Ulcerative colitis is a chronic recurrent disease of the colon of unknown etiology, characterized by hemorrhagic-purulent inflammation of the colon with the development of local and systemic complications.
The reasons
Precise data on the prevalence of ulcerative colitis is difficult to obtain, as mild cases often go unrecorded, especially in the initial period of the disease. These patients, as a rule, are observed in non-specialized outpatient facilities and are difficult to record.
The greatest number of cases falls on the age of 20-40 years. The second peak of incidence is noted in the older age group – after 55 years. The highest mortality rates are observed during the 1st year of the disease due to cases of extremely severe fulminant course of the disease and 10 years after its onset due to the development of colorectal cancer in a number of patients.
The role of environmental factors, in particular smoking, remains unclear. Numerous epidemiological studies have shown that ulcerative colitis is more common in non-smokers. This even allowed nicotine to be proposed as a therapeutic agent. People who have had an appendectomy are at a lower risk of getting ulcerative colitis, as are those who exercise excessively.
Symptoms
Characterized by local symptoms (intestinal bleeding, diarrhea, constipation, abdominal pain, tenesmus) and general manifestations of toxemia (fever, weight loss, nausea, vomiting, weakness, etc.). The intensity of symptoms in ulcerative colitis correlates with the extent of the pathological process in the intestine and the severity of inflammatory changes.
Severe total damage to the colon is characterized by profuse diarrhea with an admixture of a significant amount of blood in the feces, sometimes blood clots, cramping abdominal pain before defecation, anemia, symptoms of intoxication (fever, weight loss, severe general weakness). This variant of ulcerative colitis can develop life-threatening complications such as toxic megacolon, colonic perforation, and massive intestinal bleeding. A particularly unfavorable course is observed in patients with a fulminant form of ulcerative colitis.
Diagnosis
The diagnosis of ulcerative colitis is established on the basis of an assessment of the clinical picture of the disease, sigmoidoscopy data, endoscopic and radiological studies.
Treatment
Therapeutic tactics in ulcerative colitis is determined by the localization of the pathological process in the colon, its extent, the severity of the attack, the presence of local and / or systemic complications. Conservative therapy is aimed at the most rapid relief of the attack, prevention of recurrence of the disease and progression of the process. Distal forms of ulcerative colitis – proctitis or proctosigmoiditis – are characterized by a milder course, so they are most often treated on an outpatient basis. Patients with left-sided and total lesions, as a rule, are treated in a hospital, since the course of the disease in them is characterized by a greater severity of clinical symptoms and large organic changes.
The food of the sick must be high-calorie and include foods rich in proteins, vitamins, with the restriction of animal fats and the exclusion of coarse vegetable fiber. Low-fat varieties of fish, meat (beef, chicken, turkey, rabbit), boiled or steamed, pureed cereals, potatoes, eggs, dried bread, walnuts are recommended. Raw vegetables and fruits are excluded from the diet, as they contribute to the development of diarrhea. It is not often that patients have lactase deficiency, so dairy products are added only if they are well tolerated.