[New results in the diagnosis and therapy of functional disorders of the large intestine].

Abstract

The most important pathophysiological mechanism of functional disorders of colon is motility disturbance. The best term for these disturbances is considered to be "colon dyskinesia". Dyskinesia can be classified as primary and secondary, and as hyperand hypokinetic. The following clinical forms are distinguished: with constipation, painless diarrhea, isolated pain syndrome, colica mucosa. Inflammatory diseases of colon are accompanied by chemical changes in feaces: the increase of enterokinase and alkalien phosphatase activity (enzymorrhea), the increase of feacal excretion of protein (proteinorrhea). Both enzymorrhea and proteinorrhea are absent in colon dyskinesia. The investigation of enzymes and protein in faeces can be of great help in differential diagnostics of functional and inflammatory colon diseases. In treating colon dyskinesia psychopharmacological, cholinolytical, spasmolytical and antidiarrrheal preparations are used, as well as some drugs with purgative effect. Clinical and instrumental methods make it possible to determine which type of the motility disturbances predominates. The latter is important for differential prescription of drugs correcting colon motility in colon dyskinesia. Colon motility in man ist actively affected by adrenergic drugs: it is inhibited by adrenomimetics and stimulated by adrenolytics which justifies their prescription in colon dyskinesia. Diazepam and phenobarbital inhibit colon motility. Diphenoxylate and metoclopramide have a normalizing effect.