Form of ulcerative colitis

Comparative study of the mucous in the above mentioned methods of research that reveals the following main forms, characteristic for ulcerative colitis.
Inflammatory-hemorrhagic. The mucous membrane is grainy, is easily damaged and covered with point hemorrhages. In mild cases, and also in the periods of remission mucosa at first glance may seem normal. However on closer inspection it turns out that the mucous lost wet, shiny appearance, became dull, slightly grainy and swollen. Vascular figure disappeared completely or preserved only in the form of Islands scattered on anemic background. In severe defeat in the rectum contains a lot of blood, mucus or pus, the withdrawal of which is found grained surface, usually heavily bleeding. The bowel lumen narrows due to the swelling and infiltration its walls.
Ulcer. Throughout the rectum and Sigma visible on the mucous multiple surface erosion or different in size and shape, ulcers with saped edges. These sores produce pus and bleed, and the bottom of them is covered with necrotic bloom. Often all mucous looks almost continuous trophic ulcers.
Hypertrophic. Rectum and Sigma executed multiple bleeding growths of granulation tissue - pseudopolyps. View ulcer in a proctoscope reminds stalactite cave. With a bright red inflamed mucous hang soft, with indistinct edges tabs crimson. Vetas and touching each other, they form in the bowel lumen intricate pattern. Pseudoprime easily separated edge proctoscope or nippers.
When ray study of patients with nonspecific ulcerative colitis most characteristic symptoms include loss of Australia and a substantial reduction of the colonic lumen.
If you have many superficial ulceration or pseudopolyps internal crane bowel loses smooth clear line becomes jagged, rough and relief-mucous - grained. If there are deep ulcers, penetrating to the serosal layer reveals a double loop of the intestine wall. The relief of the mucous becomes a characteristic marbling, due to the flowing of barium ulcers (x-ray examination). Sometimes there is lots of enlightenment, representing the Islands of hyperplastic mucosa (pseudoprime). They are better identified using the double contrast study. However, with severe ulcerative colitis specified method should be used with caution due to the danger of perforation of ulcers.
Especially great value colonoscopies research becomes in rare cases the driver or regional ulcerative colitis, when the rectum is not affected and, therefore, rectoskopia can not give any information about the pathological process.
It must be emphasized that if the positive data of x-ray examinations are reliable indication of the pathological process in the colon, the negative should be treated with great caution. In contrast radiological endoscopic examination does not reveal surface changes in the mucous membrane. Therefore for correct diagnosis, x-ray examination should not be used in isolation but in conjunction with other examination methods, taking into account the clinical picture of the disease.
Let's stop more in detail on the complications of ulcerative colitis. Local complications include bleeding, acute toxic dilation and perforation of the colon, fistulas, infiltrates and abscesses in the abdominal cavity, stricture, cancer.
Massive bleeding occur in about 14% of patients. Complication think and blood loss is no less 300-500 ml/sut. In most cases, bleeding cope conservative measures, however some patients have to resort to surgical treatment.
The mechanism of development of acute toxic dilation includes degenerative neuromuscular apparatus, which is caused by severe intoxication and often lead to bowel paresis, Profound metabolic disorders are accompanied by a significant lack of protein and electrolytes, as well as the accumulation of gas and liquid in the intestinal lumen.
The diameter of the colon with toxic dilation may reach 18-20 see it manifests Clinically first some improvement, there has been a decrease in the frequency of bowel movements.
Further appears bloating with increased pain, tachycardia, dry language, reduction in blood pressure. The diagnosis is based on clinical symptoms and data review x-ray of the abdomen simple.
Treatment of acute toxic dilation is the appointment of starvation, cold locally, the introduction of exhaust pipes and massive transfusion therapy, including first of all the introduction of substitution proteins (albumin, protein, plasma) and electrolytes. If within 6-24 hours, the complication is not exposed to the opposite development, showing surgery.
Perforation, ulcers, colon cancer in ulcerative colitis is most often develops on the background of acute toxic dilation, aided by thinning the walls of advanced cancer.
The peculiarity of this complication is that usually the perforation are multiple and most often occur in the sigmoid and transverse colon.
Clinically perforation of the colon in nonspecific ulcerative lesions flows atypical compared to that in other diseases. You may experience only a slight strengthening of existing pain, or even the lack of them. Rarely expressed the tension of the abdominal wall. More common is testovatoj her. Symptoms of peritoneal irritation, as a rule, are absent. Just change the General appearance of the patient, the increase in tachycardia and increased dryness of the language may be suspected threatening complication.
Not only clear picture of perforation, but even suspected it is an indication for immediate operation.
Speaking about the total extra-intestinal complications, you must specify at various diseases of the skin and mucous membranes (dermatitis, piodermia, knotty and multiform of eritema, ulcers of the lower extremities, stomatitis and other), the defeat of joints, eyes, liver. In most cases, these lesions disappear when clinical symptoms subsided underlying disease.