MIL-therapy / Method of treatment / 7.7. Diseases of the gastro-intestinal tract.
7.7. Diseases of the gastro-intestinal tract.
Stomach and duodenal ulcer
MIL-therapy is indicated in patients with recurrent ulcers having persistent exacerbative course or in patients who are allergic to medicamentous therapy.
MIL-treatment begins only after the patient’s thorough examination (gastroscopy, X-ray, biopsy) because in some patients a chronic gastric ulcer may be the first manifestation of malignant process. MIL-therapy is not indicated in patients who have been operated on for malignant neoplasms.
MIL-therapy has to be combined with traditional treatment. The terminal is applied (roughly) to the ulcer projection (Fig.15), as well as to painful places revealed by palpation on the front abdominal wall (zones 3, 4, 5) and paravertebrally at ThVII - LIII (zones 6, 7, 8). During one session 6-7 zones are irradiated. Impulse frequency is 80 Hz, LED radiation power is 70 mWt, exposure to one zone is 1-2 min. Left subclavicular area (zone 2) and carotids (zones 1) are irradiated transcutaneously in a day with 1 min. exposure on each zone. The course consists of 10-12 daily procedures. MIL-therapy may be repeated in 2 weeks ( if indicated).
Decrease of inflammation and pain, improvement of microcirculation and rapid reconstruction of the connective tissue on the ulcer defect fundus are observed during endoscopic examination after 1-2 MIL-therapy procedures.
Fig. 16. Zones for MIL-irradiation in treating ulcers
While analysing cases with ineffective MIL-therapy results it has been shown that there is no statistically significant correlation of effectiveness with patients’ sex, age, duration of the disease or the thickness of subcutaneous adipose cellulose. One of the main factors determining the absence of dynamic ulcer scarring is a surgery in anamnesis (ulcer suturing, selective vagotomy, etc.). “Mirror” ulcers and ulcer defects more than 1,5 cm are prone for longer treatment.
Gastritis, duodenitis, dyskinesia of the digestive tract
Gastritis and duodenitis are treated as ulcers. For dyskinesia of the digestive tract the approach is the following (Fig. 16): irradiation of gallbladder area (zone 2), left subcostal area (zone 3), right iliac area (zone 5) for 2 min on each zone, on the umbilicus (zone 4) - 1 min. Frequency is 80 Hz, LED radiation power is 60 mWt. In addition to LILR SLRB is performed every other day (zone 1)( frequency 5000 Hz, LED radiation power 30 mWt , duration 1 min.). This course has 8-10 procedures.
Fig. 17. Zones for MIL-irradiation in treating gastritis, duodenitis and dyskinesia of the digestive tractDiseases of the liver and gallbladder
Topical MIL-irradiation decreases inflammation in the liver and gallbladder, normalises their function, reduces spasms of the preliver bile tract, improves bile colloidal stability. Consequently, local immunity impaired by the pathologic process is improved. Contraindications for MIL-therapy are the following: gallbladder dropsy, nonfunctioning gallbladder, mechanical hepatocholedoch occlusion (because during MIL-irradiation the secretion of liquid from the gallbladder mucous is stimulated), destructive cholecystitis.
Acute liver failure
Acute liver failure caused by acute exogenous poisonings or exacerbation of chronic liver disorders is treated with a complex approach: MIL-therapy is performed simultaneously with active detoxication (plasmapheresis, biologic dialysis) and conventional therapy. Indications for MIL-therapy: hyperbilirubinemia higher than 80 mkmol/l and elevation of AST and ALT enzymes in patient’s blood serum more than by 5 times. If patient’s blood prothrombin is less than 80% and fibrinogen is less than 1,8 g/l, MIL-therapy is not a reasonable treatment.
During MIL-procedure a patient lays down on the back; the terminal is put (Fig. 17) to the stomach projection in the right subcostal area along the medlavicular line (zone 1) and is slowly moved with round movements over the projection of the left and right liver lobes during 5 min (impulse frequency 50 Hz, LED radiation power 30 mWt). After that the thymus (zone 2) and the left subclavicular area (zone 3) are irradiated for 2 min each zone. The course has 10-12 daily procedures.
The effectiveness of complex treatment in liver failure is assessed by the clinical picture, by laboratory analyses and by the data of ultrasound and radioisotopic investigations.
A positive effect of the described method is caused by the activation of liver blood circulation due to the increased arterial in-flow; This effect is evident, as a rule, after 5-6 procedures. Pains in the liver are reduced, liver dimensions are reduced, bilirubin level is normalised, transaminase activity is decreased by 40% on the average, and the activity of the malon aldehyde is decreased by 12%. Hepatographic investigation reveals improvement of microcirculation clearance function in the liver. All basic values of liver functional state are usually normalised by the 10th procedure. Such clinical picture indicates that MIL-therapy has fulfilled its task and is to be cancelled; however, the patient continues his conventional conservative therapy. MIL-therapy reduces terms of treatment in patients with liver failure by 5-7 days on the average.
Fig.18. Zones of MIL-irradiation in treating acute liver failureChronic hepatitis
The problem of chronic hepatitis attracts physicians’ special attention because of the increasing morbidity of virus hepatitis which leads to aggressive hepatitis in 80% of cases. Despite a long lasting experience of a-interferone application in clinical practice a constant positive effect is received in less than 50% of patients. Experimental and clinical investigations have approved a stimulating effect of MIL-irradiation liver regenerative processes.
The terminal is put (Fig. 18) onto the skin (by a contact stable method) in the liver projection (zones 1 and 2), then to zone 5. Exposure on each zone is 2 min. Impulse frequency is 50 Hz for the first three procedures, 80 Hz - later; LED radiation power is 50 mWt. Treatment - 10-12 procedures.
After 2-3 weeks the second course of treatment is performed (10 daily procedures). The liver area (zones 1 and 2) and left subcostal area(zone 3) along the mediaclavicular line are irradiated (80 Hz, LED radiation power is 70 mWt, exposure is 2 min ); then MIL-irradiation is done parasternally (zones 4) at the second intercostal level (impulse frequency is 50 Hz, exposure is 2 min on each zone), at the inguinal vascular bundle (zone 5) from one side (impulse frequency is 80 Hz, exposure is 2 min).
Biophotometry data taken in the liver projection area can help a physician to prognose the recovery processes and to correct MIL-therapy (see Article 8).
Fig. 19. Zones for MIL-irradiation in treating chronic hepatitisChronic cholecystitis
The terminal is put onto the skin (Fig. 19) on the gallbladder projection (zone 4) and paravertebrally to the right on a painful zone (zone 2) at ThV up to ThXII area (defined by palpation). Then the thymus projection (zone 3), left subclavicular area (zone 1) and right iliac area (zone 5) are irradiated. Impulse frequency is 50-80 Hz, LED radiation power is 50 mWt, exposure is 2 min on each zone. The course has 10-12 procedures.
Fig. 20. Zones of MIL-irradiation for treating chronic cholecystitis, dyskinetic disorders in the biliary systemDyskinetic disorders in the biliary system
Gallbladder hypokinesy and its combination with Oddi sphincter spasm are clinically manifested by the feeling of heaviness, discomfort in the right subcostal area. Objective investigations (fractional chromatic duodenal probing, cholecystography, liver and gallbladder USI, microscopic and biochemical bile investigations) do not reveal signs of inflammation in the bile ducts. Half of the patients have elevated alkaline phosphotase in their biochemical blood tests which indicate the development of initial stages of liver functional deterioration caused by the formation of cholestatic syndrome.
MIL-therapy is performed as an independent method (drugs are cancelled). The terminal is put (Fig. 19) on the zone of gallbladder projection (zone 4), after that on the painful zones in the epigastric region (defined by palpation), on 1-2 zones paravertebrally to the right from ThV up to ThVII (zone 2) and on the right iliac area (zone 5). Impulse frequency is 50 Hz, LED radiation power is 70 mWt, exposure is 2 min on each zone. For complete erradication of pain syndrome 2-5 procedures of MIL-therapy are required (in combined dyskinesia - 6-8). During such treatment dyspeptic syndromes disappear too. The course consists of 10-12 procedures. Laboratory and diagnostic investigations show the elimination or marked reduction of liver cholestasis, marked positive dynamics in biochemical bile indexes.
The terminal is put onto the skin (Fig. 20) in the gallbladder projection (zone 1), paravertebrally on the painful zone on the left (zone 2) from ThVII up to ThIX. Impulse frequency is 50 Hz, LED radiation power is 70 mWt, exposure is 2 min on each zone. Then the painful zones in the epigastrial region (zone 3), in the area of umbilicus (zone 4) and the left subcoastal area (zone 5) are irradiated. Impulse frequency is 80 Hz, LED radiation power is 50 mWt, exposure on each zone is 1 min. The number of zones for one procedure is 5-6. The course has 10-12 procedures daily or every other day.
After two weeks the second course is performed (7-8 daily procedures). MIL-irradiation is done to the zone of gallbladder projection (zone 1), to the painful left subcostal area (zone 5), to the left subclavicular area (zone 6). Impulse frequency is 50 Hz, LED radiation power is 50 mWt, exposure time to one zone is 2 min.
Fig. 21. Zones for MIL-irradiation in treating chronic pancreatitis