Neurosis of the stomach: signs, how to diagnose?

The complex and diverse activity of the digestive organs is innervated by a whole system of nerves that enter their walls and are weaved by a dense network around glands and smooth muscle tissue consisting of layers of nerve cells that perceive and regulate the process of digesting food. The stomach is provided with such very powerful plexuses, localized between bundles of smooth muscles and located directly under the mucous membrane. Neurosis of the stomach (gastronecrosis) is considered as a violation of his work due to an innervation disorder in the absence of an organic pathology, both gastroenterological and brain.

The modern rhythm of life predisposes to nervous exhaustion, we encounter more stressful situations than our ancestors who lived a more measured life. In addition, the wrong regime of the day and nutrition - nedosyp, snacks on the move, bad habits, a state of dissatisfaction, and we are beginning to worry about discomfort in the epigastric region, and regularly. The clinical picture is not specific and resembles many pathologies of the digestive tract. Therefore, do not swallow analgesics, pills and herbs "from the stomach." This is an occasion to consult a doctor, to be examined and to establish the cause of the digestive disorder.

[1], [2], [3], [4], [5]

Epidemiology

The prevalence of all types of neuroses grows both in developed and developing countries, and due to cases with complex vegetative-visceral disorders (organic, including stomach neurosis). The frequency of occurrence of classical forms of the disease decreases. According to selected data, neuroses constitute about a fifth of all neurological pathologies. The disease manifests itself in the period of the highest vital activity, usually after 30 years. According to the research, mainly complaints are made about symptoms, the corresponding neurosis of the stomach and intestines, patients whose average age is about 36-37 years, most of them are female (65-70%). In women, neurotic etiology is more difficult and, more often than men, results in disability.

[6], [7], [8], [9], [10], [11], [12], [13]

Causes of the neurosis of the stomach

At the heart of the development of gastro neurosis are in most cases psychological factors: frequent stress and depression, physical and mental overstrain, interpersonal conflicts, internal dissatisfaction, psychological trauma. This is in the full sense - a disease of nerves. This condition often fits into the clinical picture of neurasthenia, hysterical and obsessive-phobic neurosis.

Risk factors for gastro neurosis symptoms are overeating or, conversely, lack of appetite, eating disorders (when a prolonged period of hunger is replaced by excessive absorption of food), alcohol abuse, drug dependence, smoking, poisoning.

Individual personality characteristics also increase the risk of developing a stomach neurosis. Very susceptible to this pathology hypochondriacs, hypochondriacs, excessively sensitive to sensations from the internal organs. The likelihood of getting sick increases in individuals who are not in control of their emotions - frequent attacks of anger, jealousy, jealousy are provocateurs of the disease. In the risk group are hyperintellectual people who voluntarily perform many duties, have an overestimated self-esteem and do not cope with increased workload. It is not strange, their antipodes, who do not want to make decisions and are shy of problems, also run the risk of becoming ill with this kind of neurosis.

The physiological factors that provoke neurosis of the stomach include diseases of the digestive organs, nervous system, mental disorders, viral and bacterial infections, and - in some cases, gastric irritation and its neurosis is caused by gynecological diseases - inflammation or tumors of the uterus and ovaries.

The causes of gastrononeurosis appear to be clear. Like other neurotic states, it causes a combination of provoking factors. A major role in the emergence of neuroses is played by genetic predisposition, constitutional features, traumatic experiences of children's experiences, poor adaptive capacity for unfavorable life situations.

[14], [15], [16], [17], [18], [19], [20]

Pathogenesis

Personal accentuations and individual psychoemotional features are crucial in the modern treatment of the pathogenesis of organic neurosis of any clinical type. The impetus for its development is usually an internal personal conflict with the possibility of a different resolution, which does not always correspond to the moral values of the individual. This causes a prolonged excitation of nervous activity with a sharply emphasized emotionality of experience. The individual at the same time falls into a stressful situation. Dyspepsia symptoms of stress felt in one way or another almost everything - the sensation of a lump in the throat, nausea, vomiting, diarrhea, lack of appetite and others. Various studies have shown a direct relationship of stress factors to the digestive process. Their constant action inhibits the process of digestion and develops dyspepsia. Neuroses are often accompanied by gastroenterological symptoms.

The pathogenesis of this nervous disorder is well studied, although there are still "white spots" in the issue of choosing a symptom complex that determines the specific gastroenterological signs of neurosis. The main role of the provoking factor is assigned to the individual psycho-physiological properties of the patient's personality. The pathophysiological features of the digestive system of the patient are also taken into account in the mechanism of gastro neurosis development, whether they are congenital or acquired due to diseases, intoxications and traumas suffered during the course of life that are supported by an unresolved emotional conflict and, at the same time, can lead to the formation of persistent dysfunctions of the internal organs.

[21], [22], [23], [24], [25], [26], [27]

Symptoms of the neurosis of the stomach

Gastroenterological symptoms are classified into two types: gastric and intestinal. However, in their pure form, each of the neuroses is extremely rare, mixed forms are much more common - neurosis of the stomach and intestines. And first, as a rule, there are symptoms of stomach neurosis, a little later they are joined by intestinal colic, constipation or loose stool (intestinal symptoms). Quite often, there is such a very sensitive form as gastralgia. Sometimes the pain in the stomach on the nerves is the only symptom on the part of the gastrointestinal tract. Some researchers have even considered it separately as an independent form of neurosis, however, modern neurology regards it as a clinical organic symptom of nervous system damage.

The first signs of gastro neurosis may be different, there may be several of them listed below, there may be some one:

• nausea, habitual vomiting and / or heaviness in the stomach after eating, sometimes not long enough;
• sudden attacks of hunger, reminiscent of "hunger ulcer";
• severe heartburn;
• sour belch;
• gastric colic, flatulence;
• lack of appetite, even smells cause nausea until vomiting of bile;
• discomfort, epigastric pain
• feeling of fullness or, conversely, emptiness in the stomach
• inefficiency of traditional gastroenterological therapy.

The symptom complex usually contains neurological signs - anxiety, anxiety, irritability, panic attacks, obsessive fears, insomnia, sudden awakenings in the middle of the night from nightmares, difficulties with falling asleep, headache, dizziness, unstable blood pressure. Symptoms of cardiac neurosis may include symptoms such as tachycardia, arrhythmia, severity or pain in the retina, and frequent urination. Recently, mixed symptoms are much more common. For organic neuroses is characterized by increased manifestations in the evening. Usually they are reversible, last for an average of six months, the symptoms pass as the psychoemotional conflict resolves. Although there are protracted currents that last for years and lead to irreversible morphofunctional disturbances.

Often neurosis of the stomach develops with ulcers, and it can be provoked by another organic disease of the stomach and organs close to it. Especially dangerous are tumors that occur at the beginning of asymptomatic and manifest themselves neurotic symptoms. However, organic disorders are differentiated from neuroses, in which they are not detected. Thanks to modern methods of diagnosis, the incidence of gastrointestinal diseases has significantly decreased, since many of their cases were the result of organic pathologies, in the first place, thus the ulcer of the antrum of the stomach and / or duodenum manifests itself. A violation of the regulation of gastric function in peptic ulcer, although accompanied by neurotic symptoms, but neurosis is not.

You can distinguish such types of gastronews as secretory, motor and sensory. However, they do not occur in a pure form, all functions are immediately violated, and therefore modern medicine does not consider it expedient to focus on this.

Clinical disorders of the gastrointestinal tract without detection of organic lesions are very numerous. The so-called gastronouzies come across among them most often. They are also called: functional, non-ulcerative or neurogenic gastric dyspepsia, pseudo-ulcer syndrome, irritated stomach syndrome and so on. The interpretation is quite broad, however, experts warn that identification of functional abnormalities of the stomach only with neurotic is incorrect. In fact, the term "functional" is much broader than "neurotic," and not every violation of gastric functions is a manifestation of a neurosis.

Classification of neuroses in general is also not approved, however, neurology identifies such types of them: hysterical, obsessive-compulsive (obsessive-phobic) and neurasthenia. They are usually accompanied by gastroenterological symptoms, which differ slightly depending on the type of neurosis, and this may be of interest.

Thus, patients with hysterical neurosis have more pronounced symptoms, accompanied by a vivid demonstration of ill-health in the gastrointestinal tract, the desire to "have a diagnosis", often express a desire to undergo surgery and sometimes even achieve this, although they do not need surgical treatment.

The obsessive-phobic appearance of the neurosis is characterized by an emphatic observation of the dietary diet and diet, the physical processing of dyspeptic complaints, and the persistent search for a cancerous tumor.

The neurasthenics, on the contrary, try to make sure that they do not have serious organic pathologies, and carry it out through an infinite number of examinations both out-patient and in-patient.

Such a symptom as neurotic vomiting in gastroenterology is also distinguished by species: hysterical and habitual. The first is a symptom of stressful situations, is a way of emotional expression and has a demonstrative nature, the second - occurs often in a state of rest and is interpreted as an expression of suppressed emotions. There is also a neurotic vomiting, induced, for example, by watching a loved one who had stomach cancer, and is an involuntary imitation. Symptoms of psychogenic vomiting are characterized by "ease" of execution - the absence of preliminary painful attacks of nausea, are not accompanied by pallor, sweating, salivation. As a rule, they do not lead to a noticeable weight loss. Although there are exceptions. In severe hysteria, as a result of repeated vomiting, dehydration, demineralization, and other metabolic disturbances may occur.

With gastralgia, the most common form of gastronews, there is a direct interdependence of emotional stress with the appearance of signs of functional gastric disorder - pain, burning, severity, nausea, and also the absence of any connection between clinical manifestations and the nature of nutrition. The stomach in this case is the "organ of self-expression."

The main manifestation of gastronews infection can be aerophagia - demonstratively loud, reminiscent of a cry of eructation as a result of ingesting more than usual amounts of air in the process of eating. It often manifests itself in hysterical neurosis, often accompanied by a cardiological symptomatology.

An aversion to food, a lack of appetite, or outright overeating can also be an expression of a neurotic disorder. Both types can be accompanied by vomiting (with bulimia - after eating, with anorexia - at the sight of food, often demonstrative (hysterical)).

Another typical prevalent symptom of gastronews is painful heartburn, in which neither diet nor gastrointestinal drugs help.

Neuroses of any kind develop, passing through several stages of development. In the beginning, the connection of a nervous disorder with its cause is usually usually well traced, with the passage of time this connection is weakened and disappears completely without treatment. Neurotic reactions continue, based on the mental image of the primary effect. Sometimes the resolution occurs on its own as the emotions fade away and the significance of the underlying cause. In other cases, there is the formation of emotional loops, a person is obsessed with a mental image. Prolonged flow leads to personal neuroticization - pathological changes are built into the psychological structure of the individual.

The first stage is a neurogenic reaction, short-lived, which either passes quickly itself, or is replaced by the second stage-asthenia, in the vast majority of cases (approximately 90%) accompanied by depression. This stage is still self-reversible, however, if the situation has not been resolved, the neurosis is formed as a disease (the third stage). At this stage, recovery is still possible, in rare cases even without treatment, but more often asthenia develops and neuroticism of the person occurs.

The consequences and complications of this disease, in general, not representing a mortal threat, may still not be very pleasant. Prolonged course and progression of the disease can lead to chronic neurosis, morphological changes occur in the organs, caused by endless diagnostic procedures and the use of gastroenterological drugs, which turned out to be ineffective. Patients, before getting into the field of vision of neurologists and psychotherapists, were repeatedly examined and had on hand a pile of documentation about it. Some patients even underwent surgery. Surgical interventions conducted by patients on the basis of their persistent complaints are usually not just useless, but harmful.

With a long course of the disease a person ceases to adequately perceive the reality, he constantly has a bad mood, the accompanying illnesses worsen, the immunity decreases. Chronic neurosis adversely affects relationships with the outside world, prolonged neuroticism can lead to a violation of the psyche.

Diagnostics of the neurosis of the stomach

Gastroenterological symptoms of neurosis are nonspecific. It is inherent in many diseases of the gastrointestinal tract, therefore the diagnosis is made by the method of excluding organic pathologies. For this, the patient passes the tests and undergoes a comprehensive gastroenterological examination. Instrumental diagnosis necessarily includes fibrogastroduodenoscopy, other methods of investigation may be prescribed - ultrasound, radiography. Differential diagnosis is carried out with peptic ulcer, gastritis, neoplasms, diseases of organs located in close proximity to the stomach.

When organic pathologies are not detected, the question of neurosis is raised. The patient passes into the hands of a neurologist and a psychotherapist, who, after studying the patient's history and lifestyle, will take care of the correction of his psychoemotional state.

[28], [29], [30], [31], [32]

Prevention

Prevention of neurotic disorders is a complex task, however, quite feasible. Its main goal is to normalize the rhythm and lifestyle, to provide oneself with a beloved environment that allows them to relax and relieve emotional stress, to cope with negative emotions in the event of their occurrence.

It is very important to observe an acceptable mode of work and rest: it is necessary to use annual leave, not work on weekends, get enough sleep, try to spend more time with loved ones and close people.

A huge role is played by high-grade food, refusal from bad habits and an active way of life - walks on fresh air, feasible physical activities, hardening measures increase our stress resistance.

We should try to avoid conflict situations, but do not delay with their permission, if they did arise.

Use all - autogenous training, yoga, other practices that educate us in a positive attitude. If you feel that you can not cope, you can always seek help from a psychotherapist.

[33], [34], [35], [36], [37]

Forecast

Gastronoeurosis belongs to the number of reversible psychogenic disorders. This is not a fatal disease, although it can ruin the quality of a patient's life. The earlier it is detected, diagnosed, and the patient will be provided with professional help and treatment, the easier it will be to overcome the disease. A chronic chronic neurosis can adversely affect the work of many body systems.

[38]