Treatment of chronic enterocolitis in adults. Enterocolitis: symptoms and treatment in adults

Enterocolitis is a nonspecific inflammatory disease of the colon and small intestine of various origins, accompanied painful sensations in the abdominal area and dyspeptic symptoms.

As a result, inflammation forms in the wall of the small intestine (enteritis), large intestine (colitis), or both parts (enterocolitis). The process may involve the stomach and other organs, resulting in various symptoms.

It is important to know that during the disease the intestines cannot fully perform their function, so the patient may experience other signs of pathology.

Enterocolitis can occur in two main forms

Spicy. Characterized by inflammation surface layers intestines. Most often provoked by aggressive irritants (burn, injury, etc.).
Chronic. This form is justified if more than 6 months have passed since the onset of the disease. In this case, the structure of the mucous membrane completely changes and the inflammatory process moves to the deeper layers. The villi are less pronounced, the activity of enzyme complexes is disrupted, as a result of which parietal digestion and absorption are reduced.

Five reasons that provoke enterocolitis

It should be noted that not everyone develops enterocolitis, since certain conditions must be created:

decrease in general immunity (IgA concentration, number of macrophages and other protective factors);
genetic predisposition(more often in women);
concomitant diseases Gastrointestinal tract (for example, atrophic gastritis).

Depending on the type of damage, there may be various shapes enterocolitis: catarrhal, ulcerative, ulcerative-necrotic and others.

Symptoms

It is difficult to identify signs that would accurately indicate that the patient has enterocolitis. All symptoms are not specific and reflect only the severity of this pathology.

Main symptoms

Abdominal pain is a key symptom of gastrointestinal pathology. The pain intensifies upon palpation, is paroxysmal in nature and is localized in the navel area and along the flanks.
Diarrhea or constipation. In the chronic form, these conditions can replace each other.
General manifestations. We are talking about fever, weakness, muscle pain.
Flatulence. Patients complain of bloating and gases. This is due to disruption of digestive processes.
Scatological changes. Feces may change in color and consistency, and fatty patches, streaks of blood, and mucus may appear. All this may confuse the patient, and he will consult a doctor.

Diagnostics

To make a diagnosis of enterocolitis, signs of the disease and epidemiological data (with whom and when the patient had contact, what food he took, etc.) play an important role. Also shown additional tests and instrumental methods:

complete blood count and liver tests;
bacteriological and scatological examinations of feces;
barium radiography;
if necessary, CT;
sigmoidoscopy.

Effectively treating enterocolitis: eight key steps

A comprehensive approach to the treatment of enterocolitis should include influence on all parts of the pathological process and symptoms. Therapy of acute forms of this disease carried out strictly under the supervision of a doctor in an infectious diseases hospital. Chronic enterocolitis in adults can be treated at home. And pediatricians and pediatric surgeons are fighting the necrotic variant (which is more typical for newborns).

Treatment includes the following:

Diet. With the exception of foods that irritate the intestines, fatty foods, and dairy products. The diet lasts about 1.5 months.
Taking antibiotics or antifungal agents. This is etiotropic (directed at the very cause of the disease) treatment.
Enzymes – eliminate the symptoms of the disease.
Multivitamins. In any case, nutrients and vitamins occur.
Probiotics. Improves intestinal motility. And lactobacilli (normalize microflora).
Sorbents. To improve the removal of toxins from the gastrointestinal tract resulting from indigestion.
Herbal preparations.
Steroid treatment (15-30 mg per day Prednisolone).

Diet for enterocolitis

In the hospital, patients with enterocolitis are always prescribed diet No. 4. In addition to this, such a diet should be followed for at least 1.5 months before it occurs. full recovery intestines.

Nutritional features of adult patients with enterocolitis

the basis of the diet is soups made from finely chopped seasonal vegetables, porridge with water (except pearl barley and semolina);
the diet provides for fractional meals, in small portions, 4-5 times a day, overeating is prohibited;
dishes should be steamed (in a double boiler, multicooker) with limited addition of fat;
do not consume foods that increase putrefaction (indole formation) in the intestines;
for diarrhea - frequent and small drinks in the form of strong tea, decoctions of dried fruits;
Despite the presence of exception products, the patient's diet should consist of foods rich in vitamins.

It is also important to remember about foods that should be excluded from the diet during treatment for both acute and chronic enterocolitis:

the diet excludes dairy products (milk, butter, cheese);
fatty meat and fatty fish(including soups with fatty meat);
any hard-to-digest carbohydrates;
sweets (except honey, you can have it 2 weeks after disappearance clinical manifestations diseases);
alcohol and other substances containing alcohol;
hot spices and seasonings.

It is advisable to introduce fruits into the diet of patients who have suffered acute enterocolitis two weeks after stopping antibiotics, gradually, starting with apples and bananas.

Drug treatment

Treatment of acute enterocolitis in adults, as a rule, begins with gastric lavage, laxatives or cleansing enemas. For the first couple of days, such patients are prescribed bed rest, detoxification therapy (infusions of solutions and oral hydration), sorbents.

Treatment for chronic enterocolitis

antibacterial drugs wide range actions (for example, Fthalazol 1-2 g every four to six hours in the first 1-3 days, then half the dose, Furazolidone 0.1-0.15 g four times a day);
lactobacilli and probiotics to eliminate the symptoms of dysbiosis (Linex two capsules three times a day, Bifikol);
sorbents (Enterosgel, Polysorb 1.2 g dissolved in water, taken 3-4 times a day before meals);
water-electrolyte imbalances are corrected intravenous administration saline solution sodium chloride, calcium gluconate, panangin (20 ml three times a day);
herbal preparations (Australian Ectis from plant extracts).

Depending on what symptoms are observed in the patient, more points may be added to this treatment. Any correction of therapy is made by the attending physician.

Traditional methods of treating enterocolitis

Enterocolitis is a disease that people have encountered for a long time before the advent of pharmacology as such. Then it was necessary to be treated with herbal remedies, and the most effective methods were passed down from generation to generation until the present day.

Popular means

for constipation in adults, it is recommended to use laxative tea made from cilantro, licorice root and buckthorn bark before bed (10 g of cilantro seeds and licorice root, plus 80 g of buckthorn bark, pour a glass of hot water and boil for 10 minutes, strain before use);
in case of diarrhea, freshly squeezed carrot juice on an empty stomach, 1/3 cup three times a day, will help (not only will it stop diarrhea, but will also help replenish vitamin A deficiency);
An infusion of nutmeg, 50 ml three times a day before meals, has an analgesic effect (1 g of nutmeg is crushed into powder, poured with a glass of boiling water, left for 60 minutes;
to normalize intestinal function, use a couple of drops 4-6 times a day essential oil myrtle.

Enterocolitis is a disease that requires long-term and complex therapy. To recover, patients must modify their diet, take medications, and take multivitamins regularly. Some patients with enterocolitis (for example, necrotizing) even require surgical treatment.

Enterocolitis is perhaps one of the most unpleasant diseases, which overtakes sooner or later almost all of us. It comes suddenly, sweeps like a storm throughout the body, and disappears, fortunately, without a trace, causing significant “devastation” in the form of dysbacteriosis, temporary indigestion, and asthenic syndrome.

But, before delving into the treatment methods and symptoms of intestinal enterocolitis in adults, you need to understand the level of damage to the gastrointestinal tract. intestinal tract, since it consists of several departments and each of them has its own characteristic symptoms defeats.

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What is it?

As you know, a medical diagnosis resembles a train of several cars, led by a locomotive. In this case, our “train” looks like this: (entero)+(col)+(it), which means damage to the small intestine (entero), damage to the large intestine (colon), of inflammatory origin. The suffix “-itis” indicates an inflammatory nature.

Of course, inflammation refers to inflammation of the internal mucous membrane, and not all layers of the intestine. But enterocolitis is a disease that rarely occurs in its “pure” form. After all, the infection most often enters the body through the fecal-oral transmission mechanism, which is realized, for example, through the water or food route.

Therefore, the first symptoms of enterocolitis appear in the stomach, and gastroenterocolitis is most common. Then the symptoms of gastric damage, as toxins and microorganisms advance, are replaced by signs of enteritis, and then colitis.

It should be understood that this diagnosis is syndromic, that is, the most various reasons, for example, not only infections, but also autoimmune disorders, for example, nonspecific ulcerative colitis. But in this case, nevertheless, isolated damage to the gastrointestinal tract occurs, and enterocolitis is almost always a diagnosis of infectious disease specialists.

What are the symptoms of enterocolitis? Let us be completely clear on this issue.

Symptoms of enterocolitis and upper gastrointestinal tract lesions

At first, for example, when eating an old “salad”, an incomprehensible malaise arises. Sometimes, if the food contained a large amount of microbial toxins, severe chills occur with a rise in temperature.

But most often, the first symptoms that occur are nausea and repeated vomiting, which brings weak and temporary relief. This is how any even more or less serious intestinal infection. And nausea and vomiting are signs of gastritis, or damage to the stomach.

These symptoms are also called signs of upper, or gastric dyspepsia.

Enteritis

Infectious toxins and living microorganisms then descend into the intestines and signs of enteritis develop. These include following symptoms which are called signs of intestinal dyspepsia:

The appearance of copious, watery loose stool, or the occurrence of diarrhea syndrome, frequent urge to defecation;
“Twisting” abdominal pain localized in the umbilical region;
Rumbling in the stomach, bloating.

Often a situation in which the symptoms of acute enteritis occur against a background of nausea and vomiting. This leads to loss of fluid and salts due to the development of dehydration syndrome, or dehydration.

In some cases, especially in young children, it is dehydration that causes the development of a serious condition, and even fatal outcome. An example of such an infection, which causes severe enteritis “in its pure form”, without signs of gastritis and is cholera.

It is with cholera that dehydration and blood thickening reaches its limit; within 24 hours a person can lose up to a quarter of his weight with diarrhea, turning from a blooming young man into a wrinkled, dehydrated old man.

There is even the concept of a “cholera bed” - this is a bed under which a bucket of bleach is placed, and a hole is made in a certain place so that the patient can recover while lying down. I simply don’t have the strength to get up. It is dehydration in cholera that needs to be dealt with first.

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Enterocolitis and colitis

Now the “baton” is taken up by large intestine, since microbial inflammation reaches its departments. As always, against the background of fading symptoms of enteritis and almost completed symptoms of gastric dyspepsia, signs of damage to the large intestine appear. Therefore, symptoms of acute enterocolitis include:

The appearance of another type of abdominal pain - cramps;
The occurrence of frequent and false urge to defecate – tenesmus;
A gradual decrease in the volume of stool, up to bloody mucous “spit”.

This dynamics of symptoms is very characteristic of dysentery. The classic sign is bloody, scanty stools, general signs intoxication, and painful, fruitless urge to empty the bowel.

Dysentery can be caused by either Shigella ( bacterial form), and amoebas - the simplest organisms.

Infectious enterocolitis is a condition that can disrupt the balance for a long time normal microflora, which “lives” in the large intestine. Not only does copious and frequent loose stools pass away beneficial microbes, so prescribing antibiotics completes the matter.

Therefore, after prescribing antibacterial therapy, treatment with eubiotics and bacterial preparations, which improve the condition of the intestinal microflora.

Thus, with enterocolitis there is a combination of watery, profuse and relatively painless small intestinal stool and spastic, scanty, cramping and painful colonic stool. Since these two types of stool cannot occur simultaneously, enteritis is usually replaced by colitis within 2 to 3 days.

Symptoms and course of enterocolitis in children

Acute enterocolitis in children is not a specific, “children’s” infection, such as rubella, measles or mumps. But this does not diminish its severity. Children's body is not as balanced as the body of an adult. Therefore, dehydration is the hardest thing for babies, and fever comes in second place.

But febrile seizures, which inexperienced parents are so afraid of, are much less dangerous than exicosis, or dehydration.

At first glance, the loss of fluid through stool does not seem significant to parents, but for a baby, the loss of a liter of water is a life-threatening condition. The following signs indicate its development:

“Dry” crying and lack of tears in the baby;
Dry mouth;
Hoarse and silent voice and crying resulting from dehydration of the vocal cords;
Retraction of fontanelles on the skull;
A sharp decrease in tissue turgor.

If these symptoms are present, urgent hospitalization in an infectious diseases hospital is required, since it is very difficult to force the baby to replenish the body with fluid through drinking.

In the smallest children, a serious complication can occur - necrotizing enterocolitis in newborns. In this case, inflammation penetrates deep into the intestinal wall, with possible development necrosis. The most common occurrence is the presence of ulcers and necrosis. This form occurs due to the pronounced necrotizing effect of pathogenic microflora. After all, the newborn’s body has no immunological protection other than mother’s milk.

Most often, these severe forms of the disease occur due to perinatal infection Streptococcus aureus, and various types of pathogenic streptococci. Quite often, intestinal inflammation is associated with prematurity, various options child underdevelopment.

Diagnosis and treatment of this condition must be very prompt, since without treatment, irreversible changes can develop in 1-2 days, which can cause the death of the baby.

Treatment of enterocolitis in adults, drugs and techniques

Working with a patient begins with assessing his danger to others. Quite often it is necessary not only to hospitalize a person in the intestinal department of an infectious diseases hospital, but also to place him in a separate box. Rospotrebnadzor, together with epidemiologists, removes suspicious goods from the retail chain; in the case of waterborne transmission, swimming is prohibited, etc., and the patient is treated according to the rules.

The basic principles of treatment of acute enterocolitis in adults are the following:

1) Diet

The diet for enterocolitis is called “intestinal”. Appointed. His distinctive features are complete sparing of the intestines and digestive organs - chemical, mechanical, thermal. All food should be easily digestible and not cause a laxative effect, as well as an increase in peristalsis.

Examples of such dishes are rice soup with chicken broth and lingonberry jelly. The diet is prescribed until stool normalizes.

2) Fighting dehydration

Prevention and treatment of exicosis is the basis of treatment of acute enterocolitis. So, with cholera, people die from dehydration, and not from fever or terrible pain. Cholera diarrhea is painless.

There are two types of rehydration, or fluid replacement. Oral type, in which the patient diligently drinks saline solutions (“Regidron”, “Citraglucosolan”), which are optimally balanced in ionic and osmolar composition, taking into account the body’s losses. With dehydration, acidification of the body develops, and with severe vomiting, alkalization, or metabolic alkalosis, develops.

In order to have an idea of the volume of water exchange in the intestines, it must be said that 8-9 liters of liquid pass through it every day: this is food, drink, secretion of bile and pancreatic, gastric juices, saliva. 150-200 g of water per day comes out with feces, everything else is absorbed.

Therefore, in case of severe diarrhea, you need to replenish these 8-9 liters. The rate of fluid consumption should be 1-1.5 liters per hour, until a volume equal to 50-55 ml/kg of weight is reached. This means that a 100 kg man must drink at least 5 liters of saline solution in 5-7 hours, and the solution must be heated to body temperature.

In severe cases, heated solutions are infused through two subclavian catheters (small veins collapse and become empty), with simultaneous treatment of hypovolemic shock. Intravenous rehydration is carried out with isotonic solutions (Trisol, Quartasol, Acesol).

3) Fighting infection

This section includes all antibacterial therapy, use of antibiotics. Of course, in the case of viral diarrhea, antibiotics are not used, but pathogenetic therapy and fluid replacement continue.

4) Symptomatic therapy

In the treatment of acute enterocolitis, this includes the administration of antipyretics, the administration of myotropic antispasmodics, which reduce spasms and peristalsis, thereby reducing abdominal pain, and the prescription of enzyme preparations to facilitate digestion during the recovery period;

5) Treatment of dysbiosis

After relief of diarrhea syndrome, medications are prescribed that prepare the environment for normal microflora. These include “Hilak-Forte”. Then they use drugs such as Baktisubtil and Linex.

Of course, treatment of enterocolitis includes the use various drugs and ways. So, on the first day of profuse diarrhea, indomethacin can be used, which reduces the secretion of fluid into the intestinal lumen.

Sorbents are prescribed (“SUMS”, polyphepan, “Enteros-gel”, regular activated carbon). In severe cases, treatment of the patient in intensive care is required, since infectious-toxic shock occurs.

Forecast

Classic infectious enterocolitis can be severe and even fatal. The main complications that arise with this disease are the following:

Development is infectious - toxic shock. Appears with pronounced antigenicity and immunogenicity of pathogens, for example, with salmonellosis and shigellosis dysentery. It develops more often in children, as well as in weakened elderly patients;
Sharp development of dehydration due to profuse diarrhea (cholera, salmonellosis, food intoxication, typhoid fever), with the occurrence of hemoconcentration, blood thickening, and the occurrence of intravascular thrombosis;
The appearance of perforated ulcers in the colon with long-term colitis. If there are many of them, then the entire intestinal wall may resemble a “sieve”, and peritonitis develops. Severe, diffuse peritonitis against the background of infectious shock, as a rule, leads to the death of an exhausted patient suffering from prolonged dysentery;
The occurrence of DIC, a syndrome that often accompanies severe intestinal infections.

In conclusion, it should be noted that one should not equate ordinary “diarrhea” with serious illness. Enterocolitis, the symptoms and treatment of which in adults we have examined, requires a special approach in children, in patients with diabetes mellitus and, since massive administration of fluids and salts, despite the obvious need, can occur with various complications.

But, so that ordinary “diarrhea” does not lead to severe complications, you need to promptly notify your infectious disease doctor, and treatment at home should begin with replacement of fluid losses.

You should not use antibiotics without a doctor’s prescription, since this can not only be a rash step, but also “blur” the entire clinical picture of the disease. And after that, you may simply not find the pathogen that caused acute infectious enterocolitis. In turn, this can complicate the treatment of enterocolitis and lengthen the recovery time of the body.

Group of diseases digestive tract, which can be both acute and chronic, is called enterocolitis. They are characterized by numerous symptoms, the main of which is inflammation of the intestinal lining. Both the mucosa of the small intestine and the large intestine may be affected. In addition, the pathology causes indigestion and pain. How can enterocolitis be detected and treated in adults - the actions of doctors.

This disease requires mandatory clinical diagnosis and comprehensive treatment.

By definition enterocolitis is a syndrome of impaired digestion, which is caused by an inflammatory process of an infectious or non-infectious nature, localized in the small or large intestine. The disease is divided into two types - acute and chronic.

Acute form

Often combined with acute gastritis. This symbiosis even has its own name - gastroenterocolitis. It may occur due to infectious or non-infectious reasons. May be caused by allergies. The cause of formation is sometimes poisoning - with poisons or drugs.

Important! Unlike the chronic form, the pathology spreads superficially throughout the mucosa, without affecting the deeper layers. Also acute period lasts a little while.

Chronic form

Most often it occurs as a consequence of the acute form, due to poor quality treatment. This disease lasts much longer. Remission periods are replaced by new exacerbations, during which destructive changes are formed not only in the upper layer of the mucosa, but also in the submucosal layer of the intestinal walls.

Chronic enterocolitis causes severe digestive distress and reduces bowel function.

Table. Classification of enterocolitis by cause of occurrence.

Cause	Characteristics
	Bacterial enterocolitis is divided into two types. Specific - occurs due to infection with bacteria that cause intestinal infection, such as dysentery bacillus, salmonellosis and others. Nonspecific - formed as a result of neutralization of bacterial infections.
	In this case, the mucous membrane is damaged by toxic agents. They can be chemicals and poisons, as well as various medications.
	This type of enterocolitis is called alimentary, and it occurs due to regular and persistent eating disorders.
	If constipation is frequent and prolonged, enterocolitis forms, called mechanical. That is, inflammation of the mucous membrane is of a mechanical nature.
	This type is called secondary. This is a complication that can develop after suffering a disease of any of the digestive organs.

Clinical symptoms and diagnosis

It is necessary to consider separately the symptoms of acute and chronic forms, infectious and non-infectious etiologies, as well as chronic forms in the acute stage. The onset of the acute form is usually sudden, accompanied by pronounced symptoms:

nausea turning into vomiting;
the center of the abdomen hurts on palpation;
the stomach growls and there is bloating;
coating on the tongue;
diarrhea;
weakness;
mucus or blood in stool;
temperature;
muscle pain;
headaches.

Vomiting is one of the symptoms of the disease

The last five points most often characterize a pathology of infectious origin, the first five - non-infectious, although there is the presence of almost all symptoms and their mixing.

By the way. The chronic form does not usually have pronounced symptoms, and this is dangerous, since over a certain period severe complicated situations can develop that are risky for the patient’s life.

An exacerbation can be recognized by the following symptoms.

Abdominal pain in the navel area is felt most often, but here it can only begin, and then spread throughout the entire abdomen.
If the exacerbation is severe, the pain will be more pronounced.
Pain usually occurs or intensifies in the afternoon or afternoon.
If the process is predominantly localized in small intestine, the pain will not be acute and will be of moderate severity.
If inflammation affects the colon mucosa, the pain is more intense and acute.
If there has been no bowel movement for a long time, two hours after eating, with any physical activity (from walking to running and jumping), the pain will intensify.
Defecation disorders will be expressed ambiguously, most likely by alternating diarrhea with constipation.
Indigestion occurs.
As a result of abnormal gas formation, flatulence will occur.
It will be possible to observe dyspeptic syndrome, when food rots and ferments in the intestines.
If the disease is long-standing, there is astheno-vegetative syndrome, in which tissue metabolism is disrupted. Its manifestations are apathy and indifference, lethargy and decreased attention, weakness and fatigue.
When there is disease in the small intestine, body weight will begin to decrease. Also, weight may begin to decrease in any form, as the patient refuses to eat for fear of causing increased pain.

Diagnostic measures

When diagnosing acute enterocolitis, the disease is detected according to three parameters:

anamnesis;
symptoms;
coprogram.

The doctor collects anamnesis, then records the presence necessary symptoms and prescribes a bacteriological examination of stool. If clarifying or confirming actions are necessary, rectoscopy is performed.

To diagnose chronic enterocolitis, you will have to carry out more different studies.

Anamnesis data must be collected, as in the first case.
This is followed by a physical examination by a physician.
The next stage is laboratory-analytical.
The latter is done using instrumental diagnostics.

Important! The most informative and in a fast way To diagnose chronic enterocolitis, “dormant” in the intestines (mainly in the colon) and masquerading as other diseases, is colonoscopy.

Diagnosis using colonoscopy helps to identify not only the presence of inflamed and erosive areas of the intestine, but also to determine their exact location. Also, during the study, biopsy samples can be taken immediately.

If an x-ray is taken, the purpose of the study is to identify narrowing or expansion of the intestinal lumen, defects in the walls and folded structure.

Laboratory research is carried out with biomaterials such as blood and feces. In the first, characteristic signs of digestive disorders are identified: ion imbalance, anemia, as well as an abnormal number of leukocytes, dysproteinemia, and so on. In stool analysis, they look for an increase in the content of mucus or other secretions, steatorrhea, creatorrhoea, amilorrhea.

Treatment process

The diagnosis has been made, treatment can begin. If the process is acute, first therapeutic measure becomes gastric lavage.

In acute process

It is not necessary to cleanse the stomach by inducing vomiting and using special drugs. If the degree of the disease is moderate, the doctor may limit himself to prescribing a water-tea diet. The second important point is the restoration of fluid volume, which is normal for the body. If the disease occurs with severe debilitating diarrhea and is accompanied by vomiting, hydration therapy is necessary to prevent dehydration.

Advice. At this stage the patient should not eat anything. If he experiences an insurmountable hunger, you can drink rice water and eat rice porridge with a liquid consistency, boiled with water, in small portions.

Drugs

In a chronic process

Here the goal is not to eliminate the symptoms first, as in the treatment of the acute form, but to destroy the cause of the disease. Therefore, treatment begins with normalization of nutrition.

Important! All patients with chronic enterocolitis are prescribed a diet, but different options. In case of exacerbation - table No. 1. If there is no exacerbation, table No. 2. If constipation is present, table No. 3. And for predominant diarrhea - No. 4.

Drugs

Decoctions can be used as enemas medicinal plants: bird cherry, oak bark, chamomile, St. John's wort. But it’s better not to do it on your own therapeutic actions. Even before use folk recipes, proven by numerous generations, you should consult a doctor.

Video - Enterocolitis in adults (acute, chronic): what it is, symptoms, treatment

... The intestine is a single system consisting of two sections - the small and large intestines. The inflammatory process in the small intestine is called enteritis, and in the large intestine - colitis.

It is unrealistic to diagnose a patient with only colitis or exclusively enteritis, since the onset of inflammation, affecting one part of the intestine, immediately affects the other. Therefore, there is no clear distinction between colitis and enteritis.

Enterocolitis has the character of a complex lesion of the mucous membrane, both inflammatory and non-inflammatory in origin. The entire gastrointestinal tract can be affected by the disease - the stomach, parts of the small and large intestines, as well as the rectum.

There is no age group at risk for the disease. Enterocolitis can develop at any age, regardless of the patient's gender. It affects up to 12 to 34% of the world's population. The prevalence of the disease depends both on living conditions and on the economic development of the country as a whole.

Nature of the disease

There are acute and chronic forms of enterocolitis. Acute course diseases affects top part epithelial layer of the intestinal mucosa. Lack of therapeutic effect during exacerbation leads to delay inflammatory process and its transition to a chronic form of the disease.

The acute form of enterocolitis manifests itself as symptoms of bursting pain in the abdominal area, accompanied by upset stool and possible impurities in the stool in the form of pus, mucus or blood. as a rule, it is accompanied by flatulence and spontaneous vomiting, the masses of which are dominated by digested food. With infectious enterocolitis, signs appear that indicate general intoxication of the body:

raising body temperature to high levels;
pain in joints and muscles;
pronounced weakness;
constant drowsiness.

The chronic form of the disease is characterized by unsystematic manifestation pain syndrome. Depending on the location of the inflammatory focus, the nature and intensity of pain changes. If pathological process occurs in the large intestine, the pain is acute and pronounced. Gain pain can be observed after eating, and a decrease - only after defecation.

The inflammatory process occurring in the small intestine causes moderate pain.

The course of the chronic form of enterocolitis, which remains without therapeutic intervention, leads to severe disruption of the digestive process, since not only the surface, but also the internal layers of the mucous membrane begin to become inflamed, affecting large areas of the stomach and intestinal tract as a whole.

Forms of the disease

A long and sluggish process of the chronic form of enterocolitis is accompanied by alternating loose stools with constipation. It is not systematic, appearing spontaneously, depleting the patient’s body. One of the main symptoms of enterocolitis is a rapid decrease in total body weight. This happens for two main reasons.

Firstly, the affected areas of the intestinal mucosa cease to take part in the digestive process. They are not perceived nutrients and elements important for the human body.

Enterocolitis received infectiously accompanied by bouts of vomiting and acute diarrhea, but, as a rule, is well exposed therapeutic effects and is quickly treated.

Secondly, a person suffering from a chronic form of enterocolitis limits himself to food intake, since during half-starvation the process does not cause pronounced pain.

The symptoms of infectious enterocolitis are quite easily confused with the occurrence of necrotizing ulcerative colitis or severe forms of diseases of the stomach and intestinal tract as a whole, which can lead to disability. To diagnose them, it is necessary to carry out complex analyzes using special equipment.

Often, the diarrhea syndrome that accompanies enterocolitis can occur against the background of fermentopathy - the congenital absence of one or a group of enzymes in the human body. To eliminate the syndrome, it is necessary to install this enzyme and exclude the corresponding foods from the diet.

Symptoms of exacerbation of enterocolitis

The disease may begin suddenly with the manifestation of pronounced acute clinical symptoms:

pain in the abdomen;
bloating and excessive flatulence;
nausea accompanied by vomiting;
intrauterine rumbling.

In this case, as a rule, a dense coating appears on the tongue with a grayish tint. On palpation, the abdomen responds with painful sensations. Diarrhea with purulent inclusions or bloody discharge. Enterocolitis is often accompanied by low-grade fever with associated symptoms acute intoxication:

muscle aches;
headache;
weaknesses.

The development of chronic enterocolitis can begin with mild clinical symptoms early stage, and with the development severe forms leading to dangerous complications.
The most characteristic features exacerbations of chronic enterocolitis are considered:

Firstly. Acute pain, located in the navel area. The severity of pain depends on the severity of the disease. The onset of pain is observed in the afternoon with intensification in the evening. inflammation, Pain during inflammation localized in the small intestine is moderate, more dull in nature than during the inflammatory process located in the large intestine. The inflammatory process in the large intestine is characterized by intense, pronounced pain that intensifies before defecation. Their strengthening also occurs with any effort - increasing physical activity, walking, jumping, running.
Secondly. Disorder of the process of defecation with a pronounced alternation of diarrhea and constipation with the occurrence of dyspeptic syndrome, accompanied by disturbances in the processing of food by the body. Putrefactive or fermentative processes can occur in the stomach, and often both at the same time.
Thirdly. against the background of digestive disorders. Excessive gas formation leads to painful forms of flatulence.
Fourthly. The occurrence of astheno-vegetative syndrome against the background long term a disease caused by a disorder of interstitial metabolism. The syndrome causes lethargy, weakness, increased fatigue, impaired attention and a tendency to apathy.
Fifthly. Intensive loss of a person's own weight. It is observed in patients with damage to the small intestine, mainly suffering from colitis. Patients lose weight due to the patient’s refusal to good nutrition, since patients experience fear of pain after eating food. This attitude leads to progressive forms of the disease.

Causes of the disease and its types

About 80% of the occurrence of a disease such as enterocolitis is caused by damage to both the stomach and intestinal tract by various infections or microorganisms. The main cause of development may be opportunistic Escherichia coli, which has been exposed to the infectious effects of microorganisms and provoked an inflammatory process.

The causes of enterocolitis can be various multiple factors. They may depend on the etiology or changes in clinical picture course of the disease and can be divided into following types development:

Enterocolitis is a large group of diseases that includes damage to the entire intestine (small and large). Given the large area of inflammation, the symptoms of the disease are pronounced and affect the well-being and health of the sick person.

The course of the disease can be acute or chronic. Acute enterocolitis is most often associated with infection, food poisoning. It affects only the superficial layer of the mucous membrane and does not spread deeper. Flows with acute gastritis. Therefore, a diet for enterocolitis is prescribed taking into account the damage to the stomach.

The chronic form is associated with damage to the liver, pancreas, and bile ducts. Symptoms of enterocolitis in this case are layered and add signs of other diseases of the digestive system. It is difficult to decide which disease is primary and which is secondary. Treatment requires simultaneous action on all parts of the digestive process.

The causes of enterocolitis are expressed in the clinical classification of the disease.

The role of infection in the etiology of enterocolitis

Infectious enterocolitis is divided into 2 subgroups:

It is practically important that this type of disease is contagious to others, transmitted through dirty hands, contaminated food products if incorrect culinary processing. The disease is associated with a lack of compliance with sanitation rules. It is important for epidemiologists to investigate and determine the source of the infection. The possibility of bacterial carriage in untreated acute processes is characteristic.

Staphylococcal enterocolitis most often spreads in children's groups. The disease is most severe in infants. In adults, staphylococci live in the intestines and do not cause disease until the immune system weakens.

In addition, doctors distinguish specific enterocolitis, caused by an infectious pathogen, and nonspecific, which appears as a result of therapy.

There is a pathogen, Clostridium difficile, which affects the mucous membrane not independently, but with its potent toxins. This is how pseudomembranous enterocolitis occurs. This type of inflammation results from a response to the use of antibiotics for treatment. various diseases. All the most popular groups antibacterial drugs can cause the proliferation of clostridia in the intestines.

It has been established that up to three percent of the adult population are carriers of clostridia and do not get sick. For the disease to develop, the body must be weakened ( old age, renal failure, malignant formations and treatment with cytostatics, surgical operations, impaired blood supply to the intestines).

Other reasons

Non-infectious enterocolitis is not contagious. Only affects those sensitive to external reasons people.

Toxic enterocolitis - occurs under the influence of chronic intoxication when working with toxic substances, when taking certain medications for a long time, and in alcoholism.
Nutritional - caused by consumption by adults fatty meat, fried and spicy foods. Children suffer from untimely introduction of complementary foods and unclean preparation of baby food.
Mechanical - associated with long-term constipation caused by intestinal dyskinesia (atony), narrowing of the intestine by the tumor process, partial intestinal obstruction.
Allergic - accompanies others allergic manifestations (bronchial asthma, hay fever, polyarthritis).
Intestinal ischemia - causes necrotizing enterocolitis, it is the cause of the disease in premature newborns, in adults as a result of thrombosis of mesenteric vessels against the background of heart failure, abdominal trauma.

Disturbance of the bacterial flora is called dysbacteriosis. This problem has become very acute in modern world. The fact is that the bacteria living in the intestines perform an important function - they destroy what we do not need. It has been proven that the composition and quantity of necessary bacteria is “convened” by a signal from the oral cavity. As soon as a person begins to chew food, receptors in the mouth transmit information through the brain to the intestines. Nowadays, the introduction of genetically modified foods into food is causing great controversy among scientists. American biologists have proven that the human body does not recognize them or takes them into account as foreign agents. Therefore, they do not accumulate in the intestines necessary bacteria and arise severe symptoms allergic inflammation.

What happens in the intestines?

Mild damage includes local inflammation in certain areas of the intestine. It is manifested by swelling of the mucous membrane, accumulation of inflammatory infiltrate, and vasodilation. This picture is typical for acute enterocolitis.

With prolonged chronic inflammation, damage occurs to the internal layers of the intestine, even to the point of perforation. Ulcers with loose edges and bleeding vessels form. Ulcerative enterocolitis significantly worsens the disease. In the absence of timely treatment, ulcers do not scar, but cause areas of necrosis (necrosis). Necrotizing enterocolitis is often a consequence of a pseudomembranous type of disease, localized in the rectum, sigmoid and ascending colon, and contributes to wall rupture.

Necrotizing enterocolitis in newborns causes thinning of the wall, creates conditions of increased permeability for bacteria, and promotes sepsis.

Manifestations of enterocolitis

The manifestations of enterocolitis will vary slightly depending on the form of the disease.

Symptoms of acute enterocolitis

Clinical manifestation depends on the form, severity, and type of pathogen. Most often, patients complain about:

abdominal pain, cramping in nature, localized over the entire surface;
bowel dysfunction - diarrhea several times a day, possible blood in the stool;
nausea and vomiting of sour contents, sometimes mixed with bile;
increased temperature due to an infectious disease;
as symptoms of intoxication - headache, dizziness, muscle and joint pain.

The disease occurs suddenly. Pseudomembranous enterocolitis can develop during treatment with antibiotics or some time (up to eight weeks) after their discontinuation. Diarrhea is frequent and debilitating, accompanied by significant loss of fluid, and the temperature rises to 40 degrees. Chills are typical.

Upon examination, the doctor finds a painful bloated belly, pays attention to the rumbling of the intestines, spasmodic areas, the tongue is dry with a white coating.

Staphylococcal enterocolitis in children can occur as necrotizing and cause severe sepsis with convulsions, lethargy, and loss of consciousness.

Signs of chronic enterocolitis

The chronic form occurs with periods of exacerbation and remission. During an exacerbation, the following symptoms can be observed:

abdominal pain ranging from aching to cramping, without precise localization, typically intensifying after motor activity, 2–3 hours after eating, there is a connection with the act of defecation;
diarrhea is rare, followed by constipation;
bloating, rumbling;
loss of appetite, nausea;
weight loss is observed with primary damage to the small intestine;
from the outside nervous system- headaches, fatigue, irritability, obvious dependence of mood on bowel movements.

Diagnostics

Diagnostic symptoms and signs of enterocolitis can be divided into nonspecific, characteristic of any inflammatory process, and specific for this type of disease.

Nonspecific include: leukocytosis and increased ESR in the general blood test, a slight decrease in hemoglobin, the presence of C-reactive protein.

Specific ones include:

the appearance in the analysis of stool for coprogram of a significant number of leukocytes, blood, undigested food, fatty inclusions;
detection of infectious pathogens in feces;
sigmoidoscopy data on examination of the most lower sections intestines;
picture during colonoscopy (the device allows you to examine the large intestine) - areas of ulceration, accumulation of mucus and pus, bleeding necrotic intestinal wall;
fluoroscopy of the intestine - shows a narrowing or expansion of the intestinal lumen, a change in the pattern of folds, a filling defect.

Treatment

Treatment of acute enterocolitis is carried out in inpatient conditions. Special attention required to be given to young patients.

Treatment of chronic enterocolitis requires more attention to the cause of the disease: it is not always indicated antimicrobial agents, therapy for other digestive diseases is necessary, and importance is given to a long-term diet.

Enzymatic preparations are prescribed to improve the digestion of food, means to scar ulcers and stop bleeding.

At the same time, you need to remember to restore intestinal motility and microflora balance.

The diet for the treatment of enterocolitis depends on the nature of the stool: if you are prone to constipation, table No. 3 is prescribed, for diarrhea - table No. 4. All spicy, fried, salty, fatty foods are excluded. Depending on the form of dyspepsia established according to the coprogram, restrictions are required:

for putrefactive dyspepsia - coarse fiber, fermented milk products, protein foods;
for fermentative dyspepsia - fresh milk, brown bread, sweets, cabbage are not recommended.

For damage to the small intestine with persistent diarrhea, it is prescribed protein products, vitamins, microelements.

Complications

Complications arise from a severe infectious process - sepsis. With ulcerative necrotizing enterocolitis, perforation in the abdominal cavity with the development of peritonitis. In such cases, urgent surgery. The affected area of the intestine is removed and an anastomosis is formed. Sometimes the operation is performed in two stages.

Folk remedies

Treatment of enterocolitis with folk remedies can be carried out in the form of local procedures: microenemas, intestinal lavage. For this, warm decoctions of herbs with anti-inflammatory effects are used.