis, it is important to find out in advance. Timely treatment will help to avoid serious complications.
Possible complications
Increased intestinal pressure in hyperpneumatosis contributes to a change in the shape of intestinal loops with the formation of intussusception or inversion. The increase in the number of bubbles or their size contributes to the development of partial or complete blockage of the intestinal lumen with the formation of obstructive intestinal obstruction. This pathological condition is often accompanied by severe intoxication of the body, which can lead to the development of toxic toxic shock and the onset of death.
The growth of air cavities contributes to the development of intestinal adhesions. Excessive pressure on the wall of the intestine provokes a violation of the processes of its nutrition, the occurrence of ischemia, and subsequently necrosis.
The mortification of some sections of the intestine and the excess pressure of the gases causes ruptures of the intestinal walls, penetration of the contents of the intestine into the abdominal cavity. In this case, peritonitis develops, in which emergency measures are necessary. In their absence or untimely conduct, the patient develops sepsis.
Diagnostic procedures
In the absence of specific severe symptoms in the case of the development of limited intestinal hyperpneumatosis, the diagnosis of the disease is quite difficult. If severe pain occurs, digestive disorders, patients need to consult a gastroenterologist. The specialist at the same time carries out a comprehensive examination, examines the concomitant pathology and medical history, pays special attention to the pathology of the digestive tract. In certain cases, during deep palpation of the abdomen, the doctor manages to feel small rounded formations that run along the length of the intestinal tract and resemble clusters of grapes. Ultrasound of the abdominal cavity with hyperpneumatosis may be uninformative.
In order to adequately diagnose, the following diagnostic tests may be prescribed:
- Panoramic x-ray of the abdominal cavity. This procedure allows you to determine the presence on the intestinal wall of gas bubbles of various sizes, arranged in a chain. An ailment is characterized by the presence of ring-shaped double shadows in the swollen loops of the intestine.
- Colonoscopy This endoscopic examination helps to visualize gas bubbles, assess the condition of the mucous membrane of the organ and the extent of its damage. If necessary, an endoscopist performs a biopsy of the intestinal area for histological examination. Differential diagnosis of hyperpneumatosis should be carried out with nonspecific colitis, diverticula, pneumoperitoneum and intestinal duplication. With complete obstruction, intestinal obstruction of a different nature of origin is excluded.
- Irrigoscopy. Using this diagnostic technique, the presence of excess gas in the enlarged loops of the colon in the form of several nearby rounded shadows that are separated by a wall is determined. During the study, you can also find areas of intestinal narrowing, the presence of pathological neoplasms, ulceration of the intestinal tube.
Now it’s clear what it is - intestinal hyperpneumatosis.
Treatment
Given the fact that this pathological process develops a second time, accompanied by other diseases of the digestive organs, first of all, it is necessary to eliminate the initial cause of the disease. The therapeutic tactics for eliminating hyperpneumatosis is aimed at stopping bloating and stabilizing the exit of gases from the intestine in a natural way. In accordance with the fact that after resection of the affected area, relapses of the disease often occur, surgical removal of blisters is extremely rare. Treatment of intestinal hyperpneumatosis is carried out, as a rule, in the following areas:
- Taking medications, which includes the appointment of drugs based on simethicone and fennel, eliminating the symptoms of flatulence. With pain and abdominal cramps, antispasmodics are used, with constipation, laxatives, and with the development of diarrhea, antidiarrheal drugs. If the patient has a slowdown in peristalsis, prokinetics are prescribed. With the infectious nature of the development of the pathological process, the use of antibacterial therapy may be required.
- Diet for intestinal hyperpneumatosis. A well-designed diet should include only low-fat, fresh food. It is recommended to use various cereals, soups, lean species of fish and poultry. Among drinks, preference should be given to fruit drinks, kissel, and weak tea. Dishes are recommended to be consumed in small quantities, 4-5 times a day in boiled, fresh or stewed form. In addition, products that provoke excessive gas formation should be excluded from your diet: tomatoes, beans, cabbage, smoked and fried foods, apples, canned goods, baked goods, sweet pastries, carbonated drinks. It is also necessary to refuse the use of alcoholic beverages.
Hyperbaric oxygenation
An additional technique for the treatment of hyperpneumatosis is hyperbaric oxygenation (HBO). Due to the active saturation of blood with oxygen, the total pressure of the gases of the venous blood decreases, which in some cases contributes to the resorption of air bubbles. Surgical therapeutic methods are used exclusively in case of complications of this pathology (intestinal obstruction, intestinal invagination, peritonitis, etc.).
Prevention and prognosis
With the timely elimination of the primary pathological process that provoked the occurrence of gastrointestinal tract hyperpneumatosis, as well as with a diet and all necessary medical measures, the prognosis for patients is usually favorable. The formation of multiple or large gas cysts increases the likelihood of developing serious complications (intestinal obstruction, peritonitis) and significantly worsens the prognosis of the disease.
Prevention of intestinal hyperpneumatosis involves the timely diagnosis and treatment of gastrointestinal diseases, the use of high-quality and fresh food. In the presence of chronic forms of pathologies of the digestive system, it is recommended to regularly and abdominal ultrasound.
Power Features
Proper nutrition helps to significantly alleviate the condition, normalize the passage of gases and stools, and also serves as a prevention of complications of the disease. It provides:
- Exclusion of food that enhances fermentation and gas production in the intestines (grapes, bananas, sweet apples, radishes, legumes, turnips, cabbage, bread and pastries, milk, garlic, cucumbers, onions, oats, mushrooms, turnips, gas drinks, raisins).
- Inclusion of the following products: wheat bread (dried), low-fat meat (boiled), carrots, greens, zucchini, pumpkin, dairy products, beets, green tea, cereals (except for pearl barley and millet), freshly squeezed juices, prunes, apricots, pomegranates.
- Six meals a day. During exacerbation, the basis of nutrition is puree-shaped dishes that do not have mechanical irritation to the intestines.
- Steam and boiled cooking methods. Eating vegetables is also recommended in boiled form.
- With a predominance of diarrhea - foods rich in tannin and reduce motility (compotes, tea, infusions of blueberries, quince, pomegranate, bird cherry), viscous dishes (mashed soups, jelly, mashed cereals).
- With a predominance of constipation - boiled beets, prunes, baked fruits, whole grains.
We examined what it is - intestinal hyperpneumatosis. The treatment of this pathology, prevention and diagnosis are also described in detail.