Jelly-like stool with blood and anal pain

Symptoms such as jelly-like stools with blood and anal pain are most likely caused by ulcerative colitis. There are many symptoms of ulcerative colitis. We can first understand the disease and make a comprehensive judgment based on other symptoms we have. Ulcerative colitis requires professional treatment. If you are uncertain, it is best to go to the hospital for diagnosis and treatment as soon as possible.

Clinical manifestations of ulcerative colitis

The initial presentation of ulcerative colitis can take many forms. Bloody diarrhea is the most common early symptom. Other symptoms include abdominal pain, bloody stools, weight loss, tenesmus, vomiting, etc. Occasionally, the main manifestations are arthritis, iridocyclitis, liver dysfunction, and skin lesions. Fever is a relatively uncommon sign; in most patients the disease presents as a chronic, low-grade course, but in a minority (about 15%) it presents as an acute, catastrophic outbreak. These patients present with frequent bloody stools, up to 30 times a day, as well as high fever and abdominal pain.

Signs are directly related to the stage of the disease and clinical manifestations. Patients often have weight loss and pale complexion. During the active stage of the disease, the colon is often tender during abdominal examination. There may be signs of an acute abdomen with fever and decreased bowel sounds, particularly in acute or fulminant cases. Toxic megacolon may present with abdominal distension, fever, and signs of acute abdomen. Due to frequent diarrhea, the skin around the anus may be abraded and peeled. Perianal inflammation such as anal fissures or anal fistulas may also occur, although the latter is more common in Crohn's disease. Rectal examination is painful. Examination of the skin, mucous membranes, tongue, joints, and eyes is extremely important.

treat

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 ineffective after hours rather than days of treatment; ③ fulminant acute ulcerative colitis that is ineffective with steroid hormone therapy, 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 is currently no effective long-term prevention or treatment method. Among the four existing types of surgery, radical colorectal resection and ileal pouch-anal anastomosis are relatively reasonable and optional methods.