Symptoms, causes, treatment of ulcerative colitis

Dr Maxwell Adeyemi

COLITIS refers to inflammation of the inner lining of the colon. It causes symptoms such as abdominal pain, cramping, bloating, blood in the stool, and diarrhoea.

An inflamed colon can be caused by several conditions, one of which is ulcerative colitis. This is a type of inflammatory bowel disease, which is a term referring to a group of diseases affecting the gastrointestinal tract.

Ulcerative colitis develops when the lining of the colon and rectum become inflamed. This creates ulcers on the colon’s lining, starting in the rectum and spreading upward, and can result in frequent bowel movements and discharge of mucus and pus.

Symptoms

The seriousness of ulcerative colitis symptoms varies among people who have the condition. The symptoms can also change over time. Common symptoms include: abdominal pain, increased abdominal sounds, bloody stools, diarrhoea, fever, rectal pain, weight loss, malnutrition.

There may be additional symptoms, such as: joint pain, joint swelling, nausea and decreased appetite, skin problems, mouth sores, eye inflammation.

Causes and risks

Ulcerative colitis may be the result of an overactive immune system. However, it’s unclear why some immune systems respond by attacking the large intestines and others do not.

Most people affected do not have a family history of the condition. However, over ten per cent of people with ulcerative colitis do have a family member with irritable bowel disease.

Ulcerative colitis can develop in a person of any race, but it’s more common in white people.

Other than your genes, environmental factors like bacteria, viruses, or antigens can trigger your immune system. Oral contraceptives have also been found to be associated with an increased risk of irritable bowel syndrome.

Types of ulcerative colitis

It can be categorised according to the parts of the intestine that it affects.

Ulcerative proctitis: In ulcerative proctitis, only the rectum is inflamed.

Left-sided colitis: Left-sided colitis causes inflammation in the area between the splenic flexure (near the upper part of the colon, where it bends) and the last section of the colon.

Proctosigmoiditis: Proctosigmoiditis is a form of left-sided colitis. It causes inflammation in the rectum and sigmoid colon.

Extensive colitis: Extensive colitis, also known as pancolitis, causes inflammation past the left side of the colon, although it can include the entire colon. It’s considered a severe form of the disease.

Diagnosis

Tests to diagnose ulcerative colitis often include:

Blood tests: A complete blood count looks for signs of anaemia (a low red blood cell count). Other tests indicate inflammation, such as a high C-reactive protein level and a high sedimentation rate.

Stool test: This is for certain inflammatory markers, bacteria, and parasites.

CT scan: This is a specialised X-ray of your abdomen and pelvis.

Endoscopy: to examine your stomach, esophagus, and small intestine to determine whether it’s ulcerative colitis or Crohn’s.

Biopsy: Removal of a tissue sample from your colon for analysis.

Flexible sigmoidoscopy: Flexible sigmoidoscopy is a type of endoscopy.

Colonoscopy: Use of a lighted scope called a colonoscope into your rectum to examine the inside of your colon.

Treatment

Ulcerative colitis is a chronic condition. The goal of treatment is to reduce the inflammation that causes your symptoms to prevent flare-ups and have longer periods of remission.

Medication

The choice of medication you will take will depend on your specific situation, including how severe your symptoms are. For mild symptoms, your doctor may prescribe a medication to reduce inflammation and swelling. This will help alleviate many symptoms.

These types of medications include 5-aminosalicylates (5-ASA drugs). Some people may need corticosteroids to help reduce inflammation, but these can have adverse effects, so doctors try to limit their use. If an infection is present, you may need antibiotics. If you have moderate to severe symptoms, a doctor may prescribe a type of medication known as a biologic. Biologics are made from antibodies, and help block inflammation.

Complications

Ulcerative colitis increases your risk of developing colon cancer. The longer you have the disease, the higher your risk of this cancer.

Other complications of ulcerative colitis include: thickening of the intestinal wall, intestinal bleeding, sepsis, or blood infection, severe dehydration, toxic megacolon, or a rapidly swelling colon, rupture of your colon, inflammation of your skin, joints and eyes, kidney stones.

Contact Dr Maxwell at 3631807 or 7575411