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　　There are many causes of chronic colitis, specifically as follows:

　　1. Allergic factors

　　Allergic lesions are influenced by individual differences. The main type is intestinal allergic, and it sometimes affects the skin. Some people have allergies to high-protein foods such as fish, shrimp, crab, and milk, which are all allergens that produce a large amount of histamine when they enter the human body, triggering an allergic reaction. Allergic reactions are caused by stimulation from allergens, leading to reactions from the body's immune system, releasing defensive substances that activate a large number of immune cells to aggregate and adhere to the surface of the digestive tract mucosa, thereby causing inflammation such as edema, congestion, and effusion on the mucosal surface. Allergic reactions are one of the main factors in digestive allergies, influenced by changes in human living habits and dietary habits, as well as individual differences.

　　2. Infection factors

　　Infection, as one of the main causes of colitis etiology, is not detectable in the stool for pathogenic bacteria, viruses, or fungi. When an attack occurs, the use of antibiotics has varying degrees of control over the condition and therapeutic effects, indicating that antibiotics have the effect of inhibiting Escherichia coli and other pathogenic bacteria, which can reduce clinical symptoms. It is generally believed that it is related to infection. Humans are omnivores, and eating unclean or spoiled food often leads to intestinal lesions, which account for the majority of the etiology of colitis.

　　3. Autoimmune

　　With the development of society, the progress of medicine, and the rapid growth of immunology, many unknown causes have been elucidated. Currently, the incidence of immune diseases is high, treatment is difficult, and it has attracted attention. Therefore, chronic colitis is difficult to cure under routine treatment.

　　Chronic colitis often leads to many diseases, specifically as follows:

　　1. Toxic megacolon

　　It occurs during the acute active phase, with an incidence rate of about 2%. It is caused by inflammation involving the colonic muscular layer and the intermuscular plexus, leading to low colonic wall tension, segmental paralysis, and a large accumulation of intestinal contents and gas, thereby causing acute colonic dilation. The colonic wall is thin, and the lesions are often seen in the sigmoid colon or transverse colon. Triggers include hypokalemia, barium enema, and the use of anticholinergic drugs or opiate drugs, etc. Clinical manifestations include rapid deterioration of the condition, marked toxic symptoms, accompanied by bloating, tenderness, rebound pain, decreased or absent bowel sounds, increased white blood cells, and X-ray abdominal flat film showing widened intestinal lumen and disappearance of colonic haustra. It is prone to complications such as intestinal perforation. The mortality rate can reach 11% to 50%.

　　2. Ulcer perforation

　　It is easy to cause ulcer perforation and acute diffuse peritonitis on the basis of colonic dilation.

　　3. Ulcer hemorrhage

　　In addition to bleeding due to ulcer involvement of blood vessels, hypoprothrombinemia is also an important cause. It often requires treatment due to large amounts of bleeding.

　　4. Carcinoma

　　The occurrence of cancer is related to the duration of the disease and the extent of the lesion. The longer the course, the wider the range, the more cancerous changes. The incidence rate is about 5%, ten times higher than that of those without colitis, and it is more common in patients with colitis lesions involving the entire colon, onset in childhood, and a history of more than 10 years.

　　5. Colonic stricture and intestinal obstruction

　　During the repair process, a large amount of fibrous tissue scar formation can cause colonic stricture and intestinal obstruction, which is more common in the distal colon.

　　The symptoms of chronic colitis are many, as follows:

　　1. Gastrointestinal symptoms

　　Gastrointestinal symptoms often manifest as intermittent hidden pain in the abdomen, bloating, and abdominal pain as the main manifestation of colitis. It is more pronounced when exposed to cold, eating greasy foods, or emotional fluctuations, or after fatigue. The frequency of defecation increases, ranging from several times a day to dozens of times, with a feeling of rectal prolapse and uncomfortable defecation.

　　2. Diarrhea

　　Diarrhea is the most common symptom of colitis, with symptoms such as mucous blood stool, watery stool, mucous stool, and loose stool. Mild cases may defecate once every 1 to 2 hours, and sometimes it may be all mucous pus blood or watery stool without faecal matter. Five percent of patients with ulcerative colitis may have constipation, which is often the case in colitis type cases, as the stool contains blood and is often mistaken for hemorrhoids.

　　3. Constipation

　　Colitis and proctitis are causes of constipation, ranging from systemic metabolic disorders and neurological disorders to local anal fissures.

　　4. Hematochezia

　　Blood in the stool is one of the initial main symptoms of ulcerative colitis, and in most cases, the blood is mixed with liquid stool and can be attached to the outside of the stool during defecation.

　　5. Signs of enteritis

　　Long-term abdominal discomfort or occasional pain in the lower abdomen, physical examination may show abdominal, umbilical, or lower abdominal pain, with mild tenderness, hyperactive bowel sounds, and rectal prolapse.

　　6. Abdominal pain

　　Patients with chronic recurrent episodes often have abdominal pain, which is usually mild to moderate spastic abdominal pain, mainly in the lower left abdomen and left side of the abdomen. Most of the time, the pain is intermittent, transient, and mild. Abdominal pain is significant during diarrhea, and there is a regular pattern of abdominal pain, defecation urge, and pain relief after defecation. Severe patients may experience persistent and severe pain, and the rectum may be severely affected, accompanied by symptoms of urgent need to defecate.

　　7、便血

　　7. Hematochezia

　　Blood in stool is one of the main symptoms of this disease, with mild cases of blood adhering to the surface and severe cases of fresh blood flowing, which can lead to shock.

　　8. Urgency and frequency of defecation

　　This is one of the main symptoms of colitis and is common in this disease.

　　9. General manifestations

　　How to prevent chronic colitis

　　Chronic colitis is often developed from acute enteritis, with the main characteristics being a long duration of illness and easy recurrence. Therefore, the main way to prevent chronic colitis is to actively treat acute enteritis and to pay attention to avoid recurrence.

　　1. Pay attention to the combination of work and rest, and do not overwork; patients with acute onset, acute episodes, and severe chronic types should rest in bed.

　　2. Maintain a pleasant mood, avoid mental stimulation, and relieve various mental stresses. Also, pay attention to clothing and maintain appropriate temperatures; engage in moderate physical exercise to enhance physical fitness.

　　3. Generally, soft, easily digestible, nutritious, and sufficient calorie foods should be consumed. It is advisable to eat small and frequent meals to supplement various vitamins. Avoid eating raw, cold, greasy, and high-fiber foods; patients with chronic colitis should avoid gas-producing foods. This disease, due to its recurrent episodes, alternates ulcers, scars, and fibrosis in the colonic mucosa, thus reducing the elasticity of the inner wall of the colon. If too much gas-producing food such as soybeans, soy products, fried broad beans, and sweet potatoes is consumed, it may lead to intestinal gas, acute intestinal dilation, or ulcer perforation and other complications.

　　Patients with chronic colitis generally need to undergo the following examinations:

　　1. Peripheral blood examination: White blood cells and red blood cells can be elevated in blood routine, and the erythrocyte sedimentation rate can increase.

　　2. Stool routine examination or culture: Abnormalities are common, with a small number of white blood cells and red blood cells or a small number of pus cells visible. If there is bacterial infection, the pathogenic bacteria can be detected.

　　3. Physical examination during an episode may show abdominal tenderness.

　　4. X-ray barium enema and colonoscopy can exclude other specific intestinal inflammatory diseases.

　　Chronic colitis, due to its recurrent episodes, can be quite耗损 for patients, leading to malnutrition. Therefore, patients with chronic colitis should arrange their diet properly.

　　1. Low-fat, low-fiber diet. Foods with too much fat are not only difficult to digest but also often exacerbate diarrhea symptoms due to their lubricating effect on the intestines. Therefore, patients should avoid eating fried, oil-fried, cold, and high-fiber foods, and choose easily digestible foods such as thin noodles, cooked noodle slices, wontons, tender leaves, fish, shrimp, eggs, and soy products, so that the intestines can rest.

　　2. If chronic colitis patients have dehydration, they can drink some dilute salt water, vegetable soup, rice soup, fruit juice, congee, etc., to supplement water, salt, and sugar.

　　3. When flatulence and intestinal rumbling are too strong, eat less sucrose and easily gassy and fermentable foods, such as potatoes, sweet potatoes, white radish, pumpkin, milk, soybeans, etc.

　　4. Most chronic colitis patients are physically weak and have poor resistance, so they should pay more attention to dietary hygiene, not eat cold, stimulating, hard, and deteriorated food, and not drink alcohol.

　　5. Apples contain tannins and fruit acids, which have astringent and anti-diarrheal effects. Chronic colitis patients can eat them regularly.

　　The TCM differential diagnosis and treatment of chronic colitis is divided into 4 types, as follows:

　　1. Liver qi attacking spleen typeDiarrhea occurs after emotional changes, characterized by fullness and pain in the chest and hypochondrium, abdominal pain followed by diarrhea, pain reduced after defecation, and poor defecation. The coating is thin and white, and the pulse is wiry and thin. The prescription is Xiaoyao Powder combined with Tongxia Yaofang with modifications. Add more Baishao and Zhigancao to relieve urgency and stop diarrhea, and add Biejiao and Jiaosan to both eliminate and reinforce.

　　2. Deficiency of spleen with dampness type:Characterized by fatigue, poor appetite, epigastric stuffiness, intestinal rumbling and diarrhea, and feces mixed with undigested substances, the tongue is pale with white coating, and the pulse is soft and slow. The prescription is Shenling Baizhu Powder or Xiangsha Liujunzi decoction with modifications. For cold, add Rougui and braised ginger; for heat, add Coptis and Huangqin with braised ginger to use both cold and hot.

　　3. Deficiency of both spleen and kidney type:This is the severe and difficult-to-treat stage of the disease, with a long course, characterized by aversion to cold, pale complexion, soreness in the loins and knees, intestinal rumbling and diarrhea mostly before dawn, or slippery diarrhea, or defecation of undigested food. The tongue is pale with white slippery coating, and the pulse is deep, thin, and weak. The prescription is Si Shen Wan combined with Lianli decoction with modifications. Change dry ginger to braised ginger, add Wu梅, Eguizi, Wu Yao, etc., to warm and astringe the intestines.

　　4. Downward flowing damp-heat type:The initial and attack symptoms of this disease are characterized by fever, abdominal pain, urgent need to defecate, diarrhea with red and white sticky mucus or pus, red tongue with yellow greasy fur, and slippery and rapid pulse. The prescription is Baishoutong decoction combined with Shaoyao decoction with modifications. For severe heat, add Jinhuahua and Hongteng; for heavy dampness, add Houpu and Cangzhu.