Nonspecific Ulcerative Colitis: symptoms, diagnosis and treatment
Nonspecific Ulcerative Colitis (NUC) is a common ulcerative lesion of the colon mucosa, starting from the rectum, which is characterized by a protracted course and is accompanied by severe local and systemic complications. The etiology of the disease is not fully understood, but there is reason to believe that it is an autoimmune process, which is accompanied by toxicoallergic and infectious lesions.
CNJ can begin acutely or as a primary chronic process. The clinical picture includes a triad of main symptoms: diarrhea, blood in the stool and abdominal pain. At first, loose stools mixed with mucus and blood and general weakness usually appear. Diarrhea can progress (20-30 times a day) and lead to dehydration, exhaustion, severe anemia, disturbances in electrolyte metabolism with convulsive syndrome. Other symptoms may include peritoneal irritation, bloating, and systemic lesions.
To diagnose CNU, sigmoidoscopy or colonoscopy are used, which are performed with great care. They make it possible to detect contact bleeding of the colon mucosa, its swelling, disappearance of the vascular pattern and scattered small or merging superficial erosions and ulcers with the presence of mucus and pus in the lumen.
Treatment of CNU should be comprehensive and aimed at compensating metabolic processes, treating complications and increasing regenerative processes in the wall of the colon. Bed rest, a high-calorie mechanically and chemically gentle diet, parenteral administration of fluids, solutions, proteins and glucose are recommended, and in case of severe anemia - red blood cell transfusion. For the prevention and treatment of purulent complications, sulfonamides and broad-spectrum antibiotics are used. Orally prescribed (if tolerated) sulfasalazine up to 4-8 g/day or salazopyridazine up to 2 g/day for 3-7 weeks. Hormone therapy (prednisolone, hydrocortisone) in combination with or without sulfasalazine often plays a decisive role in the treatment of severe acute and chronic forms of the disease.
Surgical treatment is indicated for severe, dangerous complications such as bleeding, intestinal perforation, intestinal stenosis or the presence of tumors. If necessary, resection of the affected area of the intestine is performed, followed by the creation of a colostomy. However, surgical treatment does not prevent relapses of the disease and is not the method of choice in the treatment of CNU.
The prognosis of the disease depends on many factors, including the degree of intestinal damage, the presence of complications, the timeliness and effectiveness of treatment. Despite modern treatment methods, CNJ remains a serious and dangerous disease that requires an integrated approach and long-term therapy. Regular follow-up with a gastroenterologist and adherence to dietary and lifestyle recommendations can help control the disease and prevent complications.