Enteritis - Causes, Symptoms, Diagnosis and Treatment
Enteritis - Inflammation of the small intestine, accompanied by a violation of its functions and degenerative changes in the mucosa. It is characterized by symptoms of disorders of the chair, which becomes a liquid or mazevidny character, bloating, rumbling, pain in the navel. Violated the general state of health, the patient loses weight. In severe cases, may develop degenerative changes, vitamin deficiencies, adrenal insufficiency.
Enteritis
acute enteritis may be an acute intestinal infection is bacterial or viral origin (cholera, salmonellosis, typhoid fever), poisoning of toxic substances (arsenic, mercuric chloride) or toxic products (pale toadstool, stone fruits, organs and parts of some fish, inedible berries, etc. etc. .), overeating spicy, spicy, fatty foods, drinking strong alcohol), allergic to foods or drugs.
Chronic enteritis may develop as a consequence of intestinal protozoa or helminths settlement, bad eating habits (tendency to rough, spicy food, alcohol), chronic poisoning by heavy metals, caustic substances. Enteritis can result from prolonged use of drugs, develop radiation sickness.
Factors contributing to the rise of enteritis, is smoking, renal failure, atherosclerosis, susceptibility to allergies, autoimmune processes, enzimopatii, inflammation of the mesenteric vessels.
Enteritis may be connected to other disease of the digestive tract, be the result of genetically determined disorders of absorption, surgery on the stomach and intestines.
eyunit) and ileum (ileitis) and emit a total enteritis, when the inflammation has affected all departments.
Depending on the nature of morphological changes distinguish enteritis without atrophy, moderate partial and subtotal villous atrophy.
Enteritis may be mild, moderate and severe, chronic enteritis may remain in the phase of exacerbation or remission.
Also note the nature of functional disorders of the small intestine: presence of a syndrome of malabsorption, maldigestion, enteral insufficiency, exudative enteropathy.
If the process involved the mucosa of the large intestine, then talk about with concomitant enteritis colitis. Also note the associated extra-intestinal disease.
diarrhea, nausea and vomiting, the occurrence of abdominal pain. There may be fever, headache. The chair can be up to 10-15 times a day, copious, watery. General condition: fatigue, pallor, dry skin, white patches on the tongue. Bloating, rumbling in the intestine marked.
When prolonged diarrhea develops clinical picture of dehydration in severe cases up to the occurrence of muscle cramps, disseminated intravascular coagulation.
Symptoms may include the hemorrhagic diathesis (increased bleeding, a tendency to thrombosis).
Chronic enteritis is characterized by enteric and extraintestinal manifestations.
By enteric symptoms include diarrhea, flatulence, pain, cramping in nature in the upper part of the abdomen, around the navel, rumbling, bubbling in my stomach. Symptoms are usually more pronounced in the period of greatest activity of the digestive system - in the afternoon.
Chair in chronic enteritis or pasty liquid containing undigested food, with a frequency of about 5 times a day, defecation, usually accompanied by the appearance of weakness, obessilivaniem. After that there may be a sharp drop in blood pressure, tachycardia, dizziness, limb tremor (up to the development of collapse).
Sometimes there painful, accompanied by wildness and abdominal cramps urge to defecate, with the release of greenish watery stools scanty.
Language enteritis coated with white bloom, along the edges of the prints of the teeth are visible. Belly distended, palpation cecum responds to noise and splash (Obraztsova's sign).
Chronic enteritis extraintestinal manifestations associated with the development of malabsorption syndrome - malabsorption of nutrients in the small intestine. A long-term lack of substances entering the body leads to numerous Hypovitaminosis, not enough minerals (iron deficiency anemia, osteoporosis due to calcium deficiency, and so on. P.), Protein starvation. Progressive decrease in body weight, dystrophy.
gastroenterologist enough information for primary diagnosis, additional confirmation is the total inspection data, palpation and percussion of the abdominal wall.
As a laboratory diagnostic methods used coprogram, on gross examination mark consistency, color, smell. Microscopic examination showed the presence of large amounts of muscle fibers (kreatoreya), starch (amylorrhea), fat (steatorrhea). Usually varies acid-base indicator.
Functional tests for the diagnosis of disorders of absorption in the small intestines (Absorption test): Definition of blood, urine, saliva and other carbohydrate substances taken prior to analysis (sample with D-xylose, iodine-potassium).
Methods eyunoperfuzii helps to identify disorders of intestinal digestion at the cellular and molecular level.
Bacteriological examination of feces is performed to identify dysbiosis, or intestinal infection. Blood results show signs of anemia (iron deficiency, vitamin B12 deficiency, mixed), leukocytosis, and sometimes - neutrophilia, accelerated ESR.
Biochemical analysis of blood flowing long chronic enteritis can mark signs of malabsorption syndrome.
Endoscopic examination of the small intestine is a significant challenge. Available for the introduction of the endoscope have only terminal units: Postbulbarnye part of the duodenum and ileum edge portion. During the endoscopic examination of the mucous produced biopsy sampling for histological analysis. As a rule, note dystrophic and atrophic phenomena from the epithelial cells and intestinal villi.
X-ray examinations of the intestine with the introduction of contrast medium allows you to mark a change of folded structure, uncover segmental lesions and tumor formation, ulceration. It is also possible to assess the state of the motor function of the intestine.
Endocrine diseases with similar clinic: thyrotoxicosis, diabetes mellitus, Addison's disease and Simmonds.
Persistent diarrhea may also occur when other intestinal pathologies: ulcerative colitis, Crohn's disease, malignancies and intestinal amyloidosis. It is also necessary to exclude abdominal syndrome with insufficient blood supply to the mesentery of the small intestine (ischemia). Calling digestive disorders in the small intestine may be hormone-producing tumors, gastric diseases, liver and pancreas.
gastroenterology, infectious enteritis is an indication for hospitalization in infectious boxing.
Patients prescribed bed rest, diet (mechanically and chemically gentle diet, restriction of carbohydrate and fat), drink plenty of liquids (if necessary hydration therapy measures), symptomatic and restorative treatment.
With the development of severe dysbiosis produce drug correction of the intestinal flora, diarrhea cropped astringent. In case of violation of protein metabolism produces introduction polypeptide solutions.
Treatment of acute enteritis usually takes about a week, a statement from the hospital performed after the acute symptoms subside.
Patients with severe enteritis and enteritis toxic origin (further course which is difficult to determine in the first hours of the disease) must be hospitalized. Patients with infectious enteritis admitted to the infectious diseases hospital.
polyps, diverticula), you need surgical removal.
bleeding, perforation, severe dehydration, the emergence of areas of necrosis) requiring urgent action.
The course and prognosis of chronic enteritis
Chronic enteritis proceeds with alternating periods of remission and relapse, gradually progressing (inflammation compounded and distributed by the gastrointestinal tract, malabsorption symptoms worse). In the absence of proper treatment measures for a long period of enteritis threatens lethal disorders of severe internal homeostasis and exhaustion. Also, untreated chronic enteritis is fraught with the development of life-threatening complications, the addition of infections.
In mild and moderate enteritis ability to work is usually kept, difficulties are caused by heavy exercise and frequent psycho-emotional stress. Severe lead to a reduction and disability.