What is ulcerative colitis?
Ulcerative colitis is a chronic non-specific inflammatory disease of the colon, with ulceration in severe cases, involving mainly the mucosa and submucosa of the colon; the scope of the disease starts from the distal colon and can progress retrogradely to the proximal segment, even involving the whole colon and the terminal ileum, with a continuous distribution; the main clinical manifestations are diarrhea, abdominal pain and mucopurulent stools.
Refractory chronic ulcerative colitis. It is recurrent worsening, chronic persistent symptoms, may have malnutrition, weakness, inability to work, and inability to participate in normal social activities.
What is the diagnosis of ulcerative colitis?
When there are symptoms such as purulent stools and abdominal pain, stool microscopy and culture should be done to differentiate from bacterial enteritis to exclude bacillary dysentery, amebic dysentery, chronic schistosomiasis, intestinal tuberculosis and other infectious colitis, ischemic colitis, radiological colitis and other diseases; fiberoptic colonoscopy and mucosal biopsy have diagnostic value; barium meal imaging and barium enema examination of the gastrointestinal tract also help in diagnosis.
What are the symptoms of ulcerative colitis?
(a) Bloody diarrhea is the most common early symptom.
It is caused by increased intestinal peristalsis due to inflammatory stimulation and impaired absorption of water and sodium in the intestinal lumen. The degree of diarrhea varies from 3-4 times a day in mild cases, or alternating diarrhea and constipation; in severe cases, the number of bowel movements can be as many as 30 times a day, with mucus, pus and blood, and the lesions involving the rectum are urgent and severe.
(B) abdominal pain Mild type and lesions in remission may have no abdominal pain, or mild to moderate vague pain, a few colic, mostly confined to the left lower abdomen and lower abdomen, or total abdominal pain. The nature of the pain is often spasmodic, with a pattern of pain followed by bowel movements and relief after bowel movements, often accompanied by abdominal distension.
(C) other symptoms Severe cases may have loss of appetite, nausea and vomiting, fever, tachycardia, wasting, anemia, hypoalbuminemia, imbalance of water and electrolyte balance and malnutrition.
What should be noted in the diet of ulcerative colitis?
1. During the active phase of the disease, a low residue diet helps patients avoid foods that are difficult to digest completely. The symptoms can be reduced. Such as elemental diet, lotus root powder, etc;
2. During the remission period, patients may be able to eat all foods without any symptoms. However, cold, spicy and coarse fiber foods such as chili, raw onion and garlic, leek, celery, etc. should still be avoided.
3. Some patients are not able to drink milk or can drink only a small amount of milk due to lactase deficiency or reduction.
4, many residual foods such as raw or dried fruits, raw vegetables, nuts and seeds, wheat bran and whole grains. They should be avoided.
5. Alcoholic beverages should be avoided.
What are the treatments for ulcerative colitis?
The goals of treatment are to control acute attacks, induce remission, maintain remission of clinical symptoms and mucosal healing, re-establish intestinal mucosal barrier balance, reduce recurrence and complications, and improve the quality of life of patients.
IBD treatment drugs – three major drugs
l Salicylic acid drugs
l Adrenocorticosteroids
l Immunosuppressants
Recently biologic agents, probiotics and other treatments have also achieved encouraging results . However, there are still
Approximately 20-30% of patients with ulcerative colitis will eventually require surgical treatment.
Prognosis of patients with ulcerative colitis
1. Ulcerative colitis is mostly chronic and progressive, and although it can resolve on its own, it is mostly recurrent. The vast majority of patients can obtain some degree of recovery after appropriate treatment.
2, acute severe cases often have serious toxemia and complications, the prognosis is poor, the recent mortality rate is about 3% to 10%.
3. Because of the risk of cancer in ulcerative colitis, cancer occurs in up to 10-20% of cases within 20 years of onset. Generally from the onset of 5 to 8 years onwards, the diagnosis of cancer needs to be made in a timely manner. For cases with a history of more than 10 years, it is advisable to have a barium enucleation examination once a year or a fiberoptic colonoscopy once every 6 months.
4, recurrent ulcerative colitis as its characteristics, should be long-term follow-up, and timely control attacks, maintain remission, prevention and control of complications. The duration of drug maintenance therapy should be more than 2 years or even lifelong maintenance therapy.