Treatment of ulcerative colitis

Colitis poses a great threat to human health and is a very common disease. People of certain ages, especially those between the ages of 20 and 30, are most likely to suffer from this disease. Ulcerative colitis has many symptoms. The treatment of ulcerative colitis depends on the severity of the disease. Many patients have a slow onset and often suffer from diarrhea. Different symptoms require different treatments.

Ulcerative colitis is often a slow-onset disease. If the condition is severe, the patient will have diarrhea several times a day or even bloody stools, so it must be treated as soon as possible. Many patients may even experience elevated body temperature and symptoms similar to poisoning throughout the body, so this condition should not be taken lightly, especially in the elderly or children.

Ulcerative colitis is a chronic nonspecific inflammatory disease of the colon and rectum with an unclear etiology. The lesions are limited to the large intestinal mucosa and submucosa. The lesions are mostly located in the sigmoid colon and rectum, but may also extend to the descending colon or even the entire colon. The disease has a long course and often recurs. This disease occurs at any age, but is most common in those aged 20 to 30 years. The cause of ulcerative colitis remains unknown. Genetic factors may play a role. Psychological factors play an important role in the progression of the disease, and pre-existing morbid mental conditions such as depression or social distance can be significantly improved after colectomy. Some people believe that ulcerative colitis is an autoimmune disease.

It is currently believed that the onset of inflammatory bowel disease is the result of the interaction between exogenous substances causing host response, genes and immune influences. According to this view, ulcerative colitis and Crohn's disease are different manifestations of the same disease process.

For patients with fulminant and severe disease, such as those who are not responding well to medical treatment, surgical treatment will be considered.

1. Medical treatment

(1) Bed rest and systemic supportive treatment including fluid and electrolyte balance, especially potassium supplementation. Hypokalemia should be corrected. At the same time, attention should be paid to protein supplementation to improve the overall nutritional status. Total parenteral nutritional support should be given when necessary. Blood transfusions can be given for those with anemia. Milk and dairy products should be avoided as much as possible during gastrointestinal intake.

(2) Drug treatment ① Sulfasalazine salicylic acid preparations are the main treatment drugs, such as Edisal, Mesalazine, etc. ② Commonly used corticosteroids are prednisone or dexamethasone, but it is not currently believed that long-term hormone maintenance can prevent recurrence. During the acute attack period, hydrocortisone or dexamethasone can be used for intravenous drip, and hydrocortisone can be added to normal saline for retention enema every night. The value of hormone therapy during the acute attack period is certain, but there is still disagreement on whether hormones should be used continuously in the chronic stage. Because it has certain side effects, most people do not advocate long-term use. ③The value of immunosuppressants in ulcerative colitis is still questionable. Rosenberg et al reported that azathioprine has no effect on disease control during exacerbations, but it helps reduce the use of corticosteroids in chronic cases. ④ Treatment of diarrhea-type ulcerative colitis with traditional Chinese medicine can be treated with traditional Chinese medicine, and the effect is relatively ideal. At the same time, you should pay attention to your diet and lifestyle habits.

2. Surgical treatment

20% to 30% of patients with severe ulcerative colitis eventually undergo surgery

(1) Indications for surgery Indications for emergency surgery include: ① massive, uncontrollable bleeding; ② toxic megacolon with adjacent or definite perforation, or toxic megacolon that is not responsive to treatment within hours rather than days; ③ fulminant acute ulcerative colitis that is not responsive to steroid hormone treatment, that is, no improvement after 4 to 5 days of treatment; ④ obstruction due to stenosis; ⑤ suspected or confirmed colon cancer; ⑥ recurrent exacerbations of refractory ulcerative colitis, chronic persistent symptoms, malnutrition, weakness, inability to work, inability to participate in normal social activities and sexual life; ⑦ worsening of the disease when the dose of steroid hormones is reduced, so that hormone treatment cannot be stopped for months or even years; ⑧ children suffer from chronic colitis that affects their growth and development; ⑨ severe extracolonic manifestations such as arthritis, pyoderma gangrenosum, or biliary and liver diseases that may be responding to surgery.

(2) Surgical options There are currently four surgical options available for ulcerative colitis. ① Total colorectal resection and ileostomy; ② Total colectomy and ileorectal anastomosis; ③ Controlled ileostomy; ④ Total colorectal resection and ileal pouch-anal anastomosis.

There are many stubborn diseases in life, ulcerative colitis is one of them. There is currently no effective cure for ulcerative colitis, so we must pay attention to preventing colitis in our daily lives. The cause of ulcerative colitis is not very clear, so we must maintain an optimistic attitude in our daily lives, avoid depression, and live a healthy life.