Bowel inflammation: symptoms and treatment of colitis

The intestine is one of the vital organs and ensures the functioning of the human digestive and immune systems. In the intestine, water and vitamins are absorbed, which are absorbed by the mucous membranes, after which they enter the systemic circulation and are transported to tissues and organs. In the intestine, the growth of a person's own microflora also occurs - a set of microorganisms, providing digestive processes and participating in the formation of immunopathological reactions. If the work of the intestines is disrupted, there is an accumulation of toxic products of putrefaction, which leads to systemic intoxication and problems in the work of all internal organs.

The most common bowel disease (prevalence is more than 40%) is colitis. This is an inflammation of the mucous membrane of the large intestine - the closing part of the gastrointestinal tract, in which water is absorbed and the final digestion of food gruel occurs. With inflammation of the colon, the design of feces is disturbed, therefore, the main symptom of colitis is upset stool and a change in the appearance and consistency of feces. In women, the disease occurs several times more often than in men. Doctors attribute this to the instability of the hormonal background, which changes during pregnancy, menstrual cycle, as well as emotional lability, which affects about 37% of women aged from 20 to 50 years old.

Why is the intestines inflamed?

The main cause of damage to the epithelial membrane of the intestine is inaccuracies in nutrition. Acute or chronic colitis can develop against the background of abundant consumption of foods high in fat (sausages, bacon, canned fish), salt, spices and herbs. Various chemical additives, for example, flavor enhancers, preservatives, stabilizers, negatively affect the functioning of the intestines, therefore, it is not recommended to consume foods containing them daily.

Soda, alcohol, industrial seasonings, which contain a large amount of food additives and dyes, can provoke inflammation. Even if a person rarely includes the listed foods in the diet, but does not consume enough foods that are a source of coarse plant fibers, the risk of colitis will be very high. This is especially true for patients with reduced body resistance: pregnant and lactating women, elderly and senile people, patients with alcohol and tobacco dependence.

Other reasons and provoking factors include:

• infectious diseases of the rectum;
• genital infections (with poor intimate hygiene, an ascending infection of the colon can occur);
• non-compliance with the timing of admission and the recommended dosing regimen for some drugs (drug colitis);
• violation of the intestinal microflora, provoked by insufficient consumption of vegetables, fruits and fermented milk products or taking antibacterial drugs;
• intestinal infections;
• helminthic invasion;
• systemic diseases of the hematopoietic system, which increase the risk of ischemic intestinal damage.

Separately, doctors isolate radiation colitis, which is a secondary disease in malignant tumors of the digestive tract. Inflammation of the mucous membrane occurs with radiation and radiation therapy.

Note! In men, intestinal colitis develops mainly after 40 years. In women, the age limits are much lower: in about 30-40% of patients with this disease, the primary inflammatory process was diagnosed at the age of 20-30 years.

Clinical picture: symptoms and features of the course

All types of intestinal colitis have common symptoms. The basic symptom complex is manifested by pain in the lower abdomen, frequent stools, painful urge to empty the intestines, which are accompanied by a feeling of pressure and distention. After a bowel movement, relief does not always come, and pain may persist for several hours. Impaired absorption of water leads to stool disorder. Most often it is constipation, which can persist up to 4-5 days, but in some patients the inflammation is manifested by diarrhea (the frequency of bowel movements can be up to 15 times a day).

Many patients experience nausea, vomiting, and subfebrile reactions may occur. After eating, flatulence and bloating may occur. The increased formation of gas bubbles leads to rumbling, tension of the abdominal muscles, intestinal cramps, and flatus syndrome. Colitis gases have a putrid odor and leave the intestines with a characteristic "explosive" sound. Other symptoms of colitis depend on the form in which the disease occurs and are listed in the table below.

Signs of inflammation in the intestines, depending on the form of pathology

A type of colitis	Clinical course, signs and symptoms
Acute form	In the acute phase, colitis is often combined with inflammation of the stomach and small intestine - gastroenteritis. The patient's condition worsens, subfebrile fever occurs, profuse diarrhea appears - an almost incessant release of water from the intestines (watery feces). The number of urges to defecate can be up to 20-25 times a day, so the patient has severe symptoms of dehydration: decreased daily urine output, dry lips, pale skin. Feces in acute colitis may contain large amounts of mucus and blood impurities
Chronic form	It is characterized by subsiding of the main symptoms. The patient may be disturbed by dull abdominal pain, a feeling of severity of distention after eating, intestinal colic. With inflammation of the right side of the large intestine, stool thinning and diarrhea are more common. If the sigmoid colon is affected, constipation may occur, as well as false stools, which is the secretion of mucus with lumps of digested food and blood streaks
Ulcerative form	The main clinical sign is the appearance of blood on the surface of the feces or mixed with excrement
Ischemic form	It is characterized by weight loss, dry skin, loss of strength, anemia and visual impairment. Specific signs of circulatory disorders of the blood vessels of the colon and the associated inflammation are the urge to defecate immediately after a meal and the desire to empty the bowels in the morning, before waking up ("stool alarm clock ")

Infectious colitis (for example, with salmonellosis or dysentery) is acute and characterized by high body temperature, vomiting, diarrhea and severe cramping pain in the lower parts of the abdomen.

Important! To diagnose the inflammatory process, it is necessary to study feces (including culture and analysis for helminthiasis), palpation of the abdomen, digital examination of the rectum. Of the instrumental diagnostic methods, the most popular are anoscopy and colonoscopy of the intestine. If intestinal ischemia is suspected, the doctor may prescribe an angiography of the vessels of the large intestine - a method X-ray examination of blood vessels using contrast solutions, which allows you to determine them patency.

Video - Symptoms and treatment of ulcerative colitis of the intestine

How to treat?

Any form of colitis requires complex treatment aimed at eliminating the cause, stopping the inflammatory process and stimulating the regeneration of damaged tissues. It may include physiotherapy, medication, massage, exercise therapy and nutritional therapy.

Diet

A diet that limits the intake of coarse fiber and intestinal irritants is prescribed for any form of colitis. In the acute phase, your doctor may recommend complete fasting for 1-3 days. During this period, the patient is allowed to drink weak black or green tea (you can not use hibiscus tea and rooibos), fresh or dried fruit compote without added sugar, chamomile, mint or linden flower tea. The use of berry fruit drinks, coffee, cocoa, milk drinks, fresh juices is not allowed. In the absence of contraindications, you can drink sodium bicarbonate mineral water ("Narzan", "Borjomi"). Before use, it must be warmed up to a temperature of 40 °. The daily intake of mineral water for colitis is about 300-400 ml.

On the second or third day, the following products can be included in the menu:

• rye or wheat flour croutons (no bran added);
• pureed soups;
• mashed vegetables or fruits (you can eat baked fruits);
• vegetable broths;
• meat puree, soufflé or casseroles;
• liquid porridge;
• rice broth;
• jelly.

After the relief of acute inflammation, the patient is transferred to the treatment table No. 4.

Drugs

The mainstay of treatment for infectious colitis caused by intestinal infections are drugs with antimicrobial, antiparasitic and antibacterial action. For bacterial infections, these are broad-spectrum antibiotics, which are selected after bacterial inoculation of feces, determination of the causative agent of the infection and its sensitivity to antibiotics. The drugs of choice in most cases are penicillin drugs, which are taken orally in the form of a suspension or tablets. These include:

• "Amoxicillin";
• Augmentin;
• "Panklav";
• Ospamox;
• Flemoxin.

For infections of mild and moderate severity, the use of funds based on nifuroxazide, a broad spectrum antimicrobial agent, is indicated. "Nifuroxazide" is effective in infectious colitis caused by salmonella, staphylococci, streptococci and other representatives of the pathogenic flora. You can use it even in childhood, starting from the age of two months. Analogs of "Nifuroxazide" - "Enterofuril", "Stopdiar", "Ersefuril".

If inflammation in the intestine was provoked by a helminthic invasion, anthelmintic drugs are prescribed (Levamisole, Pirantel, Dekaris). Many of the antiparasitic drugs need to be taken once, but 21 days after taking the therapeutic dose, the course of treatment should be repeated to avoid re-invasion.

In ischemic colitis, treatment with antiplatelet agents, adenosinergic agents and microcirculation correctors is indicated. These drugs include "Pentoxifylline" and its analogues: "Radomin", "Trental", "Vazonit", "Flexital". You need to take "Pentoxifylline" 2 tablets 2-3 times a day for 1-3 months. The maximum daily dosage is 1200 mg.

The scheme of symptomatic and supportive treatment of colitis is shown in the table below.

Drugs for symptomatic and supportive therapy

Group of drugs and purpose of use	What drugs should I use?	Image
Antispasmodics to relieve stomach and intestinal cramps and relieve pain	"Papaverine hydrochloride 1%" (rectally); "Spazmalgon"; Pentalgin; "Ple-Spa"; Drotaverin; "Trust"; Unispaz	Trust
Regeneration stimulants for mucosal healing	"Meturakol"; "Methyluracil"	Methyluracil
Antidiarrheal medicines for diarrhea	Loperamide; "Imodium"; "Diara"	Imodium
Laxatives and osmotic drugs to stimulate intestinal motility (for constipation)	Portalak; Microlax; "Magnesium sulfate"; "Guttalax"	Guttalax
Vitamin complexes	"Pikovit"; "Alphabet"; Complivit; Selmevit	Complivit

According to the indications, the treatment is supplemented with enterosorbents ("Smecta", "Polyphepan") and prebiotics ("Bifidumbacterin", "Normobact").

Important! For recurrent forms of colitis with exacerbations, more often 2-3 times a year, immunostimulating therapy with the use of antioxidants, for example, polyoxidonium, is indicated.

Massage

Massage has a general strengthening effect and increases the overall resistance of the body, reducing the risk of exacerbations. Massage also helps to eliminate congestion in the pelvic area and improve blood circulation in the bowel vessels. You can perform massage movements yourself, but it is better to entrust this to a specialist, since the wrong technique can lead to a deterioration in the existing dynamics.

The simplest massage option is a rough mitten massage, which should be performed in the shower. The abdomen and lower back should be massaged with rubbing and circular movements for 3-5 minutes in a row. The procedure will be more effective if combined with a contrast shower.

Exercise therapy

Physiotherapy is necessary to normalize blood circulation, improve intestinal peristalsis and prevent constipation, increase the elasticity of the intestinal musculo-ligamentous apparatus. Below are a few exercises you can do daily to reduce the risk of inflammatory bowel disease and improve bowel function.

Swing your legs

Perform leg swings (do not bend at the knees) forward, diagonally and to the side. Repeat 10-15 times in each direction.

Bicycle

Lie on any hard surface, raise your legs and bend your knees at a right angle. Perform circular movements with your legs, simulating pedaling, for 1-3 minutes.

Forward bends

Legs apart shoulder-width apart, arms raised to the sides parallel to the floor. Tilt the body forward, then bend back with a range of motion of about 180 °. Repeat 10 times.

Turns

Perform torso turns to the right and left sides, keeping your hands at the waist. Repeat 15 times in each direction.

Daily walks can improve the effectiveness of treatment - they also help to eliminate stagnation of blood and lymph in the vessels and enrich the body with oxygen necessary for the prevention of intestinal ischemia and other vital organs. You should walk every day for at least 1-2 hours a day, choosing for walks the so-called "green zones": parks, squares, forest, river or lake banks.