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Chronic enteritis

Table of contents
Chronic enteritis
Diagnosis
Treatment

Chronic enteritis — a polyetiological disease which cornerstone the dystrophic process in a small bowel leading to decrease in barrier and digestive and transport function of a small bowel, settling of upper parts its large number of microorganisms, to secondary metabolic and immune disturbances, and also disorders of functions of a nervous system is.

Epidemiology
Data on prevalence of chronic enteritis are absent. Nevertheless the disease is eurysynusic. Among the patients hospitalized in specialized department of pathology of a small bowel of central research institute of gastroenterology, this disease reaches 91,6%.

Etiology and pathogeny
Various infections, helminthic and parasitic invasions, disturbances of food, disturbance of functions, digestive glands at diseases of the digestive system, various allergens, exogenous and endogenous toxins, the ionizing radiation, mechanical and thermal factors, an alcohol abuse cause acute diseases of intestines from the outcome in chronic or gradual forming of a chronic disease without acute stage.
Transformation of an acute disease in a chronic form is more often observed at the wrong or late begun treatment, defective food, at the exhausted persons, convalescents, at overfatigue, in the period of heavy nervous shocks etc.

The pathogeny of a disease is closely connected with disturbance of barrier function of a wall of intestines. It is provided by the cells producing slime and a lysozyme, immunoglobulins, an apical membrane with a glycocalyx. Damage of a barrier layer leads to decrease of the activity of the membrane enzymes providing the final stages of hydrolysis of feedstuffs, to dysfunction of transport channels via which hydrolysates, ions and water are soaked up. Pathogenic agents influence also other digestive organs, TsNS and a vegetative nervous system.

In a pathogeny of chronic enterit not only pathological processes in the intestines, but also functional disturbances in other digestive organs and a liver, disturbance of enzymatic activity of digestive glands, an intestinal dysbiosis, frustration of a metabolism, immunity change which for the second time can support intestinal dysfunctions have essential value, creating "vicious circle" with continuous change of relationships of cause and effect.

Classification
Classification of chronic enteritis is provided in the table. It is further development of classifications of I. S. Savoshchenko (1963) and A. V. Frolkis (1971).

Classification of chronic enteritis

Etiology

Characteristic

anatomo-morphological

functional

clinical

Infections (dysentery, salmonellosis, iyersinioz, viral infections, etc.)

Superficial enteritis with dystrophy of enterocytes

Disturbances of membrane digestion (disakharidazny insufficiency)

I. Severity of a syndrome of the broken absorption

Helminthic invasions, lyambliya

Chronic enteritis without atrophy

Disturbances of absorption of electrolytes, iron, water, vitamins, proteins, fats, carbohydrates

2. Current: seldom, often recurrent

Alimentary factors (unbalanced food, etc.)

Chronic enteritis with a partial atrophy vorsin

Disturbances of motor function (hyper - and hypokinetic)

3. Illness phase: aggravation, remission

Physical and chemical damages (antibiotics, alcohol, the ionizing radiation)

Jejunitis
Ileitis
Enteritis

 

4. Complications: solar plexitis, nonspecific mesadenitis

Stomach diseases, liver, bilious ways, pancreas

 

 

 

 

Approximate formulation of the diagnosis: 1. Chronic enteritis of an infectious etiology. With dystrophy of a superficial epithelium, a syndrome of the broken absorption of the I severity with frustration of a water and electrolytic exchange expressed by proliferation of microbic flora in a jejunum, an aggravation phase. 2. Chronic secondary enteritis (a stomach resection concerning a peptic ulcer in 2004) with a subtotal mucosal atrophy of a jejunum, a syndrome of the broken absorption and severity with frustration of a protein and vitamin metabolism, proteyny dysbacteriosis, often recurrent current, a phase of unstable remission.


 
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