Which part of poppy treats ulcerative colitis and how to use it?

1 Etiology Editor The cause of ulcerative colitis is still unknown. Genetic factors may have a certain position. Psychological factors play an important role in the deterioration of the disease, and the original morbid spirit such as depression or social distance has been obviously improved after colectomy. Some people think ulcerative colitis is an autoimmune disease. At present, it is believed that the pathogenesis of inflammatory bowel disease is the result of the interaction of host reaction, gene and immune influence caused by exogenous substances. According to this view, ulcerative colitis and Crohn's disease are different manifestations of a disease process. 2 Clinical manifestations Editing The initial manifestations of ulcerative colitis can take many forms. Bloody diarrhea is the most common early symptom. Other symptoms include abdominal pain, bloody stool, weight loss, acute diarrhea and vomiting. Occasionally, the main manifestations are arthritis, iridocyclitis, abnormal liver function and skin lesions. Fever is a relatively uncommon sign. In most patients, the disease is chronic and low-grade malignant, and in a few patients (about 15%), it is an acute and catastrophic outbreak. These patients present with frequent bloody stools, up to 30 times a day, high fever and abdominal pain. Signs are directly related to disease stages and clinical manifestations. Patients often lose weight, look pale, and the colon is often tender during abdominal examination during the active period of the disease. There may be signs of acute abdomen accompanied by fever and decreased bowel sounds, especially in acute or explosive cases. Toxic megacolon may show signs of bloating, fever and acute abdomen. Because of frequent diarrhea, perianal skin may be scraped and peeled off. Perianal inflammation such as anal fissure or anal fistula can also occur, although the latter is more common in Crohn's disease. Rectum fingers feel pain. Examination of skin, mucous membrane, tongue, joints and eyes is extremely important. The diagnosis editor is helpful to the diagnosis of this disease according to the following clinical manifestations and auxiliary examinations. 1. Except for a few patients with sudden onset, the clinical manifestations are generally slow and the severity of the disease varies. The main symptom is diarrhea, discharge of feces containing blood, pus and mucus, often accompanied by paroxysmal colonic spasmodic pain, which can be relieved after defecation. Mild patients have mild symptoms and diarrhea is less than 5 times a day. Severe diarrhea is more than 5 times a day, which is watery diarrhea or bloody stool, with severe abdominal pain and fever symptoms. The body temperature can exceed 38.5℃, and the pulse rate is greater than 90 times/minute. Outbreaks are rare. Sudden onset, rapid development of the disease, large amount of diarrhea, frequent bloody stool. The body temperature can be as high as 40℃, and severe cases have symptoms of systemic poisoning. If the disease persists for a long time, emaciation, anemia, malnutrition and weakness may occur. Some patients have parenteral manifestations, such as erythema nodosum, iritis, chronic active hepatitis and cholangitis. 2. Auxiliary examination and diagnosis mainly rely on fiberoptic colonoscopy, because 90% ~ 95% of patients have rectal and sigmoid colon involvement, so in fact, fiberoptic sigmoidoscopy can make a definite diagnosis. Microscopically, the mucous membrane with congestion and edema is brittle and easy to bleed. In progressive cases, ulcers can be seen, surrounded by swollen granulation tissue and edematous mucosa, which looks like polyps, or pseudopolypoid formation. In chronic progressive cases, the rectum and sigmoid colon cavity can be significantly reduced. In order to define the scope of the lesion, colonoscopy should be used in the whole colon examination, and multiple biopsies should be done at the same time to distinguish it from clonal colitis. Barium enema double contrast examination is also a diagnostic examination, which is especially helpful to determine the scope and severity of the lesion. Barium radiography showed that the colonic pouch disappeared, the intestinal wall was irregular, pseudopolyps formed, and the intestinal cavity became thin and stiff. Although barium enema examination is valuable, we should be careful to avoid intestinal cleaning preparation because it can worsen colitis. Cases without diarrhea can be given liquid diet for 3 days before examination. Cases with abdominal signs should not be examined by barium enema, but by abdominal X-ray plain film to observe whether there are signs such as toxic megacolon, colon dilatation and free gas under the diaphragm. 4 Complications editor 1. Toxic colonic dilatation occurs in acute active stage, and the incidence rate is about 2%. It is because the inflammation spreads to the muscular layer and myenteric plexus of colon, which makes the intestinal wall tension low, showing stage paralysis, and a large amount of intestinal contents and gas accumulate, causing acute colon dilatation and intestinal wall thinning. Lesions are more common in sigmoid colon or transverse colon. The inducement is hypokalemia, barium enema, use of anticholinergic drugs or opioids, etc. The clinical manifestations are rapid deterioration of the disease, obvious poisoning symptoms, abdominal distension, tenderness, rebound pain, weakening or disappearance of bowel sounds, and increased white blood cell count. X-ray plain film showed that the intestinal cavity widened and the colon bag disappeared. Easily complicated with intestinal perforation. The mortality rate is high. 2. The incidence of intestinal perforation is about 65438 0.8%. Most of them occur on the basis of toxic colon dilatation, causing diffuse peritonitis and free gas under the diaphragm. 3. Hemorrhage refers to patients who need blood transfusion because of large blood volume, and its incidence rate is 1. 1% ~ 4.0%. In addition to bleeding caused by ulcers involving blood vessels, low prothrombinemia is also an important cause. 4. The incidence of polyp complications in this disease is 9.7% ~ 39%, which is often called pseudopolyp. It can be divided into mucosal prolapse type, inflammatory polyp type and adenomatous polyp type. Rectal polyps are prone to occur. Some people think that descending colon and sigmoid colon are the most common, and they decrease in turn upward. Its outcome can disappear with the recovery of inflammation, can be destroyed with the formation of ulcers, and can exist for a long time or become cancerous. Canceration mainly comes from adenomatous polyposis. 5. There are different reports about the incidence of canceration, and some studies think that it is many times higher than that without colitis. It is more common in patients with colitis involving the whole colon, childhood onset and a medical history of more than 10 years. 6. The pathological changes of enteritis complicated with enteritis are mainly at the end of ileum, manifested as periumbilical or right lower abdominal pain, watery stool and fatty stool, which accelerates the process of patients' systemic failure. 7. The common complications related to autoimmune reaction are: ① Arthritis and ulcerative colitis. The incidence of complications of arthritis is about 1 1.5%, which shows the complications in the severe stage of enteritis. Large joint involvement is more common, often a single joint lesion. Joint swelling, synovial fluid oozing, but no damage to bones and joints. The serology of rheumatism has not changed. And often coexist with eye and skin-specific complications. ② Erythema nodosa is common in skin and mucosa lesions, and the incidence rate is 4.7% ~ 6.2%. Others such as multiple abscess, localized abscess, pustular gangrene, erythema multiforme, etc. Intractable ulcer of oral mucosa is not uncommon, sometimes it is thrush, and the treatment effect is not good. ③ Eye diseases include iriditis, iridocyclitis, uveitis and corneal ulcer. The former is the most common, with an incidence of 5% ~ 10%. The treatment editor will consider surgical treatment for fulminant and severe patients, such as cases with poor medical treatment results. 1. Medical treatment (1) Bed rest and systemic support treatment include liquid electrolyte balance, especially potassium supplementation, and hypokalemia should be corrected. At the same time, we should pay attention to the supplement of protein, improve the nutritional status of the whole body, give total parenteral nutrition support when necessary, and give blood transfusion to anemia patients, and try to avoid milk and dairy products when ingesting gastrointestinal tract. (2) drug therapy ① sulfasalazine salicylic acid preparation is the main therapeutic drug, such as Aidisha and mesalazine. ② Prednisone or dexamethasone is commonly used in corticosteroids, but it is not considered that long-term hormone maintenance can prevent recurrence. Hydrocortisone or dexamethasone can also be used in acute attack, and hydrocortisone can be added to normal saline every night to keep enema. The value of hormone therapy in acute attack is positive, but there are still differences on whether hormone should be used continuously in chronic attack. Because of its side effects, most people do not advocate long-term use. ③ The value of immunosuppressants in ulcerative colitis is questionable. According to Rosenberg et al, azathioprine can't control the disease when it gets worse, but it helps to reduce the use of corticosteroids in chronic cases. ④ Traditional Chinese medicine can be used to treat diarrhea ulcerative colitis, and the effect is ideal. At the same time, we should pay attention to diet and living habits. 2. Surgical treatment: 20% ~ 30% of patients with severe ulcerative colitis were finally treated by surgery (1). The indications for emergency operation are: ① massive uncontrollable bleeding; (2) Toxic Hirschsprung's disease with adjacent or definite perforation, or toxic Hirschsprung's disease is ineffective after several hours rather than days of treatment; (3) patients with fulminant acute ulcerative colitis who have no response to steroid hormone therapy, that is, those who have not improved after 4 to 5 days of treatment; ④ Stenotic obstruction; (5) Suspected or diagnosed colon cancer; ⑥ Recurrent refractory ulcerative colitis, chronic persistent symptoms, malnutrition, weakness, inability to work, and inability to participate in normal social activities and sexual life; ⑦ When the dose of steroid hormones is reduced, the condition will get worse, so that hormone therapy cannot be stopped for months or even years; 8 when children suffer from chronic colitis, which affects their growth and development; Pet-name ruby serious extracolonic manifestations such as arthritis, pyoderma gangrenosum or hepatobiliary diseases may be effective. (2) Choice of surgery At present, there are four kinds of surgery for ulcerative colitis. ① Total colectomy and ileostomy; ② Total colectomy and ileocecal anastomosis; ③ Controllable ileostomy; ④ Total colorectal resection and ileal pouch anus anastomosis. At present, there is no effective long-term prevention or treatment. Among the four existing surgical procedures, total colorectal resection and ileal pouch anus anastomosis are reasonable and alternative methods. 6 prevention editor 1. Pay attention to the combination of work and rest, don't be too tired; Patients with fulminant type, acute attack type and severe chronic type should stay in bed. 2. Pay attention to clothes and keep warm and cold; Proper physical exercise can enhance physical fitness. Generally, you should eat soft, digestible, nutritious and high-calorie food. It is advisable to eat less and eat more meals and supplement multivitamins. Don't eat cold, greasy and cellulose-rich food. 4. Pay attention to food hygiene to avoid intestinal infection inducing or aggravating the disease. Avoid drinking, smoking, spicy food, milk and dairy products. 5. Maintain a good mood at ordinary times, avoid mental stimulation and relieve various mental pressures.