Colitis

Colitis is an inflammation of the colon. Colitis are acute and chronic.
Etiology. Acute colitis is often a symptom of infectious diseases, such as dysentery, paratyphoid A, tuberculosis and other infectious colitis), and also develops as a result of a poisoning with poison (lead, mercury and others), substandard products, sometimes in helminthic invasions. Causes of chronic colitis are the same as acute. Sometimes they can be the result of a sharp transition process in chronic. In some cases, to the development of colitis cause increased sensitivity to certain food substances (allergic colitis) and the violation of the nervous control of the gastrointestinal (dyskinesia).
Pathogenesis and pathological anatomy. Among the mechanisms of colitis is the main toxic effects of the poison, circulating in the blood and released by the intestinal wall. As a result, developing morphological and functional changes in the mucous membrane of the intestines, it neuromuscular apparatus, regional ganglia, as well as changes of the intestinal flora and therefore a violation of a number of enzymatic processes.
The inflammatory process can spread throughout the large intestine or capture its separate segments. There are proktoshigmoidit (defeat sigmoid and rectum), teplocold (defeat blind and ascending colon), transverse (defeat of the transverse colon) and Silvinit (defeat of the sigmoid colon).

colitis
Fig. 1. Catarrhal colitis (foodborne diseases). Fig. 2. Hemorrhagic colitis (dysentery). Fig. 3. Fibrinous colitis. Fig. 4. Difteriticheskoe colitis (uremia). Fig. 5. Diparities ulcerative colitis (poisoning mercuric chloride). Fig. 6. Ulcerative colitis when amebiasis. Fig. 7. Necrotizing colitis.

On the basis of pathological changes distinguish four forms of colitis: catarrhal (Fig. 1) - the mucous membrane of the colon swollen, hyperemic, covered with slime, with superficial erosions; fibrinous (Fig. 3) - lobar and diferitele inflammation of mucous membranes; ulcer (Fig. 6) on the surface of the mucous membrane ulcers are usually small in size, round, penetrating into the submucosal, less muscular layer; necrotic (Fig. 7) giperergicakie inflammation, accompanied centers necrosis of the mucous membrane (see Inflammation).
Over and symptoms. In acute colitis disease begins suddenly. Appear bloating, sharp cramping pain in the lower half, often desires and separation of liquid stool with a large number of mucus, pus, blood. Sometimes there is a putrid smell of feces. In infectious colitis temperature rises up to 39-40°appear dry mouth, nausea, weakness. Tongue coated. Sometimes vomiting. At a palpation of the abdomen are rumbling, splash, diffuse tenderness around the intestines. For chronic colitis is characterized by a wavy current: alternating exacerbations and remissions. With acute diarrhea are replaced constipation, bowel movements are highlighted with a large number of mucus. As a result of the disease, colon cancer can develop vitamin deficiency, weight loss, weakness, lethargy, fatigue, lack of appetite, anemia.
Complications: the development of perivisceral (inflammatory reaction of the peritoneum, covering the colon), exhaustion, anemia.
The diagnosis at the typical pattern of disease is fairly easy; should be differentiated from gastritis, an enteritis, appendicitis. Help in the diagnosis of colitis sigmoidoscopy (see), the research of excrements (bacteriological, protozoa and other).
Forecast - for uncomplicated forms of recovery with timely and correct treatment.
Treatment depends on the cause. When poisoning - special events (see Poisoning). When food poisoning - stomach wash with a weak solution of potassium permanganate (1 : 10 000) or sodium bicarbonate (1 table spoon on 3 litres of warm water) by means of a thick tube or "restaurant" way (the patient drink 2-3 cups of the above solutions, and then vomits artificially putting two fingers on the back of the tongue, subsequently appointed a laxative (15 g of sodium sulfate dissolved in 1/4 Cup warm water). Siphon enema.
After the hunger within 1 day is required strict diet: first hot tea with sugar and lemon, mucous soups, then meat broth with white biscuits, jelly, mashed porridge on the water. Dairy products are excluded. Compliance with bed rest, pain - heating pad or a warm compress on his stomach. In infectious colitis is treated with antibiotics and other
Treatment of chronic colitis in the period of exacerbation in uncomplicated cases conducted in the outpatient setting. If there colitis, complicated by periclita, and expressed General disorders (exhaustion, anemia), patients may be taken to the hospital. For outpatient treatment in the period of exacerbation shown antispastic funds (belladonna 0.015 g 3 times a day, papaverine 0,04-0,06 g 3 times a day, platifillin 0,002 g 3 times a day), antibiotics, anteroseptal 1 tab. 3 times a day after meals, sulfa drugs (sulgin 0.5 g 4 times a day for 3-5 days). The diet of the type of the meeting # 4 for 5-7 days, followed by a gradual expansion of the diet to a balanced diet. Mandatory appointment of vitamins, especially of the complex with ascorbic acid.
During periods of exacerbation of colitis useful purpose days of discharge: Apple (1 to 1.5 kg pureed apples a day) or cottage cheese (500 g of cottage cheese per day). During remissions shows the physiotherapy: application of paraffin, ozokerite, mud on the bottom half of the abdomen, and the resort in Yessentuki, Zheleznovodsk, Borjomi and other
Prevention: prevention of intestinal infections, rational treatment of acute colitis, proper diet. Personal hygiene (washing hands, vegetables, fruits, berries), not to consume poor-quality products. Strict sanitary supervision over the enterprises of public nutrition, and regular medical examinations of employees of catering, trade, children's institutions.
Cm. also nonspecific Ulcerative colitis.