Signs of spastic colitis and how to treat it

What is spastic intestinal colitis

Failure of intestinal motor activity, decreased colonic motility leads to spasms (painful involuntary contractions of the intestine), which can appear in various parts, which indicates the presence of this pathology.

Women are more susceptible to spastic colitis (ICD10 code K58). The disease usually affects adults aged 20-40 years; in children, signs of a similar pathology are rare.

Spastic colitis is difficult to diagnose, since it is based not on organic malfunctions of the organ, but on innervation disorders. In clinical studies, biochemical changes in tissues, inflammatory or pathological foci are not visible against the background of the disease.

Treatments for Irritable Bowel Syndrome

Treatment of spastic colitis involves the use of medications, physiotherapy and folk remedies. Let's consider all the options.

Medications

To eliminate the symptoms of IBS and improve the patient’s condition, a number of effective drugs are used:

• Antispasmodics (Drotaverine, Platiphylline, Spazoverine, Papaverine, No-Shpa) – relieve spasms and pain;
• Laxatives (Kafiol, castor oil, Microlax, Clam, Macrogol 4000, buckthorn fruits, plantain seeds, lactulose) - soften hard feces and eliminate constipation;
• Antifertilizers (Kaopectate, Diarol, Rifaximin, Creon, Loperamide, Smecta, Imodium) – relieve diarrhea;
• Antidepressants - relieve pain and spasms, help improve mood and get rid of depression;
• Preparations for restoring water balance (Chlosols, saline solution, Acesoli) - prescribed for severe diarrhea;
• Probiotics (Linex, Bifiform, Narine) – restore normal intestinal microflora;
• Anti-inflammatory non-steroidal drugs (Diclofenac, Paracetamol, Indomethacin) - relieve the inflammatory process, relieve pain and spasms, reduce temperature;
• Antibiotics (Azithromycin, Sumamed, Ceftriaxone, Hemomycin, Cefazolin) – kill pathogens;
• Enterosorbents (Polysorb, Polyphepan, Enterosorb, activated carbon) – cleanse the body of toxic substances;
• Enzymes (Festal, Penzital, Digestal, Pancitrate) - improve the functioning of the digestive system;
• Vitamins (Centrum, Complivit, Vitrum) – strengthen the body;
• Enveloping drugs (Gastal, Cimetidine, Omeprazole) – cover the intestinal mucosa with a special protective film that eliminates irritation and spasm;
• Sedatives (valerian, motherwort) – relieve anxiety, calm the nerves.

Important! The course of treatment and dosage is prescribed only by a doctor!

Physiotherapy

Among the physiotherapeutic methods that are quite effective are pine and oxygen baths, paraffin baths, exposure to galvanic current (galvanic collar) and ozokerite therapy.

Folk remedies

Treatment of spastic intestinal colitis with folk remedies is an excellent addition to drug therapy. However, before using them, you must consult a doctor and conduct an allergy test.

Recipe No. 1. Enema with chamomile and calendula

1. Mix dried chamomile and calendula flowers, taken in equal quantities.
2. 1 tbsp. l. collection, pour 200 ml of boiling water.
3. Let the product brew.
4. Filter through a sieve.
5. Use this infusion for enemas.
6. Repeat the procedure 2 times a day. The course of treatment ranges from 1 to 3 weeks.

Recipe No. 2. Anise tea for increased gas formation

1. Pour in 1 tsp. anise seeds 200 ml boiled water.
2. Let the product sit for 30-60 minutes.
3. Strain through a sieve.
4. Take 8 tbsp every day. l.

Recipe No. 3. Microenema with honey

1. Dissolve 100 grams of honey in warm boiled water.
2. Use for micro enemas.

Recipe No. 4. Soothing tea

1. Pour in 2 tsp. dried mint or lemon balm leaves 200 ml of boiled water.
2. Leave for about 5 minutes.
3. Drink instead of tea.

Recipe No. 5. Potato juice for inflammation

1. Peel a few raw potatoes.
2. Pass them through a meat grinder.
3. Strain the resulting pulp through cheesecloth.
4. Take 40 minutes before meals 2-3 times a day, 100 ml.

Recipe No. 6. Herbal mixture against spasms

1. Mix dill and cumin with dry mint leaves (take 10 grams in total).
2. Pour 1 tbsp. l. collecting 200 ml of boiled water.
3. Leave for 3 hours.
4. Filter through a sieve.
5. Take 4 times a day, ¼ cup.

Recipe No. 7. Herbal infusion

1. Combine oregano and chamomile flowers (15 g each) with valerian root (2 g).
2. Grind well.
3. Pour 1 tbsp. l. collecting 200 ml of boiling water.
4. Leave for 2 hours.
5. Filter through a sieve.
6. Take ½ cup twice a day.

Recipe No. 8. Wormwood infusion

1. Pour 200 ml of boiled water into 1 tbsp. l. wormwood.
2. Leave for 4 hours.
3. Strain through cheesecloth.
4. Take 2 tbsp three times a day. l.

On a note! Non-traditional methods of treating spastic colitis include herbal medicine, acupuncture and reflexology. Unfortunately, the effectiveness of these methods has no scientific basis, but they still help most patients.

Types of spastic colitis

This type of colitis can be classified according to several parameters.

Based on the nature of its course, the disease can be divided into two forms:

• spicy. Signs of pathology appear quickly and are distinguished by their intensity.
• chronic. Chronic spastic colitis is characterized by alternating phases of exacerbations (with an increase in the intensity of symptoms) and remission (during this phase the disease does not manifest itself).

According to etiology there are:

1. Allergic colitis. It appears due to the prolonged influence of allergens on the intestinal mucosa.
2. Alimentary colitis. It occurs when the diet is disrupted.
3. Mechanical colitis. Its appearance is associated with chronic constipation.

Causes of spastic colitis

The disease is caused by a functional disorder of the gastrointestinal tract. The main factors that provoke the disease are stress and physical overload of the body.

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The most common causes that contribute to the development of spastic colitis are:

• unhealthy eating for a long time;
• using large amounts of laxatives or long-term antibiotic therapy;
• surgical intervention in the gastrointestinal tract;
• lack of proper rest and normal sleep;
• the appearance of pathogenic organisms in the intestines.

The activity of the intestines is controlled by the nervous system, because of this the main causes of spastic colitis are associated with malfunctions in its functioning.

Gastrointestinal diseases can also cause intestinal colitis:

• congenital anomalies;
• pancreatitis;
• dysbacteriosis;
• enteritis;
• gastritis.

Any of the pathologies has an irritating effect on the intestinal walls, which ultimately fail to cope with their functions. 20-60% of patients with spastic colitis have symptoms such as: anxiety, sexual dysfunction, panic attacks, irritable bladder syndrome, depression, hysteria.

Also, a sharp transformation of hormonal levels (menopause or pregnancy) and allergies to food can lead to the appearance of pathology. The reaction to the allergen is not limited to skin rashes.

In about a third of patients, colitis appears after salmonellosis, dysentery, and other acute infections.

Causes

The cause of spastic colitis is always pathogenic bacterial flora or autoimmune aggression. But the following factors predispose to the occurrence of this particular form of the disease:

1. Systematic stress and psycho-emotional stress. Neurogenic factors play a key role in the development of pathology.
2. Changes in hormonal levels due to taking oral contraceptives or premenstrual syndrome.
3. Overwork (both physical and mental).
4. The presence of active helminth activity in the intestinal lumen.
5. Taking certain medications (NSAIDs, discontinuation of calcium channel blockers).
6. Chronic diseases of the intestines and other parts of the gastrointestinal tract (chronic colitis and enteritis, pancreatitis, gastroduodenitis, etc.).
7. Poisoning with toxic substances (for example, alcohol).

Expert opinion

Sevastyanov Roman

General practitioner, hepatologist, gastroenterologist, highest qualification category. Site Expert

A large role in the development of spastic colitis is given to dietary habits. When consuming a significant amount of fried, spicy food and spicy seasonings, not only the work of various departments is disrupted, but also the local mechanisms of the immune system are disrupted.

Signs of spastic colitis

All symptoms accompanying spastic colitis are divided into the following groups:

• intestinal symptoms;
• complaints about other parts of the gastrointestinal tract;
• complaints that do not relate to gastroenterology.

If symptoms of all three groups are present, this diagnosis is more likely.

Among the most commonly observed symptoms:

• flatulence;
• disturbances in the process of defecation (diarrhea, constipation, possibly their alternation);
• loss of appetite;
• a feeling of incomplete bowel movement and a feeling of heaviness;
• nausea;
• pain in the intestines that disappears after bowel movement;
• intense abdominal muscle tension.

Depending on the characteristics of bowel movements and the frequency of bowel movements, the disease can occur in four forms: with constipation, with diarrhea, and in a mixed, unclassified form.

Forms of chronic colitis

The disease comes in several types:

• Spastic. It manifests itself as severe pain that occurs in various parts of the intestine, so the dislocation of pain sensations changes.
• Nonspecific ulcerative colitis. This disease is characterized by the spread of pain throughout the intestines. Ulcers and bleeding are also possible.

Depending on the cause, chronic colitis can be allergic, infectious, ischemic, radiation, toxic, or combined. In the latter case, several etiological factors are combined.

According to the prevalence of the lesion, colitis is:

• segmental - when only a specific part of the intestine is involved in the pathological process;
• total - the entire colon is affected.

By severity:

• mild degree - when it is easy to achieve remission;
• moderate severity - to ensure long-term relief of symptoms, medications and diet are needed;
• severe degree - exacerbation prevails over remission, and it is difficult to achieve the latter.

Forms of spastic colitis.

With this disease, patients do not experience bloody impurities in the stool, loss of body weight, fever and other signs that are characteristic of infectious intestinal diseases.

Against the background of a disorder in the defecation process, the patient experiences dehydration (with diarrhea) and intoxication (with constipation). Toxic poisoning leads to irritation of the mucous membrane, bitterness appears in the mouth, absorption of microelements and vitamins worsens, and the functioning of other organs is disrupted. The load on the liver increases due to the fact that it needs to neutralize toxins that have accumulated, so in the absence of therapy, pathologies of the liver and gallbladder appear over time.

Spastic colitis has a milder course than other forms of the disease. In acute spastic colitis, diarrhea is observed, and impurities of pus and blood may be found in the stool. Characterized by tenesmus (false urge to defecate) and increased flatulence. Patients feel dizzy, complain of headache, severe weakness.

Forms of the disease

There are two main forms of spastic colitis according to the type of course:

1. Chronic is a consequence of acute infectious damage to the intestinal lining, regular irritation by multiple factors, and lack of adequate treatment.
2. Acute is accompanied by active symptoms; this is a reaction of the gastrointestinal tract to external and internal factors.

The chronic form often leads to intestinal dysbiosis, a persistent intestinal disorder that worsens the patient’s socialization and quality of life.

Other forms of the disease are distinguished according to the type of manifestations:

• unclassifiable - clinical manifestations are varied, the disease cannot be attributed to any form of spastic colitis, and the cause is not differentiated;
• mixed - constipation with IBS constantly alternates with diarrhea;
• colitis with constipation - painful defecation with hard feces, incomplete emptying is felt, stool frequency - once every 2-3 days;
• colitis with diarrhea - patients complain of frequent diarrhea, the structure of the stool is watery, liquid, and sometimes constipation may occur.

Colitis with constipation occurs most often ; in children, the disease occurs mainly with diarrhea or is of an unspecified nature.

Complications of pathology

With spastic colitis, there is no increase in symptoms and no other pathological processes in the digestive tract develop. Although the pathology reduces the quality of life, it does not lead to complications or long-term consequences.

In the absence of adequate therapy, spastic colitis can lead to intestinal obstruction. In this case, surgery is performed.

In children

The symptoms and treatment of spastic colitis in adults are somewhat different from the symptoms of colitis in children, since in the latter it usually occurs due to parasitic infestations and frequent allergic reactions to food. The child becomes restless, his bowel movements are disrupted, he may refuse to eat, and complain of abdominal pain. Treatment is carried out to eliminate the cause of the disease, followed by symptomatic therapy and normalization of the intestinal microflora.

In pregnant women

In pregnant women, colitis may appear due to hormonal changes or displacement, due to an enlarged uterus or abdominal organs. The symptoms of pathology during pregnancy have no obvious differences. Treatment is symptomatic and is aimed at normalizing the beneficial microflora of the gastrointestinal tract. After childbirth, full therapy is carried out.

In the elderly

In elderly patients, spastic colitis is detected 2 times more often than in young patients, since with age there is a physiological decrease in intestinal motility. The pathology is accompanied by chronic constipation, because of this, the main therapy should be aimed at regulating bowel movements. In addition to drug therapy, a special diet is used for spastic colitis. Cleansing enemas are carried out in exceptional cases.

Complications

The course of the disease in 3-5% of cases is complicated by pathologies such as:

1. Formation of ulcers. Caused by trophic disturbances due to increased gas formation or prolonged stool retention (from 5 days).
2. Perforation (communication with the abdominal cavity) or penetration (breakthrough of an ulcer into the walls of other organs - ligaments, greater and lesser omentum, spleen, etc.).
3. Paracolitis is the involvement of the fiber surrounding the large intestine in the inflammatory process.
4. Proliferative pathologies. Malignancy in spastic colitis occurs in every 1000th patient, the development of benign tumors (polyps) - in every 10th.
5. Volvulus and intussusception of individual intestinal segments. Complications are the result of discoordinated smooth muscle function.
6. Paraintestinal abscesses.
7. Bleeding – occurs as complications of peptic ulcer when the vessel wall melts due to aggressive factors in the intestinal lumen. It happens less often when a vessel ruptures in “critical places” - the points of entry of blood vessels into the intestinal wall, lacking the muscular layer.

Diagnosis of the disease

To make a diagnosis, the following types of diagnostic studies are performed:

• palpation of the abdominal cavity to determine the degree of intestinal swelling;
• blood test, stool test;
• X-ray contrast examination of the intestine;
• anorectal manometry. It is performed to determine muscle tone and the strength of spasms;
• colonofibroscopy, sigmoidoscopy. They identify signs of spastic colitis, symptoms of atrophy, inflammation and dystrophy of the colon;
• FGDS (fibrogastroduodenoscopy).

Differential diagnosis is carried out with diseases such as inflammation of the small intestine and functional disorder of abdominal motility.

Diagnostics

To diagnose chronic colitis, you will need to consult a therapist and gastroenterologist. Its measures are as follows:

• 
  a conversation with the patient, during which he must talk about all the symptoms he has;

• examination of the patient: palpation of the abdomen and eye examination. In the presence of inflammation of the latter, diagnosis is also carried out by an ophthalmologist;
• blood test (acute and biochemical);
• immunological analysis;
• stool analysis;
• colonoscopy (helps distinguish exacerbation from remission);
• X-ray using a contrast agent;
• Ultrasound.

Treatment of pathology

Treatment for spastic colitis requires an individual approach. The complex effect reduces nervous tension, accelerates the restoration of motor function of the colon, and improves digestion.

Patient therapy has three components:

• medicines (folk remedies);
• diet;
• psychotherapy.

Drug therapy is prescribed depending on the examination results.

To reduce pain, antispasmodics are prescribed - “No-shpa”, “Dicetel”. When suffering from constipation, enzymatic agents are prescribed: “Digestal”, “Festal”. For diarrhea - “Creon”, for bloating - “Mezim”. In case of increased gas formation, enterosorbents are used (Enterosgel, Polysorb, activated carbon), to reduce the acidity level - Acidin-pepsin, and enzyme preparations are prescribed to stabilize the digestive function.

When dehydration develops due to diarrhea, infusion replacement of fluid that has been lost by the body is performed.

In the acute stage, medications are taken - depending on the causes of the disease, these can be anti-inflammatory or antiparasitic drugs. When spastic colitis occurs against the background of chronic stress, sedatives are used. To normalize the intestinal microflora, probiotics are prescribed.

In the chronic form, therapy is carried out to eliminate constipation; cleansing enemas can be used for this. The use of laxatives in this case is undesirable. They contribute to irritation of the intestinal mucosa, which is an additional factor of irritation of the organ mucosa.

When diet therapy and medications do not lead to a positive effect, local treatment of organ inflammation is carried out using medicinal or cleansing enemas.

There are two types of cleansing enemas: acting immediately and with subsequent action.

In the first case, enemas stimulate intestinal activity due to the temperature of the water and the volume of liquid. In case of spastic colitis, the use of enemas for cleansing with cold water is prohibited; this can lead to even greater intestinal spasm.

In the second option, enemas are given in this way: the liquid is injected into the intestine and left in it, so the effect occurs after some time. Such enemas are given with vegetable oil or a water-oil suspension, their volume varies - 200-500 ml. The injected oil spreads upward and separates dense feces from the intestinal walls, gently stimulating peristalsis.

Nutrition for spastic colitis

Diet for this type of colitis is very important because it helps restore the functioning of the digestive system. For diarrhea, it is recommended to follow the therapeutic diet “Table No. 4”, and for constipation - “Table No. 2”.

For constipation, the diet should contain a large amount of fresh fruits and vegetables, juices from them; it is good to include boiled and baked beets and pumpkin, whole grain bread, baked goods with bran, and dried fruits in the diet.

For diarrhea, the menu includes: pureed soups, steamed fish and meat, jelly, cereals, fruit and vegetable purees.

Nutrition for pathology is based on the following principles:

• food should not irritate the gastrointestinal mucosa;
• The food consumed should be easily digestible, but sufficiently high in calories;
• It is recommended to steam, boil or stew;
• meals should be fractional - up to 5 times a day;
• Products that cause gas formation and fermentation are excluded from the diet (it is recommended to avoid flour and baked goods);
• Prohibited foods include spicy, fatty, fried foods;
• It is recommended to use fermented milk products instead of milk;
• The diet must include a predominance of fresh vegetables and fruits. But you should limit your consumption of cabbage, legumes, and fruits high in sugar;
• white bread is replaced with black bread;
• Products with preservatives should be avoided.

Traditional methods of treating pathology

The following folk recipes are most effective:

• Pour 1 teaspoon of anise with boiling water (1 glass), leave and drink in small portions throughout the day;
• to relax the intestines and relieve cramps and spasms, take yarrow juice;
• To normalize the digestion process, use celery juice. It helps remove excess gas and helps get rid of constipation. The root vegetable is peeled, crushed, juice is squeezed out of the mass and taken 3 teaspoons half an hour before meals;
• Dried leaves of coltsfoot take one third of a teaspoon three times a day half an hour before meals, washed down with hot milk or honey water.

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How to deal with stool retention with spastic colitis

Treatment of spastic colitis with constipation is carried out in several ways. First of all, treatment for this problem consists of taking medications that are prescribed exclusively by a specialist.

The main remedy against spastic constipation is antispasmodic drugs. They are selected purely individually, since some of them have a number of side effects and restrictions on use.

Medicines to help relieve constipation come in the form of suppositories, drops and tablets. Often, for spastic colitis, accompanied by delayed defecation, drugs are prescribed that are administered intramuscularly. Only an experienced specialist can select the most suitable drug. To do this, it is necessary to establish the exact root cause of the development of the pathology, for which the patient should undergo a thorough diagnosis.

For constipation of spastic etiology, the patient may be prescribed the following medications:

1. Papaverine.
2. Duspatalin.
3. Diabazol.

To eliminate microflora disturbances, a course of prebiotics or probiotics is prescribed. To relieve increased gas formation, they resort to the use of enterosorbents. For prolonged constipation, the patient is recommended to use oil-based laxatives. In order to reduce the irritating effect on the intestinal walls, which is always observed with colitis, drugs with an enveloping effect are prescribed.

The course of therapy is selected for each person individually and exclusively by the doctor. Self-medication can aggravate the situation and lead to irreparable consequences.

Treatment of spastic constipation should be carried out comprehensively. In addition to taking antispasmodic drugs, the patient must resort to the use of enemas, as well as adhere to a special diet.

The temperature of the enema water should not exceed 39 degrees. The procedure should be carried out lying on your side. It is better to add special oils to the solution to help relax peristalsis and soften stool.

Therapeutic diet

As for diet, people who often suffer from spastic constipation need to avoid foods that contribute to gas formation. You should also exclude from your diet:

• strong tea;
• coffee;
• rice and pea porridge;
• mushrooms;
• jelly;
• fatty meats;
• legumes;
• potatoes (only baked ones are allowed);
• hard varieties of cheese.

The menu needs to include more fiber of plant origin. Boiled vegetables are perfect for this; before eating, it is better to chop them and add a little butter or sunflower oil to them. This will help relieve spasms in the colon and promote the passage of stool.

Useful products for spastic constipation are:

• boiled beets and carrots;
• whole grain cereals;
• stale gray wheat bread with bran;
• raw vegetables and fruits (without peel);
• prunes;
• dairy products;
• pumpkin (boiled or baked).

Meals should be in small portions and always in fractions (5-6 times a day). Instead of tea, it is better to drink freshly squeezed fruit or vegetable juices.

Traditional therapy

Traditional medicine also knows how to treat spastic colitis with constipation This type of therapy includes taking herbal decoctions and infusions. For example, anise seeds, which can be infused and drunk instead of tea, are an excellent remedy for increased gas formation.

For systematic constipation, a decoction of wild flax, which should be drunk together with the seeds without straining, is a great help. A tincture of cumin and wheat is also effective.

To prepare remedies for constipation in spastic intestinal colitis, alternative medicine resorts to the use of components such as:

• rowan berries;
• cowberry;
• elder;
• summer aloe leaves;
• blackberry;
• buckthorn bark;
• oregano herb;
• senna;
• cucumber broth;
• honey;
• Dill seeds.

Chamomile and dandelion roots also help to cope with the lack of bowel movements. Castor oil is considered the best remedy against constipation. But you need to drink no more than 5 drops, otherwise you can provoke diarrhea.

If spastic constipation occurs due to nervous strain, then mint tea with lemon balm will be an effective remedy. There are quite a lot of similar recipes for combating constipation. But before starting unconventional treatment, you should consult your doctor.

Prevention of pathology

For effective prevention, it is recommended to follow the following rules:

• Healthy food;
• reduce stress levels, normalize sleep patterns. You can use breathing exercises and mild sedatives to relieve anxiety attacks.
• perform simple exercises in the morning or throughout the day to stimulate motor skills.
• do not drink alcohol, do not smoke, limit the consumption of coffee and strong tea.
• receive massage sessions to improve intestinal motility.

Preventive measures are mandatory for those who suffer from gastrointestinal disorders. At the initial signs of pathology, it is recommended to consult a specialist and not treat the disease yourself.

Prognosis of spastic colitis

This disease is quite treatable if you see a doctor in a timely manner. Possible complications and transition of the disease to a chronic form are possible in the absence of the necessary treatment.

List of references: https://abc-medicina.com/gastrojenterologija/spasticheskiy-kolit https://yandex.ru/health/turbo/articles?id=4413 https://biotus.com.ua/bolezni1/patologija-organov -pischevarenija/spasticheskij-kolit.html nadejdamed.ru/medical/proktologiya/lechenie-kolita/lechenie-spasticheskogo-kolita/ https://www.poltavalk.com.ua/index.php?option=com_content&view=article&id=801: 2010-10-12-11-50-35&catid=116&Itemid=160 https://biolika.ua/213-spasticheskiy-kolit https://www.dobrobut.com/library/c-priznaki-spasticeskogo-kolita-i- drugih-ego-form-lecenie-profilaktika https://naran.ru/bolezni/zheludochno-kishechnyy-trakt/spasticheskiy-kolit/ https://doc.ua/bolezn/kolit Notes from the author of the article, based on personal experience. This material is purely subjective and is not a guide to action. Only a qualified specialist can determine an accurate diagnosis and prescribe treatment.

Last modified: 03/14/2020