What are the clinical manifestations and treatment of chronic enteritis?

In daily life, our stomachs may suffer from diarrhea, abdominal pain, nausea and other symptoms due to unclean diet and irregular work and rest. Many friends are always worried about whether they have chronic enteritis. In fact, the real clinical manifestations of chronic enteritis are much more complicated, and reasonable treatment methods can only be formulated based on different clinical manifestations.

1. Clinical manifestations of chronic enteritis

The clinical manifestations are long-term chronic or recurrent abdominal pain, diarrhea, indigestion, etc. In severe cases, there may be mucus or watery stools.

The severity of diarrhea varies. In mild cases, patients may have bowel movements 3 to 4 times a day, or diarrhea and constipation may occur alternately; in severe cases, patients may have bowel movements every 1 to 2 hours, and may even suffer from fecal incontinence. Some patients may have nocturnal diarrhea and/or postprandial diarrhea. When the rectum is severely affected, a feeling of tenesmus may occur. The feces are mostly paste-like, mixed with a large amount of mucus, and often contain pus and blood.

Some patients have fresh blood in their stools, and the lesions are limited to the rectum, which is called hemorrhagic proctitis. The blood or stool is discharged separately, or attached to the surface of normal or dry stool, which is often mistaken for hemorrhoidal bleeding. Patients with proctitis often have mucus and blood in their stools, and may even suffer from fecal incontinence. If the lesions extend above the rectum, blood is often mixed with the stool or bloody diarrhea occurs.

Physical examination may reveal mild tenderness around the umbilicus or lower abdomen, hyperactive bowel sounds, and rectal prolapse.

2. Symptoms of chronic enteritis

1. Physical signs

The patient will experience long-term abdominal discomfort or dull pain in the lower abdomen. Physical examination will reveal that the pain is mainly around the navel, lower abdomen and abdomen.

2. Systemic symptoms

The patient will have symptoms such as lack of energy, sallow complexion, unwillingness to speak, and weakness in the limbs. You may also feel cold. If it is during the acute inflammatory stage, you may also suffer from dehydration, acidosis, fever, or even shock and bleeding.

3. Blood in stool

In milder cases, blood may be attached to the surface, while in severe cases, blood may flow down, which can easily cause the patient to go into shock.

4. Gastrointestinal symptoms

Intermittent abdominal pain, abdominal distension, abdominal pain and diarrhea are the main manifestations of this disease. It is especially prevalent when exposed to cold, eating greasy food, experiencing emotional fluctuations, or after being tired. The frequency of bowel movements increases, with several times or dozens of times a day, anal prolapse, and uncomfortable bowel movements. During acute attacks of chronic enteritis, high fever, abdominal cramps, nausea and vomiting, and urgent watery or sticky, frozen, bloody stools may occur.

3. Treatment of chronic enteritis

Replenish fluids and correct electrolyte and acidosis. For those who are mildly dehydrated and do not vomit severely, oral rehydration can be given. The WHO-recommended oral rehydration formula is sodium chloride, sodium bicarbonate, potassium chloride, glucose or sucrose, plus water. For patients with severe dehydration or vomiting, normal saline, isotonic sodium bicarbonate and potassium chloride solutions, and glucose can be given intravenously.

Drugs that reduce intestinal motility and secretion. Atropine, belladonna, and propantheline can be used in small amounts to reduce intestinal motility, relieve pain, and stop diarrhea. Chlorpromazine can also be used. It has a sedative effect and can inhibit excessive secretion of intestinal mucosa caused by enterotoxins, thereby reducing the frequency and amount of bowel movements.

(1) Get adequate rest, eat easily digestible food, and avoid fried or spicy food. (2) Antidiarrheal agents can be used as appropriate, such as bismuth subcarbonate 1-2g, 3 times a day; compound camphor tincture 4ml, 3 times a day.

(3) Antispasmodics: Atropine 0.3-0.6 mg, 3 times a day; Probenzine 15 mg, 3 times a day.

(4) Antibiotics are selected based on bacterial culture and drug sensitivity tests, but the disease will last for a long time. You can also use 3% berberine solution or 5-10g garlic extract 2

00ml, retention enema, once a day, 10 to 20 days as a course of treatment. Other treatments are the same as for acute enteritis.

(5) For patients with psychogenic diarrhea, 10 mg of chlordiazepoxide 3 times a day or 15-30 mg of phenobarbital 3 times a day can be used.