The Treatment of Modern Western - Biblio.nhat-nam.ru

78ULCERATIVE COLITISUlcerative colitis (UC) is a chronic, non-specific, inflammatory,and ulcerative condition of the large intestine characterizedby diarrhea, tenesmus, and pus and blood in the stools. Nonspecificin the preceding sentence means that no specificmicrobial entity is involved. Colitis may afflict patients at anyage. However, most cases occur between the ages of 15-30with a smaller peak between 50 and 70 years of age. The diseaseusually starts in the recto-sigmoid area and may thenextend proximally until the entire colon is involved or it mayattack the entire colon all at once. The usual manifestations area series of attacks of bloody diarrhea of varying intensity andduration interspersed with periods of asymptomatic remission.Most often, attacks begin insidiously with increased urgencyto defecate, mild lower abdominal cramps, and the appearanceof blood and mucus in the stools. Eventually, there may be 10-20 bowel movements per day as well as severe cramps and rectaltenesmus. In that case, there may be fatigue, malaise, anemia,anorexia, and weight loss. Patients with long-standing,extensive ulcerative colitis have an increased risk of colon cancer.Extracolonic complications include peripheral arthritis,ankylosing spondylitis, sacroiliitis, posterior uveitis, erythemanodosum, pyoderma gangrenosum, episcleritis, and, in children,severely retarded growth and development.The Western medical diagnosis of ulcerative colitis is basedon the patient’s history, their presenting signs and symptoms,and stool examination. This presumptive diagnosis is thenusually confirmed by sigmoidoscopy. In certain difficultcases, colonoscopy and biopsy may aid in assessing the extentof the disease. The Western medical treatment of this diseaseconsists of avoidance of raw fruits and vegetables and a dairylessdiet as well as antidiarrheal agents, such as diphenoxylate,diordorized opium tincture, loperamide, and codeine,and corticosteriods such as Prednisone. Severe disease withmore than 10 bloody bowel movements per day may requirehospitalization. Emergency colectomy is indicated for massivehemorrhage, fluminating toxic colitis, or perforation.In terms of prognosis, a rapidly progressive initial attack maybe fatal in nearly 10% of patients. Patients who develop thisdisease after 60 years of age have an especially poor prognosis,with mortality from severe attacks exceeding 25%.Complete recovery after a single attack may occur in another10%. Nearly one third of all patients with extensive ulcerativecolitis ultimately require surgery, while patients withlocalized ulcerative proctitis have the best prognosis. Theincidence of colon cancer is greatest when the entire colon isinvolved and the disease has lasted for more than 10 yearsindependent of disease activity.CHINESE DISEASE CATEGORIZATION: This diseaseis categorized as xie xie, diarrhea, tong xie, painful diarrhea,chi bai li, red and white dysentery, jiu li, enduring dysentery,chang pi, intestinal afflux, bian xue, hemafecia, and chang bi,intestinal impediment.DISEASE CAUSES: The six environmental excesses, theseven affects, unregulated eating and drinking, and taxationfatigueDISEASE MECHANISMS: Damp heat evils invade thebody from the outside or damp heat may be engenderedinternally due to over-eating hot, spicy, greasy, fried, fattyfoods and drinking alcohol. If damp heat pours downward tothe large intestine it may affect the intestine’s conveyanceand conduction, thus resulting in diarrhea. If damp heatbrews and damages the network vessels, there may behemafecia. Damp heat may also be caused by liver depressiontransforming heat and spleen vacuity engendering dampnessinternally. If this dampness and heat combine, they may alsoform damp heat. The causes of liver depression are mainlyunfulfilled desires and anger. However, liver depression maybe aggravated by blood vacuity and/or yang vacuity. Spleenvacuity in Western patients is most commonly due to overeatingsugars and sweets and uncooked, chilled foods, over-