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1. Modern representations about an aetiology and a pathogenesis of functional disturbances of a motility of organs of digestion

It is possible to consider as functional disturbances various combinations gastrointestinalnyh symptoms without structural or biochemical disturbances (D.A. Drossman) [51].

In the terminological plan it is necessary to differentiate functional disturbances and the function disturbances, two conformable, but a little various the concepts closely bound among themselves.

Disturbance of function of this or that organ can be bound to any reason, including with its organic damage. Functional disturbance (TNFS), in this light, it is possible to survey as a special case of disturbance of function of the organ which has been not bound to its organic damage [74].

From the pathophysiological point of view of disturbance of a motility (dyskinesia) of any parentage it is possible to section as follows:

• retardation of moving contained in a direct direction

• acceleration of moving contained in a direct direction

• retrograde moving of contents (refluxes).

Motility disturbances are defined by propulsive activity of an intestinal tube (acceleration - a hypermotility, retardation - a hypomotility), a condition of sphincters (a spastic stricture - a hypertonia, zijanie - a hypotension), a difference of pressure in interfacing departments GASTROINTESTINAL TRACT and retroperistalsis possibility. Accordingly to speak not simply about a hypermotor or hypomotor condition (characterising propulsive activity) more correctly, but

Also about a hypotension and a hypertonia (to characterise a condition of sphincters) as it is accepted for a long time in domestic classification of a dyskinesia zhelchevyvodjashchih ways. Only such approach will allow to avoid mess which inevitably arises at an estimation of motor activity GASTROINTESTINAL TRACT and, the most important thing to prescribe adequate therapy. Proceeding from it, retardation of moving contained in a direct direction can be bound to depression of propulsive activity and-or rising of a tonus of corresponding sphincters, and acceleration - with rising of propulsive activity and-or sfinkternoj a hypotension. There are also any other combinations, for example, intensifying of propulsive activity and a spastic stricture of sphincters (a hypermotor hypertensive dyskinesia,

Characterised by the expressed painful syndrome). For a retrograde dyskinesia depression of a tonus of a sphincter and presence of a negative gradient of pressure between two departments GASTROINTESTINAL TRACT and-or retroperistalsises is necessary.

The reasons of functional disturbances lay out of an organ which function is broken, and are bound to disturbance of regulation of the given organ. Mechanisms of disturbances of the nervous regulation, caused or the vegetative dysfunctions quite often bound to psychoemotional and stressful factors, or an organic lesion of the central nervous system, a secondary vegetative dystonia are most studied. In many works efficiency kognitivnoyopovedencheskoj therapy and relaxation methods [1,13, 84, 85, 117] is proved. Humoral disturbances are studied to a lesser degree, but are obvious enough in situations when against disease of one organ, dysfunction of the next develops: for example, a dyskinesia zhelchevyvodjashchih ways at JADK. Motility disturbances are well studied at a number of endocrine diseases, in particular, at a thyroid gland pathology. Disturbances of a motility of organs of digestion of any parentage inevitably cause the secondary
Changes, the main things from which are disturbance of processes of digestion and an absorption, and also disturbance of a microbiocenosis of an intestine. The listed disturbances aggravate motor disturbances, closing pathogenetic "vicious circle" [13,60,75,76,90].

Digestion organs possess the electric activity defining a rhythm and intensity of muscular reductions and a motility as a whole. The question on localisation of the electric driver of a rhythm zheludochnoyokishechnogo a tract remains opened. The carried out researches have shown, that the driver of a rhythm of a stomach is located in a proximal part of the big curvature, and for a small bowel the given role is played by proximal department of a duodenum which generates slow electric waves of the highest for all small bowel of frequency. Rate of diffusion of the basic electric rhythm in various departments of a gastroenteric tract neodinakova also depends on its functional condition and the driver of a rhythm. It is necessary to notice, that always there is a gradient both the basic electric rhythm, and rhythmic reductions of unstriated muscles of a gastroenteric tract on frequency and rate of carrying out of excitation in a caudal direction. For an estimation of character of a motility of organs of digestion radiological (contrast) and electrophysiological methods of research (elektrogastroenteromiografija) can be used. The last have received now new impulse for development and introduction in practice on the basis of new technical base and the computer technologies which have allowed in real time to carry out the difficult mathematical analysis of received data. The method is based on registration of electric activity of organs of digestion [17,29,30,49].

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Scientific source AKOPJAN AJARPI NORIKOVNA. Diagnostics and treatment of functional disturbances of a motility of organs of digestion at children (electromyographic and metabolic aspects). The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

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