Enterocolitis is an inflammatory process that immediately affects both the small and large intestines.
This is one of the most common diseases of the digestive tract, which can lead to the development of atrophic processes in the intestinal mucosa with concomitant disorders of its functioning.
When making a diagnosis, pay attention to the localization of the lesion of the pathological process. Enterocolitis is often accompanied by a primary lesion of the mucous membranes of the small and large intestine.
Pathology is characterized by a long course. Infectious intestinal diseases, excessive use of acute, alcoholism, drug or industrial intoxication, prolonged antibiotic therapy and other factors can cause its development. Before prescribing treatment, it is important to establish the cause of enterocolitis, otherwise the therapy will be ineffective.
Classification and causes of enterocolitis
Enterocolitis can occur in acute and chronic form. For the acute phase of the pathology, only the upper, epithelial, layer of the intestinal mucosa is affected. Chronization of the disease causes damage to the deeper layers of the intestinal walls. Chronic enterocolitis develops with the wrong treatment of its acute phase, or in the absence thereof.
According to the classification by etiology, enterocolitis are:
- Infectious. Various groups of microorganisms - Salmonella, Shigella, E. coli, etc. - can provoke the development of the disease. The disease may also have a viral etiology (for example, if the organism is affected by rotavirus or enterovirus). Infectious enterocolitis is the most common occurrence. They have a sharp current.
- Parasitic, developing on the background of helminthiasis, as well as with the defeat of the intestinal mucosa by representatives of the protozoa group.
- Alimentary. Such enterocolitis is often caused by malnutrition. Abuse of alcohol and harmful dishes - the main factors causing inflammation of the intestinal walls.
- Toxic. In such a situation, the development of enterocolitis is transmitted by the ingestion of chemicals, low-quality alcohol, medicines in the overdose, and other toxins.
- Mechanical. Enterocolitis may be the result of persistent constipation, in which hardened fecal masses damage the intestinal mucosa.
- Autoimmune or allergic. This group includes the development of ulcerative colitis.
- Stressful. Against the background of stress, a violation of the innervation and blood supply of the intestinal wall occurs, which often entails inflammation.
If the development of enterocolitis occurs against the background of other pathologies of the digestive tract, in this case we are talking about its secondary nature.
Symptoms of enterocolitis in adults
In the acute form of enterocolitis, patients often complain of such symptoms:
- acute abdominal pain;
- bloating, flatulence;
- rumbling in the stomach;
- vomiting (not always);
- appearance of a raid on the tongue
Infectious enterocolitis is often accompanied by diarrhea with the discharge of fetid stool, in which there may be mucus or blood streaks. A clinical picture of intoxication of the body develops, accompanied by fever, headaches, weakness, muscle pain.
The exacerbation of chronic enterocolitis is accompanied by abdominal pain localized in the navel. It can spread throughout the abdomen.
Pain increases in the second half of the day, during physical activity, in 1.5 - 2 hours after a meal or before an act of defecation. The patient loses his appetite, he has bloating, flatulence, constipation, alternating diarrhea.
The occurrence of symptoms characteristic of enterocolitis, should be the reason for seeking medical help.
Symptoms in children
Enterocolitis in children appears somewhat differently than in adults. First of all, the child develops pain syndrome with localization in the umbilical region of the abdomen. The patient feels discomfort, he has a headache, he becomes nervous and irritable. Against the background of increasing intensity of unpleasant symptoms, even dizziness is possible.
A few hours after eating, the children begin to have a heightened urge to defecate, and diarrhea begins. A child can go to the toilet up to 6 times a day, and traces of mucus, foamed rot or pieces of undigested food are often traced in the faeces. On the first day of the development of enterocolitis sick child suffers from nausea, accompanied by vomiting. At first, all food particles are eliminated from the body, and then the vomit will consist only of bile and saliva.
The development of enterocolitis in newborn babies contributes to the penetration of pathogenic microflora to the fetus through the placenta. The disease can also be the result of protracted or difficult childbirth, injury to the child during passage through the birth canal of the mother, etc.
Premature babies are at risk of developing necrotizing enterocolitis. In most cases, it is a chronic course of pathology. When the disease is exacerbated, the baby cries a lot and sometimes even screams loudly.
So, for necrotic enterocolitis in children is characterized by the appearance of:
- prolonged constipation, alternating diarrhea;
- swelling (when you press the baby’s tummy, you feel its firmness, and the baby starts to cry and squirm);
- restless sleep.
In children, enterocolitis appears much brighter, and therefore diagnosed easier and faster. When a child has anxiety symptoms, parents should show it to the doctor.
Acute enterocolitis is very easy to diagnose, based on the data of the anamnesis and the results of the coprogram - laboratory examination of feces. Sometimes, as an additional diagnostic method, rectoscopy is performed.
To determine the chronic form of enterocolitis, a number of studies are carried out:
- history taking;
- physical examination;
- instrumental diagnostic procedures (colonoscopy, which helps to detect the presence of erosions, ulcers or foci of the inflammatory process on the walls of the mucous membrane of the large intestine).
If necessary, a biopsy can be performed. Radiography helps to identify changes in the intestinal lumen.
If an enterocolitis is suspected, a number of laboratory tests are also carried out. So, using the blood test can reveal anemia, as well as a low content of lipids and proteins, ionic imbalance.
In the feces marked increase in the content of mucous impurities and leukocytes. It is also possible to detect steatorrhea, amilorrhea, creatorei. Of great importance is the conduct of differential diagnosis. This is important in order to distinguish chronic enterocolitis from prolonged dysentery, or from congenital fermentopathy.
How to treat enterocolitis in adults?
The treatment regimen is developed depending on what caused the development of enterocolitis in an adult. Syndromocoplexus resulting from viral pathologies is treated symptomatically. The patient is recommended to use a lot of fluids, so that after a few days he will feel much better.
After the patient's condition has stabilized, he is prescribed a course of therapy with enterosorbents and antispasmodics, and fever-reducing agents are also included in the treatment regimen at a temperature. Be sure to hold the gastric lavage. If profuse vomiting or diarrhea occurs, it is important to control the amount of fluid that enters the patient. In this case, you should use as much unsweetened tea as possible, liquid low-fat soups, porridges boiled in water. You can resort to the use of rehydration drugs.
In case of necrotizing enterocolitis, conservative treatment is carried out, which involves the intravenous administration of antibiotics, the use of rehydration drugs and nutrients. Gas from the stomach or intestines is removed using a special plastic tube.
In the absence of effectiveness from the conduct of conservative therapy, the patient is undergoing surgery. During the operation, the affected intestinal area is removed.
In chronic enterocolitis, the patient's nutrition is corrected, all medications that interfere with the gastrointestinal tract are canceled, and parasitic and infectious diseases are cured.
It is possible to use pharmacy microclysters or enemas based on decoctions of medicinal plants. When diarrhea, an infusion or decoction of hypericum, yarrow, bird cherry will be a good “fastening” means. If constipation occurs, you can use sea buckthorn oil. To get rid of flatulence helps chamomile and dill water.
To consolidate the results of therapy, the patient may be prescribed a course of physiotherapy. Reflex therapy, magnetic therapy, bowel cleansing manipulations - all these manipulations can significantly improve the patient's health.
A good dynamics of recovery is observed in patients who, after the main therapy, underwent a course of sanatorium-resort treatment. Keeping an active lifestyle in the period of remission of chronic enterocolitis is also important.
When enterocolitis is important integrated therapeutic approach. The treatment regimen may include the use of:
- Antibiotics - to suppress pathogenic microflora. Often, doctors resort to the appointment of Nifuroksazid, Furazolidone, Enteroseptola.
- Enzyme-containing drugs that help restore the digestive process. The use of Pancreatin, Festal, Plestila has proven itself well.
- Probiotics and prebiotics, important for restoring intestinal microflora after the patient underwent antibiotic therapy. Bifidumbacterin, Linex Forte, Acidolac, Laktimak - the most effective drugs that can be prescribed to patients who have undergone antibiotic therapy for enterocolitis.
- Regidratantov - Regidrona, Hydrovita, Humana Elektrokolit, etc.
- Antipyretic drugs - Paracetamol, Panadol, Ibuprofen, Nurofen, Ibufen, etc.
Also important are medications that promote intestinal peristalsis. They relieve spasm, eliminate flatulence, constipation and diarrhea. These tools include Trimebutin, Loperamide, Mebeverin.
Bactericidal colitis is treated with the use of furazolidone. In addition to the antibacterial, tablets have an immunostimulating effect. The drug should be used in diseases of the gastrointestinal tract, urogenital area, skin.
Take 2-3 tablets 4 times a day. They should be swallowed whole, in no way chewing. The duration of treatment is from 5 to 10 days.
Side effects when taking the drug can occur:
- pain in the abdomen;
- skin rashes and itching;
- Quincke's edema.
The drug is strictly not recommended for patients with:
- individual intolerance of its components;
- CRF, which is in terminal stage;
- pathologies of the kidneys and liver;
- diseases of the nervous system.
The tool is not assigned to pregnant and lactating women, patients whose work is associated with driving ATS, as well as children under 1 month.
Of great importance is the use and enzymatic means. One of the most commonly prescribed drugs is Pancreatin. With the help of medication, the balance of the enzymes of the pancreas enzymes is replenished, and the process of splitting lipids, proteins and carbohydrates in the duodenum is improved. The drug helps to normalize the process of digestion.
Pancreatin is advisable to use for diarrhea non-infectious etiology, bloating, flatulence, digestive disorders. Take 1-4 tablets with meals. Per day is allowed to take no more than 21 pills. You can continue the course of treatment for several days or for several months.
The drug is prohibited for use in patients with intestinal obstruction, individual intolerance to its components and pancreatitis. The drug is also contraindicated in children under 2 years.
Pancreatin can cause side effects such as constipation, diarrhea, nausea, and allergic reactions.
Nutrition and Diet
Inpatient patients with enterocolitis assigned dietary table number 4. It will have to comply with even after discharge for 1.5 months.
Here are the main nutritional features of adult patients with enterocolitis:
- the basis of the diet are vegetable soups and cereals;
- it is necessary to eat fractional, 4-6 times a day every 4-5 hours;
- preference should be given to steamed dishes with a minimum amount of fat;
- with diarrhea, you should often drink a small amount of strong brewed black tea, or dried fruit compote.
In parallel, the menu should be excluded:
- products that accelerate the process of decay in the intestine;
- dairy products;
- fatty meats and fish;
- complex carbohydrates;
- sweets (except honey);
- alcoholic beverages (including low alcohol);
- spices, spicy seasonings and spices.
Fruits are introduced into the diet of an adult who has suffered acute enterocolitis, 14 days after discontinuing a course of antibiotic therapy. It is necessary to begin with the use of limited quantities of apples and bananas.
The timely detection of the disease, the urgent start of its treatment and the absence of its attendant complications makes the prognosis for recovery as favorable as possible.
Frequent exacerbations of chronic enterocolitis can lead to the development of protein deficiency. Often, on the background of uncontrolled recurrence of pathology, patients experience electrolyte imbalance in the blood. Such pathological changes are dangerous for the patient, because they disrupt the process of feeding the internal organs, which can lead to depletion of the body.
Such a deviation, in turn, can lead to a number of serious complications. They can manifest in the form of impaired functioning of the nervous system, as well as through the development of inflammatory processes in the neighboring sections of the gastrointestinal tract.