Colitis, Ulcerative
What is it?
Ulcerative colitis is a persistent inflammation of the lining of the colon; small ulcers form and eventually may affect the entire colonic surface. Episodes of painful, bloody diarrhea and other symptoms may vary in intensity and alternate with symptomless periods of normal bowel function. The condition may develop gradually over a period of years or appear without warning in a sudden, severe attack. In very severe episodes, the patient is at risk for potentially life-threatening blood poisoning (due to toxins found in the distended, inflamed colon) and excessive blood loss (due to bloody diarrhea). Other serious complications include massive dilatation of the colon (toxic megacolon) and perforation of the colon wall, allowing intestinal contents to infect the abdominal cavity (peritonitis). Those who have had ulcerative colitis for 10 years or more are at increased risk of colorectal cancer.
What Causes It?
- The precise cause of ulcerative colitis is unknown, though it appears to be an autoimmune disorder (the body's immune system attacks its own tissues).
- Hereditary factors may play a role.
- Though not a cause, stress, anxiety, or depression may intensify symptoms.
- Certain foods may exacerbate symptoms in people sensitive to them (such as milk in those with lactose intolerance).
Prevention
- There is no proven way to prevent ulcerative colitis. However there are various medications that can keep symptoms under control.
Diagnosis
- Blood and stool samples are taken.
- Sigmoidoscopy or colonoscopy (use of a lighted, flexible viewing tube) is used to inspect the large intestine. A biopsy of the colon lining is usually taken during the sigmoidoscopy or colonoscopy.
- A barium enema with x-ray may be performed.
- Regular periodic screening for early colon cancer (with colonoscopy) is recommended for those who have had ulcerative colitis for more than 5 years.
How to Treat It
- A hot water bottle or a heating pad may be applied to the abdomen to relieve cramps.
- Guard against irritating the colon during a flare-up by avoiding milk and milk products if sensitive.
- Bed rest and hospitalization may be necessary during severe attacks.
- Anti-inflammatory drugs such as sulfasalazine are often prescribed for mild attacks and to prevent recurrence.
- Corticosteroids are the most effective treatment for more severe attacks.
- Enemas containing corticosteroids or aspirin-like drugs may be used to treat internal inflammation.
- Nutritional supplements may be recommended if there is malnutrition or anemia.
- When diarrhea is severe, patients may be hospitalized and fed intravenously.
- Surgical removal of part or all of the colon may be required if the inflammation does not respond to medication. Results of such surgery are often very favorable. Some physicians recommend removal of the colon to prevent colon cancer in those who have had active ulcerative colitis for 10 to 20 years.
When to Call a Doctor
- Call a doctor if you experience diarrhea that contains blood or mucus or if abdominal pain becomes severe, especially with a high fever.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.