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Ulcerative colitis (UC – colitis ulcerosa)) is, next to Crohn’s disease (CD – Crohn’s Disease) included in the so-called. chronic inflammatory bowel disease (IBD).
These are diseases of an unknown cause, although it is believed that their origin lies in the immune system of those affected – in other words, they are inflammatory diseases, but it is not known what causes the inflammation.
The human digestive tract is a very long channel, starting from the oral cavity, through the esophagus, stomach, small intestine and ileum, large intestine (colon), up to the anus. The longest sections are the small intestine, which can be up to 7 m long, followed by the large intestine, up to 1,5 m in length. Such a length of the intestines has its justification, because it increases the absorptive surface of the digestive tract and it is possible to absorb most of the nutrients from the food content moving along the intestines (the so-called intestinal passage).
Congenital colitis – symptoms
Ulcerative colitis (UC) affects only the large intestine (colon) and does not affect the rest of the digestive tract, unlike Crohn’s disease (CD). The colon can only be partially involved, usually in its final segment (sigmoid colon and rectum), and this is actually 100 percent. cases. Less frequently, inflammatory changes cover the entire length of the large intestine.
Symptoms may include frequent diarrhea with blood and / or mucus, and painful urgency. Intestinal fistulas (that is, unnatural connections between the gut and the skin) and abscesses are rare, unlike CD. Inflammatory lesions, which are the main triggers of symptoms, can occur along the entire length of the colon as superficial ulcerations. This is very important because, unlike Crohn’s disease, pathological changes do not cover the entire wall of the large intestine, on its cross-section, but only the surface of the mucosa.
Diagnosis of ulcerative colitis
The diagnosis is made on the basis of an interview and personal examination, i.e. a series of diagnostic tests. The tests include the determination of basic blood count parameters, such as the number of erythrocytes, hemoglobin level, hematocrit level, iron level, ESR, CRP. This allows you to determine whether the patient is suffering from blood loss and anemia due to bleeding that may appear in the gastrointestinal tract, and whether the patient develops inflammation. Often, the doctor also decides to perform a stool test for the so-called occult blood to determine if there is blood in the digestive tract that is not visible to the naked eye. The faeces are also examined to exclude possible bacterial or parasitic infections that may cause symptoms mimicking UC.
An abdominal ultrasound scan (USG) is also important, as it will show any changes in the liver and pancreas, which may also affect the patient’s symptoms.
The definitive and most important test for the diagnosis of ulcerative colitis is endoscopy (endoscopy) of the colon. A rectoscopy or sigmoidoscopy can be performed to view the end of the bowel, or a more detailed colonoscopy can be performed to view the entire colon from the inside with a flexible instrument equipped with a camera and inserted through the rectum into the bowel. Colorectal endoscopy allows not only a visual (macroscopic) assessment of the condition of the intestinal mucosa, but also allows for the collection of biopsies for histopathological examination. Such a test will confirm or rule out the diagnosis of IBD and will make it possible to differentiate which form of the disease the patient suffers from, CD or CD. Ideally, diagnostics should be carried out by a gastroenterologist who is a specialist in the treatment of gastrointestinal diseases.
To determine if your intestines are inflamed, it is worth performing a Dispatch test for fecal calprotectin.
Complications of UC
Inflammation of the large intestine, lasting at least 10 years, increases the risk of developing colorectal cancer, so it is very important that patients diagnosed with UC are constantly monitored by a doctor in order to detect any unfavorable changes in time.
Other possible complications of UC include the so-called toxic colon dilatation (megacolon toxicum). The causes of this complication are not fully known, but its course indicates deep damage to the intestinal wall. If the disease is not controlled, colon necrosis occurs, which results in the need to perform the so-called colectomy, i.e. complete removal of the colon. This leads to the injury of the patient and significantly worsens the quality of life, but at the same time it allows to save life and at the same time leads to the cure of ulcerative colitis, because, as we remember, this disease affects this organ. Colectomy is a last resort, but if it is performed, the aim is to connect the rectum with the small intestine, creating a fecal collection reservoir, the so-called panniers (poucha). The pannier serves as the rectum and allows you to control bowel movements. Sometimes, however, it is necessary to derive the so-called stoma, which is an artificial opening of the intestine to the surface of the skin of the abdomen, through which the feces exit.
Prophylactically for the digestive system and against ulcers, use FOR OILS – a dietary supplement Herbapol in Krakow available at a promotional price on the Medonet Market.
Inflammation markers are used to detect and monitor inflammation in the gut. Medonet Market offers a mail-order test of calprotectin level, based on the analysis of a stool sample.
Pharmacotherapy for the treatment of ulcerative colitis
Surgical interventions in the treatment of UC are the last resort, and the mainstay of treatment is pharmacology. As the symptoms of UC indicate progressive inflammation, it is used anti-inflammatory drugs, which are derivatives of acetylsalicylic acid (aspirin), e.g. sulfasalazine. They also apply drugs based on steroidssuch as budesonide or prednisolone.
Another type of drug therapy is immunosuppressive therapy, i.e. the use of drugs that suppress the immune system (e.g. azathioprine, cyclosporine), as is the case with organ transplants when it is necessary to prevent rejection. By inhibiting the reaction of the immune system, the symptoms of UC are reduced.
It is also used antibiotic therapybecause, as noted, it often alleviates the symptoms of the disease. It is probably related to the influence of microorganisms inhabiting the large intestine on the course of UC. The immune system does not respond properly to their presence, which can increase its pathological effects.
The most effective pharmacological therapy so far is biological treatment, which use antibodies against immune stimulating factors (e.g. infliximab) for an inflammatory response. Such therapy allows to obtain the best treatment results and keep the patient in good condition for a long time, but its costs are enormous and therefore the National Health Fund does not reimburse it in all cases.
Ulcerative colitis (UC) is a serious condition of unknown etiology (cause), but the symptoms of the disease can be treated with medicine. Effective therapy, and hence the good condition of the patient, can only be achieved if there is trust between the doctor and the patient. It is also important to have access to the latest treatment methods, such as biological therapy.