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Ulcerative Colitis

Ulcerative colitis is a chronic condition, which causes inflammation and formation of sores (ulcers) in inner lining of the gastrointestinal tract. It usually begins in the rectum and spreads upwards to the colon and large intestine. The exact cause of the disease is not known. However, some researchers claim that it is caused by an abnormal immune response to the normal bacteria in the digestive tract. This condition can affect people across all ages. However, most cases are reported between 15-35 years of age. Ulcerative colitis is known to run in families.


Complications of ulcerative colitis can be deadly. If not treated on time, ulcerative colitis can lead to intestinal bleeding, perforated colon, sepsis (infection in the blood) and severe dehydration. Studies have proven that ulcerative colitis highly increases the risk of colon cancer.


Signs and Symptoms

The most common symptoms of ulcerative colitis include

Diarrhea (often with blood or pus)

Abdominal cramps

Rectal pain and bleeding

Fever and fatigue

Weight loss

Malnutrition

Severe ulcerative colitis may cause additional symptoms such as:

Joint pain

Inflammation of eyes

Skin rashes

Diagnosis

If you have severe diarrhea which does not resolve with over the counter medication, and abdominal pain, you must get yourself checked. Your physician would assess your abdominal sounds and check for abdominal tenderness. You would be referred for the following tests for confirming the cause of your symptoms

Blood tests: Blood tests are done to check for the following:

Inflammation: This can be assessed by checking the levels of ESR, and C- reactive protein.

Anemia: Loss of blood can result in anemia. This can be assessed by determining the levels of red blood cells and hemoglobin.

Stool tests: Stool sample is used for check for infection of the gastrointestinal tract. Presence of pus and white blood cells in the stool may indicate ulcerative colitis. Stool sample can also be sent for culture to check for bacterial, viral or parasitic infection.

Colonoscopy and sigmoidoscopy: These procedures involve inserting a thin flexible, lighted tube with an attached camera to view the insides of the colon. Colonoscopy is preferred as it helps in viewing the entire colon whereas sigmoidoscopy is helpful only to view the end part(sigmoid part) of the colon. A tissue sample of the inner lining of the colon can also be collected using these procedures and sent for lab analysis(biopsy). Studying this tissue can help in confirming ulcerative colitis.

CT Scan: A CT scan of abdomen or pelvis is performed to assess how much of the colon is inflamed and also to look for complications such as perforated colon.

CT Enterography and Magnetic Resonance (MR): Your doctor may recommend this non-invasive test to exclude if any inflammation in the small intestine. These tests are more sensitive to assess inflammation in the bowel than conventional imaging test. MR enterography is a radiation free test.

Management of Ulcerative colitis

The treatment of ulcerative colitis includes drug therapy or surgery. Medications: Drug therapy focus on relieving the symptoms and preventing the complications of the disease. Anti-inflammatory drugs and immunosuppressants relieve inflammation, analgesics help in relieving pain, antidiarrheal control diarrhea, and antibiotics control infection. Iron supplements can also be prescribed if the patient is anemic.

Surgery: Protolectomy (complete removal of colon and rectum) may be indicated in patients with severe ulcerative colitis. Surgery can also be used to treat complications such as intestinal bleeding and perforated colon.

Home Remedies: Changes in the lifestyle and food habits may prevent the symptoms from worsening. Certain problem foods that may aggravate the symptoms of ulcerative colitis include:

High fiber foods- raw fruits, vegetables and whole grains

High fat food- Deep fried foods, butter, mayonnaise

Spicy foods

Carbonated drinks and alcohol

Certain medications such as non-steroidal anti-inflammatory drugs can also cause flare ups and should thus be avoided.

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References

Ulcerative Colitis. https://www.healthline.com/health/ulcerative-colitis#Overview1. Assessed on 27-10-2017.

Ulcerative Colitis Causes. https://www.crohnsandcolitis.com/ulcerative-colitis/causes. Assessed on 27-10-2017.

Ulcerative Colitis. https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/diagnosis-treatment/drc-20353331. Assessed on 27-10-2017.

Ulcerative Colitis. https://en.wikipedia.org/wiki/Ulcerative_colitis#Signs_and_symptoms. Assessed on 27-10-2017.

Ulcerative Colitis. https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis. Assessed on 27-10-2017.

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