Hospital therapy. Clinical picture of ulcerative colitis (most important)

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Hospital therapy. Clinical picture of ulcerative colitis (most important)

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51. Clinical picture of ulcerative colitis

clinical picture. The clinic of ulcerative colitis is polymorphic and depends on the severity of the course and the severity of the process. The course of the inflammatory process, considered more often as chronic, in some cases takes on an acute character. The extent of the colonic lesion may also vary. For nonspecific ulcerative colitis, 3 leading symptoms are characteristic: the release of scarlet blood during bowel movements, impaired bowel function, and abdominal pain.

Intestinal dysfunction manifests itself in the form of complaints of repeated unstable stools, which is the result of extensive damage to the mucous membrane and a decrease in the absorption of water and salts. Most often, diarrhea occurs with severe ulcerative colitis. However, diarrhea is not a reliable indicator of the severity of the process. The severity of diarrhea in combination with the presence of red blood in the stool matters. In a significant number of patients with ulcerative colitis, blood and mucus are periodically found on the surface of the formed feces, which is often mistakenly regarded as a manifestation of hemorrhoids.

The mild course of nonspecific ulcerative colitis is characterized by a satisfactory condition of patients. Pain in the abdomen is moderate and short-term. The chair is decorated, speeded up, up to 2-3 times a day. Blood and mucus are found in the stool. The process is localized within the rectum and sigmoid colon. The clinical course is recurrent. The effect of treatment with salazopreparations is satisfactory. Relapses occur no more than 2 times a year. Remissions can be long (more than 2-3 years).

The moderate course of the disease is diagnosed if the patient has diarrhea. The chair is frequent (up to 6-8 times a day), in each portion an admixture of blood and mucus is visible. Cramping pains in the abdomen are more intense. There are intermittent fever with a rise in body temperature up to 38 C, intense general weakness. There may also be extraintestinal manifestations of the disease (arthritis, uveitis, erythema nodosum). The course is continuously recurrent, the effect of salazopreparations is unstable, hormones are prescribed during exacerbations.

The severe form of the disease is characterized by an acute onset. A total lesion of the large intestine rapidly develops with the spread of the pathological process deep into the intestinal wall. The patient's condition deteriorates sharply. The clinic is characterized by a sudden onset, high fever, profuse diarrhea up to 24 times a day, profuse intestinal bleeding, and a rapid increase in dehydration. Tachycardia appears, blood pressure decreases, extraintestinal manifestations of nonspecific ulcerative colitis increase. Conservative treatment is not always effective, and emergency surgery is often required.

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