Ulcerative colitis in adults

The disease tends to follow a relapsing path, that is, the symptoms become pronounced for a while, severe, and then mild. However, the severity of the clinical picture varies.

Ulcerative colitis is most prevalent in the United States, Canada, and Europe. In Russia, epidemiological data are limited. Although one thing can be said with certainty: the detection of the disease occurs already in the later stages of development, when the symptoms cannot be ignored, when a large amount of the intestine is affected.

What is ulcerative colitis

This is an autoimmune disease, that is, one’s own immune system literally attacks and destroys intestinal tissue – this is how symptoms form. Inflammatory processes in the colon are formed by the interaction of genetic and environmental factors. Recently, the so-called Western lifestyle has been noted in the etiology of the disease, many studies have been devoted to this fact.

As the pathology develops, ulcers form on the mucous membrane, which can bleed, secrete pus and mucus, and the name of the disease is associated with this.

Causes of ulcerative colitis in adults

The exact causes of ulcerative colitis are still unknown, perhaps like many autoimmune diseases. But based on the data that are already available, we can conclude that this is a polyetiological disease, that is, several factors act at once in its formation, and they can be as follows:

• Genetics. The data show that people who suffer from ulcerative colitis have certain genetic characteristics. More than 200 genetic DNA variations have been linked to inflammatory bowel disease.
• environmental factors. Nutrition, smoking, and a traumatic factor can cause and provoke a worsening of existing symptoms.

• Features of the immune system. With the penetration of pathogens, whether it be a virus or bacteria, the immune system triggers a defense mechanism – inflammation. But after the infection is stopped, the immune system continues to attack, which causes prolonged inflammation. Another theory says that as a result of some mistakes and features, the immune system mistakenly believes that an infection is operating in the intestine and is fighting a non-existent enemy.

Symptoms of ulcerative colitis in adults

The undulating course of the disease is also characteristic: the symptoms appear in all their diversity, and then disappear for a while. Manifestations of ulcerative colitis vary and depend on the age, health status, severity of the disease, as well as the affected part of the large intestine.

Proctitis. That is, the defeat of the final section of the colon and rectum. It is characterized by the development of rectal bleeding, and in some cases, this may be the only symptom. But more often it is accompanied by pain, the inability to defecate, despite strong urges.

These symptoms are usually worrisome, but nevertheless, this is the mildest type of ulcerative colitis.

Proctosigmoiditis. Inflammation affects the rectum and lower end of the colon. The symptoms are quite serious: diarrhea with blood, severe pain, constant urge to defecate, decreased performance, poor health. Against the background of chronic blood loss, symptoms of anemia appear.

Left sided colitis. The process is concentrated in the rectum, sigmoid and descending on the left side. Patients are concerned about diarrhea, severe cramps on the left side of the abdomen, weight loss.

Pancolitis. Ulcerative lesion of the colon. Characterized by severe bloody diarrhea, abdominal pain, reduced performance, increased fatigue and weight loss.

Fulminant colitis. This form of ulcerative colitis is the most serious and dangerous, posing a direct threat to life. In this case, the entire large intestine is affected. Manifested by severe pain, diarrhea, which can lead to dehydration and shock. This form is associated with a high risk of colonic rupture and septic shock.

Diagnostics

Diagnosis begins with a survey, clarification of complaints and the collection of a family history of the disease. Great importance is given to the factor of heredity – whether blood relatives have had cases of ulcerative colitis or Crohn’s disease.

It is important to detect anemia in a timely manner, and examination methods will help to exclude other possible diseases, for example, irritable bowel syndrome, etc.

The required examination methods include:

• laboratory tests of blood, feces;
• radiography with a contrast agent (barium);
• sigmoidoscopy – endoscopic examination of the rectum;
• colonoscopy – endoscopic examination of the entire colon;
• CT and MRI of the abdominal cavity and pelvis.

Based on these data, the severity of the disease is determined, and treatment tactics are developed.

Treatment of ulcerative colitis in adults

Usually, treatment is carried out on an outpatient basis, and only 15% of patients have a severe form of the disease. And out of this number, each 5 needs inpatient treatment.

The main goal of treatment is the relief of acute symptoms, that is, it is necessary to transfer the exacerbation to the stage of remission, and then it should be supported by all means.

Long-term therapy is usually prescribed, which targets the main mechanism for the development of the disease – the immune system. Prescribed medications can help control and relieve moderate to severe symptoms.

Treatment of severe forms of the disease often takes place in a hospital, where it is possible to exclude the possibility of malnutrition, prevent dehydration and other dangerous complications that pose a threat to the health and life of patients.

And only in difficult cases, when other methods do not bring the desired result, surgical treatment is prescribed, that is, removal of part or all of the colon, installation of an ileostomy, etc.

Modern treatments

The National Institute of Digestive Diseases notes that some dietary measures can help relieve and even control the symptoms of ulcerative colitis:

• 5 – 6 meals a day in small portions;
• compliance with the drinking regime, where most of the liquid is represented by drinking water;
• exclude the use of carbonated drinks and sweet sodas, which increase the likelihood of gas formation and other unpleasant consequences;
• you need to keep a food diary, which will help to calculate the foods that worsen the condition.

The doctor may recommend following certain dietary principles: low in fiber, no lactose, low in salt or fat.

Prevention of ulcerative colitis in adults at home

It is almost impossible to prevent the development of ulcerative colitis. And all preventive measures come down to reducing the number of exacerbations and increasing the duration of remission. For this you need:

• get rid of bad habits: smoking and alcohol abuse;
• prevent stress;
• exclude spices, canned food, spicy;
• follow the principles of healthy eating;
• normalize the daily routine: sleep and wakefulness, work, etc .;
• monitor and promptly treat comorbidities;
• it is reasonable to take medications for any reason.

Popular questions and answers

Popular questions related to ulcerative colitis were answered by gastroenterologist Natalia Zavarzina.