Hospital therapy. Treatment, prognosis of chronic enteritis (the most important)

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Hospital therapy. Treatment, prognosis of chronic enteritis (the most important)

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46. Treatment, prognosis of chronic enteritis

Treatment. Treatment of chronic enteritis should be comprehensive, including agents that affect etiological factors, pathogenetic mechanisms, as well as local and general symptoms of the disease.

The basis is dietary nutrition, which helps to reduce the increased osmotic pressure in the intestinal cavity, reduces secretion, and normalizes the passage of intestinal contents.

Drug therapy should be etiotropic, pathogenetic and symptomatic. Etiotropic treatment: for grade II-IV dysbiosis, antibacterial drugs are prescribed: metronidazole (0,5 g 3 times a day), clindamycin (0,5 g 4 times a day), cephalexin (0,5 g 2 times a day). day), biseptol (0,48 g 2 times a day), sulgin (1 g 3-4 times a day), furazolidone (0,1 g 4 times a day). After using antibacterial drugs, eubiotics are prescribed - bifidumbacterin or bificol 5 doses 3 times a day 30 minutes before meals, colibacterin or lactobacterin 3 doses 3 times a day before meals, hilak-forte 40 drops 3 times a day before meals. Treatment with bacterial preparations is carried out for a long time: 3 courses of 3 months each year. For staphylococcal dysbacteriosis, an antistaphylococcal bacteriophage is prescribed (20 ml 3 times a day for 15-20 days), for proteus dysbacteriosis - coliprotean bacteriophage orally, 20 ml 3 times a day, the course of treatment is 2-3 weeks.

To improve the digestion process, enzymes are recommended: pancreatin, panzinorm forte, festal, digestal, pankurmen, mezim forte, trienzyme, the doses of which are selected individually (from 1 tablet 3 times a day to 3-4 tablets 4 times a day) and which are prescribed directly before or during meals for 2-3 months. If necessary, enzyme replacement therapy is continued for a longer time.

To correct water and electrolyte disorders, intravenous administration of panangin 20-30 ml, calcium gluconate 10% 10-20 ml in 200-400 ml of isotonic solution or glucose solution, polyionic solutions "Disol", "Trisol", "Quartasol" are indicated. Electrolyte solutions are administered intravenously for 10-20 days under the control of the acid-base state and the level of blood electrolytes.

Forecast and prevention. The prognosis for life and working capacity in most cases is favorable. Prognostically unfavorable signs are a continuously relapsing course of the disease, a sharp significant weight loss, anemia, a syndrome of endocrine disorders (decreased libido, dysmenorrhea, infertility).

Prevention of chronic enteritis consists in the timely treatment of acute intestinal infections and concomitant diseases of the gastroduodenal zone, in observing the diet, in the prophylactic administration of bacterial preparations during X-ray and radiotherapy.

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