Acute colitis - This is an acute inflammatory reaction of the mucous membrane of the colon in response to the influence of infectious, toxic, pharmacological or endogenous factors. It manifests itself with pains mainly in the left half of the abdomen, liquid watery stools with impurities of mucus, blood and pus, high fever and symptoms of dehydration. For the diagnosis of collecting complaints and anamnesis, palpation of the colon, colonoscopy, sigmoidoscopy, complete blood count, clinical and microbiological analysis of feces. For the treatment of the acute form of colitis, antibacterial agents, eubiotics, antispasmodics are prescribed, therapy aimed at combating dehydration is carried out.
What is colitis?
Intestinal colitis is an inflammation of the colon that results from an intestinal lesion. In most cases, its chronic form develops, as well as ulcerative colitis of unknown etiology, and the intestinal mucosa becomes prone to ulceration.
The simplest bacteria get on the mucous membrane of the colon, damage it. The onset of the inflammatory process leads to symptoms. The wall of the colon is swollen, it is not correctly reduced. At the same time, mucus secretion begins, adverse symptoms appear. Appears:
- pulling or cramping pains,
- increased gas generation
- violation of the chair,
- general weakness of the body.
Before treating colitis, it is necessary to identify the cause of its occurrence, otherwise the treatment becomes vain: the reason will remain - the disease will remain.
There are several factors, the impact of which can lead to the emergence of a disease such as intestinal colitis:
- intestinal infection,
- disorders of the intestine due to the medication of certain groups (neuroleptics, lincomycin, laxatives),
- intestinal ischemia
- eating disorders (excess flour, spicy, alcohol abuse),
- food allergy
- helminthic invasions,
- heavy metal poisoning (arsenic, lead),
- genetic predisposition
- Also, the reason may be unjustified and too frequent use of enemas for treatment and cleansing, uncontrolled intake of laxatives.
Most often, the occurrence of colitis is affected by several etiological factors at once, leading to inflammation in the large intestine, then it is a question of combined colitis.
The disease is usually classified according to several criteria. Depending on the flow emit:
- Acute colitis - symptoms of pathology appear sharply, strongly expressed.
- Chronic intestinal colitis - the disease develops slowly, its symptoms are often blurred, they are difficult to differentiate from other gastroenterological diseases. The causes are: infectious diseases (dysentery - shigella and salmonella), exposure to toxic substances, drugs, etc.
The following types of colitis are distinguished:
Acute colitis is a pathology of the large intestine, which is characterized by the development of inflammation of the mucous membrane with a violation of its function. This nosological form is most common between the ages of 15 and 40 years. The second peak of the incidence is 60-80 years. In this case, women and men suffer from colitis with approximately equal frequency. Scientists have shown that the representatives of the white race are sick more often than Asians and African Americans. Today, more than half a million cases of acute colitis are reported every year in Europe.
In the etiology of the disease, infectious agents, medication and colon ischemia as a result of mesenteric atherosclerosis play a major role. In most cases, the process ends with recovery, provided the treatment is properly carried out. However, sometimes acute inflammation of the large intestine can become chronic. Pathology treatment is carried out by specialists in the fields of medicine such as clinical proctology and gastroenterology.
Acute colitis can be caused by various reasons, the main one being the ingestion of infectious agents. The disease is provoked by viruses, bacteria, fungi and protozoa. The most common cause of acute colitis are infectious diseases such as dysentery, salmonellosis and foodborne diseases. In addition, non-specific pathogens such as streptococci or staphylococci play a certain role in the development of this pathological process. The infectious agent is ingested with dirty water or unwashed products, such as fruit or vegetables. When pathogenic microorganisms hit the intestinal mucosa, local inflammation occurs, which leads to the development of colitis. Also, infectious pathogens produce toxins that penetrate into the systemic circulation and cause general intoxication of the body.
In addition, acute colitis can be provoked by taking antibacterial drugs and other medicines, such as laxatives. In elderly people, colitis often occurs on the background of atherosclerosis of the mesenteric vessels, which develops colon ischemia. Of the rare causes of the disease can be noted radiation damage, food allergies and chemical poisoning. In some cases, it is not possible to establish the exact cause of acute colitis.
Symptoms of acute colitis
Regardless of the cause of the development of the disease is accompanied by flatulence, spastic pain along the large intestine, tenesmus and severe diarrhea. The frequency of the chair at the same time can reach 20-25 times a day. In the feces are often noted impurities of mucus, pus and even blood. In the initial stages of the development of the pathological process, the stool has a malodorous character. Subsequently, it becomes watery due to impaired absorption of water in the intestine.
In addition to local manifestations, acute colitis is accompanied by general symptoms of varying severity. Hyperthermia is noted in patients, the temperature often exceeds 38 degrees. This is due to the entry of toxins into the blood. Against the background of a pronounced loss of fluid, dry skin is observed, a gray deposit appears on the tongue. Due to intoxication in patients with acute colitis, general weakness and loss of appetite are progressing. As a rule, the disease proceeds quickly and with the right treatment, the normal state is restored within a few days. In severe form, the course of the disease may be protracted. In addition, in some cases, complications may develop, such as dehydration shock, subhepatic abscess, peritonitis, pyelitis, sepsis.
At the initial stage, a proctologist collects complaints and anamnesis for the diagnosis of acute colitis. These clinical methods allow to suspect the cause that could cause the disease. In addition, there is a palpation of the abdomen in the area of the large intestine, in which pain and rumbling are determined mainly in the left half, which is in favor of colitis.
In the diagnosis of acute colitis used instrumental and laboratory methods. Of the instrumental techniques, endoscopy, in particular, colonoscopy and sigmoidoscopy, has the greatest information content. When conducting these studies revealed hyperemia and edema of the intestinal mucosa. In the case of severe disease during endoscopy, pus, hemorrhage, erosion and even ulcers are visualized on the walls of the large intestine.
From laboratory methods, a complete blood count, microbiological examination of feces. In acute colitis, an increase in the number of leukocytes, band forms and accelerated erythrocyte sedimentation rate is noted in the general blood test. These are non-specific signs of inflammation, which allow to evaluate the severity of the inflammatory process in the colon. In the analysis of feces (coprogram), a large amount of mucus and blood elements attracts attention. The stool is often watery in nature. Microscopic examination of feces can reveal an abundance of leukocytes, which indicates the bacterial nature of inflammation. To identify a specific pathogen, a microbiological examination of feces is carried out. It allows not only to detect the pathogen, but also to determine its sensitivity to antibiotics.
Treatment of acute colitis
Required to observe peace and hunger for several days. Only warm drinks are allowed, such as tea or lemon juice. After a few days, the diet is expanded by adding porridge, lean meat and broths to the diet. In the next two weeks, patients are advised to refrain from spicy, greasy or fried foods, as well as vegetables and alcohol, which irritate the intestines. This diet corresponds to table No. 4. If the disease was caused by eating food contaminated with pathogenic microflora or toxins, the stomach and colon are washed with warm soda solution in parallel with the administration of laxatives.
In acute colitis, which is accompanied by severe paroxysmal pain in the intestine, antispasmodics are injected subcutaneously: platifillin, papaverine or atropine. The appointment of narcotic analgesics is not recommended. In addition, sulfonamide preparations, antestezin and activated carbon are used to treat acute colitis. From the first days, empirical antibiotic therapy is prescribed, which, after receiving the results of bacteriological examination of feces, is adjusted for the sensitivity of the pathogen. In parallel with antibiotics, patients are prescribed eubiotics and probiotics to normalize the intestinal microflora.
In the case of severe disease, these therapeutic measures complement the therapy aimed at combating dehydration and collapse. For this purpose, cordiamine or sodium benzoate is injected into patients with acute colitis. With the development of heart failure on the background of dehydration, cardiac glycosides are shown. In addition, infusion therapy is carried out in parallel with saline or 5% glucose in an amount of up to 2 liters per day. If a patient with acute colitis has persistent vomiting, then metoclopramide or chlorpromazine is administered.
Prognosis and prevention
For the prevention of acute colitis it is necessary to strictly follow the rules of personal hygiene, which provide for thorough washing of hands before eating food. You should always wash the fruits and vegetables that are eaten. Prevention involves the heat treatment of meat and fish, as well as boiling water. In addition, the recommended preventive measures aimed at combating viral infections that can cause acute colitis.
The prognosis for acute colitis is usually favorable. When prescribing timely and correct treatment, the symptoms of the disease usually stop within a few days. In severe form of acute colitis and the absence of adequate therapy, a more protracted course is possible with the development of complications.
Ulcerative colitis of the intestines
Ulcerative colitis is one of the most severe forms of the disease, due to the occurrence of lesions in the mucous membrane of the large intestine. The main manifestation is destructive changes in the shell of the organ. For five years or more, periodic screening is recommended to detect colon cancer at an early stage.
Nonspecific ulcerative colitis
The development of colitis is based on a serious inflammatory reaction in the intestines, which starts due to a malfunction of the immune system and leads to significant tissue damage. Characteristic signs: pain in the abdomen, often on the left, decreasing after a bowel movement. Violations are necrotic. Doctors advise to exclude from the diet those foods that are food allergens. This helps to alleviate the patient’s condition.
Erosive colitis is an inflammation of the lining of the stomach adjacent to the duodenum, which is accompanied by the appearance of many ulcers on the surface of the duodenum adjacent to the stomach.
It is a type, or more precisely, one of the stages of inflammation that began in the mucous membrane of the colon. The inflammatory process often leads to the fact that the intestinal walls begin to redden and swell. Its lumen is slightly narrowed. Because of this, various cracks often occur. Inflammation can cover both individual areas of the colon and its entire surface.
Almost always is not an independent form of the disease, from this phase another colitis debuts, which will manifest itself later.
Causes of Chronic Colitis
There are various causes of chronic colitis, among which gastroenterologists put the violation of the regime and diet in the first place.
The following are the secondary causes of chronic colitis of the intestine:
- Dysbacteriosis and intestinal dysbiosis, including those provoked by improper use of antibacterial drugs,
- Consequences and complications of intestinal infections (salmonellosis, dysentery, cholera, viral colitis, intestinal flu and others),
- Secretory and enzymatic failure against the background of chronic pancreatitis, cholecystitis and gastritis,
- Prolonged penetration of toxic and toxic substances into the digestive tract, which can have a negative effect on the mucous membrane of the large intestine (arsenic, acetic acid, lead, manganese, mercury).
Patients aged 30 to 45 years are most often diagnosed with primary forms of nutritional chronic gastritis. The main cause of pathology is improper diet, deficiency of fiber and microelements in the diet. Eating refined and defatted foods causes an achilic condition in which mucosal cells stop producing mucus. There is a delay of feces, which lead to primary catarrhal inflammation.
Another cause of chronic colitis in children and adults is nutritional allergy, which can be combined with galactosemia and gluten intolerance. To identify such a pathology is possible only with the help of special tests. Consultation with an allergist.
In women, chronic intestinal colitis can develop due to regular fasting in order to reduce body weight. Enemas and the use of laxatives, including those of plant origin, pose a great danger. Many components of slimming products cause irreparable harm to the mucous membrane of the colon, paralyzing its normal secretory work.
Atrophic bowel colitis
Atrophic colitis is an inflammatory process that occurs in the large intestine, due to which the intestinal walls are depleted.
- Infectious - the occurrence of this type of disease is caused by the vital activity of bacteria and intestinal parasites, which can be ingested with inadequate processing of food, drinking polluted water.
- Drug - another type of colitis caused by taking a number of antibiotics and laxative drugs for a long period of time. Such drugs have a negative effect on the intestinal microflora.
- Radiation due to exposure to radiation or radiation sickness.
- Ischemic - is inflammation in the digestive tract, caused by vascular lesions that do not lead to tissue necrosis. Various diseases and pathological processes lead to a decrease in blood flow in the mucous membranes and chronic ischemia of the colon.
The scheme of its treatment directly depends on what kind of colitis happens. For each type and form of flow, individual techniques are applied.
Symptoms of colitis in adults
Colitis intestine in adults has a lot of symptoms that are very characteristic:
- Discomfort and pain in the lower abdomen. Such manifestations accompany intestinal colitis in 90% of cases. Exacerbation of pain occurs after therapeutic procedures, food intake, and the effects of mechanical factors (shaking in vehicles, running, walking, etc.).
- Constipation or diarrhea, sometimes alternating,
- Many patients also experience flatulence, heaviness in the stomach, bloating.
- Tenesmus is a false urge to defecate, accompanying pain. In this case, the chair may be missing.
- Detection in the feces of fluid, mucus, blood streak, in severe cases - pus.
- The weakness of the body associated with impaired absorption of various substances or the activity of pathogenic microorganisms.
Symptoms of the disease are aggravated during exacerbations and almost disappear during remission.
Pain in colitis with colitis is aching or dull. From time to time, the patient complains of arching pain. In some patients, the pain may be dull, constant, and diffuse throughout the abdomen. Then it is enhanced, it is cramped and localized in the lower part of the abdominal cavity: on the left or above the pubis. The attack may be accompanied by a desire to stool or discharge of gas.
Inflammation of the mucous membrane of the large intestine can affect both parts of the large intestine and spread to all its divisions. The extent of the lesion can range from mild inflammation, which causes minor painful spasms and seizures in the abdomen, to pronounced ulcerative changes. Colitis may be complicated by inflammation of the small intestines or the stomach.
|Stage of intestinal colitis||Symptoms|
|Initial||At the initial stage of the disease, the symptoms are not so pronounced that the person does not notice the presence of a deviation. There may be:|
|Average||The average degree of colitis in adults is characterized by the following features:|
The urge to defecate occur 4-6 times a day, mostly at night.
|Heavy||It occurs at a high temperature (over 38.1) on the background of disorders of the cardiovascular system (tachycardia). It is observed:|
Complications can only cause ulcerative colitis. The consequences can be:
- blood poisoning or the spread of infection to other organs
- bleeding in the intestines - this indicates chronic ulcerative colitis,
- the appearance of cancer,
- gangrene of the affected areas of the intestine and colon. At the same time, a person is tormented by low blood pressure, weakness and high fever,
- perforation of the ulcer, which often causes peritonitis. Symptoms of chronic colitis in this case will be expressed in a strong bloating and tension of the abdominal muscles, chills, accompanied by high fever, plaque on the tongue and weakness of the body.
Symptoms of acute colitis
In the acute course of the disease in adults, the following symptoms occur:
- excessive pain in the abdomen, sometimes the pain can be located in the epigastric zone,
- meteorism and active gas formation may occur,
- at the time of cleansing the intestines, the patient can have significant discomfort, and the urge to go to the toilet can be very painful,
- traces of blood can be seen in the feces,
- often the patient has diarrhea,
- the general condition of the patient is characterized by increased fatigue, body weight may begin to decrease,
- in some cases, there is a lack of appetite, after eating nausea.
Symptoms of chronic colitis
The manifestations of the chronic form of the disease include:
- spastic constipation
- false urge to defecate, accompanied by flatulence,
- mild pain during physical exertion, as a rule, ischemic colitis causes them,
- aching dull cramping pain, covering the entire lower abdomen, radiating in some cases to the left hypochondrium,
- headache and nausea.
Contact your doctor if you have diarrhea with blood or mucus, or if you have severe abdominal pain, especially in combination with high fever.
Complications of colitis can be the following diseases:
- if the infection is severe, dehydration and poisoning can occur,
- with ulcerative lesions - acute blood loss and anemia,
- in chronic colitis, there is a decrease in the quality of life (chronic poisoning of the body, as well as all sorts of consequences),
- Chronic forms of colitis are a risk factor for cancer, and signs of colitis can manifest themselves directly in tumors.
Laboratory examination methods:
- Complete blood count indicates the presence of inflammatory changes in the body and anemia (an increase in the number of leukocytes, a shift to the left leukocyte formula, a decrease in the number of red blood cells),
- Urinalysis indicates dehydration (increased specific gravity, protein admixture),
- Biochemical analysis of urine displays the degree of dehydration, loss of blood electrolytes, indicates the presence of inflammation.
Instrumental methods for the diagnosis of colitis:
- sigmoidoscopy - an inspection of a section of the intestine (up to 30 cm) is performed; for this, a rectoscope is inserted through the anus, a special endoscopic device,
- irrigoscopy - examination of the intestine with X-rays, before the procedure, the intestine is filled with a contrast agent,
- A colonoscopy is performed on the same principle as a sigmoidoscopy, however, a section of the intestine is up to one meter in length.
The diagnosis must necessarily be made by the doctor after lengthy examinations, which reveal the condition of the intestinal mucosa, the tone and elasticity of its walls.
What is intestinal colitis?
Colitis is an acute or chronic inflammatory process that occurs in the large intestine, which is caused by a toxic, ischemic or infectious organ damage.
In the view of the average person without special medical knowledge, colitis is associated with intestinal colic. However, these two states are far from the same. Intestinal colic is an uncomfortable paroxysmal pain sensation in the lower abdomen. Colic is just a symptom characterizing a huge number of diseases and pathologies, from banal meteorism to oncological processes.
Colitis, in turn, is an independent disease, distinguished by its own etiology, symptomatology and flow characteristics.
To better understand what this pathology is, you need to turn to the basics of the anatomy of the gastrointestinal tract.
The intestine is divided into two sections: the large intestine and small intestine. Each has its own digestive functions. Thin section begins immediately after the stomach and there are major digestive processes (including the final processing of food, the release of nutrients and transport them into the bloodstream through the walls of the body).
From the large intestine thin is separated by a mucous membrane. Thanks to her, waste and microorganisms from the colon do not enter the previous section. In the large intestine the final processing of food and the absorption of liquid take place. Not the last role in this process is played by special bacteria (in the colon their volume reaches about 1.5 kg or even more).
In addition to “beneficial” bacteria (which contribute to the processing of food debris), pathogens also live in the colon. These microorganisms in the course of life produce a huge amount of active substances with high toxic potential. If as a result of consumption of poor-quality food or for other reasons, the concentration of pathogenic microflora in the body increases, the colon mucosa becomes inflamed. This is how an immune reaction is manifested in order to prevent the penetration of toxins into the bloodstream. Colitis develops.
In some cases, pathogenic microflora can penetrate into the small intestine, in which case an even more severe form of pathology develops - enterocolitis. It should be noted that if conditionally useful microflora gets into the small intestine, the enterocolitis does not develop and everything is limited to discomfortable sensations and abdominal distention.
The etiology of colitis is not limited to infection. Some medications have the same effect (side effect), and colitis can also accompany some other pathological processes.
Treatment of intestinal colitis
When exacerbation of chronic or acute colitis in adults, treatment should be carried out in a hospital in the proctology department, if the infectious nature of colitis is found out, then in specialized departments of infectious diseases hospitals.
Treatment involves taking medication and a strict diet. Drug treatment of intestinal colitis in adults involves taking drugs in the following groups:
- "No-shpa" (domestic analogue - "Drotaverin"). It is used to relieve cramps. This drug will help to stop the symptoms until the doctors say exactly how to treat inflammation of the intestines.
- If inflammation in intestinal colitis is caused by pathogenic flora, various types of antibacterial agents are used to reduce its activity and suppress it. The etiological treatment for helminthiases consists of anti-helminth therapy, dysbacteriosis is treated with the help of probiotics.
- Pathogenetic therapy consists in prescribing abundant drinking of alkaline mineral waters. In severe cases, intravenous infusions of saline, reosorbilact and other saline solutions are prescribed.
In the treatment of acute intestinal colitis from drugs once used saline laxative. For the treatment of infectious forms used sulfide drugs in combination with antibiotics. Symptomatic drugs help well, Papaverine - with severe pain.
With the development of chronic colitis, a follow-up clinic is recommended to the patient with regular examination by a specialist and all necessary tests. For the patient to prevent recurrence of exacerbation, it is necessary to normalize the diet, avoid stress and heavy loads.
The use of drugs aimed at improving immunity (aloe extract), reducing inflammatory processes (sulfanilamide suppositories), reducing pain symptoms (spasmatone) is recommended. Be sure to use vitamin therapy.
For the recognition of colitis, as well as for the appointment of drugs and treatment methods, you should contact your gastroenterologist or proctologist, who will determine the optimal solution in each case.
Physiotherapy for colitis is due to the pathogenetic orientation of the impact of the corresponding physical factor and is aimed at improving the motor-evacuation and secretory functions of the colon. For this purpose, as well as to eliminate dangerous symptoms, the following physiotherapy methods are provided in modern treatment-and-prophylactic centers:
- UV exposure local exposure
- electrophoresis using drugs (papaverine, drotaverine),
- paraffin applications on certain areas of the abdomen,
- mud applications
- magnetic therapy.
- Ulcerative colitis - surgery to remove ulcers and neoplasms is indicated only when all measures of conservative therapy have been unsuccessful. Surgery for ulcerative colitis requires only 10% of patients. The surgical method can be radical.
- Ischemic colitis - a surgical method is used in the case of blood clots in the abdominal aorta and its branches, which directly affects the development and progression of the pathological process in the large intestine.
Symptoms of ulcerative colitis
A special case of intestinal colitis is ulcerative colitis. Its main difference is the presence of ulcers on the walls of mucous membranes (up to perforation), which causes a much more severe pathology. Ulcerative colitis is distinguished by particular symptoms.
Frequent false urges to defecate. At the beginning of the process - scanty diarrhea (up to 15-20 times a day), inability to hold a chair. Symptom is observed in more than half of patients (55-60%).
Impurities in the stool. Blood, greenish mucus, pus ribbons. Blood excretion varies from negligible (found only on toilet paper) to a rich, visible to the naked eye in the feces.
Sudden constipation, indicating inflammation of the small intestine. Occurs in approximately a quarter of patients.
Manifestations of intoxication. Manifestations are similar to ARVI. In severe lesions, there is an increased heartbeat (tachycardia), general weakness, fever, nausea, vomiting, and decreased appetite. Diarrhea can also lead to dehydration.
In some cases, symptoms may develop that are not associated with lesions of the gastrointestinal tract. Violations of vision, skin rash, itching of the mucous membranes, the formation of blood clots, pain in the joints. In addition, the liver and gall bladder may suffer.
Colitis pains in intestines
Pain when colitis colitis is aching or dull character. Sometimes patients complain of arching pain. Unpleasant sensations can be persistent and painful, but most often the pain manifests periods (cramping).
Localization of pain varies from case to case. Often, localization is impossible to determine, the pain spreads all over the stomach or wanders. In the initial period, discomfort occurs in the lower left abdomen.
The pain radiates to the back, sacrum, left side of the chest. For this reason, the patient is often unable to independently determine the source of pain, taking colitis for problems with the spine or heart.
After taking medications (antispasmodic, anticholinergic), discharge of intestinal gases, defecation, warming of the affected area, the pain subsides, but after a certain period of time it returns. In some patients, the discharge of gases, on the contrary, leads to increased pain.
Causes of intestinal colitis
At the moment, the causes of intestinal colitis are not fully known. Numerous scientific studies are being conducted, but scientists still have not come to a common opinion. Despite this, one can name a number of provoking factors. They act as triggers that initiate the beginning of the pathological process.
Infectious lesions of the body. The situation when a person consumes low-quality expired food is quite trivial. Food poisoning caused by pathogenic microflora, which multiplies actively in the intestine. In addition, under other conditions, a person can become a carrier of intestinal infection, Vibrio cholerae, dysentery amoeba, salmonella, and other infectious agents. Such agents can be bacteria of tuberculosis, shigellosis.
In all cases, pathogenic microorganisms secrete toxins that irritate the intestinal walls and cause specific symptoms. Despite the origin of the disease in this case, the colitis caused by the infection is considered non-infectious.
Eating disorders (alimentary causes of colitis). At the household level, colitis caused by a violation of the regime of food consumption, called "indigestion." Alimentary colitis is caused by excessive consumption of fast food, irregular meals, alcohol abuse, lack of fiber consumed, insufficient use of “healthy” food (vegetables, fruits, natural meat products), etc.
Genetic factors. Some genetic mutations can cause congenital bowel problems.
The presence of concomitant pathologies. Cholecystitis, hepatitis, pancreatitis, various forms of gastritis contribute to the disruption of the bowels and the development of colitis. The same effect produces a decrease in immunity and weakening of the body after viral diseases.
Reception of medicines. Many drugs have a negative effect on the intestinal microflora and reduce intestinal motility. Antibiotics, anti-inflammatory drugs, aminoglycoside drugs, laxatives, drugs for contraception, etc.
Toxic poisoning. They can be both exogenous in nature (poisoning with mercury salts, phosphorus, arsenic) and endogenous (for example, poisoning with urate salts with gouty lesions).
Allergic reaction . Food and other forms of allergy contribute to the disruption of the bowels.
Mechanical impact. Abuse of cleansing enemas or suppositories leads to disruption of the intestine due to constant irritation of the intestinal mucosa.
Chronic intestinal colitis
Gastroenterologists agree that the main cause of intestinal colitis is a violation of the diet. Therefore, among persons aged 25 to 40 years, colitis is much more widespread than can be expected.
In some cases, colitis caused by:
Complications of infectious diseases of the intestine (salmonellosis, cholera, intestinal forms of influenza, etc.),
Long-term effects on the body of salts of heavy metals and toxic non-metals (typical for people working in hazardous industrial plants),
Dysbacteriosis, as a result of which the concentration of beneficial microflora and intestinal peristalsis is disturbed,
Enzyme deficiency as a result of diseases of the gallbladder, pancreas and stomach.
However, malnutrition remains the primary cause. The lack of fiber in the diet leads to a decrease in the secretion of mucus and disruption of the normal evacuation of fecal masses from the colon. Congestion of feces in the intestines leads to irritation and inflammation of the mucous membrane.
An abnormal diet plays a significant role in the development of colitis (therefore, women are an additional special risk group).
Chronic form is not necessarily preceded by a pronounced acute phase. A situation is possible in which there will be only one symptom of the acute form, and that is very sluggish. In other cases, the symptoms may not be at all, then the pathology proceeds in the reverse order.
The bright and severe course of chronic colitis is possible only at an advanced stage.
The first symptoms, which should immediately pay attention:
If the necessary treatment is not carried out, the disease will be completely formed, and the manifestations will subside.
Suddenly and out of nowhere chronic intestinal colitis does not appear. In order for the disease to manifest itself “in all its glory”, a trigger is needed. Such a trigger can be food poisoning, infection, trauma, an attack of allergies, etc.
Only in 10-12% of the total number of patients after the development of a trigger, the colitis does not manifest itself, but subsides and gradually spontaneously heals, in other cases this unpleasant pathology becomes a lifetime companion of a person.
During periods of exacerbation, there is a picture of the acute form of pathology, however, as was said, the specific symptoms (albeit in a weakened form) accompany the patient even in the period of remission.
Spastic bowel colitis
Spastic colitis differs from other types of this pathology by a significantly reduced function of the colon due to insufficient peristalsis. Unlike ulcerative colitis, spastic severe pathology is not considered and refers, rather, to a disorder of bowel function.
Normally, bowel movements occur with a certain frequency. For someone, the norm is considered 1 time per day, for others - 1 time per week. In spastic colitis, the main symptom is persistent constipation. The severity of the course of the disease is purely individual and in two patients the symptoms will be completely different.
Symptoms, in general, are similar to other forms and include:
heaviness in the stomach, bloating,
aching pain in left side or lower left,
A sharp alternation of constipation and diarrhea with a predominance of the latter,
Most of the time, constipation persists,
increased gas production.
Spastic intestinal colitis is easier, because the patient's condition can be characterized as satisfactory.
On palpation of the colon, as well as carrying out ultrasound diagnostics, spasmodic parts of the colon are clearly visible. This type of disease is characterized by intestinal changes. In some areas it is excessively expanded, in others - on the contrary, narrowed.
A long-term illness causes gradual atrophic changes of the smooth muscles of the colon caused by a decrease in work. The intestinal tone falls, the entire length of the body is observed mucus secretion, swelling. These signs are detected by sigmoidoscopy. If degenerative or atrophic processes are detected, a more thorough diagnosis is necessary, since in this case the intestinal walls become dry and begin to crack. Cracks can be mistaken for ulcers that distinguish ulcerative colitis.
For this reason, it is important to take into account the complex of symptoms and factors in conjunction with the data of instrumental diagnostics for accurate diagnosis.
Erosive bowel colitis
Erosive colitis is not always distinguished by specialists as a separate type. It would be more accurate to speak of this type as the initial stage of development of ulcerative colitis. The only and main difference is that erosive changes are insignificant and do not end with perforation, but the symptoms are sufficiently characteristic to isolate erosive colitis without much difficulty.
Almost always, regardless of the individual characteristics of the organism, erosive colitis is represented by the whole complex of typical manifestations, including:
Nausea (patient "stirs up"), vomiting is possible.
Severity in the abdomen (localized, mainly in the region of the stomach).
Stomach pain. Due to this symptom, an inexperienced doctor may take erosive colitis as a form of gastritis and prescribe a wrong treatment.
Sound in the stomach (rumbling).
Metallic sour taste in the mouth.
Belching and heartburn (also usually characteristic of gastritis with high acidity).
In addition to the complex of symptoms that accompany erosive colitis, symptoms typical for any colitis, like stool disorders, etc., accompany the disease.
Diffuse bowel colitis
Diffuse intestinal colitis most often affects both departments at once, leaking heavily. Since colitis affects both the large intestine and the small intestine, the symptoms are bright from the first day. The symptoms are present as signs of gastritis, and signs of enteritis.
Diagnosing diffuse colitis is usually not so difficult with minimal medical training.
This type of pathology is distinguished by a number of symptoms:
Pain sensations. Pain in a diffuse type of colitis is not localized in any one area, but spreads all over the abdomen. Often there is a movement of discomfort from one part of the abdomen to another (wandering pain). In some cases, on the second or third day, the pain becomes distinguishable in nature and is located in the lower left or lower right part of the abdomen. In the latter case, additional appendicitis functional tests should be carried out. The pains are aching or dull, they are colicky.
The pain may radiate to the region of the heart. Coupled with a heartbeat, this gives grounds for the patient to assume heart disease, not the digestive tract.
Often, when a diffuse type is detected, there is not a decrease in appetite, but its complete absence.
Very frequent tenesmus. On the first day - profuse diarrhea with characteristic impurities. After the act of defecation pain increases, but not immediately, but after 1.5-2 hours. 2-3 day diarrhea continues. A small amount of liquid with an extremely unpleasant smell of feces. Almost always diarrhea begins at night, usually - 5-7 am (the so-called “diarrhea-alarm”).
Nausea, vomiting. The urge to vomit persist even with an empty stomach.
The clinical picture is controversial. On radiographic examination with a contrast agent, both areas of narrowing and pathological expansion of the intestine are visible. Peristalsis can both accelerate at times, and be oppressed.
The patient's tongue is coated with a gray or yellowish bloom.
On palpation, hard, cramped areas are noted, and on palpation, patients indicate pain.
How to treat intestinal colitis?
In order to prescribe treatment or recognize colitis, you must consult a gastroenterologist or coloproctologist. The main link in the chain of treatment of colitis is a special diet.
The treatment of colitis, in contrast to the treatment of many other diseases, is characterized by the fact that diet is an essential element of therapy. Since the mucous membrane of the colon (and possibly the small intestine) is irritated, in no case should one irritate it even more. Therefore, the goal of the diet is to reduce the load on the intestines to a minimum, while maintaining an optimal diet rich in everything necessary.
Foods rich in fiber are temporarily excluded from the diet:
Raw fruits and vegetables
Marinade and smoked meats
All salty, sour and sweet foods
Food should be bland, so during heat treatment, stewing and cooking are preferred.
Food should be fractional, 4-6 times a day to avoid unnecessary load on the digestive tract. Products that improve intestinal motility and have a laxative effect and also should not be eaten. This applies to prunes, milk, pumpkins, cabbage, etc. It is best to eat pureed food.
When the colitis should drink plenty of fluids, because the body is quickly dehydrated.
Methods of drug treatment
We also list a number of measures that can be applied during treatment:
Antibiotics and antimicrobials. Appointed if the infectious etiology of the disease. Enterofuril, Alpha Normix (Rifaximin), Cyfran are prescribed. The course of treatment is short, 3-5 days strictly according to the indications and under the supervision of the attending physician.
Helminthiasis If the cause of intestinal colitis is helminthiasis (parasitic bowel disease), specialized anthelmintic drugs are prescribed (specific names depend on the type of helminth and the degree of damage).
Removal of pain. A pronounced pain syndrome is relieved by antispasmodic drugs, such as No-shpa, Papaverin. In more severe cases anticholinergic drugs are added to antispasmodics.
Treatment of related complications. With intestinal colitis, proctitis or proctosigmoiditis is often formed. To eliminate these effects of colitis, specific local therapy is used with the use of suppositories (rectally injected drugs, based on belladonna, anestezin, astringents are injected), as well as enemas (phytotherapy with calendula, chamomile, or tannin preparations, protorgol).
Elimination of stool disorders. Constipation and diarrhea are eliminated in different ways. Binding agents (oak bark, bismuth nitrate salt, tanalbin, white clay, etc.) are recommended to stop diarrhea, and a cleansing enema is performed to eliminate constipation.
Normalization of microflora. Normal and stable peristalsis is impossible without useful microflora. As a result of diarrhea or constipation microflora dies. If cleaning measures were taken - the bacteria are washed out, as a result of which a prolonged constipation can begin. Special probiotic preparations are prescribed, such as Linex, enzymes (if the disease proceeds against the background of their insufficiency), enterosorbents (Polysorb, activated carbon, Polifepan, Enterosgel, Filtrum and others).
How to treat ulcerative colitis?
Ulcerative colitis is more difficult to treat. More intensive therapy is required, which means it is longer and more expensive. Preparations for the treatment of this type of pathology are not only expensive, but also have a lot of side effects, because they are used strictly as prescribed by a specialist.
They are produced in the form of rectal suppositories, enemas, in pill form (Salofalk, Pentasa, Mesavant, Mesacol). In some cases, resort to the use of biological therapy drugs, such as drugs Humir (Adalimumab), Remicade (Infliximab). In the most severe cases, the use of corticosteroid medicines (Prednisolone, Methylprednisolone, Hydrocortisone) is acceptable. The drugs are available in the form of rectal droppers, suppositories, tablets.
If immunosuppressants (Cyclosporin, Azathioprine, Methotrexate) are prescribed as the cause of the disease in an autoimmune disease or allergic reaction.
Also in case of chronic colitis, sanatorium treatment is recommended.
Education: A diploma in the specialty “Medicine” was received at the Russian State Medical University. N.I. Pirogov (2005). Postgraduate Studies in Gastroenterology - educational and scientific medical center.
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Types of colitis
Worldwide, colitis is commonly divided by flow, shape, location and causative factor. The course of colitis can be acute and chronic.
But most often, patients have proctosigmoiditis, which is also called distal colitis - a simultaneous lesion of the sigmoid and rectum.
Depending on the nature of the factor that provoked the disease, there are The following types of colitis:
- infectious colitis (dysentery, eshirichiosis), which develops as a result of exposure to the mucous membrane of the colon of pathogenic microbes,
- ulcerative colitis (ulcerative colitis (NUC), Crohn's disease), which is characterized by the appearance of ulcers on the mucous membrane of the colon,
- spastic colitis appears in persons with a labile nervous system due to stress, physical or mental fatigue, hormonal imbalance, internal experiences and fears,
- toxic colitis due to damage to the colon mucosa with various poisons, as well as drugs,
- ischemic colitis, the main cause of which is thrombosis of the mesenteric vessels,
- radiation colitis occurs in individuals who have been exposed to high doses of radiation,
- allergic colitis is characteristic of persons prone to allergic reactions,
- alimentary colitis, the causes of which lie in an unbalanced and unhealthy diet, alcohol abuse, etc.,
- mechanical colitis occurs due to mechanical damage to the epithelium of the colon during an enema, the introduction of rectal suppositories or foreign objects.
Symptoms of intestinal colitis in women
In the process of clinical observations, it was concluded that women develop colitis more often than children or men.
Very often, the cause of colitis in women is the use of cleansing enemas to remove toxins and reduce weight. In addition, most of the means for weight loss, which are so popular among women, negatively displayed on the work of the intestine and its condition and can even cause colitis.
In women can be observed The following symptoms of colitis:
- violation of the general condition (weakness, loss of appetite, decreased performance, etc.),
- abdominal pain,
- heaviness in the stomach
- temperature increase and others.
Symptoms of intestinal colitis in men
Male sex is less prone to colitis than female sex. Inflammation of the large intestine often affects middle-aged men.
The disease in the representatives of the stronger sex is manifested by the same symptoms as in women namely:
- increased flatulence in the intestines,
- abdominal pain of a different nature
- sometimes vomiting,
- stool instability
- appearance of blood, pus or mucus in the feces,
- painful false urge to empty the bowel and others.
The intensity of the clinical manifestations of colitis directly depends on the etiology, course, type of colitis, as well as the individual characteristics of the patient.
Symptoms of colitis in children
The course of colitis in children is more turbulent and more severe than in adult patients.
The child can be identified The following symptoms of acute colitis include:
- severe weakness
- pains that are localized around the navel,
- diarrhea, with increased stools up to 15 times a day,
- watery, frothy, often greenish stools that contain a lot of mucus and blood streaks,
- reduced skin turgor
- dry skin and mucous membranes,
- a decrease in the daily amount of urine and others.
Most often the child have a place symptoms such as:
- aching pain in the stomach, which is associated with food intake or defecation, and noted in the navel, right or left half of the abdomen, depending on the segment of the colon lesion,
- constipation or diarrhea,
- feces contain a lot of mucus, blood streaks and undigested food particles,
- change in the consistency of feces (sheep feces, ribbon-like feces, watery feces, etc.),
- rumbling in the stomach
Because of constipation or diarrhea, the child may experience anal tears and loss of rectal mucosa.
Ischemic colitis: symptoms and treatment
With intestinal ischemia, the leading symptoms are severe pain and intestinal obstruction. The clinical picture of ischemic colitis depends on how extensive the lesion is, as well as whether the mesenteric artery is completely blocked or partially.
The pain has a spastic character and most often appears immediately after a meal. Patients also have intestinal distention, nausea, vomiting, constipation, or diarrhea.
With massive thrombosis of the intestinal arteries, patients may develop a painful shock - lowering blood pressure, tachycardia, pale skin, cold sweat and impaired consciousness.
Treatment of colitis caused by intestinal ischemia is almost always in surgical intervention, in which part of the ischemic or dead intestine is removed.
Infectious intestinal colitis: symptoms and treatment in adults
Infectious colitis almost always has an acute or subacute course. Patients complain of fever, frequent loose stools (watery, mushy, jelly-like), with blood, mucus, pus, cutting abdominal pain, flatulence and others. The manifestation of colitis infectious genesis will depend on the microorganism that provoked it.
Diet with colitis
Nutrition for colitis depends on the leading symptom of the disease. But in any case, the diet should be followed in the period of exacerbation, and in remission.
In the period of exacerbation or in case of acute course of colitis, the menu consists of boiled or steamed dishes. Food should not have coarse particles that can irritate the intestinal mucosa, so the soups and porridges are interrupted by a blender or rubbed through a sieve.
The list of prohibited products at colitis:
- rye and fresh bread,
- baking pies,
- rich broths,
- fatty meats, fish and poultry,
- hard-boiled or fried eggs,
- barley porridge and soup
- raw fruits
- fruit juices that increase flatulence in the intestines,
- alcoholic drinks,
- carbonated drinks.
During remission, nutrition should be balanced and healthy. It is necessary to eat fractionally (5-6 times a day) in small portions, it is also important to use a sufficient amount of liquid.
It is recommended to exclude from the diet of spicy and fatty foods, whole milk, as well as products that contain coarse vegetable fiber and promote gas formation - cabbage, beans, black and whole grain bread, grapes and others. It is strictly forbidden to drink alcohol.
When cooking, preference should be given to roasting, boiling, or steaming.
When the colitis, which is accompanied by constipation, the menu must necessarily contain beets, carrots, dried fruits, apricots, kiwi, and also help to loosen the stool drinking 1 tablespoon of any vegetable oil in the morning on an empty stomach.
With colitis, where the leading symptom is diarrhea, nutrition should be such as not to cause fermentation in the intestine and spare its mucous membrane. In the daily diet, they reduce the amount of fat and pickles, smoked meats, whole milk, hot spices, as well as alcoholic and carbonated drinks are completely removed.
In toga, we can say that colitis is a rather serious disease with a long and complicated treatment, the result of which depends on its timeliness and correctness. Therefore, if you identify symptoms characteristic of colitis, do not self-medicate, but consult a specialist.
Diagnosis and treatment of infectious and toxic colitis is dealt with by an infectious disease doctor, and in the case of other forms of the disease, by a gastroenterologist, coloproctologist or proctologist.
Have you ever encountered colitis? Leave your feedback on the treatment of this disease in the comments under the topic.
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How to treat?
Therapeutic treatment of chronic colitis is divided into the following stages:
- Suppression of signs of exacerbation.
- Maintenance therapy in the period of remission of the disease.
In case of exacerbation of chronic colitis, inpatient treatment is simply necessary. The first few days recommended fasting, after the patient is transferred to a diet number 4.
Eating should be frequent, the products are thoroughly crushed. Spicy and salty dishes, pickles, flour products, smoked products and fatty meat, dairy products, cereals from millet and barley, fresh vegetables and fruits, soda and sweet treats are completely excluded from the diet.
It also helps with drug treatment, which is also used at the remission stage:
- Intestinal motility stimulants (Dokuzat),
- Saline laxatives (bisacodyl, magnesia sulfate).
- Laxative drugs of plant origin (Senade).
- Antispasmodics (Papaverina hydrochloride, No-spa, Duspatalin).
- Enzyme preparations to improve digestion (CREON 10,000, Mezim).
- Adsorbents for the removal of toxic substances from the body (activated carbon, Smecta and Neosmectite).
- Nicotinic acid and B-group vitamins to speed up the renewal of damaged tissues.
- Anti-inflammatory and antimicrobial drugs (Loperamide, Furozolidon, Tetracycline, Enterofuril).
- Cholagogue in the pathology of the gallbladder and the lack of bile acids in the digestive system (Holosas, Hofitol, Allohol).
Taking medical medication is recommended only after consulting a doctor.
In case of chronic colitis, sanatorium treatment is indicated. Sanatoriums of Pyatigorsk, Yessentuki, Kislovodsk are considered to be the best resorts for the treatment of the digestive organs. In them, in addition to the reception of mineral waters, baths are used, washing the intestines, treatment with microclysters enriched with active biological substances.
Gastroenterologists recommend courses of physiotherapy procedures (magnetic therapy, mud applications, acupuncture). For surgical intervention resorted to emergency indications for complicated course of chronic colitis.
From popular recipes are shown:
- From inflammation - decoctions of sage, peppermint, St. John's wort, cumin.
- Nettle, motherwort and mint help with increased gas production.
- To relieve spasms in the intestines, microclysters are recommended with a decoction of chamomile, calendula.
- With ulcerative colitis, sea buckthorn oil is shown in microclysters for the night.
All auxiliary methods require a long time, held courses with interruptions. It is better to first consult with your doctor.
Diet for chronic colitis
Diet for chronic intestinal colitis is called "treatment table number 4." It implies a fractional (in small portions) food intake - up to 7 times a day.
- barley, barley, millet porridge,
- smoked meat, canned food,
- fat sea fish,
- pork, beef,
- sour cream, milk,
- strong coffee, tea, carbonated drinks.
In chronic colitis, you can eat foods such as:
- boiled chicken, rabbit meat, veal,
- non-sour cottage cheese,
- white crackers
- lean fish in boiled or steamed,
- liquid porridge on the water,
- vegetable broths,
- jelly, rosehip decoction, weak green tea.
The basic principle of nutrition in chronic colitis: the exclusion of products and dishes that cause mechanical and chemical irritation of the intestinal mucosa.
To avoid complications and serious health problems, timely treatment is necessary, as well as preventive measures:
- maintaining a healthy lifestyle
- use of personal household items
- strict compliance with the prescribed diet, diet,
- timely food intake (breakfast cannot be ignored),
- compliance with basic hygiene rules (washing and washing hands),
- elimination of raw water intake and thorough washing of fruits and vegetables before consumption,
- visits to doctors, regular medical check-ups at the dentist, family doctor, gastroenterologist.
It is very important to know and understand how to treat chronic colitis, but the most basic thing is not to get involved in self-treatment, but still resort to the help of qualified specialists. Do not avoid hospitalization in severe stage and acute manifestation of the disease. In stationary conditions, relief and improvement in health comes much faster than at home.
Sample menu for the day
|Breakfast||Semolina and galete cookies.|
|Afternoon tea||Several crackers with tea, you can eat an apple.|
|Dinner||soup with chicken and stewed fruit. For dessert, one or two soufflés.|
|Before bedtime||At bedtime, drink either a mousse or non-acidic kefir.|
|Afternoon tea||grated baked apple|
Thus, it is necessary to strictly monitor nutrition to achieve a high therapeutic effect. Food should be fractional, with a minimum of fiber. It is also important to exclude coarse foods, salted, smoked, spicy dishes. All dishes should be served in a crushed and shabby form. Only in this way can you quickly forget about colitis.
Elimination of chronic intestinal colitis and other types can be accomplished with the help of folk remedies. The patient needs to consult with the doctor, and not to apply the means at its discretion.
- Remove the inflammatory process will help mint. To prepare two large spoons of this herb, pour 450 ml of boiling water and insist for 20 minutes. Take 2-3 tablespoons, 3-4 times daily before meals.
- At 500 ml of boiling water should take two tablespoons of dry grass. Mixture insist in a glass or enamel bowl for two hours. It is better to cover the solution with a tight lid. Take filtered infusion for one month. The daily dosage of Hypericum is 250 ml, while this number is divided into three doses. Hypericum should be drunk half an hour before meals.
- Decoction of chamomile and centaury. One teaspoon of the centaury and a teaspoon of chamomile is poured with a glass of boiled water and infused. Drink with intestinal colitis in a tablespoon of infusion for every two hours. After 1-2 months, reduce the dose, and the intervals between medications do more
- Pomegranate (peel). Take 20 g of dry crusts or 50 g of fresh pomegranate with seeds, boil over low heat for 30 minutes in 200 ml of water. Strain thoroughly. Drink 2 tbsp. l cooked broth 2 times a day. Pomegranate decoction is a very effective remedy for the treatment of allergic colitis and enterocolitis.