Inflammation of the colon

introduction

Of the Large intestine (lat: Colon), also called colon, is part of the 5-6 meter long intestine of man in whom the food is from their Ingestion through the mouth are to Elimination in the stool is transported. The large intestine closes here to the small intestine in which already the vast majority Nutrients from food have been absorbed into the body.

The large intestine is responsible for thickening. It removes most of the water contained in the digested food pulp, as well as the salts (= electrolytes) dissolved in it, so that in healthy people only the solid stool remains until it ends in the rectum (lat: rectum). In addition, the colon bacteria are found in the colon, which form important amino acids as a component of proteins and vitamins for humans. All previous sections of the intestine are free of bacteria.

The food can also be temporarily stored in the large intestine before it is transported further, and mucus can be released for better lubricity.

If you look at your stomach from the outside, the large intestine is roughly like a frame around the contour of the abdomen. It begins at the bottom right in the area of ​​the appendix (lat: Caecum), runs up to the liver under the right costal arch, then pulls to the left under the costal arch in the direction of the spleen and then runs back down the left side of the abdomen to the rectum and anus. Inflammation of the intestine is called colitis in medical jargon, with the ending "-itis" after the medical term for the organ always describing the inflammation of the organ.

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root cause

Inflammation of the large intestine can have many causes that are responsible for either short-term or, in the worst case, lifelong recurring inflammation of the large intestine.

Short-term inflammations, which then cause typical gastrointestinal flu, are mostly caused by viruses or bacteria, rarely fungi or protozoa. Since infection with pathogenic viruses or bacteria is referred to as an infection, this type of disease is called infectious gastroenterocolitis as an indication of the involvement of the stomach (lat: Guest), the small intestine (lat: Enterum) and the large intestine (lat: Colon) from the infection with the bacteria.
The bacteria or viruses responsible for infectious bowel inflammation are mostly E. coli bacteria, Yersinia or campylobacter bacteria, as well as rota or noroviruses. These nest in the intestinal mucous membrane, whereupon it becomes inflamed and a short time after ingestion of the bacteria through food or contact, the affected person experiences diarrhea, nausea and vomiting. Most of these infections heal on their own within two weeks and do not require any treatment other than fluid and salt intake.

An inflammation caused by bacteria that only affects the colon in Europe is the so-called dysentery caused by Shigella bacteria. It is not to be confused with amoebic dysentery, which is triggered by other bacteria and occurs more in subtropical areas.

Another very sudden inflammation of the colon can cause appendicitis. The appendix itself is the first part of the large intestine. In appendicitis, however, only a small appendix becomes inflamed, the so-called appendix (lat: appendix vermiformis).

So-called chronic inflammatory bowel disease is an important cause of permanent inflammation in the large intestine. Its most important representatives are ulcerative colitis and Crohn's disease. They differ in terms of their appearance and the course of the disease. Its causes are not yet fully understood, but autoimmune processes against the intestinal mucosa are suspected. Autoimmune means that the body no longer recognizes the intestinal mucous membrane as belonging to the body and tries to fight it with the help of the immune system, which ends in inflammation of the fought mucous membrane.
In addition to these causes of inflammatory bowel disease, genetic components, psychological influences, and certain diet and lifestyle habits are also examined. Crohn's disease can occur in the entire gastrointestinal tract and cause inflammation of the wall mucosa everywhere, while ulcerative colitis is limited to the large intestine. In ulcerative colitis, the inflammation is limited to the uppermost layer of the mucous membrane, while in Crohn's disease it can also spread to deeper layers of the intestinal wall.
Both clinical pictures run in bursts, which means that symptom-free and almost inflammation-free phases alternate with phases of inflammation. In the vast majority of cases, both diseases are incurable and require lifelong, recurring therapy in order to cope with the recurring attacks of inflammation.

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Recurring inflammation in the colon can also trigger so-called diverticula. Diverticula are protrusions or bulges in the inner layers of the intestine. These arise at weak points in the muscles of the intestinal wall, which can turn the inner parts outwards due to increased pressure in the intestine, such as in the case of constipation or general weak connective tissue. The resulting small cavities in the intestinal wall can become inflamed, among other things, by bacteria growing in them or pent-up food pulp and cause abdominal pain. Even though the diverticula can occur in all sections, they are most often found at the end of the colon in the S-shaped sigmoid.

Symptoms

Depending on the cause, the signs of inflammation in the colon differ from one another. Common to most, however, are diarrhea and abdominal pain.

The infectious inflammation caused by the various pathogenic germs usually begins hours after ingestion, e.g. of foods that carry the germ with nausea, which is followed by diarrhea and vomiting. A fever can also occur. These symptoms usually go away on their own within a few days.

Appendicitis usually begins with stabbing or pressing abdominal pain around the navel, which then typically migrates to the right lower abdomen.

An inflammation of a diverticulum (lat: Diverticulitis) usually manifests itself with abdominal pain in the affected area, usually in the lower left part of the abdomen where most of the diverticula are located. This inflammation is accompanied by a fever, and it is not uncommon for people to have blood in their stool.

A chronic inflammatory bowel disease is usually only recognized during its course. A striking indication is often persistent diarrhea, which in ulcerative colitis can also contain blood. Often no blood is visible in Crohn's disease. In the episode of a chronic inflammatory bowel disease, the diarrhea is often accompanied by colic-like, i.e. swelling and decongesting, abdominal pain and fever. The extent of the complaints depends on the extent of the intestinal inflammation, which can change continuously as the disease progresses. Due to the permanent inflammation of the intestinal cells, they are restricted in their function and a lack of nutrients in the body can lead to weight loss and deficiency symptoms.

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therapy

Inflammation as part of a Abdominal influenza usually ends by itself within a few days to a maximum of two weeks. Drug therapy is available in most cases unnecessary. Since most cases are caused by viruses, there is also a antibiotic rarely necessary and should only with proven bacterial cause can be used.

The important thing in all cases is Compensation for fluid loss through diarrhea and the loss of important salts in the body. This loss can lead to total dehydration of the body and in extreme cases life threatening be. Above all, they are threatened with dehydration fairly quickly Infants or the elderly. A Hospitalization is then necessary to prevent the loss of fluid and salt through direct fluid administration into the Vascular system of the body, the so-called "drip".
Outside the hospital it applies to fluid loss through adequate drinking as low as possible.They are particularly suitable for this tea, here Herbal teas like black tea or Camomile teabecause this one additional calming effect attributed to the gastrointestinal tract. It is also very suitable colathat through his high sugar content also promotes fluid absorption in the body.

A Appendicitis can only by a distance finally be treated. With less pronounced signs of inflammation can also waited under pain therapy whether it will heal on its own. The inflammation can then recur at any time and then require surgery.

Chronic Inflammatory Bowel Disease are harder to treat and only In the most rare events to heal. It is not uncommon for a chronic inflammatory bowel disease to require one lifelong therapy with medication. In order to contain the inflammation, a Cortisone therapy or therapy with drugs that do that Suppress the immune system, applied, e.g. Mesasalazine. This is considered to be very well tolerated and is available as a suppository. For severe relapses, a drug called Azathioprine can be used. This one has one strong inhibitory effect on the human immune system. It takes several months to work, and it is very rich in side effects. To prevent a relapse often you have to consistently a low dose one of the drugs being taken.
As non-drug measure applies to one balanced nutrition to watch out for and foods that Intolerances trigger should be avoided. Recommended during an attack light, low-fiber diet. It may be necessary in severe flare-ups of ulcerative colitis Surgically removing parts of the colon about tearing open the intestinal wall through a severe inflammation to prevent.
With Crohn's disease you are much more cautious compared to the potential removal of parts of the intestine, since the Inflammation affects all parts of the intestine can and only remove certain amounts of the intestine to be agreed with adequate digestion are.

The Treatment of a diverticulum differs depending on Degree of inflammation. If the inflammation is mild, antibiotics can be used as well anti-inflammatory drugs be treated. Those affected can have a positive effect on the healing of the inflammation regular bowel movements, low-fiber diet and adequate fluid intake. If the inflammation is more severe mandatory hospitalization necessary. In order not to strain the intestine there is a complete food leave and continued antibiotics, pain relievers, and anti-inflammatory drugs. However, if there is a risk of the intestinal wall tearing open, the diverticulum must be treated surgically become. However, the emergency surgery should be prevented and suspicious diverticula already in an inflammation-free interval removed.

diagnosis

The Diagnosing gastrointestinal flu can often through Questioning the patient can already be clearly established. Mostly is no further investigation necessary because the infection is independent of the causative germ heals by itself. Only in special cases is a Evidence of the germ necessary and so this can be based on the microscopic examination of a stool sample taken in the laboratory by one special therapy tailored to the germ initiate.

Appendicitis can unfortunately only clearly during the operation to be established. To estimate the probability, however, you can use a Ultrasound examination as well as a Blood test Give hints.

A Diverticulitis becomes in patients next to the survey by a physical examination in which there is a hardening lets feel. In addition, procedures such as roentgen, Ultrasonic or Computed Tomography (= CT) depict diverticula and the diagnosis can then be made. These procedures can be seen in the pictures Inflammation, thickening, pouches or even intestinal perforations often easy to recognize.
Not least in the case of inflammatory bowel disease or diverticula, the Colonoscopy the crucial hint at the Search for the cause. With diverticula, however, this is only in the interval without inflammation allowed. The small camera in the tube can be used in the case of inflammatory bowel disease inflamed areas redness and whitish-yellow deposits detect. Last uncertainties can also be caused by a colonoscopy small sampling (= Biopsy) and microscopic examination mostly to be clarified. Diagnosing a inflammatory bowel disease However, it may only be finally put if all other causes of inflammation like that bacterial infection excluded are.

forecast

Even if complaints how diarrhea and Vomit The symptoms of an infectious bowel inflammation are not among the most pleasant sensations in our body adequate attention to the fluid and salt balance most of time temporarily and end within a few days even without medication.

The inflammatory bowel disease are through medication though treatable, but in the vast majority of cases not curableso that flare-ups of the inflammation can be expected for a lifetime.

Diverticulum in the intestine are not dangerous in principleHowever, inflammation can lead to the entire intestinal wall breaking through, which can then be life-threatening. Because the diverticula should usually get bigger with age suspicious diverticula observed and removed in time become.

prophylaxis

The easy transmission routes prevent infection with the bacteria and viruses that cause intestinal inflammation very difficult. It applies above all else to pay attention to your own personal hygiene.
Regular hand washing can enormously reduce the number of germs on the hands, since most pathogens can only survive outside the gastrointestinal tract for a very short time. This is especially important Washing hands after using the toilet such as before preparing food in the kitchen.

Just against a small part of the pathogen is a Vaccination possible.

A Prophylaxis of inflammatory bowel disease is through the partly hereditary origin difficult to do. As with many other intestinal diseases, there are also diseases of the rectum adversely affected by smoking and nicotine should be avoided in diseases of the intestine.