Chronic proktit – a chronic inflammation of a mucous membrane of a rectum. It is quite often combined with sigmoidity (proktosigmoidit). Is followed by tenezma, discomfort, an itch, burning and not intensive pains in a rectum zone. In Calais traces of slime, blood and pus come to light. In the period of an aggravation symptoms of a chronic proktit become more expressed, temperature increase to subfebrilny figures is possible. The calla and other techniques is diagnosed taking into account complaints, the anamnesis of a disease, survey of anal area, a rectal research, a rektoskopiya, a biopsy, analyses. Treatment – a diet, medicamentous therapy, non-drug methods.
Chronic proktit – the chronic inflammatory process in a mucous rectum which arose owing to specific and nonspecific infections, chronic diseases of overlying departments of a GIT, helminthoses, violations of a diet, stagnation a calla, chemical, mechanical and beam influence and other factors. Usually the inflammation is not limited to a rectum, and extends to overlying department of intestines with development of a proktosigmoidit. Perhaps also involvement of pararectal cellulose with development of a paraproktit. Chronic proktit meets more often an acute inflammation of this body. Men and women suffer equally often. Treatment is carried out by experts in the field of a proktologiya.
Reasons and classification of a chronic proktit
Scientists specify what chronic proktit is among polietiologichesky diseases. Taking into account the causes it is possible to allocate the following types of this pathology:
- Infectious chronic proktit. Develops as a result of influence of pathogenic and opportunistic microorganisms: cocci, colibacillus etc. At penetration of activators from a vagina or anal sexual intercourses chronic proktit can be provoked by gonokokka, pale spirokheta, a herpes virus, hlamidiya and so forth. Sometimes this pathology is caused by tuberculosis mikobakteriya.
- Parasitic chronic proktit. Arises at helminthoses, protozoan infections, etc.
- Stagnant and alimentary chronic proktit. Are result of constant violations of a diet with excessive alcohol intake, spicy, spicy, greasy and fried food and development of the chronic lock which is followed a constant travmatizatsiy wall of a rectum by too firm kalovy masses.
- Chronic proktit, caused by chemical and mechanical damages. Develops at self-treatment (violations of the technology of statement of an enema, use of the irritating substances), anal sexual contacts, self-stimulation of a rectum various objects for the purpose of satisfaction, existence of rough elements (stones of various fruits, incidentally swallowed objects, pieces of too firm food) in Calais. Can arise after rectum operations, the next bodies and fabrics.
- Beam chronic proktit. It is observed against the background of or after a while after the termination of radiation therapy concerning oncological diseases of bodies of a small pelvis.
- Autoimmune chronic proktit. It is diagnosed at ulcer colitis, a disease Krone, Whipple's disease and an amiloidoza.
Besides, chronic proktit can develop at local violations of blood supply and an innervation, at disintegration of new growths of a rectum and the next bodies. The contributing factors promoting emergence of a chronic proktit are overcooling, decrease in immunity and an inflammation of other bodies of a small pelvis. Taking into account characteristic changes of mucous distinguish atrophic and hypertrophic chronic proktit. At an atrophic form thinning and a smoothness of folds of mucous is observed. At a hypertrophic proktit mucous friable, its folds are thickened.
Symptoms of a chronic proktit
The disease can become an outcome of a sharp proktit or have initially chronic current. Characteristic symptoms are the discomfort, burning, an itch, insignificant morbidity, tenezma, feeling of incomplete depletion of intestines and pathological impurity in excrements. During remission chronic proktit can proceed asymptomatically or be shown by one-two poorly expressed signs. Insignificant or moderate impurity of slime in Calais becomes often only symptom of a disease.
In the period of an aggravation the symptomatology of a chronic proktit becomes more expressed. Temperature increase of a body to subfebrilny figures in combination with pains, the expressed burning and false desires is noted. At a long current chronic proktit quite often is complicated by an anal crack, hemorrhoids or a chronic paraproktit. On skin of pararectal area ekzematozny changes appear. The itch in a zone of an anus becomes so expressed that begins to exert negative impact on quality of life of the patient. Working capacity decreases, there are sleep disorders. The patient becomes irritable.
Diagnostics of a chronic proktit
The diagnosis is established taking into account complaints, by clinical records, data of a rectal research, survey of perianalny area, a rektoskopiya, biopsy, laboratory analyses a calla and other methods of laboratory and tool diagnostics. At survey of perianalny area of the patient with a chronic proktit pay attention to a condition of an anus and surrounding fabrics. The hypertrophy of skin folds is characteristic. In some cases maceration signs, traces a calla, slime and blood on skin come to light. When carrying out a manual research proctologists estimate a sphincter condition, find morbidity in a zone of crypts, a hypertrophy of nipples and puffiness of a wall of a gut.
Rektoskopiya at a chronic proktit demonstrates strengthening or a smoothness of the vascular drawing, existence of separate petekhialny hemorrhages and sites of slime on a gut wall. In the course of the endoscopic research the doctor carries out a biopsy. Material is sent to a histologic research for specification of character and the reasons of an inflammation. Besides, for determination of the causes of a chronic proktit appoint the analysis a calla to eggs a worm, a bacteriological research a calla and other analyses.
Treatment of a chronic proktit
Treatment is conservative, long, it is performed on an outpatient basis. To the patient appoint the special diet excluding alcohol intake, carbonated drinks, greasy, fried, spicy and spicy food. To the patient with a chronic proktit recommend to limit the use of the products containing a large amount of rough cellulose, causing the increased gas generation and irritating an intestines wall (vegetables, fruit, bean, etc.). The basis of the menu is made by soups and the low-fat meat steamed.
Explain to the patient importance of strict observance of a diet. For improvement of a psychoemotional state, decrease in irritability, normalization of a dream and creation of the favorable psychological situation promoting observance of a diet and implementation of recommendations of the doctor, a sick chronic proktit appoint sedatives. At selection of medicines avoid use of the medicines rendering irritant action on mucous intestines.
In the period of an aggravation of a chronic proktit perform antibacterial therapy, to patients appoint microenemas with broth of a camomile and kollargoly. Apply spazmolitik to elimination of spasms, reduction of pains and simplification of the act of defecation. Use the local means (ointments, candles) promoting elimination of an inflammation and activization of regeneration processes. In some cases appoint ointments with glucocorticosteroids. After knocking over of the sharp phenomena recommend to the patient with a chronic proktit sedentary bathtubs with potassium permanganate, oil microenemas and a promezhnostny shower.
During remission of patients with a chronic proktit direct to sanatorium treatment. At a stenosis of a rectum carry out conservative therapy (expansion of a buzhama of Gegar, physiotherapeutic procedure), in case of inefficiency perform surgeries. The forecast at a chronic proktit rather favorable. At adequate therapy, observance of the technology of use of local means (candles, microenemas) and implementation of recommendations of the doctor steady long remission is possible.