Colitis ulcerative ulcerative

Colitis ulcerative ulcerative - a common ulcerative lesion of the mucous membrane of the colon, starting with a straight line, characterized by a protracted course and accompanied by severe local and systemic complications.

The etiology is unclear. There are reasons to consider this disease as an autoimmune process, which is accompanied by toxicoallergic and banal infectious lesions.

Multiple, merging ulcers of the mucous membrane of the large intestine lead to severe intoxication, an abundance of mucus, blood and pus from the rectum, abrupt disturbances in metabolic processes and septic-piemic skin lesions (pyoderma), eyes (iridocyclitis), joints (purulent arthritis ), Liver, etc. Due to increased permeability of the ulcerous wall affected by the ulcer and directly as a result of perforations of the ulcers, localized or diffuse peritonitis occurs.

Symptoms, the course is varied. Initially, there usually appears a loose stool with an admixture of mucus and blood and a general weakness. Diarrhea can progress (20-30 times a day) and lead to dehydration, exhaustion, severe anemia, disruption of electrolyte metabolism with convulsive syndrome. The temperature is subfebrile, the pronounced shifts of the inflammatory character are increasing in the laboratory data. There may be irritation of the peritoneum, bloating (acute toxic dilatation of the intestine), systemic lesions.

There are a fulminant, acute, chronic recurrent and constant (torpid) farm disease course. The fulminant form lasts several days and often ends in death due to complications (perforation, bleeding, toxic dilatation). Acute, chronic recurrent and torpid forms are differentiated according to the severity of the manifestations, they can be accompanied by a variety of local and systemic complications that are life-threatening (peritonitis, septicopyemia, deep anemia and dystrophy). Other, less severe complications can independently or under the influence of the treatment subside, and the disease itself passes into the stage of remission with a high probability of exacerbation under stressful situations or in the spring and autumn periods of the year.

The diagnosis is made on the basis of a clinical picture and is confirmed with a sigmoidoscopy or a colonoscopy (performed with great care!) On the basis of detection of contact bleeding of the mucous membrane of the colon, edema, disappearance of the vascular pattern and scattered small or merging superficial erosions and ulcers with the presence of mucus and pus in A lumen.

Treatment only in a hospital. It should be comprehensive and aimed at compensating for metabolic processes, treating complications and increasing regenerative processes in the wall of the colon. Recommended bed rest, high-calorie mechanically and chemically sparing diet, parenteral administration of fluids, solutions, proteins and glucose, with severe anemia - transfusion of erythrocyte mass. To prevent and treat purulent complications, sulfonamides and broad-spectrum antibiotics are used. Inside appoint (with tolerability) sulfasalazine to 4-8 g / day or salazopyridazine to 2 g / day for 3-7 weeks. Often, hormone therapy (prednisolone, hydrocortisone) in combination with sulfasalazine or without it becomes crucial in the treatment of severe acute and chronic forms of the disease. Surgical treatment is indicated for severe, life-threatening complications (perforation, profuse intestinal bleeding, acute toxic dilatation) and inefficiency of complex conservative treatment.

The prognosis depends on the severity of the disease, the nature of the complications and the effectiveness of complex therapy. A greater propensity to chronic, often recurrent, even with prolonged persistent treatment leads to a significant percentage of disability. Surgical treatment significantly reduces the severity of the manifestations of the disease, eliminates the possibility of dangerous complications, but is accompanied by the removal of the greater part of the colon and, therefore, determines the relatively small possibilities of medical and social rehabilitation of such patients.