What is Inflammatory bowel disease - Ulcerative colitis : Causes, Symptoms and Treatment

INFLAMMATORY BOWEL DISEASE:

Inflammatory bowel disease (IBD) encompasses chronic inflammation of all or part of the digestive tract. IBD primarily includes Crohn's disease and ulcerative colitis. 

ULCERATIVE COLITIS:

Ulcerative colitis is an inflammatory bowel disease that causes long-lasting inflammation and sores (ulcers) in the innermost lining of your large intestine (colon) and rectum. The inflammation causes the bowel to move its contents rapidly and empty frequently.  As cells on the surface of the lining of the bowel die, ulcers form. The ulcers may cause bleeding and discharge of mucus and pus. However, this disease does not cause obstructions, narrowing (stenosis), and tunneling through the bowel wall (fistulas) of the large intestine like Crohn’s disease. 

CAUSES:

The cause of this condition is unknown. Researchers no longer believe that stress is the cause. Today, research focuses on the immune system and heredity for possible causes.

Risk Factors:

  1. Age.  Ulcerative colitis usually begins before 30; some people develop the disease after age 60.
  2. Race or ethnicity.  Whites and people of Ashkenazi Jewish descent have a higher risk.
  3. Family history.  You're at higher risk if a parent, sibling, or child suffer the disease.
  4. Isotretinoin. Used to treat scarring cystic acne or acne is a risk factor for IBD.

SYMPTOMS:

  1. Diarrhea, often with blood or pus.
  2. Abdominal pain and cramping.
  3. Rectal pain.
  4. Rectal bleeding — passing small amount of blood with stool.
  5. Urgency to defecate.
  6. Inability to defecate despite urgency.
  7. Weight loss.
  8. Fatigue.
  9. Fever.
  10. In children, failure to grow.
  11. There may be, in addition, joint pain, joint swelling, nausea, vomiting, skin ulcers, and mouth sores.

COMPLICATIONS:

  1. Severe bleeding.
  2. A hole in the colon (perforated colon).
  3. Severe dehydration.
  4. Liver disease (rare).
  5. Bone loss (osteoporosis)
  6. Inflammation of your skin, joints and eyes.
  7. Sores in the lining of your mouth.
  8. An increased risk of colon cancer.
  9. A rapidly swelling colon (toxic megacolon).
  10. Increased risk of blood clots in veins and arteries.

DIAGNOSES:

A blood test looks for signs of anemia (low blood count).  A blood test also checks for a high level of the C-reactive protein (CRP) and a high sedimentation rate (ESR).  Both are indicators of inflammation in the body.

Tests to diagnose ulcerative colitis include:

  1. Stool test:  The doctor examines your stool for blood, bacteria, and parasites.
  2. Upper GI endoscopy: The doctor uses a flexible tube to examine the stomach, esophagus, and small intestine.
  3. Colonoscopy: A diagnostic test that involves insertion of a long, flexible tube into the rectum to examine the inside of the colon.
  4. Biopsy: A surgeon removes a tissue sample from the colon for exam.
  5. Barium enema: X-rays are taken of your colon and rectum, using barium to provide contrasting pictures.

TREATMENT

Ulcerative colitis is a chronic condition. Treatment usually involves drug therapy or surgery. The goal of treatment is to reduce the inflammation that causes your symptoms.

Diet  -  Certain foods and beverages can aggravate your signs and symptoms. It is helpful to keep a food diary to keep track of what you're eating. Limit dairy products. Try low-fat foods (avoid butter, margarine, cream sauces, and fried foods).  Eat a lot of fiber (fresh fruits, vegetables, and whole grains). Avoid broccoli, cauliflower, nuts, seeds, corn, and popcorn. Avoid spicy foods, alcohol, and caffeine.  Eat small frequent meals (five or six small meals a day). Drink plenty of liquids (water is best). Avoid alcohol, coffee, and carbonated drinks. Consider multivitamins and mineral supplements. Probiotics, fish oil, aloe vera, and prebiotics are helpful.

Exercises  -  Exercise can help reduce stress, relieve depression, and normalize bowel function. Biofeedback is a stress-reduction technique that may train you to reduce muscle tension and slow your heart rate with the help of a feedback machine.  Regular relaxation and breathing exercises help you to cope with stress.

Medications  -  The doctor may prescribe a medication to reduce inflammation and swelling. The medications include sulfasalazine (Azulfidine), mesalamine (Asacol and Lialda), balsalazide (Colazal), and olsalazine (Dipentum). Reducing inflammation will help alleviate abdominal cramps and diarrhea.  More serious cases may need corticosteroids, antibiotics, or medications to suppress immune function.

Surgery  -  Surgery is necessary when there is massive bleeding, chronic and debilitating symptoms, perforation of the colon, or if there is a risk of cancer. Surgery has helped ulcerative colitis, in the form of removal of the affected bowel (resection), surgical repair of a bowel narrowing (stricture), creating a temporary or a permanent opening of the large intestine to the outside of the body (colostomy), creating an opening of the 3rd part of the small intestine to the outside of the body (ileostomy), removal of the diseased colon and attaching the ileum inside the rectum and forming a pouch (ileoanal anastomosis) and removal of the rectum and the colon (proctocolectomy). Waste will drain through the opening into a bag. Surgery cannot cure Crohn’s disease.

Tags: Inflammatory bowel disease , chronic inflammation , Ulcerative colitis , persistent diarrhea , Rectal bleeding , constipation

 

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