chronic colitis
Introduction
Introduction to chronic colitis Chronic colitis is a chronic, repetitive, multiple incidence of the colon, sigmoid colon and rectum. Refers to the inflammatory edema, ulcers and hemorrhagic lesions of the intestine caused by various pathogenic causes. Symptoms are left lower abdomen pain, diarrhea, urgency and heavy weight, occasional fluid, constipation or diarrhea alternately occur, when the time is good or bad, lingering and breaking, repeated attacks. Chronic colitis is classified according to the cause of the disease, that is, colitis with obvious causes, and colitis with non-specific cause of unknown cause. Chronic colitis and irritable bowel syndrome have a longer course of disease, so it is more difficult to treat. Western medicine mainly uses antibiotics for anti-inflammatory and pain-relieving and anti-infective treatment. According to the overall concept of TCM, it is possible to treat different causes and treat multiple angles, and to give full play to the advantages of TCM syndrome differentiation and treatment, so the curative effect is remarkable. basic knowledge Sickness ratio: 0.1%-0.5% Susceptible people: no specific population Mode of infection: non-infectious Complications: perforation of ulcer disease intestinal obstruction
Cause
Causes of chronic colitis
Allergic factors (15%):
Allergic lesions are affected by individual differences. Mainly intestinal allergies, but also involving the skin. Some people are allergic to high-protein foods such as fish, shrimp, crabs, and cow's milk. These are the large amounts of histamine that are produced when allogeneic proteins enter the body, triggering allergic reactions. Allergic reactions are stimulated by sensitizing substances, causing self-immunization to cause reactions, releasing self-defense substances and stimulating a large number of immune cells to aggregate, which are all accumulated on the mucosal surface of the digestive tract, thereby causing inflammation of the mucosal surface edema, congestion and exudation. Allergic reactions are individual changes in human life, eating habits, and are major factors in digestive allergy.
Infection factor (20%):
Infection is one of the main causes of colitis. Although no pathogens, viruses or fungi were detected in the feces. Whenever the disease occurs, the use of antibiotics has different degrees of control and treatment effects, which indicates that antibiotics have the ability to inhibit E. coli and other pathogenic bacteria, which can reduce clinical symptoms and are generally considered to be related to infection. Humans are omnivorous. When eating unclean or degraded foods, intestinal lesions often occur, which is the majority of the cause of colitis.
Autoimmune (10%):
With the development of society, the advancement of medicine, and the rapid growth of immunology, there are many unknown causes to be identified. At present, the incidence of immune diseases is high and treatment is difficult, which has attracted attention. Therefore, chronic colitis is difficult to cure under conventional treatment.
Humoral immune blood (14%):
In the body fluid immune blood, anti-colitis antibody (IGM) is generally found, and the antigen is a lipopolysaccharide in the colon epithelial cells, so that the cytotoxic cells kill the epithelial cells of the colon, forming a partial or whole piece of wound, easy Causes secondary infection and inflammation. Therefore, in the stool of patients, a large number of epithelial cells are often found to fall off, which also explains this reason.
Cellular immunity (10%):
In the human immune system, cellular immunity is the main immunity of the human body, including "neutrophils and lymphocytes." The occurrence of chronic colitis often causes a large number of lymphocytes to accumulate in the lymph nodes surrounding the intestinal hormone, against viruses that cause intestinal infection and intestinal mucosal damage (reported as enterovirus infection). Neutrophils play an immune role against bacterial infections. Under prolonged inflammation, they can cause immune cells to enhance their power, kill each other, destroy normal cells, cause inflammation to worsen, and cause long-term inflammation. one.
Prevention
Chronic colitis prevention
1. Avoiding cold and controlling emotions, diet is a very important aspect. The disease can not eat beans and soy products, wheat and noodles, as well as garlic, leeks, yam, preserved eggs, cabbage, peanuts, melon seeds and other gas-producing foods during the attack period. Because once the food is eaten, the gas in the gastrointestinal tract is increased, and the gastrointestinal motility is affected, which can induce the disease and even aggravate the symptoms.
2, persimmon, pomegranate, apple contain citrate and pectin components, have astringent antidiarrheal effect, chronic colitis can be eaten in moderation, patients with chronic colitis usually strengthen exercise, enhance physical fitness, strengthen food hygiene and water management; Eat spoiled food, do not drink raw water, eat raw fruits to be washed. Pay attention to rest and increase nutrition. In addition, you should maintain a good mood, avoid strong stimulation, and build confidence in the fight against disease.
Complication
Chronic colitis complications Complications , perforated intestinal obstruction
1, toxic colon expansion
In the acute active period, the incidence rate is about 2%, because the inflammation affects the muscular layer of the colon and the intermuscular nerve plexus, resulting in low intestinal wall tension, segmental paralysis, large accumulation of intestinal contents and gases, causing acute colonic expansion. The intestinal wall is thin and the lesion is more common in the sigmoid colon or transverse colon. The causes are hypokalemia, barium enema, and the use of anticholinergics or opioids. The clinical manifestations are rapid deterioration of the disease, obvious symptoms of poisoning, abdominal distension, tenderness, rebound tenderness, weakening or disappearance of bowel sounds, leukocytosis, X-ray abdominal plain film showing widening of the intestine, disappearance of the colonic bag. It is easy to have intestinal perforation, and the mortality rate can reach 11% to 50%.
2, ulcer perforation
On the basis of colonic expansion, it is easy to cause ulcer perforation and acute diffuse peritonitis.
3, ulcer bleeding
Low prothrombinemia is also an important cause of ulceration involving vascular bleeding. It is often necessary to treat because of the large amount of bleeding.
4, cancer
The occurrence of cancer is related to the disease time limit and the extent of the disease. The longer the course of the disease, the wider the range and the more cancerous. The incidence rate is about 5%, which is 10 times higher than that of patients without colitis. It is more common in patients with colitis involving the whole colon, early onset and medical history for more than 10 years.
5, colon stenosis and intestinal obstruction
During the repair process, scars formed by a large amount of fibrous tissue can cause colon stenosis and intestinal obstruction, which is more common in the distal part of the colon.
Symptom
Chronic colitis symptoms common symptoms stool abnormal diarrhea abdominal pain with blood in the stool after acute watery stool diarrhea-like stool diarrhea and constipation alternate infectious fever intestinal bleeding
1, gastrointestinal symptoms
Often presented intermittent abdominal pain, abdominal distension, abdominal pain is the main manifestation of enteritis. In case of cold, greasy things or emotional fluctuations, or especially after exertion. The number of stools increased, several times a day or dozens of times, the anus fell, the stool was unhappy. In the acute onset of chronic enteritis, high fever, abdominal cramps, nausea and vomiting, and urges such as water or sticky blood can be seen.
2, diarrhea
It is the most common symptom of colitis, and there are many abnormalities such as mucous bloody stools, watery stools, mucus, and loose stools. Lighter defecation every 1 to 2 hours, sometimes all mucus pus and bloody stools without faeces. 5% of patients with ulcerative colitis may have constipation. This condition is mostly enteritis-type cases. Because it has blood in its stool, it is often mistaken for bleeding.
3, constipation
Colitis and proctitis are the causes of constipation, which can be caused by systemic metabolic disorders, neurological disorders, and small anal fissures in the anus.
4, intestinal bleeding
It is one of the main symptoms of ulcerative colitis. In most cases, blood is mixed in liquid feces and can be attached to the outside of the stool.
5, intestinal inflammation signs
Long-term abdominal discomfort or less abdominal pain, the body can be seen in the abdomen, umbilical or abdomen, with mild tenderness, bowel sounds, prolapse and so on.
6, abdominal pain
Patients with chronic recurrent episodes often have abdominal pain, mostly mild to moderate abdominal abdominal pain, mostly in the left lower abdomen and left abdomen. In most cases, there are paroxysmal, transient, mild abdominal pain, and abdominal pain during diarrhea. Abdominal pain - constipation - the law of relief after defecation. Severe patients can cause persistent severe pain, and the rectal involvement is more severe with symptoms of urgency and weight.
7, blood in the stool
Blood in the stool is one of the main symptoms of this disease. The blood of the light is attached to the surface, and the blood of the severe blood flows down to the shock.
8, after the emergency
This is one of the main symptoms of colitis, the disease is common.
9, the whole body performance
Chronic depletion symptoms, lack of energy, lack of energy, lazy words, limbs fatigue, warm and cold. For example, in the acute inflammatory phase, in addition to fever, loss of water, acidosis or shock bleeding can be seen.
Examine
Examination of chronic colitis
1. Colonoscopy: In this examination, the doctor will use a thin lighting tool to view the entire inside of the colon. At the same time, the doctor may also clamp the inner layer of the colon for examination (biopsy).
2, drinking enema X-ray examination: can observe the entire colon, rectal morphological changes, provide a diagnostic basis, choose treatment options, estimate the length of the disease have a certain value.
3, sputum enema X-ray examination: visible intestinal mucosal fold disorder, and even the colonic pocket becomes shallow, disappear, intestinal mucosa congestion, edema, capillary texture is not clear or disappear, or accompanied by superficial erosion, bleeding points.
4. Blood test: This test is to check for infection and inflammation.
5, fecal examination: in order to find blood, infected with white blood cells.
Diagnosis
Diagnosis and diagnosis of chronic colitis
The cause of chronic colitis is complex, and diagnosis is particularly important. A series of tests should be performed. Examination can help doctors to rule out other diseases that can cause similar symptoms, such as Crohn's disease, irritable bowel syndrome, and diverticulitis.
Colonoscopy is especially important in a series of tests including blood tests and fecal tests. Chronic colitis must be examined by endoscopy to determine the extent of inflammation and the extent of the lesion, thus confirming the diagnosis. After the chronic colon has undergone pathological examination and continuous periodic endoscopic follow-up examination, the treatment plan is continuously adjusted to achieve reasonable and effective treatment of colitis. Olympus electronic colonoscopy advantages: integrated examination, diagnosis and treatment functions, clear images, delicate lens depth of field, can directly observe the human colonic mucosal lesions of the ascending colon, transverse colon, descending colon, tumor lesions, An accurate examination of early colon cancer examinations, another important function is: microscopic treatment of colon polyps.
