Colitis pseudomembranous: symptoms and treatment
ColitisPseudomembranous is an inflammatory process in the intestine of an infectious genesis that occurs against the background of uncontrolled use of antibactercial means, whereby the mucous membrane formed white-yellow fibrous plaques.
In other words, this is a severe form of liquid stool induced microorganism Clocsridium difficile, which is part of the normal intestinal microflora. Inflammation of the intestinal mucosa, fibrous plaque on its walls in the absence of treatment leads to acute intoxication of the body, the occurrence of ulcers and dehydration.
Causes
causative microorganisms isolated during their life type 2 toxin - toxin A and B, which damage the intestinal wall and cause diarrhea. Normally, they are contained in the intestinal microflora in a minimal, not dangerous concentration, but after the intake of some antibiotics grow, causing pseudomembranous colitis, what is it is known far from many.
It can be antibacterial preparations of a number of penicillins, macrolides, cephalosporins. The likelihood of a severe diarrhea increases if the drugs are combined, use gold preparations, antipsychotics, NSAIDs, drugs for the treatment of tumors and chemotherapy.
risk of severe pseudomembranous colitis increased in the presence of chronic intestinal pathologies, malignancies, ischemic colitis( poor circulation in the intestine), after surgical interventions in the abdominal cavity, after receiving cytostatics, with frequent diagnostic interventions, such as colonoscopy.
What are the symptoms of the disease can be determined
first symptoms of pseudomembranous colitis occur during treatment with antibiotics or immediately after their reception:
- frequent loose, watery stools, sometimes mixed with blood, in severe cases, 3-30 times a day. Sometimes there is mucus in the stool. At times, diarrhea can alternate with the normalized calves, but last for several weeks or months.
- Intoxication of the body - lethargic muscles, drowsiness, cramps, tachycardia, dry skin.
- Abdominal pain of unclear localization, having a cramping character.
- High temperature. For a long time it can fluctuate at the readings of 37-37.5 degrees, but sometimes there are sharp jumps up to 40 degrees.
These symptoms of pseudomembranous colitis require immediate treatment.
Diagnosis of pathology
To determine if a patient has pseudomembranous colitis, diagnosis is simply necessary. The doctor relies on the analysis of complaints: is there a liquid frequent stool, abdominal pain, how long they last, how many times a day diarrhea. Whether the patient took antibacterial drugs and what, whether there have been recent operations on the abdominal cavity. When palpating the abdomen, pain often occurs.
doctor measures pressure and temperature, and assigns the laboratory studies:
- possible to diagnose anemia assigned common blood analysis which show a reduced content of hemoglobin and erythrocytes presence of inflammation.
- If an infection is suspected in the intestine and renal failure is associated, a general urine test is administered.
- A biochemical blood test is used to determine the ionogram and total protein level.
- Inoculation of the stool reveals a violation of the natural intestinal microflora.
- Stool analysis shows the presence of the causative agents of colitis and the toxins they produce.
To make a diagnosis of pseudomembranous colitis, treatment prescribe the correct and effective, also need to use instrumental methods of research:
- Biopsy( take a piece of the intestine for analysis).
- X-ray of the intestine, which allows to identify and assess the degree of changes in the intestine.
- Recto-manoscopy and colonoscopy for the diagnosis of the condition of the large and small intestine, which is carried out using a special endoscope.
- Computed tomography or magnetic resonance imaging, revealing the pathology of the intestine.
pseudomembranous colitis To determine and prescribe treatment, will also need advice gastroenterologist.
Proper treatment of pseudomembranous colitis
If after surgery, uncontrolled use of antibiotics appeared acute pseudomembranous colitis, the symptoms of which showed a doctor, you must hold it competent treatment aimed at eliminating the intestinal infections and prevention of complications.
It can be surgical or conservative. With mild forms of the disease, it can be eliminated at the initial stage, by abolishing antibiotics that caused diarrhea, and appointing a temporary strict diet.
In severe cases, when revealed toxic dilatation of the colon, or peritonitis, it is necessary to remove the affected part of the bowel, which can lead to negative consequences and complications for the patient. Mortality after surgery reaches 57%.
First of all, antibacterial therapy is prescribed to eliminate the causative agent of the disease, as well as a special diet and fractional meals. As drugs, Metronidazole is administered 4 times a day for 250 mg, Vancomycin 4 times a day for 250 mg. Such drugs are prescribed for 10-14 days.
Usually, the improvement of the condition is observed after a few days of admission. In 10-20% of patients, after a course of antibiotics for 3-20 days, relapse may occur. In this case pseudomembranous enterocolitis is treated repeatedly with the same drugs to which probiotics and lactobacilli are added. When intolerance of the main antibacterial drugs orally, intravenous injections may be prescribed.
Due to frequent and liquid stools, sufficient fluid intake is necessary to prevent dehydration.
for removing toxins from the gut prescribed chelators, such as smectite and prebiotics for restoring the natural intestinal microflora. It can be Hilak-Forte or Lineks.
To get rid of dysbiosis, Bifikol, Bifidumbacterin, Colibacterin are also prescribed. Treatment with such drugs usually lasts at least a month. More about preparations for the treatment of dysbacteriosis →
The patient needs to restore electrolyte and protein metabolism and conduct detoxification of the body. To remove the symptoms of dehydration, the intravenous solution of Lactasol or Hartmann is prescribed. Protein loss is replenished with the introduction of albumin solution. Electrolyte balance in the body is restored by drugs enriched with chloride and potassium, for example, Cholestyramine.
The diet for pseudomembranal colitis is aimed at reducing inflammation and diarrhea. It is recommended to eat more bananas, boiled rice, baked potatoes, apples, drink jelly. From the diet, fatty, spicy, salty, fried foods, dairy products are necessarily excluded, which further strengthens diarrhea.
Complications
If pseudomembranous colitis appeared, diet and basic treatment has not brought results, or they were temporary, and the disease came back, we can talk about the chronic form.
The classic treatment of the disease, alas, helps in about 70 cases. Against the background of untreated pathology, a new inflammation, damage to the mucous membrane, up to the necrosis of the epithelium, may occur.
Consequences of pseudomedial colitis
Spores of pathogenic microorganisms without proper and timely treatment can cause toxic dilatation of the colon, intestinal rupture( perforation) requiring urgent surgical intervention, and edematous syndrome: swelling of the subcutaneous tissue, fluid accumulation in the peritoneum, Kidney failure and even blood poisoning.
Often there arterial hypotension( low blood pressure), chronic dehydration of the body.
Prevention of disease
In order not to face such a disease as pseudomembranous colitis, etiology, pathogenesis, a clinic whose treatment is very complicated, it is necessary to prevent uncontrolled long-term use of antibiotics. If they are appointed by a doctor, then they should be combined with the intake of prebiotics, which restore the microflora.
Intestinal pathogens of the disease can spread by household means, therefore enter hygienic measures, if the family is ill, you can not eat and drink with it from one dish.
Colitis pseudomembranous is an inflammatory process with the prospect of serious complications. He is due to self-medication, uncontrolled intake of antibiotics and other medications. If you notice the symptoms of this disease, do not repeat the error twice - see a doctor for professional treatment.
Author: Daria Tyutyunnik, doctor,
specially for Moizhivot.ru
