Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Department faculty and hospital therapy of medical faculty and department internal diseases of medical prophylactic faculty. • Chronic enteritis. • Chronic colitis. As a person digest food? Chronic enteritis - poly etiological disease of the small intestine characterized by the development of inflammatory-degenerative processes, regenerative discrete changes, atrophy of the small intestine mucosa of varying degree, a violation of all functions of the small intestine, primarily absorptive and digestive. The structure of the digestive tract The structure of the small intestine Etiology and pathogenesis Main aetiological factors: infection, nutritional factors, parasitic infestations, toxic effects, the abuse of certain drugs, radiation exposure, mechanical stress, genetic factors, developmental abnormalities of the intestine, etc. Leading pathogenic mechanisms intestinal dysbiosis, allergies (microbial , food allergy, allergic tissue), congenital and acquired enzymopathy. Classification of chronic enteritis (AV Frolkis, 1996, as amended). 1. Etiology. 1.1. Infectious 1.2. Parasitic. 1.3. Toxic. 1.4. Medication. 1.5. Nutritional. 1.6. Radiation. 1.7. After operations on the small intestine. 1.8. Congenital anomalies of the intestine and enzimopaty 1.9. In case of insufficiency ileocecal valve and the major duodenal papilla. 1.10. Secondary (other diseases) Classification (continued) 2. The preferential localization. 2.1. Chronic jejuunit. 2.2. Chronic ileitis. 2.3. Chronic total enteritis. 3. The character of morphological changes in thin (lean) intestine. 3.1. jejunit without atrophy. 3.2. jejunit with moderate partial villous atrophy. 3.3. With subtotal villous jejunit atrophy. 4. clinical course. 4.1. Mild course. 4.2. Moderate. 4.3. Severe. Classification (continued) 5 .Phase of the disease. 5 1. Phase of exacerbation. 5.2. Phase of remission. 6. Character of functional disorders of the small intestine. 6.1. Deficiency syndrome digestion (maldigestion). 6.2. Deficiency syndrome intestinal absorption (malabsorption). 6.3. Exudative enteropathy syndrome. 6.4. Syndrome multifunctional failure of the small intestine (enteral insufficiency). 7. The involvement of the colon. 7.1. Without a concomitant colitis. 7.2. With concomitant colitis. 8. extraintestinal disorders CLINIC Local symptoms Common symptoms Local symptoms 1. Diarrhea (diarrhea), 4-6 times a day 2. Poly feces 3. In the stool remnants of undigested food 4. Steatorrhea "toilet stool smears“ 5. Flatulence and rumbling in the stomach 6. Abdominal pain (at the navel) 7. Abdominal distention 8. Tenderness 9. Deficiency syndrome ileocecal angle 10.Reflux enteritis Common symptoms (due to disturbances of intestinal absorption) 1. 2. 3. 4. 5. 6. Epigastric pain Dyspeptic disorders Gastratrophia Reactive hepatitis Reactive pancreatitis Symptoms of dumping syndrome, or hypoglycemia 7. Loss of flesh 8. Trophic disorders (dry skin, hair loss, increased fragility of the nails) 9. Metabolic disease, hypoproteinemia Common symptoms (due to disturbances of intestinal absorption) 10. 11. 12. 13. 14. 15. 16. 17. 18. Hypopolyvitaminose Hyponatremia Hypokalemia Atrophic stomatitis Paradontapatiya Anemia (by B12) Neurodermatitis OEdema Decreased libido Coprogram in chronic enteritis • Physical properties: light brown color, texture or dense pappy (cal decorated). • Chemical properties: pH 6.5-7 (slightly acidic - neutral), the reaction of bilirubin in the positive or negative, reaction to stercobilin - positive reaction to an inflammatory protein and white blood cells - positive. • Microscopy: a combination of soaps and fatty acids or soap in large quantities Diagnosis of chronic enteritis I. To diagnose ch. Enteritis Signs of malabsorption: test with a load of D-xylose chemical study of the daily allocation of oil by van de camera radioisotope methods to load the isotope fatty acids, fat, albumin, vitamin B12 Jodi kali tests Sconoperphuse method enteral scatological syndrome: steatorrhea, amylorrhea, creatorea in the intestinal juice: enterokinase () alkaline phosphatase () in violation of food-cooking cavitypeptidase, -amylase () entero biopsy DIFFERENTIAL DIAGNOSIS chronic enteritis 1. Infectious intestinal diseases (dysentery, typhoid, cholera, etc.) 2. Tumors of the intestine, sprue 3. Habitual constipation (spastic colitis) tuberculosis of the intestine 4. Chronic pancreatitis, NUC Treatment of chronic enteritis 1. Diet (diet options № 4) 2. Antibacterials (intestinal action) 3. Derivatives of 8-hydroxyquinoline (intestopan, meksoferm, meksaze),Bactrim 4. Nitrophuran Drugs (furazolidone, furadonin) 5. Biologics (colibacterin, bifidum-bakterin, bifikol, Linex, bacteriophages) 6. In severe cases - corticosteroids low rate of 5-7 days of 20-40 mg per day, to support. 5.10 mg Treatment with ch. Enteritis (continued) 7. Protein preparations. Metiluratsil pentoksil (anti-inflammatory and immuno respect to the stimulating effect) In severe cases – immunosuppressants Vitamins, anabolic hormones, salts of Ca, Mg, Co, anemia - iron supplementation Enzymes, hydrochloric acid with pepsin With diarrhea - reasek, codeine, etc. To stimulate the intestinal absorption ephedrine Inderal, aminophylline Chronic colitis • Chronic inflammatory and dystrophic disease of the colon, leading to mucosal atrophy and dysfunction of the bowel. • Etiology and pathogenesis Main aetiological factors: infection, parasitic infestations, toxic effects, the abuse of certain drugs, radiation exposure, mechanical stress, genetic factors, etc. Leading pathogenic mechanisms intestinal dysbiosis, allergies (microbial, food allergies, allergic interstitial) congenital and acquired enzymopathy. • Classification of chronic colitis by AA Askarov and WA Askarov (1969) • I. On the etiology and pathogenesis: • 1. Infectious colitis: - Specific - nonspecific • 2. postinfectious colitis • 3. Parasitic colitis: protozoan helminthic • 4. colitis nutritional • • • • • 5. Toxic colitis: endogenous exogenous 6. Colitis and allergic toxic allergic: medical food 7. Neurogenic colitis – dyskinetic 8. colitis mechanical 9. Colitis on the basis of developmental abnormalities and the location of the colon. • 10. colitis secondary • 11. Colitis of unknown etiology • II. By the nature of anatomical changes and the • • localization process: 1. By the nature of anatomical changes: catarrhal, erosive, atrophic, mixed. 2.Po preferential localization process: a) pancolitis b) segmental colitis: right, transversitis, left-sided c) enterocolitis III. By the nature of functional disorders of intestinal spasms, atonic, and combinations thereof. IY. On the severity of the disease: Mild form Moderate - Severe severe form • Y. By stage of the disease: • • • 1. phase exacerbation 2. phase damping 3. remission YI. By type of course: a chronic, latent, recurrent, rapidly progressing, and sharp, lightning-like in the cases of ulcerative colitis. YII. The presence of complications: Uncomplicated forms. Complications: a) colitis with local (from the intestine) complications, and b) colitis with the overall system complications YIII. Outcome: complete recovery, clinical improvement, significant improvement, deterioration. Chronic colitis CLINIC Local symptoms Common symptoms Local symptoms 1. Diarrhea and constipation 2. Diarrhea are frequent in distal colitis 3. "Diarrhea - Alarm“ 4. Pain in lower abdomen on the left more 5. Flatulence and rumbling in the stomach 6. Intestinal colic 7. In a lot of mucus stool, starch 8. The cecum is stretched, painful 9. Often tenesmus 10.Coprogram: leukocytes, red blood cells, 11.muscle cells of the epithelium, there is no food residue 12.Sigmoid colon spasm, painful Common symptoms 1. Irritability 2. Headaches 3. Poor sleep 4. Language with the imprints of the teeth, swollen 1. 2. 3. 4. 5. Diagnosis of chronic colitis Sigmoidoscopy (with biopsy) Colonoscopy Scatological survey Biochemical study of fecal (enterokinase, alkaline phosphatase, soluble protein) X-ray investigation (a pariah by passage colon irrigoscopy) Coprogram in fermentation dysbacteriosis (colitis) • Physical properties: consistency pappy, frothy, with mucus • Chemical properties: pH 5-5.5 (the • reaction is strongly acidic), an inflammatory reaction to the protein and white blood cells - positive reaction to the bilirubin positive or negative reaction to stercobilin - positive. Microscopy: digestible fiber, starch intracellular and extracellular, pathological iodophilic flora. Treatment of chronic colitis 1. Diet - Table № 4 2. Therapeutic enema 3. Normalizing the intestinal motility of funds (salt laxative not shown) 4. Physiotherapy, exercise therapy 5. Effects on CNS