Home Hygiene How many bacteria live in the intestines? Bacterial intestinal infections (bacterial gastroenteritis), symptoms, treatment, causes, signs

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How many bacteria live in the intestines? Bacterial intestinal infections (bacterial gastroenteritis), symptoms, treatment, causes, signs

Dysbacteriosis is a condition caused by a violation of the intestinal microflora associated with a change in the species composition of bacteria. The number of beneficial bifidobacteria and lactobacilli is reduced, and the number of pathogenic (disease-causing) microorganisms increases. Intestinal dysbiosis is not an independent disease. Often it turns out to be a consequence of other ailments (sometimes quite formidable). According to statistics, it occurs in 90% of adults.

Learn more about what kind of disease this is - intestinal dysbiosis - what the first signs and symptoms are, as well as how to properly treat it in adults and children with diet and medications.

What is dysbiosis?

Gut dysbiosis (also dysbiosis) - This is a state of microbial imbalance on or within the body. With dysbacteriosis, the ratio of beneficial and opportunistic microorganisms is disturbed, for example, in the intestines or in the reproductive organs.

The adult intestine normally contains about 2-3 kg of various microorganisms(about 500 species). 60% of all microorganisms are settled in the gastrointestinal tract.

Microorganisms help digest food, synthesize vitamins, remove toxins and carcinogens, and break down all unnecessary elements. The main representatives of the intestinal flora are aerobic lactobacilli and anaerobic bifidobacteria.

In the human body, three types of bacteria take part in the digestion of food:

beneficial (bifidobacteria, lactobacilli). They maintain the ratio of other bacteria in the stomach, prevent the development of allergic diseases, weakened immunity and many other negative effects on the human body. They also control the number of harmful bacteria;
neutral. They live in a certain place. They do not bring any particular benefit or harm;
harmful (candida fungus, staphylococcus, streptococcus). Provoke various diseases and disruptions in the gastrointestinal tract.

Causes

The number of each type of bacteria that live in the intestines is governed by laws natural selection: those that have multiplied greatly do not find food for themselves, and the excess ones die, or other bacteria create unbearable living conditions for them. But there are situations in which the normal balance changes.

The reasons for the suppression of normal intestinal flora during dysbacteriosis may be the following factors:

Sometimes almost completely healthy people can suffer from dysbiosis. In this case, the reason should be sought in the characteristics of the profession, or in seasonal changes in nutrition.

Kinds

Depending on the cause of intestinal dysbiosis syndrome in modern medicine is divided into several types.

Dysbacteriosis that occurs in healthy people:
Professional (violations occur due to harmful professional activities)
Age-related (flora is disrupted due to aging of the body)
Nutritional (associated with poor nutrition)
Seasonal (flora changes depending on the time of year, mainly in cold weather).

By severity:

light;
medium-heavy;
heavy.

With the flow:

acute (up to 30 days);
prolonged (up to 4 months): with clinical manifestations (continuous or recurrent) and without clinical manifestations;
chronic (more than 4 months): with clinical manifestations (continuous or recurrent) and without clinical manifestations.

Dysbacteriosis of the small intestine

Dysbacteriosis of the small intestine begins to manifest itself when it is over-contaminated. In this case, the microbial composition changes, which provokes disruption of the normal functioning of the gastrointestinal tract. The pain is localized in the navel area.

Dysbacteriosis of the large intestine

Colon dysbiosis is an extremely common pathology that disrupts the microflora simultaneously in the stomach, duodenum, and intestines. The disease can be long-lasting, take a more severe form and disrupt a person’s normal lifestyle.

Symptoms of intestinal dysbiosis

The clinical picture of the development and course of dysbiosis depends on both the stage and the microbiological variant of the disorder.

Characteristic signs of dysbiosis in adults:

Stool disorders. Stool disorders due to dysbacteriosis are one of the most common and characteristic symptoms. Most often it manifests itself in the form loose stool(diarrhea). With age-related (in older people) dysbiosis, constipation most often develops, which is caused by a decrease in intestinal motility (due to a lack of normal flora).
With pronounced processes of decay and fermentation, which are observed in only 25% of patients, the composition, shape and color of feces are disrupted. It becomes foamy, liquid, acquires a light color and a sour odor. You may experience a burning sensation in the anus.
change in the smell of feces (it becomes sharply putrid or sour);
increased gas formation (gases can be smelly or odorless, sonorous or not);
bloating of varying intensity (it is more pronounced in the evenings, and may worsen after certain foods);
Dyspeptic disorders: nausea, vomiting, belching, loss of appetite, are the result of impaired digestion;
The intestines do not empty completely.
Rotten taste, belching.

Symptoms that appear during dysbacteriosis may not be observed in everyone, this is individual characteristics. About half of those suffering from this disorder experience nothing other than loose stools or constipation.

With dysbacteriosis, digestion suffers the most. Since food in the intestines is first broken down by bacteria, and only then absorbed into the blood. Without the help of microorganisms, the body cannot absorb many nutrients. Therefore, nausea, vomiting, and loose stools appear.

Stages of dysbiosis in adults

There are the following stages of the disease:

Stage 1	The first degree of intestinal dysbiosis is characterized by a decrease in the protective endogenous flora by no more than two orders of magnitude. Bifidoflora and lactoflora are not disturbed, Clinical signs there are no diseases. This degree is characteristic of the latent phase of the disease.
2	In this case, the decrease in beneficial microorganisms - lacto- and bifidobacteria - becomes critical. Along with this, the development of pathogenic microflora is growing extremely rapidly. At this stage, the first signs of dysbiosis appear, which indicate a disruption in the functioning of the intestine.
3	The inflammatory process begins to damage the intestinal walls, which aggravates chronic indigestion. This stage of the disease requires serious treatment not only with a proper diet, but also with medications.
4	develops when there is no treatment for dysbiosis or it is not intensive enough. At this stage, harmful microorganisms practically crowd out beneficial ones, which leads to the development of diseases such as vitamin deficiency, depression, intestinal diseases, which are dangerous not only to the health, but also to the life of the patient.

With intestinal dysbiosis, other symptoms and manifestations are possible, but they will most likely relate to complications of the disease or to an exacerbation accompanying pathologies. These symptoms are not directly related to a violation of the intestinal microflora. For example, signs of hypovitaminosis and vitamin deficiency are possible. The lack of vitamin is due to the fact that it is not absorbed normally in the intestines.

Diagnostics

With intestinal dysbiosis, symptoms such as enterocolitis, inflammation of the colon, small intestine. The doctor’s task is to make a correct diagnosis, excluding the above pathologies of the digestive organs.

It is difficult to diagnose dysbiosis without tests. The symptoms of the disease are very similar to the symptoms of other diseases. To make a diagnosis, the doctor needs to have diagnostic results. After collecting the patient’s complaints and palpation, the specialist prescribes 2-3 necessary procedures.

Put accurate diagnosis will help:

Stool analysis. The most specific technique laboratory diagnostics intestinal dysbiosis - analysis and bacterial culture of stool.
Clinical blood test - shows the presence of inflammation and possible bleeding in the intestines. With severe dysbacteriosis, a decrease in the level of hemoglobin in the blood is noted.
Colonoscopy. Allows you to assess the condition of a section of intestine up to one meter long.
Ultrasound examination of the abdominal cavity. It can be used to detect concomitant pathologies.
Fibroesophagogastroduodenoscopy. It consists of examining the mucous membrane of the stomach, esophagus and duodenum, which is carried out using an endoscope.
X-ray of the intestines. To discover pathological changes, a contrast agent is used during the procedure.

Treatment of dysbiosis in adults

At mild degree imbalance in the intestinal microflora, it may be enough to eliminate these causes through a balanced diet, taking prebiotics or probiotics. At severe violation Dietary nutrition is also indicated simultaneously with complex antimicrobial therapy.

How to treat intestinal dysbiosis? Treatment activities consist of:

elimination of excessive bacterial contamination of the small intestine;
restoration of normal microbial flora of the colon;
improvement of intestinal digestion and absorption;
restoration of impaired intestinal motility;
stimulating the body's reactivity.

Medications

To treat dysbiosis, drugs are used that help restore normal intestinal flora. Typically, a product from one of the following groups is selected:

Antibacterial drugs are necessary primarily to suppress the excessive growth of microbial flora in the small intestine. The most widely used antibiotics are from the group of tetracyclines, penicillins, cephalosporins, quinolones (tarivid, nitroxoline) and metronidazole.
Bacteriophages (intestibacteriophage, staphylococcal bacteriophage, pyobacteriophage, coliproteus bacteriophage, etc.);
Antibiotics (fluoroquinolones, cephalosporins, penicillins, macrolides, aminoglycosides, etc.);
Probiotics for dysbacteriosis (sporobacterin, enterol, cereobiogen, bactisubtil, etc.).
Antifungal agents. Prescribed when an increased amount of yeast is detected in the intestinal contents.
Enzymes are prescribed in case of severe digestive disorders. Mezim tablets, 1 tablet 3 times a day, before meals. In order to improve the absorption function, Essentiale, Legalon or Karsil are prescribed, since they stabilize the membranes of the intestinal epithelium. Propulsive bowel function is improved by imodium (loperamide) and trimebutine (debridate).
Sorbents are prescribed for severe signs of intoxication. Activated carbon is prescribed 5-7 tablets at a time, for 5 days.

Assign medications against dysbacteriosis, determine their dosage and duration of use only a doctor can. Self-medication risks complications.

At long-term treatment antibiotics, be sure to include in therapy a special diet containing foods rich in beneficial bacteria, antifungal and immunostimulating, as well as antihistamine therapy.

Treatment of intestinal dysbiosis is prescribed comprehensively depending on the degree of the disease. Since the disease develops under the influence of many factors, it is important to eliminate the cause of its development, otherwise taking probiotics will not have a positive effect. Elimination of foci of infection and chronic diseases is the main task in treatment.

Diet and proper nutrition

There is no special diet for each person, you just need to follow some rules, avoid unwashed fruits, low-quality foods and eat food every three hours in small portions. It is important to eat hot liquid food every day: soup, broth.

Basic principles of proper nutrition for dysbiosis:

eating regularly at the same time;
eating warm food (within 25-40 degrees) and avoiding too cold or hot food;
avoiding aggressive and spicy foods;
chewing food thoroughly;
eating food frequently (every two and a half hours) and in small portions;
drink plenty of fluids, but not during meals (so as not to interfere with the digestion of food).

When following a diet, you are allowed to eat the following foods:

white or Rye bread– not fresh, but yesterday’s;
crackers;
soups in low-fat broths with pureed cereals and vegetables;
boiled, steamed or stewed meat dishes;
lean meats;
lean fish, boiled, steamed, stewed or fried without breading;
vegetables (excluding cabbage, legumes and mushrooms) boiled, baked or steamed;
fruits and berries in jelly, compote, puree or mousse;
baked or raw grated apples;
low-fat dairy products;
butter in small quantities;
sauces without spices;
all drinks except alcoholic, carbonated, kvass and fruit drinks.

Along with the diet, patients may be prescribed probiotics and prebiotics. These drugs improve intestinal function and restore healthy flora.

Folk remedies

Traditional medicine, if proven remedies are used correctly, can improve the condition and alleviate the symptoms of the disease. But it can only be used as a supplement to the main treatment prescribed by a doctor.

As traditional treatment allowed:

plants that give an antiseptic effect: pomegranate and rosehip juice diluted with water, strawberries, raspberries;
mint extract, chamomile tea, and St. John's wort infusions provide an analgesic effect;
have an astringent effect, anti-inflammatory blueberries, bird cherry, beets.

Traditional methods include the use of the following means:

Oak bark . A decoction of oak bark has an astringent effect and helps with diarrhea, which often accompanies dysbacteriosis. A tablespoon of raw material, poured with 250 ml of boiling water, is simmered over low heat for a quarter of an hour. The liquid is cooled, filtered and taken half a glass up to 3 times a day.
Garlic . It contains antibacterial compounds that destroy pathogenic microflora and preventing the development of putrefactive processes. To prepare the medicine, you need to crush a clove of garlic in a mortar and pour a glass of low-fat kefir over it. Drink 2 glasses of the resulting drink every day.
A healthy and tasty cure for dysbiosis is a mixture of sunflower seeds, pumpkin seeds and walnut kernels. Well-dried ingredients must be ground in a coffee grinder and taken 2 tablespoons of the resulting powder daily, washed down with warm water.
Serum. Sold in stores or left over after making homemade cottage cheese. The heated whey is drunk in the morning on an empty stomach for a month, 1 glass.
If digesting food is accompanied by bloating. Pour 4 tablespoons of dill seeds into a glass hot water, leave for 2 hours, then strain and drink every 2 hours throughout the day.
Based on propolis honey: A teaspoon of this honey should be diluted in a glass of warm water or rosehip decoction and taken 2 times a day after meals for 1.5 months.
The most simple options herbal decoction – this is eucalyptus and mint. To prepare the first 3 tbsp. dry eucalyptus is poured with 500 ml of boiling water. For the second recipe, use 2 times less boiling water – 250 ml. Eucalyptus decoction is drunk a quarter of a glass 3 times a day, and mint decoction is drunk of 3 quarters of a glass 4 times a day. The course of treatment lasts 14 days.

Treatment exclusively with herbs is possible only in cases of mild dysbacteriosis. In other cases traditional methods- only an addition to the main treatment prescribed by a specialist.

Prevention

Preventive measures include following recommendations for proper nutrition, maintaining hygiene and carrying out sanitary and hygienic processing of products.

Basic preventive measures for adults are as follows:

healthy eating;
taking antibiotics only as prescribed by a doctor;
timely treatment of diseases digestive system.

To get rid of dysbiosis and prevent further relapses, it is most effective to use A complex approach. At the first symptoms, be sure to seek help from a gastroenterologist. Be healthy and always watch your lifestyle!

Thousands of species of microorganisms live in the human intestine. The bacteria in the intestines determine what kind of person a person will be: thin, plump, cheerful, depressed, sick, or resistant to disease.

In the intestine, microorganisms attach to the crypts (villi) and produce a mucous biofilm. Biofilm is of great importance for maintaining the bacterial population and is their protection from external influences. Inside the mucous intercellular matrix, microorganisms exchange amino acids, multiply, and foreign organisms that enter are destroyed, displaced, or adaptation occurs and new bacteria take part in vital activity.

Important functions performed by bacteria in the human intestine:

epithelial protection;
breaking down and digesting food;
synthesis of vitamins and amino acids, participation in metabolism;
formation of an immune response;
protection against pathogenic microorganisms entering the intestines.

Changes in the quantitative and qualitative composition of symbiont bacteria lead to a qualitative change in the state of the human body. I.I. was also involved in the study of intestinal microorganisms, their significance and influence. Mechnikov. Annually scientific journals publish research on the function and importance of bacteria in the gut.

Microbiota (microflora) is a community of symbiont bacteria inhabiting the human body. In the intestines of a healthy person, up to 500 types of microorganisms with a total mass of up to 3 kg are found. The majority of bacteria live in the large intestine, with a small amount found in the small intestine and appendix.

Small intestine

In the small intestine, parietal intestinal digestion due to the enzymes of intestinal juice, which is produced by the mucous membrane. This is where nutrients are absorbed into the blood and lymph.

In the upper parts of the small intestine, the microflora is not rich in bacteria. The lower part of the small intestine (ileum) is populated by yeast-like fungi, bacteroides, bifidobacteria, and E. coli, which performs important functions:

Protects the body from “foreign” bacteria. Microbes enter the intestines from the stomach along with food. E.coli attacks intruders, preventing them from colonizing and spreading in the small intestine.
Collects oxygen that enters the intestines from the stomach. For E. coli, oxygen is necessary, but for anaerobic bifidobacteria it is detrimental.

E.coli is present in the intestines of a healthy person in small quantities and does not cause any harm. Absorbing oxygen that is harmful to anaerobes and displacing foreign microorganisms, this bacterium is of great importance in the digestion process.

Colon

The final processing of food occurs in the large intestine. Nutrients and water are released from food and distributed throughout the body using lymphatic and blood vessels.

Yeast-like fungi, cocci, E. coli, archaebacteria, bifidobacteria, lactobacilli are inhabitants of the large intestine that participate in the digestion process.

Bacteria, processing plant carbohydrates, release low molecular weight hydrogen, which is dangerous for them. The vital activity of anaerobic bacteria and their number depend on the most ancient microorganisms - archaebacteria. Archaebacteria absorb hydrogen and carbon dioxide and remove ammonia from the body.

Symbiotic bacteria are of great importance in protecting against viruses and infections. When viruses appear, these cells send signals to the immune system. Antibodies are created that suppress foreign microorganisms.

The role of E. coli

For the digestion process and the formation of immunity, Escherichia coli (Escherichia) plays an important role. Escherichia is an opportunistic bacterium that spreads toxins when it enters the body. And in the colon, Escherichia has become an indispensable participant in the symbiosis and is beneficial (if present in normal quantities).

Functions of E. coli:

E.coli is considered the main competitor to pathogenic microbes that enter the intestines. When “strangers” enter, it displaces them;
Escherichia “trains” the body’s immune system, since it itself is opportunistic;
participates in the processes of metabolism of cholesterol, bilirubin, a number of fatty acids, iron, calcium;
participates in the digestion of proteins and carbohydrates;
collects oxygen, which is harmful to anaerobic flora;
breaks down lactose.

An increase or decrease in the number of E. coli is considered a disorder and is called dysbiosis.

There are more than 100 strains of this microbe, including pathogenic ones that can cause disease. A small concentration of pathogenic Escherichia is suppressed by the immune system, so a person for a long time may be a carrier of one of the following types:

Enterotoxigenic E.coli is the cause of cholera-like diseases. Symptoms: diarrhea, nausea, vomiting. Infection occurs through water and food. Distributed in Asian countries.
Enteroinvasive Escherichia, which provokes a disease similar to dysentery. Occurs in children under 3 years of age. Symptoms: nausea, vomiting, high fever.
Enteropathogenic bacilli are the cause of infections similar to salmonellosis (common in the USA). Transmitted through household contact and food.
Verotoxic (enterohemorrhagic) Escherichia, which causes hemorrhagic colitis. Symptoms: high fever, nausea, vomiting, bloody stool.

Treatment of infectious diseases is carried out in inpatient conditions. Self-medication is unacceptable, since some pathogenic strains are resistant to drugs, self-administration antibacterial agents may lead to complications.

In order to prevent infection, it is necessary to observe the rules of personal hygiene, and also not to drink raw water and dairy products. Fruits and vegetables must be thoroughly washed under running water and doused with boiling water.

In the process of evolution, relationships have formed between bacteria; none of the species acts in the interests of only its population. Within the community, microbes exchange amino acids, and mutations occur, which are necessary for survival in unfavorable conditions.

Appendix

For a long time, the appendix (an extension of the cecum) was considered a vestige and was removed at every opportunity. Today they are increasingly talking about its effect on the intestinal microflora. A large number of lymph nodes led scientists to think about the importance of this organ for the process of formation of the immune system:

It is in the appendix that bifidoactive carbohydrates are deposited, on which colonies of microorganisms then develop. When the number of bifidobacteria in the appendix increases, they spread throughout the large and small intestines. Thus, it plays the role of a “depot”, growing new colonies of beneficial bacteria.
The appendix grows E. coli.
Hormones are produced here, immune cells(the mechanism is still poorly understood).

The human immune system is located in the intestines. The body's resistance to diseases depends on the state of the microflora, the presence and activity of bacteria. Fatigue, irritability, frequent colds– symptoms of changes occurring in the microflora.

Dysbacteriosis

Dysbacteriosis is a condition in which there is a violation of the ratio of the number of microflora representatives in the intestine. An unpleasant consequence Dysbacteriosis becomes vitamin deficiency, decreased immunity.

Symptoms of dysbiosis:

bloating, “rumbling”;
nausea;
stool disorder;
abdominal pain.

Dysbiosis is a symptom of changes in the microbiota. Diets, infectious diseases, treatment with antibacterial drugs, stress lead to changes in the body.

Treatment of dysbiosis causes the greatest controversy among doctors. On the one hand, unpleasant symptoms disturb a person, on the other hand, the intestinal microflora is constantly changing, depending on food and habits. The need to take prebiotics and probiotics to normalize the flora is exaggerated: microorganisms in the intestine die due to a lack of nutritional medium, taking antibiotics and colonize the intestines when favorable conditions are created within 2-3 weeks.

The human intestine is home to microorganisms that make up a total mass of up to two kilograms. They form the local flora. The ratio is strictly maintained on the principle of expediency.

Bacterial contents are heterogeneous in function and significance for the host organism: some bacteria in all conditions provide support through the proper functioning of the intestines, and therefore are called beneficial. Others are only waiting for the slightest disruption in control and weakening of the body in order to turn into a source of infection. They are called opportunistic.

The introduction of foreign bacteria into the intestines that can cause disease is accompanied by a violation of the optimal balance, even if the person is not sick, but is a carrier of the infection.

Treatment of the disease with medications, especially antibacterial ones, has a detrimental effect not only on the causative agents of the disease, but also on beneficial bacteria. The problem arises of how to eliminate the consequences of therapy. Therefore, scientists created large group new drugs that supply live bacteria to the intestines.

What bacteria form the intestinal flora?

About five thousand species of microorganisms live in the human digestive tract. They perform the following functions:

They help with their enzymes to break down substances found in foods until they are properly digested and absorbed through the intestinal wall into the bloodstream;
destroy unnecessary residues of food digestion, toxins, toxic substances, gases in order to prevent rotting processes;
produce special enzymes for the body, biologically active substances(biotin), vitamin K and folic acid, which are necessary for life;
participate in the synthesis of immune components.

Studies have shown that some bacteria (bifidobacteria) protect the body from cancer.

Probiotics are gradually replacing pathogenic microbes, depriving them of nutrition and directing immune cells to them

The main beneficial microorganisms include: bifidobacteria (comprising 95% of the total flora), lactobacilli (almost 5% by weight), Escherichia. The following are considered opportunistic:

staphylococci and enterococci;
mushrooms of the genus Candida;
clostridia.

They become dangerous when a person’s immunity declines, changes acid-base balance in organism. Examples of harmful or pathogenic microorganisms are Shigella and Salmonella - the causative agents of typhoid fever and dysentery.

Beneficial live bacteria for the intestines are also called probiotics. So, they began to call specially created substitutes for normal intestinal flora. Another name is eubiotics.
Now they are effectively used to treat digestive pathologies and the consequences of the negative effects of drugs.

Types of probiotics

Preparations with live bacteria were gradually improved and updated in properties and composition. In pharmacology, they are usually divided into generations. The first generation includes drugs containing only one strain of microorganisms: Lactobacterin, Bifidumbacterin, Colibacterin.

The second generation is formed by antagonist drugs containing unusual flora that can resist pathogenic bacteria and support digestion: Bactistatin, Sporobacterin, Biosporin.

The third generation includes multicomponent drugs. They contain several strains of bacteria with bioadditives. The group includes: Linex, Atsilakt, Acipol, Bifiliz, Bifiform. The fourth generation consists only of preparations from bifidobacteria: Florin Forte, Bifidumbacterin Forte, Probifor.

Based on their bacterial composition, probiotics can be divided into those containing as the main component:

bifidobacteria - Bifidumbacterin (forte or powder), Bifiliz, Bifikol, Bifiform, Probifor, Biovestin, Lifepack Probiotics;
lactobacilli - Linex, Lactobacterin, Atsilakt, Acipol, Biobakton, Lebenin, Gastrofarm;
colibacteria - Colibacterin, Bioflor, Bifikol;
enterococci - Linex, Bifiform, dietary supplements of domestic production;
yeast-like fungi - Biosporin, Bactisporin, Enterol, Baktisubtil, Sporobacterin.

What should you consider when purchasing probiotics?

Under different names Pharmacological companies in Russia and abroad can produce identical analogue drugs. Imported ones are, of course, much more expensive. Studies have shown that people living in Russia are more adapted to local strains of bacteria.

It’s still better to buy your own drugs

Another negative is that, as it turned out, imported probiotics contain only a fifth of the declared volume of living microorganisms and do not settle in the intestines of patients for a long time. Before purchasing, consultation with a specialist is required. This is caused by serious complications from improper use of drugs. Patients registered:

exacerbation of cholelithiasis and urolithiasis;
obesity;
allergic reactions.

Live bacteria should not be confused with prebiotics. These are also medicines, but do not contain microorganisms. Prebiotics contain enzymes and vitamins to improve digestion and stimulate growth beneficial microflora. They are often prescribed for constipation in children and adults.

The group includes those known to practicing doctors: Lactulose, pantothenic acid, Hilak forte, Lysozyme, inulin preparations. Experts believe that it is necessary to combine prebiotics with probiotic preparations to achieve maximum results. For this purpose, combination drugs (synbiotics) have been created.

Characteristics of first generation probiotics

Preparations from the group of first-generation probiotics are prescribed to young children when first-degree dysbiosis is detected, as well as when prevention is necessary, if the patient is prescribed a course of antibiotics.

Primadophilus is an analogue of drugs with two types of lactobacilli, much more expensive than others, since it is produced in the USA

The pediatrician chooses Bifidumbacterin and Lactobacterin for infants (includes bifidobacteria and lactobacilli). They are diluted in warm boiled water and given 30 minutes before breastfeeding. For older children and adults, medications in capsules and tablets are suitable.

Colibacterin - contains dried E. coli bacteria, used for prolonged colitis in adults. The more modern single drug Biobakton contains acidophilus bacillus and is indicated starting from the neonatal period.

Narine, Narine Forte, Narine in milk concentrate - contains the acidophilic form of lactobacilli. Comes from Armenia.

Purpose and description of second generation probiotics

Unlike the first group, second-generation probiotics do not contain beneficial living bacteria, but include other microorganisms that can suppress and destroy pathogenic microflora - yeast-like fungi and bacilli spores.

Mainly used for the treatment of children with mild form dysbacteriosis and intestinal infections. The duration of the course should be no more than seven days, then switch to live bacteria of the first group. Baktisubtil (French drug) and Flonivin BS contain bacillus spores with wide range antibacterial action.

Spores are not destroyed inside the stomach hydrochloric acid and enzymes, reach the small intestine intact

Bactisporin and Sporobacterin are made from Bacillus hay, maintained antagonistic properties to pathogenic pathogens, resistance to the action of the antibiotic Rifampicin.

Enterol contains yeast-like fungi (Saccharomycetes). Comes from France. Used in the treatment of diarrhea associated with antibiotics. Active against clostridia. Biosporin includes two types of saprophytic bacteria.

Features of third generation probiotics

Live bacteria or several strains of them collected in combination are more active. Used to treat acute intestinal disorders moderate severity.

Linex - contains bifidobacteria, lactobacilli and enterococci, produced in Slovakia in a special powder for children (Linex Baby), capsules, sachets. Bifiform is a Danish drug, several varieties are known (Baby drops, chewable tablets, complex). Bifiliz - contains bifidobacteria and lysozyme. Available in suspension (lyophilisate), rectal suppositories.

The drug contains bifidobacteria, enterococci, lactulose, vitamins B 1, B 6

How are fourth generation probiotics different?

When producing preparations with bifidobacteria of this group, the need to create additional protection for the digestive tract and relieve intoxication was taken into account. The products are called “sorbed” because the active bacteria are located on the activated carbon particles.

Indicated for respiratory infections, diseases of the stomach and intestines, dysbacteriosis. The most popular drugs in this group. Bifidumbacterin Forte - contains live bifidobacteria sorbed on activated carbon, available in capsules and powders.

Effectively protects and restores the intestinal flora after respiratory infections, acute gastroenterological pathology, dysbacteriosis. The drug is contraindicated in people with congenital deficiency of the lactase enzyme or rotavirus infection.

Probifor differs from Bifidumbacterin Forte in the number of bifidobacteria; it is 10 times higher than the previous drug. Therefore, the treatment is much more effective. Appointed to severe forms intestinal infections, diseases of the large intestine, dysbacteriosis.

It has been proven that the effectiveness in diseases caused by Shigella is equal to that of fluoroquinolone antibiotics. Can replace the combination of Enterol and Bifiliz. Florin Forte - includes lacto- and bifidobacterial composition, sorbed on coal. Available in capsule and powder form.

Use of synbiotics

Synbiotics are a completely new proposal in the treatment of intestinal flora disorders. They provide a double action: on the one hand, they necessarily contain a probiotic, on the other, they include a prebiotic, which creates favorable conditions for the growth of beneficial bacteria.

The fact is that the effect of probiotics does not last long. After the intestinal microflora is restored, they may die, which again causes the situation to worsen. Accompanying prebiotics feed beneficial bacteria, ensure active growth and protection.

Many synbiotics are classified as dietary supplements, not medicinal substances. Do right choice Only a specialist can. It is not recommended to make treatment decisions on your own. The drugs in this series include the following.

Lb17

Many authors refer to the most the best drugs to date. It combines the beneficial effects of 17 types of living bacteria with extracts of algae, mushrooms, vegetables, medicinal herbs, fruits, and grains (more than 70 components). Recommended for course use, you need to take from 6 to 10 capsules per day.

Production does not involve sublimation and drying, so the viability of all bacteria is preserved. The drug is obtained by natural fermentation for three years. Strains of bacteria work in different areas of the digestion. Suitable for lactose intolerant people, gluten and gelatin free. Supplied to the pharmacy chain from Canada.

Multidophilus plus

Includes three strains of lactobacilli, one - bifidobacteria, maltodextrin. Made in the USA. Available in capsules for adults. The Polish product Maxilak contains: oligofructose as a prebiotic, and live cultures of beneficial bacteria as a probiotic (three strains of bifidobacteria, five strains of lactobacilli, streptococcus). Indicated for diseases of the gastrointestinal tract, respiratory system, and impaired immunity.

Prescribed for children from three years of age and adults, 1 capsule in the evening with meals.

Which probiotics have target indications?

With an abundance of information about bacterial preparations with living microorganisms, some people rush to extremes: either they do not believe in the advisability of use, or, conversely, they spend money on products of little use. It is necessary to consult a specialist about the use of probiotics in a specific situation.

Children with diarrhea during breastfeeding (especially those born prematurely) are prescribed liquid probiotics. They also help with irregular bowel movements, constipation, and retarded physical development.

Children in such situations are shown:

Bifidumbacterin Forte;
Linux;
Acipol;
Lactobacterin;
Biphilis;
Probifor.

If a child’s diarrhea is associated with a previous respiratory disease, pneumonia, infectious mononucleosis, false croup, then these drugs are prescribed in a short course for 5 days. For viral hepatitis, treatment lasts from a week to a month. Allergic dermatitis treated in courses from 7 days (Probifor) to three weeks. A patient with diabetes mellitus It is recommended to take courses of probiotics different groups for 6 weeks.

Bifidumbacterin Forte and Bifiliz are most suitable for prophylactic use during the season of increased morbidity.

What is best to take for dysbiosis?

To be sure of a violation of the intestinal flora, it is necessary to take a stool test for dysbacteriosis. The doctor must determine which specific bacteria the body lacks and how severe the disorders are.

If a deficiency of lactobacilli is established, it is not necessary to use only drugs. containing them. Because it is bifidobacteria that determine the imbalance and form the rest of the microflora.

Monopreparations, which contain only the same type of bacteria, are recommended by a doctor only for mild disorders

In severe cases it is necessary combined agents third and fourth generations. Probifor is most indicated (infectious enterocolitis, colitis). For children, it is always necessary to select combinations of drugs with lacto- and bifidobacteria.

Products containing colibacteria are prescribed very carefully. When identifying ulcers in the intestines and stomach, acute gastroenteritis, probiotics with lactobacilli are more indicated.

Typically, the doctor determines the duration of treatment based on the generation of the probiotic:

I – a monthly course is required.
II – from 5 to 10 days.
III – IV - up to seven days.

If there is no effectiveness, the specialist changes the treatment regimen, adds antifungals and antiseptics. The use of probiotics is a modern approach to the treatment of many diseases. This is especially important for parents of young children to remember. It is necessary to distinguish drugs from biological additives to food. Existing dietary supplements with intestinal bacteria can only be used by a healthy person for the purpose of prevention.

Microflora is a complex of microorganisms living in the human intestine, which is their reservoir, in symbiosis with it.

These microorganisms help their host by providing energy by fermenting undigested carbohydrates followed by the breakdown of short-chain fatty acids into the more common ones: butyrate, metabolized in the epithelium of the colon; liver propionates; muscle tissue acetates.

Bacteria in the intestines digest unused energy substrates, stimulating cell growth and inhibiting the growth of harmful pathogens. The intestinal microflora suppresses the growth of such harmful microorganisms like Clostridium, excessive amounts of which cause colitis.

Intestinal microflora suppresses the proliferation of entire types of pathogenic microorganisms, which, as a rule, enter or are found in the intestines in small quantities.

Gut bacteria also play a huge role in the synthesis of vitamin K and vitamin B, in metabolism bile acids, xenobiotics and sterols.

What is normal intestinal flora?

The human intestines contain microbes that are vital to the human body. The approximate amount of normal intestinal flora is about 10 14 microbes, which corresponds to 2 kilograms and includes about 500 species of bacteria. Concentration of microbes in different departments intestines is not the same: in the duodenum and jejunum about 10 5 microorganisms in 1 ml of intestinal contents, in the ileum about 10 7 - 10 8, in the large intestine about 10 11 microorganisms in 1 g of feces.
Normally, the intestinal flora is represented by 2 groups of bacteria:

1st degree and most often 2nd degree intestinal dysbiosis does not manifest itself clinically.

Symptoms characteristic of 3rd And 4th degree of intestinal dysbiosis:

Abnormal stool:

Most often it manifests itself in the form of loose stools (diarrhea), which develops as a result of increased formation of bile acids and increased intestinal motility, inhibiting the absorption of water. Later, the stool becomes unpleasant, putrid odor, mixed with blood or mucus;
With age-related (in older people) dysbiosis, constipation most often develops, which is caused by a decrease in intestinal motility (due to a lack of normal flora).

Bloating, due to increased formation of gases in the large intestine. The accumulation of gases develops as a result of impaired absorption and excretion of gases by the altered intestinal wall. A swollen bowel may be accompanied by rumbling and cause discomfort in the abdominal cavity in the form of pain.
Cramping pain associated with an increase in pressure in the intestines; after the passage of gas or stool, it decreases. With dysbiosis of the small intestine, pain occurs around the navel; if the large intestine suffers, the pain is localized in the ileal region ( Bottom part abdomen on the right);
Dyspeptic disorders: nausea, vomiting, belching, loss of appetite are the result of impaired digestion;
Allergic reactions in the form of itchy skin and rashes, develop after consuming foods that usually do not cause allergies, are the result of insufficient antiallergic action, disturbed intestinal flora.
Symptoms of intoxication: May be slight increase temperatures up to 38 0 C, headaches, general fatigue, sleep disturbances, are the result of the accumulation of metabolic products (metabolism) in the body;
Symptoms characterizing vitamin deficiency: dry skin, seizures around the mouth, pale skin, stomatitis, changes in hair and nails and others.

Complications and consequences of intestinal dysbiosis

Chronic enterocolitis- This chronic inflammation small and large intestines, developing as a result long acting pathogenic intestinal flora.
Deficiency of vitamins and microelements in the body leads to the development of iron deficiency anemia, hypovitaminosis of B vitamins and others. This group of complications develops as a result of impaired digestion and absorption in the intestines.
Sepsis(blood infection) develops as a result of pathogenic flora from the intestines entering the patient’s blood. Most often, this complication develops when untimely application patient for medical help.
Peritonitis develops as a result of the aggressive action of pathogenic flora on the intestinal wall with the destruction of all its layers and the release of intestinal contents into the abdominal cavity.
Addition of other diseases as a result of decreased immunity.
Pancreatitis develop as a result of the spread of pathogenic intestinal flora through the digestive tract.
Reducing the patient's weight develops as a result of impaired digestion.

Diagnosis of intestinal dysbiosis

The diagnosis of intestinal dysbiosis is made based on the patient’s complaints, an objective examination and the results of microbiological examination of stool.

Using an objective examination, which includes palpation of the abdomen, pain is determined along the small and/or large intestine.
Microbiological examination of stool is carried out to confirm the diagnosis of intestinal dysbiosis.

Indications for microbiological examination of stool:

Intestinal disorders last a long time in cases where it is not possible to isolate a pathogenic microorganism;
Long recovery period after acute intestinal infections;
The presence of purulent-inflammatory foci that are not amenable to antibiotic therapy;
Impaired bowel function in persons undergoing radiotherapy or exposure to radiation;
Immunodeficiency conditions (AIDS, oncological diseases and others);
Lag infant in physical development and others.

Rules for collecting stool for microbiological research: before collecting stool, you must be on a special diet for 3 days, which excludes products that increase fermentation in the intestines (alcohol, lactic acid products), as well as any antibacterial drugs. The feces are collected in a special sterile container equipped with a lid with a screwed-in spoon. To correctly evaluate the results, it is recommended to conduct the study 2-3 times, with an interval of 1-2 days.

Degrees of intestinal dysbiosis

There are 4 degrees of intestinal dysbiosis:

1st degree: characterized by a quantitative change in ischerichia (intestinal bacteria that can cause a wide group of human diseases) in the intestine, bifidoflora and lactoflora are not changed, most often not clinically manifested;
2nd degree: quantitative and qualitative changes in ischerichia, i.e. a decrease in the amount of bifid flora and an increase in opportunistic bacteria (fungi and others), accompanied by local inflammation of intestinal areas;
3rd degree: change (decrease) in bifido and lactoflora and the development of opportunistic flora, accompanied by intestinal dysfunction;
4th degree: the absence of bifid flora, a sharp decrease in lacto flora and the growth of opportunistic flora can lead to destructive changes in the intestine, with the subsequent development of sepsis.

Treatment of intestinal dysbiosis

Drug treatment

Treatment of intestinal dysbacteriosis is carried out with the help of drugs that restore normal intestinal flora and correct other disorders in the body (with the help of enzymes, sorbents, vitamins). The dosage, duration of treatment and group of drugs are prescribed by the attending physician, depending on the degree of dysbacteriosis.

The dosages of drugs for adults are indicated below; for children, the dosage depends on the weight and age of the child.
Groups of drugs used for intestinal dysbiosis:

Prebiotics- have a bifidogenic property, i.e. contribute to the stimulation of both the growth and reproduction of microbes that are part of the normal intestinal flora. Representatives of this group include: Hilak-forte, Duphalac. Hilak-forte is prescribed 40-60 drops 3 times a day.
Probiotics (eubiotics)- these are drugs containing live microorganisms (i.e. bacteria of normal intestinal flora), they are used to treat dysbacteriosis 2-4 degrees.

1st generation drugs: Bifidumbacterin, Lifepack probiotics. They are liquid concentrates of lactobacilli and bifidobacteria and are not stored for long (about 3 months). This group of drugs is unstable under the influence of gastric juice or enzymes of the gastrointestinal tract, which leads to their rapid destruction and the intake of insufficient concentrations, the main disadvantage of 1st generation probiotics. Bifidumbacterin is prescribed orally, 5 doses of the drug 2-3 times a day, 20 minutes before meals;
2nd generation drugs: Bactisubtil, Flonivin, Enterol. They contain spores of bacteria of normal intestinal flora, which in the patient’s intestines secrete enzymes for the digestion of proteins, fats and carbohydrates, stimulate the growth of bacteria of normal intestinal flora, and also suppress the growth of putrefactive flora. Subtil is prescribed 1 capsule 3 times a day, 1 hour before meals;
3rd generation drugs: Bifikol, Linex. They consist of several types of bacteria from the normal intestinal flora, and therefore are highly effective compared to the previous 2 generations of probiotics. Linex is prescribed 2 capsules 3 times a day;
4th generation drugs: Bifidumbacterin forte, Biosorb-Bifidum. This group of drugs consists of bacteria of normal intestinal flora in combination with an enterosorbent (with activated carbon or others). Enterosorbent is necessary to protect microorganisms; when passing through the stomach, it actively protects them from inactivation by gastric juice or enzymes of the gastrointestinal tract. Bifidumbacterin forte is prescribed 5 doses 2-3 times a day, before meals.

Symbiotics(Bifidobak, Maltodophilus) are combined preparations (prebiotic + probiotic), i.e. simultaneously stimulate the growth of normal flora and replace the missing number of microbes in the intestines. Bifidobac is prescribed 1 capsule 3 times a day with meals.
Antibacterial drugs are used when 4th degree intestinal dysbiosis to destroy pathogenic flora. The most commonly used antibiotics are: tetracyclines (Doxycycline), cephalosporins (Cefuroxime, Ceftriaxone), penicillins (Ampiox), nitroimidazoles: Metronidazole, prescribed 500 mg 3 times a day, after meals.
Antifungal drugs(Levorin) are prescribed if there are yeast-like fungi such as Candida in the stool. Levorin is prescribed 500 thousand units 2-4 times a day.
Enzymes prescribed in case of severe digestive disorders. Mezim tablets, 1 tablet 3 times a day before meals.
Sorbents prescribed for severe signs of intoxication. Activated carbon is prescribed 5-7 tablets at a time for 5 days.
Multivitamins: Duovit, 1 tablet 1 time per day.

Diet for intestinal dysbiosis

Diet therapy is important point in the correction of intestinal flora. In case of intestinal dysbiosis, first of all, it is necessary to exclude the use of alcoholic beverages, acute, fatty foods, smoked meats and products that enhance fermentation processes in the intestines: sweets (cakes, candies, and others), homemade pickles, sauerkraut.

Secondly, you need to eat fractionally, at least 4 times a day. Try not to drink water while eating, because it dilutes the gastric juice and the food is not digested enough. Eliminate from the diet foods that increase flatulence (gas formation) and intestinal motility: legumes (beans, peas, soy and others), bran bread, carbonated drinks. It is necessary to increase the amount of protein in the diet through boiled or stewed meat (lean). Try not to eat fresh bread; dry it a little before eating.

Try to cook all food with herbs (parsley, dill and others), as it enhances the effect of normal intestinal flora against pathogenic ones. Products that enhance the restoration of intestinal microflora include: wheat, rice, buckwheat, oats, fresh vegetables or salads, non-acidic fruits. Indispensable products for restoring normal intestinal microflora are all lactic acid products: kefir, fermented baked milk, yogurt and others. You can also use special products that are enriched with biocultures: yoghurts, biokefirs and others. Applesauce has excellent prebiotic properties, it also has an astringent effect and is recommended for diarrhea. Before going to bed, it is recommended to drink a glass of kefir.

Prevention of intestinal dysbiosis

In first place in the prevention of intestinal dysbiosis is correct application antibiotics, which are one of the main causes of disruption of normal flora. Antibiotics should be used strictly according to indications after the results bacteriological research with an antibiogram. In order to select the dose of an antibiotic for a particular patient, the attending physician must take into account the age and weight of the patient. Under no circumstances should you self-medicate by taking antibiotics for minor illnesses (for example, a runny nose). In cases where you have been prescribed long-term antibiotic therapy, you must take them in parallel with prebiotics, with periodic monitoring of the state of the intestinal flora ( microbiological examination feces).
In second place for the prevention of intestinal dysbiosis is a balanced diet and a rational regimen.

In third place are all acute and chronic diseases that lead to intestinal dysbiosis, primarily diseases of the gastrointestinal tract. General strengthening therapy for patients with chronic diseases. Timely treatment Such diseases can reduce the number of patients with intestinal dysbiosis.

Persons who are exposed to occupational hazards (radiation) should include fermented milk products in their diet.

Most of the flora of the colon is made up of bacteria; up to 60% of the mass of feces is made up of bacteria. The intestinal microflora consists of 300 to 1000 species of bacteria. Moreover, 99% of these microorganisms originated from 30-40 species.

Part of the intestinal microflora also consists of fungi, archaea and protozoa, whose activities are currently poorly studied.
Research conducted by scientists proves that the relationship between microorganisms of the intestinal microflora and humans is not only synanthropic, but even most likely mutualistic.

Intestinal microorganisms perform many functions useful for human life and health, such as fermentation of energy substrates, increasing immunity, preventing the growth of pathogenic bacteria, regulating the formation of vitamin K and biotin in the intestines, and producing hormones responsible for fat metabolism.But despite this, some of the microorganisms of the intestinal microflora under certain conditions can provoke diseases and also increase the risk of cancer.

Approximately 99% of the bacteria in the gut are anaerobic bacteria, with the exception of the cecum, where the majority of bacteria are aerobic.

Not all species of intestinal bacteria have been identified, as some are not culturable, making identification difficult.

The population of bacterial species varies among individuals, but will remain essentially the same within an individual throughout life.

The dominant bacteria of the intestinal microflora are Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria.

Most bacteria in the gut belong to the genera Bacteroides, Clostridium, Fusobacterium, Eubacterium, Ruminococcus, Peptococcus, Peptostreptococcus and Bifidobacterium. The bacterial genera Escherichia and Lactobacillus are present to a much lesser extent. One third of all bacteria in the intestines is the genus Bacteroides, which indicates the special importance of this genus of bacteria for maintaining the vital functions of the body.

Clusters of fungi Candida, Saccharomyces, Aspergillus and Penicillium are also observed in the intestinal microflora.

A large class of intestinal microorganisms are archaea, which play an important role in the metabolism of bacterial fermentation products.

Experiments conducted on laboratory mice showed that the composition of the intestinal microflora can change and it can be forcibly changed. To do this, you just need to change your diet. During the experiments, changes were made to the composition of the products taken, each containing different concentrations of four ingredients: casein, corn starch, corn oil, sucrose. Based on information about the amount of these ingredients, it was possible to predict the population of each type of bacteria in the intestinal microflora. The change in population size of each bacterial species was associated with the amount of casein consumed. For example, seven of the indicated species of bacteria positively tolerated the proposed amount of casein, and three species of bacteria negatively. The linear model predicted 60% of the variation in species abundance given the concentration of components in the diet.

In some particularly rare cases, the intestinal flora contains bacteria (brewer's yeast) that convert starch into ethanol, which then enters the blood.

It was found that there are also general patterns evolution of microbiome composition throughout life. Analyzing bacterial V4 16S rRNA in 528 volunteers different ages and places of birth, it was found that the diversity of microflora composition in adults is significantly higher than in children, while interpersonal differences are higher in children. It is known that the maturation of the microflora to the state of an adult occurs in children during the first three years of life. Metagenomic analyzes of stool samples combined with V4 16S rRNA analyzes showed that although there are no phylotypes unique to adults or children, phylotypes belonging to Bifidobacterium longum are dominant during breastfeeding and their representation decreases in proportion to increasing age.

The study also found that adult microbiomes had high concentrations of enzymes that are involved in fermentation, methanogenesis and the metabolism of arginine, glutamate, aspartate and lysine, while children's microbiomes were dominated by enzymes that are involved in cysteine metabolism.