Ulcerative Colitis

What Is Ulcerative Colitis?

Inflammatory bowel disease (IBD) is the name of a group of disorders that cause the intestines to become inflamed. The two kinds of inflammatory bowel disease are Crohn's disease and ulcerative colitis (UC). Ulcerative colitis only occurs in the large intestine. It is characterized by inflammation of the inner lining, or mucosa, of the colon and rectum. The inflammation in turn will cause ulcers or sores to form in the mucosa leading to the most common symptoms of UC, diarrhea with blood or mucus. Ulcerative colitis can occur in people of any age, but it usually starts between the ages of 15 and 30, and less frequently between 50 and 70 years of age. It affects men and women equally and appears to run in families.

What Are The Symptoms Of Ulcerative Colitis?

  • Diarrhea, usually with blood or mucus
  • Crampy lower abdominal pain
  • Dehydration
  • Fever
  • Weight loss
  • Fatigue
  • Anemia

What Causes Ulcerative Colitis?

The cause of UC is unknown. A number of theories have been put forward. One of the most popular is that it is caused by an abnormality of the immune system (a system that normally protects our bodies from infection). In patients with UC it is thought that there is an over expression of the products of the immune response. Genetic factors certainly play some role in the development of UC because between 10% and 20% of people with UC have family members with the disease. Environmental factors have also been thought to play a part, given that UC is significantly more common in North America when compared with any other country in the world. It is likely that all of the factors mentioned contribute in some way to the development of UC.

How Is Ulcerative Colitis Diagnosed?

Your doctor will take a history and perform a thorough physical examination. You may have blood tests to check for anemia and inflammation. The exam that will provide the most valuable information is a colonoscopy. This is a procedure in which a lighted flexible tube with a camera at the end is used to look at the entire length of the colon. Your doctor will be able to see any inflammation, bleeding, or ulcers in the colon. During the exam, the doctor may take a biopsy, which involves taking a sample of tissue from the lining of the colon to view with a microscope. The biopsy can confirm the diagnosis of UC.

What Is The Treatment For Ulcerative Colitis?

Drug therapy is the first line treatment for UC. The primary goal of drug therapy is to reduce the inflammation in the intestine and the accompanying symptoms. There are three main classes of drugs that your doctor may use depending on the severity of your symptoms. These include:

  • Aminosalicylates (aspirin-like medications)
  • Steroids
  • Immunosuppressant drugs

While drug therapy may improve the quality of life for some patients with UC, it is important to realize that these medications will not cure UC. Surgery is the only way to cure the disease.

The surgical procedure to cure UC is called a proctocolectomy, and involves removing the entire colon and rectum. The main job of the rectum is to store stool before bowel movements. Since the rectum is removed with this operation, a pouch is constructed out of the small bowel to collect waste. The pouch is connected to the anus and allows the patient to pass bowel movements normally through the anus. A temporary abdominal opening (ileostomy) is usually required, to allow the pouch to heal before it is used. The opening is typically closed up in a second, smaller operation a few months later, so that patients do not need a permanent ileostomy (bag).

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