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ENFERMEDADES COMUNES DE COLON Y RECTO
Las Enfermedades del Colon, del Recto y del Ano, abarcan un gran abanico de patologías de lo más común del aparato digestivo. Fuera del cáncer y algunas otras enfermedades, no suelen ser padecimientos que nos amenazan la vida, pero sin duda siempre reducen sensiblemente la calidad de vida que las personas pueden tener. Las razones es que suelen ser enfermedades que muchos de ellos no tienen una cura específica, son de origen múltiple (participan más de un origen) y por lo tanto suelen ser padecimeintos crónicos y/o recurrentes. Muchas veces pueden conducir incluso a severos trastornos emocionales, como depresión, crisis de pánico y de ansiedad que terminan agravando como un círculo vicioso, el cuadro digestivo. Como algunas de las causales del síndrome son también enfermedades emocionales, se dificulta saber que fue primero. Aquí comentamos brevemente algunas de estas así como una lista de los síntomas o signos en ésta área del tubo digestivo, que como médicos consideramos “Signos de Alarma”, que deben hacer acudir por ayuda o revisión médica de manera rápida.
SINDROME DE COLON IRRITABLE ( SCI)
Este síndrome es conocido por varios nombres, entre ellos síndrome de irritabilidad intestinal, enfermedad intestinal funcional, colon nervioso, colon espástico y/o colon irritable, etc.
Unos de los motivos por los cuales varían es porque hay poca información con respecto a las causas de esta entidad. Sin embargo poco a poco se va conociendo más respecto a esta entidad. Lo cierto es que suele iniciar antes de los 40 años y se convierte en un problema crónico. Puede influenciar su estilo de vida pero no requerirá de cirugía y ciertamente no lo predispone a problemas más serios como el cáncer, aunque si puede enmascarar la presencia de signos o síntomas de alarma porque el paciente se acostumbra tanto a tener síntomas digestivos que terminan ignorando cuando los de alarma deben ser atendidos.
¿Que es el colon Irritable?
Este desorden puede afectar todo el tracto digestivo, pero primordialmente afecta al colon o intestino grueso. Se estima que 10 a 20% de la población mexicana padece este problema y dos terceras partes son mujeres. Sin embargo solo 10% busca atención medica. La mayoría prueba remedios mil que le sugieren amistades o familiares antes de buscar ayuda médica.
Es importante reconocer que este síndrome de irritabilidad intestinal NO ES UNA ENFERMEDAD GRAVE, no debe confundirse con otras entidades tales como diverticulitis o enfermedades pélvicas. En ocaciones los síntomas son similares y existe la necesidad de establecer la diferencia entre estas entidades a través de estudios como la llamada colonoscopia o el colon por enema.
¿ Cuáles son los síntomas?
El nombre “Síndrome” implica una constelación de síntomas que ocurren juntos. Estos incluyen dolor abdominal, gases, distención, cambio en los hábitos intestinales, diarrea, constipación (estreñimiento) y en ocasiones diarrea alternada con normalidad y luego pasar a constipación. Esta alternancia caótica entre constipación y diarrea puede ocurrir varias veces al día o semana. El sangrado rectal nunca se asocia con esta entidad. Es un problema que solo ocurre en el día, si estos síntomas se presentan de noche hay que sospechar otros problemas orgánicos.
Generalmente, el dolor abdominal dura por varios meses y además:
Se alivia con defecación
Se asocia con cambios en los hábitos intestinales
Se asocia con cambio en la consistencia de las heces.
En algunos casos ocurre después de tomar alimentos.
Otros síntomas extra intestinales en pacientes con colon irritable son:
Dolor de espalda
Cansancio constante, letárgicos
Mal aliento o mal sabor de boca
Dolores de cabeza frecuentes
Dolor en relaciones sexuales
Dolor en los muslos
Urgencia y frecuencia urinaria.
¿Cuál es la casusa de este síndrome?
Existen tres mecanismos responsables y que interactúan en este síndrome:
(1) Alteración de la motilidad intestinal.
(2) Factores psicosociales
(3) Hipersensibilidad visceral o percepción intestinal alterada.
Alteración de la motilidad Intestinal
La función de colon está controlada por músculos intestinales, flora bacteriana normal, vellosidades, nervios y hormonas. Se cree que la mayoría de los síntomas ocurre cuando los músculos del colon no funcionan en forma normal. Esto puede tener un problema secundario en los nervios.
Estas contracciones anormales o espasmos pueden retrasar el paso de excremento, resultando en constipación y/o dolor. En otras ocasiones estas alteraciones en la motilidad intestinal pueden resultar en evacuaciones diarreicas por aceleramiento de los movimientos naturales del intestino grueso.
Factores Psicosociales
Estudios han demostrado que el estrés afecta la motilidad y el tiempo de tránsito intestinal. Varios estudios han demostrado que cerca de la mitad de los pacientes con este síndrome tienen alteraciones emocionales coexistentes. Estos trastornos son comunes tales como depresión y ansiedad. En una encuesta de 200 pacientes son colon irritable 44% de estos pacientes demostraron evidencia de diferentes tipos de abuso físico, mental y/o sexual.
Hipersensibilidad Visceral
Esto significa que los pacientes con irritabilidad intestinal tienen un umbral de dolor mas bajo, es decir que son más sensibles al dolor. Esta percepción aumentada es responsable de los síntomas del paciente. Estos pacientes inconscientemente crean una sensibilidad intestinal extrema con estimulos minimos creando un círculo vicioso y repetitivo que es necesario romper.
¿ Qué Hacer?
Aunque la casusa exacta se desconoce, se reconocen varios factores que se pueden modificar. Uno de los primeros pasos usted ya lo ha tomado y es buscar atención médica, el segundo y quizás el más importante también ya lo han tomado y esto es EDUCACION. Al igual que otras la diabetes, artritis, hipertensión el colon irritable puede ser controlado mas no curado.
Es importante desarrollar una buena relación con su médico y con paciencia enfrentar el problema.
Recuerde que el estrés, el abuso de narcóticos, alcohol y otros fármacos así como malos hábitos alimenticios pueden simular este problema o empeorarlo.
Cada persona es diferente y responde en varias maneras a las diferentes dietas que se sigan, en general se recomienda evitar comida grasosa y condimentada, cafeína, bebidas gaseosas, refrescos de cola, chocolate y productos lácteos. AUMENTE LA FIBRA EN SU DIETA. Procure llevar un registro de los alimentos que toma para poder identificar aquellos que le causan más molestias. Haga cambios graduales en su dieta y dele tiempo a su organismo a que acostumbre a las modificaciones que haga.
¿En cuánto tiempo espera ver mejoría?
El manejo de este problema es lento y puede tomar más de seis meses para ver mejoría. Paciencia es extremadamente importante al estar lidiando con esta entidad.
Aspectos Ginecológicos
No es raro encontrar en pacientes femeninas con colon irritable otros síntomas que no están en relación con la función intestinal. Estos síntomas son importantes ya que no solo causan muchas molestias pero además hay temor por parte de las pacientes a comentar estos síntomas por miedo a ser consideradas como Neuróticas.
Cansancio, dolor de espalda media y espalda baja, síntomas urinarios y ginecológicos son especialmente difíciles de manejar.
Es característico observar que estas pacientes tienen dolores durante sus periodos menstruales muy intensos, al mismo tiempo notan que sus molestias digestivas se acentúan más aun durante este periodo y frecuentemente refieren dolor durante relaciones sexuales.
Hasta un 70% de las pacientes que sufren dispareunia (dolor durante las relaciones sexuales) prefieren evitar las relaciones sexuales por falta de placer o satisfacción. Un problema que obviamente es muy serio, a pesar de tener compañeros muy comprensivos. El dolor que manifiestan semeja al dolor intestinal típico y puede presentarse hasta un día después de la relación sexual (coito)
En resumen:
Los desórdenes intestinales de la vejiga y órganos pélvicos pueden producir síntomas muy similares pero en general el colon irritable se asocia con dolores abdominales altos y se asocia también con hábitos intestinales anormales.
Otras enfermedades comunes de Colon, Recto y Ano pueden ser las Hemorroides, las Fisuras Anales, la Comezón en la región anal, los gases y el estreñimiento.
SINTOMAS DE ALERTA
Existen en esta rama de la Salud Digestiva lo que llamamos Síntomas de Alarma, que significa que por la naturaleza de su presencia, pueden significar enfermedades graves como el cáncer, y que al tenerlos debe uno visitar a un especialista para su estudio y tratamiento oportuno.
Esos síntomas de alarma son:
Sangrado Transanal.- No importa la cantidad, es necesario ante la presencia de sangrado transanal (directo, en el excremento, en el papel de aseo, etc.) de cualquier cantidad, visitar a su médico.
Dolor Rectal.- El dolor hacia dentro de la pelvis puede estar relacionado con enfermedades graves como el cáncer.
Cambio del Hábito Intestinal: Cuando aparece repentinamente o de manera paulatina cambio en el calibre del cuerpo de las heces, es de vital importancia visitar a su médico.
Ardor Anal o Intestinal.- El ardor es necesario tomarlo en serio cuando aparece.
Falta de Paso de Gas/Evacuaciones.- Dejar de evacuar, dejar de pasar cuando ,menos gas através del ano, es un síntoma a revisar de inmediato.
Baja de Peso No Deseado.- La baja de peso no deseado siempre es señal de que algo mal puede estar pasando en su cuerpo y requiere revisión inmediata.
Dr. Jorge E. Balli Martínez
Cirugía Laparoscópica
Gastroenterología Quirúrgica
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Описание датчиков давления Метран-150
Можно отметить следующие отличительные особенности датчика Метран-150 по сравнению с его предшественниками:
новый улучшенный дизайн и более компактная конструкция;
блок электроники и ЖКИ с клавиатурой могут поворачиваться с шагом 90 гр.;
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наличие выхода по протоколу HART, благодаря чему датчик можно интегрировать в современные системы регулировки/управления техпроцессами;
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на корпусе находится внешняя кнопка, защищенная металлической пластиной установки «нуля»;
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простота обслуживания и ввода в эксплуатацию;
ценовой диапазон, соответствующий бюджетному сегменту отечественных аналогов в отличие от более дорогих устройств иностранного исполнения.
Какие возможности доступны с преобразователем Метран-150:
конструкция модуля сенсора Coplanar обеспечивает гибкость при выборе варианта подсоединения датчика к процессу: или разные фланцевые исполнения, или сборка с вентильными блоками, или сборка с выносными разделительными мембранами;
исполнение М150 для температуры атмосферы до минус 55 гр. дает возможность использовать датчики без установки дополнительных обогревающих устройств;
исполнение с ЖК-индикатором и с локальным интерфейсом позволяет быстро сразу по месту установки датчика производить изменения настроек;
также существует специальное кислородное исполнение.
Управление и перепрограммирование настроек датчика имеет следующие особенности:
возможно на самом преобразователе М150 при помощи универсального HART-коммуникатора;
возможно удаленно при помощи ПО H-Master/Metran-150, HART-модема для преобразователя М150, персонального компьютера или находящихся на производстве средств программирования АСУТП;
возможно при помощи специального прибора, поставляемого на заказ, оснащенного ЖКИ с пленочной клавиатурой.
В каких средах может эксплуатироваться преобразователь Метран-150:
в жидких кислотных и щелочных;
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Датчик может измерять давление тех сред, которые не вызывают коррозионные изменения материалов, с ними контактирующих. Специально очищенные преобразователи предназначены для измерения давления кислорода в газообразном состоянии и кислородосодержащих смесей (опция кислородного исполнения — UC).
Датчик давления функционирует в следующих диапазонах давления: min — 0-0,025кПа, max — 0-60МПа и в широком диапазоне температур среды от -40гр. до +80гр.
По току различаются следующие типы аналоговых выходных сигналов:
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