What is ulcerative colitis?
Treatment could involve either medical or surgical treatment, depending on the severity. Patients would also require lifestyle changes.
Ulcerative colitis is an inflammatory bowel disease (IBD) that affects the inner lining of the large intestine (large bowel or colon) leading to erosion and ulcers. It is a lifelong illness with no specific cause or cure. Patients have repeated cycles of flare-ups and the disappearance of the disease. Moreover, ulcerative colitis can cause disease elsewhere in the body, apart from the intestine. There is often an emotional and social impact on ulcerative colitis.
What are the causes of ulcerative colitis?
The exact cause of ulcerative colitis is unknown. However, possible factors involved include:
- Genetics: If you have a family history you maybe more likely to have develop the disease.
- Immune reactions: The body’s own antibodies attack the inner lining of the large intestine (autoimmune disorder).
- Lifestyle factors:
- A diet that contains high fats, vitamin B6, sulphur, and a high amount of meat.
- Alcohol and substance abuse.
- Psychological stress.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of flares of ulcerative colitis.
- Consuming milk may exacerbate the disease.
What are the early signs and symptoms of ulcerative colitis?
Initially, patients commonly note:
- Rectal bleeding
- Frequent bowel movements
- Mucous discharge from the rectum
- Tenesmus (constant feeling of the evacuation of the bowels)
- Lower abdominal pain and cramps
- Dehydration
What are the other signs and symptoms of ulcerative colitis?
Severe diarrhea and abdominal cramps
- Fever
- Abdominal distention/ bloating
- Increased heart rate
- Severe abdominal pain
- Weight loss
- Pus discharge through the anus
Ulcerative colitis is also associated with various manifestations outside of the colon, such as inflammation of the eyes, joints, skin, and lungs.
What are the types of ulcerative colitis?
- Ulcerative proctitis: Inflammation limited to the area close to the anus (rectum). Symptoms are usually mild and rectal bleeding may be the only sign.
- Proctosigmoiditis: Inflammation involves the lower end of the colon.
- Left-sided colitis: Inflammation extends from the rectum up through the sigmoid and descending colon.
- Pancolitis: Pancolitis involves the entire colon.
- Acute severe ulcerative colitis: This rare form of colitis affects the entire colon and causes severe pain, profuse diarrhea, bleeding, fever, and the inability to eat.
The severity of ulcerative colitis is usually described as mild, moderate or severe.
- Mild: Bleeding per the rectum and fewer than four bowel movements per day.
- Moderate: Bleeding per the rectum with more than four bowel movements per day.
- Severe: Bleeding per the rectum with more than four bowel movements per day and systemic illness with the loss of protein.
How is ulcerative colitis diagnosed?
The physician
- conducts a complete physical assessment, and
- recommends a series of specialized blood and radiological investigations (X-ray, CT scan, etc.).
- A colonoscopy, endoscopy, biopsy, stool examination and other tests are evaluated.
What is the treatment of ulcerative colitis?
Treatment could involve either medical or surgical treatment, depending on the severity. Patients would also require lifestyle changes.
Medical treatment includes:
- Medication to suppress and/or modulate the immune system may be required
- Painkillers
- Anti-diarrhea medication
- Antibiotics for infections may be prescribed
- Surgical treatment includes:
- Surgical removal of part of the colon or whole colon (colectomy) in the most severe situations
- Dietary changes:
- A diet with low fat, meat, vitamin B6, sulfur, and milk
- Managing psychological stress and getting emotional support