When a patient consults a specialist about a digestive function disorder, he can often hear a diagnosis such as ulcerative colitis( NJC).This is a rather serious bowel disease that develops in its mucous membrane and carries a lot of very unpleasant symptoms to a person, disrupting its habitual way of life.
This inflammatory disease begins to develop usually in the rectum of the large intestine and gradually spreads throughout its mucosa. The changes that occur in it depend on the phase of inflammation:
- Acute. When nonspecific ulcerative colitis is found in this phase, it is possible to observe such changes at the mucosal level as a strong puffiness, bleeding that occurs either spontaneously or from contact with calves, numerous erosions, ulcers and pseudopolypes( such tumor-like formations similar in appearancetype with polyps, but are formed only during inflammation);
- The phase of remission of ulcerative colitis, during which atrophy( thinning) of the mucous membrane occurs, lymphatic infiltrates appear in it, as well as the absence of a vascular pattern.
Causes of atypical ulcerative colitis
Quite often the patient can be asked about the source of this disease in his intestines. It is difficult to give an unambiguous answer to it, because the causes of this disease are still a contentious issue. It is assumed that the conditions for the appearance of nonspecific ulcerative colitis are the factors causing a violation of the immune response. The most at-risk groups are those patients who have the following factors:
- Genetic predisposition. The risk of developing this inflammatory pathology is sufficiently high in those patients in whom a close relative had a history of this disease;
- Infectious component. Concerning his, namely the participation of certain microorganisms in the development of this disease, there are 2 theories. From the first it follows that inflammation in the mucosa causes an infection, namely pathogenic bacteria, among which, for the most part, a species such as Mycobacterium paratuberculosis is isolated. And the second explains the development of ulcerative colitis by the fact that a person has developed an excessive immune response to the antigens of nonpathogenic bacteria;
- Autoimmune factors. According to some scientists, in case of connection of these factors, failures occur in the immune system, and immunity ceases to recognize the antigens that are native to the body, taking them for strangers and, accordingly, destroying them. As a result, the cell in which they are located is destroyed, and this leads to inflammation and development of ulcerative colitis.
In addition, NUK is often a continuation of the erosive form of intestinal colitis. This situation arises when there were any errors in the treatment, or the patient completely ignored it, believing that everything will pass by itself.
Manifestations of nonspecific ulcerative colitis
The clinical picture of NNC depends both on the severity of developing inflammation and on the prevalence of the disease in the rectum and thick intestine. Leading symptoms of this disease can be called such as:
- Frequent liquid stool, accompanied by bleeding with an admixture of mucus, and often pus;
- Painful sensations and cramps in the abdomen.
In addition to symptoms of intestinal disturbances, more than half of patients with atypical ulcerative colitis have extraintestinal manifestations, among which most are various lesions of the liver, eyes, mouth, skin and joints.
Nonspecific ulcerative colitis and pregnancy
This problem is very relevant for patients with a history of this disease, because the woman's childbearing age coincides with the peak of its development. But until now there is no unequivocal solution for this issue, since doctors do not have full information about the safety of the influence of modern methods of treating ulcerative colitis on the features of the course of pregnancy.
Many experts insist on the inadmissibility of pregnancy in patients with this pathology of the digestive organs. But the rejection of procreation has a negative impact on the quality of life of a young woman and can lead to severe psychosocial consequences.
Recent studies in this area have given patients with this inflammatory pathology a hope for normal conception and fetal bearing only if pregnancy will occur during remission. Thanks to the latest data obtained, we managed to find out that fertility decline occurs in only 10% of women who have a history of ulcerative colitis.
The rates of pregnancy in this disease are decreasing due to the violation of the menstrual cycle due to the adhesions that have occurred as a result of the operations performed on the digestive organs.
In order for a woman to successfully tolerate a healthy baby with this pathology, it is necessary to plan the forthcoming pregnancy only during the remission of ulcerative colitis and after obligatory consultation with the attending physician. This is necessary for the selection of such medicines that not only protect women from the development of exacerbation of inflammatory bowel disease, but also do no harm to the future baby or his mother.
What is the effect of such a disease as ulcerative colitis on fetal bearing and childbirth? First, in the case when conception had to take an active form of the disease, the risk of premature birth, miscarriage and fetal hypotrophy is very high. These are the most common complications that can occur against the background of an active course of ulcerative colitis.
Secondly, with atypical ulcerative colitis from the stage of the inflammatory processes in the intestine, the outcome of pregnancy also depends. At the same time, the number of spontaneous miscarriages and premature births increases 2-fold. Proceeding from this, it turns out that the most favorable prognosis for the bearing of a child by a woman with a disease like NNC is possible only in the inactive stages of this inflammatory bowel disease.
Complications of nonspecific ulcerative colitis
If there is a violation in the treatment of ulcerative colitis complications are:
- Constriction of the lumen in the intestine;
- Formation in it of erosions, abscesses and fistulas;
- Strong intestinal bleeding possible with rupture of intestinal walls.
All these possible complications make atypical ulcerative colitis a rather dangerous disease that can cause a lot of problems to the patient not only by their manifestations, but also by very dangerous consequences.
Risk of Occurrence of Evidence in Ulcerative Colitis
The presence of this inflammatory pathology in the digestive organs of the patient significantly increases the risk of cancer in the rectum and large intestine. The statistical data of the latest studies in this field indicate that the incidence of cancer with ulcerative colitis fluctuates in patients with susceptible to this disease from 3 to 10%.
Cancer in this pathology can develop in any part of the intestine. And more than half of the tumors are diagnosed in the rectum and the left parts of it. Therefore, in the event that there are risk factors for the development of cancer in NUS, it is necessary to agree on a program for monitoring the development of the disease with the attending physician for the timely detection of a malignant neoplasm.
There is also evidence that in patients with atypical ulcerative colitis, cancer develops almost 20 years earlier, the average in the population. Presumably it can be said that the early development of oncology in this pathology of the digestive organ is related both to the disease itself and to the treatment carried out for it. The greatest predisposition of the patient to develop a malignant tumor in case of ulcerative colitis depends on the presence of the following risk factors:
- Sufficiently long duration of this disease, exceeding 8 years;
- A significant prevalence of lesions of mucous erosions and ulcers;
- Age of the patient at the first exacerbation of the disease( younger than 30 years).
Forecasts for Ulcerative Colitis
In most cases, peptic( inactive) flow occurs in ulcerative colitis. But even if the disease is in a progressive form, and the mucosa is almost completely affected, a long-term remission is possible. But also about this disease can be said that no patient, even in case of complete clinical recovery, is immune from a possible relapse.
The dependence of the prognosis on how timely the treatment was prescribed, and on its correctness is very large. The most unfavorable is when the course of nonspecific colitis progresses very quickly. Mortality in this case reaches 50%.The main causes of such outcomes are peritonitis and perforation of the gut.
Preventive measures for this disease are under development. Those preventive measures that exist are aimed at prolonging the periods of remission and preventing relapses. This is appropriate medication, gentle treatment, proper nutrition, as well as the exclusion of stressful situations.