How does intestinal dysbiosis manifest in adults? What is normal intestinal flora? The most common infections that aggravate the condition of dysbiosis

It is important to note that dysbiosis does not have any characteristic combination possible symptoms. In other words, two patients with this pathology may have different manifestations of the disease. This is explained by differences in the composition of the intestinal microflora in each person, different states of the immune system, and different dominant pathogens.

If we talk in general about the manifestations of dysbiosis, then in most patients its symptoms are very mild, and many do not have any manifestations of the disease or complaints at all. Asymptomatic dysbacteriosis is very common. In these cases, pathology can only be detected using bacteriological methods. However, in the case of an asymptomatic course, the harm to the body is minimal, and the microflora most often recovers on its own over time. Severe disorders in patients are not so common. Usually these are patients with concomitant anatomical abnormalities, chronic diseases, and severe weakened immunity. In severe cases, the disease may various violations and complications that threaten the patient's health.

In patients with intestinal dysbiosis, the most common symptoms are:

• Stool disorders. Stool disorders due to dysbacteriosis are one of the most common and characteristic symptoms. They can wear different character and will be considered separately.
• Flatulence. Flatulence is the name given to increased gas production, which leads to frequent passing of gas and bloating. Against the background of flatulence, the patient may experience dull pain due to stretching of the intestinal walls. The reason for the appearance of this symptom is the predominance of bacteria in the microflora that cause rotting and fermentation. Instead of the normal breakdown of food, it is fermented, during which a lot of gas is released. It accumulates in the intestinal loops and gradually leaves naturally. In patients on a diet ( less meat, carbonated drinks, beer and kvass), flatulence is less pronounced.
• Stomach ache. Abdominal pain due to dysbacteriosis can appear for several reasons at once. Firstly, there is the above-mentioned flatulence and stretching of the walls. Secondly, it is a spasm of smooth muscles. It may be associated with the absorption of toxic breakdown products that are not released by normal microflora. Thirdly, the cause may be a primary or secondary inflammatory process. With primary dysbiosis, pain usually appears later than other symptoms, and with secondary dysbiosis, it precedes them. The pain itself may be associated with concomitant diseases that caused dysbiosis ( Crohn's disease, ulcerative colitis, etc.). In this case, other symptoms that are not typical for dysbiosis may be observed. In general, abdominal pain does not appear in all patients with this disease. Most often it is absent, but many patients complain of discomfort. If pain appears, it is often localized in the lower abdomen and presents as cutting or dull, “migrating” pain. In general, the nature of this symptom may be different and no obvious pattern is observed.
• Losing weight. Normal intestinal microflora takes an active part in the absorption of nutrients. In its absence, the so-called malabsorption syndrome develops ( malabsorption of nutrients in the intestines). Thus, the patient can eat well and follow various diets, but still the body will not have enough nutrients. With prolonged dysbacteriosis against the background of malabsorption syndrome, the patient begins to gradually lose weight. The more serious the violations, the faster this process will become noticeable. Since chronic protracted dysbacteriosis is quite rare, weight loss in patients is not very common.
• Rumbling in the stomach. Rumbling in the stomach is caused by the accumulation of gases that do not find a way out naturally, as well as contractions of the intestinal muscles. Gases accumulate due to the fermentation process against the background of dysbiosis, and hyperactive muscle function can be explained by the absorption of various bacterial toxins. Particularly characteristic this symptom with dysbiosis in children. In older people, dysbacteriosis often occurs with signs of paralytic intestinal obstruction ( intestinal muscles do not contract). Then there can be no rumbling in the stomach.
• Bad breath. Many patients go to the dentist when they experience bad breath. Upon careful examination, most of them are found to have dysbacteriosis ( mouth or intestines). Intestinal dysbiosis can give bad smell due to processes of decay and fermentation caused by atypical microflora. As a result, gases are formed, some of which rise up the gastrointestinal tract. The result may be belching with an unpleasant odor or taste, or simply bad breath. This symptom can appear even with minor deviations in the composition of the microflora and may be the only manifestation of the disease.

Diarrhea and constipation due to intestinal dysbiosis

With dysbacteriosis, diarrhea has the following features:

• Usually the frequency of stools is about 4 – 6 times a day ( but there is more in severe cases );
• diarrhea is not always accompanied by pain and cramping in the abdomen;
• in most cases, the stool is not completely liquid, but simply “unformed” ( mushy);
• often the stool has a strong unpleasant odor - the result of rotting and fermentation processes;
• The duration of diarrhea if untreated can be weeks or even months ( in this case, the patient's condition gradually worsens due to progressive dehydration);
• episodes of diarrhea may be followed by intermittent constipation.

Constipation in patients with dysbiosis is much less common than diarrhea. They are more typical for elderly patients, since in them dysbiosis often causes deterioration in motor skills ( abbreviations) intestines. As a result, food moves more slowly through the gastrointestinal tract, water from feces completely absorbed. Tenesmus, a painful false urge, is also common.

Does temperature occur with dysbacteriosis?

Temperature is more typical for secondary dysbiosis, which appears against the background of other diseases. For example, low-grade fever ( 37 – 37.5 degrees) can be observed in Crohn's disease or ulcerative colitis. Acute inflammatory processes in the abdominal cavity can cause a very significant increase in temperature ( 38 – 39 degrees), but they almost never occur in dysbacteriosis.

Chronic dysbacteriosis

Chronic dysbacteriosis is somewhat less common. At the same time, disturbances in the composition and quantity of microflora do not return to normal long time (months, years). As a rule, there are prerequisites that do not allow normal microflora to recover. However, in most cases, this problem can still be solved with proper treatment.

At chronic course dysbacteriosis, it is important to pay attention to the presence of the following factors:

• weakened immune system;
• chronic inflammatory diseases intestines;
• non-compliance with the prescribed diet;
• self-medication and unqualified treatment;
• the presence of a constant source of infection ( poor quality drinking water and etc.);
• possible resistance of bacteria to prescribed antibiotics ( checked by antibiogram);
• presence of intestinal tumors;
• chronic diseases of the liver, pancreas, stomach.

Dysbacteriosis in children

The development of microflora in the intestine is strongly influenced by several factors. Firstly, this is the nature of nutrition ( breast milk or formula). The intestines react differently to food incoming in the first year of life, and the normal limits for such children will be different. Secondly, age also plays a role. How older child, those closer composition its microflora to the norm of an adult. Thirdly, we must take into account the possibility of anatomical and physiological abnormalities in young children, which often become the root cause of dysbiosis.

Normal composition of intestinal microflora in children

Functions normal microflora in a child’s body they are the same as in an adult, but they play a more significant role. A child's body is growing and constantly needs nutrients. For example, adults have a certain “reserve” of vitamins, but young children usually do not. With dysbiosis in these cases, the most noticeable vitamin deficiencies are B1 - B6, B12, K, E. The risk of allergic reactions and various metabolic disorders also increases. As a result, the child's growth and development are delayed. It is believed that the younger the child, the more noticeable the dysbacteriosis disorders will be.

In addition to the reasons typical for adults, dysbiosis may appear in children in the following cases:

• weakened immune system due to colds, sore throats, etc. ( which is very common in children);
• the presence of congenital anomalies of intestinal development ( diverticula, narrowing, etc.);
• use of hormonal and antibacterial drugs without consulting a doctor;
• tendency to food allergies or intolerance to certain substances ( gluten, lactose, etc.).

In children, manifestations of dysbiosis depend on the severity of the disease:

• Compensated intestinal dysbiosis. Manifestations of the disease will be moderate, and at first there may be no symptoms at all. Young children may experience rumbling in the stomach, loss of appetite, general anxiety, and poor sleep. Stools usually become more frequent up to 2 - 3 times a day, but depending on the dominant pathogen it can be 6 - 8 times a day ( when Klebsiella multiplies, the stool also greenish color ). In the case of compensated dysbacteriosis, the symptoms of general intoxication are mild. There may be no fever, vomiting or severe pain.
• Subcompensated intestinal dysbiosis. In addition to the above symptoms, signs of general intoxication and metabolic disorders may appear. Stools become more frequent up to 6–8 times a day, sometimes with blood. Children who can already talk complain about severe pain in a stomach. Blood test shows anemia ( reduced level hemoglobin), increased level of leukocytes ( leukocytosis with a left shift and eosinophilia), increased ESR ( erythrocyte sedimentation rate) . All this indicates the proliferation of opportunistic bacteria. Sometimes they enter the bloodstream, forming infectious foci outside the intestine.
• Decompensated intestinal dysbiosis. The frequency of stools is 8–10 times a day or more. It contains undigested food, mucus, and blood impurities. Significant abnormalities appear in the blood test. The child is pale and weak due to anemia. For chronic treatment severe forms may take up to several months. During this period, there is a periodic increase in temperature ( up to 39 degrees or more in the presence of secondary infectious foci), clouding of consciousness, allergic rash, vomiting, severe headaches and abdominal pain, enlarged liver and spleen ( hepatosplenomegaly). Without qualified treatment, young children face a serious risk to their lives.

Treatment of dysbiosis in children involves proper nutrition ( for each age and for different conditions it is different), which will be explained in detail by the attending physician. To normalize the number of bifidobacteria in children artificial nutrition mixtures NAN 1 and 2 are recommended. For children older than six months - NAN 3 and kefir.

For persistent diarrhea, antibiotics may be prescribed ( metronidazole, vancomycin, etc.). Bacteriophages, enzyme therapy, and vitamin therapy are used. Sometimes enterosorbents are required ( enterodesis, enterosgel, etc.) to absorb toxins and reduce intoxication.

Also, for dysbiosis in children, the following eubiotics can be used:

• lacidophilus;

It is believed that treatment is not required at all in the following cases:

• when the amount of E. coli with normal enzyme activity is more than 300 ml/g;
• number of E. coli ( lactose-negative and hemolyzing) less than 10% of the total;
• increase in the number of enterococci ( more than 125% of the norm) in the absence of symptoms and complaints;
• growth of cocci without hemolytic activity up to 125% of normal in the absence of symptoms;
• an increase in the number of lactobacilli and bifidobacteria.

For children, preventive treatment for dysbacteriosis is prescribed in the following cases:

• if the mother suffered from colpitis or other urinary tract infections during pregnancy and childbirth;
• during exacerbation of chronic diseases in children ( amygdalitis, sinusitis, etc.);
• frequent allergies in a child;
• anemia;
• if the mother received corticosteroid drugs during pregnancy;
• children born by caesarean section;
• children born prematurely.

Dysbacteriosis during pregnancy

In general, during pregnancy there are the following prerequisites for the development of intestinal dysbiosis:

• Compression of intestinal loops. The growth of the fetus causes the intestinal loops in the abdominal cavity to rise, which is why its contents may be difficult to pass. As a result, atypical bacteria actively multiply in the resulting “kinks.”
• Changing your diet. Often, women during pregnancy try to change their diet in order to optimize the supply of nutrients to the growing fetus. However, the intestines may not be prepared for such changes. An unusually large amount of plant matter ( or, conversely, meat) food often causes dysbiosis.
• Hormonal changes. During pregnancy, a whole cascade of hormonal changes occurs, which to one degree or another affect almost all organs and systems of the body. For example, many women experience deteriorating motor skills ( reductions) intestines, causing its contents to be less excreted. As a result, pathogenic bacteria can develop in the intestines.
• Weakening of the immune system. During pregnancy, a woman's body is somewhat weakened. This is due not only to the increased consumption of various nutrients ( they are consumed by both the mother’s body and the fetus’ body), but also by forced inaction of the immune system. It weakens to allow the fetus to grow normally. This opens the way for pathogenic bacteria, including creating the preconditions for their development in the intestines.

To prevent the appearance serious problems, pregnant women are recommended to undergo prophylactic stool testing for microbiological testing. Changes in the composition of the intestinal microflora will allow you to notice developing dysbiosis in time. Prescribing antibiotics during this period is not recommended ( they can harm the fetus and do not always help with dysbiosis). Therefore, it is important to compensate for the disorders caused by the disease ( for example, taking certain vitamins) and stimulate the growth of normal microflora. In most cases, dysbiosis in pregnant women is not so difficult to cure. The main thing is to contact a specialist in a timely manner for diagnosis and prescribing the correct treatment. It will be individual for each patient, depending on the symptoms and test results.

Why is frequent dysbacteriosis dangerous?

Also, to obtain reliable results, patients must adhere to the following rules:

• Diet. It is advisable to start following a diet before submitting stool for analysis. For 2–3 days, exclude beer, kvass, alcohol, and lactic acid products. All of them can temporarily affect the composition of the microflora, and the results will be unreliable.
• Early stage of the disease. It is advisable to have stool tested in the first days after the onset of symptoms of the disease, before starting any treatment. After you start taking antibiotics, many sensitive bacteria will already die, and the number of microorganisms in the sample will generally decrease. This will make it more difficult for the laboratory to make a correct diagnosis.
• Proper sample collection. If possible, stool analysis is taken not from the toilet, but from a clean album sheet. It is recommended to take a sample from the middle portion, as this is where the bacteria count is greatest.
• Repeated tests. A one-time test does not always give an objective result. Sometimes, for a more accurate diagnosis, feces are tested 2–3 times with an interval of several days.

In the vast majority of cases, it is the microbiological analysis of stool that makes it possible to make a final diagnosis in the case of dysbacteriosis. It is also used to roughly determine the stage of the disease and its severity. The resulting colonies of pathogens can be tested for sensitivity to various antibiotics ( using an antibiogram). Based on the results of this analysis, the doctor will prescribe the correct treatment.

Where can I get tested for dysbacteriosis?

Treatment of dysbiosis

In a narrower sense, the treatment of dysbiosis is aimed at restoring normal intestinal microflora. Also, in severe cases, supportive and symptomatic treatment may be necessary to improve the patient's general condition.

The vast majority of patients with intestinal dysbiosis do not see a doctor for early stages diseases. With absence concomitant diseases and the normal functioning of the immune system, recovery occurs on its own, without taking any medications, and sometimes without following a diet. In more severe cases, treatment is carried out on an outpatient basis ( the patient visits the doctor almost every day, but does not go to the hospital). If there are any complications or serious accompanying pathologies, the patient may be admitted to the gastroenterology department. The leading specialist will, accordingly, be a gastroenterologist.

The following specialists may also be involved in the treatment of patients with intestinal dysbiosis:

• surgeon– in case of serious complications associated with inflammatory processes;
• family doctor/generalist– treats mild forms of dysbacteriosis, observes the patient for a long time;
• gynecologist– with dysbacteriosis during pregnancy;
• pediatrician/neonatologist– for dysbacteriosis in children;
• immunologist– rarely, for consultation and identification of possible causes;
• microbiologist– the main specialist who deals with diagnostics ( identification, classification, recommendation of antibacterial treatment) dysbacteriosis.

Drugs for dysbacteriosis

In general, the following groups of drugs can be used in the treatment of intestinal dysbiosis:

• Eubiotics. This group of drugs contains representatives of normal intestinal microflora and substances that promote their growth. In other words, the restoration of normal intestinal microflora is stimulated. The choice of a specific remedy is made by the attending physician. Eubiotics Linex, Lactobacterin, Hilak-Forte, etc. are very common.
• Antibacterial drugs. Antibiotics could be the main cause of dysbiosis, but they are also often necessary for its treatment. They are prescribed when an abnormal dominant microorganism is isolated ( for example, with staphylococcal intestinal dysbiosis). Of course, in in this case antibiotics are prescribed only after an antibiogram, which shows which drug is best suited to treat a particular microorganism.
• Antifungal agents. Prescribed when an increased amount of yeast is detected in the intestinal contents.
• Multi vitamin complexes. With dysbacteriosis, the absorption of vitamins is often impaired, and hypovitaminosis and vitamin deficiency develop. This aggravates the patient's condition. Vitamins are prescribed to compensate for deficiencies, as well as to maintain the immune system, which is also important in the fight against dysbiosis. Vitamin complexes from various manufacturers can be used ( picovit, duovit, vitrum, etc.). In case of severe malabsorption in the intestine, vitamins are administered intramuscularly in the form of injections.
• Antidiarrheals. These drugs are prescribed to combat diarrhea - the most unpleasant symptom dysbacteriosis. In fact, there is no treatment. The drugs impair contractions of the intestinal muscles and improve water absorption. As a result, the patient goes to the toilet less often, but there is no direct effect on the intestinal microflora. Antidiarrheals are a temporary solution and should not be taken for a long time. The most common are lopedium, loperamide and a number of other drugs.
• Bacteriophages. Currently, this group of drugs is rarely used. Into the intestines ( often in the form of a suppository) introduce special microorganisms ( viral) that infect certain bacteria. Bacteriophages are specific and infect only a certain group of microorganisms. There are, accordingly, staphylococcal bacteriophages, coliproteus bacteriophages, etc.

Diet for intestinal dysbiosis

Since the normal intestinal microflora is represented mainly by bacteria that decompose sugar, consuming lactic acid products will be beneficial ( contain milk sugar - lactose). It is also important to have sufficient consumption of plant fibers, which stimulate intestinal contractions and normalize bowel movements.

For mild dysbacteriosis, the following products must be included in the diet:

• kefir;
• yogurt;
• cheeses;
• curdled milk;
• cottage cheese.

It is also important to exclude the following foods from your diet:

• carbonated drinks ( including beer and kvass);
• fried meat, tough meat, rare meat;
• fruits, causing bloating intestines ( apricots, plums, etc.);
• legumes ( may increase gas accumulation and discomfort);
• cream cakes and other confectionery products in large quantities;
• alcoholic drinks and coffee;
• canned and pickled foods;
• hot and salty seasonings.

In general, there are dietary features for various types dysbacteriosis. It depends on the type of stool disorder ( constipation or diarrhea predominates), as well as on the frequency and intensity of abdominal pain. In each individual case, the attending physician can adjust the diet at his own discretion.

Folk remedies for intestinal dysbiosis

Folk remedies to combat the symptoms of dysbiosis

Prevention of dysbacteriosis

In general, the following preventive measures can be identified to prevent intestinal dysbiosis:

• diet;
• limited consumption of kvass and beer;
• eating fresh, high-quality foods;
• timely treatment chronic diseases;
• timely consultation with a doctor at the first signs of intestinal pathology;
• breastfeeding;
• rational and justified prescription of antibiotics;
• strict adherence to prescribed antibacterial treatment by the patient.

Is it okay to drink alcohol if you have dysbiosis?

Strong alcoholic drinks in large quantities can, under various conditions, lead to diarrhea, dehydration, a weakened immune system, and impaired motor skills ( abbreviations) intestines. All this does not directly affect the intestinal microflora, but creates the preconditions for the proliferation of some pathogenic bacteria. Some types of wine, beer and other alcoholic drinks directly related to the fermentation process have a direct effect on the microflora. For example, brewer's yeast is a separate type of fungal microorganism. Excessive consumption of these drinks ( especially with existing dysbacteriosis) stimulates the processes of fermentation and putrefaction in the intestines. As a result, all symptoms of the disease will intensify and the risk of various complications. That is why abstinence from alcoholic beverages is an essential component of the diet for patients with intestinal dysbiosis.

The term “Dysbacteriosis” comes from the Greek “dys”, which means “negation” and the words “bacteria”, “bacteria or microorganism”. Intestinal dysbiosis is a quantitative and qualitative disturbance of the normal intestinal flora. The human intestine is populated by bacteria, about 2/3 of the contents of the large and small intestines are represented by microorganisms. A certain quantity and quality of such microorganisms constitute the normal intestinal microflora. Normal intestinal flora is a biomass of obligate (obligatory) microbes involved in the development of immunity. With intestinal dysbacteriosis, there is a disruption in the development of immunity, the colonization of foreign microorganisms, and the development of putrefactive flora instead of the normal one. As a result, putrefactive flora causes chronic inflammation intestines, with characteristic clinical manifestations. An imbalance between microorganisms is the background for the development of various intestinal diseases (the most dangerous, intestinal cancer).

Anatomy and physiology of the intestine

In order to understand in which anatomical structures dysbiosis occurs, let’s talk a little about the anatomy of the intestine.

The intestine is the longest section of the digestive tract, located in the abdominal cavity, originating from the pylorus of the stomach and ending in the anus. The length of the entire intestine is about 4 meters. It is divided into the small intestine and the large intestine, each of which has its own anatomical features.

1. Small intestine, is the initial section of the intestine, consists of loops, longer than the thick one (from 2.2 to 4.4 m) and smaller in diameter (from 5 to 3 cm). The processes of digestion of proteins, fats and carbohydrates take place in it. The small intestine begins at the pylorus of the stomach and ends at the ileocecal angle. The small intestine is divided into 3 sections:

• The initial section is the duodenum, starts from the pylorus of the stomach, has the shape of a horseshoe, goes around the pancreas;
• The jejunum is a continuation of the duodenum, it makes up approximately the initial 6-7 loops of the small intestine, the border between them is not pronounced;
• The ileum is a continuation of the jejunum and is represented by the following 7-8 loops. It ends at a right angle into the initial part of the large intestine (cecum).

1. Colon, is the final section of the digestive tract, where water is absorbed and formed feces are formed. It is located so that it borders (surrounds) the loops of the small intestine. Its wall forms protrusions (haustra), which is one of the differences from the wall of the small intestine. The length of the large intestine is about 150 cm and the diameter is from 8 to 4 cm, depending on the section. Consists of colon, from the following departments:

• The cecum with the appendicular process is the initial section of the large intestine, located below the ileocecal angle, its length is from 3 to 8 cm;
• Rising part colon, is a continuation of the cecum, occupies the extreme right lateral position of the abdominal cavity, rises up from the level ilium to the level of the lower edge of the right lobe of the liver, and ends with the right bend of the colon;
• The transverse colon starts from the right flexure of the colon (level of the right hypochondrium), passes in the transverse direction and ends with the left flexure of the colon (level of the left hypochondrium);
• The descending part of the colon occupies the extreme left lateral position of the abdominal cavity. Starts from the left flexure of the colon, goes down to the level of the left ilium;
• The sigmoid colon, 55 cm long, is a continuation of the previous section of the intestine, and at the level of the 3rd sacral vertebra it passes into the next section (rectum). The diameter of the sigmoid colon, compared with the diameter of the rest of the large intestine, is the smallest, about 4 cm;
• The rectum, is the final section of the large intestine, has a length of about 18 cm. It starts from the level of the 3rd sacral vertebra (end of the sigmoid colon) and ends with the anus.

What is normal intestinal flora?

The human intestine contains microbes that are vital for human body. The approximate amount of normal intestinal flora is about 10 14 microbes, which corresponds to 2 kilograms and includes about 500 species of bacteria. The concentration of microbes in different parts of the intestine is not the same: in the duodenum and jejunum about 10 5 microorganisms in 1 ml of intestinal contents, in the ileum about 10 7 - 10 8, in the large intestine about 10 11 microorganisms in 1 g of feces.
Normally, the intestinal flora is represented by 2 groups of bacteria:

• Obligatory bacteria bifidobacteria (comprise about 85-95% of the flora), lactobacilli (1-5% of the flora), Escherichia coli (Escherichia), enterococci, peptostreptococci) are always part of the normal flora;
• Facultative bacteria (peptococci, staphylococci, yeast-like fungi, clostridia and others), they are optional and non-permanent representatives. They enter the intestines with insufficiently thermally processed food. This group of bacteria is often present in healthy people without causing any problems, but when immunity decreases, they multiply and develop various infectious intestinal diseases.

Normal composition of bacteria in the intestines

• bifidobacteria – 10 9 - 10 10 CFU/g;
• lactobacilli – 10 7 – 10 8 CFU/g;
• bacteroids – 10 7 – 10 9 CFU/g;
• Escherichia – 10 6 – 10 8 CFU/g;
• peptococci and peptostreptococci – 10 5 – 10 6 CFU/g;
• eubacteria – 10 3 – 10 5 CFU/g;
• staphylococci - 10 3 CFU/g;
• streptococci – 10 4 – 10 5 CFU/g;
• clostridia – 10 5 – 10 7 CFU/g;
• yeast-like mushrooms – 10 9 – 10 10 CFU/g;
• opportunistic enterobacteria - 10 3 CFU/g.

Functions of normal intestinal microflora

1. Protective function is to prevent the colonization of foreign microorganisms in the intestines, which can cause various infectious intestinal diseases. Microbes (bifidobacteria) of the normal intestinal flora produce special substances (lactic and acetic acid) that suppress the development of foreign microbes. In order for foreign bacteria to gain a foothold on the intestinal mucosa, they need to displace the normal flora, but the latter prevent this process, since the place is already “occupied.”
2. Immune stimulation, due to bifidobacteria, is to stimulate the formation of antibodies and other substances (cytokines, interferons) involved in the development of immunity.
3. Removal of toxins (detoxification function), consists in the absorption of various toxins (phenols, heavy metal compounds and others) by bifidobacteria of the intestinal flora.
4. Digestive function, bacteria of the intestinal flora are involved in the breakdown of proteins, fats, carbohydrates, into amino acids, fatty acids and monosaccharides. They also enhance intestinal motility, preventing the development of constipation.
5. synthesis function, Bacteria of normal intestinal flora are involved in the formation of vitamins (B, K, C), some acids, and enzymes.
6. Regulatory function those. flora bacteria regulate the gas composition of the intestines, water-salt metabolism, cholesterol and others.
7. Anticarcinogenic (anticancer) effect, consists in the absorption of cancer cell precursors by bifidobacteria.
8. Antiallergic effect, occurs with the help of lactobacilli.

Symptoms of intestinal dysbiosis

The 1st degree and most often the 2nd degree of intestinal dysbiosis do not manifest themselves clinically.
Symptoms characteristic of 3rd and 4th degree intestinal dysbiosis:

1. Abnormal stool:

• Most often it manifests itself in the form of loose stools (diarrhea), which develops as a result of increased formation of bile acids and increased intestinal motility, inhibiting the absorption of water. Later, the stool becomes unpleasant, putrid odor, mixed with blood or mucus;
• With age-related (in older people) dysbiosis, constipation most often develops, which is caused by a decrease in intestinal motility (due to a lack of normal flora).

1. Bloating, due to increased formation of gases in the large intestine. The accumulation of gases develops as a result of impaired absorption and excretion of gases by the altered intestinal wall. A swollen intestine may be accompanied by rumbling and cause unpleasant sensations in the abdominal cavity in the form of pain.
2. Cramping pain associated with an increase in pressure in the intestines, after the passage of gas or stool, it decreases. With dysbiosis of the small intestine, pain occurs around the navel; if the large intestine suffers, the pain is localized in iliac region(lower abdomen on the right);
3. Dyspeptic disorders: nausea, vomiting, belching, loss of appetite are the result of impaired digestion;
4. Allergic reactions, in the form of itchy skin and rashes, develop after consuming foods that usually do not cause allergies, is the result of insufficient antiallergic action, disturbed intestinal flora.
5. Symptoms of intoxication: there may be a slight increase in temperature up to 38 0 C, headaches, general fatigue, sleep disturbance, are the result of the accumulation of metabolic products (metabolism) in the body;
6. Symptoms characterizing vitamin deficiency: dry skin, seizures around the mouth, pale skin, stomatitis, changes in hair and nails and others.

Complications and consequences of intestinal dysbiosis

• Chronic enterocolitis, is a chronic inflammation of the small and large intestines, developing as a result of prolonged action of pathogenic intestinal flora.

• Deficiency of vitamins and microelements in the body, leads to the development of iron deficiency anemia, hypovitaminosis of B vitamins and others. This group of complications develops as a result of impaired digestion and absorption in the intestines.
• Sepsis(blood infection), develops as a result of pathogenic flora from the intestines entering the patient’s blood. Most often, this complication develops when the patient does not seek medical help in a timely manner.
• Peritonitis, develops as a result of the aggressive action of pathogenic flora on the intestinal wall, with the destruction of all its layers and the release of intestinal contents into abdominal cavity.
• Addition of other diseases, as a result of decreased immunity.
• Gastroduodenitis, pancreatitis, develop as a result of the spread of pathogenic intestinal flora through the digestive tract.
• Reducing the patient's weight, develops as a result of impaired digestion.

Diagnosis of intestinal dysbiosis

The diagnosis of intestinal dysbiosis is made based on the patient’s complaints, an objective examination and the results of microbiological examination of stool.

1. Using an objective examination, which includes palpation of the abdomen, pain is determined along the small and/or large intestine.
2. Microbiological examination of stool: carried out to confirm the diagnosis of intestinal dysbiosis.

Indications for microbiological examination of stool:

• Intestinal disorders last a long time, in cases where it is not possible to isolate a pathogenic microorganism;
• Long period of recovery after acute intestinal infections;
• The presence of purulent-inflammatory foci that are not amenable to antibiotic therapy;
• Impaired bowel function in individuals undergoing radiotherapy or exposure to radiation;
• Immunodeficiency conditions (AIDS, oncological diseases and others);
• Infant delay in physical development and others.

Rules for collecting stool for microbiological research: before collecting stool, 3 days before, it is necessary to be on a special diet, which excludes foods that increase fermentation in the intestines (alcohol, lactic acid products), as well as any antibacterial drugs. The feces are collected in a special sterile container equipped with a lid and a screwed-in spoon. To correctly evaluate the results, it is recommended to conduct the study 2-3 times, with an interval of 1-2 days.

Degrees of intestinal dysbiosis
There are 4 degrees of intestinal dysbacteriosis:

• 1st degree: characterized quantitative change ischerichia in the intestines, bifidoflora and lactoflora are not changed, most often not clinically manifested;
• 2nd degree: quantitative and qualitative changes in ischerichia, i.e. a decrease in the amount of bifid flora and an increase in opportunistic bacteria (fungi and others), accompanied by local inflammation of intestinal areas;
• 3rd degree: change (decrease) in bifido and lactoflora and development opportunistic flora, accompanied by intestinal dysfunction;
• 4th degree: absence of bifid flora, a sharp decline lactoflora and the growth of opportunistic flora can lead to destructive changes in the intestine, with the subsequent development of sepsis.

Treatment of intestinal dysbiosis

Drug treatment

Treatment of intestinal dysbacteriosis is carried out with the help of drugs that restore normal intestinal flora and correct other disorders in the body (using enzymes, sorbents, vitamins). The dosage, duration of treatment and group of drugs are prescribed by the attending physician, depending on the degree of dysbacteriosis. Below are the dosages of drugs for adults; for children, the dosage depends on the weight and age of the child.
Groups of drugs used for intestinal dysbiosis:

1. Prebiotics- have a bifidogenic property, i.e. contribute to the stimulation and growth and reproduction of microbes that are part of the normal intestinal flora. Representatives of this group include: Hilak-forte, Duphalac. Hilak-forte is prescribed 40-60 drops 3 times a day.
2. Probiotics (eubiotics), these are preparations containing living microorganisms (i.e. bacteria of normal intestinal flora), they are used to treat grade 2-4 dysbiosis.

• 1st generation drugs: Bifidumbacterin, Lifepack probiotics. They are liquid concentrates of lactobacilli and bifidobacteria and are not stored for long (about 3 months). This group of drugs is unstable under the influence of gastric juice or enzymes of the gastrointestinal tract, which leads to their rapid destruction and the intake of insufficient concentrations, the main disadvantage of 1st generation probiotics. Bifidumbacterin is prescribed orally, 5 doses of the drug 2-3 times a day, 20 minutes before meals;
• 2nd generation drugs: Bactisubtil, Flonivin, Enterol. They contain spores of bacteria of normal intestinal flora, which in the patient’s intestines secrete enzymes for the digestion of proteins, fats and carbohydrates, stimulate the growth of bacteria of normal intestinal flora, and also suppress the growth of putrefactive flora. Subtil is prescribed 1 capsule 3 times a day, 1 hour before meals;
• 3rd generation drugs: Bifikol, Linex. They consist of several types of bacteria of the normal intestinal flora, therefore they have high efficiency, compared to the previous 2 generations of probiotics. Linex is prescribed 2 capsules 3 times a day;
• 4th generation drugs: Bifidumbacterin forte, Biosorb-Bifidum. This group of drugs consists of bacteria of normal intestinal flora in combination with an enterosorbent (with activated carbon or others). Enterosorbent is necessary to protect microorganisms when passing through the stomach, it actively protects them from inactivation by gastric juice or enzymes of the gastrointestinal tract. Bifidumbacterin forte is prescribed 5 doses 2-3 times a day, before meals.

1. Symbiotics(Bifidobac, Maltodophilus) , represent combination drugs(prebiotic + probiotic), i.e. simultaneously stimulate the growth of normal flora and replace the missing number of microbes in the intestines. Bifidobac is prescribed 1 capsule 3 times a day, with meals.
2. Antibacterial drugs, are used for the 4th degree of intestinal dysbiosis, to destroy pathogenic flora. The most commonly used antibiotics are: tetracyclines (Doxycycline), cephalosporins (Cefuroxime, Ceftriaxone), penicillins (Ampiox), nitroimidazoles: Metronidazole, prescribed 500 mg 3 times a day, after meals.
3. Antifungal drugs(Levorin) , are prescribed if there are yeast-like fungi such as Candida in the stool. Levorin is prescribed 500 thousand units 2-4 times a day.
4. Enzymes, are prescribed in case of severe digestive disorders. Mezim tablets, 1 tablet 3 times a day, before meals.
5. Sorbents, are prescribed for severe signs of intoxication. Activated carbon 5-7 tablets are prescribed at a time, for 5 days.
6. Multivitamins: Duovit, 1 tablet 1 time per day.

Diet for intestinal dysbiosis

Diet therapy is an important point in the correction of intestinal flora. In case of intestinal dysbiosis, first of all, it is necessary to exclude the use of alcoholic beverages, acute, fatty foods, smoked meats and products that enhance fermentation processes in the intestines: sweets (cakes, candies, and others), homemade pickles, sauerkraut. Secondly, you need to eat fractionally, at least 4 times a day. Try not to drink water while eating, because it dilutes gastric juice and the food is not digested enough. Eliminate from the diet foods that increase flatulence (gas formation) and intestinal motility: legumes (beans, peas, soy and others), bran bread, carbonated drinks. It is necessary to increase the amount of protein in the diet through boiled or stewed meat (lean). Try not to eat fresh bread, dry it a little before using.

Try to cook all food with herbs (parsley, dill and others), as it enhances the effect of normal intestinal flora against pathogenic ones. Products that enhance the restoration of intestinal microflora include: wheat, rice, buckwheat, oats, fresh vegetables or salads, non-acidic fruits. Essential products To restore normal intestinal microflora, all lactic acid products are used: kefir, fermented baked milk, yogurt and others. You can also use special products that are enriched with biocultures: yoghurts, biokefirs and others. Applesauce has excellent prebiotic properties, and it also has an astringent effect and is recommended for diarrhea. Before going to bed, it is recommended to drink a glass of kefir.

Prevention of intestinal dysbiosis

In the first place in the prevention of intestinal dysbiosis is the correct use of antibiotics, which are one of the main causes of disruption of the normal flora. Antibiotics should be used strictly according to indications, after the results of a bacteriological examination with an antibiogram. In order to select the dose of an antibiotic for a particular patient, the attending physician must take into account the age and weight of the patient. Under no circumstances should you self-medicate by taking antibiotics for minor illnesses (for example, a runny nose). In cases where you have been prescribed long-term antibiotic therapy, you must take them in parallel with prebiotics, with periodic monitoring of the state of the intestinal flora (microbiological examination of stool).
In second place for the prevention of intestinal dysbiosis is balanced diet and rational mode.

In third place are all acute and chronic diseases that lead to intestinal dysbiosis, primarily diseases of the gastrointestinal tract. General strengthening therapy for patients with chronic diseases. Timely treatment of such diseases can reduce the number of patients with intestinal dysbiosis.

Persons who are exposed to occupational hazards (radiation) should include fermented milk products in their diet.

Is there any intestinal dysbiosis at all? Does such a disease exist?

Officially, such a diagnosis does not exist. Dysbacteriosis is not an independent disease, but always a consequence of some other diseases. In itself, a change in the composition of the intestinal microflora is not the main problem. Usually, once the underlying disease is cured, dysbiosis goes away on its own. If the symptoms continue to bother you, the person is not fully treated. In such a situation, it is pointless to continue the fight against dysbiosis - you need to look for the root cause.
Western doctors never give this diagnosis to their patients. In Russian healthcare, dysbacteriosis is mentioned in a document called “Standards (protocols) for the diagnosis and treatment of diseases of the digestive system,” approved by order of the Ministry of Health of the Russian Federation No. 125 dated April 17, 1998. But even here it does not appear as an independent disease, but only in connection with other intestinal diseases.
Surely, when you took a blood test, you heard terms such as “increased leukocytosis”, “increased ESR”, “anemia”. Dysbacteriosis is something similar. This is a microbiological concept, one of the manifestations of the disease, but not the disease itself.

How is intestinal dysbiosis designated in the ICD?

International Classification of Diseases(ICD) is a document that lists all possible human diseases, each assigned its own code. In the ICD there is no such concept as dysbiosis. A doctor who makes such a diagnosis for a patient finds himself in a difficult situation - after all, he must indicate medical documentation code.
Most often, such doctors use two codes: .
Sometimes dysbiosis is a temporary condition, for example, in travelers, especially if they have poor personal hygiene. “Foreign” microflora enters the intestines, which a person does not encounter at home.

Which doctor treats intestinal dysbiosis?

Since dysbiosis is not an independent disease, it is necessary to look for the original cause, and then begin treatment with an appropriate specialist.
Most often, diseases that lead to disruption of the intestinal microflora should be treated by an infectious disease specialist or gastroenterologist. A number of diseases are treated by a general practitioner in adults and by a pediatrician in children.

What is the best treatment for intestinal dysbiosis?

Since such a diagnosis does not exist, “treatment of dysbiosis” is a meaningless term, in principle.
Although, relevant recommendations still exist - they are specified in the OST 91500.11.0004-2003 standard. It was put into effect by Order of the Ministry of Health of the Russian Federation dated 06/09/2003 N 231. This document proposes to treat dysbacteriosis with the help prebiotics And eubiotics, antibacterial And antifungal drugs.
But the effectiveness of these medicines for dysbacteriosis has not been proven. In the same OST there is the following phrase: “the degree of persuasiveness of evidence is C.” This means that there is not enough evidence. There is no evidence on which to recommend treatment of dysbiosis with these drugs.
Here it is once again appropriate to remember that doctors who work in clinics outside the CIS never give such a diagnosis to their patients, much less prescribe treatment against dysbiosis.

Is there a connection between intestinal dysbiosis and thrush?

Thrush, or candidiasis- a disease that is caused yeast-like fungi sort of Candida.
The infection can develop in any organ. In this regard, candidiasis of the skin and nails, oral mucosa (this form is called thrush), intestines, and genitals is isolated. The most severe form of the disease is generalized candidiasis, or candidal sepsis when the fungus affects the skin, mucous membranes, and internal organs.
Candida – fungi opportunistic. They are not always capable of causing infection, but only under certain conditions. One of these conditions is decreased immunity. Thrush may well be combined with intestinal damage, which leads to dysbiosis. There is, in fact, a connection between these two conditions.
In this case, the same reasons lead to the development of thrush and intestinal dysbiosis - decreased immunity and fungal infection. They need to be treated.

Is it possible to use folk remedies to treat intestinal dysbiosis?

Traditional medicine, if proven remedies are used correctly, can improve the condition and alleviate the symptoms of the disease. But it can only be used as a supplement to the main treatment prescribed by a doctor.
Due to the fact that the topic is inflated and very popular, “remedies against dysbacteriosis” offer all kinds of traditional healers, healers, manufacturers of dietary supplements, MLM companies. Food producers did not stand aside either.
As already mentioned above, dysbiosis as a disease does not exist; it does not have its own specific symptoms, and it cannot be cured without eliminating the root cause. Therefore, first of all, you need to visit a doctor, undergo an examination, establish the correct diagnosis and begin treatment.

What can a dysbacteriosis test show?

Most reputable doctors and scientists deeply doubt the informativeness of microbiological analysis of stool for dysbacteriosis. There are certain reasons for this:

• The concept of “normal microflora” is very vague. Nobody knows the exact standards. Therefore, if you force any healthy person to take a test, many will be “identified” as having dysbacteriosis.
• The content of bacteria in feces differs from their content in the intestines.
• While the stool is delivered to the laboratory, the composition of the bacteria present in it may change. Especially if it is collected incorrectly, in a non-sterile container.
• The composition of the microflora in the human intestine can change depending on different conditions. Even if we take the analysis in different time in the same healthy person, the results can vary greatly.

Sometimes in the intestines and reproductive organs there is a violation in the ratio of beneficial and opportunistic microorganisms. Such an imbalance of microflora is called dysbiosis. In this article we will pay attention to the most common type of dysbiosis – intestinal dysbiosis.

Intestinal dysbiosis is a clinical and laboratory syndrome in which changes occur in the qualitative and quantitative composition of the intestinal microflora, after which metabolic and immunological changes, one of the consequences of which may be gastrointestinal upset.

Causes

Dibacteriosis cannot appear out of nowhere. The main reasons for the development of dysbiosis include: intestinal infections, poorly balanced diet, taking antibiotics, treatment with hormones or NSAIDs (non-steroidal anti-inflammatory drugs) for a long time, previous radiation or chemotherapy, immunodeficiency in the body.

A child is born with a completely sterile intestine, which over time begins to fill with flora. Most the best option, if this flora is maternal, it is therefore very important to establish contact between the mother and the child immediately after his birth, as well as to ensure their continued stay together. The best option in this case, breastfeeding, since the most beneficial microorganisms enter the newborn’s intestines along with mother’s milk. As a rule, the balance of the baby's intestinal flora is achieved by two months, however latest research in this area indicate that The child's intestinal flora is fully established at the age of two years. That is why even a completely healthy child before reaching two years of age may experience deviations from the norm in flora tests. Dysbacteriosis is often used to describe problems typical among children in the first three months of life - infant colic and problems with the introduction of complementary foods. In reality, this problem is associated with enzymatic immaturity of the intestines of newborns. Colic, which is typical for three-month-old children, just needs to be waited out and complementary foods introduced in accordance with the rules and on time. However, this is a separate topic for discussion.

Against the background of changes in the environment-forming component of the intestine, all sorts of disturbances in the vital functions of the human body occur. They manifest themselves as follows: from the gastrointestinal tract there is nausea, vomiting, flatulence, pain and bloating in the abdomen, diarrhea or constipation, “sheep” feces, the appearance of a metallic taste in the mouth; there is dry skin and mucous membranes caused by hypovitaminosis, the manifestation of an allergic syndrome (itching of the skin and mucous membranes, skin rashes allergic nature); in addition, the disorders are accompanied by a number of general symptoms, such as weakness, fatigue, sleep disturbances, and headaches.

Symptoms of dysbiosis

Dysbacteriosis causes the greatest damage to the digestive system , since incoming food is first broken down by bacteria and then enters the blood. The body does not have the ability to absorb most nutrients without the help of microorganisms; it regards them as foreign and rejects them. The consequence of this is the appearance of vomiting, nausea, and loose stools.

Stages of dysbiosis

For first stage Dysbacteriosis is characterized by a moderate decrease in the number of obligate bacteria in the intestinal cavity. The pathogenic microflora is developed to a small extent, there are no symptoms of the disease (that is, signs of intestinal dysfunction).

At second stage dysbacteriosis, a critical decrease in the number of intestinal lactobacilli and bifidobacteria is observed. Against this background, there is a rapid increase in the population of pathogenic bacteria. At the second stage, the first signs of an imbalance in the intestines are observed, such as loose stools, bloating and pain in the abdomen.

On third stage under the influence of pathogens, the intestinal walls become inflamed. Diarrhea becomes chronic, and particles are present in the stool undigested food. Children may experience developmental delays.

Fourth stage is the last before the onset of acute intestinal infection. The necessary intestinal flora at the fourth stage of dysbiosis is practically absent. The vast majority of microbes are opportunistic and pathogenic bacteria and fungi. Among the pronounced signs are general exhaustion of the body, anemia.

Diagnostics

There is another method for diagnosing dysbiosis. It consists of culture of an aspirate of small intestinal contents or a biopsy of the small intestinal wall. This technique allows you to obtain data on the state of the flora of the small intestine. However, in practice this method is used quite rarely due to its technical complexity.

In recent years, a method called PCR diagnostics has become widespread - this is a method for determining the types of microorganisms using polymerase chain reaction. The method consists of complementary addition of a section of pathogen RNA or genomic DNA, carried out in vitro (in vitro) using the enzyme thermostable (preserves its properties when heated) DNA polymerase. PCR diagnostics makes it possible to determine the type of some components of the microflora that have membrane or intracellular localization, that is, not present in the intestinal lumen. This method is characterized by fairly fast execution. However, it can only be used to identify certain types of opportunistic and pathogenic microorganisms and viruses. It is usually used to detect infections.

The main problem in diagnosing dysbiosis is that until today there is no clear definition of the norm of intestinal biocenosis anywhere in the world. It is known for certain that the composition of microbes in the intestines can change depending on climatic conditions, time of year, weather outside, food preferences, during the period of recovery from illness, etc. Despite this, no serious research has been carried out on this topic in the scientific world until now. Therefore, a reliable interpretation of the obtained test results remains impossible. Speaking more in simple language, if you have clinical signs of the disease, but the results of the tests show “conditionally normal” results, then they will not be taken into account, attributing this to an error in diagnosis. If there is a deviation from the norm according to some indicators, then the diagnosis of “dysbacteriosis” will most likely be confirmed, although there is always the possibility of temporary physiological-related deviations in the composition of the intestinal flora.

Treatment

Probiotics are a group of drugs that contain live microorganisms or products of microbial origin, the therapeutic and preventive effect of which is based on the regulation of the normal microflora of the human intestine. An integral characteristic of a probiotic is its ability to survive and exist in the intestinal microenvironment, as well as the ability to maintain the viability of bacteria throughout long term storage

Probiotics available in Lately, are conditionally divided into four groups:
multicomponent, that is, including several types of bacteria (bifidum-, lacto-, colibacteria, etc.)
monocomponent, that is, containing one of the types of bacteria: lactobacilli, bifidobacteria or colibacteria
combined, including symbiotic communities of the main microorganisms, including long-living strains that are immune to the action of most types of antibiotics in combination with compounds (immunoglobulin complexes or nutrient medium), accelerating the growth process of representatives of normal microflora (Linex (lacto, bifidobacteria + streptococci ), bificol from six months (bifidobacteria + E.coli))
recombinant (they are also called genetically engineered), which, in addition to the obligatory bacteria, include cloned genes that monitor the process of alpha-interferon synthesis

To stimulate the growth of intestinal microorganisms, prebiotics are prescribed. Prebiotics are substances of non-microbial origin designed to stimulate the growth and development of normal microflora. Prebiotics include indigestible disaccharides, such as dietary fiber, lactulose, pectins (hilak-forte (lactic acid), lactitol, duphalac (disaccharide). Prebiotics help the growth and/or metabolic activity of its own microflora, while suppressing the growth of pathogenic microflora. The human body does not reject them.In addition, they do not require special packaging and do not require special conditions for administration.

It is not uncommon to healing effect was the most persistent, probiotics and prebiotics are prescribed together. There are drugs called synbiotics. They are ready-made complex medicines obtained after a competent combination of probiotics and prebiotics.

First and second degrees of dysbacteriosis

Third degree of dysbacteriosis

Fourth degree of dysbacteriosis

Dysbacteriosis is pathological condition, in which the balance of the intestinal microflora is disturbed, expressed in a decrease in the number of beneficial bifidobacteria and lactobacilli against the background rapid growth and activity of pathogenic microorganisms. The bacterial flora of the intestine can change under the influence of various factors. Most often, the cause of the pathology is intestinal infections and the use of potent antibacterial drugs, but sometimes severe stress or psycho-emotional shock can become a provoking factor.

Taking antibiotics

The most common cause of intestinal dysbiosis in women is treatment with antibiotics. These are broad-spectrum drugs that affect all bacteria living in the lumen of the gastrointestinal tract. Antibiotics destroy not only pathogenic microorganisms that cause the disease, but also beneficial microflora. It is for this reason that during therapy strong drugs Patients often experience diarrhea, flatulence and other digestive disorders.

Advice! Treatment with antibiotics must be combined with the intake of probiotics and lactic acid bacteria. This will help avoid the development of dysbiosis, speed up recovery and strengthen the immune system. For the drugs to be effective, it is important to observe the interval between taking medications (at least 3 hours).

Diseases of the gastrointestinal tract

Pathologies of the digestive system can cause a decrease in the number of beneficial bacteria and the development of dysbiosis. For example, infectious diseases of the gastrointestinal tract lead to the digestion and destruction of beneficial flora. To restore it, it is also recommended to take probiotic cultures or prebiotics.

Intestinal infections

Salmonellosis, dysentery and other infections in 90% of cases cause an imbalance in the intestinal microflora. The growth of pathogenic flora leads to the formation of colonies of the infectious agent. When the number of pathogenic bacteria begins to exceed the number of beneficial microorganisms, the destruction of beneficial flora begins.

"Women's" reasons

The occurrence of intestinal dysbiosis in women can be caused by reasons specific to the fairer sex. Most often, lovers of diets suffer from pathology, especially if they are mono-diets. A mono-diet involves eating only one type of food for a short period of time (no more than 1-3 days). Severe dietary restrictions lead to an imbalance of intestinal microflora and a deficiency of nutrients (namely, vitamins are involved in the growth of beneficial microorganisms on the intestinal mucous membranes).

Advice! To maintain intestinal health, women are not recommended to go on strict diets for a long period. Nutritionists advise replacing mono-diets fasting days(no more than 1-2 times every 7-10 days). If, after all, a woman opts for a “starvation” diet, she should definitely supplement her daily diet with fermented milk products (it is best to choose kefir) or take probiotics.

One of the causes of dysbiosis in women is mono-diets

Another reason leading to dysbiosis in women is the abuse of mechanical bowel cleansing methods. These include:

• frequent use of enemas (for weight loss or cleansing);
• colon therapy (removal of feces from the intestines using volumetric lavage);
• drinking drinks, teas and other weight loss products.

In the presence of overweight You should not self-medicate. It is best to seek help from an endocrinologist or nutritionist - this is much safer and more effective than fasting and other methods of losing weight at home.

Other reasons

Sometimes the balance of intestinal microflora is disturbed under the influence of negative factors (which are favorable for the growth of pathogenic colonies), which include:

• insufficient consumption of fermented milk products;
• stress and emotional unrest;
• drug or food allergies;
• deficiency of vitamins and minerals;
• decreased immunity and diseases characterized by a state of immunodeficiency ( malignant tumors, HIV, etc.);
• undergoing chemotherapy and radiation therapy for cancer;
• helminthic infestation, helminthiasis.

Important! Can provoke intestinal dysbiosis long-term use hormonal drugs (“Yarina”, “Zhanine”, “Diane 35”). Medicines in this group are prescribed to women to stop uterine bleeding, treatment of chronic diseases of the uterus and other organs of the reproductive system, as well as protection from unwanted pregnancy.

Video - What is intestinal dysbiosis? How to treat dysbiosis?

How does dysbacteriosis manifest itself in women?

Symptoms of intestinal dysbiosis in women can be divided into several groups. They depend on the cause, additional factors and the general health of the patient. Most often, the pathology is manifested by disturbances in the functioning of the gastrointestinal tract, but sometimes the first symptoms of dysbiosis are skin dermatitis, allergic reactions or vaginosis.

Allergic reactions

When the intestinal microflora is disturbed, allergies appear mainly to food, since nutrients “adapt” to the changed bacterial composition. This condition may be accompanied by intestinal disorders, rumbling and even pain syndrome. A deficiency of lactic bacteria, which are responsible for the comfortable digestion and absorption of food, leads to a rejection reaction, which externally manifests itself as allergy symptoms.

A woman may notice the following signs of pathology:

• sneezing;
• lacrimation;
• redness of the skin in certain areas;
• skin itching;
• dermatitis;
• hives;
• nasal discharge.

Important! You can suspect dysbiosis based on these symptoms if they appear after eating foods (provided that the woman does not suffer from allergies) and do not go away after taking antihistamines and antiallergic drugs.

Vaginal dysbiosis

More than half of the cases of intestinal dysbiosis in women are accompanied by the development of vaginal dysbiosis. This is a condition in which the number of lactobacilli that inhabit the acidic environment of the vagina decreases. The pathology affects the acidity level of the vaginal tract and can lead to infectious diseases caused by bacteria, microbes or fungi. There are two forms of vaginal dysbiosis: vaginal candidiasis and bacterial vaginosis.

To prevent the development of serious infectious diseases, you need to respond promptly to the signs and symptoms of vaginal microflora disorders. These include:

• dryness of the mucous membranes of the vagina and genitals;
• insufficient lubrication during intimacy;
• an increase in the volume of discharge or a change in its color, odor or consistency;
• unpleasant odor (subject to sufficient intimate hygiene).

Important! These signs may indicate the development of vaginal dysbiosis or sexually transmitted infections. It is impossible to determine the diagnosis on your own. To determine the cause that caused the appearance of uncharacteristic symptoms, an examination by a doctor using a gynecological speculum and examination of biological material (plant culture) is required.

Manifestations from the gastrointestinal tract

Digestive disorders are a classic sign of intestinal dysbiosis. They may have different intensity and appear in combination or occur in isolation from other clinical symptoms of the pathology. One of the main signs of an imbalance in the intestinal microflora is stool instability. A woman may suffer from constipation or diarrhea, and there is often a painful urge to defecate, but no feces are released.

Other manifestations of dysbacteriosis include:

• bloating;
• rumbling;
• loss of appetite or decreased appetite;
• mucus in stool;
• pain in the abdominal area.

In rare cases, dysbiosis may be accompanied by vomiting and nausea. In this case, the woman needs to go through full examination to eliminate the possibility of serious illness.

Manifestations of vitamin deficiency

Vitamin deficiency, insufficient nutrition with minimum content vegetables and fruits leads to specific symptoms of dysbiosis. Beneficial substances entering the intestines are not absorbed by the mucous membranes, but are excreted from the body almost unchanged, since beneficial bacteria (lactic acid microorganisms) are responsible for the absorption of useful elements in the intestines. In this case, external signs of pathology most often occur, which include:

• dry skin and lips;
• angulitis (sticking in the corners of the mouth);
• hair loss, split ends;
• formation of white spots and stripes on the nail plates;
• peeling of the skin;
• pale skin.

Often, women with dysbiosis are diagnosed with oral pathologies, for example, stomatitis. In case of chronic deficiency, it may appear constant fatigue, weakness, decreased performance.

Symptoms of drug dysbiosis

An imbalance in the intestinal microflora after treatment with antibiotics or other antibacterial drugs occurs in 74% of cases. The main manifestation of the pathology is a change in the nature of the stool (diarrhea occurs most often). In some cases, diarrhea and constipation may alternate, with constipation accompanied by increased gas formation and pain in the intestines and stomach.

In half of the cases, bacterial vaginosis is associated with intestinal dysbiosis, so prophylactic intake of probiotics and lactobacilli is a mandatory component of drug therapy.

Diagnostic features

Dysbiosis can be diagnosed in only one way - a biochemical study of stool, which takes into account not only the cavity microflora, but also wall colonies of microorganisms. 72 hours before submitting the material for analysis, the woman is prescribed a special diet that excludes foods that can cause fermentation reactions. These include:

• alcoholic drinks;
• chocolate and other confectionery products with increased content sugars;
• baked goods made from wheat flour;
• dairy products;
• some vegetables (turnips, onions, all types of cabbage).

During this period, you should not take drugs with antibacterial action. If dysbacteriosis is diagnosed, it is recommended to re-test after 2-3 days.

Based on the results of the analysis, the woman is prescribed appropriate treatment and given recommendations on hygiene and care.

How to treat?

Intestinal dysbiosis can be treated in several ways, but it is often used complex therapy to achieve maximum effect.

Drug therapy

Treatment using medical supplies is aimed at eliminating the symptoms of dysbiosis, strengthening the immune system, colonizing the intestines with beneficial microorganisms and preventing complications. Women may be prescribed different medications pharmacological groups which are listed below.

If vaginal dysbiosis is combined with intestinal dysbiosis, the woman is prescribed topical treatment agents, which can be used in the form of vaginal suppositories, gels or ointments. Preparations containing beneficial lactobacilli - suppositories - have an excellent therapeutic effect. Bifidumbacterin" And " Acylact" Medicines have only one drawback - they are sold only in large populated areas, so residents of small towns and villages have to choose other means for the treatment of vaginal dysbiosis.

Diet for dysbiosis

Women are advised to eat rich in fiber and coarse plant fibers. These are vegetables, herbs, berries, fruits, cereals, rye flour, bran. These products improve intestinal function, cleanse it and improve the absorption of nutrients, which prevents disturbances of the intestinal microflora. The diet must include fermented milk products: kefir, yogurt, fermented baked milk. In stores now there is a huge selection of products with the addition of healthy dairy crops, so make correct menu won't be difficult.

• semi-finished products;
• sausages;
• products containing monoatrium glutamate, flavorings, dyes and preservatives;
• alcoholic drinks;
• chips, crackers;
• carbonated drinks;
• herbs and spices.

Important! This diet is recommended for women not only during the period of treatment of dysbiosis - constant adherence to the recommendations will help improve the condition of the skin, improve the functioning of the digestive system, increase immunity and lose excess weight, if any.

Folk recipes

The following remedies have been successfully used to treat dysbiosis in women:

• oak bark decoction (drink 1 glass on an empty stomach until symptoms are completely eliminated);
• a mixture of garlic and honey (take a teaspoon 2-3 times a day 30-60 minutes before meals for 5-7 days);
• rice water (drink half a glass 2 times a day, regardless of meals, for 10 days).

Intestinal dysbiosis is a common pathology that can be asymptomatic or cause the appearance of uncharacteristic clinical signs. Timely treatment will help women not only avoid serious complications and infections of the gastrointestinal tract, but also maintain “women’s” health, which directly depends on the state of the intestinal microflora.

Video - How to treat intestinal dysbiosis with folk remedies

The human intestine is a complex biocenosis. The microflora living in it is necessary for normal operation immune and digestive system. If for any reason the microecology is disrupted, disruptions in the functioning of the human body begin. Which? In this article we will discuss the symptoms of intestinal dysbiosis.

The intestinal microflora is 90% represented by bifidobacteria and bacteroides - this is the so-called obligate flora, and 9% - by lactobacilli, enterococci, E. coli - accompanying flora.
These microorganisms

• produces succinic, lactic, formic acid, as well as antibiotic-like substances that prevent putrefactive processes in the intestines;
• support nonspecific immunity;
• secrete enzymes that ensure cavity digestion;
• synthesize B vitamins, folic and nicotinic acid, promote the absorption of iron and vitamin D;
• prevent tumorigenesis.

The remaining 1% is represented by facultative (residual, opportunistic) flora, its composition is variable and is represented in different proportions by Proteus, Pseudomonas aeruginosa, staphylococci and citrobacter, clostridia, yeast-like fungi and so on.

If under the influence of any factors:

• operations on the gastrointestinal tract,
• past intestinal infections, helminthic infestations,
• antibiotic treatment, radiation and chemotherapy,
• unbalanced diet,
• diseases of the stomach, liver,
• emotional and physical stress

the ratio of the obligate and facultative forms changes in favor of the latter, they speak of dysbacteriosis.

Severity of dysbacteriosis

1. Latent. The amount of obligate flora remains within normal limits, the accompanying flora is slightly reduced, and the facultative flora is increased. At this stage there may be
   hypovitaminosis (cheilitis, glossitis, hair loss and brittle nails),
   tendency to constipation (intestinal atony due to deficiency of B vitamins),
   flatulence,
   food allergy,
   tendency to frequent colds.
2. Moderate severity. Number of bifidobacteria and bacteroides per lower limit norms or moderately reduced (10-100 million microbial bodies in 1 gram of feces), and on the contrary, there are significantly more representatives of opportunistic flora permissible norm(1-10 thousand microbial bodies in 1 gram of feces). In addition to hypovitaminosis, iron and calcium deficiency may appear,
   loss of appetite, nausea, unpleasant taste in the mouth, belching of bitter or airy foods,
   dull pain in the abdomen, rumbling, distension,
   unstable stool: constipation may alternate with loose stools, mucus in the stool,
   irritability, depression, fatigue,
   The temperature may rise slightly.
3. Severe degree. At the same time, along with an increase in the level of facultative flora, the amount of obligate flora is noticeably reduced (from a million microbial bodies or less). Among other things, this degree of dysbacteriosis can be accompanied by fever, frequent loose stools up to 5 times a day, and weight loss.

The clinical picture depends not only on the degree of microbial imbalance, but also on what type of opportunistic bacteria predominates. Most often it happens

• staphylococcal
• Proteaceae
• fungal dysbacteriosis, as well as
• Escherichia coli (unusual strains of E. coli appear),
• Pseudomonas aeruginosa
• associated.

Staphylococcal dysbacteriosis

It is more severe than others, can take generalized forms, and lead to sepsis. An increase in temperature to 37-37.5 occurs even in a mild form, and in moderate to severe cases there may be fever with chills, there is often an admixture of blood in the stool, there may be nausea and vomiting, and cramping abdominal pain.

Proteus dysbacteriosis

There is no severe septic form, but there may be a prolonged low-grade fever; astheno-neurotic manifestations and hypochondriacal reactions are typical.

Fungal dysbiosis

Septic forms are rare, but sometimes occur. Is different foamy stool with films and lumps, often complicated by bleeding. Dysbacteriosis is often accompanied by candidiasis of the oral cavity, genitourinary organs, and perianal area, then patients complain of itching and burning, and often plaques and redness in the affected area. Often, against the background of such dysbiosis, exacerbations of bronchial asthma or atopic dermatitis occur.

Dysbacteriosis Escherichiosis, Pseudomonas aeruginosa

Usually the course is erased, symptoms of dyspepsia, unstable stools with mucus, dull pain in the abdomen, especially in the area of ​​the sigmoid colon, are disturbing.

Associated dysbiosis

With excessive growth of several opportunistic bacteria, dysbiosis is more severe and more often leads to sepsis or perforated intestinal ulcers.

You should think about dysbiosis if

• complaints appear after treatment with antibiotics, cytostatics;
• the recovery period after an acute intestinal infection is prolonged;
• complaints of dyspepsia and stool disorders persist for a long time, and pathogenic microorganisms are not sown.

Such a diagnosis can only be made subject to laboratory confirmation of microbial imbalance (stool analysis for dysbacteriosis). We will talk about this in the next article.

Which doctor should I contact?

If you have problems with your intestines, you need to contact a gastroenterologist. The doctor will prescribe appropriate stool tests, which will ensure the correct treatment tactics for this complication. It will also be useful to consult with a nutritionist on issues of proper nutrition for intestinal dysbiosis.

Dr. Komarovsky about dysbiosis: