Physical therapy for chronic colitis

Chronic colitis is an inflammatory-dystrophic lesion of the colon, characterized by the localization of pathological changes (typhlitis, proctosigmoiditis or total colitis), changes in the motor-evacuation function (atonic or spastic colitis with corresponding constipation or diarrhea), a certain morphology of the lesion substrate (atrophic or superficial colitis) and the etiology of the disease (infectious, intoxication, alimentary or neurogenic colitis).

Physiotherapy for chronic colitis is determined by the pathogenetic direction of the impact of the corresponding physical factor and is aimed at improving the motor-evacuation and secretory functions of the colon.

Treatment of chronic colitis is usually carried out in a hospital setting. Various authors recommend the following list of physiotherapeutic prescriptions for this pathology.

In case of increased motor-evacuation function of the colon, it is recommended:

• electrophoresis of papaverine or platifillin, or no-shpa on the abdominal area;
• diadynamic therapy of paravertebral regions (ThV - ThXII) using a relaxation technique;
• inductothermy;
• UHF therapy;
• SMV therapy;
• UHF therapy;
• local and general ultraviolet irradiation;
• paraffin applications to the abdominal area;
• mud therapy;
• balneotherapy.

In case of reduced motor-evacuation function of the colon, the following is prescribed:

• electrophoresis of pilocarpine or carbachol;
• diadynamic therapy of paravertebral regions (ThV - ThXII) using a stimulating technique;
• amplipulse therapy (in case of intolerance to diadynamic therapy) of the paravertebral regions (ThV - ThXII) using a stimulating technique;
• interference therapy;
• high intensity pulsed magnetothermal therapy;
• local and general ultraviolet irradiation;
• mud therapy;
• balneotherapy.

Our long-term clinical experience convincingly demonstrates the sufficiently high therapeutic efficiency of using low-energy laser radiation, mainly of the near infrared part of the optical spectrum (wavelength 0.8 - 0.9 μm), using differentiated methods for treating patients with chronic colitis. This is one of the few physiotherapy methods that can be recommended to general practitioners (family doctors) for use by patients at home.

Impact fields using OR emitters with an impact area using the contact method of about 1 ^cm2:

• I - Pirogov's sphincter zone - 2 cm to the left from the middle of the distance between the pubic symphysis and the navel;
• II - Rossi's sphincter zone - the middle of the distance from the wing of the left iliac bone to the navel;
• III - Bali sphincter zone - along the left anterior axillary line at the level of the navel;
• IV - 1 cm below the middle of the left hypochondrium;
• V - Horst sphincter zone - the middle of the distance from the xiphoid process of the sternum to the navel;
• VI - 1 cm below the middle of the right hypochondrium;
• VII - the zone of the sphincters of Busi and Varolius - the middle of the distance from the wing of the right ilium to the navel.

Sequential action is performed on the fields on the anterior abdominal wall, starting with the area of the ascending colon, then the transverse colon, and then along the descending and sigmoid colon - from the VII to the 1st field. Infrared emitters are used in continuous mode generating PPM OR 5 - 10 mW/cm2. Induction of the magnetic attachment during magnetolaser therapy is 20 - 40 mT. The exposure time per field is 30 sec for atonic colitis and up to 2 min for spastic colitis.

Fields of action using a matrix emitter: - right iliac region, II - region of the middle of the right hypochondrium, III - region of the middle of the left hypochondrium, IV - left iliac region. Sequential action is carried out from I to IV field. Infrared matrix emitters are used in continuous OR generation mode. The action time for one field is up to 20 sec for atonic colitis and up to 60 sec for spastic colitis.

For both “point” and matrix emitters, the course of treatment for atonic colitis is 5-7 procedures daily, for spastic colitis - up to 10 procedures daily, once a day in the morning (before 12 o’clock).

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