Ulcerative Colitis

How does Ulcerative Colitis affect our life and health?

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Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes inflammation and ulcers in the digestive tract and affects the innermost lining of the large intestine (i.e., colon) and rectum. It causes diarrhea with blood, cramping, and urgency. It affects men and women equally, appears to be hereditary, and occurs in people of any age, but usually starts between 15 and 30 years and less frequently between 50 and 70 years of age.

Ulcerative colitis is classified according to its location and include:

  1. Ulcerative proctitis – inflammation of the area closest to the anus (rectum).
  2. Proctosigmoiditis – inflammation of the rectum and sigmoid colon.
  3. Left-sided colitis – inflammation that extends from the rectum up through the sigmoid and descending colon.
  4. Pancolitis – affects the entire colon.

Gastric Disorders

  What Causes Ulcerative Colitis?

  1.  The exact cause of Ulcerative colitis is unknown.
  2. It is thought to be an autoimmune disease – the immune system misidentifies the healthy cells in the digestive tract as a threat and attacks them, leading to inflammation and bleeding.
  3. It is common in families where a member has the disease, suggesting heredity could be one of the possible causes.

 What are the Risk Factors?

  • The use of the drug isotretinoin (Amnesteem, Accutane, Claravis, or Sotret) to treat cystic acne has increased the risk of developing Ulcerative colitis.
  • Age – UC usually begins before the age of 30, but it can occur at any age.
  • Race or ethnicity – whites have the highest risk of the disease, though it can occur in people form any race.
  • Family history – there is a higher risk if a close relative, such as a parent, sibling, or child, has the disease.

 Ulcerative Colitis: Signs and symptoms

Depending on the severity and site of inflammation, signs and symptoms may include:

  • Abdominal pain and cramping
  • Diarrhea, often with blood or pus
  • Rectal pain
  • Rectal bleeding leading to anemia
  • Urgency to defecate
  • Inability to defecate despite urgency
  • Weight loss

 What are the Complications?

  1.  Severe bleeding
  2. A hole in the colon – Perforated colon
  3. Severe dehydration
  4. Osteoporosis
  5. Inflammation of the skin, joints, and eyes
  6. Increased risk of colon cancer
  7. Toxic megacolon
  8. Rupture of the colon

 

Diagnosis: How to diagnose Ulcerative Colitis?

  •  Medical history – Check for symptoms and other risk factors.
  • Physical examination – to check for abdominal tenderness, fever, inflammation of the iris and uvea, skin rash, inflammation of the joints, aphthous (benign) ulcers, and clubbing of the fingers. Are you worried about a Peptic ulcer? Know the treatment
  • Diagnostic tests – The tests performed are:
    • Blood tests – to check for anemia or signs of infection
    • Stool cultures – to check for white blood cells or specific proteins in stool that can indicate UC.
    • Endoscopic procedures like Colonoscopy, Flexible sigmoidoscopy, etc., to check for abnormality in the colon.
    • Imaging procedures – CT scans, MRI scans X-rays, Computerized tomography (CT) enterography and magnetic resonance (MR) enterorrhaphy, etc.

Read Diagnosis and Screening for Gastric Conditions

 Treatment: How is the Ulcerative Colitis treated?

  •  Surgery: proctocolectomy involves removal of the entire colon and rectum. Read more: What is the scope of GI Surgery or Gastrointestinal Surgery?
  • Medications: Following medications are used:
    • Anti-inflammatory drugs like 5-aminosalicylates [e.g., sulfasalazine (Azulfidine), mesalamine (Asacol HD, Delzicol, others)] and Corticosteroids 9e.g., prednisone and budesonide).
    • Immunosuppressant drugs like Azathioprine (Azasan, Imuran), mercaptopurine (Purinethol, Purixan), Cyclosporine (Gengraf, Neoral, Sandimmune), Tofacitinib (Xeljanz).
    • Biologics (e.g., Monoclonal antibodies) – Infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi), Vedolizumab (Entyvio), Ustekinumab (Stelara). 
    • Other medications – Anti-diarrheal medications (loperamide)., Pain relievers (acetaminophen), Antispasmodics, Iron supplements.

 Prevention: Can we prevent it?

 Prevention of disease –

  •  The following steps may help:
  1. Drinking water in small amounts throughout the day.
  2. Eating smaller meals throughout the day.
  3. Limiting the intake of high fiber foods.
  4. Avoiding fatty foods.
  5. Lowering the intake of milk if you’re lactose intolerant.

 Living with the disease–

  1.  Consult the doctor immediately if any signs and symptoms like bleeding are visible.
  2. Eat a low-fat diet.
  3. Take in more vitamin C.
  4. Eat more fiber.
  5. Take the medications as prescribed, even when you don’t have symptoms.
  6. Avoid skipping medications as this can lead to flareups and make the disease harder to control.
  7. The best way to manage ulcerative colitis is to regularly follow the treatment plan and talk to your healthcare provider. Are you worried about a Peptic ulcer? Know the treatment

Consult a Gastroenteroligst in India

     When to see a doctor? :

     It is wise to consult with a gastroenterologist immediately if observed any symptoms. The typical consultation fee for a gastroenterologist ranges from Rs. 500 to Rs. 1500 in India.

    Are you aware of the different types of Gastric diseases?

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