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Ulcerative Colitis: Symptoms and Treatment

Ulcerative Colitis: Symptoms and Treatment

Ulcerative colitis, or the inflammation of the colon, is a chronic disease that is closely related to Crohn's disease. The condition usually affects the large intestine, and causes rectal bleeding. The possible causes, symptoms, as well as the treatment options available for this condition are discussed in this article.
Chandramita Bora
Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes inflammation of the colon or the large intestine, which can eventually cause the development of sores or ulcers. This condition is closely related to Crohn's disease, which is also a type of inflammatory bowel disease or IBD.
In ulcerative colitis, the inflammation or the ulcers develop in the inner lining of the rectum or the large intestine. On the other hand, Crohn's disease is characterized by the inflammation of the deep layers of the intestinal wall, that usually takes place in the ileum or the lowest part of the small intestine.
Types
Depending on the location and the extent of inflammation, this inflammatory bowel disease can be classified into the following five types:

Ulcerative Proctitis: The rectum and the lower portion of the colon is affected in this type of colitis.

Proctosigmoiditis: This occurs when the rectum, along with a small part of the colon adjacent to the rectum, i.e., the sigmoid colon is affected.
Pancolitis: When the entire colon or the large intestine is affected.

Limited or Distal Colitis: This type of colitis affects the left side of the colon.

Fulminant Colitis: It is a severe form of pancolitis, which can lead to serious complications, and may necessitate surgical removal of the diseased colon, in order to prevent colon rupture.
Possible Causes
What exactly causes this inflammatory bowel disease is not known with certainty. Therefore, this condition is considered to be idiopathic in nature, which means that it develops on its own without any apparent external reasons or factors. However, experts believe that certain factors may be responsible for triggering this condition, which are given below.
Abnormal Activation of the Immune System: The immune system usually activates the immune cells and antibodies whenever harmful bacteria, viruses, or any other foreign infectious agents enter the body. But in the case of ulcerative colitis, the immune system in the intestine gets activated even in the absence of any foreign element, and it starts attacking the beneficial bacteria present in the intestine. This eventually causes inflammation and the development of sores.
Genetic Factor: Although 85% people affected by ulcerative colitis do not have any close relative suffering from the disease, the remaining 15% do have a family history of colitis. The fact that this disease is more prevalent among close-bred communities points to the possibility that genetic factors may be associated with this condition.
Symptoms
The most common symptoms of this condition are, rectal bleeding, pain in the abdomen, and diarrhea. But the symptoms may vary from one individual to another depending on the extent and the severity of the disease.
Patients of ulcerative proctitis and proctosigmoiditis may experience mild rectal bleeding. If the inflammation is severe in nature, then it can cause rectal pain, urgency to defaecate, and difficulty and pain during defecation (tenesmus), along with bleeding.
The symptoms of limited or distal colitis are, bloody diarrhea, pain in the left side of the abdomen, abdominal muscle cramps, and loss of weight, while those suffering from pancolitis may experience fever and night sweats.
The symptoms of fulminant colitis include, dehydration, prolonged bloody diarrhea, severe pain in the abdomen, and shock. Patients of fulminant colitis may also develop toxic megacolon (dilation of the colon due to severe inflammation) that can result in colon rapture.
Diagnosis and Treatment
Bacteria and parasites can sometimes cause colitis or inflammation of the colon, which can mimic the symptoms of ulcerative colitis. To differentiate between these two conditions, a stool test is usually conducted.
A blood sample of the patient is also tested to determine the severity of the inflammation. If the individual is suffering from ulcerative colitis, then the blood test would detect a deficiency of red blood cells (anemia), and an increased sedimentation rate (the rate at which red blood cells sediment or settle in a test-tube per hour).
A confirmed diagnosis can be made with the help of an endoscopy. In an endoscopy, thin and lighted, flexible tubes called colonoscopes and sigmoidoscopes, are inserted through the anus and the rectum, in order to examine the interior of the colon. A small sample of tissue is also collected from the colon to determine the severity of the disease. This process is known as biopsy.
A barium enema is a special X-ray examination that is used in diagnosing this condition. In this test, the rectum and the colon are filled with a chalky substance containing barium. Since barium is radio-opaque, it can sketch the colon in an X-ray.
Although there is no cure for ulcerative colitis, there are medications that can relieve the symptoms and some complications associated with the disease. Generally, steroids and 5-aminosalicylate (5-ASA) compounds are used to reduce the inflammation. They can be taken as tablets, enemas, and suppositories, depending on the severity of the condition. However, the prolonged use of steroids can cause some side effects.
Immunomodulators are medicines that suppress the immune system, and help prevent the abnormal immune response and the inflammation, either by reducing the number of immune cells, or by interfering with the production of proteins or antibodies by the immune cells. They are usually used for patients who do not respond to regular anti-inflammatory medicines.
When the condition is limited to the rectum and a small portion of the colon, it can be treated and managed with anti-inflammatory medicines and immunomodulators. But if the condition is severe, surgical removal of the colon may be required. Proctocolectomy is a surgical procedure, wherein the rectum, and all or a part of the colon is removed, and the end of the small intestine is attached to the anus.
Another method is Ileostomy, wherein the colon and the rectum are removed, and the end of the small intestine (the ileum) is brought to the surface of the skin through the stoma (an opening in the abdominal wall). The intestinal waste passes through the stoma, and then into an external pouch placed on the surface of the skin, usually on the right side of the abdomen.
Alternative Treatment
Steamed apples can help cure the ulcers of the intestine. Another home remedy for this condition is drumstick leaf juice. You can mix one teaspoon of drumstick leaf juice with an equal amount of honey, and a glass of tender coconut water, and take it two to three times a day. Buttermilk and coconut water have been found to be very effective in relieving the symptoms of this inflammatory bowel disease.
Ripe bananas are also beneficial, as they are easily digestible and have laxative properties. Boiled rice mixed with buttermilk and ripe bananas makes a healthy and nutritious meal for the patients of colitis. Wheatgrass juice can be used as an enema for cleansing the rectum and the colon. It has detoxifying properties, and so, it can be effective in curing any kind of disorder associated with the colon.
Ulcerative colitis is associated with several complications, like colon cancer, arthritis (inflammation of the joints), and the appearance of small painful red nodules on the skin. Sometimes, the affected individuals have to go through a lot of mental stress, as there is no permanent cure for this condition. Social support groups can help patients in dealing with the mental stress associated with the disease. So, along with medical treatment, one can take the help of such social support groups to cope with this condition.
Disclaimer: This article is for informative purposes only, and should not be treated as a substitute for professional medical advice.