inflammation of the colon.
Colitis is one of the commonest diseases of the gastrointestinal tract. It may be caused by infection (dysentery bacilli, salmonellas, amoebas, balantidia), poor food habits, or poisoning (by mercury and other chemicals). It can result from uremic autointoxication or as an independent disease of autoimmune nature (for example, nonspecific ulcerative colitis); in addition, it can arise secondarily from digestive disorders of the stomach and small intestine (gastric achylia, pancreatitis, gastroenteritis). Depending on the cause and severity of the colitis, the changes in the colon may vary from superficial catarrh to necrotic-ulcerative inflammation.
Colitis may be either acute or chronic. Acute colitis is accompanied by general malaise, loss of appetite, spastic abdominal pains, diarrhea, and, sometimes (especially in dysentery), painful straining at stool (tenesmus). The temperature may rise in acute colitis of infectious origin. The feces are pulpy or liquid and mixed with mucus (in severe cases, with mucus and blood). Acute colitis may become chronic.
Chronic colitis is accompanied by loss of appetite, nausea, and general weakness. Dull or paroxysmal abdominal pains often appear before or after defecation. Stool disturbances generally appear as an alternation of constipation and diarrhea. There is a sensation that the abdomen will burst, accompanying borborygmus and copious gas formation. With diarrhea, stools may be passed three or four times a day; they are generally pulpy or liquid and, in severe cases, mixed with mucus and streaks of blood. In spastic colitis, the fecal matter takes the form of small hard lumps. The abdomen is somewhat distended and tender upon palpation along the colon (with spastic constriction). The diagnosis of colitis is confirmed by X-ray examination, proctosigmoidoscopy, and laboratory analysis of the fecal matter.
The treatment of acute colitis (and exacerbations of chronic colitis) involves a starvation or semistarvation diet for one or two days, followed by a mostly protein diet, if fermentative processes are predominant in the intestine, or a carbohydrate diet, if putrefactive processes are predominant. Thereafter, a special colitis diet is recommended (strained, steamed, nourishing foods, with the exception of fruits, vegetables, and fresh milk). Antimicrobial and antiparasitic preparations and preparations that normalize the intestinal flora are indicated for infectious colitis. Therapeutic enemas are prescribed to act on the mucosae in cases of inflammation of the rectum and sigmoid colon. Antispasmodic and cholinolytic agents are used for spasms. Physical therapy (thermal procedures) and sanatorium-health resort treatment (Essentuki, Zheleznovodsk, Piatigorsk, Borzhomi, Morshin) are prescribed for patients with chronic colitis. Surgery is sometimes performed in cases of severe ulcerative colitis. The prevention of gastrointestinal infections, the treatment of diseases of the alimentary canal, and proper diet are helpful in preventing the occurrence of the condition.
A. L. GREBENEV