Reactive states - what is it?
Reactive state doctors call a disorder that occurs as a response of the body to the effect of an unfavorable factor. This term is used both in somatic medicine and in psychiatry. Harmful conditions can cause both disruption of the internal organs( liver, pancreas), and damage to mental health. In the first case, bodily ailments become the cause of the deviations, and in the second - serious mental trauma. These pathologies are usually temporary. Next, the main types of negative reactions from the organs and systems of the body( liver, pancreas and psyche) will be considered, as well as the causes, symptoms and treatment of these disorders.
What is reactive hepatitis
The reactive state of the liver is in the form of hepatitis. However, in this case, the pathology is caused not by the virus, but by diseases of other organs. This is the response from the liver to harmful effects. Reactive hepatitis proceeds more easily and has a more favorable prognosis than infectious lesions. The disease does not pro
Reasons for reactive hepatitis
This disease is always secondary. The following pathologies may provoke its development:
- gastrointestinal ailments: ulcerative processes, pancreatic inflammation, nonspecific colitis;
- autoimmune rheumatic lesions: systemic lupus erythematosus, scleroderma, rheumatoid arthritis, dermatomyositis, rheumatism, nodular periarthritis;
- disruption of the endocrine system: diabetes mellitus, hypo- and hyperthyroidism;
- burns a large area of the body;
- infectious diseases;
- malignant tumors;
- surgical interventions;
- long-term use of drugs with a hepatotoxic effect.
The pathological process most often affects only the parenchymal tissue and is reversible.
Reactive hepatitis is more common in adulthood. This is due to the fact that children are less likely to suffer from chronic diseases. But if the child still had this pathology, then it proceeds with a marked symptomatology. In children, the cause of reactive changes in the liver most often become diseases of the digestive tract, as well as helminthic invasion.
Symptoms and treatment of reactive hepatitis
In adults, the reactive state is very often asymptomatic, which makes diagnosis difficult. Sometimes the following uncomfortable symptoms are observed:
- general malaise;
- feeling tired;
- subfebrile temperature;
- discomfort and pain under the ribs on the right side;
- slightly yellowish skin tone.
The patient does not always associate these signs with a dysfunction of the liver. It is very important to identify these deviations in time. During a medical examination, small pain sensations are possible during probing. The liver is somewhat enlarged. Assign a blood test for biochemistry. The results of the study determined a slight increase in bilirubin, hepatic enzymes and a decrease in protein. It is important to separate reactive inflammation from viral hepatitis. To do this, blood tests are performed for infection.
With a timely treatment, the reactive state has a favorable outcome. All violations are of a functional nature. For successful therapy, it is necessary to find out the cause of the disorders and treat the underlying disease. In addition, hepatoprotectors are prescribed, the patient is recommended to maintain a sparing diet. If the pathology is caused by poisoning or long-term administration of hepatotoxic medicines, enterosorbents should be taken.
This condition is not dangerous, but it is unacceptable to delay with the reference to a doctor and engage in self-medication. Without therapy, disruptions can take a persistent character and complicate the course of already existing diseases.
What is reactive pancreatitis
The pancreas is closely related to the digestive system. Therefore, many pathologies of the gastrointestinal tract negatively affect the work of this organ. Iron produces pancreatic juice, which is then mixed with bile and along the ducts enters the intestine. However, various diseases disrupt this process, and then there is a reactive state of the pancreas( reactive pancreatitis).
Enzymes of pancreatic juice begin to work after entering the intestine. In the pancreas they are in an inactive form. Special intestinal fluids lead these enzymes into action. This is how the digestive process functions in a healthy person. But in diseases of the gastrointestinal tract, intestinal fluid can be thrown into the bile ducts. In this case, the pancreatic juice becomes active, being in the pancreas, and the enzymes begin to negatively affect this endocrine organ. There is inflammation - a reactive pancreatitis.
Causes of reactive pancreatic pathology of the pancreas
The following diseases and disorders are the provoking factors of the development of the pancreatic reactive state:
- abnormalities of the stomach and intestines: gastritis, peptic ulcer, gastroduodenitis, infections and injuries of the digestive system;
- liver disease: gallstones, cirrhosis, biliary dyskinesia;
- operations on the gastrointestinal tract and gallbladder;
- autoimmune pathological processes;
- alcohol abuse;
- inadequate and defective food.
In children, this disease often develops as a complication of ascaridosis. With a strong invasion, the helminths clog the bile ducts, which leads to stagnant phenomena and inflammation of the pancreas.
Symptoms and treatment of reactive pancreatitis
Symptoms of reactive pancreatic inflammation are usually pronounced. At the initial stage, the patient has the following symptoms:
- There is severe pain in the abdomen and under the ribs, unpleasant sensations intensify after eating.
- Vomiting often occurs, which does not bring relief.
- Patient is suffering from heartburn and belching.
- In the intestine, an increased amount of gas is formed, a bloating is determined.
- Diarrhea occurs several times a day.
Then comes a strong intoxication of the body. The patient pales skin, limbs become cold, heart palpitations appear, blood pressure drops. The general condition deteriorates rapidly. In severe forms of reactive pancreatitis, immediate hospitalization is required.
The clinical picture depends on the cause that caused the pathology. If the reactive state arose because of liver and gallbladder diseases, then patients complain of pain in the solar plexus area. If pancreatitis was triggered by lesions of the gastrointestinal tract, unpleasant sensations are localized in the upper abdomen.
Symptomatic of the reactive state of the pancreas in a child has its own characteristics. In addition to the above manifestations, children have a high fever, plaque in the tongue, dry mouth, diarrhea is replaced by constipation. In the analysis of blood, the level of sugar increases. In infancy, the disease often occurs without severe symptoms, but you can notice lethargy and decreased appetite in the baby.
Diagnosis of the disease is carried out using ultrasound. In this case, not only the pancreas, but also all the digestive organs are examined. This is necessary to establish the cause of reactive inflammation. In addition, urinalysis is prescribed for pancreatic enzymes, blood testing for leukocytes and ESR, as well as endoscopy of the duodenum.
Treatment of the underlying disease that caused reactive pancreatitis is under way. And also prescribe anti-inflammatory drugs, analgesics and antispasmodics. This helps relieve pain. A diet with restriction of acute and fatty foods is necessary.
Reactive pancreatitis has a favorable prognosis. Timely therapy leads to complete recovery. In the absence of treatment, the inflammatory process can go on to a chronic form, in addition, patients often have increased blood sugar levels.
Reactive Mental Disorders
In psychiatry, reactive states are temporary mental disorders that develop after emotional shocks. Violations are reversible and disappear after treatment. Such pathology can occur in any person after severe experiences, for example, after death or serious illness of a loved one, family breakdown and other sad events. However, the unfavorable and prolonged course of these disorders is observed in people suffering from psychopathy or vascular diseases.
Reactive states are the body's response to a trauma. There are two main subspecies of such disorders:
- reactive neuroses;
- reactive psychosis.
Neurosis usually occurs with a prolonged traumatic situation. Psychoses appear as a reaction to acute emotional experiences and stresses.
The following forms of reactive states of a neurotic character can be distinguished:
- obsessive-compulsive disorder;
There are also several types of reactive psychoses:
- depression of psychogenic etiology;
- paranoid disorders;
- psychogenic hallucinosis;
- is a delusional fantasy;
- syndrome of "savagery";
- imaginary dementia.
Symptomatic of such disorders is always pronounced. The duration of the course of reactive mental disorders depends on the presence of concomitant vascular pathologies and the type of patient's personality. In vulnerable people with a subtle emotional organization, as well as in patients with atherosclerosis, such disorders can continue for a long time.
Symptoms of reactive psychiatric disorders
The clinical picture of reactive disorders is extremely diverse. The signs of the disease depend on the form of the disorder.
The main symptoms observed in different forms of psychogenic neurotic conditions should be considered:
- Neurasthenia. The patient is mentally and physically exhausted. The patient easily tired, feels constant fatigue, headaches, sleep is violated. Decreased efficiency. The person becomes excitable, irritable, anxious. At the same time, the mood is constantly lowered.
- Obsessive-compulsive disorder. Such a deviation after a psychotrauma is observed infrequently. The patient constantly produces the same actions, for example, counting objects or touching them. Sometimes a person makes different movements. For the patient, this acquires the character of preserving rituals. Disturbing obsessive thoughts, memories, fears that arise against the will of the patient.
- Hysteria. There is a strong crying with screams and motor excitement. In some cases, a person can not stand and walk with a completely healthy musculoskeletal system. These phenomena are accompanied by vegetative disorders: sensation of a coma in the throat, suffocation, nausea.
With reactive psychoses, there are more severe disorders:
- Psychogenic depression. Patients have a persistent decline in mood. The severity of this symptom can be different: from a small depression to severe anguish. Often patients blame themselves, for example, in the death and illness of a loved one. Movement and facial expressions are sharply inhibited.
- Paranoid disorders. Against the background of a melancholy mood and increased anxiety, delusions of persecution or external influence arise. Patients become fearful, restless or aggressive. The content of delusions is usually associated with a psychotrauma.
- Psychogenic hallucinosis. The patient has auditory hallucinations. He hears voices that discuss him. Thus the patient feels strong fear. Varies of sight are possible, when the patient takes surrounding objects for people. The content of hallucinations is associated with the stress experienced.
- Puerilism. The patient copies the behavior of a small child. Patients are talking in a child's voice, they are capricious, crying.
- The delusions of fantasy. Periodically, the patient has ideas of greatness or imaginary wealth. In contrast to paranoid delusions, these violations are not persistent and permanent. One idea quickly replaces another. In the treatment of phantasy disappear.
- Stupor. The patient becomes extremely inhibited, stops moving, eating and talking.
- Syndrome of "savagery".This kind of reactive state of the psyche is extremely rare. In the behavior of the patient, traits characteristic of the habits of animals are noted. Patients moo, bark, crawl on four limbs, become aggressive.
- Imaginary dementia. There are signs of dementia. Patients are disturbed by memory, they can not give a correct answer to simple questions or perform usual actions. However, unlike true dementia, this condition is easily cured and has a good prognosis.
Diagnosis of reactive psychoses is often difficult. It is necessary to distinguish these states from schizophrenia and bipolar disorder. The psychiatric doctor should conduct a conversation with the patient and his relatives to identify the presence of a stressful situation. Chronic mental illness develops independently of psychotrauma, and reactive disorder is always a consequence of moral upheaval.
Reactive disorders of the psyche in childhood
Reactive state in children occurs after suffering fright and other traumatic factors. Most often it is observed in infancy and preschool age. There are two types of reactions of the child's psyche to trauma. The child either becomes restless( rushes, cries, screams), or freezes on the spot and stops talking. This is accompanied by disorders of vegetation: sweating, redness of the skin, tremor, involuntary urination and defecation.
Then the child becomes languid, tearful, he is worried about fears. Behavior may appear features that are characteristic of younger children. For example, a child of 5 to 6 years begins to behave like a baby for 1.5 years. Reactive mental states in children require immediate treatment. All changes are reversible.
Therapy of reactive disorders of the psyche
In the treatment of neurotic disorders, sedatives are used. If the symptomatology is poorly expressed, then you can prescribe herbal remedies( valerian, motherwort) or the drug Afobazol. In more severe disorders, tranquilizers are indicated. Used not only medicines, but also psychotherapeutic methods.
The treatment of reactive psychoses is more difficult. With a dreary mood with ideas of self-blame, antidepressants are used. If the patient has delusions and hallucinations of psychogenic origin, then use antipsychotics and sedatives.
Forensic Expertise for Reactive Mental Disorders
Forensic psychiatric evaluation of reactive conditions should take into account the form of the disorder. With neuroses, patients are usually recognized as sane. They can be held responsible for the committed offenses.
Regarding reactive psychoses, it is necessary to take into account the degree of their expression. For mild violations, a person usually gives a record of his actions. In severe delusional disorders and hallucinations, the patient can be considered insane. It is also important to remember that depressed patients with ideas of self-incrimination often talk about themselves and sometimes confess to offenses that they did not commit.
Acute reactive states with delirium and hallucinations are considered as mental pathologies that are temporary. In the period of painful manifestations a person can be recognized incompetent. In this case, all civil acts( transactions, wills, etc.), committed by him during a mental disorder, are recognized as invalid.