Ulcerative colitis, referred to as ulcerative nodes, is a nonspecific inflammatory bowel disease of unknown etiology that may be associated with genetics, dietary allergies, infection, autoimmunity, depression, and anxiety. The disease mainly involves the mucosal layer of the large intestine, and the lesions develop from the distal to the proximal rectum in a continuous manner, with the distal end being heavier than the proximal end. Clinical involvement of the rectum and sigmoid colon is common, and those with lesions confined to the rectum are called ulcerative proctitis or distal colitis. The main complications include toxic colonic dilatation and carcinoma. The disease can occur at any age, but is more common in people aged 20 to 40 years. It is common in nonsmokers. Diagnosis The disease has a chronic course, with an insidious onset and a prolonged course of several years to more than 10 years, often alternating between an active phase and a remitting phase. Most patients present with abdominal pain, diarrhea, and mucopurulent stools. The number of diarrhea and blood in the stool is related to the severity of the lesion: 2-4 bowel movements per day in mild cases, with little or no blood in the stool; 10 or more times per day in severe cases, with pus and blood evident. Patients are often accompanied by abdominal distension, fever, and weight loss. Those with typical clinical manifestations, combined with colonoscopy, barium enema found to begin in the distal colon mucosal continuity, erosive ulcerative inflammation can make the initial diagnosis. Clinically, it can be divided into chronic recurrent, chronic persistent, fulminant and primary types. The severity can be classified as mild, moderate or severe. The extent of the lesion can involve the rectum (>95%), recto-big colon, left hemicolectomy, and total colon. The disease stage can be divided into active and remission stage. The extraintestinal manifestations and complications include joint, skin, eye, liver and biliary system involvement; complications include hemorrhage, perforation, toxic megacolon and carcinoma. The main conditions to be differentiated are infectious diarrhea, colonic Crohn’s disease, ischemic enteritis, radiological colitis, etc. Multiple stool cultures for S. dysenteriae, non-typhoid Salmonella, Campylobacter jejuni, smears for ameba and excluding schistosomal infections are required. Treatment The purpose of treatment is to control acute attacks, relieve symptoms, prevent complications and prevent recurrence. In mild cases, salicylic acid preparations are the mainstay, supplemented by local enemas or Chinese medicinal preparations if necessary; in heavy cases, on the basis of salicylic acid preparations and local enemas, glucocorticoid drugs are required, and immunosuppressive drugs or biological agents are added for those with poor results or intolerance. At the same time, systemic nutrition and symptomatic treatment should be strengthened, water-electrolyte balance should be maintained, blood and albumin should be transfused, and TPN or elemental diet should be given in severe and fulminant cases. Both active and remission phases are treated with drugs, but the types and doses of drugs are not the same. Salicylic acid preparations are the main drugs Salicylic acid preparations traditionally include salazosulfapyridine, which is a relatively inexpensive drug that needs to be broken down by intestinal bacteria into 5-aminosalicylic acid (5-ASA) after oral administration to exert therapeutic effects. 4-6g/d of the drug is administered orally in 4 doses during the exacerbation period and is changed to 2g/d for maintenance after remission. Overall the new salicylic acid formulations are clinically similar to SASP in terms of dosing and efficacy, but with a low incidence of side effects. In general, lifelong maintenance therapy is recommended for all ulcerated patients, especially those with left-sided colitis or extensive colitis, and those with distal colitis that recurs more than once a year, but treatment may be discontinued for those with ulcerative proctitis that has been in remission for 2 years or who do not wish to receive this type of medication. Topical enema therapy Fewer oral drugs can reach the rectal area and most may be embedded in the stool, so enema therapy is more important and more effective for patients with blood in the stool. The enema solution mainly consists of lidocaine, metronidazole, dexamethasone, etc. The enema can also be reserved with traditional Chinese medicine such as tin class san and ice borax, bitter ginseng alkali combination. Patients can learn to take enemas at home under the guidance of health care professionals, which can facilitate treatment and save a lot of money.