Ulcerative enterocolitis        Prepared by       Junaid Hamid
DefinitionIt is a chronic, reapsing and remitting, nonspecific inflammatory disease of the colon,characterized by suppurat...
Epidemiology•   5 to 10 per 100000 in a year•   Age 10 to 40 years•   More common in females•   Less common in smokers tha...
Pathology• Retrosigmoid region in 50 % cases• Left sided involving rectum, sigmoid  and descending colon in 30 %• May invo...
• The mucosa is red inflammed and bleeds  easily. With severe disease there is  xtensive ulceration with inflammatory  pol...
Clinical features…• Emotional stress, intercurrent infection,  gastroenteritis, antibiotics and NSAIDs are  all the precip...
Clinical features…contd.• In moderate case there is more severe  diarrhea with frequent. Abdominal pain  and tenderness is...
In chronic colitis the bowel is permanentlydamaged by fibrosis and there is loss of theabsorbing property of the bowel.The...
Investigations•   blood count od RBCs and leukocytes.•   ESR elevated•   Stool culture•   Sigmoidoscopy•   Plain x ray of ...
Differential diagnosis•   Infectious colitis•   Amoebic colitis•   Pseudomembranous colitis•   Crohn’s disease•   Intestin...
Complications•   Ischiorectal abscess•   Formation of fistula (rectovaginal)•   Constriction of rectum or colon•   Toxic d...
Treatment• Avoid caffeine and gas producin vegs.• Fibers decrease diarrhea.• Antidiarrheals should be avoided in  acute at...
Treatment….contd• Mesalazine enema 4 grams at bed time• Hydrocortisone enema 80 to 100 mg• Sulfasalazine 500 mg twice dail...
Treatment….contd• If no improvement still then avoid oral  intake and use total parenteral nutrition.• Restore circulatory...
Treatment….contd• Corticosteroid therapy  methylprednisolone• Immunosuppressive therapy iv  cyclosporine or azathioprine i...
THANX
Upcoming SlideShare
Loading in...5
×

Enterocolitis

452
-1

Published on

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
452
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
5
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Enterocolitis

  1. 1. Ulcerative enterocolitis Prepared by Junaid Hamid
  2. 2. DefinitionIt is a chronic, reapsing and remitting, nonspecific inflammatory disease of the colon,characterized by suppurative ulceration ofthe colon.
  3. 3. Epidemiology• 5 to 10 per 100000 in a year• Age 10 to 40 years• More common in females• Less common in smokers than in non smokers
  4. 4. Pathology• Retrosigmoid region in 50 % cases• Left sided involving rectum, sigmoid and descending colon in 30 %• May involve the whole colon called as total colitis in 20% cases
  5. 5. • The mucosa is red inflammed and bleeds easily. With severe disease there is xtensive ulceration with inflammatory polyps.• Microscopically the mucosa has inflammatory cell infiltrate with goblet cell depletion
  6. 6. Clinical features…• Emotional stress, intercurrent infection, gastroenteritis, antibiotics and NSAIDs are all the precipitating factors.• First attack is severe and then exacerbations and remissions occur.• In mild form there is gradual onset of infrequent diarrhea with rectal bleeding. There is also left lower quadrant cramps relieved by defecation.
  7. 7. Clinical features…contd.• In moderate case there is more severe diarrhea with frequent. Abdominal pain and tenderness is also present. Mild fever anemia and hypoalbuminemia.• In severe disease 6 to 10 bloody diarrhea per day. Severe anemia, hypovolemia, abdominal pain and tenderness.
  8. 8. In chronic colitis the bowel is permanentlydamaged by fibrosis and there is loss of theabsorbing property of the bowel.There is a persistent diarrhea.
  9. 9. Investigations• blood count od RBCs and leukocytes.• ESR elevated• Stool culture• Sigmoidoscopy• Plain x ray of the abdomen• colonoscopy
  10. 10. Differential diagnosis• Infectious colitis• Amoebic colitis• Pseudomembranous colitis• Crohn’s disease• Intestinal neoplasm• Diverticulus• Ischemic colitis
  11. 11. Complications• Ischiorectal abscess• Formation of fistula (rectovaginal)• Constriction of rectum or colon• Toxic dilation in severe acute attack• Carcinoma of colon
  12. 12. Treatment• Avoid caffeine and gas producin vegs.• Fibers decrease diarrhea.• Antidiarrheals should be avoided in acute attack.
  13. 13. Treatment….contd• Mesalazine enema 4 grams at bed time• Hydrocortisone enema 80 to 100 mg• Sulfasalazine 500 mg twice daily and inreased gradually to 2 grams daily.• Steroids are used if the patient is not improving.
  14. 14. Treatment….contd• If no improvement still then avoid oral intake and use total parenteral nutrition.• Restore circulatory volume with fluids and blood as needed.
  15. 15. Treatment….contd• Corticosteroid therapy methylprednisolone• Immunosuppressive therapy iv cyclosporine or azathioprine in remission• Surgical treatment in patients who do not respond to corticosteroids and other therapy. Removal of colon and rectum (proctocolectomy) with connecting ileum to the body surface (ileostomy)
  16. 16. THANX
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×