Chronic non-ulcer colitis: treatment
Last reviewed: 23.04.2024
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In the period of exacerbation of chronic colitis, hospitalization is indicated. Treatment should be aimed at eliminating the etiologic factor, normalizing the functional state of the intestine and reactivity of the body, correcting the violations of water-electrolyte balance (with diarrhea) and the microbial spectrum of the intestine, reducing the inflammatory process in the intestine.
When exacerbating appoint a mechanically and chemically sparing diet (№ 46, with frequent liquid stool - № 4 for several days), frequent fractional meals (5-6 times a day). The diet should be high-grade and contain 100-120 g of protein, 100 g of fat, except refractory, 300-450 g of carbohydrates, 8-10 g of table salt. Excluded whole milk and "store" lactic acid products with their poor tolerance, coarse vegetative fiber (white cabbage, radish, etc.), gas-forming products (rye bread, beans, etc.), cold dishes. In the diet, foods and dishes that reduce intestinal peristalsis are introduced: mucous soups, mashed cereals, kissels, blueberries, bird cherries, pears, quinces, strong tea. Vegetables and fruits are given in boiled, wiped or homogenized form.
From medications during the exacerbation, short courses of antibacterial drugs are prescribed (sulgin, phthalazole, levomycetin or other broad-spectrum antibiotics, intefix, nevi-gramon upon detection of protea, etc.) followed by administration of colibacterin, bifidumbacterin, bifikol, lactobacterin by 5-10 doses per day for normalization of the intestinal microflora. A good and more stable effect is observed with a gradual withdrawal of these drugs.
With diarrhea, astringents, enveloping and adsorbing agents (tanalbine, calcium carbonate, kaolin, bismuth, dermatol) are recommended. The decoctions of plants containing tannic substances (fruits of bilberries, bird cherry, aplicata of alder, rootstock of serpentine, lapchatka, blood-grouse, etc.) also have a similar effect. In flatulence, carbolene is shown, a decoction of camomile flowers, peppermint leaves, dill. With pronounced dyskinesia of the intestine, anticholinergic and antispasmodics are effective. In secondary colitis associated with secretory deficiency of the stomach and pancreas, the use of enzyme preparations is justified; with hypovitaminosis - vitamins, with a tendency to constipation - naturoolax.
A certain place in the treatment of chronic colitis is the so-called local treatment (candles, microclysters), which is shown not only in "left-side colitis", but in a number of cases in pancolitis. When sphincteritis treatment should begin with the use of suppositories (with chamomile, Shostakovskiy balsam, solcoseryl) and lubricating the sphincter with folliculin solution or solcoseryl in the form of jelly or ointment. After elimination of the lesion in the area of the internal sphincter of the rectum, it is possible to prescribe microclysters, if necessary, which are best used without preliminary cleansing enemas. This will avoid additional irritation of the colon, and most importantly, this is not necessary, since the lower part of the intestine, where certain substances are introduced by means of microclysters, is usually free of stool. Microclysters are placed in the evening, in the knee-elbow position or position on the right side; keep them until the appearance of a call for a chair. The volume of microclysters should not exceed 50 ml at 40 ° C. The nature of the drugs administered depends on the stage and characteristics of the course of chronic colitis. For example, with diarrhea, astringents, adsorptive, anti-inflammatory agents are shown; with flatulence and
Pain in the abdomen - carminative and spasmolytic, with constipation and insufficient emptying of the intestine - oil.
Of the physiotherapeutic procedures during the period of exacerbation accompanied by abdominal pain, warming compresses (water, semi-alcohol, oil) are recommended, and in the period of remission - dirt, ozocerite, paraffin, diathermy, thermal baths. Widely used electrophoresis of novocaine, platifillin, calcium chloride, as well as UHF, ultrasound. Sanatorium treatment in specialized sanatoriums (Essentuki, Zheleznovodsk, Druskininkai, Jermuk, etc.) is shown only during remission. To the appointment of mineral water, intestinal irrigation, sub-aqua baths should be approached with great care, especially with diarrhea and perivistseritis, since they can cause severe exacerbations of the disease. Sanatorium treatment of chronic colitis with erosive-ulcerative process or bleeding hemorrhoids is contraindicated.
Prevention consists in preventing acute intestinal infections, timely etiologic treatment of acute colitis, elimination of infectious foci in the body, rational nutrition, observance of rules of personal hygiene and food hygiene, medical examination of patients with acute colitis and suffering from often aggravated chronic colitis.
Forecast. With timely and active treatment of chronic colitis, the observance of the recommended regimen is favorable - patients, as a rule, retain a long-term remission.
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