Колит кишечника симптомы, treatment,diagnostics

Update: December 2018

Colitis is an inflammatory process in the colon that
is caused by ischemic, medicinal or infectious
intestinal lesions. It is both chronic and acute.

With colitis (inflammation of the intestines), the symptoms are characterized
the presence of blood, mucus in the stool, abdominal pain, nausea and
false urge to defecate.

In most cases, its chronic form develops, as well as
ulcerative colitis of the intestine of unknown etiology, with
this intestinal mucosa becomes prone to ulceration.

Causes and classification of colitis

Causes of colitis are being actively studied, carried out
numerous studies but still accurate data about
the origin of this disease is not, and there are only assumptions about
provoking factors. Depending on the alleged reasons
occurrence of intestinal colitis is divided into:

  • Infectious – food poisoning, intestinal infections (colitis with
    salmonellosis, dysentery), other infectious agents
    (tuberculous colitis, mycoplasma).
  • Alimentary – violation of the nature and diet,
    unbalanced food – junk food abuse,
    irregular food intake, excessive drinking, poor
    fiber diet, persistent habit of using only harmful, but
    tasty food.
  • Congenital – with congenital bowel disease,
    functional failure due to genetic mutations
  • Stress, reduced immunity, deterioration of the general condition
    health, the presence of other chronic diseases of the digestive tract (pancreatitis,
    cholecystitis, hepatitis, atrophic gastritis, superficial gastritis)
    cause secondary reactive colitis.
  • Medicinal – long reception of various medicinal
    agents affecting the intestinal microflora and general
    state of the body – antibiotics, NSAIDs, aminoglycosides,
    contraceptives, laxatives for constipation and other drugs,
    leading to impaired acid-base balance in the intestine.
  • Toxic – which in turn are subdivided into
    exogenous (long-term arsenic, phosphorus, mercury poisoning) and
    endogenous (uratah intoxication with gout).
  • Allergic – with food allergies, drug allergies
    remedies or certain bacteria.
  • Mechanical – abuse of enemas for constipation, suppositories for
    constipation due to permanent mechanical irritation of the mucous membrane
    intestine.
  • Political science of obscure origin.

Most often, the occurrence of colitis is affected by several
etiological factors leading to inflammation in the thick
intestine, then it comes to combined colitis.

Колит кишечника Among all types of intestinal colitis most
considered dangerous and difficult to conservative treatment
ulcerative colitis when occurs
destructive ulcerative inflammation of the colon
intensity. This disease affects mainly urban residents.
in the developed countries of the world, most often the population of more northern
regions. A colitis can appear as in middle age, after 30
years, and in the elderly.

Advanced medical technology, modern technical equipment
medical institutions, facilitate the diagnosis of patients with colitis
intestine. Но симптомы и treatment этого заболевания требуют от врача
and patient of joint efforts and mutual understanding, since it calls
chronic illness that is difficult to treat and is sometimes treated
for years.

Colitis classification

  • Acute, chronic (with the flow)
  • Primary secondary (by origin)
  • By location: total (pantcolit), segmental (typhlitis,
    transversitis, sigmoiditis, rectosigmoiditis, proctitis).

      • Causal colitis. Insert the entire classification here.
        Yours for reasons other than ulcerative (with edits),
        adding membranous colitis (against clostridia after the course
        antibiotics, for example. Macrolides)
      • Nonspecific colitis: non-specific ulcerative,
        granulomatous, ischemic.
      • Functional lesions of the colon: IBS, spastic
        constipation, atonic constipation, functional diarrhea.

Symptoms of intestinal colitis

  • Pain sensations

Pain in chronic colitis of the intestine is usually aching, dull,
localized in the lower abdomen, usually on the left. Sometimes the pain wears
character spilled, without clear localization. Increased pain
observed after cleansing enema, eating, shaking,
fast walking, and relief comes after defecation, discharge
gases.

  • Upset stool

This symptom of colitis is not a major indication of this.
the disease because the disorder of the stool in the form of constipation
alternations of diarrhea and constipation are common to almost anyone.
intestinal tract disease. The only distinguishing feature
colitis is what appears to be an admixture of blood and mucus.

  • Tenesmus

Tenesmus — это ложные позывы к испражнению, нередко при колитах
this urge can only end with the discharge of mucus. Often
inflammation of the large intestine occurs as proctosigmoiditis
or proctitis, which causes persistent constipation,
abuse laxatives, cleansing and therapeutic enemas,
as well as acute intestinal infection. When colitis develops in a straight line
and sigmoid colon, the pain is localized on the left side, and false
the urge to disturb patients especially often at night, with a chair
often resembles sheep feces with mucus, pus and blood.

  • Flatulence and bloating

Many patients also experience flatulence, heaviness in the stomach,
swelling.

Symptoms of ulcerative colitis

Any disease in each clinical case proceeds
differently, all signs are very individual and depend on the degree
lesions of the intestine, human age, associated diseases.
With ulcerative bowel disease, the symptoms can also be as bright,
and mild.

In some patients for a long time, the colitis does not manifest itself,
only occasionally can exacerbation be manifested by hidden blood or overt
blood in the feces, while a person can bind such a sign
as a manifestation of hemorrhoids (see how to treat hemorrhoids in home
conditions) and delays in visiting the doctor and conducting a thorough
survey.

In other situations with ulcerative colitis, the patient is urgent.
hospitalized with fecal incontinence symptoms, bloody diarrhea,
fever, general weakness, pain and tachycardia:

  • Incontinence of feces, especially frequent nightly urge to
    defecation, small diarrhea in 60% of patients, up to 20 times a day
  • Mucus, pus, blood in feces. Blood can be like from
    insignificant, found only on toilet paper, up to
    bloody feces
  • 20% have constipation, indicating sigmoid inflammation.
    or rectum
  • Also characterized by false urges to defecate, while often
    only mucus, pus, and blood are released
  • Abdominal distention, signs of general intoxication, if inflammation
    bears a heavy character or a large lesion area then arises
    tachycardia, dehydration, high temperature, vomiting, decreased
    appetite.
  • Every 10 patients can develop symptoms
    associated with the gastrointestinal tract – thrombosis, visual disturbance, articular
    lesions, skin reactions in the form of a rash or on mucous membranes,
    disruption of the liver and gallbladder. These manifestations can
    precede manifestations of intestinal colitis, and may not be
    associated with the defeat of the intestine.

 Differential diagnosis of colitis

Among diagnostic methods can be distinguished laboratory and
instrumental:

Laboratory methods for the diagnosis of colitis is a complete blood count,
which may indicate an inflammatory process (high numbers
platelets, leukocytes, low hemoglobin and high ESR),
coprogram – it can identify hidden blood, white blood cells and
erythrocytes, bakposevy feces for dysentery, tuberculosis, etc.
infections, PCR diagnostics – definition of helminthic invasion or
viral damage, autoantibody assessment or pANCA, as well as such
parameter as fecal calprotectin.

Instrumental diagnostic manipulations include:
Contrast irrigoscopy is an x-ray with a contrast agent,
which can exclude tumors, contractions, fibroecolocolonoscopy –
This endoscopic examination, which allows you to specify
the length of colitis, its nature, it also allows you to take
biopaths for histological examination. Based on histology
in case of intestinal colitis, it is important to identify or exclude
precancerous or cancerous changes. It is also possible to conduct an ultrasound,
which can reveal expansion of the intestine or thickening of the walls
intestinal or hydro MRI.

Differential diagnosis:

  • Proctologist to exclude paraproctitis, anal fissures
    or hemorrhoids should conduct a digital examination of the anus and direct
    guts.
  • The symptoms of chronic intestinal colitis are the same as with
    colon dyskinesia, enteritis.
  • Ultrasound examination of abdominal organs, liver function tests
    inflammation of the pancreas, gallbladder and liver.
  • Colitis symptoms and clinical picture are very similar to
    malignant neoplasms of the colon, therefore
    biopsy of suspicious areas of the intestine should be performed with
    the purpose of determining or excluding cancer
    changes.

Treatment of intestinal colitis

When exacerbation of chronic or acute colitis, treatment should be
carry out in a hospital in the proctology department, if
it turns out the infectious nature of colitis, then in specialized
departments of infectious diseases hospitals.

  • Diet

Diet for any diseases of the gastrointestinal tract is
integral part of the treatment. And intestinal colitis is no exception. The most
The main rule of therapeutic nutrition is the exclusion of mechanical
irritants, that is, coarse fiber, namely it is impossible to eat
nuts, seeds, raw vegetables, bran, legumes, and also to exclude from
diet all chemical irritants – salty, sharp, sour,
marinated, smoked products. Meals 4-5 times a day, allowed
cook everything steamed, cook vegetables, preferably eat ground
food should be completely abandoned milk, cabbage in any form.
Monitor normal daily fluid intake.

  • In the infectious nature of colitis, antimicrobial treatment is indicated.
    by means

To suppress reproduction of infectious agents prescribed
short courses of antibiotics Rifaximin (Alpha Normiks), Digran, and
also Enterofuril, etc., these drugs are prescribed only by a doctor
according to indications.

  • When identifying parasites – prescribed anthelmintic drugs
    (see worms drugs for children and adults)
  • With a strong pain syndrome, antispasmodic drugs are shown.
    – Papaverine, No-shpa, with severe cramps can be assigned
    anticholinergics.
  • With proctitis and proctosigmoiditis spend the following local
    treatment

Make microclysters with medicinal herbs – calendula,
chamomile, protorgolom, tannin. When proctitis is shown candles with
anesthesin, belladonna, astringents.

  • If colitis is accompanied by diarrhea or constipation.

To stop diarrhea, it is necessary to include colitis in the treatment regimen.
intestinal enveloping, astringent inside, such as infusions
oak bark, tanalbin, white clay, bismuth nitrate, etc.
chronic constipation may be prescribed
colon hydrotherapy.

  • Correction of intestinal microflora

After the main course of treatment,
enterosorbents – Polysorb, Enterosgel, activated carbon,
Polyphepan, Filtrum STI, also probiotics for recovery
normal microflora (see the list of probiotics, analogs of Linex),
enzyme preparations if enzyme diagnosed
failure.

  • При язвенном колите кишечника treatment более мощное, тяжелое,
    expensive

Назначаются медикаментозное treatment только квалифицированным
doctor, these drugs have many side effects
contraindications and must be taken under the supervision of a specialist in
Inpatient treatment is in the form of suppositories, finished enemas, pills,
containing 5 acetylsalicylic acid – Mezavant, Salofalk,
Mesacol, Pentas. Biological agents may be prescribed.
терапии –  Адалимумаб (Хумира), Инфликсимаб (Ремикейд). Strictly
According to indications, it is possible to use drugs of corticosteroids in
suppositories, rectal droppers, tablets – Prednisolone,
Гидрокортизон, Метилпреднизолон,  а также иммуносупрессоров –
Methotrexate, Cyclosporine, Azathioprine.

  • In chronic colitis, a good effect is observed from
    regular spa treatment.

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