World Inflammatory Bowel Disease Day | Protecting a healthy new “intestinal” state

May 19

World Inflammatory Bowel Disease Day

"If you have diarrhea, choose the right medicine. There are also tips for choosing medicine. Don't look at the advertisement. Look at the effect..." Do you still remember this advertisement from a few years ago? If you have diarrhea, take some medicine and drink fluids, and you may get better soon. However, there is a kind of diarrhea that persists and recurs, which is more serious than ordinary diarrhea, and may even cause mucus and blood in the stool. This may be inflammatory bowel disease.

So, what is inflammatory bowel disease and how is it treated?

Inflammatory bowel disease with persistent or recurrent diarrhea is a chronic, nonspecific intestinal inflammatory disease with an unknown cause. It has a tendency to relapse throughout life and mainly includes ulcerative colitis and Crohn's disease. It is caused by the interaction of multiple factors such as environment, genetics, infection, and immunity.

The peak age of onset of the disease is 20 to 49 years old. The clinical manifestations are persistent or recurrent diarrhea, mucus, pus and blood in the stool accompanied by abdominal pain and systemic symptoms of varying degrees. The course of the disease is usually more than 4 to 6 weeks, and there may be extraintestinal manifestations such as skin, mucous membranes, joints, eyes, liver and gallbladder.

Relieve symptoms and reduce recurrences. Currently, the disease cannot be cured and may recur throughout life. The general principle of treatment is to control acute attacks, relieve symptoms, reduce recurrences, and prevent complications. The following drugs are mainly used in treatment:

1

Aminosalicylic acid preparations: They are the main drugs for the treatment of inflammatory bowel disease, including sulfasalazine and mesalazine. Among them, sulfasalazine has less adverse reactions than mesalazine.

2

Hormones: For moderate patients and those who do not respond to aminosalicylic acid preparations, especially those with extensive lesions, oral systemic hormones such as prednisone can be used instead, administered at 0.75 to 1 mg/(kg·d).

3

Azathioprine: Suitable for patients who are ineffective or dependent on hormones. For patients with ulcerative colitis, aminosalicylic acid preparations are often used in combination with mercaptopurine drugs in clinical practice, but it should be noted that mercaptopurine drugs have a bone marrow suppressive effect.

4

Thalidomide: Suitable for refractory ulcerative colitis, but it is only a small sample study and is not the first choice treatment drug.

5

Methotrexate: For patients who are ineffective or cannot tolerate thiopurine drugs, methotrexate may be considered as a substitute.

6

Infliximab: It is a relatively effective treatment for patients with severe inflammatory bowel disease. When patients develop serious complications such as intestinal obstruction and intestinal perforation, surgical treatment is required.

Patients with inflammatory bowel disease need to pay more attention to their diet. Patients with inflammatory bowel disease are more sensitive to adverse stimulation from food. Food, especially improper diet, usually induces or aggravates abdominal pain and diarrhea symptoms in patients. Some patients are afraid to eat because of this, which further aggravates malnutrition and nutritional risks. Therefore, special attention needs to be paid to the diet of such patients.

1

Rice soup and porridge are easy to digest and absorb, and have little residue. They have a good regulating effect on the digestive tract and can be consumed by patients with inflammatory bowel disease.

2

Although fruits and vegetables are rich in dietary fiber, patients with inflammatory bowel disease cannot eat them at will. For example, patients in the active stage should avoid choosing crude fiber vegetables, because a large amount of crude fiber food will irritate the intestines and affect the absorption of nutrients, which will aggravate the condition of patients who are already malnourished. In the remission stage, fruits and vegetables can be eaten in moderation. Fruits should be peeled and deseeded, chewed slowly or squeezed into juice to avoid burdening the intestines.

3

Milk has strong immunogenicity. Patients with inflammatory bowel disease have overactive immune functions, and milk contains lactose. These patients are more likely to be lactose intolerant, which will induce aggravated abdominal pain and diarrhea after taking milk.

4

Don’t eat too much meat. Studies have shown that the occurrence and development of inflammatory bowel disease is related to eating too much red meat such as beef, so it is not advisable to eat too much meat.

5

Eggs can be made into egg custard, which is not only nutritious but also easy to digest and absorb. Raw eggs, especially egg whites, have strong immunogenicity and can induce or aggravate intestinal inflammation by activating the intestinal mucosal immune system to produce a strong immune response, thereby inducing or aggravating abdominal pain and diarrhea. Therefore, patients with inflammatory bowel disease should not eat raw eggs.

6

Nuts are difficult to digest and absorb, and easily produce gas, which increases the burden of digestion and absorption. They should be eaten in moderation as appropriate.