La ulcerative colitis just like the Crohn’s disease is a inflammatory disease chronic intestinal (MICI) du colon and rectum While Crohn’s disease can start anywhere in the digestive tract and reach deep tissue, ulcerative colitis is a superficial involvement of the mucosa, which begins in the rectum and moves up into the colon (see diagram). It also bears the name of ulcerative colitis.

There are 4 forms of ulcerative colitis, depending on the extent of the disease:

• la ulcerative proctitis, which is limited to the rectum;
• la proctosigmoïdite, which affects the rectum and sigmoid colon;
• la distal colitis, which affects the part of the colon on the left side of the body (from the rectum to the top of the descending colon);
• la pancolite, which affects the entire colon.

In Canada, it is estimated that almost 2 in 1 people (men, women and children) have ulcerative colitis¹.

In France the incidence of UC has decreased to 3.5 / 100 inhabitants while it is increasing for Crohn’s disease. In Europe it is from 000 to 1.7 / 20.3 and it is more frequent in the North of Europe than in the South (Norway / Portugal gradient) (source EPIMAD)

The disease is a disease of the “young” subject, diagnosed mainly in elderly of 30-40 years, but it can be declared at any age. Men and women are affected in almost the same proportions, but not at the same ages. This could be related to the status of smoker or former smoker. There is a female predominance for Crohn’s disease, less marked male predominance for UC.

Causes

There is a genetic predisposition to ulcerative colitis.

La ulcerative colitis (UC) is caused by an imbalance in the immune system that attacks cells in its own body.

Scientists believe that the inflammation of the colorectal mucosa is due to an excessive immune reaction of the body against viruses or bacteria in the intestine. The most probable hypothesis is that this autoimmune reaction is directed against the “harmless” bacteria normally present in the digestive tract (intestinal flora).

UC could also be linked to environmental factors that have not yet been elucidated.

Stress and food intolerances can trigger symptoms in some people, but these factors are not believed to be the cause of the disease.

Evolution

Ulcerative colitis progresses from rectum to colon and evolves in spurts (or crises).

Inflammation leads to the formation of ulcers, or a diffuse erosion without interval of healthy mucosa, which can bleed and produce mucus or pus, by a scarring mechanism, hence functional discomfort (urgent urge to defecate with little stool and nocturnal awakenings.

The disease lasts a lifetime, unless you have a surgery to remove the entire colon. The severity of the disease differs from person to person; many experience few symptoms and can live without constant treatment. Often, symptoms can go away for months and even years, only to inevitably reappear.

Possible complications

Ulcerative colitis may be accompanied by problems with the joints (axial or extremity), skin (erythema nodosum), inflammation of the eyes or problems with the liver (sclerosing cholangitis). These disorders are linked to related to the autoimmune reaction involved in the disease.

Acute complication the most serious ulcerative colitis is called ” toxic megacolon “. It occurs when the inflammation of the colon is so severe that the colon expands and is at risk of collapsing. perforate. This causes severe pain, fever, vomiting and swelling of the abdomen. We have to see a doctor urgently in the presence of these symptoms to prevent the colon from puncturing and peritonitis. Fortunately, this complication occurs only rarely (in less than 2% of cases).

People with ulcerative colitis should be aware of the risk of anemia. In fact, when the disease is severe, the blood loss can be so heavy as to cause anemia, which can be compensated for with iron supplements.

Several complications related to long-term use from some pharmaceuticals, such as corticosteroids or immunosuppressants, may occur. Thus, the use of corticosteroids over long periods increases the risk of osteoporosis, cataracts, hypertension, type 2 diabetes, etc. Corticosteroids and immunosuppressants can also increase the risk of infection.