Stenosis
Causes, signs and symptoms of stenosis
Definition of stenosis
It is customary to call stenosis any pathological narrowing of the tubular organs or blood vessels, including the openings of the heart. A narrowing or stricture (congenital or acquired narrowing of the urethra), in the language of doctors, can be observed for a long time and it does not go away by itself.
Reasons for the development of stenosis
The causes of stenosis are not only congenital anomalies, the disease can develop as a result of mechanical action (the so-called organic stenosis), when the vessels or hollow organs are compressed by a tumor, metabolic processes are disrupted. Stenosis can be a consequence of trauma and inflammatory diseases. Arterial stenosis is most often the result of thrombosis or atherosclerotic changes in the vessels, functional or inorganic stenosis develops as a result of smooth muscle spasm.
There are few differences between organic and inorganic stenoses, since functionally spastic processes sooner or later lead to organic narrowing of the opening (pyloric stenosis, hypertension) precisely due to the hypertrophy of those elements that are involved in contraction and give the walls of organs or vessels elastic properties (smooth muscles, elastic fibers).
The degenerative form of stenosis develops mainly in elderly people, as a result of natural aging of the body. The consequences of stenosis depend on the location, age and nature of the process itself leading to the stenosis.
Signs and symptoms of developing stenosis
The signs and symptoms of stenosis are different and appear depending on which organ or vessels the structure develops in.
Arterial stenosis is often asymptomatic. It can cause short-term ischemic attacks in the form of one-sided impairment of vision, speech, and motor function. The attack usually lasts no more than 20 minutes and within an hour all signs of malaise disappear.
Laryngeal stenosis can develop in both acute and chronic forms. The acute form is characterized by a sudden onset with attacks of suffocation, more often in the dark. In the chronic form, it grows over a long period of time, the patient's condition is slowly deteriorating. It is accompanied by wheezing, dry persistent cough. Hoarseness of the voice appears, the skin is pale with a bluish tinge.
Aortic stenosis in the early stages does not have clinical manifestations, as the patient develops, fainting may occur, dizziness appears when bending, standing up, shortness of breath. Puffiness appears and in especially severe cases there are attacks of suffocation.
Mitral stenosis, with a small degree, does not have characteristic symptoms; with more pronounced signs, there is a blue discoloration of the nasolabial triangle and nail plates. In addition, there are signs of heart failure. Mitral stenosis in most cases is a consequence of a congenital malformation of the heart valve and is detected at a very early age, ideally in the first year of life of children.
Stenosis of the stomach and duodenal ulcer is most often localized in the pylorus (the place where the stomach passes into the duodenum 12). It develops gradually, in 3 stages. Typical symptoms: sour taste in the mouth, belching, a feeling of not digesting food. With a further increase in stenosis, there is a feeling of distention of the stomach and vomiting after eating, bringing relief. Painful sensations occur even after eating a small amount of food. Over time, vomiting increases and the patient is threatened with exhaustion.
Stenosis of the esophagus is accompanied by unpleasant sensations when eating hard food, vomiting, belching, heartburn.
Diagnosis of stenosis
Methods for diagnosing stenosis also depend on its location:
· Stenosis of the arteries can be determined by listening to the carotid artery with a conventional stethoscope, as additional methods are used ultrasound and magnetic resonance angiography;
With stenosis of the aortic orifice, the diagnosis is made on the basis of an electrocardiogram, X-ray examination, cardiac catheterization;
· Endoscopic diagnostic methods, such as X-rays, with contrast agents, esophagoscopy, gastroduodenoscopy, can reveal stenosis of the esophagus and pylorus;
· Excretory urography, X-ray with radioisotopes, renal scan and angiography with X-ray contrast agent are prescribed for suspected renal artery stenosis;
· To establish the diagnosis of laryngeal stenosis, simple methods are sufficient - auscultation (listening) and examination of the patient, as well as a thorough collection of anamnesis.
Stenosis treatment
In the overwhelming majority of cases, stenosis is treated with a surgical intervention. Drug treatment is very rarely effective, mainly, it is used for stenosis of the larynx and stenosis of the pylorus in the postoperative period. In any case, with the slightest discomfort in the general condition of the body, it is best to seek qualified medical help.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
