Ulcerative colitis
Definition
Ulcerative colitis is inflammation and ulceration of the inner lining of the colon and the rectum. There are three main types of ulcerative colitis; proctitis (only rectum has the disease), limited or distal colitis (only left side of the colon is diseased) and pancolitis (entire colon is diseased). The condition is chronic.
Alternative names
Colitis-ulcerative, Inflammatory bowel disease-ulcerative colitis
Causes, incidence and risk factors
The exact cause of ulcerative colitis is not known. Genetic factors, infections, immune system and dietary factors are believed to be playing a role in the pathogenesis of ulcerative colitis. There may be environmental factors acting as triggers in susceptible individuals.
Age between 15-35, living in northern climate and in industrialized countries, refined foods, high fat diet, bile duct inflammation and family history of ulcerative colitis are the risk factors for ulcerative colitis.
Symptoms
The symptoms of ulcerative colitis depend on the severity of inflammation and extent of spread of disease. The symptoms may be sudden or they may develop gradually. They may be intermittent or continuous. They may be mild or very sever making the patient disable. The symptoms are abdominal cramps, diarrhea, blood in stool and difficulty or pain while passing the stool. Other generalized symptoms are nausea, fatigue, fever, weight loss and loss of appetite.
The disorder is differentiated into four categories depending on the severity of symptoms: mild disease, moderate disease, severe disease and fulminant disease.
Signs and tests
The diagnosis is done on the basis of medical history, physical examination and some tests. There are no definite tests available for the diagnosis of ulcerative colitis. But findings of some tests help in diagnosis of the disease. The tests are endoscopy, barium X-ray, biopsy and laboratory tests. Laboratory tests are blood test (complete blood count for increased white blood cells and platelet count, erythrocyte sedimentation rate, anemia and presence of C reactive protein), liver function test, renal function test, urine analysis, and stool test (for presence of infection or blood or both). Endoscopy is the best test for the diagnosis of ulcerative colitis.
Treatment
There is no treatment available for ulcerative colitis. Changes in diet and medications help to reduce the inflammation and to relieve the symptoms. Well balanced diet or vitamin and iron supplements are helpful. Diet changes are effective in treatment thought they do not cause the disease. Small quantities of food throughout the day; lots of fluids; no spicy and fibrous food; soft and bland food; avoiding or limiting alcohol, caffeine and milk are recommended. Medications used for the treatment of ulcerative colitis are aminosalicylates, immunosuppressants, corticosteroids and biological drugs. The anti-inflammatory drugs are sulfasalazine, mesalamine, balsalazide and corticosteroids. Immunosuppressants are azathioprine, mercaptopurine, cyclosporine and infliximab. Other drugs are anti-diarrheal drugs, laxatives, iron supplements and pain relievers.
Surgery is also an option for the treatment of ulcerative colitis and is generally done in cases those they do not respond to medications.
Expectations (Prognosis)
In some people the disease is mild and in others it develops into severe form. In some cases after one episode of illness the symptoms subside and in some cases it turns into chronic condition. More severe disease is difficult to treat.
Complications
Malabsorption, malnutrition, toxic megacolon (spread of inflammation to the deeper layers), perforated colon, intestinal infections, bleeding, and colorectal cancers are the intestinal complications of ulcerative colitis. The complications of ulcerative colitis outside the intestine are dehydration, anemia (due to bleeding), inflammation of the pigmented part of the eyes (uveitis); arthritis of the joints of spine and limbs; primary sclerosing cholangitis; osteopenia (decreased bone density); osteoporosis (loss of bones); disorders of skin, gallbladder and liver; autoimmune anemia; blood clots (thromboembolism), clubbing, deformity of the end of the fingers; growth and development delay in children and emotional consequences are the complications of ulcerative colitis.
Calling your health care provide
When there are symptoms of ulcerative colitis then one must take a medical advice immediately.
Prevention
Reference
Nih.gov, wikipedia.com, mayoclinic.com