Ulcerative Colitis

WHAT IS ULCERATIVE COLITIS?

Ulcerative Colitis is an Inflammatory Bowel Disease (IBD), the general name for diseases that cause inflammation in the small intestine and colon. It can be difficult to diagnose because its symptoms are similar to other intestinal disorders and to another type of IBD called Crohn’s Disease. Crohn’s Disease differs because it causes inflammation deeper within the intestinal wall and can occur in other parts of the digestive system including the small intestine, mouth, esophagus, and stomach.

Ulcerative Colitis is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers form where inflammation has killed the cells that usually line the colon, then bleed and produce pus. Inflammation in the colon also causes the colon to empty frequently, causing diarrhoea.

Ulcerative Colitis (UC) can occur in people of any age, but it usually starts between the ages of 15 and 30, and less frequently between 50 and 70 years of age. It affects men and women equally and appears to run in families, with reports of up to 20 percent of people with Ulcerative Colitis having a family member or relative with Ulcerative Colitis or Crohn’s Disease.

WHAT ARE THE SYMPTOMS OF ULCERATIVE COLITIS?

The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhoea. Patients also may experience

• anaemia
• fatigue
• weight loss
• loss of appetite
• rectal bleeding
• loss of body fluids and nutrients
• skin lesions
• joint pain
• growth failure (specifically in children)

WHAT CAUSES ULCERATIVE COLITIS?

The exact cause of Ulcerative Colitis is unknown. Hereditary, infectious and immunological factors have been proposed as possible causes.

WHAT ARE THE SYMPTOMS?

The symptoms of Ulcerative Colitis can vary considerably.

• The disease is characterised by periods with diarrhoea, mixed with pus, blood, and mucus, which alternate with periods of few or no symptoms.
• When the Colitis is active, the patient often has mild stomach pains, and sometimes a fever.

The symptoms vary according to the extent of the disease. A quarter of patients only have the disease in the rectum, which means that the symptoms are fairly mild. In one third of patients, the disease also affects the lower part of the large intestine. In the remaining patients, Ulcerative Colitis affects all of the large intestine.

HOW IS ULCERATIVE COLITIS DIAGNOSED?

• Stool specimens are collected for cultivation and microscopy to exclude infection caused by bacteria and parasites.
• The diagnosis is confirmed by means of an endoscopy in the large intestine and the rectum. Small tissue samples from the mucosa are usually obtained during the procedure, which can in many cases confirm the diagnosis.
• An endoscopic examination of the entire intestine (colonoscopy), or a barium enema X-ray examination can help determine the extent of the disease.
• Blood samples can help determine the severity of the inflammation, and show whether the patient suffers from anaemia (low haemoglobin count).
  

WHAT ARE THE POSSIBLE COMPLICATIONS?

• In rare cases, life-threatening bleeding, perforation of the intestine, and inflammation of the abdominal cavity may occur.
• Malnutrition.
• Inflammation of joints, eyes, and skin.
• The risk of colon cancer and rectal cancer begins to rise after 10 years of Ulcerative Colitis.

HOW IS ULCARATIVE COLITIS TREATED?

• When the disease is active, it is often treated with tablets. When the disease is in remission, the treatment often continues in order to suppress the inflammation.
• Medical treatment is usually sufficient.
• If the disease cannot be controlled by medical treatment, it can be cured by surgical removal of the large intestine.
• Severe cases may require hospitalisation.

SURGERY

Unfortunately, not everyone with UC has their symptoms well controlled with medication. About 3 in 10 people with UC need surgery at some stage. The most common operation is to remove the large intestine. There are different techniques used for this. Removing the large intestine will usually cure symptoms of UC permanently.

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