There are few people who have never had a stomachache. In most cases, this unpleasant symptom is associated with malnutrition or with diseases of the digestive system, such as gastritis, ulcers or cholecystitis. If the abdominal pain is acute, plus the patient has nausea and vomiting, appendicitis is often diagnosed. And the cause of all these health troubles may be Payr's syndrome. Not every doctor knows what this disease is and how it manifests itself, which is why the wrong treatment is prescribed. Moreover, the patient not only does not improve, but the problem is exacerbated. As a result, it is only necessary to solve it surgically. In fairness, it must be said that clinically diagnosing Payr's syndrome, based only on the anamnesis and palpation of the abdomen and not having the results of special tests, is really difficult. But this ailment has some features that distinguish it from other gastrointestinal diseases. About how to recognize this dangerous syndrome and whether it is possible to cure an ailment without surgery, is our article.
Pyre's syndrome - what is it?
Recall school anatomy. All the food that we ate begins to be digested in the stomach, and then moves to the small intestine, where the digestion process ends. There, everything valuable comes into the blood from the food mass, and everything that is useless for the body passes into the colon. Here, water is absorbed from this mass, leaving a thicker waste material that we call feces. The large intestine has several sections, the longest of which is the colon. Simplified, it can be represented as a hollow tube with a diameter of about 7 cm, like a rim that borders the small intestines. The colon is divided into three segments. The ascending segment is located on the right side of the abdomen. It rises to the liver, where it bends at an angle close to 90 ° and passes into the transverse segment. This part of the colon reaches the region of the spleen (an organ lying in the left hypochondrium), bends again, passes into the descending segment, then into the sigmoid colon and into the rectum. Fecal masses, starting to form at the exit of the small intestine, go all this long way, gradually thickening. As a result, at the exit, we have formed a feces quite dense in density. Pyre's syndrome, or Pyre's disease, is observed when the second bend of the colon (in the spleen area) is much larger than physiologically necessary. At this point, the diameter of the intestinal cavity narrows significantly, which is called stenosis in medicine. Through a narrow hole, already thickened feces do not have time to move fast enough to make room for those who follow. As a result, a kind of congestion is formed from what the body is trying to bring out. Often to the feces added gases generated during the digestion of food.
What is the danger of Payr's syndrome?
In the small intestine, useful trace elements, vitamins and other substances pass from food to the blood, and all unnecessary and even harmful remain, forming fecal masses. Normally, we should remove them from the body every day, that is, perform an act of defecation. If feces are delayed, which is observed with constipation, the harmful substances present in them begin to flow into the blood, a gradual poisoning of the body begins (intoxication). This is the main danger that Payr's syndrome causes. Intoxication has many adverse effects, one of which is the suppression of immunity. This, in turn, leads to a decrease in resistance to various kinds of diseases. In addition, solid feces irritate the intestinal wall, leading to ulceration, and human attempts at constipation can cause hemorrhoids. Another serious problem caused by Payr's syndrome is colonoptosis, which means the prolapse of the colon. This leads to bowel obstruction, and sometimes to intestinal inversion.
Etiology
Pyre's Syndrome was described by the German surgeon Irwin Pyre in the distant 1905. Over more than 100 years, the prevalence of this pathology has increased and reached approximately 40% among the adult population of the planet. An excess of the colon is observed with a congenital pathological structure of the intestine, for example, with an elongated transverse segment of the colon. Since these abnormalities are congenital, the causes of their occurrence lie in any malfunctions of the formation of the intestine at the embryo stage. Among them can be called a dysfunctional ecology, mother’s illness during pregnancy, medication, bad habits, nervous stress, drinking alcohol from a pregnant woman and other factors affecting the development of the fetus. According to medical statistics, children whose father and mother suffer from diseases of the gastrointestinal tract are born with Payr's syndrome more often than children of absolutely healthy parents.
Pathogenesis
Payra's syndrome symptoms are standard for many other diseases of the gastrointestinal tract, and therefore the diagnosis is often made incorrectly. Patients may experience:
- constipation;
- nausea;
- loss of appetite;
- pain in the peritoneum;
vomiting
- bloated abdomen (due to the fact that the gases cannot escape from the colon);
- headache;
- irritability.
In addition, Payr's syndrome may be indicated by its manifestations:
- paroxysmal pains of unclear localization (due to accumulation of gases and feces in the place of inflection of the intestine);
- severe pain in the area of the location of the heart (sometimes they give under the shoulder blade or in the left hand);
- reduction of pain when the patient lies down horizontally.
Stagnation of feces causes inflammation of the intestinal walls, and throwing them into the small intestine, which often happens with Payr's syndrome, leads to reflux ileitis. In these cases, the symptoms of these associated diseases are added:
- mucus in the stool, sometimes with blood;
- temperature rise.
Dolichosigma
One of the departments of the colon is the sigmoid colon, so named because of its shape, somewhat resembling the letter "S". It is located directly in front of the rectum, the functions of which are to evacuate feces from the body. Dolichosigma is called pathology, when a person has a sigmoid colon formed longer than necessary anatomically. At the same time, stagnation of fecal masses unplanned by nature also occurs in it, and the symptoms resemble Payr's syndrome. Dolichosigma can be not only congenital, but also acquired. It is believed that the sigmoid colon can be extended with prolonged (years) malnutrition, eating too much meat and carbohydrates, and sedentary work. One of the main symptoms of this pathology is constipation. In addition, patients complain of pain in the navel and left hypochondrium, flatulence, and general deterioration of well-being.
Diagnostics
Pyre's syndrome in adults and children is not easy to diagnose. The anamnesis for this disease is very similar to other problems with the digestive tract. It happens that patients with Payr's syndrome were even diagnosed with appendicitis and underwent surgery. At this time, there is a very accurate method for diagnosing this pathology - irrigography. This is the most effective method that allows you to accurately determine the presence of an excess of the colon in the patient. The procedure is carried out using barium suspension. The process of its introduction to the patient is controlled by an X-ray screen. When the colon is full, the picture is taken while the patient is lying down, and when the colon is empty, it is standing.
Children of the age group of 10-15 years use the radioisotope method to study the colon. In this case, a colloidal solution of radioactive gold.
With Payr's syndrome, the picture shows that the colon, like a garland, sagged in the pelvic area.
Features of Payr's syndrome in children
Unfortunately, while Pyre's syndrome has not been studied in children, there are no unambiguous recommendations on how to diagnose it more accurately taking into account the age characteristics of small patients, and how to treat it more effectively. Studies by medical scientists have shown that in girls this disease is more common than in boys.
The manifestation of Payr's syndrome begins already in the first 12 months after birth, most often during the period when the baby is given complementary foods. New food makes the stool of the child more dense, which contributes to their delay in the place of inflection of the colon.
The first symptoms of the disease, indicating Payr's syndrome, are as follows: against the general background of complete health, the child has constipation and abdominal pain. Further signs of intoxication (nausea, vomiting) are added due to the accumulation of feces and their long stay in the intestine. Without treatment, in children by the age of 12-15 years, the same symptoms of Payr's syndrome are observed as in adults. When examining a child with suspected presence of Payr's syndrome, the doctor must definitely find out how the pregnancy progressed, whether there are immediate relatives in the family with gastrointestinal problems, in order to exclude inflammatory processes in the intestine, to prescribe a blood test. The final diagnosis should be made based on the results of irrigography.
Pyre Syndrome: Diet Treatment
With this ailment, patients should pay great attention to proper nutrition. Food should be high-calorie, but at the same time light, not containing many toxins. The menu must necessarily contain cottage cheese, butter, sour cream, jelly. To increase intestinal motility, patients should introduce whey, kefir, fermented baked milk, yogurt in their diet. You can not refuse sweets that attract liquid into the intestines, which helps to liquefy feces and an easier defecation process. Patients should eat a lot of fruits, honey, consume fruit syrups.
In the presence of Payr's syndrome, as with constipation of another etiology, it is useful to drink vegetable decoctions and compotes, as well as freshly prepared juices from carrots and raw potatoes.
Compliance with the diet does not eliminate the disease, but greatly facilitates its course.
Conservative treatment
Doctors can often observe a situation that they are afraid of surgery and first want to try drug therapy for patients who have Payr's syndrome. What pills can cure this ailment? Doctors may recommend lactulose medications. They can be given to children already during infancy. Lactulose somewhat dilutes the stool, enhances intestinal motility and at the same time colonizes the intestines with beneficial microflora. Anti-inflammatory drugs are prescribed for adults and everyone who, due to prolonged constipation, has begun inflammation of the intestinal wall. To relieve pain syndromes, antispasmodics "Drotaverin" or "Platifillin" can be advised, courses of prebiotics, probiotics, vitamins are also useful.
Payr's syndrome is treated with medication only at the very initial stages of the disease, and the results, as a rule, are short-lived. In parallel with the tablets, doctors prescribe physiotherapy (electrophoresis with a solution of novocaine, paraffin applications on the abdomen, diathermy, UHF, a stomach massage is mandatory, and exercises are prescribed to strengthen its walls.
Surgical intervention
This is the most effective treatment method, as a result of which all symptoms completely disappear, and forever, and not temporarily, as with other methods of therapy. The operations are performed according to different methods, which depends on the anatomical indications. On one of them, a median laparotomy is performed , a resection of the transverse section of the bypass gut in the middle part, a direct anastomosis is applied. Further, the transverse colon moves under the base of the trans-gastric ligament and is fixed by special technology so that the bends in the region of the liver and spleen are rounded.
According to the second method, the ligaments fixing the colon (colon-splenic and colon-diaphragmatic) are excised, the splenic flexure is reduced with a loroscope in order to remove the bowel bend. The operation is performed using medical trocars and an electrocautery.
Combined operations are performed for those diagnosed with Payr's syndrome, dolichosigma. Reviews of patients after such treatment are very favorable. In humans, pain completely disappears, constipation ceases, and with them the symptoms of intoxication disappear. During combined operations, patients in addition to manipulations with the colon in the transverse part and the splenic bend perform laparoscope resection of the sigmoid colon.
Forecast
Conservative treatment gives results in the initial stages of the disease, but since it is caused by anatomical pathology in the structure of the intestine, only surgical intervention helps completely defeat Payr's disease. Treatment with folk remedies is used only as an adjunct. Traditional medicine offers infusions and decoctions that dilute stool (laxatives) and agents that enhance intestinal motility. Also, immunity enhancing agents that improve the general condition are also offered. You can use decoctions of plantain, potato juice, stewed plums, dried fruits. It is important to know that with Payr's syndrome, enemas are contraindicated.
The prognosis for patients who received the right treatment on time is completely favorable. If Payr's disease is started, life-threatening complications may appear in the form of tumors, ulceration of the walls, hemorrhoids, developing from constant injury to the intestines by fecal masses.