Ulcerative Colitis

What Is Ulcerative Colitis?

Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD), which is a group of disease that affects your gut, that results in chronic inflammation in your gastrointestinal tract. This inflammation can result in sores or ulcers in the colon.

As it is a chronic condition, it progresses slowly, and symptoms develop late. It affects the innermost lining of the rectum and colon. It is a debilitating condition and can result in life-threatening complications. As of now, there is no cure, and treatment aims at relieving the signs and symptoms.

This inflammation increases gastric motility, which causes frequent bowel movements. Ulcers are formed as the cells of the lining of your bowel die. These ulcers can bleed. Most people affected are between ages 15 and 35 or older than 50 years.

What Are the Symptoms of Ulcerative Colitis?

The severity of the disease changes over time, and different individuals experience varying degrees of symptoms. The common symptoms of ulcerative colitis are:

• Stomach pain.

• Abdominal sounds.

• Blood in stools.

• Diarrhea.

• Fever.

• Unintentional weight loss.

• Malnutrition.

• Pain in the rectum.

• Fatigue.

In severe cases, it can result in:

• Joint swelling and pain.

• Decreased appetite.

• Mouth ulcers.

• Uveitis.

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Most people have periods of mild or no symptoms (remission) and periods of severe symptoms (flare-up).

What Are the Causes of Ulcerative Colitis?

It was believed that our diet and too much stress results in UC, but now it is understood that they only aggravate the condition and not cause it. The exact cause is still not known. Doctors now think that when our immune system fights off infection, it also attacks the normal cells in the gastrointestinal tract causing UC. It has also been seen that genetics and family history all seem to play a role.

What Are the Risk Factors for Ulcerative Colitis?

The risk factors are:

• Family history - 12 % of people suffering from UC have a positive family history.

• Race - It can affect people of any race, but it more commonly affects Caucasians.

• Certain drugs - The use of Isotretinoin is said to cause UC.

• Age - It can affect people of any age, but commonly seen in people between the ages of 15 and 30 and older than 60 years.

What Are the Types of Ulcerative Colitis?

Ulcerative colitis is classified according to its location, and the types are:

• Ulcerative proctitis - Inflammation in and surrounding the rectum (anus). It is the mildest form and can cause rectal bleeding.

• Proctosigmoiditis - Inflammation of the anus and lower end of the colon (sigmoid colon). It causes dysentery, stomach cramps and pain, and tenesmus (the inability to empty the bowel even with an urge).

• Left-sided colitis - Inflammation of the rectum, sigmoid and descending colon. It results in dysentery, left-sided stomach cramping and pain, and weight loss.

• Pancolitis - Inflammation of the entire colon. It causes severe blood loss in stool, stomach cramps and pain, tiredness, and unintentional weight loss.

• Acute severe ulcerative colitis - Inflammation of the entire colon. It results in severe abdominal pain and diarrhea, blood in stools, etc.

How Is Ulcerative Colitis Diagnosed?

Many conditions can result in symptoms similar to UC. So to rule out all other possible causes, your doctor might suggest you undergo the following tests:

• Blood tests - To check for anemia and infection. Severe rectal bleeding can result in anemia.

• Stool test - Stool sample is checked for the presence of white blood cells (seen in UC), and to rule out bacterial, viral, and parasitic infections.

• Colonoscopy - A thin and flexible tube with a camera and light attached to one end is inserted into the rectum to view the entire colon. If needed, a tissue sample from the lining of the colon is also taken.

• Sigmoidoscopy - In cases of severe inflammation of the colon, a very thin and flexible tube is used to examine the rectum and sigmoid instead of performing a colonoscopy.

• X-ray of the abdomen - To rule of perforation of the colon.

• CT scan of the pelvis and abdomen - To detect the severity of colon inflammation and to rule out other complications of UC.

What Are the Treatment Options for Ulcerative Colitis?

Ulcerative colitis is either treated with the help of medicines or surgery.

Medications:

Depending on the severity of the condition, the drugs used are:

• Anti-inflammatory drugs:

  • 5-aminosalicylates - Sulfasalazine, Mesalamine, and Balsalazide.

  • Corticosteroids - Prednisone and Hydrocortisone.

• Immunosuppressant drugs:

  • Azathioprine and Mercaptopurine.

  • Cyclosporine.

  • Infliximab and Adalimumab.

  • Vedolizumab

• Other drugs:

  • Antibiotics.

  • Anti-diarrheal medications - Loperamide.

  • Painkillers - Paracetamol, Ibuprofen, and Diclofenac sodium.

  • Iron supplements.

Always consult a doctor before taking any medication, as the medicines that work for others might not work for you.

Surgery:

In severe cases, surgery is done to remove the entire colon and rectum, which is called proctocolectomy. In such cases, to allow the patient to pass motion almost normally and to avoid wearing a bag to collect stool, a procedure called ileal pouch-anal anastomosis is done. Here, the surgeon constructs a pouch and attaches it to the small intestine and anus.

If ileal pouch-analpouch anal anastomosis is not possible, the doctor attaches a bag to your abdomen, where the stool gets collected.

Natural Treatment:

• Probiotics - Probiotics are beneficial bacteria usually found in the digestive tract. Adding more probiotics in your diet might help fight this disease.

• Fish oil - It acts as an anti-inflammatory.

• Aloe vera - It also has anti-inflammatory properties.

• Acupuncture - It is done by inserting fine needles into specific points in the body.

• Psyllium husk - Helps in regular bowel movement.

• Bromelain - It is an enzyme found in pineapple and helps in reducing inflammation.

• Turmeric - It is an antioxidant and reduces inflammation.

Always consult your doctor before trying any natural treatment, as it can make your condition worse.

Home Remedies:

• Consume a low-fat diet.

• Include more vitamin C in your diet.

• Consume a fiber-rich diet.

• Maintain a food diary.

What Are the Complications of Ulcerative Colitis?

Some of the possible complications of UC are:

• Severe rectal bleeding.

• Perforated colon.

• Dehydration.

• Sepsis.

• Kidney stones.

• The intestinal walls thicken.

• Ankylosing spondylitis.

• Increased risk of blood clots.

• Rarely, liver disease.

• Osteoporosis.

• Inflammation of the skin, joints, and eyes.

• Colon cancer.

• Toxic megacolon (rapid swelling of the colon).

Medicines and home remedies will only help relieve symptoms to some extent, and the only cure is the removal of the colon and rectum. Surgery is done only if you develop some severe complications. To know more about this condition, consult a gastroenterologist online now.