Colitis

Colitis, also called nonspecific ulcerative colitis, usually has an insidious onset, occasionally acute, with a chronic course lasting years to over a decade. Severity varies, often with alternating exacerbations and remissions or progressive worsening, occasionally acute fulminant onset. Main manifestations are diarrhea, abdominal pain, mucoid and bloody purulent stool, tenesmus, and sometimes constipation with no bowel movement for days, alternating diarrhea and constipation, often with weight loss and fatigue, frequently relapsing. Abdominal pain is usually dull or cramping, often in the left lower quadrant or lower abdomen. Other findings include anorexia, bloating, nausea, vomiting, and hepatomegaly; left lower quadrant tenderness and sometimes palpable spastic colon. Common systemic symptoms are weight loss, fatigue, fever, and anemia. A minority of patients have sudden worsening during the chronic course or present as fulminant from onset, with severe diarrhea 10-30 times daily, bloody purulent mucoid stool, high fever, vomiting, tachycardia, cachexia, dehydration, electrolyte disturbance, coma, and even colonic perforation; without timely treatment this can be fatal. Colonoscopy findings: Active phase shows diffuse congestion and edema, abundant mucus and pus in the lumen, rough mucosal surface with visible ulcers; remission shows mucosal atrophy and inflammatory pseudopolyps; acute fulminant type often forms toxic megacolon with disappearance of haustra and semilunar folds, merging ulcers extending to the muscularis making the bowel wall thin as paper. Most scholars consider this an autoimmune disease, given the high rate of associated autoimmune diseases (e.g., autoimmune hemolytic anemia), the response to corticosteroids, and anti-colonic epithelial cell antibodies found in some patients' serum.

Common Symptoms

Fever with abdominal pain; ...; diarrhea; fulminant watery diarrhea; tenesmus; hematochezia; mucoid stool; constipation; ...; toxic megacolon

Causes and Pathogenesis

Most scholars consider this an autoimmune disease, given the high rate of associated autoimmune diseases, response to corticosteroids, and anti-colonic epithelial cell antibodies. Additionally, some patients develop immune reactions against colonic epithelial antigens after intestinal bacterial infection, damaging the mucosa; patient lymphocytes are cytotoxic to fetal colonic epithelium, suggesting cell-mediated immunity may also play a role. Pathology and clinical manifestations resemble some colonic infectious diseases (e.g., bacillary dysentery), leading some to propose infection as the cause; among bacteria, fungi, and viruses, current research favors viruses. Family incidence is high; Western statistics show about 15-30% of first-degree relatives of ulcerative colitis patients are affected. Twin studies show monozygotic twins are more often affected than dizygotic, suggesting genetic factors. Psychological factors may play a role; patients often have certain personality traits and poor coping with major life events, making this a psychosomatic disease. Seven diseases are listed as psychosomatic: asthma, rheumatoid arthritis, ulcerative colitis, primary hypertension, neurodermatitis, hyperthyroidism, and duodenal ulcer.

Treatment

Rest, diet and nutrition, drug therapy, supportive therapy

Preventive Measures

Dietary prevention of colitis: 1. Eat regularly, three meals at fixed times and portions, avoid excessive hunger or overeating to maintain intestinal digestive balance and prevent dysfunction. 2. Diet should be light, easy to digest, and low in fat; eat spleen-strengthening foods such as Chinese yam, lentils, lotus seeds, lily bulb, and red dates. Eat less cold drinks and gas-producing foods such as watermelon, cantaloupe, leeks, onions, garlic, fried foods, coffee, and carbonated drinks. 3. Eat less high-fat food to avoid burdening digestion, such as high-fat fast food. 4. Avoid excessive alcohol. 5. Do not consume excessive fiber daily; choose whole grains, citrus fruits, spinach, and carrots. 6. Avoid allergenic foods; if a reaction occurs after eating a certain food, substitute alternatives.

Department to Visit

It is recommended to visit the General Surgery department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.