Than to treat an acute colitis of an intestine


Acute colitis, treatment and symptoms

In the emergence of the disease, various infections play a role, especially dysentery, as well as some intoxications (mercury poisoning, uremia).

Pathogenesis and pathological anatomy of acute colitis

Among the mechanisms of the appearance of the main signs of acute colitis, most attention is usually paid to toxic effects a poison that circulates in the blood and is released by the wall of the intestine into its lumen, as is the case with mercury and uremic colitis. With a number of bacterial colitis, for example, with bacillary dysentery, an effect on the intestine of the toxin through the blood or the formation of irritants within the intestine itself has also been established. Significant importance in the origin of acute colitis should be attributed to the violation of the nervous regulation of the intestinal activity that occurs under the influence of the underlying cause of the disease. This is especially the case with severe forms of the disease, in the clinical

picture of which are noted as signs of an acute dystrophic process of nervous nature, and various reflected signs of the disease from other organs, arising from a variety of reflexes from the intestine (the pylorus, the bile duct, etc.). When examined, the mucosa of the large intestine is edematous, loosened, full-blooded, covered with mucus and pus. In severe cases, inflammation takes the form of diphtheria (dysentery, mercury, uremic colitis) and gangrenous process.

Clinical picture of acute colitis

The onset is acute, with colic pain in the abdomen, diarrhea, fever, loss of appetite, nausea, sometimes vomiting. The pains are strong from the intestinal spasm, more to the right or left, depending on the location of the process.
With left-sided colitis, sigmoidoproctitis is a false urge, a feeling of pressure in the rectum. Stools are very frequent, sometimes up to 100 times a day, first stained, fetid; soon they become very scarce and lose their fecal character, consisting almost exclusively of mucus an admixture of blood, sometimes from pieces of dead mucosa, with a high content of soluble protein, mainly due to irritation and increased secretion of the mucous sigmoid and direct guts with usually delayed stool in the proximal parts of the intestine due to intestinal reflex effects (with acute colitis there are so-called false diarrhea).
With right-sided colitis (tiflokolite), tenesmus are absent, stools are not more frequent 10 times a day, feces are fetid, liquid, feces, without residues undigested food (unless the small intestine is affected), without visible mucus, blood, pus, but contain a lot of ammonia, phenols, sometimes soluble protein.

Patients look pale; in severe cases dehydrated, tongue dry. When you feel your abdomen, soreness, diffuse or predominantly in the region of the blind and ascending or descending gut. In the area of ​​the cecum, rumbling is due to the accumulation of gases and liquid stool. Gastric secretion can be lowered.

The course and complications of acute colitis

In mild cases, after a few days, there is an improvement; more severe cases are delayed up to 2-4 weeks. Of complications, there is polyarthritis, conjunctivitis, pyelitis, hepatitis. When recovering, there may be a tendency to repeat disease. In the most severe cases, death sometimes occurs from collapse, peritonitis, sepsis, or liver abscess; with mercury colitis-death from uremia, defeat of the heart and other organs.

The diagnosis of acute colitis

To clarify the etiologic form of acute colitis, a detailed anamnesis (mercury poisoning, uremia) is important and a general study patient, including the study of feces on the dysentery bacillus and the protozoa, the agglutination reaction, sigmoidoscopy. Acute colitis is often diagnosed erroneously, only on the basis of the presence of blood in the stool, especially in cases of hemorrhoids, cancer of the rectum and colon, hemorrhagic capillarotoxicosis, etc.

Treatment of acute colitis

Treatment aims to eliminate the underlying cause of antimicrobial agents, to bind or remove poison, and so on. and also the restoration of the normal state of the organism as a whole, the settlement of its higher nervous activity, the weakening of excessive reflex phenomena, and so on. which is also the so-called symptomatic treatment.
Apply sulfonamides, with mercury and other poisoning, special measures; In addition, as with acute enteritis, a strict bed rest regime, hunger, a single laxative or in mild cases, a fractional appointment 1-2 days a tablespoon of 2% sodium sulfate solution up to 1 l in day. Against pain and to ease other neuro-reflex symptoms of atropine and papaverine inside, in candles or subcutaneously, with tenesmus-especially antipyrine (, ) in microclyster or candle; enemas hot oil, with adrenaline or opium (20 drops of 1 ° / 00 solution of adrenaline or 20 drops of tincture of opium for half a cup of water), novocaine in vein. In severe cases, salt infusions, exciting (adrenaline in injections), transfusion of plasma or whole blood.

Acute colitis

Acute colitis is a common disease, often associated with an accompanying acute inflammation mucosa of the small intestine (acute enterocolitis), and in some cases, the stomach (gastroenterocolitis).

Causes of acute colitis

The causative agents of acute colitis are salmonella, shigella.

Other bacterial pathogenic flora, viruses, etc., may appear less frequently. The cause of colitis can be gross errors in nutrition, as well as food non-bacterial poisoning. Causes to a lesser extent can be: food allergy, some common infections, toxic substances. The onset of the inflammatory process in the large intestine is due to the action of damaging factors locally on the intestinal mucosa that are contained in the intestine, or (bacteria, toxins, etc.) come in the hematogenous way and, when secreted by the mucosa (excretory function of the gut) exert their influence.

Symptoms of acute colitis

The first symptoms of colitis are a sharp pain of a spastic or drawing character, loss of appetite, rumbling in the abdomen, general malaise, diarrhea.

Appears liquid stool with an admixture of mucus. In severe cases, the stools are watery, sometimes contains blood, and a large amount of mucus; number of urges for defecation comes to 15-20 times a day; may manifest imperative urges for defecation, painful spasms appear and tenesmus. Body temperature exceeds 38 # 17;. General intoxication can be expressed by sharp symptoms in especially severe cases. In this case, note the dryness of the tongue, overlaid with a gray bloom; the stomach is swollen, and retracted with severe diarrhea. When palpation rumbling in some parts of the colon and painful sensations are noted.

The definition of hyperemia is due to a sigmoidoscopy. In the course of the examination, edema of the mucosa of the colon of the distal sections is determined, and a large the amount of mucus on the walls of the intestine, and in more severe forms - pus; may be ulceration, erosion, and hemorrhage. A blood test indicates an increase in ESR, a moderate leukocytosis with a stab shift. The patient quickly recovered in mild cases, but in severe cases # 8212; the disease can take a protracted character. Complications: peritonitis, liver abscesses, sepsis, pyelitis.

Treatment of acute colitis

Patients with acute colitis are subject to hospitalization (if there is a suspicion of the infectious nature of the disease - in the infectious departments of hospitals).

In such cases, antiparasitic or antibacterial therapy is prescribed, saline laxatives are indicated for toxic colitis. If dehydration occurred # 8212; drip iv or s / c injected solution of sodium chloride,%, hemodez or glucose solution 5%. Astringents and enveloping agents are prescribed inside (tanalbin, 1 g of bismuth nitrate basic up to 6 times in day, kaolin, etc.), preparations of digestive enzymes (polizim, abonin, etc.), holinoliticheskie facilities. To normalize the intestinal flora appoint colibacterin, bifikol, enteroseptol, intestopan, etc. Hospitalized with this disease non-infectious nature are subject to medical examination for 6 months.

Nutrition for acute colitis

Nutrition regimen for the first symptoms of the disease: the first day only a plentiful drink (semisweet or unsweetened tea), maximum can add white rusks.

The composition of the daily diet: proteins - 100 g, fats - 70 grams, carbohydrates - 250 g, table salt 8-10 g.

Limit the use of products that irritate the gastrointestinal mucosa, stimulate the secretion of digestive glands, enhance the processes of fermentation and putrefaction in the intestine and irritate the liver.

  • Meat and fish are low-fat and cooked on steamed or boiled on water, meat to be eaten.
  • Soups cook on low-fat broths (fish, meat).
  • Rice, buckwheat, oatmeal, semolina porridge on the water.
  • White rusks
  • Low-fat freshly prepared cottage cheese, soufflé from cottage cheese.
  • Very useful jelly and jelly from ripe pears, bird cherries, blueberries. You can # 8212; rose hips, tea, cocoa on water, black coffee.
  • Limit the eggs. Sugar # 8212; not more than 40 g per day.

Exclude from the diet:

  • Milk whole and lactic acid foods, dairy dishes.
  • Compotes and jam.
  • Fried dishes, smoked, sour, spicy, spicy dishes, snacks, pickles and marinades.
  • Raw vegetables, berries and fruits.

Thus, the food should be cooked on steam or welded on water, taken in a grated form in small portions 4-5 times a day.

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