Cause Of Mucous Colitis Directs Treatment Ordered
( Originally Published 1936 )
In treating colitis, several forms of the disease must be considered. One is spastic colitis, which sometimes becomes mucous colitis, and the other is ulcerative colitis.
Before the treatment of mucous colitis is started, it is advisable to try to find the cause. This sometimes lies in dietary indiscretions or the habitual use of purgatives. Sometimes the general bodily form induces it; very frequently mental states, nervousness, and an excitable, emotional condition will induce it.
The general indications for diet in these cases are, first, to irritate the colon as little as possible; second, to keep the general nutrition of the patient at par; and, third, to provide adequate elimination. No one single diet can be prescribed for all such cases. Some patients have to have an absolutely smooth, non-irritating diet. The essential feature of this is that coarse foods with fiber, seeds, skin and gristle should not be allowed, nor should salads, tomatoes, pineapple, cu-cumbers, raw fruit or too much sugar. Frequently, however, one meets the patient who, on this smooth, non-irritating diet, does not obtain enough elimination, and fruits and salads have to be added. Drugs should play little part in the treatment of the disease, and purgatives and laxatives absolutely withheld.
In the treatment of ulcerative colitis, dietetic regulations play an important part. There have been some modifications of our views within the last few years. Whereas, formerly we gave an absolutely non-residue diet, of late years it has been found that a high vitamin content of the diet is valuable. Therefore, tomato juice and cod liver oil, oranges, orange juice and lemonade are sometimes added.
The use of acidophilus milk is also beneficial in both these types of colitis. Careful studies have been made upon the number of bacteria in the intestines before and after using acidophilus milk. The milk, if properly given and sufficiently potent, will usually change the putrefactive organisms into a more beneficial aceturic form. It also reduces fermentation and gas.
In the atonic type of colonic disease—ordinary atonic constipation —which is usually symptomless and produces few, if any, changes in nutrition, the type of diet should be entirely reversed. A diet consisting of an increasing amount of roughage in the form of fruit, bran, green vegetables, and sometimes accompanied by mineral oil, is indicated. Salads and such vegetables as contain a large amount of fibre, such as cabbage, celery, radishes, corn and all fruits are beneficial. The use of bitter chocolate, as advised by Cohnheim, has been recommended as being extremely helpful in the correction of constipation. Three or four ounces should be consumed daily for this purpose. The patient is given one and one-half ounces in the morning before break-fast, and a similar amount at bedtime, to be followed by three or four ounces of water.