Paresis of the intestine: causes, symptoms, treatment

The medical term "paresis" in Greek "πάρεσις" means weakening. Paresis is the weakening of voluntary movements, a special neurological syndrome caused by damage to the motor centers of the brain and / or spinal cord, as well as the conducting pathways of the peripheral and central nervous systems. Deep paresis, also called plethia or paralysis (with Greek "παράλυσις" - relaxation) is the absolute absence of arbitrary movements, which is due to the same causes as paresis.

Paresis and deep paresis (paralysis) are motor disorders caused by damage to the pyramidal system of the brain. Very often, after surgical interventions develop intestinal paresis, which can also be accompanied by an expansion of the stomach. In this case, the paresis of the intestine is caused by a violation of the water and electrolyte balance, as well as the operating injury. Besides. Intestinal paresis often occurs in the presence of hypokalemia, which develops due to blood loss during surgery or as a result of profuse multiple vomiting in the postoperative period.

In most cases paresis of the intestine develops on the second-third day after the operation. This condition requires immediate therapy, since the intestinal dilated as a result of the paresis further aggravates the existing electrolyte disturbances, and also contributes to the development of intoxication. Sometimes, in very weakened patients against paresis, peritonitis develops. In addition to the so-called postoperative paresis, paresis of the intestine in children, which occurs due to hypoxia, microcirculatory disturbances in the intestine, and increased gas formation, is quite common.

The first and, perhaps, the main symptom of the paresis of the intestine is its swelling, which is often accompanied by bloating. The condition worsens with the accumulation and retention of gases and with the increase in swelling of the intestine. As a result of stagnation in the contents of the intestine, rotting processes develop in it, and the accumulation of gases increases. At the same time, damaged and distended intestinal walls, which are unable to absorb gas, react to these processes by increased release of mucus and liquid. In addition, there are irreversible changes in intestinal walls and there is dehydration of tissues, the volume of circulating blood decreases - and the state of "protoplasmic shock" comes.

A special place in the diagnosis of paresis of the intestine belongs to the X-ray examination, which begins with an overview radiograph of the abdomen. The examination is carried out in two patient positions: horizontal and vertical.

Paresis of the intestine: treatment and prevention

Depending on the mechanism of paresis development and its transition to acute intestinal obstruction, therapeutic and preventive measures are carried out in several main areas.

First, the implementation of surgical interventions should be carried out with careful observance of the principles of gentle technique, which is an important element in the prevention of postoperative paresis.

If there is an obvious threat of paresis development, for example, in acute pancreatitis, severe abdominal and lumbar injuries, it is necessary to make a permanent emptying of the stomach with a probe.

In addition, a blockade of sympathetic innervation is used, which is achieved with a novocaine paranephric blockade. If there is a threat of development of dynamic obstruction and for the treatment of persistent paresis, the most effective is the peridural blockade.

The next direction of the therapeutic effect on the fight against paresis is the use of methods of reflex stimulation of intestinal motility, such as abdominal wall massage, oil, etheric or semi-alcohol compresses, curative enemas and irritation with a gas outlet tube of the rectum.