Chronic bowel disease

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Terminology chronic intestinal diseases currently very diverse. With the adoption of new methodological approaches in clinical practice and, in particular, lifetime morphological method of research, as well as clarification of the mechanism of development of individual syndromes number of names of intestinal diseases is increasing. Until recently it was believed that the main and most frequent bowel disease is inflammation of its mucosa and, accordingly, most of the pathological conditions it was designated as enteritis (duodenitis, colitis (enterocolitis).
According to some authors, inflammatory lesions of the mucous membrane of intestine and colon among chronic intestinal diseases occupies very little space (Berndt et al., 1969) or not recognized at all (3. Margada, 1967). This is less relevant for the duodenum. The term "chronic duodenitis" not controversial and is recognized by all (Bockus, 1964).
In the Soviet Union the concept of "chronic enteritis and chronic colitis, introduced as early as 1896, B. N. Obraztsov, are used by most of the authors in the present (A. G. Ghukasyan, 1964; E. A. Beyul, 1965; A. B. Frolkis, 1968; A. M. Kharatyan, 1969 and others). Recognizing that these diseases are the most numerous among lesions of the intestine, the term "enterocolitis" is much wider. In particular, draws attention to the fact that the leading histopathological changes at enterocolitis are not so much inflammatory, how many degenerative and atrophic processes (N. B. Shalygina, 1969) or vasomotor-trophic disorders that lead to atrophy of the secretory apparatus and rebuilding of tissue (M. M. Gurevich, and M. I. Razumov, 1968). Draws attention to the considerable diversity of pathogenetic mechanisms in the development of chronic enterocolitis (I. E. Atakhanov, 1966).
Therefore, in the terminology of intestinal diseases are currently two trends. Abroad offers all new names of pathological States associated with disorders of the intestine, which together increasingly displace the term "enterocolitis". So, 3. Marjetka (1967) results for 30 names (such as "primary syndrome, malabsorption", is divided by 7 independent species). Among these names enteritis and colitis no. In the Soviet Union most of the researchers of the terms "enteritis and colitis (enterocolitis), but significantly expand this concept is not limited to the interpretation of it only as the inflammatory process mucous membranes.
Difficulties in terms of intestinal diseases associated with the complex interrelationship between organic lesions of the mucous membranes, functional changes and clinical manifestations of the disease. At least we can still identify six immediate closely related to each other reasons leading to the clinical manifestations, pointing to the intestinal damage.
1. Structural and ultrastructural changes of the intestinal mucosa (mainly the small intestine). These changes can be documented in vivo using the method biopsy histologically, histochemically and electron microscope.
2. The enzymatic deficiency as a consequence of inborn and acquired defects functions furnace bowel and pancreas, leading to the violation of digestion in the small intestine.
3. Failure suction in the narrow sense (violation of the processes of absorption of substances that are not subject enzymatic processing in the small intestine).
4. Changing microbial flora in the gut as a consequence of the unilateral power and influence of a number of medicines (antibiotics).
5. Violation of motor function of thin and thick intestines.
6. Immunological (autoimmunological) reaction of the intestine.
Not all of these reasons are for different departments of the intestine to the same value. For pathology duodenum most important are the structural changes of the mucous membrane and impaired motor function. Pathology of the small intestine is most often linked together with structural (ultrastructural changes, impaired digestion, absorption and less frequently with immunological changes. Changing microbial flora, impaired motor function and immune disorders are often the causes of the pathology of the colon.
In this connection it is expedient in the description of the pathology duodenum to distinguish between two main types of its diseases:
1. Violations related to changes in motor function of the duodenum (dyskinesia duodenum), in which it is possible to allocate a large group of diseases - chronic duodenostaza.
2. Diffuse structural changes of the mucous membrane duodenal ulcers with the presence of atrophy of the mucous membrane or without, for whom rational to keep the term "chronic duodenitis" in the broadest sense.
It is quite possible that these two processes (structural changes and motor disorders) may be combined in one and the same patient.
More complex classification of diseases of the lower intestine (jejunum, ileum and colon), taking into account peculiarities of pathological process.