Ulcerative colitis of the intestine: symptoms

Ulcerative colitis is a chronic pathology characterized by the development of an inflammatory process in the colon and rectum with further formation of ulcerations on the mucous membrane. To date, the exact etiology of the disease is unknown, but unfavorable factors that can contribute to its progression have been established. Ulcerative colitis is diagnosed more often in young people from 15 to 25 years old and in people who have reached old age (from 60 years old).

The disease is characterized by a cyclical course. This suggests that periods of exacerbation alternate with periods of subsidence of clinical signs (remission). The symptoms of ulcerative colitis are usually quite pronounced. A person is worried about abdominal pain, diarrhea with pathological impurities (blood and mucus), intestinal bleeding. It is important to start treating the disease in a timely manner in order to prevent the development of complications.

Diagnostics involves the use of instrumental techniques, as well as laboratory tests. The greatest diagnostic value is possessed by colonoscopy, irrigoscopy, CT. The selection of treatment tactics will be based on the data obtained. Conservative and surgical techniques are used.

Why does ulcerative colitis develop?

Ulcerative colitis refers to pathologies of unknown origin. This suggests that the true cause of its progression has not yet been established by scientists. Previously, it was suggested that the development of the inflammatory process in the colon and rectum is facilitated by unhealthy diet and severe stress. But the theory has not been confirmed, so now these factors are attributed to triggers that can aggravate the course of pathology, but not provoke.

Possible reasons for the progression of ulcerative colitis:

• disruption of the immune system. It is believed that in an attempt to defend against bacteria and viruses, an abnormal immune response is formed. As a result, the immune system begins to attack its own cells in the gastrointestinal tract;
• hereditary predisposition. The risk of developing ulcerative colitis in a person increases significantly if one of his closest relatives already has this pathology;
• smoking and drinking alcoholic beverages;
• taking certain groups of pharmaceuticals, such as oral contraceptives;
• frequent stress;
• the development of inflammatory diseases;
• abnormal structure of intestinal loops;
• the presence of pathologies of the heart and blood vessels;
• parasitic diseases;
• unbalanced diet and regular use of "harmful" foods.

Sometimes the development of the disease occurs against the background of the use of roaccutane or isotretinoin. But such cases are extremely rare.

Classification of ulcerative colitis

Ulcerative colitis is classified based on three criteria - the location of inflammation and ulceration, the form and nature of the course of the disease, as well as the degree of its severity. Such a division is simply necessary, as it allows the doctor to accurately assess the risk, predict the prognosis of the disease, and also determine the appropriate treatment tactics.

Classification by forms of pathology:

• typical;
• fulminant;
• chronic recurrent;
• chronic continuous.

Depending on the localization of the inflammatory process and ulceration, ulcerative colitis can be:

• distal;
• left-sided;
• total;
• subtotal;
• total with reflux ileitis.

Severity classification:

• easy form. In this case, the patient is worried about liquefied stools, in which blood streaks sometimes appear. Other symptoms are often absent;
• moderate severity. The patient complains of frequent loose stools (up to 7 times a day), pain in the lower abdomen and in the umbilical region. This condition is usually accompanied by anemia, subfebrile condition;
• severe degree. The clinical picture is very clear. Diarrhea worsens - the patient can go to the toilet more than 10 times a day. He has severe anemia, fever, tachycardia. A severe form of ulcerative colitis is very dangerous, as it is accompanied by intraintestinal bleeding.

It is necessary to seek help already at the first signs that indicate a disruption in the functioning of the intestines. In this case, the chances that it will be possible to cure the pathology without surgery increases significantly. Delay can be very costly. Against the background of severe ulcerative colitis, complications often develop - massive bleeding, hemorrhagic shock, sepsis.

How does ulcerative colitis manifest?

The clinical picture depends on the localization of the inflammatory process, on the rate of development of the pathology, as well as on the intensity of damage to the mucous membrane of the large intestine. All symptoms that appear as the disease progresses can be conditionally divided into local and general. They are most pronounced during the period of exacerbation.

Ulcerative colitis symptoms:

• diarrhea up to 10 times a day. In severe cases, there may be more. Sometimes there is constipation;
• the presence of pathological impurities in the feces - blood and mucus. Special attention should be paid to the color of the blood. With ulcerative colitis, it is bright, while with other pathologies of the gastrointestinal tract, it is dark or even almost black. A bright color indicates that areas of the intestine that are closer to the anus are damaged;
• false urge to defecate;
• rectal pain;
• painful sensations in the abdomen;
• weight loss and loss of appetite;
• fever;
• bloating;
• pain in muscles and joints.

During the period of exacerbation, the clinical picture is complemented by tachycardia, increased body temperature, symptoms of body intoxication. Diarrhea often leads to insomnia.

Diagnostics

To confirm the diagnosis, it is necessary to pass tests in the laboratory, as well as undergo an examination using instrumental techniques. A specialized specialist who is engaged in the diagnosis and therapy of gastrointestinal diseases is a gastroenterologist. To begin with, the patient needs to pass a general and biochemical blood test. With their help, the doctor can determine the level of leukocytes, as well as hemoglobin.

Other laboratory tests required to confirm NUC:

• analysis of feces for fecal calprotectin;
• coprogram;
• biopsy - histological examination of a tissue sample;
• immunological blood test;
• bacterial sowing.

Instrumental diagnostic methods allow you to accurately determine the localization of the pathological process, the degree of its intensity. The most informative endoscopy. It is carried out in several ways. The patient must be properly prepared for it. No food is allowed 12 hours before endoscopy. In addition, the intestines should be cleansed of feces with the help of several enemas.

Endoscopic diagnostics:

• colonoscopy;
• rectosigmoidoscopy.

Additional diagnostic methods include barium x-rays, CT, and MRI. Based on the data obtained, the final diagnosis is made and the optimal treatment method is selected.

How is ulcerative colitis treated?

Treatment of ulcerative colitis is symptomatic. The main task is to eliminate the inflammatory process and prolong the period of remission as long as possible. For this purpose, the patient is prescribed drug therapy and a special diet. In the event that taking medications was not effective, surgical intervention may be required.

Conservative therapy

The success of treatment directly depends on the qualifications of the attending physician and on the efforts of the patient himself, who will strictly follow all the recommendations.

Drug therapy:

• anti-inflammatory drugs;
• corticosteroids;
• antibacterial drugs;
• immunomodulators;
• vitamin and mineral complexes.

To stabilize the patient's condition, doctors may resort to the use of physiotherapy. Diadynamic therapy, interference therapy and exposure to alternating current help to achieve a positive result.

Treatment of patients is carried out mainly in inpatient conditions. Only people with a mild course of this disease can undergo outpatient therapy. Correct implementation of all the prescriptions of the attending physician can reduce the severity of clinical manifestations, reduce the risk of complications and increase the period of remission.

Surgical intervention

Doctors resort to surgery if medication treatment is not effective. The patient needs to be told in detail how the intervention is carried out, why it is necessary. Many people experience not only physical but also psychological discomfort after surgery. The task of the doctor is to help you get used to a new life, to provide psychological support.

Indications for surgical intervention:

• profuse bleeding;
• perforation of the intestinal wall;
• the presence of symptoms that indicate intestinal obstruction;
• fistulas;
• abscess formation;
• the presence of a tumor of a benign or malignant nature.

Types of operations:

• partial or total excision of the affected colon;
• removal of both the colon and rectum, leaving the anus;
• removal of the colon and rectum, but with the formation of an ileostomy, through which feces will leave the body.

After surgery, the patient undergoes a long period of rehabilitation in inpatient conditions. It will include taking medications, physiotherapy and special dietary meals. The diet will need to be strictly adhered to at all times.

Video: Ulcerative colitis of the intestine - symptoms, causes, treatment

Proper nutrition for ulcerative colitis

The diet for this disease is simply colossal. The main task is to reduce the chemical, thermal and mechanical effects on the intestinal walls. The recommendations are quite strict. It is necessary to observe them throughout life. Spicy sauces, fried and fatty foods are completely excluded from the diet. You can only eat thermally processed foods - boiled or steamed.

Recommendations:

• chop food before eating;
• it is forbidden to drink alcoholic beverages;
• raw vegetables and fruits cannot be eaten, only thermally processed;
• during an exacerbation, it is best to switch to pureed semolina or rice porridge;
• bread is best consumed minimally. Crumbs are suitable instead.

A strict diet for ulcerative colitis helps not only to normalize digestion and metabolism, but also to eliminate diarrhea. The most important thing is to adhere to it constantly, and not only during periods of exacerbation.

Ulcerative colitis is a rather serious disease, the treatment of which should not be postponed for a long time. If the first symptoms appear, then you should immediately seek help from a medical institution. There is no specific prevention of the disease. You can reduce the likelihood of its development if you eat right, do not drink alcoholic beverages and do not smoke, and avoid stress.

Sources:

https://diseases.medelement.com/disease/%D1%8F%D0%B7%D0%B2%D0%B5%D0%BD%D0%BD%D1%8B%D0%B9-%D0%BA%D0%BE%D0%BB%D0%B8%D1%82/15033

Minutes of meetings of the Joint Commission on the Quality of Medical Services of the Ministry of Health of the Republic of Kazakhstan, 2017

https://gastroe.ru/files/rekomendatsii_yazvenniy_kolit_2017.pdf

CLINICAL RECOMMENDATIONS OF THE RUSSIAN GASTROENTEROLOGICAL ASSOCIATION AND THE ASSOCIATION OF COLOPROCTOLOGISTS OF RUSSIA ON THE DIAGNOSTICS AND TREATMENT OF ULCERIC COLLITIS

Belousova E.A., Nikitina N.V., Tsodikova O.M.. Treatment of mild to moderate ulcerative colitis. Pharmateca. 2013. № 2. WITH. 42-46

Khalif I.L. Therapeutic tactics for ulcerative colitis. Russian Journal of Gastroenterology, Hepatology, Coloproctology, 2006. T16. №3. WITH. 58-62