Hospital therapy. Chronic enteritis. Etiology, pathogenesis, classification (most important)

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Hospital therapy. Chronic enteritis. Etiology, pathogenesis, classification (most important)

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44. Chronic enteritis. Etiology, pathogenesis, classification

Chronic enteritis is a disease of the small intestine, characterized by a violation of its functions (digestion and absorption) against the background of dystrophic and dysregenerative changes, culminating in the development of inflammation, atrophy and sclerosis of the mucous membrane of the small intestine.

Etiology and pathogenesis. This is a polyetiological disease that can be the outcome of acute inflammation of the small intestine or a primary chronic process.

In recent years, Yersinia, Helicobacteria, Proteus, Pseudomonas aeruginosa, rotaviruses, numerous representatives of protozoa and helminths (giardia, ascaris, tapeworms, opisthorchia, cryptosporidium) have been given great importance as an etiological factor in chronic enteritis.

Of great importance in the occurrence of chronic enteritis are alimentary factors - overeating, eating dry food, unbalanced, predominantly carbohydrate foods, abuse of spices. Enteritis is caused by ionizing radiation, exposure to toxic substances, and drugs. Among the common pathogenetic mechanisms of chronic diseases of the small intestine, there are changes in the intestinal microflora against the background of a decrease in local and general immunity.

Changes in the immune status - a decrease in the content of secretory lgA, an increase in the level of lgE, a decrease in blast transformation of lymphocytes and inhibition of leukocyte migration - lead to colonization of the small intestine by representatives of opportunistic microflora and a decrease in normal anaerobic flora.

Morphologically, chronic enteritis is manifested by inflammatory and dysregenerative changes in the mucous membrane of the small intestine. If the process progresses, its atrophy and sclerosis are observed.

Classification (Zlatkina A. R., Frolkis A. V., 1985).

1. Etiology: intestinal infections, helminthic invasions, alimentary, physical and chemical factors, diseases of the stomach, pancreas, biliary tract.

2. Phases of the disease: exacerbation; remission.

3. Degree of severity: mild; moderate; heavy.

4. Flow: monotonous; recurrent; continuously recurring; latent.

5. Character of morphological changes: eunit without atrophy; jeunitis with moderate partial villous atrophy; jeunitis with partial villous atrophy; eunit with total villous atrophy.

6. The nature of functional disorders: disorders of membrane digestion (disaccharidase deficiency), malabsorption of water, electrolytes, trace elements, vitamins, proteins, fats, carbohydrates.

7. Complications: solaritis, nonspecific mesadenitis.

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