ABSTRACT
The majority of foreign gastroenterologists have their doubts whether there exist "undifferentiated" colitisis. They consider these to be a variant of the irritable bowel syndrome. We have examined 173 patients. Of these, 67 percent were less than 45 years of age with significant intestinal disorders caused by chronic colitis. Diagnosis of Crohn's disease and nonspecific ulcerative colitis had been excluded. The main complaints of the patients were constipations alternated sometimes with short-time diarrhea (61%), diarrhea (13%), spasmodic pains in the inferior parts of the abdomen (20%), abdominal distention, and rumbling (74%). In 79% there was tenderness in the sygmoid colon and caecum and spasm thereof. Rectoromanoscopy (RRS) revealed normal mucosa of the rectum and sygmoid colon in 70%, proctosygmoiditis (predominantly catarrhal) in 30 percent of cases. In proctosygmoiditis (vs the normal mucosa) motor dysfunctions, disorders of the contrast mass passage through the intestine, gaustrations were more often seen but the relief of the mucosa was intact. Results of morphological investigations of biopsy specimens of rectal and sygmoidal mucosas were compared with endoscopy findings. No histological changes were revealed in 23% patients with proctosygmoiditis whereas in cases of endoscopically normal mucosa moderate inflammation was rarely detectable. Inflammatory changes in the mucosa were to be seen more frequently by cytologic analysis than by biopsy but more rarely than by RRS. In this way, 25% patients with endoscopical diagnosis of proctosygmoiditis had normal cytological picture. The increased amount of intestinal enzymes (enterokynase, alkaline phosphatase) in stools does not permit differentiating the functional and organic types of the disease, but it significantly contributes to endoscopical, morphological, cytological, and clinical data. Our investigations show that "undifferentiated" colitis is a rarity and that one finds difficulty in differentiating between the above condition and the irritable bowel syndrome.
Subject(s)
Colitis/diagnosis , Colonic Diseases, Functional/diagnosis , Dyskinesias/diagnosis , Dyskinesias/physiopathology , Intestine, Large/physiopathology , Adult , Biopsy , Chronic Disease , Diagnosis, Differential , HumansSubject(s)
Ethics, Medical , Philosophy, Medical , Clinical Medicine , Humans , Physician-Patient RelationsSubject(s)
Constipation , Adult , Aged , Cathartics/therapeutic use , Child , Chronic Disease , Constipation/etiology , Constipation/therapy , Diet , Female , Humans , Male , Middle Aged , Physical Therapy Modalities , PregnancyABSTRACT
Current ideas on the etiology and pathogenesis of functional disorders of the large intestine are discussed. Their classification, clinical picture, principles of diagnosis and differential diagnosis are outlined with emphasis of the most spread functional diseases of the large intestine: functional (common) obstipation, irritation of the large intestine pruritus ani, insufficiency of anal sphincters, proctalgia. Special attention is paid to treatment (diet, drugs, physiotherapy, spa).
Subject(s)
Colonic Diseases, Functional/diagnosis , Colonic Diseases, Functional/etiology , Colonic Diseases, Functional/therapy , Constipation/diagnosis , Constipation/etiology , Constipation/therapy , Diagnosis, Differential , Humans , Intestinal Pseudo-Obstruction/diagnosis , Intestinal Pseudo-Obstruction/etiology , Intestinal Pseudo-Obstruction/therapy , Pain/diagnosis , Pain/etiology , Pain Management , Prognosis , Rectal Diseases/diagnosis , Rectal Diseases/etiology , Rectal Diseases/therapySubject(s)
Digestive System Diseases/diagnosis , Aerophagy/diagnosis , Aerophagy/therapy , Anorexia Nervosa/diagnosis , Anorexia Nervosa/therapy , Diagnosis, Differential , Digestive System Diseases/therapy , Dumping Syndrome/diagnosis , Dumping Syndrome/therapy , Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/therapy , Humans , Somatoform Disorders/diagnosis , Somatoform Disorders/therapy , Stomach Diseases/diagnosis , Stomach Diseases/therapy , SyndromeSubject(s)
Syncope/classification , Diagnosis, Differential , Humans , Syncope/diagnosis , Syncope/etiology , Syncope/therapyABSTRACT
In this lecture the authors analyze so-called functional disease of the digestive organs, namely disorders of these organs where modern means are unable to reveal organic changes. The role of emotional and psychic factors on functions of the digestive tract and its blood supply is stressed. From 30 to 50% of gastroenterological patients suffer of functional diseases of the digestive organs. Women prevailed (3:1, 2:1). The etiology, diagnosis and treatment of this condition is described in detail.