How to treat intestinal colitis: medications and how to use them

The large intestine is the final part of the digestive tract, in which the formation of feces occurs, as well as the absorption of water, vitamins and nutrients from the food bolus. The large intestine is formed by the cecum, which has a vermiform appendix in which lymphoid cells accumulate (appendix), as well as the colon and anal canal (rectum). The walls of the large intestine are covered with mucous membranes made up of epithelial cells and lined with mucus secreted by goblet cells. If the lining of the colon becomes inflamed, the patient is diagnosed with colitis.

Colitis treatment requires complex measures. The basis of therapy is a therapeutic diet: the patient is assigned a table number 4, excluding any foods that can irritate the mucosal layer of the intestine and contribute to increased gas production. The patient is also shown treatment with mineral and mineral-table waters, physiotherapy exercises and drug correction. The drug therapy regimen is compiled individually and depends on the severity of the main diagnosis, the existing symptoms, the degree pain syndrome and accompanying complications, which may exclude the possibility of using certain medications funds.

General scheme and principles of treatment

Treatment of acute and chronic intestinal colitis includes the use of medications aimed at eliminating pathological symptoms, as well as combating the cause of the inflammatory process. It is important that from the first day of treatment, the patient should follow a special diet, stop smoking, use drugs and alcoholic beverages, and reduce physical activity.

Often, problems in the work of the intestines are observed in persons prone to frequent stress and suffering from emotional lability (frequent mood swings), so it is important to control psychological state and, if necessary, take medications with a slight sedative effect: tincture of motherwort or valerian, infusion of hop cones, homeopathic remedies "Tenoten" and "Persen".

For all forms of colitis, patients are shown a short-term intake of sorbents. These are drugs that selectively absorb gases, harmful vapors, toxins, allergens and waste products of bacteria, which can cause acute intoxication and poisoning of the body. Almost all enterosorbents have no contraindications for use (with the exception of chronic constipation and intestinal obstruction), so they can be used in patients of any age, including especially vulnerable categories: children, pregnant and lactating women, patients with chronic and systemic diseases, people over 60 years old.

Table. Enterosorbents for the complex treatment of colitis.

Drug name	Release form	How to use	Cost (indicated for a package with a minimum volume)
Enterosgel	Internal paste and sugar paste.	1.5 tablespoons 3 times a day 2 hours before or after meals. The course of treatment is 3 to 21 days.	361 rubles
"Neosmectin"	Powder for preparation of suspension with orange, raspberry, lemon and vanilla flavors.	Dissolve 1 sachet in 60 ml of water and stir thoroughly so that there are no lumps. Take 1 packet 3 times a day for 5-7 days.	154 rubles
"Smecta"	Powder for preparation of suspension with orange and vanilla flavor and suspension for internal use with caramel flavor.	6 sachets per day, divided into 3-4 doses. The duration of treatment is up to 5 days.	136 rubles
"Filtrum-STI"	Pills	2-3 tablets (pre-crushed) up to four times a day for 2-3 weeks.	70 rubles
"Polysorb"	Powder for solution preparation	The daily dose for adults is 6-12 g. The duration of treatment is up to 2 weeks.	472 rubles

Why are probiotics needed?

To restore the normal balance of the intestinal microflora, prebiotics, probiotics, lactobacilli and bifidobacteria are used. When choosing a suitable drug, it is necessary to take into account the patient's age: for children, drugs of this group are prescribed in the form of syrups, suspensions, drops and chewable tablets. Chewable tablets "Normobact Junior" in the form of bears with a taste of white chocolate have a good therapeutic effect. 1 package contains 20 tablets, which are enough for a course of treatment lasting 10 days (1 tablet 2 times a day).

Depending on the indications available and the severity of the inflammatory process, the following prebiotic drugs may also be prescribed for the treatment of colitis:

• Linex;
• "Bifiform";
• "Acipol";
• "Bifidumbacterin".

Note! It is necessary to take funds of this group from 7 to 30 days.

Enterol or Enterofuril?

Both drugs are quite effective in the treatment of intestinal colitis and gastroenteritis, but correct diagnosis is necessary to achieve a positive result. Enterofuril is a topical antimicrobial drug based on nifuroxazide. It is used when there is a suspicion of an infectious pathology. Nifuroxazide has a wide spectrum of antibacterial activity and helps to cope with diarrhea - one of the main symptoms infectious colitis - if it is caused by salmonella, staphylococcus, klebsiella, streptococcus and other types of pathogenic microorganisms.

Enterol is a complex preparation with antihelminthic and antimicrobial activity, as well as normalizing the bacterial composition of the intestinal microflora. The drug is prescribed primarily for the elimination of functional diarrhea and the treatment of non-infectious gastroenteritis and colitis.

Table. How to take Enterol and Enterofuril (Stopdiar) for colitis.

Characteristics and parameters	Enterol	Preparations based on nifuroxazide (Stopdiar, Enterol)
Single dosage	1 capsule (1 sachet)	200 mg
Number of applications per day	1-2 times	4 times
Duration of treatment	7-10 days	7 days
Before or after meals	After meals (do not drink hot drinks or alcohol).	There is no data on the relationship of absorption of nifuroxazide with food intake.
Possible side effects	Allergic skin reactions, moderate pain and discomfort in the abdominal space (do not require discontinuation of treatment).	Nausea, vomiting, skin rash, itching. In severe cases, anaphylactic and angioneurotic reactions are possible.
What drugs should not be taken at the same time	It is forbidden to take it simultaneously with antifungal drugs.	There are no data on drug interactions.
Suitable for use in children	From 1 year (if there are strict indications, it is possible earlier).	From 1 month (for capsules - from 3 years).

Symptomatic treatment: drugs

One of the main tasks in the treatment of colitis of any etiology is stool normalization and pain relief. For this purpose, antispasmodics can be used, for example, tablets based on drotaverine: Drotaverin, No-shpa, Spazmol, Spazmonet. In some cases, antispasmodics are prescribed in the form of rectal suppositories ("Papaverine"). They need to be used 2-3 times a day for 5-10 days.

For colitis accompanied by chronic constipation (absence of stool for more than 3 days and painful movement of feces through the intestines), the use of the laxatives listed below.

1. Portalak. Laxative medicine in the form of a syrup based on lactulose, a synthetic isomer of milk sugar (lactose). You need to take the syrup on an empty stomach or immediately after a meal once a day. The dosage for adults is 15 to 45 ml. Suitable for the treatment of children under 1 year old (dosage - 1 teaspoon).
   

   "Portalak"

2. Duphalac. Structural analogue of Portalak. Used in the same dosages. Contraindicated in galactosemia, a hereditary pathology in which the conversion of galactose to glucose is impaired.
   

   "Duphalac"

3. "Magnesium sulfate". An inexpensive drug (the cost of a package is from 16 to 49 rubles) in the form of a powder for preparing a suspension and a solution for intravenous administration. It also has a sedative, hypotensive and antispasmodic effect. Effective in case of convulsive syndrome caused by magnesium deficiency.

Note! To restore damaged tissues in case of damage to the rectum and sigmoid colon, experts advise using "Methyluracil". It is a stimulant of tissue regeneration with an immunostimulating effect in the form of a rectal suppository and ointment for external use. The ointment must be used for applications using loose tampons 1-2 times a day for 30 days. Candles are used 1 to 4 times a day. The course of treatment can range from 1 week to 4 months.

If the patient has diarrhea

For diarrhea, drugs of choice in most cases are drugs based on loperamide - an opioid drug, used for the treatment of acute and chronic diarrhea in gastroenteritis and inflammatory processes in thick and thin intestines. The most popular medicine in this group is Imodium. In acute colitis, the drug is used at an initial dose of 4 mg, followed by a dose reduction to 2 mg after each bowel movement. The tablet must be put on the tongue and wait for it to dissolve, then swallow the melted mass along with saliva. You do not need to take the drug.

Analogues of "Imodium" are:

• Loperamide (tablets - 6-10 rubles);
• "Diara" (chewable tablets - 83 rubles);
• Lopedium (tablets - 32 rubles);
• "Laremid" (capsules and tablets - 64 rubles).

Note! Loperamide hydrochloride is also a structural analogue of Loperamide.

With bloating and flatulence

Gas production - one of the typical symptoms of colitis and gastroenteritis - may also require medical treatment. To eliminate unpleasant symptoms, drugs based on simethicone, for example, "Espumisan", are included in the treatment regimen. It has a carminative effect, destroys gas bubbles and hinders their formation. Simethicone is not absorbed by the intestinal mucosa and is excreted unchanged from the body.

The following drugs have a similar effect: "Sub-Simplex", "Antiflat Lannacher", "Bobotik".

The cause of inflammation is helminthiasis

If the cause of the inflammatory process in the colon is helminthic invasion, the patient will need a course of treatment with antiparasitic drugs (Vermox, Levamisole, Dekaris). Some of them can be used even during pregnancy, but strictly if indicated and after consultation with a specialist. Any means for fighting helminths are highly toxic and can cause serious damage to the liver and heart muscle, therefore, the independent use of these drugs is unacceptable.

After treatment, it is necessary to pass an analysis for the eggs of the worm and scraping for enterobiasis. If the result is negative, there is no need to continue therapy.

Cases when colitis is caused by disturbances in the functioning of the heart and blood vessels are considered atypical. In ischemic colitis, therapy is supplemented with drugs that normalize blood flow and prevent thrombosis. Simultaneously with them, the patient is prescribed antispasmodics to relax the smooth muscles of the vascular walls. If there are indications after the relief of an acute inflammatory process, the doctor can choose a course of vitamin and immunomodulatory therapy. Immunostimulants should be prescribed with increased caution, especially in individuals with signs of autoimmune disorders and pathologies.

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