What is it?
Ulcerative means that ulcers form, while colitis means inflammation of the colon. Ulcerative colitis therefore, is an autoimmune disease in which there is chronic inflammation of the colon, otherwise known as the large intestine, where there is ulceration of the lining of the colon. It is one of the two inflammatory bowel diseases (IBD), the other being Crohn’s disease.
Who gets it?
IBD affects millions of people from all over the world, with men and women both being affected equally. It is more common in The US, northern Europe, as well as England. It can occur in childhood and later life, but mostly manifests during the adolescent years.
Causes
Ulcerative colitis is one of those diseases where the exact cause is not known. What is known is that the immune system is abnormally activated. In people without the disease the immune system only kicks in when there is a foreign organism present, but in this condition the immune system is activated regardless of whether organisms are present or not. This persistent activation results in inflammation, and eventually in ulceration.
Symptoms
The most common symptoms are diarrhea, abdominal pain and cramping, as well as intermittent rectal bleeding. Other symptoms will be related to which part of the colon is affected. If the rectum is affected (proctitis) you may get a feeling that you have the need to defecate after just having defecated (tenesmus), or that you have to rush to get to the bathroom because you cant keep it in (urgency). If it involves the rectum and sigmoid colon (proctosigmoiditis) then in addition to tenesmus and urgency you will have bloody diarrhea and abdominal cramps.
If it involves the entire colon (pancolitis) then you may experience additional symptoms of weight loss, fever, fatigue, as well as night sweats. In some cases the pancolitis may be severe and become fulminant. Such people will become very ill and may suffer from severe diarrhea, very bad abdominal cramping, dehydration and shock.
Diagnosis
The symptoms will lead a doctor to suspect the disease. Then there are a number of investigations that can be done to confirm this suspicion. A stool sample is taken to exclude that the symptoms are due to an infection. Blood tests may show anemia as a result of the blood loss. A high white cell count and erythrocyte sedimentation rate are indications of an inflammatory process. A colonoscopy can be done to view the colon.
Treatment
People with the condition have periods of worsening inflammation and then periods of remission when the symptoms subside. The two main types of treatment for ulcerative colitis are medication and surgery. While medication cannot cure the condition it helps to relieve symptoms so that you will be able to have a better quality of life. This includes anti-inflammatories like corticosteroids, and immune modulators, both of which aim to decrease the amount of inflammation.
Surgery for the condition is only indicated for those who have severe symptoms or who have had severe complications as a result of the condition.
