Duodenal dyskinesia: causes
Last reviewed: 23.04.2024
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According to the generally accepted viewpoint, the direct cause of functional evacuation disorders is the changes in the motor function of the duodenum associated with disorders of its regulation, which, in the opinion of several authors, can appear reflexively, against the background of diseases of adjacent organs, with damage to nerve conductors or due to other causes (illness of the central nervous system, endocrine, damage to the nerves and muscles of the duodenum, etc.).
The researches of K. M. Bykov and his students testify to the possibility of cortical genesis of duodenal dyskinesia.
VS Levit (1934), L. 3. Frank-Kamenetsky (1948) and other authors among the most probable causes of functional motor-evacuation disorders of the duodenum isolated disorders of external innervation of the intestine, provided by parasympathetic and sympathetic fibers of the autonomic nervous system.
No less important role in the nervous regulation of the motor function of the duodenum is played by the local intramural nervous apparatus formed by five closely intertwined plexuses. According to AP Mirzaev, with acquired persistent atony, ectasia of the intestine, and duodenosis, reactive and degenerative changes are found in the intramural nervous apparatus of the gut, in particular in the nerve fibers of the musculo-intestinal (Auerbach) plexus. With Chagas disease, the development of megaduodenum and evacuation disorders is associated with the destruction of the intramural nerve nodes of the duodenum by Trypanosome Kruci. The results of anatomical and physiological studies confirm the existence between the organs of direct neural-reflex connections, in which diseases of adjacent organs, according to the mechanisms of direct visceral-visceral reflexes, can lead to disorders of the motor function of the duodenum. In the regulation of motor function of the duodenum, humoral factors are also important, among which, first of all, the group of gastrointestinal polypeptides should be noted. Most of them have been discovered relatively recently, and their properties have not been sufficiently studied. However, data have already been accumulated that indicate that the changes in the secretion and nature of the action of these substances (gastrin, cholecystine-kinin-pancreosimine, secretin, motilin, glucagon, insulin, vasoactive intestinal peptide, gastric inhibitory polypeptide, pancreatic polypeptide, substances P, etc. .) can play a significant role in the occurrence of motor disorders of the duodenum. The circle of humoral factors affecting the motor and evacuation function of the duodenum is not exhausted by hormones. According to the data of AG Sahakyan et al (1978), VG Avdeev (1983), etc., gastric juice, bile, pancreatic enzymes and other local factors also affect the motor function of the gut, in particular, the increase in gastric acid formation accompanied by increased motor function of the gut.
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