Chronic colitis

Under chronic colitis should be understood inflammatory, degenerative and atrophic changes of the mucous membrane of the large intestine are accompanied by a functional disorders of the body (motor and secretory) and clinical manifestations.
The etiology and pathogenesis. Chronic colitis is polietiologic disease. E. I. Atakhanov (1966) proposes to distinguish six groups etiological factors, should be related to the development of chronic colitis (nutritional, infectious, parasitic, toxic, allergic and related diseases of other organs), A. C. Frolkis. (1968) - 8 groups, and U. A. Askarov (1970) - already 12, adding to these factors mechanical, mixed, neurogenic-dyskinetic, anomalies of development and, finally, outstanding. Each group etiological factors still divided into subgroups (for example, infectious - specific, non-specific and post-infectious).
The recognition of such a large number of causes leading to chronic colitis (in fact, the vast majority of the harmful factors of the external and internal environment), requires first of all answer the question of why these etiologic factors, only a relatively small number of people called chronic colitis. It is known that not all suffered acute dysentery ill with chronic colitis. The same applies to the influence of numerous other factors that may cause this disease.
Therefore, all these multiple causes of chronic colitis optional. The relative importance of them is also proved by the frequent absence of the expected clinical effect from the relevant etiological therapy (e.g. antibiotics for infectious chronic colitis). It can be assumed that the disease is related to intensity of one or another reason (such as expressed by the virulence of the organism, the dose of toxic substances and other). Thus, we would expect a certain specificity of the pathological process, i.e. infectious chronic colitis both clinically and morphologically would be different from toxic or parasitic. However, there was unanimous agreement that pathological changes in the colon are not specific and have a stereotypical character regardless of the causes leading to their development (b.p. Stepanov, 1966; A. B. Frolkis, 1968; A. G. Sahakyan, 1970).
Thus, in the etiology of chronic colitis should distinguish two aspects: the above optional causative factors and the nature of the reaction to them of the mucosa of the colon. The latter may be such that the disease does not develop (more often), or it is inflammatory and degenerative changes of the mucous membrane (rarely), and then develop chronic colitis. From this it follows that morphological features of chronic colitis to a much greater extent depend on the reaction of the mucous membrane and less from the reasons which cause it.
The above optional etiological factors can act in two ways: or there is an acute disease of the colon and may be linked with the development of chronic colitis, or the latter occurs without prior acute stage of the process. In the first case, you have to think that the effect of the factor causing the disease, very intensively, and therefore the response to it is expressed (acute disease). Such patients in most cases recover, thanks to the protective factors and appropriate therapy and only some of them, the disease becomes chronic, as a rule, without further action pathogenic factor. An example of such development of the pathological process is the so-called postdizenteriyny chronic colitis. Should incidentally be emphasized that for the last time in history of patients with chronic colitis, acute dysentery occurs much less frequently than had been the case earlier (only 31,9% - U. A. Askarov, 1970).
Etiological factors may act neinterese, but constantly and long-term. In these cases, the disease develops over a long time after the commencement of the causative agent and without prior acute stage. An example of such a disease development can serve as chronic colitis nutritional origin. The violations of their basic food hygiene long time (and sometimes always) occurs with impunity (period of payment), and only a number of people at some stage appear pathological manifestations typical of chronic colitis.
The recognition of the essential role of reactivity of the colon in the pathogenesis of chronic colitis gives grounds to believe that in the development of this disease are important pre-functional disorders of the large intestine (dyskinesia, excessive mucus discharge), climatic conditions, in particular high ambient temperature, neuro-endocrine disorders, immunological changes. All these factors determine the reaction of the large intestine and can cause inflammation in the mucous membrane, to break its physiological recovery when foregoing optional etiologic factors.