| What
is Ulcerative Colitis?
Ulcerative colitis is an chronic inflammatory bowel disease.
It can cause frequent bouts of
diarrhea that may contain blood and mucus. It can also cause
severe abdominal pain.
Ulcerative colitis tends to have flare-ups and then settle
down again for variable amounts of
time, although it is possible to have a single attack of the
condition.
Ulcerative colitis affects the rectum and variable amounts
of the rest of the colon (the large
bowel or intestine). The other main inflammatory bowel disease,
Crohn's disease, can affect
any part of the digestive tract from the mouth to the anus.
In around 10% of cases, it is not
possible for doctors to distinguish between ulcerative colitis
and Crohn's disease.
Approximately 1 in 100 people are affected by ulcerative
colitis. The disease affects men and
women equally and can develop at any age, but most commonly
affects adults aged 20-40. It
is not an infectious illness.
What causes Ulcerative Colitis?
The cause of ulcerative colitis is not fully understood.
Inflammatory bowel disease tends to
run in families and 10 to 20% of people with either ulcerative
colitis or Crohn's disease are
likely to have at least one other person in their family affected.
Researchers are also looking
at the links between environmental factors such as nutrition
and exposure to various
infections and potentially toxic metals like lead or mercury.
Symptoms of Ulcerative Colitis
The main symptom of ulcerative colitis is frequent,
watery diarrhea, which may be
accompanied by cramping abdominal pain and the passage of
blood and/or mucus. When the
disease affects only the rectum - the final portion of the
bowel, it is known as proctitis. When
ulcerative colitis affects more of the colon than the rectum
alone, symptoms are more severe.
The symptoms vary according to the degree of inflammation
in the bowel and whether or not
the lining of the bowel has become ulcerated. In addition
to the symptoms already mentioned,
there may also be:
- pain on opening the bowels
- urgent and frequent need to open the bowels
- the sensation of incomplete emptying of the bowels
- diarrhea, even during the night
- nausea
- loss of appetite
- weight loss
- extreme tiredness
- general symptoms of infection, like fever or sweats
A number of other problems may be associated with ulcerative
colitis. These are more likely
when the disease is active and include skin rashes, mouth
ulcers, joint pains and anemia.
Ulcerative colitis is defined as mild, moderate or severe,
according to the frequency of
diarrhea, the presence of blood and how generally unwell the
person is.
Complications
During a severe attack, around 1 in 20 people develop an inflamed
and enlarged colon
(mega colon), causing abdominal pain and tenderness. This
requires urgent medical treatment
to avoid the bowel perforating (a hole forming in the bowel
wall). Half of people with
mega colon improve with drug treatment but the other half
need surgery. In some instances,
one can develop abscesses within the colon wall, this usually
requires antibiotic treatment
and often surgery.
Ulcerative colitis can cause changes in the liver (called
sclerosing cholangitis), which may be
picked up on blood tests to test the liver function.
Having ulcerative colitis increases the risk of developing
bowel cancer, particularly for people
who have had frequently recurring symptoms for more than 10
years. For this reason, people
with ulcerative colitis are encouraged to do all they can
to keep the condition under control.
They are also offered bowel screening at regular intervals,
to look for pre-cancerous changes.
Diagnosing ulcerative colitis
The pattern of symptoms, and a physical examination will indicate
to your doctor whether
ulcerative colitis is a possible diagnosis. A stool sample
will usually be sent to the laboratory
to rule out an infection, the most common cause of diarrhea.
When ulcerative colitis is
suspected, blood tests are also done to help assess the severity
of the illness.
Your GP may be able to perform a limited examination of
the rectum or lower bowel.
However, for a more thorough examination, your GP may need
to refer you to hospital.
A gastroenterologist (a doctor specializing in the digestive
system) will assess the
amount of bowel inflammation and take samples of the lining
of your bowel for
laboratory testing.
To do this, gastroenterologists use endoscopes - flexible
telescopic instruments with a light
and lens at the tip, which send pictures of the lining of
the bowel to a video monitor. The usual
procedure for suspected ulcerative colitis is called a flexible
sigmoidoscopy, which can be
done even during a severe attack.
A colonoscopy uses a similar, but longer, instrument. The
whole of the large bowel can be
viewed, but it is not usually performed during a severe attack
as it can increase the risk of
complications.
The biopsy results can show whether ulcerative colitis is
present. The results may also help
doctors to distinguish ulcerative colitis from Crohn's disease.
Dealing with Ulcerative Colitis
Having ulcerative colitis can be physically and emotionally
stressful. Having frequent bouts of
diarrhea can easily interfere with work and normal social
activities. Support, explanation and and the hospital specialists
involved.
For a detailed approach to an excellent treatment program,
please contact us by clicking
here.
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