Enterocholitis:

etilog:
1-infections:
salmonella, staphy, strepto, parasites, dysentery.
2- toxicity: intake of drugs or chemical.3radiation, 4- mechanical; long period of
constipation, 5- diet: abnormal meal without
enough protein, 6- congenital changes: deficiency
of enzyme, 7- other disease from Gi as
pancreatitis,
cholecystitis.
Pathogenes:
inflammation: exudative process in the bowel,
ifiltration of macrophages + lymphocytes. In the
second period changes in motor function (spastic
activity or paralysis). Inflama leads to
dysbacteriosis prevail E-coli, produce enzymes
that affect bowel, overgrowth of flora
hypersensitivity of bowels allergic component.
Maldigestion that cause dyspepsia. involvement
of whole organ, - after some years of disease
changes of morphological structure of bowel :
atrophy, cilia disappears malabsorption.
Classific:
Iprimary
localization
of
inflammation: 1- colitis: a- pan-colitis, bsegmental divided to distal & proximal. 2enteritis 3- generalized enterocolitis. IImorphological characteris of disease : 1superficial variant with early stage of the disease,
2- atrophic variant long period
malabsorption. 3- erosion, 4- ulcer (erosion
become more deeper) III- severity: 1- mild: if
only localized syndrom from bowel, dyspepsia, 2
moderatepain, abdominal canges but more severe
dyspepsia, then generalized syndromes start like
toxicity, loss of weight, malabs but not severe.3severe: generalize4d toxicity, loss of weight,
cant survive more than 5 years. IV- duration &
phase: 1- stage of aggrvation 2- stage of
remission 3- permanent aggrevation V- the main
syndromes: 1- diarrhea, 2- constipation. Clinics:
1- pain syndrome: associated with changes in
motor function: paralysis of bowel &
hypermotility. Pain associated with lymph node
enlargement permanent, severe. 2- dyspepsia
syndrome: a- fermentation variant: abnormal
polysacc digestion due to enzyme activity
chanhes, spastic activity, meteorism, gas without
bad smell, stool is bright yellow color+ big
amount. B- rotter: inability to digest protein,
discomfort of bowel is less aggressive. #asthenic synd: typical: subjective complains,
cancerophobia, changes their behavior with
relatives, anxiety, very emotional, cant
concentrate. 4- malabsorption syndrom: anemia+
signs of dystrophy: abnormal protein absorption
+ lipid soluble, dry skin, changes in nail, loss of
hair & weight. Anemia: early synd of malabs
even with good weight: fe deficiency or B 12.
Osteopathy: pain in bones with fractures,
irritation of peripheral neurves neurological
syndrom. If enteritis is dominant : maldigestion
synd: diarrhea only, typical spastic pain,
fermentation. If colitisL if proximal it is like
enteritis & diarrhea prevalent, right flank pain ,

malabs not typical. Investiga: objective

examination: tenderness on palpation, spastic
bowel on palpation like tough cylinder,
hyperinflated bowel, hyperstasis or paralysis like
splashing sound, additional mass may be palpated
like diverticulum. Laborat: blood; anemia, sign of
inflam: Increase ESR+ leukocytosis, Biochem:
low albumin severity opf diseae malabs.
Examinat of stool: (coprologic changes) mucous,
blood. Bowel juice, immunologival invest, X-ray,
eregoscopy, endoscopy. Treatment: etiological ttt:
if low tolerance to polysacc diet. Avoid drug
intake. Treat bacteriosis : bifidobacterium. If
infection antibacterial , ATB: erythromycin,
lincomycin, ttt not more than 10 days if continue
dysbacteriosis.for changes of motor functin give
myolitics, anticholinergic. Substitutional therapy:
5% gluc, complex of vit. Allergic: antihistamin
against mast cells , physiotherapy: hot water in
abdomen. Complication: GI bleeding, tumor after
many years, malabsorption, psychosis, disease of
other Gi tract (majority gastritis).