What it means to be affected by colitis?

  1. Gastroepato
  2. Gastroenterology
  3. Colitis
  4. Constipation and diarrhea
  5. Constipation
  6. Constipation, the causes
  7. Constipation, diets for constipation
  8. Laxative abuse, melanosis coli
  9.  Why acute and chronic diarrhea?
  10. Malabsorption syndrom
  11. Food allergy

Doctor, have I a colitis?

There is a lot of confusion around the topic "colitis" . In fact the subjects that report occasional diarrhea discharges, perhaps connected to stressful events (for example, discharges during an exam or a lite!), They certainly do not suffer from colitis, that is a specific process of inflammation of the colonic mucosa, particularly located at the rectum-sigma in most cases, ie they do not suffer from an inflammatory bowel disease. In most cases, it is a common irritable bowel syndrome which, however annoying, recognizes a motor disorder of the colon, with painful spasms, even if in recent years the theory that an inflammation, though modest, is at the base of irritable bowel syndrome.Rappresentazione microscopica della mucosa dell'intestino It is expressed in the varieties with constipation and / or diarrhea, and can be associated with crampiform pains of the "a colic" type, that is accentuated and reduced, referring to the lower abdomen, in the left iliac fossa, mainly, that is at the bottom of the left flank, generally correlable with gas and lumen dilations; for this purpose we have spoken extensively about our site of important intestinal symptoms, including abdominal pain and surgical abdominal pain.


Classification of colitis

The intestinal colitis inflammations of the mucosa are determined by specific causes (for example, infections) and from non-specific causes as well as in inflammatory bowel disease. Infectious colitis are characterized by diarrheal discharges and depend from a bacterial etiology in 50% of cases, eg. Campylobacter jejuni, Salmonella spp and some pathogenic bacteria such as E. coli. But in other cases the etiology is viral, such as in infections with rotavirus.

infectious colitis

Typhoid and Paratyphoid fever

Are caused by Salmonella typhi and paratyphi, A and B, bacterial diseases that people contracted orally through contaminated food (eg. Vegetables grown with sewage, mussels grown in standing water, etc ..). After Incubation of 7-20 days, the first symptoms are fever, anorexia, bradycardia. After other symptoms appear, a macular rash of pink, splenomegaly, vomiting and diarrhea, with the involvement of the lymph tissue Peyer's patches along the longitudinal axis of the intestine that can give ulcerations oval. Diarrhea is a characteristic color that defines the color of pea puree, greenish and is accompanied by abdominal bloating, leukopenia (that is another sign of the disease is the decrease of white blood cells).

Diagnosis.

The diagnosis provides the positive Widal test, at the end of the 2nd week, that is, after the incubation period, whereas the blood culture can be positive in the first 7-10 days and the coproculture after the third week.

Therapy

Chloramphenicol in 4 doses / day, at doses up to 1 mg x kg. The therapy should be continued for nearly 15 days. Clinical recovery is characterized though 3 stool cultures are negative. Alternatively, you can use Thiamphenicol, or ampicillin 100 mg / kg / day or clotrimoxazolo. And '' Clearly, you need to provide intravenous fluids to the patient dehydrated. To tell if a patient is dehydrated must observe the tongue of the patient, who appears sharp and dry, like a parrot); You will, therefore, be administered into a vein fluids, saline and glucose solutions. If there is a enterorragia, you need to put an ice bag on the abdominal surface and if there is a severe toxemia treatment with cortisone, for example predisone 40 mg IV is indicated. The typhoid bacillus carriers should be treated with ampicillin. Prophylaxis for those who came into oral contact obtained by vaccines, even with agents live and attenuated.

YERSINIA.

Y. enterocolitica or pseudotubercolosis infections can cause gastrointestinal disease. It is a gram negative bacterium, anaerobic optional that can cause infections in humans and in animals. It is transmitted by the fecal oral route. The Y. enterocolitica can make in children and young adults a syndrome similar to appendicitis and is responsible for most cases of gastrointestinal disease in temperate climates. In adults you can have nodouses erythema and reactive arthritis, and toxic megacolon, myocarditis, and glomerulonephritis. The symptoms may last for several months. The diagnosis is difficult and is done by coproculture. The survey RX direct examination of the small intestine shows nodularity and superficial ulcers. The infection occurs mainly in children and is responsible for adenites; test used to diagnose is that the cultural and serological tests.

Abdominal tuberculosis.

The tuberculous enteritis can develop as a primary intestinal lesion or as a secondary lesion in from another location. The enteritis tubercolaris is often secondary to pulmonary location; Mycobacterium infection with bovine tuberculosis is rare, thanks to treatments for the central milk pasteurization. The symptoms are nonspecific: fever, night sweats, weight loss and anorexia, nausea, and intestinal discomfort or diarrhea affecting half of the patients. The ileocecal region is the most frequently affected; sometimes there is a palpable mass in the right iliac fossa, a positive Mantoux reaction (ie for TB) may be useful for diagnosis. Radiological images remind us of Crohn's disease with ulceration and stenosis of the distal small intestine. There may be lesions of the intestinal mucosa similar to Crohn's disease, such as ulceration and stenosis, and ipertrophia. There are other features mucosal lesions: confluent granulomas, expression of a chronic inflammatory process that attracts the cells of the white line in epiteliod transformation. Granuloma, as a result of the chronic inflammatory process with deposition of fibrous tissue that determines stenosis and inflammation.

Colitis by shighelle and entoameba histolytica.

These diseases are characterized by acute diarrhea and blood in the stool, with leukocytes. Rectal biopsy performed endoscopically shows specific injuries as marked edema, mucosal erosion, which is friable and bleeding, infiltrates with leukocytes and presents destruction of the epithelium and crypts rarefied. In ulcerative amebical the infection is caused by Entamoeba histolytica, and is a feature tropical areas infection, due to poor hygienic conditions, which can also infect the liver, by a cyst, called amebical cysts. The cystic amebical is the most widespread form of cysts in the environment; it reaches the human intestine being contained in contaminated food. In the intestine it becomes movable trophozoita, which represents the vegetative form: it is possible, however, that these cysts do not cause symptoms. Amebic disease has several clinical aspects; we can have the condition of asymptomatic carrier, or the form of severe and acute colitis. Colitis is characterized by abdominal pain with spasmodic emission of your diarrhea, watery and bloody stools and mucus. It 'also possible to obtain the intestinal perforation in the more severe forms. Sigmoidoscopy show in 80% of cases, the typical sores, represented by bleeding ulcers with multiple surfaces, usually located blind intestine and / or the rectum, are the circular ulcers that can penetrate the muscular layer of the intestinal tube, with thin edematous edge.
Diagnosis. Amoebas are evident in fecal smear too. However, the diagnosis is made by serological tests, in order to make a differential diagnosis with chronic inflammatory bowel disease. With the chronic form can be determined stenosis and amoeboma, due to large masses granulomatoses (result of chronic inflammation). The quick answer metronidazole, 500 mg 3-4 / day for 7-10 days to make a difference with cancer lesions. During the histological examination of amoebomi, however, amoebae are easy distingued by color PAS.

Cytomegalovirus colitis.

CMV is not responsible for the symptomatic colitis in immunocompetent individuals, but in AIDS patients or cyclosporine therapy immunosuppressed. CMV is responsible for a life-threatening illness, because the therapy is limited. The virus is responsible for ischemic heart shape with deep mucosal ulcerations and bowel perforation.

Schistosomiasis


The S. affects more than 200 million people in developing countries; Schistosoma mansoni and S.japonicum can induce proctocolitis because they lay their eggs in the venous system of the superior mesenteric vein system (female S. japonicum), while S. mansoni in the inferior mesenteric vein system. The affected intestinal mucosa ulceration has raised, with polypoid lesions and granulomatous reactions. Schistosoma can also go to the liver by the portal system to a presinusoidal position, where it is responsible for a granulomatous reaction, as a result of obstruction and portal hypertension flow presinusoidal portal. Constant is the identification of peripheral eosinophilia, hepatosplenomegaly, lymphadenopathy, and proctitis with friable mucosa.

ASPECIFIC And ULCERATIVE IDIOPATHIC

Pseudomembranous colitis.

Training pseudomembranous on colonic mucosa is an event that can occur in cases such as highly variable in mercury poisoning, intestinal ischemia or broncopolmonitis, but especially in antibiotic-associated colitis. In one third of the subjects symptoms resolve with discontinuation of antibiotic therapy, even when it was used metronidazole, which is generally used for its resolution. It seems that the Clostridium diffcult is the patogeneticoi agent, because you lose the normal intestinal flora, microbiota. The secretes C. diffcult least three heat-labile toxin, and even if the toxin A, B and C all lead to the accumulation of fluid in the small intestine, toxins A and C also cause disepiteliation, but only A is responsible for the necrosis and serious bleeding. The clinical picture is represented by profuse diarrhea, abdominal cramps and abdominal sedabile not, because of the widespread use of antibiotics. Abdominal RX shows nonspecific signs: swelling bowel loops. The pseudomembrans are formed by a series of small yellowish plates, with many foci and crypts destroyed.

Crohn's disease and UC

The non-specific inflammatory processes (terminal ileitis) affecting the rectum, sigmoid and ileum. The colonoscopic investigation in CD documents the presence of severe, confluent, linear and serpiginous ulceration of the mucous membranes, sometimes with pebbles appearance. The right colon is more interested than the left from Crohn's disease. The appearance of fistulas is characteristic. Ulcerative colitis is generally limited to the rectum-sigma; It affects the rectum and the proximal colon. The symptoms are bloody diarrhea and rectal spasm. And 'possible association with skin lesions: pyoderma gangrenosum. The mucosa of the rectosigmoid endoscopic appears finely granular, hyperemic, bleeding and friable, up to the third degree of proctitis framework characterized by severe ulcers, bleeding from contact when passing the instrument. Ulcers are in the shape of circular craters in the rectum and radiological examination of the colon with barium shows a mucosa that sometimes takes aspects pseudopolipoidi (post-inflammatory polyps). The risk of perforation is possible, or intractable bleeding, toxic megacolon bowel cancer. With the coprocoltural examination you can rule out infectious inflammation.

ischemic colitis.

And 'it caused by lack of circulation of blood in the colon, in atherosclerosis of elderly patients. And it is caused by arterial embolism, dissecting aneurysm of the abdominal aorta and by a series of vasculitic processes. The most vulnerable areas are the splenic flexure and rectosigmoid region. The mucosa of the colon loses its luster, and the mucosa appears with narrow lumen and bleeding that is pathognomonic.
 

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