Colitis symptoms in children. Colitis in a child: causes, treatment and prevention

Gastroenterologists around the world are concerned about the sharp increase in the number of inflammatory bowel diseases among the child population. Colitis in children has a different origin, a variety of clinical signs. A doctor is able to recognize colitis in a child, distinguish it from other diseases of the gastrointestinal tract after a series of tests and a comprehensive examination. Pathology treatment methods are developed according to an individual plan.

Signs of colitis in a child

Colitis in children is a violation of the functions of the mucous membrane of the large intestine due to inflammation. The disease is detected in babies, starting from infancy. Intestinal colitis begins with an acute inflammatory reaction.

Signs of acute colitis in children:

• fever, weakness, dehydration;
• nausea, vomiting;
• frequent episodes of diarrhea - up to 10-15 times a day;
• watery greenish feces foaming;
• painful stomach;
• urge to go to the toilet without emptying.

In the absence of treatment of an acute process or with improper treatment, the disease passes into a chronic stage. Chronic colitis occurs with alternating phases of exacerbation and temporary remission.

Symptoms of chronic colitis in a child are:

• pain in the center of the abdomen, right and left. Increases after eating, with the urge to empty, with movement;
• change of attacks of diarrhea and constipation;
• diarrhea occurs up to 7 times a day. Detect blood, mucus, undigested food particles in liquid feces;
• constipation in children is accompanied by the release of dense lumps of feces, leading to the formation of an anal fissure;
• distension, bloating, rumbling in the abdomen;
• increased gas formation;
• fast fatigue, light sleep.

Colitis is a disease that affects children of all ages, from infants to teenagers. A feature of the disease in infants is the transition of inflammation from the mucous membrane of the colon to the small intestine (enterocolitis) and even to the stomach (gastroenterocolitis). In adolescents, isolated inflammation of the large and small intestines occurs.

Types of colitis in children

In childhood, various forms of the disease develop. According to the location of the affected segment, types of intestinal colitis in children are distinguished:

• right-sided localization, when the caecum is inflamed. The stomach hurts in the right iliac zone;
• left-sided inflammation with involvement in the process of the sigmoid and rectum. One of the manifestations is aching pain in the left iliac lobe of the abdomen;
• transversitis is characterized by pain in the navel, which in children is a symptom of a lesion of the transverse part of the colon;
• if the entire thick section is sick, total colitis is stated.

During endoscopic examination of the intestine in a child during an exacerbation, the stages of the inflammatory reaction are revealed:

• At the beginning of an exacerbation of colitis, there is inflammation. A swollen, reddened inner lumen of the intestine separates a transparent mucous exudate;
• then superficial minor lesions (erosion) are formed on the mucosa, affecting closely spaced capillaries. This is an erosive type of inflammation;
• deepening and expanding, erosion turns into ulcers. Ulcerative lesions of the intestine are distinguished into a separate type of disease - ulcerative colitis;
• aggravation of the disease leads to fibrinous colitis. Dead, necrotic foci are found on the mucosa, medium and large vessels are destroyed.

The nature of the disease is both smooth and undulating, with sharp changes from remission to exacerbation. The severity ranges from mild to moderate to severe.

Why does a child have colitis

The causes of colitis in children have a fairly impressive list. The origins of the disease are divided according to the type of infectious agent, the age of the child, living conditions and nutrition, and innate qualities.

Infectious, invasive lesion

An acute form of the disease gets sick from infection:

• intestinal coli infection in children (Escherichia coli);
• salmonella;
• dysentery;
• shigella;
• clostridia with the abuse of taking antibacterial drugs;
• rotavirus infection, especially severe in newborns;
• worms (roundworms, pinworms), lamblia.

A baby can become infected from an asymptomatic adult carrying the infection. So, rotavirus is excreted in breast milk, saliva. Rotavirus was found in feces in 20% of children's institutions workers.

Non-communicable causes of illness

Other culprits of inflammation in the large intestine in children are:

• hypersensitivity, which provokes allergic colitis in children. Often, babies fed artificially suffer from allergies. Allergic colitis in infants is caused by casein. In addition to specific intestinal symptoms, it manifests itself as a rash on the skin, itching, weeping crusts in the skin folds (on the elbows, under the knees);
• long-term treatment with anti-inflammatory, antibacterial;
• systematic violations of the diet associated with skipping meals, the use of semi-finished products, fast food, snacks, highly carbonated drinks;
• exposure to radiation, toxic substances;
• congenital and acquired metabolic disorders;
• neuropsychic stress;
• developmental pathology of the digestive system.

The causes of bowel disease can overlap each other, complicating the course of the disease. Let's say a bottle-fed baby with a tendency to allergies has caught rotavirus. Teenagers, in addition to passion for fast food, begin to try alcohol and tobacco products.

How to distinguish colitis from other diseases

The course of the inflammatory process of the large intestine has an outward resemblance to other diseases. When diagnosing, it is necessary to exclude such pathologies as:

• wheat protein intolerance, cystic fibrosis;
• Crohn's disease;
• changes in the motor function of the intestine;
• enteritis, gastritis;
• diverticulosis.

Diagnosis of the disease is based on the collection of anamnesis, blood, feces, urine tests. Coprological examination of feces shows the presence of blood, mucus. An analysis of feces for dysbacteriosis will reveal the pathogen, the degree of imbalance of the intestinal microflora. Conduct sigmoidoscopy, colonoscopy, irrigoscopy to clarify the nature and localization of violations. Biological material is taken for microscopy.

How to treat colitis in children

The main principles of treatment of colitis in children suggest:

• elimination of the infectious agent;
• replenishment of lost fluid during diarrhea;
• stool normalization;
• restoration of intestinal motility;
• exacerbation warning.

The fight against the causative agent of the disease is carried out with antibiotics, sulfonamides, nitrofuran preparations. The doctor prescribes potent medicines, individually determining the dose, frequency of administration and course of treatment.

To restore the water-electrolyte balance, Regidron, Gastrolit, Oralit are used. The powder of the product is diluted in a liter of warm boiled water and allowed to drink throughout the day. You can give your baby water, weak chamomile tea, compote. A sachet of Smecta dissolved in 100 ml of boiled water will help stop diarrhea.

Gut dysbiosis can be treated with probiotics and prebiotics. Probiotics are preparations with live dried bifidus and lactobacilli. Prebiotics - a breeding ground for beneficial bacteria - inulin, fiber, starches. Combinations of prebiotics and probiotics are called symbiotics.

Nutrition for colitis in a child

The diet is prescribed depending on the age of the child, type of nutrition, stage of the disease, severity of symptoms. Babies need to continue breastfeeding as long as possible.

Artificialists should choose a mixture with complete hydrolysis of milk protein from the series:

• Nutrilon Pepti Gastro, Amino Acids;
• Similac HA 1;
• Nestle Nan 1 Hypoallergenic;
• Hipp Combiotik.

Features of the nutrition of older children are the preparation of boiled, pureed soups, cereals, vegetable and fruit purees. They include in the menu mucous decoctions based on rice, semolina, oatmeal, fruit jelly. Dishes are served pleasantly warm, catering in small portions, but often.

Nutrition for nonspecific ulcerative colitis should contain a sufficient amount of protein foods. The source of animal protein will be steam meatballs from lean beef, rabbit, chicken, low-fat varieties of white fish.

The list of prohibited foods includes fatty, spicy, pickled, smoked products. Do not give your child sweets, chocolate, fresh pastries, fatty cream cakes and cakes. Soda, strong coffee and tea, kvass, milk, cocoa are excluded from drinks.

Prevention of childhood colitis

It is much easier to prevent the development of the disease than to deal with its consequences. Prevention of colitis in children consists of a set of measures:

• prolonged breastfeeding;
• the introduction of complementary foods in agreement with the pediatrician;
• diet balanced in terms of essential nutrients;
• maintaining a diet;
• age-appropriate physical activity;
• wet cleaning in the child's room, airing;
• hand and body hygiene;
• drinking boiled water, thoroughly washing fruits and vegetables
• treatment of the initial stages of gastrointestinal diseases;
• regular medical examinations with the implementation of medical recommendations.

Parents, using prevention methods, protect the child from health problems in the long term. A healthy baby develops rapidly both intellectually and physically. The student successfully masters the program, does not miss classes due to illness, can play any sport.

Colitis in a child occurs as with the transition to the chronic stage. The sick kid vilifies, eats badly, is naughty. The doctor can make an accurate diagnosis based on the results of the examination. Treatment is based on antibiotic therapy, normalization of bowel function. Prevention of colitis consists of a healthy diet, following the advice of a doctor for caring for a child.

The information on our website is provided by qualified doctors and is for informational purposes only. Do not self-medicate! Be sure to contact a specialist!

Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and conducts treatment. Expert of the group on the study of inflammatory diseases. Author of more than 300 scientific papers.

A fairly common intestinal disease in children is. Such a pathology is characterized by the development of an inflammatory dystrophic process in the mucous tissues of the large intestine.

Due to the anatomical features of the body of babies up to one year of age, in such patients, colitis causes simultaneous inflammation of the large and small intestines, which in medical language sounds like. In older children, inflammation is localized directly in the mucous membranes of the large intestine.

Definition

So, colitis in children is called a polyetiological inflammatory pathology of the large intestine, which is accompanied by dystrophic processes in the mucous tissues. It is characterized by dysfunctional disorders of the colonic activity and proceeds with severe pain.

According to statistics, about 10% of chronic colitis begins to develop in childhood. Diagnosis of the disease is complex and involves bacteriological, coprological examination of feces, etc.

Causes

Pediatric gastroenterologists identify many causes that can lead to colitis. Acute forms develop against the background of:

1. Intestinal infectious lesions like or, salmonellosis and, rotavirus infection or food poisoning. With a similar etiology, childhood colitis is usually combined with gastroenteritis, or gastritis.
2. It happens that acute colitis occurs against the background of individual hypersensitivity or intolerance to certain food components, non-compliance with the recommended diet or radiation exposure.

Chronic colitis develops against the background of an untreated acute type of the disease, as well as with pathologies like:

In addition, inflammatory colonic lesions occur against the background of childhood vegetovascular dystonia, psychogenic disorders, genetic predisposition, congenital abnormalities of intestinal development, and physical inactivity.

Often, cases of teenage colitis are caused by the presence of bad habits in the younger generation. Lesions of the large intestine of a secondary nature are closely related to endocrine pathologies such as myxedema and hypothyroidism, as well as nervous system pathologies (and myasthenia gravis).

Classification

Children's colitis are classified into several groups. In accordance with the number of affected segments and the localization of the inflammatory process, colitis is as follows:

• Sigmoiditis when the sigmoid colon is affected;
• Typhlitis, when the blind intestine becomes inflamed in isolation;
• Proctitis is characterized by damage to the rectal region;
• Typhlocolitis is a cumulative inflammation of the caecum and ascending colon;
• Angulit is an inflammatory lesion of the descending and transverse colon;
• Proctosigmoiditis - the lesion covers the rectum and sigmoid colon;
• Transversitis is an inflammation of the transverse colon.

According to clinical forms, colitis is divided into chronic and acute, and according to structural changes, inflammation is divided into, catarrhal or. Depending on the severity of intestinal inflammation are severe, mild or moderately severe.

Symptoms of colitis in a child

Acute inflammation of the rectum, provoked by infectious factors, occurs with toxic symptoms, which include:

• Hyperthermia and weakness;
• Anorexia and vomiting;
• The intestines are disturbed by spasms, which cause severe pain and false bowel movements;
• The chair can disturb the child up to 15 times a day;
• Fecal masses with colitis are frothy and watery, greenish in color with impurities of bloody streaks and mucous masses.
• Sometimes in the process of defecation, the child has a prolapse of the intestine.
• Typically, children with this diagnosis are distinguished by the presence of signs of dehydration, which include dry tissues, oliguria and lethargy of the skin, and external features become pointed.

As for, they are distinguished by an undulating course with a periodic change of remission periods and exacerbations. Painful signs and stool disorders are the main signs of colonic inflammatory lesions.

Pain symptoms can manifest themselves in the umbilical or iliac region, it has a aching character, and manifests itself mainly after eating. In addition, painful manifestations tend to increase with motor activity or before bowel movements.

Problems with the stool in chronic colitis can manifest as diarrhea, constipation, or their periodic alternation. At the same time, rumbling is observed in the intestines, bloating is disturbing, gas formation increases.

Prolonged development of chronic intestinal inflammation provokes in young patients the development of anemia, excessive weakness, weight loss and insomnia, as well as hypovitaminosis or growth retardation.

Complications

Lack of proper treatment can provoke the development of internal bleeding that threatens the life of a small patient.

Also, one of the frequent complications is perforation of the intestinal walls, turning into peritonitis, or appendicitis.

Such complications are very dangerous, therefore, the appearance of the first signs of pathology requires a mandatory visit to a specialist in order to avoid undesirable, and in some cases, irreversible consequences.

Diagnostics

To confirm the diagnosis, a small patient is given a set of diagnostic measures with the appointment of such procedures as:

• Biochemistry of blood;
• Examination of feces;
• Endoscopic examination of the intestine;
• X-ray examination of intestinal tissues, etc.

Treatment of the disease in children

Therapy for colitis in pediatric patients should be complex, and not limited to antibiotic therapy and dietary intake.

The treatment consists in taking antibacterial drugs (Eithromycin or Enteroseptol), enzymatic (Mezim) and probiotic agents (Bifidumbacterin), painkillers (Novocain or Platifillin), which help relieve young patients from severe pain symptoms.

An excellent remedy for eliminating the symptoms of colitis is a group of drugs with enveloping and astringent action.

These include bismuth, infusions of St. John's wort or chamomile. Practice shows that the use of these funds can speed up the process of recovery of children. Since quite often colitis in a child is the result of an allergic reaction, the symptoms of the disease are significantly reduced when taking antihistamines such as Fenistil or Suprastin.

Important for the treatment process is the observance of a dietary diet. Children should not be given rich soups, fatty and fried foods. It is better to cook food for a couple, from meat varieties it is allowed to use lean veal or chicken meat, as well as low-fat fish products. You can drink juices and herbal teas.

Usually, in pediatrics, the treatment of colitis is limited to exclusively conservative methods, and only in very rare, advanced cases, surgical intervention is necessary. Therefore, a timely appeal to a gastroenterologist will help protect a small patient from surgical treatment and the consequences associated with it.

Forecast and prevention

If the inflammation in a child is chronic, then with strict adherence to dietary recommendations and drug prescriptions, stable remission can be achieved. With frequent cases of exacerbations, a serious violation of the psychosocial adaptation of children occurs, problems arise with physical development.

Preventive measures involve adherence to dietary principles in nutrition, timely treatment of emerging intestinal infections, or dysbacteriosis. Children with this diagnosis are treated by a pediatric gastroenterologist or a pediatrician.

Preventive vaccination is carried out upon reaching a stable remission period for a sufficiently long time.

If the disease still could not be avoided, then after the end of therapy, the child needs to prevent the recurrence of inflammation of the large intestine.

Content

Any illness of the child worries the parents. They want to relieve the baby of pain as soon as possible. Colitis in children is a common disease. Comprehensive information about the causes of its occurrence, symptoms, possible negative consequences, methods of treatment and prevention of relapse will help to provide immediate assistance to young patients.

Causes of colitis in children

In recent years, chronic diseases of the digestive system in children have increased significantly. About 20% of them are colitis - structural changes in the mucous membrane of the large intestine. It is accompanied by inflammatory processes and a characteristic clinical picture: pain in the abdomen, flatulence, impaired stool, etc. Colitis in infants (under 1 year of age) is called enterocolitis. In newborns, the disease often affects both the small and large intestines.

Types and forms of the disease are varied. Dysfunction of the large intestine of adults and children in clinical course and etiology is not much different. Childhood colitis is classified according to:

Symptoms

It is very important to consider the first symptoms of a dangerous disease. Spastic colitis in children manifests itself in the form of bloating, gas formation, and frequent rumbling of the intestines. These manifestations are accompanied by pain in the iliac region. The baby becomes weak, his temperature may rise, vomiting may open. There is a violation of the defecation process: frequent liquid foamy stools with mucus (blood). In connection with dehydration of the body, dryness of the skin and mucous membranes increases.

Acute colitis in a child caused by an intestinal infection develops rapidly. Defecation becomes more frequent up to 4-15 times a day, stools become liquid, greenish-colored foamy structure with streaks of blood. The body temperature rises sharply. The patient complains of spasmodic colic in the abdomen. Perhaps a reflex eruption of the contents of the stomach. The turgor of cells of integumentary tissues decreases, dryness in the mouth is felt, facial features are sharpened, the baby loses weight. At the slightest suspicion of a disease, you should immediately seek medical help.

Diagnostics

Diagnostic methods can identify the cause of colitis in children. The diagnosis is based on the following studies:

• Anamnesis. Questioning the patient and those who know him to obtain the necessary information.
• Blood test. These results of laboratory tests often reveal anemia in a patient, an insufficient level of electrolytes in the blood serum, and hypoalbuminemia.
• Scatological. Fecal analysis indicates the effectiveness of the gastrointestinal tract (gastrointestinal tract): the speed and quality of food digestion. This method is able to detect an increased level of leukocytes in feces, steatorrhea (fat), starchy substances, etc.
• Bacteriological. The infectious nature of the disease is confirmed or refuted by the laboratory.
• Analysis of feces for dysbacteriosis. The species composition of the intestinal microflora, quantitative indicators of the presence of pathogenic microorganisms (staphylococci, candida, etc.) help determine the subsequent measures of drug treatment of the patient.
• Endoscopic. With the help of various types of endoscopes (special devices), the internal cavity of the intestine is examined to determine the localization of the disease, the presence of inflammatory, erosive, degenerative processes:

1. Rectoscopy - examination of the rectum using an endoscopic tube.
2. Colonoscopy is a diagnostic method with a long flexible probe.
3. Biopsy of the mucosa - sampling of material (biopsy) with special biopsy forceps for histological examination.

• Irriographic. The method of X-ray examination of the severity of colitis is called irriography. Specialists conduct an examination of the organ using X-rays after cleansing the colon and filling it with a radiopaque substance.
• X-ray of a barium passage. X-ray examination is carried out one day after taking the barium suspension. It is used to determine the evacuation capacity of the large intestine.

Treatment of colitis in children

Infectious colitis is treated with a course of antibiotics. At the same time, adsorbing preparations such as activated carbon, Chitin, Polysorb are prescribed. When spasms appear, it is permissible to use no-shpy, but not earlier than half an hour after taking absorbents.

Intestinal antiseptics suppress the development of pathogenic microorganisms, while beneficial bacteria for humans are not affected by drugs. The best of them: Intetrix Nifuroxazide. There are complex drugs that exhibit adsorbing and antiseptic properties at the same time: Enterosgel, Smecta.

With diarrhea, it is necessary to take special solutions that will protect the baby's body from dehydration: Oralit, Regidron. It must be remembered that any prescription of medications should be done only by a doctor. Self-medication leads to negative consequences. A pediatrician or a pediatric gastroenterologist treats colon dysfunctions with the help of several groups of medications:

Diet

Colitis is not only treated with medication. When the colon is dysfunctional and it is affected by infections, doctors prescribe a therapeutic diet to small patients to prevent fermentation and rotting of food in the intestines. In medical terminology, the concept of "Table No. 4" is used, which describes a healthy diet for intestinal problems. Its main principles are:

• Switching to protein foods.
• Fractional consumption of food (up to 6 times a day) in the form of heat. With diarrhea - in a wiped form.
• Acceptance of only boiled or steamed foods.
• The use of carbohydrates in a minimum amount.
• Refusal to overeat.
• Limiting the energy value of the daily diet to 2000 kcal.

The therapeutic diet for diseases of the colon involves the use of certain foods and the prohibition of certain types of food. Recommended:

1. lean fish;
2. low-fat dairy and sour-milk products;
3. omelette;
4. pasta;
5. lean poultry meat;
6. not strong tea, jelly, compotes;
7. rice, buckwheat;
8. butter in small quantities.

Forbidden:

1. sauces;
2. carbonated drinks;
3. vegetables, fruits, berries, citrus fruits;
4. bakery products;
5. canned food;
6. spices.

The menu of a baby with an upset gastrointestinal tract should be carefully developed taking into account the above requirements. An example of a daily diet table number 4 for children:

• 1st breakfast: omelette 150 g, 250 ml of rosehip broth, two crackers.
• 2nd breakfast: fat-free cottage cheese - 100 g;
• Lunch: 200 ml chicken broth with grated chicken breast, 100 g pasta with butter and a steam cutlet.
• Snack: boiled rice - 100 g;
• Dinner: pasta - 200 g, boiled sea fish - 100 g, a glass of weak tea;
• Before going to bed: a glass of fat-free yogurt with crackers.

Features of nutrition depending on the type of colitis in a child

Colon dysfunction often causes bowel failure. Depending on whether the child has constipation or diarrhea due to colon dysfunction, the list of prohibited foods changes. If there is no bowel movement for more than 3 days:

1. soups in fatty broth;
2. mushrooms;
3. pork;
4. pasta;
5. semolina;
6. chocolate;
7. strong tea;
8. canned food;
9. seasonings.

For diarrhea:

1. milk and dairy products;
2. muffin;
3. candies;
4. sugar;
5. legumes;
6. nuts;
7. fresh fruits and raw vegetables;
8. high-calorie, fatty foods.

Nutrition for ulcerative and nonspecific colitis

Nonspecific ulcerative colitis in children is characterized by damage to the mucous membrane of the colon. The food of the patient with this disease should be of a soft consistency so that it is quickly absorbed by the body. Solid fecal masses of the large intestine can injure the broken mucosa, causing inflammation. The patient should be offered food, boiled or steamed, always warm. Food should be protein and fractional. List of prohibited products:

• semi-finished products;
• smoked meats;
• legumes;
• cabbage;
• radish;
• carrot;
• fruits.

Features of the diet for spastic colitis in children

Untreated spastic colitis often becomes chronic. To prevent this from happening, it is necessary, in accordance with the age of the child, to enrich his diet with foods rich in vegetable fiber. All kinds of cereals, black bread will be useful. If pain occurs, doctors recommend excluding foods with coarse fibers for a while and introducing them into the diet gradually. It is strictly forbidden to feed a child:

• dairy products;
• fatty meat;
• oil;
• sugar.

Products during an exacerbation and in remission

If there is an exacerbation of colitis, food intake should be reduced to a minimum, especially in the first day. If the child normally tolerates the lack of food, he should be offered only a decoction of rose hips half a glass 5 times a day during the day. In this way, a rapid functional unloading of the intestines and the disposal of the colonic mucosa from the chemical and mechanical effects of food are achieved.

Further, the therapeutic diet involves the gradual introduction of mashed protein foods (broths with poultry meat, cottage cheese). Do not offer your child cold and fried foods. Fermentation processes can be prevented by eliminating sugar, cereals, and bread from the diet. At this time, the following are prohibited:

• vegetables and fruits;
• milk;
• pickles, seasonings;
• carbonated drinks;
• fatty meats and fish;
• canned food.

In the remission stage, the therapeutic diet can be expanded, but the products should be as natural as possible. Vegetables and fruits are baked before use, peeled, wiped. Gradually introduce pasta, milk. Over time, grated food is changed to chopped, increasing the load on the intestines. If the body normally perceives innovations, raw vegetables and fruits are added to the diet.

Complications

In the absence of timely treatment, colitis in children passes into the chronic stage, complicated by bloating and peritonitis (a severe form of inflammation of the peritoneum). In addition, the disease may have the following complications:

• anemia;
• endocrine disorders;
• obstruction of the colon;
• ulcer perforation;
• necrosis of intestinal tissues;
• hypovitaminosis.

Prolonged illness delays weight gain, normal growth. Concomitant factors of the chronic course of the disease are visual impairment and lethargic condition of the baby. Protracted nonspecific colitis in children can cause:

• development of paraproctitis;
• anal fissures;
• haemorrhoids;
• irritation of the anal sphincter and its spasm.

Prevention

To prevent the development of colitis in children, it is necessary to protect them from intestinal infections, food poisoning, helminthic invasions, and dysbacteriosis. The most important measures to prevent colon dysfunction are:

• A varied diet based on natural food with enough plant fiber in proportion to the age of the child.
• Lack of stress and excessive physical exertion.
• Hygiene.
• Timely sanitation of the large intestine at the first symptoms of the disease and clinical examination if necessary.

Video

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

Pathology proceeds with severe pain, dyspeptic disorders, persistent changes in stool and general malaise. Treatment of colitis in children depends on the pathogenesis of the disease and includes a whole therapeutic complex: symptomatic and antibacterial treatment, diet therapy, herbal medicine and normalization of the intestinal microflora.

Classification

Inflammatory-dystrophic changes in the large intestine can be limited, that is, they are localized within one or more segments, and widespread.

In this regard, there are:

• typhlitis - isolated inflammation of the caecum;
• typhlocolitis - inflammation of the ascending and caecum;
• transverse - inflammation of the transverse colon;
• angulitis - inflammation of the transverse colon and descending intestine;
• sigmoiditis - inflammation of the sigmoid colon;
• proctosigmoiditis - inflammation of the sigmoid and rectum;
• proctitis - inflammation of the rectum.

Depending on the cause of the disease, colitis is:

By the nature of the disease, colitis can be progressive, recurrent and latent. According to the severity of the disease, mild, moderate and severe colitis can be distinguished. According to the clinical condition, the disease is acute and chronic.

Cause of colitis in children

Colitis in children occurs for the following reasons:

• bacterial and viral infections: E. coli, salmonella, clostridia, etc.;
• congenital pathologies of the digestive system;
• helminthic invasions;
• heredity;
• autoimmune diseases;
• tendency to allergic reactions;
• food poisoning;
• gross malnutrition: early introduction of complementary foods, replacement of breast milk and milk formula with whole milk, etc .;
• frequently repeated antibiotic therapy;
• unfavorable state of ecology;
• stress factors.

Symptoms

Symptoms of colitis in children in acute form are manifested in the form of nausea, weakness and fever. The child complains of abdominal pain. Bowel emptying occurs up to 15 times a day. The feces are watery, greenish, with an admixture of blood. Symptoms of colitis in infants can be complicated by rectal prolapse and dehydration.

Symptoms of colitis in children in the chronic form can worsen and subside depending on the phase of the disease and recovery. The dominant symptoms of colitis in a child are abdominal pain, stool disorders such as diarrhea and constipation. In some cases, there is a deterioration in the general well-being of the baby, exhaustion of the nervous system, headaches and chronic fatigue. Also, colitis can cause a lack of body weight, anemia and beriberi.

Diagnostics

To find out how to treat colitis in a child, you need to conduct the following laboratory and instrumental studies:

1. Blood chemistry. The presence of colitis can be suggested by a decrease in hemoglobin and red blood cells in the blood, an increase in ESR.
2. Analysis of feces for the presence of leukocytes and pathogenic flora (staphylococcus, candida, etc.).
3. Intestinal endoscopy. Allows you to identify the form of the disease.
4. X-ray of the intestine. It is carried out to clarify the clinical picture of the disease and the severity of the inflammatory process.

Features of the course of the disease in childhood

The clinical picture and causes of this disease in children are significantly different from adults, so the symptoms and treatment of intestinal colitis in children will be different.

Acute intestinal colitis in a child whose symptoms last more than two weeks, in case of ineffective treatment, passes into the stage of chronic colitis. This condition is dangerous with complications, such as peritonitis, the development of adhesions, chronic diarrhea, and much more. Therefore, the treatment of symptoms of colitis in children should begin from the first days of the disease.

Acute colitis is most dangerous for children under one year old. Allergic colitis is more common in infants, which develops in response to a certain type of allergen - lactose, a drug, a separate strain of bacteria, etc. It is important to identify the allergen and eliminate it in full. Otherwise, colitis in infants often leads to dehydration against the background of repeated vomiting and diarrhea, followed by the development of seizures and even death of the child.

Treatment

Treatment of symptoms of colitis in children is aimed at destroying the pathogenic flora of the intestine and restoring its work.

Drug treatment of symptoms of colitis in a child is carried out using the following drugs:

• antibiotics - Enteroseptol, Erythromycin, Mexaform: course of treatment 7-10 days;
• enzyme agents - Mezim, Pancreatin, Panzinorm: a course of treatment from 2 to 4 weeks;
• analgesics and anticholinergics - Atropine, Novocain, Platifillin;
• probiotics - Bifidumbacterin, Colibacterin;
• astringent and enveloping preparations, adsorbents - bismuth, starch, chamomile;
• antiallergic drugs - Suprastin, Fenistil;
• vitamins A, B, PP.

Physiotherapeutic treatment of symptoms of colitis in children is prescribed during the period of remission. This may be treatment with paraffin, ozocerite and diathermy. In case of exacerbation of the symptoms of intestinal colitis in a child, the doctor may advise dry heat on the epigastric zone.

Surgical treatment is carried out in extreme cases. The essence of the operation: subtotal removal of the affected part of the colon, followed by the formation of the junction of the ileum and rectum.

Rehabilitation after treatment

For the period of remission, the following therapeutic and preventive measures are indicated:

1. Breathing exercises, physiotherapy exercises, massage of the abdomen.
2. Spa treatment.
3. Appointment of prophylactic courses of probiotics and enzymes.
4. Exemption from physical education and exams.

Forecast

Under the condition of timely and successful treatment of the symptoms of colitis in children, as well as after a full rehabilitation, the acute form of the disease ends in recovery.

In the chronic form of colitis, strict adherence to the regimen recommended by the doctor guarantees a long-term remission. If, after treatment of colitis, the child has a stable remission, after 2 years he is removed from the dispensary registration of a gastroenterologist.

Complications

Untreated colitis can cause life-threatening internal bleeding. It can also lead to perforation of the intestinal wall with the subsequent development of peritonitis, appendicitis, intestinal obstruction against the background of adhesions in inflamed tissues, etc. That is why the symptoms of colitis in a child cannot be ignored, at the first signs of the disease, you should consult a doctor.

Prevention

Prevention of colitis in a child is primarily aimed at normalizing the diet from the first days of life. It is dietary errors that most often cause this disease.

Secondly, it is necessary to prevent any ways of contracting intestinal infections. It is important to pay attention to the observance of the rules of personal hygiene, as well as the selection and processing of food products.

Thirdly, preventive vaccination plays an equally important role in the prevention of colitis in infants and older children.

If, despite the efforts made, it was not possible to avoid the disease, then after the treatment of colitis in children, secondary prevention should be carried out, the purpose of which is to prevent the recurrence of the pathology.

Diet

Symptoms of intestinal colitis in a child require not only drug treatment, but also the appointment of diet therapy. The therapeutic diet for this disease excludes all types of food that can chemically or mechanically injure and irritate the inflamed intestinal mucosa. All food is consumed in pure form, at least 5 times a day.

Diet in the treatment of symptoms of colitis in children does not recommend the use of milk and dairy products, legumes and cabbage. Meat, steamed fish and "yesterday's" wheat bread are allowed. During the period of remission, the diet expands, but in the future, chilled meals, sour-milk products, sour foods should be excluded, and salt intake should be limited.

It is important to remember that any form of colitis is dangerous for the development of a chronic process with subsequent inflammation of the abdominal cavity and perforation of the intestinal wall. All this is fraught with even greater complications, such as exhaustion of the body, anemia, disruptions in the endocrine system. Timely diagnosis and treatment of colitis is very important for a child, since a disease not cured in childhood can cause him suffering and problems with the work of the digestive organs for the rest of his life.

Useful video about intestinal colitis

One of the most common diseases of the colon is colitis. The disease causes inflammatory-dystrophic changes in this organ. In newborns, pathology also affects the small intestine, so they are diagnosed with enterocolitis. Regardless of the type, colitis causes bowel problems, abdominal pain, and malaise. The disease is more often provoked by intestinal infections, but there are other reasons for its development. Depending on them, treatment is prescribed. It includes etiotropic and symptomatic therapy.

What is colitis

The disease is an inflammation of the large intestine, which eventually leads to degeneration of the mucous layer. This is dangerous by the development of complete organ dysfunction. According to statistics, colitis is more often diagnosed in people of the middle and older age categories, but the risk of its development remains high in infants and preschool children. The disease has no specific symptoms. All signs of colitis can be observed in other diseases of the gastrointestinal tract. The basis of the clinical picture are violations of bowel movements and abdominal pain.

Causes

The sources of intestinal inflammation in children are diverse. Acute colitis is more often provoked by causative agents of infections of the digestive tract:

• salmonella;
• retrovirus;
• rotavirus;
• Escherichia;
• shigella.

Also, the acute form of colitis develops as a result of gastritis of any nature, enteritis and gastroenteritis. Chronic causes dysentery, ascariasis, giardiasis, pancreatic dysfunction and poisoning with toxic substances. Risk factors for developing any form of colitis:

Kinds

Taking into account morphological signs, colitis is divided into atrophic, catarrhal and ulcerative-erosive. By the nature of the course, it is mild, moderate, severe, by type - monotonous, latent, progressive and recurrent. The broadest classification divides colitis into the following types:

Acute, chronic, non-specific ulcerative and spastic colitis in children is diagnosed more often - in contrast to adults. There is another classification of this disease. Since the large intestine consists of several sections, colitis can have different localizations. Based on this criterion, there are:

• typhlitis (inflammation of the caecum);
• transversitis (inflammation of the transverse colon);
• sigmoiditis (colitis of the sigmoid colon);
• pancolitis (generalized inflammatory process);
• proctosigmoiditis (colitis of the sigmoid and rectum);
• angulitis (inflammation of the transition of the transverse colon to the descending colon);
• proctitis (inflammation of the rectum);
• typhlocolitis (inflammatory process in the caecum and ascending colon).

Symptoms of intestinal colitis in a child

The acute form of colitis is accompanied by symptoms of general intoxication: hyperthermia, weakness, chills, vomiting. Due to spasms of the intestines, the child is disturbed by tenesmus (false urge to defecate), pain in the iliac region. The frequency of stool increases from 4-5 to 15 times a day. Other signs of acute colitis:

• greenish, watery, foamy stools;
• impurities in the feces of mucus or streaks of blood;
• rectal prolapse;
• nausea;
• decrease in tissue turgor;
• dry skin;
• sharpening of facial features.

Disorder of the stool is manifested by constipation, diarrhea, or their alternation. With the passage of solid feces, the child may develop anal fissures. During bowel movements, a small amount of red blood comes out with the stool. Chronic colitis is characterized by an undulating course: periods of remission are replaced by exacerbations. Pain is felt in the navel, iliac region. It occurs after eating and has a aching character. In addition to such pain, chronic colitis is indicated by:

• loss of appetite;
• bloating;
• rumbling in the intestines;
• fatigue;
• irritability;
• headache;
• sleep disorders;
• delay in weight gain and height.

At the baby

A striking sign of colitis in infants are significant changes in the stool. It is either liquid or solid, i.e. diarrhea alternates with constipation. There are streaks of blood in the feces. Other symptoms of colitis in infants:

• loss of appetite;
• bad sleep;
• high excitability;
• frequent regurgitation;
• vomit;
• dryness and pallor of the skin;
• increase in body temperature;
• capriciousness;
• refusal to eat;
• frequent crying.

Complications

Allergic colitis in infants leads to a delay in growth or weight gain. The same applies to other forms of intestinal inflammation in a small child. Older children may develop the following complications:

• hypovitaminosis;
• anemia;
• anal fissures;
• intestinal perforation;
• peritonitis;
• anemia;
• ulcer perforation;
• sphincter weakness;
• vascular thrombosis;
• intestinal obstruction;
• paraproctitis;
• intestinal abscesses.

Diagnostics

A pediatric gastroenterologist can detect intestinal colitis in children. First, he conducts an external examination and palpation of the abdomen. This is necessary to identify visual signs of disease and pain in the abdominal region. Additionally, the doctor prescribes laboratory and instrumental studies:

• Colonoscopy. In this study, a colonoscope with a micro-camera at the end is inserted through the anus. At the same time, air is supplied to the intestine to expand its walls. This procedure is necessary to detect latent bleeding, diverticulum, inflammation, tumors.
• Sigmoscopy. Compared to colonoscopy, this technique is more gentle. During the procedure, a flexible long sigmoscope connected to a video camera and monitor is inserted into the anus. This helps the specialist to assess the condition of the mucous membrane of the large intestine.
• Endoscopic biopsy. During the procedure, the endoscope is inserted into the intestine through the rectum. With the help of the instrument, the state of the gastrointestinal tract is studied. During endoscopy, biopsy material is taken from a suspicious site in order to determine the nature of the altered tissues and differentiate the type of colitis.
• Blood test. The study helps to identify anemia, low electrolyte levels and hypoalbunemia. These signs confirm the presence of inflammatory processes in the body.
• Coprology of feces. During this procedure, the color, smell, texture, number of bowel movements are studied. Coprology reveals and diagnoses:
  • the presence of mucus, leukocytes in the feces;
  • creatorrhoea (undigested muscle fibers);
  • steatorrhea (fat deposits);
  • amylorrhea (presence of undigested starch).
• Irrigography. The large intestine is filled with a contrast agent, after which an x-ray is taken. With this type of radiography, you can evaluate the contours, location and size of the organ under study.
• Rectoscopy. This is a study of the rectum and the lower part of the sigmoid. By inserting a special tube into the anus, the doctor diagnoses erosive, tumor, infectious or inflammatory processes.

Treatment of colitis in children

• Nonspecific ulcerative form of intestinal inflammation is treated with antibiotics, immunomodulators, non-steroidal anti-inflammatory drugs.
• In the acute course of the disease, a food poisoning treatment regimen is used: a warm, plentiful drink, rest, Festal, Almagel or activated charcoal are prescribed.
• The chronic form of intestinal inflammation is eliminated with the help of antispasmodics (No-Shpa) in combination with adsorbents (Phosphalugel). Additionally, a diet is prescribed with the exception of fried, spicy, fatty, canned foods.
• Spastic colitis in children is treated with Trimedat, which improves intestinal motility. Additionally, Buscopan is prescribed, which relieves pain. Loperamide helps to get rid of diarrhea.

Drug therapy for intestinal inflammation consists of several groups of drugs at once. To eliminate unpleasant symptoms, drugs with astringent and enveloping actions are often used. Such properties are possessed by bismuth, infusions of chamomile or St. John's wort. With an allergic nature of the disease, antihistamines are prescribed:

• Suprastin;
• Diazolin;
• Fenistil.

Antibiotics are the mainstay of treatment for most children. They should be prescribed only by a doctor after receiving the results of the analysis to identify the causative agent of the disease. Have a wide spectrum of antibacterial activity:

• Mexaform;
• Sulfasalazine;
• Erythromycin.

Treatment of the disease is not limited to antibiotic therapy. To alleviate the condition, the child is prescribed a number of medications:

• Probiotics: Bifikol, Intestopan, Bifidumbacterin. Against the background of antibiotic therapy, these drugs restore the disturbed intestinal microflora.
• Analgesics: Novocaine, Platifillin, Metacin. Help to relieve the child from severe pain syndrome.
• Enzymatic: Mezim, Digestal, Abomin, Mexazu. They help improve digestion.

Physiotherapy is prescribed only when the disease is in remission. A dry warm or heating pad is applied to the epigastric region of the child. Additionally, the treatment is reinforced with ozocerite, paraffin therapy, diathermy. Most of the young patients are helped by the described therapy regimen. If conservative treatment fails, the doctor advises surgery. It consists in resection of the problematic section of the colon, after which the straight segment is fused with the ileum.

Diet

Important in the treatment is the observance of a special diet. Throughout the therapy, children should not be given fried foods, rich soups. Products need to be baked, boiled or steamed. If the child is breastfed, then his mother is advised to give up aggressive foods that can provoke allergies. The food of a nursing woman should be well digested.

A light diet for lactation includes mashed potatoes, low-fat soups, grated cereals, chicken broths. Fresh vegetables with fruits should be excluded. More specific dietary rules are determined by the type of colitis: