Chronic non-ulcerative colitis - Treatment

During 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 the body's reactivity, correcting water-electrolyte imbalance (in case of diarrhea) and the microbial spectrum of the intestine, reducing the inflammatory process in the intestine.

In case of exacerbation, a mechanically and chemically gentle diet is prescribed (No. 46, in case of frequent loose stools - No. 4 for several days), frequent fractional meals (5-6 times a day). The diet should be complete and contain 100-120 g of protein, 100 g of fats, except for refractory ones, 300-450 g of carbohydrates, 8-10 g of table salt. Whole milk and "store-bought" fermented milk products are excluded if they are poorly tolerated, coarse plant fiber (white cabbage, radish, etc.), gas-forming products (rye bread, legumes, etc.), cold dishes. Products and dishes that reduce intestinal peristalsis are introduced into the diet: slimy soups, mashed porridges, jelly, blueberries, bird cherry, pears, quince, strong tea. Vegetables and fruits are given boiled, mashed or homogenized.

In the period of exacerbation, short courses of antibacterial drugs are prescribed (sulgin, phthalazole, chloramphenicol or other broad-spectrum antibiotics, intetrix, nevigramon if proteus is detected, etc.) followed by colibacterin, bifidumbacterin, bificol, lactobacterin 5-10 doses per day to normalize the intestinal microflora. A good and more lasting effect is observed with the gradual withdrawal of these drugs.

In case of diarrhea, astringent, enveloping and adsorbing agents (tannalbin, calcium carbonate, kaolin, bismuth, dermatol) are recommended. Decoctions of plants containing tannins (fruits of blueberries, bird cherry, alder fruits, rhizomes of snakeroot, cinquefoil, burnet, etc.) have a similar effect. In case of flatulence, carbolene, decoction of chamomile flowers, peppermint leaves, dill are indicated. In case of severe intestinal dyskinesia, anticholinergic and antispasmodic drugs are effective. In case of secondary colitis associated with secretory insufficiency of the stomach and pancreas, the use of enzyme preparations is justified; in case of hypovitaminosis - vitamins, in case of a tendency to constipation - naturolax.

A certain place in the treatment of chronic colitis is occupied by the so-called local treatment (suppositories, microclysters), which is indicated not only for "left-sided colitis", but also in some cases for pancolitis. For sphincteritis, treatment should begin with the use of suppositories (with chamomile, Shostakovsky's balm, solcoseryl) and lubrication of the sphincter with a solution of folliculin or solcoseryl in the form of jelly or ointment. After eliminating the lesion in the area of the internal sphincter of the rectum, microclysters can be prescribed if necessary, which are best used without preliminary cleansing enemas. This will avoid additional irritation of the colon, and most importantly, there is no need for this, since the lower section of the intestine, where certain substances are introduced using a microclyster, is usually free of feces. Microclysters are administered in the evening, in the knee-elbow position or on the right side; they should be held until the urge to stool appears. The volume of micro enema should not exceed 50 ml at 40 °C. The nature of the administered drugs depends on the stage and characteristics of the course of chronic colitis. For example, in case of diarrhea, astringent, adsorbent, anti-inflammatory agents are indicated; in case of flatulence and

Abdominal pain - carminative and antispasmodic, constipation and insufficient bowel movement - oil.

Of the physiotherapeutic procedures, warming compresses (water, semi-alcoholic, oil) are recommended during an exacerbation accompanied by abdominal pain, and mud, ozokerite, paraffin, diathermy, and thermal baths are recommended during remission. Electrophoresis of novocaine, platifillin, calcium chloride, as well as UHF and ultrasound are widely used. Sanatorium treatment in specialized sanatoriums (Yessentuki, Zheleznovodsk, Druskininkai, Jermuk, etc.) is indicated only during remission. The prescription of mineral water, intestinal irrigation, subaquatic baths should be approached with great caution, especially in case of diarrhea and perivisceritis, as they can cause severe exacerbations of the disease. Sanatorium and resort treatment of chronic colitis with an erosive-ulcerative process or bleeding hemorrhoids is contraindicated.

Prevention consists of preventing acute intestinal infections, timely etiological treatment of acute colitis, elimination of infectious foci in the body, rational nutrition, compliance with the rules of personal hygiene and food hygiene, medical examination of patients who have had acute colitis and suffer from frequently exacerbated chronic colitis.

Prognosis. With timely and active treatment of chronic colitis, compliance with the recommended regimen, the prognosis is favorable - patients, as a rule, maintain long-term remission.

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