What does ulcerative colitis look like?

  Ulcerative colitis is a chronic inflammatory disease of the intestine, which is a type of “inflammatory bowel disease”. The inflammation here is medically known as “non-specific inflammation”, which is not the same as the common term “inflammation”, which refers mainly to inflammation caused by bacterial infection. The etiology of the disease is still unclear, but most believe that it is an immune disease, certain exogenous substances, the body’s own immune deficiency and intestinal mucosal barrier dysfunction may be involved in the development of the disease, mental factors also have a certain relationship with the disease. Liu Kui-Liang, Department of Gastroenterology, Beijing Saitan Hospital, Capital Medical University, is characterized by alternating acute attacks and remission periods, with a recurrent course that can last for several years to decades, and can be triggered by mental stimulation, fatigue, dietary disorders, infections, and decreased body resistance due to various reasons. Because the cause of the disease is unclear, and long-term recurrent attacks, it is easy to cause a large psychological burden. The only way to control the development of the disease, maintain remission, and prevent recurrence is to correctly understand the characteristics of the disease and to take care of yourself from various aspects such as rest, diet, and rational use of medication.  The condition of ulcerative colitis is divided into mild, moderate and severe. Patients with mild and moderate disease have a better prognosis, while patients with severe and fulminant disease are prone to multiple comorbidities, high mortality and poor prognosis. The patient with mild disease can engage in general light work, life should be regular, pay attention to the combination of work and rest, warm and cold, keep the mood comfortable, at the same time need to carry out appropriate physical exercise to enhance physical fitness, should also pay attention to the prevention of intestinal infections. Patients with diarrhea should protect the skin in and around the anus to be clean and dry, with soft handkerchiefs and gentle wiping movements to reduce mechanical stimulation, and rinse with soap and warm water after defecation to reduce the contact between excrement and skin and thus avoid local irritation and discomfort. The diet should be easy to digest, less fiber, less stimulation, low residue, low fat, nutritious balanced diet, avoid eating raw, cold, spicy food, seafood, peanuts and other foods suspected of intolerance should be avoided. Vegetables and fruits are prohibited during acute attacks, and milk and dairy products should generally be suspended. The staple food should be mainly refined rice and noodles, avoid coarse grains and dry legumes (such as cornmeal, millet, sorghum rice and red and green soybeans). Side dishes can be lean meat, chicken, eggs and other high-quality protein food as the main source of protein, limiting the use of fatty meat and other greasy food. Chili, pepper, mustard and other strongly stimulating foods and alcohol should be prohibited.  Of course, these recommendations are still inconclusive and need to be further studied and discussed. Patients who have been diagnosed with ulcerative colitis should pay attention to the changes in their condition and the relationship between their mood, diet and life changes in their daily life, and avoid foods and habits that cause discomfort in order to minimize acute attacks.  Long-term ulcerative colitis can lead to an increased risk of colorectal cancer, especially extensive colitis, total colitis, left hemicolectomy and recto-b colitis of several decades’ duration. The treatment standard of ulcerative colitis formulated by the Chinese Medical Association recommends that patients with extensive colitis with a disease duration of more than 8-10 years, patients with total colitis and patients with left hemicolectasis and recto-b colitis with a disease duration of more than 30-40 years should undergo surveillance colonoscopy for early detection of possible cancerous lesions, and the examination should be performed at least once every 2 years. Patients with heterogeneous hyperplasia should be followed up closely.