Synonyms.—Tubular Diarrhea; Membranous Enteritis.
Definition.—A chronic disease of the colon, characterized by the formation of masses or plugs of mucus, which are voided in strings, shreds, or in tubular form.
Etiology.—The definite cause is not known. It most frequently occurs in women of nervous temperament and hysterically inclined, and in neurasthenic males. It is often found in connection with other rectal troubles, such as hemorrhoids, pockets, papilla, and hypertrophy of the rectal mucosa and prolapsus of the bowel. It is occasionally found in delicate children with prolapsus of the bowel.
Pathology.—The pathological changes are not very marked and can not be said to be characteristic. There may be seen localized catarrhal areas, and the sigmoid and the rectum may be relaxed, of a purplish hue and bathed in tenacious mucus. It may possibly be due to irritation of the sympathetic system of nerves, for the correction of rectal irritation and urethral and uterine disorders is invariably followed by an improved condition of the entire intestinal tract.
Symptoms.—The mucus may be passed daily, though usually it occurs in paroxysms at intervals of three or four weeks. Each attack is usually marked by pain, tenesmus, and more or less nervous excitement. An attack may last for several days, when there is an interval of rest for a few weeks. The passing of the mucus gives some relief to the pain. Any undue or prolonged excitement brings on an attack.
Diagnosis.—This is readily recognized by the character of the stool.
Prognosis.—The disease is chronic in character, and requires not only treatment for the colon, but also to improve the nervous condition of the patient. They are usually very unsatisfactory patients to treat, though there is little danger to life. When the causes can be removed the prognosis should be favorable.
Treatment.—A thorough examination should be made of the rectum and reproductive apparatus, and any wrongs that are found, corrected. Sometimes colonic flushing with water, medicated to suit the case, will give very good results. Where there is catarrh of the sigmoid, and there usually is in these cases, the local application of balsam of Peru, as mentioned in treatment for chronic enteritis, will be highly beneficial. The diet of the patient should be carefully selected, avoiding such articles of food as experience has proved harmful.
All sources of irritation to the mind and body should be avoided. Change of one's surroundings is often far more beneficial than medication. Nux vomica and hydrastin is a good tonic. and should be given three times a day. Potassium bichromate. 2x, in three-grain doses, will do much to overcome the excessive secretion of mucus. Agrimony one dram, to water four ounces, a teaspoonful every three hours, will benefit some cases. When an attack comes on, the patient should be put to bed and all excitement avoided.
The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.