THE ROLE OF ASTHENO-NEUROTIC SYNDROME IN THE DEVELOPMENT OF GASTRIC AND DUODENAL ULCER, CHOICE OF TREATMENT APPROACH.
Abstract
In recent years, more and more attention has been paid to the influence of the ANS on the development and course of gastrointestinal diseases. Studies confirm that chronic stress, psychoemotional tension and dysfunction of the autonomic nervous system contribute to the occurrence and exacerbation of diseases such as gastritis, gastric ulcer and duodenal ulcer, irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD). The main pathogenetic mechanisms include impaired gastrointestinal motility, changes in acid production, microflora imbalance and decreased protective mechanisms of the mucous membrane. When choosing a treatment approach, it is important to take into account both the gastroenterological and psychoneurological components. Complex therapy should include pharmacological correction: sedatives, antidepressants in the presence of severe anxiety and depressive disorders, probiotics, prokinetics, proton pump inhibitors and gastroprotectors.
References
1. Ivashkin V. T., Rapoport S. I. The decision of the board of the Ministry of Health - the way to solving urgent problems of gastroenterology // Russian journal of gastroenterology, hepatology, proctology. (Appendix 23). 2004. Vol. XIV, No. 5. P. 30
2. Boger M.M. Ulcer disease. Novosibirsk, 1986. 256 p.
3. Vasilenko V.Kh., Grebenev A.L., Sheptulin A.A. Ulcer disease M., 1987.
4.Piper D., Hent I., Heap T. The healing rate of chronic gastric ulcer in patients admitted to hospital // Scand. J. Gastroent. 1980. Vol.15, No. 1. P. 113-117.
5. Kolotilova, M. L. Neurogenic-genetic theory of the etiology and pathogenesis of peptic ulcer disease / M. L. Kolotilova, L. N. Ivanov // Bulletin of the Russian Academy of Medical Sciences. - 2014. - No. 7-8. - P. 10-16.
6. Zimmerman, Ya. S. Peptic ulcer: current issues of etiology, pathogenesis, differentiated treatment / Ya. S. Zimmerman // Clinical medicine. - 2012. - V. 90. - No. 8. - P. 11-18.
7. Chizhikov, D. A. Gastric ulcer and duodenal ulcer: focus on idiopathic ulcers and autonomic regulation / D. A. Chizhikov, T. V. Kopytova, V. I. Borisov // Journal of Medial. - 2015. - No. 3 (17). - P. 125-138.
8. Herszényi L, Juhász M, Mihály E, Tulassay Z. A fekélybetegség és a stressz [Peptic ulcer disease and stress]. Orv Hetil. 2015 Aug 30;156(35):1426–9. Hungarian. doi: 10.1556/650.2015.30249. PMID: 26299834.
9. Fink G. Selye's general adaptation syndrome: stress-induced gastro-duodenal ulceration and infl ammatory bowel disease. J Endocrinol. 2017 Mar;232(3): F1-F5. doi:10.1530/JOE-16–0547. Epub 2016 Dec 20. PMID: 27999087.
10. Siddiqui, A.H. Ulcer, Curling (Stress-induced Gastric). StatPearls Publishing LLC. 2018
11. Shilova, M. V. Gastric ulcer / M. V. Shilova // Bulletin of medical Internet conferences. - 2014. - V. 4. - No. 5. - P. 527.
12. Baranovsky A. Yu. Gastroenterology: reference book. – St. Petersburg: Peter, 2011. – 512 s.
13. Hausteiner – Wiehle C., Henningsen P. Irritable bowel syndrome: relations with functional, mental, and somatoform disorders. World J Gastroenterol, 2014 Vol. 28, p. 20.
14. Chitkara DK, Rawat DJ, Talley NJ The epidemiology of child – hood recurrent abdominal pain in western countries: a systematic review. Am. J. Gastroenterol, 2005, Vol.100 (8), pp. 1868–1875.
15.Levy RL Psychosocial aspects of the functional gastrointestinal disorders. Gastroenterology, 2006, Vol. 130(5), pp. 1447–1458.
16. Dong L., Dingguo L., Xiaoxing X., Hanming L. An epidemiological study of irritable bowel syndrome in adolescents and children in China: a school? based study. Pediatrics, 2005, V. 116, no.3, pp.393–396.
