What suppositories are used in the treatment of proctitis. Scheme of drug therapy for nonspecific ulcerative colitis in children. Drugs for the treatment of colitis

2. Basic therapy

Means of basic therapy affect the main pathogenetic mechanisms: the synthesis of inflammatory mediators and immune disorders including autoimmune reactions.

2.1. Treatment with drugs containing S-ACK

Sulfasolosin (salazosulfapyridine, salazopyridine) - is a compound of sulfapyridine and 5-aminosalicylic acid (5-ASA). Under the influence of the intestinal flora, sulfasalazine breaks down into sulfapyridine and 5-ASA, which is an effective component of the drug, and sulfapyridine is only its carrier. 5-ASA inhibits the synthesis of leukotrienes, prostaglandins and inflammatory mediators in the colon, resulting in a pronounced anti-inflammatory effect. P. Ya. Grigoriev and E. P. Yakovenko (1993) indicate that, perhaps, sulfasalazine also exhibits an antibacterial effect in the intestine, inhibiting the growth of anaerobic flora, especially clostridia and bacteroids, mainly due to unabsorbed sulfapyridine.

Sulfasalazine should be taken in divided intervals between meals. The drug can be taken orally, as well as injected into the rectum in the form of a therapeutic enema or suppository. The daily dose of sulfasalazine depends on the severity of the disease, the severity of inflammation, the extent of the pathological process in the intestine.

With mild forms of the disease and with forms moderate sulfasalazine is prescribed 3-4 g per day, in severe forms - 8-12 g per day. On the first day, it is recommended to take 1 tablet (0.5 g) 4 times a day, on the second day - 2 tablets (1 g) 4 times a day and on subsequent days, if the drug is well tolerated, 3-4 tablets 4 times a day , bringing the dose in severe form to 8-12 g per day.

After the onset of remission, treatment should be continued at the same dose for another 3-4 weeks, and then gradually reduce the dose every 3-5 weeks to a maintenance dose (1-2 g per day), which should be taken for at least a year and canceled while maintaining remission (P. Ya. Grigoriev, 1993).

Treatment with sulfasalazine in 10-30% of cases is accompanied by the development of side effects:

gastrointestinal manifestations (anorexia, nausea, vomiting, epigastric pain);

common symptoms (headache, fever, weakness, arthralgia);

hematological disorders (agranulocytosis, pancytopenia, anemia, methemoglobinemia, hemorrhagic syndrome);

granulomatous hepatitis;

oligospermia and male infertility.

With the development side effects the drug is canceled until they disappear completely, then you can re-assign the drug at half the dose and try to increase it to the optimal one.

Sulfasalazine inhibits the absorption of folic acid in the small intestine, so patients receiving sulfasalazine should also take folic acid 0.002 g 3 times a day.

With left-sided distal localization of NUC (proctitis, proctosigmoiditis), sulfasalazine can be used in the form of microclysters and suppositories.

With enema administration, sulfasalazine is used as a suspension of 4-6 g in 50 ml isotonic solution sodium chloride or boiled water daily for 1-1.5 months.

Sulfasalazine suppositories are injected into the rectum 2 times a day. One suppository contains 1 g of sulfasalazine and 1.6 g of cocoa butter.

Salofalk (tidocol, mesacol, mesalazine) is a drug containing only 5-aminosalicylic acid and devoid of sulfapyridine. It is believed that the side effects of sulfasalazine are primarily due to the presence of sulfapyridine in its composition. Salofalk does not contain sulfapyridine in its composition, therefore, it causes side effects much less often, its tolerance is better than sulfasalazine. Salofalk is prescribed for intolerance to sulfasalazine.

A. R. Zlatkina (1994) recommends that in mild forms of UC, prescribe Salofalk 1.5 g (6 tablets of 0.25 g) daily. At medium severe forms the dose is doubled. In acute attacks of proctosigmoiditis, salofalk enemas are more effective, containing 4 g of the drug in 60 g of suspension, which are done once after a stool for 8-10 weeks.

For the treatment of distal forms of UC, suppositories are also used: 2 suppositories (500 mg) 3 times a day (morning, afternoon, evening), daily.

Salazopyridazine, salazodimetoksin - 5-ASA-containing preparations of domestic production, they are less toxic and better tolerated. The mechanism of action is the same as sulfasalazine. The activity of these drugs is higher than that of sulfasalazine. Salazopyridazine and salazodimethoxine are available in tablets of 0.5 g. Treatment with these drugs is carried out mainly with mild to moderate forms of chronic ulcerative colitis.

P. Ya. Grigoriev and E. P. Yakovenko (1993) in the active stage of the disease prescribe these drugs in a daily dose of 2 g (0.5 g 4 times a day) for 3-4 weeks. In the event of a therapeutic effect, the daily doses are reduced to 1-1.5 g (0.5 g 2-3 times a day) and continue treatment for another 2-3 weeks. In severe forms of the disease, it is possible to increase the daily dose to 4 g.

2.2. Treatment with glucocorticoid drugs

Glucocorticoid drugs accumulate in the area of ​​inflammation in the large intestine in UC and block the release of arachidonic acid, prevent the formation of inflammatory mediators (prostaglandins and leukotrienes), reduce capillary permeability, i.e. have a powerful anti-inflammatory effect. In addition, glucocorticoids have an immunosuppressive effect. Indications for the appointment of glucocorticoids in NUC are as follows (A. R. Zlatkina, 1994):

left-sided and total forms of ulcerative colitis with severe course, with III degree of activity of inflammatory changes in the intestine (according to endoscopic examination);

acute severe and moderate forms of the disease in the presence of extraintestinal complications;

lack of effect from other methods of treatment in chronic forms of ulcerative colitis.

Glucocorticoids can be used orally, intravenously and rectally.

Inside, glucocorticoids are prescribed for a common process (prednisolone - 40-60 mg per day, and according to A. R. Zlatkina - 1-2 mg / kg, but not more than 120 mg per day), and in severe cases, if it does not occur significant improvement within 4-5 days from taking salicylic sulfonamides, P. Ya. Grigoriev recommends intravenous administration of hydrocortisone hemisuccinate (initial dose of 200-300 mg, and then 100 mg every 8 hours). After 5-7 days, the introduction of hydrocortisone is stopped and treatment is continued by taking oral prednisolone at a dose of 40-60 mg per day, depending on the patient's condition. After the onset of clinical remission, the dose of prednisolone is gradually reduced (no more than 5 mg per week). A full course of glucocorticoid therapy lasts from 10 to 20 weeks, depending on the form of ulcerative colitis. When the patient's condition improves, it is advisable to include sulfasalazine or salofalk and take prednisolone until complete withdrawal.

In patients with UC, limited to the rectum and sigmoid colon, glucocorticoids can be administered in suppositories or enemas. Hydrocortisone is prescribed rectally by drop of 125 mg, and prednisolone - 30-60 mg in 120-150 ml of isotonic sodium chloride solution 1-2 times a day. Prednisolone suppositories are also used, 1 suppository 2 times a day (1 suppository contains 5 mg of prednisolone).

It should be remembered about the possibility of developing side effects of glucocorticoid therapy: systemic osteoporosis, steroid diabetes mellitus, arterial hypertension, cushingoid syndrome, the development of a stomach or duodenal ulcer. The development of steroid gastric ulcers and bleeding from them require the abolition of glucocorticoids, other side effects are corrected by symptomatic therapy.

2.3. Treatment with cytostatics (non-hormonal immunosuppressants)

The question of the advisability of treating patients with UC with cytostatics has not been finally resolved.

P. Ya. Grigoriev (1993) believes that the cytostatic 6-mercaptopurine is not indicated for exacerbations of UC, it is preferable to use it in cases where the patient is in remission and it is desirable to reduce the dose of glucocorticoids or stop their treatment.

Cytostatics have a pronounced immunosuppressive effect, suppress the immune mechanisms of the pathogenesis of UC.

When azathioprine (Imuran) is combined with prednisolone, remission occurs faster. With such complex therapy it is possible to reduce a large dose of glucocorticoids. Azathioprine is recommended at an average dose of 150 mg per day (2-2.5 mg/kg).

Due to the high risk of side effects in the treatment of non-hormonal immunosuppressants (pancytopenia, anemia, leukopenia, the development of pancreatitis, the addition of infectious and inflammatory diseases, etc.), short courses of treatment (3-4 weeks) are recommended, followed by a decrease and cancellation of cytostatics.

AT last years data have appeared on the possibility of using the immunosuppressant cyclosporine in the treatment of UC. It has the main effect on the cellular link of immunity, suppressing the synthesis and release of interleukin-2, inhibiting the function of T-lymphocytes-helpers and the production of autoantibodies. Interleukin-2 plays an important role in the progression of UC. Treatment with cyclosporine is indicated when all previous treatments have failed (i.e. cyclosporine is a "last line" drug). Assign treatment with doses of 15 mg / kg per day for 2 weeks, then reduce the dose to a maintenance, individually selected, which can be used for many months (up to a year). The drug does not affect Bone marrow but may be toxic to the kidneys.

3. Application of astringents, adsorbents and antidiarrheals

These funds, having an astringent, enveloping effect, contribute to the rapid improvement of the functional state of the intestine and the relief of the inflammatory process. Antidiarrheals are prescribed to patients who have stools more than 4 times a day.

For the use of astringents, adsorbents, antidiarrheals, see "Treatment of chronic enteritis".

4. Correction metabolic disorders and anemia

Correction of metabolic disorders and anemia is the most important therapeutic measure in patients with a severe form of the disease and less often - with a form of moderate severity. Intravenous administration of albumin, mixtures of amino acids, plasma, intralipid, saline solutions, glucose is used. Transfusion therapy promotes detoxification, improves the state of the microcirculation system. It is also necessary to provide for measures to correct the level of electrolytes in the blood.

Correction of anemia is carried out by intravenous drip infusion of polyfer (400 ml drip), intramuscular injection of the iron-containing drug ferrum-lek, in case of severe anemia - transfusion of erythrocyte mass.

For details on the implementation of this section of the treatment program, see "Treatment of chronic enteritis".

5. Detoxification therapy

With UC, especially with severe course disease, toxemia syndrome develops due to a violation of the barrier functions of the colon.

To combat intoxication, the following are used: intravenous drip infusion of glucose solutions, electrolytes, hemodez, isotonic sodium chloride solution, Ringer's solution. Hemosorption is very effective in terms of detoxification, in addition, this method has an immunomodulatory effect, helps to remove immune complexes.

6. Antibacterial therapy and treatment of intestinal dysbacteriosis

Antibacterial therapy for UC is prescribed when there is a threat of developing toxic megacolon, septicopyemia, secondary purulent infection. Antibacterial agents are prescribed, taking into account the type of fecal flora and its sensitivity to antibiotics. Semi-synthetic antibiotics, cephalosporins, metronidazole, biseptol, etc. are used. For staphylococcal dysbiosis, ampioks, erythromycin, oleandomycin can be used, for yersiniosis - chloramphenicol, for anaerobic flora (clostridia, bacteroids) - metronidazole, for proteic dysbiosis - nevigramon, furazolidone.

After the suppression of the pathogenic flora, the normal intestinal flora is reimplanted by using colibacterin, bificol, bactisubtil and other drugs for 2-3 months.

This section is described in detail in "Treatment of chronic enteritis".

7. Local treatment of proctosigmoiditis

In addition to microenemas with preparations of 5-aminosalicylic acid, hydrocortisone, other types of local treatment described in Chap. "Treatment of chronic colitis".

Chronic diseases of the stomach and intestines are quite common among the population. Improper nutrition, lack of essential substances, stress and a sedentary lifestyle can trigger the development of colitis. Candles from colitis allow you to gently eliminate unpleasant symptoms and cure the disease.

Benefits of using candles

Colitis is an inflammatory disease of the mucous membranes of the colon. Most often, middle-aged people are affected by the disease. A low fiber content in the diet and dysbacteriosis of the microflora of the gastrointestinal tract can provoke the development of colitis.

Varieties of colitis:

• Ulcerative. The causes of occurrence are not fully understood;
• Infectious. Caused by pathogenic microflora (dysentery and coli, streptococci and staphylococci);
• Ischemic. The result of lesions of the branches of the abdominal aorta;
• Toxic. It is caused by drug, chemical or radiation poisoning.

Colitis can be acute or chronic. Acute colitis accompanied by constant urge to defecate, rumbling, abdominal pain, diarrhea.

Treatment of acute and chronic colitis is aimed at managing the symptoms. Among the other funds are assigned and rectal suppositories depending on individual symptoms.

The action of suppositories for colitis:

• regeneration;
• healing;
• removal of edema;
• anesthesia;
• relief of defecation.

Some suppositories can be used in children, pregnant and lactating women due to the absence of hazardous components.

Means with anti-inflammatory effect

• Proctosan.

• Candles with propolis.

Natural healing agent. The drug has effective antiseptic properties and suppresses pathogenic microflora intestines in infectious colitis. The fat-soluble component is well distributed along the intestinal walls.

• Beauty candles.

The drug contains belladonna alkaloids. Main action: pronounced pain relief, spasm relief. In its pure form, candles with belladonna are sold strictly according to the recipe. AT complex means with other names, the extract is enhanced by other substances. Drugs are dispensed without a prescription.

• Sea buckthorn candles.

Sea buckthorn oil is a remedy that accelerates tissue regeneration. It has such an effect in the composition of suppositories for rectal use. Candles with rosehip oil have a similar effect.

• Ichthyol candles.

Ichthyol has an antiseptic and irritating effect, which leads to increased blood circulation in the intestinal walls, accelerated tissue regeneration and relieve inflammation.

• Methyluracil.

The active substance has strong healing properties and is widely used not only for colitis, but also for the treatment of many other diseases of the rectum and large intestine, including hemorrhoids. The line of products also has an ointment with methyluracil with a wide range of applications.

Most of the funds are inexpensive and can cure colitis as part of complex therapy. A proctologist or gastroenterologist will help you choose the right combination of drugs. For constipation, suppositories gently stimulate the intestines and help relieve stools.

Candles with analgesic effect

• Diclofenac.

Refers to non-steroidal anti-inflammatory drugs. It has an intense analgesic effect by blocking the production of prostaglandins in the body.

The drug is prohibited for use during pregnancy, as it can provoke hypoxia and fetal growth retardation.

Preparations with its content have many names and are widely represented in pharmacies.

• Papaverine.

Candles do not have strong anesthetic properties, but they effectively relieve intestinal spasms. The restrictions include simultaneous reception alcohol due to the risk of an excessive drop in blood pressure.

The drug is widely used to reduce the tone of the uterus in pregnant women, so it can also be used for colitis during childbearing.

Glucocorticoid suppositories

In severe cases and in the presence of intense symptoms, the use of hormonal suppositories may be required. Among the most active and frequently used drugs is hydrocortisone. Its use is justified in the case of severe forms of colitis, accompanied by severe hemorrhoids or the presence of hemorrhoids.

A unique preparation is the Posterizan Forte candles. They include corpuscular components and metabolic products of Escherichia coli. The drug has a powerful healing effect and allows you to get rid of even severe manifestations of colitis and hemorrhoids in the shortest possible time.

Escherichia coli stimulate local immunity, suppress pathogenic microflora and stimulate regeneration.

The right choice of ingredient complex treatment help to get rid of the unpleasant symptoms of colitis for short term, and preventive courses, especially with a tendency to hemorrhoids, will completely forget about painful sensations.

Video about folk remedies for the treatment of colitis:

Therapeutic tactics in ulcerative colitis is determined by the localization of the pathological process in the colon, its extent, the severity of the attack, the presence of local and / or systemic complications. Conservative therapy is aimed at the most rapid relief of the attack, prevention of recurrence of the disease and progression of the process. Distal forms of ulcerative colitis - proctitis or proctosigmoiditis - are characterized by a milder course, so they are most often treated on an outpatient basis. Patients with left-sided and total lesions, as a rule, are treated in a hospital, since the course of the disease in them is more pronounced. clinical symptoms and great organic changes.

The food of patients should be high-calorie and include foods rich in proteins, vitamins, with the restriction of animal fats and the exclusion of coarse vegetable fiber. Recommended low-fat varieties of fish, meat (beef, chicken, turkey, rabbit), boiled or steamed, mashed cereals, potatoes, eggs, dried bread, walnuts. excluded from the diet raw vegetables and fruits, as they contribute to the development of diarrhea. Often, patients have lactase deficiency, so dairy products are added only if they are well tolerated. These recommendations correspond to diets 4, 4B, 4B of the Institute of Nutrition of the Russian Academy of Medical Sciences.

All drugs used in the treatment of ulcerative colitis can be divided into two categories. large groups. The first combines basic anti-inflammatory drugs and includes aminosalicylates, i.e. drugs containing 5-aminosalicylic acid (5-ASA, mesalazine), corticosteroids and immunosuppressants. All other drugs play either an auxiliary role in the treatment of ulcerative colitis or are under clinical study.

The first drug containing 5-ASA was sulfasalazine (salazosulfapyridine), which was introduced into clinical practice in 1942. Sulfasalazine consists of two components linked by a nitrogen bond - sulfapyridine sulfanilamide and 5-ASA. It has been proven that only 5-ASA has an anti-inflammatory effect. Sulfapyridine was compulsorily included in the composition of the sulfasalazine molecule, since "pure" 5-ASA is well absorbed in the small intestine, and in the mucous membrane it turns into an inactive metabolite - N-acetyl-5-ASA. Sulfapyridine acts in sulfasalazine exclusively as a "carrier" that allows you to deliver 5-ASA to the affected areas of the colon. Under the influence of the colonic microflora, the nitrogen bond is destroyed. Sulfapyridine is absorbed in the colon, detoxified in the liver by acetylation and excreted in the urine, and 5-ASA, in contact with the mucous membrane, has an anti-inflammatory effect.

The mechanisms by which 5-ASA exerts its anti-inflammatory effects are not fully understood. Nevertheless, numerous effects are known, due to which mesalazine inhibits the development of inflammation. So, by inhibiting cyclooxygenase, mesalazine inhibits the formation of prostaglandins. The lipoxygenase pathway of arachidonic acid metabolism is also suppressed, the release of leukotriene B4 and leukotriene sulfopeptide is inhibited.

At high concentrations, mesalazine may inhibit certain functions. neutrophilic granulocytes in humans (eg, migration, degranulation, phagocytosis, and generation of toxic free oxygen radicals). In addition, mesalazine inhibits the synthesis of platelet activating factor. Due to its antioxidant properties, mesalazine is able to scavenge free oxygen radicals.

Mesalazine effectively inhibits the formation of cytokines - interleukin-1 and interleukin-6 (IL-1, IL-6) - in the intestinal mucosa, and also inhibits the formation of IL-2 receptors. Thus, mesalazine interferes directly with the course of immune processes.

It has been shown that the "ballast" component of sulfapyridine is mainly responsible for the overall frequency of side effects of sulfasalazine. Literature data on the frequency of side effects caused by sulfasalazine range from 5 to 55%, averaging 21%. In addition to nausea, headache, male infertility, anorexia, dyspeptic disorders, hematological reactions (leukopenia and hemolytic anemia) and hypersensitivity reactions with multiple organ lesions occur.

In order to preserve the anti-inflammatory activity inherent in sulfasalazine and avoid the side effects associated with the sulfapyridine component, preparations containing "pure" 5-ASA have been developed in recent years. As an example of a new generation of amino salicylates, salofalk, developed by the German pharmaceutical company Dr. Falk Pharma, can be cited. The drug is available in three dosage forms: tablets, suppositories and microclysters. In tablets, mesalazine is protected from contact with gastric contents by a special acid-resistant polymer shell that dissolves at pH values ​​above 6.5. It is these pH values ​​that are usually recorded in the lumen of the ileum. After dissolution of the membrane in the ileum, a high concentration of the active anti-inflammatory component (mesalazine) is created. Selecting a specific dosage form salofalk is determined by the length of the zone of inflammation in the colon. With proctitis, it is advisable to use suppositories, with left-sided lesions - microclysters, and with total colitis - tablets.

Pentasa, which has recently appeared in Russia, being equally effective, has a number of features. It differs from other mesalazine preparations in its microgranular structure and coating. Pentasa tablets consist of microgranules in an ethylcellulose shell, the dissolution of which does not depend on the pH level in the gastrointestinal tract. This provides a slow, gradual and even release of 5-ASA throughout the intestinal tube, starting from the duodenum. Uniformity of release contributes to a constant concentration of the drug in different departments intestine, which does not depend not only on pH, but also on the speed of transit, so Pentasa can be successfully used in inflammatory bowel diseases with diarrhea with virtually no loss. These features make it possible to use the drug not only in ulcerative colitis and Crohn's disease with damage to the colon and ileum, but also, which is especially important, in patients with high-intestinal localization of Crohn's disease.

The daily dose of aminosalicylates is determined by the severity of the attack of ulcerative colitis and the nature of the clinical response to the drug. To stop an acute and moderate attack, 4-6 g of sulfasalazine or 3-3.5 g of mesalazine per day are prescribed, divided into 3-4 doses. In the absence of a good clinical response, the daily dose of mesalazine can be increased to 4.0-4.5 g, however, it is usually not possible to increase the daily dose of sulfasalazine due to the development of severe side effects.

Sulfasalazine blocks the conjugation of folic acid in the brush border of the jejunum, inhibits the transport of this vitamin, inhibits the activity of enzymatic systems associated with it in the liver. Therefore, in the treatment complex of patients with ulcerative colitis receiving treatment with sulfasalazine, it is necessary to include folic acid at a dose of 0.002 g 3 times a day.

It usually takes 3-6 weeks to stop an attack of ulcerative colitis. This is followed by anti-relapse treatment with sulfasalazine (3 g/day) or mesalazine (2 g/day).

Of the modern drugs for the treatment of proctosigmoiditis and left-sided colitis, salofalk suspension is most often used. The disposable reservoirs contain, respectively, 4 g of mesalazine in 60 ml of suspension or 2 g of mesalazine in 30 ml of suspension. The drug is injected into the rectum 1-2 times a day. The daily dose is 2-4 g, depending on the severity of the process in the intestine. If the length of the inflammatory process in the rectum is not more than 12 cm from the edge of the anus, it is advisable to use salofalk suppositories. The usual daily dose in these cases is 1.5-2 g.

When using aminosalicylates, it is possible to achieve remission in 75-80% of cases of ulcerative colitis.

The most effective anti-inflammatory drugs in the treatment of ulcerative colitis remain steroid hormones, which, in severe forms of the disease, are superior in activity to aminosalicylates. Corticosteroids accumulate in inflammatory tissue and block the release of arachidonic acid, preventing the formation of prostaglandins and leukotrienes, which cause the inflammatory process. By blocking chemotaxis, steroid hormones indirectly exhibit an immunomodulatory effect. Influence on tissue fibrinolysis leads to a decrease in bleeding.

Acute severe and moderate forms of the disease and the presence of extraintestinal complications;

Left-sided and total forms of ulcerative colitis with severe and moderate course, if present III degree activity of inflammatory changes in the intestine (according to endoscopic examination);

Lack of effect from other treatments for chronic forms of ulcerative colitis.

In acute severe ulcerative colitis or a severe attack of chronic forms of the disease, treatment should begin with intravenous administration of prednisolone at least 120 mg / day, evenly distributed over 4-6 injections with simultaneous correction of water and electrolyte disorders, administration of blood and blood substitutes and (if possible) hemosorption for the purpose fast elimination endotoxemia. Hydrocortisone suspension should be administered intramuscularly, however, the duration of such administration is limited to 5-7 days due to likely development abscesses at injection sites and possible delay liquids. After 5-7 days, you should switch to oral administration of prednisolone. During this time, gastroscopy is performed to exclude peptic ulcer of the stomach and duodenum. With a moderate form and the absence of clinical signs, as well as anamnestic indications for gastroduodenal ulcers, treatment should be started immediately with oral intake prednisolone. Usually prednisone is prescribed at a dose of 1.5-2 mg/kg of body weight per day. A dose of 100 mg should be considered the maximum.

With good tolerance of hormonal drugs, it is recommended to take the prescribed dose until a stable positive result is obtained - within 10-14 days. After that, a decrease is carried out according to the so-called stepwise scheme - by 10 mg every 10 days. Starting from 30-40 mg, a single dose of prednisolone in the morning is recommended, which practically does not cause serious complications. At the same time in treatment regimen include mesalazine or sulfasalazine, which should be taken until complete withdrawal of hormones. Starting from 30 mg, the abolition of prednisolone is carried out more slowly - 5 mg per week. In this way, full course hormone therapy lasts from 8 to 12 weeks. depending on the form of ulcerative colitis.

With distal forms of damage and I-II degree of activity of the process, according to sigmoidoscopy, hydrocortisone should be administered rectally by drop or microclysters. Moreover, if patients do not hold large volumes well, then the introduction of hydrocortisone (65-125 mg) should be started in 50 ml of isotonic sodium chloride solution and as the inflammation subsides, the frequency of false urges decreases, gradually increase the volume to 200-250 ml per therapeutic enema. The drug is usually administered after a stool in the morning or at bedtime.

With ulcerative proctitis and sphincteritis, it is enough good effect provide suppositories with prednisolone (5 mg), administered 3-4 times a day. With a more severe course of distal forms, accompanied by an increase in body temperature, general weakness, anemia and III-IV degree of activity according to rectoscopy, in cases of no effect from sulfasalazine or mesalazine, treatment with oral prednisolone at a dose of 30-50 mg / day is indicated.

In middle-aged and elderly patients, the dose of prednisolone should not exceed 60 mg, since they are characterized by the presence of concomitant diseases: atherosclerosis, hypertonic disease, diabetes and others. In cases where ulcerative colitis occurs against the background of atherosclerotic lesions of the mesenteric arteries, it is necessary to introduce into the treatment complex vascular preparations: trental, prodectiny etc.

Hormone therapy is associated with the development of side effects: retention in the tissues of fluid, chlorides and sodium (possible swelling), arterial hypertension, hypokalemia, calcium loss, osteoporosis, various autonomic disorders, violation carbohydrate metabolism, adrenal insufficiency, stomach ulcers, gastrointestinal bleeding. In these cases, the appointment of adequate symptomatic therapy is recommended: antihypertensive drugs, diuretics, calcium preparations, antacids. If carbohydrate metabolism is disturbed, a carbohydrate-restricted diet is necessary, according to indications, fractional administration of insulin (corresponding to glycemia) or oral antidiabetic drugs. To prevent the development of thrombosis in patients with severe forms of ulcerative colitis receiving hormonal treatment, constant control blood coagulation system and at the same time prescribe antiplatelet agents: chimes, prodectin, etc.

ACTH-zinc-phosphate is effective only in acute ulcerative colitis, since its effect is mediated by the preserved function of its own adrenal glands. The drug is administered intramuscularly at a dose of 20-40 mg, depending on the severity of the attack.

In recent years, in the treatment of inflammatory bowel diseases, especially Crohn's disease, drugs containing as active ingredient glucocorticosteroid budesonide. Unlike traditional glucocorticosteroids, budesonide has a very high degree of affinity for receptors and a high (about 90%) first-pass metabolism in the liver. Due to this, it has a very powerful local anti-inflammatory effect in minimum quantity systemic side effects. Budenofalk can be recommended as an alternative to prednisolone and hydrocortisone. When developing the structure of Budenofalk, the physiological characteristics of the gastrointestinal tract were taken into account. Each Budenofalk capsule contains about 350 microspheres, consisting of budesonide, coated with a polymer shell resistant to action. gastric juice. The release of budesonide from microspheres occurs in the ileum and colon at pH values ​​above 6.4. Budenofalk is used to treat mild to moderate exacerbations of ulcerative colitis. The recommended daily dose is 1 capsule of budenofalk containing 3 mg of budesonide, 4-6 times a day.

The most serious problem in the treatment of ulcerative colitis is hormonal dependence and resistance. This group of patients had the worst results. conservative therapy and the highest surgical activity. According to the GNCC, hormonal dependence is formed in 20-35% of patients with severe ulcerative colitis. Often, signs of dependence and resistance are observed simultaneously, forcing the resort to unsafe and aggressive methods of influence.

Hormonal dependence is a reaction to glucocorticoid therapy, in which a positive therapeutic effect is replaced by a reactivation of the inflammatory process against the background of dose reduction or withdrawal of corticosteroids. This is a special variant of refractory colitis. We believe that there are at least 4 different etiopathogenetic variants of hormonal dependence: true hormonal dependence, combined with steroid resistance, false, due to inadequate treatment, chronic adrenal insufficiency itself, and a mixed or combined form.

Currently, the causes and mechanisms of the formation of hormonal dependence are not fully known. Nevertheless, we believe that among the etiological factors, defects in hormone therapy itself, persistent activity of inflammation, a transient or persistent decrease in the function of the pituitary-adrenal system will undoubtedly find their place. Probably, in some cases, hormonal dependence and resistance are hereditary, in others they are an acquired defect. hormone receptors and imbalance between cell proliferation and death, i.e., deregulation of apoptosis. The hypothesis of a low density of hormone receptors in patients with inflammatory diseases of the colon, especially in refractory course, has recently received convincing confirmation.

It is immunosuppressants that play a responsible role in the treatment of patients with inflammatory diseases of the colon with hormonal dependence and resistance. However, this role is various drugs regarded as ambiguous. Among the drugs of the 1st line and long-term use include 6-mercaptopurine and azathioprine. They are excellent sparring partners for glucocorticoids. Purine analogues can reduce and cancel hormones in 60-70% of patients with hormonal dependence, subject to certain rules, namely: they must be administered simultaneously with hormones so that their action has time to manifest itself. The daily dose of azathioprine should not exceed 150 mg. The effect can be expected only by the end of the 3rd month of continuous use. Purine analogs have relatively few side effects and should be used in patients with hormonal dependence for as long as possible - 2-3 years or more.

Methotrexate is the 2nd line drug for long-term therapy, which is used for intolerance to azathioprine or the need to accelerate the effect. It is administered orally or intramuscularly at a dose of 30 mg/week. The result can be obtained in 2-4 weeks. Side effects are few. Unfortunately, like azathioprine, it does not provide a lasting effect. When canceled, exacerbations occur. Outbreaks are milder than before, sometimes occur on the background of therapy after 6 months. from the start of admission.

Cyclosporine can be used orally, intravenously at a dose of 4-6 mg/kg of body weight with good and quick effect coming in 5-7 days. The action is short. It is more often used to interrupt an attack, followed by a transition to immunosuppressants suitable for prolonged use.

Violation of the barrier functions of the colon in ulcerative colitis may be the cause of the development of toxemia syndrome. For its correction, it is necessary to prescribe an appropriate complex, restore eubiosis, antibiotic therapy, hemosorption, ultraviolet autologous blood.

Due to pronounced metabolic disorders and the catabolic effect of steroid hormones, it is advisable parenteral administration protein preparations: serum albumin, plasma protein, essential amino acids.

To improve the processes of microcirculation and transcapillary exchange, the introduction of rheopoliglkzhin, hemodez (in normal dosages) is indicated.

In case of anemia (hemoglobin 90 g / l and below), which is a sign of a severe attack of ulcerative colitis, it is recommended to carry out a hemotransfusion of 250 ml of one-group blood with an interval of 3-4 days. With a decrease in the level of iron in the blood serum, it is necessary to include iron preparations in the treatment complex.

Given the immunological disorders in ulcerative colitis, immunomodulators, levamisole, thymalin, etc. are used in the treatment of the disease. However, their role is not completely clear, the therapeutic effect of their use is short-lived, so the activity of these drugs as basic drugs is doubtful.

Vitamins of groups B, C, A, D, K are prescribed, which also contribute to the restoration of eubiosis in the intestine.

The medical complex includes psychotropic drugs in the usual dosages, focusing on individual tolerance.

Exacerbation of ulcerative colitis in some cases is accompanied by irritable bowel syndrome, most often manifested by constipation. In this case, the appointment is justified wheat bran or proprietary preparations containing ballast substances (mucofalk, etc.), which contribute to the normalization of the stool and at the same time are enterosorbents.

Inpatient treatment ends when clinical and endoscopic remission is achieved, after which the patient is subject to dispensary observation in the clinic with a general practitioner, gastroenterologist or proctologist.

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At the mention of this disease, many people have associations with colic in the abdomen. In fact, these are different things. The disease in question is an inflammation of the intestines. When this disease is exacerbated, a person experiences a mass discomfort, and the lack of proper treatment leads to sad consequences. Knowing this, you should be more attentive to your health. Learn about intestinal colitis, its symptoms, and treatment in adults so you know what to do when a health hazard arises. So let's discuss this issue in more detail.

What is colitis

From the Latin language the word "kolon" is translated as "large intestine". The prefix "-it" indicates that the disease is inflammatory. Based on this, we come to a simple conclusion: intestinal colitis is nothing more than inflammation of the internal mucous membrane of the large intestine. This dangerous disease can occur due to various circumstances. The most common causes of intestinal colitis include the following factors:

1. Presence in the body intestinal infection. The causative agents of colitis can be numerous bacteria, fungi, viruses and protozoa.
2. Long-term use powerful antibiotics and other medicines. These can be laxatives, antipsychotics, etc.
3. Violation of blood circulation in the intestines. This factor often leads to inflammation of the large intestine in the elderly.
4. Eating disorder. Intestinal colitis can develop with excessive consumption of animal / starchy foods, abuse of spicy foods / alcohol and single meals.
5. hereditary factors. If one of your parents suffered from chronic inflammation of the large intestine, be on the lookout.
6. Helminth infestation. In the absence of proper treatment helminthic infestations lead to inflammation of the large intestine and other diseases of the digestive tract.

Symptoms of inflammation of the intestine

Medicine distinguishes several varieties of intestinal colitis. Each of them differs in its etiology, pathogenesis, symptoms, diagnosis. A detailed study of all these aspects is a task for doctors. The average citizen needs to have at least general idea about the manifestations of these diseases, so that you know when to seek treatment medical care. In the list below, you will find common symptoms that are common to all types of intestinal colitis:

1. Discomfort/ pain in the lower abdomen. Such manifestations accompany intestinal colitis in 90% of cases. Exacerbation of pain is noted after therapeutic procedures, eating, and exposure to mechanical factors (shaking in transport, running, walking, etc.).
2. Tenesmus ( false urges to a bowel movement). This symptom may indicate a number of diseases of the gastrointestinal tract. In this regard, colitis is distinguished by the rare occurrence of tenesmus - no more than two or three times a day. If the inflammatory process is localized in the sigmoid or rectum, the urge becomes more painful. As a rule, they occur at night and end with the release of small volumes of feces. In some cases, there are impurities of blood / mucus / pus.
3. Disorder (unstable stool). This symptom cannot be considered the main one, however, in the presence of other signs, it can indicate intestinal colitis with a high degree of accuracy. The main difference between the stool in this disease and all other cases is the admixture of greenish or colorless streaks of mucus and / or drops of dark blood.
4. Heaviness in the abdomen.
5. Flatulence.
6. Bloating.

To determine the type of disease more specifically, you need to pay attention to the characteristic signs and symptoms. Some of them are not so easy to fix, however, with careful monitoring of the state of health, it is still possible to make a preliminary diagnosis with a high degree of accuracy. By reading the table below, you will learn how inflammation of the colon manifests itself in different forms.

Methods for the treatment of colitis

The fight against inflammation of the large intestine is a complex long process, during which the patient is forbidden to use harmful products and subject yourself to intense physical activity. Traditional medicine practices the treatment of colitis with medicines in the form of tablets and injections. In addition, there are many effective folk recipes to fight intestinal inflammation. The combination of techniques provides the fastest recovery.

medicines

An extensive arsenal of pharmaceutical drugs allows you to quickly stop the process of inflammation, strengthen internal defensive forces body and alleviate the general condition of the patient. Nowadays, doctors often use drugs from the list below:

1. "No-shpa" ( domestic analogue- "Drotaverine"). Used to relieve spasms. This drug will help numb the symptoms until the doctors tell you exactly how to treat the inflammation of the intestine.
2. "Colibacterin". An effective drug that contributes to the normalization of intestinal microflora. "Colibacterin" replenishes dead microorganisms, increasing resistance in case of damage to the mucous membranes of the large intestine.
3. "Dekamevit". A sedative that normalizes the flow of metabolic and digestive processes.
4. "Levomycetin". Tetracycline drugs have long been called gastric antibiotics, since they effectively fight many diseases and disorders of the digestive tract. Levomycetin provides powerful anti-inflammatory and antibacterial effects without causing much damage. beneficial bacteria intestines.

Folk remedies

On the early stages inflammation of the intestines can easily be dispensed with pharmaceuticals. Traditional medicines will help to cope with the disease in the bud. If you have reason to beware of this ailment, write down some of your grandmother's recipes for yourself:

1. Mumiyo. Place in a small metal container (like a coffee pot) 1 gram of this product and add 250 ml of water. Drink 40-45 ml of the resulting solution once a day. To increase the effectiveness of the treatment of intestinal colitis, use rectal suppositories with mumiyo. The maximum daily dose of this remedy is 0.2 grams. Keep this in mind so as not to harm your intestines.
2. Propolis. The antibacterial properties of this remedy leave far behind many pharmaceuticals against colitis. If you do not know how to treat the intestines, and are not even completely sure that this is necessary, start taking a daily 20% propolis tincture on vodka, 80-90 drops per day. Such prevention normalizes the state of the gastrointestinal tract and does no harm.
3. Microclysters. Using a small syringe or a simple medical syringe through anus enter 55-65 ml of sea buckthorn or rosehip oil. Make sure that the medicine does not leak out. Lie on your left side and try to sleep until morning. During the night, the exacerbation of intestinal colitis will noticeably ease.
4. Honey with water. Simple home remedy, demonstrating high efficiency in the fight against intestinal colitis. Start systematically drinking honey with water half an hour before taking a meal, and in a few days the inflammation will pass. After a few days, the symptoms of the disease will disappear completely.
5. Herbal infusions. A decoction of St. John's wort will help cure intestinal colitis in a matter of days. Mix 10 grams of dry leaves and 50 ml of vodka, divide the total volume into three equal portions and drink throughout the day. Do the described actions every day, and after 2 weeks, intestinal inflammation will recede.

Video: Symptoms and treatment of ulcerative colitis of the intestine

modern medicine offers a variety of drugs in the fight against various ailments. But in order for them to give a positive result, a person needs in no case to self-medicate, but simply to find a good specialist who will take control of your drug therapy.

• Description of candles Salofalk

Description of candles Salofalk

These suppositories have an anti-inflammatory effect due to the active substance in their composition called mesalazine. At the same time, the medicine Salofalk is produced not only in the form of suppositories, but also in the form of tablets, granules and enemas.

The dosage form is chosen by the attending physician, depending on the extent and localization of the intestinal lesion.

For example, with ulcer nonspecific colitis patients are prescribed Salofalk in tablets, with proctitis and proctosigmoiditis - in the form of suppositories and enemas. Sometimes it is recommended to combine suppositories with tablets.

Candles Salofalk is prescribed for:

• Crohn's disease
• ulcerative colitis
• diverticulitis

They can also be used as a prophylaxis for colon cancer in people who are prone to this disease.

However, there are a number of contraindications in which you will have to look for an analogue of Salofalk with another active substance.

Among them:

• high sensitivity to salicylic acid
• disorders in the functioning of the kidneys and liver
• peptic ulcer of the stomach and duodenum in acute form
• age up to 2 years

As you can see, the drug cannot be used independently. In addition, in pharmacies it is sold only by prescription.

Causes and symptoms of ulcerative colitis

Ulcerative colitis is a chronic disease that affects the lining of the colon. At the same time, it swells, becomes inflamed, and ulcers form on it.

If we talk about the causes of ulcerative colitis, then scientists put forward a number of theories. Some are inclined to believe that ulcerative colitis is infectious disease, but the pathogen has not yet been installed.

Other doctors believe that this disease is an autoimmune, that is, the immune system a person produces antibodies that destroy the lining of the colon. And, of course, we must not forget about the genetic factor.

Predisposing factors:

• following a diet that is low in protein but high in carbohydrates
• dysbacteriosis
• stress
• passive lifestyle

According to statistics, people who have had their appendix removed are much less likely to develop ulcerative colitis. With what it is connected, nobody knows.

Ulcerative colitis in each patient proceeds differently, but common symptoms include: malaise, fever, weakness, cramping abdominal pain, frequent stools (up to 5 times a day). There may be blood in the stool.

As you can see, delay in going to the doctor using folk remedies, not worth it. This is fraught with serious complications that are much more difficult to cure.

Crohn's disease: causes and symptoms

Chronic inflammatory Crohn's disease is characterized by the fact that it affects the entire gastrointestinal tract, from the oral cavity to anus. In this case, as a rule, inflammation begins in the ileum, and then goes to the rest of the intestine.

Symptoms of inflammation of the ileum are identical to those of acute appendicitis. Therefore, often, starting a patient to operate, doctors detect Crohn's disease and make the correct diagnosis.

As for the causes of this ailment, doctors are inclined to an infectious nature, since antibiotics cope well with it.

Predisposing factors:

• measles transmission
• food allergy
• stress
• smoking
• heredity

AT clinical picture allocate local, general and extraintestinal symptoms of the manifestation of Crohn's disease.

Symptoms:

• general symptoms appear due to a disorder of the immune system and the presence of intoxication (chills, malaise, weakness, weight loss, fever)
• local symptoms include diarrhea with blood in the stool, abdominal pain (stool frequency can vary from 3 to 10 times a day)
• extraintestinal symptoms: decreased vision, skin rash and ulcers in oral cavity, joint pain and limitation of their mobility

With such a symptomatic picture, you should immediately consult a doctor, and not wait until the pain subsides. Many people start to warm up painful places, but this is fraught with the development of the inflammatory process.
https://youtube.com/watch?v=jbTtmYI49U8
Thus, the drug Salofalk is quite serious, and it is dangerous to use it at your own discretion. And do not forget about preventive measures: positive emotions, balanced diet and active image life.

Before treating colitis, it is worth learning about its features, types, causes.

Colitis is a disease characterized by inflammation inner wall human large intestine. violated slime layer due to malnutrition, stress and other factors, which is the cause of the disease. Inflammation leads to a violation of the absorption of fluid from food waste and intestinal motility. The shell does not perform its functions or performs incompletely. The degree of damage determines the type of disease.

Types of intestinal colitis

Depending on the cause of inflammation, these types of colitis are distinguished:

• Ulcerative - a type of colitis that is characterized by ulcers on the walls of the large intestine.
• Acute - a type in which not only colon, but the thin one is also inflamed, and the stomach is also affected.
• Ischemic - consequences poor circulation in the intestine.
• Chronic is the consequences of acute incompletely cured colitis.
• Spastic manifests itself with spasms, swelling. Not considered severe.
• Alcohol occurs with alcohol dependence.
• Erosive - characterized by ulcers over a larger area of ​​the duodenum.
• Atonic is typical for the elderly. Bowel activity is reduced frequent constipation, hemorrhoids afterwards.
• Hemorrhagic is characterized by bloody discharge - diarrhea.
• Radiation colitis occurs later radiation exposure obtained in cancer.
• Nonspecific ulcerative - similar to chronic with relapses, the origin of the immune type.

Symptoms

Symptoms of colitis:

• Dull pain in the lower side of the abdomen. Time after eating exacerbates pain.
• Constipation changing to diarrhoea.
• Symptom of intense gas formation.
• Nausea.
• When stool, sensation of incomplete emptying of the rectum.
• Bad smell of feces.
• Weight loss.
• Prostration.

Acute form:

• Loss of appetite.
• Diarrhea.
• High body temperature.
• Drawing pain in lower abdomen.

Causes of the disease

The inflammatory process is caused by such reasons:

• hereditary predisposition.
• Stress, nervous breakdowns.
• Absence of normal blood circulation in the intestinal walls.
• Violation of the work of food microorganisms.
• Intoxication.

Treatment of the disease

Diagnosis entails treatment. Therapy provides an integrated approach in this case. Experts advise going through all the stages:

• Diet.
• Sessions with a psychotherapist.
• Sanatoriums.
• Medical treatment.

Treatment with medicines involves the prescribing of a complex of drugs. Let's dwell on this in more detail.

Prescription of antibiotics

Antibiotics are not always used to treat colitis. The reason for this is the contraindications for different types colitis.

Antibiotics - drugs aimed at the destruction of bacteria-provocateurs of an infectious type of disease. They are prescribed if the use of other methods was ineffective.

Antibiotics are not prescribed along with antibacterial drugs due to unexpected reactions.

Furazolidone is a representative of antibiotics, has a pronounced antimicrobial function. An effective drug whose properties depend on the dose. Tablets are drunk without chewing. Treatment course individual. The average course of the course is a week when taking the medicine four times a day.

Levomycetin is an antibiotic that is available in the form of tablets, powder. Effective as furazolidone. The course is prescribed by a doctor.

Metronidazole is another antibiotic with an antimicrobial effect. It has contraindications: pregnancy, problems with the central nervous system.

The described means are used for mild and moderate severity of the disease.

Painkillers (antispasmodics)

Painkillers help relieve pain caused by the acute form of the disease. Used for ulcerative, acute colitis.

No-shpa - suitable for moderate pain, has contraindications for heart failure, preschool age, individual intolerance to the composition of the drug. Available in the form of a solution, yellow tablets.

Dicetel - solves the problem of spasms, thereby destroying pain. Take tablets three times a day. Contraindicated in children. Available in orange tablets.

Mebeverine is an antispasmodic that soothes intestinal irritation and relieves pain. Applied inside. Contraindication - hypersensitivity to drug components.

Anti-inflammatory drugs

Inflammation is the main feature of the disease. To remove it, the doctor ascribes anti-inflammatory drugs that improve the general condition of a person.

Prednisolone is prescribed for ulcerative colitis, with chronic form illness. The drug relieves inflammation, inhibits the process of its development. The dosage is individual.

Restoration of microflora

The disease, the use of drugs destroy the normal microflora of the human intestine. Antibiotics, in addition to killing bacteria, destroy beneficial microflora, the absence of which leads to depression, obesity, asthma, allergies and dysbacteriosis.

Medicine does not yet have in its arsenal drugs without side effects. Therefore, curing one, you have to solve the problem with the consequences. It turns out that it is almost impossible to cure a form of chronic colitis completely.

Microflora restorers: Bifikol, Bifidumbacterin. The time of treatment with drugs is up to one and a half months. This also includes Linex, Lactobacterin.

Linex is a medicine in the form of capsules that restores the microflora. Apply capsules three times after meals. Contraindications - allergy to the components of the drug.

Lactobacterin is a prebiotic in powder form. Take one hour before eating as a drink. Treatment should be carried out within a month.

Bificol is a lyophilisate intended for the preparation of a suspension. Consume half an hour before meals twice a day. Used to restore microflora after nonspecific ulcerative colitis. Contraindications - simultaneous use with antibiotics.

Bifidumbacterin is available in capsules, tablets, lyophilisates for the preparation of a suspension, liquid concentrate. The use depends on the prescribed form of the drug. The dosage is individual. Do not use for children under three years of age.

Solving problems with intestinal motility

After the restoration of the microflora or simultaneously with it, drugs are prescribed to improve intestinal motility.

Mezim-forte - a drug in the form of tablets that activates the process of digestion - high level digestion of proteins, carbohydrates, fats. The drug is contraindicated in pancreatitis.

Creon is a medicine in the form of gelatin capsules to improve digestion. The dosage depends on the severity of the disease. Like Mezim, it is contraindicated in chronic pancreatitis.

The use of vitamins

At chronic colitis in addition to medicines, vitamins of groups C, B, PP, U are attributed. These organic compounds used orally, parenterally, in the form of injections. Injections are made with some B vitamins.

B1 is used to better cleanse the body.

Vitamin B3 improves the production of gastric acid, harmonizes the functionality of the intestinal tract.

U is used as building material. With the help of it, damaged parts of the intestine are restored. PP includes activities secretory function human stomach.

Nutrition Features

Being treated for colitis, dieting is almost the most important component convalescence. For bowel disease, you can eat the following foods:

• Yesterday's whole wheat bread, crackers. White fresh bread, rich products increase the production of gases, peristalsis accelerates - this will negatively affect the patient's condition.
• Soup, porridge on the water, vegetable broth. Soup and not only on animal fats burdens the work of the stomach, intestines, liver.
• Meat, fish in the form of steamed cutlets.
• Eat low-fat dairy products.
• Confectionery in moderation.
• Tea, cocoa, soft coffee.
• No more than two tablespoons of sugar per day, a few sweets.

Should be avoided:

• legumes, pasta- cause excessive gas formation;
• raw fruits, vegetables - fiber enhances peristalsis;
• canned, pickled, smoked, pickled - these products irritate the intestinal lining, cause inflammation;
• fast food;
• spices, condiments

It is known that the treatment of colitis with drugs is an integral part of the fight against this disease. Needs to be considered in more detail various occasions manifestations of colitis and select medicines corresponding to them.

Characteristics of the disease

Colitis is a local inflammation that occurs on the mucous membrane of the colon, as a result of which there are violations of the absorption and motor functions of the intestine. Separately, it is worth highlighting spastic colitis, which is a long-term painful spasms of the intestine.

The detection of this disease requires not only medication, but also a complete adjustment of a person's lifestyle. First of all, you need to follow a complex diet.

Men over the age of 40 and women over 20 are most susceptible to the disease.

For staging preliminary diagnosis fecal analysis is required. To clarify the diagnosis, the doctor prescribes endoscopic examinations such as retromanoscopy and colonoscopy.

Eliminate the causes of the disease

To identify the causes of colitis, the doctor will need to collect information about the patient's condition. To do this, he will ask him some questions about how he feels, and also write a referral for tests.

If spastic colitis has been diagnosed, then most often it is enough to adjust the diet and diet.

If the patient has other problems with the gastrointestinal tract, the doctor should prescribe their diagnosis. It is often possible to treat colitis and other problems in this area with drugs alone.

Regardless of the causes of the disease, the patient is recommended a strict diet, restriction of exercise, abstinence from smoking and alcohol. Drugs used for other illnesses may also be discontinued.

Use of antibiotics

Treatment without antibiotics can be done if the diagnosis is spastic colitis. In other cases, as a rule, the use of antibiotics is necessary. In this case, sulfonamides are prescribed as a medicine, for example, Ftalazol and Sulgin. They are used strictly according to the doctor's prescription. Most often they are prescribed according to the following scheme:

• the first period of active suppression of inflammation (the number of days when the reception is carried out depends on the neglect of the process and the actual resistance of the body) - 6 times a day;
• second suppression period residual inflammation(2 days) - 4 times a day;
• the third fixing period (2 days) - 3 times a day.

Similarly, the patient can be prescribed antibiotics of directional action that affect the pathogenic intestinal microflora.

Attention should be paid to antibiotics containing oxyquinoline. Their peculiarity lies in the effect on microorganisms resistant to other antibacterial drugs. As an example, we can mention Intestopan and Enteroseptol. Dosage and regimen depends on the course of the disease. It will be necessary to treat the disease for 10-12 days.

Formation of microflora

In the course of treatment with antibiotics, the intestinal microflora is seriously damaged. Therefore, after the end of their course, it is necessary to conduct a restorative course of treatment for dysbacteriosis and enzymatic disorders. For this purpose, the doctor will prescribe probiotics. They are not medicines.

In addition to restoring the intestinal microflora, these drugs help to remove toxins. As a result of their intake, the stool is normalized, gas formation is reduced and appetite is improved.

Today there are many different probiotics. The essence of their action is the same. Differences lie in small fluctuations in doses active substances, flavoring additives and manufacturing companies. When choosing a drug, you should rely on the advice of a doctor or purchase it based on the price range.

With dysbacteriosis, all kinds of enzymatic disorders. To combat them, drugs containing pancreatin are prescribed. The most common among them are Mezim, Festal and Panzinorm.

Problems with intestinal motility

Spasm often occurs with any colitis smooth muscle intestines. To eliminate this condition, antispasmodic drugs are used, such as No-shpu, Drotaverine or Papaverine. For more effective impact it is possible to use Platyfillin.

In order to improve motor skills, they take Motilium or Cerucal.

In case of constipation, mild laxatives that are not irritating to the intestinal mucosa can be used. Vaseline oil is considered the safest drug, which, when taken orally, covers the colonic mucosa and facilitates the movement of feces due to their softening.

Another problem in the case of irritable bowel syndrome is the excess mucus produced by the intestinal wall as defensive reaction for the presence of inflammation. Its excess worsens the already poor peristalsis. To combat it, astringents are used. These include Phosfalugel, Almagel and some others. To bind excess mucus, adsorbing substances are used. These include calcium carbonate and bismuth compounds.

Vitamin body support and antidepressants

The course of colitis can be quite painful for a person. As a result of internal discomfort, irritability develops, a feeling of fatigue that does not go away, and insomnia. To normalize the patient's condition, it is desirable that the therapy includes sedative and light sedative tablets, for example, Persen or Glycine.

To reduce the load on the body, patients are often recommended to take B vitamins, primarily B6 and B12. They are most often prescribed in the form of tablets or ampoules for oral administration. Perhaps the appointment of injections, but they are very painful.

Nutrition of the patient

As with any disease of the digestive tract, the treatment of colitis involves the presence of strict diet. Without it, the disease will progress, and taking drugs will not give the desired result.

During the first day, it is recommended to refrain from eating any food at all, only drinking is allowed. Doctors often advise drinking warm or hot black tea without sugar. The use of any liquids other than water is unacceptable because it causes irritation of the digestive tract.

A day after the exacerbation, it is allowed to drink decoctions of rice, rose hips or quince.

After 2 days, homogenized porridges are carefully introduced. The best option will be rice. But from millet and pearl barley, you should refrain at first. After cereals, well-boiled vegetable soups on the water.

On the 4th day after the exacerbation, in the presence of positive trends, the patient is allowed to use a small amount of stale white bread or crackers, soft-boiled eggs and low-fat kefir.

• fatty;
• roast;
• smoked;
• flour;
• sweet;
• sausage;
• coffee;
• cocoa;
• sparkling water;
• any cold drinks.

Patients must eat meat dishes. But it is necessary to cook them only from minced meat and steamed. It is preferable to use lean and easy-to-digest meats. These include chicken, turkey, rabbit, as well as veal and beef. Pork is prohibited.

It is important to ensure that the patient's diet contains all essential vitamins, micro and macro elements. But the calorie content can be sacrificed to facilitate the work of the digestive tract.

Thus, in the treatment of colitis with drugs, the main drugs are antibiotics that suppress the inflammatory process. In parallel with them, vitamins and antidepressants are taken to maintain the general condition of the patient. At the end of the course of antibiotics, probiotics are prescribed to restore the intestinal microflora.

Problems with the intestines are increasingly worrying people of all ages. Even those who lead relatively healthy lifestyle life and has no bad habits.

Among all diseases of the intestine in patients, the most frequently diagnosed is an inflammatory lesion of the walls of the colon. This condition should not be left to chance, because an untreated chronic inflammation process in the abdominal organs is fraught with backfire, which require surgical intervention.

Inflammation of the intestinal wall, called colitis, is pathological changes in the mucous membrane of this organ of the digestive system.

Colitis is separate disease may occur in acute or chronic form.

Colitis may occur due to infectious, toxic or ischemic damage to the intestinal walls. The place of localization of the pathological focus in this disease is the large intestine. If the inflammation also spreads to the small intestine, the disease is already called enterocolitis, i.e. more extensive intestinal damage.

Types of colitis

If there are not so many forms of colitis - acute and chronic, then there are more types of this disease. The following types of colitis are most often diagnosed in patients.

Ulcerative colitis

Inflammatory process accompanied by ulceration on the surface of the colonic mucosa. At the same time, the walls of the affected intestine become edematous, degenerative changes occur in their epithelium. may affect the entire surface of the colon. The causes of ulcerative colitis are not fully established, so treatment does not always lead to the desired result.

spastic colitis

Spastic colitis is accompanied by heaviness and palpable bloating in the abdomen, alternating diarrhea and constipation, increased gas formation. Often occurs as a result of a decrease functional activity colon. Unlike ulcerative colitis, it responds well to treatment.

catarrhal colitis

It usually proceeds for a short time and is characterized by severe symptoms: abdominal pain, bloating, in some cases - the appearance of blood in the stool. May be due to food poisoning.

atrophic colitis

Inflammatory processes in the intestines can thin its walls

May develop in the background spastic colitis and is more late stage this ailment. There is atrophy of smooth muscles in the colon. Over time it may turn into ulcerative variety diseases.

erosive colitis

It often represents initial stage ulcerative colitis, as they are not as deep as ulcers, and are not accompanied by perforation of the intestinal walls. Accompanied by nausea, marked abdominal pain, rumbling, sometimes belching or heartburn.

diffuse colitis

It can affect both the large and small intestine. Accompanied severe pain, diarrhea, vomiting. It often occurs in severe form.

The consequences of colitis can be the most serious, so it is necessary to start treatment on time, for example, use suppositories on the advice of a doctor for intestinal colitis.

Efficiency and expediency of using suppositories for colitis

Rectal suppositories have some advantages over others. methods of treatment of diseases of the intestine:

• act directly on the walls of the intestine, without exerting negative impact on the stomach, unlike many tablets;
• the active ingredients of suppositories do not lose their effectiveness before they reach the site of exposure, since they are not affected by enzymes in the stomach;
• have a minimum of contraindications;
• the expected effect is achieved faster.

However, before using suppositories for ulcerative colitis or other lesions of the colon, you should get a doctor's recommendation regarding the method of treatment.

The most commonly used drugs in the form of suppositories for colitis

The choice of medicines in the form of suppositories should be determined by the type and stage of colitis., severity of symptoms, possible limitations for a particular patient. Most effective for intestinal disorders the following drugs, produced in the form of rectal suppositories:

Salofalk

Salofalk

It is used in the inflammatory process of the intestinal walls. Eliminates swelling, manifestations of inflammation, reduces the sensation of pain. This medicine is contraindicated in kidney failure or pathologies of the kidneys, ulcerative or hemorrhagic disease. Salofalk should be used three times a day - one suppository administered at a time.

Relief

The active parts of the drug eliminate the feeling of pain, as well as itching in the walls of the rectum, contribute to the disappearance of bleeding in ulcerative proctitis. It is important that shark liver oil, which has a noticeable analgesic effect, is included in the candles. These suppositories are shown for colitis and proctitis.

Candles with sea buckthorn oil

Also used for colitis, proctitis, and also for hemorrhoids. Components sea ​​buckthorn candles heal damaged mucosa, prevent its damage stool. It is advisable to use them only after a preliminary bowel movement.

The suppositories have a bright red-orange color, therefore, in order not to stain the underwear, it is recommended to use daily pads for several hours after using the drug.

Candles with propolis

Indicated for colitis, proctitis. Active ingredient of these suppositories is propolis. It is important that cocoa butter, which has a softening effect, is also included in the composition of the candles. This rectal preparation has antibacterial, antioxidant, anti-inflammatory, antiallergic and antitumor effects.

Ultraproject

Candles Ultraprokt

These rectal suppositories are recommended for proctitis and colitis. To achieve the desired effect, it is enough to apply one candle at a time. They help to get rid of pain, itching, eliminate problems with defecation. They are hormonal since these suppositories contain fluocortolone.

Viburkol

These candles are homeopathic remedy. Viburkol is used for disorders of the intestines. It has a calming, noticeable antipyretic, anesthetic and antispasmodic effect. Allowed for all patients, including children, pregnant patients, and nursing mothers.

Proctosan

The components of these suppositories have a drying, analgesic, anti-inflammatory and palpable effect. astringent action. They contain lidocaine (an anesthetic), bufexamak, bismuth, and titanium dioxide. Patients feel relief when using Proctosan no later than 3-5 days later.

Diclofenac

Popular suppositories that allow you to quickly get rid of pain in the intestinal area. Quickly eliminate pain in the intestine. The suppositories contain only two components: diclofenac itself, as well as solid fat. The tool is affordable. Recommended for acute bowel disease.

Candles Ultraprokt

The period of treatment with Diclofenac in the form of suppositories should not be longer than three days. These suppositories are contraindicated in ulcerative form diseases, kidney damage, pregnancy, liver pathologies.

Compliance with the principles of healthy eating

We should not forget about dieting, because the diet for intestinal diseases is very important. Eating healthy food rational mode days and using the recommended medicines, it is quite possible to restore health and forget about the pains in the abdomen that bothered you earlier!

Conclusion

When choosing suppositories for the treatment of intestinal colitis, the name should be chosen, guided by the recommendation of a doctor. Only a specialist - gastroenterologist, proctologist or surgeon - will be able to determine the cause of abdominal pain, determine the severity of the disease and find the most appropriate treatment option.

The patient will only need to decide on the price category of the drug and choose one or more funds from the list proposed by the doctor. If you use candles in strict accordance with the doctor's prescription and the attached instructions, you can quickly improve your condition and normalize digestion.