tailieunhanh - Anal and rectal diseases explained - part 6

Y tế nhẹ bệnh trung bình ban đầu được điều trị với 5-ASA có chứa các đại lý quản lý hoặc bằng miệng hoặc trực tràng trong các hình thức của một thuốc đạn hoặc thuốc xổ. Những loại thuốc này cũng được sử dụng để điều trị duy trì của bệnh. Trường hợp nghiêm trọng hơn là điều trị cấp tính với các corticosteroid được hoặc nuôi, bằng miệng | Ulcerative proctitis anti-inflammatory drug-induced colitis. Because rectal bleeding and changing bowel habits may indicate the presence of other diseases eg colonic malignancy. Evaluation of the entire colon with a colonoscopy may be required if typical symptoms of colitis are not revealed on sigmoidoscopy. Colonoscopy is also used to determine the extent of colonic involvement and endoscopic severity of the disease. Treatment Medical Mild to moderate disease is initially treated with 5-ASA-containing agents administered either by mouth or rectally in the form of a suppository or enema. These drugs are also used for maintenance therapy of the disease. More severe cases are treated acutely with corticosteroids given either parenterally orally or into the rectum. Patients requiring repeated courses of corticosteroid treatment are started on immune-modulating agents so-called steroid-sparing drugs such as azathioprine and 6-mercaptopurine. Typical doses for treatment are as follows Acute colitis severe prednisone 40-60 mg day with dose tapering following relief of symptoms. Hospitalized patients are treated with methylprednisolone 40 mg day by continuous intravenous IV drip or 15 mg IV piggyback IVBP four times per day. Acute colitis mild to moderate and maintenance therapy oral mesalamine g day. A variety of forms of mesalamine are available on the market. These vary in their release properties and the vehicle that is utilized to prevent the destruction of mesalamine prior to delivery to the appropriate inflamed portions of the gastrointestinal tract. Mesalamine suppositories 500 mg dose are administered once or twice today. Mesalamine retention enemas are given as a single 4 g 60 mL dose that is retained for 8 hours at night. Recommended doses of azathioprine and 6-mercaptopurine which are generally reserved for maintenance therapy in patients requiring repeated corticosteroid treatment are mg kg day and mg kg day respectively. Surgical Surgery is .