Enteral formula for intestinal lavage, correction of metabolic disorders of the body, prevention and treatment of intestinal dysbiosis

 

(57) Abstract:

The invention relates to medicine, more specifically to the field of gastroenterology, proctology, surgery, therapy, clinical toxicology, dermatology, Nephrology, combustology and others , and can be used in patients for washing the gastrointestinal tract (GIT) to detoxify the body and correction of metabolic disorders, prevention and treatment of intestinal dysbiosis. Enteral mixture contains balanced proportions of the main microelectronica, microelements and vitamins, and medicinal substances on the basis of the waste products of normal intestinal microflora, eubiotics and pectin in a daily dose. The physiology of the mixture, the presence of probiotics and pectin provide normalization of mineral and vitamin metabolism between enteral and internal environments of the body, microbiocenosis.

The invention relates to medicine, more specifically to the field of gastroenterology, proctology, surgery, therapy, clinical toxicology, dermatology, Nephrology, combustology and others , and can be used in patients for washing the gastrointestinal tract (GIT) with the aim of detoxification of the body and the left-wing solutions for intestines washing, containing microelectronic used for putting in dialysis Nephrology and surgery [1] .

The disadvantage of these solutions is that their composition, chosen empirically, does not match the electrolyte composition of the gut contents (chyme) that causes the development of water-electrolyte disorders of the body as a result of their use [1] .

Known tablets for preparation of salt solution enteral application for rehydration of the body "Glyukosolan, Regidron" [2] .

The disadvantage of this solution is incomplete electrolyte set that is dangerous when used in large quantities and electrolyte losses of the body.

Known aqueous solution of high molecular weight polyethylene glycol and electrolytes, such as "Lavage", "Fortran" for intestinal lavage (CL) in a volume of 2 liters to mechanically cleanse the digestive tract in preparation of the colon for diagnostic and surgical interventions [3, 4] . A feature of these solutions is that the glycol holds water and creates volume in the cavity of the intestine, acts as osmotically active laxative.

These rastvoriaetsia, treatment of a dysbacteriosis.

The disadvantage of these solutions is that their composition is sodium bicarbonate, which causes a shift in the pH of the intestinal environment in the alkaline side (pH solutions from 7.9 to 8.5), which creates unfavorable conditions for the existence of the normal intestinal flora - bifidum-coli and lactobacilli, who live in a slightly acidic environment. This contributes to the development of conditionally pathogenic and pathogenic microorganisms, i.e., the emergence of a dysbacteriosis of the intestine [5] .

The closest technical solution of the present invention are salt enteral solution prepared in accordance with the concentration of anions and cations contained in the chyme [6] .

The composition of this solution include the following cations and anions: sodium is 95.6 mmol/l, potassium of 20.5 mmol/l, calcium 7.5 mmol/l, magnesium 6.6 mmol/l, phosphorus 15.6 mmol/l, chlorine 98.6 mmol/l sulfur 0.32 mmol/L. pH value of 5.5 to 5.8; osmolarity - 235 mlOsm/L.

Salt enteral solution used for intestinal lavage in peritonitis and other acute surgical pathology of the abdominal organs, functional intestinal obstruction in surgical patients and acute oral poisoning[7, 8, 6, 9] .

The lack of salt enteral solution is that it does not contain minerals and vitamins that are necessary for digestion and the normal exchange of nutrients [10, 11] . It is known that the composition of the chyme is committed to consistency, which is achieved through a continuous exchange of substances between enteral and internal environment of the body. The absorption of some electrolytes from the intestines into the blood is only possible after filling in the chyme other, missing substances by entering them in a strict proportion of the internal environment of the organism, i.e., from the blood [7, 6] .

The mass transfer of substances between enteral and internal (blood, tissue) of the body is constantly and continuously (enterohepatic and interagency cycles) [12, 13, 14] . The speed and volume of this exchange can be significant [15] . Therefore, if the solution for intestinal lavage missing any necessary body nutrients, including minerals and vitamins, they are doing from the blood into the intestine, will inevitably be "washed out" from the body.

Another disadvantage is that the result of enema saline enteral solution Obnovlenie number of microorganisms occurs only for 5 days, however, their qualitative composition remains the same [3] . That is, if lavage dysbacteriosis was quality, then it becomes more and quantitative.

The disadvantage of this solution can be attributed to an unpleasant sour-salty taste. Although this fact is not directly related to the medicinal properties of the solution, however, the negative attitude to the organoleptic characteristics of the solution some patients narrows the scope of its use. This negative time points and N. Century Kostenko (1998). In addition, specialists in the production of soft drinks believe that most people prefer to drink, painted in a certain color.

The present invention is the prevention and elimination disorders microelement and vitamin metabolism, gastrointestinal dysbiosis in the earliest periods of treatment of patients with various pathological conditions.

This object is achieved in that the enteral solution containing sodium phosphate, sodium chloride, sodium acetate, potassium chloride, magnesium sulfate, calcium chloride, citric acid and distilled water, in which the electrolyte composition close to egesta based waste products of normal intestinal microflora, eubiotics and pectins in daily quantities and doses in the following ratio of components in a mixture of 1 liter:

Sodium phosphate disubstituted N2O - 5,6-7,39 g

Sodium chloride - 3,43-4.52

Potassium chloride - 1,54-2,03 g

Sodium acetate 3H2On - 0,68-0,91 g

Citric acid anhydrous - 0.5-1.5 g

Magnesium sulfate - a 1.25-1.64 g

Calcium chloride - 1,5-1.98 g

Acetate retinol /Vit. A - 1.5-2.0 mg

Acetate alphatocopherol /Vit. E - 12,0-15,0 mg

Ergocalciferol /Vit. Dr. of 0.0125, 0.025 mg

Ascorbic acid /Vit. With - 60,0-100.0 mg

Thiamine Mononitrate /Vit. B1a 1.5-2.6 mg

Riboflavin /Vit. IN2to 0.8-1.7 mg

Pyridoxine hydrochloride /Vit. IN6- 2,0-3,0 mg

Cyanocobalamin /Vit. IN12- 0,003-0,006 mg

Folic acid /Vit. Bc- 0.2-0.4 mg

Calcium Pantothenate /Vit. IN3- 5,0-10,0 mg

Niacinamide /Vit. PP - 15,0-25,0 mg

Biotin /Vit. N - 0,03-0,3 mg

Phytonadione /Vit. K1- 0,025-1.5 mg

Potassium iodide - 0.15-0.2 mg

Fumarate iron - 10,0-15,0 mg

The copper oxide is 1.5-3.0 mg

Zinc oxide - 12,0-15,0 mg

Manganese sulfate - 2,0-5,0 mg

Chloride chromium 0.05 to 0.2 mg

The sodium molybdate is 0.025-0.2 mg

Sodium selenate is 0.025-0.07 mg

The Nickel sulfate is from 0.005 to 10.0 mg

Hilak-Forte - 1-9 ml

Bificol - 10-25 doses

Pectin - 7-30 g

Distilled water Up to 1 liter

Food dyes and flavorings to taste

Preparation of a mixture.

In measuring the dishes put salt linkage consisting of sodium phosphate, sodium chloride, potassium chloride, sodium acetate and citric acid, which is dissolved with distilled water in the amount of 2/3 of the proper. Then add salt, magnesium and calcium. After stirring and dissolving salts microelectronics (solution should be clear and without sediment) into the container, add the remaining ingredients and add water until the calculated volume of the mixture. Minerals and vitamins are added in the form of officinal preparations, such as "Centrum" LEDERLE LABORATORIES DIVISION American Cyanamid Compani.

To prepare the mixture in the amount of more than 1 liter produce a corresponding recalculation of the amount of salts microelectronics, leaving the rest of the ingredients in the specified amounts.

The proposed mixture is used as follows:

I. Option (Gastric lavage).

The patient on an empty stomach give to drink the proposed mix of 200-400 ml every 5-10 minutes. As the filling of the intestine develops diarrhea. E. main one procedure an average of 3-6 liters. Patients in severe condition or with disorders of consciousness mixture is injected into the cavity of the digestive tract through a tube.

II. Option. (As food additive) Patient on an empty stomach daily fractional 0.2 to 1.0 liter of the mixture.

Physiological values of the osmolarity of human blood range from 280 to 310 mlOsm/L. Osmolarity lavagnoli solution mainly ensured by the presence of macroelectronics. Offer enteral mixture has an osmolarity of from 235 to 310 mlOsm/L. the Minimum and maximum values of the osmolarity of the mixture are provided, respectively, the minimum and maximum salt content presented in the recipe. When using Hypo osmotic swelling solution (less than 235 mlOsm/L) may develop such complications CL as hyperhydration of the body by increasing the resorption of water from the intestines. In cases of exceeding the osmolarity of the solution values of the osmolarity of the blood flow of water will be directed from the blood into the cavity of the intestine, leading to dehydration. These complications are dangerous to life and health of the patient. Therefore, for individuals who do not have disorders of water metabolism, prepare a mixture with a minimum salt content in the sample. For patients who are prone to fluid retention in the body (pastaboy water through the intestinal wall into the CL process (or parity counter-flows) pre-determine the amount of blood osmolarity individual patient and using the corresponding calculations adjust the value of the osmolarity of the mixture to the value of the osmolarity of blood.

The presence Lavagna solution substances, adequate composition of chyme healthy person, prevents loss of internal environment of the body in the CL, and if the existing metabolic disorders allows you to skorrelirovat water and electrolyte composition of blood [7, 6, 9] . It is obvious that the same is true in regard to the mass transfer of trace elements and vitamins.

P. Bergner (1998), referring to data of different authors, indicates that the diet of modern inhabitants developed continental countries chronically short of minerals, trace elements, vitamins and some other nutrients and associates with this common at the present time "Western diseases - cardiovascular, cancer, autoimmune, and skin ulcer. In this sense, the use of the proposed mixture in the form of CL or food supplements not only protects the body from undue losses of these substances, but also contributes to the elimination of their initial deficit and, therefore, may be a method of prevention and treatment of these diseases.

The human intestinal microflora (biocenosis) consists of the following groups: main, associated and residual. In the main group, for example the residual - Staphylococcus, Proteus, yeast and fungi [16] .

The normal microflora is of great importance for the organism: suppressing pathogenic germs, protects it from diseases, participating in the process of digestion, delivers vital substances, etc. the Importance of microbiocenosis confirmed with no future experimental animals with "sterilized" by the intestine [16] .

Under the dysbacteriosis mean increase (excessive colonization of the digestive tract) or decrease the total number of microorganisms, as well as violation of proportions between groups, the emergence of pathogenic flora.

Dysbiosis is a complication of various diseases and conditions (the latter include such as errors in diet, erratic meals, unbalanced, refined food, sedentary way of life, course of treatment with antibiotics, hormones, stress, harmful production factors). He may not have expressed clinical manifestations or Vice versa take place rapidly in the form of bloating, pain, rumbling, diarrhea, constipation. Common form may be accompanied by bacteremia, generalization of infection, sepsis, septicopyemia [5, 17, 16] .

Arose the TB vitamins C, IN6IN12, With all the ensuing consequences, etc.

The known method of application of bacterial preparations (eubiotics) in the form of tablets, capsules, suspensions for the treatment of intestinal dysbiosis (along with treatment of the underlying disease) is a long process (1-2 months). During this period you can join intercurrent diseases by reducing immunity. In addition, this method is not always effective. This is because the restoration of normal intestinal flora is impeded by many factors: deficiency (honours) of microorganisms in health care preparation and antibacterial properties of gastric juice and bile, the state of the propulsive function of the intestine, the intestinal epithelium, the pH of the enteric environment and enzymatic activity of the intestinal juice, the presence of acidophilic barrier in the terminal ileum, the antagonism from the predominant group of bacteria. For normal development of the main bacteria groups needed dietary fibre [5, 17, 16] .

The advantages of using the proposed mix for the prevention and treatment of dysbacteriosis.

Using the CL manages a "one-off" conditions of distribution and habitat of the normal microflora. This is achieved by washing the cavity of the intestine with high speed transit lavagnoli solution (3-6 litres for 3 hours), align the pH of the enteric environment. Under this condition, the proposed mixture containing pectin, eubiotics and drug-based products of the normal metabolism of micro-organisms in the intestine (hilak-Forte), allows you to skorrelirovat microbiocenosis due to selective suppression of conditionally pathogenic and pathogenic bacteria and create the optimal environment for the development of normal microflora of the intestine [16] .

Through the restoration of the intestinal normal digestion, synthesis and metabolism of vitamins and other vital for a host of substances, stimulates the regeneration of epithelial cells of the intestinal wall, which improves the barrier function of the intestine, normal water and electrolyte balance in the lumen of the intestine, improving the immune and hormonal status of the organism [16, 18] .

Staining of the proposed mix and give it a taste, for example, tomatoes through a food additive improves its organoleptic characteristics and allows us to expand the scope.

The proposed solution is stegnuti goal: the prevention and elimination disorders of the metabolism of trace elements and vitamins in the body, the dysbacteriosis of the intestine in the earliest periods of treatment of patients, which is useful.

The literature taken into consideration.

1. Glozman O. S. , Kasatkina, A. P. Modern methods of active therapy of acute toxicosis. - M , Medgiz. 1959. 276 C.

2. Mashkovsky M. D. Medicines. In two parts. H II-12 ed. , Rev. and extra - M. : Medicine, 1993. S. 134.

3. Kostenko N. Century Intestinal lavage as a method of preparation of the colon for examination and operations. - Abstract. Diss. K. M. N. , M. , 1998. - 20 S.

4. Delmotte J. S. et aL, Ann. Gastroenterol. Hepatol. , 1988, 24, n 4 211 to 216.

5. Pinegin B. C. , Maltsev Century. N. Korshunov Century M a Dysbacteriosis // M , Medicine, 1984. - 135 C.

6. "Reservation Of Book N. M. the Composition and preparation of media for intracolonic injection with peritonitis. Methodical recommendations. M. , 1986. - 19 S.

7. Galperin Y. M., Popova T. S. In the book. : Path correction of metabolic disorders in emergency and planned surgery. - M. , 1976.

8. Karasev N. A. Prevention and treatment of functional intestinal obstruction in surgical patients. Abstract. Diss. K. M. H. M. , 1985.

9. Matkevich Century A. Intestinal lavage in acute oral poisoning. - Abstract. Diss. K. M. N. , M. , 1988.

Agency, 1997 - 480 S. /B-ka practitioner. The most important questions of internal medicine/.

11. The Bergner P. the Healing power of minerals, special nutrients and trace elements /Lane. from English. U. Sapzinos. - M. : crown PRESS, 1998. -288 C.

12. Enterosorption// Ed. by N. A. Belyakov - L. , 1991. - A 336 S.

13. Shlygin, K. Involvement of the gastrointestinal tract in General metabolism/ Physiology of digestion. - L. , 1974.

14. Nozdruhina L. R. Biological role of trace elements in the body of animals and humans. - M.: Nauka, 1977. - 184 S.

15. Morozov, I. A. , Lysikov Y. A. , Petran B. C. , Khvylya S. I. Absorption and secretion in the small intestine: submicroscopic aspects of // the Academy of medical Sciences of the USSR. - M. : Medicine, 1988. - 224 S.

16. Parfenov A. I. , The Researcher Y. K. , S. Safronova, A. , Fedorova N. , Dysbiosis // Moscow medical journal 1, 1998. C. 12-18.

17. Krasnoholovets Century. N. Dysbacteriosis of the intestine. // 2nd ed. , Rev. and extra-M. : Medicine, 1989. - 208 S.

18. Kostyuchenko A. L. , Costin D. E. , Corigin A. A. Enteral nutrition. -M. , 1996.

Enteral formula for intestinal lavage, correction of metabolic disorders of the body, prevention and treatment of intestinal dysbiosis, containing sodium fosfornogo the acid, distilled water, characterized in that it further contains vitamins a, E, D, C, B1IN2IN3IN6B12Bc, K1, N, PP, compounds of trace elements: potassium iodide, fumarate, iron, copper oxide, zinc oxide, manganese sulfate, chromium chloride, sodium molybdate, sodium selenate, sulfate Nickel, douglaston tin, metasilicate sodium, metaand sodium, medicinal substances on the basis of the waste products of normal intestinal microflora, eubiotics and pectins in the amount of one daily dose, remineralise flavorings and food colorings in the following ratio of components in a mixture of 1 liter:

Sodium phosphate disubstituted N2On - 5,6-7,39 g

Sodium chloride - 3,43-4.52

Potassium chloride - 1,54-2,03 g

Sodium acetate 3H2On - 0,68-0,91 g

Citric acid anhydrous - 0.5-1.5 g

Magnesium sulfate - a 1.25-1.64 g

Calcium chloride - 1,5-1.98 g

Acetate retinol/Vit. A - 1.5-2.0 mg

Acetate alphatocopherol/Vit. E - 12,0-15,0 mg

Ergocalciferol/Vit. Dr. of 0.0125, 0.025 mg

Ascorbic acid/Vit. With - 60,0-100.0 mg

Thiamine Mononitrate/Vit. B1a 1.5-2.6 mg

Riboflavin/Vit. IN2to 0.8-1.7 mg

Pyridoxine hydrochloride/Vit. IN63- 5,0-10,0 mg

Niacinamide/Vit. PP - 15,0-25,0 mg

Biotin/Vit. N - 0,03-0,3 mg

Phytonadione/Vit. K1- 0,025-1.5 mg

Potassium iodide - 0.15-0.2 mg

Fumarate iron - 10,0-15,0 mg

The copper oxide is 1.5-3.0 mg

Zinc oxide - 12,0-15,0 mg

Manganese sulfate - 2,0-5,0 mg

Chloride chromium 0.05 to 0.2 mg

The sodium molybdate is 0.025-0.2 mg

Sodium selenate is 0.025-0.07 mg

The Nickel sulfate is from 0.005 to 10.0 mg

Douglaston tin - 0.01 to 1.7 mg

Metasilicate sodium/Silicon - 0.01 to 50.0 mg

Metewand sodium/vanadium - 0,01-0,1 mg

Medicinal substances on the basis of the waste products of normal intestinal microflora (hilak-Forte) - 1 daily dose (1-9 ml)

Eubiotics (for example, biotical) - 1 daily dose (10-25 doses)

Pectins - 1 daily dose (7-30 d)

Distilled water Up to 1 liter

Food dyes and flavorings to taste

 

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