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Chronic enteritis

 
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Last reviewed: 23.04.2024
 
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Chronic enteritis is a chronic disease of the small intestine, characterized by a violation of its functions, primarily digestion and absorption, resulting in intestinal disorders and changes in all types of metabolism. The term "chronic enteritis" is mainly used in the defeat of the small intestine (the decision of the Presidium of the "Association of Societies of Gastroenterologists" - the former All-Union Scientific Society of Gastroenterologists).

Chronic enteritis is not an inflammatory disease in the classical sense of the term. Along with the elements of inflammation in the small intestine, pronounced dystrophic changes develop, mucosal regeneration is disrupted, and its atrophy develops, which leads to the development of malignant and malabsorption syndromes. Endocrine, immunological and motor functions of the small intestine also suffer. With the primary lesion of the proximal part of the small intestine, it is customary to talk about the ulcer, with the primary lesion of the distal ileum - about ileitis.

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Causes of the chronic enteritis

Causes of chronic enteritis

Chronic enteritis is a polyethological disease. Often, it can be the outcome of acute enteritis, but it can also develop independently. Infectious agents play an important role in the onset of the disease, although some researchers believe that after acute intestinal infections, functional disorders are most often observed, which is difficult to accept.

Causes of chronic enteritis 

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Symptoms of the chronic enteritis

Symptoms of chronic enteritis

Symptoms of chronic enteritis are composed of two symptom complexes, which should be considered as a manifestation of functional disorders associated with changes in the structure of the mucosa of the small intestine. One of them - local enteral syndrome - is caused by disruption of the processes of parietal (membrane) and cavitary digestion (maldigestion); another - a common enteral syndrome - a violation of absorption of food ingredients (malabsorption), resulting in disorders of all kinds of metabolism and changes the general state of the body.

Symptoms of chronic enteritis

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Types of chronic enteritis

Classification of chronic enteritis (AV Frolkis, 1996, with changes)

  1. Etiology.
    1. Infectious.
    2. Parasitic.
    3. Toxic.
    4. Medicamentous.
    5. Almentary.
    6. Radiation.
    7. After operations on the small intestine.
    8. Congenital abnormalities of the intestine and enzymes.
    9. Inadequate ileocecal valve and large duodenal nipple.
    10. Secondary (for other diseases).

Types of chronic enteritis

Diagnostics of the chronic enteritis

Diagnosis of chronic enteritis

  • The general analysis of a blood: iron deficiency hypochromic enough is quite often revealed, In 12- deficient hyperchromic or polyfactorial anemia.
  • General urine analysis: without significant changes. With the development of hypothalamic-pituitary insufficiency and the syndrome of diabetes insipidus, the density of urine decreases. With a severe course of chronic enteritis, a small proteinuria, a microhematuria, is possible; with putrefactive dyspepsia of the intestine - increased allocation of the indicator.
  • Biochemical analysis of blood: a decrease in the blood levels of total protein, albumin, calcium, sodium, iron; often - hypoglycemia; when developing reactive hepatitis, an increase in bilirubin, alanine aminotransferase, cholesterol.

Diagnosis of chronic enteritis

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Treatment of the chronic enteritis

Treatment of chronic enteritis

When the disease worsens, inpatient treatment is recommended, bed rest.

Treatment should be comprehensive, including agents that affect the etiological and pathogenetic factors, as well as local and general manifestations of the disease. According to the research, a positive result of complex treatment, including a diet, enzyme and weak choleretic preparations, antibacterial, enveloping, astringent, absorbent, neutralizing organic acids, along with preparations normalizing the passage of contents through the intestines and reducing inflammatory processes in it, % of patients with chronic enteritis. The patients stopped diarrhea, abdominal pain, swelling, rumbling, which in 52% of cases was combined with a decrease in the degree of colonization of the upper parts of the small intestine by microorganisms.

Treatment of chronic enteritis

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