Chronic enterocolitis

Chronic enterocolitis (enteritis) often develops after acute gastroenterokolit. The transition of acute inflammation in chronic associated with reactive properties of the organism, with improper treatment of acute process. Initially emerging chronic enterocolitis (enteritis) may be a consequence of the long use of poor quality, rough, spicy food, abuse alcohol, helminth infection, chronic intoxications industrial substances, such as arsenic, mercury, lead), misuse of drugs (Adonis, codeine).
In diseases of the stomach, gall bladder, liver, insufficient function of the pancreas, chronic enteritis caused by irritation of the intestinal wall is not enough-digested food and lack of bactericidal action of hydrochloric acid. The pathogenesis of chronic enterocolitis (enteritis) is complex and in many ways is not clear. A large role in their occurrence belongs to the breach of the physiological microflora of the intestine dysbacteriosis).
Pathological anatomy. There are atrophic changes in the mucosa of the small and large intestine and defeat all walks of its walls, the smoothness of the villi, which leads to the violation of absorption and motor function of the small intestine.
The clinical picture is characterized by the wave-like currents: the periods of remission followed by periods of aggravation caused by errors in nutrition, mental injuries, hypothermia, the overheating of the body and other Clinical manifestations acute exacerbation of chronic enterocolitis (enteritis) are the same as for acute. With frequent and severe exacerbations and progression of chronic enterocolitis (enteritis) due to malabsorption of nutrients in the small intestine more and more clearly identify violations of metabolism (protein, vitamin and others)that leads to change of the functions of digestive, nervous, blood and endocrine systems.
Forecast in mild cases and with the right treatment is favorable. In severe cases, accompanied by atrophy of the mucous membrane of the small intestine,is bad.

Chronic enteritis (enterocolitis). Patients complain of discomfort and pain around the navel, rumbling and transfusions in the abdomen, weight after eating, nausea, diarrhea after eating or early in the morning, sometimes dizziness and General weakness. The watery feces, yellow, mixed with undigested muscle fibers, neutral fat and fatty acids. Pain arises from flatulence and bowel spasm, are cramping the nature and often spread around the abdomen. Sometimes there hypotension, bradycardia, phenomena vascular insufficiency. The disease occurs with periodic remissions and relapses, the last coming in connection with the error in diet, hypothermia, overheating, inflammatory diseases of the upper respiratory tract, physical and mental stress.
In chronic enteritis (enterocolitis) there is a violation of intake of protein, fat, carbohydrates. Develops hypoproteinemia, and it called giponatriemia swelling. Hypoproteinemia due to a significant loss of proteins with inflammatory exudate. Violation of the processes of absorption of other nutrients, the disorder of metabolism and synthesis of vitamins in the changes of the intestinal microflora leads to Hypo - and avitaminosis. The lack of vitamin B1 cause the accumulation in the blood and tissues of pyruvic acid, products of incomplete combustion of carbohydrates that have a toxic effect on the body (weakness, irritability, peripheral and Central nervous system, sense of crawling and burning sensation in the soles, tingling of the skin, itching and others). Points to signs of deficiency of nicotinic acid (burning language and the atrophy of his buds, cracks, erosion language), synthesized from tryptophan, the content of which is clearly not enough in the body due gipoproteinemii. Deficiency of vitamin C causes an increase in capillary permeability, bleeding. The human intake of calcium salts in the small intestine, developing due to a deficiency of vitamin D causes brittle bones, osteoporosis. In patients with chronic enteritis (enterocolitis) there was a decrease of the functions of the pituitary-adrenal axis, resulting in hypotension, increased pigmentation of the skin, weakness of sexual function in men and amenorrhea in women. For severe forms of the disease characterized by hypochromic anemia iron deficiency (anisocytosis and poikilocytosis) due to malabsorption of iron, which is confirmed by a significant reduction of serum iron. Observed in patients with anemia may be caused by lack of vitamin WG, synthesis and absorption of which is also violated.
In the study of duodenal content juice is murky with the presence of flakes, mucus, white blood cells, cells of the intestinal epithelium. The number of enzymes protein nature - enterokinase and alkaline phosphatase is reduced. Elaboration of such humoral active enzymes, as secretin, pancreozymin, cholecystokinin, which stimulate the activity of digestive glands, sharply reduced. When combined enteritis (enterocolitis) ahilia of the stomach due to the deposition of bactericidal properties of free hydrochloric acid, and also due to the spread of inflammatory process ascending (hematogenous and lymphogenous) by may cause hepatitis, angioholity and even liver cirrhosis, acute and chronic pancreatitis. It is established that observed in the liver fatty infiltration. For chronic enterocolitis is no characteristic coprogram. It may be normal in mild cases without involvement of the colon, as well as pathological, but the latter can also occur with the disease Addison - Biermer, toxic goiter, liver and pancreas, avitaminosises and other
The color of stool is yellow because it contains unrestored bilirubin; dark color characteristic Kala, normally passes through the intestines, and due to change of stercobilinogen in stercobilin. In the forms of severe and moderate stinky feces, greenish-brown, light yellow or clay color, has viscous due to significant admixture of mucus, closely mixed with faeces. Sometimes mucus may not be, if it is destroyed by enzymes and bacteria in the distal segments of the intestine. With abundant content in Calais neutral fat, fatty acids and washed its surface is covered with shiny oily film (steatorrhea, soap dyspepsia Porges). Microscopic examination of feces find a significant amount of undigested muscle fibers with saved cross striation and sometimes the pieces of meat (creatore). Creatore very typical for chronic enteritis (enterocolitis), unless it is caused by damage to the pancreas. Steatorrhea and creatore can be absent if the muscle fiber and fat are further digestion in the distal intestine during slow passage of feces.

Treatment. The elimination of the causative factors, if possible. Place is a great health food. When building a diet is necessary to consider not only the state of the intestines, but also changes in other organs (stomach, liver, pancreas). Appoint fractional 5-6 meals a day.
The diet should contain high amounts of protein (120-150 g); fats give in moderation (up to 100 g), carbohydrates - in small quantity (300-400 g). Milk in its pure form is not given. Vitamins should be administered orally and intramuscularly: thiamine-bromide (B1) - 50 mg, Riboflavin (B2) - 20 mg, nikotinova acid 50-100 mg, folic acid 40-60 mg, ascorbic acid 100-300 mg (given daily dose). Anemia - iron products: reduced iron up to 5 g / day; with the lack of secretory function of the stomach, pancreas - natural gastric juice on 1 table. L. 2-3 times a day before meals, Pancreatin to 6 g / day; anteroseptal 0.5 g 3 times a day. In the period of the compensation process is recommended sanatorium-and-Spa treatment (Essentuki, Zheleznovodsk, Staraya Russa and others). In severe exacerbation of the process is shown hospitalization.