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30. Nonspecific ulcerative colitis
Nonspecific ulcerative colitis (NUC) is an autoimmune inflammatory-dystrophic lesion of the colon mucosa with the development of hemorrhages and erosions, the formation of extraintestinal manifestations of the disease and complications of a local and systemic nature.
The main reasons for the development of NUC:
1) viral or bacterial;
2) milk intolerance;
3) emotional stress reactions;
4) violation of the biocenosis of the intestine and the environment;
5) hereditary predisposition;
6) immunological changes and allergic reactions to food products (most often to cow's milk).
Diagnosis of nonspecific ulcerative colitis. When examining blood (anemia, accelerated ESR, leukocytosis, hypoproteinemia, dysproteinemia):
1) coprogram;
2) bacteriological examination of feces;
3) sigmoidoscopy;
4) irrigoscopy, irrigography.
Endoscopy for NUC: active stage - redness, loss of vascular pattern; granularity of the mucous membrane; vulnerability on contact, petechiae, bleeding; mucus, pus; ulceration of the mucous membrane, flat, confluent, superficial; pseudopolyps (inflammatory, not tumorous); continuous spread from the rectum in the proximal direction; "relapsing ileitis". The inactive stage is a pale, atrophic mucosa.
Treatment. Crohn's disease is a granulomatous inflammation of any part of the digestive tract with the development of ulcerations of the mucous membrane, narrowing of the lumen, fistulas and extraintestinal manifestations of the disease.
Treatment of UC and Crohn's disease.
1. Rational diet: frequent, fractional meals.
2. Basic drug therapy: azo compounds (sulfasalazine, salazopyrin, salazopyridazine; salofalk, salozinal); angioprotectors (trental, parmidine); multivitamins. Crohn's disease (azathioprine, cyclosporine, methotrexate).
3. Corticosteroids.
4. Eubiotics (intetrix, trichopolum, ercefuril, enterol).
5. Treatment of intestinal dysbacteriosis.
6. Infusion therapy. Hemosorption and plasmapheresis.
7. Anabolic hormones.
8. Treatment of anemia: iron preparations (ferrumlek, ectofer) parenterally.
9. Antihistamines (diazolin, suprastin, tavegil).
10. Normalization of bowel function antispasmodics and analgesics (papaverine, no-shpa, halidor); enzymes (pancreatin, panzinorm, digestal, mezimforte); imodium; fight against constipation (bran, vaseline oil).
11. Sedatives.
12. Dimephosphon.
13. Sandostatin is an analogue of somatostatin.
14. Phytotherapy.
15. Physiotherapy.
16. Local treatment.
17. Surgical treatment.
Author: Pavlova N.V.
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