What is acute colitis: causes, signs, treatment and diet, prevention. Treatment of acute colitis. How to treat colitis in adults

One of the most common diseases digestive tract considered to be colitis. The occurrence of this pathological condition is accompanied by many unpleasant manifestations and significantly worsens the well-being of a person. The inflammatory process in the large intestine develops due to negative impact various factors external and internal environment and may be spicy or chronic. When symptoms of acute colitis appear you should consult a gastroenterologist or coloproctologist.

Only after a thorough examination of the body, the doctor can determine exact reason occurrence of the disease and prescribe effective treatment. Self-administration of medications to eliminate the underlying unpleasant symptoms can lead to chronic inflammatory process and various complications.

The appearance of such a pathological condition as acute colitis can be triggered different factors. It is the main cause of the disease that usually affects its course and clinical picture. In most cases, the elimination of the factor that led to the development of colitis is key point in the treatment of the disease. The main reasons leading to acute inflammation large intestine include:

Infectious processes: There are a number of intestinal infections that are characterized by damage to the colon. They are caused by pathogens various etiologies(bacteria, viruses, protozoa) and have their own characteristics in symptoms and treatment. Acute colitis found in shigellosis, amoebiasis, yersiniosis, campylobacteriosis and other infectious diseases. Infection with pathogens of the above nosologies most often occurs through contaminated food and dirty hands. special group the risk of intestinal infections are children of preschool and primary school age, but often these diseases occur in adults;
Reception antibacterial drugs: the appointment of a long course of antibiotic therapy may lead to such unpleasant complication like intestinal dysbacteriosis. Violation of the normal microflora in the large intestine is a favorable background for the development of the inflammatory process. Also, this condition is accompanied by a violation of the digestion of food and the absorption of useful vitamins and minerals;
Insufficient blood supply to the large intestine: ischemia may be the result of pathology of cardio-vascular system and is also common in the elderly. Due to the violation of the normal trophism of the tissues of the large intestine, its functional properties change, which leads to inflammation and other pathological manifestations;
Poor nutrition: an important role in the occurrence of acute colitis is played by the consumption of excessive amounts of fats, spices, flour products, alcoholic beverages. In some cases, the presence of a monotonous diet for a long time also leads to inflammation;
Exposure to ionizing radiation: acute colitis can develop against the background of radiotherapy with oncological pathologies or during exposure due to emergencies at industrial facilities;
Poisoning with toxic substances: lead, arsenic, mercury and others chemical substances have a strong damaging effect on the organs of the digestive tract, including colon. Poisoning is accompanied by pronounced intoxication, erosive and ulcerative changes in tissues and dysfunction of organs;
Pathologies nervous system: Acute colitis may occur due to chronic stress or acute psycho-emotional overstrain. Also, disorders of the innervation of the large intestine are considered a predisposing factor for the development of the inflammatory process;
For the development of an acute inflammatory process in the large intestine, hereditary predisposition also matters;

Clinical picture

Symptoms of the disease appear due to damage to the mucous membrane of the large intestine. When infectious pathology micro-organisms that release specific toxins and products of their metabolism have a damaging effect. The mucous membrane becomes edematous, hyperemic, the processes of normal absorption and secretion of fluid are disrupted. Against the background of such changes, the following symptoms appear:

Pain in the lower abdomen. The pain is acute, spasmodic in nature;
Severe diarrhea. Stool more than 3 times a day, in some cases the number of bowel movements per day reaches 20 and more;
Change in the nature of feces: hallmark colitis are impurities of mucus and blood in the feces;
flatulence and rumbling in the abdomen;
Increase in body temperature: with acute process the temperature reaches 38-39 ⁰С;
Intoxication syndrome: weakness, fatigue, sleep and appetite disorders, decreased blood pressure, tachycardia, sweating;
Dehydration: manifests itself in the form of dryness of the mucous membranes, a pronounced feeling of thirst, a decrease in elasticity and turgor of the skin;

Often, the patient has combined dysfunctions of the large, small intestine and stomach. In such cases, vomiting, nausea, pain in the epigastric and umbilical region join the symptoms.

Diagnostics

Similarity of the clinical picture of acute colitis with other pathologies gastrointestinal tract requires a thorough examination of the body to clarify the diagnosis. First, the doctor conducts a detailed questioning regarding complaints, the onset of the disease, chronic diseases digestive organs, contact with infectious patients.

During a palpation examination, pain in the colon is detected; in some pathological conditions, an increase in the liver and spleen may be noted. The patient also needs to go through a series of laboratory research:

: helps determine inflammatory changes in the body. Exclude anemic conditions, suspect a bacterial, helminthic or viral etiology of infection;
Urinalysis: evaluate the severity of intoxication of the body, kidney function;
: examine the composition of feces, the amount of mucous, bloody impurities, the presence shaped elements blood;
Bacterial culture of feces: to identify pathogens of intestinal infections;
: exact method to identify the genetic material of pathogenic microorganisms;

The instrumental methods used for suspected acute colitis include ultrasound examination of the abdominal organs, sigmoidoscopy,. They allow you to assess the condition of the walls of the large intestine, the presence and localization pathological changes. If necessary, also carried out to examine the stomach and biochemical research blood to assess the function of the liver and pancreas.

Treatment

After diagnosis, select best option therapy. Treatment of acute intestinal colitis is carried out taking into account the cause due to which pathological condition. Colitis on the background of an intestinal infection is considered the most common option. In such cases, etiotropic drugs occupy a key place in the treatment. After identifying the causative agent of the infection, an antibacterial, antiviral or anthelmintic drug is selected. The duration of administration and dosage is determined solely by the attending physician. It is highly undesirable to stop taking medications on your own, as this significantly reduces the effectiveness of the therapy.

It is mandatory to prescribe funds to restore the normal intestinal microflora, therefore, the course of treatment includes probiotics. To normalize the stool is prescribed antidiarrheals if dehydration is noted due to diarrhea, then rehydration therapy is carried out by intravenous infusion or oral preparations.

You should also pay attention to the diet for acute colitis of the intestine. After the appearance of the main symptoms, it is recommended to refrain from eating during the day. In addition to water, unsweetened black tea and white bread crackers are allowed. In the following days, you should follow these recommendations:

Do not eat foods that can irritate the intestines: spicy, fatty, smoked foods, alcohol;
Low-fat varieties and fish to steam or boil;
A small amount of fresh, low-fat dairy products;
Limit the amount of fiber-rich foods fresh vegetables, fruit);
Allowed buckwheat, rice porrige on the water;
White bread crackers;
From fruits, you can eat bananas and apple puree;

To avoid chronicity of the process and prevent complications, the doctor should be contacted as soon as possible after the appearance of complaints. In some cases, acute colitis is treated exclusively in stationary conditions.

Colitis is a disease in which there is an inflammatory process of the mucous membrane of the colon. Inflammation can take place in both acute and chronic forms. It is provoked like chronic inflammation intestines and infections that cause viruses and bacteria . Symptoms of colitis sometimes complicate inflammation of the stomach or small intestines. This disease in some cases is mistaken for due to the similarity of symptoms. But with the development of irritable bowel syndrome, there is no connection with the large intestine.

Causes of colitis

The most common cause of colitis is the constant consumption of food that is difficult to digest, alcoholic beverages, spicy food. They also lead to the occurrence of colitis, as a result of which fecal residues accumulate in a person. Sometimes colitis develops as a result of a violation sanitary regulations like an allergy to a certain food. Intestinal colitis is often a reaction to emotional stress, on intestinal infections, on their improper treatment.

Acute colitis

Acute colitis often occurs in combination with acute enterocolitis - inflammation of the mucous membrane of the small intestine. Sometimes the patient is also diagnosed gastroenterocolitis - inflammation of the stomach.

The causative agents of acute colitis are salmonella , shigella , in more rare cases, its occurrence is provoked by other bacteria and viruses. Also, acute colitis can develop as a result of non-bacterial food poisoning, constant gross errors in everyday nutrition.

To a lesser extent, the occurrence of acute colitis is affected by common infections, toxic substances, allergic reactions. Inflammation in the colon manifests itself as a result of local exposure to factors that damage the intestinal mucosa. These substances are found in the masses that are contained in the intestine, or can enter there by the hematogenous route, and affect the condition of the intestine after excretion by the mucous membrane.

chronic colitis

chronic colitis rightly considered one of the most common ailments digestive system. Often this disease can be combined with inflammation of the small intestine and stomach.

Chronic colitis, which has an infectious origin, is caused by pathogens of intestinal infections, mainly shigella and salmonella. Other mycobacteria, as well as conditionally pathogenic and saprophytic intestinal flora, can also provoke the development of the disease. Inflammation of the intestines can also support helminths . Most often, people are diagnosed with chronic colitis, which is of non-infectious origin.

So, alimentary colitis intestines is manifested due to gross malnutrition, as well as due to poor nutrition. Associated colitis appears as an accompaniment gastritis , chronic enteritis . This form diseases as a consequence of constant irritation of the mucous membrane of the colon, which is provoked by products of incomplete digestion of food. Associated colitis may also occur as a result of dysbacteriosis . Toxic colitis - a consequence of exposure to intoxication chemical compounds. Drug-induced colitis occur due to prolonged and uncontrolled use of certain drugs - , laxatives and other medicines.

Ischemic colitis is a segmental lesion of the colon, which occurs due to a violation of the blood supply to the organ. Allergic colitis often occurs in people who suffer food allergies, as well as those who do not tolerate certain chemicals and drugs, have high sensitivity organism to the bacterial flora of the intestine.

The diagnosis of "chronic colitis" can be established with the help of a number of studies. For this, irrigoscopy, endoscopic examination, laboratory tests.

Chronic colitis proceeds in a progressive form, as a rule, the prognosis is unfavorable. As a complication of the disease often occurs necrosis part of the intestine and subsequent peritonitis , intestinal .

Ulcerative colitis

Ulcerative colitis chronic and often relapsing disease. Most commonly seen in humans young age, from 20 to 40 years, there is also an increase in cases of the disease in patients older than 55 years. With ulcerative colitis, a number of characteristic symptoms are observed: diarrhea, constipation, pain in the abdomen, intestinal bleeding. In addition, nausea is also present, the patient's weight gradually decreases, the person feels severe weakness and fatigue. Symptoms increase if the severity and extent of inflammatory changes increase.

With a severe total lesion of the colon, the patient has profuse diarrhea, in which a significant amount of blood is present in the feces. Often the blood comes out relatively big clumps, before emptying appear cramping pains in a stomach. A person develops anemia, pronounced signs of intoxication. In this case, the disease is fraught with complications that pose a danger to the life of the patient. This is colon perforation, toxic megacolon, and heavy bleeding in the intestine. The most unfavorable course of the disease is observed in patients with a fulminant form of ulcerative colitis.

In the process of prescribing a course of treatment for ulcerative colitis, the doctor is guided by a number of individual factors: the localization of the pathology, its extent, and the presence of complications. First of all, with the help conservative treatment the attack of the disease is prevented, its progress and relapses are prevented. Ulcerative colitis of a distal nature ( proctitis , proctosigmoiditis ) are easy, therefore, these ailments can be treated at home. Such diseases are considered the most frequently manifested forms of chronic colitis. They mainly arise as a result of chronic constipation, constant irritation of the rectal mucosa due to frequent use candles, enemas. At similar diseases pain occurs in the iliac region on the left, as well as in the anus, flatulence is manifested.

In ulcerative colitis, it is recommended to consume high-calorie, mainly protein food and vitamin-containing foods. At the same time, the amount of animal fats is limited, and coarse fiber plant origin excluded altogether.

Colitis symptoms

Symptoms of acute colitis

In acute colitis, a person, first of all, feels an increase in pain, which is pulling or spastic in nature. In addition to pain, in this case, other symptoms of colitis also appear: the patient has a strong rumble in the stomach, he loses his appetite, suffers from persistent diarrhea, and complains of a general malaise. Constantly stands out liquid stool with mucus, sometimes with blood. If the disease is severe, the stools may be watery, and its frequency can reach up to twenty times a day. In addition, there are often painful tenesmus , that is false urges to defecation. Body temperature rises to 38 degrees, sometimes rises higher.

Symptoms of colitis, which occurs in a particularly severe form, complement the signs general intoxication, dry tongue, coated grayish coating. It is observed, but if the diarrhea is very strong, the stomach may be drawn in. During palpation, the large intestine is painful, and in its different departments rumbling is felt. In the process of research by the method of sigmoidoscopy, the doctor determines in the patient hyperemia and swelling of the mucous membrane in the distal colon. Mucus, sometimes pus is present on the walls of the intestine. It is also possible to have erosions, hemorrhages, ulcerations.

If acute colitis occurs in mild form, then improvement may come on its own. In severe forms of the disease, it has lingering course. Due to acute colitis, a person may later develop a number of complications: pyelitis , liver , sepsis , peritonitis .

Symptoms of chronic colitis

In chronic colitis, a person most often affects the large intestine as a whole ( pancolitis ). Symptoms of colitis in this case are manifested by a violation of the stool (both chronic diarrhea and constipation may occur). In addition, patients suffer from abdominal pain, painful tenesmus, . As a rule, in chronic colitis, especially right-sided, there is a strong . The chair can occur up to fifteen times a day, while the person feels that the intestines are not completely emptied. If the process escalates, the patient feels a false urge to defecate. He periodically leaves gases, lumps of feces with mucus, sometimes with blood. If a person has spastic colitis , the stool looks fragmented. Similar symptom manifests itself if the distal colon is involved in the inflammatory process. In spastic colitis, defecation occurs at an indefinite time. In addition, patients with spastic colitis present with headaches, insomnia, and fatigue.

With chronic colitis in progress x-ray examination in the large intestine, there is a delay in the contrast mass. The disease lasts for a long time, sometimes for many years.

Pain in chronic colitis is usually aching, dull. They occur in the lower abdomen and in its lateral sections. Sometimes heat can help relieve pain. pain attacks often accompanied by urge to defecate and passing flatus. If the inflammation spreads to serosa colon, then constant pain may increase when walking, and when a person takes lying position she subsides. Painful sensations of a aching nature that spread throughout the abdomen, sometimes appear regardless of nutrition, defecation. Patients with colitis also have persistent flatulence, arising as a result of problems with the digestion of food in the small intestine, as well as due to dysbacteriosis. In addition, symptoms of chronic colitis are often nausea, anorexia , belching, presence, constant rumbling in the abdomen. As a result, a person has weakness, reduced ability to work, manifested polyhypovitaminosis and anemia .

Diagnosis of colitis

To determine the diagnosis, a superficial and deep palpation abdomen, during which painful areas are found on abdominal wall, affected areas of the colon and other signs of the disease.

Corpological research is also being carried out. As a rule, the stools are fetid, they contain a lot of mucus, undigested fiber. In ulcerative colitis, stools also contain .

In addition, patients with suspected chronic colitis are prescribed irrigoscopy, sigmoidoscopy, sigmoidoscopy, colonoscopy. In the process of these studies, it is possible to detect an inflammatory process of the mucous membrane of the colon, sometimes - purulent, necrotic-ulcerative lesions.

In acute colitis, laboratory tests reveal moderate leukocytosis, low-grade fever, and an increase.

Colitis treatment

Drug therapy for colitis is prescribed depending on which type intestinal disorder takes place in the patient. So, if a person has spastic colitis, then the treatment of colitis should be carried out in order to reduce peristaltic activity. During an exacerbation of colitis, intestinal antiseptics are recommended. To weaken peristalsis, you should take antispasmodics soft action.

Under constant control doctor during treatment in a hospital, it is possible to receive blockers and cholinergic funds. In order to eliminate the excessive production of mucus in the intestines, they are used binders and enveloping drugs that, moreover, protect the intestines from the negative effects of mucus. With a concomitant decrease in acidity gastric juice patients are prescribed of hydrochloric acid or while eating.

In the process of treating colitis, taking multivitamins is important. In the case of spastic colitis, treatment involves taking laxatives. Also in the process of treating colitis, the use of cleansing and medicinal enemas is used.

If there is an associated exacerbation chronic gastritis, then antibiotics are also prescribed to treat colitis.

In the treatment of colitis, it is very important to adhere to a diet that excludes muffins, fatty fish, meat, eggs, dairy products, legumes, spices, coffee, and alcohol from the diet. However, it is important that the diet must contain all the substances needed by the body.

As folk remedies for the treatment of colitis, you can use an infusion of watermelon peels, decoctions and infusions of herbs of chamomile, sage. Chamomile enemas are also recommended.

The doctors

Medications

Prevention of colitis

To prevent colitis, it is important to eat right and stick to healthy diet. Food must be chewed very carefully. Timely treatment of acute colitis is assumed as a prevention of chronic colitis. For this, it is important to apply for medical assistance, stick to a diet, exercise.

Diet, nutrition for colitis

List of sources

Belousova, E.A. Ulcerative colitis and Crohn's disease / E.A. Belousova.- M.: Triada, 2002,
Vorobyov, G. I. Nonspecific inflammatory bowel diseases / G. I. Vorobyov, I. L. Khalif. - M.: Miklosh, 2008,
Ivashkin, V. T Gastroenterology. National leadership / V. T. Ivashkin, T. L. Lapina. - Moscow: GEOTAR-Media, 2008,
Semionkin E. I. Coloproctology / M .: "Medpraktika", 2004.

Acute colitis - inflammatory disease intestinal mucosa. In addition to an acute attack, the disease can also occur in a chronic form. The symptomatology of the pathology completely depends on the location of the lesion, since the main function of the intestine is the digestion and absorption of products. Decreased appetite may indicate the presence of an ailment, general malaise, diarrhea, abdominal pain.

Sometimes the disease is recognized by doctors as irritable bowel syndrome, but these diseases are not interconnected in any way. But the doctor during the diagnosis must definitely conduct a differential examination.

The disease is characterized by the fact that inflammation is formed in the mucosa and the functionality of the membrane is impaired. Quite often, pathology is diagnosed in people aged 15–40 years. The second peak of the disease is observed at 60-80 years. The disease can affect both women and men in an absolutely equal part.

Etiology

The period of exacerbation of the disease is characterized by the presence of infectious agents, the use of drugs or ischemia of the colon, as a result of mesenteric atherosclerosis. Quite often, the disease begins to progress from the ingestion of viruses, bacteria, fungi. Also, the disease can manifest itself with the development of infectious diseases - dysentery, salmonellosis, food poisoning. Progressive factors also include non-specific pathogens, such as streptococci or staphylococci.

Infections get into human body in a different way. Often, intestinal damage occurs due to dirty water, unwashed foods. Getting on the mucosa of the gastrointestinal tract, a strong inflammatory process begins there, which provokes the development of colitis. Pathological pathogens produce toxins that enter the circulatory system, and for this reason intoxication develops.

The disease can occur not only against the background of various infections, but also under the influence of such factors:

taking antibacterial, laxative drugs;
atherosclerosis of mesenteric vessels;
radiation exposure;
chemical damage.

Classification

Clinicians determine that the disease may present in different forms. The classifications used by physicians are based on the etiology of the disease and the localization of the lesion. Thus, based on the causes of the development of the disease, the following types of disease are distinguished:

According to the location of the inflammatory process, clinicians identified 4 main forms of pathology:

sigmoiditis;
left-sided;
right hand;
total.

Symptoms

Acute colitis of the intestine is characterized as a very painful disease with unpleasant symptoms. If you do not start therapy on time, then the disease can go into chronic stage, while the symptoms become more pronounced and inconsistent.

The clinical picture of the pathology is very specific and manifests itself in severe discomfort which cannot be ignored. At the beginning of an exacerbation, the patient feels severe spasms that arise from edema and thickening of the walls of the intestinal lining.

Together with severe attacks The patient experiences the following symptoms of pain:

vomit;
nausea;
diarrhea;
apathy;
fatigue;
weakness;
pain during bowel movements;
bloating.

An exacerbation of the disease can develop over two weeks, and all this time a person feels excruciating discomfort that interferes with normal work and life. If therapy is not started, then the symptoms may subside, and the disease itself may become chronic. At this stage, the patient may experience temporary symptoms that periodically subside.

Especially help will be needed for those patients who begin to secrete mucus along with feces. Such characteristic signs indicate that serious problems have begun in the human intestine. pathological processes that need to be removed urgently.

Depending on the form of the disease, clinical picture may differ slightly. For example, sharp ulcerative colitis characterized by diarrhea pain syndrome in the abdomen, especially on the left side. Symptoms such as joint pain and rectal bleeding may indicate a severe course of the pathology.

The following morphological changes will inform about the presence of pathology:

mucus or pus in the distal intestine;
redness of the gastrointestinal tract;
erosion and ulcers on the walls;
hemorrhages.

Diagnostics

In order to determine the disease, the doctor needs to conduct a full examination of the patient's state of health. Initially, the doctor clarifies the patient's complaints, anamnesis of the disease and life, after which he conducts a physical examination.

Then the patient is assigned to conduct a laboratory and instrumental examination. To diagnose the disease, a blood, urine and stool test is prescribed. From the instrumental examination, the patient is recommended to do ultrasound, radiography, endoscopy, colonoscopy, sigmoidoscopy and biopsy.

Treatment

Acute colitis has characteristic symptoms that make it easy to identify the disease. After the doctor has made a diagnosis and identified the causes of intestinal damage, therapy can be prescribed. All drugs and treatments are used to eliminate the etiology, and not just to reduce the signs of pathology and improve the general condition of the patient.

If the cause of the development of the disease lies in the infection, then antibiotic therapy is prescribed. If an illness is detected from drugs, the patient must urgently stop using them. Chronic colitis in the acute stage is treated in the same way as acute attack diseases.

With spastic colitis, the doctor prescribes drugs to the patient to reduce peristaltic activity.

To reduce pain mild antispasmodics are used.

With inpatient therapy, the patient may be prescribed adrenergic blockers and anticholinergic drugs. They are needed in order to reduce the secretion of mucus in the digestive tract. In parallel, the patient is recommended to take astringent and enveloping preparations that protect the walls from negative impact mucus.

During treatment, the patient is prescribed multivitamins, laxatives, cleansing drugs, and medicinal enemas are also made.

Together with the use various drugs, the patient is prescribed diet therapy. In the diet of a person with colitis, there must be foods that will enrich the body with useful substances.

In the first days after the discovery of the disease, the patient should not eat any food, and then you can gradually start eating light soups, cereals, white bread crackers. In diet therapy, it is important to adhere to the following rules:

with frequent constipation, you need to eat vegetarian first courses, lean meat and fish. It is advisable to boil or stew all foods. Vegetables are recommended to be consumed either raw or boiled. The diet should have a lot of dishes from zucchini, carrots, beets, cauliflower. You can also change the menu fermented milk products, cheese, sweet berries, bread from flour of the first grade;
with a prolonged acute form of the disease, the diet should consist of low-fat cottage cheese, kefir, fermented baked milk. You can cook wheat and barley porridge, rice. Sugar in cooking is undesirable;
if the patient has started ulcerative form colitis, then the patient is assigned a strict dietary restriction. You can eat boiled vegetables, meat and dry bread products. It is necessary to exclude dairy products, soda, tomatoes, nuts, alcohol from the menu;
It is recommended to eat in small portions, but often.

The diet for acute colitis is selected by the doctor absolutely individually. The patient's menu should contain many vitamins and components that will help normalize bowel function. Be sure to cleanse the intestines, frequent constipation can lead to damage to the walls of the mucosa, which will provoke an excessive amount of mucus.

Sometimes patients are allowed to treat the disease not in the hospital, but at home. Such a light version of therapy is possible only if the patient has a mild course of colitis, and it does not pose a serious threat to human life.

For the purpose of additional therapy, doctors are allowed to use alternative medicine. Alternative treatment of acute colitis consists in the use of tinctures from watermelon peels, decoctions of chamomile, yarrow and sage, and enemas can also be made from chamomile. But patients should remember that ethnoscience is not the only method of eliminating colitis, it is only an addition. The use of such funds must be agreed with the attending physician.

Prevention

So that the patient does not know problems with the intestines, doctors recommend following simple preventive actions:

eat healthy food;
chew or grind food thoroughly;
wash vegetables and fruits before eating;
observe the rules of hygiene;
regularly undergo a medical examination;
treat diseases in time.

Inflammatory diseases of the digestive tract are very common in recent times. One of the most serious and severe diseases of this type is acute colitis - inflammation of the mucous membrane of the large intestine. Except local symptoms, the disease is characterized by worsening general well-being because absorption takes place in the intestines. nutrients and synthesis of many vitamins. And with the inflammatory process, all the functions of the rectum are violated. Therefore, it is very important to start treatment as early as possible when the first symptoms of inflammation appear.

general characteristics

The disease is characterized by damage to the intestinal mucosa and its inflammation. Because of this, edema develops, the walls of the intestines thicken, erosions and ulcers can form. In this case, the functionality of the intestine is disturbed. The inflammatory process develops under the influence of various provoking factors. It could be infection, toxins, food poisoning or the use of certain medications.

Acute colitis occurs most often in adults at a young and middle age. But the peak incidence also occurs at the age of 60–80 years. Equally often the disease occurs in both women and men.

Acute colitis usually does not last long. At timely treatment the main symptoms may subside in a few days. A more severe form of the disease lasts about 2 weeks. Most often, then recovery occurs, but often the development of chronic colitis, which can be recurrent or permanent.

The reasons

Inflammation is usually caused by some adverse factors affecting the mucous membrane. Most often it is an infection that enters the intestines with food or contaminated water. Acute colitis can develop with salmonellosis, dysentery, food poisoning. Staphylococci or streptococci, which have increased their activity due to a violation of the intestinal microflora, can also provoke inflammation.

But there are also other causes of acute colitis. Often, inflammation develops after taking certain medications that adversely affect the intestinal mucosa. First of all, these are antibiotics that destroy beneficial microorganisms. As a result, there is a decrease protective functions mucous, and pathogenic bacteria are starting to multiply. Laxatives, glucocorticosteroids, non-steroidal anti-inflammatory drugs can also provoke inflammation.

Sometimes colitis develops due to a violation of blood circulation in the abdominal cavity. Atherosclerosis of vessels or varicose veins leads to tissue ischemia. The intestinal mucosa suffers most from this, inflammation develops in it. AT severe cases the disease proceeds in the form of enterocolitis or gastroenterocolitis, when the inflammation spreads to other parts of the digestive system.

Varieties of the disease

In addition to the fact that colitis can occur in acute or chronic form, there are other varieties of it. The classification of the disease is based on the causes of the inflammatory process, and also depends on the location of its localization. Determination of the form of colitis is necessary for the appointment proper treatment, since the choice of drugs largely depends on why the inflammation appeared.

To choose the right treatment, it is necessary to correctly determine the type of acute colitis.

When diagnosing, the following types of colitis are often distinguished:

In addition, the manifestations of the disease may differ depending on where the inflammatory process is localized. It can spread throughout the intestines, then they talk about total colitis. There is also a left-sided or right-sided form of the disease. Depending on the characteristics of the course of the inflammatory process and the presence of complications, ulcerative colitis is isolated, a variety of which is Crohn's disease, microscopic and pseudomembranous. But microscopic and ulcerative colitis occur most often in a chronic form with frequent exacerbations.

pseudomembranous

This form of acute colitis is caused by clostridia. This microorganism is transmitted household way through furniture, linen, toilets. Therefore, most patients get sick in hospitals. Those who are predisposed to disease long time takes antibiotics that disrupt the intestinal microflora. Especially often the cause of pseudomembranous colitis is the use of Metronidazole, Ampicillin, Clindamycin, fluoroquinolones and cephalosporins.

The disease is characterized by necrosis of cells of the intestinal mucosa. At this point, peculiar films are formed, called pseudomembranes. They disrupt the functioning of the intestines. With a mild course of the disease, the main symptom of inflammation is loose stools, which disappear after stopping antibiotics.

ulcerative

This form of the disease is chronic. But at the stage of exacerbation, all the symptoms are the same as in acute colitis. In addition, sometimes from the appearance of the first signs of the first six months, the disease also has an acute character.

Nonspecific ulcerative colitis is autoimmune pathology. The reasons for its appearance are still unclear to scientists. A type of the disease is Crohn's disease, which is incurable. It gradually progresses, even with the right treatment. The inflammatory process can cover not only the intestines, but also upper divisions digestive system. Crohn's disease can even occur in children, although it is very rare.

Ischemic

This form of the disease occurs due to a violation of the blood supply to the intestines. Ischemic colitis develops due to vascular pathologies, for example, with atherosclerosis. But it can also be caused by compression of the aorta in the abdominal cavity. Inadequate blood supply to the intestinal walls leads to their ischemia and inflammation. With this form of the disease, there can be not only diarrhea, but also constipation due to stagnation of feces. Often this form of the disease is diagnosed in old age.

How does it manifest

Acute colitis is very painful and unpleasant disease. Discomfort and other signs are difficult to ignore, often they completely disrupt the patient's habitual lifestyle and reduce performance. Therefore, usually patients immediately go to the doctor. In most cases, the diagnosis is made after a conversation with the patient and his examination. After all, the symptoms of pathology are very specific.

The disease usually begins acutely. Appear severe pain in the lower abdomen, most often localized on the left. They appear in the form of spasms or colic, which can be permanent or occur before and during bowel movements. Often there is also a painful urge to defecate.

Acute pain in the lower abdomen is the main symptom of acute colitis.

The second characteristic sign of acute colitis is frequent loose stools. With a mild course of the disease, it can be observed 5-6 times a day, in a more severe form - up to 20 times. Moreover, bowel movements are observed even at night. The stool is at first fetid, liquid, then becomes watery due to a violation of the absorption of water. Often in the feces there are impurities of mucus, blood and even pus.

In addition, there are other symptoms of acute intestinal colitis that are less specific and may be seen in other conditions. Therefore, when making a diagnosis, the doctor must take into account all the signs and general condition of the patient.

The following symptoms are often observed:

nausea, vomiting;
bloating, flatulence;
loss of appetite, heaviness in the abdomen, slow digestion;
weakness, apathy, decreased performance;
increase in body temperature;
signs of dehydration of the body: dry skin and mucous membranes, gray coating on the tongue, headaches;
in a severe form of the disease, joint pain may appear.

Features of treatment

Usually acute colitis has well-defined specific features. The main one is frequent watery stools. But not always when such symptoms appear, patients go to the doctor, taking diarrhea for ordinary poisoning. It happens that the doctor immediately makes the wrong diagnosis.

Important: to select an adequate treatment for pathology, it is very important to conduct an examination.

Ultrasound, colonoscopy, radiography, endoscopy are usually prescribed. Sometimes a mucosal biopsy is also required. The patient is also taken blood, urine and feces. After such comprehensive examination the doctor can accurately determine the type of disease and choose the appropriate treatment.

All therapeutic methods in acute form of colitis or exacerbation of chronic should be aimed not only at reducing symptoms. It is also necessary to eliminate the causes of inflammation, prevent complications and improve the general condition of the patient. Therefore, therapy must be comprehensive. Most often used conservative methods treatment. Only in the most severe cases can surgery be prescribed. It is required in about 20% of patients, for example, in the presence of intestinal bleeding, Crohn's disease, purulent inflammation, or suspected cancer.

Acute colitis is treated with medications. They are prescribed individually, depending on the causes and severity of the inflammation. But sometimes the disease occurs against the background of taking medications in the treatment of other pathologies. In this case, therapy begins with the abolition of all drugs.

In addition to taking medication, it is very important for patients to follow a diet, since nutrition often causes an increase in the inflammatory process. Additionally, after consultation with your doctor, you can use folk recipes. Basically it's decoctions medicinal herbs taken orally or as an enema. They can alleviate the patient's condition and speed up recovery.

Medical therapy

The choice of drugs for the treatment of colitis depends on individual characteristics sick. If the inflammation is caused by an infection, antibiotics or antimicrobials. In parallel with antibiotic therapy, it is necessary to prescribe probiotics to normalize intestinal microflora. The most commonly used are Bactisubtil, Enteroseptol, Lineks, Bifiform. In addition to them, the use of sorbents is effective. It can be Smecta, Polyphepan, Enterosgel, activated carbon.

Total ulcerative colitis is treated with Mesalazine. It is used in the form of tablets, injections, and also rectal suppositories. Similar action also has Sulfasalazine, but it is worse tolerated by patients.

In acute pain, which most often manifests itself in the form of colic, antispasmodics are prescribed. It can be Platifillin, Duspatalin, Atropine, Papaverine. It is not recommended to use NSAIDs or narcotic analgesics to relieve pain. For persistent vomiting, metoclopramide or chlorpromazine may be used. Loperamide or cholestyramine is prescribed to reduce diarrhea. Preparations containing bismuth subsalicylate are also effective.

The most common treatment for acute colitis is a complex drug therapy.

At heavy losses fluid, which is often due to prolonged diarrhea prescribe dehydration procedures. For this, they can be used ready solutions, normalizing water-salt balance. In severe cases, treatment is carried out in a hospital, where the patient is given a dropper with saline or glucose. He may also be given sodium benzoate or Cordiamin.

Food

Needed for acute colitis special diet. It is selected individually depending on the cause and severity of the disease. But there are general principles of nutrition that must be observed by all patients. Usually, table number 4 is assigned for colitis.

First of all, the first few days after the onset of the inflammatory process, it is recommended to starve. You can only drink tea lemon drink or a rosehip decoction. Only after 2-3 days, depending on the condition of the patient, you can gradually include porridge in the diet, vegetable soups, lean meat and crackers. After the inflammation decreases and the symptoms subside, the patient's diet can become more varied.

It is allowed to eat cereals on the water, dried white bread, low-fat cottage cheese, vegetables, low-fat meat. Kissels from berries, rosehip decoctions, cocoa on the water are useful. All food should be well cooked and chopped. It is forbidden to fry it, you must also limit the use of salt and sugar.

Within 2-3 weeks with acute colitis and - forever - with a chronic form, it is imperative to exclude such foods from the diet:

alcoholic and carbonated drinks;
coffee, strong tea;
fruit juices;
fatty meat, offal;
fried food;
spicy seasonings and vegetables, such as radish, radish, horseradish, onion, garlic;
whole milk;
eggs.

Prevention

Acute colitis is a very painful pathology that causes severe discomfort to the patient. Therefore, it is desirable to prevent the development of the inflammatory process. For this, certain preventive measures:

monitor the balance of nutrition;
do not eat junk food, expired or of poor quality;
subject fish and meat to serious heat treatment;
do not drink raw water;
observe the rules of personal hygiene, especially when processing food;
chew all food thoroughly;
consult a doctor on time and undergo regular examinations;
lead active image life.

conclusions

Acute colitis is a fairly common severe inflammatory disease. It not only causes severe suffering to the patient, but also disrupts the activity of the entire digestive system. Only with timely therapy in most cases the prognosis of recovery is favorable. If the patient follows all the doctor's recommendations and diet, inflammation can be dealt with in a couple of weeks.

- this is an acute inflammatory reaction of the colon mucosa in response to the action of infectious, toxic, pharmacological or endogenous factors. It is manifested by pains mainly in the left side of the abdomen, loose watery stools with impurities of mucus, blood and pus, high temperature and symptoms of dehydration. For diagnosis, they collect complaints and anamnesis, palpation of the large intestine, colonoscopy, sigmoidoscopy, complete blood count, clinical and microbiological analysis feces. For the treatment of acute colitis are prescribed antibacterial agents, eubiotics, antispasmodics; therapy to combat dehydration.

ICD-10

K52 Other non-infectious gastroenteritis and colitis

General information

Diagnostics

At the initial stage, for the diagnosis of acute colitis, the proctologist collects complaints and anamnesis. These clinical methods allow us to suspect the cause that could cause the disease. In addition, palpation of the abdomen in the region of the large intestine is performed, in which soreness and rumbling are determined mainly in the left half, which testifies in favor of colitis.

In the diagnosis of acute colitis, instrumental and laboratory methods are used. Of the instrumental techniques, endoscopy is the most informative, in particular, colonoscopy and sigmoidoscopy. During these studies revealed hyperemia and swelling of the intestinal mucosa. In the case of a severe course of the disease, during endoscopy, pus, hemorrhages, erosion, and even ulcers are visualized on the walls of the large intestine.

From laboratory methods a general blood test is performed, microbiological research feces. In acute colitis general analysis blood, there is an increase in the number of leukocytes, stab forms and an acceleration of ESR. These are nonspecific signs of inflammation, which allow us to assess the severity of the inflammatory process in the colon. In the analysis of feces (coprogram), a large amount of mucus and blood elements attract attention. The chair often has watery character. Microscopy of feces can reveal an abundance of leukocytes, which indicates the bacterial nature of the inflammation. To identify a specific pathogen, a microbiological study of feces is carried out. It allows not only to detect the pathogen, but also to determine its sensitivity to antibiotics.

Treatment of acute colitis

It is required to observe peace and hunger for several days. Only warm drinks are allowed, such as tea or lemon juice. After a few days, the diet expands by adding porridge to the diet, lean meat and broths. In the next two weeks, patients are advised to refrain from spicy, fatty or fried food, as well as from vegetables and alcohol, which irritate the intestines. This diet corresponds to table number 4. If the disease was caused by eating food contaminated with pathogenic microflora or toxins, the stomach and colon are washed with warm soda solution in parallel with the appointment of laxatives.

In acute colitis, which is accompanied by severe paroxysmal pain in the intestines, antispasmodics are injected subcutaneously: platifillin, papaverine or atropine. Purpose narcotic analgesics Not recommended. In addition, for the treatment of acute colitis are used sulfa drugs, antesthezin and activated charcoal. From the first days, empirical antibiotic therapy is prescribed, which, after receiving the results bacteriological research feces are adjusted taking into account the sensitivity of the pathogen. In parallel with antibiotics, patients are prescribed eubiotics and probiotics to normalize the intestinal microflora.

In the case of a severe course of the disease, these therapeutic measures are supplemented with therapy aimed at combating dehydration and collapse. For this purpose, patients with acute colitis are administered cordiamine or sodium benzoate. With the development of heart failure against the background of dehydration, cardiac glycosides are indicated. In addition, in parallel infusion therapy saline or 5% glucose in a volume of up to 2 liters per day. If a patient with acute colitis has persistent intense vomiting, then he is given metoclopramide or chlorpromazine.

Forecast and prevention

To prevent acute colitis, it is necessary to strictly observe the rules of personal hygiene, which include thorough hand washing before eating. Always wash fruits and vegetables that you eat. Prevention provides heat treatment meat and fish, as well as boiling water. In addition, preventive measures are recommended to combat viral infections that can cause acute colitis.