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About English name Ulcerative Colitis is a basic overof limited colonic mucosa and submucosa of the inflammatory process. Much in the sigmoid colon and rectum disease can also be extended to the descending colon, and even the entire colon. Pathological long, often repeatedly. Found in any of the disease, but most see 20-30 years of age. Pathology of ulcerative colitis - causes
The cause of ulcerative colitis is still unknown. Although many theories, but there are no definite conclusions. Bacterial causes have been ruled out, because the virus does not like, because the disease is not contagious, the virus particles are not be confirmed. Cloning of lysosomes increased in patients with serum, compared with normal patients with ulcerative colitis. Genetic factors may have a certain status, because the non-Jewish whites 2 to 4 times the Jews, not less white than the whites about 50%, Gilat and other Jewish husband of Tela Wei study also reported in the pathogenesis of ulcerative colitis rate was significantly lower for the 3.8/10 million, and Denmark Copenhagen 7.3/10 million, million and Oxford 7.3/10 7.2/10 million in Minnesota. In addition, the proportion of women and men while the other reported only 0.8 to 1.3. Clear geographic and ethnic differences affect the disease. Psychological factors in disease progression, an important position, it is now clear of patients with ulcerative colitis compared with matched control cases, there is no incentive for an exception. Fur


thermore, the existence of the morbid spirit of the original, such as depression or social distance improved significantly in the colon resection. Some people think that ulcerative colitis is an autoimmune disease, many patients with the blood of normal colon epithelium and intestinal bacterial lipopolysaccharide antigen specific cross-reactive antibodies from. Furthermore, lymphocytes colitis patient's serum may have changed on the colonic epithelial cell toxicity. In addition, in colitis patients with T and B lymphocyte population were found to have changed. But after the recognition of these abnormalities is not necessary for disease, but rather the result of disease activity. In fact, Brandtzueg not such clear evidence of residual gland in patients with ulcerative colitis, the level of organization activities have immunoglobulin deficiencies, IgA transport normal, and IgG immune response is 5 times the control patient. Therefore, it is possible the process of IgG in chronic disease has a role, but is not related with the disease. Ulcerative colitis (UC) pathogenesis as: intestinal flora, a number of harmful intestinal bacteria or toxins secreted by pathogenic bacteria, LPS and other activating intestinal mucosal immunity and reduction of production butyricum bacteria, causing susceptible patients intestinal mucosal immune dysfunction caused by injury. Therefore, the effective treatment of UC, not only to anti-inflammatory therapy must also improve the intestinal micro-environment, added butyricum producing bacteria, eliminate the predisposing factors, restore the immune balance. Jinan Military General Hospital, Dr. Jiang Xueliang and other types of chronic recurrent observation of UC patients were followed up for 1 year showed that the mesalazine treatment Ataining UC joint total effective rate was 95%, 75% complete remission rate, relapse rate decreased by 3.5 times . Its mechanism is the active ingredient Ataining and produce a lot of Clostridium butyricum to improve the intestinal microenvironment, inhibit excessive expression of inflammatory cytokines and restore immune function and repair the damaged intestinal mucosa, to achieve effective treatment of UC. Ulcerative colitis - the beginning of pathological lesions as mucosal crypt has a round base Lieberk lin neutral multinucleated cells and cell infiltration, crypt abscess formation, covered by light microscope, the epithelial cells were stained too shallow and vacuolization. Electron microscopy shows mitochondrial swelling, cell gap widened and widened within the sarcoplasmic reticulum quality. As the lesions progress, crypt abscess, epithelial shedding and coverage combined to form ulcers. Ulcers compared with relatively normal adjacent mucosa, but edema, a meat sample from the appearance of ulcers in the adjacent room became very isolated. Ulcer area is indulgence of collagen and granulation tissue to grow by occupation and in-depth ulcers, but rarely penetrate the muscle layer. In fulminant ulcerative colitis and toxic megacolon, these lesions penetrate the intestinal wall, causing perforation. Fortunately, this type of lesion is rare, accounting for 15% and 3%. Pathological changes of the clinical presentation provides a clear explanation. Almost every day in more than 20 bloody stools. Because the intestinal wall light peel, significant deformation of the mucosa can no longer absorb water and sodium, and each time bowel movements are exposed to the granulation tissue from the surface out of a lot of blood. X-ray findings of early colonic mucosa muscle paralysis bags disappear is, therefore, to barium enema in the colon shortening and stiffness was repeated chimney pipe is the result of scar formation after injury. Ulcerative colitis involving the rectum are mostly, but if lesions can be confined to the rectum is called ulcerative proctitis. It is not known why some cases of lesions confined to the rectum only, while others affected the entire colon. Most of inflammation to the proximal extension, violations of the left colon, about 1 / 3 of the patients involved the entire colon is called pancolitis. Colitis in 10% of all patients at the end there are a few centimeters of ileum ulcer, known as anti-hydraulic of ileitis. Ulcerative colitis lesions are adjacent, rare was segmental or jump distribution. Determine disease severity and stage of the factors is not clear, these factors may be related to the scope and immune disorders. There is evidence that prostaglandins may be acute exacerbation of the disease has an important position, unfortunately, not on prostaglandin synthetase inhibitors such as indomethacin reported a good effect. Clinical history and symptoms are usually have bloody diarrhea or sepsis, severe bloody stools, more than 10 times a day. With left lower abdomen or lower abdomen paroxysmal spasmodic colic, tenesmus associated with it, or Italian. Occasional nausea, vomiting, abdominal discomfort, fever and other symptoms. Light patients are often left lower quadrant abdominal tenderness with bowel or full hyperthyroidism. Patients may have severe and fulminant muscle tension, rebound tenderness, or palpable spasm or bowel wall thickening of the sigmoid colon and descending colon. Rectal examination is often tenderness. Laboratory examinations: routine blood test showed small-cell anemia, neutropenia increased. ESR. Lower serum albumin globulin increased. Severe electrolyte imbalance, hypokalemia. Pus and mucus in stool appearance, microscopy, red white and pus cell. Intestinal lesions of colon examination showed diffuse congestion, edema, erosion, shallow small ulcers, with pus moss, or visible bowel thickening, stenosis, pseudo polyps. Barium enema shows coarse mucosal folds change in insurrection or fine particles, multiple light Kanying or small filling defects, shortened intestine and colon can be tubular bags disappeared. clinical symptoms showed multiple superficial involvement of colon ulcer, accompanied by congestion, edema; disease and more starting from the rectum, often involving the colon, showed diffuse distribution. Rough appearance intestinal mucosa, showing a fine granular, organization vulnerable easy bleeding, or covered with thick secretions, like a thin layer of moss attached. colon bags tend to become flat or dull, and even New Zealand and bags disappear, sometimes to see the number of false polyps of varying sizes. changes in colonic biopsy showed inflammation, but often can be seen mucosal erosion, crypt abscess, colonic epithelial glandular abnormalities and changes in alignment. Symptoms of ulcerative colitis 1. Diarrhea, constipation, mild early symptoms, stool mucus surface, it would be time increased, often mixed with pus and blood and fecal mucus, it can be a paste of soft. 2. Abdominal pain, and more limited in the left lower abdomen or lower abdomen, mild abdominal pain who can not. 3. Indigestion, often show loss of appetite, fullness, belching, abdominal discomfort, nausea and vomiting. Patients with acute fulminant severe, fever, fluid and electrolyte imbalance, vitamin, protein loss, anemia, weight loss. Diagnosis is based . Abdominal pain, diarrhea, bloody mucus discharge.
2. Systemic manifestations, and intestinal manifestations. 3. Multiple stool examination and culture not found in conventional pathogens. Barium enema showed 4.X line granular or nodular mucosa, thick folds, disorder. diagnostic criteria have colonoscopy or X lines in a characteristic change; atypical clinical manifestations, but a typical colonoscopy or x-ray or biopsy confirmed; exclude bacillary dysentery, amoebic dysentery, schistosomiasis disease, intestinal tuberculosis and Crohn disease, radiation enteritis and other colitis. Clinical manifestations 1. Onset and slow, mostly chronic, persistent, recurrent nature. 2. Digestive performance: the most common abdominal pain and diarrhea, abdominal pain in left lower abdomen, pain, cramps. 3. Systemic symptoms: anemia, weight loss, hypoproteinemia, water and electrolyte disturbance, mental anxiety. 4. Extraintestinal manifestations: often arthritis, erythema nodosum, chronic active hepatitis, oral ulcers. 5. The left lower quadrant tenderness 6. Complication of corresponding performance. Symptoms of ulcerative colitis one, digestive performance: 1. Diarrhea 2. Pain 3. Other symptoms Second, systemic manifestations: acute phase or acute exacerbation of often low or moderate fever, weight may have high fever and heart too fast, course development, there may be weight loss, weakness of water and electrolyte imbalance and other symptoms. Third, the intestinal manifestations: eye pigment often, ulcers, chronic active hepatitis, hemolytic anemia, abnormal changes in immune status. Four clinical types: (a) light (b) heavy (c) the performance of fulminant in the endoscopic performance of mild acute phase: mucosal edema, increased secretions, a dense distribution of small bleeding points, and see scattered oozing and bleeding. Moderate: mucosal hyperemia, edema. Severe: mucous membrane bleeding, edema, more significantly, the lesion almost normal mucosa, the mucosa was granular and thickness ranging from pseudo-polyps. the performance of active chronic phase: disappearance of visible structure of normal mucosa, intestinal wall stiffness, narrow tubular lumen, with inflammatory polyps or ulcers. Quiescent: mucosal inflammation light, pale, less bleeding, the normal structure disappeared, become dry and rough. Inspection methods barium radiology generally not suitable for acute barium enema. The special attention is heavy as barium enema in ulcerative colitis, there is evoked the possibility of intestinal perforation Expansion. Under normal circumstances, only when clinical symptoms little irritating laxatives in order to avoid induced acute attack. Quiescent bowel preparation should be routine operation. Barium enema for the diagnosis and differential diagnosis value. Especially for Crohn's disease, colon malignant meaningful. Clinically quiescent barium enema can be used to determine the proximal colon disease, Crohn's disease are advised to be excluded from all further barium meal examination, double contrast barium method easier to find superficial mucosal lesions. Conventional barium enema X-ray examination shows patients with mild ulcerative colitis, X-ray examination negative, moderate and severe patients compared with the typical performance
X-ray examination system colon wall was a small jagged edges of shadow and highlight tracks like barium fold phase. filling defect, false polyp formation, a few cases due to polyps in the colon wall fibrosis and hyperplasia, can cause narrowing of the intestine. bags disappear or shallow colon, colonic shortening stiff, even if water samples. snowflake sign: As the tiny ulcers and erosions and adhesion of barium, barium spots, double contrast barium shows such as snowflakes. row of barium anomalies. rectum up to 2cm or more after the gap increases, said after the rectum and rectal tissue with severe inflammation. should be noted that the presence or absence of colon malignancy. Most of the clinical endoscopy in the rectum and sigmoid colon lesions, the use of sigmoidoscopy is valuable for patients with chronic or suspected to be the entire colon, colonoscopy should be OK. Generally not as clean enema, severe acute phase should be considered taboo, to prevent perforation. Have confirmed the value of endoscopy, under direct vision through the repeated observation of changes in the colon of gross and histological changes, both to understand the nature and dynamics of inflammation, but also the early detection of premalignant lesions that can accurately capture the microscopic lesions and specificity of intestinal secretions to facilitate the exclusion of infectious diseases. Microscopic changes, sub-acute and chronic phase the performance of two cases of mild acute : mucosal edema, increased secretions, a dense distribution of small bleeding points, and see scattered oozing and bleeding. Moderate: mucosal hyperemia, edema. Granular mucosal surface, with intestinal bleeding brittle easily understood, there are many small superficial ulcers, mucosal secretions increase. Severe: mucous membrane bleeding, edema, more significantly, the lesion almost normal mucosa, the mucosa was granular and thickness ranging from pseudo-polyps. Or the ulcer increased significantly and the integration into the film, a mucosal bridge formation. Easy bleeding or mucous membrane exposure to erosion, colon spontaneous bleeding, pus and blood of pseudomembranous exudate or mucous membrane covering, and sometimes see the island or false polypoid mucosal hyperplasia. the performance of active chronic phase: disappearance of visible structure of normal mucosa, intestinal wall stiffness, narrow tubular lumen, with inflammatory polyps or ulcers. Mucosal secretions increase, there is congestion, edema, or bleeding. Quiescent: wall stiffness, narrow tubular lumen, the formation of a majority of false polyps. Mucosal inflammation light, pale, less bleeding, the normal structure disappeared, become dry and rough. Colonoscopy Colonoscopy is currently agreed that the diagnosis of ulcerative colitis and differential diagnosis are of great value. Exacerbation of the disease, ulcerative colitis, endoscopic colonic mucosa showed typical lesions were continuous, the disease often remote from the colon (rectum, sigmoid colon), the development of the proximal colon. More common in left colon. Mucosal vascular lesions of the lines disappear, crisp easily understood mucosal bleeding, purulent mucus, mucous membrane particles like change, accompanied by erosion or the majority of irregular shape and size of the different shades of ulcers, covered with yellow-white exudate or blood. Can be expressed in advanced bowel wall thickening, luminal stenosis, polyps can be multiple false formation, on this basis can be cancerous. Mucosal lesions for biopsy taken, showing non-specific inflammatory disease and fiber scars, mucosal erosions often seen at the same time, thick swollen crypt, which is very important to diagnose this disease. By colonic biopsies, can be clearly the nature of disease. Extraintestinal complications of ulcerative colitis as a systemic disease, therefore, in addition to intestinal manifestation, the disease can also occur on parenteral disease, patients and their families need to pay attention to: (1) anemia: iron deficiency, mostly anemia, often caused by blood loss and liver disease, which is more common in patients with low to moderate. Autoimmune hemolytic anemia caused by too frequent. (2) hypoproteinemia: see, especially in patients with chronic persistent, chronic diarrhea due to long-term consumption, negative nitrogen balance Erzhi. (3) liver injury: see chronic active hepatitis, fatty liver and cirrhosis, hypoalbuminemia is also one of the reasons. (4) arthritis: a single common hypertrophic arthritis, transient migratory arthritis pain, or lower lumbar region around the joint pain and arthritis, food poisoning, occasionally ankylosing spondylitis. (5) skin, mucosal injury: can occur, erythema nodosum, pyoderma gangrenosum ulcers, leg ulcers, mouth ulcers. (6) eye damage: The iritis, pigment layer of inflammation, uveal go far more common. (7) Other: If the acid-base balance, electrolyte imbalance, and hypoalbuminemia, thromboembolism, arterial inflammation, systemic vascular Yandeng also occur. A common complication of ulcerative colitis 1. A lot of blood in the stool: blood in the stool is the main clinical manifestations of this disease, one of the number of blood in the stool is also a measure of the severity indicators, but sometimes difficult to absolutely quantify. A lot of blood in the stool are talking about here is a short time a large number of intestinal bleeding, accompanied by rapid pulse, blood pressure and hemoglobin decreased need for blood transfusion. 2. Bowel stenosis: disease mostly occurs in a wide range, the course continues, as long as 5-25 years of cases, occurred in the left part of colon, sigmoid colon or rectum. The reason because of thickening of muscularis mucosa, polyps in the form of pellets or false lumen obstruction. General clinical symptoms, can cause some serious intestinal obstruction. 3. Bowel perforation: more toxic for the expansion of intestinal complications also can occur in severe type. Application of corticosteroids is considered a risk factor for intestinal perforation. 4. This is the expansion of toxic bowel is a serious complication of the disease, occurs in the entire colon of patients, the mortality rate of up to 44%. Clinical manifestations of intestinal symptoms associated with a high degree of expansion and abdominal bloating was the most obvious part of the expansion in the transverse colon, abdominal examination may have tenderness or rebound tenderness, bowel sounds were significantly decreased or disappeared. 5. Colorectal cancer has been complicated by ulcerative colitis were identified opportunities for colon cancer than the same age and sex group was significantly higher general population is generally believed that cancer related trends and disease duration, duration of 15-20 years, the risk of cancer annual increase of about 1%. The low incidence of people. For the duration of ulcerative colitis for more than 10 years to pay attention to the possibility of cancer. 6. Polyps: incidence of 10% to 80% of these polyps is often called pseudo-polyps. Good polyps in the rectum, also suggested that the descending colon and sigmoid colon up to, in order to reduce upward, which can be cured with the disappearance of inflammation, with ulceration and destruction, long-term retention and easy cancer. 7. Fistula: the intestine and intestinal lumen or other hollow organs (such as the bladder, vagina, etc.) adhesion to each other to form a fistula; intestinal fistula formation of similarities with the skin, although less, but occasionally occur . 8. Anal and perianal diseases: such as anal fissure, rectal abscess, anal fistula, hemorrhoids prolapse and so on. 9. Other complications such as non-specific arthritis, erythema nodosum, pyoderma gangrenosum, iritis, iridocyclitis, keratitis, stomatitis, and mumps, as well as fatty liver, bile duct around go far . Children suffering from ulcerative colitis ulcerative colitis will face the problem What is the life-long disease. That is, suffering from ulcerative colitis, even though children may not attack, but generally will not completely get rid of age the disease. Many children may be time for several years without symptoms, but there will be a considerable part of the same children can not attend school due to illness. They often suffer from abdominal pain, frequent diarrhea or nausea and vomiting, there is no way to healthy children as quiet as sitting in a classroom or school to participate in social activities. Some children suffer from malnutrition due to illness, need to go to hospital for parenteral nutrition. These children not only need regular medication and dietary management, but also humane care and social assistance. Some children may experience slow growth, need growth hormone treatment. Some anti-inflammatory drug treatment of UC's growth rate will slow down the children, or cause other adverse reactions, such as obesity and moon face. Children should be around friends and classmates to hold the attitude of understanding and empathy towards them. Diarrhea and gastrointestinal transit acceleration diarrhea; by anatomic site can be divided into the stomach immunogenicity diarrhea, intestinal immunogenicity diarrhea, diarrhea, endocrine disorders and functional diarrhea. Among them, according to different causes diarrhea, intestinal immunogenicity can be divided into pathogenic infectious diarrhea, inflammatory non-infectious diarrhea, cancer diarrhea, malabsorption and diarrhea, malabsorption, food (poisoning, allergic) diarrhea, drugs or chemicals toxic diarrhea and functional diarrhea. Laboratory test for ulcerative colitis (1) blood: moderate and severe patients, such as tips for low blood hemoglobin, small-cell anemia, iron deficiency and blood loss caused by system, some patients with hemolytic related. Normal or elevated white blood cells, significantly increased with a left shift, seen in severe poisoning particles appear. Hematocrit less than 25%. Reticulocyte increase seen in those conditions continue. (2) ESR: ESR is a disease activity index of one of the simple and reliable. (3) Serum protein electrophoresis: 1 glycoprotein increased reliability index for the active, 2 glycoprotein increased the response in remission. Hypoproteinemia that extensive lesions, usually have crossed the sigmoid colon. -globulin decreased to a poor prognosis of megabytes. (4) coagulation factors and fibrinogen: the lack of blood clotting factor is the cause of prolonged prothrombin time may be related to a lack of vitamin K and the concurrent related. Fibrinogen often reduced, but can occur in patients with severe disseminated intravascular coagulation, with high coagulation state, causing thrombosis, mainly due to increased activity of factor, common disease activity in this period of poor prognosis. At this time showed increased fibrinogen. (5) electrolyte determination: Serum electrolyte disturbances seen in severe disease. Hypokalemia most common, followed by hyponatremia, hypomagnesemia may occur as well. (6) Liver function: Some patients have abnormalities. (7) Iron metabolism: often caused by chronic blood loss can be reduced iron stores, serum iron, ferritin and transferrin decrease. (8) serum zinc: Application of ACTH in the treatment or who complete parenteral nutrition, blood levels of zinc can be reduced. (9) about 30% of the activities of people, showing intestinal xylose absorption barriers. 40% of patients with water, sodium, chloride, fat malabsorption, and occasionally 12, malabsorption of vitamin K or vitamin deficiency. (10) stool: visual inspection found blood, mucus and pus and blood, microscope, a large number of red blood cells, white blood cells, pus cell and phagocytic cells, stool cultures no growth of pathogenic bacteria and fungi. Treatment of the general treatment of rest, into the soft, easily digested nutritious diet, multivitamin supplement. Severe cases of anemia blood transfusions, severe diarrhea should be rehydration, correction of electrolyte disorders. Drugs sulfasalazine, 1.0g, orally, 4 times / d, Smecta, 3.0g, orally, 3 times / d, Bitenuoer 165mg, orally, 3 times / d, lower part of the oral drugs plus those available hydrocortisone 50-100mg, retention enema, 1-2 times / d, severe bleeding can be added with hemostatic agents. Oral prednisone in the heavy-duty may 40mg / d, or intravenous hydrocortisone sodium succinate 300mg / d, symptoms gradually improved after the reduction. Plus broad-spectrum antibiotics is sometimes needed to control secondary infection. Surgical treatment of intestinal perforation, severe bleeding, intestinal obstruction, cancer, multiple polyps, toxic megacolon, colon abscess or fistula formation may be surgery. Ulcerative colitis, also known as non-specific ulcerative colitis, a rectal and colon disease. Clinical manifestations of multiple daily unexplained diarrhea, accompanied by blood in the stool or mucous, and abdominal pain, mostly recurrent, by diet, the spirit evoked. Surgical treatment of ulcerative colitis: indications for surgical treatment of ulcerative colitis are: colon perforation or perforation. lot of blood in the stool. toxic megacolon. fulminant onset, severe illness, the medical treatment not satisfied after 1 week. chronic or recurrent processes, long-term treatment by medical, nutritional status is poor, it is difficult to maintain normal work and life. colon has become the fiber narrow tube-like, losing its normal function resulting in persistent diarrhea. has occurred or suspected occurrence of cancer complications. parenteral complications, especially arthritis, has been increasing. There are indications of the first three patients, the need emergency surgery, surgery aims to control disease progression, to save the patient's life. Is a disease of such patients in a wide severe illness, poor general condition, and they therefore can not expect an operation to cure purposes. Selected for emergency surgery methods include: subtotal colon, ileum and sigmoid colostomy. After subtotal colon, poisoning, bleeding can significantly relieve the symptoms, the possibility of perforation is also no longer exist. Without excision of the rectum, sigmoid colon is not sewn closed ends can reduce the burden on the patient's surgery, and to prevent the suture ends due to poor healing of the abdominal cavity caused by infection. simple colostomy ileum ends. While relatively simple surgery, but still in the colon lesions, poisoning, bleeding, perforation and other issues can not be a more satisfactory solution, so this operation is only applicable to impossible due to systemic or local causes subtotal line the colon of patients. stump ileum and transverse colon or sigmoid colostomy stoma, for patients with acute toxic colon but can not tolerate the expansion of most colon resection, colostomy can be achieved after the purpose of decompression to prevent perforation. After emergency surgery, to be clinically stable and improved, according to need and then of the second elective surgery. The most effective treatment of ulcerative colitis surgery was colorectal total removal, permanent end ileostomy. Although permanent ileostomy patients unhappy life and work does have some inconvenience, but refractory ulcerative colitis serious damage to health, in the absence of more effective non-surgical treatment methods, the use of this surgery can achieve "radical "purposes, results were satisfactory. Weigh the pros and cons, or worthy of acceptance. More than 90% of patients after surgery may be a good long-term effects, health recovery, living and working can still maintain or close to normal. In order to reduce the number of distal ileum of mouth or bowel movements a certain degree of control in the surgical methods have many different designs, such as stoma set short section near reverse peristalsis lateral intestinal mixed, or proximal intestinal loop stoma do long-form side to side anastomosis to the ileal pouch to Xucun more large intestinal contents, or impose a set of overlapping in the way of stoma formation of lip-like valve to control the bowel and so on. Ulcerative Colitis: Granulocyte adsorption therapy granulocyte adsorption therapy refers to the removal of particles from the blood cells, monocytes, T lymphocytes and other destruction, leukocyte activation, thereby inhibiting inflammation therapy. Granulocyte adsorber is a blood filtration device, the internal cellulose acetate for the filling of small beads, thus blood flow in patients after the activation of about 60% of granulocytes, monocytes, to be adsorbed. 1 week of the therapy, each 1 hour, 5 times for one course, since this is symptomatic treatment, requiring regular maintenance therapy. Incidence of adverse reactions, adsorption therapy is only 8.5%. Granulocyte adsorption therapy is expected to be applied to a variety of inflammatory disorders, Italy has begun for the AIDS clinical trials. Western Medicine Western medicine treatment of KD treatment of ulcerative colitis, the main points of non-surgical therapy and surgical therapy. For cancer prone UC, who concurrent toxic megacolon, fulminant UC, UC is difficult to control with conservative treatment, more complications of UC, refractory UC, etc., should be considered or should prompt surgical treatment. Non-surgical therapy, including oral administration, intravenous administration and retention enema. According to the disease, three to be used in conjunction with treatment to do. TCM Syndrome Differentiation of ulcerative colitis, oral him for the medical treatment of UC's main purpose is to start from the internal environment, improving the overall status of yin and yang Piansheng partial failure, usually in four clinical syndromes. (1) cold and heat mixed type: The more common type of clinical, when the feature is only when this condition, endless, both abdominal pain, according to the virtual image thermophilic hi, cold as, another upset, red, moss Huang thermal imaging, and sometimes mixed with pus and blood, tenesmus of the evidence. In short, the disease is very complex machine, cold and heat in sight of the actual situation, non-professional practitioners can not discern, ebony oral pill results were better, or Wu Mei Wan addition and subtraction with the disease changed him for the medical and decoction, bear fruit will be faster. (2) heat stagnation type: moderate and severe acute fulminant UC or UC or acute exacerbation of chronic UC more common in this type. This type is characterized by acute onset, abdominal pain, obviously, the next storm forced injection, tenesmus, fever or chills. This card table when both form two-disease solutions, services Gegen Quan Yi decoction, when disease-free table to dampness heat treatment of the law Zhili, Chinese soup can be served Pulsatilla. This card also with other therapies to manage the disease. (3) alpine stagnation type: chronic persistent UC more this type, this type is characterized by abdominal pain, rain, thermophilic hi press, loss of appetite, mild tenesmus sense. Slippery or greasy white tongue. Expelling warm in the cold, spleen dampness of the law, can choose Weiling soup, Wenpitang, taking Xiangsha Liujunzi soup. (4) lack of blood type: UC long-term diseases, patients with mental and physical exhaustion, easy to see such type. This type is characterized by lack of blood, under the coke virtual failure, more common symptoms are Shenpi fatigue, limb temperature, weight loss, anemia, belly pain, diarrhea, thin, pale tongue, thin pulse. Expelling Warming spleen and kidney of the law, available Fuzi Lizhong Tang, Jin Bian kidney pill. Ulcerative colitis 7 non-surgical therapy (1) diet: plenty of rest and avoid fatigue and psychological stress. To the irritating little easily digestible nutritious diet, avoid foods with rough fiber, temporarily do not eat milk and dairy products. Appropriate fluid and electrolytes, vitamin B and calcium. Clothes iron preparations and folic acid treatment of anemia. Severe, frequent diarrhea, severe malnutrition in patients, gastrointestinal factor may be to a period of diet or parenteral nutrition. (2) anti-infectives: salicylic acid azo SASP ministries colitis treatment to prevent complications has a good effect. Beginning to low-dose daily 1 ~ 2g, divided into 4 times, and gradually increased to a daily 4 ~ 6g, continuous use. Also 2 weeks continuous service, stopping 10, and then clothes. Medication at least 1 year to prevent the increase. Some cause nausea, vomiting, headache, rash, neutropenia, anemia and liver dysfunction. If not effective and have adverse reactions, could be replaced by metronidazole da yl 0.5 ~ 1g, 2 times a day. Neomycin and phthalocyanine sulfonate is also effective with thiazolidinediones. (3) hormone therapy: adrenocorticotropic hormone, cortisone and prednisone hydrogen can improve the body condition, the duration of remission, reduce the frequency of defecation, recurrent symptoms were relieved and increased appetite. But some patients to be ineffective, and allows ulcer perforation, bleeding and slow healing. Now that the small range of applications for early onset of acute fulminant or severe symptoms of patients can significantly reduce, the condition improved; for long-term effects of repeated seizures is not satisfied; promoting steroid 5 to 25 units of glucose solution dissolved in 500 ~ 1000ml , intravenous infusion, 8 to 24 hours a time, the symptoms improved after the switch to intramuscular injection. Hydrogen cortisone injecti00mg, l ~ 2 times a day, or 10 ~ 20mg orally, daily l ~ 4 times. 2.5 ~ 5mg prednisone daily 3 to 4 times. After the gradual reduction of symptoms, can be administered 4 to 6 weeks. Corticosteroids to alleviate symptoms better than the cortisone effect, but to maintain the effectiveness of mitigation as cortisone. This treatment if no improvement of symptoms should not continue to exceed 2 weeks. (4) immunosuppressive drugs: azathioprine 1 ~ 2mg/kg, day 1, can change the disease process, inhibition of clinical manifestations, but can not change the underlying diseases, commonly used in the stationary phase reduce relapse, may also be toxic, should be added attention. 6 thio purine (6-MP) reduce the symptoms of estrogen and progestin combination. (5) diarrhea medicine: To reduce the frequency of defecation and reduce abdominal pain, often compound diphenoxylate, codeine, and compound tincture of camphor. Anti-diarrhea drugs on the acute onset of ulcerative colitis may cause toxic megacolon, should be used cautiously. Can also sedative and antispasmodic drugs. (6) Chinese Herbal Medicine: The heat and cooling blood and Rougan mainly diarrhea, raw white peony 12g, Chun root bark 9g, cuttlebone 15g, Oriental Arborvitae 15g, wind 9g, Chishi Zhi 30g, licorice 3g, SJ 15g, decoction orally once a day. (7) retention enema: commonly used in the rectum and sigmoid colon inflammation, relieve symptoms, promote ulcer healing. Hydrogen dissolved in 60ml saline or hydrocortisone 100mg prednisone 40mg dissolved in 75ml of methyl acetate, water, defecation, after retention enema, 1 or 2 times a day. Amino-5-salicylic Acid 5g day 1, sedative. Portulaca oleracea, to the small grass, saw hi, ants grass, Pulsatilla, and SFAS each 30g, thick fry 100ml, 1 enema daily, 10 to 14, a course of treatment. (8) Chinese medicine, on with the recurrence of back and forth for ulcerative colitis, according to course taking, "permanent positions antidiarrheal blame Ling Capsule" good results. Principles of treatment of ulcerative colitis attack, mainly by symptomatic treatment, to correct malnutrition and to improve the amount of blood solution, to improve the anemia, suppress complications, and actively encourage patients to increase confidence in medical treatment, adhere to reasonable treatment. Therapeutic remission, and strive to maintain remission. Reduce the number of attacks, reducing the extent and reduce the onset of seizure duration. (1) Rest: fulminant and acute exacerbation of the patient should rest in bed, close observation of changes in condition, fever and diarrhea back and then gradually recovered to stop activities. Patients with chronic persistent light can not complete remission, they may engage in whatever modest activity. (2) diet and nutrition: should drink nutritious and easy to digest food. Attack of crude fiber not to eat more vegetables, fruits and cereals, not drinking and eating too much seasoning. Daily protein intake should reach 2g/kg weight, total calories for the 2500 ~ 3500kcal, smaller meals, more than 3 months. Expensive therapies such as intravenous nutrition to supplement the protein and calories, and to promote gastrointestinal rest, positive nitrogen balance and improve clinical symptoms. Acute diarrhea, giving a daily vitamin A25000 units of vitamin D1000 units of vitamin B110mg, vitamin B25mg, pantothenate 20mg and vitamin C200mg. Such as prolonged prothrombin time, oral administration of vitamin K. (3) spasm pain: abdominal pain, diarrhea, intestinal cramps caused may be used Tincture 0.3 ~ 0.5ml, 3 to 4 times a day, or intramuscular injection of atropine, and appropriate use of other anticholinergic drugs. 15 ~ 30mg of codeine and atropine 1mg subcutaneous or intramuscular injection. Should be noted that the expansion in toxic colon, the Disable antispasmodic agents and sedatives, so as not to aggravate the disease, caused by toxic dilatation of the colon. Severe diarrhea may be used with caution against short-term creep antidiarrheal agents such as easy Mongolia stop, disable morphine anesthetic. (4) to correct anemia: the discretion given to the input of whole blood, plasma and hydrolyzed protein. Of disease activity, especially when the bleeding, not oral iron, because not only can not work immediately but increased diarrhea. Active ulcerative colitis treatment 1, treatment of mild ulcerative colitis: can choose SASP agent ,0.75-1 .0 g / time, 3 times / d orally; or substantial doses of 5-ASA preparations. 2, moderate ulcerative colitis treatment: the amount of salicylic acid preparations are available preparations such treatment, those in poor response, the appropriate dosage or change of oral corticosteroids, commonly used prednisone 30-40mg / d, divided tid . 3, the treatment of severe ulcerative colitis: a wide range of general disease, progression of the disease change rapidly, making timely diagnosis treatment, dosage should be enough, treatment is as follows: (1) The application of broad-spectrum parenteral antibiotics to control intestinal Road secondary infection, such as ampicillin, and quinolones nitroimidazole preparations. (2) Zhu Huanzhe bed rest, adequate fluid, electrolyte supplement, to prevent water and salt balance disorders. (3) blood in the stool volume, Hb 90g / L and continued bleeding the following should be considered a blood transfusion. (4) malnutrition, disease can be heavier elements diet, parenteral nutrition should be serious condition. (5) vein 7-10 days after the steroid use could be considered ineffective intravenous injection of cyclosporine 2-4mg/kg body weight per day. Since immunosuppressive drugs, kidney toxicity and other adverse reactions, should be strictly monitored plasma concentrations. (6) If the poor efficacy of drug treatment should be timely, surgical consultation, to determine the timing of the colon surgery and how. (7), antidiarrheal agents and antispasmodic agent used with caution to avoid the induced toxic megacolon. (8) closely monitor the patient's vital signs and abdominal signs of change, early detection and treatment complications. The top five surgical treatment of ulcerative colitis method 1, colorectal resection and ileostomy 2, removal of all colorectal stoma ileal pouch 3, total removal of the colon or rectum retained subtotal (back to rectal or ascending colon rectal) 4, total removal of the colon 5 ileal anal anastomosis, removal of all colorectal anastomosis ileal pouch anal how to prevent the prevention of chronic ulcerative colitis
Ulcerative colitis is a chronic disease of unknown cause, the main clinical manifestations were diarrhea, mucus pus and blood stools, abdominal pain and tenesmus, severity and the poor. Its etiology is unclear. Scholars believe that ulcerative colitis is an autoimmune disease state, immune factors and a major cause of the disease, psychological factors have a certain relationship with the Bunsen. Clinically, the patients found to have more anxiety, tension, and the performance of autonomic dysfunction.
At present it was suggested that the incidence of ulcerative colitis is caused by host response to foreign substances, the role of genetic and immunological results of the three. As the host of exogenous antigens allergies, intestinal immune started once established, any increase in the permeability of mucosal damage to these antigens may induce inflammation of the intestinal wall response. For prevention of ulcerative colitis, there are certain degree of difficulty, only to food conditioning. Usually should be soft, easy to digest, nutritious principles, smaller meals, multivitamin supplement, Wu Shi raw, cold, alcohol, spicy foods; do any work, well-being affordable, the nerves, proper physical exercise, enhance physical fitness. Once intestinal infection, and early treatment. Intestinal manifestations of ulcerative colitis intestinal manifestations of ulcerative colitis refers to the systemic manifestations. In recent years, progress in the immunology research has found that the disease may be associated with autoimmune related to the parenteral (systemic) as following: (1) skin and mucous membrane manifestations: may have erythema nodosum, erythema multiforme, aphthous ulcers , Pyoderma gangrenosum, limitations abscess, thrush and so on. Including erythema nodosum were more common, the incidence rate of 11.5%. (2) eye damage: There iritis, iridocyclitis, uveitis, corneal ulcers, uveitis. Up to uveitis, the incidence rate of 5% to 10%. (3) Arthritis: Ulcerative colitis complicated by the incidence of arthritis in 11.5%, and often associated with specific damage to the eye and skin complications exist. Its characteristics are more severe stage of disease in the enteritis complicated, and a large joint involvement common, and often for a single joint disease, manifested as joint swelling, synovial effusion, and bone without damage. Serological testing examination without change in terms of Rheumatology. (4) liver: may have fatty liver, bile duct inflammation, chronic active hepatitis, post-necrotic cirrhosis, sclerosing cholangitis and so on. (5) the performance of the blood system: iron-deficiency anemia can occur, autoimmune hemolysis, microvascular hemolysis and so on. (6) renal disease: often pyelonephritis and kidney stones. (7) in children, can affect growth and development. Ulcerative colitis disease risk factors in the etiology and pathogenesis is not very clear. Although infection, heredity, mental factors and allergic disease such as doctrine, but they can not fully explain the whole picture of this disease.
(1) infection factors: bacterial infection is not the direct pathogenesis of ulcerative colitis. However, many patients with intestinal bacteria count was more than normal in some patients the patient's spouse and family members living together can be detected in the cell toxin, a large number of cases from the follow-up, did find that 0.5% and 8.2% of the bacillary dysentery patients are often evolve based disease. Therefore can not rule out intestinal bacteria in the pathogenesis of ulcerative colitis. (2) autoimmune factors: the most attention in recent years, research in-depth, according to research the following facts to support the autoimmune etiology. often and have clinical autoimmune diseases. humoral immunity. There are a variety of serum autoantibodies, such as anti-colon antibodies (mainly IgM), the antigen is the LPS of colonic epithelial cells, although the colonic epithelial cells of the fetus and other non-cytotoxic effect, but it can mediate antibody-dependent cytotoxic cells, play a role in the wizard, so that cytotoxic cells kill target cells - colonic epithelial cells; serum may also contain from colonic epithelial cell antigen cross-reactivity of anti-Escherichia coli O14? type and other antibodies. In addition, the serum also often contain a (or some) inhibit macrophage migration inhibitory factor. cellular immunity. Lymphocytes in patients with normal adult or fetal colonic epithelial cells were cultured, the colonic epithelial damage, indicating that the lymphocytes had been sensitized patients, there was cytotoxicity. This cytotoxicity may be E. coli O14, O19? So forth bacterial lipopolysaccharide and stimulate normal lymphocytes, K cells and stimulate production. Cytotoxic effects of this disease is an important pathogenic role. immune complexes exist. Colonic lamina propria in patients with IgG, complement C3, F and S phenotype and fibrin deposition of immune complexes, circulating immune complexes, is likely to cause extraintestinal disease factors. local intestinal mucosa. Often contain a large number of IgG cells, the Department of T8 (suppressor) cells decreased, T? 4 (helper) cell number of results. thymus organ. Immune organs of thymus hyperplasia and swelling is often obvious, showing lymphoid follicles and epithelial cells in B cell aggregation, but also found in retroviral particles, can be induced by the B cells spto other cells. glucocorticoid therapy is often played a significant effect. In summary shows that rapid progress in immunological factors, though not yet a common understanding of, but has some encouraging results. Infection was a direct cause, then the cause of autoimmune disease caused by reasons, has gradually been accepted by the majority of medical workers. (3) allergic factors: in particular, to food allergies such as milk and so on. In some patients, when removed from the dairy food, can receive a significant therapeutic effect. Also found that the disease intestinal mechanical stimulation of allergy exists; also found that the lack of a small number of patients with jejunal lactase, when the disease acute attack, peripheral blood eosinophils seen in active proliferation, hormone treatment is effective; the disease mast cells in intestinal mucosa of patients increased after stimulation can release large amounts of histamine and other substances, these phenomena are indications of the close relationship between disease and allergic reactions. (4) mental and neurological factors: the complexity of the patients condition or worse, each and mental stress, inner conflict and anxiety and other emotional changes, and therefore physical and psychological factors in the initiation and development of this disease may play an important role. Recognizing this as an incentive now is a mediator produced by autonomic secretion of the colon, blood vessel disorders and motor response, each trigger or exacerbate the disease worse. (5) theory of lysozyme: Lysozyme is an enzyme that dissolves mucus, the concentration of larger volumes of patients with ulcerative colitis, and in reducing recovery time, that this enzyme in vivo in patients with ulcerative colitis over the formation of the colon loss of protective effect of mucus, and formed the local environment to facilitate cell invasion. (6) Genetic factors: family in Europe and America the incidence and the incidence of inter-ethnic differences are obvious, and the disease associated with certain HLA's are supported and genetic factors. How to prevent your baby has diarrhea colitis person family, the patient should be isolated, and its excretion in the stool or vomiting utensils should be disinfected, waste should be handled carefully to avoid sping disease to other children. First, pay attention to household hygiene, equipment screens, fire flies, cockroaches, and a clean environment. Second, to avoid public places with children. Third, avoid eating raw, cold, dirty things. Fourth, pay attention to safety devices in children of food and clean. Fifth, careful isolation of patients and their droppings. VI, personal hygiene and health education, especially people with children to always wash your hands, give children to wash their hands after changing that; in with children should also wash their hands after secretion, so as not to infect bacteria in children. Women suffering from ulcerative colitis can be pregnant? Pregnancy and ulcerative colitis have an impact on each other, the data indicate that: (1) When in active ulcerative colitis, the pregnancy symptoms are often aggravated the colitis ( 30% -100%), especially in first 3 months of pregnancy, particularly at night, a few patients can be improved. (2) When remission of ulcerative colitis, the 25% -52% of patients in the first 3 months of pregnancy relapsed within larger, less recurrence in the postpartum period; higher rate of spontaneous abortion; some patients after abortion appear severe persistent disease. (3) during pregnancy with acute ulcerative colitis, generally more common in the first 3 months of pregnancy; childbirth and the postpartum period often has moderately or extremely serious illness; mortality is high (40% -80%). Prevention of ulcerative colitis little blueberry blueberry contains a series of fiber can prevent intestinal diseases such as ulcerative colitis. Experts said that if the blueberry yogurt with the same food, then its effect on intestinal health is more obvious, because yogurt contains probiotics, the beneficial bacteria on human health can be shared with the protection of blueberries in the intestinal tract of fibers. Lund University Institute of Technology researchers said that in order to identify a variety of fiber and healthy bacteria can reduce the risk of bowel disease and colon cancer, who conducted the study. Camilla first of the study - Branning, said: "For those who do not believe they have the risk of suffering from intestinal diseases people, the latest research results will make them interested. In recent years, scholars increasingly recognize that a person's health by the large intestine is largely determined by the situation occurring. "The results show that blueberries along with the consumption of yogurt with probiotics, the health effect is most obvious. Principles and requirements of healthy eating ulcerative colitis is a chronic colitis of unknown cause disease. Lesions were confined to the colon mucosa, and the ulcer-based. The main symptoms are abdominal pain, diarrhea, stool blood, often accompanied by pus and mucus. Daily stool 2 - 4 times, up to 10 times more severe. Patients are often malnourished performance, weight loss anemia. Because of ulcerative colitis is a chronic disease requiring long-term treatment, so the deployment of nutrition and diet is very important. The general principle is high energy, high protein, high in vitamins, low residue diet with less oil. 1. High energy, high protein to compensate for the chronic diarrhea caused by nutrient consumption, digestion and absorption can be tolerated by the patient gradually improved supply. General energy by 40 kcal per kg body weight per day supply. Protein 1.5 g per kg body weight per day, of which 50% of high-quality protein as well. 2. Vitamin salt should be sufficient to compensate for the loss of nutrients caused by diarrhea. 3. Limit fat and dietary fiber: diarrhea, often accompanied by fat malabsorption, severe diarrhea associated with fat. Therefore, to limit the amount of dietary fat, the food should be used less oil and less oil in cooking. Associated with steatorrhea of those chain fatty acids in oils can be used. Avoid irritating and consumption of food containing high fiber foods such as spicy foods, sweet potatoes, carrots, celery, raw vegetables, fruits and onions with a pungent, ginger, garlic and coarse grains, dried beans and so on. 4. Shaoshiduocan: To reduce the burden of intestinal to Eat small meals often means nutrition intake. 5. Meal Plan: 1. Acute attack or surgery before and after the use of semi-liquid slag flow of food or less food, the food contents: rice soup, egg, by powder, generally do not advocate the use of milk. Fruits and vegetables must be disabled. The dish can be made of water, pur e, juice, puree, jelly and other food. Less semi-liquid slag containing high-quality protein can choose fish, lean meat, eggs and less oil is made of soft food, such as the boil for a short fish balls, lotus porridge, chicken Longxumian and bs; 2. Of oral disease is not serious elements were used tube feeding or parenteral nutrition diet, nutritional status improved gradually be increased oral natural food. 1, the supply of sufficient quantities of proteins, salts and vitamins, as far as possible to avoid malnutrition, hypoproteinemia to enhance physical fitness, which will help in remission. 2, should avoid eating more food and fiber irritant, such as pepper, mustard and other spicy foods, and sweet potato, Radish, celery and other food residue, disease onset should not eat raw vegetables, fruit, and with irritating onions, ginger, garlic and other spices. Knife should be fine, do not use large pieces of meat cooking, we should always use minced meat, diced meat, pork, minced meat and steamed custard, boiled eggs, try to limit dietary fiber, such as leek, carrot and celery. 3, should not eat oily food and fried foods, cooking oil and a variety of dishes should be minimal, often used steaming, boiling, boil for a short, stewing, water slide and other methods, can tea, coke rice soup convergence drinks. Snacks should be smaller meals, more nutrition. In the diet to restore the process, patients and family members should observe the disease, attention the impact of food on the patient, such as which foods the patient felt sick after drinking or have an allergic reaction, should sum up experience and trial and error for the patient's diet. Solid onset of the disease can not eat vegetables, fruits, vitamin supplements should be noted that adequate preparations to ensure that the body needs vitamins. The principle of ulcerative colitis diet ulcerative colitis involving the gastrointestinal tract directly, its influence on the eating and nutritional deficiencies are often linked. Ulcers caused by cell renewal rate, due to bleeding ulcers and diarrhea caused by the loss of nutrients, energy can occur - protein malnutrition and fat-soluble vitamins, folic acid, minerals and trace elements, particularly iron and zinc deficiency. Generally slow onset of ulcerative colitis, a few abrupt. Varying severity, so repeatedly. Incentives for mental stimulation, fatigue, eating disorders, secondary infections. Clinical manifestations of bloody diarrhea, which is the main symptom, blood in feces, pus, mucus, light 2 to 4 times a day, severe cases can be as many as 10 to 30 times per day, was bloody like. Often confined to the left lower quadrant abdominal pain or lower abdomen, as paroxysmal spasmodic colic. Meaning of pain associated with it, can relieve pain after defecation. Rectal inflammation, patients often tenesmus. In addition, upper abdominal discomfort, belching, nausea, vomiting are common, the acute phase may have fever. The principle of a dietary treatment, diet should be soft, easy to digest, nutritious, and adequate energy. 2 Eat small meals should minimize intestinal burden. 3, acute exacerbation of dietary elements needed in order to minimize waste volume, if necessary, and total parenteral nutrition. 4, with the condition gradually improved low residue, light diet. Carbohydrate supply to the main energy , add the appropriate protein. 5, diarrhea, severe dehydration can occur and potassium, chloride, sodium ions large number of missing, it is timely intravenous rehydration. The choice of food is appropriate to the food: rice, strong flour, eggs and other easily digestible food. Vitamin and mineral supplement available soup, juice, jelly, etc., if necessary, to take nutrient supplements. Food should not be used: 1, alcohol and other spicy food. 2, hard fruit, nuts, beans and multi-fiber fruits and vegetables. 3, most of colitis causes lactose intolerance, should be less milk. 4, red meat (beef, lamb, pork). 5, no smoking, smoking is also stimulating effect on the gut. 6, alcohol, wine, raw heat, is not conducive to disease recovery. TCM treatment of ulcerative colitis, ulcerative colitis, mainly by the Chinese believe that the invasion of exogenous pathogens, food of the injury, internal injuries impassioned, caused by weak spleen and stomach. Diarrhea is a traditional Chinese medicine, intestinal wind, blood in the stool, abdominal pain and other areas, Chinese medicine treatment of the disease has shown its advantages and broad prospects. Patients for the hot and humid dampness, peony soup, Pulsatilla soup, fragrant with pills, many Gegenqinlian Decoction is used to heat dampness. The stomach Ling Tang, Angelica decoction, Xiangsha Liujunzi, do not change much in the clinical gold upright scattered wet and cold to warm. Lian Li Tang, Wu Mei Wan, San Patrinia Coix monkshood, BanxiaxiexinTang more to Wenzhong Qing intestine. Part of liver depression and spleen were treated with Tong Xie Yao Fang, Xiao Chai Hu Tang, Sijunzitang, Xiaoyaosan other to achieve the purpose of reconciling the liver and spleen. With the disease recurring, protraction, the long injury blood, spleen and kidney damage characteristic of Shibuya and applied in the treatment of complement to highlight the importance of Shiquandabutang, SHENLINGBAISHU dispersed, raising real dirty soup, warm the spleen Tang, loess soup, four gods pills, Fuzi Lizhong Wan parking pills, was chosen Sijunzitang more to spleen and kidney, adjusting the internal organs function. Advocated the treatment of blood circulation and more physicians choose Taohongsiwutang, Xuefuzhuyutang, Shaofuzhuyu soup. Chinese medicine treatment of ulcerative colitis accompanied mainly enema oral dosage form (decoction enema). However, more than in the stomach and oral absorption, low bioavailability, and do not adapt to spin the colon of ulcerative colitis lesions pathological features of each section; decoction enema, patient compliance is poor, to a certain extent, reduce the the efficacy of medical treatment. Enteritis, ulcerative colitis diagnosis is based on anorectal under the China National Institute of Traditional Chinese Medicine in 1987 to develop a "diagnosis of chronic non-specific ulcerative colitis classification and treatment standards." (1) Clinical aspects: a chronic mucous, bloody stool, abdominal pain, was chronic recurrent seizures or persistent, with varying degrees of symptoms. Only a small number of colitis patients do not appear bloody. Past medical history should pay attention to joints, mouth, eyes, film, skin, liver and spleen and other extraintestinal clinical manifestations. (2) sigmoidoscopy or colonoscopy examination showed: involved colon showed multiple superficial ulcers, associated with congestion, edema; disease and more starting from the rectum, often involving the colon, showed diffuse distribution. Rough appearance intestinal mucosa, showing a fine granular, organization vulnerable easy bleeding, or covered with thick secretions, like a thin layer of moss attached. colon bags tend to become flat or dull, and even New Zealand and bags disappear, sometimes to see the number of false polyps of varying sizes. changes in colonic biopsy showed inflammation, but often can be seen mucosal erosion, crypt abscess, colonic epithelial glandular abnormalities and changes in alignment. (3) barium enema shows: the colon shortened intestine, colon bags disappear, or colon tubular appearance. recurrent ulcers or polyps in the performance of multiple false. colon rough, disordered or see fine granular changes. (4) Pathological examination: exclude bacillary dysentery, amoebic dysentery, schistosomiasis and other specific infectious colitis and granulomatous colitis, radiation colitis. (5) to determine the method: According to the clinical aspects and sigmoidoscopy or colonoscopy examination (1), (2), (3) one and three (or) mucosal biopsy can diagnose this disease. clinical aspects and a barium enema (1), (2), (3), one of three the disease can be diagnosed. clinical manifestations are not typical, but a typical colonoscopy or barium enema were typical changes, diagnosis was established. have typical clinical symptoms or past history of typical, and the sigmoidoscopy, colonoscopy or barium enema no typical changes, should be classified as "suspected" and should be followed. Note 1 in patients with ulcerative colitis. Attention to work and rest, not too tired; fulminant, acute and severe chronic-type patients should stay in bed. 2. Attention to clothing, to maintain proper heating phase; appropriate physical exercise to enhance physical fitness. 3. General should eat soft, easy to digest, nutritious and adequate calories. Should be smaller meals, multivitamin supplement. Wu Shi raw, cold, greasy and multi-fiber foods; 4. Attention to food hygiene, to avoid intestinal infection induce or aggravate the disease. Avoid alcohol, spicy foods, milk and dairy products. 5. Usually to keep their minds at ease, avoid mental stimulation to relieve a variety of mental stress. What are the characteristics of ulcerative colitis, ulcerative colitis, there are two classifications. That is classified by the severity of ulcerative colitis and ulcerative colitis according to disease through the classification. According to the severity of ulcerative colitis can be divided into 3 levels: mild: the most common type, usually involving only the distal part of the colon, the condition light, less than 4 times a day of diarrhea, abdominal pain, then serum or rare, the lack of body signs and symptoms. Moderate: between between mild and severe, sudden onset of diarrhea 4 to 5 per day for this, as loose stools and bloody diarrhea, severe abdominal pain, with fever, weight loss, anorexia, may have gut manifestations. Severe: rapid onset, significant diarrhea, blood in the stool, there are persistent severe abdominal pain, low blood pressure can occur, and even shock. By ulcerative colitis can be divided into the following course of the disease after 4 types: early onset: is the absence of past history and for the first attack, the severity ranges can be converted to other types. Chronic relapsing type: the most common clinical, pathological range of small, mild symptoms, often in remission, but easy to relapse, the prognosis is good, most of salicylic acid, sulfasalazine treatment is effective. Chronic persistent: There were a wide range of sustainable after the first attack, ranging from mild diarrhea, blood in the stool, and often last for six months or more, may have acute attack. Acute outbreak of type: a rare, rapid onset, severe local and systemic symptoms, often fever, watery diarrhea, acute colonic expansion, prone to gastrointestinal bleeding and other complications following entry and intestinal perforation. Fulminant cases in urgent need of corticosteroids, blood transfusion and other treatment, the prognosis is poor, some cases of ulcerative colitis, if not promptly treated, can often die within 2 weeks. Patients with ulcerative colitis colonoscopy must be done it? Colonoscopy showed normal colonic mucosa under the orange-red, shiny surface moist. Splenic flexure of the colon mucosa was light blue, hepatic flexure of the mucous membrane color slightly darker than the splenic flexure, splenic flexure and hepatic flexure of the mucous membrane of vascular smaller, the texture clearly visible. Thin layer of the colonic mucosa, the submucosa can see through the blood vessels, called vascular texture, thin section of vascular bundle was bright red, thick trunk submucosal blood vessels, and separation of multiple dendritic branches, away from the trunk blood vessels, tapering, terminal branches of fine silk, and another vessel branches is consistent and staggered to form a more regular network structure of a bright red beam section. Usually in the hepatic flexure, splenic flexure than in other parts of the small blood vessels, rectum, sigmoid colon remote, often due to enema of the local mucosal irritation, mucosal hyperemia, edema, and reflective more obvious, but still see the blood vessels clear and the texture may be rectum and sigmoid colon inflammation phase difference. Ulcerative colitis patients with ulcerative colitis for commonly used drugs, many patients like to take medicine for the treatment, some doctors are not professional strongly advocated drug efficacy, rapid onset of drug that can cure enteritis good, then we take a look colitis patients eat the drug. 1, anti-inflammatory analgesic: bacterial infection, illness, fever, dehydration, shock may be an appropriate use of antibiotics, if necessary, transfusion, or oxygen. More effective use of antibiotics cause bacteria culture, one anti-inflammatory pain. 2, antidiarrheal agents: such as diarrhea, sometimes severe, most patients will choose a number of drugs in order to antidiarrheal antidiarrheal agents. 3, Chinese medicine, on with the recurrence of back and forth for ulcerative colitis, according to course taking, "permanent positions antidiarrheal blame Ling Capsule" good results. These drugs, many patients are taking over, but the results are not very obvious, some of many patients is often some side effects. Therefore, drug therapy, the patient should be cautious in the selection. Ulcerative Colitis Ulcerative Colitis What harm hazards for the treatment of ulcerative colitis is still no clear method, which belongs to a kind of disease colitis, ulcerative colitis symptoms are: discharge of pus and blood stools, bloody mucus or bloody stools, often accompanied by tenesmus, etc.! for what causes the disease is caused by the medical profession so far no clear explanation, but its etiology may be caused by bacterial or viral infections, mental stimulation, and nervousness, food allergies, autoimmune reaction and so on. Ulcerative colitis against large, the illness requires prompt treatment, because the disease may lead to the occurrence of other diseases. Ulcerative Colitis Ulcerative Colitis prevention and health care you know it? Do you know of ulcerative colitis preventive health care approach? 1 Prognosis: Prognosis is good or bad ulcerative colitis, depending on disease type, complications and treatment conditions. Light good prognosis, remission rate of 80% to 90%, heavy by about 50% response rate. All enteritis-type mortality rate 25%. 35% mortality rate in acute fulminant. In short, more persistent recurrent disease, few patients can also be long-term remission. 2, ulcerative colitis preventive health care: As the cause of the disease is unclear, there is no specific preventive measures, recurrent or persistent long-term instability of the patient, ease of mind to keep quiet and pay attention to eating festival, living there often, to avoid fatigue, prevention of intestinal infections, the prevention of recurrence or have a role in the further development of the disease. Also should be noted that the patient's psychological adjustment and control diet, on abdominal pain, diarrhea, Yi Shi less slag, digestible, low fat, high protein diet; of allergic foods such as fish, shrimp, scorpion, shark, milk, peanut and so should avoid eating; should not eat chili, eat frozen, cold food and refrain from smoking habit. Health and prognosis of ulcerative colitis treatments for ulcerative colitis, the prognosis and health care play an important role, how do health prevention of ulcerative colitis? 1, the prognosis of ulcerative colitis: a good prognosis of this disease bad, depending on the disease type, complications and treatment conditions. Light good prognosis, remission rate of 80% to 90%, heavy by about 50% response rate. All enteritis-type mortality rate 25%. 35% mortality rate in acute fulminant. In short, more persistent recurrent disease, few patients can also be long-term remission. (For more details, see Res) the principle of ulcerative colitis diet foods for diet to the intake of high calorie, high nutrition, less fiber, less stimulation, low fat and easily digestible food; of suspected food intolerance, such as shrimp, turtle, and so should avoid eating peanuts; milk can cause diarrhea increase, should avoid taking milk and dairy products; not eat chili, avoid freezing, cold food, quit smoking wine. The diseases ulcerative colitis easily confused with 1. Crohn's disease identification of points in Table 2.2. Pathogenesis of irritable bowel syndrome and mental, psychological disorders, often abdominal pain, bloating, abdominal Ming, may present with constipation and alternating diarrhea, accompanied by systemic symptoms of neurosis. Stool with mucus but no pus and blood, microscopic examination occasionally a little white, colonoscopy and other tests without organic lesion. 3. Colorectal cancer more common in middle-aged people, rectal palpation examination often palpable mass, positive fecal occult blood test often has. Colonoscopy and barium enema differential diagnosis value, but must be differentiated from cancer and ulcerative colitis. 4. Chronic disease often involving the large intestine both ends of the amoebic dysentery, the rectum, sigmoid colon and cecum, ascending colon. Ulcers usually darker, edge stealth, ulcers and ulcers, mostly between the normal mucosa, stool examination can be found in amebic trophozoites or cysts dissolve organizations, through the colonoscope to the ulcer exudate or ulceration of the edge of the organization to find amoeba , the positive rate higher; anti-amoebic treatment is effective. 5. Colonic schistosomiasis have Schistosoma history of exposure to contaminated water, often hepatosplenomegaly, chronic granuloma of the rectum can be hyperplasia, may have malignant tendencies; stool examination can be found in schistosome eggs, miracidium hatching positive results. Rectal endoscopy in the acute phase can be seen mucosa brown particles, mucosal biopsy, or histopathological examination tablet schistosome eggs can be found. 6. Chronic dysentery of acute diarrhea generally have a history of cultured fresh feces several times a detachable Shigella, antibiotic treatment is effective. 7. Ischemic colitis more common in the elderly, caused by arteriosclerosis, sudden onset, lower abdominal pain with vomiting, 24 ~ 48h after bloody diarrhea, fever, increased white blood cells. Light were reversible process, the l ~ 2 weeks to 1 to 6 months to be cured; severe, intestinal necrosis, perforation, peritonitis. Barium enema X-ray examination, the visible sign that the indentation, pseudo tumor, intestinal wall of jagged changes and spindle-shaped narrow. Under the microscope, the mucosal bleeding caused by the uplift of dark purple, mucosal bleeding and ulceration stripped, a clear demarcation with the normal mucosa. Multiple lesions in the colon and splenic flexure. 8. Other diseases must also identify the intestinal tuberculosis, pseudomembranous colitis, radiation enteritis, colon polyps, colon diverticula and so on. Complications 1. In toxic megacolon is a serious complication. Found in acute fulminant severe ulcerative colitis and acute type patients. 2. Colonic perforation, toxic megacolon and more expansion in the basis occurs. Lead to diffuse peritonitis after perforation or localized abscess, perforation of the sigmoid colon or more parts of the colon at the splenic flexure. High fever and infection in patients with multiple symptoms, abdominal distension, extensive abdominal muscle tension left. 3. Lower gastrointestinal bleeding rectum and colon bleeding can be extensive, the vast majority will be manifested as blood, pus and blood will. 4. Straight, colon cancer incidence rate of 0.7% to 8% or even up to 13% higher than the general population of 5 to 20 times. 5. Rectum and colon strangulation, is a late complication, but rarely cause bowel obstruction. 6. Fistula or intestinal lumen and the intestine and other hollow organs (such as the bladder, vagina, etc.) adhesion to each other to form a fistula; intestinal fistula formation of similarities with the skin, although less, but occasionally occur. 7. Anal and perianal diseases such as anal fissure, rectal abscess, anal fistula, hemorrhoids prolapse, etc. 8. Other complications such as non-specific arthritis, erythema nodosum, pyoderma gangrenosum, iritis, iris ciliary body inflammation, keratitis, stomatitis, and mumps, as well as fatty liver, small bile duct go far. Forward of the complications of intestinal complications of ulcerative colitis: more common in cases of severe and fulminant. 1 (1) expansion of toxic colon: activity in the acute phase occurred, the occurrence rate of about 2%, occurred in the sigmoid colon or transverse colon, incentives are low blood potassium, barium enema, the use of anticholinergic drugs or opiate drugs. (2) intestinal perforation: incidence rate 1.8% or so more in the occurrence of toxicity based on the expansion of the colon, causing diffuse peritonitis, there subdiaphragmatic free gas. (3) hemorrhage: need for that large amount of blood transfusion treatment, the rate was 1.1% ~ 4.0%. In addition to involving the blood vessels due to bleeding ulcers, the low prothrombin hyperlipidemia is also important causes. (4) polyps: incidence of 10% to 80% of these polyps is often called pseudo-polyps. Good polyps in the rectum, also suggested that the descending colon and sigmoid colon up to, in order to reduce upward, which can be cured with the disappearance of inflammation, with ulceration and destruction, long-term retention and easy cancer. (5) cancer: incidence of 5%, more common in lesions involving the entire colon, juvenile onset and history more than 10 years of. (6) Other complications also arthritis, the incidence of 11.5% or so, skin and mucous membrane lesions, eye lesions and so on.


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