Ulcerative colitis: what it is, treatment, symptoms, signs, causes. Ulcerative nonspecific colitis: symptoms and treatment

Nonspecific ulcerative colitis is one of the most mysterious gastroenterological diseases. The exact reasons for its development have not yet been determined, but effective treatment methods that can maximize the quality of life of a chronic patient have already been developed.

With nonspecific ulcerative colitis, the mucous membrane of the large intestine suffers. It becomes inflamed, causing the patient severe pain. Unlike viral or infectious diseases, when the pathogen enters the body from the outside, UC is an autoimmune pathology. It originates inside the body, with a certain failure of the immune system, the exact nature of which has not yet been determined. Accordingly, it is not possible to develop preventive measures that 100% guarantee protection against UC. There are only theories that allow us to talk about risk factors:

Genetic. Statistics have revealed that the disease has a family predisposition.
Infectious. Some experts suggest that UC occurs as a result of the body's reaction to the action of certain bacteria, which under normal conditions are non-pathogenic (safe). What exactly contributes to the modification of bacteria into pathogenic ones is not yet clear.
Immune. According to this theory, with UC there is an allergic reaction to certain components in food products. During this reaction, the mucous membrane produces a special antigen that comes into “confrontation” with the natural intestinal microflora.
Emotional. A less common theory is that UC develops against the background of prolonged deep stress.

The diagnosis of “nonspecific ulcerative colitis” is rapidly becoming younger. More than 70% of cases, according to statistics from the last twenty years, are teenagers and people under 30 years of age. Pensioners suffer from ulcerative colitis much less frequently. According to the latest statistics, the incidence is 1 case in approximately 14 thousand people.

Is it possible to be cured for good?

This question worries many who hear their diagnosis for the first time. Unfortunately, no doctor who calls himself a professional can guarantee a cure. The fact is that UC is a chronic disease, which means that the disease can only be “healed”, but not completely eliminated. Colitis has a cyclical course, that is, relapses (periods of exacerbation) alternate with months of stagnation, when the disease hardly manifests itself. The goal of therapy for UC is to delay the onset of relapse as much as possible, and when it occurs, to reduce the severity of symptoms.

Some patients, upon learning their diagnosis, panic, believing that they will have to spend the rest of their lives on a strict diet. Meanwhile, the emotional state of the patient is an important factor determining the success of therapy. Therefore, under no circumstances should you give up. Strict dietary restrictions are necessary only during the acute phase of the disease; during periods of remission, the diet is much gentler.

Treatment options

The search for effective methods of treating UC has been going on since the 80s of the last century. Currently, the best results have been achieved with an integrated approach to therapy, combining different treatment methods:

taking medications;
diet;
psycho-emotional correction.

Surgical treatment of UC is also practiced, but in recent years there has been a tendency to replace surgical therapy with conservative therapy.

The treatment plan is developed based on the individual characteristics of the body (gender, age, presence of other chronic ailments, etc.). General treatment for ulcerative colitis has long proven ineffective. Therefore, before prescribing certain medications or surgery, the patient must undergo a long examination.

If a complete cure is not possible, therapy for ulcerative colitis sets itself the following tasks:

reduction of disease symptoms;
relapse prevention;
improving quality of life.

Video - Nonspecific ulcerative colitis: symptoms and treatment

Drug therapy for UC

The main group of drugs prescribed for the treatment of ulcerative colitis are anti-inflammatory drugs. Their goal is to stop the inflammatory process in the mucous membranes of the large intestine.

Glucocorticoids(Prednisolone, Hydrocortisone, Methylprednisolone). A group of medications that were the first to be used to reduce inflammation of the rectum. The greatest effectiveness of glucocorticoids is observed in the treatment of left-sided forms of UC. Previously, these medications were used in the form of enemas; in recent years, a special medicinal product—rectal foam—has become widespread. Glucocorticoid therapy shows good results in moderate and severe forms of UC. The duration of the course is often no more than 10 days, then the question of the advisability of replacing glucocorticoids with drugs of another group is considered.
Sulfasalazine. This drug was originally developed to combat bacterial infections. It has shown high effectiveness in the treatment of mild and moderate forms of inflammation of the rectal mucosa. Prescribed in the form of enemas or suppositories. The main disadvantage of this drug in the treatment of ulcerative colitis is the abundance of side effects even with a small overdose. Patients develop diarrhea, nausea, weakness, and severe abdominal pain. Therefore, a adjusted dosage is the main key to successful treatment with sulfasalazine.
Medicines group 5-ASK(aminosalicylic acid) - Mesacol, Mezavant, Kansalazine, Salofalk, etc. The effectiveness of UC therapy with these drugs is similar to that of sulfasalazine, but, unlike the latter, 5-ASA is less toxic to the body. Used as the main medicine for mild and moderate forms of colitis. May be prescribed in addition to glucocorticoid drugs.

Analysis of the effectiveness of a particular anti-inflammatory drug is carried out within a week from the moment of administration. If stabilization of the patient's condition is not observed, the drug is replaced with another.

Reducing mucosal inflammation is the main, but not the only task that a UC treatment plan should solve. In addition to anti-inflammatory drugs, your doctor may prescribe medications from the following groups:

Depending on the form of the disease and individual sensitivity to individual drugs, the gastroenterologist can prescribe all of the above-described drugs, as well as drugs from groups 1-2.

When is surgery needed?

Currently, surgical intervention is prescribed in 10-15% of all cases of UC. At the beginning of the 2000s, this figure was at least twice as high. Surgery is recommended in extreme cases when conservative treatment has failed and the patient's condition is deteriorating. Against the background of UC, a malignant intestinal tumor (colorectal cancer) can develop. Then the operation is necessary to save the patient’s life, and not to improve its quality.

The following types of surgical intervention are currently practiced:

The choice of one or another surgical intervention technique, as in the case of conservative treatment, depends on the patient’s condition and the presence of concomitant diseases.

Features of the diet for UC

Nutrition for ulcerative colitis requires strict control of the balance of nutrients in the foods consumed. Exceeding the norm of carbohydrates or fats during remission can lead to relapse. Therefore, visits to a nutritionist, who will adjust the menu during different cycles of the disease, are mandatory.

In case of UC, it is recommended to completely remove foods containing coarse fiber or milk protein from the diet. Flour increases intestinal peristalsis, which in case of inflammation of the mucous membranes is fraught with sharp, paroxysmal pain. As for the ban on dairy products, it is due to the body’s increased sensitivity to the protein contained in them. If in healthy people the allergy to this protein is suppressed by the immune system, then in UC the body cannot cope with this task. Also prohibited are sweets with a high lactose content (chocolate, candies, various syrups, etc.). Consumption of vegetables and fruits during an exacerbation should be kept to a minimum. Baked apples and pears are allowed only in stable remission; it is better to exclude citrus fruits altogether.

The basis of the diet of a patient with nonspecific colitis during the acute phase should be porridge and broth. Meat and fish are allowed only boiled or steamed, without crust. As a side dish, in addition to porridge, soft-consistency mashed potatoes are recommended. Eggs are also allowed, but only in the form of a steam omelet.

The main principle of forming a menu during the period of remission is to assess the body’s reaction to the addition of a particular product. Diet correction is carried out only under the supervision of a gastroenterologist.

A properly selected treatment regimen for ulcerative colitis and adherence to a diet ensure stable, long-term remission, in which dietary restrictions are kept to a minimum. The example of thousands of patients has shown that with nonspecific ulcerative colitis you can lead a bright, fulfilling life, the quality of which depends primarily on the desire to comply with the treatment plan.

When intestinal pathologies occur, patients begin to experience very unpleasant symptoms that significantly worsen the quality of life. Ulcerative colitis is considered one of the most common pathological conditions.

Definition and code according to ICD-10

Ulcerative colitis is a chronic pathological condition that affects the mucous tissue of the large intestine. The pathology is accompanied by hyperedema, inflammatory processes and ulcerative lesions.

The mucous membranes of the colon become inflamed, and ulcerative lesions and necrotic areas form on them.

The pathology occurs in patients of any age, but ulcerative type colitis is most typical for patients in the 20-40 year old age groups, as well as for people over 55.

Statistics show that the disease is more common in women (30%) than in men. Moreover, urban residents are more prone to the disease than rural residents.

A synonym for ulcerative colitis is purulent hemorrhagic rectocolitis. In the classification of diseases, ulcerative colitis is assigned code K51.

Can ulcerative colitis be cured?

When a gastroenterologist diagnoses a patient with ulcerative colitis, everyone is worried about only one problem - whether this pathology can be cured and how this can be done.

After all, ulcerative colitis belongs to the category that, as a rule, cannot be completely cured. Unfortunately, it is impossible to get rid of such a disease forever, but it can be controlled.

In order to prolong remission as much as possible and minimize exacerbations, it is necessary to strictly follow medical prescriptions, diet therapy, take prescribed medications, etc.

The right approach will help avoid exacerbations and improve the quality of life of a patient with such an unpleasant chronic disease.

Symptoms

The clinical picture of the disease depends on the specific pathological form, but all types of ulcerative colitis are accompanied by rectal bleeding, abdominal pain and diarrhea.

The remaining symptoms are determined by the localization and extent of ulcerative lesions, as well as the severity of the pathological process.

In general, the following manifestations may be present:

Tides;
Purulent or bloody impurities in the stool;
Diarrhea;
Convulsive contractions in the pelvic organs and abdomen;
Swelling and soreness of joint tissues;
Rapid weight loss;
A feeling of gurgling in the intestinal tissues;
Nausea and vomiting syndrome;
Ulcerative formations on the skin and tongue.

The pathology usually begins latently, but develops rapidly, so it begins to manifest itself very quickly.

Causes

Experts find it difficult to name exactly the reasons that provoke the development of ulcerative colitis, but there are a number of assumptions according to which bacterial or viral agents, autoimmune disorders (when there is sensitization of immune structures to their own cells), etc., play a role in the development of the ulcerative intestinal process.

It was also possible to establish that the disease may be caused by a genetic predisposition. Scientists have discovered a number of genes that may be responsible for a hereditary predisposition to such a peptic ulcer disease.

Classification

Ulcerative colitis can vary in the extent of the pathological process or its location.

Picture (photo) of types of ulcerative colitis

With left-sided colitis, the tissues of the sigmoid and descending colon are affected, with proctitis, inflammation in the rectal tissues is characteristic, and with the total form of colitis, the entire intestine is affected.

Spicy

The third disability group can be assigned to those patients when intestinal processes characterize the distal form. Such a course of the ulcerative process makes it impossible for the patient to find employment.

Prevention

Significant preventive measures have not been developed to avoid the likely consequences, because the exact causes are not known. Therefore, it is quite difficult to prevent complications. And there is no special program for this.

Video about nonspecific ulcerative colitis of the intestine:

Nonspecific ulcerative colitis is a disease that has a chronic course and is characterized by ulcerative-inflammatory damage to the mucous membrane of the large intestine.

The disease most often affects people aged 20 to 40 years. It almost never occurs in people over 40 or under 15 years of age. The likelihood of developing ulcerative colitis is 15% higher if close relatives suffer from this intestinal disease.

Causes

The exact causes of nonspecific ulcerative colitis have not yet been established. It is assumed that its development is influenced by genetic, immunological, infectious factors, as well as various environmental factors. Most researchers suggest that this disease is autoimmune or genetically determined. Emotional factors play a significant role in the occurrence of exacerbations of ulcerative colitis, but in themselves do not lead to the development of this disease.

Nonspecific ulcerative colitis: symptoms

The disease may begin acutely or develop gradually. All symptoms of ulcerative colitis are caused by a chronic ulcerative-inflammatory process in the mucous membrane of the large intestine. These include:

Pasty stools or diarrhea mixed with mucus, pus and blood in the stool. Patients often experience a false and rather painful urge to defecate – tenesmus;
Pain in the left half of the abdomen. Sometimes they spread throughout the abdomen;
Increased body temperature;
Weight loss;
Lack of appetite;
Various degrees of water-electrolyte imbalance.

Extraintestinal symptoms of ulcerative colitis include:

Arthritis and spondylitis;
Blepharitis, conjunctivitis, iritis;
Stomatitis;
Cholelithiasis, cholangitis, cirrhosis;
Nephrolithiasis;
Erythema, pyoderma gangrenosum;
Thromboembolism and thrombophlebitis.

Complications

Like any other disease, ulcerative colitis can lead to the development of various complications:

Toxic megacolon. With it, a significant expansion of the lumen of the transverse colon occurs. This complication occurs in 5% of cases and often leads to death;
Perforation of colon ulcers. It is observed in 3–4% of patients and in 70–100% of cases leads to their death;
Strictures of the colon or rectum - a narrowing of the intestinal lumen in a certain area, which interferes with the passage of feces and can cause intestinal obstruction;
Intestinal bleeding. This complication is observed in 6% of cases;
Acute toxic dilatation (expansion) of the colon. Relatively rare;
Perianal complications, which include fissures, fistulas, paraproctitis. These complications are observed in 30% of patients;
Colon cancer. Patients suffering from ulcerative colitis for more than 10 years have an increased risk of developing malignant neoplasms of the large intestine. Moreover, each year of existence of this disease increases this risk by 2%.

Diagnostics

Diagnosis of nonspecific ulcerative colitis is based on the characteristic clinical symptoms of the disease, medical examination data, laboratory diagnostics (stool culture tank, coprological and histological analyses) and instrumental diagnostics (x-ray and endoscopic examinations).

Nonspecific ulcerative colitis: treatment

All patients with a newly diagnosed disease or with the development of its exacerbation must be hospitalized. Conservative treatment of nonspecific ulcerative colitis includes the following components:

Infusion therapy – carried out for the purpose of correcting disturbances in water-electrolyte balance and detoxification;
Vitamin therapy;
Antibiotic therapy (prescribed after bacteriological examination of stool);
Sedatives;
Antidiarrheal therapy;
Sulfasalazine;
Cytostatics;
Corticosteroid hormones.

For nonspecific ulcerative colitis, it is very important to follow a diet high in easily digestible proteins.

Surgical treatment of ulcerative colitis is carried out when complications of the disease develop (massive bleeding, intestinal perforation, cancer, intestinal obstruction, etc.).

Nonspecific ulcerative colitis: diet

During the period of exacerbation of the disease, it is necessary to adhere to the most gentle diet. After acute manifestations, such as abdominal pain and diarrhea, have subsided, the patient can be switched to a less strict diet, which may include unprocessed foods.

It is very important that all dishes are not only tasty, but also varied. Patients are recommended steamed or boiled lean meat, pureed porridge, eggs, dry cookies, dried white bread, rosehip decoction, some juices (tomato, orange), compotes of ripe berries and fruits. The diet for nonspecific ulcerative colitis must include walnuts. But fried, salty, fatty or spicy foods, legumes, chocolate, raw vegetables and fruits, mushrooms, beets, dried apricots, kiwi, and plums should be completely excluded.

The diet for nonspecific ulcerative colitis involves eating small portions of food over relatively short periods of time (fractional meals). This is due to the fact that a large amount of food will not be fully digested and absorbed, and in addition, it can cause increased diarrhea.

Nonspecific ulcerative colitis: alternative treatment

In many cases, doctors recommend to their patients not only medication, but also alternative treatment for ulcerative colitis. Microenemas with sea buckthorn or rosehip oil are quite effective in the treatment of this disease. In addition, you can use a decoction of Burnet officinalis internally. It is taken one tablespoon five times a day before meals. The course of treatment is at least a month.

However, alternative treatment for nonspecific ulcerative colitis should in no case completely replace traditional drug therapy. This is a very serious chronic disease that can lead to the development of deadly complications, and its treatment must be carried out only under the guidance of a doctor!

Video from YouTube on the topic of the article:

Ulcerative colitis, or nonspecific ulcerative colitis (often abbreviated as UC) is a disease in which inflammatory processes develop in the mucous membrane of the rectum. The disease is characterized by a transition to a chronic stage with alternating exacerbations and periods of remission. Among the main causes of ulcerative colitis are a combination of genetic factors of predisposition to pathology and the negative influence of the external environment. The prevalence of ulcerative colitis ranges from 40 to 117 cases per 100 thousand population. The most vulnerable part of the population is 20-40 years old. The highest incidence of deaths from UC is observed when the disease progresses at lightning speed; in the first year of the disease, with its severe course, malignant tumors quickly develop, and also 10 years after manifestation.

Etiology of ulcerative colitis

Ulcerative colitis is a disease with incompletely understood trigger factors. It is known that the presence among close relatives of patients with nonspecific ulcerative colitis of the intestine or, also characterized by a chronic inflammatory process of the intestinal walls, increases the risk of developing UC.
Most often, nonspecific colitis is registered at a young age, from 20 to 25 years, the second most vulnerable age group is 55-65 years.
There is evidence that ulcerative colitis is provoked by infections of a bacterial and viral nature, but there is no clear correlation yet.

Reliable data include some environmental factors that influence the occurrence of the disease and its exacerbation. The most fully studied are the use of oral contraceptives and certain hormonal medications, smoking, and addiction to certain types of diets. The dependence on hormonal agents and fluctuations in natural hormonal levels (mainly when the level of estrogen in the blood increases) is indirectly confirmed by statistical data: among adults, the number of female patients diagnosed with UC exceeds the male part by almost 30%.

There is a correlation between the increased risk of developing the disease and long-term use of non-steroidal anti-inflammatory drugs, the presence of food allergies uncorrected by diet and/or medications, and severe or prolonged stress conditions.
The main theory of the occurrence of the disease is based on the presence of immunological factors and autosensitization of the patient’s body.

Protective and preventive factors for UC

Various studies have identified factors that reduce the likelihood of developing ulcerative colitis and increase the effectiveness of its diagnosis and treatment.

It is likely that appendectomy for true appendicitis, performed at a young age, reduces the risk of developing ulcerative colitis.
Breastfeeding is a potential protective factor: in women who did not suppress lactation after childbirth, ulcerative colitis is less common.
The relationship between intestinal colitis and tobacco smoking is ambiguous: among the smoking part of the population, the prevalence of ulcerative colitis is higher than among non-smokers. However, the incidence of the disease increases sharply in those who quit smoking, and therefore a study was conducted on the effect of nicotine on the manifestation of symptoms of ulcerative colitis. Based on the results, it was concluded that it is possible to include nicotine preparations (in the form of patches, etc.) in the general course of drug therapy for nonspecific ulcerative colitis.
Oleic acid is considered a means of preventing the onset and development of the disease, having the ability to block chemical compounds responsible for inflammation of the intestinal walls, and can be included in the diet of patients and patients at risk in order to prevent the development or exacerbation of the disease. The average recommended dose is based on acid intake in foods, such as 2-3 tablespoons of olive oil.

Ulcerative colitis: symptomsdiseases

Ulcerative colitis of the intestine is characterized by a long, chronic course, in which the clinical picture of the disease combines periods of exacerbation and remission. The severity and specificity of symptomatic manifestations depend on the localization of the destructive process and its intensity, as well as the depth of tissue damage.

Ulcerative nonspecific colitis at the initial stage is accompanied by swelling and hyperemic changes in the intestinal mucosa. After a certain time (depending on the speed of development of the pathology, the body’s resistance and the timeliness of diagnosis of nonspecific colitis and the start of therapy), ulceration of the intestinal walls begins with inflammatory damage to the submucosal layer, and in severe forms of the disease, muscle tissue can also be involved in the destruction process. The formation of so-called pseudopolyps, narrowing of the intestinal lumen and other complications are likely.

With the development of nonspecific ulcerative colitis, symptoms are divided into intestinal and extraintestinal, depending on the location of the manifestation. Both types of symptoms, depending on the stage of the disease and the general condition of the body, can appear either pronounced or minimal or completely absent.
Among the intestinal symptoms of nonspecific ulcerative colitis are:

frequency of liquid, pasty stools with various inclusions (mucus, blood, purulent discharge);
the presence of false and imperative urges to defecate;
pain in the abdominal area, mainly in the left lower quarter. However, depending on the location of the pathology, pain in the lower abdomen may be observed, accompanied by a false urge to defecate with pain. Pain with left-sided localization can be cutting, cramping, wave-like, etc.;
appetite disturbances (usually decreased), weight loss, in the long-term acute stage up to cachexia;
disturbances of water-electrolyte balance of varying severity;
increase in body temperature from subfebrile to febrile (from 37 to 39°C);
general malaise, weakness, joint pain.

Extraintestinal manifestations with a high prevalence include skin inflammatory processes spreading to the subcutaneous tissue (pyoderma gangrenosum, nordular erythraema), lesions of the oral mucosa (aphthous and other stomatitis), manifestations of inflammation in articular tissues (arthralgia, ankylosing spondylitis), visual organs, and the development of uveitis, episcleritis, primary sclerosing cholangitis, pathologies of the cardiovascular system, kidneys, liver, biliary tract, etc. is likely. In the presence of these diseases, especially in combination with intestinal symptoms, a diagnostic examination of the gastrointestinal organs should be performed to identify the etiology tract to confirm or exclude nonspecific ulcerative colitis.

Types of ulcerative colitis: classification of the disease

Ulcerative colitis is divided into types depending on the location of the inflammatory process, the course of the disease and its severity.
Classification of types of ulcerative colitis by localization of inflammation:

with inflammation of the rectal mucosa, proctitis is diagnosed;
with combined damage to the mucous membranes of the sigmoid and rectum, they speak of nonspecific ulcerative proctosigmoiditis;
total damage to a significant part of the intestinal mucosa makes it possible to diagnose total nonspecific ulcerative colitis, the most severe form of the disease;
colitis, which is characterized by an inflammatory process in the left side, is separated into a separate specified diagnosis as left-sided UC with an inflammatory process in the intestinal section located above the rectum and limited to the splenic flexure of the colon;
the remaining localizations are combined into a diagnosis of “regional nonspecific ulcerative colitis” with specification of the location of the lesion.

Depending on the dynamics of the disease, its forms are distinguished:

spicy;
chronic;
recurrent form of ulcerative colitis.

The clinical picture and severity of symptoms allow us to classify ulcerative colitis according to the severity of its course:

ulcerative colitis of the intestine in a mild form is characterized by pasty stools with a frequency of no more than 5 times within 24 hours, a satisfactory general condition, a small amount of impurities in the stool (blood, mucus, pus), the absence of other pronounced manifestations, including water-electrolyte disturbances balance and the resulting tachycardia and other complications. In laboratory tests, hemoglobin levels are usually normal, elevated body temperature is not recorded;
moderate severity is accompanied by pain in the abdomen, frequent (up to 8 times) loose stools with impurities, low-grade body temperature, signs of anemia, tachycardia;
in severe forms, there is diarrhea, loose stools, 8 or more times a day, a significant amount of impurities in the stool, febrile body temperature (above 38°C), anemia (hemoglobin levels not more than 90 g/l), severe tachycardia, general condition is unsatisfactory up to heavy. Prolonged internal bleeding can not only be accompanied by anemia, hypoproteinemia, vitamin deficiencies, but also lead to hemorrhagic shock, which can be fatal.

Diagnostic criteria for the disease

Unambiguous diagnostic criteria for nonspecific ulcerative colitis have not been developed due to the complex manifestation of the disease and the similarity of symptoms with various other pathologies. When making a diagnosis, differentiation is required from helminthic infestations, acute intestinal infections (dysentery), protozoal infestations (amoebiasis), Crohn's disease, and tumor formations in the colon cavity.
In general, the clinical manifestation of the disease and studies can accurately determine the presence of ulcerative colitis using the following diagnostic methods:

collecting anamnesis by examining the medical record and interviewing the patient. Both complaints and information about the presence of close relatives with intestinal pathologies of an inflammatory and non-inflammatory nature, a list of medications taken, trips to countries with a high epidemiological level for certain diseases, a history of intestinal infections, food poisoning, smoking, allergies and food are of diagnostic importance. intolerance in the patient;
data from a detailed physical examination of the patient with an assessment of heart rate, body temperature, blood pressure, body mass index, assessment of peritoneal (abdominal) symptoms, identification of the presence or absence of signs of intestinal dilatation, as well as examination of the oral mucosa, skin, sclera and joints;
examination of the anus, digital examination and/or sigmoidoscopy of the rectum;
plain radiography of the gastrointestinal tract;
total colonoscopy with the inclusion of ileoscopy in the study;
biopsy of the mucous membranes of the colon or other parts for local, regional inflammation;
Ultrasound of the abdominal organs, pelvis, etc.;
laboratory tests of stool, urine, blood.

In order to differentiate the diagnosis, it is possible to prescribe other research methods, including magnetic resonance imaging, computed tomography, transabdominal and transrectal ultrasound examinations of the intestines, radiography with the introduction of contrast, capsule endoscopy and others.

Complications of the disease

Ulcerative colitis is a disease that requires constant therapy and compliance with doctor’s prescriptions, both in taking medications and following dietary rules. Violations of the treatment regimen, distortions in prescriptions and untreated forms of ulcerative colitis, in addition to pathologies of various organs and the development of inflammatory processes in tissues non-adjacent to the intestinal mucosa, can also cause serious complications requiring urgent hospitalization due to the high mortality rate of the disease. These include:

megacolon of a toxic variety, or dilatation of a section of the intestine, more often of the transverse colon, with impaired wall tone. An expansion diameter of 6 or more centimeters is characterized by severe intoxication of the body, exhaustion, and without emergency treatment leads to death;
a pronounced inflammatory process in the mucous membrane in every 30 patients leads to perforation, perforation of the colon and is also the cause of total sepsis and deaths;
profuse intestinal bleeding leads to severe forms and exhaustion;
complications localized in the perianal area: fissures, fistulous changes, paraproctitis, etc.;
According to studies, with complete damage to the colon up to the hepatic flexure, patients with a history of nonspecific ulcerative colitis for more than 10 years have a high risk of developing intestinal cancer.

Extraintestinal complications include severe pathologies and dysfunctions of the cardiac system, blood vessels (thrombophlebitis, thrombosis), kidneys, liver, etc. A long-term inflammatory process of the intestine has a significant impact on the entire body and, without effective therapy, becomes the cause of disability and death of the patient.

Treatment methods for ulcerative colitis of the intestine: treatment and prevention of exacerbations

In case of UC, treatment is selected depending on the localization of the inflammatory process and the extent of coverage, the severity of the disease, the extent of the disease, the presence of extraintestinal manifestations and complications, as well as the risk of their development. The effectiveness of previously conducted courses of treatment is also assessed.
Nonspecific colitis in the mild stage and moderate course of the disease without exacerbations do not require hospitalization, and therapy can be carried out independently at home. Severe forms of the disease require hospital stay for examination, relief of acute stages and treatment.

Nonspecific ulcerative colitis: patient diet

Regardless of the stage of the disease, the severity of symptoms and the presence of exacerbations, everyone is strongly recommended to adhere to the principles of gentle nutrition and diet with the following dietary restrictions:

all products containing coarse fiber that can irritate the inflamed intestinal mucosa. These include wholemeal flour, fruits, vegetables rich in fiber, grains with preserved shells, legumes, nuts, etc.;
any dishes made with hot spices, marinades, high salt content, vinegar, etc.

When preparing a diet for patients with ulcerative colitis, it is recommended to focus on the following food groups and methods of processing them:

the basis of the diet consists of lean varieties of meat, poultry, fish, egg whites, cottage cheese in the absence of contraindications to these products, which is associated with the high incidence of hypoproteinemia in this disease (protein deficiency);
all food requiring processing must be boiled or steamed;
It is strongly recommended to grind foods and dishes before eating until they are almost homogeneous.

Conservative treatment of nonspecific ulcerative colitis

Conservative therapy for nonspecific colitis is based on the principles of suppressing the inflammatory process with anti-inflammatory nonsteroidal drugs, hormonal agents (corticosteroids) and suppressing the body's immune autoreaction with immunosuppressants. These groups of drugs are used sequentially; if there is a good therapeutic response to anti-inflammatory drugs, additional medications are not added to the course of treatment.
Main groups of drugs and features of their prescription:

5-acetylsalicylic acid (acetylsalicylic acid of prolonged action with a long period of release of the active substance, which allows the effect on the intestinal mucosa in the desired area of the intestine. Such drugs include Pentasa, Mefalazim, Sulafalk, Sulafalazine, etc. The use of conventional acetylsalicylic acid ( Aspirin) is highly not recommended due to a possible increase in symptoms;
hormonal drugs - corticosteroids. They are used in short (up to 3-4 months) courses to achieve remission and reduce the severity of the disease. Corticosteroid drugs equally affect inflammatory processes throughout the body, affecting tissue reaction mechanisms. However, long-term use may cause multiple side effects. The most common include night sweats, increased hair growth of the skin, including in the facial area, sleep disturbances (insomnia), excitability, hyperactive state, decreased general immunity with increased susceptibility to the effects of pathogenic microorganisms. With a long course of therapy, the development of type 2 diabetes mellitus, hypertensive reaction (increased blood pressure), cataracts, osteoporosis and a tendency to injury due to impaired absorption of calcium is possible. When treated in childhood, body growth may slow down. Prescribing a course of corticosteroid drugs is justified in cases of persistent severe ulcerative colitis that does not respond to other types of treatment;
drugs that suppress the reaction of the immune system (immunosuppressants) affect the severity of the inflammatory process by reducing the body’s autoimmune aggression. The main effect - suppression of immune defense - leads to increased susceptibility to infections, as a result of which drugs are prescribed in short courses and under close medical supervision. During the period of therapy and for 2 months after it, it is recommended to refrain from contact with virus and bacteria carriers, and to avoid crowded places during the season of increased epidemiological danger.

Nonspecific ulcerative colitis (proctitis, proctosigmoiditis, colitis and other varieties) may require additional methods of conservative therapy in severe cases, severe symptoms (fever, severe pain, severe diarrhea, etc.). In such cases, specialists can add the following groups of drugs to the course of therapy:

group of antibiotics. In case of an extensive inflammatory process, accompanied by elevated body temperature and the growth of pathogenic bacterial flora, antibacterial drugs are selected in accordance with the patient’s data (age, general condition, allergic reactions or individual intolerance, etc.). It is possible to use both intestinal antibiotics and antibacterial drugs with low absorption, and systemic medications, depending on the severity of the condition;
antidiarrheals for nonspecific ulcerative colitis, even in a severe stage of the disease with severe diarrhea, are used only as prescribed by a doctor. The combination of an inflammatory process of the intestinal mucosa and fixative drugs can lead to acute toxic megacolon (dilation of the colon, loss of tone of an intestinal area), which without emergency help can be fatal. If it is necessary to use antidiarrheals, Loperamide and Imodium are considered the first choice drugs;
painkillers are also selected by a specialist. Taking common nonsteroidal anti-inflammatory drugs (ibuprofen, aspirin, etc.) may worsen the course of the disease due to an increased risk of gastrointestinal side effects;
to compensate for iron deficiency and reduce the severity of iron deficiency anemia, which often accompanies the development of ulcerative colitis due to blood loss, iron supplements are prescribed, both in mono- and multivitamin complexes;
To maintain electrolyte balance, it is possible to take rehydration solutions, as well as potassium, magnesium, etc.

With the development of diseases accompanying nonspecific ulcerative colitis, drug and supportive therapy are chosen taking into account the main diagnosis and the effect of drugs on the affected intestinal walls. If possible, therapy is recommended during the period of remission.

Surgical methods for treating ulcerative colitis

Nonspecific ulcerative colitis requires surgical treatment in the following cases:

in acute, transient form of the disease with no therapeutic response to conservative therapy for 14-28 days;
in subacute, recurrent, progressive forms of ulcerative colitis with unsuccessful results of drug therapy for six months;
for chronic colitis with alternating exacerbations and remissions and irreversible changes in the mucous membranes of the walls of the colon;
for severe, life-threatening complications, regardless of the stage of the disease.

Surgical treatment of UC may be required as an emergency, urgently or as a planned operation. Indications for emergency surgical therapy are intestinal perforation and peritonitis, as well as intestinal obstruction. If acute intestinal obstruction is not diagnosed, the operation can be classified as urgent or requiring clarification, however, intestinal perforation of any degree is an absolute indication for emergency intervention, since the mortality rate with perforation is up to 40% of the total number of patients with this pathology.

Urgent surgical intervention is performed in the diagnosis of profuse bleeding of the walls of the colon, abdominal abscesses, acute toxic dilatation (megacolon, enlargement) of the colon.
Planned surgical treatment methods are prescribed:

with a form of the disease that is resistant to drug treatment, a hormone-dependent form, etc.;
with a disease duration of more than 10 years with moderate or high degree of dysplasia of the epithelium of the intestinal walls;
at the onset of carcinogenic processes, degeneration of mucosal tissue into tumor formations.

The total number of patients with UC undergoing surgical treatment is about 10%, of which approximately a quarter are patients with intestinal pancolitis.
Various methods of surgical treatment of UC are conventionally divided into three main groups:

The first includes palliative intervention on the autonomic nervous system. This type of surgical treatment is recognized as ineffective with a short-term effect and is not currently recommended when choosing a method of treatment for ulcerative colitis. This technique is not applicable to urgent and emergency operations;
ileostomy, colostomy and similar surgical methods. It is carried out in the area above the registration site of the destructive process in order to exclude the affected area of the intestine from the digestive process. This type of palliative intervention in most cases is a preliminary, supporting stage before the next method of surgical therapy. However, in some patients, such operations followed by combined conservative treatment can lead to long-term remission of the disease;
Radical surgery involves removing the area or the entire colon affected by inflammatory changes.

An option such as appendicostomy, used previously, is not recommended today in surgical practice for the treatment of ulcerative colitis and other inflammatory and destructive intestinal pathologies (Crohn's disease, etc.).
Options for segmental and subtotal resection (partial removal) of the colon are currently recognized as not entirely effective techniques due to the high risk of disease recurrence in the remaining area.

The optimal technique is considered to be coloproctectomy with the formation of an end ileostomy. This type of surgical treatment is characterized by the lowest number of postoperative complications and the need for repeated surgical treatment. Also, during coloproctectomy, the formed ileostomy is easy to care for and easy to access.

However, due to the peculiarities of the location of the ileostomy, patients often prefer the colostomy version of the operation, in which dense stool comes out of the formed opening, rather than the liquid contents of the small intestine, as with an ileostomy. However, the effectiveness of the ileostomy technique is much higher and suggests the patient’s possible recovery without radical intervention. Any type of hole can be repaired after the patient has recovered.

Methods of washing the colon with antiseptic and antibacterial solutions through a hole formed during surgery rarely lead to the expected effect. It is worth remembering that after these types of palliative intervention it is necessary to critically assess the condition, distinguishing between long-term remission and complete restoration of the mucosa. If the assessment is incorrect, a repeat similar operation or radical removal of the colon may be required.

Radical surgery, indicated for patients with severe forms of the disease, is often recommended to be carried out in two stages. At the first stage, an operation is performed with the imposition of an ileostomy hole, which makes it possible to improve the general condition of the patient when the large intestine is excluded from the digestive process. After a recovery period against the background of stabilization of appetite, sleep, weight gain, improvement of protein levels, hemoglobin and reduction of vitamin deficiency, as well as restoration of mental balance, radical surgical therapy is carried out with removal of the colon. On average, it takes from several months to six months to restore physical and mental stability, reactivity and resistance of the body. It is important not to stop at this stage if there are previous indications for radical treatment.

Prevention methods

Since the exact causes of the development of the disease have not been identified, prevention methods include a healthy lifestyle, balanced diet, timely elimination of symptoms and treatment of intestinal infections, correction of food allergic reactions, etc. Preventative and preventive measures are especially important for people with inflammatory bowel diseases family history.

Colitis is a fairly common disease that mainly affects older people. This is an extremely unpleasant disease that significantly impairs a person’s quality of life. If left untreated, the inflammatory process can lead to a lot of unpleasant consequences.

That is why people are quite often interested in the question of what such an illness is. What are the first symptoms of inflammation? When should you see a doctor immediately? What treatment does modern medicine offer? Are there any means of prevention? This information will be useful for many readers. So, next we will look at the different types of intestinal colitis and their treatment.

What is colitis?

Colitis is an inflammatory disease that affects the large intestine. According to statistics, men aged 40 to 60 years most often suffer from this disease, and for women the age threshold is even lowered: even twenty-year-olds are among the patients.

Today there are many varieties of this disease. The reasons for it may be different. For the most part, the inflammatory process is associated with the activity of bacterial microorganisms and viruses. Risk factors also include dysfunction: insufficient blood supply to intestinal tissues (observed with high blood pressure, vasospasm, diabetes, atherosclerosis), as well as poor nutrition (fiber deficiency), bad habits (smoking), and the presence of infections in other parts of the digestive system. In addition, there is also some genetic predisposition.

In most cases, colitis responds quite well to drug treatment, especially if therapy was started in a timely manner. That is why it is important to know about the main causes and first symptoms of the disease.

The main types of intestinal colitis and the causes of their occurrence

Unfortunately, this disease cannot be called rare. It is not surprising that many patients are interested in additional information about the disease. One of the most common questions is: “What is ulcerative colitis of the intestine?” and the reasons for the development of pathology also do not remain aside. However, it's worth knowing that there are dozens of different forms of intestinal inflammation and several commonly used classification systems.

For example, depending on the course of the disease, acute (symptoms are pronounced and appear quickly, intestinal inflammation is often associated with gastritis or enteritis) and chronic colitis (symptoms either fade or worsen).

Depending on the location of the inflammatory process, forms such as proctitis (inflammation of the rectum), sigmoiditis (affected transversitis (transverse colon)) and typhlitis (inflammation of the entire large intestine become inflamed in some cases - this condition is called pancolitis. In addition, simultaneous damage to several departments is possible.

Depending on the causes of the development of the disease, it is customary to distinguish the following types:

Infectious colitis. Develops against the background of bacterial microflora activity. The disease can be caused by streptococci or staphylococci. An infection can enter the digestive system from the outside, for example, colitis develops against the background of dysentery. In addition, inflammation occurs against the background of a decrease in the activity of the immune system, as a result of which the intensive reproduction of opportunistic microflora begins.
Ischemic colitis. It develops when the normal blood supply to the large intestine is disrupted, which is observed, for example, with atherosclerosis of the branches of the abdominal aorta.
People with chronic radiation sickness develop what is called radiation colitis.
There is also a toxic form of colitis, which is caused by exposure to toxins or medications. For example, quite often uncontrolled use of non-steroidal anti-inflammatory drugs leads to inflammation of the intestinal mucosa and other organs of the digestive tract.
Quite common and dangerous is ulcerative colitis, which is accompanied by the formation of ulcers on the intestinal walls. Unfortunately, the exact etiology of this disease is unknown - scientists were able to find out that the autoimmune process, genetic inheritance and certain infectious agents play a role in the formation of the disease.

Naturally, there are other classification schemes, as well as forms of inflammation. For example, colitis can develop against the background of allergies. In addition, erosion of the mucous membrane or its gradual atrophy may develop in parallel.

What symptoms are accompanied by acute colitis?

As you can see, there are a variety of types of intestinal colitis. Symptoms of acute forms for the most part look the same, regardless of the form of the disease, so it is worth familiarizing yourself with them.

Often, an acute inflammatory process begins with an increase in temperature and the appearance of signs of general intoxication of the body. In particular, patients complain of weakness, body aches, muscle pain, headache, loss of appetite, and chills.

There are also more specific symptoms that accompany colitis. How does this disease manifest itself? First of all, disorders of the digestive system. In particular, many patients complain of severe sharp pain in the abdomen, especially in the navel area. Often any food intake is accompanied by rumbling and bloating.

A feature of inflammation of the large intestine is constant diarrhea - bowel movements become more frequent up to 5-6 times a day. Often patients feel the urge immediately after eating, in the morning, or even wake up at night. Feces, as a rule, are relatively liquid and foul-smelling, which is associated with the activity of intestinal bacteria.

There are some quite dangerous symptoms of ulcerative colitis of the intestines. In particular, if there is serious damage to the mucous membrane, blood may appear in the stool. If unchanged blood appears constantly, you must tell your doctor about it.

Chronic colitis and features of its course

Chronic intestinal colitis is a rather dangerous disease. Periods of exacerbation are followed by periods of relative calm, when a person feels normal and therefore does not believe that he needs medical help. Moreover, the chronic form of the disease is much more difficult to treat.

This disease is also accompanied by disturbances in the digestive processes. Patients often suffer from problems with stool - diarrhea is often replaced by constipation, and vice versa. Sometimes the act of defecation is accompanied by abdominal pain. In addition, the inflammatory process can spread to other parts of the digestive system.

It is worth noting that in the absence of treatment, gradual changes are observed in all organ systems. Sick people lose their appetite, resulting in weight loss. In addition, food is not completely absorbed, which gradually leads to the development of anemia, hypo- and avitaminosis, disruption of the normal balance of electrolytes, and exhaustion. The disease also affects a person’s emotional state - depression, worsening mood, increased irritability, sleep problems, and constant fatigue are observed. Therefore, under no circumstances should you ignore the problem.

Modern diagnostic methods

What should you do if you are worried about symptoms resembling colitis? What to do in such cases? Of course, the first thing you need to do is see a doctor. The fact is that the same symptoms can mask other, more serious diseases, including cancer.

First, the doctor must collect a complete medical history. He will probably ask about the symptoms present, their intensity, time of occurrence, etc. These facts are very important, so be sure to provide the specialist with all the necessary information.

This is followed by a standard inspection. The doctor will palpate the abdomen to look for abnormally enlarged organs. If colitis is suspected, it is necessary for a specialist to quickly detect swelling or swelling in the rectum.

The patient is also required to undergo blood tests (to detect inflammation, hidden bleeding, bleeding disorders) and stool tests (infection or blood impurities can be detected). The results of laboratory tests in this case are very informative.

If necessary, sigmoidoscopy and colonoscopy are prescribed - these studies help to carefully examine the mucous membrane of the large intestine. If the causes of colitis cannot be determined, or there is a suspicion of a malignant process, a biopsy is also performed during the examination - tissue collection with further laboratory testing of samples.

There are some other studies that help not only to detect colitis, but also to assess the degree of damage to the mucosa, find out the location of the inflammatory process, etc. For example, an X-ray examination with a barium enema allows the doctor to study the anatomy and assess the condition of the large intestine. Patients are often recommended to have a computed tomography scan, which allows the specialist to make a specific diagnosis by assessing the characteristics of the inflammatory process.

In any case, during the diagnostic process it is important not only to find out whether the patient has colitis. The causes, degree of damage, location, stage of development - all these are no less important points on which the choice of treatment regimen directly depends.

Drug treatments

What to do after you are diagnosed with colitis? Only a doctor knows how to treat it, so in no case should you try to cope with the problem yourself. The choice of drugs directly depends on the cause of the disease.

For example, with an infectious form of the disease, it is necessary to take antibacterial agents. Treatment of ulcerative colitis of the intestine involves the use of a whole range of medications. In particular, aminosalicylates and glucocorticoids (hormonal substances that inhibit the inflammatory process) are used.

If an autoimmune reaction is suspected, cytostatics are used - drugs that inhibit the activity of the immune system. Quite often, patients are prescribed to take Mercaptopurine, Methotrexane, Azathioprine and other drugs.

Naturally, symptomatic treatment is also an important part. If there is severe pain, analgesics are prescribed to help alleviate the patient's condition. Antispasmodic drugs, in particular Papaverine and No-Shpa, help restore normal intestinal motility. In the presence of severe diarrhea, Loperamide or other antidiarrheal drugs are prescribed. The presence of bleeding requires taking hemostatic drugs, for example, Tranexam or Dicynon.

In some cases, additional measures are required. For example, with severe digestive disorders, patients are advised to administer intravenous nutrients. Persistent diarrhea can lead to dehydration, so patients are given mineral solutions to help maintain fluid and electrolyte balance.

It is immediately worth noting that the decision on hospitalization is made by the doctor. In mild cases, treatment at home is possible, but only if all recommendations of the treating specialist are followed. If the patient is in serious condition (intestinal bleeding, dehydration, exhaustion), then he must be constantly under the supervision of medical personnel - such restorative therapy can only be carried out in a hospital setting.

When is surgery necessary?

Unfortunately, conservative treatment of ulcerative colitis of the intestine (or any other types of this disease) is not always effective enough. In such cases, surgical intervention is required.

The indication for surgery is the ineffectiveness of drug therapy for severe forms of the disease. In addition, the surgical procedure is performed if the patient develops so-called “emergency” conditions that are life-threatening. In particular, this is toxic dilatation, the onset of malignant tissue degeneration, as well as massive bleeding, etc.

Quite often, radical procedures are performed in which the large intestine is completely removed. In some cases, doctors place a permanent ileostomy on the anterior abdominal wall to allow for emptying, while preserving the intestinal stump. Unfortunately, such treatment leads to loss of the ability to have anal bowel movements, resulting in patients becoming disabled. Partial removal of the intestine is also performed, but the percentage of relapses is very high among patients.

How are chronic forms of the disease treated?

Unfortunately, getting rid of chronic inflammation is very difficult. Therefore, therapy in this case is symptomatic, and is aimed at maintaining normal intestinal function and preventing complications.

During periods of exacerbation, which, by the way, are accompanied by almost the same symptoms as acute forms, patients are prescribed anti-inflammatory, antidiarrheal, and painkillers. It is also extremely important to provide the body with the necessary amount of fluid to prevent dehydration.

During periods of remission, proper diet comes to the forefront of therapy. In particular, you need to exclude foods that irritate the intestinal mucosa. In addition, doctors recommend eating only warm food (the same applies to drinks). But during exacerbations, the diet should be more strict. In addition, some doctors prescribe patients periodic intake of vitamin-mineral complexes, which help prevent the development of vitamin deficiencies and also normalize the functioning of the immune system.

Proper diet is an important part of therapy

Today, many people are interested in questions about what ulcerative colitis actually is. We have already discussed the symptoms, treatment and causes of this disease. But it is also worth understanding that proper nutrition is an integral part of therapy. Moreover, in severe forms of the disease and chronic inflammatory processes, a special diet must be followed even after the end of the course of treatment.

Colitis is an inflammation of the intestines, which consequently affects the digestive processes. That is why the diet for such a disease must be gentle. To begin with, it should be noted that all dishes should be either steamed or boiled (the diet can be slightly varied with baked foods). Patients are recommended to eat fractional meals - they need to eat often (sometimes up to 7-8 times a day), but in small portions to prevent stagnation and fermentation of food in the large intestine. By the way, the last meal should be no later than 7 pm.

It is imperative to include a sufficient amount of animal protein in the diet - these can be eggs, lean meats (for example, poultry, veal, rabbit), but in no case fried foods.

There are some categories of foods that irritate the intestinal lining, leading to increased symptoms. Such food should be completely excluded from the diet. In particular, patients are prohibited from eating fatty meats, raw vegetables (fiber, of course, is necessary, but vegetables must be boiled), as well as legumes, corn, mushrooms, and spices. The menu should not include fried, fatty or salty dishes. Prohibited foods also include sunflower seeds, carbonated drinks, alcohol, dried apricots and prunes.

If the patient does not suffer from excess weight, then the diet must be high-calorie (at least 2-3 thousand kcal per day) in order to avoid sudden weight loss.

Intestinal colitis: treatment with folk remedies

Of course, many people are interested in questions about whether there are any other ways to get rid of such a disease. Is it possible to cure, for example, ulcerative colitis at home?

Treatment with folk remedies, of course, exists. But here you need to be very careful. Firstly, before starting to use any home remedy, be sure to consult your doctor - only he can assess the possible benefits or harms.

In most cases, traditional healers recommend taking a decoction of chamomile, sage and centaury. To prepare it, you need to take one teaspoon of dry herbs from each plant, mix and pour a glass of boiling water. After the herbs have infused, the liquid can be strained. It is recommended to take one tablespoon every two hours. The duration of the course of treatment should be at least a month - only then the visible results of such therapy will begin to appear.

There are other recipes. For example, dried watermelon rinds are considered beneficial for colitis. 100 g of crusts need to be poured with 400 ml of boiling water and allowed to brew. You need to drink half a glass 4 to 6 times a day. In addition, you can prepare a decoction of pomegranate peels. 2 g of dry crusts should be poured with a glass of water and boiled over low heat for half an hour. It is recommended to take two tablespoons twice a day.

In any case, it is tedious to understand that traditional treatment of colitis is possible only as an auxiliary method and in no case can replace full-fledged drug therapy.

Prevention of colitis

Colitis is a very common inflammatory disease, and, unfortunately, no specific preventive measures exist today. Naturally, you can follow certain rules that will help reduce the risk of developing the disease. In particular, you need to carefully monitor the quality of the food and water you consume, follow all food preparation rules, adhere to basic sanitary and hygienic standards, wash your hands before eating, etc.

Since the development of colitis is often associated with an abnormal immune response of the body, you need to take care of the state of the immune system. An integral part of any prevention is a proper diet rich in vitamins and minerals, as well as feasible physical activity.

It has been proven that some types of colitis develop much more often against the background of insufficient blood circulation, so it is extremely important to observe the prevention of diseases such as atherosclerosis and hypertension, and also to stop smoking.

If you have the first alarming signs, you should immediately consult a doctor: the sooner the disease is diagnosed and adequate therapy is started, the easier it will be to get rid of the disease without any serious complications.