Ulcerative Colitis

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 occurs.

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 recur.

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 balsalazide (Colazal).

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 is recommended.

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.

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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.