Intestinal hyperpneumatosis (pneumatosis) is a pathological process characterized by the formation of air cysts in the intestinal wall. The disease is manifested by cramping diffuse pains and a feeling of fullness in the abdomen. In this case, there are frequent disorders of the stool, belching, nausea, vomiting. The complex of diagnostic measures includes a consultation with a gastroenterologist, an abdominal X-ray, colonoscopy, irrigoscopy.
Depending on which symptoms predominate in this condition, carminative, laxative, antispasmodic or antidiarrheal drugs are prescribed for hyperpneumatosis, a diet with limited consumption of foods that cause excessive gas formation.
General information about the disease
Intestinal hyperpneumatosis is enougha rare disease of the digestive system, in which gases penetrate from the intestinal cavity into the thickness of its walls and form air cavities in them. In most cases, this pathological process is localized in the subserous or submucosal layer of the jejunum or colon. The disease can affect people of all ages, but it mostly occurs in the elderly and infants due to frequent digestive disorders and reduced physical activity.
The size of air cysts in diameter varies from 0.5 to 5 cm. According to the prevalence of the process, hyperpneumatosis is divided into diffuse and limited, which affects only one area of the intestine. The diffuse form is characterized by the uniform distribution of pathological formations along the entire length of the intestinal tract.
Frequent questions from patients: "Is there intestinal hyperpneumatosis without structural changes?", "How to treat the disease?". The disease never goes away without structural changes, as air cysts disrupt the structure of the intestinal walls, after which more serious organic lesions can develop.
Causes of occurrence
This disease rarely acts as an independent pathology. It most often develops against the background of a primary lesion of the digestive tract. The main cause of intestinal hyperpneumatosis is the excessive formation and prolonged presence of gases in it, which is observed due to the following pathological conditions:
- Gastrointestinal tumors. As a result of the development of benign and malignant neoplasms in the intestine, a blockage or narrowing of its lumen occurs, which contributes to the development of intestinal obstruction, excessive accumulation of gases and their penetration into the intestinal walls.
- Various intestinal infections. In severe intestinal infections (cholera, dysentery, food poisoning, salmonellosis), excessive gas formation is the result of the fermentation process and the formation of gaseous substances by pathogens.
- Other diseases of the digestive system. They can be atony, intestinal pathologies of inflammatory origin (enterocolitis, colitis, Crohn's disease), the presence of adhesions, in particular between intestinal loops, which contributes to disruption of gas utilization and the development of hyperpneumatosis.
- Unhe althy lifestyle. Frequent nervous breakdowns, weakness, the use of an excess volume of products that provoke excessive gas formation (bread, cabbage, legumes, etc.) can lead to digestive disorders, flatulence and the formation of air cavities in the intestinal wall.
Pathogenesis
The mechanism for the formation of air cysts in the intestine is not fully understood today, but there are three main theories for the development of intestinal hyperpneumatosis: infectious, pulmonary and mechanical.
According to the pulmonary theory, pneumatosis occurs as a result of chronic lung pathologies (COPD, bronchial asthma). Due to persistent persistent coughmicroscopic tears of the alveoli, pneumomediastinum develops, which contributes to the spread of air in the retroperitoneal space. From there, free gas begins to diffuse into the intestinal wall and accumulate under the serous membranes.
According to the infectious theory of the origin of this disease, the gases that are released by bacteria penetrate the inflamed intestinal walls and begin to merge to form large blisters.
In the field of gastroenterology, the mechanical theory of the development of severe intestinal hyperpneumatosis has earned the greatest recognition. According to this concept, air cysts in the intestine occur as a result of the primary pathology of the digestive system (enterocolitis, tumor, stenosis), as well as as a result of congenital defects in the lymphatic and blood vessels of the intestine. Against the background of diseases of the gastrointestinal tract, regular trauma and a gradual thinning of the inner lining of the intestine occur. Gas under the action of intra-intestinal pressure penetrates through microdefects, then into the submucosal lymphatic vessels, and then spreads through peristalsis through the submucosal layer of the intestine.
Inside, air cysts are lined with a layer of epithelial cells. They can contain different gases: oxygen, nitrogen, hydrogen, carbon dioxide, argon, etc.
Intestinal hyperpneumatosis in a child
In most cases, pneumatosis in children appears with the development of infectious pathologies. Somewhat less often - as a result of intestinal obstruction, which is formed against the background of tumors in the intestine and after surgical interventions. In addition, in children thisthe disease can be caused by lack of physical activity. In infancy, children have insufficient maturity of the digestive system, as a result of which they often experience flatulence. Intestinal hyperpneumatosis in a child has an extremely negative effect on motor functions. With excessive formation of gases in a child, treatment is carried out with the help of gas suppressants and long massage courses.
Children's body has the ability to rapidly recover due to the speed of cell regeneration processes. With the timely diagnosis of this disease, an absolute recovery is possible without a transition to a chronic form.
Clinical picture of this pathological process
Symptoms of intestinal hyperpneumatosis depend on the number of gas cavities and the degree of spread. Patients most often complain of a constant feeling of discomfort and excessive heaviness in the abdomen, impaired gas discharge (flatulence). In addition, there are often periodic abdominal cramping pains that do not have a clear localization.
The formation of air cysts in the intestines leads to inhibition of peristalsis processes and the development of constipation. Prolonged absence of stool is replaced by diarrhea, in which mucus impurities are observed in the feces. The patient experiences belching with an unpleasant odor, vomiting, nausea. The diffuse spread of the disease leads to a significant deterioration in the general condition of the patient: pallor of the skin is noted.cover, increasing weakness, lowering blood pressure, compensatory increases in heart rate.
What is intestinal hyperpneumatosis, it is important to find out in advance. Timely treatment will help to avoid serious complications.
Possible Complications
Increased intra-intestinal pressure in hyperpneumatosis contributes to a change in the shape of intestinal loops with the formation of intussusception or volvulus. An increase in the number of bubbles or their size contributes to the development of partial or complete blockage of the intestinal lumen with the formation of obstructive intestinal obstruction. This pathological condition is often accompanied by severe intoxication of the body, which can lead to the development of infectious-toxic shock and death.
The growth of air cavities contributes to the development of intestinal adhesions. Excessive pressure on the intestinal wall provokes a violation of the processes of its nutrition, the occurrence of ischemia, and subsequently necrosis.
The necrosis of some parts of the intestine and the excess pressure of gases causes ruptures of the intestinal walls, the penetration of the contents of the intestine into the abdominal cavity. In this case, peritonitis develops, in which emergency measures are necessary. In their absence or untimely implementation, the patient develops sepsis.
Diagnostic procedures
Due to the absence of specific severe symptoms in the case of the development of limited intestinal hyperpneumatosis, the diagnosis of the disease is sufficientdifficult. In the event of a severe pain syndrome, violations of the digestive process, patients should consult a gastroenterologist. At the same time, the specialist performs a comprehensive examination, studies concomitant pathologies and anamnesis of the disease, pays special attention to the pathologies of the digestive tract. In certain cases, during deep palpation of the abdomen, the doctor manages to feel small rounded formations that run in a row along the length of the intestinal tract and resemble grapes. Ultrasound of the abdominal cavity with hyperpneumatosis may be uninformative.
In order to make an adequate diagnosis, the following diagnostic tests may be ordered:
- Overview x-ray of the abdominal cavity. This procedure allows you to determine the presence of gas bubbles of various sizes on the walls of the intestine, located in a chain. The disease is characterized by the presence of annular double shadows in swollen bowel loops.
- Colonoscopy. This endoscopic examination helps to visualize gas bubbles, assess the state of the mucous membrane of the organ and the extent of its damage. If necessary, an endoscopist performs a biopsy of a section of the intestine for histological examination. Differential diagnosis of hyperpneumatosis should be carried out with nonspecific colitis, diverticula, pneumoperitoneum and intestinal duplication. With complete obturation, intestinal obstruction of a different nature of origin is excluded.
- Irrigoscopy. With helpThis diagnostic technique determines the presence of excess gas in enlarged colonic loops in the form of several nearby rounded shadows that are separated by a wall. In the course of the study, it is also possible to detect areas of narrowing of the intestine, the presence of pathological neoplasms, ulceration of the intestinal tube.
Now it is clear what it is - intestinal hyperpneumatosis.
Treatment
Taking into account the fact that this pathological process develops secondarily, accompanied by other diseases of the digestive organs, first of all, it is necessary to eliminate the original cause of the disease. The therapeutic tactic for eliminating hyperpneumatosis is aimed at stopping bloating and stabilizing the release of gases from the intestines in a natural way. In accordance with the fact that recurrence of the disease often occurs after resection of the affected area, surgical removal of blisters is used extremely rarely. Treatment of intestinal hyperpneumatosis is carried out, as a rule, in the following areas:
- Taking medication, which includes the prescription of drugs based on simethicone and fennel, eliminating the symptoms of flatulence. With pain and cramps in the abdomen, antispasmodics are used, with constipation - laxatives, with the development of diarrhea - antidiarrheal drugs. If the patient has a slowdown in peristalsis, prokinetics are prescribed. With the infectious nature of the development of the pathological process, it may be necessaryuse of antibiotic therapy.
- Diet for intestinal hyperpneumatosis. A well-designed diet should include only low-fat, fresh foods. It is recommended to use various cereals, soups, lean types of fish and poultry. Among drinks, preference should be given to fruit drinks, jelly, weak tea. Dishes are recommended to be consumed in small quantities, 4-5 times a day, boiled, fresh or stewed. In addition, foods that provoke excessive gas formation should be excluded from your diet: tomatoes, beans, cabbage, smoked and fried foods, apples, canned food, bakery products, sweet pastries, carbonated drinks. It is also necessary to refuse the use of alcoholic beverages.
Hyperbaric Oxygen Therapy
An additional method of treating hyperpneumatosis is hyperbaric oxygen therapy (HBO). Due to the active saturation of blood with oxygen, the total pressure of venous blood gases decreases, which in some cases contributes to the resorption of air bubbles. Operative therapeutic techniques are used only in case of complications of this pathology (intestinal obstruction, intestinal intussusception, peritonitis, etc.).
Prevention and prognosis
With the timely elimination of the primary pathological process that provoked the occurrence of hyperpneumatosis of the gastrointestinal tract, as well as with diet and all necessary therapeutic measures, the prognosis for patients is usually favorable. Formation of multipleor large gas cysts increases the likelihood of developing serious complications (bowel obstruction, peritonitis) and significantly worsens the prognosis of the disease.
Prevention of intestinal hyperpneumatosis implies timely diagnosis and treatment of gastrointestinal diseases, eating high-quality and fresh food. In the presence of chronic forms of pathologies of the digestive system, it is recommended to routinely and regularly conduct an ultrasound of the abdominal cavity.
Features of food
Proper nutrition helps to significantly alleviate the condition, normalize the discharge of gases and stools, and also serves as a prevention of complications of the disease. It provides:
- Exclusion of foods that increase fermentation and gas formation in the intestines (grapes, bananas, sweet apples, radishes, legumes, turnips, cabbage, bread and pastries, milk, garlic, cucumbers, onions, oats, mushrooms, turnips, drinks with gas, raisins).
- Inclusion of the following products: wheat bread (dried), lean meat (boiled), carrots, greens, zucchini, pumpkin, dairy products, beets, green tea, cereals (except pearl barley and millet), freshly squeezed juices, prunes, apricots, pomegranates.
- Six meals a day. During an exacerbation, the basis of nutrition is mashed dishes that do not cause mechanical irritation to the intestines.
- Steam and boiled cooking methods. Boiled vegetables are also recommended.
- With the predominance of diarrhea - foods rich in tannin and reducing motility (compotes, tea, infusions of blueberries, quince, pomegranate, bird cherry), viscous dishes(mashed soups, kissels, pureed cereals).
- With the predominance of constipation - boiled beets, prunes, baked fruits, whole grains.
We examined what it is - intestinal hyperpneumatosis. Treatment of this pathology, prevention and diagnosis are also described in detail.
