Colitis Ulcerative (UC), Symptom and cause
unknown cause of chronic intestinal inflammation. Ulcerative colitis is a mucosal disease which always result to the inclusion of rectum and may continue proximally to all or part of the colon. However, the condition cause the present of blood in the stool, but note that the following disease also result to blood in the stool; e.g. amoebiasis and schistosomiasis, and dysentery e.g. shigellosis, in such case proper measure should be put in place to isolate the cause of bloody stooling before commencing treatment. In other to isolate the cause of bloody stool, you hear by requested to do stool m/c/s ( stool microscopy and sensitivity), the test always take 48 hours before the result will come out so after that proper treatment can commence.
Surveillance colonoscopy to exclude dysplasia (abnormal development of organs or cells or an abnormal structure resulting from such growth), and must be carried out for every 1–2 years in chronic ulcerative colitis of more than 10 years duration. But when a patience is found to have a disease which did not exceed rectum, require no colonoscopy monitoring.
RECOMMENDED MEDICINE TREATMENT
Firstly electrolyte balance in the patient body should be Corrected, medicine that increases the hemoglobin content of the blood; used to treat iron-deficiency anemia i.e haematinic should be administered to the patient and nutritional deficiencies should be given, all through the enteral or parenteral route.
Avoid administering Loperamide on acute sudden recurrence or worsening of symptoms period, the drugs should be avoided because it portray high risk of megacolon.
1-2g Sulfasalazine should be administered orally on an account of acute episode to average disease, and frequent full blood count are followed up for drugs monitoring.
After the administration of sulfasalazine drugs and no respond, add 1.5mg/kg of prednisone orally daily until there is an improvement of the patient condition, once there is an improvement of the sign and symptom, reduce the given dosage to 5mg/week, and it should last for 3 months.
In case of Severe disease
The patient should be given an Intravenous corticosteroids, e.g. • Hydrocortisone, IV, 100 mg 6 hourly. When this is administered and the patient did not respond to the given intravenous corticosteroids after 10 days, there is an indication of emergency colectomy. 2mg/kg Azathioprine should be added oral daily. Seek for specialist, and the treatment should be continue until corticosteroid are on the verge to be reduced.
Local disease: proctosigmoiditis less diseased Patients hardly required inpatient treatment. There system often appear well. At such the following medication is recommended for them;
• 1g of Mesalazine, rectal daily. Specialist initiated. or and
• 1.5mg/dl of Prednisone, oral, daily for 14 days.
Maintenance of degree in the manifestations of a disease
• 500mg of Sulfasalazine oral, 12 hourly. Or it can be diluted to 1 g 6 hourly.
When there is frequent reoccurrence attack of degree of manifestation of the disease, give the patient 2mg/kg of Azathioprine oral daily, and seek for specialist advice.
Confirmation of diagnosis.
Initiation of long-term therapy.
Refractory cases. Fulminant colitis needs hospital admission and surgery may be required.
All patients with a severe worsening of symptoms should have abdominal X-rays. Markers of a severe worsening of symptoms are:
Tachycardia (100 beats per minute).
Temperature 38ºC. 6 bloody stools per day.
Dilated colon or small bowel on X-ray.
Toxic megacolon (transverse colon diameter 6 cm on X-ray) requires hospital admission, parenteral fluids, corticosteroids, antibiotics and nasogastric suction. This is a medical emergency and if the colonic dilation does not resolve within 24 hours an emergency colectomy is indicated, as the risk of a line of small holes for tearing at a particular place is high. Surgery.
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