БОЛЕЗНИ ТОНКОЙ КИШКИ. ЧАСТЬ 2. ЭНТЕРОПАТИИ С НАРУШЕНИЕМ МЕМБРАННОГО ПИЩЕВАРЕНИЯ

Abstract

This part of the article begins with a description of the clinical manifestations and their causes in the pathology of the small intestine in patients who complain of excessive bloating, recurrent abdominal pain, and violation of the bowel movement with a tendency to relax. Such patients repeatedly return to the doctor. Evidence of a decrease in the activity of disaccharidases in this cohort of patients is presented. The emphasis is placed on the need to study the food history, identify products that provoke a violation of the membrane digestion. The classification of carbohydrates with the indication of products containing them is given. It explains the essence of repeated and non-passing clinical manifestations due to a violation of membrane digestion and absorption of carbohydrates in the small intestine, which leads to their appearance in the large intestine in different volumes, which is accompanied by the breakdown of carbohydrates with the formation of gases. On the one hand, this is a normal process, but when it gets out of control, the patient goes to the doctor. It describes the essence of a diet with a restriction of carbohydrates – this is the low FODMAP diet and its’ decoding. These products contain oligosaccharides that can be broken down by the enzyme alpha-galactosidase, which is absent in the human body, but is present in the microflora of the large intestine. Advice is given on limiting the intake of such products, both in terms of the frequency of intake and the volume of portions containing them, in order to avoid excessive amounts of intestinal gases, the development of a clinically painful condition. A thorough study of the food history and the necessary correction of eating behavior is the main idea of this part of the article, which is devoted to the same type of clinical picture with different degrees of manifestations of its symptoms.