Diagnostic criteria for colitis.
In daily life colitis is better confirmed, such as diarrhea stools are not shaped, abdominal pain, intestinal tinnitus, constipation, mucus stools and pus and blood stools, this disease at first taking sulfonamide and antibiotic drugs can control the disease, after several relapses, the efficacy of this drug will be very low, you should go to the local hospital to ask a specialist to help diagnose. 1993, the National Symposium on chronic non-infectious intestinal diseases, combined with the situation in China formulated The trial diagnostic criteria were
1, ulcerative colitis needs to exclude bacterial dysentery, aphthous colitis and other colitis with clear etiology.
2, with recurrent episodes of diarrhea, abdominal pain, mucus, pus and other typical clinical manifestations, at least one of the characteristic changes in the colonoscopy “X-ray”.
3, clinical manifestations are not typical, but there are typical colonoscopic or X-ray manifestations or histological manifestations of mucosal biopsy.
Diagnostic methods of chronic colitis
1, ulcerative colitis need to exclude chronic bacterial dysentery, amoebic dysentery, intestinal tuberculosis and other colitis with clear etiology first.
2, with recurrent episodes of diarrhea, abdominal pain, mucus stool, pus and blood stool and other typical clinical manifestations, routine blood tests may have mild to moderate anemia, and in severe cases, increased white blood cell count and accelerated blood sedimentation. In severe cases, serum albumin and sodium, potassium and chloride are reduced. Immunological examination of IgG and IgM may be slightly increased, and anti-colonic mucosal antibodies are positive. Stool examination has red and white blood cells, mucus, and even macrophages, and no specific pathogens are found in repeated stool cultures and incubations.
Diagnosis of allergic colitis
1, Allergic colitis has narrowing of the intestinal canal, disappearance of the colonic pouch, and thread-like signs similar to ulcerative colitis.
2. In ulcerative colitis, in addition to narrowing of the intestinal canal, there is also stiffening and shortening into a salami tube.
3. Allergic colitis is characterized by easy degeneration of mucosal folds, which can be one of the main points of differential diagnosis.
Examination methods
1, radiological barium examination: barium examination is generally inappropriate in the acute phase. Routine barium enema x-ray examination can be seen as.
(1) In mildly ulcerative patients, X-ray examination is negative, while moderate and severe patients have typical manifestations.
(2) Barium shadow with small jagged protruding edges of the colonic wall and railroad track-like crease phase.
(3) Filling defect, pseudo-polyp formation, and narrowing of the intestinal lumen in a few cases due to fibrosis of the colonic wall and polyp hyperplasia.
(4) Loss of colonic pouch or shallowing, shortening and stiffening of the colon, even like a water pipe.
(5) Snowflake sign: due to tiny ulcers and erosion and adherence of barium, barium spots, air-barium dual imaging shows like snowflakes.
(6) Abnormal barium discharge.
(7) Enlargement of the posterior rectal space up to 2 cm or more indicates severe inflammation of the rectum and posterior rectal tissue.
(8) The presence or absence of which should be noted.
2, endoscopy: clinically most lesions in the rectum and sigmoid colon, the use of sigmoidoscopy is valuable, for patients with chronic or suspected total colon, it is appropriate to perform fiberoptic colonoscopy.
Differential diagnosis.
Colitis presents with chronic diarrhea, blood in the stool, mucus stools, and abdominal pain, but none of these symptoms are specific and can be easily confused with other diseases. Therefore, the diagnosis must be differentiated from the following diseases.
1, chronic bacterial dysentery: manifested as chronic diarrhea or mucopurulent stool, but often have a history of acute bacillary dysentery. Bacillus dysenteriae can be isolated by culture of the exudate obtained from stool, cecum swab or colonoscopy.
2, chronic amoebic enteropathy: often have a history of travel to the epidemic site, the lesion is mainly in the right colon, colonoscopy can be seen mucosal ulcers, ulcer margins are subterranean, between the ulcer colonic mucosa is normal, can be found in the stool lysis group amoebic encapsulation or trophozoites, treatment with anti-amoebic drugs effective.
3, schistosomiasis: can also have chronic diarrhea abdominal pain, but there is a history of contact with epidemic water to endemic areas, the stool can be detected positive for schistosome eggs or hatching trichurias. On colonoscopy, typical manifestations such as submucosal yellow granules can be seen, and eggs can be found in cecum or sigmoid mucosal biopsies. In addition, patients often have hepatosplenomegaly, and in severe cases, ascites may appear, and the symptoms improve after effective anti-schistosomiasis treatment.
The above three infectious diseases, in the past, were the most common causes of chronic diarrhea patients, so in the diagnosis of ulcers, – must exclude the three disease diseases.