Recto hemorrhagic colitis

hemorrhagic rectocolitisDefinition

Hemorrhagic rectocolitis is a chronic inflammatory bowel disease, whose lesions always affect the rectum and spread to the colon, in part or in whole. This condition develops in successive attacks, interspersed with long periods of spontaneous remission. At the time of seizures, it is characterized by a muco-hemorrhagic syndrome.

It can occur inminor forms (60% of cases), localized to the rectum, with superficial lesions. Moderate forms (25%) are generally more widespread andserious forms (15%) sometimes occur immediately, sometimes they are an aggravation of an initially minor or moderate attack. These serious forms can, in some cases, endanger the patient's life.

Epidemiological data

Much more widespread in the Anglo-Saxon and Scandinavian countries, it nevertheless affects 3 to 10 people for 100 00. The subjects are often young, from 20 to 35 years old, with a slight female predominance.

It may be due to genetic factors (5 to 10% of cases), but also to environmental factors.

Symptoms of the disease

Hemorrhagic rectocolitis is characterized by digestive but also extradigestive manifestations. Here are the main ones.

Digestive symptoms :
- urgent and afecal glairo-blood emissions, associated with false needs and sometimes constipation ;
- abdominal colic preceding the emissions ;
- in the case of a severe outbreak, glairo-blood emissions are very frequent, with violent abdominal colic, fever, tachycardia.

Extradigestive symptoms :
- joint manifestations, such as peripheral rheumatism (arthralgia of the inflammatory schedule, arthritis of the large joints of the limbs...) ;
- mucocutaneous manifestations (mainly erythema nodosum, sometimes also mouth ulcers) ;
- ocular manifestations (episcleritis, iritis and uveitis).


• Medical treatment is based on drugs that reduce inflammation: salicylates, for mild attacks, and corticosteroids, which are more powerful anti-inflammatory drugs.
Surgical treatment is recommended in the following cases:
- in severe relapses after failure of intensive and brief medical treatment ;
- in case of perforations or profuse bleeding ;
- in case of cancer ;
- in continuous chronic disabling forms despite medical treatment.
• Dietary measures : a fibre-free diet may be necessary.