CHRONIC ENTERITIS

Chronic enteritis - a chronic recurrent inflammatory-dystrophic diseases of the small intestine,

accompanied by violation of its basic functions (digestion, absorption) and therefore a violation
of all types of metabolism.

In the structure of pathology of the digestive chronic enteritis as a major disease registered in 4-
5% of cases.

Etiology

Chronic enteritis - polietiologicheskoe disease, which can be both primary and secondary.

The defeat of the small intestine often develops after acute bacterial (dysentery, salmonellosis,
yersiniosis, campylobacteriosis, etc.) and viral (rotavirus, enterovirus, herpes viral and other)
infections, as well as against parasitic (giardiasis, cryptosporidiosis, trihotsefalez,
hymenolepiasis etc. .) or fungal disease.

Great importance attached to nutritional factors: eating "dry rations", overeating, excess in the
diet of carbohydrates and fats with a deficiency of protein, vitamins and trace elements, early
transfer to artificial feeding, etc.

In recent years, frequently isolated aetiological factors such as the impact of toxins, salts of
heavy metals (lead, phosphorus, cadmium, etc.), drugs (salicylates, glucocorticoids, NSAIDs,
immuno-depressants, cytostatic agents, certain antibiotics, especially with prolonged use) ,
ionizing radiation (eg X-ray). "

Emergence of diseases of the small intestine contribute to innate and acquired enzimopatii,
malformations of intestinal immunity disorders (both local and general), food allergies, surgical
interventions on the intestines and other diseases of the digestive system (primarily the
duodenum, pancreas, yellow-chevyvodyaschih ways ), etc.

In the development of chronic enteritis in a child is usually difficult to isolate one causative
factor. Most often reveal a combination of factors as exogenous or endogenous nature.

Pathogenesis

Under the influence of any of the above-mentioned factors or combination thereof in the mucosa
of the small intestine develops an inflammatory process, which becomes chronic in connection
with immune deficiency and compensatory-adaptive reactions. Violated the enzymatic activity of
intestinal glands, is accelerating or slowing the passage chyme, the conditions for microbial
proliferation flora, disturbed digestion and absorption of essential nutrients.

Clinical picture
The clinical picture of chronic enteritis polymorphous and depend on prescription and phase of
the disease, the degree of change in the functional state of the small intestine, concomitant
pathology. There are two main clinical syndrome - local and general.

Local intestinal (enteric) syndrome is caused by a violation of the wall (membrane) and the
digestive cavity. Watch flatulence, rumbling, abdominal pain, diarrhea. Excrements usually
abundant, with pieces of undigested food and mucus. Perhaps alternating diarrhea and
constipation. Palpation abdominal pain determined mainly parumbilical field, positive symptoms
Obraztsova and Porges. In severe cases, can the phenomenon of "psevdoastsita." Intestinal
symptoms tend to occur in the use of milk, raw vegetables and fruits, confectionery.

* Total intestinal (enteric) syndrome associated with water-electrolyte imbalance, malabsorption

of macro-and micronutrients and involvement in the pathological process of other bodies
(syndrome malabsorb-tion). Characteristic fatigue, irritability, headache, weakness, weight loss
of different severity. Note the dryness of the skin, nail changes, glossitis, gingivitis, will call, hair
loss, breach of twilight vision, increased fragility of vessels, bleeding. The above symptoms are
due poligipovitaminozom and trophic disorders. Young children (up to 3 years) often reveal
anemia and metabolic disorders, manifested osteoporosis and fragility of bones, bouts of
seizures. Expression of the general and local enteral syndromes determines severity of disease.

Diagnosis and differential diagnosis

Diagnosis is based on data from medical history, clinical manifestations, results of laboratory
and instrumental methods of examination. They carry out differentiated carbohydrate load with
mono-and disaccharides, the sample with d-xylose. Informative and endoscopy with targeted
biopsy and subsequent histological study of biopsy. In koprogram-me identify creators,
steatorrhea, amiloreyu.

The differential diagnosis most often carried out with developing hereditary and acquired
diseases that occur with malabsorption syndrome <- acute enteritis, intestinal form mukovis-
tsidoza, a form of gastrointestinal food allergy, celiac disease, Dis-haridaznoy failure, etc.

Treatment

See below in the section "Chronic enterocolitis.