Ulcerative colitis
About a disease
Ulcerative colitis is the disease that inflammation and an ulcer (festering) generate on the mucous membrane of the large intestine (colon and rectum). It was rare one of illness, but increased with the westernization of the eating habits rapidly in Japan until about 1960. It is common in relatively young people and is seen toward 15 years old - around 30 years old well. There is not the local difference. The ratio of the man and woman is 1:1. The patients in our country enrollment is approximately 20,000 people now, but is said to be it if there are more real numbers. It is that this characteristic of illness improves a symptom and traces the chronicity becoming bad. In addition, attention is necessary for not only the large intestine but also other places when a symptom became extremely bad as I cause a disease (complications).
Many researchers check it, but do not yet understand the cause now. But it is thought that inflammation may be caused by an enteric immune system (the structure which the foreign enemies such as bacteria prevent from invading it from an intestinal wall) acting excessively. Therefore it becomes very important perseverance is good and continues treatment, and to prevent a recurrence even if a disease improves.
I am appointed as specific disease (intractable disease) of the Ministry of Health and Welfare, and the copayment of medical expenses is paid in total amount public money.
Many researchers check it, but do not yet understand the cause now. But it is thought that inflammation may be caused by an enteric immune system (the structure which the foreign enemies such as bacteria prevent from invading it from an intestinal wall) acting excessively. Therefore it becomes very important perseverance is good and continues treatment, and to prevent a recurrence even if a disease improves.
I am appointed as specific disease (intractable disease) of the Ministry of Health and Welfare, and the copayment of medical expenses is paid in total amount public money.
Symptom
A pain of nenchiben where viscous liquid and blood were mixed in being seen in a flight as for the main symptom of the ulcerative colitis and the abdominal whole "is unwilling, and a limited pain is rose" (a flight does not leave to hold defecation desire frequently) to inferior belly. When a symptom gets worse, fever, tachycardia (a pulse becomes fast), lassitude (tiredness), the pain of the joint may appear. The stool frequency has much less than four times of 1st for the slight illness in nenchibenhododo, but even a slight illness may be accompanied by whole body symptoms such as the fever for this disease. In addition, I may invite aggravation of illness by a change of the living environment, e.g., the change of the season and examination, a divorce, big stress such as the failure of the business. It is thought that there are the change of the eating habits and modern stress society in the background as for the disease of the colitis including the ulcerative colitis.
The local symptom of complications: A narrow fence (the bowels become narrow), toxic megacolon (the bowels spread suddenly), massive bleeding, fistula (there is a hole in the bowels), colon cancer.
The whole body symptom of complications: Eyes lesion, aphthous stomatitis, hepatic dysfunction, urinary tract calculus, skin lesion, joint pain
A classification by the disease severity: There is the hemoid diarrhea of the time in the slight illness /1 days, but there is not from head to foot the symptom. Medium grade symptom / slight illness and the seriously ill middle. It is whole body symptoms such as fever, tachycardia, a leukocyte increase, the sedimentation of blood sthenia other than the hemoid diarrhea that is more than it on ten times of seriously ill /1 days.
The whole body symptom of complications: Eyes lesion, aphthous stomatitis, hepatic dysfunction, urinary tract calculus, skin lesion, joint pain
A classification by the disease severity: There is the hemoid diarrhea of the time in the slight illness /1 days, but there is not from head to foot the symptom. Medium grade symptom / slight illness and the seriously ill middle. It is whole body symptoms such as fever, tachycardia, a leukocyte increase, the sedimentation of blood sthenia other than the hemoid diarrhea that is more than it on ten times of seriously ill /1 days.
Inspection, diagnosis
The diagnosis of the ulcerative colitis begins with nenchiben, the confirmation of loose bowels and confirms existence of the ulcerative colitis by inspection with proctoscopic (fiberscope to see the rectal inside). I gather a part of the mucous membrane as well as presence of illness by this method, and the inspection of the cellular tissue is possible, too. Let's provide right treatment by the right diagnosis that we got in this way. If I consult a specialist if often seen without diarrhea with viscous liquid and the blood in stool being cured and examine a rectal finger and receive ka proctoscopy, I am connected for early detection.
Large intestine endoscopy: It is retrograde, and the large intestine inside is profound and advances a fiberscope from anus and sends air and performs the photography while blowing up large intestine, and observing the inside of the large intestine. I enlarge a developed film and am diagnosed.
As it is necessary to empty the large intestine before inspection, I may prepare a special diet from 3rd before inspection. I take a laxative on the day before and give an enema on the day. When the bowels have inflammation, attention is necessary for the use of the laxative. It is fast, but takes coffee, tea, the juice with sugar on the day when I was hungry by all means. (I forbid the milk)
As it is necessary to empty the large intestine before inspection, I may prepare a special diet from 3rd before inspection. I take a laxative on the day before and give an enema on the day. When the bowels have inflammation, attention is necessary for the use of the laxative. It is fast, but takes coffee, tea, the juice with sugar on the day when I was hungry by all means. (I forbid the milk)
Treatment of the ulcerative colitis
Medical treatment
Treatment with medicine of the 5-ASA preparation becomes the basics for the slight illness. I use a massive dose therapy and the immunosuppressive drug of the steroid in the seriously ill patient and medium grade symptom example with the whole body symptom.
New cure
Leukapheresis
Ulcerative colitis is a disease to cause diffuse inflammation that a lesion does not remain to one place, but the white blood cell causing inflammation is supplemented by erasion blood (I say blood streaming down blood vessel by the words for the bone cerebrospinal fluid.) circulating through a whole body. Inflammation of the large intestine came to be tried with a thought to be settled if I removed this white blood cell itself. I gather blood from the vein of the elbow and remove a white blood cell by a leukocyte removal filter in an extracorporeal circulation course and continue the work that victim's blood does in a contralateral elbow vein for one hour and do it with one treatment. This treatment takes effect once a month after having been able to introduce remission once a week at the start. The side effect is hard to come out, but there seems to be big individual difference in curative effect. If the effectiveness is authorized by the Ministry of Health and Welfare, a medical service under health insurance is enabled, but cannot provide this treatment newly during then.
Besides, the methods using the super oxide dismutase (SOD) controlling a function of cyclosporine and active oxygen of the strong immunosuppressive drug are attracting attention.
Ulcerative colitis is a disease to cause diffuse inflammation that a lesion does not remain to one place, but the white blood cell causing inflammation is supplemented by erasion blood (I say blood streaming down blood vessel by the words for the bone cerebrospinal fluid.) circulating through a whole body. Inflammation of the large intestine came to be tried with a thought to be settled if I removed this white blood cell itself. I gather blood from the vein of the elbow and remove a white blood cell by a leukocyte removal filter in an extracorporeal circulation course and continue the work that victim's blood does in a contralateral elbow vein for one hour and do it with one treatment. This treatment takes effect once a month after having been able to introduce remission once a week at the start. The side effect is hard to come out, but there seems to be big individual difference in curative effect. If the effectiveness is authorized by the Ministry of Health and Welfare, a medical service under health insurance is enabled, but cannot provide this treatment newly during then.
Besides, the methods using the super oxide dismutase (SOD) controlling a function of cyclosporine and active oxygen of the strong immunosuppressive drug are attracting attention.
Diet cure
Generally, the nourishment from intestinal tract is disturbed when a symptom is a season, and it is a basic boiled rice, I stew it, and to supply udon, bread, high energy food such as the rice porridge, high quality protein (soybean food such as white-fleshed fish, chicken except the skin, a beef red meat, tofu or the dried bean curd eggs), good food of the digestion as it may cause consumption of the physical strength. It prevents you from taking the thing with many dietary fiber (a burdock, a shiitake, a bamboo shoot, edible wild plants come, and there are no jellyfish, myoga, celery persimmons) stimulating large intestine and fat which is easy to have loose bowels, but the diet cure that I put together is necessary for each by degree and a range of inflammation. It is not necessary to become such nervous in a remission, but please avoid overeating and overdrinking and the intake of the excessive alcohol. In addition, you should wait as coffee or spice, the soda do enteric peristalsis lively. In addition, I do not mind it in the normal eating habits if the cold things of the heat potato usually extremely avoid intakes of the food considered not to be good for a stomach. The self-control that a stimulant and alcohol, the thing with much fat content avoid is important if I feel that I am ill-conditioned for the revival period.
Operative treatment
By many kuhaha medical therapy of the ulcerative colitis self-; is the disease that can control, but become a target of the surgical treatment with the following cases, and there is a thing.
■When massive bleeding is seen,
■Toxic megacolon flame (the thing that large intestine swells up, and a toxin circulates through a whole body),
■Perforation (large intestine ruptures), ■Canceration or the doubt,
■Serious case example not to react to medical treatment such as the medical therapy,
■When I cannot use the drugs such as steroids for a side effect
A basic way of thinking of the operation is to remove mucosa of large intestine becoming the mother place of inflammation as much as possible, and all knobs of the large intestine become the basics. An operation to set up an artificial anus was carried out before, but an operation to keep anus becomes mainstream afterwards and thinks about possibility of the revival of now future inflammation, and the operation that the rectum removes is chosen mainly. It is a method that this operation makes a bag to accumulate mail with the small intestine after large intestine excision and ties anus to. However, the most suitable thing is chosen in an individual patient not to speak of these methods.
Excision of the large intestine is great treatment, and a limit in the everyday life may be forced to to some extent afterwards. However, it is not necessary to become pessimistic at all as the merit that family life and work, a hobby, leisure become able to release adversely by paying such a sacrifice is big.
■When massive bleeding is seen,
■Toxic megacolon flame (the thing that large intestine swells up, and a toxin circulates through a whole body),
■Perforation (large intestine ruptures), ■Canceration or the doubt,
■Serious case example not to react to medical treatment such as the medical therapy,
■When I cannot use the drugs such as steroids for a side effect
A basic way of thinking of the operation is to remove mucosa of large intestine becoming the mother place of inflammation as much as possible, and all knobs of the large intestine become the basics. An operation to set up an artificial anus was carried out before, but an operation to keep anus becomes mainstream afterwards and thinks about possibility of the revival of now future inflammation, and the operation that the rectum removes is chosen mainly. It is a method that this operation makes a bag to accumulate mail with the small intestine after large intestine excision and ties anus to. However, the most suitable thing is chosen in an individual patient not to speak of these methods.
Excision of the large intestine is great treatment, and a limit in the everyday life may be forced to to some extent afterwards. However, it is not necessary to become pessimistic at all as the merit that family life and work, a hobby, leisure become able to release adversely by paying such a sacrifice is big.
Fixed form operation style of the ulcerative colitis
