Hemorrhagic Rectocolite
ulcerating colitis or hemorrhagic rectocolitis (RCH) is one chronic ofdigestive system who affects the end distal colon and it . Its etiology is unknown, although a component is extremely probable.
Its diagnosis rest primarily on coloscopy.
Just like disease of Crohn it can be accompanied by extra-intestinal demonstrations (articular, , ...) and sometimes even of extra-digestive localizations.
Synopsis |
Symptoms
Mainly one diarrhoea bloody (several weeks in several months), douleureuse and frequently accompanied by glaires mixed or not with the saddles. The patients often suffer from rectal burns, expulsives colics and also complain about false needs. It can exist extra-intestinal demonstrations, mainly osteo-articular but also hépato-billiaires, occulaires or cutaneous.
Incidence
Several thousands of new cases per annum (probably of about a 2000 to 2500). The RCH is fortunately rare. It concerns the young adults preferentially (peak at 20 years for first pushed disease). One estimates at 40 000 the number of patients touched in France.
Causes
Still mainly unknown. The last assumptions evoke a genetic predisposition (several identified genes), environmental factor starting (bacterium?) and occurred of a not controlled inflammatory cascade. One is thus in the presence of a multifactorielle disease as well as the disease of Crohn or the polyarthite rhumatoïde, other close diseases.
Complications
in the short run
One fears especially a colectasy (dilation toxic of the colonist) or a serious colitis (very severe push of start).
long-term risks
There exists, after 10 years of evolution, an increase of the risk of Cancer colorectal. This risk is especially important in the event of wide attack and requires a regular monitoring (coloscopies).
Treatment
The treatment of attack rests especially on salicylated (5ASA or mesalazine) with strong amount. The preventive treatment also uses salicylated (generally with semi-amount). Into the forms corticodépendantes or corticoresistantes, and quite simply into the acute forms of the disease one introduces a treatment more and more by immunosuppressor (AZA or other).
Acute treatment
Salicylated for the light pushes with modéres. Corticoids for the severe pushes. Ciclosporine (immunosuppressor) or surgery for the serious pushes or in the event of failure of the preceding treatments.
Treatment of maintenance (preventive)
Salicylated (5ASA or mesalazine) and more rarely azathioprine (immunosuppressor).
Surgery
Used as a last resort, it allows débarasser of the disease (if the rectum and the colonist are removed).
Mode
Of a discussed interest. Some probiotic could be useful in particular after surgery.
Differential diagnosis
Difficult to make because the disease can, wrongly, be labelled like a digestive, intestinal functional disorder (TFD, TFI or functional colopathy). One can easily confuse disease of Crohn (being able to touch all the digestive tract) and RCH, both chronic inflammatory diseases intestinal. Certain infectious colites can also present a misleading table.
See too
- aphthous stomatitis
- Cholangiocarcinomist
- Disease of Crohn
- Irritable colon
- cholangite sclerosing primary
External bonds
- Association François Aupetit
- (in) National Association for Colitis and Crohn' S disease (the U.K.)
- (in) Crohn' S and Colitis Foundation of America
- (in) Crohn' S Zone Support for Crohn' S and Colitis
- (in) IBD Directory- Listings for Crohn' S and colitis resources
- (in) Teen IBD- Support for teens with Colitis & Crohn' S
References
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