Ulcerative Colitis

What is Ulcerative Colitis?

Ulcerative colitis is an inflammatory disease that causes frequent diarrhea and ulcers in the lining of the colon and rectum. It can occur at any age, but is most common in people ages 15-30.

Ulcerative colitis has a tendency to run in families.

Primary symptoms of ulcerative colitis include:

  • Pain in the abdomen
  • Blood stained diarrhea
  • Anemia
  • Tiredness
  • Loss of appetite
  • Rectal bleeding
  • Sores on skin
  • Pain in the joints

In most of the cases, the symptoms of ulcerative colitis are very mild, but severe symptoms can include:

  • Frequent fever
  • Nausea
  • Painful cramps in the abdomen

Stunted growth may occur in children with ulcerative colitis.

The exact cause of ulcerative colitis isn’t known. Immune system abnormalities are common in patients with ulcerative colitis, but it’s unclear whether they’re a cause or a symptom of the disease. It is believed that the body’s immune system may react in an abnormal way to the bacteria found naturally in the digestive tract.

Your physician may order few diagnostic tests to test for ulcerative colitis after routine physical examination.

Diagnostic tests include:

  • Blood tests: Blood tests are done to check for anemia, which can suggest bleeding in the colon or rectum. An increased white blood cell count indicates inflammation in the body
  • Stool sample: A stool sample may be examined to detect the presence of blood and also to reveal white blood cells, bacteria or viruses in the stool
  • Colonoscopy or Sigmoidoscopy: These endoscopic tests are the most accurate methods to diagnose ulcerative colitis and rule out other conditions. Your doctor inserts an endoscope into the anus to check for bleeding, inflammation or ulcers on the colon wall. A tissue sample may be taken from the colon wall during the colonoscopy or sigmoidoscopy as well. The tissue is further examined under a microscope to confirm the diagnosis
  • Barium enema
  • CT scans

Treatment options include:

  • Drug Therapy: The goal of drug therapy is to alleviate symptoms and improve quality of life. Medications are used to reduce inflammation and relieve symptoms.

They include:

  • Anti-inflammatory drugs
  • Corticosteroids
  • Immunomodulators to reduce inflammation
  • Pain relievers
  • Anti-diarrhea medications
  • Intravenous administration
    • This replenishes lost blood and fluids for patients with severe bleeding and diarrhea.
  • Surgery: Surgical removal of the colon, known as a proctocolectomy, will be recommended if drug therapy is unable to relieve symptoms.

It may also be recommended in people with:

  • massive bleeding
  • rupture of the colon
  • risk of colon cancer

Proctocolectomy can be performed using two techniques.

The techniques include:

  • Ileostomy: During ileostomy the surgeon makes a small opening in the abdomen and attaches the end of the small intestine, known as the ileum, to the opening in the abdomen. Waste products will be excreted through this opening
  • Ileoanal anastomosis: In this technique, the colon and the inner part of the rectum are removed, leaving behind the outer muscles of the rectum. Then the ileum is attached to the inside of the rectum and anus to create a pouch where waste is stored until it is excreted through anus in a normal way
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