The large intestine is part of the GI tract.
What is Ulcerative Colitis?
Ulcerative Colitis refers to a chronic, long-lasting & life-threatening disease causing inflammation, irritation or swelling, and sores called ulcers on the inner lining of the large intestine. It is also called inflammatory bowel disease (IBD). Ulcerative colitis may occur to anyone and anytime, from mild to severe and may become worse over the period of time. Symptoms may disappear sometime or may last for weeks or years. People suffering from Ulcerative Colitis should consult to the gastroenterologist or the one who specializes in digestive diseases.
Causes of Ulcerative Colitis?
Although the exact causes are unknown some of the reasons are mentioned below as per the researchers;-
- An Abnormal or Overactive Intestinal Immune system or Reaction in the intestine
- Certain abnormal genes may appear and drive to family members causing Ulcerative colitis as per the research.
- Some studies say Environment may increase the chance of a person getting Ulcerative colitis, although the overall chance is low.
- Nonsteroidal anti-inflammatory drugs, antibiotics, and oral contraceptives
- A high-fat diet or certain foods
- Stress, or emotional distress
Any age group can be affected with the Ulcerative colitis.
Signs & Symptoms of Ulcerative colitis
The Exact symptoms are:-
- Diarrhea with blood
- Diarrhea with pus
- Abdominal pain or discomfort
Diagnosis of Ulcerative colitis
Following proven techniques are used by the healthcare professional to diagnose the actual cause of Ulcerative colitis:-
- Medical and Family History
- Physical Exam
- Blood tests
- Stool Tests
- Endoscopies of the Large Intestine
- Flexible sigmoidoscopy
Treatments for Ulcerative Colitis:-
Depending upon the symptoms of the colon or in case of mild pain, Ulcerative colitis can be treated with the help of certain medicines as mentioned below:-
- Aminosalicylates:- It contains 5-aminosalicylic acid (5-ASA), which helps control inflammation. It is given to treat people with mild symptoms. Aminosalicylates can be prescribed as combined therapy of an oral medication or a topical medication (rectal)—by enema or suppository with extensive Ulcerative colitis.
- Corticosteroids:- It is also called steroids which helps reducing immune system activity, decrease inflammation and executive remission. Although it is not useful for long-term remission
- Immunomodulators:- It helps reducing immune system activities, & inflammation in the colon. The effective results can be seen within several weeks to 3 months.
- Biologics:- It includes adalimumab, golimumab, infliximab, and vedolizumab targeting a protein made by the immune system called tumor necrosis factor (TNF). It helps to decrease inflammation in the large intestine by neutralizing TNF. Anti-TNF therapies work quickly to bring on remission, especially in people who do not respond to other medications. Infliximab and vedolizumab are given through an IV; adalimumab and golimumab are given by injection.
If medicines are not effective and the stage is more than the mild pain or abdominal discomfort, it is prescribed to perform surgery to remove patients colon or rectum to treat the Ulcerative colitis:-
Proctocolectomy and Ileostomy
Proctocolectomy is an extensive surgery which is done to remove patient's entire colon and rectum. An ileostomy is a stoma or opening in the abdomen that a surgeon creates from a part of the ileum—the last section of the small intestine. The surgeon brings the end of the ileum through an opening in the patient's abdomen and attaches it to the skin, creating an opening outside of the patient's body. The stoma most often is located in the lower part of the patient's abdomen, just below the belt-line.
A removable external collection pouch (ostomy pouch or ostomy appliance) is attached with the stoma and collects intestinal contents outside the patient's body. Intestinal contents pass through the stoma instead of the anus. The stoma has no muscle, so it cannot control the flow of intestinal contents, and the flow occurs whenever peristalsis occurs. Peristalsis is the movement of the organ walls that propels food and liquid through the GI tract. People who have this type of surgery will have the ileostomy for the rest of their lives.
Proctocolectomy and Ileoanal Reservoir
An Ileoanal Reservoir is an internal pouch made from the patient's ileum. It is a common alternative to an ileostomy and does not have a permanent stoma. The ileoanal reservoir is called a J-pouch, a pelvic pouch, or an ileoanal pouch anastomosis. The ileoanal Reservoir connects the ileum to the anus. The surgeon preserves the outer muscles of the patient's rectum during the proctocolectomy. Next, the surgeon creates the ileal pouch and attaches it to the end of the rectum. Waste is stored in the pouch and passes through the anus.
Effects of the Proctocolectomy and Ileoanal Reservoir surgery:-
- Bowel movements may be water and more frequent
- People may have fecal incontinence- an accidental passing of stools or mucus from the rectum.
- Women may get infertile after the surgery
- Pouchitis may get developed which causes irritation and inflammation of the lining of the ileoanal reservoir. Medications and antibiotics are given to treat pouchitis
- If pouchitis become chronic, a surgeon may recommend longterm medication and operation based on the symptoms, severity of disease, age, lifestyle etc.
Note:- Full recovery from both operations may take 4 to 6 weeks.
People having problems with Ulcerative colitis or trouble in the large intestine are required to consult the surgeon immediately to have prompt results.