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Severe IBS. MCSC patient history


In the MCSC named after A. S. Loginov, a patient G. 25 years old complained of loose stools up to 6-7 times a day with unexpected and very strong urges to defecate, forcing him not to leave home.

The young man fell ill during the period of military service in the army, when diarrhea first appeared against the background of conflict situations. In subsequent years, the disease became permanent: loose stools with abdominal pain appeared daily, limiting the patient's exit to the street by routes with the presence of toilets and preliminary intake of loperamide (Imodium). He also began to limit himself in nutrition, which is why he lost 6 kg.  

The patient was hospitalized in the Department of non-inflammatory bowel pathology of the MCSC named after A. S. Loginov, where he underwent complex diagnostics:

  • Laboratory tests (tests of blood, feces and urine).
  • Acute intestinal infections are excluded.
  • Bacteriological Analysis of feces for toxins was carried out.
  • Instrumental examinations (colonoscopy, gastroscopy, ultrasound, CT-enterography).
  • Histological examination of the small and large intestine to detect celiac disease, Whipple's disease, microscopic colitis.
  • Study of the activity of enzymes of the small intestine.

According to the results of the survey, organic pathology and diseases of the gastrointestinal tract have not been identified.

The patient was prescribed a balloon dilation test to assess the level of visceral sensitivity of the intestine. During it, a balloon is inserted into the rectum, into which air is supplied. According to the level of air injection into the cylinder, the appearance of the first, intense and maximum tolerable urge to defecate is estimated.

This test showed a decrease in the threshold of sensitivity of the colon in the patient. This explained the symptoms of the disease-a sudden urge to defecate appeared whenever the rectum filled with feces.

Also, a high level of depression and anxiety is established, the patient is consulted by a psychiatrist.

Taking into account personal characteristics, complaints and the results of the examination, the patient was given a final diagnosis: irritable bowel syndrome with a predominance of diarrhea, severe course.

Specialists of the Center prescribed complex therapy:

  • proper diet and drinking regime;
  • preparations for the regulation of intestinal motility;
  • antidepressants for the correction of somatoform disorders.

The patient is discharged home with improvement. He was recommended to continue observation by a gastroenterologist, psychiatrist and neurologist-vegetologist of the Polyclinic at the place of residence.

Irritable bowel syndrome - one of the most common diseases of the gastrointestinal tract. Especially often IBS develops in young people, adolescents, more often female. Predisposing factors are psychoemotional stresses that disrupt the connections between the brain and the intestine, forming an increase in the sensitivity of the intestine to tactile sensations. As a result, even the usual amount of intestinal contents and gases causes the patient to persistently visit the toilet. Therefore, IBS is considered as a biopsychosocial pathology that requires the participation of not only a gastroenterologist, but also a psychiatrist and neurologist specializing in this field.

The patient's history demonstrates the complexities of diagnosing and treating IBS. Patients with somatoform disorders (abdominal pain, diarrhea, etc.) and anxiety-phobic disorders (fears, irritability, etc.) associated with IBS need comprehensive treatment and monitoring.

Specialists have all the conditions for optimal treatment of patients with irritable bowel syndrome departments of non-inflammatory bowel pathology and Laboratory of functional pathology of the intestine MCSC named after A. S. Loginov.

GBUZ Moscow Clinical Scientific Center named after Loginov MHD