Chronic colitis is long-term inflammation of the colon. It is characterized by inflammatory changes in the colon lining and impaired colon function. The two most common causes are ulcerative colitis and Crohn's disease. Diagnosis involves medical history, clinical exam, testing stool samples, and examination of colon tissue under a microscope. Treatment focuses on diet, medications to control symptoms and inflammation, and sometimes surgery. The condition requires monitoring over time and lifestyle modifications to prevent flare-ups.

1. CHRONIC COLITIS
BY ANNABEL

2. DEFINITION
Colitis is inflammation of your colon, also known as your
large intestine.
Polietiological disease characterized by inflammatory
and degenerative changes in the mucosa and impaired
function of the colon.
Pathologists use the word chronic to describe any
condition that has been going on for a prolonged period
of time. For many patients with chronic colitis,
inflammation may have been present in the colon for
months or even years before a diagnosis is made.

3. The colon
The colon is divided into sections which include the
cecum, ascending colon, transverse colon, descending
colon, sigmoid colon, and rectum. The colon absorbs
water from the food that we eat and move waste out
of the body.

5. Classification
By localization : • total •
segmental (rightsided, cecitis,
transversitis , sigmoiditis ,
Proctosigmoiditis )
Phases of the disease : acute
phase ; • phase of partial
remission ; • phase of complete
remission .
Severity : • mild ; • moderate ; •
severe .
By the nature of functional
disorders : • with impaired motor
function of the colon ; • without
dysfunction ; • with symptoms of
intestinal dyspepsia ; • without
the effects of intestinal dyspepsia
.
The morphological features : •
catarrhal ; • atrophic ; • mixed .

6. Classification

7. Etiology
The most common cause of chronic colitis is
inflammatory bowel disease (IBD).
There are two types of inflammatory bowel disease,
ulcerative colitis, and Crohn’s disease.
Because both types of IBD can look similar when
examined under the microscope, you may not be able to
say whether the changes seen in your tissue sample are
caused by ulcerative colitis or Crohn’s disease.

9. Clinics
The clinical picture of chronic colitis is dependent on the etiology ,
localization process , the degree of morphological and functional
changes in the intestine.
• abdominal pain – character :aching, pressing, sometimes paroxysmal appearing,
aggravating factor- 30-90 minutes after eating, before stool, Localized in different
departments , but can be spilled , often radiates to the back , the area of the anus ,
decreases after a bowel movement or flatus .
• When distributing the pathological process in the bowel serosa ( pericolitis ) or lymph
nodes ( mesadenitis ) pain is constant monotonous character , not associated with
food intake , but can be aggravated by motion, after defecation, from warmer .

10. Clinics
A violation of stool: At one and the same patient may has unstable stool , constipation alternating with diarrhea. Urging to stool may
disturb immediately after meals , at bedtime. Often patients complain of incomplete emptying of the bowel . There are so-called "
locking diarrhea " when constipation is replaced once or twice a profuse diarrhea.
Flatulence
Bloating located mainly in the lower and lateral parts , accompanied by rumbling , a feeling of heaviness
In some patients the dyspeptic symptoms (nausea, burping air , bitter taste in the mouth , loss of appetite ) .
Patients concerned about poor sleep , weakness, irritability, emotional lability .

11. • In the absence of total lesions of the colon, clinical manifestations associated with
localization of pathological process .
1. In right-sided colitis or diarrhea cecitis often observed up to 10 times a day,
pain in the right part of the abdomen , especially in the iliac region , radiating
to the leg, loin . On palpation revealed spasm or extension of the cecum .
2. Transversitis - the defeat of the transverse colon - is characterized by pain ,
rumbling , feeling of fullness in the middle of the abdomen, appearing
immediately after a meal , alternating constipation and diarrhea . With the
defeat of the splenic flexure of the colon ( Angulitis ) patient concerned severe
pain in the left upper quadrant, radiating to the back and left side of the chest ,
unstable stool , a loud rumbling in the right upper quadrant . When percussion
in the left upper quadrant determined thympanitis , palpation - soreness.
3. Left-sided colitis ( proctitis, sigmoiditis , Proctosigmoiditis ) are the most
common . This form is characterized by pain in the left iliac region , rectum ,
tearing in mesogaster worse after a bowel movement. Possible false desires
with flatus and mucus. On palpation the sigmoid colon cut , sore , swollen
gases. It can be defined dense stool , giving it a lumpy appearance.

12. Diagnosis
• The diagnosis of chronic colitis is based on
1. medical history
2. clinical data
3. results coprological and bacteriological examination of feces
4. confirmed by barium enema
5. sigmoidoscopy
6. colonoscopy with biopsy mandatory and morphological study of
mucosal biopsies
7. ultrasound of the colon.

13. When examining tissue samples from the colon under the microscope,
pathologists look for specific microscopic changes before making the
diagnosis of chronic colitis. Some of these changes tell your pathologist
that the damage has been ongoing for a long period of time. These
changes include
1. crypt distortion
2. basal lymphoplasmacytosis
3. and Paneth cell metaplasia.
Other changes tell your pathologist that the damage is active and
continuing to cause new damage. These changes include
1. Cryptitis
2. crypt abscesses
3. and ulcers.

14. • Atrophy – Atrophy is a loss of
tissue compared to normal. In the
colon, atrophy means that the
crypts that are seen are smaller
than normal, healthy crypts.
• Crypt loss – There is a
complete loss of crypts in some
areas of the mucosa.
• Branching – Instead of being
long and straight, these crypts
split to form multiple branches.
Crypt distortion

19. • Granulomas are a sign of chronic colitis. It is a clue that the changes seen are caused by
Crohn’s disease rather than ulcerative colitis

20. Treatment
given the state of the patient and the phase of the disease , it can be
performed on an outpatient basis or in the hospital.
1. gentle mechanical and chemical diet , split meals 4-6 times a day .
2. Supplied food must be in a shabby , cooked by steaming or broth.
3. Should be excluded from the diet, , milk , salted, smoked and spicy
dishes . Patients with severe constipation shown products
containing adequate amounts of fiber , dietary fiber , as well as
vegetable and fruit juices .
4. Stop alcohol consumption

21. pharmacological
1. astringent for diarrhea , enveloping and adsorbing agents : De-nol , smectite (1 pack .
3 times a day ) , bismuth nitrate (1 g three times a day) .
2. Normalization of motor-evacuation function diarrhea contributes metaclopramide (
0.001 3 times a day ) . Have a similar effect and decoctions of plants containing tannins
- fruits dried blueberries, oak bark , sage leaf , stems alder. Flatulence in fees
herbs suitable to add the cumin seeds , fennel , chamomile .
3. In the presence of inflammatory changes of the mucous shown antibacterial drugs .
Increasingly used sulfa - ftalazol (0.5 to 4 times a day) , nitrofuranovye drugs -
furagin , furadonin ( 0.1 , 3 times a day) . Treatment 7-14 days.
4. When expressed pain syndrome prescribe antispasmodics
( drotaverin , Nospanum ) platifillin .
5. With the defect of the rectum have a good effect microclysters - oil ( sea buckthorn,
rose) , decoction of chamomile.

22. Treatment
physiotherapy - electrophoresis with
novocaine platifillina , calcium chloride ,
UHF , ultrasound, Amplipuls , diathermy,
warm baths, hot compress .
If necessary, in the range of therapeutic
interventions include sedatives ,
psychotherapy , acupuncture .
Sanatorium treatment indicated only in
remission ( sanatorium " Krynica ", "
Riverlands " resorts "Naroch ", " Bobruisk
," " Druskeninkay ", " Essentuki" ).

23. Medical and social assessment
• During an exacerbation of chronic colitis patients need relief from
work. In chronic colitis patient contraindicated moderate trips, daily
and night shifts . Limitation of employment may necessitate the
establishment of their three disability groups .

24. Prevention
prevent acute intestinal infections
elimination of chronic foci of infection
compliance culture and nutrition
healthy lifestyle
Restriction of the use of alcohol
constant physical training and sports
strengthening the nervous system.

25. The end
Thanks for your attention