Colitis

Description:

Colitis is an inflammatory process in a cover of a large intestine which quite often arises at chronic inflammatory diseases of intestines, and also viral and bacterial infections, and can extend on mucous a small bowel and a stomach. This inflammation of thick department of intestines can proceed in an acute or chronic form.
The name of a disease came from the Greek word "kolon" that "large intestine" means,  the termination "-ит" indicates the inflammatory nature of a disease. By the morphological nature colitis happens different: ulcer (formation of ulcer defects on a mucous membrane of thick department of intestines), infectious (an etiological factor – bacteria, viruses, the elementary), ischemic (disturbance of blood circulation in gut walls), medicinal, radiation, etc. Often the disease is confused to a syndrome of the angry intestines because of similar symptoms, however the syndrome of the angry intestines is not connected with a large intestine.

Colitis reasons:

Colitis is a polyetiological disease.
The reasons of development of colitis will include:
• Infectious nature of a disease. Colitis can be caused by bacteria, viruses, fungi, the elementary, etc. Colitis can be observed at salmonellosis, diphtheria, cholera.
• Medicinal etiology of colitis. Long reception of some antibiotics (for example, lincomycin) and other drugs (laxatives, neuroleptics, etc.) can provoke development of inflammatory process in a large intestine;
• Ischemic colitis develops owing to disturbance of blood supply in a gut wall (it is observed at elderly people);
• The wrong diet (excess amount of flour and animal food in a diet, abuse of spicy food and alcohol, uniform food);
• An adverse effect of radiation causes beam (radiation) colitis;
• Worms;
• Food allergy;
• Intestinal dysbiosis;
• Development of colitis against the background of  exogenous poisonings teteraetilsvintsy, arsenic, etc.;
• The burdened heredity;
• Spread of an infection from a gall bladder and a pancreas;
• Psychogenic factor;
• Unspecified reasons. In particular, still etiologies of nonspecific ulcer colitis and a disease the Krone is not found out up to the end.

Pathogeny:

Damage of a mucous membrane of thick department of intestines is the cornerstone of development of colitis.  Bacteria, viruses, fungi and protozoa, getting to a gut gleam, damage its wall therefore inflammatory reaction is started. Further puffiness, disturbance of secretion of slime and a vermicular movement develops. Pathological influence of the etiological agent is resulted by painful desires on defecation (tenesmus), a diarrhea (it is frequent with blood and slime), morbidity in a stomach. Ekzo-and the endotoxins emitted by bacteria get to blood that leads to organism intoxication which is shown by fervescence and weakness. At chronic colitis mucous intestines lead various factors to damage: disturbance of blood supply of a wall of a gut, improper feeding, food allergy, etc. Quite often colitis develops against the background of anomalies of development of a large intestine.

Colitis symptoms:

Acute colitis is followed by the expressed pain of the pulling or spastic character, abdominal murmur, a loss of appetite, diarrhea, intoxication phenomena. The frequent liquid chair is characteristic, it is frequent with slime impurity. In more hard cases the chair watery, contains a large amount of slime, sometimes blood. Frequency of a chair can reach  20 times a day. At deterioration in a course of acute colitis there are imperative desires on defecation with tenesmus which gain painful character. Raise body temperature (to 38o With above). In especially hard cases symptoms of the general endointoxication (intoxication),  language dry, laid over by a gray or dirty-gray plaque are sharply expressed; the stomach is blown a little up, and at a severe diarrhea will involve.
When carrying out a palpation morbidity on the course of a large intestine, in its various departments - rumbling is characteristic.
In mild cases the condition of the patient quickly improves; hard cases the disease gains long character. For acute colitis development of complications, such as liver abscesses, a pyelitis, peritonitis, sepsis is possible.

Such clinical manifestations as abdominal pain, disorder of defecation, painful desires to defecation are characteristic of chronic 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 (a diffuse abdominal pain). Morbidity in a stomach amplifies  after meal, and is weakened after defecation and a passage of flatus. Besides, strengthening of pain can be promoted by walking, jolting, a cleansing enema. The specified symptoms are followed by feeling of weight in a stomach, swelling, a meteorism.

The lock is more characteristic of chronic colitis, however can be noted also alternation of locks and ponos. In the presence of diarrhea pay attention to character of a chair – more often it watery, with streaks of slime or blood. There can be tenesmus – false desires to defecation. Quite often they have painful character.  The desire to defecation can come to an end with mucifying.
Characteristic localization of inflammatory process at chronic colitis – terminal departments of a large intestine in the form of a proctitis or a proctosigmoiditis.  The reasons of a proctitis and a proctosigmoiditis include in acute intestinal infection, also chronic locks are more often in the form of dysentery, and. Besides, the proctosigmoiditis is frequent result of abuse of the clearing and medical enemas, reception of purgatives.
Pains in the left ileal area are characteristic of this form of chronic colitis, there are frequent and painful tenesmus, especially at night. The chair, as a rule, scanty, can be as 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 sigmoid gut. Congenital anomaly of development – an additional loop of sigma is sometimes palpated.

Diagnosis:

The diagnostic program includes the general blood test, the analysis a calla (kaprogramma) within which carry out macro - and microscopy a calla, identification of eggs of helminths, бакпосев fecal masses. The leukocytosis with band shift, increase in SOE is characteristic of clinical blood test at acute colitis or aggravations chronic.
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 large intestine. Besides, carrying out a kolonoskopiya allows to take bioptata of a mucous intestinal wall for a further histologic research.
With the diagnostic purpose at colitis the rektoromanoskopiya where  the hyperemia and hypostasis of a mucous large intestine of distal departments is defined is shown, on walls of a gut a large amount of slime, and in more hard cases - pus is visible; quite often find erosion, ulcerations and hemorrhages.
For an exception of hemorrhoids, a proctal crack, a paraproctitis and other proctologic pathologies the proctologist carries out a manual research of an anus.

Treatment of Colitis:

Acute colitis as well as an aggravation of chronic, it is necessary to treat in a hospital, in department of a proctology. Colitis of the infectious nature treats in specialized infectious departments.
Very much the importance 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. Recommend frequent food, it is desirable to use to food in the wiped look. As dairy products can cause fermentation and gas generation, it is desirable to refuse them for the period of treatment. 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 and other products rich with cellulose.  Improvement of passing of intestinal masses is promoted by vegetable oil and enough the liquid used in days, it is desirable the purified water.
In the period of an aggravation it is forbidden to use crude fruit and vegetables. It is necessary to refuse 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 the confided 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 antibiotics short courses (drugs цифран, enterofurit, рифаксимин). Consultation of the gastroenterologist is necessary for selection of an adequate antibioticotherapia. The analysis a calla on eggs of worms is indicative, and at their detection purpose of protivogelmintny means is necessary.
For simplification of a pain syndrome appoint antispasmodics (Drotaverinum, a papaverine). At chronic colitis purpose of a sulfosalazn and other anti-inflammatory drugs, and also glucocorticoids is shown.
At treatment of a proctosigmoiditis local therapy is useful: microclysters with broths of herbs with antiinflammatory effect - camomiles, calendulas, with tannin or protargol. At a proctitis appoint rectal suppositories with a belladonna, anaesthesin for removal of the expressed morbidity, astringents (Dermatolum, a zinc oxide, a xeroform).
At ponosa the knitting and enveloping means are appointed inside (Tannalbinum, bismuth nitrate, white clay, bark broth the oak, other broths and infusions of collecting containing tannic components). At locks carrying out a gidrokolonoterapiya (purgation) is shown.
Strong spasms at colitis can become the indication for purpose of cholinolytics.
In addition to above-mentioned means, at colitis can appoint enterosorbents (for fight against a meteorism), fermental drugs (at disturbance 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.