The old Wang is 40 years old, but has a history of chronic diarrhea and abdominal pain for nearly 20 years, and has been diagnosed with “chronic colitis” by colonoscopy in major hospitals for many times. This is not, after autumn, with the weather turned cool, and abdominal pain, diarrhea symptoms, after being referred to see my colitis clinic, I carefully asked Wang’s medical history, the application of metronidazole, pyridoxine, flavopiridol and other drug treatment is ineffective, I gave him a stool microscopy, culture and other laboratory tests are normal, colonoscopy found that the colon mucosa is congested edema, pathology report is the mucosa lamina propria in the inflammatory The pathology report was that there was inflammation in the lamina propria of the mucosa, mainly monocytes (including lymphocytes), and less neutrophilic leukocytes. Based on the above, I told Wang that he had a non-specific type of colitis. Jiang Xueliang, Department of Gastroenterology, General Hospital of Jinan Military Region
Non-specific colitis is not uncommon in clinical practice, and this type of colitis is different from both ulcerative colitis and Crohn’s disease, as well as from chronic infectious colitis, which is common in clinical practice. However, because there is no unified standard, the diagnosis and treatment are very irregular, with some classifying it as ulcerative colitis or early Crohn’s disease, and some treating it as chronic infectious diarrhea. In fact, nonspecific colitis refers to inflammatory lesions of the colon of unknown cause, but does not include relatively independent diseases such as ulcerative colitis, Crohn’s disease, eosinophilic colitis, microscopic colitis, transient colitis, isolated rectal ulcer, and leukoaraiosis. Since the unknown cause is a relative and temporary concept, nonspecific colitis may be a group of diseases.
For treatment, symptomatic treatment may be used first. Patients with diarrhea, if the symptoms are not severe, do not need medication, and if the diarrhea is more frequent and affects the quality of life, drugs such as Simethicone may be applied for a short time. In patients with abdominal pain, if the pain is mainly during the day and the number of stools is basically normal, give Rotundine 30-60 mg, 3 times/day, if the pain is mainly at night or in the morning, take Rotundine 60 mg before going to bed; if the abdominal pain is paroxysmal colic with diarrhea, give Scopolamine 10 mg, 3 times/day, if the patient also has irritability, anxiety, poor sleep at night, add Glutamine 10 mg, 3 times/day If the patient also has irritability, anxiety and poor sleep at night, add glutamine 10 mg 3 times/day. If the above symptomatic treatment does not relieve, non-specific anti-inflammatory treatment can be used, and the symptoms will be relieved and then discontinued for observation. After 6 weeks of treatment as described above, Wang’s diarrhea was completely relieved and no recurrence has occurred since the follow-up.
The prognosis for this type of colitis is generally good, but attention should be paid to follow-up, especially in patients with recurrent attacks or poor outcomes, some can develop into typical ulcerative colitis or Crohn’s disease, and some are inflammatory lesions of the colon caused by other causes.