The syndrome of Payra: the causes, symptoms, treatment

There are few people who have never had a stomach ache. In most cases, this unpleasant symptom is associated with malnutrition or with diseases of the digestive system, such as gastritis, ulcer or cholecystitis. If the abdominal pain is acute, plus the patient has nausea and vomiting, they often diagnose appendicitis. And the reason for all these troubles with health can be the syndrome Payra. What kind of ailment it is and how it manifests, not even every doctor knows, why the wrong treatment is prescribed. In this case, the patient not only does not improve, but the problem is also aggravated. As a result, it has to be solved only surgically. In fairness, it must be said that it is really difficult to clinically diagnose Piyr's syndrome based solely on anamnesis and palpation of the abdomen and not having the results of special analyzes. But this ailment has some peculiarities that distinguish it among other gastrointestinal diseases. How to recognize this dangerous syndrome and whether it is possible to cure an ailment without surgery is our article.

The syndrome of Payra - what is it?

Let us recall the school anatomy. All the food that we ate, begins to be digested in the stomach, and then moves to the small intestine, where the digestion process ends. There, from the dietary mass, everything valuable comes into the blood, and everything that is useless for the organism passes into the large intestine. Here, water is sucked from this mass, leaving more dense waste in the consistency, which we call feces. The large intestine has several parts, the longest of which is the colon. Simpler it can be represented in the form of a hollow tube about 7 cm in diameter, like a rim bordering the small intestine. The colon is divided into three segments. The ascending segment is on the right side of the abdomen. It rises to the liver, where it bends at an angle close to 90 ° and passes into the transverse segment. This part of the colon reaches the region of the spleen (the organ lying in the left hypochondrium), bends again, goes into the descending segment, further into the sigmoid colon and into the rectum. The fecal masses, beginning to form at the exit from the small intestine, pass all this long way, gradually thickening. As a result, at the output we have a sufficiently thick calf. The syndrome of Payra, or the disease of Pyrus, is observed when the second bend of the large intestine (in the region of the spleen) is much more than physiologically needed. In this place, the diameter of the intestinal cavity is greatly narrowed, which in medicine is called stenosis. Through a narrow aperture, already thickened stool does not have time to move quickly enough to make room for those following. As a result, a kind of congestion is formed from what the body is trying to bring out. Often, the caloric masses are added to the gases formed during the digestion of food.

What is the danger of Payra syndrome

In the small intestine, useful micronutrients, vitamins and other substances pass from the food to the blood, and all unnecessary and even harmful remain, forming fecal masses. Normally, we have to take them out of the body every day, that is, perform an act of defecation. If the stool masses are delayed, which is observed with constipation, the harmful substances that begin to flow into them begin to enter the body, intoxication begins. This is the main danger that causes the Payra syndrome. Intoxication has many adverse consequences, one of which is immunosuppression. This, in turn, leads to the fact that the resistance to various kinds of diseases decreases. In addition, solid fecal masses irritate the walls of the intestines, leading to their ulceration, and human attempts at constipation can cause the appearance of hemorrhoids. Another serious problem caused by the syndrome of Payra is colonoptosis, which means colon omission. This leads to intestinal obstruction, and sometimes to the curvature of the intestines.

Etiology

Piir's syndrome was described by the German surgeon Irwin Pyr in the far distant 1905. For more than 100 years the prevalence of this pathology has increased and reached about 40% among the adult population of the planet. Inflection of the large intestine is observed with congenital pathological structure of the intestine, for example, with an elongated transverse segment of the colon. Since these anomalies are congenital, the causes of their occurrence lie in any failure of intestinal formation at the embryo stage. Among them you can call unsuccessful ecology, mother's diseases during pregnancy, medication, bad habits, nervous stress, alcohol consumption in pregnant women and other factors affecting fetal development. Medical statistics show that children, the father and mother of whom suffer from diseases of the digestive tract, are born with the syndrome of Paira more often than children of absolutely healthy parents.

Pathogenesis

The syndrome of Payra symptoms has the standard for many other diseases of the digestive system, and this is often misdiagnosed. Patients can observe:

- Constipation;

- nausea;

- loss of appetite;

- pain in the peritoneum;

- vomiting;

- bloated stomach (due to the fact that gases can not escape from the colon);

- headache;

Irritability.

In addition, the Payra Syndrome may indicate such manifestations of it:

- paroxysmal pain of unclear localization (due to accumulation of gases and feces at the inflection point of the intestine);

- severe pain in the area of the location of the heart (sometimes they are given under the scapula or in the left arm);

- Reduction of the pain syndrome, when the patient lies horizontally.

Stagnation of fecal masses causes inflammation of the walls of the intestine, and casting them into the small intestine, which often occurs with Piyr's syndrome, leads to reflux-ileitis. In these cases, the symptoms of these associated diseases are added:

- mucus in the stool, sometimes with blood;

- temperature increase.

Dolihosigma

One of the departments of the colon is the sigmoid colon, so named because of its shape, somewhat resembling the letter "S". It is located directly in front of the rectum, the functions of which are to evacuate the feces from the body. A dolichosigmoid is called pathology, when a sigmoid colon was formed longer than anatomically. At the same time, there is also an unplanned nature stasis of stool, and the symptoms resemble the Payra syndrome. Dolihosigma can be not only congenital, but also acquired. It is believed that the sigmoid colon may extend with prolonged (years) inefficient nutrition, when eating too much meat and carbohydrates, with sedentary work. One of the main symptoms of this pathology is constipation. In addition, patients complain of pain in the navel and left hypochondrium, in flatulence, in general deterioration of well-being.

Diagnostics

The syndrome of Payra in adults and in children is not easy to diagnose. Anamnesis in this disease is very similar to other problems with the organs of the digestive tract. It happens that patients with Piir's syndrome were even diagnosed with appendicitis and had an operation. At this time, there is a very accurate method of diagnosing this pathology - irrigography. This is the most effective method, allowing you to determine with great accuracy in the patient the presence of inflection of the colon. The procedure is carried out using barium suspension. The process of its administration to the patient is controlled by an x-ray screen. When the colon is filled, the picture is taken in the patient's posture, while standing under the emptied bowel.

Children aged 10-15 years are used to study the colon radioisotope method. In this case, a colloidal solution of radioactive gold.

With the syndrome of Payra in the picture, one can see that the colon, like a garland, sagged into the pelvic area.

Features of the Payra syndrome in children

Unfortunately, while the Piyr syndrome in children has been studied little, there are no unambiguous recommendations how to more accurately diagnose it, taking into account the age characteristics of small patients, and how to treat it more effectively. Studies conducted by medical scientists have shown that in girls this disease is observed more often than in boys.

The manifestation of the Payra syndrome begins already in the first 12 months after birth, most often in the period when the child is started to give a lure. The new food makes the feces of the baby more dense, which contributes to their retention in the place of inflection of the colon.

The first symptoms of the disease, indicating the syndrome of Payra, are: against the general background of complete health, the child has constipation and abdominal pain. In the future, signs of intoxication (nausea, vomiting) are added due to the accumulation of stool and prolonged stay in the intestine. Without treatment in children by the age of 12-15, the same symptoms of the Payra syndrome are observed, as in adults. When examining a child with suspicions of having a Paira syndrome, the doctor must find out how the pregnancy has progressed, whether the family has immediate relatives with gastrointestinal problems, in order to exclude the inflammatory processes in the intestine, prescribe a blood test. The final diagnosis should be based on the results of the irrigography.

The syndrome of Payra: treatment with diet

With this ailment, patients should pay much attention to proper nutrition. The food should be high in calories, but at the same time light, not containing a lot of slag. In the menu must necessarily be present cottage cheese, butter, sour cream, jelly. To increase the peristalsis of the intestines, patients should enter into their diet whey, kefir, fermented baked milk, curdled milk. You can not refuse and sweets that attract liquid into the intestines, which contributes to liquefaction of fecal masses and an easier process of defecation. Patients should eat plenty of fruit, honey, eat fruit syrups.

In the presence of the syndrome Payra, as with constipation of another etiology, it is useful to drink vegetable decoctions and compotes, as well as freshly prepared juices from carrots and raw potatoes.

Compliance with the diet does not relieve the disease, but greatly facilitates its course.

Conservative treatment

Doctors often can observe the situation that they are afraid of surgery and want to first try medicament therapy patients who have found the syndrome Payra. What kind of pills can cure this disease? Physicians can advise preparations of lactulose. They can be given to children already during infancy. Lactulose somewhat dilutes the stool, strengthens the peristalsis of the intestine and simultaneously infects the intestines with a useful microflora. Adults and anyone who, due to prolonged constipation, started inflammation of the intestinal wall, prescribe anti-inflammatory drugs. For the removal of pain syndromes, you can advise spasmolytics "Drotaverin" or "Platyphylline", also useful courses of prebiotics, probiotics, vitamins.

Piura's syndrome is medicated only at the earliest stages of the disease, and the results are usually short-lived. In parallel with the tablets, physicians prescribe physiotherapy (electrophoresis with a solution of novocaine, paraffin applications on the abdominal area, diathermy, UHF, a belly massage is required, and exercises are prescribed to strengthen its walls.

Surgical intervention

This is the most effective method of treatment, as a result of which all the symptoms disappear completely, forever, and not temporarily, as with other methods of therapy. The operations are performed according to different methods, which depends on the anatomical indications. In one of these, a median laparotomy is performed, a resection of the transverse region of the bypass gut in the middle part is made by direct anastomosis. Further, the transverse colon moves under the base of the transverse-gastric ligament and is fixed by special technology so that the bends in the region of the liver and spleen are rounded.

In the second method, ligaments that fix the large intestine (colon-splenic and membranous-diaphragmatic) are excised, a splenic flexure is reduced by the laparoscope in order to remove the kink of the gut. The operation is performed using medical trocars and an electric cautery.

Combined operations are carried out for those who are diagnosed with the syndrome Payra, dolichosigma. The patient's feedback after such treatment is very favorable. People completely suffer pain, constipation ceases, and with them symptoms of intoxication disappear. During combined operations, patients in addition to manipulation of the colon in the transverse part and splenic flexure perform a laparoscope resection of the sigmoid colon.

Forecast

Conservative treatment gives results at the initial stages of the disease, but since it is caused by an anatomical pathology in the intestinal structure, only surgical intervention helps to completely defeat the disease of Pay. Treatment with folk remedies is used only as an auxiliary. Traditional medicine offers infusions and decoctions that dilute stool (laxatives) and agents that increase peristalsis of the intestines. Also offered are immunity-enhancing drugs that improve overall health. Use can be decoctions of plantain, potato juice, compotes of prunes, dried fruits. It is important to know that enemas are contraindicated in the syndrome of Payra.

The prognosis in patients who have been correctly treated on time is completely favorable. If Piura's disease is started, life-threatening complications can appear in the form of tumors, ulceration of the walls, hemorrhoids, developing from constant bowel trauma to the calves.