Chronic colitis is the inflammatory process affecting a mucous membrane of a thick gut, which is followed by "intestinal" symptoms (diarrhea, a meteorizm, rumbling, locks, a pain syndrome). For diagnosis of a disease use the koprologichesky analysis, a radiological and endoscopic research of a large intestine (an irrigoskopiya, a kolonoskopiya). The principles of treatment of chronic colitis are based on observance of a diet, use of the anti-inflammatory, spazmolitichesky and anesthetizing medicines. An important element in complex treatment of a chronic form of colitis are physiotherapeutic procedures.
Chronic colitis – the most often found form of inflammatory defeat of mucous, submucous and muscular layers of a large intestine which is followed by sekretorny and motor violations. The course of pathology has wavy character with alternation of aggravations and remissions. Quite often this pathology is combined with development of inflammatory processes in other bodies of digestive tract. According to statistical data, chronic colitis is diagnosed for 50% of the people having problems with digestive organs. At women the disease develops aged from 20 up to 65 years, at men a bit later - in 40–65 years. Decrease in immunity, dysbacteriosis, a lack of vegetable cellulose of a daily diet or inflammatory gastrointestinal diseases contributes to colitis.
Reasons of chronic colitis
The reasons which can initiate development of a chronic form of colitis are various. Can act as the factors promoting developing of a disease violation of a diet, hypo - and avitaminosis, the use of alcoholic beverages and narcotic medicines. The leading position among the main reasons for pathology is taken by the postponed earlier sharp intestinal infections (salmonellosis, a food toksikoinfektion or dysentery). Besides bacteria, mushrooms or protozoa can serve development of inflammatory process (lyambliya, balantidiya). Lead to the inflammatory and dystrophic processes promoting malfunction of body and severe forms it is long the current intoxications (including alcoholism).
Not the last place in development of a chronic form of colitis is taken by harmful effects of habits of the person: so, intake of nicotine with cigarette smoke promotes deterioration in blood supply of a wall of a large intestine, decrease in immunity, and, as a result, penetration into a mucous membrane of pathogenic microflora. Medicinal colitis is, as a rule, connected with long and uncontrolled reception of depletive, antibiotics or nonsteroid anti-inflammatory medicines. The allergy, both food, and medicinal, chemical or even congenital sensitivity of an organism to some species of bacteria can become one of the reasons.
Violation of fermental exchange – one more factor which action can lead to irritation of mucous. At excessive use of rectal candles and enemas the risk of development of a chronic form of colitis also increases. As a result of violation of blood circulation of a large intestine ischemic colitis develops.
Allocate three main links of pathogenesis of a chronic form of colitis: intestinal dysbacteriosis, immunodeficiency and intestines dyskinesia. At dysbacteriosis the total of the pathogens influencing directly a wall of a large intestine and the heavy inflammatory processes leading to development increases further. The immunodeficiency at a chronic form of colitis is shown in the form of decrease in fagotsitarny activity of leukocytes. Dyskinesia of intestines cause the main clinical symptoms – a pain syndrome and frustration of a chair.
Depending on the reason of development and the nature of morphological changes, chronic colitis subdivides into the following forms: catarrhal colitis, atrophic colitis, ulcer colitis, erosive colitis and the mixed colitis.
Symptoms of chronic colitis
The pain syndrome in the form of the aching and dull aches which are localized in any of the departments of a stomach having as skhvatkoobrazny, and poured character is characteristic of chronic colitis. Violation of a chair, rumbling, a meteorizm, painful tenezma or dispepsichesky frustration are a number of the specific symptoms characteristic only of the pathological processes affecting a GIT. As the distinctive symptom of chronic colitis allowing to differentiate it from other pathologies serves strengthening of pain at once after meal, cleaning enemas, tension of an abdominal tension and simplification after depletion of intestines, an otkhozhdeniye of the accumulated gases or application of spazmolitik. Quite often at this pathology process of defecation happens on 6-7 times a day to release of slime or a blood streak. During a palpation of abdominal organs the pain syndrome is determined by the course of a thick gut.
Proktit and proktosigmoidit - it is common forms of chronic colitis which arise owing to chronic locks, regular mechanical irritations of a mucous membrane and bacterial diskineziya. These forms of a disease are followed by existence of the pain syndrome which is localized in podvzdoshny area, the expressed meteorizm, a general malaise, nausea and often slight increase of body temperature. At an aggravation of pathological process specific false desires to the act of defecation, an exit of the accumulated gases and kalovy masses in a look "sheep a calla", covered with slime and streaks of blood allocations are noted. At a palpation pain is localized in the field of a sigmovidny gut.
Besides specific symptoms, chronic colitis is followed by a general malaise, dizziness, decrease in working capacity, weakness, loss of body weight, an asteno-neurotic syndrome. The psychological status of the patient is also violated: it is shown in the form of characteristic feeling of alarm, inexplicable panic, excessive irritability and concern, violation of the mode of a dream and wakefulness.
Mark out three severity of chronic colitis. At easy degree "intestinal" symptoms are almost not expressed, at the same time the general condition of the patient satisfactory; painful feelings are noted at a palpation only of some departments of intestines. Average extent of pathological process is clinically expressed more brightly. Essential manifestation of "intestinal" simptomokompleks, decrease in body weight, rumbling, swelling, splash in the field of a blind gut is characteristic of this degree; palpatorno morbidity is noted in any of departments of a large intestine.
Heavy degree is characterized significantly by the expressed signs demonstrating involvement in inflammatory process of other bodies of digestive tract. This state in the form of the expressed swelling, a syndrome of malabsorption, frequent ponos is shown; at a palpation morbidity is poured on all stomach, most focused in okolopupochny area. Adhesive process, narrowing of a gleam of a gut, perforation of ulcers or the local necrosis leading to peritonitis, intestinal bleedings belong to complications of chronic colitis.
Diagnosis of chronic colitis
For confirmation of the estimated diagnosis laboratory and tool researches are carried out. In the general blood test slight increase of SOE, and , as a rule, comes to light. The Koprologichesky analysis the calla (koprogramma) allows to carry out microscopy of the received material and its chemical analysis with determination of amount of cellulose, protein, fat, starch, organic acids and ammonia.
By means of a kolonoskopiya the center of inflammatory process, existence of erosion, atrophic changes owing to the long course of pathological process is found, expressiveness of the vascular drawing is estimated. In the course of an irrigoskopiya at a chronic form of colitis it is possible to reveal changes of a relief of a mucous membrane, an atoniya, an asymmetric gaustration, violation of a vermicular movement.
For verification of the diagnosis it is necessary to exclude all diseases which are followed by similar symptoms (a colon cancer, a disease Krone, chronic appendicitis or enteritis). At the second stage of diagnostics differentiation is carried out with such diseases as , chronic dysentery, diseases of a liver and a pancreas and other pathological processes affecting digestive organs.
Treatment of chronic colitis
The actions directed to treatment of chronic colitis in aggravation stages have to include therapy which purpose - elimination of an initial cause of illness, normalization of work of intestines and reactivity of an organism. For treatment hospitalization in office of a proktologiya is shown.
In the period of an aggravation to patients the diet No. 4a which part the meat and fish dishes steamed white loaf, broths on the basis of low-fat types of meat, boiled eggs, broths from a dogrose, green tea and cocoa on water are is appointed. Portions should not exceed 200-300 g. In process of elimination of inflammatory process of patients transfer to a diet No. 4b to which soups with different types of grain, pasta, vegetable baked pudding, the baked apples, cheese, porridges on milk, butter are added. In a stage of remission reception of even less sparing diet - No. 4v is allowed.
At a diarrhea recommend to use the knitting and enveloping means – bismuth nitrate, a calcium carbonate, alum, copper sulfate, herbs tinctures which part tannins are. Spazmolitichesky means are appointed at a spastic form of colitis. At a proktosigmoidita microenemas on the basis of camomile broth which works as the means eliminating the inflammation center are shown. At a proktita recommend to use astringents in candles – zinc an oxide or .
At the expressed abdominal distension absorbent carbon, white clay, , peppermint tincture is appointed. At diarrhea of various etiology apply loperamide.
One of important places in complex treatment of a chronic form of colitis is occupied by physical therapy. Experts recommend to complete an electrophoresis course with application of antibiotics, sulfate of zinc or calcium. At hypomotor colitis appoint diadynamic currents and an amplipulsterapiya. In the period of an exacerbation of a disease it is the best of all to use the warming compresses or hot-water bottles, the period of remission has to be followed by application of thermal bathtubs, parafinoterapiya or mud cures.
Forecast and prevention of chronic colitis
Preventive actions are based on the prevention of development of a sharp form of a disease; purpose of the treatment directed to elimination of the etiologichesky factors promoting developing of pathology; balanced food, observance of elementary rules of personal hygiene. Timely assistance to patients with a sharp stage of colitis and often becoming aggravated chronic form are also one of stages of prevention of a disease. At observance of all recommendations of specialists proctologists the period of remission remains for a long time.