Chronic non-ulcerative colitis

Chronic non-ulcerative colitis is a chronic inflammatory disease of the colon, characterized by the development of inflammatory-dystrophic, and with prolonged existence - atrophic changes in the mucous membrane, as well as a violation of the function of the large intestine.

In the pathological process, the entire colon (total colitis), and primarily its various departments (right-sided colitis, left-sided colitis, proctosigmoiditis, transversitis) can be involved. Often, chronic colitis is combined with chronic enteritis.

The issue of isolating chronic non-ulcerative colitis into an independent nosological form has not been resolved, there is no unambiguous attitude to this problem. In the US and Western Europe, this disease is not recognized. Thorough examination of patients using endoscopy, bacteriological and morphological methods makes it possible to distinguish the following etiological forms of colitis: ischemic, infectious, pseudomembranous (after antibiotic treatment), drug, radiation, collagen, lymphocytic, eosinophilic, diverticular disease, systemic diseases, transplant cytotoxic neyropenichesky).

About 70% of all colitis occurs in ulcerative colitis and Crohn's disease of the large intestine (granulomatous colitis).

In the International Classification of Diseases of the 10th revision (ICD-10), the K50-52 classes include non-infectious enteritis and colitis:

• K-50 - Crohn's disease of the small and large intestine.
• K-51 - Ulcerative colitis.
• K-52 - Other non-infectious gastroenteritis and colitis.
  • 52.0. - Radiation colitis and gastroenteritis.
  • 52.1. - Toxic colitis.
  • 52.2. - Allergic gastroenteritis and colitis.
  • 52.8. - Other forms.
  • 52.9. Unclassified gastroenteritis and colitis.

In the USSR there was a point of view according to which chronic non-ulcerative colitis is allocated as an independent nosological unit. And now many famous gastroenterologists believe.

The following proposition of P. Ya. Grigoriev (1998) should be considered correct: if the type of colitis after a bacteriological study of feces, colonoscopy with biopsy and radiographic examination of the colon is not etiologically verifiable, it should be attributed to chronic non-ulcerative colitis.

[1], [2], [3], [4]

Causes of chronic colitis

1. Past acute intestinal diseases - dysentery, salmonellosis, food poisoning, typhoid fever, yersiniosis, etc. Particular importance is attached to the transferred dysentery and yersiniosis, which can take a chronic course. Many gastroenterologists suggest the allocation of post-dysenteric colitis. According to AI Nogaller (1989), the diagnosis of postdisenteric colitis can be valid only within the first three years after acute acute dysentery. In the future, in the absence of bacterial transport, various other etiological and pathogenetic factors lie at the basis of the development of chronic colitis, in particular, dysbacteriosis, sensitization to augomicroflora, etc.

Causes of chronic colitis

[5], [6], [7], [8], [9]

The pathogenesis of chronic colitis

The main pathogenetic factors of chronic colitis are the following:

1. Direct damage to the mucous membrane of the colon under the influence of etiological factors. This applies primarily to the effects of infection, drugs, toxic and allergic factors.
2. Violation of the immune system, in particular, a decrease in the protective functions of the gastrointestinal immune system. Lymphoid tissue of the gastrointestinal tract serves as the first line of specific protection against microorganisms; most Ig-producing cells of the body (B-lymphocytes and plasmocytes) are in the L. Propria of the intestine. The presence of local immunity, the optimal synthesis of the intestinal wall of immunoglobulin A, lysozyme is a reliable protection against infection and prevents the development of an infectious inflammatory process in the intestine. With chronic enteritis and colitis, the production of the intestinal wall of immunoglobulins (primarily IgA), lysozyme, decreases, which contributes to the development of chronic colitis.

The pathogenesis of chronic colitis 

Symptoms of chronic colitis

Chronic colitis is characterized by pain localized mainly in the lower abdomen, in the flank region (in the lateral parts of the abdomen), i.e. In the projection of the large intestine, less often around the navel. Pain can be of a varied nature, stupid, aching, sometimes paroxysmal, spastic type, bursting. A characteristic feature of pains is that they decrease after gas exhaustion, defecation, after applying heat to the abdominal region, and also after taking antispasmodics. Pain intensification is noted when taking rough vegetable fiber (cabbage, apples, cucumbers and other vegetables and fruits), milk, fatty, fried foods, alcohol, champagne, carbonated drinks.

Symptoms of chronic colitis 

Diagonalism of chronic colitis

• General analysis of blood, urine and biochemical blood test without significant changes.
• Coprologic analysis. Stool analysis provides for microscopy, a chemical study (determination of the daily amount of feces of ammonia, organic acids, protein [by the Tribula reaction], fat, fiber, starch), bacteriological study.

Diagnosis of chronic colitis 

[10]

Treatment of chronic colitis

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.

Treatment of chronic colitis