Ulcerous Nonspecific Colitis

Ulcerous Nonspecific Colitis is a disease characterized by necrotizing inflammation of the entire large intestine or parts of it. It occurs mainly in people aged 20 to 40 years. Women are sick more often than men. In the emergence of the disease, the damaging effect of metabolic products of the intestinal flora plays a role, immune mechanisms (autoimmune reactions) participate.

With a mild course of the disease, the stool frequency is 4 to 5 times a day, and there is an admixture of blood in the feces. In severe cases, stool frequency more than 6 times a day, in feces a significant admixture of blood, pus and mucus, characterized by painful diffuse pain in the abdomen, tenesmus, by the evening the body temperature rises above 38 0С, tachycardia (up to 90 beats / min and more) , An increase in ESR (above 30 mm / h). Signs of intoxication, dehydration, anemia are expressed.

Isolate acute, chronic continuous and chronic recurrent forms. The acute form is rare, it is difficult; The disease reaches its height in 2 to 3 days. There are frequent abundant blood-purulent discharge from the rectum, tenesmus, cramping pains in the abdomen, repeated intestinal bleeding, often vomiting , fever , exhaustion, dehydration, intoxication, sepsis . Chronic continuous form is severe, characterized by the gradual involvement of various parts of the colon in the process and the continuous increase in the symptoms described above. With chronic recurrent form of the disease often begins gradually. Characteristic diarrhea, blood and mucus in the bowel movement, cramping pain in the lower abdomen, intensifying before defecation and subsiding after it. In 30 - 50% of cases there are constipations . The exacerbation is replaced by remissions.

Local complications include acute toxic expansion of the colon, massive bleeding, perforation of the intestinal wall with the development of peritonitis, hemorrhoids, paratheal abscesses, fistulas, etc. Common complications include joint damage (polyarthritis), internal organs (eg, hepatitis , pancreatitis , pneumonia, pyelonephritis ), Eyes (conjunctivitis, keratitis), skin (pyoderma, erythema nodosum, etc.).

In acute form or exacerbation of the disease, patients are hospitalized. Assign a diet number 4 with a high protein content and a limited amount of plant fiber, exclude milk from the diet. The main drug is corticosteroids. With a light current apply sulfonamides - derivatives of salazole (for example, sulfosalazine). In complex therapy include sedatives, preparations of belladonna, vitamins, enzyme preparations, etc. In severe cases that are not amenable to conservative treatment, with the development of massive bleeding, acute toxic expansion of the colon, surgical intervention is shown - partial or total columnectomy.