Nonspecific ulcerative colitis is a chronic inflammatory disease of the colon. Diagnosed three times more often than Crohn's disease. There are 10-12 people with UC per 100 thousand people. Most patients are women from 15 to 25 years old or over 55. It is extremely rare in children.
Causes and risk factors
The exact cause of the disease is not known. The most reliable is the autoimmune theory. But factors have been identified that increase the risk of developing this pathology:
- Genetics. Having blood relatives with UC increases the chances of getting it in the future by 255. Sickness is common among isolated ethnic groups, such as Ashkenazi Jews.
- Ecology. Environmental pollution negatively affects immunity. Most patients are registered in Eastern Europe and America.
- Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs).
Clinical picture
Symptoms of UC depend on the location of the disease process, its intensity and duration. The main signs of pathology include:
- chronic diarrhea (feces streaked with blood, mucus or pus);
- stomach ache;
- frequent urge to defecate.
Patients complain of weakness, lethargy, significant weight loss, and decreased appetite. Ulcerative colitis is characterized by a wave-like course - exacerbations are replaced by remissions. With each relapse, new symptoms are added:
- arthritis;
- stomatitis, gingivitis;
- swelling, redness and pain in isolated areas of the skin;
- inflammation of the eyes.
In severe cases, the temperature rises to 38.5-39.0 o C, breathing becomes frequent and shallow, tachycardia and arrhythmia appear.
Diagnostics
Based on the clinical picture alone, it is impossible to diagnose UC. It is necessary to exclude such diseases. For differentiation it is prescribed:
- Colonoscopy with biopsy (examination of the intestinal mucosa).
- Clinical blood test (anemia, leukocytosis).
- Coprogram (presence of blood, leukocytes, parasites or bacteria).
- X-ray of the intestine with contrast (excludes perforation).
- CT or MRI (additional method).
Treatment
Even radical surgical treatment does not guarantee complete relief from the disease. The main goal of therapy is to reduce the manifestations of UC and maintain the state of remission for as long as possible. The following groups of drugs are prescribed:
- Nonsteroidal anti-inflammatory drugs (NSAIDs).
- Glucocorticosteroids.
- Immunosuppressants (azathioprine, cyclosporines, infliximab).
- Antibiotics.
- Prokinetics (to eliminate diarrhea).
- Painkillers.
- Iron supplements (correction of anemia).
During surgical treatment, part of the intestine is removed, often along with the anus. A calostomy is formed on the anterior abdominal wall. Sometimes the second stage involves plastic surgery of the excised area using a loop of the small intestine, but this still does not completely solve the problem.
Prognosis and prevention
Well-chosen therapy can extend the asymptomatic period for years. Especially if the patient adheres to recommendations regarding diet and lifestyle in general. Serious complications - intestinal cancer - are extremely rare (only 5% of patients). But the longer the duration of the disease, the higher the chances of developing an oncological process.
There are currently no preventative measures. People with a genetic predisposition are recommended to regularly see a surgeon and coloproctologist.
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