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Medica Superspecialty Hospital

Stomach Pain? Could be Ulcerative Colitis

Ulcerative colitis is a chronic disease that causes inflammation/irritation and sores called ulcers on the inner lining of the large intestine or the colon. Here the lining of the colon becomes inflamed and develops tiny open sores, or ulcers, that produce pus and mucous. Usually the cells and proteins that make up the immune system protect one from infection. In people with inflammatory bowel diseases, however, the immune system mistakes food, bacteria, and other materials in the intestine for foreign or invading substances. During such situations the body sends white blood cells to the lining of the intestines, where they produce chronic inflammation and ulcerations. Temporary inflammation is caused by the immune system to combat an illness or infection, and then the it is reduced but in people with ulcerative colitis, however, this inflammation can persist long after your immune system finishes its job.

Thus, Ulcerative colitis is a chronic inflammatory disease of the gastrointestinal (GI) tract, and is also called inflammatory bowel disease (IBD).

Causes of Ulcerative colitis

The exact cause of ulcerative colitis remains unknown. Diet and stress were previously suspected for it, but now doctors know that these factors may aggravate but don’t cause ulcerative colitis. One possible cause for it could be an immune system malfunction. When your immune system tries to fight off an invading virus or bacterium, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.

What are the risk factors of Ulcerative colitis?

The exact cause of ulcerative colitis is unknown. The following factors may play a role in causing ulcerative colitis among people:

  • Ulcerative colitis may begin before the age of 30. It can occur at any age, and may even occur in people at the age of 60.
  • Race or ethnicity. It can occur in any race but Jewish descent people, have a higher risk
  • Family history. One is at a higher risk if you have a close relative, such as a parent, sibling or child, with the disease

Symptoms

Ulcerative colitis symptoms may be different for different people and may also depend on the severity of inflammation and where it occurs. Signs and symptoms may include:

  • Diarrhoea, accompanied by blood or pus
  • Abdominal pain and cramping
  • Rectal pain & bleeding
  • Urgency to defecate
  • Inability to defecate despite urgency
  • Weight loss & Fatigue
  • Fever
  • failure to grow in children
  • Anaemia

Diagnosis of the disease

In order to confirm a diagnosis of ulcerative colitis, you may have to undergo one or more of the following tests and procedures:

  • Blood tests. Blood tests may be done to check for anaemia, a condition in which there aren’t enough red blood cells to carry adequate oxygen to your tissues or to check for signs of infection.
  • Stool sample. The presence of white blood cells in the stool can indicate ulcerative colitis. A stool sample can also help rule out other disorders caused by bacteria, viruses and other infections.
  • Colonoscopy. Here the doctor views your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, small samples of tissue (biopsy) can be taken for laboratory analysis which may help to confirm a diagnosis.
  • Flexible sigmoidoscopy. A slender, flexible, lighted tube is used to examine the rectum and sigmoid, the last portion of your colon. For a severely inflamed colon, this test may be performed instead of a full colonoscopy.
  • X-ray. In severe cases X-ray of your abdominal area is done to rule out serious complications, such as a perforated colon.
  • CT scan. A CT scan of your abdomen or pelvis may be performed to reveal how much of the colon is inflamed.

 CT enterography and MR enterography. These noninvasive tests may be prescribed to exclude any inflammation in the small intestine and are better than the conventional imaging tests. MR enterography is a radiation-free alternative

Treatment

Ulcerative colitis can be treated in different ways depending upon the severity of the situation.

  • Anti-inflammatory drugs are often the first step in the treatment of ulcerative colitis
  • Immune system suppressors reduce inflammation, and suppress the immune system’s response that starts the process of inflammation
  • Other Medication like antibiotics, pain relievers and iron supplements can be used effectively
  • Surgery can often eliminate ulcerative colitis. But that usually means removing your entire colon and rectum (proctocolectomy).Your surgeon may create a pouch from the end of your small intestine. The pouch is then attached directly to your anus, allowing you to expel waste relatively normally. In some cases a pouch is not possible and surgeons create a permanent opening in your abdomen (ileal stoma) through which stool is passed for collection in an attached bag
  • Since for such patients the risk of Colon Cancer increases, it is essential to be on constant follow up
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