THERAPEUTIC EXERCISE FOR DISEASES OF THE DIGESTIVE ORGANS. Diseases of the digestive system occupy an important place in clinical medicine. Diseases of the digestive system often affect people of the most working age, causing a high rate of temporary disability and disability.

In diseases of the digestive system, changes in the motor, secretory and absorption functions are observed. Pathological processes of the gastrointestinal tract are in the closest relationship with each other and are caused by a violation of nervous regulation. As a result of a violation of the secretory function, gastritis, gastric ulcer and duodenal ulcer, etc. develop, and in case of motor function disorder - colitis, constipation, etc. The main means of treating diseases of the digestive system are diet therapy, drugs, massage, movement (exercise therapy, moderate physical activity, etc. .), physiotherapy and hydrotherapy.

Exercise therapy for this pathology has a general tonic effect, debugs neurohumoral regulation, stimulates blood and lymph circulation in the abdominal organs, strengthens the abdominal muscles, helps to normalize the evacuation and motor functions of the intestine, etc. The result of the effect of physical exercises depends on their type, dosage, rhythm and the pace of implementation, from the stage of their application, the duration of the course, as well as from their combination with diet and other therapeutic agents.

Studies have shown that moderate physical education normalizes the secretory and evacuation functions of the stomach, and intense physical training, on the contrary, depressing. The use of special exercises and segmental reflex massage helps to normalize impaired functions. So, exercises for the muscles of the abdominal wall and pelvic floor help well with chronic colitis, cholecystitis, dyskinesias, and others, and breathing exercises have a "massaging" effect on the internal organs, improving blood and lymph circulation in the abdominal cavity. At the same time, exercises for the abdominal press, as studies have shown, sharply increase intra-abdominal pressure, therefore, they are contraindicated in patients with exacerbation of gastric ulcer and duodenal ulcer, with spastic colitis.

Breathing exercises, relaxation exercises lying on the back with the legs bent at the knee and hip joints, or in the knee-elbow position are useful for such patients.

The massage facilitates the secretion of bile by increasing blood and lymph circulation in the liver and abdominal organs. Exercise helps to normalize impaired functions with dyskinesia of the gastrointestinal tract and biliary tract. Thus, exercise therapy and massage have a positive effect on the abdominal organs, stimulate the regulatory mechanisms of the digestive system.

Gastritis Gastritis is an inflammation of the stomach lining that can be acute and chronic. Acute gastritis is most often the result of ingestion of substances that irritate the mucous membrane, more often alcohol, the use of poor-quality or unusual food, certain medications, food poisoning, acute poisoning. In mass surveys of the population of industrially developed countries, approximately 50% of people, many of whom did not complain of changes in the stomach, reveal signs of gastritis (V.Kh. Vasilenko, A.P. Grebnev; K. Villako et al.). It was also established that oxygen starvation of the body, being an important pathogenetic factor, has a great influence on the course and outcome of many internal diseases.

Another thing is known: the glands of the gastric mucosa are very sensitive to oxygen deficiency. Prolonged hypoxia leads to atrophy of the gastric mucosa with the development of enzymatic and secretory insufficiency.

Hypoxia of the gastric mucosa is aggravated by blood redistribution during heavy physical exertion. The main portion of blood is directed to vital organs (brain, heart, liver, and also to muscles), while exchange blood flow in the abdominal organs is reduced. Thus, hypoxia is the cause of chronic atrophic gastritis. Chronic gastritis is an inflammatory change in the gastric mucosa of an endogenous or exogenous nature. The characteristic signs of chronic gastritis are: unpleasant taste in the mouth, sour belching, nausea, especially in the morning, heaviness in the epigastrium, flatulence and pain resembling ulcers; with gastritis with secretory insufficiency, diarrhea is possible.

A large role in the occurrence of chronic gastritis is played by alcohol abuse, smoking, drugs, malnutrition (chronic lack of food proteins of animal origin, vitamins B, A, C, E) and irregularity (violation of the diet) of food intake. Often the cause of chronic gastritis is the performance of intense physical activity, including during sports.

Gastritis are subdivided (taking into account the secretory function of the stomach) into gastritis with secretory insufficiency; gastritis with increased secretion and acidity; gastritis with normal secretory function. Athletes often have gastritis with increased secretion and acidity, which often turns into peptic ulcer disease.

Most often, chronic gastritis with high acidity occurs in men. Symptoms: heartburn, sour belching, burning sensation, pressure and heaviness in the epigastric region. On palpation of the abdomen, there is moderate pain; sometimes neurasthenic syndrome is noted (increased irritability, poor sleep, fatigue, etc.) For treatment, diet therapy, drug therapy, vitamins and other means are used. Exercise therapy, walking, skiing, swimming, cycling are recommended.

In spa treatment: swimming, walking and running along the seashore, playing on the seashore, diet, taking an oxygen cocktail, exercise therapy, etc. LH includes general developmental and breathing exercises, relaxation exercises. With a painful symptom, cryomassage of the abdominal wall is indicated. However, abdominal exercises are contraindicated. Walking, contrast shower, LH lying down (breathing exercises, exercises for the distal parts of the lower extremities) are useful. The objectives of the massage are: to provide an analgesic effect; normalize the secretory and motor functions of the stomach; activate blood and lymph circulation; eliminate the usually existing venous congestion; stimulate bowel function.

Massage technique. The abdominal massage is performed with the maximum relaxation of the muscles of the abdominal wall. Plane stroking, rubbing, kneading the muscles of the abdominal wall, oblique muscles of the abdomen, as well as vibration are used. Then, along the course of the large intestine (starting from the ascending part), stroking is carried out with the tips of the fingers of the right hand. Stroking techniques are repeated 4-6 times, after which they do several superficial circular strokes to give the abdominal wall a rest, and then tap them with fingertips along the intestine and shake it to affect its wall.

Finish the massage of the abdominal wall with planar stroking and diaphragmatic breathing. The duration of the massage is 10-15 minutes. Biliary dyskinesias Biliary dyskinesias are characterized by a disorder of the motor function of certain parts of the biliary system, including the sphincter of Oddi. This is facilitated by various autonomic-nervous disorders.

Dyskinesia of the biliary tract is the initial stage in the pathogenesis of other diseases of the biliary tract, contributing to the formation of stones in the gallbladder and the development of infection. Often combined with other functional disorders - duodenal dyskinesia, changes in the function of the stomach, intestines, pancreas. With a spastic, or hyperkinetic, gallbladder, there are short-term pains in the right hypochondrium and epigastric region.

For an atonic, or hypokinetic, gallbladder, dull, prolonged pain after eating, aggravated by a prolonged sitting position, is characteristic. Bile evacuation is slowed down. Dyskinesias are quite common in athletes (cyclists, skiers, distance runners, etc.). For the hyperkinetic form of dyskinesia, paroxysmal pains (biliary colic) are characteristic, which occur after physical exertion (overload) and are often accompanied by nausea, vomiting, stool disorders, as well as irritability, headache, and deterioration of the general condition.

Hypokinetic dyskinesia is manifested by recurrent pain and a feeling of fullness in the right hypochondrium, sometimes dyspeptic symptoms and deterioration of the general condition. Complex treatment includes massage, LH, diet therapy, drinking mineral water, physiotherapy and hydrotherapy, drug therapy, herbal medicine and other remedies.

LH consists of general developmental and breathing exercises; the choice of the starting position is of great importance. The best conditions for blood circulation in the liver, the formation and secretion of bile are created in the supine position. To enhance the influence of the diaphragm, breathing exercises can be used while lying on the right side, since the excursion of its right dome increases. In addition, LH is carried out in an emphasis on knees, as well as knee-elbow, which help to relax the abdominal press and unload the spine, allow you to perform exercises with lifting and adduction of the legs without abrupt changes in intra-abdominal pressure.

In the hypokinetic form of dyskinesia, LH is performed lying on the back, on the left and right sides, kneeling in support, kneeling with hands on the floor, sitting and standing. General developmental and breathing exercises are performed with a gradually increasing amplitude and tempo of movements. The LH complex also includes exercises for the abdominal press, walking; "Belly breathing" helps to reduce (or eliminate) pain.

Duration of classes is 20-30 minutes. During the period of complete remission, games, skiing, rowing, ice skating, cycling, swimming, etc. are recommended. In case of hyperkinetic dyskinesia, LH is performed lying on the back, right and left side. Includes general developmental, breathing and relaxation exercises. Exercises for the abdominal press, exercises with shells (dumbbells, medicine balls), as well as straining and holding the breath are not recommended.

The pace of exercise is slow and medium. Duration of classes is 15-20 minutes. During the period of complete remission - dosed walking, skiing, swimming, occupational therapy, ice skating, etc. The objectives of the massage: normalization of the psychoemotional state and function of the biliary tract, analgesic effect, elimination of congestion in the gallbladder. Massage technique. First, a massage is performed on the collar and back (segmental zones VIII-X of the thoracic and I-II lumbar vertebrae, especially on the right) using segmental techniques.

The massage is carried out in a sitting position. Then, in the supine position, the abdomen and oblique abdominal muscles are massaged. The procedure is completed by squeezing the lower segments of the lungs (as the patient exhales). Repeat 3-5 times, then ask the patient to "breathe with his stomach" for 1-2 minutes (while the legs are bent at the knee and hip joints). Techniques are excluded: chopping, tapping and deep kneading (especially in the area of ​​the right hypochondrium). The duration of the procedure is 8-12 minutes. The course is 10-15 procedures.

End of work -

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Ministry of Education of the Russian Federation

Khabarovsk State Pedagogical University

abstract

" Physiotherapy at diseases digestive organs "

Completed: 1st year student 213 gr.

Lagoiko Evgeniy Vladandmirovich

Checked by the teacher:

Ushakov Stepan Vladimandrovich

Khabarovsk 2002

"Movement can in its action replace any means, but all the remedies in the world cannot replace the actions of movement" ( T isso ).

Physiotherapy is an integral part of general physical education and one of the most important methods of complex treatment of patients with peptic ulcer disease, as well as an effective means of preventing exacerbations with the correct structure of classes and the entire complex.

The purpose of this work is to indicate the physiological basis for the use of exercise therapy for this disease, some methodological recommendations, as well as an approximate structure of classes and basic exercises.

Let's start with physiology. Impulses from the receptors of internal organs enter the central nervous system, signaling the intensity of functioning and the state of the organs. With the disease, a violation of reflex regulation occurs, pathological dominants and vicious (pathological) reflexes appear, which distort the course of normal processes in the human body.

The disease suppresses and disorganizes motor activity - an indispensable condition for the normal formation and functioning of any living organism. Therefore, exercise therapy is a very important element in the treatment of ulcerative processes.

It is already known that the performance of dosed physical exercises, accompanied by positive shifts in the functional state of the centers of the submilky region and an increase in the level of basic life processes, causes positive emotions (the so-called psychogenic and conditioned reflex influence). This is especially applicable in case of peptic ulcer disease, when the neuropsychic state of patients leaves much to be desired (normalization of the manifestations of dystonia from the nervous system expressed in patients. It should be noted the effect of physical exertion on the nervous regulation of the digestive apparatus.

With regular exercise, as in the process of physical training, energy reserves gradually increase, the formation of buffer compounds increases, the body is enriched with enzyme compounds, vitamins, potassium and calcium ions. This leads to the activation of redox processes and to an increase in the stability of the acid-base balance, which in turn has a favorable effect on the scarring of the ulcer (influence on the trophic and regenerative potencies of the gastrointestinal tract tissues).

The effect of exercise is determined by its intensity and time of use. Small and moderate muscle tensions stimulate the basic functions of the gastrointestinal tract, while intense ones depress.

The beneficial effect of exercise therapy on blood circulation and respiration is noted, which also expands the functional capabilities of the body and increases its reactivity.

Depending on the clinical orientation of the disease and the functional capabilities of the patient, various forms and means are used. Since usually in educational institutions, whenever possible, only the third (general developmental) health-improving set of exercises is used, then I will also adhere to it.

Contraindications to classes include:

Fresh ulcer in the acute period.

Ulcer complicated by bleeding.

Preperforative state.

Ulcer complicated by stenosis in the stage of decompensation.

Fresh massive paraprocesses during penetration.

Exercise therapy when applied to patients suffering from peptic ulcer disease, the healing effect is carried out in the following directions:

exercise therapy digestion disease

Influence the regulation of the processes of excitation and inhibition in the cerebral cortex; to enhance cortico-visceral innervation and alignment of subordinate disorders of autonomic innervation. Improve the coordinated functioning of the circulatory, respiratory and digestive systems.

By the correct organization of the regime of movements, physical exercises and passive rest, influence the regulation of the neuropsychic sphere of the patient.

Improve redox processes in all organs, promote the normal course of trophic processes.

To counteract the dysfunctions of the digestive apparatus, which can occur with peptic ulcer disease (constipation, loss of appetite, congestion, etc.).

The principle of individualization in the use of physiotherapy exercises for this disease is mandatory.

General tonic training exercise regimen

Assign after the disappearance of pain and exacerbation in the absence of complaints of the main signs of the disease with a general improvement in the condition. Appointment dates - in 20-26 days.

Target setting - Restoration of the patient's adaptation to the loads of the extended regimen. Increasing stimulation of metabolic processes, impact on the regulation of excitation and inhibition processes in the cerebral cortex, impact on the normalization of autonomic functions. Fight abdominal congestion. Promotion of regenerative processes in the gastrointestinal tract.

The content of the regime - With a relative sparing of the abdomen, strength and endurance training is carried out. The range of motion in large joints gradually expands and breathing deepens to the maximum possible in each case. To combat dyskinesia of the large intestine, changing the starting positions is more frequent. Abrupt movements are excluded.

Characteristics of the applied physical. exercise. From the starting positions lying, on the side, etc., gradually expand the movements to full amplitude for large joints at a slow and medium pace. Includes exercises for all abdominal muscles, performed at a slow pace with limited amplitude and with the exception of sudden movements.

The intensity of resistance exercises for the muscles of the shoulder girdle and intercostal muscles gradually increases (up to about 40-50% of the swing) in order to reflexively influence the digestive organs in segments D 6-9. You can use dumbbells weighing up to 2-4 kg, stuffed balls weighing no more than 2-3 kg, exercises on sports equipment. To combat congestion, a good effect is given with diaphragmatic breathing from various starting positions, which is brought to great depth, alternating with chest and full breaths; a more frequent change also helps. etc., exercises, games and loads when they become more complex. Gradually, more and more difficult exercises for attention are included in the classes. At the same time, the density of classes remains no higher than average.

Walking is brought up to 4-5 km per day. With general good health and no pain, ball games (volleyball, etc.) are allowed, taking into account individual reactions lasting no more than 25-35 minutes. The inclusion of various types of games in the course helps to maintain interest and increases the production of positive emotions during general physical activity.

In the course of the entire course, students should be pointed out to the positive changes achieved in his condition and physical development, to suggest that stomach disorders are insignificant and easily corrected (psychological impact).

Exercise therapy is effective only under the condition of a long, systematic exercise with a gradual increase in the load both in each of them and throughout the course. Both the trainer and the student must know this in order to achieve appropriate results.

Below is a table of an approximate construction of a lesson for the stage of remission of the ulcerative process. Of course, it cannot be accepted as a standard - each trainer and methodologist makes his own amendments and additions and creates his own, unlike all other courses, specific tactics and methodology of exercises.

Strict consistency in increasing the load and its individualization are the main conditions for all classes. In this case, the condition, the reaction of the trainees, the features of the clinical course, concomitant diseases and physical characteristics should be taken into account. preparedness of students.

Another thing is also important: while doing physical exercises, the patient himself actively participates in the therapeutic and recreational process, and

this has a beneficial effect on his psycho-emotional sphere.

Classes also have educational value: students get used to systematically doing physical exercises, this becomes his daily habit. Exercise therapy classes are transferred to general physical education, and become a human need after recovery.

Physiotherapy exercises for gastritis

It is advisable to include also physiotherapy exercises in anti-draining treatment. Physical education has a tonic effect on the entire body, improves metabolism, normalizes nervous reactions, changes intra-abdominal pressure, improves blood circulation in the abdominal cavity.

Physical therapy for patients with chronic gastritis, proceeding with secretory insufficiency should be moderate and aimed at strengthening the abdominal muscles, fortifying. Walking is recommended, as well as dosed walking.

In patients with increased secretion, the workload in the classroom should be much greater - at the level of submaximal work power, but the number of exercises for the abdominal muscles should be limited and they should be performed with a moderate load. With a combination of dietary nutrition, mineral water intake and physiotherapy exercises, it is most advisable for chronic gastritis with increased secretion of the digestive glands to drink mineral water before physical education, and take food 15-20 minutes after exercise.

In case of gastritis with reduced secretion, you should drink mineral water after exercise 15-20 minutes before meals.

Compliance with the correct diet, the fight against smoking and alcohol abuse, the identification and treatment of other diseases of the digestive system, the sanitation of the oral cavity - all these measures will prevent the onset and progression of chronic gastritis.

Running helps to normalize the acidity of gastric juice. So with a reduced secretion of gastric juice before running, drink a glass of magnetized water - this will enhance the secretory function of the stomach. Run for at least 30 minutes and no more than an hour.

When secretion is high or normal, you can drink a glass of oatmeal or rolled oats before running to neutralize the acidity.

Approximate scheme in the period of remission

Literature

1. Gishberg L.S. Clinical indications for the use of physiotherapy exercises for diseases of internal organs., SMOLGIZ, 1948

2. Moshkov V.N. Physiotherapy exercises in the clinic of internal diseases., M., 1952

3. METHODOLOGICAL LETTER: Physiotherapy in inpatient treatment., M., 1962

4. Yakovleva L.A. Physiotherapy exercises for chronic diseases of the abdominal organs., Kiev 1968

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Chelyabinsk State University

Department of Computational Mechanics and Information Technologies

on the topic: “Diseases of the digestive system. Physiotherapy exercises for gastrointestinal diseases "

Completed by: Zhukova Oksana Sergeevna

Group: MT-201.

Chelyabinsk 2010

DISEASES OF THE DIGESTIVE ORGANS

Age-related changes.

The organs of the digestive apparatus, like other organs and systems of the body, undergo a number of structural and functional changes with age. The most noticeable of them are changes in the oral cavity, expressed in the loss of teeth, atrophy of the chewing muscles, flattening of the papillae of the tongue. Phenomena of atrophy are also observed in the salivary glands, esophagus, stomach, intestines, liver, and pancreas.

All this leaves a noticeable imprint on the frequency of occurrence and features of the clinical course of diseases of the digestive system in the elderly and old people.

The main symptoms of diseases.

Abdominal pain is one of the most common complaints of diseases of the digestive system. They can be sharp and dull, persistent and intermittent, associated and not associated with food intake, localized and spilled. The localization of pain is of great importance, but in some cases it may not coincide with the topographic location of the affected organ. Sometimes abdominal pain is observed in diseases that are not related to either the digestive system, or generally to the abdominal cavity. Pain in the epigastric region can be associated with irritation of the solar plexus, with diseases of the stomach, liver, pancreas, with some others, such as myocardial infarction with diaphragmatic hernia. In the right upper abdomen, they are characteristic of diseases of the liver, gallbladder, hepatic bend or the right curvature of the colon, right kidney. Pain sometimes radiates to the same area in cases of right-sided diaphragmatic pleurisy, as well as diseases localized in the lower right part of the stomach. Pain in the left upper abdomen can also be characteristic of diseases of the stomach, pancreas, spleen, splenic flexure or left curvature of the large intestine, left flow.

In the right lower abdomen, they are more common with appendicitis, lesions of the cecum, right kidney and genitals, and in the left lower abdomen, they are often associated with lesions of the sigmoid colon and genitals.

Stomach pains differ in a number of features. In patients with gastritis and dyspepsia, they occur after eating, but do not differ in frequency, that is, these periods do not alternate with the so-called light intervals, which can last for months. In case of peptic ulcer (stomach and duodenal ulcer), pain is characterized by frequency, seasonality, connection with food intake and localization in the epigastric region. For duodenal ulcers, their occurrence is typical at night and on an empty stomach, for intestinal diseases - the absence of a strict dependence on the time of food intake and a connection with the act of defecation. These pains are usually relieved by having a bowel movement or passing gas. In diseases of the liver and biliary tract, pain is mainly localized in the area of ​​the right hypochondrium, often radiating to the right shoulder or interscapular space. They often occur after excessive eating, especially after fatty and spicy foods, and intensify with movement. In cases of damage to the pancreas, they are encircling, radiating to the left half of the body (left hypochondrium, left shoulder blade, left shoulder, sometimes to the lower back).

Abdominal pain can be an important symptom of acute abdominal surgery.

Therefore, even if the pain is very severe, a nurse should not give the patient any pain relievers without a doctor's prescription. Eliminating or relieving pain after using these drugs, especially drugs, can make diagnosis difficult, and as a result, surgery will be performed late. It should also be borne in mind that in a number of acute surgical diseases of the abdominal organs, heating pads, laxatives and enemas are contraindicated.

Nausea and vomiting are common symptoms of gastrointestinal diseases, but they can occur without any connection with them. They are based on a complex neuroreflex mechanism. They are typical for diseases of the stomach (gastritis, peptic ulcer, cancer), intestines (enteritis and colitis), liver and biliary tract (hepatitis, cholecystitis, cholelithiasis), acute surgical diseases of the abdominal cavity, accompanied by irritation of the peritoneum (acute appendicitis, perforated ulcer stomach and duodenum, peritonitis, etc.), general intoxication (poisoning, infectious diseases, pulmonary tuberculosis, uremia, toxicosis of pregnant women, etc.), lesions of the brain and its membranes (meningitis, tumors, cerebral hemorrhages) ...

The diseases listed above do not exhaust the causes of these symptoms. Nausea and vomiting also occur due to irritation of the root of the tongue, pharynx, pharynx and epiglottis; they can also be of conditioned reflex origin and occur with the smell of unpleasant food or the appearance of an object that causes disgust.

The time of appearance, the relationship of vomiting with food intake are of great importance for diagnosis; the appearance and amount of vomit, the presence and nature of impurities (mucus, blood, bile, pus). All these data, together with other signs, help the doctor understand the complex picture of the disease.

Stomach nausea and vomiting are characterized by the onset after a meal. Vomiting in this case usually brings relief. However, these symptoms can be considered as a manifestation of gastric pathology only if there are other signs typical of a stomach disease.

It should also be mentioned that nausea in gastric diseases, as in some other cases, precedes vomiting. The exception is cerebral vomiting, which occurs without prior nausea. It is also characterized by a combination with a headache and sometimes with an increase in blood pressure.

It should also be remembered that vomiting is often a sign of acute surgical diseases of the abdominal organs, usually combined with symptoms of peritoneal irritation. Vomiting of blood is a sign of massive gastric bleeding from the vessels of the stomach wall or dilated veins of the esophagus. The cause of profuse bloody vomiting is most often peptic ulcer and stomach cancer, sometimes - cirrhosis of the liver; if vomiting follows bleeding, the vomit consists of scarlet blood, and in cases where the blood is in the stomach for some time, they look like coffee grounds. Profuse, dirty-brown, foul-smelling vomiting (called fecal vomit) is an important symptom of intestinal obstruction or gastrointestinal fistula.

Stool disorders and changes in its character are most often manifested in the form of constipation and diarrhea and are accompanied by changes in the shape, consistency, color, and smell of stool. The nature of the stool can change, however, in the absence of violation of its frequency.

Diarrhea occurs due to a violation of the motor and secretory functions of the intestine, which is observed during inflammatory processes in its mucous membrane (enteritis, colitis); mechanical irritation by her coarse food containing a lot of fiber; irritation of the mucous membrane with chemicals (poisoning with mercury, arsenic, etc.), endogenous, i.e., poisons formed in the body (release into the intestinal lumen of nitrogenous products of protein metabolism during uremia), and products of putrefaction or fermentation. There may be other causes of diarrhea. In some cases, they arise with excitement or fear due to neurogenic acceleration of peristalsis.

Diarrhea in old people is usually dangerous, as it leads to dehydration.

Loose and frequent stools mixed with mucus and blood is the main symptom of acute colitis of dysenteric and non-dysenteric origin. Tenesmus is characteristic of them, expressed in painful and frequent urges to the bottom, accompanied by a feeling of pain in the rectum and in the anus. Diarrhea with vomiting is typical for toxicoinfections and cholera. Toxic infections are caused by Salmonella and some other microorganisms, cholera - Vibrio cholera and its variety El-Tor vibrio. In cases of toxicoinfections, diarrhea is preceded by nausea and vomiting, and defecation is associated with paroxysmal abdominal pains, which decrease after stool. There is an increase in body temperature and chills. The first clinical manifestations of cholera are urge to go down. Vomiting joins later.

Diarrhea proceeds without pain, and the temperature reaction may be completely absent or there may be a slight subfebrile condition. As a result of profuse diarrhea and vomiting with cholera, there is a sharp dehydration of the body.

The cause of constipation is the delayed movement of intestinal contents and its prolonged stay in the intestines. In this regard, an increased absorption of the liquid part of the feces occurs in the intestine, and they acquire an abnormal dense consistency.

The slowdown in the advancement of intestinal contents may be associated with mechanical obstacles, impaired motor function of the intestines and insufficient amount of intestinal contents due to the consumption of food containing little vegetable fiber. There are other reasons for the slowed movement of intestinal contents.

In some cases, stool retention requires emergency treatment. One of these cases is the occurrence of fecal obstruction, that is, the formation of hardened fecal masses in the rectum, which, if not removed in a timely manner, can petrify. Their pressure on the rectal wall can cause pressure ulcers. With the formation of fecal impaction, mechanical removal of hardened feces is required. For this purpose, a vessel is placed under the patient, and the sister, putting on a glove, inserts an index finger lubricated with vaseline oil into the rectum and removes the hardened feces in parts. After this, a cleansing enema is given. Stool retention can also be a symptom of a formidable condition - intestinal obstruction. In this case, constipation is combined with non-discharge of gas, severe abdominal pain and a severe general condition. Such patients require emergency surgical care.

Treatment of constipation can only be effective if its etiology is taken into account. An important link in the treatment is a balanced diet, sports and medical gymnastics. The systematic use of cleansing enemas and laxatives should be avoided. The intake of such mineral waters as Batalinskaya and Essentuki No. 17 (1-1 / 2 glasses of water at room temperature in the morning and in the evening) has a beneficial effect.

Changes in stool color that are not associated with impaired bowel movement can be of great diagnostic value. So, the release of discolored feces, which looks like a whitish-gray clay, indicates a blockage of the bile ducts (common bile and hepatic), as a result of which bile does not enter the intestines. Black tarry stools are observed with bleeding from ulcers of the stomach or duodenum, as well as with cancer of these organs.

It must, however, be remembered that black stools also occur in patients taking iron supplements, vicalin and activated charcoal.

You should pay attention to the presence of various impurities in the stool. For example, a large number of films of connective tissue in the feces indicates a decrease in the acidity of gastric juice and may indicate a complete absence of hydrochloric acid in it. The detection of undigested meat in the feces indicates a violation of the exocrine function of the pancreas.

A large amount of fat in the stool is observed in severe diseases of the pancreas and insufficient flow of bile into the intestine due to blockage of the hepatic or common bile duct.

Diseases of the esophagus

Esophagitis is an inflammation of the mucous membrane of the esophagus, the cause of which in old people is most often the "throwing" of peptic active gastric contents from the stomach. Conditions for the ingress of gastric contents into the esophagus arise when a patient has a diaphragmatic hernia, a violation of the tone of the cardiac sphincter of the esophagus due to gastric ulcer or biliary tract diseases, as well as after surgical interventions. The cause of esophagitis can also be foreign bodies, stomatitis and candidiasis developed from antibiotic treatment.

Esophagitis is characterized by burning and pain behind the breastbone, aggravated by eating. Pain can radiate to the neck and back. Often, hypochromic anemia develops as a result of latent bleeding from the eroded surface of the inflamed mucous membrane of the esophagus.

Esophageal carcinoma. More often men get sick after the age of 60 years. Scars after a burn or injury to the esophagus, as well as diverticula and leukoplakia, predispose to the development of cancer.

Clinically, esophageal cancer is manifested by progressive difficulty in swallowing first solid and dry food, and then mushy and finally liquid. During a meal, the patient may feel pain and burning sensation behind the breastbone. In the later stages of the process, when food stagnates above the narrowing of the esophagus and undergoes rotting, an unpleasant odor can come from the mouth. The patient is gradually losing weight, weakening. Severe general weakness, exhaustion and anemia develop.

Occasionally, in elderly patients, swallowing is slightly impaired. In these cases, general weakness, exhaustion and anemia are the predominant symptoms. Cancer of the esophagus metastases to the paraesophageal lymph nodes of the mediastinum, lungs and liver.

DISEASES OF THE STOMACH

Acute gastritis (acute catarrh of the stomach) is an acute inflammation of the gastric mucosa that occurs when exposed to poor quality food, chemicals, alcohol and other harmful substances. Overeating can also be a cause of acute gastritis.

Patients complain of pain in the epigastric region, nausea and vomiting. Vomit contains remnants of recently eaten or stagnant, undigested food mixed with mucus or bile. The urge to vomit can be combined with cramping pain in the epigastric region. A sharp general weakness develops. Dizziness, headache, sometimes an increase in body temperature up to 38 °, complete aversion to food are noted.

Sometimes diarrhea joins. In the latter case, the phenomena of dehydration of the body may develop, expressed in a sharp deterioration in the general condition of the patient with adynamia, darkening of consciousness and other phenomena.

Chronic gastritis is quite common in old and senile age. In old people, its hypoacid and anacid forms predominate. This is due to the fact that with age, structural changes occur in the nervous apparatus and the vasculature of the stomach wall, as a result of which the prerequisites are created for the development of trophic changes on the part of various elements of the stomach wall and, in particular, the glandular apparatus.

Patients complain of a feeling of heaviness and fullness, I also dull pain in the epigastric region, arising or worsening after eating. Lowered appetite. After eating, nausea occurs. Often there is belching with air, sometimes with a rotten egg. Pain in the mouth and tongue may bother you.

Peptic ulcer disease in old and senile age is not uncommon. Among patients with peptic ulcer diseases, persons over 60 years old make up from 20 to 25%.

Senile ulcer has a number of essential features. Its age, as a rule, is small, its size is large, and its location in the stomach is higher. More often, the ulcer is combined with a reduced content or absence of hydrochloric acid in the stomach contents. Unlike peptic ulcer disease in young patients, it is not characterized by the frequency of exacerbation in spring and autumn.

The dependence of pain on food intake is also not expressed. Appetite is usually preserved. Vomiting in uncomplicated ulcers is usually absent. Localization of pain is often atypical. Pain can be noted in the right side of the abdomen or in the left side of the chest. The latter is often perceived as a symptom of angina pectoris.

Frequent constipation. The older the patient is, the more often the clinical course is characterized by extremely poor symptoms. So, the first manifestation of the disease may be profuse gastric bleeding or perforation. The diagnosis of gastric ulcer and duodenal ulcer is usually established on the basis of history, clinical data, X-ray examination and gastroscopy.

The most serious complications of gastric ulcer and duodenal ulcer: bleeding, perforation, degeneration into cancer, pyloric and duodenal stenosis.

Bleeding. Gastric bleeding is one of the dangerous complications of gastric ulcer and duodenal ulcer. Its frequency in elderly and senile patients is 2 times higher than in young people. With profuse gastric bleeding, severe general weakness, dizziness, pallor of the skin, vomiting of blood and tarry stools, severe thirst, tachycardia and a drop in blood pressure occur. If bleeding continues, collapse may occur. In this case, the patient loses consciousness.

The skin becomes covered with cold sweat, the pupils are dilated, the pulse is barely palpable (it is impossible to count), the pressure is constantly decreasing and may not be detected.

For minor bleeding, mild general weakness, increased heart rate, and a moderate decrease in blood pressure are characteristic. Vomiting of blood and tarry stools are sometimes absent. However, the study of feces for occult blood in these cases gives a positive reaction.

A small amount of blood loss (150-200 ml) can cause only short-term weakness, subsequently manifesting itself as tarry stools.

Perforation. One of the most severe complications of gastric ulcer and duodenal ulcer is the perforation (perforation) of the ulcer. The main symptom is sudden, extremely severe pain in the abdomen (according to the figurative expression of patients - "like from a blow with a dagger"). Initially, it occurs in the epigastric region, then spreads to the right iliac part. The patient often takes a forced position - lies or sits motionless with the legs brought to the stomach and bent at the knees. The most important objective signs of perforation include a sharp tension in the muscles of the anterior abdominal wall, especially in the epigastric region. Palpation of the abdomen is painful.

The most severe pain occurs with a sudden withdrawal of the hand, palpating the abdominal wall (Shchetkin-Blumberg symptom). This is a very important symptom indicating peritoneal irritation. In the presence of the above symptoms, the diagnosis is not difficult.

However, in elderly and senile patients, the clinical picture is not always so typical.

Often there is no symptom of the suddenness of the onset of pain, the tension of the abdominal wall is not so clearly expressed, general phenomena prevail. In such cases, one should be especially attentive to subjective complaints and changes in the general condition, so as not to miss such a formidable complication, since only an operation performed as early as possible can save the patient's life.

The degeneration of a stomach ulcer into cancer. In elderly and senile people, this complication occurs in about 10% of cases, mainly with callous stomach ulcers, which are chronic persistent non-healing ulcers with callous edges. Symptoms are usually very mild.

Stenosis of the pylorus and duodenum is a narrowing of the lumen of the outlet of the stomach due to scarring of the ulcer located at the outlet of the stomach or in the initial section of the duodenum. In elderly and senile patients, this complication is relatively rare.

In severe cases, that is, in the stage of decompensated stenosis, patients complain of a feeling of fullness and heaviness in the epigastric region, profuse vomiting of food eaten the day before, bloating and rotten belching; an unpleasant odor comes out of the mouth. Patients with sharply reduced nutrition. In the upper abdomen, the peristalsis of the stomach is determined. Dehydration phenomena may occur. The amount of urine decreases up to anuria. The level of residual nitrogen in the blood rises. Occasionally, due to a significant violation of the electrolyte composition of the blood, convulsions are noted. X-ray reveals a large stomach, the lower pole of which is in the small pelvis.

Stomach cancer. Stomach cancer is most common between the ages of 40 and 70. After 70 years, its frequency decreases. Clinical manifestations of the disease, especially in the initial period, are usually mild. Patients complain of rapid fatigue, poor appetite, aversion to certain types of food, a feeling of heaviness in the epigastric region, belching and regurgitation, periodic mild pain in the upper abdomen, weight loss. Mild iron deficiency anemia and accelerated ROE may occur. In the later stages of the disease, a tumor is palpated in the epigastric region, vomiting (with cancer of the gatekeeper) and impaired swallowing (with cancer of the cardiac region), progressive emaciation, pain syndrome develops, metastasis occurs in the cervical lymph nodes, liver, lungs, bones.

Diseases of the intestine

disease gastritis digestion exercise therapy

Acute appendicitis is an acute inflammation of the appendix. In old people, it is much less common than in people of young and mature age, and its clinical manifestations are much less pronounced. At the same time, it is characterized by a high severity of pathological changes and a high frequency of complications. The disease often begins with diarrhea. Abdominal pains are not strong and their localization is not typical, they are often localized not in the right iliac region, but in the lower abdomen and are diffuse in nature. There is little or no protective muscle tension in the right iliac region. Body temperature usually does not exceed subfebrile numbers. The increase in the number of leukocytes, as a rule, is insignificant, but at the same time there is a clear shift to the left with a noticeable increase in stab forms. The deterioration of the general condition and cardiac activity develops rapidly.

Chronic appendicitis. In older people, this disease is not common. Its clinical course is sluggish. Subjective symptoms usually prevail over objective ones. Chronic appendicitis is often very difficult to distinguish from chronic bowel disease - chronic colitis and typhlitis, which are common in old age.

Colitis is a disease of various etiology that affects the entire colon or some parts of it. Distinguish between acute and chronic colitis.

Acute colitis. Of the acute colitis, dysentery is the most common. It is observed in persons of older age groups as often as in young people.

Typical cases are characterized by an acute onset, paroxysmal abdominal pain (more in the lower parts), general weakness, dizziness, nausea, vomiting, fever, flatulence, loose stools with a fetid odor and admixture of mucus and blood. Tenesmus - painful, sterile urge to the bottom with discharge of mucus, blood and pus may occur. Recognition in typical cases does not present any particular difficulties. Often, however, the disease proceeds in an erased form, which greatly complicates the diagnosis.

Chronic colitis. Chronic colitis comes in a variety of etiologies. The disease usually begins at a young or middle age. After 60 years, its first symptoms are noted in about 5% of cases. The disease manifests itself most often with constipation, which sometimes alternates with diarrhea, less often only diarrhea alone, bloating and mild pain in its lower part. Constipation, flatulence and mild pain in the lower abdomen can also occur with purely age-related changes in the gastrointestinal tract, however, the diagnosis of “senile constipation is valid only after excluding organic changes in the intestines and neighboring organs. To exclude these changes, a thorough X-ray examination of the gastrointestinal tract, sigmoidoscopy are required. Chronic colitis in the elderly is often combined with a decrease in gastric secretory function, impaired liver and pancreas function.

Ulcerative colitis, nonspecific. Streets over 60 years old are relatively rare. The impetus for its development can be infections, mental trauma, irritation of the gastrointestinal tract with certain drugs (for example, 5-fluorouracil in the treatment of cancer) and other reasons. The disease is characterized by frequent exacerbations, accompanied by an increase in body temperature, diarrhea and abdominal pain. Diarrhea can lead to dehydration and impaired electrolyte metabolism. The feces contain impurities of mucus, blood and sometimes pus. The disease can be complicated by bleeding from an ulcer or perforation of the intestinal wall. Colon cancer sometimes develops in the elderly and old people against the background of ulcerative nonspecific colitis.

Hemorrhoids - varicose veins in the anus and lower rectum, resulting from a violation of the outflow of venous blood and a decrease in the tone of the venous walls. Its development is facilitated by chronic constipation, difficulty in defecation due to a crack in the anus, a sedentary lifestyle, uterine fibroids and other factors leading to venous stasis in the small pelvis.

Subjective symptoms are discomfort and itching in the anus, pain during bowel movements. There are often no complaints.

The most important objective symptom is recurrent bleeding, usually at the end of a bowel movement.

Hemorrhoidal bleeding is often the cause of severe iron deficiency anemia. During bowel movements or walking, hemorrhoids may fall out. They can become inflamed and impaired, complicated by paraproctitis and thrombophlebitis.

LIVER DISEASES

Hepatitis is an acute and chronic inflammatory liver disease of various etiology.

The most common is Botkin's disease, which can occur in the form of acute and chronic epidemic hepatitis. Its causative agent is a virus, and the source of infection is a sick person. The virus is found in the blood, liver and other organs and is excreted in feces. Infection occurs through the mouth with infected food, water, hands, as well as objects that have been in contact with the patient and his contaminated secretions. With improper sterilization of medical instruments, infection can also occur during vaccinations, blood transfusions, injections, etc. Botkin's disease is a very contagious disease. If, during its epidemic spread, young people are more likely to get sick, then vaccination forms equally often affect the population of all age groups.

In acute epidemic hepatitis, the incubation period is 3-4 weeks for an independent disease and 3-4 months for inoculated forms. In the clinical picture, the preicteric and icteric stages can be distinguished. In the preicteric period, body temperature is normal or subfebral. Patients complain of general weakness, headache, lack of appetite, bitterness in the mouth, nausea, stool retention or diarrhea, joint pain. The color of the urine turns dark yellow. Pulse slows down. Swelling of the liver and occasionally of the spleen may occur. On the 5-7th day, and sometimes even later, jaundice develops and itching of the skin appears. The body temperature continues to remain normal or rises to subfebrile numbers, but the general condition of patients worsens. General weakness increases. Apathy or irritability appears. The liver is enlarged, sometimes the spleen. The amount of urine decreases. Its color becomes dark brown. The stool is discolored. The icteric period lasts 2-6 weeks, sometimes longer. Recovery occurs in about 43% of cases (S.M. Ryss and V.G. Smagin). In other cases, the disease becomes chronic. Complications may develop: acute toxic liver dystrophy, cholangitis and cholecystitis, liver cirrhosis, pneumonia, etc. The most severe of them is acute yellow dystrophy of the liver. It manifests itself by agitation of the patient, insomnia, severe headache, fever, tachycardia, mental disorder, a sharp decrease in the size of the liver, intense jaundice and bleeding. An unpleasant sweetish-putrid ("liver") odor emanates from the patient's mouth. Initially, small disturbances in consciousness intensify. Consciousness becomes confused and then a deep unconscious state occurs - a coma. In this case, the patient's pupils are dilated and weakly react to light. Involuntary bowel movements and urination occur.

Chronic hepatitis is a common liver disease that is characterized by a recurrent course for many years without pronounced progression.

It usually occurs as a result of the transition of acute epidemic hepatitis (Botkin's disease) to chronic, although this is not always clearly established. Symptoms during periods of exacerbations resemble acute epidemic hepatitis. Chronic epidemic hepatitis can be the cause of the development of liver cirrhosis, angiocholitis, duodenitis, pancreatitis and some other complications.

Liver cirrhosis is the final stage of hepatitis and dystrophic damage to the liver tissue. It occurs mainly in people over 40 years old.

Its greatest frequency falls on the age of 50-70 years; more often men are ill. In almost 50% of cases, it is the outcome of Botkin's disease. Of the other reasons, the most important are alcoholism, malnutrition and malnutrition, infectious diseases (malaria, brucellosis, etc.), toxic liver damage.

In the early period of the disease, patients usually complain of general weakness, rapid fatigue, poor sleep, impaired appetite, nausea, vomiting, and a feeling of heaviness in the epigastric region. Constipation is often observed, followed by diarrhea. The body temperature may periodically rise. Gradually the patient loses weight. The sclera is subicterous. The skin becomes dry, wrinkled, and acquires a grayish-yellow color. Itching of the skin joins these phenomena. On the face, cheeks, arms, in the region of the shoulder girdle and in other areas of the skin, "spider veins" are observed, which are small angiomas with a corolla of dilated vessels. Redness of the skin of the palms is noted. It should, however, be remembered that this symptom, which is generally characteristic of liver cirrhosis, can be observed in elderly people without liver damage. Flatulence is common. The sizes of the liver are different and depend on the stage of the disease. Its lower edge is pointed and compacted. The surface of the liver may be uneven. The spleen is usually enlarged and dense. The patient continues to lose weight, and the second so-called ascitic period of the disease develops, when free fluid appears in the abdominal cavity. During this period, there are bleeding from the dilated veins of the esophagus. Anemia develops. Cirrhosis of the liver in elderly people progresses slowly. Death most often occurs from liver failure, exhaustion, bleeding from the dilated veins of the esophagus.

Cholelithiasis, cholecystitis, cholangitis. The incidence of these diseases increases with age. Mostly they are observed at the age of 50-70 years. Among the patients, women predominate. However, after 70 years, men and women get sick equally often. Distinguish between acute and chronic cholecystitis. Because of the close anatomical and physiological relationship between the gallbladder and bile ducts, isolated cholecystitis is rare. Usually it is combined with inflammation of the bile ducts - cholangitis (synonym - angiocholitis).

Symptoms of cholelithiasis and cholecystitis are basically similar, with the exception of the intensity of pain attacks, which at the first is much more pronounced. These diseases differ mainly in the fact that in case of gallstone disease, a mechanical factor is added to the main infectious component, which is often the cause of serious complications.

Acute cholecystitis is characterized by severe pain in the right hypochondrium, radiating to the right shoulder, neck and under the right scapula. These pains are identical to hepatic colic in cholelithiasis. Patients with acute cholecystitis have a more persistent increase in body temperature, leukocytosis with a shift to the left, tachycardia.

In both diseases, pain is accompanied by nausea and vomiting. Also frequent are chest pains and pains in the region of the heart, cardiac arrhythmias, shortness of breath. If, after an attack of hepatic colic, an icteric staining of the skin and sclera appears, and the stool becomes discolored and dark brown urine is separated, this may indicate a blockage of the common bile duct by a stone. In such cases, bile stagnation inevitably occurs, which in turn leads to the development of an ascending infection of the extra- and intrahepatic biliary tract, i.e., to the development of cholangitis. At the same time, multiple abscesses sometimes develop in the liver, as a result of which there is an increase in body temperature up to 39-40 ° with tremendous chills and profuse sweating.

It should be borne in mind that cholelithiasis and cholecystitis in old and senile age often proceed atypically, not accompanied by attacks of hepatic colic, so characteristic of a younger age. Older patients more often complain of a feeling of pressure or slight pain in the right hypochondrium, poor appetite, bitter taste in the mouth, nausea and vomiting, and bloating. The absence of hepatic colic attacks in these cases, apparently, is associated with senile atony of the gallbladder.

Clinically, chronic cholecystitis can be expressed in pain of varying strength, arising in the right hypochondrium due to an error in diet, exercise, or intercurrent infection. During the out-of-attack period, which can last months and years, there are mainly dyspeptic disorders, manifested by heartburn, nausea, bloating, constipation, subicteric sclera and low-grade fever (37.2-37.6 °), intolerance to fatty foods.

Liver cancer. Distinguish between primary and metastatic liver cancer. The first of them is extremely rare, the second is about 50% of malignant tumors of the abdominal cavity. Patients complain of constant pain in the right hypochondrium. There is an increase in the liver, especially in the final stage of the disease. The liver is hard, its surface is knotty. Jaundice is often associated with these phenomena. Ascitic fluid can accumulate in the abdominal cavity.

DISEASES OF THE PANCREAS

Pancreatitis is a disease expressed in inflammation of the pancreas due to infection or stagnation of secretions in it. Their frequency increases with age. Distinguish between acute and chronic pancreatitis.

The first of them is one of the most serious and dangerous diseases of the abdominal organs. Although success has been achieved in its treatment, mortality from it continues to be quite high, especially among elderly and senile patients. They often have acute pancreatitis in the form of pancreatic necrosis, that is, in the most severe form. This is due to the fact that in this disease, conditions are created for disrupting the outflow of pancreatic juice containing proteolytic enzymes and lipase, which, under certain conditions, cause the gland to self-digest. Patients complain of sharp pains of a girdle nature in the upper abdomen, excruciating, frequent vomiting, and bloating in the epigastric region. Abdominal pain usually radiates to the left shoulder, heart region and behind the sternum. Vomiting does not provide relief. The patients are restless. The skin is pale. In cases of compression of the common bile duct by an inflammatory infiltrate, jaundice occurs. The body temperature rises to 38-39 °. Breathing quickens up to 28-30 per minute or more. Collaptoid states sometimes develop. Despite the severity of subjective complaints, the abdomen may be soft and painless on palpation, or only slightly painful. Leukocytosis in some cases reaches high numbers, up to 20,000 leukocytes and more with a shift to the left, the content of urine diastase is several thousand units (normally 16-64 units).

With the development of pancreatic necrosis, the deterioration of the general condition and blood picture rapidly progresses, intoxication increases, abdominal pain intensifies, muscle tension appears in the epigastric region. The content of urine diastase can sharply decrease within a few hours.

Pancreatic cancer, Under the age of 40, it is extremely rare. Then its frequency increases. Among the patients, men predominate.

In the early period of the disease, there is severity in the epigastric region, deterioration or lack of appetite, nausea and vomiting. Then these symptoms are joined by pains in one or another part of the upper abdomen, Their localization depends on which part of the pancreas is affected by the tumor. With damage to the head of the gland (the most frequent localization), they are observed to the right of the navel or in the area of ​​the right hypochondrium, with damage to the body and tail of the gland - under the spoon and in the left upper quadrant of the abdomen with irradiation to the lower back and spine. The pain is very intense, especially in cases of damage to the body and tail of the gland, poorly docked. If the head of the gland is affected, jaundice develops and Courvoisier's symptom appears (a distended gallbladder is palpable).

Patients lose weight, exhaustion quickly sets in. An increase in the level of blood and urine diastase is observed in less than 50% of cases. Retroperitoneal pneumography in combination with tomo- or angiography of the pancreas helps to diagnose. Surgical treatment.

THERAPEUTIC EXERCISE FOR DISEASES OF THE DIGESTIVE ORGANS

Physiotherapy is an integral part of general physical education and one of the most important methods of complex treatment of patients with peptic ulcer disease, as well as an effective means of preventing exacerbations with the correct structure of classes and the entire complex.

Let's start with physiology. Impulses from the receptors of internal organs enter the central nervous system, signaling the intensity of functioning and the state of the organs. With the disease, a violation of reflex regulation occurs, pathological dominants and vicious (pathological) reflexes appear, which distort the course of normal processes in the human body.

The disease suppresses and disorganizes motor activity - an indispensable condition for the normal formation and functioning of any living organism. Therefore, exercise therapy is a very important element in the treatment of ulcerative processes.

It is already known that the implementation of dosed physical exercises, accompanied by positive shifts in the functional state of the centers of the submilky region and an increase in the level of basic life processes, causes positive emotions (the so-called psychogenic and conditioned reflex influence). This is especially applicable in case of peptic ulcer disease, when the neuropsychic state of patients leaves much to be desired (normalization of the manifestations of dystonia from the nervous system expressed in patients. It should be noted the effect of physical exertion on the nervous regulation of the digestive apparatus.

With regular exercise, as in the process of physical training, energy reserves gradually increase, the formation of buffer compounds increases, the body is enriched with enzyme compounds, vitamins, potassium and calcium ions. This leads to the activation of redox processes and to an increase in the stability of the acid-base balance, which in turn has a favorable effect on the scarring of the ulcer (influence on the trophic and regenerative potencies of the gastrointestinal tract tissues).

The effect of exercise is determined by its intensity and time of use. Small and moderate muscle tensions stimulate the basic functions of the gastrointestinal tract, while intense ones depress.

The beneficial effect of exercise therapy on blood circulation and respiration is noted, which also expands the functional capabilities of the body and increases its reactivity.

Depending on the clinical orientation of the disease and the functional capabilities of the patient, various forms and means are used. Since usually in educational institutions, whenever possible, only the third (general developmental) health-improving set of exercises is used, then I will also adhere to it.

Contraindications to classes include:

· Fresh ulcer in the acute period.

· Ulcer complicated by bleeding.

· Preperforative state.

· Ulcer complicated by decompensated stenosis.

· Fresh massive paraprocesses during penetration.

Exercise therapy when applied to patients suffering from peptic ulcer disease has a healthy effect in the following directions:

Influence the regulation of the processes of excitation and inhibition in the cerebral cortex; to enhance cortico-visceral innervation and alignment of subordinate disorders of autonomic innervation. Improve the coordinated functioning of the circulatory, respiratory and digestive systems.

By the correct organization of the regime of movements, physical exercises and passive rest, influence the regulation of the neuropsychic sphere of the patient.

Improve redox processes in all organs, promote the normal course of trophic processes.

To counteract the dysfunctions of the digestive apparatus, which can occur with peptic ulcer disease (constipation, loss of appetite, congestion, etc.).

The principle of individualization in the use of physiotherapy exercises for this disease is mandatory.

Physiotherapy exercises for gastritis

It is advisable to include also physiotherapy exercises in anti-draining treatment. Physical education has a tonic effect on the entire body, improves metabolism, normalizes nervous reactions, changes intra-abdominal pressure, improves blood circulation in the abdominal cavity.

Physical therapy for patients with chronic gastritis, proceeding with secretory insufficiency should be moderate and aimed at strengthening the abdominal muscles, fortifying. Walking is recommended, as well as dosed walking.

In patients with increased secretion, the workload in the classroom should be much greater - at the level of submaximal work power, but the number of exercises for the abdominal muscles should be limited and they should be performed with a moderate load. With a combination of dietary nutrition, mineral water intake and physiotherapy exercises, it is most advisable for chronic gastritis with increased secretion of the digestive glands to drink mineral water before physical education, and take food 15-20 minutes after exercise.

In case of gastritis with reduced secretion, mineral water should be drunk after exercise 15-20 minutes before meals.

Compliance with the correct diet, the fight against smoking and alcohol abuse, the identification and treatment of other diseases of the digestive system, the sanitation of the oral cavity - all these measures will prevent the onset and progression of chronic gastritis.

Running helps to normalize the acidity of gastric juice. So with a reduced secretion of gastric juice before running, drink a glass of magnetized water - this will enhance the secretory function of the stomach. Run for at least 30 minutes and no more than an hour. When secretion is high or normal, you can drink a glass of oatmeal or rolled oats before running to neutralize the acidity.

Bibliography

1) A.F. Chebotarev "Clinic of Internal Diseases" Ed. Health 1989

2) V.I. Boyko and D.F. Chebotarev "Nursing of the elderly and senile patients" Publishing house: "Health" 1995

3) Gishberg L.S. Clinical indications for the use of physiotherapy exercises for diseases of internal organs, SMOLGIZ, 1948

4) Moshkov V.N. Physiotherapy exercises in the clinic of internal diseases, M., 1952

5) METHODOLOGICAL LETTER: Physiotherapy in inpatient treatment, M., 1962

6) Yakovleva L.A. Physiotherapy exercises for chronic diseases of the abdominal organs, Kiev 1968