Disorder-diet therapy

Unloading-dietary therapy (EDT) or dosed therapeutic fasting is a complete abstinence from food intake without limiting water intake during the unloading period, followed by a gradual transition to exogenous nutrition (food intake) with the help of special diets.

Indications

• bronchial asthma of all degrees of severity, predominantly atonic, resistant to conventional therapy;
• corticosteroid-dependent forms with a duration of glucocorticoid use of no more than 2 years;
• bronchial asthma combined with obesity, polyvalent and drug allergies, ulcerative, urolithiasis, hypertension, chronic colitis, irritable bowel syndrome, psoriasis, eczema, neurodermatitis.

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General information detox therapy

Mechanism of therapeutic action of RDT:

• hyposensitization;
• increasing non-specific resistance and anti-infective immunity;
• suppression of allergic inflammation in the bronchi;
• stimulation of glucocorticoid function of the adrenal glands;
• detoxification;
• improving bronchial patency;
• suppression of the immunopathological component of the pathogenesis of bronchial asthma;
• autolysis of pathologically altered cells;
• formation of biogenic stimulants that enhance regenerative processes.

The methodology for conducting RDT provides for 3 periods: preparatory, unloading, and recovery.

In the preparatory period, indications for RDT are established, a clinical and laboratory examination of the patient and active treatment of the inflammatory process in the bronchopulmonary system are carried out, and psychotherapeutic preparation for RET is carried out.

The main task of the fasting period is to switch from exogenous to endogenous nutrition. This period lasts 10-14 days. During this period, the body switches to predominantly using fats, while acidosis develops, hypoglycemia is possible. Therefore, in the first days of fasting, lethargy, fatigue, headaches are noted. On the 7-14th day, the state of acidosis is smoothed out. For the entire period of fasting, medication is discontinued, in some cases, expectorants, diuretics, sedatives are allowed. Smoking and alcohol are strictly prohibited.

On the eve of the first day of fasting, the patient does not have dinner and receives a saline laxative (50 ml of 25% magnesium sulfate), then daily cleansing enemas are given. During defecation, self-massage of the abdomen is performed to better empty the intestines.

After the enema, take a general bath (water temperature 37-38°C, duration 10 min) or a circular shower. General massage, self-massage, including facial massage, is performed daily.

After the massage and shower (bath), rest for 1 hour is required, then, if you feel well, a walk is allowed (3-4 hours per day).

There is no limit to drinking liquids, the amount should be at least 1 liter per day. Usually this is boiled water at room temperature or mineral water.

In the presence of acidosis, alkaline mineral waters (Borjomi) are recommended, as well as a 3-4% solution of sodium bicarbonate in an enema (0.5-1 l) or less often intravenously - 200-300 ml.

You should check your urine for acetone daily; if you have severe acetonuria, take 1-2 pieces of sugar orally.

If blood pressure drops to 85 and 50 mm Hg, fasting should be stopped.

Asthma attacks disappear or become less severe by the 7th day of fasting.

The recovery period is equal in duration to half of the unloading period. From the first day of the recovery period, walks, massages, baths, enemas are cancelled. The first 4-5 days, patients should rest (lie down, sit in a comfortable chair).

The diet is gradually expanded over the days. Meat and table salt are prohibited for the entire period of rehabilitation treatment.

In some cases of moderate bronchial asthma, medications have to be used in the first days of RDT, which are gradually discontinued in the first 3-4 days. In severe cases of bronchial asthma, RDT is combined with medication, physiotherapy, these measures are gradually discontinued as the condition improves.

S. G. Osinin (1981) suggested combining RDT with acupuncture, which should be connected from the 1st-2nd day of the recovery period and carried out for 8-12 days. The goal of acupuncture is to reduce the discomfort in the abdominal cavity that occurs in the first days of eating, normalize sleep, eliminate psychoemotional lability, and enhance the effect of RDT. The combination of RDT and acupuncture allows for a significant reduction in the dose, and sometimes even complete cancellation of glucocorticoids in patients who have previously received them. In general, RDT gives good results in 62% of cases.

Contraindications

• active pulmonary tuberculosis;
• diabetes mellitus;
• circulatory failure IIB - III stage;
• exhaustion;
• malignant tumors;
• early childhood (up to 14 years) and old age (over 70 years);
• pregnancy and lactation;
• decompensation of liver and kidney function;
• helminthiasis;
• mental illness;
• active inflammatory process of any localization.

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Complications

Possible complications during RDT:

• exacerbation of chronic foci of infection;
• severe ketoacidosis; in this case, alkaline mineral waters or sodium bicarbonate (2-3 g every 2-3 hours) are used internally, less often - intravenous infusions of 200-400 ml of 4% sodium bicarbonate solution. If ketoacidosis does not resolve, RDT is stopped;
• orthostatic syncope;
• disturbance of cardiac rhythm and conduction; in this case, potassium preparations are prescribed and RDT is stopped;
• renal or biliary colic, in which case RDT stops;
• acute erosive and ulcerative changes in the gastroduodenal zone - therapeutic fasting in such situations is stopped;
• convulsive syndrome;
• "food overload" syndrome during the first 3-5 days of the recovery period;
• "salt edema" due to dietary violations during the recovery period;
• exacerbation of radiculitis.

RDT should be carried out under the supervision of a physician who has undergone special training.

In recent years, it has been proposed to use a combination of enterosorption and therapeutic fasting. The main mechanism of action of enterosorption is detoxification of intestinal contents, freeing the body from toxic or potentially dangerous substances of exogenous and endogenous nature by binding and neutralizing them in the gastrointestinal tract.

Enterosorption is connected in the unloading period, patients take 30-60 ml of enterosorbent SKNP-2 (nitrogen-containing activated carbon of spherical granulation, oral, large-pored) orally in 3-4 doses at intervals of 4-6 hours, washing down with water and without chewing the granules. From the 8-10th day of the unloading period, when the probability of acidosis is significantly reduced, the dose of enterosorbent is reduced by 2 times and continued until the end of the unloading period.

In the presence of erosive gastritis, gastric ulcer and duodenal ulcer, ulcerative colitis, granulated sorbents are not used, but other preparations with sorption action (vazulene, polyphepan, enterodesis, belosorb). The combination of RDT and enterosorption is highly effective in bronchial asthma and allows to completely prevent acidosis during therapeutic fasting.

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