Treatment of enterocolitis

Enterocolitis — is an inflammatory process that simultaneously affects the small and large intestine and disrupts the normal functioning of the digestive system. The disease may begin acutely — with abdominal pain, stool disorder, fever — or develop gradually, with less pronounced manifestations. Without proper treatment, it may progress to a chronic form with periods of exacerbation.

Most often, enterocolitis in adults occurs after intestinal infections, food poisoning, or against the background of other diseases of the digestive system. It is important not to ignore the first symptoms, because a timely consultation with a doctor makes it possible to determine the cause of the disorders and begin treatment in order to avoid complications and chronicity of the process. Sign up for a consultation with a gastroenterologist at the medical center «Oxford Medical» at a time convenient for you — use the online appointment form or contact the indicated phone number.

Intestinal enterocolitis is classified by the course and cause of development.

According to the course of the disease:

• Acute enterocolitis — develops suddenly, most often against the background of infection, food poisoning, or toxic influence. It is characterized by pronounced symptoms: abdominal pain, bloating, frequent bowel movements, nausea, fever. With timely treatment, it usually has a favorable prognosis.
• Necrotizing — a severe form of the acute inflammatory process, in which the lesion spreads deeper than the mucous membrane and may lead to the death of areas of the intestinal wall. It is more common in newborns, especially premature infants, and is associated with impaired blood supply and infectious factors. In adults, it occurs rarely.
• Chronic — is formed gradually or occurs after a previous acute form under the condition of incomplete restoration of the mucous membrane. The course is wave-like: periods of exacerbation alternate with remission. It may be accompanied by unstable stool, periodic abdominal pain, and decreased appetite.

According to the cause of development:

• infectious — caused by bacteria, viruses, or parasites;
• toxic — occurs under the influence of medications, poisonous substances, or poor-quality food;
• alimentary — is associated with systematic eating disorders and prolonged irritation of the mucous membrane;
• secondary — develops against the background of other diseases of the digestive system, when inflammation is a consequence of the underlying pathology.

Understanding the form and cause of enterocolitis makes it possible to choose the most effective treatment regimen.

The development of enterocolitis is associated with the influence of factors that damage the mucous membrane of the small and large intestine and trigger the inflammatory process. At the same time, inflammation may arise either suddenly or gradually — depending on the strength and duration of the action of the provoking factor.

Main causes of enterocolitis:

• intestinal infections — bacteria, viruses, or parasites that enter the body with food or water;
• food poisoning and toxic effects of poor-quality products;
• prolonged or uncontrolled use of antibiotics;
• disturbance of the intestinal microflora;
• enzymatic insufficiency and concomitant diseases of the digestive system;
• chronic eating disorders — excessive consumption of fatty, spicy food.

In some cases, enterocolitis develops as a complication of other pathologies of the gastrointestinal tract or after previous inflammatory processes in the intestine. It is important to establish the exact cause, because the further treatment strategy and prevention of repeated exacerbations directly depend on it.

Timely diagnosis of enterocolitis makes it possible to establish the cause of the inflammatory process, assess its extent, and select the optimal treatment. The scope of the examination is determined individually depending on the symptoms and duration of the disease.

Main methods:

• blood tests — help detect signs of inflammation, dehydration, anemia, and assess the general condition of the body;
• coprological examination and bacteriological stool culture — make it possible to identify the infectious pathogen or assess disturbances of the microflora;
• ultrasound examination of the abdominal organs — is used to exclude concomitant pathologies;
• colonoscopy — is performed in prolonged or chronic course to assess the condition of the mucous membrane of the large intestine;
• fibrogastroduodenoscopy (FGDS) — may be prescribed in the presence of symptoms of lesions of the upper parts of the digestive tract.

A comprehensive examination helps distinguish enterocolitis from other diseases of the digestive system and determine the exact cause of the inflammation.

The treatment strategy depends on the cause of the disease, the severity of the course, and the general condition of the patient. The main goal is to eliminate the factor that caused the inflammation, reduce the symptoms, and restore the normal functioning of the intestine.

In acute course, the priority is stabilization of the condition. The patient is recommended:

• restoration of water-electrolyte balance (rehydration);
• a gentle dietary regimen;
• drugs to reduce spasms and pain;
• according to indications — antibacterial therapy (in confirmed bacterial infection).

If the cause is food poisoning or a viral infection, the treatment is predominantly supportive in nature with monitoring of the patient's condition.

In chronic course, treatment is aimed not only at eliminating symptoms, but also at correcting the causes that maintain the inflammatory process. It may include:

• normalization of the intestinal microflora;
• enzyme preparations in digestive disorders;
• correction of concomitant diseases of the gastrointestinal tract;
• an individually selected diet;
• control of the dietary regimen and lifestyle.

During the period of subsiding exacerbation, on the doctor's recommendation, physiotherapy may be used, which is aimed at improving blood supply to tissues, reducing residual inflammation, and normalizing intestinal motility. Such methods are prescribed individually and are not used in the active phase of the disease.

The main task is to reduce the frequency of exacerbations, stabilize the functioning of the intestine, and prevent structural changes in the mucous membrane.

Inpatient treatment may be necessary in the following cases:

• pronounced dehydration;
• frequent bowel movements with a risk of electrolyte disturbances;
• high temperature and intoxication;
• suspicion of complications;
• lack of effect from outpatient treatment.

Hospitalization makes it possible to carry out infusion therapy, constant monitoring of the condition, and quickly adjust the treatment.

In most cases, with timely treatment, enterocolitis has a favorable course. However, in the absence of medical care or in a severe course, the development of complications is possible.

The most common of them:

• dehydration and disturbance of electrolyte balance — arise with frequent bowel movements and vomiting, may lead to weakness, dizziness, and heart rhythm disturbances;
• intoxication of the body — in the infectious form without adequate therapy;
• transition into a chronic form — the inflammatory process persists for a long time and is accompanied by periodic exacerbations;
• disturbance of nutrient absorption — with prolonged damage to the small intestine, a decrease in body weight, deficiency of vitamins, and microelements are possible;
• exacerbation of concomitant diseases of the digestive system — in particular gastritis, duodenitis, or pancreatitis, which may intensify digestive disorders and pain syndrome.

To reduce the risk of complications, it is important not to self-medicate and to consult a doctor at the first symptoms of the disease.

After the acute period, it is important not only to relieve the symptoms, but also to help the intestinal mucous membrane recover. Rehabilitation is aimed at normalizing digestion, restoring the microflora, and preventing repeated exacerbations.

The diet in enterocolitis is selected individually depending on the form of the disease and the stage of recovery. In the first days after the acute process, the most sparing nutrition is recommended:

• warm, well thermally processed dishes without raw vegetables and products with coarse fiber;
• boiled or steamed lean meat and fish;
• porridges on water;
• mucous soups;
• kissels, baked apples.

Fatty, fried, spicy dishes, smoked foods, carbonated drinks, and alcohol are excluded. Meals should be fractional — 5–6 times a day in small portions.

Nutrition in enterocolitis during the recovery period is gradually expanded, adding new products step by step. It is important to assess the reaction of the body and avoid products that provoke bloating or pain.

In addition to correction of the diet, rehabilitation may include:

• restoration of water balance;
• normalization of sleep and rest regimen;
• moderate physical activity after stabilization of the condition;
• on the recommendation of a doctor — maintenance therapy for restoring the microflora.

A systematic approach to recovery helps reduce the risk of the disease transitioning into a chronic form and support stable functioning of the digestive system.

The cost of treatment depends on the cause of the disease, the form of the course and, accordingly, the scope of the necessary diagnostics and the chosen therapy tactics. In each case, the examination and treatment plan is selected individually after a doctor's consultation.

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