For the first time, fermentative dyspepsia was described at the very beginning of the twentieth century, the authors of the scientific work were Schmidt and Strasburger. The disease is most often recorded in the spring, its appearance is directly related to a violation of the digestion of carbohydrates.
Symptoms of fermentative dyspepsia
A factor contributing to the development of pathology is the diet, the observance of which in this case can be called exaggerated. Provokes the appearance of symptoms of fermentative dyspepsia food rich in carbohydrates, especially if coarse vegetable fiber is consumed in large quantities. An important role is also played by violations of the masticatory apparatus and hasty eating, since the process of splitting carbohydrates in the oral cavity by salivary amylase remains incomplete.
The disease can also occur against the background of a decrease in the secretion of gastric juice, which is associated with insufficient digestion of the connective tissue membranes of plant fibers. Carbohydrates found in plants thus become inaccessible to the enzymes of the pancreas and small intestine. A decrease in the volume of pancreatic amylase can also cause symptoms of fermentative dyspepsia.
In the development of the symptoms of the disease, an increase in motor function in the small intestine also plays a role, this is due to irritation of its walls with coarse fibers of plant fiber, while the time required for the enzymatic processing of carbohydrates is significantly reduced.
A large concentration of carbohydrates that have not had time to be completely digested and are inside plant fiber enhances fermentation processes in the caecum, as well as in the lower ileum. Later, the fermentative microflora moves to the overlying sections of the small intestine, where microorganisms can enter along with the food bolus, especially if the gastric contents do not have bactericidal properties due to a decrease in the secretion of gastric juice.
Fermentation processes in the intestines can also increase with the frequent use of carbonated drinks and fermented foods. An increase in the intensity of fermentation processes entails the formation of a large amount of organic acids and gas-forming products that irritate the intestines, stimulating its motility. The result of increased work of the muscles of the intestine is the separation of a large volume of liquid intestinal secretion, as well as diarrhea. Fermentation products, absorbed in the intestines, cause intoxication of the body.
Favorable conditions for the development of the disease creates heat. A decrease in the secretion of hydrochloric acid in the stomach and the secretory function of the pancreas in a hot climate occurs against the background of dilution of digestive enzymes with a large amount of fluid consumed. Chilled water and drinks also cause an increase in the contractile activity of the gastrointestinal tract, which even more adversely affects the human condition. Thus, the intake of food rich in carbohydrates, subject to a persistent increase in air temperature outside, contributes to the onset of symptoms of fermentative dyspepsia.
Patients are concerned about bloating, rumbling, transfusion. The disease is accompanied by a feeling of heaviness and fullness, in more rare cases, patients are disturbed by recurrent dull pain in the middle part of the abdomen, which subsides after defecation. Over time, the stool becomes more frequent, light yellow in color or mushy, containing fragments of undigested fruits and vegetables. The stool foams and has a sharp sour smell. The disease is accompanied by the discharge of flatus, in rare cases – sour eructation. Fermentative dyspepsia is also characterized by symptoms of intoxication: nausea, headache, weakness, irritability. On examination, you can notice bloating, splashing and rumbling in the area of the small and large intestines. To make a more accurate diagnosis, they resort to a scatological examination of feces. With fermentative dyspepsia, laboratory analysis can detect a large number of starch grains, iodophilic flora, cellulose in digested and undigested form, as well as organic acids in the feces.
The course of the disease in most cases is not severe and, provided that treatment is started in a timely manner and medical care is provided in full, it ends very soon with a complete recovery. At the same time, under certain conditions, the pathology may be accompanied by relapses, and in the case of improperly selected therapy, the disease can become chronic and cause enteritis and enterocolitis.
Treatment of fermentative dyspepsia
Treatment of fermentative dyspepsia usually begins with one or two fasting days, during which the patient is only allowed to drink tea without sugar. With the exhaustion of the body and the loss of a large volume of fluid, parenteral administration of solutions of glucose and sodium chloride 0,9% is recommended. From the eighth to twelfth day, the patient is transferred to a protein diet, sharply limiting the intake of carbohydrates and completely excluding vegetable fiber, as well as drinking that causes fermentation: kvass, milk, black bread, carbonated drinks.
Optimal for patients is diet No. 4a according to Pevzner. Over time, the proportion of carbohydrates in the patient’s diet is increased, starting with foods that are easily digested. If errors in the diet are allowed as part of the treatment of fermentative dyspepsia, then the disease can turn into a putrefactive form, which is more difficult to treat.
In the treatment of the disease, adsorbents, an infusion of chamomile, an infusion of carminative herbs are used. Of the drugs, astringents, tincture of opium, belladonna, papaverine, platyfillin can be prescribed.
If the disease is accompanied by a decrease in the secretory activity of the stomach, then patients are recommended to take diluted hydrochloric acid along with pepsin, with a decrease in pancreatic function, pancreatin is prescribed. Antiseptics and vitamins of group B have a beneficial effect on the patient’s body. If the therapy is not effective enough, a short course of antibiotics (sulfonamides) is recommended.
After the end of the treatment, the reception of low-mineralized mineral waters in a warm form, in small portions before meals (15–20 minutes before a meal), helps to consolidate the results.
[Video] Dr. Zaur Orudzhev – What is Dyspepsia? (Indigestion):