Management of postprandial distress syndrome in a young patient with the course application of still mineral water “Uvinskaya”

Aim. The purpose of the article is to study the possibilities of MRI diagnosis of postprandial distress syndrome using the drinking test and its correction with mineral water.

Materials and methods. Clinical observation is described. Patient A., 24 years old, came to the clinic with symptoms of functional dyspepsia. After a comprehensive examination, the diagnosis of Postprandial Distress Syndrome was established. The capabilities of MRI diagnostics of functional dyspepsia were assessed by drinking test. The study lasted 50 minutes. Scans were performed 5, 13, 20, 35 and 50 minutes after water intake. For the next 4 weeks, the patient ingested the non-carbonated mineral water “Uvinskaya” room temperature 30 minutes before taking a meal of 100 ml in the first 6-7 days, followed by an increase in volume to 200 ml 3 times a day.

Results. An MRI study with a drinking test in dynamics showed an increase in the volume of water drunk. When assessing the morphofunctional state of the stomach, differences were revealed at the level of the fundus: before treatment - the wall is tense, after course therapy - relaxed, relaxation accommodation is more pronounced. An acceleration of evacuation of the received water into the duodenum after treatment was also found. The positive dynamics of the state of motor-evacuation function of the stomach is due to the chemical composition of mineral water and the regimen of balneotherapy.

Conclusions. Gastric MRI is an informative and safe diagnostic method for Postprandial Distress Syndrome, which allows to evaluate the structural and functional features of the gastroduodenal zone. Drinking test can help in the MRI diagnosis of functional dyspepsia, increasing the information content of the study. The use of drinking mineral waters in postprandial distress syndrome is pathogenetically justified, but requires further research to develop rational balneotherapy regimens.

1. Дорофеев А.Э., Руденко Н. Н., Куглер Т. Е. Фун кци ональ ная диспепсия. Разные механизмы, комплексное лечение // Гастроентерологiя. – 2017. – № 3.–С. 209–212. Dorofeev A. E., Rudenko N. N., Kugler T. E. Functional dyspepsia. Different mechanisms, complex treatment. Gastroenterology. 2017, no,3, pp. 209–212.

2. Маев И.В., Кучерявый Ю. А., Цуканов В. В. и др. Резуль таты проспективной наблюдательной программы «Одиссей»: эффективность мебеверина у пациентов с постхолецистэктомическими спазмами // Терапевтический архив. – 2018. – № 8. – С. 40–47. Maev I. V., Kucheravy Y. A., Tsukanov V. V., et al. Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”. Therapeutic archive. 2018;90(8):40–47.

3. Успенский Ю.П., Барышникова Н. В. Функциональная диспепсия и хронический гастрит // Педиатр. – 2018. – № 6. – С. 77–83. Uspensky Yu.P., Baryshnikova N. V. Functional dyspepsia and chronic gastritis. Pediatrician. – 2018. No. 6, pp. 77–83.

4. Ткач С. М. Функциональная диспепсия в свете Римских критериев IV // Гастроентерологiя. – 2016. – № 4. – С. 65–71. Tkach S. M. Functional dyspepsia in the light of the Roman criteria IV. Gastroenterology. 2016, no. 4, pp. 65–71.

5. Баранов С.А., Нечаев В. М. Функциональная диспепсия в практике врача-терапевта // Медицинский совет. – 2018. – № 3. – С. 15–17. Baranov S. A., Nechaev V. M. Functional dyspepsia in practice of the doctor-therapist. Meditsinskiy sovet = Medical Council. 2018;(3):15–17. (In Russ.) DOI: https://doi.org/10.21518/2079-701X-2018-3-15-17

6. Мязин Р. Г. Функциональная диспепсия: современные аспекты диагностики и лечения с позиций Римских критериев IV // Медицинский совет. – 2019. – № 6. – С. 82–85. Myazin R. G. Functional dyspepsia: modern aspects of diagnosis and treatment from the positions of the Rome criteria IV. Meditsinskiy sovet = Medical Council. 2019;(6):82–85. (In Russ.) DOI: https://doi.org/10.21518/2079-701X-2019-6-82-85

7. Лазебник Л.Б., Алексеенко С. А., Лялюкова Е. А. и др. Рекомендации по ведению первичных пациентов с симптомами диспепсии // Терапия. – 2019. – № 3. – С. 12–18. Lazebnik L. B., Alekseenko S. A., Lyalyukova E. A. et al. Recommendations on management of primary care patients with symptoms of dyspepsia. Therapy. 2019, no.3, pp. 12–18.

8. Горбунов А.Ю., Тронина Д. В. Изменение гормонального статуса при желчнокаменной болезни в процессе лечения минеральной водой «Увинская» // Экспериментальная и клиническая гастроэнтерология. – 2017. – № 8. – С. 75–78. Gorbunov A. Yu., Tronina D. V. Change in the hormonal status in cholelithiasis in the process of treatment with mineral water “Uvinskaya”. Experimental and Clinical Gastroenterology Journal. 2017;144(08):75–78.

9. Якубович Н. А., Сысой Т. С. Опыт применения минеральной воды «Ружанская» при заболеваниях желудочно-кишечного тракта и метаболических нарушениях // Международные обзоры: клиническая практика и здоровье. – 2017. – № 4. – С. 104–113. Yakubovich N. A., Sysoy T. S. The experience of using Ruzhanskaya mineral water for diseases of the gastrointestinal tract and metabolic disorders. International reviews: clinical practice and health. 2017, No. 4, pp. 104–113.