What is Ulcerative Colitis?
Ulcerative colitis is an inflammatory bowel disease. Inflammatory bowel diseases are characterized by chronic inflammation of the gastrointestinal tract. In ulcerative colitis, inflammation occurs in the innermost lining of the large intestine (colon) and rectum and can cause the development of sores or ulcers. This can lead to the formation of pus, frequent bowel movements, and diarrhoea.
Causes of Ulcerative Colitis
The exact cause of ulcerative colitis is unclear, however, some of the factors include:
- Immune system abnormalities: It may be an autoimmune condition in which the immune system functions abnormally by considering the gut bacteria and the cells in the lining of the colon as foreign particles and attacks and destroys them.
- Genetic factors: As ulcerative colitis tends to run in families there may be a hereditary component.
- Environmental factors: This includes factors such as smoking, bacteria, air pollution, and poor hygiene.
Symptoms of Ulcerative Colitis
Some of the symptoms of ulcerative colitis include:
- Rectal bleeding
- Abdominal cramps and pain
- Weight loss
- Recurrent diarrhoea with bloody stools
- Rectal pain
- Mucous in stool
- Frequent defecation
Types of Ulcerative Colitis
Types of ulcerative colitis vary based on the different areas in the colon and this includes:
- Proctosigmoiditis: Inflammation in the lower end of the colon (sigmoid) and rectum.
- Pancolitis: The whole colon area is inflamed with sores resulting in bloody diarrhoea
- Ulcerative proctitis: Inflammation at the end of the rectum
- Acute severe ulcerative colitis: Rarest and life-threatening form of colitis that affects the entire colon resulting in severe pain and bleeding
- Left-sided colitis: Inflammation occurs in the descending colon and the left side of the sigmoid
Diagnosis of Ulcerative Colitis
Your doctor will review your symptoms and medical history. Based on the symptoms, diagnostic tests will be ordered that include:
- Stool examination: The stool is examined for any colour change or blood cells and the presence of bacteria or parasites to see if infection is present. It also helps to evaluate the presence of elevated calprotectin, a protein present due to intestinal inflammation.
- X-rays: X-rays of the abdomen can help detect serious complications such as colon perforations.
- Blood test: A blood draw to determine the presence of anaemia, check C-reactive protein levels that determine inflammation, and to check liver function.
- Colonoscopy: A thin flexible light tube with a camera attached to its end will be inserted inside your rectum to view your colon and a biopsy (sample of tissue) will be taken for further examination under a microscope.
- CT scan: This is a specialized X-ray technique that produces clear images of the abdomen and pelvis.
- Flexible sigmoidoscopy: A slender tube with a light and camera at one end is inserted into the last portion of the colon to examine the sigmoid and the rectum.
- Barium enema X-ray: This test involves injecting liquid barium into the colon through the rectum. As x-rays do not pass through barium, the outline of the colon can only be visualized in the images.
Treatment for Ulcerative Colitis
Treatment for ulcerative colitis is mainly focused on relieving symptoms and preventing further eruption of the disease. Based on the type and severity of the condition treatment may include:
- Diet: You will be instructed to follow a balanced diet containing fruits and vegetables, proteins, nutrients and vitamins.
- Medications: Your doctor will prescribe some medications that include:
- Anti-inflammatory medication: To reduce inflammation and control symptoms corticosteroids are prescribed in case nonsteroidal antiinflammatory drugs are found to be ineffective, but these are only prescribed for a short duration until symptoms are controlled.
- Antibiotics: These medications treat bacterial infections and heal the sores.
- Immunomodulatory drugs: These medications suppress the immune response and prevent inflammation.
- Biologics: These are made from the proteins present in living cells and include antitumor necrosis agents that help control inflammation mediated by the immune system. This is mainly used in patients with severe ulcerative colitis.
- Your doctor may also prescribe medications to treat diarrhoea.
You may require hospitalization to manage complications of ulcerative colitis such as severe bleeding, dehydration and colon perforation.
- Surgery: If medications are found to be ineffective, surgery is recommended that may include:
- Colectomy: The entire colon or a part of it is surgically removed.
- Proctocolectomy: The entire colon and rectum are excised.
- Ileostomy: Your surgeon will make a small incision in the abdomen, and the end of the small intestine is connected to a pouch that collects intestinal waste.
- Ileal pouch-anal anastomosis: An opening will be created at the end of the small intestine that is attached to the anus to collect stool.
Prevention of Ulcerative Colitis
Preventive measures include:
- Drinking water in small amounts regularly
- Limiting consumption of food with high fibre content
- Avoiding eating fatty foods
- Reducing milk consumption
- Eating small meals
- Avoiding stress
- Regular exercise