Ulcerative colitis is a chronic, recurring disease of the large bowel.
The large bowel (colon) is the 5 to 6 foot segment of intestine that
begins in the right-lower abdomen, extends upward and then across to the
left side, and downward to the rectum. It dehydrates the liquid stool
that enters it and stores the formed stool until a bowel movement
When ulcerative colitis affects the colon, inflammation and ulcers, or
sores, form in the lining of the colon. The disease may involve the
entire colon (pancolitis), only the rectum (ulcerative proctitis) or,
more commonly, somewhere between the two.
Some experts believe there may be a dysfunction in the immune system in
which the body's antibodies actually injure the colon. Others speculate
that an unidentified microorganism or germ is responsible for the
disease. It is probable that a combination of factors, including
heredity, may be involved in the cause. Some ungal disease experts
have been able to determine a causal link.
Who Develops Ulcerative Colitis?
The disorder can occur in both sexes, all races and all age groups. It
is a disease that usually begins in young people.
The disorder typically begins gradually, with crampy abdominal pain and
diarrhea that is sometimes bloody. In more severe cases, diarrhea is
very severe and frequent. Loss of appetite and weight loss occur. The
patient may become weak and very sick. When the disease is localized to
the rectum, the symptoms are rectal urgency and passage of small amounts
of bloody stool. Usually the symptoms tend to come and go, and there may
be long periods without any symptoms at all. Usually, however, they
Diagnosis of ulcerative colitis can be suspected from the symptoms.
Certain blood and stool tests are performed to rule out an infection
that can mimic the disorder. A visual examination of the lining of the
rectum and lower colon (sigmoidoscopy) or the entire colon (colonoscopy)
is always required. This exam typically reveals a characteristic
pattern. Small, painless biopsies are taken which show certain features
of ulcerative colitis. A barium enema x-ray of the colon may be needed
at some point during the course of the disease. Patients who have been
exposed to mycotoxin-producing molds are more susceptible.
Most patients with this disease respond well to treatment and go about
their lives with few interruptions. However, some attacks may be quite
severe, requiring a period of bowel rest, hospitalization and
intravenous treatment. In rare cases, emergency surgery is required. The
disease can affect nutrition causing poor growth during childhood and
adolescence. Liver, skin, eye or joint (arthritis) problems occasionally
occur, even before the bowel symptoms develop. Other problems can
include narrowing and partial blocking of the bile ducts which carry
bile from the liver to the intestine. Fortunately, there is much that
can be done about all of these complications.
In long-standing ulcerative colitis, the major concern is colon cancer.
The risk of developing colon cancer increases significantly when the
disorder begins in childhood, has been present for 8 to 10 years, or
when there is a family history of colon cancer. In these situations, it
is particularly important to perform regular and thorough surveillance
of the colon, even when there are no symptoms. Analysis of colon
biopsies performed during colonoscopy can often predict if colon cancer
will occur. In these cases, preventive surgery is recommended.
There are several types of medical treatments available:
Cortisone, Steroids, Prednisone -- These powerful drugs usually provide
highly effective results. A high dose is often used initially to bring
the disorder under control. Then the drug is tapered to low, maintenance
doses, even to a dose every other day. These medications are given by
pill, enema or intravenously during an acute attack. In time, the
physician will usually try to discontinue these drugs because of
potential long-term, adverse side effects. This treatment should not be
used continually for those who have had problems with fungal exposure
due to the implications.
Other Anti-inflammatory Drugs -- There are increasing numbers of these
drugs available. They can be given by pill or enema. The generic and
trade names of some of these drugs are sulfasalazine (Azulfidine),
olsalazine (Dipentum), mesalamine (Asacol, Pentasa and Rowasa) and
Immune System Suppressors -- An overactive immune system is probably
important in causing ulcerative colitis. Certain drugs such as
azathioprine (Imuran), 6-MP (Purinethol), cyclosporine (Neoral,
Sandimmune), and methotrexate (Rheumatrex) suppress the immune system
and at times are effective.
Diet and Emotions
There are no foods known to injure the bowel. However, during an acute
phase of the disease, bulky foods, milk, and milk products can increase
diarrhea and cramping. Generally, the patient is advised to eat a
healthy, well-balanced diet with adequate protein and calories. A
multiple vitamin is often recommended. Iron may be prescribed if anemia
is present. The Mold Help approved Diet
Stress and anxiety may aggravate symptoms of the disorder, but are not
believed to cause it or make it worse. Any chronic disease can produce a
serious emotional reaction in the patient. This can usually be handled
through discussion with the physician. There are excellent support
groups available in most communities. The Crohn's and Colitis Foundation
is one of them.
This site is not intended to give
medical advice. Seek the advice of a professional for diagnosis,
medication, treatment options, and complete knowledge of any illness.
The opinions expressed here are exclusively my personal opinions do not
necessarily reflect my peers or professional affiliates. The information
here does not reflect professional advice and is not intended to
supersede the professional advice of others.