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Insufficient digestion syndrome: symptoms
Last reviewed: 19.10.2021
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In the clinical picture of dyspepsia, depending on the prevalence of signs of digestive disorders in various parts of the gastrointestinal tract, gastric, intestinal, and sometimes pancreatogenic forms are distinguished.
The occurrence of gastric dyspepsia is associated with atrophic gastritis, characterized, as is known, by secretory insufficiency, as well as with decompensated stenosis of the pylorus, stomach cancer. The clinical picture of this dyspepsia is characterized by loss of appetite, a feeling of heaviness, bursting and pressure in the epigastric area after eating, belching out air, food with a rotten smell, unpleasant taste in the mouth, nausea, flatulence, diarrhea. In the study of gastric secretion, Achilles or Achlorhydria are identified.
The appearance of intestinal dyspepsia is caused by chronic inflammatory diseases of the intestine, especially the small intestine. The main clinical signs of this form of dyspepsia are rumbling and transfusion in the intestine, abdominal distension, heaviness and raspiranie in the stomach, a significant separation of gases, unstable stools with predominance of diarrhea (liquid feces with putrefactive or acidic odor).
With a coprological examination, the intestinal steatorea is more often detected, when fatty acids, soaps, amylorrhea, creators, an increased content of ammonia, and lowered stercobilin predominate. Excretion of the indicator in the urine is increased, the amount of bilirubin and bile acids in it is increased, and urobilin is reduced. At the X-ray examination of the upper sections of the digestive tract, an accelerated passage of the contrast medium through the small intestine is more often detected. When cultures of gastric and intestinal contents by the method of serial dilutions, various microorganisms are detected - more than 10 000 cells per ml. The degree of disturbance of the cavity digestion can be judged by the content of enzymes in intestinal contents and feces (enterokinase and alkaline phosphatase), and also by the nature of the glycemic curve with starch load, the study with trioleate glycerol and olive oil labeled 131 I.
The emergence of pancreatogenic dyspepsia is associated with exocrine insufficiency of the pancreas. In the clinical picture of this dyspepsia, anorexia, meteorism, rumbling, transfusion, colicky abdominal pain, abundant "pancreatogenic" diarrhea predominate. In coprologic analyzes, steatorea is predominantly pancreatic (mainly due to neutral fat), amylorrhea, and creatorrhea.
In diseases of the intestine, all three types of dyspepsia are often combined.
The syndrome of digestive deficiency I and II severity was in fact all patients with chronic enteritis and enterocolitis, and it was also characteristic of Crohn's disease, Whipple's disease, and gluten enteropathy.