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What is Ulcerative Colitis?
An inflammatory disease that has a long-lasting effect on the intestines and the digestive tract, Ulcerative Colitis is ulcers in your digestive system. The innermost lining in between the rectum and the large intestine is affected by the Ulcerative Colitis. It is a bowel disease and of left unattended turns to complications that are life-threatening.
Ulcerative Colitis leads to swelling and irritation in the large intestine. This eventually paves the way for sores and thereby regarded as an ulcer in the lining. Though the disease has symptoms similar to Crohn’s Disease or the irritable bowel syndrome, this is different from them. Also, there is no cure for the disease, but with treatment and significant medications, the effect can be largely reduced. Inducing the right treatment helps to prevent the disease from flaring.
Causes of Ulcerative Colitis
The prime task of an immune system is to protect the body from various invaders. But at times, the system makes an error. Instead of deterring outside invaders, it considers food, gut bacteria and also the cells that are in line with a colon as the harmful invaders. The colon lining which is majorly protected by the white blood cells is now seen inducing inflammation and ulcers to the colon lining.
As of now, the doctors do not have any such certified cause for the onset of the disease. Some believe that genetics or hereditary could be one of the reasons people develop ulcerative colitis. Others consider the environment as the major role player determine the extent to which the disease flares up. Other causes could be stress and foods. Though they aren’t the direct symptoms but can very well trigger the disease.
Another major factor that flares the disease is the malfunctioning of the immune system. Consider your immune system trying to cope with the invaders and an unexpected response of the system might cause the immune to attack the digestive tract lining. This then leads to inflammation and corresponding disease.
Risk Factors of Ulcerative Colitis
Ulcerative Colitis is one such disease that does not age or gender. Any person irrespective of their age or sex can develop Ulcerative Colitis. Few of the risk factor includes
- Age: Though people of any age could develop the disease, yet it seems that people of age more than 30 are at greater risk of ulcerative colitis. Though this is not mandatory as few do not develop the same even after they cross 60.
- Race: It is seen that the whites are at greater risk of developing the Ulcerative Colitis. However, this is also not obligatory. It is understood that the descendants of Ashkenazi Jews have the maximum possibility of developing the disease.
- Hereditary: One of the major reasons for having Ulcerative Colitis is a strong family background. You are at higher risks if any close relative is suffering from the disease.
Several complications of the disease include:
- Intense bleeding
- Hole in the colon (perforated colon)
- Severe dehydration
- Liver disease
- Loss of Bone (osteoporosis)
- Eyes, joints or skin Inflammation
- Risk of colon cancer
- Colon swelling rapidly(toxic megacolon)
- Greater risk of blood clotting in veins and also arteries
Symptoms of Ulcerative Colitis
The symptoms if the disease Ulcerative Colitis varies drastically and depends upon the intensity of the inflammation. Few of the signs and symptom include:
- Pus or blood in diarrhoea.
- Rectal Pain
- Cramps or abdominal pain.
- A small amount of blood accompanied with stool – Rectal Bleeding.
- An urgent need to defecate.
- An absence of defecation even though it’s urgent.
- Unexplained Weight Loss
- Children fail to grow
Not all have all symptoms. Many experiences only a few of the above. And the course to depends upon the moderations and the treatment given to the person with Ulcerative Colitis.
Types of Ulcerative Colitis
The location of the disease is primarily responsible for the disease type. Few of them includes:
1. Ulcerative Proctitis:
Here the only symptom you would notice is rectal Bleeding, and the inflammation is confined to areas adjacent to the anus. This is one of the mildest forms of ulcerative colitis.
Here both the sigmoid colon and the rectum witnesses inflammation. Symptoms that you will notice range from pain, cramps in abdomen and blood in diarrhea along with tenesmus.
3. Left side colitis:
Here, the inflammation starts from the rectum, passing through the sigmoid and then enter the colonising. The major symptoms include watery diarrhea and pain on the abdomen left along with unexpected weight loss.
This is one of the severe types of the disease. The entire colon is affected by the disease, and the symptoms include bloody lumps in diarrhea and fatigue, pain and cramps in the abdomen.
5. Acute severe ulcerative colitis:
This is both severe and rare. This cause inflammation in the entire colon and fever, bleeding and the inability to eat foods are few of the most common symptoms.
Diagnosis of Ulcerative Colitis
Series of tests are performed to rule out various possibilities of different diseases.
- Blood tests are done to see where you have inflammation or anemia.
- Stool tests are done by the doctor to see whether the inflammation in the colon is due to a parasite or an infection. Also, the presence of blood in stool is easily detected.
- X Rays are primarily helpful and can easily give a view of the disease. However, only in extreme cases does the doctor seek an x-ray.
- CT scan helps the doctor asses the complications of the disease if any.
Flexible Sigmoidoscopy: This gives a clear view of the lower part of your colon to the doctor. A bendable tube is inserted from your back inside to provide a more comprehensive view. One end of the tube has a camera with a small light. In rare cases, the doctors take out a lining out from your colon for biopsy. The above lining sample is then studied by an expert for further treatment.
Colonoscopy: The is the same as the flexible Sigmoidoscopy with the only difference being the former seeks the entire colon, and the latter has a view of only the lower part of the colon. A blue dye might be sprayed inside the colon for the process of Colonoscopy. The above process is referred to as chromoendoscopy and helps the doctor analyse which path of the colon is affected by the Ulcerative Colitis.
Treatments for Ulcerative Colitis
Ulcerative Colitis seeks either surgery or a medication a drug therapy. Few of the drugs are most helpful in treating disease at the most. However, it is not the same for all. Few are treated well while few do not notice any improvement. All varies from person to person. Additionally, few complaints about side effects associated with the drugs.
Medication for Ulcerative Colitis
The first and the foremost step to treat the Ulcerative Colitis is an intake of anti-inflammatory drugs. These comprise of
- 5-aminosalicylates: few of these kinds include sulfasalazine (Azulfidine), balsalazide (Colazal) and olsalazine (Dipentum), mesalamine (Asacol HD, Delzicol, others). The time and the way of intake depend upon the intensity of your inflammation.
- Corticosteroids: These drugs are useful in treating ulcerative colitis from moderate to severe stages. But doctor refrains from taking these as they have a bunch of side effects.
Immune System Suppressors.
Most of the time, doctors give a combination of drugs instead of one. These are helpful in curbing the effect of the immune system. The immune system is majorly responsible for the inflammation of the colon, and so if the result is reduced, the disease can be prevented from flaring.
Some of these include:
- Azathioprine (Azasan, Imuran) & mercaptopurine (Purinethol, Purixan).
- Infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi).
Apart from the above mentioned Medicine and drugs, doctors also prescribe medications to relieve stress and combat the disease faster. Never take medicine without consulting your doctor. Few add-ons include:
- People who have ulcerative colitis might be at risk of frequent fevers, and so an antibiotic is a must.
- Diarrhea is one primary symptom of the disease. Hence, your doctor might suggest you a drug to recover from diarrhea.
- Few doctors also give pain relievers in case you have mild or severe abdominal pain.
- Iron supplements are given to people with internal bleeding.
If you are a higher risk than your doctor might suggest you go for a surgery. In such a scenario, the entire section of colon and your rectum has to be removed. This induces a process namely ideal pouch-anal anastomosis. An artificial pouch us creates which is attached to your rectum. You can then pass on waste to the pouch.
Very rare cases show up signs and symptoms of colon cancer. Though this is rare if encountered is dangerous mainly. A deep screening needs to be done to affirm the presence of the malignant tissue. The schedule primarily depends upon the area infected and the duration of the disease. If cancer has spread beyond your colon, then the doctor might advise you to go for a frequent colonoscopy every one or two years. Even after the disease is looked after, you would need an additional colonoscopy after eight years of diagnosis. But if it’s only left colon the colonoscopy is done after 15 years.