Causes and symptoms of acute and chronic intestinal colitis
- What is intestinal colitis?
- Intestinal colitis symptoms
- Intestinal colitis causes
- Forms of intestinal colitis
- Types of intestinal colitis
- Consequences of intestinal colitis
- Differential diagnosis
- How to treat intestinal colitis?
What is intestinal colitis?
Colitis is an acute or chronic inflammatory process occurring in the large intestine, which occurs due to toxic, ischemic or infectious organ damage.
In the minds of the average layman without special medical knowledge, colitis is associated with intestinal colic. However, these two conditions are far from the same. Intestinal colic is an uncomfortable, paroxysmal pain sensation in the lower abdomen. Colic is just a symptom that characterizes a huge number of diseases and pathologies, from banal flatulence to oncological processes.
Colitis, in turn, is an independent disease characterized by its own etiology, symptoms and characteristics of the course.
To better understand what this pathology is, it is necessary to turn to the basics of the anatomy of the gastrointestinal tract.
The intestine is divided into two sections: the large intestine and the small intestine. Each has its own digestive function. The thin section begins immediately after the stomach and the main digestive processes take place in it (including the final processing of food, the release of nutrients and their transport into the bloodstream through the walls of the organ).
The small intestine is separated from the large intestine by a mucous membrane. Thanks to it, waste products and microorganisms from the large intestine do not enter the previous section. In the large intestine, the final processing of food and the absorption of fluid takes place. Not the least role in this process is played by special bacteria (in the large intestine, their volume reaches about 1.5 kg or even more).
In addition to the “good” bacteria (which help to process food residues), the colon is also home to pathogenic organisms. In the course of their vital activity, these microorganisms produce a huge amount of active substances with high toxic potential. If, as a result of the consumption of poor-quality food or for other reasons, the concentration of pathogenic microflora in the organ increases, the colon mucosa becomes inflamed. This is how the immune response manifests itself in order to prevent the penetration of toxins into the bloodstream. Colitis develops.
In some cases, pathogenic microflora can penetrate the small intestine, in which case an even more severe form of pathology develops - enterocolitis. It should be noted that if a conditionally useful microflora enters the small intestine, enterocolitis will not develop and everything will be limited to uncomfortable sensations and bloating.
The etiology of colitis is not limited to infection. Some medications have the same effect (side effect); colitis can also accompany some other pathological processes.
Intestinal colitis symptoms
The first signs of acute and chronic colitis differ significantly in the intensity and degree of increase in symptoms.
Acute colitis symptoms
Colitis in the acute phase is characterized by a rapid increase in manifestations and their high intensity. However, this is not an axiom, and much depends on the individual characteristics of the patient's body (in particular, the characteristics of the immune system). In some patients, the symptoms appear brightly, the disease is difficult. Others have minor discomfort, and the pathology is characterized by a sluggish course.
In addition to the characteristics of the immune system, important factors are: the patient's age, the degree of toxic, infectious or ischemic intestinal lesions, the presence of other concomitant pathologies.
Among the symptoms, the following are most characteristic:
Discomfort and pain. Often accompany the disease, aggravated after therapeutic procedures (enemas), food intake, mechanical impact (for example, shaking in transport), walking or running.
- Stool upset and instability. This manifestation cannot be called basic or characteristic only of intestinal colitis. Diarrhea and constipation, as well as their alternation, characterize most gastrointestinal disorders, from cholecystitis to botulinum toxin poisoning. The main difference between stools with colitis is the presence of colorless or greenish mucous veins or blood impurities in it.
False urge to defecate (so-called tenesmus). They are characteristic not only for colitis, but also for a number of other diseases, such as, for example, proctosigmoiditis (inflammation of the sigmoid and small intestine) or proctitis. Discharge scanty, slimy. With the development of colitis in the colon - the urge is relatively rare, the patients are disturbed no more than 2-3 times a day. However, if the process is localized in the rectum or the sigmoid colon, the urge is more painful, often occurs at night and ends in a small amount of excreted feces (like "sheep feces") with copious impurities of blood, mucus, pus.
- Heaviness in the abdomen.
Chronic colitis symptoms
If the treatment was started late, or carried out incorrectly, the disease can subside, becoming a chronic form.
Exacerbations can occur up to several times a year. Symptoms are similar to those of acute colitis. Even at the stage of remission, sluggish manifestations are observed in 35-40% of cases.
- Flatulence (increased gas production).
- Stool problems. In 80% of cases, we are talking about severe spastic constipation, which is associated with a lack of "useful" microflora and a violation of intestinal motility.
- Rumbling in the abdomen, which occurs several hours after eating.
- Mild abdominal pain after exercise or stress.
- - Skin rash caused by toxic damage to the body due to impaired excretion of feces.
- Weakness, headaches, nausea.
The symptomatology increases during periods of exacerbation.
Ulcerative colitis symptoms
Ulcerative colitis is a particular case of intestinal colitis. Its main difference is the presence of ulcerative defects on the walls of the mucous membranes (up to perforation), which causes a much more severe course of pathology. Ulcerative colitis is characterized by special symptoms.
- Frequent false urge to defecate. At the beginning of the process - scanty diarrhea (up to 15-20 times a day), the inability to hold a chair. The symptom is observed in more than half of patients (55-60%).
- Foreign matter in the stool. Blood, greenish mucus, streaks of pus. Discharge of blood ranges from negligible (found only on toilet paper) to profuse, visible to the naked eye in the stool.
- Sudden constipation, indicating inflammation of the small intestine. It occurs in about a quarter of patients.
- Manifestations of intoxication of the body. The manifestations are similar to ARVI. In severe lesions, there is an increased heartbeat (tachycardia), general weakness, fever, nausea, vomiting, and decreased appetite. Diarrhea can also lead to dehydration.
- In some cases, symptoms not associated with gastrointestinal lesions may develop. Visual impairment, skin rash, itching of the mucous membranes, blood clots, joint pain. In addition, the liver and gallbladder may suffer.
Pain with intestinal colitis
Pain sensations with colitis of the colon are aching or dull in nature. Sometimes patients complain of bursting pain. Unpleasant sensations can be persistent and excruciating, but most often the pain is manifested in periods (cramping).
The location of pain differs from case to case. Often it is impossible to determine the localization, the pain spreads throughout the abdomen or wanders. In the initial period, discomfort occurs in the lower left abdomen.
The pain radiates to the back, sacrum, left side of the chest. For this reason, the patient is often unable to independently determine the source of pain, mistaking colitis for problems with the spine or heart.
After taking drugs (antispasmodic, anticholinergic), discharge of intestinal gases, defecation, warming of the affected area, the pain subsides, but after a certain period of time they return again. In some patients, the passage of gases, on the contrary, leads to increased pain.
Intestinal colitis causes
At the moment, the causes of intestinal colitis are not fully understood. Numerous scientific studies are being conducted, but scientists still have not come to a consensus. Despite this, there are a number of provoking factors. They act as triggers initiating the onset of the pathological process.
- Infectious lesions of the body. It is quite a trivial situation when a person consumes low-quality expired food. Food poisoning is caused by pathogenic microflora, which actively multiplies in the intestines. In addition, under other conditions, a person can become a carrier of intestinal infection, cholera vibrio, dysentery amoeba, salmonella, and other infectious agents. Such agents can be bacteria of tuberculosis, shigellosis.
In all cases, pathogenic microorganisms release toxins that irritate the intestinal wall and cause specific symptoms. Despite the origin of the disease in this case, colitis caused by infection is considered to be non-contagious.
Eating disorders (alimentary causes of colitis). At the household level, colitis caused by eating disorders is called "indigestion." Alimentary colitis is caused by excessive consumption of fast food, irregular diet, alcohol abuse, lack of fiber consumed, insufficient consumption of "healthy" food (vegetables, fruits, natural meat products), etc.
- Genetic factors. Certain genetic mutations can lead to congenital bowel disorders.
- The presence of concomitant pathologies. Cholecystitis, hepatitis, pancreatitis, various forms of gastritis contribute to the disruption of the intestines and the development of colitis. The same effect is produced by a decrease in immunity and a weakening of the body after viral diseases.
- Taking medications. Many drugs negatively affect the intestinal microflora and reduce intestinal motility. Antibiotics, anti-inflammatory drugs, aminoglycoside drugs, laxatives, contraceptive drugs, etc.
- Toxic poisoning. They can be both exogenous (poisoning with mercury salts, phosphorus, arsenic) and endogenous (for example, poisoning with urate salts with gouty lesions).
- Allergic reaction. Food and other forms of allergy contribute to bowel disruption.
- Mechanical impact. Abuse of cleansing enemas or suppositories leads to intestinal disruption due to constant irritation of the intestinal mucosa.
Forms of intestinal colitis
Acute intestinal colitis
The acute form of intestinal colitis is caused by one of the above reasons and proceeds in most cases rapidly with a gradual increase in characteristic symptoms.
Most often, acute colitis is provoked by food poisoning, an allergic reaction (as a result of which the mast cells-basophils are destroyed and histamine is released in large quantities, which violates the integrity of the cells of the intestinal mucosa, as a result of which the intestines are irritated) or excessive intake of certain medications.
The disease begins with the development of hyperthermia (the temperature rises to 37.2-38.1 degrees). The patient experiences weakness, followed by fever, cramping pains and abdominal cramps. The large intestine is painful along its entire length and, when pressed, responds with a dull pain.
The urge to defecate is frequent, accompanied by scanty mucus or a small amount of liquid feces.
Painful attacks are accompanied by sweating, dizziness, pallor of the skin. There is a picture of the body's intoxication.
In addition to specific symptoms, general phenomena on the part of the body are also observed.
- A sharp drop in body weight by 2-6 kg.
- Periodic increase in body temperature.
- Sleepiness and fatigue.
- nausea, vomiting.
These phenomena can persist for a rather long period after acute colitis (up to 10-25 days).
If adequate treatment of the pathology has not been carried out from the very first days, colitis can become chronic with periodic relapses. With the transition of the disease to a different form, the symptoms also subside and disappear by themselves.
Chronic intestinal colitis
Gastroenterologists agree that the main cause of intestinal colitis is a violation of the diet. Therefore, among people aged 25 to 40 years, colitis is much more common than one might think.
In some cases, colitis, caused by:
- Complications of previous infectious diseases of the intestine (salmonellosis, cholera, intestinal flu, etc.);
- Prolonged exposure to the body of salts of heavy metals and toxic non-metals (typical for people working at hazardous industrial enterprises);
- Dysbacteriosis, as a result of which the concentration of beneficial microflora and intestinal motility is disturbed;
- Enzymatic deficiency as a result of diseases of the gallbladder, pancreas and stomach.
However, malnutrition remains the primary cause. Lack of fiber in the diet leads to a decrease in mucus secretion and disruption of the normal evacuation of feces from the colon. Stool stagnation in the intestines leads to irritation and inflammation of the mucous membrane.
An incorrect diet plays a significant role in the development of colitis (therefore, women are additionally a special risk group).
The chronic form is not necessarily preceded by a pronounced acute phase. A situation is possible in which one single symptom of an acute form will be observed, and then very sluggish. In other cases, there may be no symptoms at all, then the pathology proceeds in the reverse order.
A bright and severe course of chronic colitis is possible only at an advanced stage.
The first symptoms that you should immediately pay attention to:
- Dry mouth;
- Stool disorders;
- Constant thirst;
- Lack of appetite.
If the necessary treatment is not carried out, the disease will form completely, and the manifestations will subside.
Chronic intestinal colitis does not appear suddenly and out of nowhere. For the disease to manifest itself "in all its glory" you need a trigger, a trigger. This trigger can be food poisoning, infection, trauma, allergy attacks, etc.
Only in 10-12% of the total number of patients, after the development of the trigger, colitis does not appear, but subsides and gradually spontaneously heals, in other cases this unpleasant pathology becomes a lifelong companion of a person.
During periods of exacerbation, there is a picture of an acute form of pathology, however, as mentioned, specific symptoms (albeit in a weakened form) accompany the patient even during remission.
Types of intestinal colitis
- Ulcerative colitis of the intestine
- Spastic intestinal colitis
- Intestinal catarrhal colitis
- Atrophic intestinal colitis
- Erosive intestinal colitis
- Diffuse intestinal colitis
Ulcerative colitis of the intestine
Ulcerative colitis of the intestine is an inflammation of the mucous membrane of the large intestine, accompanied by ulceration of its surface, edema and degenerative changes in the epithelium of the membrane.
The high-risk group includes young people aged 20 to 40, as well as older people (after 50-55).
The pathological process is characterized by ulceration of the walls of the large intestine throughout the organ.
The etiology of this type of colitis is not fully understood, at the moment a number of theories are being put forward:
- Infectious. It is based on the fact that ulcerative colitis of the intestine is caused by a virus or bacteria. The exact strain, however, is unknown.
- Genetic. It says that ulcerative colitis is an autoimmune disease in which cells secrete antibodies that destroy epithelial cells of the intestinal mucosa (similar to how antibodies produced against iodine-containing substances destroy thyroid cells in thyroid gland with Hashimoto's autoimmune thyroiditis)
- Hereditary. According to this theory, ulcerative colitis is inherited and caused by aggressive environmental factors affecting the parents.
The disease is caused by the following triggers:
- Hypodynamia (inactivity);
- A diet rich in carbohydrates;
- Lack of fiber in the diet;
- The disease occurs in three main forms: mild, moderate and severe.
- With a mild degree of damage, the intestinal wall does not undergo serious ulceration. The disease practically does not make itself felt, except for small streaks of mucus and blood in the stool. Colitis-specific symptoms may not be present at all.
The average degree of the pathology is characterized by an increase in body temperature (up to a maximum of 38.1), cramping pain and general malaise. The urge to defecate occurs 4-6 times a day, mainly at night.
A severe degree occurs at a high temperature (over 38.1) against the background of disorders of the cardiovascular system (tachycardia). There is a pallor of the skin, uneven breathing. Abdominal pains are severe, cramping. Desire at least 7-10 times a day. Pain is especially pronounced just before the act.
In especially severe cases, intestinal perforation may develop, followed by sepsis, peritonitis and massive bleeding.
Spastic intestinal colitis
Spastic colitis differs from other types of this pathology by a significantly reduced function of the colon due to insufficient peristalsis. Unlike ulcerative colitis, spastic colitis is not considered a severe pathology and rather refers to a disorder of bowel function.
Normally, acts of defecation occur with a certain frequency. For some, once a day is considered the norm, for others - once a week. In spastic colitis, persistent constipation is the main symptom. The severity of the course of the disease is still purely individual and in two patients the symptoms will be completely different.
Symptoms are generally similar to other forms and include:
- heaviness in the abdomen, bloating;
- aching pain in the left side or lower left;
- A sharp alternation of constipation and diarrhea with a predominance of the latter;
- Constipation persists most of the time;
- increased gas production.
Spastic intestinal colitis is easier, because the condition of the patients can be described as satisfactory.
On palpation of the colon, as well as during ultrasound diagnostics, spasmodic areas of the colon are clearly visible. This type of disease is characterized by changes in the intestines. In some areas, it is excessively expanded, in others, on the contrary, it is narrowed.
Long-term illness causes gradual atrophic changes in the smooth muscles of the colon, caused by a decrease in work. Intestinal tone falls, along the entire length of the organ, mucus secretion and swelling are observed. These signs are found during sigmoidoscopy. If degenerative or atrophic processes are found, a more thorough diagnosis is needed, since in this case the intestinal walls become dry and begin to crack. Cracks can be mistaken for ulcerative colitis.
For this reason, it is important to take into account the complex of symptoms and factors in conjunction with the data of instrumental diagnostics for an accurate diagnosis.
Intestinal catarrhal colitis
Catarrhal colitis is rather not an independent type of this pathology, but a stage in its development. Catarrhal colitis is the initial stage in the formation of a pathological process. In terms of duration, the catarrhal type proceeds in 2-3 days for a period and is distinguished by pronounced symptoms.
In addition, catarrhal colitis may not be the beginning of the disease, but just a manifestation (for example, food poisoning) which, with proper treatment, will come to naught and will not become chronic.
Symptoms of this type of colitis:
- Gradual inflammation of the intestinal mucosa causes increased discomfort in the iliac region, in the lower left abdomen, or in the pubic region.
- The inflamed intestine increases in size, and therefore the patient feels severe heaviness and bloating.
- A large amount of bloody discharge is found in the stool, which indicates the process of mucosal degeneration.
- The damaged areas are subject to necrosis, therefore, even after the end of the acute phase of intestinal dysfunction, as well as pain sensations will persist.
For catarrhal colitis, like any other type, general manifestations are characteristic, such as symptoms of intoxication (weakness, headache, irritability and fatigue, drowsiness, etc.), constipation or diarrhea, frequent tenesmus, pain, etc.
Catarrhal colitis is easy to detect even by a non-specialist without medical training, therefore, special diagnostic manipulations, in addition to collecting anamnesis, are not required to make a general diagnosis. You should carefully consider the treatment of the catarrhal type of pathology, since it is prone to rapid progression and after 8-10 days it turns into the fibrinous type, and after another week and a half it can begin to turn into the ulcerative type.
Atrophic intestinal colitis
Atrophic colitis often goes hand in hand with spastic colitis and develops at a later stage. The essence of the pathological process is atrophy of the smooth muscles of the colon due to a long stagnant process. An important point should be noted. While other types of intestinal colitis affect both the large and small intestines, atrophic colitis is characteristic only of the large intestine.
Often, gastritis is diagnosed along with atrophic colitis, but it is not known if there is a causal relationship between these diseases.
Symptoms are similar to other types and do not have any special manifestations. Over time, atrophic colitis can turn into an ulcerative form, since the mucous membrane of the large intestine becomes thinner over time, and the number of pathological microorganisms in the organ does not decrease, which can lead to rapid degeneration of epithelial tissue. In especially advanced cases, everything can result in colon perforation and severe complications, such as sepsis or severe bleeding.
The complexity of this disease lies in the complexity of diagnostic measures. Only a competent and attentive specialist doctor is able to correctly differentiate the diagnosis.
Erosive intestinal colitis
Erosive colitis is not always identified by specialists as a separate type. It would be more correct to speak of this type as the initial stage of development of ulcerative colitis. The only and main difference is that erosive changes are insignificant and do not end in perforation, however, the symptoms are characteristic enough to highlight erosive colitis without any particular difficulties.
Almost always, regardless of the individual characteristics of the organism, erosive colitis is represented by the whole complex of typical manifestations, including:
- Nausea (the patient is "sick"), vomiting is possible.
- Severity in the abdomen (localized mainly in the stomach).
- Stomach pain. An inexperienced doctor, because of this symptom, can take erosive colitis for one of the forms of gastritis and prescribe a fundamentally wrong treatment.
- Sound in the stomach (rumbling).
- Metallic sour taste in the mouth.
- Belching and heartburn (also commonly associated with acidic gastritis).
- Appetite disorders.
In addition to the complex of symptoms that accompany erosive colitis, the disease is accompanied by symptoms typical for any colitis, such as stool disorders, etc.
Diffuse intestinal colitis
Diffuse intestinal colitis most often affects both departments at once, proceeding severely. Because colitis affects both the colon and the small intestine, symptoms are prominent from day one. Symptoms contain both signs of gastritis and signs of enteritis.
Diffuse colitis is usually not difficult to diagnose with minimal medical training.
This type of pathology is distinguished by a number of symptoms:
- Painful sensations. Pain in diffuse colitis is not localized in any one area, but spreads throughout the abdomen. Discomfort is often observed to move from one part of the abdomen to another (wandering pain). In some cases, on the second or third day, the pain becomes distinguishable and is located in the lower left or lower right abdomen. In the latter case, additional functional tests for appendicitis should be performed. The pains are aching or dull, are colicky in nature.
- The pain can radiate to the region of the heart. Together with the palpitations, this gives the patient reason to assume pathologies of the heart, and not the gastrointestinal tract.
- Often, when a diffuse type is detected, not a decrease in appetite is observed, but its complete absence.
- Very frequent tenesmus. On the first day - profuse diarrhea with characteristic impurities. After the act of defecation, pain increases, but not immediately, but after 1.5-2 hours. On day 2-3, diarrhea continues. A small amount of liquid with an extremely unpleasant odor is excreted. Almost always, diarrhea begins at night, usually 5-7 am (the so-called "alarm diarrhea").
- Nausea, vomiting. The urge to vomit persists even with an empty stomach.
- Heartburn, belching.
- The clinical picture is contradictory. On x-ray examination with a contrast agent, both areas of narrowing and pathological expansion of the intestine are visible. Peristalsis can accelerate at times or be depressed.
- The patient's tongue is coated with a gray or yellowish coating.
- On palpation, there are hard, spasmodic areas, on palpation, patients indicate pain.
Consequences of intestinal colitis
Colitis of the intestine, despite not serious at first glance manifestations, as well as the relative ease of treatment, can cause serious complications. Acute colitis, as it was said, in the absence of proper therapy in 90% of cases turns into a chronic incurable form and haunts the patient throughout his life.
The disease is especially dangerous in childhood. Even if the child received the necessary treatment, the risk of the pathology becoming chronic is high and is close to 95-100%.
In adults, both acute and chronic colitis can cause four severe consequences:
- Internal bleeding.
- Blood poisoning (sepsis).
Ulcers form mainly in the chronic form of chronic colitis, when an aggressive agent constantly affects the intestinal mucosa. Ulcers can lead to perforation of the wall and the release of intestinal contents outside of it.
As a result of perforation, profuse internal bleeding rapidly develops, requiring immediate surgical intervention. Without medical care, the patient risks dying from blood loss. In addition, as a result of perforation, the contents of the intestine enter the abdominal cavity and cause an infectious infection, which can also be fatal.
Sepsis. The intestine has a developed and complex circulatory system, therefore, any damage to the walls of the organ entails at the same time damage to the blood vessels. Feces are rich in harmful substances and pathogens, which, once in the blood, can cause its infection. The risk of sepsis is especially high with an infectious cause of intestinal colitis.
In addition, colitis, especially chronic colitis, is always accompanied by stagnant processes in the large intestine. As a result, harmful substances are not removed from the body in time and are absorbed back into the blood, poisoning the body. Patients constantly have signs of intoxication: weakness, headache, appetite disorders, etc.
Also, colitis can lead to dehydration, since most of the water does not have time to be absorbed in the large intestine and comes out with frequent diarrhea.
Quite a frequent and dangerous consequence of colitis is intestinal obstruction. Since intestinal motility weakens, feces are not evacuated from the body and acquire a stony structure. Gradually accumulating, they are able to cause a complete closure of the intestinal lumen. In this case, one cannot do without surgical intervention in the shortest possible time.
Differential diagnosis of intestinal colitis
Modern medicine has a wide range of laboratory and instrumental research methods. With their help, you can determine the presence of pathology, its stage and form.
Laboratory methods for the differential diagnosis of colitis include:
- General blood analysis. The clinical picture of intestinal colitis is characterized by an inflammatory process, which means that a high erythrocyte sedimentation rate (ESR), a significant concentration of platelets, leukocytosis, and a low level of hemoglobin will be determined in the blood.
- Stool analysis (coprogram). In the feces, the content of blood, leukocytes and erythrocytes can be observed.
- Crops of stool for infectious and bacterial agents (dysentery, cholera, tuberculosis, etc.).
- PCR diagnostics. Allows you to identify helminthiasis, as well as viral intestinal lesions.
- Analysis for the presence of specific antibodies to the cytoplasm of neutrophil cells (pANCA) allows you to determine the presence of genetic autoimmune pathologies that reduce the efficiency of the intestine.
- Analysis for fecal calprotectin. It is carried out in order to identify Crohn's disease, a secondary symptom of which may be colitis.
Instrumental methods for the differential diagnosis of colitis include:
- Contrast irrigoscopy. During the study, a contrast agent is injected into the patient's rectum. After a while, X-ray is taken to assess the degree of functional disorders of the organ. Irrigoscopy makes it possible to exclude the growth of tumors, stenosis of the intestinal walls, etc.
- Fibroilecolonoscopy. Endoscopic examination of the intestines. It allows you to determine the location of the pathological process, its nature and stage, as well as to take biological material for research (to exclude malignant neoplasms and the possibility of their formation).
- Ultrasonography. It is carried out in order to identify changes in the lumen of the intestine or the walls of the organ.
- Examination by a proctologist with a digital examination of the anus and rectum. It is carried out in order to exclude the pathology of the rectum: paraproctitis, as well as anal fissures and hemorrhoids.
- An abdominal ultrasound and liver function tests reveal inflammation of the liver, pancreas, and gallbladder.
- Biopsy. The symptoms and clinical picture of colitis are very similar to the symptoms of various malignant neoplasms. Suspicious intestinal fragments must be biopsied to rule out oncology.
How to treat intestinal colitis?
In order to prescribe treatment or recognize colitis, you need to consult a gastroenterologist or a coloproctologist. The main link in the chain of colitis treatment is a special diet.
Treatment of colitis, in contrast to the treatment of many other diseases, is characterized by the fact that diet is an integral part of therapy. Since the mucous membrane of the colon (and possibly the small intestine) is irritated, in no case should it irritate it more. Therefore, the goal of the diet is to minimize the load on the intestines, while maintaining an optimal diet rich in everything you need.
Fiber-rich foods are temporarily excluded from the diet:
- Sunflower seeds, pumpkin seeds
- Raw fruits and vegetables
- Marinade and smoked meats
- All salty, sour and sweet foods
Food should be soft, therefore, during heat treatment, preference is given to stewing, boiling.
Meals should be fractional, 4-6 times a day, to avoid unnecessary stress on the digestive tract. Foods that improve intestinal motility and have a laxative effect are also not worth eating. This applies to prunes, milk, pumpkin, cabbage, etc. It is best to eat pureed food.
If you have colitis, you should drink enough fluids, as the body quickly becomes dehydrated.
On the subject: Diet for intestinal colitis
Methods of medical treatment
We also list a number of measures that can be applied during treatment:
- Antibiotics and antimicrobials. Appointed if an infectious etiology of the disease is identified. The drugs Enterofuril, Alfa Normix (Rifaximin), Tsifran are prescribed. The course of treatment is short, 3-5 days strictly according to indications and under the supervision of the attending physician.
- Helminthiasis. If the cause of intestinal colitis is helminthiasis (parasitic lesions of the intestines), specialized anthelmintic medicines are prescribed (specific names depend on the type of helminth and the degree of damage).
- Removal of pain syndrome. A pronounced pain syndrome is relieved by antispasmodic drugs, such as No-shpa, Papaverine. In more severe cases, anticholinergic drugs are added to antispasmodics.
- Treatment of accompanying complications. With intestinal colitis, proctitis or proctosigmoiditis is often formed. To eliminate these consequences of colitis, specific local therapy is carried out using suppositories (drugs based on belladonna, anesthesin are administered rectally, astringents are introduced), as well as enemas (phytotherapeutic with calendula, chamomile, or tannin, protorgol).
- Elimination of stool disorders. Constipation and diarrhea can be eliminated in different ways. To stop diarrhea, astringents are recommended (oak bark, bismuth nitrate salt, tanalbin, white clay, etc.), to eliminate constipation, a cleansing enema is performed.
- Microflora normalization. Normal and stable peristalsis is impossible without beneficial microflora. As a result of diarrhea or constipation, the microflora dies. If cleaning measures have been carried out, the bacteria are washed out, as a result of which lingering constipation may begin. Special probiotic preparations are prescribed, such as Linex, enzymes (if the disease proceeds against the background of their deficiency), enterosorbents (polysorb, activated carbon, Polyphepan, Enterosgel, Filtrum, etc.).
How is ulcerative colitis treated?
Ulcerative colitis is more difficult to treat. More intensive therapy is required, which means longer and more expensive. Drugs for the treatment of this type of pathology are not only expensive, but also have a lot of side effects, therefore they are used strictly according to the prescription of a specialist.
They are produced in the form of rectal suppositories, enemas, in tablet form (Salofalk, Pentasa, Mezavant, Mesakol). In some cases, they resort to the use of biological therapy drugs, such as Humir (Adalimumab), Remicade (Infliximab). In the most severe cases, the use of corticosteroid medications (Prednisolone, Methylprednisolone, Hydrocortisone) is acceptable. The drugs are available in the form of rectal droppers, suppositories, tablets.
If the cause of the disease is an autoimmune disease or an allergic reaction, immunosuppressants (Cyclosporine, Azathioprine, Methotrexate) are prescribed.
Also, for chronic colitis, spa treatment is recommended.
The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist
Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.