Collagenous colitis

　　The etiology of collagenous colitis is multifactorial, and its onset is related to immune dysregulation.
　　1. Most patients with systemic sclerosis have involvement of the small intestine, with pathological changes including atrophy of smooth muscle, patchy deposition of collagen fibers in the submucosal layer, muscular layer, and serosal layer, and chronic inflammatory cell infiltration in the mucosal固有层.
　　2. During dermatomyositis, the small intestine has varying degrees of expansion and segmentation changes, accompanied by hypokinesis and prolonged transit time. Grossly, the intestinal wall is edematous and thickened. Microscopically, multiple mucosal erosions, submucosal edema, muscular atrophy, and fibrosis with lymphocyte and plasma cell infiltration are observed. Thrombosis and luminal occlusion are prone to occur in the small arteries and veins from the submucosal layer to the serosal layer of the intestinal tube.
　　3. The intestinal damage of systemic lupus erythematosus is mainly the result of vasculitis, manifested as fibrinoid degeneration, thrombosis, hemorrhage, and ischemia, mainly affecting the submucosal layer, muscular layer, and mesenteric small arteries and veins of the intestine.
　　4. Polyarteritis nodosa can affect any part of the intestine, but mainly invades mesenteric medium and small arteries, submucosal and muscular layer small arteries, and then small veins. The damage is segmentally distributed, and all layers of the vessel wall are involved. The histological characteristics are fibrinoid degeneration, necrosis, and thrombosis, accompanied by inflammatory cell infiltration.
　　5. Rheumatoid arthritis can also lead to malabsorption of the small intestine, steatorrhea, and selective lactose intolerance. Malabsorption is caused by concurrent amyloidosis of the small intestine and can be accompanied by protein loss in the gastrointestinal tract.

　　A small number of patients with collagenous colitis have villous atrophy, accompanied by protein-losing enteropathy, regional enteritis, and other diseases. Severe cases can cause intestinal ulcers, necrosis, and perforation. Therefore, early detection and treatment are essential.

　　Connective tissue colitis can be seen in various autoimmune diseases. The specific clinical manifestations are as follows:
　　1. Patients with systemic sclerosis may have abdominal discomfort, bloating, rumbling in the abdomen after eating, decreased appetite, nausea, vomiting, and alternating diarrhea and constipation, which are manifestations of intestinal dysfunction.
　　2. During dermatomyositis, the small intestine has varying degrees of dilation and segmentation changes, accompanied by hypokinesia and prolonged transit time. Grossly, the intestinal wall is edematous and thickened.
　　3. The intestinal damage of systemic lupus erythematosus is mainly the result of vasculitis, common gastrointestinal symptoms include abdominal pain, anorexia, nausea, vomiting, diarrhea, melena, and occasionally intestinal obstruction. A few patients have villous atrophy, accompanied by protein-losing enteropathy, regional enteritis, non-specific ulcerative colitis, acute appendicitis, and other diseases.
　　4. Intestinal symptoms are very common in结节性多动脉炎, when there is local ischemia of the intestine, abdominal pain, vomiting, or diarrhea may occur; occlusion of the diseased blood vessels can cause intestinal ulceration, infarction, or perforation. Sometimes the clinical symptoms are very similar to regional enteritis or non-specific ulcerative colitis.

　　To prevent connective tissue colitis, attention should be paid to the following aspects in daily life.
　　1. Pay attention to household hygiene, exterminate flies and cockroaches, and keep the environment clean.
　　2. Avoid taking children to public places.
　　3. Avoid eating uncooked and unclean things.
　　4. Pay attention to the safety and cleanliness of the child's utensils.
　　5. Those who take care of children should often wash their hands, wash the child's diapers and wash their hands immediately after; wash hands after contacting the child's excrement to avoid bacterial transmission to the child.

　　Connective tissue colitis can be seen in various diseases, and the examination methods are also different. The common examination methods are as follows:
　　1. Scleroderma
　　X-ray examination shows characteristic dilation of the duodenum and proximal jejunum, sometimes the entire small intestine is dilated, the annular folds are often thickened, and the edge of the barium-filled intestinal lumen is spiky.
　　2. Dermatomyositis
　　Microscopic examination shows multiple mucosal erosions, submucosal edema, muscular atrophy, and fibrosis with lymphatic and plasma cell infiltration. The small arteries and veins of the submucosal layer to the serosal layer of the intestinal tract are prone to thrombosis and luminal occlusion due to thickening of the intima.
　　3. Necrotizing polyarteritis
　　X-ray examination shows intestinal mucosal disorder, ulceration, polypoid hyperplasia, segmental stricture, and other conditions.

　　In addition to routine treatment, patients with connective tissue colitis can also try dietary therapy. The specific food therapy formula is as follows:

　　1. Duhuo black soybean decoction
　　Preparation: Duhuo 9-12g, black soybean 60g, and an appropriate amount of rice wine. Soak the black soybean until soft, then place it in a pot with Duhuo, add about 2000ml of water, and simmer over low heat until 500ml remains, then remove the residue and take the juice, mix with rice wine. Take it in two doses, warm, within 1 day.
　　Indications: Used for patients with wind-cold-damp obstruction. The decoction is characterized by a bitter and acrid taste and mild temperature, used for dispelling wind and dampness, relieving cold and pain, especially good for dispelling the hidden wind in the kidney meridian; black soybean has a sweet and neutral taste, and is good for dispelling wind, promoting diuresis, activating blood circulation, detoxifying, and nourishing the kidney. The Duhuo black soybean decoction, with rice wine as the guide, not only has the effects of dispelling wind and dampness, activating blood circulation, relaxing tendons and bones, and dispelling cold and alleviating pain, but also strengthens the vital energy and controls the acrid and dry nature of Duhuo.

　　2. Caterpillar Chicken Soup
　　Preparation: Winter caterpillar summer grass 15-20g, longan meat 10g, jujube 15g, chicken 1. Clean the chicken, remove the internal organs, remove the kernel of the jujube with the winter caterpillar summer grass and longan meat, put them into an earthen pot, add an appropriate amount of water, cook over low heat for about 3 hours, season and eat.
　　Effect: Used for patients with lung, spleen, and kidney deficiency. The winter caterpillar summer grass in the decoction is sweet and warm, enters the lung and kidney meridians, nourishes the lung and tonifies the kidney; the jujube is sweet and warm, enters the spleen meridian, tonifies the spleen and kidney, generates body fluid and nourishes the fluid; the longan meat is sweet and mild, enters the heart and spleen meridians, tonifies the heart and calms the mind, nourishes blood and benefits the spleen; the chicken is sweet and warm, enters the spleen and stomach meridians, benefits the five internal organs, mainly for lowering Qi, treating nausea and vomiting.

　　3. Ginseng and Aconite Returning Yang Decoction
　　Preparation: Ginseng 10g, prepared aconite 10g, dragon bone 30g, oyster 30g, light soybean sprout 50g. First, add water to the prepared aconite, dragon bone, and oyster, boil and remove the dregs, take the juice, add the light soybean sprout to cook until soft and烂, decoct the ginseng separately, and combine the two liquids for consumption.
　　Effect: Used for patients with spleen and kidney yang deficiency and cold congealed blood stasis. The ginseng in the decoction is sweet and slightly bitter with a warm nature, enters the spleen and lung meridians, greatly replenishes qi, invigorates the spleen and lung, generates body fluid and nourishes the fluid; prepared aconite is very pungent and hot, enters the heart, spleen, and kidney meridians, returns yang and replenishes fire, warms the middle and disperses cold; dragon bone and oyster calm the mind and subdue yang; light soybean sprout relieves the exterior and relieves irritability.

　　Connective tissue colitis can be seen in various diseases, and the treatment methods are also different. Common treatment methods are as follows:

　　1. Scleroderma
　　57% of the patients have involvement of the small intestine, 50% of whom have malabsorption syndrome and steatorrhea. This is due to the expansion and stasis of the intestinal lumen, leading to the excessive proliferation of flora, decomposition of bile salts, resulting in a decrease in conjugated bile salts, thereby affecting the formation of micelles and the absorption of fats. Bacteria hinder the absorption of the latter by binding to the vitamin B12 intrinsic factor complex. The use of antibiotics to suppress the proliferation of bacteria in the peritoneal cavity can restore the characteristic fat in the stool and vitamin B12 absorption impairment to normal within a few days.

　　2. Systemic lupus erythematosus
　　Drug treatment is mainly with adrenocortical hormones and azathioprine. Early surgical treatment should be performed for complications such as intestinal perforation.

　　3. Necrotizing polyarteritis
　　Prednisone can alleviate gastrointestinal symptoms. If there is no obvious intestinal bleeding, anticoagulants can be added. Patients with large intestinal bleeding or perforation should undergo surgical treatment as soon as possible.