Ledda Syndrome

Intestinal obstruction is a pathology faced by both adults and children. Consider its main causes, symptoms, methods of diagnosis, methods of treatment and prevention.

Ledd's syndrome or recurrent intestinal obstruction, arises from the inversion of the midgut around the high fixation of the cecum and the superior mesenteric artery. Data pathology of fixation and rotation of the intestine are united by a single concept - malrotation. Sidrom refers to its frequent manifestations. The disease is characterized by squeezing the duodenum with embryonic abdominal cords due to incomplete bowel rotation.

[1], [2], [3], [4], [5], [6], [7], [8]

Causes of the ledd's Syndrome

There are many factors that cause congenital intestinal obstruction. The causes of the syndrome of ice can be associated with:

• Pathology of the structure of internal organs.
• Movable cecum.
• Abnormal size of the sigmoid colon.
• Twisting of intestinal loops and formation of nodes.
• Congenital abdominal cords.
• Injury of the hernia.
• The twist of one of the intestine parts.
• Constriction of the intestinal lumen due to vascular disease or endometriosis.

The pathological condition can be caused by neoplasm, which closed the lumen of the intestine, various tumors of the abdominal cavity organs. Invagination of the intestinal wall and the accumulation of meconium, this is another cause of the defect.

If the vice of fixation and rotation of the intestine has a dynamic character, then it can be spastic or paralytic. The latter arises from traumatic operations on the organs of the abdominal cavity, with open and closed abdominal injuries, inflammatory lesions of the internal organs and diverticular disease of the intestine.

[9], [10], [11], [12], [13],

Pathogenesis

Frustration of the ice is based on a violation of the structure of the internal organs of the peritoneum. If we consider the pathogenesis in the surgical sense, then the middle intestine includes divisions from the duodenum to the transversal. The pathological condition arises from the squeezing of the duodenum by the caecum, which has an abnormal fixation with a turn of the middle intestine and a common mesentery at 180-720 ° counterclockwise.

The mechanism of the development of the disease can be associated with a change in motility and the food regime. The use of a large amount of high-calorie food after prolonged starvation provokes a turn of the intestines and an obstruction of the intestine. A sharp increase in the diet of a child of fruits and vegetables or the transfer of a baby to artificial feeding, also cause malaise.

[14], [15], [16]

Symptoms of the ledd's Syndrome

Malrotation is characterized by unstable symptoms, which makes it very difficult to diagnose it. Symptoms of the syndrome of ice depends on the stage of pathology and age of the patient, consider them:

• Pain in the abdomen of a paroxysmal nature.
• Vomiting and regurgitation of bile.
• Stagnation of gases and stools.
• Lowering of the lower abdomen.
• Inflammation of the epigastric region.

Consider the features of clinical symptoms of various forms of intestinal obstruction:

• Acute high congenital - vomiting with bile, loss of body weight, flatulence, departure of meconium.
• Acute low congenital - vomiting, a sharp deterioration in overall health, an increase in the size of the lower abdomen, the absence of meconium.
• Chronic high congenital - regurgitation and vomiting with bile several months after birth, slow physical development.
• Recurrent congenital - systematic bouts of anxiety, bloating and vomiting in infants, improvement of condition after cleansing enema. Periods of remission from several days to a month with the renewal of pathological symptoms.

Focusing on the symptoms, the doctor makes a plan for diagnosis, prescribes tests and thinks out methods of treating the patient.

[17], [18], [19], [20], [21], [22], [23]

First signs

Recurrent vomiting of the mid-gut, like other lesions of the peritoneal organs, has the first signs, allowing to recognize pathology. Since the disorder is most often diagnosed in newborns, its main symptoms are:

• Attacks of vomiting with bile.
• Impossibility of withdrawal of gases and stool.
• Cramping pain in the navel and "under the stomach".
• Asymmetry of the abdominal muscles.
• Lack of appetite.

The clinical picture, as a rule, appears from the first days, and even hours after a birth. The first sign of the disorder is a profuse vomiting, with or without an admixture of bile, sometimes with blood. The number of vomit masses and their frequency depend on the type of intestinal obstruction. In addition to these basic signs, there are specific symptoms in which only the doctor can understand.

With the progression of the disease and the absence of medical care, the symptomatology described above ceases for 2-3 days. But this is a negative prognostic sign, since it indicates a complete cessation of intestinal peristalsis. Vomiting acquires a pronounced character, becomes indomitable and multiple. Gradually, blood pressure drops, pulse speed increases and shock develops. This condition arises from the lack of fluid and electrolytes due to the constant vomiting and intoxication of the body with the contents of the intestine.

[24], [25], [26]

Syndrome of ice in adults

Defects in the development and functioning of the abdominal organs are diagnosed in patients of all ages. Syndrome of ice in adults is characterized by complete or partial obstruction of the digestive tract due to mechanical obstruction of the intestinal lumen, hyperkinesia, neuromuscular pathologies of the esophagus or hypokinesis of peristalsis.

The causes of the syndrome of ice in adults:

• Stenosis (constriction of the intestinal lumen).
• Incomplete turn of the intestine.
• Duplicate gut.
• Neuronal dysplasia of intestinal walls.
• Atresia of the esophagus.
• Adhesions in the peritoneum (occur after inflammatory diseases).
• Injuries and cavitary operations.
• Malformations of the mesentery, intestines, ligaments.
• Neoplasms in retroperitoneal space and peritoneum.
• Unbalanced nutrition.
• Increased intraperitoneal pressure (due to increased loads).

To determine the cause of the pathology, a series of tests, instrumental diagnostics and a study of the symptoms. The method of treatment depends on the stage of the syndrome.

The disorder has 3 stages with increasing symptoms:

1. There are severe pain and turbulence in the lesion with spread throughout the abdomen. This state is maintained for 16-24 hours.
2. Intoxication - a painful sensation is associated with severe vomiting, constipation and flatulence. In some cases, bloody diarrhea is noted. The patient becomes covered with a cold sweat, the condition sharply worsens, the abdomen asymmetrically swells. Such symptoms persist for 30-36 hours.
3. Peritonitis - at this stage the patient enters the hospital, where the intestinal obstruction is diagnosed. Without medical assistance, a lethal outcome is possible.

Conservative therapy is possible with early signs of obstruction. In other cases, the patient is carried out: gastric drainage or a surgical operation. In addition, antispasmodics, antibiotics, probiotics and other drugs are prescribed to restore the functioning of the abdominal organs.

Syndrome of ice in neonates

The bowel disease can be diagnosed from the first days of a child's life. Peculiar symptomatology allows you to suspect the syndrome of ice. In newborns, this pathology is associated with such factors:

• Injury of intestinal loops.
• Disturbance of rotation and fixation of the middle part of the intestine.
• Abnormal narrowing of the intestine.
• Elongated sigmoid colon.
• Pathologies that cause the intestinal walls to close.

Symptoms of malrotation are manifested as cramping pains, severe vomiting, bloating. If the large intestine is not affected, then there is no vomiting, but there is flatulence, stomach tension due to a strong swelling.

Possible causes of the defect:

• Intestinal blockage with feces of increased viscosity (meconium). The baby has a stool missing, the gases accumulate, which leads to a swelling of the upper abdomen, there is a strong vomiting with an admixture of bile.
• Invagination is characterized by the introduction of the small intestine into the large intestine. The child suffers from severe pain, vomiting, and instead of stool, mucus is released from the blood. The anomaly develops because of the immaturity of the mechanism of peristalsis at the age of 5-10 months.
• Adhesive process after the transferred operations, intestinal infections, immaturity of the digestive system or birth injuries. Adhesions in the abdominal cavity provoke a turn of the intestines.

Regardless of the cause, the syndrome of ice in newborns requires immediate hospitalization. Treatment involves surgical intervention, conservative therapy is possible only with functional disruption of the intestine.

Forms

Malrotation has several types:

• By origin - innate and acquired. Congenital diagnosed with: no anus, pathologies of the small or large intestine. In other cases, the obstruction is acquired.
• On the mechanism of occurrence - mechanical, dynamic.
• According to the clinical course - full, partial, chronic, acute.
• By squeezing the vessels that feed the gut - obturational (in the presence of a mechanical obstacle), strangulation (squeezing the vessels of the splash), combined.

The disease is characterized by high strangulation intestinal obstruction. The severity of symptoms depends on the degree of curvature and disturbances of mesenteric circulation. Pathology manifests itself on the 3-5th day of life and has an acute onset. The main symptoms that allow her to confirm: regurgitation of bile, vomiting, meconial stool, paroxysmal abdominal pain, flatulence. Without emergency treatment, the patient's condition deteriorates sharply, signs of exsicosis, toxicosis, a collapoid state

[27]

Complications and consequences

Unfinished bowel rotation without timely diagnosis and medical treatment leads to serious problems. The consequences of a pathological condition adversely affect the functioning of all organs and systems. Dangers of the syndrome of ice:

• Gangrene guts.
• Necrosis of the intestine.
• Chronic curvature (intermittent torsion of the mesentery is not accompanied by pronounced disturbances of the blood supply to the intestine).
• Progressive venous congestion in the veins of the small intestine.
• Reactive changes in the gastrointestinal tract.

The consequences of malorotation are serious enough, therefore for their elimination operative intervention is shown. Any delay in treatment can lead to death.

[28], [29], [30], [31]

Complications

The lack of adequate treatment of bowel development can lead to life-threatening complications. The most probable pathologies are:

1. Necrosis of the intestinal wall with the discharge of the contents of the intestinal tube into the abdominal cavity. Cells and tissues of the intestine begin to die. The general state of health deteriorates rapidly, blood pressure decreases, and the temperature rises. There are possible attacks of tachycardia, constant thirst, dry mouth, violation of salivation.
2. Abdominal sepsis (blood infection).
3. Peritonitis is a severe inflammation of the peritoneum with a high risk of death. This condition is characterized by poisoning the body with toxins and disrupting the work of all organs and systems. This is a life-threatening violation, which without a timely request for medical help has a negative outlook.

These complications require immediate treatment, as they threaten the patient's life.

[32], [33]

Diagnostics of the ledd's Syndrome

Signs of intestinal obstruction are quite smeared, so for their recognition, use a variety of medical approaches. Diagnosis of the syndrome of an ice pack consists of examination by a doctor, delivery of laboratory tests and instrumental examination.

Methods for studying orthodontia:

• Radiographic examination of the abdominal cavity - visualizes horizontal fluid levels.
• X-ray contrast (with oral administration of barium sulfate) - visualizes the duodenum and the location of the small intestine in the right parts of the abdominal cavity. The spiral course of the small intestine confirms the presence of pathology.
• Irrigography - allows to objectify the location of the cecum. The syndrome of the ice is confirmed with: high location of the cecum and its abnormal fixation, medial sigmoid colon location, in the presence of a rounded acute angle between the descending and transverse colon, shortening of the transverse colon.
• Ultrasound of the abdominal cavity organs - the presence of pathology is confirmed by such signs: vein mesentery of the small intestine, disturbance of blood flow in the superior mesenteric artery, widening of the veins of the small intestine, spiral course of the small intestine in the twist.

In a hospital setting, the patient is laparoscopically guided by a puncture of the anterior abdominal wall. Using an endoscope, the doctor assesses the condition of the internal organs. Rectal or vaginal examination can reveal blockage of the rectum and pelvic tumors.

[34], [35], [36]

Analyzes

Invagination of the intestine is a complex disease, for the diagnosis of which various methods, including laboratory tests, are used. Analyzes allow to reveal the characteristic deviations indicating a defect.

To make a diagnosis, you must pass:

• Blood test - determines the level of erythrocytes (hematocrit values) in the plasma.
• Biochemical analysis - is necessary for assessing the condition of internal organs.
• Hemostasiogram - determination of the level of blood coagulability.
• Radiography of the abdominal cavity.
• The Schwartz test - determines the high intestinal obstruction.
• Irrigoscopy - examination of the large intestine with the introduction of a contrast agent.

Based on the results of the tests, the doctor prescribes additional methods for drawing up an effective treatment plan.

[37], [38], [39], [40], [41], [42], [43], [44], [45]

Instrumental diagnostics

The examination of a patient with suspected syndrome of ice consists of several stages. Instrumental diagnostics is one of such stages. Let's consider more detailed methods:

• X-ray examination - is aimed at examination of the abdominal cavity organs and revealing signs of malorotation. In the pictures, the pathology is defined as the gas bubbles of the intestine.
• Ultrasound examination - the syndrome is indicated by swollen loops of the intestine and the presence of free fluid in the peritoneum.
• Colonoscopy - before the procedure the patient is given an enema for cleaning the large intestine. An endoscope is inserted into the anus for visualization. This allows you to identify tumors, take tissues on a biopsy, intubate the narrowed area of the intestine, eliminating the acute form of obstruction.

If the pathological condition has been confirmed by the results of instrumental diagnostics, the patient is sent to the surgical department. In a hospital, repeated examinations are possible.

Differential diagnosis

Paroxysmal pain in the abdomen with vomiting, flatulence and problems with bowel movements is a symptomatic complex of many gastrointestinal and intestinal diseases. Differential diagnosis is used to separate the syndrome of ice from other forms of intestinal obstruction. In order to establish an accurate diagnosis and not to be mistaken, intussusception in adults is differentiated with:

• Acute cholecystitis, appendicitis, pancreatitis.
• Renal colic.
• Perforated gastric ulcer.
• Low-floor pneumonia.
• Ectopic pregnancy.

When examining children, the pathology of the ice is differentiated with such lesions:

• Glistular invasion is a common disease in older children, which is accompanied by pain in the abdomen. Discomfort is localized in the navel, can be accompanied by nausea, vomiting. As a rule, during the collection of anamnesis and examination, parasitic infection is identified. But with strong and prolonged painful attacks, the surgeon may suspect a malformation of the intestine.
• Lambliasis cholecystitis is similar in its symptoms to recurrent obstruction. The patient complains of paroxysmal pains that are localized in the right hypochondrium. During the examination, an enlarged liver is detected on the X-ray, which will make it possible to correctly diagnose.

The most important thing in diagnosing is to determine the type of intestinal obstruction. Since the methods of treatment of the dynamic and mechanical forms are different.

Treatment of the ledd's Syndrome

If the diagnosis of malrotation has been confirmed, the patient is referred to a surgical hospital. Treatment of the syndrome of ice involves surgery. Preoperative preparation lasts for 3-4 hours, its nature depends on the patient's condition and the degree of intestinal obstruction.

Before the operation it is necessary:

• Clear the stomach
• To carry out detoxification
• Normalize hemodynamics
• Correct metabolic disorders

If there are signs of peritonitis and an inversion complicated by impaired circulation of the intestine, then the preparation for surgery is accelerated to 2 hours. This is due to the rapid development and vastness of necrosis.

As a treatment, Ledda's operation, suggested by the author, was used, which discovered and described the pathology. Patients undergo a transverse laparotomy in the mesogastrium on the right, but other methods of surgical intervention are possible. Having access to the abdominal cavity, the doctor assesses the position and condition of the intestine. Because of the exit of organs beyond the abdominal cavity, that is, the event, information is collected to determine the location of the operation:

• The presence of a curvature, circulatory disturbance or necrosis.
• Fixation and degree of rotation of the colon, length of the superior mesenteric artery.
• Form and features of the development of segments of the duodenum. The ratio of its terminal compartment to the superior mesenteric vessels.
• The size of the mesentery of the small intestine, the presence of branching vessels and nuances of the peritoneal cover.
• Type of peritoneal connections, formations between the liver, colon and duodenum, in the region of the posterior abdominal wall.
• The presence of atresia, diverticulum, membranes, that is, defects in the development of the digestive tube.

After collecting the necessary data, the characteristics of bowel defects, abnormalities of the abdominal cavity, volume and type of operation are determined. The main task of treatment is not only to eliminate the curvature of the midgut and obstruction, but also to restore all conditions for normal growth, development and functioning of the abdominal cavity organs.

During the procedure, it is important to release the duodenum from abnormal peritoneal seizures and separate the initial section of the small intestine. The operation ends with the complete liberation of the mesentery from peritoneal fusion and its spreading. The organ should get a leaf-like shape. The large intestine is placed in the left half of the abdominal cavity, and the duodenum should go to the thin to the right of the mesentery vessels. Novocaine is administered to spread mesentery.

Compulsory appendectomy is performed by the invagination method, since after treatment the cecum is localized in the left upper quadrant of the abdominal cavity, and in the case of appendicitis this significantly complicates the diagnosis. If malorotation is complicated by intestinal necrosis, resection of the altered tissues is carried out and enteroenteroanastomosis is applied to the intestine.

After surgery, prolonged conservative therapy should be used to restore the body. All activities are aimed at eliminating pain syndrome, intoxication, removal of stagnant bowel contents and restoration of water-salt metabolism.

Medications

Treatment for the syndrome of ice is carried out by surgical methods. Medications are used in the pre and postoperative period, as a drug therapy. This helps to minimize the pain after surgery, restore normal functioning of the whole body and the digestive tract. Patients are prescribed drugs to stimulate contractions of the intestinal muscles, which promotes the movement of the contents along the digestive tract. Also used antibiotics, vitamins B and C, heart funds.

Consider the drugs that are most often used in the treatment of malorotation:

1. Metoclopramide

Specific blocker of dopamine and serotonin receptors. It has antiemetic properties, regulates the functioning of the gastrointestinal tract, improves the tone and motor activity of the digestive organs, soothes hiccups. Promotes healing of ulcerative lesions of the duodenum and stomach, does not change the level of secretion.

• Indications for use: antiemetic for nausea and vomiting, complex therapy of ulcerative lesions of the digestive tract, intestinal obstruction, gastritis, dyskinesia, postoperative paresis. The therapeutic effect is based on increasing the tone of the intestine and stomach, accelerating the emptying of the gatekeeper. It is used as a facilitating and improving X-ray diagnosis of diseases of the small intestine and stomach.
• The way of application and dosage depends on the form of release. As a rule, the remedy is used inside, in severe cases, intramuscular or intravenous administration is indicated. Orally take 1 tablet 3 times a day before meals, intramuscularly - 1 ampoule 1-3 times a day. For patients in childhood use the minimum dosage. The duration of treatment is determined by the doctor.
• Side effects are rare, as the medicine is well tolerated. In rare cases, there are disorders of coordination of movements, tremor of extremities. For their elimination, caffeine is administered intravenously. In children under 14, the drug may cause dry mouth, drowsiness and tinnitus. As a treatment, it is recommended to take a medicine after eating.
• Contraindications: individual sensitivity to active substances. It is not used in the form of injections for patients whose work is related to the management of mechanisms and increased concentration of attention.

2. Trimedat Valente

A drug for regulating gastrointestinal motility. Its active components affect opioid receptors. Used for symptomatic therapy of pain associated with functional disorders of the gastrointestinal tract and biliary tract. It is prescribed as a preparatory agent before endoscopic or X-ray examination.

• The recommended daily dosage for oral administration is 300 mg, rectally - up to 200 mg, intramuscularly / intravenously - 50 mg. Duration and frequency of application depend on the clinical picture and medical indications.
• Side effects are manifested in the form of skin allergic reactions. With intravenous administration, short-term syncope is possible. Do not appoint for treatment of pregnant women, breastfeeding and for newborns.

3. Hemodez-H

Detoxification drug for parenteral use. Active substances bind toxins that circulate in the blood and remove them from the body. The drug enhances renal blood flow and diuresis, increases glomerular filtration.

• Indications for use: detoxification with toxic forms of acute intestinal pathologies, peritonitis in the postoperative period, liver failure, sepsis, hemolytic disease of infants, intrauterine infections.
• Contraindicated use when hypersensitivity to active substances, cardiovascular insufficiency and hemorrhagic stroke.
• Dosage depends on the age of the patient. Before administration, the solution is warmed to body temperature and injected dropwise - 40-80 drops per minute. The dose is calculated at 2.5 ml / kg of body weight of the patient.
• Side effects: shortness of breath, arterial hypotension, allergic reactions. To eliminate them, you must stop using Hemodez-N and seek medical help.

4. Dinaton

Hemostatic agent for intravenous and / or injection with the active substance - serotonin adipate. The therapeutic effect is based on increasing platelet aggregation and increasing the durability of capillaries, reducing bleeding time. Serotonin has an antidiuretic effect, binds to serotonin receptors of the smooth muscles of the internal organs, normalizes peristalsis, endogenous vasomotorics. Reduces the signs of local hypoxia, restores motor-evacuation functions of the gastrointestinal tract.

• Indications for use: functional intestinal obstruction, hemorrhagic vasculitis, thrombocytopenia, hemorrhagic syndrome, aplastic and hypoplastic anemia. Dosage depends on the form of release, so the duration of therapy and frequency of use are individual for each patient and are selected by the attending physician.
• Contraindications: hypersensitivity to components, kidney disease, acute thrombosis, glomerulonephritis, bronchial asthma, hypercoagulation, arterial hypertension.
• In case of an overdose, there is hyperemia of the skin and tachypnea. To eliminate them, you must stop using the medication and seek medical help. Dynaton is not used during pregnancy and lactation.
• Possible side effects: decreased diuresis, abdominal pain, nausea, shortness of breath, increased blood pressure. With rapid administration, there may be a feeling of pain along the vein and pain in the injection site.

5. Lactoprotein-c®

Plasmo-replacing and perfusion solution. Rapidly increases blood pressure, keeps fluid in the bloodstream. Neutralizes metabolic acidosis, has anti-shock and detoxification properties.

• Indications for use: correction of acid-base balance in hypoproteinemia. Reduces the intoxication of the body with intestinal obstruction, liver cirrhosis, sepsis, hepatitis, prolonged suppuration, infections and excoxes due to gastrointestinal diseases. It is used in severe cavitary operations, in the complex therapy of hepatic pathologies.
• The drug is injected and drip. Dosage and duration of treatment depend on the indications, therefore, they are individual for each patient. It is not used during pregnancy and lactation. In case of an overdose, signs of dehydration and alkalosis appear. There may be nausea, flatulence, pain in the epigastric region. To eliminate these effects, drug treatment is stopped.
• Side effects occur in rare cases. Patients may experience lumbar pain, allergic reactions. Possible irritation of peripheral veins at the injection site. Contraindications: susceptibility to allergic reactions, alkalosis, cardiovascular decompensation, hypertension, thromboembolism.

Alternative treatment

Since the syndrome of ice is a complex form of intestinal obstruction, in the postoperative period, for restoration of motility of the gastrointestinal tract can be used as pharmaceutical means, and unconventional methods. Alternative treatment is carried out only in consultation with the attending physician. The independent use of any prescription can lead to serious complications and even death.

Alternative treatment can prevent recurrence of the disease and avoid the development of dangerous complications. Consider the popular recipes:

1. The juice and berries of sea-buckthorn have anti-inflammatory properties, and the oil is an excellent laxative. To prepare the juice, take 1 kg of berries, rinse them thoroughly and chop them. The resulting raw materials must be squeezed through a gauze or sieve. The juice is taken 100 grams per day for 20-30 minutes before meals.
2. To prepare sea buckthorn oil, apply 1 kg of berries with a wooden spoon and leave for 24 hours. As soon as the mass settles on its surface appear up to 90 g of oil. It must be carefully collected and taken on a spoon 3 times daily before meals.
3. Dried fruits stimulate intestinal peristalsis and have a laxative effect. The medicine is prepared from 200 g of prunes, dried apricots, figs and raisins. All ingredients must be washed and poured overnight with boiling water. In the morning, drain the water and let the dried fruits through the meat grinder, add 50 g of honey and mix. The received medicine is taken 1 scoop before breakfast.
4. Another option for a safe soft laxative is a plum broth. Take 500 g of sink, previously cleaned from the stone. Fruits should be poured cold water for 20 minutes, and boil over low heat for 1-1.5 hours. The broth should be taken chilled, 100 ml 2-3 times a day.
5. Take a 5 l pot, fill it with water, putting in it 500 g of beetroot. The broth should boil, after which it is insisted under the lid for 3-4 hours. Once the product has settled and cooled down, filter, add 1 spoonful of dry yeast and 150 grams of sugar. Thoroughly mix all the ingredients and close the lid for 24 hours. The received infusion is taken daily in unlimited quantities.

All of the above recipes are not an alternative to surgical treatment, but only help to restore the normal functioning of the intestine.

[46], [47], [48], [49], [50]

Herbal Treatment

Various means are used to maintain normal bowel function, but the most popular and safe are herbal remedies. Treatment with herbs is possible only with the permission of the attending physician. Self-medication is dangerous, as it can lead to irreversible consequences.

Popular herbal recipes:

1. Take in equal parts: oregano, yarrow, motherwort, nettle, birdwalker, St. John's wort and shepherd's bag. Pour two tablespoons of the mixture into a thermos bottle and pour 500 ml of boiling water. Infusion is better to steal from the evening, since it should stand for 8 hours. The received liquid should be filtered and taken in 100 ml 2-3 times a day.
2. To maintain the normal operation of the intestine is suitable such a herbal collection: chamomile, yarrow, fennel, St. John's wort, buckthorn bark and mint. All the ingredients must be taken in equal proportions, crushed, mixed. 20 g of the mixture pour a glass of boiling water or brew in a thermos. The medicine should be infused for 2-3 hours. Drink before bed, the course of therapy 20 days.
3. 20 grams of eyebrows fill with 350 ml of boiling water and let it brew for 1-2 hours. The resulting infusion is filtered, divided into 3 parts, which are recommended to be taken throughout the day, an hour after eating.
4. 50-60 g of chopped grass heather and motherwort mixed with 30 g of cucumbers. Pour into a thermos and pour boiling water. The product should be infused during the day, after which it is filtered and taken 3-4 times a day.

Homeopathy

One of the alternative methods of medicine, based on the use of highly diluted drugs that cause healthy people symptoms of the disease - is homeopathy. Such preparations are prepared from plant components, so with proper selection, they have a minimum of side effects and contraindications.

To treat the symptoms of maltreatment, many patients are prescribed Nux vomica-Homaccord. We will familiarize with his instruction:

Nux vomica-Homaccord - a combined homeopathic remedy in the composition, which includes such substances: nuks vomica-chilibukha, bryonia, lycopodium, colocintis. They have anti-inflammatory and laxative properties. The medicine is available in 30 ml vials with a dispenser.

• Indications for use: dysfunction of the gastrointestinal tract, inflammation in the digestive system, gastritis, intestinal obstruction, constipation, hemorrhoids, cholecystitis. Helps in cleaning the connective tissue matrix.
• Therapeutic daily dose for adults is 30 drops, for children under 2 years - 9 drops, from 2-6 years - 15 drops. The daily dosage is divided into three doses, diluting in a glass of water. It should be taken 15 minutes before meals or an hour after.
• Adverse reactions occur when the components of the drug are intolerant. Contraindicated to use during pregnancy and lactation.

As a rule, patients are prescribed combined preparations, for this they can use: Nux vomica 6, 12, 30, Alumina 6, 12, Opium 6, 12, Plumbum 3,3 (trit), 6,12, Anacardium orientale х3, 3, 6 , 12, Silicea 6, 12. Homeopathy is used for medical purposes.

Recovery

To normalize the operation of the intestine after the operation of the ice, the patient is expected to have a long recovery period. The process of intestinal and gastrointestinal tract regeneration during the normal course of the postoperative period is observed on the 4th-6th day. This is manifested as follows:

• Reduction of the volume of the waste stagnant contents of the intestine along the nasogastric tube.
• There is a peristalsis
• The chair begins to retreat

If these processes do not occur, then drug therapy is used to stimulate peristalsis (the administration of drugs Ubretid, Proserin) and colon washing. To restore the children of childhood after the syndrome of ice, apply various physiotherapy procedures, respiratory gymnastics, mustard wraps and more. 

• If treatment has passed without violations of the intestine, then by the end of the first day after the operation it is allowed to drink water.
• To reduce painful sensations and prevent intestinal paresis, epidural anesthesia is performed for 3-4 days. If there was a resection or bypass anastomosis, then parenteral nutrition is shown within 2 days.
• Particular attention is paid to the replacement of protein deficiency, which arose due to eating disorders and losses during surgery. The patient is given plasma of blood and albumin.
• The best way to restore is oral nutrition, which is carried out from 2-3 days. The patient is given liquid food (broth, grated fruits and apples, kefir). From 7-9 days the food is expanded.
• On the 10th day, surgical sutures are removed and tampons are removed for 16-20 days. After that, the cavity is washed with solutions of antibiotics and again plugged. These procedures are carried out for 2 months to prevent complications.

These measures are shown if the treatment was without a gut resection and the organ is fully viable, that is, the vomiting is eliminated. Once there are persistent signs of normalization of bowel function, then a full-fledged dietary meal is shown. Before discharge from the hospital, the patient undergoes an X-ray examination.

Prevention

Prevention of intestinal obstruction is a complex of methods that support the normal functioning of the digestive system. Prophylaxis is based on timely diagnosis and treatment of abdominal injuries, various tumors, helminthic invasions, adhesions and other disorders.

Particular attention is paid to nutrition. Features of the preventive diet:

• Limitation of the amount of food consumed. Overeating can cause aggravation of malotonia. Caloric content should be at the level of 1100 Kcal. Daily need to eat: carbohydrates 200 g, fats 30-50 g and proteins 80 g. Particular attention is paid to the liquid - to drink about 2 liters of water per day.
• It is necessary to abandon the products that cause increased gas formation: whole milk, cabbage, food of dense consistency, soda. This is due to the fact that the established task of the diet is to minimize putrefactive and fermentative processes in the digestive tract. Therefore, any stimuli of thermal, chemical or mechanical form are excluded. Food should be gentle, at room temperature, with a gelatinous or frayed consistency.
• The basis of the diet should be low-fat meat and mucous broth / broth, porridge, egg and curd soufflé, steam cutlets. Of the drinks are suitable: green tea, herbal and fruit decoctions. Thus it is not recommended to use various smoked products, pickles, raw vegetables, legumes, rich broths.

The main goal of prevention is unloading of the intestine. The exclusion of indigestible food, and the restriction of its quantity, will improve the patient's condition and avoid exacerbation of the syndrome.

[51], [52],

Forecast

The syndrome of ice is most often congenital in nature. The prognosis is determined by the form of pathology, the speed of diagnosis and the period of hospitalization of the patient. The outcome is favorable if the patient has asked for help on time, and effective therapy has been performed. Particular attention is paid to the period of recovery and prevention. If the bowel anomalies are accompanied by additional complications, then the prognosis is less favorable. According to statistics, in 13% of cases intestinal obstruction recurs.

[53], [54]