Chronic colitis is found in gastroenterological practice somewhat more often than other inflammatory lesions of the large intestine. The colitis of the chronic type flows wavy, alternating with remission and acute periods.
Quite often the disease is accompanied by inflammatory pathologies in other GIT structures. According to statistics, about half of patients with digestive problems suffer from chronic colitis.
Among patients, pathology occurs in the age of 20-65 years, but the age of men suffering from this disease is somewhat older and is 40-65 years.
Definition and code of disease according to ICD-10
Chronic colitis is the inflammatory lesion of the intestinal mucosa, which is accompanied by dyspeptic symptoms such as flatulence and diarrhea, constipation and rumbling, pronounced tenderness and swelling.
Reasons for
There are many factors provoking the development of chronic forms of colitis, but the main ones, according to experts, are:
- Glaive infestations and other parasitic lesions;
- Pathogenic microorganisms;
- Intoxication and poisoning of the body;
- Radiation exposure to radiation therapy of tumor pathologies;
- Presence of congenital metabolic abnormalities;
- Genetic predisposition to pathology;
- Prolonged and uncontrolled administration of medicines, which negatively affect the integrity of intestinal mucosa;
- Food allergy;
- Arterial lesions in vessels that nourish intestinal tissues;
- Harmful production, with employment in which the patient gets into arsenic, mercury, heavy metals, etc.;
- Autoimmune connective tissue pathologies;
- Postoperative complications;
- Pernicious alcohol abuse for a long time.
Chronic colitis worsens on a background of stressful conditions and excessive excitement, weakened immunity, nutritional deficiency, low-calorie food consumption and even minor doses of alcohol.
Species of
There are several types of pathology:
- Spastic Colitis;
- Non-ulcer;
- Nonspecific ulcerative;
- Atrophic, etc.
In accordance with the etiology of inflammation of the colonic mucosa, chronic colitis is also radiation and ischemic, allergic or toxic, infectious and combined. And depending on the nature of the spread of the pathological process, colitis is total when there is a lesion of all colonic sections.
Similar is characteristic of ulcerative nonspecific colitis. Also, the pathology is of a segmental nature, when the lesion covers only a certain intestinal department.
Spasmodic form
Spastic chronic colitis is a functional disorder and is manifested by intestinal disturbances and painful sensations in the abdomen.
Spastic colitis of a chronic form provokes the propensity of patients to diarrhea, whereas its atonic forms, on the contrary, provoke a tendency to constipation.
Spastic colitis develops mainly on the nerves, when the patient for a long time is disturbed by stress and nervous experiences, hormonal failures or psychophysical overwork. Also, the pathology is a consequence of malnutrition, when the patient abuses alcohol, sharp or greasy dishes.
This pathological form more often affects women, which experts explain by the typicality of hormonal disorders for this category of patients, because ladies experience hormonal changes in pregnancy, menstruation, childbirth, etc.
Chronic constipation, intestinal infections, especially prolonged ones, can also provoke such a colitisalso an allergic response to certain foods.
Nonspecific ulcerative
Nonspecific ulcerative colitis is the diffuse inflammatory ulcerative lesions of the mucous membranes, which are accompanied by the emergence of severe systemic and local complications and often cause massive gastrointestinal bleeding.
- For this form of colitis, grippy abdominal pain, bloody diarrhea, intestinal bleeding, etc. are typical.
- A characteristic feature of the pathology is the tendency to mucosal ulceration.
- Pathology is characterized by a cyclic course, in which acute periods are replaced by remission states.
The exact etiology of a similar form of colitis is unknown, although experts do not exclude that genetic and immune factors are far from the last role in the development of the pathological process.
The cause may be bacteria and viral agents that activate immune forces, or autoimmune failures, accompanied by sensitization of immune structures against their own cells.
Non-ulcer
Chronic non-ulcerative colitis is the inflammatory lesion of the large intestine, which is characterized by the presence of dystrophic and atrophic changes in the mucous tissues leading to dysfunction of the large intestine.
Non-ulcerative colitis of a chronic type develops against the background of intestinal pathologies such as dysentery, toxicoinfections or salmonellosis, yersiniosis, typhoid, etc.
In addition, non-ulcerative chronic colitis stimulates the development of helminth and parasitic infestations, intestinal dysbacteriosis, nutritional factors, radiation and toxic effects,allergic reactions and uncontrolled drug therapy, congenital enzymatic pathologies, etc.
There is a pathology of soreness in the abdomen - in neitherit and its side parts that can wear aching, dull, or paroxysmal or spasmodic bursting with character.
Atrophic
Atrophic chronic colitis is characterized by thinning of the mucous membranes of the colonic region, accompanied by impaired secretory glandular functions.
In clinical practice, there is no diagnosis of atrophic colitis. This term is used by physicians to describe the nature of the changes that have occurred in the mucous tissues, but it can not display the causes and severity of the pathological process.
With the development of these pathologies, thinning of mucous tissues affected by inflammation occurs, and in some areas it is completely replaced by granulomatous tissue, which leads to atrophy.
Signs in adults and children
The chronic form of inflammation of the intestine requires a periodic alternation of remission and acute periods, therefore it is natural that patients turn to specialists when the exacerbation of chronic colitis occurs. In remission, this symptomatology is weak or worn out, or completely absent.
The signs of chronic colitis include:
- Stool disorders manifested by periodically changing constipation / diarrhea;
- An unpleasantly smelling burp;
- Pain syndrome in the lateral parts of the peritoneum, and the pain can have a variety of character - from spasms to aching soreness;
- Constant rumbling in the intestine;
- Increased abdomen;
- Increased gas generation;
- Even after defecation, the patient develops a feeling that he has not completely emptied the intestines;
- There are often false defecation urges, although the intestine is emptied only once every few days;
- There is a constant malaise and nausea, weakness;
- In the mouth there is an unpleasant odor;
- Pale skin and sleep disorders;
- Fragility of nail plates and hair loss;
- Flavor changes, etc.
Symptoms of exacerbation
In general, with aggravation, each of the above symptoms can be clearly manifested in patients. But gastroenterologists distinguish a number of signs of an exacerbation of colitis, at occurrence of which it is necessary urgently to address to the expert.
These include intolerable soreness in the abdomen, which has a spastic character, and at night transforming into a deaf and aching pain.
Most often, this pain is located on the left side of the ileum. When palpation of the intestine on some of its site, the pain may increase.
Also a sign of exacerbation of colitis can be considered constant bloating, which occurs against the background of imbalance of microflora.
The consistency of the stool during exacerbation also changes and can be expressed in prolonged diarrhea or constipation, and on the feces may be found whitish mucous impurities or spotting spots. When such a symptom appears, you need to see a specialist for treatment sooner.
Diagnostics
For the detection of colitis of a chronic type, the patient undergoes instrumental and laboratory diagnostics. The results of a study of blood in colitis show the presence of leukocytosis, neutrophilia and an increase in the rate of erythrocyte sedimentation. Patients are also given a coprogram that shows the chemical composition of feces and their microscopic data.
Colonoscopy helps to detect an inflammatory focus, to reveal the presence of erosive and ulcerative processes, atrophic changes, vascular injuries, etc. Irrigoscopic diagnostics can diagnose the presence of peristaltic disorders, relief changes in the mucous membranes, intestinal atony, etc.
Complications of
Chronic forms of colonic inflammation can lead todevelopment of quite serious complications:
- Perforation of the wall of the large intestine followed by peritonitis, which is usually the naturebut for ulcerative colitis of nonspecific form;
- Bleeding in intestinal structures, which provokes the development of serious anemia;
- Intestinal obstruction, formed against the background of strictures, adhesions and scars.
Treatment of chronic colitis
Chronic forms of colitis in the acute phase should be treated under inpatient conditions under the guidance of an experienced proctologist, and infectious chronic inflammation of the bowel is treated in infectious disease units.
The main goal of the treatment is to eliminate the causative etiological factor of the disease and restore intestinal activity.
Diet
During acute periods, patients with colitis are recommended treatment table number 4a, which assumes the use of fish and meat dishes for a couple, low-fat broths, white bread, boiled eggs and green tea, dog-rose broth or cocoa. One portion should be only 250-300 g.
Gradually, when the inflammatory processes are stopped, the patient is transferred to the treatment table №4b.
This diet allows patients to eat cereal cereals and soups, pasta and vegetable dishes, milk and cream butter. When a persistent remission condition is established, patients with chronic colitis are assigned an even more extensive diet number 4c.
Folk remedies
If colitis is complicated by proctosigmoiditis, it is recommended to microclyze with chamomile decoctions that have an anti-inflammatory effect. A similar effect is provided by decoctions of cumin and St. John's wort, sage, etc.
Increased gas formation is easily eliminated by folk remedies based on mint, motherwort and nettle.
With intestinal cramps, phytotherapists recommend combating calendula or chamomile decoctions, and for treating ulcerative colitis microclisms with sea buckthorn oil are recommended as an ideal tool, which patients are recommended to put before bedtime.
To restore the broken stool often use alder bumps, blueberries or bird cherry.
Preparations
In case of infectious origin of colitis, patients are prescribed antibiotic therapy and sulfonamides. Since these drugs often provoke dysbacteriosis, they are appointed by a short course after determining the causative agent of the infection.
- If helminthic infestations or parasitic lesions are detected, then antiparasitic therapy is prescribed.
- To eliminate intestinal spasms - preparations of antispasmodic action such as Platyphylline, No-shpa or Galidor.
- If worried about persistent diarrhea, patients are advised to use enveloping and astringents such as calcium carbonate, bismuth nitrate, copper sulfate, alum or herbal infusions, which contain tannic components. Also help to cope with diarrhea drugs like Loperamida, Imodium or Smekty.
- In the presence of concomitant inflammation of the rectal mucosa, patients are shown to use astringent suppositories like Xerobes or zinc oxide.
- For the early withdrawal of toxins and toxins, as well as with a pronounced abdominal swelling, white clay, activated charcoal, polysorb, dimethicone or mint tincture are prescribed.
- To restore the bacterial microflora in the intestine, reception of pre- and probiotics Bifikol, Lineks, Bifidumbacterin or Normobakt, etc. is shown.
- Vitamin preparations are used to accelerate the wound healing effect and restore the immune status.
- With pronounced constipation - Guttalax, Slabilen or Senada.
Prevention of
Prophylaxis of chronic colitis is reduced to timely therapy of acute forms of colonic inflammation and their prevention. Also relieve the problems with the intestines compliance with the rules of hygiene and the principles of healthy eating.
Chronic colitis can be monitored and maintained in a state of remission if the patient follows exactly all the medical instructions and takes a set of prescribed medications.
Video transmission about features of chronic colitis of the intestine: