Related articles: Spastic colitis
Definition
Spastic colitis is a functional disorder that affects the last part of the intestine. It is a disorder characterized by problems of motility of the gastrointestinal system, which depending on the case may be higher (too fast → diarrhea) or lower (too slow → constipation) than normal.
Spastic colitis tends to begin in young adults and, generally, has a chronic course, with recurrent symptomatic attacks separated by irregular periods of stasis.
The underlying causes of spastic colitis are still not entirely clear, but it seems that some factors may favor their development. These include genetic predisposition, sedentary life, infections, food intolerances, changes in bacterial flora, anxiety, stress and somatization disorders.
In order to be able to speak of spastic colitis, laboratory analyzes, x-ray examinations and anatomopathological investigations must be normal, therefore no organic cause must be found.
Most common symptoms and signs *
- Halitosis
- Alve alterations
- Anorexia
- Asthenia
- Bad digestion
- Abdominal cramps
- Diarrhea
- dyschezia
- Abdominal distention
- Pain in a hip
- Abdominal pain
- Abdominal pain on palpation
- Anal pain
- Belching
- Hard stools
- Ribbed stools
- Flatulence
- Abdominal swelling
- Abdominal gurgling
- Fecal incontinence
- Insomnia
- Hyperalgesia
- Headache
- Functional Meteorism
- Mucorrea
- Nausea
- Constipation
- Rectal tenesmus
Further indications
Spastic colitis is characterized by abdominal pain, more often localized to the lower quadrants, of a continuous or cramped type, which occurs in relation to changes in the alvus (in the constipated or diarrheal sense). This feeling of discomfort is attenuated typically after defecation or following the expulsion of intestinal gases.
Abdominal pain is temporarily associated with signs of altered intestinal regularity, that is, changes in the frequency of evacuations (increase in the variant with diarrhea and decrease in the one with constipation) and / or stool consistency, becoming very hard or liquid and poorly formed.
Although alterations of the alvus are relatively constant in most patients, it is not uncommon to alternate episodes of constipation with diarrheal ones.
Patients may also experience symptoms associated with defecation (difficult stool expulsion, urgency or feeling of incomplete evacuation), mucus discharge from the rectum, anal and perineal pain, abdominal swelling and / or distention.
In addition, post-prandial visceral hypersensitivity (hyperalgesia) may occur with frequent cramps and dyspeptic symptoms, such as meteorism, flatulence, early satiety and nausea.
Often, spastic colitis also causes extraintestinal manifestations, such as a sense of tiredness, easy fatigue, muscle pain and chronic headache. The symptoms of spastic colitis rarely wake the patient up during the night's rest, predisposing him to sleep disorders.
Situations with a high emotional impact, an incorrect diet (ingestion of fatty foods, poor hydration and reduced fiber ingestion), hormonal changes induced by the menstrual cycle or taking certain drugs can trigger or aggravate gastrointestinal symptoms.
Overall, spastic colitis does not represent a serious pathology, but can significantly compromise the quality of life of those suffering from it.
The diagnosis is based on the characteristics of the alvo, on the onset and on the characteristics of pain, and requires the exclusion of other pathological processes through physical examination and routine investigations.
Conditions that can be confused with spastic colitis include bacterial enteritis, diseases of the biliary tract, lactose intolerance, colonic diverticula, drug-induced diarrhea, laxative abuse, parasitic infections (eg giardiasis) and chronic intestinal inflammatory diseases initial.
The clinical evaluation can make use of blood count, biochemical profile, stool culture and parasitology (in patients with predominantly diarrheal episodes), TSH and calcemia (in case of constipation), flexible sigmoidoscopy or colonoscopy. In spastic colitis, the characteristics of the mucosa and vascularization appear normal; if objectable alterations are found, therefore, further investigations may be indicated, such as abdominal ultrasound, CT, barium enema, esophagogastroduodenoscopy and small radiological examinations.
The treatment of spastic colitis is directed to the control of specific symptoms and consists in the modification of the diet and in the taking of drugs, including anticholinergics and agents active on serotonergic receptors. Regular physical activity helps reduce stress and improves bowel function, especially in patients with constipation.
