Colitis in children 8 years old. The child has colitis: what to do? Causes of colitis in a child

Pathology proceeds with severe pain, dyspeptic disorders, persistent changes in stool and general malaise. Treatment of colitis in children depends on the pathogenesis of the disease and includes a whole therapeutic complex: symptomatic and antibacterial treatment, diet therapy, herbal medicine and normalization of the intestinal microflora.

Classification

Inflammatory-dystrophic changes in the large intestine can be limited, that is, they are localized within one or more segments, and widespread.

In this regard, there are:

• typhlitis - isolated inflammation of the caecum;
• typhlocolitis - inflammation of the ascending and caecum;
• transverse - inflammation of the transverse colon;
• angulitis - inflammation of the transverse colon and descending intestine;
• sigmoiditis - inflammation of the sigmoid colon;
• proctosigmoiditis - inflammation of the sigmoid and rectum;
• proctitis - inflammation of the rectum.

Depending on the cause of the disease, colitis is:

By the nature of the disease, colitis can be progressive, recurrent and latent. According to the severity of the disease, mild, moderate and severe colitis can be distinguished. According to the clinical condition, the disease is acute and chronic.

Cause of colitis in children

Colitis in children occurs for the following reasons:

• bacterial and viral infections: E. coli, salmonella, clostridia, etc.;
• congenital pathologies of the digestive system;
• helminthic invasions;
• heredity;
• autoimmune diseases;
• tendency to allergic reactions;
• food poisoning;
• gross malnutrition: early introduction of complementary foods, replacement of breast milk and milk formula with whole milk, etc .;
• frequently repeated antibiotic therapy;
• unfavorable state of ecology;
• stress factors.

Symptoms

Symptoms of colitis in children in acute form are manifested in the form of nausea, weakness and fever. The child complains of abdominal pain. Bowel emptying occurs up to 15 times a day. The feces are watery, greenish, with an admixture of blood. Symptoms of colitis in infants can be complicated by rectal prolapse and dehydration.

Symptoms of colitis in children in the chronic form can worsen and subside depending on the phase of the disease and recovery. The dominant symptoms of colitis in a child are abdominal pain, stool disorders such as diarrhea and constipation. In some cases, there is a deterioration in the general well-being of the baby, exhaustion of the nervous system, headaches and chronic fatigue. Also, colitis can cause a lack of body weight, anemia and beriberi.

Diagnostics

To find out how to treat colitis in a child, you need to conduct the following laboratory and instrumental studies:

1. Blood chemistry. The presence of colitis can be suggested by a decrease in hemoglobin and red blood cells in the blood, an increase in ESR.
2. Analysis of feces for the presence of leukocytes and pathogenic flora (staphylococcus, candida, etc.).
3. Intestinal endoscopy. Allows you to identify the form of the disease.
4. X-ray of the intestine. It is carried out to clarify the clinical picture of the disease and the severity of the inflammatory process.

Features of the course of the disease in childhood

The clinical picture and causes of this disease in children are significantly different from adults, so the symptoms and treatment of intestinal colitis in children will be different.

Acute intestinal colitis in a child whose symptoms last more than two weeks, in case of ineffective treatment, passes into the stage of chronic colitis. This condition is dangerous with complications, such as peritonitis, the development of adhesions, chronic diarrhea, and much more. Therefore, the treatment of symptoms of colitis in children should begin from the first days of the disease.

Acute colitis is most dangerous for children under one year old. Allergic colitis is more common in infants, which develops in response to a certain type of allergen - lactose, a drug, a separate strain of bacteria, etc. It is important to identify the allergen and eliminate it in full. Otherwise, colitis in infants often leads to dehydration against the background of repeated vomiting and diarrhea, followed by the development of seizures and even death of the child.

Treatment

Treatment of symptoms of colitis in children is aimed at destroying the pathogenic flora of the intestine and restoring its work.

Drug treatment of symptoms of colitis in a child is carried out using the following drugs:

• antibiotics - Enteroseptol, Erythromycin, Mexaform: course of treatment 7-10 days;
• enzyme agents -, Pancreatin, Panzinorm: a course of treatment from 2 to 4 weeks;
• analgesics and anticholinergics - Atropine, Novocain, Platifillin;
• probiotics - Bifidumbacterin, Colibacterin;
• astringent and enveloping preparations, adsorbents - bismuth, starch, chamomile;
• antiallergic drugs - Suprastin, Fenistil;
• vitamins A, B, PP.

Physiotherapy treatment of symptoms of colitis in children is prescribed during the period of remission. This may be treatment with paraffin, ozocerite and diathermy. In case of exacerbation of the symptoms of intestinal colitis in a child, the doctor may advise dry heat on the epigastric zone.

Surgical treatment is carried out in extreme cases. The essence of the operation: subtotal removal of the affected part of the colon, followed by the formation of the junction of the ileum and rectum.

Rehabilitation after treatment

For the period of remission, the following therapeutic and preventive measures are indicated:

1. Breathing exercises, physiotherapy exercises, massage of the abdomen.
2. Spa treatment.
3. Appointment of prophylactic courses of probiotics and enzymes.
4. Exemption from physical education and exams.

Forecast

Under the condition of timely and successful treatment of the symptoms of colitis in children, as well as after a full rehabilitation, the acute form of the disease ends in recovery.

In the chronic form of colitis, strict adherence to the regimen recommended by the doctor guarantees a long-term remission. If, after treatment of colitis, the child has a stable remission, after 2 years he is removed from the dispensary registration of a gastroenterologist.

Complications

Untreated colitis can cause life-threatening internal bleeding. It can also lead to perforation of the intestinal wall with the subsequent development of peritonitis, appendicitis, intestinal obstruction against the background of adhesions in inflamed tissues, etc. That is why the symptoms of colitis in a child cannot be ignored, at the first signs of the disease, you should consult a doctor.

Prevention

Prevention of colitis in a child is primarily aimed at normalizing the diet from the first days of life. It is dietary errors that most often cause this disease.

Secondly, it is necessary to prevent any ways of contracting intestinal infections. It is important to pay attention to the observance of the rules of personal hygiene, as well as the selection and processing of food products.

Thirdly, preventive vaccination plays an equally important role in the prevention of colitis in infants and older children.

If, despite the efforts made, it was not possible to avoid the disease, then after the treatment of colitis in children, secondary prevention should be carried out, the purpose of which is to prevent the recurrence of the pathology.

Diet

Symptoms of intestinal colitis in a child require not only drug treatment, but also the appointment of diet therapy. The therapeutic diet for this disease excludes all types of food that can chemically or mechanically injure and irritate the inflamed intestinal mucosa. All food is consumed in pure form, at least 5 times a day.

Diet in the treatment of symptoms of colitis in children does not recommend the use of milk and dairy products, legumes and cabbage. Meat, steamed fish and "yesterday's" wheat bread are allowed. During the period of remission, the diet expands, but in the future, chilled meals, sour-milk products, sour foods should be excluded, and salt intake should be limited.

It is important to remember that any form of colitis is dangerous for the development of a chronic process with subsequent inflammation of the abdominal cavity and perforation of the intestinal wall. All this is fraught with even greater complications, such as exhaustion of the body, anemia, disruptions in the endocrine system. Timely diagnosis and treatment of colitis is very important for a child, since a disease not cured in childhood can cause him suffering and problems with the work of the digestive organs for the rest of his life.

Useful video about intestinal colitis

Colitis in a child is associated with an inflammatory process in the colon and causes pain to a small patient. This is a serious disease, but it responds well to treatment in the early stages. With advanced intestinal inflammation, long-term treatment, a strict diet, and serious complications are possible. At the slightest suspicion of colitis in a child, you should immediately consult a doctor.

Currently, medicine is studying the causes of colitis in infants up to a year and older. The identified causes and symptoms of the disease make it possible to create a clinical picture, but some factors that provoke colitis have not yet been identified. The main reasons provoking the development of the disease:

• infections;
• Allergic reaction to certain types of food;
• Violation of the immune system;
• Incorrect or prolonged use of drugs;
• malnutrition;
• Mechanical damage to the intestines due to constipation or diarrhea;
• Acute food poisoning;
• Congenital malformation or dysfunction of the digestive system;
• Polyps or neoplasms in the intestines.

Nonspecific ulcerative colitis in children is due to immune and genetic predisposition. It often occurs in children whose relatives are also susceptible to the disease.

The pseudomembranous form of the disease is caused by spore-forming microbes and develops against the background of improper or prolonged use of antibiotics and antibacterial agents. An overgrowth of microorganisms leads to improper bowel function and is diagnosed as pseudomembranous colitis.

Symptoms

• Nonspecific ulcerative inflammation of the intestine depending on the location, it can cause bleeding, diarrhea and abdominal pain during bowel movements. In 20% of patients, signs of ulcerative lesions are accompanied by skin rashes, inflammation of the joints and eyes. Timely treatment and proper diet eliminate the unpleasant consequences of the disease;
• Pseudomembranous colitis causes anxiety symptoms in children and adults. Among the frequent manifestations are nausea, vomiting, diarrhea with blood and mucous secretions. Signs are accompanied by pain and bloating, possibly a manifestation of disturbances in the work of the heart (tachycardia) and blood vessels. The pseudomembranous type of the disease is usually caused by taking medications (, Ceflaosporin, etc.), which should be immediately canceled and immediately consult a doctor;
• Acute colitis appears due to food poisoning, infections, individual intolerance to food or drugs, stress. Accompanied by pain, vomiting, diarrhea, fever and general weakness;
• Symptoms chronic inflammation include alternating constipation and diarrhea, abdominal pain, especially after eating, flatulence, increased body fatigue;
• spastic irritable bowel syndrome is defined by bloating, improper bowel function, headache, fatigue and bloody discharge.

Diagnostics

If you find the first signs of the disease, you should immediately consult a doctor. Diagnosis and treatment of colitis must be carried out in a timely manner.

The examination is carried out by a pediatric gastroenterologist and includes the preparation of a clinical picture and the appointment of appropriate tests and procedures.

Diagnosis can be carried out using the following laboratory tests:

• Blood analysis. Detects anemia, may show a decrease in electrolyte levels;
• Fecal analysis. Coprological analysis helps to detect mucus, starch, high fat or nitrogen content, as a result of a malfunction in the body. Bacteriological examination helps to exclude or confirm infectious colitis;
• Endoscopic examination of the intestine. Sigmoidoscopy, sigmoidoscopy, or colonoscopy may be ordered. The procedure allows you to assess the condition of the intestinal mucosa, identify polyps;
• Irriography. Diagnosis is carried out using an x-ray machine and a barium contrast agent. Allows you to determine the functional state of the child's colon;
• In some cases, when diagnosing nonspecific colitis, a biopsy is prescribed.

A thorough and comprehensive examination allows you to establish the correct diagnosis, determine the type of disease and prescribe the correct treatment.

Treatment

Pseudomembranous colitis should be treated by immediate withdrawal of the drug that caused the disease. The source of the disease is eliminated by antimicrobial drugs, for example, Metronidazole. The pseudomembranous form of the disease is especially dangerous for children under the age of 6 years. With the timely detection of inflammation, the treatment gives the maximum effect and patients fully recover.

Treatment non-specific ulcerative lesions of the intestine aimed at reducing inflammation and preventing possible complications. Non-steroidal anti-inflammatory drugs, antibacterial agents and immunomodulators are used. Children are required to be prescribed a therapeutic diet. Table No. 4 according to Pevzner. In some cases, with advanced or rapid development of the disease, surgical intervention is required.

Manifestation acute form of the disease should be treated, like food poisoning, with plenty of warm drinks, rest, taking Almagel, etc. It is important to follow the doctor's instructions and not self-medicate with actively advertised but useless drugs.

Doctors recommend treatment chronic colitis adsorbents (Phosphalugel) and antispasmodics (No-shpa). At home, treatment is based on a fractional nutrition system. A diet is prescribed that excludes fried, salty and canned foods, spices.

Pathological conditions of the digestive system are not uncommon in children, especially infancy. This is facilitated by the anatomical and physiological characteristics of the child's body, the location of the organs of the gastrointestinal tract, differences in the functioning of the intestines, liver and pancreas. An important role is played by the type of feeding the baby. Intestinal diseases in infants are more severe than in adults, more often they become generalized.

Colitis in children

Colitis is an inflammatory process that affects the intestinal mucosa, due to which the functioning of the intestinal epithelium is disrupted. The death of enterocytes is accompanied by a violation of the digestion and absorption of food. In this condition, there is diffuse pain in the abdomen and symptoms of dyspepsia: nausea, vomiting, and stool disorders. Usually colitis is an acute process, but without treatment it becomes chronic.

Reasons for the development of colitis

The occurrence of inflammation of the colon in a baby can be triggered by many factors and the external environment, and changes within the body. Depending on what form the doctor diagnosed, it can be assumed for what reasons an intestinal disease arose in a child.

Common factors in acute colitis:

• acute intestinal infections: bacterial (salmonellosis, escherichiosis, yersiniosis), viral (rotavirus, enterovirus) and with an indefinite pathogen, belonging to the group of food toxic infections;
• dysfunction of the immune system, for example: in premature newborns and young children;
• consumption of poor-quality food and water;
• irrational feeding, untimely introduction of complementary foods to children under one year old;
• allergic reaction to food;
• radiation exposure, some chemicals, especially when taken orally.

Chronic colitis can be caused by:

Interesting! A common cause is a neuropsychiatric imbalance caused by chronic stress and hormonal changes in the body during puberty and in children with vegetative-vascular dystonia.

Classification of colitis in children

Depending on the etiology, localization, prevalence and activity of the course of the inflammatory process, several classifications of this disease are distinguished.

Depending on the results of an endoscopic examination, during which a morphological assessment of inflammation of the intestinal mucosa is carried out, colitis is distinguished:

1. catarrhal;
2. erosive, or ulcerative, in which ulcers and perforations of the intestinal wall occur;
3. pseudomembranous;
4. atrophic, accompanied by thinning of the mucosa.

By the nature of the course of colitis are:

1. sharp;
2. chronic;
3. recurrent;
4. progressive;
5. with a long monotonous course;
6. hidden.

According to the severity of colitis are divided into:

• lungs;
• moderate;
• heavy.

In the clinic of the course of the disease, several key periods are distinguished:

• exacerbations;
• clinical remission;
• morphological remission.

Symptoms of colitis in children

Most often, the following forms occur: acute and nonspecific ulcerative colitis. Despite the fact that different forms may have different clinical manifestations, they have common features. This exhausts children, especially babies, they become lethargic and moody, so it is important to see a doctor as soon as possible. The main complaints that a child and his parents can make:

• discomfort in the abdomen, a feeling of heaviness;
• spastic pain in the abdomen without a clear localization, the intensity of which decreases significantly after the act of defecation;
• constipation or diarrhea and their alternation, and fecal masses with diarrhea can be mushy with an admixture of mucus or blood;
• nausea and vomiting;
• false urge to defecate and a feeling of incomplete emptying of the intestine;
• bloating, which is accompanied by bouts of colic;
• general weakness, confusion, dizziness, loss of appetite, decreased activity and fatigue due to intoxication;
• subfebrile and febrile temperature, and with nonspecific chronic colitis, the temperature is not higher than 37.5ºС;
• polymorphic skin rash of allergic origin.

Note! Inflammation of the colon exhausts children, especially infants, they become lethargic and moody, so it is important to see a doctor as soon as possible.

Diagnosis of colitis

Immediately after contacting a specialist, the diagnostician conducts a set of measures in order to make a diagnosis as soon as possible. In order not to make a mistake, the doctor first clarifies the complaints in detail, notes their nature and combines the symptoms. This is followed by a thorough examination of the child, starting with the skin, which is usually pale, with peripheral cyanosis at the fingertips. Due to a violation of the absorption of vitamins in the intestine, there is an increased fragility of hair, nails and dry skin. During the conversation, a fetid odor from the mouth is noted, due to the processes of decay in the intestines, belching may occur. During palpation of the abdomen, pain can be more accurately localized; under the fingers of a doctor, rumbling in different parts of the intestine, a feeling of fluid transfusion may occur.

After a physical examination, laboratory tests are prescribed, primarily a scatological examination of feces, in which a large amount of undigested food is detected. Sowing is done, with colitis in Petri dishes a large number of pathogenic colonies grow, which testifies in favor of intestinal dysbacteriosis.

The gold standard in diagnosis is sigmoidoscopy and colonoscopy. In the course of the study of the rectum, sigmoid colon and a complete examination of the colon, areas of the inflamed mucous membrane, the presence or absence of ulcerative defects, and characteristic raids are determined. If particularly suspicious areas are found in the intestine, a piece of tissue is taken with special forceps for histological examination.

Interesting! As an additional study, doctors prescribe an x-ray of the colon with contrast - irrigography, the results of which can reveal the characteristic symptoms of colitis and a clear localization of inflammation.

Colitis treatment

Therapy for colitis in children is carried out in accordance with protocols that include measures aimed at eliminating the pathogen and restoring the normal functioning of the intestine. Treatment should be rational and comprehensive in order to avoid relapse.

First of all, a diet is prescribed for a month, which includes dishes from boiled or steamed vegetables, lean meat, pureed soups on the water, a large number of cereals that have an enveloping property. Kissels, compotes from dried apples, casseroles and omelettes are shown.

Drug therapy consists of several points:

• oral rehydration with water-salt solutions, folk decoctions of medicinal herbs and fruits. In the case when fluid intake is difficult, it is administered parenterally as part of medicinal solutions.
• antibacterial therapy with Metronisazole, Furazolidone, Enterofuril, Phtalazol, especially in severe generalized inflammation;
• the use of bacteriophages: Sextaphage, bacteriophage coliproteus;
• enterosorption with activated carbon, Polysorb, Smecta, Enterodez;
• the appointment of enzyme preparations: Creon, Mezim, Pancreatin;
• restoration of intestinal microflora with probiotics, often use Bifiform, Linex;
• for constipation that is not corrected by diet, prokinetics are recommended: Loperamide.

Physiotherapeutic methods are often used, for example: electrophoresis with electrolyte solutions of potassium and magnesium on the intestinal area. Warm compresses, paraffin therapy and acupuncture are shown. It is useful for recovering children to engage in physiotherapy exercises.

Forecast and prevention of colitis

If colitis is quickly diagnosed and a full-fledged therapy is carried out, then there are no complications. Compliance with recommendations on nutrition after recovery, the implementation of personal hygiene rules allows you to achieve stable clinical and laboratory remission.

Prevention of inflammation of the colon involves the rational nutrition of children, treatment of intestinal infections, helminthic invasions.

Colitis in children can be mild or can quickly become severe. Therefore, if alarming symptoms occur, you need to contact a pediatrician or pediatric gastroenterologist for treatment and medical examination.

Video on the topic of the article:

Ulcerative colitis is a chronic inflammatory bowel disease. From which it follows that ulcerative and chronic are the same form of colitis.

What is the characteristic of chronic colitis in children. Colitis, in general, is an inflammation of the lining of the large intestine. With inflammation, the diseased organ turns red, swells and pain occurs.

With ulcerative colitis, the disease in children, entering the active phase, forms ulcers on the inner walls of the intestine.

In children, symptoms of active ulcerative colitis include diarrhea, blood in the stool, and pain in the iliac region.

However, this disease must be distinguished from another known as Crohn's disease. Symptoms of ulcerative colitis and Crohn's disease or granulomatous enturitis are similar, however, there are some differences. In Crohn's disease, the focus of inflammation can be located in any segment, starting from the oral cavity and ending with the anus. From the location of the inflammation, the symptoms of the disease also change. However, only a specialist who will prescribe the correct treatment is able to determine what kind of disease this is. Fortunately, Crohn's disease in children is extremely rare.

Causes of the disease

Despite the fact that ulcerative colitis is the object of numerous scientific studies, its causes have not yet been established. However, a hereditary mode of transmission of ulcerative colitis has been established. A child whose parents or siblings suffer from it has a high risk of getting sick too. The percentage of cases in boys is slightly higher than in girls. However, in adolescent children, colitis is more common in girls.

So, the occurrence of ulcerative colitis in a child can be triggered by the following factors:

• genetic;
• Unfavorable environment and product quality;
• Weakened immune system;
• Infections: dysbacteriosis, helminthiasis, etc.

Where does the disease reside?

Ulcerative colitis is located only in the intestines. Those. ulcers spread to only one segment of the intestine. Ulcerative colitis can appear as a form of pancolitis, which is located throughout the intestine, localized on the right or left side. Treatment depends on the location of the inflammation.

Symptoms

Symptoms of ulcerative colitis in a child occur in various variations: stomach cramps, diarrhea, bleeding from the anus, diarrhea, weight loss, chronic fatigue, loss of appetite. The child may have a fever, joint pain, multiple acne on the body, redness of the eyes. Someone may have one or two signs, while another has all the symptoms at once.

Measles, SARS, flu, abdominal trauma, stress - all these factors can serve as a favorable environment for the occurrence of ulcerative colitis. Of the children, boys are more susceptible to this disease.

Treatment

Treatment for colitis depends on the location of the ulcers and the presence of symptoms. There is a dietary and drug treatment - pills, anal suppositories, enemas, intravenous injections.

Nonspecific ulcerative colitis

Sometimes, with ulcerative colitis in children, symptoms that are not specific to the digestive system appear.

• Paleness of the skin,
• Conjunctivitis,
• Red painful knots under the skin
• Inflammation of the iris of the eye
• Stomatitis,
• Joint pain,
• Temperature increase.

The consequences of non-specific ulcerative colitis in children are anemia, secondary intestinal infections, bleeding, intestinal obstruction, peritonitis and joint damage.

To date, the causes of nonspecific ulcerative colitis in children have not been fully elucidated. However, most doctors are inclined to believe that allergens are provocateurs: food, inhalation.

In children, as a result of nonspecific ulcerative colitis, special changes are formed that are different from the changes that occur in the body of an adult. The rectum in children often remains intact.

The treatment of this colitis in children consists, first of all, of the appointment of a dietary table. A nutritionist will make a menu for the child, depending on the location of the focus of the disease and pain, tolerance or intolerance to certain types of products.

In addition, drug treatment of nonspecific ulcerative colitis is prescribed:

• Sulfasalazine to normalize biopsy data,
• antibiotics,
• Spasmalholics.

With a timely diagnosis and correctly prescribed treatment, the prognosis is more favorable for a child than for an adult. However, more often the peak of the disease falls on the period of puberty of children.

Irritation of the colon

The process of removing feces immediately after eating in a 6-month-old baby is normal. Often, such urges can be observed in older children.

The risk of disease in infants falls on the period from 6 to 18 months. A baby has bowel movements up to 6 times a day. The first feces are abundant, partially formed. All subsequent stools are scanty, containing undigested food. However, the children retain a good appetite and there is no weight loss.

After the diagnosis is made, the doctor prescribes treatment. The basic moment of treatment is a diet and medicines that soothe peristalsis.

spastic colitis

Irritable bowel syndrome or IBS is also called spastic or mucosal colitis, which is characterized by bloating, spasms, and malfunctioning of the intestines.

The reason may be food that is poor in slags (black bread, vegetables, cereals). The second possible reason is the suppression of the urge to defecate.

Symptoms: dry “sheep” feces several times a day, sometimes accompanied by pain and bloody discharge. The child does not sleep well, gets tired quickly, complains of a headache.

Spastic colitis is not a serious disease, rather, it refers to disorders of the gastrointestinal tract and manifests itself against the background of chronic fatigue, stress or overexcitement.

Like other types of colitis in children, spastic colitis is treated primarily with proper nutrition - diet and food intake.

A few tips for those diagnosed with spastic colitis: eat foods high in fiber, coarse bread, cereals, raw vegetables and fruits. It is recommended to minimize foods rich in carbohydrates.