Characteristic of disorders of motor-evacuator activities of the stomach and intestinal in chronic duodenal insufficiency

Aim. To assess the psychoemotional status and the state of the autonomic nervous system and their importance in the violation of the motor-evacuation function of the gastrointestinal tract in chronic duodenal insufficiency (CDI).

Materials and methods. A prospective study of 40 patients with CDI was carried out. The control group consisted of 30 healthy individuals. Anamnestic and physical data, results of X-ray and endoscopic studies, and intracavitary manometry were used to verify CDI. The study of the gastrointestinal tract was carried out using the "Gastroscan-GEM". Assessment of autonomic homeostasis was carried out using cardiac rhythmographic research and analysis of heart rate variability using the "Varicard 2.51" complex. To assess personal and situational anxiety – test questionnaire Spielberger–Khanin. Eysenck's test questionnaire was used to determine the type of temperament.

Results and discussion. We revealed a postprandial decrease in the contribution of the frequency spectrum of the duodenum (Pi/Ps – 1.7±0.07; p=0.000) and the colon (Pi/Ps – 39.62±2.45; p=0.000) in the total spectrum in comparison with the starving study, at the same time there is an aberrant significant increase in the contribution of the stomach to the total spectrum (46.5±5.8%; p=0.00). In patients with CDI, the prevalence of the sympathetic division of the autonomic nervous system AMo was noted – 94.0 [92.5; 97.5]% with an asymptotic type of autonomic reactivity (IN2/IN1=1.1 [1.05; 1.17]) and insufficient adaptation reserve coefficients (0.32 [0.2; 0.4]) in relation to the control group. The psychoemotional state in patients with chronic duodenal stasis is in direct correlation with changes in the postprandial ratio of the electrical activity of the stomach and duodenum (r=0.7, p=0.021), and in reverse – with the coefficient of the ratio of intraduodenal pressure to intragastric pressure (r=-0,8, p=0.000).

Conclusion. In patients with CDI, changes in the functional state of the stomach and duodenum are of a systemic nature, which is due to stimulating (parasympathetic) and inhibitory (sympathetic) effects. The relationship between the motor-evacuation activity of the stomach and duodenum and the psychoemotional state in patients with CDI was revealed.