Intestinal inflammation refers to frequent pathological conditions in gastroenterology. They are accompanied by diarrhea and digestive disorders, pronounced pain syndrome and other manifestations that worsen the quality of life. Such pathologies include pseudomembranous colitis, which is also called intestinal sepsis, enterocolitis, clostridiosis or antibiotic-associated colitis, etc.
Definition of
Pseudomembranous colitis is an enteric infection-inflammatory pathological condition caused by prolonged or inadequate antibiotic therapy that leads to the development of fibrinous formations on mucous membranesintestinal tissues.
Under the influence of pathological factors these bacteria acquire pathogenetic status. According to statistics, these microorganisms are detected in about 20% of patients. Most often these are elderly patients who have had unskilled and long-term antibiotic treatment.
The disease is diagnosed with the same frequency in patients of any gender. In the severe course of the pathological process, the patient has a pronounced intoxication symptoms, dehydration and disturbances of water-salt and electrolyte metabolism, as well as dangerous damage to the intestinal wall( perforation, etc.).
Causes of
As already mentioned, clostridium acts as a provocateur of pathology, which is capable of releasing toxins A and B of the group, damaging the intestinal walls and provoking the development of the pathological process.
Against the background of prolonged antibiotic therapy, frequent diarrhea develops, and in severe forms of pathology, colitis is pseudomembranous.
- Especially often the development of pathology provokes uncontrolled and long-term use of antibiotics of the penicillin and cephalosporin series, and also with the intake of ofloxacin and levofloxacin.
- The risk of developing pseudomembranous colitis increases with simultaneous intake of several drugs from the group of antibiotics, as well as with chemotherapeutic or immunosuppressive treatment.
- Also the probability of pathology increases with prolonged or incorrect intake of antidiarrheal or anti-inflammatory drugs, neuroleptic or gold-containing drugs.
If a patient already has certain ailments, they can significantly complicate the course of colitis pseudomembranous.
To such pathologies include onkoprotsessy or chronic intestinal pathologies, ischemic inflammation of the intestine, surgical interventions, etc.
Also provoking factors of pseudomembranous colitis are: failure of the kidneys, installation of a probe or a long stay next to infectious patients.
Symptoms of pseudomembranous colitis
The first manifestations of pseudomembranous colitis begin when the course of therapy with antibiotic drugs, but more clearly they appear after the termination of therapy.
Mild forms of the pathological process are associated with the appearance of diarrhea on the background of antibiotic therapy. After such treatment for 1-1,5 weeks, a dangerous form of complication - a clostridial colitis of severe form can develop.
It is characterized by the appearance of frequent loose stools that cause dehydration, tachycardia, muscle lethargy and constant fatigue.
Signs of dehydration due to prolonged diarrhea are dizziness and fainting, a constant thirst, nausea and frequent pulse, dry skin and rare urination. If the colitis is more severe, then bloody mucus begins to be released from the anus.
Dehydration and diarrhea provoke severe intoxication, which manifests itself:
- Headaches;
- Weakness;
- Lack of appetite, down to aversion to food;
- Painful spasms in the peritoneum;
- The expressed hyperthermia is higher than 38 ° С.
Before the process of emptying the intestine, the patient feels appreciable pain, and the defecation itself passes with difficulties. The abdomen swells, when palpating the colon, the patient experiences painful discomfort.
Diagnostics
The diagnostic process is performed by a gastroenterologist or proctologist, who compiles a picture of the disease and collects anamnestic data.
- With an external medical examination, a specialist will identify a patient with a characteristic for this condition tachycardia and hypotension, an increase in temperature and an increase in stomach volume.
- Laboratory blood tests are assigned, which for pseudomembranous colitis indicate the presence of leukocytosis.
- Analyzes of fecal matter show the presence of bloody and mucous impurities in feces, and bacteriological analysis of feces reveals the presence of clostridia.
- Endoscopy of the intestine is appointed, in which the expert assesses the condition of the intestinal wall. With such visualization, yellowish film on the intestinal mucosa - pseudomembranes are found.
Colonoscopy, sigmoidoscopy and, if necessary, radiography or computed tomography are also prescribed.
Complications of
The most common variants of complications of pathology are:
- Intestinal wall rupture( perforation);
- Toxic megacolon, in which there is a strong expansion of the gut;
- Accumulation in the peritoneum of fluid( ascites) or swelling of the subcutaneous tissue( anasarca);
- Development of arterial hypotension;
- Dehydration due to fluid loss with liquid stool;
- Kidney failure;
- Septic blood poisoning;
- Development of superinfections, when a new infectious disease develops against the background of an incomplete infectious process.
The high risk of complications requires timely therapeutic intervention for pseudomembranous colitis.
Treatment of
Therapeutic measures with a similar form of intestinal inflammation are directed primarily at eliminating the pathological factors.
Therefore, the first step towards eliminating the disease is the abolition of antibiotic drugs. Already a couple of days after this, the patient has a noticeable improvement in the condition, and after a couple of days, the diarrhea also comes to naught.
If the pathological processes are of a severe clinical nature, then additional medication is performed.
One of the frequently prescribed drugs for pseudomembranous colitis is Metronidazole. Take it for a half to two weeks.
In addition, enterosorbent drugs are prescribed that help the body cope with intoxication due to the accelerated withdrawal of toxic substances. But they are appointed after the end of taking Metronidazole. Since pseudomembranous colitis is accompanied by severe dehydration, the patient is shown plenty of drinking.
If the flow is severe, then solutions of Hartmann or Ringer, Lactosol, etc., are introduced intravenously to eliminate dehydration to the patient. Medical nutrition is of great importance in the therapeutic process. Small portions, frequent meals, table number 4 - this is the main condition of diet therapy for pseudomembranous colitis.
Such a therapeutic diet is aimed at eliminating diarrhea, so it involves the consumption of jelly, rice and bananas, toast and baked vegetables. Under the ban, fatty and spicy, fried and heavy food, dairy products.
Prognosis and prevention
Predicting pseudomembranous colitis is determined by the severity of the pathological process. In the absence of any therapy, the probability of a lethal outcome is about one third of patients.
- Mild forms of pathology pass independently after stopping the course of antibiotic therapy.
- If pseudomembranous colitis occurs with an average degree of severity, then signs of pathology will persist for several weeks, and in the future there is a chance of a repeat of the pathology.
- Severe forms of pseudomembranous intestinal inflammation are fatal, especially with the development of a perforation or megacolon. In a similar clinical situation, an operation is performed that is performed for a patient with a weakened body. Perforation is often associated with peritonitis, in which the intestine is populated with a huge number of bacteria.
The main preventive condition is the reasonable and competent use of antibiotic drugs with an individual approach to their purpose.
In addition, it is worth taking drugs that prevent dysbacteriosis. Especially at risk of this disease are elderly patients after 65, so they should not prescribe antibiotics that provoke intestinal inflammations.