Amylorrhea is the appearance in the stool of a large number of starch grains, which indicates a violation of the digestion of carbohydrates. The symptom occurs with enzyme deficiency - chronic pancreatitis, enteritis, pancreatic tumors. Amylorrhea is observed with increased peristalsis, which happens with IBS, intestinal infections, hyperacid gastritis. The diagnostic plan involves functional probe and probeless methods, coprogram, instrumental imaging of the pancreas. Treatment includes diet therapy, pancreatic enzyme preparations, antacids, and probiotics.
The appearance of a symptom is possible with IBS with a predominance of diarrhea. Amylorrhea is caused by increased intestinal motility, as a result of which digestive enzymes do not have time to act on carbohydrates. It is manifested by liquid stools of yellow or light brown color with an unpleasant pungent odor. Before defecation, spastic pain in the abdomen increases, after emptying the intestines, it decreases or completely disappears.
Amylorrhea in case of poisoning is caused not only by the activation of peristalsis, but also by the direct toxic effect of pathogenic microorganisms on the wall of the small intestine. The symptom is more typical for the onset of the disease, when there is a sufficient amount of partially digested food in the stomach and intestines. There is diarrhea, the multiplicity of which depends on the severity of the intestinal infection. Fecal masses are liquid, have a bright yellow, orange or greenish tint.
The appearance of amylorrhea is due to two mechanisms: the inactivation of salivary amylase in the acidic environment of the stomach and the accelerated movement of chyme due to the irritating effect of acid on the small intestine. Disorders of the stool are associated with errors in the diet - the use of large amounts of complex carbohydrates. There is one or two diarrhea with the release of liquid fetid feces. Amylorrhea is accompanied by abdominal cramps, epigastric pain.
With inflammation of the pancreas, signs of amylorrhea are relatively rare, which is explained by the high enzymatic activity of intestinal amylase. The condition is more often observed with advanced forms of the disease. Amylorrhea occurs when the diet consists mainly of carbohydrate foods. A person is worried about severe flatulence and pain in the epigastric region. Then there is an unformed, fetid stool, in which there may be particles of undigested food.
If the diet is followed, amylorrhea disappears. Chronic pancreatitis is characterized by a sequence of changes in the composition of feces. First, steatorrhea occurs, as evidenced by grayish soft feces with a greasy sheen. Creatorrhoea joins later, amylorrhea develops in the later stages of the disease. The symptom is also typical for a complication of pancreatitis - pancreatic fibrosis.
Violation of the exocrine function of the organ is accompanied by a decrease in the production and release of pancreatic amylase into the small intestine. In the initial stages, the condition is compensated by intestinal enzymes, but at the advanced stages of the disease, amylorrhea may begin. It has typical clinical manifestations specific to the chronic form of pancreatitis. The main causes of exocrine pancreatic insufficiency:
With an inflammatory lesion of the wall of the small intestine, the secretion of enzymes is disrupted, the processes of cavitary and parietal digestion are inhibited. Undigested carbohydrates in the form of starch move into the large intestine, increase peristalsis and increase the water content of feces. Therefore, with amylorrhea, repeated diarrhea occurs. The stool has a liquid consistency or is allocated with separate soft lumps.
Amylorrhea is provoked by an overdose of laxatives that affect intestinal motility. As a result, the person develops diarrhea. Food quickly passes through the digestive tract and does not have time to completely break down. Fecal masses are plentiful, liquid, have a sharp unpleasant odor. Amylorrhea is combined with spasms and discomfort in the abdomen, flatulence. After 12-24 hours, the effect of the drugs ends, the condition returns to normal.
During an external examination, a gastroenterologist draws attention to the lack of body weight in a patient with amylorrhea. Often, dryness and peeling of the skin, brittle nails, seizures are detected, which indicates a vitamin deficiency. It turns out the frequency and nature of the stool, especially nutrition, against which the symptoms appeared. To determine the causes of amylorrhea, laboratory and instrumental methods are used:
Starch grains in the coprogram
Regardless of the cause of amylorrhea, the first step in eliminating symptoms is diet therapy. A balanced diet in terms of protein and energy content with a high content of vitamins is recommended. Preference is given to easily digestible food, which does not cause functional overload of the digestive organs, reduces or completely eliminates amylorrhea. A prerequisite is quitting smoking, since nicotine reduces the synthesis of bicarbonates and contributes to the acidification of the small intestine.
Enzyme preparations are effective in combating amylorrhea. They are dosed according to the amount of lipase, since its secretion is disturbed in the first place. They select effective drugs in microgranular form, which are resistant to the action of gastric juice and provide a rapid release of enzymes. With amylorrhea, in addition to replacement therapy, after confirming the diagnosis, a number of drugs are prescribed:
With severe atrophy of the organ, surgical interventions are carried out in specialized centers. Patients are transplanted with islets of Langerhans followed by removal of the gland. Such treatment requires lifelong enzyme replacement therapy. In case of malignant neoplasms, a radical operation is performed - pancreatoduodenal resection or resection of the pancreas with preservation of the pyloric zone and duodenum 12.