Colitis – the disease of a thick gut which is characterized by its inflammation owing to infectious, ischemic, medicinal defeat. Colitis proceeds with a pain syndrome, disorder of digestion (locks, ponosa), a meteorizm, tenezma. Within diagnosis of colitis the research a calla (a koprogramma, , on helminths and protozoa), an irrigoskopiya, a kolonoskopiya with a biopsy mucous a large intestine is made. Treatment of colitis is appointed taking into account its etiologichesky form; includes a diet, etiotropny (antibacterial, protivogelmintny, etc. therapy), reception of enzymes and eubiotik, phytotherapy, fizio-and a balneoterapiya.
Colitis call the diseases of a gastrointestinal tract which are characterized by development of an inflammation in a mucous membrane of a wall of a thick gut. Distinguish sharp and chronic colitis. Belly-aches, a meteorizm, availability of slime and a streak of blood in Calais, nausea, desires to the act of defecation are characteristic of sharp colitis. The chronic shape, ulcer damage of intestines, bleeding, sometimes a kantserofobiya can develop.
Chronic colitis represents pathological changes in a structure of a mucous membrane as a result of long inflammatory process and dystrophy of the struck fabrics in connection with which there are violations of motor and sekretorny function of a large intestine. Chronic colitis - quite often found disease of a digestive tract, quite often an inflammation of a thick gut is followed by damage of a small intestine.
About a third of patients with chronic colitis note as the reason of its development various intestinal infections (most often dysentery and salmonellosis). In many cases the disease develops against the background of dysbacteriosis (for example, after a long course of antibiotic treatment), in connection with improper feeding, tendency to a hypodynamia, abuse of alcoholic beverages.
Etiology and pathogenesis of colitis
The causes can be connected with violation of the mode and character of food (the wrong eating habits, irregular irrational food, abuse of alcohol, reception of low-quality food). Colitis can arise as a complication of diseases of digestive tract (chronic gastritis, pancreatitis, hepatitis), and also at food poisonings and infection with intestinal infections.
Reception of many medicines can have negative effect on intestinal flora, yatrogenny dysbacteriosis can cause in turn inflammatory processes in a large intestine. Besides, colitis can be promoted by the medicines breaking acid-base balance in an intestines gleam. Sometimes congenital pathologies of development and functional insufficiency are the reasons of inflammatory diseases of intestines.
Classification of colitis
Colitis is subdivided on infectious (colitis at a shigelleza, salmonellosis, , tubercular colitis, etc.), alimentary (connected with violations of food), toxic exogenous (at long intoxications by mercury vapors, compounds of phosphorus, arsenic etc.) and endogenous (at intoxication catabolism products, for example, urata at gout), medicinal (the use of medicines which developed later: laxatives, aminoglycosides, antibiotics), allergic (allergic reaction to food components, medicines, some bacteria or products of their metabolism), mechanical (at chronic locks, abuse of enemas, rectal suppositories as a result of regular mechanical irritation of mucous).
Often takes place several etiologichesky factors promoting development of an inflammation in a large intestine then it is possible to speak about the combined colitis.
Symptoms of chronic colitis
Such clinical manifestations as belly-ache, disorder of defecation, tenezma are characteristic of colitis. The pain syndrome at colitis is characterized by the dull aching ache in the lower and side parts of a stomach (often on the left side), or the patient cannot localize rather accurately a pain source (the poured belly-ache). After food usually pain amplifies and weakened after defecation and an otkhozhdeniye of gases. Besides, walking, jolting, a cleaning enema can provoke strengthening of pain. Also the feeling of weight in a stomach, swelling, a meteorizm can be noted.
Frustration of a chair most often proceed in the form of locks, but also alternation of locks and ponos can be noted. The diarrhea with allocation watery a calla with slime streaks is characteristic of chronic colitis (blood can sometimes be noted). There can be tenezma – false desires to defecation. Sometimes the desire to defecation comes to an end with release of slime.
The inflammation of a large intestine most often develops in its terminal departments (proktit and proktosigmoidit). Often sharp intestinal infection (dysentery) or chronic locks is the reason of colitis in such cases. Besides, proktosigmoidit is frequent result of abuse of the clearing and medical enemas, reception of depletive.
At this form of colitis pain is localized from the left podvzdoshny area, there are frequent and painful tenezma, especially at night. The chair, as a rule, poor, can be like sheep a calla, contain slime in large numbers, blood and pus are more rare. At a palpation of a stomach note morbidity in the field of a projection of a sigmovidny gut. Congenital anomaly of development – an additional loop of sigma is sometimes palpated.
Diagnosis of colitis
At suspicion of colitis enters a complex of obligatory diagnostic actions macro - and microscopy a calla, a koprogramma, identifications of eggs of helminths, kalovy masses. Make the general blood test for definition of existence of signs of an inflammation.
Anatomic and functional features of a large intestine are visualized it at a contrast irrigoskopiya. Kolonoskopiya allows to study thoroughly a state mucous throughout a thick gut. Besides, carrying out a kolonoskopiya allows to take bioptata of a mucous intestinal wall for a further histologic research.
Differential diagnosis of chronic colitis is carried out with dyskinesia of a large intestine. However, it is necessary to remember that for a long time existing disorder of motility of intestines can be complicated by inflammatory process.
Besides, make differentiation of colitis and enterit. Sometimes the inflammation of both departments of intestines takes place. Data for differential diagnosis of chronic colitis and diseases of the top departments of a digestive tract give endoscopic researches (a kolonoskopiya, a fibrogastroduodenoskopiya), ultrasonography of abdominal organs and functional tests for identification of markers of an inflammation of a liver and a pancreas.
Quite often clinical picture of colitis can accompany the developing tumor of a large intestine. Make a biopsy of all suspicious sites of a wall of intestines for an exception of malignancies.
Chronic colitis can lead to perforation of an intestinal wall with development of peritonitis (a characteristic complication of hard proceeding nonspecific ulcer colitis), to intestinal bleeding (which promotes development of anemia), impassability of intestines as a result of formation of solderings, , hems.
Treatment of chronic colitis
Chronic colitis in the period of an aggravation it is expedient to treat in a hospital, in office of a proktologiya. Colitis of the infectious nature treats in specialized infectious offices. A considerable element in treatment of chronic colitis is observance of a medical diet. At the same time exclude all products which can mechanically or chemically irritate a mucous membrane of intestines from a diet, eat food in the wiped look, with a frequency not less than 4-5 times a day. Besides, for an exception of lactic fermentation by the patient recommend to refuse milk, for the purpose of decrease in gas generation limit cabbage, bean.
From bakery products the dried white unsweetened bread is resolved. It is desirable to use meat and fish of low-fat grades steamed. When subsiding of the expressed clinical symptomatology the diet is gradually expanded. For fight against locks recommend inclusion in a diet of boiled vegetables, fruit purees (kissel), bread with bran. Improvement of passing of intestinal masses is promoted by vegetable oil and enough the liquid used in days. It is undesirable to use fruit and vegetables in the raw during the sharp period of a disease. Also it is worth refusing the cooled dishes, lactic products and food with the high content of acid. For regulation of secretion of liquid in intestines limit the use of table salt.
In case of the infectious nature of colitis and for suppression of the pathogenic bacterial flora which developed as a result of dysbacteriosis appoint antibiotic treatment short courses (medicines ciprofloxacin, Nifuroksazid, ). Prescriptions of medicines it is made only by the expert. Identifications of eggs of worms is the indication to purpose of protivogelmintny means. For simplification of a pain syndrome appoint spazmolitichesky means (, a papaverine).
At treatment of a proktosigmoidit local therapy is useful: microenemas with broths of a camomile, a calendula, with tannin or protargoly. At a proktita appoint rectal suppositories with a belladonna, benzocaine for removal of the expressed morbidity, astringents (a zinc oxide, ). At ponosa the knitting and enveloping means are appointed inside (tannin + albumine, bismuth nitrate, white clay, bark broth the oak, other broths and infusions of collecting containing tannic components). At locks carrying out a gidrokolonoterapiya is shown. Strong spasms at colitis can become the indication for purpose of holinolitik.
Besides above-mentioned means, at colitis can appoint enterosorbents (for fight against a meteorizm), fermental medicines (at violation of digestion as a result of fermental nedostatochnost), eubiotik (for correction of a disbioz). At therapy of chronic colitis regular sanatorium treatment, a balneoterapiya gives good effect.
Prevention of chronic colitis
The balanced rational diet, timely identification and treatment of diseases of a gastrointestinal tract, measure of the sanitary and hygienic mode and observance of safety regulations on the productions connected with dangerous chemical poisons enters a complex of preventive measures for prevention of chronic colitis.
Prevention of aggravations at the persons having chronic diseases of a large intestine, besides, include regular dispensary observation. Working ability of patients with this pathology is limited, they should avoid excess physical activities, psycho-emotional stresses and the activity connected with frequent business trips and promoting violation of a diet. The forecast at timely detection and observance of medical recommendations about treatment of chronic colitis favorable.