Chronic colitis symptoms. Chronic intestinal colitis - what is it, symptoms and treatment? Spastic intestinal colitis, signs

Chronic colitis intestine is characterized by damage to the large intestine. This is an inflammatory disease that has a protracted course. With this pathology, dystrophic changes in the mucous membrane of the colon can be observed. In the structure of similar gastrointestinal lesions in adults, colitis occupies a dominant place.

Causes of colitis

Lives in the large intestine huge amount symbiont bacteria (up to 5% of a person’s weight). In association with them, the processes of digestion, absorption, synthesis and stimulation of the immune systems occur in this section of the gastrointestinal tract. Excretion occurs through the large intestine feces. Chronic colitis is a multifactorial pathology. Violation normal functioning colon cancer occurs for several reasons:

The most common cause of chronic colitis is a combination of factors.

How does the disease manifest itself?

Depending on the causes of the disease and its location, complaints may vary. Symptoms can be grouped as follows:

Pain. With colitis, they can be of a different nature. The most common is nagging, bursting pain in the abdomen. They may decrease or go away after a bowel movement. Spastic colitis will manifest itself as sharp pain. The predominant localization is the lateral and lower abdomen.
Abnormal stool. Patients complain of diarrhea, constipation, or alternating between them.
Flatulence. Bloating and passing gas may be the patient's main complaints. Gas formation occurs even when consuming foods that normally do not provoke flatulence.
Complaints general. Patients complain of fatigue, irritability, and deterioration in well-being.
Pathological inclusions in the stool that characterize the cause of colitis (fragments or whole helminths) or are a consequence of the inflammatory process (mucus).

How does the disease progress?

The disease is protracted. During the entire period of the disease, the appearance of complaints (exacerbation) is replaced by a successful time of absence of symptoms (remission). They can alternate over a considerable period of time and mislead the patient. Often the patient does not know what it is: a new disease or an exacerbation of an existing one. Diagnosis is made difficult by delaying contacting a doctor.

How to treat chronic colitis

Treatment of chronic colitis is determined by the causes that caused it, the form, prevalence, duration of the disease and the severity of the patient’s condition. The more detailed the diagnosis, the more favorable the prognosis for therapy. The doctor will decide how to treat colitis. It is he who will recommend a set of measures aimed at stopping the exacerbation.

Eliminating the causes of chronic colitis

Eliminating the cause of chronic colitis is the only hope for recovery. Subject to availability bacterial infection treatment with antibiotics is carried out. For secondary colitis, therapy for the underlying disease is effective. Therapy chronic poisoning(alcohol, nicotine, heavy metals, etc.) will be eliminating the cause of intoxication. A disease of allergic origin will require the use of antihistamines.

Diet and diet

The diet should be balanced, chemically and thermally gentle, fractional, small portions, frequent. Minimum quantity meals per day – 5 times.
The composition of the basic diet is poor. Slimy soups with weak broth, meat or fish are recommended low-fat varieties crushed, steamed. Eggs can be eaten soft-boiled or as a steam omelet. Fresh cottage cheese is recommended for dairy products. Whole milk should be excluded. The diet should take into account the manifestations of colitis.

For diarrhea, jelly and jelly from astringent fruits and berries (pears, bird cherry, quince), decoctions of oak, burnet, bird cherry, and pomegranate peels are added.
The difficulty is in the diet for colitis with constipation. Increasing the proportion of vegetables in the diet can aggravate the condition. Lack of fiber leads to increased constipation and increased inflammation. The solution is to add vegetable oil and boiled ground dried fruits, prunes, plum juice, decoctions of mint, fennel, dill, anise to the basic diet, followed by expanding the diet.

Symptomatic treatment

Symptomatic therapy will not lead to a cure, but by reducing the manifestations of the disease, it will alleviate the patient’s condition and improve the prognosis. Such activities will include the following.

Treatment of flatulence. Abdominal bloating can be reduced by defoamers (Espumizan), sorbents (Polysorb) and agents that affect the kinetics of the gastrointestinal tract (especially in atonic forms).
Relief of pain syndrome. Especially relevant for spastic colitis. The greatest effect will have not NSAIDs, which can aggravate the severity of the condition, but antispasmodics (No-spa). The use of physical therapy will also be positive.
Fighting diarrhea. In addition to changing your diet, you need to take medications to relieve diarrhea. It should be noted that drugs such as Loperamide can worsen the patient's condition in case of reduced gastrointestinal activity.
Eliminate constipation. When the rate of fecal evacuation decreases, not only laxatives are used. Medicines that affect intestinal motility will have a significant effect on the resolution of constipation.
Normalization of intestinal motility. Depending on the form of chronic colitis, drugs are used that increase (Prozerin) or reduce (Papaverine) the rate of contraction of the walls of the gastrointestinal tract.
Elimination of dehydration. Increasing fluid intake (orally and intravenously).

In the rhythm of today's life, it is often impossible to keep track of quality and regularity own food. This is why the main problems in the stomach area arise, complaints about painful sensations.

Chronic intestinal colitis is a disease associated with the appearance inflammatory processes in the layers of the large intestine. Always accompanied by dysfunction of motility and secretion. People who have previously experienced digestive disorders are most susceptible to this problem.

Causes of chronic colitis

There are various causes of chronic colitis, among which gastroenterologists place first place a violation of the diet and diet.

and intestinal dysbiosis, including those caused by improper use of antibacterial drugs;
Consequences and complications intestinal infections(, cholera, viral colitis, and others);
Secretory and enzymatic insufficiency against the background of, and;
Prolonged penetration into the digestive tract of toxic and poisonous substances that can have negative impact on the mucous membrane of the large intestine (arsenic, acetic acid, lead, manganese, mercury).

In patients aged 30 to 45 years, primary forms of alimentary diseases are most often diagnosed. chronic gastritis. The main cause of the pathology is not correct mode nutrition, deficiency of fiber and microelements in the diet. Eating refined and low-fat products causes an achilic condition in which mucosal cells stop producing mucus. Fecal retention occurs, which leads 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. This pathology can only be detected using special tests. Consultation with an allergist is necessary.

In women, chronic intestinal colitis can develop due to regular fasting in order to lose weight. Great danger represent enemas and the use of laxatives, including those of plant origin. Many components of weight loss products cause irreparable harm to the mucous membrane of the colon, paralyzing its normal secretory function.

Classification of the disease

IN medical practice classification of chronic colitis helps to correctly determine treatment tactics, assess the prognosis of the disease, possible consequences and complications.

According to the etiological (causal) factor, colitis is:

infectious – due to intestinal infection;
nutritional – due to poor nutrition;
allergic – due to allergization of the body;
intoxication – as a result of poisoning;
radiation – after exposure to ionizing radiation;
congenital - due to congenital anomalies development of the colon.

According to pathomorphological (intestinal wall structure) characteristics:

chronic catarrhal colitis - inflammation of the intestinal mucosa;
chronic atrophic colitis – thinning of the mucous membrane, dysfunction of the secretory glands;
chronic erosive colitis– mucosal defects prone to bleeding;
chronic ulcerative colitis– mucosal ulcers leading to intestinal bleeding.

Functionally:

chronic spastic colitis – causes a tendency to diarrhea;
chronic atonic colitis– causes a tendency to constipation.

According to statistics, when visiting a gastroenterologist, 40% of patients are diagnosed with a chronic form of the disease.

Symptoms

To fully appreciate the seriousness of this disease for the body and to understand what chronic colitis is, it is necessary to understand the general picture of its symptoms.

Most often, the disease is accompanied by sensations of dull, aching or cramping pain in the abdomen, which are localized in its lower and lateral parts, and may not have a specific location. The pain intensifies, as a rule, after eating, or before defecation. Sometimes after this they weaken for a short time, especially if gas has passed or an enema has been given.
Symptoms of the disease are accompanied by dyspeptic disorders, lack of appetite, belching and nausea. With long periods of the disease, a decrease in body weight is observed.
Patients often suffer from flatulence caused by disorders of the digestion process. The main symptom is a violation of bowel movements, accompanied by diarrhea (it can become frequent up to 15 times a day), or, conversely, the appearance of constipation. These states can alternate. Patients complain about the presence of sensations incomplete emptying. There is mucus in the stool. Possible false urges, they are accompanied by the release of gases, the release of small lumps of feces, as well as mucus containing streaks of blood.

People with chronic colitis may generally feel quite well, but if the disease is severe, signs of malaise, weakness, and decreased ability to work may appear.

Consequences

Complications can only be caused by ulcerative colitis. The consequences may be:

blood poisoning or spread of infection to other organs;
bleeding in the intestines - this indicates chronic ulcerative colitis;
the appearance of an oncological tumor;
gangrene of the affected areas of the intestines and colon. In this case, the person suffers from 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 severe bloating and tension in the abdominal muscles, chills, accompanied high temperature, coating on the tongue and weakness of the body.

Diagnostics

In order to decide how to treat chronic colitis, it is necessary to accurately establish the diagnosis, severity and form of the disease. To do this, experts carry out the following types diagnostic studies:

General and biochemical analysis blood.
Scatological research.
X-ray of the large intestine.
Irrigography.
Colonoscopy.
Sigmoidoscopy.
Anoscopy.

Only after a thorough diagnosis based on the results obtained, the collected anamnesis and the general clinical picture will a specialist be able to prescribe the optimal treatment that will be the most adequate and effective for the patient in a particular case.

How to treat?

Therapeutic treatment of chronic colitis is divided into the following stages:

Suppression of signs of exacerbation.
Maintenance therapy during remission of the disease.

In case of exacerbation of chronic colitis, hospital treatment is simply necessary. Fasting is recommended for the first few days, after which the patient is transferred to diet No. 4.

Meals should be frequent, food should be thoroughly chopped. Spicy and salty dishes, marinades, flour products, smoked products and fatty meats, dairy products, millet and pearl barley porridges, vegetables and fruits in fresh, soda and sweet treats.

Drug treatment

Drug treatment, which is also used during the remission stage, also helps:

Stimulators of intestinal motility (Dokusate);
Saline laxatives (Bisacodyl, magnesium sulfate).
Herbal laxatives (Senade).
Antispasmodics (Papaverine hydrochloride, No-spa, Duspatalin).
Enzyme preparations to improve digestion (Creon 10000, Mezim).
Adsorbents for removal from the body toxic substances (activated carbon, Smecta and Neosmectite).
Nicotinic acid and B vitamins to accelerate the renewal of damaged tissues.
Anti-inflammatory drugs and antimicrobial action(Loperamide, Furozolidone, Tetracycline, Enterofuril).
Choleretic agents for pathology of the gallbladder and deficiency of bile acids in the digestive system (Holosas, Chofitol, Allochol).

Non-drug treatments

For chronic colitis, sanatorium-resort treatment is indicated. The best resorts for treating the digestive system are rightfully considered the sanatoriums of Pyatigorsk, Essentuki, and Kislovodsk. In addition to drinking mineral waters, they use baths, intestinal lavages, and treatment with microenemas enriched with active biological substances.

From folk recipes shown:

For inflammation - decoctions of sage, mint, St. John's wort, caraway.
Nettle, motherwort and mint help with increased gas formation.
To relieve spasms in the intestines, microenemas with a decoction of chamomile and calendula are recommended.
For ulcerative colitis, sea buckthorn oil is indicated in a microenema at night.

All auxiliary methods require a long time, are carried out in courses with breaks. It is better to first consult with your doctor.

Diet for chronic colitis

The diet for chronic intestinal colitis is called “healing table No. 4”. It involves fractional (small portions) meals – up to 7 times a day.

Prohibited products:

eggs;
baking;
pearl barley, barley, millet porridge;
smoked meats, canned food;
fatty sea fish;
pork, beef;
sour cream, milk;
strong coffee, tea, carbonated drinks.

For chronic colitis, you can eat foods such as:

boiled chicken, rabbit, veal;
non-sour cottage cheese;
white crackers;
low-fat river fish boiled or steamed;
liquid porridge with water;
vegetable broths;
jelly, rose hip decoction, weak green tea.

The basic principle of nutrition for chronic colitis: exclusion of foods and dishes that cause mechanical and chemical irritation of the intestinal mucosa.

Prevention

To avoid complications and serious health problems, timely treatment is necessary, as well as preventive measures:

conducting healthy image life;
use of personal household items;
strict compliance with prescribed nutrition, adherence to diet;
timely consumption of food (breakfast cannot be ignored);
compliance elementary rules hygiene (washing, hand washing);
avoiding the intake of raw water and thoroughly washing vegetables and fruits before consumption;
visiting doctors, regular dental check-ups, family doctor, gastroenterologist.

It is very important to know and understand how to treat chronic colitis, but the most important thing is not to get carried away with self-medication, but still seek the help of qualified specialists. Hospitalization should not be avoided in severe cases and acute manifestation illness. IN inpatient conditions relief and improvement in health occurs much faster than at home.

Most people lead an active lifestyle and spend most of their time at work, forgetting to eat properly and nutritiously.

This often leads to the development of various diseases gastrointestinal tract. One of the most common ailments is chronic colitis - an inflammatory bowel disease.

This pathology most often occurs in a long-term form and is accompanied by various symptoms, negatively affecting the quality of life.

Characteristics of the disease

Chronic intestinal colitis is an inflammation that affects the mucous membrane of the large intestine. At the same time, a person begins to suffer not only from constant pain in the abdominal area, but also from constipation and diarrhea.

Doctors classify this disease into several forms. There is colitis:

Infectious. It is provoked by infection entering the intestines.
Allergic. Develops due to excessive presence of the allergen in the body.
Nutritional. Its primary source is poor nutrition.
Intoxicating. Develops as a result of poisoning of the body.
Congenital. It occurs due to the presence of congenital anomalies leading to improper development of the colon.

Depending on what type of pathology the patient is faced with, the appropriate treatment method is selected.

The disease is also classified according to the degree of its effect on the intestinal wall. There is colitis:

. Its main symptom is inflammation of the intestinal mucosa.
Erosive. This lesion usually leads to bleeding.
. Causes thinning of the mucosa and disrupts the functioning of the secretory glands.
Ulcerative. The formation of small ulcers on the intestinal mucosa, leading to bleeding.

Causes

Gastroenterologists say that in 80% of cases, the primary source of this disease is a long-term failure in nutrition and diet.

If a person constantly uses junk food, this will not only lead to a lack of vitamins and microelements, but will also provoke inflammation in the walls of the large intestine. At the same time, the likelihood of developing dysbiosis and E. coli increases several times.

Also, the main causes of chronic colitis include the following:

abuse of fatty, fried and spicy food, as well as flour products and alcoholic products;
rare meals (only in the morning and evening);
food allergies;
intoxication, since this disease can occur in people whose activities are associated with chemical products and toxic substances;
exposure to radiation;
congenital anomalies of intestinal development;
bad habits.

Symptoms

Chronic colitis is characterized by a wave-like course. Sometimes the disease may fade away and practically not make itself felt, but at certain periods the patient’s condition will sharply worsen. Clinical signs of the disease will become especially aggravated as the pathology progresses.

The main symptoms of chronic colitis:

bloating due to large cluster gases in the intestines;
stupid aching pain in the abdominal cavity after eating;
constant rumbling in the stomach and intestines;
pain in the lower abdomen and sides;
the appearance of problems with stool (constipation will be replaced by bouts of diarrhea);
there will be mucus and blood in the stool;
bowel movements will be accompanied by a strong stench;
the appearance of skin rashes;
slight increase in body temperature (up to 37.5 degrees);
loss of appetite;
weight loss;
general weakness and deterioration in performance.

If the pathology is caused by an infectious disease, the person will suffer from cramping pain in the abdominal cavity and constant diarrhea(up to 15 times a day).

Chronic colitis in children

Although the disease is most often diagnosed in people mature age, sometimes colitis can also occur in children (2-3 years old).

The danger of this disease is that in the absence timely treatment it can lead to dystrophic changes in the body and cause disruptions in the functioning of the entire digestive system. The child will suffer from intense pain, bowel dysfunction and fever.

If this disease is left to chance or is not treated to the end, it will take a chronic course and complicate later life baby. Unlike adults, in children the symptoms of the pathology are quite pronounced:

severe pain in the lower abdomen;
flatulence and bloating;
false urge to go to the toilet;
nausea and vomiting;
constipation and diarrhea;
dehydration of the body;
fever and general weakness.

If any of these symptoms occur, you must immediately make an appointment with a gastroenterologist and do all the necessary tests.

Chronic colitis during pregnancy

In pregnant women, this pathology does not occur very often, but it is potentially dangerous. Nevertheless, doctors claim that this pathology is not an indication for termination of pregnancy and does not pose a direct threat to the life of the baby.

Since physical immunosuppression occurs during pregnancy, the pregnant woman's body becomes more vulnerable and susceptible to various diseases. It is because of this that, if there is a predisposition, the expectant mother appears increased likelihood occurrence of colitis.

Chronic colitis during pregnancy is treated by taking modern medicines while following a certain diet. Also to the expectant mother It is recommended to adhere to bed rest.

How to relieve pain during exacerbation of the disease

Despite the fact that chronic colitis usually occurs in waves, in rare cases the patient may suffer from an exacerbation of the disease. In this case, the person experiences severe pain localized in the abdominal area, and it is difficult for him to move once again.

If the illness worsens, the most reasonable option is to call a medical team, and before they arrive, you can take the following measures:

You can apply a heating pad to the area where the pain is located. hot water and wrap yourself in a warm blanket.
If an attack is accompanied by diarrhea or vomiting, activated charcoal will help remove toxins from the body.
If the attack has just begun to intensify, the patient needs to undergo an enema with corticosteroids. These substances will help minimize the risk of further complications.
If the temperature rises, the patient should follow bed rest.
You can alleviate the condition before the arrival of doctors with the help of modern anabolic steroids.

If an exacerbation of colitis occurs, it is strongly recommended not to eat any food, since the intestines may simply not cope with their functions.

Diagnostics

The above describes in detail what chronic colitis is. If you suspect the presence of this disease, you must first make an appointment with a gastroenterologist, as a last resort You can also turn to a regular therapist for help.

An experienced doctor should not only carefully examine the patient, but also collect an anamnesis: find out what the nature of the pain is, whether any of the relatives had a similar disease.

It will help to confirm or refute the presence of pathology comprehensive diagnostics, it includes laboratory and instrumental methods examinations.

First of all, the patient will need to do general analysis blood, which will show whether the ESR and leukocyte levels are increased. You will also need:

Urinalysis.
Biochemistry of blood. Provides information about the functioning of the liver, kidneys, pancreas and metabolism.
Immunological analysis.
Stool analysis. Allows you to identify it chemical composition and the presence of substances such as fiber, protein, organic acids and ammonia. It also shows the presence of blood and purulent impurities.

Instrumental diagnostics includes the following methods:

Ultrasound examination of the abdominal organs.
Colonoscopy. This endoscopic examination of the large intestine, allowing to detect the source of inflammation, the presence of erosions and the severity of the vascular pattern.
FGDS. Examination of the stomach and duodenum.
Irrigoscopy. Carried out using contrast agents, it gives specialists the opportunity to assess the condition of the colon visually. Shows changes in the relief of the mucous membrane and impaired peristalsis.
Sigmoidoscopy. Indicated for a complete assessment of the rectum;

Only after all these studies have been carried out will the doctor be able to assess the overall clinical picture and select the optimal treatment method.

Treatment tactics

It is necessary to treat and eliminate pain in chronic colitis at the initial stage of the disease. Timely initiation of therapy minimizes the risk of complications and irreversible changes in the body.

If the doctor selects a competent and appropriate treatment method, the patient will be able to protect himself for a long time from the recurrence of the pathology and significantly improve his general condition.

The main method of treatment is drug therapy, and it is advisable for the patient to remain in a hospital. In addition, an essential condition for recovery is adherence to a special diet.

Drug treatment

Despite the fact that you can find many drugs on sale that are designed to treat this scourge, you should never choose medications yourself. Only an experienced specialist should calculate the duration of treatment and dosage.

In most cases, drug treatment is carried out by taking drugs such as:

probiotics that help restore and normalize the intestinal microflora (the most popular are Acipol and Bifikol);
antibacterial drugs (Tetracycline, Loperamide);
antibiotics;
choleretic agents (rosehip syrup and Allochol);
anabolic steroids that fight pain;
drugs that have an astringent effect (prescribed only if colitis is accompanied by diarrhea);
means aimed at eliminating flatulence (activated carbon, peppermint).

In addition, to speed up the recovery process, the patient will also need to take a course of multivitamins.

Treatment with folk remedies

Many people are interested in whether chronic colitis can be cured. folk remedies. Doctors say that in case of exacerbation of the disease, the best option would be to contact a specialist who will prescribe modern medications.

enjoy folk recipes possible after the end of treatment and the onset of remission. Such remedies are excellent prevention. The most effective of them:

Alder infusion. A tablespoon of the crushed product should be poured with a glass of boiling water and left to infuse for about 4 hours. After this, you need to strain the liquid and drink it three times a day, half a glass before meals. The course of treatment is 2 weeks.
Sage tea. A small amount of dry crushed plant (a tablespoon) is poured into 400 ml of boiling water and the whole thing is covered with a lid. After an hour, the liquid must be filtered. This remedy is taken three times a day, one tablespoon at a time. To achieve maximum results, you need to consume sage infusion for a month.

Special diet

With chronic colitis, a person will have to radically reconsider their diet. If you continue to eat, the effect of treatment will be short-term. The diet for chronic colitis is based on the following rules:

The patient will need to include as much fiber as possible in their diet. It can be found in cereals, fresh vegetables and bread. Fiber not only saturates the body the most valuable elements, but also normalize the activity of the gastrointestinal tract.
It is recommended to eat boiled meat and lean fish 2-3 times a week.
The diet should be dominated by dishes cooked in vegetable broth.
Before eating fruits and fresh vegetables, they must be peeled.
You will need to eat food in small portions (5-6 times a day).
The consumption of alcoholic beverages and carbonated drinks is strictly contraindicated. You should also avoid dairy products.
It is not recommended to eat if you have chronic colitis salty food and dishes with added spices.

In medicine, such a nutritional system is known as “Diet No. 4”; it is prescribed for the treatment of chronic diseases of the stomach and intestines.

This diet is especially necessary during exacerbation of the disease.. The menu can be quite varied; you need to prepare dishes based on the list of permitted and prohibited foods.

For chronic colitis, you can eat foods such as:

lean fish, steamed (or boiled);
vegetable broths;
porridge with water;
boiled chicken breast, veal;
white bread croutons;
cottage cheese.

Prohibited products:

pork;
fermented milk products with high fat content;
eggs;
baked goods;
smoked products and canned food;
strong coffee.

The diet should be sufficiently high in calories and contain a large amount of vitamins and valuable microelements.

Possible complications

If colitis is not treated, the disease can become more severe and cause ulcers and erosions on the intestinal mucosa. In this case, the person will suffer not only from severe pain, but also from the following pathologies:

Peritonitis.
Collateral cancer.
Formation.
Chronic intoxication.

Preventive measures

Is it possible to somehow protect yourself from this disease? Doctors say that proper diet and restriction will help reduce the likelihood of developing pathology. harmful products and fast food.

In order for all body systems to function properly, you need to have at least minimal physical activity and do exercises. The best option- do exercises in the morning and jog in the park several times a week.

If you experience problems with your intestines, you must make an appointment with a doctor in a timely manner.

This disease is quite unpleasant and can lead to serious complications. The most reasonable option would be to simply prevent it from occurring and constantly monitor your health.

Chronic colitis is a disease characterized by inflammatory lesion mucous membrane of the colon, the clinical picture of which is dominated by pain and dyspeptic syndromes, and the morphological basis is a combination of elements of inflammation with signs of epithelial dystrophy, a decrease in the depth of crypts and the development varying degrees severity of lymphoplasmacytic infiltration.

In cases where inflammatory changes in the large intestine are combined with damage to the small intestine, the term “ chronic enterocolitis" The term “chronic colitis” is used when the colon is predominantly affected.

EPIDEMIOLOGY. In recent years, chronic colitis has become a common pathology in children, combined with other gastroenterological pathologies. The incidence of chronic colitis ranges from 5 to 12 cases per 1000 children and accounts for about 20% of chronic pathology of the digestive system.

In addition, many factors of both the external and internal environment of the body can contribute to the development of chronic colitis: psycho-emotional stress, leading to the appearance of functional disorders in the intestines (irritable bowel syndrome), and subsequently to the development of chronic colitis; dietary disorders; previously suffered infectious diseases, with particular importance given to the aggressiveness of the pathogen, delayed and improper treatment, reducing the reactivity of the child’s body. Increased allergization of the body plays a role in the development of the disease, which can either be the cause of the disease or accompany it due to a lack of local funds protection.

Of significant importance are various gastroenterological pathologies that have a reflex effect from the site of the primary lesion against the background of a violation of neurohumoral regulatory mechanisms; congenital pathology and intestinal developmental anomalies, previous somatic and surgical diseases. PATHOGENESIS. In the pathogenesis of the disease, damage to the mucous membrane of the colon as a result of prolonged exposure to mechanical, toxic and allergic factors is essential. The nervous apparatus of the intestine is involved in the pathological process, which leads to disruption of the motor and secretory functions of the colon and aggravates trophic disorders in the intestinal wall. Dysbiosis, characterized by a decrease in the number of microorganisms constantly present in the intestines (bifidobacteria, coli, lactobacilli), a violation of the ratio of bacteria in various departments intestines, increased reproduction of opportunistic and the appearance of pathogenic flora. Secondary fermentopathy occurs and digestive processes are disrupted. IN large quantities metabolites such as indole and skatole are formed, which have pathogenetic significance in the development of the inflammatory process of the intestinal mucosa.

In addition, as a result of the vital activity of opportunistic microorganisms, the amount of histamine increases, which entails sensitization of the body, weakening of cellular and humoral protection. Having a good ability to adapt to conditions environment, opportunistic microorganisms create competition normal microflora intestines. Deficiency of bifid flora entails disruption of the processes of digestion, absorption, and assimilation of nutrients.

Disturbances are of great importance in the pathogenesis of chronic colitis nervous regulation intestines. These phenomena are based on the weakening of the inhibitory influences of the cerebral cortex on the underlying sections with a significant decrease in reactivity sympathetic division vegetative nervous system, and an increase in the blood content biologically active substances- serotonin and histamine.

An undoubted role also plays immune mechanisms. With an increase in the level of immunoglobulins in the blood of patients, autoantibodies to antigens of the colon mucosa are detected. This indicates that in the pathogenesis of the disease there is sensitization to one’s own tissue antigens.

Significant changes occur in the circulatory system: permeability is impaired blood vessels, signs of DIC syndrome develop - activation of the blood coagulation system and the formation of microthrombi, which leads to circulatory disorders and the formation erosive defects intestinal mucosa.

All this leads to the development of intestinal dyspepsia, immune disorders with the appearance of autoantibodies to antigens of the colon mucosa. The likelihood of autoimmunization in the progression and chronicity of the process is quite high. In this case, productive inflammation is combined with impaired epithelial regeneration and ends with sclerosis and atrophy of the colon mucosa. There are chronic colitis without atrophy of the mucous membrane and chronic atrophic colitis.

CLASSIFICATION. According to the recommendations of Yu.V. Belousova (2000), in pediatric practice a classification of chronic colitis can be used, which involves identifying the main parameters of the disease. When forming a diagnosis, it is necessary to reflect: the localization of the process - right-sided, left-sided, total colitis, transversitis; phase or period of the process - exacerbation, remission; the nature of motor disorders of the colon - hypo-, hypermotor, mixed dyskinesia. If intestinal dysbiosis is present, it should also be reflected in the diagnosis.

CLINIC AND DIAGNOSTICS. Chronic colitis in children often occurs with scanty clinical symptoms, especially in the early stages of the disease, and is characterized by a long, recurrent course, which creates certain difficulties in timely diagnosis.

Among the complaints, changes in the sick child’s well-being are typical: increased fatigue, weakness, deterioration in school performance, sleep disturbance, loss of appetite, headache, low-grade fever. Autonomic disorders are common. At the same time, stool disturbances are observed: constipation, diarrhea or unstable chair(alternating diarrhea with constipation). For constipation, defecation does not happen every day, usually once every 2-3-4 days, with a small amount of feces. With prolonged retention of stool, pain appears in the left iliac region, associated with fullness of the large intestine and disappears after defecation. Fecal masses pass in the form of “sheep” feces or “nuts”; sometimes at the end of the act of defecation an admixture of scarlet blood appears, which is usually a consequence of an anal fissure. With severe pain, the child suffers and tries to avoid defecation, thereby provoking long-term retention of feces in the intestines.

With prolonged constipation, complaints of nausea and vomiting appear due to fecal intoxication developing in the child.

The course of chronic colitis can be accompanied by an increase in stool up to 3-5 times a day with a change in its consistency (liquid or mushy), an admixture of mucus, symptoms of flatulence, pain in the lower parts abdomen along the large intestine. Some children alternate between constipation and diarrhea.

Chronic colitis is characterized by incomplete bowel movement syndrome: usually in the morning, immediately or 20-30 minutes after eating, the patient has an urge to defecate again. Stool may be repeated several times during the day, usually in small portions.

The child's complaints about abdominal pain are quite constant. They can be of a varied nature - from sharp contractions to aching, constant ones. They intensify or appear before defecation, decrease or disappear after defecation and release of gases. Localization of pain in the left hypochondrium, especially intensifying with physical activity(running, jumping), is often associated with a violation of the passage in the area of the splenic angle of the intestine, especially when the transverse colon, which is often interpreted as pain caused by damage to the stomach or pancreas. Flatulence, splashing noise in the intestines, and noisy rumbling are possible.

An objective examination of a child usually always reveals symptoms of chronic intoxication and polyhypovitaminosis. Particular attention should be paid to the condition of the mucous membrane of the tongue - during an exacerbation it is covered with a white coating and often has imprints of molars along the edges. In cases of dysbacteriosis digestive tract - bad smell from the mouth, belching. Examination of the abdomen reveals swelling of its various parts.

On palpation, the abdomen is painful in the area of the sigmoid and descending colon, which is explained by the predominantly left-sided localization of the inflammatory process. In addition to pain along the large intestine, the presence of positive symptoms of Obraztsov, Hertz, and “air column” is characteristic. In addition, palpation reveals rumbling and splashing noise along the colon, a symptom of “croaking frogs” in the ileocecal region.

Features of the course of chronic colitis in children are largely determined by the nature of the disorder of colon motility. Depending on the type of dyskinesia, stool and abdominal pain have a number of features. When colitis is combined with enteritis, the stool is often copious, liquid, flatulence is significantly pronounced, Obraztsov’s symptom and pain at the Porges point are often detected.

An extended scatological study is important in the diagnosis of chronic colitis, which makes it possible to judge the processes of digestion and absorption in the intestine, and according to the Triboulet-Vishnyakov reaction, the presence of an inflammatory process. Typically, in a coprogram with inflammatory changes in the colon mucosa, mucus, leukocytes, and less often red blood cells, iodophilic flora, undigested fiber and intracellular starch are detected.

A study for dysbacteriosis makes it possible to identify a violation of the intestinal biocenosis; opportunistic flora is often detected (Proteus, Klebsiella, Citrobacter, enterococci, hemolyzing Escherichia coli, staphylococcus).

Have the greatest value endoscopic methods intestinal examinations - sigmoidoscopy and colonoscopy; they make it possible to identify superficial (with or without atrophy) and destructive-inflammatory changes (hemorrhages, erosions). It should be noted that in children there are practically no significant changes in the intestinal mucosa: it is more tender, thinner, with minor inflammatory changes in the form of moderate proctosigmoiditis. For a more detailed study, a biopsy of the colon mucosa is performed. Morphological examination of biopsy specimens reveals changes of a proliferative nature: a decrease in the height of the surface and cryptal epithelium, the presence of a dense lymphohistiocytic infiltrate with a large number of lymphocytes and eosinophils in it. Edema symptoms are characterized by increased functional impairment crypt epithelium, decreased vascular tone, increased blood supply. It should be emphasized that in modern conditions, the diagnosis of chronic colitis should be based on histological data, since endoscopic and x-ray studies do not always allow verification of the presence of inflammation. At the same time, morphological examination of the intestine should be carried out according to strict indications in a specialized department.

An X-ray examination of the intestine (irrigography) shows some narrowing of the affected areas, the haustra become asymmetrical, uneven, and sometimes smoothed. After evacuation of the barium suspension, damage to the relief of the mucous membrane is noted: the folds lose their usual direction, become intermittent, expanded, and thickened. Symptoms of impaired motor function of the colon of the hypermotor or hypomotor type must be identified.

Chronic colitis must be differentiated from chronic enteritis and irritable bowel syndrome (Table 80).

TREATMENT of patients with chronic colitis should be differentiated, complex and include diet therapy, drug therapy, local rectal procedures, as well as physiotherapy and balneotherapy. During an exacerbation period, a gentle diet is essential. To reduce intestinal motility and irritating effect food on its mucous membrane is prescribed fractional meals 6-8 times a day. If you are prone to diarrhea, a table with mechanical and chemical sparing of the mucous membrane is recommended (diet No. 4 and its variants - 46 and 4c). The presence of flatulence is eliminated by limiting carbohydrates, milk, and dairy products. For colitis accompanied by constipation, beets, carrots, pumpkin, prunes, apricots, vegetables and fruit juices. The administration of bran is effective. During the period of remission, it is advisable to appoint a common table with the exception fatty meat, spicy and salty dishes, extractive substances, butter dough.

The drug complex is prescribed taking into account the nature of inflammatory changes, the type of dysbacteriosis, and the type of motor-evacuation disorders.

In the treatment of patients with chronic intestinal diseases widespread received sulfonamide drugs - phthalazole, phthazin, etazol, salazopyridazine, salosinal, salofalk (see “Nonspecific ulcerative colitis”) - due to their properties to be adsorbed in the intestines and a pronounced anti-inflammatory effect. However, when prescribing them, one should keep in mind the possible side effect(in 3-4% of patients), due toxic effect on tissue, especially when using drugs from the salazosulfapyridine group. This determines the need for careful monitoring during treatment, taking into account the pharmacokinetics of the drugs.

Significant place in complex therapy in chronic colitis it takes an effect on intestinal dysbiosis. For this purpose, during the period of exacerbation of the disease, drugs of the hydroxyquinoline series, nalidixic acid, and nitrofurans are used (see “Chronic enteritis”). They have a pronounced antimicrobial effect against pathogenic microorganisms, but, unlike antibiotics, they do not suppress the saprophytic flora, increase the body's resistance, suppress production and reduce the effect of toxins. It should be borne in mind that long-term or repeated use of these drugs may cause the development of allergic reactions. To correct intestinal dysbiosis, the use of biological drugs: colibacterin, bifidumbacterin, bificol. According to indications, these drugs should be alternated with bacteriophages - Proteus, staphylococcal.

Considering the role of the allergic factor in the pathogenesis of chronic colitis, desensitizing therapy is prescribed.

Inflammatory changes in the mucous membrane of the large intestine, as well as the associated decrease in the processes of digestion and absorption lead to the development of polyhypovitaminosis, and therefore inclusion in the complex is indicated therapeutic measures vitamin therapy (group B, C, folic and nicotinic acid).

Stimulators of reparative regeneration with a nonspecific anti-inflammatory effect - methyluracil and indomethacin - are widely used in treatment. The results of experimental and clinical observations showed them high efficiency in a complex of therapeutic measures for chronic inflammatory diseases intestines. Carrying out a course of treatment for 6-8 weeks leads to the elimination or significant reduction clinical manifestations diseases, reducing the severity of the inflammatory process in the intestinal mucosa, and the onset of a fairly long (1-3 years) remission. Methyluracil is prescribed 0.25-0.5 g 3 times a day during or after meals; indomethacin - starting with a dose of 25 mg 2-3 times a day after meals for older children, with a gradual increase in dose (under tolerance control) to 100 mg per day in 3-4 doses; The drug can also be administered in the form of rectal suppositories, 50 mg 2 times a day. However, the use of indomethacin in pediatric practice is limited by its possible side effect(vomiting, diarrhea, increased intoxication), so it must be used carefully.

Local therapy for chronic colitis includes the use of enemas and suppositories that have an anti-inflammatory effect on the mucous membrane of the colon within the anorectal region. Microenemas from chamomile, collargol are used, and for atrophic and subatrophic changes - oil ones ( fish oil, vegetable oil). The use of suppositories helps reduce intestinal spasms, pain in the anus, and bowel movements. Suppositories are inserted into the anus usually at night or in the morning before bowel movements. Used ready-made drugs antihemorrhoidal suppositories - anuzol, neoanuzol, betiol, etc.

Along with drug treatment The complex of therapy uses physiotherapeutic procedures that have an anti-inflammatory effect and help eliminate impaired intestinal motility. Thermal procedures - applications of paraffin and ozokerite to the abdominal area - improve blood supply to the intestines and reduce inflammation. Using a special rectal tip, diathermy is applied, which normalizes intestinal motility and helps eliminate pain. Depending on the type of motor disorders, electrophoresis of a mud solution is used, as well as medications: if there is a tendency to constipation with a predominance of the spastic component, anticholinergics are used, and if there is intestinal hypotension, calcium supplements are used.

Herbal medicine for chronic intestinal diseases is differentiated according to the nature of disturbances in its activity (constipation, diarrhea) and the nature of motility (hyper-, hypomotor - see “Irritable bowel syndrome”). It is more advisable to use herbal medicine for colitis during the period of attenuation of the inflammatory process, using herbal preparations:

Buckthorn bark - 30 g, elderberry flowers - 20 g, fennel fruits - 10 g, anise fruits - 10 g. One tablespoon of the collection is poured with a glass of boiling water, heated for 15 minutes in a water bath; the infusion is cooled for 45 minutes at room temperature and filtered. Take 1/2-1 glass in the morning on an empty stomach and in the evening before bed 30 minutes before meals.

Joster fruits - 20 g, licorice root - 10 g, caraway fruits - 10 g. The method of preparation and use is the same.

Senna leaves - 20 g, dandelion root - 20 g, valerian rhizome - 10 g, nettle leaves - 10 g. The method of preparation and use is the same.

All three collections are used when colitis is combined with constipation.

The use of various natural balneological factors in the treatment of chronic colitis is very appropriate and is widely used in pediatric practice. Balneotherapy is prescribed in the remission phase or no earlier than 2-3 months after an exacerbation of the disease. Taking mineral water helps normalize the motor-evacuation function of the intestine, improves the processes of digestion and absorption, and increases the secretory function of the glands of the intestinal mucosa. Used mineral waters low or medium mineralization, rich in sodium sulfate and magnesium salts, affecting the neuromuscular apparatus of the intestine. For chronic colitis accompanied by diarrhea, mineral waters are prescribed in reduced quantities, 1-2 times a day, always hot. Drinking warm mineral water is indicated for chronic colitis accompanied by spastic constipation. If intestinal motor function decreases, mineral water should be drunk cold, since in this case it helps stimulate intestinal motility.

Besides medicinal drink various mineral waters, for intestinal diseases, rectal procedures in the form of intestinal lavage and intestinal douche are widely used. Colon lavage helps remove fecal matter, mucus, and toxins. Mineral water, acting on the mucous membrane and receptors of the distal intestine, reduces the inflammatory process, has a normalizing effect on the intestinal microflora and motor-evacuation function. Contraindications for rectal procedures are increased vulnerability of the rectal mucosa, the presence of anal fissures, and the erosive nature of the mucosal lesion.

During the period of subsidence of the inflammatory process, physical therapy is indicated. In case of chronic colitis with constipation and predominance of spasms, special attention is paid to the choice of starting positions (standing on all fours, lying on your back with legs bent at the knees). At decreased tone intestines, exercises for the abdominal muscles are prescribed in various starting positions.

Clinical examination of children with chronic colitis involves their registration according to Form No. 30, systematic active observation, anti-relapse treatment, and the creation of conditions conducive to full recovery. After discharge from the hospital, treatment with vitamins (group B, C, folic acid) should be continued for 3-4 weeks. When chronic colitis is combined with enteritis, enzymes (Pancreatin, Panzinorm, Trienzyme, Festal, Creon) are prescribed for 1 - 2 months, for persistent dysbiosis - biological products for 1/2 - 2 months. Herbal medicine for 2 weeks every month for six months (with changing collections of medicinal plants). Mineral water taking into account bowel function for a month. In autumn and spring, anti-relapse courses of treatment lasting 1 - 1.5 months are recommended. Vitamins (groups B, C, nicotinic acid), eubiotics, biological products, herbal medicine are prescribed, and at the end - mineral waters. The duration of clinical observation is at least 3 years from the onset or last exacerbation of the disease.

Sanatorium-resort treatment should be carried out in local sanatoriums and balneological resorts in Ukraine (Berezovsky mineral waters, Morshyn, Mirgorod, Truskavets, etc.) during a period of remission in the absence of pronounced intestinal dysfunction.

In the rhythm of today's life, it is often impossible to keep track of the quality and regularity of your own nutrition. This causes major problems in the stomach area, and complaints of pain become more frequent. Chronic intestinal colitis is a disease associated with the appearance of inflammatory processes in the layers of the large intestine. Always accompanied by dysfunction of motility and secretion. People who have previously experienced digestive disorders are most susceptible to this problem.

Exacerbation of chronic colitis can occur for a variety of reasons. The main and most common include:

The reasons for the development of intestinal colitis can be very diverse, from infectious agents to ischemic factors. Based on this, chronic colitis can be classified as follows:

infectious;
nutritional;
toxic;
ischemic;
allergic;
ray;
combined.

Video “Causes and Symptoms”

The video talks about the causes and symptoms of the disease.

Signs and symptoms

Signs of intestinal colitis can appear only in the most advanced stage, when the pathology is already clearly expressed. At the first stages, the disease does not have a bright and pronounced character. Health problems arise that, as a rule, no one pays much attention to:

These signs are very fleeting and are perceived as one-time deviations, while the cause remains.

Chronic colitis never appears quickly and suddenly. It makes itself felt after any inflammation or injury. More than half of the cases are associated with incorrect treatment of intestinal infections. An interesting fact is that in 12% of cases the disease is able to recede on its own without any medical care. This happens when the patient simply does not seek help. qualified help and does not feel any problems in managing normal rhythm life.

In the remission stage, colitis has the following symptoms:

With visual and careful observation, one can note the presence of a whitish coating on the tongue, swelling in the stomach area; when examined with a stethoscope, wave-like contractions of the walls are observed; upon palpation examination, painful sensations appear.

Diagnostics

In order to compare the diagnosis of chronic intestinal colitis with the symptoms and prescribe treatment, a number of relevant studies are carried out, which are prescribed by the doctor.

To begin with, blood is drawn for a general analysis. The main thing that people pay attention to is an increased rate of ESR, leukocytes and neutrophils.

They also do a stool coprogram, here important indicator is the presence of fiber, protein, fat, starch, ammonia and organic acids.

A colonoscopy is performed, that is, the large intestine and its surface are examined using an endoscope. Where can the lesion be detected, the severity of the vascular pattern.

In order to trace relief changes, irrigoscopy is done - x-ray method examination of the large intestine using contrast agent, which is injected into the colon.

Against the background of all studies, the attending physician must exclude a number of diseases that have similar symptoms:

Crohn's disease;
colon oncology;
dysentery in the chronic stage;
appendicitis in a chronic condition;
amoebiasis;
enteritis;
pathologies of the digestive organs and liver.

When diagnosing the disease and prescribing treatment for chronic intestinal colitis, comprehensive research. This helps to establish the stage and form of the disease, as well as the changes that have occurred in the body under the influence of the disease.

Treatment

Colitis is treated by a special doctor - a gastroenterologist. The diagnosis is confirmed by an endoscopist. If the diagnosis is confirmed, then in case of exacerbation the patient is hospitalized. Treatment is carried out in a hospital under the supervision of doctors.

The main requirements in the treatment of the disease include methods of combating the “provocateurs” of inflammation. The basic purposes are:

review and normalization of the regime;
strict diet;
drugs that kill the infection;
medications that restore intestinal microflora, as well as immunostimulating agents;
antihistamines;
vitamin and mineral complexes.

During remission, bed rest is absolutely not necessary; on the contrary, it is necessary to live a full and active life. The main thing is to avoid putting stress on the abdominal muscles. You can do non-strength exercises. The following sports are perfect: swimming, walking, Pilates.

Sleep should be restored and normalized; walks before bedtime, teas with mint and lemon balm, you can use a special bandage, and tight underwear should be avoided.

To defeat chronic colitis and the treatment prescribed by the doctor to produce results, you need to forget about drinking alcoholic beverages and tobacco products.

Diet

The key to recovery and the “foundation” of treatment is strict special diet. It is prescribed by a gastroenterologist or nutritionist. It is necessary to eat small portions, but often. As a rule, meals should be 6 times a day. Eating takes place at equal intervals, with the exception of night sleep.

Dishes and food products must be balanced. The ratio of carbohydrates, proteins and fats should be 4:1:1 respectively. If a relapse occurs, carbohydrates are reduced.

Best for relieving tension digestive system, eat homogeneous dishes, ground. It’s good to include soups in your diet, but flour products should be excluded. It is not advisable to consume grapes, coffee, tea, chocolate, cocoa, spicy dishes, fresh cabbage, offal and fatty fish.

It is better to give up freshly squeezed juices and eat fruits and vegetables. You can add some chicken and lamb.

Preference should be given to the steam method of processing products and avoid frying. And after sleep, it is recommended to drink a glass of warm water on an empty stomach.

Treatment with drugs and medications

The treatment of colitis is based on two main stages:

elimination pain symptoms in acute form;
preventing relapse in the future.

In case of exacerbation and sharp deterioration the patient's condition, treatment is carried out in the hospital in the gastroenterology department.

Medicines are used for severe forms. In cases of allergic and enzymatic forms, appropriate medications are prescribed for a long period.

Antibacterial and antimicrobial therapy includes: Furazolidone, Loperamide, Enterofuril, Tetracycline, etc.

Antispasmodics are prescribed: No-spa, Drotaverine hydrochloride, Papaverine hydrochloride, Duspatalin. If the pain is very severe, then Platiphylline should be injected intramuscularly.

If pathology of the gallbladder is observed together with colitis, then it is necessary to prescribe choleretic drugs: Chofitol, Holosas, Allochol, rosehip syrup.

To restore damaged tissues and enhance cellular regeneration, it is necessary to take nicotinic acid and B vitamins.

To facilitate digestion processes and improve the absorption of food, enzymes are taken: Creon, Mezim, Pancreatin.

To cleanse the body and remove harmful toxic substances, adsorbents can be prescribed medicines. The most popular: Smecta, activated carbon.

In case of stool disturbances, namely for constipation, laxatives of plant origin – Sennade, and saline laxatives – Bisacodyl – are used.

The most important thing is not to prescribe a course of treatment on your own, and if the condition worsens, consult a doctor for advice and change your medication program.

Traditional medicine

Do not neglect folk remedies in the fight against the disease. There are always several simple but very effective recipes in “grandmother’s treasure trove.” Here are a few of them:

Help you cope with an unpleasant illness herbal teas, tinctures and decoctions:

20 ml tincture of hawthorn, peony, mint, calendula, motherwort; Combine 30 ml of valerian, 5 ml of belladonna and take this mixture from 1 to 8 drops per single dose. Perform the procedure 3-4 times a day 10 minutes before meals.
For constipation, which may accompany the disease, a special herbal mixture is used. It includes: dill seeds, oregano, buckthorn bark and immortelle inflorescences.

Having considered how chronic colitis manifests itself, its symptoms and treatment in various ways, the consequences associated with this disease and preventive measures should be studied.

Consequences and preventive measures

In case of exacerbation and severity of symptoms, it is necessary to call a doctor and “move” to a hospital for further treatment. If you ignore the body’s “signals” for help, the following may develop: serious complications and diseases:

kidney inflammation - nephritis;
intoxication in the body;
violation water balance, dehydration;
disturbance between blood flow to the heart and its outflow;
decrease in the content of chlorine minerals in the blood plasma;

Treatment is comprehensive, taking into account all current and accompanying symptoms of the disease. In the absence of clearly pronounced signs Serious measures must be taken to ensure the patient’s recovery, otherwise such consequences may occur.