Abdominal pain, diarrhea, and bloody stools, beware of inflammatory bowel disease!

Author: Fan Xueshun, Chief Physician of China-Japan Friendship Hospital

Reviewer: Lin Guole, Chief Physician, Peking Union Medical College Hospital

Generally, inflammatory bowel disease includes ulcerative colitis and Crohn's disease.

Ulcerative colitis is referred to as UC and Crohn's disease is referred to as CD. Currently, the incidence of these two diseases has been increasing year by year.

1. What symptoms should alert you to inflammatory bowel disease?

The main symptoms of inflammatory bowel disease are abdominal pain, diarrhea, and bloody stools.

Generally speaking, the diarrhea caused by ulcerative colitis is mainly characterized by mucous, pus and blood in the stool. The frequency of bowel movements is 2-4 times a day in mild cases, and can reach 10-30 times a day in severe cases. The abdominal pain caused by ulcerative colitis is generally mild colic. When the patient feels pain, he or she wants to defecate, and the pain is usually relieved after defecation. In addition, the pain area of ​​​​patients with ulcerative colitis is mainly in the lower left abdomen.

The diarrhea caused by Crohn's disease is mainly loose and mushy stools, without much pus and blood in the stools, but when the rectum is involved, pus and blood in the stools may also be present; the abdominal pain is mainly located in the right abdomen and around the navel; in addition, the degree of pain is related to eating, the pain will worsen after eating, and the pain will be relieved immediately after passing gas or defecation.

In addition to abdominal pain, diarrhea, and bloody stools, patients may also experience gradual weight loss, anemia, clubbing, arthritis, erythema nodosum, conjunctivitis, chronic hepatitis, oral ulcers, and even perianal diseases.

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When these symptoms appear, patients are advised to go to the hospital as soon as possible and undergo relevant examinations under the guidance of a doctor to rule out diseases with similar symptoms such as colorectal cancer, so as to make a clear diagnosis.

2. What are the causes of inflammatory bowel disease?

There are three main causes of inflammatory bowel disease: environmental factors, genetic factors, and infectious factors.

First, environmental factors. It is related to the region. According to current data, it mainly occurs in economically developed regions, such as North America, Northern Europe, Western Europe, Southern Europe, and then Japan and South America. The incidence rate in my country is relatively lower. Although this difference is subtle, it is also very important. It may be related to local eating habits, smoking, drinking and other factors, and of course it may also be related to other less obvious factors.

Second, genetic factors. Because the incidence data show that among patients with the disease, the incidence rate of their first-degree relatives is higher than that of normal people, but the incidence rate of their family members, such as spouses, is not high, so inflammatory bowel disease has certain genetic factors.

3. Infectious factors. Many people believe that microbial infection may cause inflammatory bowel disease, but no one has yet discovered which specific microorganisms can cause inflammatory bowel disease.

However, people are paying more and more attention to the fact that inflammatory bowel disease is related to the body's own immune response to intestinal flora, because this has been confirmed through animal experimental models of inflammatory bowel disease, that is, experts use genetic modification and gene knocking to observe whether animals with inflammatory bowel disease actually develop the disease. If there are normal flora in the intestine, it will develop inflammatory bowel disease; if there are no normal flora in the intestine, it will not develop the disease. Therefore, it is proved that the body's immune response to normal bacteria may cause the occurrence of this disease.

Therefore, in summary, people with irregular diet and lifestyle, people who often smoke and drink, people with weakened immunity, and people with a family history of genetic disease are more likely to develop inflammatory bowel disease.

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In terms of gender and age, there is no obvious difference between men and women, and it is more common in young people, generally between the ages of 15-35.

3. How to treat inflammatory bowel disease?

Generally, it is divided into general treatment and drug treatment in clinical practice. General treatment includes diet and symptomatic treatment.

Diet such as high-nutrition foods rich in various vitamins to ensure energy.

For drug treatment, the first one that can be used is aminosalicylic acid preparations. This drug is mainly used during the remission period when the condition is not very serious.

If aminosalicylic acid is not effective, use some glucocorticoid drugs. Glucocorticoids have a significant inhibitory effect on severe or fulminant inflammatory bowel disease. This drug is generally not used too much. When the symptoms are relieved, you can slowly reduce the dosage and then use aminosalicylic acid preparations.

If glucocorticoids are still ineffective, immunosuppressants should be used because they can reduce the body's immune response to the intestines.

For symptomatic treatment, if abdominal pain occurs, anticholinergic drugs can be used; if diarrhea occurs, antidiarrheal drugs can be used; if fever occurs, antibiotics can also be used.

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Finally, if all drug treatments are ineffective, including ulcerative colitis and Crohn's disease, the drug treatment effects are not obvious, and the patient has repeated attacks, even affecting the development of adolescent patients, or when cancer occurs, surgical treatment must be performed.