Edema from mineral water
When treating diseases of the digestive systemalong with dietary nutrition, one of the central places is receiving oral mineral water - drinking treatment. Unfortunately, I did not meet the popular science literature, which would tell about the mechanism of action and the effect of mineral water on the patient's body, so I think it is necessary to tell about it in detail.
In our country with a therapeutic purpose is usedabout a thousand names of mineral waters. Among them are such world-famous waters as Essentuki No. 4 and No. 17, Zheleznovodsk, Slavyanovskaya, Smirnovskaya, Kislovodsk narzans, and others.
Especially many sources of mineral water,suitable for internal use, was found in the North Caucasus: in North Ossetia, Kabardino-Balkaria, and also in the Caucasus Mineral Waters area, where in a relatively small area there are more than 100 active sources.
Currently, therapeutic mineral waterscalled water, which due to their special physicochemical properties can be used for the treatment, rehabilitation and prevention of various diseases.
Far from all mineral water can beis recognized as curative and especially suitable for internal use. For drinking with a therapeutic purpose, underground mineral waters extracted from sources of their natural output or from wells obtained by drilling to various depths are used.
Underground waters are formed from atmospheric waters ordue to the ancient metamorphosed sea water, lying at different depths, whose age is often millions of years. Underground mineral waters acquire a chemical composition peculiar to them due to the leaching of various rocks. Often mineral waters of deep origin on their way to surface outcrops are mixed with atmospheric waters and form new types of waters. Long-term observations of the composition of some sources and the magnitude of atmospheric precipitation showed that the path from formation to the exit of the maternal water to the surface sometimes takes about a year.
It should be noted that the places of natural outputmineral springs to the surface are sometimes spaced tens of kilometers from the places of their formation. Along the way, the formation of mineral water continues: it is enriched with new salts, loses some of its gases, its temperature decreases.
The therapeutic effect of mineral waters is determined by:
1) chemical properties - the general mineralization of water, ionic composition, the presence of gases and active ions, the content of various organic substances;
2) physical properties - reaction (pH), temperature, heat capacity, radioactivity;
3) biological properties - the content of antibacterial, hormone-like substances and other products of vital activity of microorganisms.
It should be noted, however, that there is no strictly delineated boundary between mineral and fresh water for either of these criteria.
One of the main characteristics of mineral water -total mineralization. Depending on the nature of the formation of underground mineral waters, they contain different amounts of mineral substances dissolved in water.
Total mineralization of mineral waters (total of allanions, cations and undissociated molecules in grams per liter of water) varies widely. It can be less than 1 g per liter and about 300-400 g per liter.
According to modern classification, mineral waters used for oral intake are divided into three groups:
1) slightly mineralized - with the content of salts from 1 to 5 g / l;
2) slightly mineralized - with the content of salts from 5 to 10 g / l;
3) medium mineralization - with a salt content of 10 to 15 g / l.
More highly mineralized water is used extremely rarely for special purposes as a laxative.
The water temperature is a factor not only ensuring the geochemical processes of water formation in the early rocks, but also having a medical and biological significance.
The water temperature of various sources at their outlet ranges from 0 ° C - the heavily cooled waters of the polar countries, up to 100 ° C and higher - in areas of volcanoes and geysers.
In medical practice, the temperature of the water is brought to the desired cooling or, conversely, heating. For oral administration, mineral water of three temperature regimes is used:
1) cool - 25-30 ° C,
2) warm - 35-37 ° С,
3) hot - 40 ° C and above.
The content of chemical elements, gases and organic substances in mineral water basically determines its biological and therapeutic effect when taken orally.
Dissolved in mineral water salts are presentedelectrically charged particles - ions with a positive (cation) or negative (anion) charge. The main ions are: three cations - sodium (Na +), calcium (Ca2 +), magnesium (Mg2 +), three anions - chlorine (Cr), sulfate (SO2) and hydrogen carbonate
). It is they who play the leading role in the realization of the therapeutic effect of mineral waters.
Sodium - one of the main components of blood plasma andtissue fluid. It is very quickly absorbed and already in a few minutes after ingestion of mineral water is found in almost all organs and tissues.
Sodium with chlorine supports in tissuesosmotic pressure and plays an important role in the water-salt metabolism of the body. These ions contribute to the retention of water in the body and can lead to the development of edema. Therefore, with a tendency to edema, signs of cardiac and renal insufficiency, mineral waters with a high content of salts, primarily chloride-sodium water, are generally not applied or used in small doses.
Sodium ions increase the production of intestinal enzymes, reduce protein oxidation and accelerate the absorption of glucose.
In combination with sulfates and chlorine, sodium ions have choleretic and laxative effects.
Calcium - an active participant in many physiological andbiochemical reactions of the body. The leading role of calcium as a regulator of the activity of the body's basic cells - nerve, muscle, renal, hepatic, etc. - has been proven.
Calcium tightens cell membranes, lowers thempermeability, reduces bleeding. has anti-inflammatory and anti-allergic effect, increases the body's resistance to infection, enhances urination, promotes dehydration of the body.
Magnesium is a part of muscles and fluidsorganism, plays the role of an activator of the process of carbohydrate metabolism, compacts cell membranes. In combination with sulfate strengthens the separation of bile, and in increased amounts causes a laxative effect.
Hydrocarbonates are often combined with a sodium ion,forming sodium hydrogencarbonate. Mineral waters with a predominance of these substances are classified as hydrocarbonate (alkaline) waters. They have an alkalizing effect, which is especially pronounced in the stomach. Reducing the acidity of the contents of the stomach, they reduce the spasm of the gatekeeper and accelerate the evacuation of food from it to the duodenum.
Hydrocarbonate waters dilute the secret of mucous membranesshells, thereby contributing to the rejection and removal of pathological mucus. They have a mild choleretic effect, improve the exchange of proteins, carbohydrates, nucleic acids.
A wide range of positive effects of hydrocarbonate water places them at the forefront in the drinking treatment of diseases of the digestive system.
Chlorine. Waters with a predominance of chlorine ions belong to the class of chloride waters. Often, chlorine combines with sodium to form sodium chloride. Mineral waters with a predominance of these substances belong to the class of chloride-sodium (saline) waters.
Chlorine ions serve as a material for the production ofhydrochloric acid by glandular cells of the stomach. This, combined with a powerful irritant effect on the mucous membranes of the digestive organs, determines their stimulating effect, which extends to the glands of the stomach and pancreas.
Chloride waters contribute to the improvement of processesdigestion, accelerating the assimilation of food proteins, fats and carbohydrates; increase metabolism; contribute to the growth of the body. In addition, they increase peristalsis of the intestine, have a laxative and moderate choleretic action.
Sulphates. Often combined with sodium cations ("glauber's salts"), magnesium ("bitter waters") and calcium ("gypsum water").
Sulfate waters significantly reduce gastric secretion, increase peristalsis of the intestine, have an irritant effect on its mucosa and lead to a laxative effect.
By regulating the stool, eliminating flatulence and cleaning the intestines, these waters "unload" the body and especially the liver from the effects of various toxic substances.
Sulphate waters (especially "bitter waters")increase the production of bile by liver cells, increase the contraction of the gallbladder and the release of bile into the intestine. Excretion of inflammatory products, bile acids, pigments, cholesterol with jelchew reduces inflammation in the gallbladder and the process of stone formation.
"Gypsum waters" compact the vascular wall, reduce inflammation in the stomach, intestines and urinary tract, and reduce spasm and increase the motor activity of the intestine.
It should be noted that most mineral watersrefers to mixed waters, that is, they contain several leading ions simultaneously. In such waters, the therapeutic action of ions is combined and mutually reinforced.
Mixed waters are of great value. Rarely is there an isolated disease of one organ, and with combined diseases, the use of mixed mineral waters has significant advantages, since it allows treating several sick organs at once.
Organic matter is a special componentmedicinal waters. They are usually found in mineral waters of oil and peat origin, but in some cases their presence may be due to other biological processes. Organic substances in mineral waters are often present in the form of humins and bitumen, which usually constitute 80-90% of the total organic matter.
The most famous water is "Naftusya" resortTruskavets, the therapeutic effect of which is due to the organic substances contained in it, which affect the metabolic processes in various organs and tissues, primarily in the liver and kidneys. Organic substances enhance the processes of bile and urine excretion, improve the performance of liver and kidney cells. Increasing the current and improving the composition of bile and urine lead to an anti-inflammatory effect and a decrease in the process of stone formation.
Microelements of mineral water. Sometimes they even have a leading role in the realization of the effect of drinking treatment. The physiological effect on the human body of microelements of iron, arsenic, iodine, bromine, silicon, copper, cobalt, manganese. At the content of these substances in mineral water in physiologically significant quantities, respectively, ferruginous, arsenic, iodine, bromine, siliceous and other waters are distinguished.
Mechanism of physiological and therapeutic action of mineral waters
The place of application of mineral wateringestion is primarily the mucosa of the digestive tract and the nerve endings that are present in it in large numbers, reacting to mechanical, chemical, thermal stimuli, as well as receptors of endocrine cells diffusely scattered throughout the gastrointestinal tract and producing specialized hormones.
The effect of mineral water on the human body is explained by the following effects.
Stimulation of the hormonal apparatus of the digestive tract.
In recent years, it has been established that oral administrationThe mineral water leads to an increase in the secretion of almost all the hormones of the digestive system. The most famous among them: gastrin - a stimulant of gastric secretion, secretin - a stimulant for the formation of bicarbonates of the pancreas, cholecysto-kinin - a stimulant of the contractile activity of the gallbladder and the formation of enzymes by the pancreas, enteroglycagon is a stimulant of the intestine.
Most of the hormones of the gastrointestinal tracthas a trophic effect, that is, it stimulates the processes of reproduction, growth, differentiation of the cells of the digestive organs. Therefore, increasing the level of functioning of the hormonal system as a result of drinking treatment leads to an increase and acceleration of healing, a reduction in inflammatory changes, that is, leads to recovery.
The constituent elements of mineral water enter into physicochemical reactions with the contents of the cavities of the digestive organs. The simplest example of this interaction is the dilution of gastric juice with water.
For patients with increased gastric secretiontherapeutic, and therefore the most significant is the chemical reaction of the ions of bicarbonate contained in mineral water, with hydrochloric acid of gastric juice. As a result of this reaction, hydrochloric acid is neutralized, and eventually water and carbon dioxide are formed. The latter is the cause of airborne eructation, which occurs a few minutes after drinking mineral water and does not pose any danger to the patient.
Each reception of mineral water is, figurativelyspeaking, a small gastric lavage. Mineral water, passing through its mucous membranes, rinses mucus from them, inflammation elements and all this carries with it into the intestines. If food stagnation is observed in the stomach, the mineral water carries away its stagnant contents.
Absorption of mineral water components inmainly occurs in the intestine. The absorbed substances are in the intestinal mucosa. Some of them enter into chemical reactions, and some go further into the bloodstream, enter into the metabolism and normalize it.
The main way to remove mineral water from the body are the kidneys, as well as lungs and skin. Standing out of the body, water carries with it various metabolic products and minerals.
Effects on the internal environment of the body. The constancy of the internal environment of the organism (of course,within certain limits) is the most important condition for its existence. Therefore, any external interference causes reactions that resist intrusion and are aimed at maintaining the constancy of the internal environment - homeostasis (the term "homeostasis" refers to the dynamic balance of the parameters of the internal environment of the body). The same happens when you take mineral water. As soon as the nature of the contents of the digestive organs changes (and possibly their mucous membranes), the composition of the blood, the corresponding receptors will fix this, signals will come from them to the regulatory bodies, which will do everything to ensure the rapid restoration of the medium necessary for life.
Consequently, every intake of mineral waterwill cause reactions of regulatory systems aimed at restoring homeostasis. In fact, mineral waters train mechanisms of regulation of the constancy of the internal environment, which are disturbed as a result of the disease. The ailment can also contribute to the creation of a new constancy of the internal environment, but not physiological, but pathological. And in this case, mineral waters play their positive role. The irritant seems to be weak, but, affecting the body from day to day, it shifts the processes of regulating homeostasis from entrenched pathological positions and, by training them, makes you work hard. In other words, the strength of mineral waters is that they cause relatively weak responses. And these changes occur not only during treatment at the spa (or taking mineral water at home). They persist for many months - the so-called phase of aftereffect of drinking treatment. Therefore, quite often patients feel maximum improvement not in a sanatorium, but 2-3 months after returning home.
The effect of mineral waters on the patient's bodyperson can be divided into two stages. The first of these is conditioned reflex. With the regular use of mineral water, a certain stereotype of reactions arises, which is fixed from reception to reception. Over time, only one manipulation related to drinking treatment - a walk to the source, a set of water in a mug, etc. - lead to the launch of these reactions. During the second stage, when the water comes in contact with the mucous membranes of the oral cavity, pharynx, esophagus, stomach, intestine, unconditioned reflex reactions arise when irritations from the mucosal receptors are transferred to the regulatory organs - up to the central nervous system, reaching the cerebral cortex .
Mineral water in bottles Drinking treatment is successfully carried out at home with the help of mineral waters bottled. They are divided into medical, medical-dining rooms and canteens according to their purpose.
To medicinal waters are those with mineralization from 8up to 12 g / l. In some cases, it is allowed to use waters with higher salinity ("Batalinskaya" - 21 g / l, "Lugela" - 52 g / l), and also mineralization less than 8 g / l, if there is an increased amount of arsenic , bromine, iron and other substances.
Therapeutic mineral waters have a pronounced effect on the body and are applied only according to the doctor's prescription.
The treatment-dining rooms include waters with mineralization from 2 to 8 g / l. The only exception is water "Essentuki No. 4" with mineralization up to 10 g / l.
Therapeutic and table waters are used, as well as therapeutic, according to the doctor's prescription. They can also be used as a table drink, but not systematically.
Table waters are divided into naturalmineral table (mineralization from 1 to 2 g / l or less - in the presence of biologically active substances) and natural table (mineralization less than 1 g / l), which are used as a table, liquefying and refreshing drink. For therapeutic purposes, table waters are not used.
The labels of bottles with mineral water always indicate the type of water and its chemical composition.
Filling of mineral waters is carried out bycertain technology in compliance with all necessary sanitary requirements. Before pouring water into bottles, it must be filtered. After filtration, the water is saturated under pressure with carbon dioxide, regardless of whether it is contained in it by nature or not. Saturation is necessary so that in the future when stored in a bottle does not hit the air, with prolonged contact with which the chemical composition of mineral water is disrupted, salts precipitate, and the water loses its therapeutic activity, as well as its taste qualities. Therefore, the bottles should be carefully closed so that carbon dioxide does not evaporate during storage, which is a kind of preservative for mineral water.
Recently, in the mediathere were reports of cases of detection by law enforcement agencies in many cities of Russia of mini-factories for the production of counterfeit mineral water. The benefits of this "mineral water", of course, will not be. How to protect yourself from forgery? Buy mineral water in pharmacies where the probability of selling counterfeit water is minimal, and even with minor doubts about the authenticity of the product, ask the seller for a certificate of quality, which you are required to issue.
Store bottles with mineral water is recommended in a horizontal position at a temperature of + 4 ° C to + 14 ° C, at home - in the refrigerator.
During storage, it is allowed to have individual rust spots on the outer surface of the metal cover that do not violate the tightness of the closure.
Shelf life of mineral waters (excluding glandular)in a glass container, subject to these conditions - 1 year from the date of bottling. During this period, mineral waters retain their composition and exert the same biological and therapeutic effect on the human body as those taken directly from the source (pump-room).
The fact that mineral water treatment in theresort is more effective than at home, usually due not to the deterioration of the quality of water during its filling and storage, but the simultaneous impact on the patient of all the components of sanatorium treatment (a sanatorium regime that strictly regulates the daily routine and provides alternation of rest with active movement, therapeutic nutrition , climatic factors, specific balneo-, mud and physiotherapy, positive emotional effects, etc.).
Before consuming bottled mineral waterpreservative - carbon dioxide should be removed. To do this, open the bottle should be lowered into a container with warm water for 15-20 minutes. Heated mineral water leads to the release of excess carbon dioxide.
When taking mineral water, usually reduce the amount of fluid in the diet.
The temperature, amount and time of intake of mineral water depend on the disease, and this will be discussed in the relevant sections.
The course of drinking treatment is usually no more than 1 month. After a break of 2-3 months, it can be repeated.