THE IMMUNOLOGICAL DISORDERS AS A CRITERION FOR SELECTION NUTRITIONAL SUPPORT IN SEVERE ULCERATIVE COLITIS
In article presented the theme of nutritional support in severe ulcerative colitis. A study was conducted which aimed at improving the nutritional support in ulcerative colitis and integration of schemes elaborated on the basis of pathogenesis into the structure of the treatment of ulcerative colitis. Examination of patients was performed in accordance with the standard of reference for the patient, starting with the collection of complaints, anamnesis of disease and life history of the patient. All patients underwent traditional laboratory tests, enzyme immunoassay was used to determine the concentration of IgG, IgM, IgA, intercellular adhesion molecules. Evaluation of activity of ulcerative colitis was performed according to a known scale Mayo (represented Rachmilewitz 1989), taking into account the frequency of bowel movements bleeding, endoscopic assessment of colonic and a General assessment of the condition of the patient. Nutritional status was evaluated according to the criteria known alimentation-volemic diagnosis. It is noted that the high activity of ulcerative colitis increases the level of C-reactive protein, the magnitude of which correlates with other immunological parameters. Considering the data obtained by choosing nutritional support used the compositions selected depending on the severity of immune disorders and the degree of nutritional deficiency. Conclusions: 1. If complications arise during the ulcerative colitis, leading to surgical treatment and requiring metabolic correction, assessment of nutritional risk can be considered as an additional criterion for permitting or restricting the indications for surgical treatment. 2. The severity of nutritional deficiency depends on the extent of injury, severity disease and activity of ulcerative colitis. 3. The functional reserve of the intestine is one of the main factors limiting the absorption of nutrients in severe and complicated ulcerative colitis. 4. Nutritional support in the treatment of complicated UC must include in preoperative preparation for urgent and planned interventions, as well as in the postoperative period. For nutritional environments preoperative preparation and additional nutritional rehabilitation should be considered as the degree of nutritional deficiency, and the activity of UC.