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How to restore the microflora of the oral cavity. Application of bacteriophages in otolaryngology

Numerous microorganisms live in the oral cavity and nasopharynx (there are a hundred times more anaerobes - lovers of oxygen than aerobes - living without oxygen). These are bacteroides, porphyromonas, prevotella, eubacteria, fusobacteria, bifidobacteria, lactobacilli, actinomycetes, Haemophilus influenzae, neisseria, spirochetes, leptotrichia, streptococci, staphylococci, peptococci, peptostreptococci, veillonella, Candida fungi, protozoa (Entamaeba gingivalis and Trichomonas tenax) and other organisms . Antimicrobial components of saliva (antibodies and lysozyme) inhibit the action of foreign microbes. Fibronectin(related in properties to gram-positive bacteria) covers the mucous membrane and inhibits the growth of gram-negative bacteria. All types of microflora living in symbiosis with humans are in a certain quantitative ratio with each other.

If abused antiseptic drugs and antibiotics for treatment various diseases of the oral cavity and pharynx (throat), you can upset the balance of microflora, that is, cause a imbalance in the quantitative ratio of beneficial and conditionally - pathogenic microorganisms(and in the direction of increasing pathogenic species). And against this background, dysbacteriosis (dysbiosis) develops.

Dysbacteriosis itself subsequently becomes the cause of inflammatory processes in the mouth, throat and nasopharynx. If there is a tendency to such frequent diseases as tonsillitis, tonsillitis, pharyngitis, or oral candidiasis develops, then one may suspect that the microflora is disturbed and needs to be restored. In addition to measures to support the immune system and taking additional amounts of beneficial bacteria (Lactobacteria and Bifidobacteria), bacteriophages are successfully used. In order to know what type of bacteriophage to use, a bacterial culture test is taken (smear from the oral cavity and nasopharynx). Next, it is determined whether the found strain of bacteria reacts to this bacteriophage and, if the phage sensitivity of the bacteria is confirmed, they begin taking the bacteriophage.

Suitable for the treatment and prevention of dysbiosis of the oral cavity, pharynx, nasopharynx: Pyobacteriophage polyvalent purified ( Sextaphage), Staphylococcal bacteriophage, Streptococcal bacteriophage, Pyobacteriophage combined. They are used in the form of rinsing, irrigation of mucous membranes, and instillation into the nose. When rinsing, it should be taken into account that the bacteriophage foams a lot, so you need to put a little bit of it into your mouth. Rinsing with a bacteriophage solution is carried out followed by swallowing the solution.

Bacteriophage in ENT practice.

In case of inflammatory or purulent-inflammatory processes in ENT diseases in the nose, nasopharynx, pharynx or ear (for example: tonsillitis, tonsillitis, pharyngitis, laryngitis, sinusitis, sinusitis, otitis), there is also the possibility of using bacteriophage. To treat otitis media, bacteriophage is used in the form of turundas moistened with a solution or rinsing the middle ear cavities. To treat inflammation in the sinuses, the nasal cavity and nasopharynx are washed with a bacteriophage, or the turundas moistened with the bacteriophage are left in the nose for a while. The turundas are left for an hour and a half, then changed several times during the day. Since a certain bacteriophage targets only certain type bacteria, then it is necessary to select a bacteriophage according to the pathogenic bacterium that caused purulent or inflammatory process. To do this, take a smear from the site of the lesion and do a bacterial culture. And only after identifying the pathogen is a phage selected.

It is necessary to pay attention to the fact that since the bacteriophage is stored in a refrigerator (not in a freezer!), the solution must be warmed in your hands before use, or held for a short time at room temperature. But only that part of the solution that you use, and the entire bottle with the remaining contents is put back in the refrigerator.

- This is the greatest invention of mankind. They have saved and continue to save thousands of lives every day and hour. But these drugs destroy both pathogenic microorganisms and beneficial inhabitants of our body. It is important to understand that doctors usually prescribe broad-spectrum antibiotics that act on most pathogens.

Narrowly targeted drugs are used only in exceptional cases, and they also destroy beneficial flora. As a result, we treat the underlying disease, but cripple other organs and systems. Quite often a phenomenon such as occurs.

Antibiotics kill not only pathogenic flora

– this is a violation of the ratio of the quantity and composition of microflora in the body. Our body is not sterile, and many processes occur with the participation of various microorganisms. Not all of them are beneficial; some can cause various diseases. But as long as the quantities of both are in a certain balance, the body feels good.

Antibiotics kill everyone. There is no protection and surviving pathogens - fungi, bacteria, other microorganisms - begin to colonize the mucous membranes of the intestines, stomach, oral cavity, genitals, nails and eyes. Dysbacteriosis is not considered an independent disease. This is a consequence of the illness and treatment. The most common variations of bacterial imbalance are:

Dysbacteriosis of the oral cavity
– gardnerellosis, candidiasis, E. coli damage
Everyone has their own methods of diagnosis, treatment and preventive measures.

Diagnosis, treatment

Specific individual symptoms imbalance intestinal microflora No. This is a whole complex of symptoms, but in each patient these processes can occur differently. Symptoms of intestinal dysbiosis:

The symptoms of this pathology are similar to the signs of various diseases of the gastrointestinal tract and viral ailments. Therefore, often the symptoms of imbalance are either ignored or completely different, often non-existent diseases are treated. Diagnosis of dysbiosis is the process of identifying disturbances in the microflora of the stomach and intestines. There are 2 methods for determining the degree of imbalance:

Bacterial seeding for flora - most often you will have to take it feces. In the laboratory, from 14 to 25 types of microorganisms populating the human intestine are determined. The duration of analysis processing ranges from 5 to 7 days, depending on the equipment of the laboratory. It depends on how much bacteria grow in the nutrient medium. When pathogenic organisms are detected on an alarming scale, the laboratory conducts sensitivity tests to antibacterial agents.
Study of substances that microorganisms release during their activity. The advantage of this method is speed - the results are ready within a few hours.

Treatment of dysbiosis after antibiotic therapy is as follows:

Diet
Lifestyle change
Specific therapy to neutralize the pathogen
Increasing local immunity
Treatment is selected by the attending physician according to test data.

Dysbacteriosis and gynecology. Symptoms, treatment

Dysbacteriosis after antibiotic therapy in women is observed very often

We were treated with antibiotics, discharge began, itching and burning in the perineum. We went to the gynecologist. Hello, thrush or gardella! It would seem, what do these problems have to do with dysbacteriosis? The most direct!

Normally, the vagina is home to 95% of beneficial lactobacilli and 5% of fungi, representatives of opportunistic flora. As long as the balance of microorganisms is not disturbed, the woman is healthy and feels great.

While taking antibiotics, the number of lactobacilli is reduced, and pathogens begin to actively colonize the vagina. As a result, we get candidiasis or gardnerellosis! Signs of vaginal dysbiosis:

Itching, discomfort in the genital area
Discharge
Hyperemia of the external genitalia and vaginal walls
Urinary dysfunction
Dry mucous membranes
Unpleasant smell - sharply sour milk for candidiasis, unpleasant fishy - for other diseases
Inability to have a normal sex life

A gynecological smear may lack leukocytosis and lactobacilli, but may contain fungi, cocci and other multiplied representatives of opportunistic flora. Treatment depends on the causative agent of the disease:

Antifungal
Antibacterial
A course of drugs to restore microflora
Diet
Drugs to improve immunity

Treatment of vaginal dysbiosis is a long process. Sometimes this condition can last for years with exacerbations and remissions.

Dysbacteriosis in the oral cavity

Probiotics - for the treatment of dysbiosis

This pathology develops as a result of aggressive treatment of the oral cavity with antibiotics and local antiseptics, and violation of the principles of proper nutrition. Often the disease can occur without visible symptoms. Quite often, the signs of dysbiosis are confused with other ailments, vitamin deficiency, or simply not paid attention to. Signs of oral dysbiosis:

Bad breath or simply bad breath
Cracks or bumps in the corners of the lips
Loose teeth and periodontal disease
A thick plaque forms on the teeth, which begins to destroy the enamel.
Damage to tonsils, ligaments, throat

The treatment of the oral cavity is similar to the treatment of other organs. Drugs are used to suppress pathogenic microflora, agents containing lactobacilli and bifidobacteria, immunomodulators, and a complex of vitamins.

Diet for dysbiosis

Treatment of pathology should begin with dietary correction. Sometimes this is enough to defeat dysbiosis and other concomitant diseases, and work on your figure. Products that are prohibited:

Spicy and fatty food. It irritates the intestinal mucous membranes, and this leads to the death of beneficial microorganisms. The pathogenic flora feels good at this time. Digestive processes begin to slow down, constipation occurs and dysbiosis intensifies.
Bakery, sour cabbage, products, fermentative.
only boiled or baked. Roasts and steaks are prohibited.
Sweets, strong coffee, alcohol in any form, condensed milk.
Canned or pickled foods.
Spicy seasonings - horseradish, mustard, pepper - are not for you.

Food should be natural. If possible, avoid products with preservatives, artificial colors, and various flavorings.

Dysbacteriosis is fraught with serious complications

After eating, walk for 30 minutes and only then drink tea or compote. Liquid reduces the concentration of gastric juice, and this has a bad effect on the processes of food digestion. What to pamper yourself with dysbiosis:

Products containing bifidobacteria and lactobacilli. Kefir, sour cream, fermented baked milk, natural yoghurt should be present in the diet daily. If possible, it is better to buy ready-made starter cultures and make homemade live kefir and yoghurt.
Plant fiber stimulates digestion. Vegetables, cereals, fruits - daily. Any greens - basil, cilantro, parsley - should always be on the table. Baked or mashed potatoes without oil.
Porridge – buckwheat, oatmeal. Semolina and rice should be limited, as they can lead to bowel movements.
Low-fat soups - chicken or turkey, veal or lean pork.
Applesauce is recommended for the treatment of dysbiosis. Prepared from baked or stewed apples. This dish is a kind of plant probiotic.

A diet for dysbacteriosis is not a diet in the direct sense. It's more of a healthy diet. It's easy to stick to.

Possible complications

Imbalance of microflora can have unpleasant consequences. The most dangerous of them:

Diseases caused by opportunistic microflora - colpitis, vaginitis, vaginosis, colitis and so on.
Vitamin deficiency - with intestinal dysbiosis, the absorption of vitamins and minerals. This affects all systems of the body.
Iron deficiency, development of anemia.
and immunodeficiency.

Often, doctors and patients focus their attention on treating the effect, but the cause – dysbiosis – remains and provokes new pathologies.

Oral dysbiosis is a fairly common phenomenon. Many people suffer from this disease to one degree or another. It is no secret that the human oral cavity is populated by both beneficial and harmful bacteria. At the same time, the main indicator of their successful coexistence is the condition of the mucous membrane.

Main symptoms of the disease

Like many other diseases, oral dysbiosis cannot be asymptomatic. However, symptoms that are not fully manifested may seem insignificant at first. The disease manifests itself with the formation of small painful cracks in the corners of the mouth, as well as the appearance of an unpleasant odor - bad breath.

Further development of the disease can lead to loosening of the teeth, as well as the occurrence of periodontal disease. With dysbacteriosis, the patient's teeth become covered with abundant plaque, damaging the enamel surface. An extremely unfavorable pathogenic environment is created in the cavity, which can affect the functioning of the tonsils, ligaments, and tongue receptors.

In total, more than 300 species of various microorganisms are found in the human oral cavity, as well as in the nasopharynx. The microflora of this area is divided into facultative, or otherwise - transient and obligate. The obligate flora includes, in turn, treptococci, non-pathogenic staphylococci, leptotrichia, veillonella, bacteroides, lactobacilli, as well as fusiform bacteria and yeast-like fungi of the genus Candida. Among a number of transient representatives of the flora, you can most often find enterobacteria, Pseudomonas aeruginosa, spore-forming bacteria and, again, microorganisms of the genus Campylobacter.

Reasons for appearance

There are many reasons for the appearance of dysbacteriosis in the oral cavity. This:

- long-term or complex treatment with antibiotics, as well as chemotherapeutic agents;
- allergic dermatoses;
— infectious and inflammatory processes in the intestines, chronic gastrointestinal diseases;
- decreased immunity;
- hypovitaminosis;
— diet, fasting and other eating disorders.

Degree of disease development

To date, 4 degrees of the disease have been identified:

Dysbiotic shift, which is a slight change in the amount of a certain type of opportunistic microorganism. At the same time, the normal species composition of the oral microflora is preserved. This form is called latent, or otherwise compensated, because there are no pronounced clinical manifestations of the disease;
Dysbacteriosis of the 1st-2nd degree, or as it is also called - subcompensated form. At the same time, against the background of a slight decrease in the titer of lactobacilli, according to the results of the analysis, 2-3 pathogenic species are identified;
Subcompensated, or dysbacteriosis of the 3rd degree, is the presence of a pathogenic monoculture with a significant decrease in the amount of normal microflora, or even with complete absence its representatives;
Decompensated, or grade 4 dysbiosis, is the presence of associations of pathogenic microorganisms with yeast-like fungi.

In addition, there is also a division of this oral disease into 3 degrees:

The first degree is a state of microflora in which there is a numerical change in the number of lactobacilli, as well as corynebacteria. At the same time, the number of other rod-shaped, coccal flora and fungi also decreases;
The second degree of dysbiosis is already more significant fluctuations in the level of sowing of non-pathogenic staphylococci, bacteroids, corynebacteria, fusobacteria and leptotrichia. At the same time, deviations from the level can be either in the direction of increasing or decreasing the quantitative indicator of bacteria;
The third degree is characterized by a decrease in the titer of lactobacilli, veillonella, and Neisseria streptococci. Also, there are strong fluctuations in the composition of bacteroids and corynebacteria, and the number of St. increases significantly. aureus, enterobacteria, non-pathogenic staphylococci, leptotrichia, fusobacteria and Candida spp.

Treatment of dysbiosis

Now you know the symptoms of dysbiosis and we can begin treating the oral cavity.

Treatment of this disease oral cavity requires a comprehensive approach to itself. The use of gastroenterologists is necessary. A special place in the treatment of dysbiosis is occupied by drugs of bacterial origin. They perfectly correct microbiocenosis, increase nonspecific resistance organism, form immune responses of antagonistic normal flora, regulate metabolic processes, perform antidote and antioxidant effects.

In the treatment of dysbiosis, both antibiotic drugs and immunomodulators are also widely used. Thus, the introduction of immunomodulatory drugs into the complex of therapy reduces the need for the use of antibacterial agents by 3 times.

The effect of treating dysbacteriosis implies an impact on both the microflora and various factors of local immunity. That is why, today, doctors quite often recommend including in therapy not only general immunocorrectors, but also an immunostimulating drug of bacterial origin.

Today there are many drugs that effectively cope with the problem of dysbiosis. They are available to almost everyone and are freely sold in pharmacy chains. However, it is worth considering that a disease such as jisbacteriosis can be caused by a latent form of gastritis, peptic ulcer, or infection. That is why it is necessary to undergo a comprehensive examination in order to identify the root cause of the disease and eliminate it.

When considering the oral cavity, the majority of the oral population is commensal. Such microorganisms do not cause harm, but there is no benefit either. Dysbacteriosis of the oral cavity is observed when the invasion manages to disrupt the internal balance.

The populated environment does not allow the penetration of pathogenic bacteria that cause a number of diseases. Commensals, receiving food from the human body, indirectly perform useful role: prevent invaders from entering occupied territory. Impaired immunity, taking antibiotics or alcohol significantly changes the balance. There are many causes of dysbiosis in the mouth.

Who lives in the oral cavity

The mucous membrane is populated mainly by bacteria. Much less fungi, viruses and protozoa are detected. Let us recall the designation of biological terms:

The listed organisms live peacefully inside the oral cavity until a key event occurs.

What disrupts the balance of oral flora?

Alcohol, cigarettes, antibiotics cause suppression of the vital activity of microorganisms and cells. The principles of using the listed substances in medicine and other areas of life are based on this action. For example, alcohol has a pronounced disinfecting effect, and the ancient Finns considered a smoky sauna a favorable place for nursing patients.

A person constantly exposed to disinfectants must be prepared for specific consequences. The effect of the sauna is for the most part favorable; no analogy can be drawn with alcohol or excess medications. Once a commensal strain is suppressed, a random population takes its place. In the case of the development of a pathogenic culture, a number of diseases arise, a harbinger or consequence of diseases is oral dysbiosis. When the intestines are neglected, strains begin to appear in the wrong places.

What is dysbiosis

Oral dysbiosis is a state of imbalance. The types of bacteria are unique to each person. It is impossible to generalize a nationality or population of a certain area based on the indicated criteria. The set is strictly individual. For this reason, treating the altered state of the mucosa is extremely difficult.

Half of the people on the planet have in good condition Fungi of the genus Candida are found in the oral cavity. Fungi penetrate here:

In the process of childbirth.
When eating certain foods (for example, dairy).
When breastfeeding a baby.

In many cases, Candida is destroyed by the immune system or replaced by the inhabitants of the nasopharynx. Dysbacteriosis of the oral cavity leads to excessive proliferation of the population, causing natural symptoms of white plaque on the tongue and inner surfaces of the cheeks. With such an extreme manifestation, the condition in question turns into a disease.

Symptoms and stages

Oral dysbiosis successively passes through three stages in the absence of proper care:

Compensated. Symptoms are easily suppressed by simple means or are absent.
Subcompensated, intermediate stage on the way to an uncontrolled course of the disease.
The decompensated form requires mandatory treatment.

Compensated

At this stage, specific manifestations are often absent. Laboratory tests (smear) to detect the presence of bacterial strains will help identify the disease.

Subcompensated

Harbingers of serious consequences are manifestations: irritation, redness, swelling, dryness, burning, bad breath, metallic taste. The problem of making a correct diagnosis is the nonspecificity of symptoms. Similar troubles accompany liver and kidney diseases; an unpleasant odor is often caused by ozena. The study of microflora helps to establish the cause.

Decompensated

Accompanied by severe inflammation, swelling, bleeding gums, herpes, and specific formations in the oral cavity. With candidiasis, the tongue becomes covered with a white coating, stomatitis and gingivitis develop. An experienced therapist or dentist will determine the cause based on the existing signs. It is believed that caries is a consequence of neglect of pathology. You should not delay treatment of oral dysbiosis for a long time.

Control and prevention measures

Oral problems are difficult to solve and are often caused by an unhealthy lifestyle that is difficult to give up.

Vitamins and microelements

Vitamin C and others are responsible for gum health. Scientists have shown that humans need flavonoids. Discovered in the 30s of the 20th century, vitamins have again aroused interest. Many flavonoids are found in black currant, peels of citrus fruits (for example, lemons). Taking the two vitamins mentioned together relieves symptoms of bleeding and swelling.

It has been established that the pyramid builders were given onions as food. The moderate iodine content in onion scales increased the tone of the immune system. Iodine is absolutely necessary to awaken the body's defenses. If you eat 30 g of fresh onions daily, you will be able to prevent the proliferation of a large number of harmful strains. The content of complex saccharides in the juicy pulp of the vegetable promotes the development of normal intestinal microflora, eliminating the very cause of troubles in the oral cavity. Garlic and black pepper are beneficial in moderate doses.

The importance and doses of other microelements are not so widely known. It’s easier to choose a balanced diet from your favorite foods that contain the required elements of a healthy metabolism.

Outpatient methods

Certain recommendations are given by therapists, gastroenterologists, dentists, and infectious disease specialists. The outcome is decided by the result of the analysis, which reveals the abundance of pathogenic strains. Treatment consists of a set of measures (in addition to taking vitamins):

Local antiseptics, antifungal drugs.
Strains of beneficial microorganisms (eubiotics and probiotics).
Drugs that increase the functioning of the immune system.

Not all of the measures listed are effective. Studies have shown the lack of benefit of certain probiotics for the state of intestinal microflora. However, athletes claim that taking bifidobacteria eases the course of respiratory diseases and throat diseases.

Attention! Medicines are used as prescribed by a doctor.

What to do?

Toothpastes, rinses and other measures do not protect against dysbacteriosis of the oral mucosa. Otherwise, the disease would have been eradicated long ago. An effective remedy is a technique vitamin complexes and products that restore intestinal microflora (a method of eliminating the main cause of problems with the oral cavity). It is important to eat a balanced diet.

In the 60s of the 20th century, it was proven that general physical culture has a beneficial effect on the systems of the human body. Dr. Kenneth Cooper showed the need to walk 10 km daily. Following this rule every day ensures that you stay in shape, from English to be in fit. Today the phenomenon is called fitness, and the United States, developing sports clubs, has earned billions of dollars from the sale of fitness lessons.

In the West, it is considered proven that a free gym membership for employees is a guarantee of increased productivity. In the CIS countries, there is no such concern for workers, with few exceptions. Perhaps the reason stated is that Russian doctors consider dysbiosis a disease, which Western colleagues do not agree with.

Why does oral dysbiosis occur, why is it dangerous and how to treat it?

Dysbacteriosis of the oral cavity is characterized by changes normal composition microflora in this area. During a dysbiotic failure, harmful organisms begin to attack not only the mucous membranes, but also the bone component.

As a result, the dentition loses its strength, and in the absence of treatment, active tissue destruction begins, affecting all structures of the oral cavity.

Dysbacteriosis is an imbalance between conventional and pathogenic microflora, when harmful bacteria begin to predominate in quantitative or qualitative composition, provoking a number of complications.

The growth of pathogenic microflora can be influenced by both external and internal factors. In dysbiosis, active reproduction of microorganisms of opportunistic flora leads to a decrease in the functionality and quantitative composition of bifidobacteria. In this case, representatives of pathogenic flora can produce without changes.

Composition of microflora in the mouth

The most common inhabitants of the oral cavity are bacteria. There are more than 500 strains. In addition, the mucous membranes are inhabited by protozoa, fungi and viruses. The number and composition of microflora organisms is individual for each person. All inhabitants of the oral cavity can be divided into 2 groups:

Obligate or permanent environment. These bacteria are constantly present in the human mouth. The most common are lactobacilli, streptococci, staphylococci, prevotella, and bacteroides.
Facultative or non-permanent microflora. Its penetration occurs when eating food, migration of organisms from the nasopharynx, intestines, and skin. Typical representatives of this group are pseudomonads, Escherichia coli, and Klebsiella.

Causes of imbalance

A number of factors, both external and internal, can lead to the development of oral dysbiosis:

Gastrointestinal diseases. If there is a malfunction of the digestive organs, they slow down metabolic processes in the body, the absorption of nutrients is impaired. When the internal reserve is depleted, an imbalance of the intestinal bacterial environment occurs, which contributes to the occurrence of dysbiosis in other departments.
Mouthwashes for cleaning the mouth. Most often, these products include antiseptics and alcohol. These components contribute to overdrying of the mucous membranes, which disrupts their structure.
Availability bad habits. Smoking and drinking alcoholic beverages affect the functioning of the salivary glands. As a result of prolonged drying out or excessive moisture in the oral cavity, the composition of the microflora changes.
Decreased immunity. When the body's resistance decreases, it becomes vulnerable to pathogenic microflora.
Presence of chronic diseases. If you do not treat existing ailments, the focus of the inflammatory process will gradually affect neighboring organs. Especially if it is located in the oral cavity, for example, caries, stomatitis.
Poor nutrition. A lack of vitamins in the diet leads to vitamin deficiency.
Taking certain medications. Antibiotics and antiseptics mainly have a negative effect on the composition of microflora.

Features of the clinical picture

The appearance of certain symptoms depends on the degree of development of dysbiosis in the mouth. There are 4 stages of the disease:

Latent phase. A dysbiotic shift is characterized by a slight change in the amount of one strain of pathogenic microorganisms. There are no symptoms.
The subcompensated stage is characterized by a decrease in lactobacilli. The signs of the disease are blurry.
Pathogenicity of monocultures. Lactobacilli are diagnosed in minimal quantities; the oral cavity is inhabited by a facultative pathogenic environment. Signs of dysbiosis are clearly visible.
Decompensated form of the disease. At this stage, in addition to severe symptoms, the growth of yeast-like fungi occurs.

The very first sign of the disease is the appearance of bad breath. Then an uncharacteristic taste and burning sensation occurs. These symptoms are supplemented by dysfunction of the salivary glands.

In an advanced state with dysbacteriosis of the oral mucosa, the following symptoms are observed:

inflammation of the mucous membranes and gums;
the presence of plaque on the surface of the tongue and teeth;
bleeding gums;
the appearance of ulcers and blisters, with a simultaneous increase in body temperature;
swelling, hyperemia and soreness of the tongue;
dryness of the skin of the face, in particular the area around the lips. Characteristic is the appearance of sticking in the corners of the mouth and peeling of nearby surfaces.

Diagnostic criteria

Making a diagnosis of dysbacteriosis is often difficult, this is explained by the lack obvious manifestations at the initial stage of the disease and individual differences in the composition of the microflora of the oral cavity of each person. However, if the presence of dysbiosis is suspected, the dentist sends a smear from the surface of the mucous membranes or an analysis of the patient’s saliva for microbiological examination.

The material is collected on an empty stomach. There should be no food particles on the surface of the enamel, otherwise the test result will be unreliable.

In addition, the patient needs to donate blood and urine. Additional examinations are prescribed according to test indications. Sometimes several specialists are involved in the further course of the disease. This could be a therapist, gastroenterologist, immunologist, nutritionist, infectious disease specialist.

Therapy methods

Depending on the examination indicators and the nature of the pathogen, treatment of oral dysbiosis may include:

Sanitation of the oral cavity. In this case, it is necessary to remove tartar, fill all diseased teeth, and treat the gums and mucous membranes.
Taking antiseptics to eliminate pathogenic microorganisms.
Use of immunostimulants. Such drugs help strengthen the body's defenses.
Prescription of probiotics. They restore the balance of beneficial bacteria.
Taking vitamin complexes is indicated for vitamin deficiency and for general strengthening body. Correct selection the corresponding components promote cell regeneration and strengthen bone tissue.
Antifungal agents (for candidiasis) and antibiotics (indicated only for severe dysbiosis) are prescribed extremely rarely.

In addition to taking appropriate medications to improve the effectiveness of therapy during the treatment period, it is recommended to follow the following rules:

give up bad habits: smoking and drinking alcohol;
refrain from oral sex;
review nutrition, paying special attention to products of plant origin;
After each meal, you need to clean your mouth of food debris.

The duration of treatment depends on the stage of the disease, the presence of foci of inflammation and existing complications. On average, this period is 2-4 weeks.

Possible consequences

In the absence of timely adequate therapy, the patient begins the process of destruction of bone tissue, caries, pulpitis, and cysts appear. Further pathological changes affect the oral mucosa in the form of stomatitis and gingivitis.

The gums, losing their protective functions, begin to bleed and become inflamed, which is due to the influence of periodontitis and periodontal disease. When a fungal carrier penetrates, candidiasis occurs.

All these pathological changes lead to early loss of dentition. In addition to inflammatory processes in the oral cavity, the infection can spread to other parts of the body: the nasopharynx and gastrointestinal tract, causing various diseases internal organs.

Preventive measures

To avoid oral dysbiosis and its complications, it is not enough to simply clean the oral cavity twice a day. The issue must be approached comprehensively:

you need to properly plan your diet, avoiding prohibited foods that destroy the protective membrane of the mucous membranes;
It is worth treating diseases of internal organs in a timely manner; any inflammatory process in the body affects immune system humans, which leads to a decrease in resistance to pathogenic microflora;
it is necessary to periodically take vitamin complexes;
It is recommended to stop drinking alcohol and smoking.

The appearance of dysbacteriosis in the oral cavity negatively affects the condition of the mucous membranes and bone tissue of the dentition. Without proper treatment, you can quickly lose your beautiful and snow-white smile.

Hello. I have such a problem, it all started a year ago; there was a bitter taste in my mouth and my tongue was stinging. Now there is a coating in the throat on the tongue, the papillae of the tongue are inflamed, they sting, but the duration is about 3 hours. Then everything is just thick. All tests showed excellent results except Citrobacter spp. abundant growth in the mouth. The therapist prescribed treatment, but my palms began to turn brown from the medications. Now I haven’t taken anything for a month so that my liver can recover. see a doctor in 2 weeks. and I’m already afraid maybe because of this coli have such problems in the mouth. I was already on a diet and treated my mouth with a lot of things, but everything helped for a couple of days and then again. There are no problems with the stomach. nothing to worry about. but only this E. coli.

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Symptoms and treatment of oral dysbiosis: how to get rid of bacteria on the mucous membrane and eliminate unpleasant odor?

The mucous membrane of the oral cavity contains a large amount of microflora, which is individual in each person: there are both opportunistic and completely harmless microbes. When this delicate balance is disturbed, oral dysbiosis forms in the body, which can be complicated by other infectious diseases.

What is dysbiosis in the oral cavity?

Dysbacteriosis is a chronic pathological condition that occurs as a result of an imbalance between the number of beneficial and harmful microorganisms, in which harmful ones predominate. Dysbacteriosis in the oral cavity, treatment and diagnosis of which is not special difficulties, currently occurs in every third person.

Preschool children, the elderly and people with weakened immune systems are most susceptible to the effects of the bacterium: cancer patients, patients with HIV and primary immunodeficiency. In adults healthy people symptoms of dysbiosis are rare.

Causes

Oral dysbiosis is a multifactorial disease that develops due to the influence of a whole group of completely different factors. Each of them separately from each other may not cause negative consequences, but when interacting together, the disease is guaranteed to occur.

The main factors causing the disease:

long-term use of antibiotics in the treatment of chronic diseases;
primary or secondary immunodeficiency;
intestinal infection, heavy metal poisoning;
inflammatory diseases of the gastrointestinal tract intestinal tract;
diet low in animal protein and vitamins;
allergic diseases of various origins: urticaria, dermatoses and dermatitis, Quincke's edema;
taking hormonal contraceptives or steroid drugs;
taking anti-inflammatory substances for more than two weeks;
excessive intake of nicotine into the body: active and passive smoking;
alcohol abuse.

Diagnostics

To accurately diagnose oral dysbiosis in a patient, it is necessary to conduct a series of simple bacteriological tests. You also need to analyze the symptoms that indicate dysbiosis.

Laboratory methods for diagnosing dysbiosis:

Bacteriological analysis and culture of biomaterial - saliva or scrapings from the gums - on nutrient media. This method allows you to accurately determine the level of infection of the oral cavity by pathogenic pathogens.
The urease test is based on the ratio of the amount of urease and lysozyme: if this number increases by more than one, one can accurately judge the presence of dysbiosis in the body.
Gram staining and microscopy of an oral smear. During this method, a quantitative count of gram-positive and gram-negative microbes is made, and based on the data obtained, a conclusion is made about the presence of a bacterial imbalance.
The express method is based on determining the amount of a specific bacterium in the emitted air and then comparing this figure with an oral smear. If the ratio is more than one, then the diagnosis is reliable.

Stages of disease development and symptoms

Any pathological process occurring in the body is characterized by a certain stage. Dysbacteriosis of the oral cavity has a fairly slow and long course, which makes it possible to clearly distinguish between all stages and their characteristic clinical picture.

There are three stages in the course of the disease:

Compensation stage. The pathological process is just beginning to develop, and a slight increase in the concentration of pathogenic agents is observed. The body successfully copes with the threat on its own. If you have good immunity, the disease recedes at this stage, and the only manifestation is bad breath.
Subcompensation stage. Defense mechanisms begin to fail, and the number of harmful microorganisms increases. Clinically, this stage is manifested by a burning sensation in the mouth, dry mucous membranes, coating on the tongue, and is also observed unpleasant smell from mouth. In the photographs of patients, you can see a pale gray color of the skin.
Stage of decompensation. Accompanied by complete depletion of compensatory mechanisms and decline of the immune system. Pathogenic microorganisms make up the majority of the oral microflora. The symptoms are clearly expressed: ulcerations appear in the oral cavity, the gums bleed, the tonsils and soft palate become inflamed, the process of absorption and assimilation of nutrients is disrupted, and a putrid odor appears. As the process progresses, it can spread to the throat.

How to treat?

Drugs for oral dysbiosis

Currently, two groups of drugs are widely used: probiotics and prebiotics. Both groups are successfully used for treatment various stages dysbiosis.

Probiotics contain a large number of beneficial bacteria and prevent the colonization of mucous membranes by harmful microorganisms. Lactobacterin, Biobakton and Acylact are some of the most famous representatives of the group. Long-term treatment ranges from several weeks to several months.
Prebiotics are aimed at correcting pH and helping to create optimal conditions for the reproduction of normal microflora. Hilak Forte, Duphalac and Normaze are used in a course for two to three weeks.

Folk remedies

Long before the advent of the pharmaceutical industry, people resorted to the services traditional medicine. Many methods that help cure oral dysbiosis are still relevant today.

The most effective folk methods:

Homemade curdled milk. A few pieces of dried black bread are added to a liter of boiled milk. The resulting mixture is infused in a dry and warm place for 24 hours, after which it is completely ready for use. Dysbacteriosis disappears within one week.
Strawberries. Fresh berries stimulate salivation, thus promoting the production of beneficial microorganisms and creating a favorable environment for their reproduction. A glass of fresh berries before meals will restore the imbalance.
Potentilla decoction. This plant has enormous sedative and anti-inflammatory properties, which determines its use for dysbiosis. A tablespoon of cinquefoil is poured into two glasses of water and boiled for thirty minutes. Use twice a day.

Preventive measures

Preventive measures against dysbiosis are divided into three main areas:

increasing the overall resistance of the body;
regular consultation with a specialist about chronic diseases;
stabilization of the microbial flora of the oral cavity.

The body's resistance to infections can be increased by using regular physical activity, application of hardening techniques and yoga exercises. Giving up bad habits will also have a beneficial effect on a person’s overall health.

When taking antibacterial, anti-inflammatory and hormonal drugs, you should strictly adhere to the timing of use according to the instructions for the medicine and/or the doctor’s prescription. It is also recommended to simultaneously take a course of probiotics and lactobacilli, which promote the regeneration of microflora.

A simple diet will help restore and maintain the normal balance of the microflora of the mucous membranes: it is recommended to give up fast food, fatty, salty and fried foods, and exclude packaged juices and carbonated waters. It is necessary to include more fresh vegetables and fruits in the diet, and increase the consumption of fresh water.

my son had dysbacteriosis, and better means We found nothing of traditional medicine! They constantly drank milk and yogurt, and were cured in five days. I believe that all the pills kill the liver even more!

Why just take the pills? We always buy Duphalac at the pharmacy. He helps both my daughter and my husband and me. He even helped a dog who almost died after eating a chicken bone. Still folk remedies- This extreme case when it is not possible to visit a doctor.

Dysbacteriosis of the mouth

A fairly common disease is oral dysbiosis. This disease affects many people. As you know, many different bacteria, both beneficial and harmful, live in the oral cavity. The main indicator of their vital activity is the condition of the mucous membranes.

As a result of disruption of the correct microflora of the oral cavity, the formation of certain symptoms occurs, which form the concept of dysbiosis in the mouth. Normal oral microflora is an individual concept for everyone. Normally, every person has various microorganisms in their oral cavity, which may include: fungi of the genus Candida, streptococci, lactobacilli, and staphylococci.

Dysbacteriosis of the oral cavity does not occur on its own; it often manifests itself as a consequence of developed dysbiosis of the intestinal tract. It also occurs in the presence of chronic diseases digestive organs. Common cause The appearance of intestinal dysbiosis is prolonged and uncontrolled use of antibiotics.

At proper operation The intestinal microflora favors the absorption of vitamins A, E, D, and also produces B vitamins. With developed dysbacteriosis, there is a lack of these vitamins, which is reflected in the oral cavity. The cause of the formation of dysbacteriosis can also be the use of various mouthwashes, lozenges, local antiseptics, and toothpastes.

Factors for the development of dysbacteriosis:

The presence of allergic dermatosis;

Disturbed or incorrect diet;

Chronic diseases of the gastrointestinal tract;

Inflammation or infection in the intestines.

Signs of oral dysbiosis:

Development of candidiasis (white coating on the tongue and inside cheeks);

Recurrent herpes infection that affects the lips and mouth;

Relapses of aphthous stomatitis;

Cracks in the corners of the mouth;

Inflammation of the pharynx and oral cavity.

Stages of development of oral dysbiosis

At the first stage of development of dysbiosis, an increase in the number of one or several types of pathogenic organisms in the mouth occurs. This is called a dysbiotic shift, and there are no manifestations.

At the next stage, the number of lactobacilli decreases and barely noticeable manifestations appear.

At stage 3, instead of the lactobacilli necessary for the body, a large number of pathogenic microorganisms appear.

During stage 4, yeast-like fungi actively reproduce.

In the last two stages of the development of the disease, ulcers, inflammation and excessive keratinization of the oral epithelium may occur.

Oral dysbiosis symptoms and treatment

The degree of development of the disease provokes the appearance of certain symptoms. Dysbacteriosis can be of several types: subcompensated, compensated, decompensated.

With a dysbiotic shift (compensated dysbacteriosis), there are no symptoms and the disease can only be detected using laboratory methods. When diagnosing, the number of opportunistic organisms is determined, while the normal flora of the mouth is not affected.

Symptoms of oral dysbiosis in the form of a burning sensation in the mouth, the appearance of halitosis or metallic taste They talk about subcompensated dysbacteriosis. Studies reveal a reduced level of lactobacilli, an increased volume of pathogenic microflora and the presence of pathogenic microorganisms.

The appearance of seizures, infections in the mouth, inflammation of the tongue, and gums indicates decompensated dysbacteriosis.

As a result of all of the above, the patient develops periodontal disease, stomatitis, and periodontitis. By neglecting these diseases, you can lose several teeth. It is also possible to develop an infection of the nasopharynx. In such situations, the normal flora disappears, and in its place the opportunistic flora increases.

Treatment of dysbiosis is necessary only in the most extreme situations. In other cases, it is necessary to carry out general diagnostics body, detect the presence of intestinal diseases and treat them.

If you have been diagnosed with oral dysbacteriosis, then you need to be examined by a therapist, gastroenterologist, infectious disease specialist and undergo urine and blood tests.

Often the cause of dysbiosis is improper oral care, excessive and irrational use of antiseptics and antibiotics, and a passion for sweets.

If the symptoms of oral dysbiosis are confirmed by the diagnosis, treatment is then mainly used in the form of sanitation and taking medications to normalize the microflora in the mouth. Also used as therapy:

Vitamins – which increase tissue regeneration;

Eubiotics - used to increase the number of beneficial bacteria in the oral cavity, use Acelact as baths (after that use Bifidumbacterin);

Local antiseptics will help reduce the level of pathogenic microflora;

Immunomodulators – prevent the growth of pathogenic organisms and increase local immunity;

Antimicrobial and antifungal agents, antibiotics - used for severe inflammation.

With effective therapy, it is necessary to first reduce the severity of the disease (pain and burning sensation will decrease), then the level of beneficial microflora must be normalized.

In order to completely cure dysbiosis, it is necessary to eliminate the cause of its occurrence. Dysbacteriosis in the mouth requires mandatory treatment, otherwise the condition will become stronger and have additional consequences.

Dysbacteriosis in the mouth: how and with what to treat the mucous membrane?

If you want your oral cavity to always be in excellent condition, use Super 5 Probiotic. Its formula is designed to maintain and form the correct microflora of the oral cavity.

This drug is designed to help people different ages supported the oral cavity healthy condition. It comes in the form of lozenges and has a pleasant fruity taste.

Each tablet contains about 2 billion beneficial bacteria, which contribute to the rapid restoration of the proper microflora of the mouth.

These tablets do not contain yeast or fructooligosaccharides.

Preventive measures for ARVI;

Prevention of periodontal disease, caries, strengthening of gums;

With thrush in the oral cavity;

To normalize microflora in the mouth.

Children from 4 to 12 years old: dissolve 1 tablet after meals, 1 time per day.

Over 12 years: 1 tablet after meals, morning and evening.

Pathogenic flora in the mouth causes tartar, halitosis, caries, plaque on teeth, and inflammation of the gums. The probiotic strains contained in Super 5 Probiotic will help you get rid of all these unpleasant manifestations; the drug belongs to the category of probiotics for the mouth.

Dysbacteriosis of the oral cavity after taking antibiotics

The use of broad-spectrum antibiotics negatively affects the intestinal microflora. This happens because it destroys all microorganisms, both bad and good. As a result, an environment that promotes the proliferation of pathogenic organisms develops in the intestine.

As you know, from the above information, intestinal problems can also cause the development of dysbiosis in the mouth.

Therefore, after completing a course of antibiotic treatment, it is necessary to restore the correct intestinal microflora. It will be effective to use antibiotics together with probiotics, for example probiotics from Flora m&d, which will prevent pathogenic flora from multiplying.

For effective preventive measures, probiotics must be used along with antibiotics.

The main indicator of their vital activity is the condition of the mucous membranes.

Dysbacteriosis of the oral cavity does not occur on its own; it often manifests itself as a consequence of developed dysbiosis of the intestinal tract. It also occurs in the presence of chronic diseases of the digestive organs. A common cause of intestinal dysbiosis is prolonged and uncontrolled use of antibiotics.

With proper functioning of the intestine, its microflora favors the absorption of vitamins A, E, D, and also produces B vitamins. With developed dysbiosis, there is a lack of these vitamins, which is reflected in the oral cavity. The cause of the formation of dysbacteriosis can also be the use of various mouthwashes, lozenges, local antiseptics, and toothpastes.

Factors for the development of dysbacteriosis:

The presence of allergic dermatosis;

Disturbed or incorrect diet;

Chronic diseases of the gastrointestinal tract;

Inflammation or infection in the intestines.

Signs of oral dysbiosis:

Development of candidiasis (white coating on the tongue and inside of the cheeks);

Recurrent herpes infection that affects the lips and mouth;

Relapses of aphthous stomatitis;

Cracks in the corners of the mouth;

Inflammation of the pharynx and oral cavity.

Stages of development of oral dysbiosis

At the next stage, the number of lactobacilli decreases and barely noticeable manifestations appear.

At stage 3, instead of the lactobacilli necessary for the body, a large number of pathogenic microorganisms appear.

During stage 4, yeast-like fungi actively reproduce.

In the last two stages of the development of the disease, ulcers, inflammation and excessive keratinization of the oral epithelium may occur.

Oral dysbiosis symptoms and treatment

The degree of development of the disease provokes the appearance of certain symptoms. Dysbacteriosis can be of several types: subcompensated, compensated, decompensated.

Symptoms of oral dysbiosis in the form of a burning sensation in the mouth, the appearance of halitosis or a metallic taste indicate subcompensated dysbiosis. Studies reveal a reduced level of lactobacilli, an increased volume of pathogenic microflora and the presence of pathogenic microorganisms.

The appearance of seizures, infections in the mouth, inflammation of the tongue, and gums indicates decompensated dysbacteriosis.

Treatment of dysbiosis is necessary only in the most extreme situations. In other cases, it is necessary to conduct a general diagnosis of the body, identify the presence of intestinal diseases and treat them.

If you have been diagnosed with oral dysbacteriosis, then you need to be examined by a therapist, gastroenterologist, infectious disease specialist and undergo urine and blood tests.

Often the cause of dysbiosis is improper oral care, excessive and irrational use of antiseptics and antibiotics, and a passion for sweets.

Vitamins – which increase tissue regeneration;

Eubiotics - used to increase the number of beneficial bacteria in the oral cavity, use Acelact as baths (after that use Bifidumbacterin);

Local antiseptics will help reduce the level of pathogenic microflora;

Immunomodulators – prevent the growth of pathogenic organisms and increase local immunity;

Antimicrobial and antifungal agents, antibiotics - are used for severe inflammation.

With effective therapy, it is necessary to first reduce the severity of the disease (pain and burning sensation will decrease), then the level of beneficial microflora must be normalized.

Dysbacteriosis in the mouth: how and with what to treat the mucous membrane?

If you want your oral cavity to always be in excellent condition, use Super 5 Probiotic. Its formula is designed to maintain and form the correct microflora of the oral cavity.

This drug is designed to help people of all ages maintain a healthy oral cavity. It comes in the form of lozenges and has a pleasant fruity taste.

Each tablet contains about 2 billion beneficial bacteria, which contribute to the rapid restoration of the proper microflora of the mouth.

These tablets do not contain yeast or fructooligosaccharides.

Preventive measures for ARVI;

Prevention of periodontal disease, caries, strengthening of gums;

With thrush in the oral cavity;

To normalize microflora in the mouth.

Children from 4 to 12 years old: dissolve 1 tablet after meals, 1 time per day.

Over 12 years: 1 tablet after meals, morning and evening.

Pathogenic flora in the mouth causes tartar, halitosis, caries, plaque on teeth, and inflammation of the gums. The probiotic strains contained in Super 5 Probiotic will help you get rid of all these unpleasant manifestations; the drug belongs to the category of probiotics for the mouth.

Dysbacteriosis of the oral cavity after taking antibiotics

As you know, from the above information, intestinal problems can also cause the development of dysbiosis in the mouth.

For effective preventive measures, probiotics must be used along with antibiotics.

Symptoms and treatment of oral dysbiosis: how to get rid of bacteria on the mucous membrane and eliminate unpleasant odor?

What is dysbiosis in the oral cavity?

Dysbacteriosis is a chronic pathological condition that occurs as a result of an imbalance between the number of beneficial and harmful microorganisms, in which harmful ones predominate. Dysbacteriosis in the oral cavity, the treatment and diagnosis of which is not particularly difficult, currently occurs in every third person.

Causes

Oral dysbiosis is a multifactorial disease that develops due to the influence of a whole group of completely different factors. Each of them separately from each other may not cause negative consequences, but when interacting together, the disease is guaranteed to occur.

The main factors causing the disease:

long-term use of antibiotics in the treatment of chronic diseases;
primary or secondary immunodeficiency;
intestinal infection, heavy metal poisoning;
inflammatory diseases of the gastrointestinal tract;
diet low in animal protein and vitamins;
allergic diseases of various origins: urticaria, dermatoses and dermatitis, Quincke's edema;
taking hormonal contraceptives or steroid drugs;
taking anti-inflammatory substances for more than two weeks;
excessive intake of nicotine into the body: active and passive smoking;
alcohol abuse.

Diagnostics

To accurately diagnose oral dysbiosis in a patient, it is necessary to conduct a series of simple bacteriological tests. You also need to analyze the symptoms that indicate dysbiosis.

Laboratory methods for diagnosing dysbiosis:

Bacteriological analysis and culture of biomaterial - saliva or scrapings from the gums - on nutrient media. This method allows you to accurately determine the level of infection of the oral cavity by pathogenic pathogens.
The urease test is based on the ratio of the amount of urease and lysozyme: if this number increases by more than one, one can accurately judge the presence of dysbiosis in the body.
Gram staining and microscopy of an oral smear. During this method, a quantitative count of gram-positive and gram-negative microbes is made, and based on the data obtained, a conclusion is made about the presence of a bacterial imbalance.
The express method is based on determining the amount of a specific bacterium in the emitted air and then comparing this figure with an oral smear. If the ratio is more than one, then the diagnosis is reliable.

Stages of disease development and symptoms

There are three stages in the course of the disease:

Compensation stage. The pathological process is just beginning to develop, and a slight increase in the concentration of pathogenic agents is observed. The body successfully copes with the threat on its own. If you have good immunity, the disease recedes at this stage, and the only manifestation is bad breath.
Subcompensation stage. Defense mechanisms begin to fail, and the number of harmful microorganisms increases. Clinically, this stage is manifested by a burning sensation in the mouth, dry mucous membranes, coating on the tongue, and bad breath is also observed. In the photographs of patients, you can see a pale gray color of the skin.
Stage of decompensation. Accompanied by complete depletion of compensatory mechanisms and decline of the immune system. Pathogenic microorganisms make up the majority of the oral microflora. The symptoms are clearly expressed: ulcerations appear in the oral cavity, the gums bleed, the tonsils and soft palate become inflamed, the process of absorption and assimilation of nutrients is disrupted, and a putrid odor appears. As the process progresses, it can spread to the throat.

How to treat?

Drugs for oral dysbiosis

Currently, two groups of drugs are widely used: probiotics and prebiotics. Both groups are successfully used to treat various stages of dysbiosis.

Probiotics contain a large number of beneficial bacteria and prevent the colonization of mucous membranes by harmful microorganisms. Lactobacterin, Biobakton and Acylact are some of the most famous representatives of the group. Long-term treatment ranges from several weeks to several months.
Prebiotics are aimed at correcting pH and helping to create optimal conditions for the reproduction of normal microflora. Hilak Forte, Duphalac and Normaze are used in a course for two to three weeks.

Folk remedies

Long before the advent of the pharmacological industry, people resorted to the services of traditional medicine. Many methods that help cure oral dysbiosis are still relevant today.

The most effective folk methods:

Homemade curdled milk. A few pieces of dried black bread are added to a liter of boiled milk. The resulting mixture is infused in a dry and warm place for 24 hours, after which it is completely ready for use. Dysbacteriosis disappears within one week.
Strawberries. Fresh berries stimulate salivation, thus promoting the production of beneficial microorganisms and creating a favorable environment for their reproduction. A glass of fresh berries before meals will restore the imbalance.
Potentilla decoction. This plant has enormous sedative and anti-inflammatory properties, which determines its use for dysbiosis. A tablespoon of cinquefoil is poured into two glasses of water and boiled for thirty minutes. Use twice a day.

Preventive measures

Preventive measures against dysbiosis are divided into three main areas:

increasing the overall resistance of the body;
regular consultation with a specialist about chronic diseases;
stabilization of the microbial flora of the oral cavity.

The body's resistance to infections can be increased through regular physical activity, hardening techniques and yoga exercises. Giving up bad habits will also have a beneficial effect on a person’s overall health.

Dysbiosis of the pharynx

Numerous microorganisms live in the oral cavity and nasopharynx (there are a hundred times more anaerobes - lovers of oxygen than aerobes - living without oxygen). These are bacteroides, porphyromonas, prevotella, eubacteria, fusobacteria, bifidobacteria, lactobacilli, actinomycetes, Haemophilus influenzae, neisseria, spirochetes, leptotrichia, streptococci, staphylococci, peptococci, peptostreptococci, veillonella, Candida fungi, protozoa (Entamaeba gingivalis and Trichomonas tenax) and other organisms . Antimicrobial components of saliva (antibodies and lysozyme) inhibit the action of foreign microbes. Fibronectin (similar in properties to gram-positive bacteria) coats the mucous membrane and inhibits the growth of gram-negative bacteria. All types of microflora living in symbiosis with humans are in a certain quantitative ratio with each other.

When antiseptic drugs and antibiotics are abused to treat various diseases of the oral cavity and pharynx (throat), the balance of microflora can be disrupted, that is, it can cause a imbalance in the quantitative ratio of beneficial and conditionally pathogenic microorganisms (and towards an increase in pathogenic species). And against this background, dysbacteriosis (dysbiosis) develops.

For the treatment and prevention of dysbiosis of the oral cavity, pharynx, nasopharynx, the following are suitable: Pyobacteriophage polyvalent purified (Sextaphage), Staphylococcal bacteriophage, Streptococcal bacteriophage, Pyobacteriophage combined. They are used in the form of rinsing, irrigation of mucous membranes, and instillation into the nose. When rinsing, it should be taken into account that the bacteriophage foams a lot, so you need to put a little bit of it into your mouth. Rinsing with a bacteriophage solution is carried out followed by swallowing the solution.

Bacteriophage in ENT practice.

In case of inflammatory or purulent-inflammatory processes in ENT diseases in the nose, nasopharynx, pharynx or ear (for example: tonsillitis, tonsillitis, pharyngitis, laryngitis, sinusitis, sinusitis, otitis), there is also the possibility of using bacteriophage. To treat otitis media, bacteriophage is used in the form of turundas moistened with a solution or rinsing the middle ear cavities. To treat inflammation in the sinuses, the nasal cavity and nasopharynx are washed with a bacteriophage, or the turundas moistened with the bacteriophage are left in the nose for a while. The turundas are left for an hour and a half, then changed several times during the day. Since a certain bacteriophage targets only a certain type of bacterium, it is necessary to select the bacteriophage according to the pathogenic bacterium that caused the purulent or inflammatory process. To do this, take a smear from the site of the lesion and do a bacterial culture. And only after identifying the pathogen is a phage selected.

Dysbacteriosis of the pharynx is not a reason for antibiotic therapy!

N.V. Bozhko (1), Ph.D., assistant,

T.V. Markitan (1,2), graduate student,

1. Department of Otorhinolaryngology NMAPE named after P.L. Shupika, Kyiv,

2. Medical center "SantaLen", Kyiv

The question that almost every one of us has to ask at least once in our lives and which almost any doctor has to answer repeatedly is this: what do the normal results of an analysis of the microbiological composition of the studied environment look like and how to properly treat a patient if it is disturbed? Sounds familiar, doesn't it? Indeed, this topic is relevant for doctors of any specialty: dermatologists, gastroenterologists, pulmonologists, gynecologists, urologists, surgeons. This is especially true for otolaryngologists. Interest in the microbiocenosis of the ENT organs is due to many factors - this is a fairly large proportion of these diseases among adult pathologies, and an extremely high incidence among children. It is also important that the interpretation of the results of a microbiological study, unfortunately, is not always correct, and the treatment, accordingly, is not adequate. Unfortunately, we, as practicing doctors, have to deal with just such a situation (for example, a child was diagnosed with streptococcus, which is a variant of the norm, but he was prescribed antibacterial therapy, which caused dysbacteriosis and only worsened the situation). Therefore, there is a real need:

In providing professional material on detailed analysis species composition of microbiocenosis of ENT organs;

In determining the characteristics of normal and pathogenic microflora;

In finding out the cause of its violation and ways to combat dysbacteriosis.

So, normally, all children are born exclusively sterile, i.e. do not have a single representative of the microflora. But from the first seconds of birth, the newborn comes into contact with environment. Quite quickly skin and mucous membranes communicating with the external environment are populated by various microorganisms (from the air, upon contact with the mother, medical personnel, etc.), which will accompany a person throughout his life. To understand the inevitability of such coexistence, we present several indisputable mathematical indicators. The total number of microorganisms that are found in an adult human reaches 1014, which is almost an order of magnitude (!) greater than the number of cells of all human tissues; the weight of beneficial microbes in the large intestine (dried) is up to 1.5 kilograms. Such an ecological system (a person + the microflora inhabiting it) is very dynamic, the impact on it can both be beneficial for the body and have extremely negative consequences.

And now directly about microflora of the upper respiratory tract and oral cavity. It is important to understand that ENT organs are no exception to microbial sterility, i.e. normally we can (and should!) detect certain microorganisms in the nose, pharynx and outer ear. These microbes in conditions of maintaining immune resistance not only do they not bring us any harm, but on the contrary, they have positive influence. They form the so-called biofilm(thickness from 0.1 to 0.5 mm) - the polysaccharide frame of which, consisting of microbial polysaccharides and mucin, prevents the colonization of the body by pathogenic microorganisms. Due to the release of biofilm by microorganisms various acids, alcohol, lysozyme (an antibacterial substance) and stimulation of the formation of immunoglobulin A inhibits the development of pathogenic microbes. In addition, normal microorganisms prevent pathogenic bacteria from releasing toxins.

An illustration of the work of “beneficial” microorganisms is, for example, the following fact: with each breath we inhale, on average, about microbes, and thanks, in particular, to the biological factors of nonspecific protection in the pharynx, their number is reduced to 300; in the larynx and underlying sections these microorganisms are not detected at all.

This once again confirms the importance of a balanced microflora for the full functioning of the whole organism.

Normal human microflora is divided into obligate (permanent, resident - that which is stable and permanent) and transient (temporary - that which is on the mucous membrane for a short time).

So, the normal microflora of the ear:

- V outer ear may contain staphylococci, corynebacteria, less commonly bacteria of the genus Pseudomonas, mushrooms of the genus Candida.

It is important that earwax has a bactericidal effect;

– middle ear normally does not contain microbes, but they can get there through the Eustachian tube (from the nasopharynx) or due to perforation (defect) eardrum from the external auditory canal;

– inner ear sterile.

Normal nasal microflora: corynebacteria (diphtheroids), Neisseria, coagulase-negative staphylococci, beta-hemolytic streptococci. The following may be present as transient microflora: Staphylococcus aureus, Escherichia coli, beta-hemolytic streptococci.

Normal microflora of the pharynx: the microbiocenosis of the pharynx is even more diverse, since the microflora of the oral cavity and airways are mixed here. Representatives of the resident microflora are considered to be: Neisseria, diphtheroids, and hemolytic streptococci, enterococci, mycoplasmas, coagulase-negative staphylococci, moraxella, bacteroides, borrelia, treponema, actinomycetes.

Streptococci and Neisseria predominate in the upper respiratory tract; in addition, staphylococci, diphtheroids, Haemophilus influenzae bacteria, pneumococci, mycoplasmas, and bacteroides are found.

The mucous membrane of the larynx, trachea, and bronchi is normally sterile.

It should be said that the above species spectrum of microorganisms is not constant. Its composition depends on many factors: concomitant pathology, age, conditions external environment, working conditions, nutrition, previous diseases, injuries and stressful situations etc.

The species and quantitative composition of the microflora of the ENT organs is given in Table 1.

Table 1. Species and quantitative characteristics of the microflora of ENT organs

Notes: CN – coagulase negative; CFU - colony forming units.

Considering the anatomical and functional unity of the oral cavity and ENT organs (for example, beta-hemolytic streptococcus can be found in the lacunae of the palatine tonsils or carious cavities of the teeth and cause systemic complications in the form of myocarditis, glomerulonephritis, etc.), we consider it appropriate to also give the species and quantitative characteristics of the oral microflora (Table 2).

Table 2. Species and quantitative characteristics of the oral microflora

Note: CFU – colony forming units.

The situation when the composition and function of normal microflora is disrupted has a name familiar to everyone - dysbiosis (Fig. 1).

Dysbacteriosis is a bacteriological concept that characterizes a change in the ratio of representatives of normal microflora, a decrease in the number or disappearance of some types of microorganisms due to an increase in the number of others and the appearance of microbes that are usually found in small quantities or are not detected at all.

The reasons for the violation of the qualitative and quantitative composition of microflora are diverse, but I would like to especially draw the reader’s attention to the fact that Dysbacteriosis is essentially a secondary phenomenon, i.e. this condition is always provoked by something. It logically follows from this that it is necessary not to treat dysbiosis itself, but to eliminate the cause of its occurrence. For example, you can take medications for years (probiotics, antibiotics, immunostimulants, etc.), but against the background of chronic decompensated tonsillitis or adenoiditis, the result is unlikely to be achievable, and even if achievable, it will definitely be temporary.

Therefore, before moving on to listing the main factors contributing to the development of dysbiosis, let us once again emphasize the very important point: if you find signs of dysbacteriosis, then be sure to search reasons for its occurrence and, accordingly, its liquidation.

So, here is what most often provokes a violation of the normal microbiological balance in the ENT organs:

Acute and chronic diseases of the whole body, and especially the ear, throat, nose and oral cavity;

Adverse physical factors (hypothermia, insolation, etc.);

Physical, intellectual and psycho-emotional stress;

Taking antibacterial, hormonal and cytostatic drugs;

Insufficient nutrition, hypovitaminosis;

According to statistics, dysbacteriosis is accompanied by such nosological forms of diseases as chronic adenoiditis, rhinitis, tonsillitis and pharyngitis, as well as diseases of the hormonal system, gastrointestinal tract, helminthic infestation, pathology of the urinary and cardiovascular systems.

Having dealt with the cause of dysbiosis, we move on to treatment. Therapy must be strictly

individual and aimed primarily at eliminating the source of the problem. For example, until adenoiditis is adequately treated (conservatively or surgically), it is hardly possible to get rid of dysbacteriosis. The question of the need to take an antibiotic is determined solely by the course of the underlying disease: if pharyngeal dysbiosis is caused by the child having chronic pancreatitis, then antibacterial agents are inappropriate here; if dysbiosis is associated with an advanced form chronic sinusitis or adenoiditis - most likely, you cannot do without this group of medications. Inflammatory foci in the nasopharynx and oropharynx must be eliminated - carious teeth treated, adenoid vegetations, palatine tonsils sanitized, etc. Remember that they can not only cause local inflammatory and infectious processes and dysbiosis of the oropharynx, but also be a source of autoinfection and autointoxication of the entire body. Convincing data indicate that the occurrence of a number of diseases of the respiratory, gastrointestinal, cardiovascular systems, and musculoskeletal system is caused by focal infection in the oropharynx. That's why Sanitation of the oral cavity and ENT organs is a prerequisite and the first step to recovery in many pathological processes.

We should also not forget about measures to prevent the development of infectious and inflammatory processes in the oropharynx and ENT organs. Thus, standard preventive measures are: daily hygiene measures(nasal toilet), regular visits to the doctor, balanced nutrition, hardening, creating an optimal microclimate (humidity, temperature), treatment of concomitant pathologies.

In addition to the above preventive measures, help solve the problem of infectious inflammatory diseases ENT organs and restore normal microbiocenosis of the mucous membrane can be taken by taking probiotic agents. These are preparations that contain cultures of only bacteria that are beneficial to us, i.e. those that normally populate the mucous membrane, thereby providing protection from pathogenic microorganisms. Such treatment, which in most cases is a necessary and indispensable component of complex treatment, is called biotherapy.

Particular attention is paid to the probiotic, which begins to “work” already in the oral cavity. In a number of countries (Japan, USA, Sweden), since 2004, a number of clinical studies have been conducted on the effectiveness of the use of the strain Lactobacillus reuteri Prodentis for inflammatory diseases of the oropharynx. For example, 40 volunteers from the Department of Dentistry of the University of Hiroshima (Japan) were divided into two groups. Group I (20 students) took L. reuteri Prodentis for the first 14 days, then 14 days of placebo. Group II (20 students) took placebo for the first 14 days, then 14 days L. reuteri Prodentis. Results: in group I there was a noticeable decrease in the number Streptococcus mutans in saliva (up to 80% compared to the original) after 2 weeks of taking the probiotic. After stopping the drug for the next 2 weeks in the saliva of patients in group I level S. mutans practically did not increase, which indicates a persistent therapeutic effect L. reuteri Prodentis due to colonization of the oral mucosa. In group II in the first 2 weeks (when taking placebo), the level S. mutans in saliva increased by 20% compared to the original. Over the next 2 weeks, when patients in group II took L. reuteri Prodentis, level S. mutans theirs decreased noticeably (up to 80% compared to the original). Therefore, the strain L. reuteri Prodentis is effective against S. mutans and its intake can be considered as a method of preventing and treating caries (H. Nikawa et al., 2004).

The following study examined the effect L. reuteri Prodentis on the number of periodontal pathogens. After 21 days of taking the drug, the number of periodontal pathogenic microorganisms significantly decreased compared to the placebo group, indicating the effectiveness of the probiotic (M.R. Vivekananda et al., 2010).

We also studied the influence L. reuteri Prodentis in patients with chronic periodontitis. After 30 days, the severity of bleeding and the depth of periodontal pockets significantly decreased, which indicates the effectiveness of this strain in the treatment of periodontitis of initial and moderate severity (M. Vicario et al., 2013).

Total by strain L. reuteri Prodentis, by the end of 2012, had conducted 22 studies involving 971 patients, of which 19 studies involving 871 patients were randomized, double-blind/blind, placebo-controlled.

A wide range of probiotics, which include a strain L. reuteri, is represented in Europe, Asia, and America by the Swedish company BioGaya AB.

The probiotic BioGaia is used in patients of all ages (including newborns) and is used for various pathological conditions in otolaryngology, gastroenterology and dentistry.

Thus, the probiotic BioGaya Protectis (drops, tablets) contains L. reuteri, isolated from breast milk and normally present in every person. Action L. reuteri begins already in the oral cavity and continues along the entire length of the gastrointestinal tract, maintaining and regulating the physiological balance of the microflora. The probiotic BioGaya Protectis is approved for use in children from the first days of life, even in premature newborns. In addition, the organoleptic characteristics of BioGaia are also important in pediatric practice - the drops have a neutral taste and odor, do not contain cow's milk protein components and lactose, which allows them to be used in children even with allergic conditions(diathesis, atopic dermatitis).

Probiotic BioGaia Prodentis – patented formula containing 2 strains L. reuteri(Protectis and Prodentis), which contribute to the restoration of healthy microflora of the oral cavity, which is used for the prevention and complex treatment of diseases of the oropharynx, as well as to normalize the microflora along the entire length of the gastrointestinal tract. Microorganisms in the composition of the drug:

They break down lactose, producing lactic and acetic acids;

Promote the formation of the antimicrobial substance reuterin and other substances that have antagonistic activity against pathogenic and conditionally pathogenic microorganisms in the digestive tract;

Suppress the pro-inflammatory cytokine TNF-, reducing inflammation;

Fixed to mucin and biofilm;

They colonize the mucous membrane, starting from the oral cavity.

L. reuteri increase the natural defense of the digestive system, create favorable conditions for the formation of normal intestinal microbiocenosis. Immunostimulating effect L. reuteri associated with the ability to activate the intestinal immune system as the body's first line of defense against infections. They are naturally resistant to gastric juice and bile salts and are not destroyed by them when passing through the gastrointestinal tract. The composition of the BioGaia probiotic allows, if necessary, to take it simultaneously with antibiotics, antifungal drugs, corticosteroids, antiviral and chemotherapeutic agents.

Consequently, the use of the BioGaya probiotic will not only normalize the intestinal microbiocenosis, thereby increasing the immunogenic activity of the body and indirectly influencing the process of restoration of the pharyngeal microbiocenosis, but also directly affect the pharyngeal mucosa, promoting its colonization with beneficial microorganisms. Thus, healthy “competition” of the bacteria that make up the probiotic BioGaia Prodentis (2 strains of L. reuteri: Protectis and Prodentis) leads to the displacement of pathogenic microorganisms and in some cases this alone is enough to eliminate dysbiosis. In most versions, probiotics are used in the composition complex therapy dysbiosis of the pharynx and should be its mandatory component. In addition, these drugs are indicated as a prophylactic agent after viral diseases, before and after surgical interventions(for example, adenotomy, tonsillectomy), as well as during any episode of decreased general or local immunity.

1. Bogomilsky M.R., Chistyakova V.R. Pediatric otorhinolaryngology. – M.: Geotar-Med, 2001. – 432 p.

2. Borzov E.V. Chronic pathology nose and pharynx in frequently ill preschool children and its treatment using a helium-neon laser: Dis. Ph.D. honey. Sci. - Ivanovo. – 1991. – 177 p.

3. Borovsky E.V., Leontyev V.K. Biology of the oral cavity. – M.: Medicine, 1991. – S..

4. Bondarenko V.M., Uchaikin V.F., Murashova A.O., Abramov N.A. Dysbiosis. Modern possibilities of prevention and treatment. – M., 1995.

5. Bukharin O.V., Bilimova S.I. Mechanisms of survival of enterococcus in the host body // Journal. microbiol. – 2002. – No. 3. – S..

6. Bykova V.P. Lymphoepithelial organs in the system of local immunity of mucous membranes // Pathology Archives. – 1995. – No. 1. – P. 11-16.

7. Popovich V.I. The role of the Epstein-Barr virus in etiology and overcoming the outbreak of illness in the upper respiratory roads // Health of Ukraine. – 2012. No. 3 (19). – pp. 58-59.

8. Gadzhimirzaev G.A., Gamzatova A.A., Dibirov Z.Z. Clinic, differential diagnosis, treatment of chronic adenoiditis in children in outpatient settings. Met. recommendations. – Makhachkala, 1992. – P. 10.

9. Jafek Bruce W., Stark Ann K. Secrets of otorhinolaryngology. – St. Petersburg: Nevsky Dialect, 2001. – 624 p.

10. Efimov B.A., Smeyanov V.V. Normal intestinal microflora, dysbiosis and their treatment. Methodological developments. – M., 1994.

11. Zabolotnaya D.Yu. The influence of intestinal dysbiosis on the pathology of ENT organs in children // ZhVNGKh. – 2012. – No. 3. – pp. 57 – 58.

12. Krasnogolovets V.N. Intestinal dysbiosis. – M., 1989.

13. Kargaltseva N.M. The oral cavity is an important biotope of the human body // Institute of Dentistry. – 2001. – P. 20-21.

14. Kuvaeva I.B., Ladodo K.S. Microecological and immune disorders in children. – M., 1991.

15. Makkaev Kh.M. Tactics of combined conservative treatment of chronic inflammatory diseases of the lymphoid organs of the nasopharynx in children (chronic tonsillitis and adenoiditis) // Ros. Bulletin of Perinatology and Pediatrics. – 2002. – No. 5. – P. 39-43.

16. Markova T.P., Chuvirov D.G. Long-term and frequently ill children // RMZh. – 2002. – T.10. – No. 3. – S..

17. Pyatkin K.D. Microbiology. – M.: Medicine, 1980. – S..

18. Tomnikov A.Yu. Microflora of the oral cavity: Method. manual for dentists. – Saratov, 1996. – P. 3-15.

19. Tarasova G.D., Strachunsky JI.C. Features of the microflora of the nasopharynx and the functional state of the middle ear in children // Vest. otorhinol. – 2000. – No. 4. – P.30-32.

20. Tsvetkov E.A. Adenotonsillitis and its complications in children. St. Petersburg, 2003. – 124 p.

21. Shishmareva E.V. Age-related endoscopic semiotics of the norm and pathology of the nasopharynx in children: Dis. Ph.D. honey. Sci. – M., 2005. – 131 p.

22. Hill M. Localization of IgE in adenoids and tonsils: an immunoperoxidase study. Arch. Otolaryngol. 1931; l05:.

23. Mackinnon L.T., Hooper S. Mucosal (secretory) immune system responses to exercise of varying intensity and during overtraining. Int. J.Sports. Med. 1994; 3:.

24. Murray P.R. et al. Medical Microbiology. 1998. P. 70-73.

26. Nikawa H. et al., Int J Food Microbiol. 2004; 95:.

27. Tarchalska-Krynska B. Cytological assessment of the nasal mucosa in children with adenoidal hypertrophy. Part I. Pol Merkuriusz Lek. 2001; 10(60): 405-7.

28. M.R. Vivekananda et al. Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial. J Oral Microbiol 2010; 2:2.

29. Vicario M. et al. Clinical changes in periodontal subjects with the probiotic Lactobacillus reuteri Prodentis: a preliminary randomized clinical trial. Acta Odontol Scand. 2013; 71 (3-4): 813-9.

Method for treating chronic pharyngitis against the background of intestinal dysbiosis

The invention relates to medicine, in particular to therapy, can be used for treatment chronic pharyngitis against the background of intestinal dysbiosis. The pharyngeal mucosa is sequentially treated for 6 days with a lysozyme solution at a concentration of 5 mg/ml for 2 minutes, aqueous solution trypsin at a concentration of 5 mg/ml for 2 minutes, Lugol's aqueous solution 1: 2 and boiled water at intervals of 1 minute with simultaneous correction of intestinal dysbiosis through the use of probiotics against a background of enriched dietary fiber diet, polyenzyme preparations, vitamin and herbal medicine for 30 days.

The invention relates to medicine, namely to otorhinolaryngology, gastroenterology. According to the authors, chronic pharyngitis, as a rule, is not an independent disease but only a reflection on the mucous membrane of the pharynx painful condition other organs and systems of the body. Anatomical and physiological features of the middle and lower parts of the pharynx, formed as a result of a single digestive tract embryogenesis, give the pharynx the status of the beginning of the digestive tube, and therefore the leading etiopathogenetic role in the development of chronic pharyngitis is assigned to the pathology of the digestive organs. During examination, intestinal dysbiosis was revealed in all patients with gastroenterological pathology. One of the consequences of intestinal dysbacteriosis may be the endogenous spread and engraftment of representatives of opportunistic microflora localized in the intestine in habitats unusual for them. Patients in this group have a dysbiotic process in the microflora of the oral cavity and pharynx. A number of authors point to the close correlation between pharynx dysbiosis and dysbiotic disorders in the intestine and note that disturbances in the composition of the intestinal microflora are primary in relation to pharynx dysbiosis. Therefore, various medicinal methods of local treatment of chronic pharyngitis currently used, such as 0.25-0.5% resorcinol solution for gargling, 1-2% silver nitrate solution or 2-3% solution of protargol or collargol for lubricating the pharyngeal mucosa without taking into account the microbiocenosis of the pharynx and intestines, in most cases they remain insufficiently effective, since they do not lead to the complete disappearance of subjective complaints of patients, normalization of the pharyngoscopy picture, and frequent relapses of this disease are observed. The prototype of the proposed method is the use of the eubiotic drug Lactobacterin. This drug is a lyophilisate of live lactobacilli, which is used for various gastrointestinal diseases. The authors of the prototype method use Lactobacterin only as a means of preventing inflammatory diseases of the upper respiratory tract. The essence of the prototype method is to stabilize the microecological balance of the pharynx and nose, excluding the correction of microbial imbalance (dysbacteriosis) of the intestine. In order to increase the colonization resistance of the body to pathogenic and opportunistic bacteria, patients were prescribed lactoacterin orally according to the regimen - 1 tablet 1 hour before breakfast, 1 tablet 1.5 hours after dinner for a week. The disadvantage of the prototype method, in the opinion of the authors, is the effect only on the microflora of the pharynx and nose without taking into account changes in the microecology of the intestine. The authors propose a method for the treatment of chronic pharyngitis, taking into account the microbiocenosis of the pharynx and intestines, which consists in the local treatment of pharyngitis through the sequential use of lysozyme, trypsin Lugol's solution (an application for the invention “Method for the treatment of chronic pharyngitis” has been submitted. Authors: E.V. Strelets, N.A. Grafskaya, G.M. Portenko.. Priority date 03/15/99), with simultaneous correction of intestinal dysbiosis. The implementation of the method is as follows. Sequential treatment of the pharyngeal mucosa medicines includes several stages. Patients independently gargle with an aqueous solution of lysozyme at a concentration of 5 mg/ml for 2 minutes, then after 1 minute with an aqueous solution of trypsin at a concentration of 5 mg/ml for 2 minutes, then after 1 minute with an aqueous solution of Lugol's in a dilution of 1:2 (1 part Lugol's aqueous solution: 2 parts boiled water). After 1 minute, patients gargle with boiled water. The course of local treatment is 6 days. To consolidate the obtained effect, treatment of the identified gastroenterological disease by the therapist and intestinal dysbiosis was simultaneously carried out. In this case, probiotics were prescribed (Bifikol - a dried suspension of live co-grown bifidobacteria and Escherichia coli strain M-17, 5 doses 2 times a day for 30 days). Probiotics were used against the background of a diet enriched with dietary fiber (some patients took prebiotics such as Enterol 0.2 2 times a day for 30 days or Hilak-Forte 20 drops 2 times a day for 2 weeks), and biokefir was also used according to 100 ml per day. Correction of intestinal dysbiosis was carried out according to general rules while taking polyenzyme drugs (panzinorm, mezim-forte - 1 tablet 3 times a day with meals throughout the course). All patients with this pathology received vitamin therapy (undevit - 2 dr. 3 times a day for 10 days of each month, up to 3 courses). To consolidate the treatment, they resorted to herbal medicine in the form of decoctions medicinal herbs(chamomile flowers, plantain leaves, sage, yarrow - 1 tablespoon 3 times a day for 4 weeks). Subsequently, after completion of the course of treatment, microbiological control was carried out. To practically prove the effectiveness of the proposed method, a group of patients with chronic pharyngitis was taken. Of the 32 patients we examined with chronic pharyngitis, intestinal dysbiosis varying degrees severity was detected in 28 people (87.5%), which was accompanied clinical manifestations, changes in scatological and bacteriological examination of stool. The identified dysbacteriosis was represented by stage I in 22 people (78.5%), stage II in 6 (21.5%). Taking into account the microbial landscape of feces, colidisbacteriosis (compensated) was detected in 15 patients (53.5%), staphylococcal - in 5 people (17.9%), fungal - in 8 (28.6%). The course of treatment for chronic pharyngitis against the background of intestinal dysbiosis was 30 days. Before treatment according to the proposed method, the total microbial number when examining smears from the mucous membrane back wall pharynx amounted to 10 4 CFU/tampon, after treatment CFU/tampon. A control test was carried out 2 weeks after the end of the treatment course. bacteriological culture feces When analyzing the obtained bacteriograms, recovery was observed normal biocenosis colon in 23 patients (82.1%) out of 28. Subjective improvement (reduction of sore throat, disappearance of the feeling of a “lump” and pain in the throat when swallowing), objective improvement of the condition of the mucous membrane of the posterior wall of the pharynx (during pharyngoscopy, normalization of humidity was observed and color, disappearance of the compartment or dryness of the mucous membrane, reduction in the size of lymphoid granules and lateral ridges of the pharynx) was noted in all treated patients with chronic pharyngitis against the background of intestinal dysbiosis. Examples of practical implementation of the method. Example 1. Patient E., 24 years old, examination card 5, complained of soreness and pain in the throat, with a history of irregular bowel movements. Pharyngoscopy reveals hyperemia of the mucous membrane of the posterior pharyngeal wall with injection of dilated vessels and viscous mucus. Together with a gastroenterologist, chronic catarrhal pharyngitis, hypomotor type large intestinal dyskinesia, and degree I intestinal dysbiosis were diagnosed. Complex treatment of chronic pharyngitis against the background of intestinal dysbiosis consisted of local treatment by successively rinsing the throat with an aqueous solution of lysozyme for 2 minutes, then after 1 minute with an aqueous solution of trypsin for 2 minutes and then after 1 minute with an aqueous solution of Lugol's in a 1:2 dilution with boiled water. water followed by rinsing with boiled water once a day for 6 days with simultaneous correction of intestinal dysbiosis, including taking bificol 5 doses 2 times a day for 30 days, Hilak-Forte 20 drops. 2 times a day for 2 weeks, biokefir 100 ml per day, panzinorm 1 tablet. 3 times with meals for 30 days, undevita 2 dr. 3 times a day, decoction of plantain leaves 1 tbsp. 3 times a day for 4 weeks. In a bacteriological examination of smears from the back wall of the pharynx, the total microbial number before treatment according to the proposed method was 7.CFU/tampon, and after the course - 8.CFU/tampon. After 2 weeks of completion of the course of treatment, a control bacteriological culture of stool was carried out. When analyzing the obtained bacteriogram, restoration of the normal biocenosis of the large intestine was noted. As a result of the complex treatment, the patient noted a subjective improvement in his condition (soreness and pain in the throat disappeared); during pharyngoscopy, normalization of the humidity and color of the mucous membrane of the posterior pharyngeal wall was observed (viscous mucus, hyperemia disappeared and the number of injected vessels decreased). Example 2. Patient Sh., 21 years old, examination card 16, complained of a sore throat, a feeling of a “lump” in the throat, with a history of periodic mild pain in the epigastric region. Pharyngoscopy: hyperemia of the mucous membrane, many lymphoid granules on the back wall of the pharynx. Together with a gastroenterologist, chronic hypertrophic pharyngitis, chronic gastritis with decreased secretion, and grade II intestinal dysbiosis were diagnosed. When inoculating smears from the back of the throat and bacteriological examination of stool for dysbacteriosis, the growth of fungi of the genus Candida was revealed, and therefore antifungal drugs were included in the treatment. Complex treatment of chronic pharyngitis against the background of intestinal dysbiosis included a course of local treatment according to the methodology of the proposed method by sequentially rinsing the throat with solutions of lysozyme, trypsin, Lugol, as well as simultaneous correction of intestinal dysbiosis (Diflucan 100 mg/day for 7 days, Bificol 5 doses 2 times a day for 30 days, hilak-forte 20 drops 2 times a day for 2 weeks, biokefir 100 ml per day, mezim-forte 1 tablet 3 times a day with meals for 30 days, undevit 2 drops 3 times a day, decoction of yarrow leaves 1 tablespoon 3 times a day for 4 weeks). Before treatment, the total microbial number when examining smears from the back of the throat was 9.CFU/tampon, and after treatment according to the proposed method - 4.CFU/tampon. 2 weeks after the end of the course of treatment, during a bacteriological study of sea otter dysbacteriosis, restoration of normal microbiocenosis of the large intestine was noted, the patient indicated a subjective improvement in the condition (soreness in the pharynx, sensation of a “lump” in the throat disappeared), pharyngoscopy noted the disappearance of hyperemia of the mucous membrane of the posterior pharyngeal wall, reduction in the size of lymphoid granules with resorption of some of them. The proposed method of treating chronic pharyngitis against the background of intestinal dysbiosis was well tolerated by patients. No side effects were identified. The inventive method of treating chronic pharyngitis against the background of intestinal dysbiosis has the following features: 1. simultaneously normalizes the microbiocenosis of the pharynx and intestines; 2. has an extended spectrum of binding dead bodies of various microorganisms; 3. reduces relapses of the disease and gives a faster and more lasting effect. 4. has no side effects. Sources of information 1. L. I. Kalshtein. Pathology of ENT organs in some gastroenterological diseases. Dushanbe: Irfon, 1969. 2. A.Yu.Ovchinnikov. Modern comprehensive examination and treatment of patients with combined pathology of the pharynx and stomach. Dissertation for the degree of Candidate of Medical Sciences. M., 1983. 3. T.V. Tolkacheva, G.L. Ermakova, V.A. Martynova, etc. Changes in the biocenosis of the pharynx as an indicator of intestinal dysbiosis./ Lab. business., 8, - p. 53-55. 4. B.L.Frantsuzov, S.B.Frantsuzova. Drug therapy diseases of the ear, nose and throat. - Kyiv: Health, 1988. 5. N. N. Lizko, Yu. M. Ovchinnikov, V. K. Ilyin, etc. Lactobacterin as a means of preventing inflammatory diseases of the upper respiratory tract. / Current problems of otorhinolaryngology. Republican collection of works. Issue XXXVIII, - M., p.. 6. K. G. Apostolidi. Comparative assessment of the effectiveness of endoscopic microsurgery and classical methods rhinosurgery for diseases of the nasal cavity and paranasal sinuses. Abstract of the dissertation for the degree of Doctor of Medical Sciences. - M., 1998. 7. E.V. Strelets, N.S. Maksimova, E.N. Egorova. Immobilization of lysosomal enzymes and their substrates by halogenation./ "International Jaurnal ON Immunorehabilitation". - 4, - p.187.

A method for the treatment of chronic pharyngitis against the background of intestinal dysbiosis, including stabilization of the microecological balance of the upper respiratory tract with probiotics, characterized in that chronic pharyngitis is comprehensively treated by sequentially treating the pharyngeal mucosa by rinsing for 6 days with a lysozyme solution at a concentration of 5 mg/ml for 2 minutes, an aqueous solution of trypsin with a concentration of 5 mg/ml for 2 minutes, an aqueous solution of Lugol's in a dilution of 1: 2 and boiled water with an interval of 1 minute with simultaneous correction of intestinal dysbiosis by prescribing probiotics against the background of a diet enriched with dietary fiber, polyenzyme preparations, vitamin and herbal medicine for 30 days.