IBD: Ulcerative colitis. What does the patient need to know? Ulcerative nonspecific colitis: symptoms and treatment

Colitis is an inflammation of the intestines: the colon and rectum.

The causes are varied; colitis as a group of diseases occurs mainly in adults and elderly citizens. The inflammatory process that occurs in parts of the colon causes a violation of the reabsorption of water, which leads to diarrhea (loose stools); spasm or expansion of a section of the intestine leads to disruption of the passage of feces along the entire length of the intestine. Then symptoms are noted: bloating, abdominal pain of various types and positions, constipation. Various pathological discharges with feces (mucus, etc.) may be observed.

Let's talk about the most common types of colitis, their symptoms and treatment in adults and the elderly using folk and medical remedies, diet and procedures at home and in a hospital.

Chronic colitis

Chronic colitis is one of the most common diseases in middle-aged and elderly people. Colitis is caused by nutritional errors, endogenous and exogenous intoxications, and microorganisms.

The main symptoms of the disease are pain in the intestines, discomfort manifested by flatulence, constipation, and diarrhea. Characteristic is the syndrome of incomplete bowel emptying, when the patient, after defecation, has a feeling of incomplete emptying of the rectum. The urge to defecate usually appears in patients after eating or a short period of time after eating.

Pain in this disease is often localized in the lower abdomen or along the rectum, radiating to the anus, especially at the time of defecation.

The basis for the treatment of chronic colitis is a properly selected and regulated diet. Food should contain a sufficient amount of protein, vitamins, microelements and a very small amount of carbohydrates.

Ulcerative colitis

Nonspecific ulcerative colitis is a serious disease that affects both women and men equally often. The cause of ulcerative colitis is still not clear, although many theories have been put forward.

In the initial stage of the disease, abdominal pain and frequent loose stools mixed with bloody mucus or pure blood are usually noted; less often, it begins as acute dysentery with fever, bloody diarrhea, and tenesmus. Sometimes intoxication phenomena come to the fore: joint pain, general weakness, poor health, fever. In most cases, emaciation and pale skin are observed. There is always blood and mucus in the stool.

In the treatment of colitis of any etiology, the decisive factor is diet. If you take even the most healing herbs in the world and do not adhere to the correct therapeutic diet, the treatment will be ineffective.

The course of the disease is most often chronic and relapsing. The disease often causes complications: perforation of the intestines with the development of peritonitis, intestinal stenosis, thrombophlebitis, damage to the pancreas, kidneys, and myocardium.

Due to constant blood loss, patients are asthenic, exhausted, and suffer from anemia. The prognosis of the disease is unfavorable.

For all types of colitis, bran should first be excluded from the diet, even in bread, as it irritates the intestinal mucosa. You should not eat very hot or very cold foods or drink large amounts of liquids. It is undesirable to consume raw vegetables. You should not eat foods that contain cellulose, so the skins and skins of fruits should be peeled off. It is necessary to avoid fried foods, spices, coffee, and anything that irritates the intestinal mucosa.

The diet should contain all grains (except bran), light and lean meats (chicken, lamb), all types of vegetables (without seeds, boiled), yogurt, puddings, kefir and curdled milk, stale bread.

Fats in food should be present in minimal quantities.

Laxatives should be excluded from treatment procedures. If necessary, you can do an enema 1-2 times a week.

Folk remedies for treating colitis at home

Brew 1 teaspoon in a glass of boiling water centaury, chamomile and sage. Leave for 1 hour, strain. Drink 1 tablespoon 4 times a day 30 minutes before meals. As the general condition improves, the intervals between doses of the medication should be lengthened.

Prepare an infusion of chamomile flowers. Pour a tablespoon of flowers into a glass of boiling water. Leave for 1 hour, strain. Take 1/2 cup warm 3 times a day.

2 teaspoons blueberries Brew in a glass of boiling water, leave for 2 hours, strain, sweeten. Take one third of a glass 5-6 times a day.

5 g flower baskets tansy leave for 2 hours in 300 ml of boiling water, strain. For colitis and enteritis, take 1 tablespoon 3-4 times a day.

White cabbage juice Take half an hour before meals 4 times a day. Start with half a glass per dose and gradually increase the dose to 1 glass per dose over 3-4 weeks.

Decoction rhizomes And Roots of Burnet officinalis. Grind a tablespoon of rhizomes and roots, pour a glass of boiling water, boil for 30 minutes over low heat, leave for 2 hours, strain. Take 1 tablespoon 5 times a day before meals.

Infusion fresh watermelon rind. For 100 g of fresh crushed peels - 400 ml of boiling water. Leave for 1 hour. Take half a glass 5 times a day. You can take watermelon rind powder 1 g (at the tip of a knife) 4-5 times a day.

10 g dry herb St. John's wort Brew in 200 ml of water. Boil for 2-3 minutes, leave for 2 hours. Take 1 tablespoon every 4 hours after meals.

4 g alder cones cook in 200 ml of water for 2 minutes, leave for 2 hours, strain. Take one quarter glass 4 times a day before meals.

Leaf infusion field mint. 2 tablespoons of leaves per 2 cups of boiling water. Leave for 1 hour, strain, drink half a glass 4 times a day.

Healer Lyudmila Kim in her book “Hello, Vanga” recommends the following to improve intestinal function:

a) before getting out of bed, you need to sharply inflate and lower your stomach 20-30 times, then massage your stomach in a circular motion clockwise;

b) write numbers from 0 to 10 in the air with both feet. If you don’t succeed right away, you need to gradually complicate the exercise;

c) after performing the exercises, you need to stand up, clasp your hands, and place them on the top of your head. Rising on tiptoes, stretch up and lower onto your full foot. Do the same with turning right and left 10 times in each direction.

Before going to bed, do two enemas daily: the first cleansing one from 3 glasses of clean water, and the second immediately after bowel movement from 1 glass of rice water with the addition of 30 g lactose(milk sugar). This composition should remain in the intestines all night. Lactose promotes the release of gases - this is a sign that the product is working.

After 5–7 days of treatment, despite the fact that all the symptoms of colitis will disappear, you still need to continue doing enemas and following a diet for another week. Then stop the enemas, but drink lactose 30 g twice a day for 10 days. It’s good if you have the opportunity to do warm sitz baths. If the colitis is very advanced, then every two months, despite the improvement in the condition, lactose enemas should be done again for 7 days.

1 tablespoon dry plantain leaves insist 2 hour in a glass of boiling water, strain. Take 1 tablespoon 20 minutes before meals.

2 teaspoons blackberry leaves And 1 teaspoon reed flower heads of marigolds (calendula) insist 2 hour in a glass of boiling water, strain. Take 2 times a day half an hour before meals.

To cleanse the intestines and facilitate its work, you need to do enemas of hot water with the addition of 1-2 tablespoons glycerin or lemon juice or apple 6% vinegar on 2,5 liters of water. The order of enemas is as follows: three days in a row, 3 times every other day, 3 times every two days, and so on, until there is only once a week left.

It is very useful to fast completely one day a week.

Relieves pain in the intestines well next collection.

1. St. John's wort – 100 g,
2. peppermint – 400 g,
3. burdock – 100 g.

Mix everything. Pour 1 tablespoon of the mixture with a glass of boiling water, leave

1 hour, strain. Take one third of a glass 3-4 times a day.

If we add 150 g of any dry tea to the above mixture, we will get an excellent remedy for cleansing the kidneys and pancreas.

For intestinal cracks, traditional medicine advises sugar enemas(a tablespoon of sugar per 500 ml of water). They also help cleanse the intestines.

Treatment of colitis: remedies, diet, drugs, medications

The main thing in the treatment of colitis is diet therapy, on which recovery depends. For severe colitis, treatment should begin with 2–3 days of fasting and bed rest. Then a gentle diet is prescribed (table No. 4 or 4-a).

Table No. 4 and 4-a. Prescribed for diarrhea, acute enteritis and colitis, when significant irritation of the intestinal mucosa is observed. Food should be mechanically gentle, milk and eggs are excluded.

In the first days of illness, liquid and semi-liquid foods are prescribed: weak tea, meat broth, slimy soups, jelly, blueberry or red wine jelly. Then add white crackers, butter, fresh cottage cheese, boiled meat in the form of steam cutlets, dumplings, meatballs, boiled lean fish, pureed porridge, steam pudding. For vitamins, orange or lemon juice is preferable.

For acute colitis (colon catarrh), apple days are prescribed (see “Regimes of incomplete and partial fasting”). For chronic colitis, mechanically gentle pureed food is prescribed: vegetable and meat soups, boiled pureed vegetables and fruits, lean meat in the form of cutlets, pureed cereals, pasta, noodles, stale white bread, butter, fresh cottage cheese, sour cream, milk, eggs are allowed only in food.

The patient should be fed 4-5 times a day to avoid eating large quantities of food at one time. Cold foods and drinks should be avoided, as they increase intestinal motility. In case of chronic colitis without pronounced clinical phenomena, they gradually switch to a general rational diet with the exception of raw vegetables and fruits, as well as pure milk.

If putrefactive or fermentation processes predominate in the intestines, then carbohydrates are limited in food (up to 120 mg per day), but not proteins.

A strict diet is prescribed for a short period of up to 7 days. The diet is expanded gradually as the general condition improves.

Along with the diet, it is prescribed drug therapy And physiotherapy.

For abdominal pain, antispastic agents (Belladonna, Platyfillin, Besalol, No-shpa, Aprofen), heating pads, diathermy, Sollux, paraffin and mud applications on the stomach are indicated.

For constipation - oil enemas (150 ml of sunflower or Provençal oil). Vaseline or olive oil is given orally, 1 tablespoon 2-3 times a day.

Frequent use of enemas for colitis should be avoided.

For diarrhea and flatulence, the following medications are indicated: Bismuth, Tannalbin, Carbolen.

Great importance is attached to the treatment of the nervous system. Patients are given sedatives and sleeping pills, and water treatments are prescribed.

The compress is a medicinal bandage.

How to treat colitis using traditional methods

Ulcerative colitis: treatment and prevention

Irritable bowel and ulcerative colitis are twin diseases

There are diseases whose first symptoms are similar, like twin brothers. But this does not mean that they need to be treated the same. In the next issue of the “About Medicine” section, the presenters will tell you how to distinguish irritable bowel syndrome from ulcerative colitis and how to properly treat both of these diseases.

Nonspecific ulcerative colitis

On video: clinical picture, epidemiology, endoscopy, clinical picture of ulcerative colitis (5 min. 50 sec.)

Chronic colitis: treatment, clinical picture and diagnosis

This video provides brief information about the clinic, diagnosis and treatment of chronic colitis.

Crohn's disease: chronic inflammation of the intestines

Ulcerative colitis is a chronic inflammatory pathology of the large intestine, characterized by the development of ulcers and hemorrhages in the mucous membrane.
The disease affects people between the ages of twenty and forty. Women are more likely to suffer from ulcerative colitis.

Causes of the disease

The etiological factor of the disease has not yet been established.
There are a number of hypotheses about the occurrence of ulcerative colitis of the intestine:

• Ulcerative colitis is an infectious pathology of unknown etiology,
• Ulcerative colitis is an autoimmune disease based on the immune system producing its own antibodies against the epithelial cells of the large intestine,
• Ulcerative colitis has a hereditary predisposition.

The provoking factors of the disease are:

• high carbohydrate diet low in dietary fiber,
• intestinal dysbiosis,
• mental trauma, stress, emotional stress,
• sedentary lifestyle.

Pathomorphology

Pathological anatomy is represented by diffuse superficial lesions of the walls of the large intestine. Usually the pathological process is localized in the rectum and sigmoid colon. Total damage to the entire intestine is very rare.
Morphological signs of ulcerative colitis are small ulcers on the mucous membrane of the large intestine. At the same time, it is full-blooded, the unaffected epithelium is hypertrophied and protrudes significantly above the surface of the mucosa. Ulcers, as a rule, are not deep, the intestinal walls are compacted.
It is possible that infection may occur and secondary purulent inflammation may develop. All this leads to hypersensitivity of the mucous membrane, which begins to bleed even with minor exposure.

Classification

Classification depending on the location of the pathology

1. Regional colitis is a local lesion of the colon with a small area of ​​inflammation that can enlarge and then become more severe.
2. Total colitis is manifested by inflammation that covers the entire epithelium of the large intestine and affects deep tissues
3. Left-sided ulcerative colitis.
4. Ulcerative proctitis is a regional inflammation of the final section of the colon.

Classification depending on the course of the disease

• Acute colitis is characterized by sudden onset of obvious attacks under the influence of environmental factors,
• Chronic colitis is a sluggish hereditary disease,
• Recurrent colitis is a type of chronic form of the disease that becomes acute under the influence of provoking factors, and after their disappearance returns back to chronic.

The last two types are relatively difficult to treat, since the affected area is quite large.

Symptoms of Ulcerative Colitis

Based on the severity of clinical symptoms, the disease is divided into degrees: mild, moderate and severe.
Mild and moderate severity are characterized by the patient having general symptoms of intestinal ulcerative colitis: malaise, weakness, increased body temperature up to 38°C, and local signs: increased bowel movements up to five times per bowel movement, the appearance of blood in the stool and cramping abdominal pain.
Severe course of the disease manifests itself:

• fever over 38°C,
• tachycardia,
• pulse more than 90 beats per minute,
• pallor of the skin due to developed anemia,
• dizziness,
• weakness,
• weight loss,
• frequent bowel movements more than six times a day,
• the presence of a large amount of blood in the stool, sometimes blood is released in clots,
• intense cramping pain in the abdomen preceding the act of defecation.

Nonspecific ulcerative colitis can manifest as constipation and pain in the left iliac region. At the same time, the body temperature rises slightly, and patients do not pay special attention to these signs. But soon rectal bleeding mixed with pus occurs. The amount of blood released varies from a few drops to twenty milliliters.
Clinical symptoms of ulcerative colitis are divided into intestinal and extraintestinal.
Intestinal symptoms of ulcerative colitis: diarrhea or constipation, cutting or aching pain in the left side of the abdomen, anorexia and weight loss, fever, water and electrolyte imbalance with kidney damage.
Extraintestinal symptoms: conjunctivitis with further deterioration of vision, stomatitis, gingivitis, arthritis, skin diseases, thrombophlebitis, thromboembolism.
If abdominal pain does not stop for six hours and there is bleeding from the rectum, then urgent medical care is necessary, hospitalization of the patient and a thorough examination to exclude acute surgical pathology.
The course of the disease in children and the elderly has its own characteristics.
Nonspecific ulcerative colitis develops in children of any age, but most often in adolescents. The disease manifests itself with symptoms that are very scarce and insignificantly expressed. Symptoms of ulcerative colitis in children are growth retardation and paroxysmal diarrhea. The periods of remission last quite a long time - several years.
In older people, the disease develops sluggishly, which is associated with an age-related decline in the body's immune function. In older people, complications develop much less frequently than in children and young people.
It is necessary to differentiate ulcerative colitis from dysentery, salmonellosis - this could be Crohn's disease, pseudomembranous colitis, celiac disease, diverticulum, etc. Of the entire list of diseases, Crohn's disease is considered the most similar in clinical manifestations to ulcerative colitis. The main difference is that Crohn's disease is characterized by damage to the entire thickness of the intestinal wall, and ulcerative colitis - only the mucous membrane.

Diagnostics

Diagnosis of nonspecific ulcerative colitis always begins with an analysis of the patient’s complaints and anamnestic data. Then the patient is examined, during which signs of anemia are revealed, and palpation of the abdomen determines pain on the left or throughout the abdomen.
Additional research methods are laboratory, endoscopic and x-ray.
Laboratory research methods:

• general blood test,
• blood for clotting,
• standard studies taken during hospitalization of a patient in a hospital.

The main instrumental research method is fibrocolonoscopy. It is carried out like this: a flexible probe is inserted into the rectum through the anus, which has a microcamera at the end, with which you can examine and evaluate the condition of the colon mucosa. Any endoscopic examination is prohibited in full during an exacerbation of the disease, as this can worsen the patient’s condition and even lead to perforation of the intestinal wall. Colonoscopy is a universal diagnostic method that allows you to understand what ulcerative colitis is.
Irrigoscopy is a safer and less informative research method, which consists of introducing a barium suspension into the rectum using an enema, followed by an X-ray examination. Using barium on an x-ray, you can obtain an impression of the intestinal mucosa and use it to judge the presence and severity of ulcerative defects.
X-ray diagnostics allows you to determine the localization of the pathological process, its prevalence, the presence of complications and monitoring the development of the disease.
Microbiological examination of nonspecific colitis is carried out to exclude the viral etiology of the disease. To do this, a bacteriological culture of the test material is carried out and a conclusion is made based on the results obtained. Ulcerative colitis is characterized by the release of pathogenic microorganisms from feces, an increase in the number of staphylococci, Proteus, a decrease in lactobacilli, as well as the release of specific microflora, which is uncharacteristic of the intestines of a healthy person.
Complications of ulcerative colitis - colon perforation - can be identified using plain radiography of the abdominal organs without the use of contrast agents.

Complications of ulcerative colitis

Complications of ulcerative colitis occur when treatment of the pathology is not started in a timely manner or is not effective.

1. Life-threatening bleeding.
2. Toxic dilatation of the colon, which occurs as a result of stopping peristaltic contractions and the presence of pronounced.
3. Perforation of the colon, which is a violation of the integrity of the intestinal wall with the outflow of intestinal contents into the free abdominal cavity.
4. Polyps and colon cancer.
5. Stenosis and development of intestinal obstruction.
6. Hemorrhoids and anal fissures.
7. Extraintestinal complications: arthropathy, hepatitis, cholecystitis, pyoderma, mental disorders.

Colitis is a dystrophic-inflammatory or inflammatory lesion of the colon, which leads to disruption of organ function and atrophy of the mucous membrane. Pathological processes involving the inner surface of the intestine form in some areas (segmental colitis) or in all sections (pancolitis).

During colitis, symptoms are expressed presence of abdominal pain, mucus or blood in the stool, false urge to defecate and nausea. Most often, a chronic form of this disease develops, as well as ulcerative nonspecific intestinal colitis of unknown etymology, while the gastric mucosa is prone to ulceration.

In adults, acute colitis often occurs simultaneously with inflammation of the stomach and small intestines. As a rule, the causative agents of this disease are pathogenic microorganisms.

Chronic colitis develops in the presence of infectious foci in the pancreas, gallbladder and other organs that are anatomically connected to the intestines, as well as with the abuse of alcohol and spicy foods, systematic consumption of a significant amount of indigestible foods, and a prolonged monotonous diet.

Risk factors leading to intestinal colitis in adults:

As a rule, exacerbation of colitis is caused by: overwork, consumption of foods that cause allergic reactions (canned food, marinades, cucumbers, cabbage, citrus fruits, etc.) or irritate the colon, taking significant doses of antibacterial agents, overheating, emotional overload.

Classification of the disease

Colitis is distinguished by etiology:

• Infectious - caused by pathogenic microflora, which can be opportunistic (for example, E. coli), common (staphylococci, streptococci) and specific (for example, dysenteric colitis);
• Peptic ulcer is a disease with an unknown etiology, where infections, autoimmune mechanisms and heredity play a role in the process of basic development;
• Radiation - during chronic radiation sickness;
• Medicinal or toxic - in case of poisoning with drugs (for example, NSAIDs) or certain poisons;
• Ischemic - with occlusive infections of the abdominal aortic tract (for example, with atherosclerosis), which supply blood to the large intestine.

Spastic colitis

Typically, spastic colitis is caused by errors made in nutrition, as well as unhealthy lifestyle. Doctors usually call this disease “irritable bowel syndrome,” in which a chronic inflammatory phenomenon is noted in the colon mucosa.

The disease can manifest itself after gastroenteritis, as well as after consuming soda, coffee, poor-quality food, or alcohol for a long time.

Ulcerative colitis

This disease is characterized by a hemorrhagic-purulent process of inflammation of the colon with the development of local or systemic complications. The exact origin and causes of the disease are still unclear.

There are suggestions that the disease may be caused unknown infection, unbalanced diet, genetic mutations, medications, stress and changes in intestinal flora.

Symptoms of the disease

When intestinal colitis develops, symptoms depend on the type of disease that is present, but in general, colitis in adults is most often associated with diarrhea and abdominal pain. Other signs of colitis that may occur:

• Chills.
• Bloating and intermittent or constant abdominal pain.
• Constant urge to defecate.
• Fever.
• Diarrhea.
• Dehydration. Signs of dehydration include weakness, dizziness, dry skin, eyes and mouth, and decreased urination.
• Bloody stool. In some cases, diarrhea causes hemorrhoids, which may bleed.

In some patients, local manifestations are accompanied vomiting and nausea, weakness, weight loss, increased fatigue. Symptoms last for several weeks and disappear with timely treatment. The transition of the disease to the chronic stage is accompanied by the involvement of muscles and ligaments in the process. In this case, abscesses and ulcers form, capillaries enlarge. Patients are concerned about:

• Diarrhea or constipation;
• Pain;
• Strong smell of feces;
• Flatulence;
• Tenesmus.

Patients feel satisfactory, but are concerned about decreased performance, malaise, a feeling of bitterness in the mouth, decreased appetite, nausea and belching.

Diagnosis of the disease

Diagnosis begins with collecting anamnesis. Since the symptoms are usually diarrhea and abdominal pain, the time of onset and duration of these pains, as well as any other symptoms or complaints that the patient has, are determined.

Instrumental diagnostics include:

According to the clinical picture and symptoms of colitis, similar to malignant formations large intestine, therefore a biopsy of suspicious areas of the intestine must be carried out to exclude or determine oncological changes.

Treatment regimen for colitis

During an exacerbation of acute or chronic colitis, treatment must be carried out in a hospital setting in the proctology department; if the infectious etiology of the disease is determined, then in special departments of infectious diseases clinics.

During the onset of symptoms of intestinal colitis in adults treatment is carried out comprehensively, drugs are prescribed that eliminate the cause and consequences of the disease. For any type of colitis, regardless of the cause of development, intestinal adsorbents, the Pevzner diet No. 4 (a, b, c), drugs that restore microflora (probiotics and prebiotics), stimulate regeneration (Methyluracil, etc.), and regulate stool ( antidiarrheal (Loperamide) or laxatives (Guttalax)), immunomodulators and vitamins, detoxification and desensitizing treatment, exercise therapy and mineral waters.

Treatment with traditional methods also depends on the type of colitis. The most common herbal treatment is based on taking infusions of sage, centaury and chamomile. 1 tsp. Each herb must be brewed in 200 ml of water. You need to take one tablespoon at an interval of 2 hours.

Symptoms and treatment of chronic intestinal colitis

Chronic colitis is characterized by sluggish progression of the disease, with periodic exacerbations. Pathological changes in the mucosa that occur in the large intestine with this form of the disease are the result of a long process of inflammation. The inflammatory process affects both the ligamentous-muscular apparatus and the mucous membrane; at the site of the lesion, narrowing and shortening of the intestine occurs.

In chronic colitis, general symptoms can be divided into types, taking into account morphological changes:

All these species have general clinical symptoms:

• Rumbling in the stomach;
• False urges;
• Abdominal pain after eating;
• Bloating (flatulence);
• Diarrhea, constipation;
• Nausea, vomiting;
• Bitterness in the mouth;
• Psycho-emotional discomfort.

These symptoms occur in any nosological form of the disease, but their combination and severity are individual.

Chronic colitis- This is one of the few diseases where the basis of treatment is not medications, but diets and nutrition. For the treatment of chronic colitis, symptomatic medications and antibacterial drugs are used only during an exacerbation, under the strict supervision of a physician. The diet consists of the following:

• During an exacerbation, diet No. 4a is prescribed for 2-5 days.
• Then they switch to basic diet No. 4b.
• During the period of remission, without exacerbation, diet No. 4c is recommended.

Approximate main daily menu of diet No. 4b for chronic colitis, recommended by the Institute of Nutrition of the Russian Academy of Medical Sciences.

• Rice porridge (250 gr.) with butter (5 gr.) and with the addition of 1/3 milk.
• Cup of tea.

• Noodle soup with meat broth.
• Carrot puree (200 gr.), steamed meat cutlets (100 gr.).
• A cup of apple jelly.

• Mashed potatoes (200 gr.).
• Boiled fish (100 gr.).
• “Russian” cheese (30 gr.), savory bun.
• Cup of tea.

Before bed: a cup of tea with dry biscuits (dried biscuit, biscuits, Shkolnoye) or a cup of non-sour kefir with a slice of bread.

To get rid of pathogenic bacteria, Antibiotics may be prescribed, and during the presence of dysbacteriosis - preparations containing the required bacteria for the microflora. Moreover, it should be noted that chronic colitis is usually accompanied by spasms. It is for this reason that during treatment the doctor prescribes antispasmodics. Taking adsorbent drugs is required if stool is disrupted.

A fairly common way to treat this disease is the use of physiotherapeutic procedures. When, for example, an intestinal disorder appears as a result of severe overexertion or a nervous breakdown, the doctor may additionally prescribe psychotherapeutic treatment.

Much more difficult to treat ulcerative colitis of the intestine. More intensive therapy is required, and, accordingly, longer and more expensive. Medicines for the treatment of this type of pathology are not only expensive, but also have many side effects, so they are used strictly as prescribed by a doctor.

They are produced in tablet form (Pentasa, Salofalk, Mesacol, Mezavant), in the form of enemas, and rectal suppositories. Sometimes they resort to the use of biological therapy, such as Remicade (Infliximab), Humir (Adalimumab).

In very severe cases it is possible use of corticosteroids(Hydrocortisone, Methylprednisolone, Prednisolone). The drugs are made in the form of tablets, suppositories, and rectal droppers.

So, as you can see, different types of colitis require a specific approach to treatment. Symptoms of the disease can be different, so making an independent diagnosis and carrying out treatment at home can only bring one harm. If you have signs of this disease, you should consult a doctor.

Intestinal pathologies make up the lion's share of all diseases of the digestive system. In particular, the most widespread. This disease, characterized by inflammation of the mucous layer of the colon, on which areas of necrosis and ulcers form, is characterized by either a chronic recurrent course or a continuous, wavy course. In the first case, after an exacerbation, the patient experiences complete clinical remission, sometimes lasting several years. In the continuous form, there is no need to talk about the patient’s absolute recovery: phases of improvement of the condition are immediately replaced by a worsening of the process.

Typically, the development of ulcerative colitis of the intestine is observed in adults aged 20 to 35 years or after 60. In children, this disease occurs extremely rarely and accounts for only 10-15% of cases of all identified pathologies. At the same time, girls are at greatest risk of developing the disease among adolescents, and in the preschool and primary school period, on the contrary, boys are.

Causes

The true causes leading to the development of ulcerative colitis have not yet been established. However, scientists have identified a number of factors that can provoke this pathology. This:

1. changes in the quantitative relationships and composition of the normal microflora of the digestive tract (intestinal dysbiosis);

2. infections that cause inflammation of the mucous membrane of a tubular organ;

3. autoimmune processes in the body (when the immune system produces antibodies against colon epithelial cells);

4. poor nutrition (high-carbohydrate diet with low dietary fiber content), as well as improper eating patterns combined with a sedentary lifestyle;

5. emotional stress, mental trauma;

6. hypothalamic-pituitary dysfunction;

7. long-term use of certain groups of medications (for example, non-hormonal anti-inflammatory drugs, contraceptives).

Also, experts put forward the theory of genetic predisposition as the cause of ulcerative colitis. If a person in his family suffered from destructive ulcerative inflammation of the large intestine, then his likelihood of this process doubles.

Symptoms and signs

Signs of ulcerative nonspecific colitis can be divided into 2 types: intestinal manifestations, that is, symptoms associated with the digestive tract, and extraintestinal.

Digestive symptoms include the presence in the patient of:

• Diarrhea with bloody or purulent discharge.

This symptom is considered the main diagnostic sign of ulcerative colitis. The frequency of defecation of liquid feces is different: for some it can be 2-3 times a day, for others – 15 or more times, but this number of bowel movements is observed in the most advanced cases. Some patients may experience spontaneous release of blood, pus or mucus against the background of tenesmus - a false urge to defecate. According to medical practice, it is also possible for constipation to appear instead of diarrhea, which indicates a complication of the inflammatory process and damage to the rectum.

• Pain in the projection of the abdomen.

The painful symptom of ulcerative colitis is determined by spasms of the intestinal walls. Its intensity can vary - from weak, barely perceptible sensations to pronounced ones that bring suffering to a person. Typically, the location of pain is the lower abdomen and its left iliac region. But there are situations when a painful attack occurs in the hypogastric zone - the hypogastrium. The act of defecation always contributes to increased pain, since at this moment feces press on the hollow organ.

• Flatulence.

Bloating is caused by dysbiosis or impaired digestion of food in the small intestine. Often this symptom is accompanied by rumbling in the intestines, belching, and a bitter taste.

• Increased body temperature and other signs of intoxication.

Body temperature generally increases to 37.5-38°, but can reach higher levels. Following it, as a rule, other symptoms of poisoning increase: the patient’s tongue becomes covered with a gray coating, dizziness, weakness occurs, and there is no appetite, which further explains the noticeable weight loss.

Extraintestinal manifestations of ulcerative colitis, which are not observed in all, but only in 15-20% of patients, include:

1. joint pain, more often of the nature of arthritis, less often of spondylitis and sacroiliitis;

2. various eye lesions (uveitis, keratitis, conjunctivitis, episcleritis, choroiditis);

3. rashes on the mucous membrane of the oropharynx (formation of small aphthalmic ulcerations that can merge, forming extensive necrotic ulcers);

4. damage to the skin in the form of gangrenous pyoderma or erythema nodosum (this symptom appears due to increased accumulation of cryoproteins and antigen-antibody immune complexes in the blood);

5. damage to the pulmonary system, as well as bile ducts, liver, pancreas due to endocrine disruption.

Since the inflammatory process in the intestine, accompanied by damage to its tissues, has an acute phase and a period of remission, the symptoms of ulcerative colitis are also characterized by a wave-like course. As the disease worsens, the symptoms are most pronounced, then, due to proper treatment, they weaken and subside. Continuous maintenance therapy is the key to long-term remission.

Diagnostics

Ulcerative nonspecific colitis is detected either by chance, when a person undergoes a medical examination or examination for another disease, or is diagnosed based on complaints. Patients go to the hospital at a time of exacerbation of the pathology, that is, when swelling and hyperemia appear on the walls of the large intestine, ulcers and intestinal bleeding occur.

Diagnosis in this case begins with an analysis of anamnestic information, where data regarding hereditary predisposition to the disease and clinical examination play an important role. Usually, based on the symptoms of the disease, doctors guess about the development of ulcerative colitis, but in order to differentiate it from other pathologies with a similar course, they prescribe additional studies:

• colonoscopy;
• barium radiography;
• coptogram (examination of stool for occult blood);
• sigmoidoscopy (the best way to perform a biopsy for the purpose of histological analysis of a mucosal biopsy);
• general blood test (leukocytosis, anemia confirm the presence of inflammation in the body);
• immunological blood test (an increase in the concentration of cytoplasmic antibodies also indicates the presence of the disease).

Use of medications

There is no etiological treatment for ulcerative colitis, that is, one that can influence its cause. Therefore, therapy in this case is symptomatic and supportive in nature: with the elimination of the inflammatory process, unpleasant symptoms disappear; after the period of exacerbation ends and remission is achieved, relapse and complications are prevented.

The following treatment methods are available:

1. taking non-steroidal anti-inflammatory drugs, for example, Salofalk, Dipentum, Sulfasalazine;

2. use of corticosteroids (Metyprednisolone, Prednisolone);

3. antibacterial therapy through the use of drugs such as Tienama, Cifran, Ciprofloxacin, Ceftriaxone;

4. taking immunomodulators (Azathioprine, Cyclosporine, Infliximab, Methotrexate);

5. consumption of calcium and vitamins A, C, K.

In severe forms and complications that threaten the patient's life, conservative treatment methods are of little or no effect, therefore, in such situations, surgical intervention is indicated. Also, surgery can be prescribed for patients who have suffered many relapses that are not amenable to drug therapy.

It is possible to treat ulcerative intestinal colitis surgically today in the following ways:

• through partial or total colectomy - excision of the colon;
• using proctocolectomy - removal of the colon and rectum leaving the anus;
• through a proctocolectomy and a temporary or permanent ileostomy, through which natural waste is removed from the body.

Therapy for children

Ulcerative colitis should be treated in a child with diet. Basically, the diet involves dairy-free table No. 4 (according to Pevzner). Saturation of the body with protein is achieved through the consumption of eggs, fish and meat products.

The basic drug treatment is Sulfasalazine and 5-aminosalicylic acid drugs, for example Mesalazine. They are administered to children in the form of enemas or rectal suppositories, as well as in the classical way, like adults, through the mouth. If such therapy is ineffective, or ulcerative colitis of the intestine is severe, glucocorticoids and immunosuppressants are added to treatment.

The diet for nonspecific ulcerative colitis is determined individually. If the disease is accompanied by diarrhea, doctors advise the patient to reduce the amount of fluid consumed and eat much more often than usual - every 2 hours. If a patient suffers from constipation, then he should add more fiber to his diet.

General rules include:

1. eating only moderately warm food prepared by boiling or steaming;

2. exclusion from the menu of dairy products, spices, fatty foods, mushrooms, raw vegetables, industrial sweets, from fruits - plums and kiwi, from drinks - coffee, soda, alcohol;

3. variety of diet with such foods as walnuts, eggs, mucous porridge, lean meat and fish, berries, pears; weak tea, orange and tomato juices are used as drinks.

It is better to eat in small portions, but more often, since heavy meals can lead to indigestion and pressure on the intestines, which is why the signs of pathology can increase their severity, especially during an exacerbation.

Prognosis and prevention

Modern methods of treating colitis are effective in 80-85% of patients with moderate and mild illness. Most of them manage to achieve absolute remission. In advanced situations, hemorrhagic-purulent or ulcerative-destructive inflammation of the large intestine can become complicated:

• rupture of the intestinal wall;
• bleeding from ulcers;
• narrowing of the lumen of a tubular organ;
• development of abscesses;
• degeneration into colorectal cancer (about the symptoms of intestinal cancer - in).

Cancer, perforation with peritonitis can lead to death for the patient; the only hope is surgical intervention. It is worth noting that even a successful operation does not guarantee that the patient will return to their previous quality of life.

It is very difficult to predict when its exacerbation will occur, so experts always recommend:

1. avoid mental discomfort;

2. follow a diet based on reducing trans fats, solid, hydrogenated oils in the diet;

3. avoid uncontrolled use of antibiotics;

4. monitor food tolerance, especially gluten, starch, milk;

5. undergo medical examinations and treat diseases in a timely manner;

6. lead an active lifestyle.

Nonspecific ulcerative colitis (UC) or simply ulcerative colitis is a disease that affects the lining of the large intestine. The affected area can vary from the distal rectum (proctitis) to the entire length of the large intestine. The disease is expressed in systematic inflammation of the mucous membrane of the large intestine.

The fact is that UC has not been fully studied. Gastroenterologists and proctologists still do not know for sure why the mucous membrane of the large intestine suddenly begins to become inflamed. Therefore, the exact and specific causes of this sore have not yet been identified. The most common opinion among doctors is that there is a genetic factor. However, it is not known exactly which gene, or group of genes, is responsible for the manifestation of ulcerative colitis. The genetic marker for this disease is unclear.

Genetic predisposition forms the background, but other factors can provoke the acute course of the disease. This:

• alcohol abuse,
• increased consumption of highly spicy foods (black and red peppers, raw garlic, raw onions, horseradish, radish),
• constant stress,
• intestinal infectious diseases (dysentery, serous infections),
• systematic eating disorders (dry food, fast food).

All these factors can only trigger the inflammatory process, and in the future it will increase due to the congenital tendency to UC. Ulcerative colitis is a fairly rare disease. According to statistics, less than 100 people out of 100 thousand suffer from it, i.e. this is less than 0.1%. UC most often occurs in young people aged 20 to 40 years. Both men and women get sick.

Symptoms and diagnosis of UC

Nonspecific ulcerative colitis manifests itself differently in different people, i.e. sometimes the entire symptomatic picture can be observed, and sometimes only one or two symptoms. Moreover, these are the symptoms that occur in other diseases of the large intestine. The most common symptom is bleeding before, during, or after bowel movements.

Blood may also be passed in the stool. The color of the blood and its quantity vary. There may be scarlet blood, dark blood and blood clots, since wounds can occur in any part of the colon - even in the distal sections (scarlet blood), or higher (dark blood and blood clots).

Wounds appear mainly due to the fact that the inflamed mucous membrane is easily injured by passing feces. Another common symptom is mucus production. A very unpleasant phenomenon, since during exacerbations, mucus accumulates in the large intestine literally every two hours, which necessitates frequent visits to the toilet. By the way, bowel problems (constipation, diarrhea) and increased flatulence are also included in the list of UC symptoms.

Another symptom is pain in the abdomen, especially in the left part of the peritoneum and in the left hypochondrium. Inflammation of the mucous membrane leads to weakening of colon peristalsis. As a result, even with normal stools, the patient can go to the toilet 3-4 times a day.

Usually, nonspecific ulcerative colitis is treated on an outpatient basis, but in particularly severe cases, hospitalization becomes necessary. In such cases, the temperature rises to 39 degrees, and debilitating bloody diarrhea appears. But this happens extremely rarely. Finally, another possible symptom is joint pain. Almost always, not all, but one or two symptoms are present.

For this reason, today UC can only be diagnosed using a colonoscopy procedure. This is the introduction through the anus of a flexible endoscope with a camera and manipulators for taking samples (as well as for removing polyps). Such an endoscope can be passed along the entire length of the large intestine, examining in detail the condition of the mucous membrane.

Treatment of nonspecific ulcerative colitis: drugs

Currently, the only medicine against ulcerative colitis is 5-aminosalicylic acid (mesalazine). This substance has anti-inflammatory and antimicrobial effects. The bad news is that all these medications are quite expensive.

Sulfazalin

The oldest, ineffective and cheapest is sulfasalazine. Its price is on average 300 rubles per package of 50 tablets of 500 mg each.

This pack usually lasts for two weeks. Due to the fact that in addition to mesalazine it contains sulfapyridine, the drug has a number of side effects. Sulfapyridine tends to accumulate in the blood plasma, causing weakness, drowsiness, malaise, dizziness, headache, and nausea. With long-term use, intermittent oligospermia and diffuse changes in the liver are possible.

Salofalk

Salofalk, which consists only of mesalazine, is much more effective and less harmful. The most important thing is that this drug delivers mesalazine to the colon mucosa of better quality. Actually, in all drugs against UC, the main problem is the delivery of the drug, because the active substance itself is the same everywhere. Salofalk is produced in Switzerland and imported by the German company Dr. Falk.

The drug is available in the form of rectal suppositories and tablets. Treatment and prevention must be carried out comprehensively, i.e. and suppositories and tablets. The optimal daily dose for the treatment of exacerbations: one 500 mg suppository or 2 250 mg suppositories, 3-4 tablets of 500 mg each. The average cost of one pack of 500 mg suppositories (10 suppositories) is 800 rubles. Packs of tablets (50 tablets of 500 mg) – 2000 rubles.

Mezavant

The latest development is the drug mezavant. Available in the form of tablets of 1200 mg each. The technology for delivering mesalazine is such that the tablet, once it enters the large intestine, begins to gradually dissolve, distributing the active substance evenly along the entire length of the intestine.

The course of treatment for UC is determined individually, but in general this disease requires constant supportive, preventive therapy. Sometimes hormonal drugs (for example, methylprednisolone) may be prescribed. They do not directly treat UC, but make mesalazine more effective. However, hormones have a lot of extremely negative side effects.

Diet for illness

You also need to follow a certain diet:

In general, there is nothing particularly terrible about this disease. It is quite treatable, but requires constant courses of preventive therapy and adherence to the non-strict diet described above. But you can't run it. The most common outcome of UC: gradual degeneration of the mucous membrane down to the submucosal and muscular layer. As a result, the intestines become more sluggish.

UC contributes to the occurrence of other diseases of the colon and rectum. . And do not forget that ulcerative colitis is an inflammatory disease, which means there is always a risk of neoplasms. And remember that UC will not go away on its own. He needs to be treated.