I. Overview of ulcerative colitis
Ulcerative colitis, also known as chronic nonspecific ulcerative colitis, is an extensive ulcer of the colonic mucosa. The disease mainly involves the rectum and sigmoid colon, but can also extend upward to the left and right half of the colon, and even the whole colon and the end of the ileum, accompanied by diarrhea, bloody stools or mucous blood stools and other symptoms of non-specific inflammatory disease of the large intestine. The disease varies in severity, most of the disease course is slow, easy to recur, there are also acute outbreaks.
The cause of ulcerative colitis
The cause of ulcerative colitis is not yet known. The medical science has not found the causative microorganisms and pathogens, and may be an autoimmune disease. Modern medicine has many theories about the etiology of the disease, such as infectious factors, psychological factors, enzyme factors, protective substance deficiency factors, genetic factors, immune factors, etc. In recent years, the etiology of the disease is generally considered to be the presence of both immune and genetic factors, while psychological and infectious factors are only predisposing factors.
Studies have shown that most patients with this disease have anxiety, depression, restlessness or hypochondria and other psychological disorders; mental stimulation or mood swings can often be found when the disease occurs and symptoms worsen.
The clinical manifestations of ulcerative colitis
The clinical manifestations of the disease: the age of onset of 20 to 40 years old, more than 50 years old rare, male and female no significant differences; the main symptom of the patient is diarrhea, stool up to l0 times a day, and stool containing mucus and pus blood, the general amount is not much, but there is a lot of blood stool, especially lesions involving the rectum of patients with more blood in the stool and accompanied by the urgency; in the chronic remission period, the number of bowel movements can be reduced to 3 ～In chronic remission, the number of bowel movements can be reduced to 3 to 5 times a day, the feces is atheromatous stool, while in the acute phase is significant symptoms, the patient may have elevated body temperature, loss of appetite, vomiting, abdominal distension, increased white blood cells and other symptoms; long course of the disease, can appear anemia, swelling, wasting, malnutrition and other clinical manifestations.
1, diarrhea diarrhea is one of the main symptoms of the disease, manifested as several times a day to more than 10 times a day can be purulent stool, mucus blood stool or blood in the stool. If the rectum is involved, it can be accompanied by a feeling of urgency and heaviness. Individuals do not have diarrhea but constipation.
2, abdominal pain abdominal pain is vague in mild cases, typically colic, often located in the left lower abdomen and umbilicus, with abdominal pain – stool a relief characteristics.
3, mucus blood stool or blood stool Patients can sometimes discharge a large amount of toothpaste-like material, containing necrotic mucosa, infiltrated inflammatory cells and a little mucus, the surface may carry a little blood. In some cases, the main manifestation is lower gastrointestinal hemorrhage, the incidence is about 3%.
4, extra-intestinal manifestations systemic manifestations are more common, in addition to weakness, wasting and acute fever, often accompanied by skin, mucous membrane, joints, liver, kidney, eyes, oral and other systemic manifestations. There are extraintestinal manifestations that appear before the intestinal symptoms, which makes the diagnosis very difficult. Common extraintestinal manifestations include oral ulcers, nodular erythema of the skin, arthralgia, arthritis, spondylitis, hepatomegaly, small peribiliary ductitis, ocular uveitis, conjunctivitis, keratitis, etc.
4. Microscopic manifestations of ulcerative colitis
The main manifestations of this disease under e-colonoscopy are: colonic mucosal erosion, ulceration and pseudo-polyps formation. Due to the period of lesion and the degree of lesion, the performance differs greatly. In the active phase, at first, the colonic mucosa is congested and edematous, with indistinct vascular texture, thickened semilunar folds, and frequent spasm although the intestinal lumen is normal. Subsequently, the colonic mucosa becomes rough and brittle, bleeds easily, and there is often bloody secretions in the intestinal lumen. Further development, the intestinal mucosa appears scattered dotted erosions and ulcers, and the ulcers gradually fuse into sheets, with irregularly shaped ulcerated surfaces surrounded by purulent secretions, and normal mucosa of the diseased intestinal segment is rarely seen. The remission period mainly shows atrophy of the large intestinal mucosa, pseudo-inflammatory polyps.
V. Extra-intestinal complications of ulcerative colitis
Ulcerative colitis is a systemic pathology, therefore, in addition to intestinal manifestations, the disease can also occur a variety of extraintestinal lesions that require the attention of patients and their families: 1.
1, anemia Mostly iron deficiency anemia, often due to blood loss and liver lesions, which is more common in moderate patients. Anemia caused by autoimmune hemolysis is also common.
Hypoproteinemia is especially seen in patients with chronic persistent type, caused by chronic consumption of long-term diarrhea and negative nitrogen balance.
3, liver damage Can be seen in patients with chronic active hepatitis, fatty liver and cirrhosis, one of the causes of hypoproteinemia.
4, arthritis common hypertrophic monoarthritis, transient wandering arthritis pain, peripheral or lower back area arthralgia and toxic arthritis, etc., occasionally see ankylosing spondylitis.
5, skin, mucous membrane damage can occur nodular erythema, gangrenous pustular ulcers, lower limb ulcers, oral ulcers, etc.
6, eye damage iritis, uveitis, uveitis, etc. are common.
7. Others such as acid-base imbalance, electrolyte disorders and hypoproteinemia, thromboembolism, arteritis, systemic vasculitis, etc. also occur.
VI. Treatment of ulcerative colitis
The treatment principle of ulcerative colitis: control inflammation as soon as possible, relieve symptoms, patients in remission should be required to continue maintenance treatment. Treatment should be comprehensive and personalized, using methods including diet and nutrition therapy, allopathic treatment, Western medicine therapy, Chinese herbal medicine, psychotherapy and surgery. Meanwhile, patients with extensive colitis and total colitis with a disease duration of more than 8 to l0 years and patients with left hemi-colitis and rectosigmoiditis with a disease duration of more than 30 to 40 years should undergo regular detective colonoscopy at least once every 2 years. Those with histological findings of abnormal hyperplasia should be followed up more closely; in case of severe atypical hyperplasia, surgery should be performed as soon as it is confirmed.
Patients should undergo the following treatments under the guidance of a physician.
1.General treatment, including rest, high nutrition and less residue diet, fasting, intravenous nutrition therapy, symptomatic treatment of abdominal pain, diarrhea, anemia and correction of water and electrolyte disorders, etc.;
2, combined use of salicylic acid preparations, adrenal glucocorticoids, immunosuppressants, antibiotics and biological agents and other drugs;
3, the use of Chinese medicine;
4.Surgical treatment is mainly applied to patients with serious complications.
VII. Prevention of ulcerative colitis
The best measure to prevent the occurrence of ulcerative colitis is to maintain a good psychological state. The actual fact is that the actual person who has the disease is slow and prone to recurrence, the triggering psychological factors that may cause the onset of the disease should be avoided, and those who are nervous can be given tranquilizers, such as Librium, Glutamate, and Paxil. The actual fact is that you can find a lot of people who have been in the marketplace for a lot of years, and you can find a lot of people who have been in the marketplace for a lot of years, and you can find a lot of people who have been in the marketplace for a lot of years, and you can find a lot of people who have been in the marketplace for a lot of years, and you can find a lot of people who have been in the marketplace for a lot of years. In addition, we must also pay attention to dietary regulation, eat less and more meals, eat nutritious and easily digestible food, avoid irritating food, such as ginger, onion, garlic, pepper, etc.