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Sheep in an adult and a child: treatment with alternative means, diet

 
, medical expert
Last reviewed: 23.04.2024
 
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Sheep feces are a kind of violation of the human digestive system, in which the feces are isolated as dense lumps, located in fragments. Outwardly these masses resemble feces of a sheep. Sheep can tell a lot about the doctor when diagnosing the state of the human body. It can indicate the presence of various pathologies, diseases. Most often, sheep testify to the presence of a person's constipation due to spasms. The feces resemble lumps that contain mucus impurities, fiber residues, undigested food, starch, red blood cells.

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Epidemiology

According to statistical data, at least once in a lifetime there was one fourth of the sheep's feces. About 65% of them suffer from periodic constipation, which manifests itself, including in the form of sheep stool. About 24% suffer from constipation systematically, regularly, 9% repeatedly experienced the effect of constipation, noted sheep feces. And only 2% experienced this phenomenon once in their lives.

Approximately 72% of all people with constipation, associate the occurrence of this disease with malnutrition, stress at work, fatigue, constant stress.

Approximately 19% of newborns have sheep feces. In 52% of cases, it arose as a consequence of high temperature. In 18% of cases, sheep's feces in infants were a sign of serious illness.

In children, sheep feces are found in every fifth child.

Women are more prone to atonic form of constipation, men are spastic.

Urban residents of sheep feces occur 2.5 times more often than in rural areas.

trusted-source[5], [6], [7], [8], [9], [10],

Causes of the sheep's feces

The reasons for the development of sheep stool are many. In general, the entire variety of causes can be reduced to the disturbance of microflora and unstable functioning of the intestine. Let's consider in detail each reason:

  • With a decrease in the evacuation capacity of the intestine, accumulation of feces occurs in it. Gradually, water and moisture are absorbed from the stool. There is a prolonged dehydration, as a result of which the amount of moisture decreases so much that the cala loses its binding abilities, is strongly compacted. In this case, a spasmodic contraction of the intestine takes place, because it seeks to get rid of the excessively condensed mass. To ensure more rapid and effective removal of stool from the body, fragmentation takes place. The feces break up into small lumps, which are called sheep's feces;
  • feces may linger in the intestines, be dehydrated and become densified as a result of intestinal peristalsis. The wave of contractions of the muscular layer of the intestine is so weak that the feces can not move along the intestine;
  • sheep can occur with irritation of the colon, functional disorders of the intestine, which are manifested in the form of diarrhea, constipation, with atonic and spastic colitis;
  • an allergic reaction may be one of the reasons, since the allergy promotes the production of local immunoglobulin A in the walls of the intestine. Excessive amounts of immunoglobulin and histamine also irritate the cell wall;
  • malnutrition and inadequate drinking regimen. With a lack of nutrition and moisture, normal functioning of the intestine, frequency of bowel movements, can be disturbed. Normally a person should defecate approximately every 48 hours. Other options indicate violations;
  • cause can be violations of blood circulation, hormonal metabolism, the state of the immune and nervous systems;
  • hypodynamia, low level of physical exertion, stress, fright, neuropsychic overstrain can cause disruption of the evacuation function, peristalsis;
  • disorders of microflora, dysbacteriosis, acute and chronic inflammatory processes, surgeries, excessive use of alcohol, prolonged use of medicines, abuse of digestive enzymes, harmful factors of production: such as: exposure to chemical and toxic substances, various types of radiation, radiation disrupt the normal functioning of the gastrointestinal tract.

What does sheep say about a person?

This indicates a serious violation of the intestine. In this case, the feces take the form of round, solid fragments, which are separated during defecation. We can say that sheep is a manifestation of constipation.

The process of excrement is accompanied by painful sensations, discomfort, weakness, signs of intoxication.

If a person has ovine feces, you should immediately reconsider the diet. Sheep speaks of violations of normal activity of the gastrointestinal tract and rest. This is usually a direct consequence of malnutrition. There is atony of the intestine, its instability.

Sheep can speak about the fact that human nutrition is not only irregular, but also incorrect. There is a large number of fast food, snacks, restaurant food, as well as preservatives and baking powder. These substances swell in the stomach, irritate the walls, give a false feeling of satiety. Carcinogenic supplements may be present in food. Almost no nutrition, first courses, vegetables and fruits. There is not enough fiber in the diet. All this happens against the background of emotional overstrain, chronic stress. Sheep says that a person consumes quite a lot of alcoholic beverages, lives in a tense rhythm.

trusted-source[11], [12]

Sheep after antibiotics

Antibiotics can have both positive and negative effects on the body. Eliminating the infectious process, they contribute to the removal of inflammation, the elimination of infection, the speedy recovery.

On the other hand, antibiotics can disrupt the state of normal intestinal microflora. At the same time, the number of representatives of normal microflora is sharply reduced. At the site where the normal microflora previously developed, it develops pathogenic, thereby inducing dysbiosis, dysbiosis. Bacterial, fungal infections can develop. All this leads to the development of local inflammation, irritation of the intestinal wall, a violation of the normal function of the gastrointestinal tract. As a result, constipation and diarrhea are observed. Constipation can be replaced by diarrhea, and vice versa. Often sheep are observed.

Often, the use of antibiotics requires the restoration of microflora, for which you need to see a doctor, do a test for dysbiosis, determine the characteristics of the microflora disturbance by its results. The analysis shows what kind of microorganisms are absent, or vice versa, is present in excessive amounts. Also quantitative indicators of microflora, their ratio are determined. By results, you can select the appropriate therapy.

Some doctors do not prescribe studies for dysbiosis and prescribe any remedy for microflora recovery. This can be dangerous because the situation can only worsen. For example, in the human body, the amount of E. Coli can be reduced and the number of coccal forms of microorganisms is increased. The doctor, not knowing this, can prescribe a remedy, as a result of which the amount of E. Coli will continue to decrease, and the number of cocci increases. This will entail a further disruption of the microflora, which may be accompanied by the development of the inflammatory process, including enteritis, gastroenteritis. Constipation or diarrhea accompanying these pathologies can go into a chronic form.

Typically, to restore the microflora needed drugs such as prebiotics, probiotics. The composition of these preparations includes microorganisms necessary for the normal functioning of the intestine in various forms, their spores.

Sheep feces with irritable bowel syndrome

Sheep may indicate the presence of irritable bowel syndrome in a person , in which mechanical, toxic or chemical irritation of the intestinal walls is caused by irritants of various etiologies. These can be bacterial toxins, decay products, condensed stools, and others.

Sheep feces with colitis

Sheep may indicate that the patient has colitis. Most often there is spastic colitis, in which the motor (motor) function of the small intestine is disturbed. The activity of the intestine is unstable. There are episodic constipation, sheep feces.

Risk factors

In some cases, various types of constipation, including sheep, can occur as a result or complication of certain somatic diseases. People who are prone to these diseases are at risk because they have a significant increase in the likelihood of constipation and the formation of sheep stool. Among them are the following diseases:

  • porphyrin disease
  • diabetes.

Also, various psycho-neurological diseases, disorders of the endocrine system are considered as risk factors. People at risk of hypothyroidism are also at risk, there are not enough hormones; people with high calcium content in the blood and with a lowered in the bones. Various failures in the work of the parasympathetic department of the nervous system can lead to the formation of sheep stool.

Psychogenic factors, such as depression, anorexia, the state of compulsive psychosis, are another risk group.

All people who fall under these categories must take preventive measures. It should be borne in mind that usually women are more prone to atonic constipation, due to the fact that the abdominal press is not fully developed. Men are more prone to spastic constipation. There is also a high risk of constipation in men and women prone to obesity, overweight, in bedridden patients, immobilized.

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Pathogenesis

The intestine is in most cases associated with a fixed organ, which is intended for food. However, this is not the case. The intestine consists of several layers, including the muscle. Cutting down, the muscle layer pushes food forward along the esophagus, right up to the rectum, where its dehydration, the formation of stool masses, and their further excretion takes place. Abbreviations of the esophagus are rhythmic, undulating, called peristalsis.

Intestinal motility is innervated by nerve endings. Violation of the passage of nerve impulses, violation of the hormonal background, local immunity helps reduce motor activity. With constipation, bowel movements are limited, the muscle layer weakens. Exercises are delayed in the bowel, not being able to go outside. As a result, the stool acquires a different consistency, shape, including the form of sheep's feces.

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Symptoms of the sheep's feces

First of all, it is a symptom of intestinal dysbiosis, in which there is a sharp quantitative and qualitative disruption of the composition of normal intestinal microflora. With dysbacteriosis, the amount of non-pathogenic and opportunistic microflora can decrease, and in its place a pathogenic microflora is formed. In this case, there is irritation of the intestinal walls, a violation of the structure and mobility of stool.

Also, sheep can be a symptom of a violation of intestinal motility, as a result of which the mobility of the intestine decreases, the evacuation function is disrupted, and the atony of the walls is observed. As a result, stool masses are delayed, and their excretion outside is difficult.

Sheepfish is an extremely unpleasant, painful condition that requires the adoption of curative and preventive measures. The first sign is the lack of regularity in visiting the toilet. Stools became long, painful, not always successful. There are painful conditions in the intestine, especially its thick section.

The appearance of pain directly during the act of defecation speaks of the defeat of the intestine. This is a late, neglected stage of the disease.

Also, an unpleasant sensation of a plug in the anus can appear, which clogs it and does not allow the exit of feces. Constipation may be indicated by strong straining, which does not give any result.

It is necessary to begin to show concern in the absence of defecation for 7 days. The feces vary in shape, appearance. The feces can be dry, fragmented and acquire the form of sheep feces. All this is accompanied by a feeling of incomplete cleansing of the rectum, a feeling of rasstity. Occasionally, foreign matter and mucus may be present in the stool.

All these symptoms are accompanied by a feeling of weakness, gas formation, increased blood pressure, headache.

Constipation and sheep feces

Most people do nothing to eliminate constipation. It is not right. With constipation you need to fight. First, it can turn into a chronic form, cause serious consequences and complications.

Secondly, constipation causes a constant feeling of unopened intestines. As a result, a person feels constant discomfort. Irritability, poor state of health grows. There may be intoxication, systematic headaches. Cal, which lingers in the rectum, gradually accumulates, undergoes rotting processes.

Substantially increases the load on internal organs, decreases immunity. Secondary diseases, damage and cracks of the intestine, rectum may occur.

The scheme of therapy depends on the cause of the disease. For this, a survey is necessary. Treatment is usually complex: it includes treatment of the underlying disease, concomitant, and systematic treatment.

For the treatment of constipation and sheep feces in adults, laxatives, antitoxic, antispasmodic drugs are used. Later, appropriate means are chosen to restore the microflora. It is necessary to observe proper nutrition, the diet should contain enough fiber. Important is the normalization of the drinking regime, observance of a favorable psychological microclimate at home and at work. There are traditional and alternative treatments for constipation and sheep feces.

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Sheep feces with mucus

A certain amount of mucus may be present in normal feces. Slime, as a rule, does not indicate the presence of any serious pathologies. Mucus may indicate that a person recently radically changed his diet, for example, became a vegetarian, or completely excluded from the diet of any product. Also, mucus may indicate that a large amount of an absolute new product has appeared in the diet.

Also, mucus against the background of sheep feces may appear after prolonged constipation, after prolonged antibiotic therapy, a cold transferred. The use of a large number of monotonous products, or excessive abuse of one particular product, starvation, a rigid diet can lead to the formation of mucus and sheep feces.

If mucus appears in the feces regularly, for a long time, it can indicate more serious disorders, such as dysbiosis, a violation of the basic functions of the gastrointestinal tract. In this case, you must always consult a doctor. Self-medication is not recommended, because it can only exacerbate the problem.

Sheep with blood

Detection of sheep with blood is an alarming sign. It can indicate a mechanical damage to the walls, blood vessels. It is necessary to immediately consult a doctor, since the risk of infection is high.

Sheep with blood can indicate the presence of hemorrhoids.

Also, blood can be a sign of acute colitis, ulcerative lesions of the intestine. In this case, surgical intervention may be required.

What symptom is sheep feces?

Pain during bowel movement may indicate a neglected form of impairment. It is necessary to undergo examination, to begin complex treatment.

Hard sheep may indicate 2 indicators: insufficient drinking regimen and neglect of the pathological process.

In sheep's feces, it can be assumed that a person has worms. This is due to the fact that worms are an irritating factor that irritates the intestinal wall, contributes to the additional synthesis of immunoglobulin A. As a result, the intestine may develop irritating, other pathologies may develop.

Black sheep may indicate inflammation of the duodenum, stomach. Some patients with ultrasound showed a bend of the gallbladder. Sometimes sheep can be a sign of bleeding from the upper gastrointestinal tract, ulcers. Some medicines can also stain feces black.

If a person has first ovine stool, and then he gets a normal consistency, you can assume a stressful effect. Such a chair can be a sign of colitis. Also, such a chair is found in premenstrual syndrome.

In adults, sheep can manifest along with constipation quite suddenly, even though the person feeds fully. Most often the cause is a systematic neuropsychic stress, constant stress. Changing events, situation, can aggravate the situation.

It will require a change in diet, diet and medication. In adults, sheep may be a sign of gastritis, peptic ulcer, colitis.

Sheep feces during pregnancy

Pregnancy is a special condition in which the female body undergoes significant changes. The hormonal background, the mental, physical state of the organism changes. Transformations also affect the digestive system. In this case, a frequent occurrence is constipation, which is accompanied by the formation of sheep stool.

This pathology in pregnant women is caused by the displacement of the intestine, the lowering of the uterus, a substantial increase in the uterus, which results in pressure on the internal organs, their displacement. In addition, the muscles and ligaments are significantly stretched, as a result of which the peristalsis, contractility of the muscular layer of the intestine is reduced.

With sheep feces during pregnancy, intoxication often develops. As a result, an infectious and inflammatory process can develop, infection of the genitals, hemorrhoids. Infection is especially dangerous, as it can cause fetal infection, both during the period of fetal development, and during the period of childbirth.

Sheep after delivery

In women after birth, sheep may be the result of neuropsychic stress, fear, stress, anxiety. With constipation, which does not take more than 3-4 days, it is necessary to consult with a doctor, as it can contribute to changes in microflora, which entails intoxication with the products of the vital activity of microorganisms.

Sheep feces in nursing mothers

In a nursing mother, sheep may be caused by a disturbance of the microflora (or its recovery after delivery). It can be caused by hormonal changes, the effects of stress. Danger of intoxication, which can adversely affect breast milk.

Sheep feces in children

Children are more prone to constipation and the formation of sheep feces than adults. This is due to the peculiarities of the anatomical structure of the intestine of the child, a small body weight, as a result of which the body is more prone to dehydration.

With the occasional appearance of sheep's feces, one can speak of eating disorders, of his regime. This can also indicate a lack of fluid. Usually, only changing the ration is enough for children, after which the stool immediately acquires a normal consistency.

In order to prevent, it is necessary to ensure constant control over the child's nutrition. The diet should contain enough of all the necessary substances. Necessarily the presence of fresh fruits and vegetables, berries.

When a child has ovine stool, it is necessary to consult a gastroenterologist and proctologist. Self-medication can be dangerous. Treatment is usually aimed at eliminating the root cause and strengthening the state of the immune system.

Sheep feces in infants

If a newborn has sheep, you should never hesitate to visit a doctor. In the baby, sheep can be a sign of dangerous for health, and even the life of disorders, such as diabetes, meningitis.

In a newborn, sheep can be caused by anatomical features of the intestine. The intestinal ring and sigmoid colon may be excessively elongated. Also can affect sphincter functional disorders.

Also, sheep may indicate dysbiosis. Most often the intestine is affected by microorganisms of the genus Staphylococcus, Klebsiella. Sheep and dysbacteriosis in the baby are most often due to the use of antibiotics.

Also, the negative impact of stress, nervous overexertion, mental trauma. In infants, sheep can occur as a result of high fever, as a consequence of colds. In this case, the child needs a lot of drinking. As a rule, after a day, the consistency of the stool becomes normal.

Complications and consequences

Any constipation is associated primarily with the stagnation of stool in the body. In this case, the feces solidify and compact. Stagnant phenomena develop in the intestine. With prolonged constipation, rotting processes begin in the body, which are accompanied by the release of toxic substances, decomposition products. These substances are subsequently absorbed by the walls of the intestine and spread throughout the body. There is an intoxication of the body. It is accompanied by a deterioration of health, headaches, spasms, increased irritability.

In addition to the general effect, local effects are also observed. The walls of the intestine are exposed to irritation from the formed toxins, carcinogens. Such an effect can lead to the formation of cancer cells, the development of malignant neoplasm.

This can be fraught with serious consequences. In particular, there may be a need for partial removal of the intestine. The absence of treatment can lead to the appearance of cracks in the walls of the intestine, in the anus. May develop hemorrhoids, prolapse of the rectum.

Therefore, as soon as you notice the formation of sheep feces, you should immediately consult a doctor.

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Diagnostics of the sheep's feces

Treatment of sheep feces is impossible without the correct diagnosis. First of all, it is necessary to find out the cause of this violation. Diagnosis includes instrumental, laboratory examination, examination.

In addition to traditional clinical tests, scraping is also performed to determine the presence of worms. The main is a bacteriological study (or a study for dysbiosis).

The main type of instrumental diagnosis is fibrogastroscopy. You may also need a colonoscopy.

trusted-source[22], [23], [24], [25]

What tests are needed?

Differential diagnosis

The essence of differential diagnosis is to determine the exact cause of the disease. First of all, methods such as ultrasound diagnosis, colonoscopy, gastroscopy, and laboratory tests are used.

trusted-source[26], [27], [28], [29]

Who to contact?

Treatment of the sheep's feces

If signs of sheep feces are found, a consultation of the gastroenterologist is required. This is the first step from which to begin treatment. This is due to the fact that the treatment of this disease can not begin without a preliminary examination, laboratory tests.

Treatment begins with determining the causes of the disease. You may need to consult not only the gastroenterologist, but also the proctologist. Treatment, as a rule, complex. Self-medication is not recommended, as this can lead to unpleasant consequences, complications.

Treatment is mainly carried out according to the scheme that corresponds to the underlying disease. Eliminating it, and sheep feces will disappear.

The doctor will definitely give recommendations that need to be adhered to in order for the treatment to be effective. It is important to change the diet to a more complete, balanced, enrich it with fiber, which helps to cleanse the body, removing toxins. There must be an abundant drinking regime, with the correct balance of water and salts. No less important is the normal mental state, calmness, harmony, lack of stress, overwork.

Medications

The safest drugs that do not have side effects are preparations containing lactulose: normase, lactosan, and portolac. These drugs are used on 3-4 tablespoons, morning and evening. Dosage can be increased if necessary.

Mukofalk in bags is also a relatively safe drug, side effects for which are not observed. It is recommended to use the contents of 1 packet before lunch. If this is not enough, and before dinner. If necessary, the dosage is increased to 4 sachets per day.

Duspatalin Retard - a highly effective drug that is used in 2 divided doses, 200 mg, 20 minutes before meals. Precautions: sing with water, in large quantities. Capsules need to be swallowed whole, you can not chew them, open them. Side effects: general weakness is possible with insufficient amount of drunk water.

Suppositories with chestnut from sheep's feces

Candles containing horse chestnut extract are manufactured industrially. The drug was called "Rectal". The main active substance is saponin escin. The essence of its effect is that it irritates the receptors contained in the walls of the rectum. As a result, bowel movement is observed almost immediately after the administration of the suppository.

Enterofuryl

Enterofuril is an intestinal antiseptic. Issued in the form of capsules and a suspension. The active substance is nifuroxazide. The drug has anti-infectious, anti-inflammatory, the effect stabilizes the normal activity of the intestine. Contraindicated in children, people with increased sensitivity to the active substance, with intolerance to fructose.

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Dufalac

Dufalac is a reliable drug that has well proven itself as a remedy for constipation. Before using, it is best to read the instructions. A number of studies of the drug was recognized as a mild, safe remedy. Dosage of this drug can be regulated independently, as necessary.

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Alternative treatment

For the treatment and prevention of constipation has long been used alternative means, which are highly effective. Most often they are used as a supplement to drug therapy.

Here are some recipes tested by years of practice:

  1. Enema with vegetable decoctions. It is recommended to use a light broth of fennel fruits, or chamomile medicinal.
  2. Juice from potato tubers. Drink 125 ml. 2 times a day.
  3. Sea-buckthorn buckthorn. Apply oil from fruits, for 5-10 g. Has a laxative effect, reduces irritability of the intestinal walls.
  4. Mushroom birch (chaga) - dried mushroom pour warm water, insist two days. Apply to 125 ml. At intervals of about 5 hours.

Herbal Treatment

Yarrow common (grass). Directly in the thermos mix 15 g of the previously dried plant with boiling water. After the mixture is infused, you can drink, but not more than 15ml at a time.

Dymyary officinalis (grass). Use a decoction of the thermos, which includes 5 grams of dry plant and 250 ml of boiling water. The dose for one dose should not be more than 15 ml. A day allowed to drink up to 60 ml.

Common flax (seeds). Take 5 g. Of seeds. Give the opportunity to brew in a glass of boiling water. Apply, without filtering, along with the seeds.

Homeopathy with sheep feces

For the treatment, prevention and elimination of constipation, the use of homeopathic remedies is recommended. They are usually well tolerated by the body. Many of them are allowed to use even during pregnancy, breast-feeding. However, precautions must be observed. Make sure that you do not have any allergies on them. Consult with your doctor, as these substances may not be combined with drug therapy. In some cases, the doctor can correct the treatment regimen by selecting the optimal dosage, time of administration. Do not exceed the recommended dose - homeopathic remedies have a fairly powerful effect. Many drugs have a cumulative effect, in which the effect can be seen at the end of the course of treatment.

Collection number 1. With propensity to constipation

  • The buckthorn is alder-like (bark) - 1 part
  • Yarrow common (grass) - part 1
  • Licorice is naked (root) - 1 part.

The agent is applied in the form of infusion over half a glass, at night.

Collection number 2. With propensity to constipation

  • The buckthorn is alder-like (bark) - 1 part
  • Yarrow common (grass) - part 1
  • Three-leafed watch (leaves) - 1 part
  • Apply inside in the form of infusion, for a third cup, at night.

Collection number 3. With gastritis with a tendency to constipation

  • Althaea officinalis (root) - part 1
  • Chamomile pharmacy (flowers) - part 1
  • Licorice is naked (root) - 1 part.

Take in the form of a decoction, not more than 250 ml, before going to bed.

Collection number 4. With spastic constipation, pain

  • Leaf of the hay (Alexandrian leaf) - 3 parts
  • The buckthorn is alder (bark) - 2 parts
  • Anise ordinary (fruits) - 2 parts
  • Licorice is naked (root) - 1 part.

Preparation: 5 g. Collection pour boiling water, insist, apply once, about 250 ml.

Diet and nutrition with sheep feces

It is necessary to eat small portions, but often. It is recommended to eat about 6 times a day. If there are any diseases of the stomach or intestines, you should immediately apply therapy.

The menu should change periodically. It is necessary to exclude or minimize flour products, fried and baked dishes.

It is important to use those products that weaken, and exclude those that are fastened. You need to minimize the use of products such as chocolate, persimmons, eggplant, terrene, green tea, wheat bread, pomegranate. In the diet it is recommended to include more tomatoes, cucumbers, plums, pineapples, pineapples, melons. Fruits, dried apricots, raisins, prunes are also recommended to be consumed in large quantities, especially at night. Take the rule of eating figs. It helps to normalize digestion, stimulates intestinal motility. It is enough 1-2 berries. For greater effect, fill it with water.

Food should be more vegetative than meat. Care should be taken with yogurt: fresh yogurt without sugar is weak. The old kefir with the addition of sugar - on the contrary, strengthens.

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Prevention

There are several ways to prevent constipation and sheep feces:

  • the main means of preventing constipation is proper nutrition;
  • physical culture is the second important means of prevention;
  • harmony with oneself, calmness, lack of stress is the third means of prevention;
  • it is necessary to periodically visit a gastroenterologist for preventive examination (at least 2 times a year)
  • it is important to control the drinking regime.

trusted-source[35], [36], [37], [38]

Forecast

In general, the outlook is favorable. With minor digestive disturbances, all disorders disappear on their own within a few days after a change in diet, normalization of the drinking regime. If the constipation is not systematic, it is sufficient to introduce a large number of fruits, vegetables, as well as those products that weaken in the diet. With prolonged systematic constipation during the necessary therapy, adherence to diet, water regime, the prognosis is also favorable.

The prognosis may be unfavorable if the preventive measures are not observed, in the absence of treatment. Constipation can go into a chronic form, cause complications.

An extremely unfavorable prognosis, even up to a lethal outcome, is also not ruled out. So, the use of laxatives and complex therapy are mandatory for people suffering from thrombosis, severe heart disease, blood vessels, for people with severe forms of hepatic and renal insufficiency, for people prone to hysteria, epilepsy, schizophrenia.

trusted-source[39], [40]

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