Among the diseases of the intestines, the most common are colitis - inflammation of the mucous membrane of the large intestine, enteritis - inflammation of the mucous membrane of the small intestine and enterocolitis - inflammation of the mucous membrane of the entire intestine. These inflammatory processes can be acute and chronic. The reasons for their occurrence are varied. The main reason is the entry of pathogens into the gastrointestinal tract (dysentery bacillus, salmonella, giardia). Of no small importance in the development of chronic colitis is secretory insufficiency of the stomach, pancreas and small intestine. Sometimes the development of colitis is based on a neuroreflex mechanism. Wherein various diseases stomach, biliary tract and pelvic organs can reflexively cause spasms that contribute to stagnation of intestinal contents and over-irritation of the intestinal mucosa. Colitis can be caused by eating disorders and a sedentary lifestyle.

Characteristic signs of colitis are cramping pains, diarrhea, and less commonly, constipation. Patients with colitis are treated with dietary nutrition, anti-inflammatory drugs, mineral waters, medicinal products. physical culture.

important role in the success of treatment exercise plays right choice starting positions - depending on the period of training and motor mode. So, with spastic colitis on bed rest (I period of classes), lying on the back with legs bent at the knee joints, as well as kneeling, on all fours, are used. These positions help to relax the muscles of the anterior abdominal wall and have a beneficial effect on intra-intestinal pressure. Physical exercises in the initial standing position are contraindicated, since the load in this case helps to increase the tone of the intestinal muscles. Also contraindicated are exercises in the prone position with raising and lowering straight legs and other exercises for the abdominal muscles, since they increase spastic phenomena in the intestines.

With the improvement of the general condition of the patient and the attenuation of pain, the II period of physical therapy begins. General developmental and special exercises are performed at a slow and medium pace in all starting positions. The emphasis is on relaxation exercises. Effectively relaxes the muscles of the intestine segmental massage.

With atonic colitis in the first period of training, it is recommended to perform exercises from various starting positions, with a significant load, and strength elements. However, one should follow the principles of a gradual increase in load, a differentiated approach to the choice of gymnastic exercises, and take into account the patient's reactions to exercises.

In the second period of classes, the range of general strengthening and special exercises is significantly expanded. Frequent change of starting positions is recommended.

In the remission phase (period III), exercises with shells, special exercises for the abdominal press, and dosed walking are included.

The method of therapeutic physical culture for enteritis and enterocolitis depends on the phase of the disease and is built similarly to the method for and colitis.

A characteristic symptom of many bowel diseases is constipation - a long delay in bowel movement. Distinguish constipation atonic and spastic. The former develop as a result of a weakening of the muscular layer of the intestine, the latter are due to a prolonged reduction in circular muscle fibers. The development of constipation may be facilitated by a decrease in physical activity, overstrain of the nervous system, monotonous food, the intake of certain toxic substances into the body. Constipation should be considered as a general disease of the whole organism. At the same time, patients complain of general weakness, headaches, decreased performance, weakening of memory. Constipation contributes to the development congestion and dilatation of the veins of the rectum, therefore, may be one of the causes of hemorrhoids.

With constipation of a spastic nature, patients who are on bed rest are first recommended to use the sparing effect of physical exercises that contribute to the normalization of motor function. Against the background of general developmental exercises, special exercises with diaphragmatic breathing (with and without movements), exercises in relaxation are widely introduced. When transferring patients to half-bed rest (II period), exercises for the abdominal muscles are more widely included in the exercises, but without straining.

In classes with patients suffering from atonic constipation, in bed rest (I period), in addition to general developmental exercises, special exercises are used to enhance intestinal motility: exercises for the abdominal muscles and pelvic floor in combination with deep abdominal massage. The duration of therapeutic exercises is 15-20 minutes. In the second period of classes, a large number of exercises for the muscles of the abdominal press and the pelvic floor with deep diaphragmatic breathing are included. Shows a frequent change of starting positions, tilts, turns, jumps, running. The duration of classes is increased to 30 minutes.

Colitis is a chronic inflammation of the lining of the large intestine. A significant role in their occurrence is played by prolonged malnutrition, constipation, abuse of laxatives. With this disease, physical education is useful.

Conventions: IP - starting position; TM - the pace is slow; TS - average pace.

1. Walking around the room for 30-60 seconds, alternating with breathing exercises.

2. IP - lying on your back. Flexion and extension of the body. TM. 6-8 times. Breathing is even.

3. IP - the same. Take turns bending the legs. TS. 5-7 times with each leg.

4. IP - the same. Take turns lifting your legs up. TS. 6-8 times with each leg.

5. IP - sitting, hands in support behind. Raising and lowering straight legs. TS. 5-7 times.

6. IP - on all fours. Pulling the leg back and then pulling it to the stomach. The same with the other leg. TS. 5-8 times with each leg.

7. IP - lying on your back, legs bent. Turning the legs to the left - to the right. TM. 6-8 times in each direction.

8. IP - lying on your back, bend over, hands behind. Sit down. Return to IP. TS. 5-7 times.

9. IP - the same. "Bike". TS. 25-30 sec. Breathing is free.

10. IP - sitting on a chair, emphasis with hands behind. Deep squat forward; return to IP. TS. 6-8 times.

11. IP - sitting on a chair. Leaning forward. TM. 5-7 times. When tilted - exhale.

12. IP - the same, only hands on the belt. Leaning forward. TS. 4-6 times.

13. IP - sitting, arms to the sides. Turns left and right. TS. 5-7 times in each direction.

14. IP - standing at the chair. Step with the left foot - inhale; return to IP - exhale. The same with the other leg. TS. 6-8 times with each leg.

15. IP - lying on your back. Bend - inhale; return to IP - exhale. TM. 5-7 times.

16. IP - lying down, emphasis with hands behind - bend over. Sit down - bend over. TS. 6-8 times.

17. IP - knee-elbow. Raise the pelvis up - inhale; return to IP - exhale. TS. 5-8 times.

Physical exercise has a wide range of effects on the entire body. With dosed and moderate physical activity, the process of blood circulation and nutrition of all internal organs, including the abdominal cavity. Physical education strengthens the abdominal muscles, the effective work of which plays an important role in the prevention and treatment of diseases of the stomach and especially the intestines.

In addition, it activates diaphragmatic breathing. The diaphragm is the layer of muscle that separates the chest and abdomen. She participates in the act of breathing and the organization of normal intestinal motility. Intensity physical activity depends on individual tolerance. If after performing a set of exercises there is a feeling of fatigue, the selected rhythm and load should be reduced. After doing the exercises, it is recommended to count the pulse and respiration rate. If the pulse after a 10-minute session is more than 100 beats per minute, and the respiratory rate exceeds 30 breaths per minute, it is better to slow down the pace.

It is best to exercise outdoors, in a forest or park. If this is not possible, they should be performed in a well-ventilated room. Sportswear should be comfortable, not restricting movement, best of linen or cotton. It is better to do physical education in the morning, when the body is not yet tired after a hard day. But it is undesirable to exercise immediately after waking up. You should give the body the opportunity to wake up, eat a light breakfast and take a warm shower.

A set of exercises to improve bowel function

1. Starting position: standing, feet shoulder-width apart, hands on the belt. Perform body turns to the right and left 6-8 times in each direction. Breathing is arbitrary.

2. Starting position: standing, feet shoulder width apart, hands on the belt. Slowly sit down, stretching your arms forward - exhale, take the starting position - inhale. Exercise to perform 6-8 times.

3. Starting position: standing, feet shoulder-width apart, arms spread apart. Tilt your torso forward, lower your arms down - exhale, return to the starting position - inhale. Perform 6-8 times in each direction.

4. Starting position: standing, feet shoulder-width apart, arms spread apart. Simulate the movement of a cyclist for 2-3 minutes. Breathing is arbitrary.

5. Starting position: sitting on a chair, arms bent at the elbows, palms on the back of the head. Raising the elbows to the sides - inhale, mixing - exhale. Perform 6-8 times.

6. Starting position: standing, legs together, hands on the belt. Rotate the body to the right with abduction right hand to the side - inhale, return to the starting position - exhale. Repeat the same to the left side with the abduction of the left hand. Perform the exercise 6-8 times in each direction.

7. Starting position: standing, legs together, arms along the body. Raise your arms up with the right leg abducted back and on the toe - inhale, return to the starting position - exhale. Repeat the same with the other leg. Perform the exercise 4-6 times with each leg.

Colitis is the general name for a whole group of inflammatory lesions of the colon mucosa. Different colitis has different causes, a different mechanism of occurrence, and they develop in different ways. However, outwardly, these diseases have a lot of similarities, which gave doctors reason to combine them into one group. After all, it is not the mechanism and not the cause that is important for the patient, but how the disease manifests itself in him personally and how to treat it. The art of the doctor, patience and perseverance of the patient can successfully deal with colitis even in difficult cases. Inflammation of the colon mucosa is familiar to many of us. It can spread to all departments of the large intestine or to its individual parts. The degree of damage is different - from mild inflammation, causing only bubbling in the abdomen and mild pain spasms, to pronounced ulcerative changes. So the range of symptoms of colitis is very wide, in addition, this disease can be complicated by inflammation of the stomach or small intestines. But with irritable bowel syndrome similar to it, which is not associated with the large intestine, colitis should not be confused - but this is the doctor's business.

Fortunately, the most dangerous of them, non-specific, are the least common. These are ulcerative colitis, granulomatous and ischemic colitis. But functional lesions of the colon are very common: spastic constipation, atonic constipation and functional diarrhea.

The presence of infection in the organs of the gastrointestinal tract, infection with salmonella, staphylococci, streptococci, etc. from poor-quality food, worms, allergies, monotonous malnutrition, alcohol, long-term use of antibiotics and much more, as well as any combination of these factors, are among the causes of colitis . In the case of nonspecific ulcerative colitis, the role of immunological disorders, genetic and even psychogenic factors is also indicated.

The main signs of acute colitis are abdominal pain, bloating, diarrhea or, conversely, constipation, feces mixed with mucus, and sometimes blood. The general condition worsens, the temperature rises. The duration of the disease is from several days to 2-3 weeks or more.

If acute colitis is not properly treated, it often becomes chronic. An inappropriate diet can provoke an exacerbation of chronic colitis (for example, with spastic colitis, these are vegetables, fruits and cereals containing a lot of fiber), overwork, emotional overload, overheating ...

Chronic colitis can develop regardless of acute - in the presence of foci of infection in the gallbladder, pancreas and other organs of the gastrointestinal tract, with prolonged monotonous nutrition, the systematic use of large amounts of hard-to-digest food, the abuse of spicy foods, alcohol, and some antibiotics.

Treatment of colitis depends on its form, so only a doctor should diagnose and manage treatment.

Methods for the treatment of colitis. Colitis is an intestinal disease, and the main therapeutic measures should help it perform its functions, based on the nature of the disease.

So, functional diarrhea is characterized by frequent loose stools with sudden strong urge to it, aching pain in the abdomen, bloating and rumbling. Spasmodic constipation occurs when the walls of the large intestine become tense, causing spasm. Stool retention up to 2-3 days is accompanied by sharp pains, profuse gas formation, a lot of mucus is released with feces. On the contrary, for atonic constipation (sluggish intestinal wall) is characterized not only by the absence of an independent stool for 3 or more days, but also by the absence of the urge to it. Bloating, lethargy, fatigue gradually increase, fecal stones often form.

Enemas are one of the most important methods in the treatment of colitis; there are cleansing and medicinal enemas. In order for the cleansing enema to work immediately, take from 1/2 to 1 liter of water at a temperature of 22-23 degrees (with spastic colitis - 35-36 degrees, so as not to cause spasm) and slowly, gradually introduce them into the intestines.

But there are also cleansing enemas with subsequent action. They use vegetable oil (up to 150-200 ml) or water-oil suspension (500 ml or more) - at room temperature or heated to 30°C.

The purpose of medicinal enemas is to bring a substance with an astringent, enveloping or anti-inflammatory effect (an infusion of chamomile or calendula or pharmaceutical preparations for the same purpose) directly to the inflamed mucosa. They give a good effect in all types of colitis. The volume of enemas is 500-700 ml, the temperature is 36-38°C. One tablespoon of chamomile (or 1 teaspoon of calendula) is poured with a glass of boiling water, insisted and filtered. After the introduction, they try to delay the infusion in the intestines for 5 minutes.

Usually the course of medicinal enemas is from 7 to 21 days, depending on the patient's condition, 2-3 times a day.

Colitis Diet. With colitis, you need a sparing, but complete and vitamin-rich diet that ensures normal bowel function. Do not abuse laxatives and enemas. You need to eat 4-6 times a day, but if possible do not irritate the intestines with dry, solid food. Porridges are recommended, but with a very strong exacerbation, the amount of carbohydrates supplied with food to the body should not exceed 300 g. Diets in the acute period and after it subsides are different. They are prescribed by a doctor.

With nonspecific ulcerative colitis, the complete exclusion of milk and dairy products from the patient's diet may well lead to a complete or partial cure of the disease.

If colitis occurs chronically in a person, then a protein table (150 g of protein per day) can help here. But various sweets and dough products in the diet of a patient with colitis should not be. Vegetables and fruits are best taken in pureed or boiled form. A good addition to the diet in the treatment of chronic colitis are mineral water(for example, "Essentuki" No. 17) and therapeutic mud.

Your food should not contain irritating hot spices.
Make up your diet of enough high-calorie, but easily digestible foods. It is better to eat boiled or steamed food. Smoked products are undesirable.
In case of functional diarrhea, eat more animal protein products, with the exception of whole milk. Vegetable food should be subjected to heat treatment and not contain coarse fiber.
With spastic constipation, food should contain approximately equal parts of animal protein and fiber, while coarse fiber may be present in small quantities.
With atonic constipation, you will need a lot of fiber: fresh fruit and vegetable juices, fresh vegetable salads, boiled vegetables, wholemeal or bran bread.
Start your meal with steamed boiling water for 5 minutes 1 tablespoon of bran (eaten with the first serving of food).
Activation of the intestines is facilitated by steamed peeled pumpkin, boiled beets, prunes, figs, dates.

With atonic colitis, physiotherapy exercises, abdominal massage and breathing exercises. Exercise therapy increases the overall psychophysical tone of the body, improves the functions of the gastrointestinal tract, strengthens the abdominal muscles. An exercise therapist will help you choose the exercises that are right for you.

To restore bowel function, it is recommended to massage your stomach every morning before getting out of bed, lying on your back with legs outstretched. in a circular motion clockwise, combined with slow deep breathing (exhalation - in the interval between movements).

Breathing exercises in the supine position include two exercises: abdominal breathing(when inhaling, the stomach protrudes as much as possible, when exhaling it relaxes) and wave-like breathing. First, the lower half of the abdomen protrudes, then the upper, and finally, the chest rises and straightens as much as possible. Simultaneously with the rise chest the lower half of the abdomen begins to “fall off” (the beginning of exhalation). Further exhalation occurs in the same sequence as inhalation. At the moment of "falling" of the chest, a new breath begins from the lower half of the abdomen.

Therapeutic exercise plays an important role in complex treatment various forms chronic colitis, enterocolitis and constipation. Target physiotherapy exercises- to strengthen the general condition of the patient, positively influence his neuropsychic sphere, conditioned reflex activity and, by training the patient's body, regulate the function of the autonomic nervous system and improve the condition of the abdominal muscles.

In the origin of constipation, great importance is attached to the violation of the functions of the large intestine in the direction of weakening or strengthening its peristalsis. With primary atonic constipation of a different nature, the technique therapeutic gymnastics consists in applying, against the background of general strengthening exercises, in alternation with breathing and distracting movements, special exercises for the abdominal press (in the initial exercises - lying, sitting and standing) with their gradual complication, active and deep self-massage of the abdomen - corresponding to the location of the large intestine (clockwise ) and exercises with concussion (jumps, jumps, etc.).

Dosages and selection of general and special exercises are carried out in accordance with general condition the patient and his reactivity to the load, avoiding pronounced fatigue. The duration of the therapeutic gymnastics procedure is 15-35 minutes. In addition to morning hygienic and therapeutic exercises, in accordance with the prescribed mode of movement (sparing - limited, tonic or training - extended), walking tours, excursions, moving and sport games.

For colitis with insufficient emptying and spastic constipation, apply gymnastic exercises the simplest type with their gradual complication in combination with respiratory movements, and exercises for the abdominal press are limited: a superficial shallow abdominal massage is prescribed. The duration of the procedure is 10-12 minutes. Instead of morning exercises moderate walking is recommended. In addition to therapeutic exercises in accordance with the prescribed mode of movement, walking and excursions, outdoor recreation, air baths, sports games (towns, bowling alley, volleyball, tennis with a duration of 15-30 minutes) can be used.

With atony and prolapse of the intestine, along with exercises of a general strengthening nature, exercises for the development of the abdominal muscles, including the muscles of the pelvic floor and the diaphragm, are of great importance, with a gradual complication of exercises in various starting positions: lying on your back, side, all fours, on your knees, sitting - and exercises in the transition from one position to another. The pace of movement is calm and moderate. Exercises are performed rhythmically with a gradual increase in the range of motion. Exercises that cause concussions (jumping, jumping, running, etc.) are not recommended, massage or self-massage of the abdomen can be used. In case of adhesive processes of the abdominal organs, it is desirable to carry out therapeutic exercises after a thermal procedure (mud application, mineral bath, etc.). In atonic constipation, mechanotherapy is especially recommended, which is carried out on devices with both active and passive movements. In the fight against chronic constipation of alimentary and atonic genesis, massage is very effective, which aims to improve the nutrition of the intestinal wall, stimulate peristalsis and strengthen the muscles of both the intestines and the abdominal wall.

The main techniques used in these cases are stroking, and then circular and zigzag rubbing. Elements of hydrotherapy are also widely used in the fight against constipation. It is known that cold water procedures increase intestinal motility, while warm ones calm it down and relax spasms. In some way, this principle is also the basis for the treatment of intestinal diseases. you can prescribe a Scottish douche on the stomach, fan and circular low temperature (34-35 ° C), and with excess weight - Charcot douche.In case of spastic constipation, adhesive processes in the abdominal cavity and in the presence of periprocesses, it is recommended to prescribe procedures with a higher temperature.

Electrolight therapy. In chronic colitis and enterocolitis, galvanization, faradization, iontophoresis, diathermy and phototherapy are used. Galvanization is used in the form of segmental therapy - galvanic shorts, galvanic belt or in the form of rhythmic galvanization on the intestinal area. Galvanic current contributes to the elimination of dyskinesia, since in a reflex way "through the central nervous system it affects bowel function. With inflammatory phenomena, many authors (A.S., Vishnevsky) successfully use calcium - iontophoresis or zinc - iontophoresis.

To raise the general tone in persons with an unstable nervous mental sphere, galvanic collars are prescribed.

With spastic phenomena accompanied by attacks of pain, it is advisable to prescribe diathermy, UHF and KB diameters (ultrashort and short waves).

With atonic constipation, to strengthen the neuromuscular apparatus of the intestines, rhythmic faradization, rhythmic galvanization, vibration massage. Atonic constipation can be treated with ultraviolet radiation. Illumination at first with suberythemal, and later with erythemal doses, since the products of protein cleavage (histomine-like substances) stimulate intestinal motility.