How severe is ulcerative colitis that forced Shinzo Abe to resign?

Shinzo Abe, who has just broken Japan’s longest record as a leader in a row, resigned because of illness. In fact, this is the second time that he has resigned as prime minister because of illness. Both of these two times are due to the same disease: ulcerative colitis. Ulcerative colitis is a kind of inflammatory bowel disease. IBD is characterized by chronic gastrointestinal inflammation and ulcer. Ulcerative colitis and Crohn’s disease are the two most common diseases in IBD. The difference between the two diseases is that ulcerative colitis only affects the colon and rectum, while Crohn’s disease affects the whole digestive tract from the mouth to the anus. Ulcerative colitis can be cured after surgical removal of the colon and rectum. However, Crohn’s disease can still recur in other places after surgical removal of parts of the digestive tract affected by Crohn’s disease. The annual incidence rate of ulcerative colitis in

is 10-12 of one hundred thousand, mainly in 15-25 year old population, followed by 50-60 year old group, more women than men, and the northern hemisphere is higher than that of the southern hemisphere, with a total prevalence rate of 1-3. < / P > < p > the symptoms of ulcerative colitis vary according to the severity and location of inflammation. Most people have mild symptoms. The younger the age of first onset, the more severe the symptoms are. Some people often relapse. Diarrhea is often accompanied by blood and pus. Abdominal pain and cramps. Rectal pain. Rectal bleeding, resulting in a small amount of bloody stool. Can’t hold back the stool. Weight loss. tired. have a fever. Children grow slowly. Complications of ulcerative colitis include severe bleeding, colon perforation, severe dehydration, osteoporosis, inflammation of skin, joints and eyes, increased risk of oral sores, colon cancer, toxic megacolon, and vascular embolism. < / P > < p > the exact cause of ulcerative colitis is unknown. It was originally thought that it was caused by diet and stress, but now it seems that it is likely to aggravate the disease rather than the real cause. At present, the following three factors are questionable: < / P > < p > intestinal immune overreaction: under normal circumstances, the immune system protects the intestine from virus and bacterial infection, and destroys these pathogens after discovering them. But sometimes viruses and bacteria can cause the immune system to mistakenly attack the intestinal wall, causing inflammation. Gene: ulcerative colitis has a family history, there may be some abnormal genes causing the disease, but so far, no gene association has been determined. Environment: there are some factors that can slightly increase the risk of ulcerative colitis, such as antibiotics, NSAIDs, oral contraceptives, etc. Diet and stress may also increase the risk. People under 15-30 years old and over 60 years old are susceptible to ulcerative colitis, those with family history of ulcerative colitis and Jews are susceptible to it. The use of isotretinoin seems to be associated with ulcerative colitis. The diagnosis of ulcerative colitis should first exclude other factors, such as irritable bowel syndrome, Crohn’s disease, celiac disease and other digestive tract diseases with similar symptoms, and judge according to family history and health history. < / P > < p > colonoscopy can be used to observe the whole colon and rectum, and if it is suspected, a biopsy can be taken. If there is severe inflammation, it can be examined with a sigmoid colonoscopy. Because the specific etiology is not clear, the existing suspicious causes such as autoimmune and gene are unable to prevent, so ulcerative colitis can not be prevented, and can only be controlled and treated. < / P > < p > ulcerative colitis can not be prevented, and there is no drug to cure ulcerative colitis, which makes patients feel helpless. But ulcerative colitis can be controlled, through lifestyle changes and drugs, can reduce symptoms. < / P > < p > restrict dairy products. Many people limit or do not eat dairy products, so that diarrhea, abdominal pain and gas production symptoms have been alleviated or even disappeared. This may also be due to lactose intolerance, so try lactose free dairy products. Limiting or not eating dairy products may lead to calcium deficiency, so we should pay attention to calcium supplement, and eat a little. Eat low-fat food. Fat can make diarrhea worse. Low fat food is healthy food, even if it does not help improve the symptoms of ulcerative colitis, it is also good for overall health. Limit dietary fiber, but only if it causes symptoms. Dietary fiber is a healthy food ingredient, but it can worsen the symptoms of IBD. If so, eat less raw fruits and vegetables, whole grains, nuts, melon seeds, cauliflower, you can peel fruits and vegetables, cooked. Many people don’t understand that IBD is the reason why fruits are cold and hot. But don’t limit dietary fiber easily. Eat less spicy food. Because it may aggravate the symptoms. Drink plenty of water and avoid carbonated drinks, caffeinated and alcoholic beverages. A small number of meals. Proper supplement of compound vitamins. Keep a food diary. It is possible to identify foods that worsen symptoms and then avoid them. Stress is another factor that can aggravate symptoms. Exercise, biofeedback, and various relaxing methods can reduce stress. There is no drug to cure ulcerative colitis. The existing drug treatment focuses on reducing symptoms, avoiding recurrence and improving the quality of life of patients. Many people have to take medicine for life. For such people, there is another choice: surgery. There are several types of drugs, one is 5-aminosalicylic acid drugs, which are the first-line drugs, including salicylic acid azosulfapyridine, baronmycin, mesalazine, oxalazine, mesalazine, which can effectively relieve symptoms, but also have side effects, including abdominal pain, headache, diarrhea, nausea and so on. Rare side effects include kidney and spleen problems. These drugs can be divided into oral administration and enema And suppository, according to the location of the disease. Ampicillin uses mesalazine. < / P > < p > another class of anti-inflammatory drugs are corticosteroids, such as prednisone, hydrocortisone, budesonide and methylprednisone, which can reduce the activity of the immune system and eliminate inflammation. These drugs can be divided into oral, injection, enema and suppository, which can be used according to the location of the disease. These drugs also have side effects, including acne, infection, bone mineral density loss, bone tissue death, hyperglycemia, hyperglycemia, weight gain, etc. they are mainly used in moderate to severe patients who are not sensitive to other drugs and cannot be used for a long time. < / P > < p > the other is immune system inhibitors and immunomodulatory drugs, which can achieve anti-inflammatory effect by inhibiting immunity. This kind of drugs should be used in combination. One is imidazolidine thiopurine, which should be closely observed when using, because the side effects include affecting the liver and spleen, easy to cause infection, and very small possibility of causing skin cancer and lymphoma. Second, cyclosporine, which is usually used as a second-line drug, cannot be used for a long time because of its serious side effects, including kidney and liver damage, epilepsy, fatal infection and minimal risk of cancer. Third, infliximab, which is a tumor necrosis factor alpha inhibitor, is also for those patients who have poor or intolerable effects on other drugs, and may also cause skin cancer and lymphoma. Fourth, vitozumab can block inflammatory cells to the site of infection, but also has a very small risk of cancer. < / P > < p > other drugs are used to deal with special symptoms, antibiotics are used for patients with fever to prevent and control infection; anti diarrhea drugs can be taken for patients with severe diarrhea; acetaminophen can be taken for children, but ibuprofen, naproxen and diclofenac sodium can not be taken, otherwise the symptoms will be aggravated; if there is chronic gastrointestinal bleeding, iron supplements should be taken. Surgery can usually cure ulcerative colitis. The conditions of operation include colon cancer, precancerous lesions of colon, life-threatening megacolon or bleeding, no improvement of symptoms after treatment, long-term dependence on corticosteroids, and life-threatening side effects of drugs. Colorectal resection and ileostomy were performed. After the colon and rectum are removed, an opening is made in the abdomen to excrete metabolic waste, and anal pouch is worn for life. Colorectal resection and ileal pouch. After the colon and rectum are removed, the rear of the small intestine is made into a storage bag, which is connected with the anus and can be excreted normally. Cancer risk < / P > < p > affects the entire colon. More than 8 years of illness. Persistent inflammation. With sclerosing cholangitis. Male. Colonoscopy should be performed every 1-3 years. Treatment of ulcerative colitis reduces the risk of cancer, and removing the colon and rectum eliminates the risk of cancer. < / P > < p > herbal and dietary supplements. There is no evidence that it works, and there are side effects and cross reactions with drugs. probiotics. Some studies have found that the use of probiotics and drugs at the same time can help, but it needs to be confirmed. Fish oil. Because of the anti-inflammatory effect of fish oil, some studies have found that fish oil combined with aminosalicylate can help, but can not be confirmed, and fish oil itself can cause diarrhea. aloe. Aloe has anti-inflammatory effects, but it can also cause diarrhea. Acupuncture. Only one clinical trial has shown that it helps. Curcumin. Clinical trials of curcumin combined with conventional therapy are under way, but further research is needed. 08/16/2020