Diseases of the large intestine

The thick intestine section, unlike the thin one, does not have such a diverse composition of enzymes but is enriched with microflora. Its function is to complete the digestion, the formation of stools with sufficient fluid content.

Nervous regulation of the intestinal activity is especially often disrupted by prolonged negative emotions. Predominant are fear, a sense of loss. Therefore, during the economic crisis, the number of sick people increases.

About 2 kg of dietary masses go to the beginning( the small intestine) of the thin section daily, and the stool volume is 1/10 part. Here, up to 95% of water and electrolytes, nutrients, vitamins are absorbed and all the slags are removed to the outside.

Diseases of the large intestine with impaired functions cause poisoning of the body with its own poisonous substances. These scientists call one of the reasons for the early aging of man. The frequency of the lesion is indicated by the data of preventive examinations of healthy adults. Doctors-proctologists identify diseases in more than 300 people out of 1000.

How does the change in the functions of the large intestine affect health?

It is believed that by the age of 40, the large intestine in a person is already heavily clogged with calculous stones. They are formed from petrified unsealed slags, which get stuck between the folds of the mucous membrane. Surgeons when removing part of the intestine in 70% of cases find out in it a foreign material, worms, stones accumulated over many years.

The normal width of the lumen of the ascending gut reaches 8 cm, and the sigmoidal width is 2 times narrower. Deformation causes considerable stretching. In this case, the squeezing and squeezing of neighboring organs from their places occurs in the abdomen. Accordingly, their work is disrupted. Temporal constipation occurs in everyone.

It has been established that stool stones do not move for years, they "stick" to their place, disrupt the feeding of the wall, promote the penetration of toxins into the bloodstream. As a result, develop colon diseases. They are caused by the main damaging factors:

• inflammatory - damage to the mucosa of the intestinal wall( colitis);
• varicose veins and hemorrhoids - venous congestion, compression, circulatory failure;
• overgrowth of polyps and malignant transformation - prolonged action of toxins on a specific place.

All kinds of disorders divide:

• into functional ones - when there are clinical manifestations, but there are no organic changes in the intestine, they are considered reversible;
• organic - always accompanied by anatomical signs, a breakdown in the physiological mechanisms of digestion.

On the role of microflora and dysbiosis

The important role of the large intestine in heat formation( warming of human blood) is rarely mentioned. Heat emits microflora. The loops of the intestine are covered with a fat layer to conserve the energy of the "stove".Developed useful substances can stimulate immunity. Only E. coli produce 9 vitamins( including B1).

It is proved that by consuming 1000 kcal at the expense of fruits, nuts, vegetables, a person becomes much more enduring than when consuming 3000 kcal boiled "dead" meat food. It, on the contrary, takes energy and overloads the digestive tract.

People quickly get tired, chilly. The problem of dysbiosis is reflected not only in the work of the intestines, but also on the general state of the body. Malnutrition affects it more often than colon disease.

. General symptoms of

Symptoms of colon diseases increase gradually. At the initial stage they are not taken seriously, they are considered simply discomfort. Any pathology manifests itself:

• disorder of the stool( diarrhea or constipation);
• appearance in the stool of significant mucous discharge, impurity of blood;
• pain syndrome - the most typical dull, aching pain in the side, in the anus, worsening during defecation, after eating foods rich in fiber, milk, relief after the end of defecation and the release of gases;
• bloating due to increased gas formation, constant rumbling;
• signs of neurasthenia, expressed in dependence of mood from the stool, insomnia, irritability, tearfulness, depression.

Gradually the symptoms of colon diseases become more pronounced. Allocations turn into purulent ones, false desires( tenesmus) are added to the disorder of the stool, painful pressure is constantly felt in the anus of the anus, possibly an involuntary withdrawal of gases and feces.

Adult patients have increased fatigue, weakness, children do not grow well, do not gain weight. Often patients get to the surgeon with signs of intestinal obstruction. Diseases of the large intestine have their own characteristics. We will consider the most common pathology and functional disorders.

Diseases of a functional nature

Functional diseases of the large intestine are also called dyskinesia, neurogenic colitis. A special place in modern gastroenterology is given to irritable bowel syndrome. The main unifying feature is the absence of any organic disturbances in the intestinal wall.

Significantly less risk factors are added: acute intestinal infections, insufficient physical activity, overeating of heavy meat foods. Similar signs are possible in pregnant women. Consequences are divided into 2 types:

• hypotension - is expressed in violation of the function of evacuation of stool, stasis, atonic constipation, constant gravity and dull pain in the abdomen;
• hypertension - motor activity is accelerated, water and mucus are released in a significant volume, at the same time a useful microflora is produced, the patient feels cramping pains in the abdomen, frequent diarrhea, dry mouth.

When examined in analyzes, no changes are found other than dysbiosis. Inspection of the intestine does not show a violation of the structure of the wall. Doctors try to treat such cases with:

• the correct mode of the day;
• normalization of the emotional load;
• of physical therapy;
• balneological procedures( baths, showers);
• methods of physiotherapy;
• vegetable decoctions and tinctures.

Irritable Bowel Syndrome

The disease is isolated into a separate nosological unit with an unclear nature. Unlike other dyskinesias, the symptoms are more stable and have different severity. More often observed in women.

Communication established:

• with disturbed mode and power quality - long breaks in food, hunger diets and overeating, consumption of alcoholic beverages, soda, fatty or fried foods, equal passion for strong coffee or tea, neglect of vegetables and fruits have equal importance;
• transferred stress;
• hormonal changes;
• by forced intake of anti-inflammatory drugs;
• hereditary predisposition.

Some authors consider this diagnosis to be acceptable in other chronic diseases of digestion( eg, stomach or liver).Particular importance is attached to the emergence in the human diet of food products from genetically modified plants, food additives, stabilizers, dyes. They often develop an allergic reaction from the intestinal wall.

Clinically the disease manifests itself:

• with constant discomfort in the abdomen( rumbling, feeling of bursting, heaviness);
• with intestinal colic without specific localization;
• painful diarrhea, followed by a prolonged constipation;
• inability to regulate stool by diet;
• an aching in the muscles of the back, joints;
• stabbing pain in the heart.

The diagnosis is made only after exclusion of inflammatory lesion, tumor, the effects of pancreatitis. There is an opinion that the appearance of the syndrome in childhood is a harbinger of a more severe pathology. Symptoms in children are divided into primary manifestations associated with abdominal pain and increased gas production, diarrhea, constipation.

The main reasons are: uncontrolled use of fast food, canned foods, chips, long breaks in food, overload at school and additional lessons, fear of punishment.

For treatment, a diet without irritating intestinal products, antihistamines, calming agents of plant origin is used. Spasmodic pains are removed by spasmolytics( Spazmalgon, No-shpa).

Probiotics are routinely used to maintain a normal bacterial ratio( Bifidumbacterin, Linex, Lactobacterin, Bactisubtil).Patients are recommended courses of physiotherapy, treatment with mineral waters.

Inflammatory pathology

Inflammatory bowel disease( colitis) occurs both in the case of pathogens( shigella in dysentery) and in the activation of their own conditionally pathogenic flora( clostridia with pseudomembranous colitis).It has been established that E. coli can be transformed into pathogenic strains.

Pseudomembranous colitis

The disease is a serious complication of antibiotic therapy( less often occurs under the influence of treatment with cytostatics, immunomodulators, laxatives) and dysbiosis. It is caused by excessive growth of clostridia in the large intestine. It is considered as an intrahospital infection.

The disease is accompanied by severe intoxication, high temperature, diarrhea, severe abdominal pain, vomiting, headaches, dehydration phenomena, coarse electrolyte and proteindisorders, depression of the cardiovascular system.

Particularly difficult to tolerate in the elderly, in the presence of other diseases. In the initial stage, symptoms disappear when drugs are withdrawn. In severe course, hyperkalemia and death from cardiac arrest develop. Consider two diseases that are not associated with infection.

Ulcerative colitis

Disease refers to chronic lesions. Inflammation begins in the rectum and spreads up to other parts of the large intestine. The mucous membrane is a surface covered with ulcers, easily bleeding. Usually the process does not go deeper than the submucosal layer.

In this case, the risk of transformation of ulcerative epithelium into polyps or cancer of the intestine is significantly increased. The causes of the disease have not been established to date. The most probable hereditary predisposition, genetic and immune changes in the family.

Symptoms:

• frequent diarrhea, less frequent stool;
• permanent pain with an arrangement in the left ileal region and above, decrease after defecation;
• from time to time spotting from the intestine;
• weakness, decreased performance, a constant sense of fatigue;
• weight loss.

In the treatment of the disease, a strict diet is applied with the exclusion of irritating products, milk. Long courses are prescribed Sulfasalazine. If there is no effect, corticosteroids are added. Local therapy includes rectal suppositories with anesthesin for analgesia, with methyluracil, microclysters with decoctions of herbs( chamomile, calendula).

In case of severe course, the bottom of the ulcer becomes deeper and corrodes the nearby vessel. In the presence of intestinal bleeding, patients are operated on, resection( removal) of the affected area is carried out with an abdominal wall of the anal opening. Surgical intervention is vital for bleeding, but it does not stop the inflammatory process.

Crohn's disease

Disease of an unknown genesis, capable of affecting the entire digestive tract. Teenage boys and young men are more often ill, the next "peak" of prevalence falls on the age after 60 years. In 75% of cases, inflammation is localized in the end zone of the ileum and the beginning of the large intestine( ileocolitis).

The study of Crohn's disease showed the importance of three factors:

• heredity - confirmed by the spread among twin brothers, the linkage of gene mutations with Bechterew's disease( ankylosing spondylitis), the isolation of a special mutant gene.
• infections - suspicions fall on a paratuberculous bacterium, studies are conducted on the association with viral and bacterial pathogens;
• immune disorders - proves the detection in the body of patients of an increase in T-lymphocytes, antibodies to the E. coli, but so far no specific antigens have been detected.

The inflammatory process, in contrast to ulcerative colitis, extends inward, captures the entire wall of the intestine and lymphatic vessels. Plots of lymphocyte accumulation have clear boundaries, alternating with normal tissue. Due to the sealing of the wall, the lumen narrows.

Ulcers on the mucosa have the appearance of cracks, cracks. The formation of characteristic granulomas( tubercles) makes it look like a "cobblestone pavement."This feature is used in differential diagnosis. The muscular layer eventually breaks down, abscesses and fistulous passages forming into the peritoneum or adjacent organs form on the skin of the abdomen.

Symptoms of the disease are divided into intestinal and extraintestinal. Among intestinal manifestations: prolonged diarrhea, pain more often in the right iliac region( masked for appendicitis), intensified after eating, irradiate to the navel, along the entire abdomen, nausea and vomiting, swelling of the intestine, weight loss( more often with the involvement of the small intestine).

How other organs are involved in the inflammatory process is not known. The extraintestinal signs include:

• loss of appetite;
• constant fatigue;
• wavy temperature rise;
• in the mouth - aphthous stomatitis with very painful ulcers, bleeding;
• from the eyes - inflammation of the membranes( conjunctivitis, uveitis, keratitis);
• spondylitis of the spine, inflammation of the joints of the hands and feet, development of stiffness;
• skin rash in the form of nodal erythema, pustules, vascular angiitis.

Characteristic fatty degeneration and cirrhosis of the liver, the formation of concrements in the bile ducts, sclerosing ducts( possibly forming a malignant tumor).Simultaneously, the urinary system causes cystitis, urolithiasis, pyelonephritis, amyloidosis, the kidney increases and forms hydronephrosis.

Treatment conservative, differs little from ulcerative colitis. As symptomatic help is used: enzymes, enterosorbents, probiotics, iron preparations for anemia, vitamins.

Alternative methods include:

• method of oxygen saturation in a special chamber( hyperbaric oxygenation);
• plasmasorption and plasmapheresis;
• use of stem cells.

Vascular diseases

Disturbance of nutrient intake through the arteries and venous congestion impedes metabolism in the cells of the large intestine.

Ischemic colitis

In the place of ischemia, local inflammation first develops, ulcers and cicatricial adhesions may appear. The main cause is atherosclerosis of the mesentery vessels, through which the intestinal wall feeds blood. Blood flow is disturbed in diabetes mellitus, varicose veins, thrombophlebitis. The elderly are mostly sick.

Symptoms:

• pain in the left side of the abdomen, after half an hour after eating;
• admixture of blood in the feces.

After the first manifestations, there is an asymptomatic period, the patient hopes for recovery. But exacerbation is manifested by heavy bleeding and pain. Many patients have nausea, diarrhea, weight loss, symptoms of anemia.

In the absence of treatment, necrosis of the intestinal wall occurs with perforation of the contents into the cavity of the peritoneum. Therapy uses a diet, drugs to improve microcirculation( Trental, Actovegin).If you suspect a gangrene urgent surgery is needed.

Hemorrhoids

The disease affects the hemorrhoidal venous network of the rectum. Nodular formations become inflamed, increase in size, fall through the anus, can be jammed muscles. The disease is common among people with a sedentary lifestyle, sedentary occupations, frequent constipation.

Symptoms:

• a constant sensation of a foreign body in the anal passage;
• pain during defecation, walking, in a sitting position;
• admixture of blood on stool;
• burning, itching in the anus.

If you do not start the disease, then local treatment with anti-inflammatory rectal suppositories, microclysters, healthy diet helps. In severe cases, they resort to surgery. Used sclerotherapy sites, laser treatment, removal of extended nodes. Tumor growth

Malignant Neoplasms

formation colon and rectum - the most common type of cancer. In this anatomical zone, oncological diseases predominate over benign polyps. The risk increases with age( 40 years and older), with the wrong diet with a predominance of meat products, hereditary predisposition, ulcerative colitis.

For a long time, the tumor grows asymptomatically. When there are pain and other signs the stage is already started. In 2/3 cases, it is localized in the left half of the large intestine. Attacks of pain and symptoms of intestinal obstruction require surgical intervention. At the same time, chemotherapy and irradiation are carried out.

Diverticulosis

Stretched intestinal wall forms pocket grooves with protrusion outward. The risk is growing in people with dyskinesia, atonic constipation. The most frequent localization is the descending and sigmoid colon.

Detects inflammation( diverticulitis) with all signs of a lesion of the large intestine. The disease contributes to obstruction, often detected during surgery. In uncomplicated flow appoint anti-inflammatory drugs, enzymes.

Anomalies

development among colon pathology should be mentioned anomalies:

• dolihosigmoy - a significant extension of sigmoid;
• megacolon - thickening of the entire intestine or its parts.

In dolichosigm patients may not feel disturbances. More often disturbs the expressed bloating. As the gut exceeds the normal length, the feces move with difficulty, the patients suffer from constipation.

Megacolon - similar change throughout the large intestine, or by sector. The disease is caused by impaired innervation. Can be both congenital and acquired. The formation is affected by intrauterine factors of fetal development, traumas, chronic intoxication, tumor growth.

Narrowing of the site of the large intestine forms an expansion and stagnation in the overlying areas. The disease manifests itself by prolonged constipation, enlarged abdomen. Pathology is detected by X-ray examination for other diseases.

Characteristically uneven thickening of the intestinal wall, in places the formation of obstruction. Conservative treatment usually prepares patients for surgery. Completely eliminate the pathology possible only surgically. The appearance at any age of symptoms of lesions of the large intestine requires compulsory visits to the doctor and examination, to eliminate some provoking factors on the forces themselves.