Inflammatory bowel disease (IBD) is a group of inflammatory diseases of the intestine of unknown origin, characterized by chronic inflammation.
They include: Crohn’s disease and ulcerative colitis.
Ulcerative colitis: is a chronic non-specific ulcerative rectal and colitis of unknown etiology.
Prevalent sites: large intestine, rectum, sigmoid colon;
Pathological changes: characterized by ulcer formation;
Clinical manifestations: diarrhea, mucopurulent stools, abdominal pain, urgency and heaviness.
Distribution: continuous, mucosal and submucosal
Features: early stage: diffuse fine granular, brittle, easy to bleed; extensive shallow small ulcers
Late stage: inflammatory polyps, mucosal atrophy, intestinal luminal stenosis, colonic carcinoma
Histology: inflammatory cell infiltration, intestinal glandular crypt abscess
Systemic manifestations.
1. fever Less common, moderate to heavy: low or moderate fever. Fulminant: high fever with systemic toxic symptoms
2. nutritional disorders, failure, emaciation, anemia, disturbance of water and electricity balance, hypoproteinemia.
Extra-intestinal manifestations: Eyes: iridocyclitis, uveitis; Mouth: oral ulcers Skin: erythema nodosum, gangrenous pyoderma Joints: pestle and mortar fingers, arthritis Vascular: vasculitis Biliary: sclerosing cholangitis Liver: chronic active hepatitis.
Most serious complications, mostly fulminant or severe.
1, mechanism Severe lesions, involving the muscular layer and interosseous nerves from .
2, causative factors : low potassium, barium enema, anticholinergics or laudanum.
3, clinical manifestations: toxemia, dehydration, electrolyte disorders; signs: bulging bowel, pressure pain, loss of intestinal sounds; blood count: WBC significantly ↑, abdominal plain film: colon dilatation, disappearance of colonic pouch .
4. Prognosis is very poor, easy to perforate, high mortality.
Treatment: control symptoms, reduce recurrence, prevent and control complications
General treatment
1.Rest Bed rest, work and rest
2.Diet During the seizure period – liquid food; in severe cases – fasting
3, symptomatic treatment abdominal pain, diarrhea, infection, hydropower disorders, anemia, hypoproteinemia
Drug treatment
Salicylic acid preparations (preferred)
(1) Indications: mild and medium-sized patients, heavy hormone therapy in remission: salazosulfapyridine (SASP)
(2) Drugs Mesalazine : Addisha, Pidexam, Olsalazine
Indications: For patients with fulminant or heavy disease
Dosage: oral prednisone 40mg/d
In severe cases: hydrogen cortisone 200-300mg/d; dexamethasone 10mg/d IV for 7-14 days, change to oral prednisone 60mg/d.