Chronic non-ulcerative Colitis

Question 1

What is chronic non-ulcerative colitis?

Answer 1

This is a concept that combines diseases of the colon of different etiologies with inflammatory and inflammatory-dystrophic changes in the mucosa

Question 2

Etiology of Chronic non ulcerative colitis

Answer 2

-Infectious-due to intestinal infectious agents e.g bacteria e.g Salmonella,Shiggella, Campylobacter,Escherichia
viruses e.g Norovirus or Cytomegalovirus
,Candida,fungi and parasites (Ameba)
-Coronary ateriosclerosis, vasculitis, coagulation disorders
-Drug-laxatives with antraglikozides
-Pseudomembranous-30% of cases of AAD associated with clostridium difficile
-Radiation-radiation therapy
-Allergic colitis-food and drug allergies
-In systemic diseases-vasculitis
-Transplantation cytostatic
-Endogenous intoxication-uraemia, hepatic insufficiency -
-Exogenous intoxication Mercury,AS,pg(prostaglandins)
-Congenital enzyme insufficiency e.g dissarcharides,when there is constant irritation of mucosa by products of incomplete splitting of food
-Eating disorders
-Rare forms of colitis-colitis-TB,collagen,lymphocytic(microscopic),intestinal endometriosis;amyloidosis etc
-Secondary colitis-gastritis,pancreatitis,diverticular disease,dolichosigma

Question 3

Pathogenesis of Colitis

Answer 3

Direct damage to CO under the influence of etiological factors-infection, NC, toxic,allergic
Violation of immune system function , including local immunity(IgA, lysozyme)
Development of sensitization of patients and intestinal automicroflora
Autoimmune disorders
Involvement in the inflammatory process of the nervous system of intestine
Dysbiosis-decrease of bifidobacterium, lactobacillus ,an increase in the pathogen and opportunistic pathogenic bacteria
Violation of secretion of gastrointestinal hormones, biogenic amines,prostaglandins

Question 4

Clinical picture of Chronic non ulcerative colitis

Answer 4

Unstable chair of constipation, diarrhea,alternating bloating,rumbling,transfusion
Depending on pain localisation-dumb, spastic,decreases after seasonal work-Denis gas and bowel movements receiving antispasmodic,after heat
Tenesmus-urgent situation
Astheneurotic syndrome manifested by withdrawal into illness, weakness, headache,sleep disturbance,
Weight loss associated with decrease in food intake because of fear of gain symptom

Question 5

Classification of chronic no ulcerative colitis

Answer 5

• Tiflitis-right hand colitis diarrhea, alternation of constipation and diarrhea
• transversitis-rarely in isolation,the feeling of stretching in the middle part of abdomen after eating
• angelic-splenic flexure , maybe reflex pain in region of the heart, Sedecavation, alternating constipation diarrhea
• proctosigmoiditis-left sided colitis, the most common form pain in the iliac region, tenesmus,shut off diarrhea, sheep feces ,mucus in feces

Question 6

Diagnosis of chronic non ulcerative colitis

Answer 6

CBC
Routine urine analysis 
Biochemical 
Coprogram stool test for pathogens or serological tests
ECG
Abdominal US
US of abdominal vessels (aorta and its vessels)
Angiography 
Immunological markers of vasculitis

Sigmoidoscopy with biopsy of mucosa
Colonoscopy with biopsy
Barium enema-to exclude polyps,tumours, disappearance of gaustration, diverticula, dolichosigma

Question 7

Treatment of Chronic non ulcerative colitis

Answer 7

1.Diet
During exacerbation a gentle diet is recommended to reduce peristalsis and eliminate irritation from the intestine
In the presence of flactuence limit the cracking of carbohydrate, milk, dairy products
Inclination to constipation is stopped by regular addition of products containing dietary fibre e.g (carrots,beets,cabbage apples)
Effective daily consumption of bran (wheat,rye, oats)
With the bran to bind water drink plenty of fluids up to 2litres

2.Causal treatment
New antiseptics(interix, ersefuril,nifuroxamide) with minimum bactericidal concentration and wide range of antimicrobial action
For interix-restores microbial balance of saprophytic flora including protein dysbiosis
Dose-2 capsules 3times a day for 5-7days
With dysbiosis 1 capsule(0,2g) 4times a day for 5-7days
Rifaximim 200mg x 3 for 7 days
Furadonin + Furazolidone - (0,1-0,15g x 4 for 5-10days)after meals with water
For ischemic colitis lipolipidemicescoe and anti platelet therapy-furazolidone
For pseudomembranous -Vancomycin orally 500mg x3-4times a day for 7-10days

3.Symptomatic therapy
For persistent diarrhea-adsorbents - bismuth ,polipefan
Anti diarrheal meds liked- loperamide should not be given incase of acute diarrhea

Normalisation of motor evacuation function use atropine
Constipation- pro kinetics-cisapride
Astheneurotic syndrome-tranquilizers
Abdominal pain, flactuence-antispasmodics e.g dicetel