This section is from the book "Diseases Of The Intestines", by Max Einhorn. Also available from Amazon: Diseases Of The Intestines A Text-Book For Practitioners And Students Of Medicine.
The various intestinal neuroses have been separately described. In practice combinations of different neuroses frequently occur. Following Rosenheim we designate such cases as intestinal neurasthenia. The appetite as a rule is good and the symptoms usually appear during the period when intestinal digestion takes place. The symptoms generally develop one to three hours after meals and consist in a feeling of pressure, tension, and sometimes of griping in the abdomen. Occasionally there may be a sensation of nausea, at times an evacuation of the bowels accompanied with painful sensations in the abdomen and in the anus. Sometimes palpitation of the heart occurs, sometimes again a sensation of flashes of heat or of cold extending upward. As a rule, the patients feel worse when resting, especially in the recumbent position, than when walking about. After a period of one or two hours the symptoms usually disappear, to return again later on after a meal.
Constipation is as a rule associated with this condition. The quality of the food does not seem to exert much influence upon the symptoms, although the latter are more marked after heavier meals. In a few instances, especially when the pains play a predominant part and bor-borygmi occur, diarrhoea is encountered. In these cases the diarrhoea appears in the middle of the night or toward early morning, and disturbs the patient's sleep. It is of diagnostic importance that the pains do not in any way depend upon the quality of the food. Indigestible foods, even taken in considerable quantity, are occasionally well borne, while at other times a small meal, consisting of the lightest food, causes severe symptoms. Intestinal neurasthenia is sometimes associated with gastric neurasthenia and completes the picture of the other.
In making the diagnosis of intestinal neurasthenia anatomical lesions of the intestines must first be excluded.
The treatment consists in hygienic measures which serve to tone up the system, in ample feeding, and in the administration of the bromides, occasionally in conjunction with iron and arsenic. With regard to diet all foods are allowed excepting indigestible substances, and a preponderance of vegetable food is to be recommended.