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colitis, inflammation of the colon, or large intestine. The term “colitis” may be used to refer to any of a number of disorders involving the colon. Symptoms include diarrhea (often with blood and mucus), abdominal pain, and fever.
Ulcerative colitis is a serious chronic inflammation and ulceration of the lining of the colon and rectum. Another form of colitis, called Crohn's disease, has similar signs and includes thickening of the intestinal wall. The disease typically occurs in the small intestine near the point where it joins the colon, but the colon and other parts of the gastrointestinal tract may be affected as well. The term “inflammatory bowel disease” has been used to refer to both ulcerative colitis and Crohn's disease, the causes of which are unknown. A less severe disorder, known as irritable bowel syndrome, or IBS, was formerly called mucous colitis.
Colitis is sometimes caused by infections with viruses, parasites, or bacteria. For example, two distinct types of dysentery are caused by amebas and bacteria. Infectious forms of colitis are often the result of poor hygienic practices. Prolonged use of antibiotics can also cause colitis, either by direct irritation of the colon or by killing bacteria that normally live in the intestine, allowing the toxin-producing bacterium Clostridium difficile to proliferate. Colitis is also sometimes caused by diverticulitis (see under diverticulosis) or by colon cancer.
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.
REFERENCESMen’shikov, F. K. Bolezni kishechnika. Moscow, 1962.
Bolezni organov pishchevareniia. Edited by S. M. Ryss. Leningrad, 1966.
A. L. GREBENEV