Ulcerative Colitis is a condition characterized by chronic inflammation of the large intestine (colon), resulting in ulceration of its lining, with the sores producing pus and mucus. These ulcerations cause abdominal discomfort and other bothersome symptoms similar to other conditions grouped under Irritable Bowel Diseases, such as Crohn’s disease. It may also be mistaken for Irritable Bowel Syndrome, a disorder that is not characterized by inflammation.
Ulcerative colitis results from an abnormal inflammatory response by the immune system, which affects the colon. While the immune system normally protects the body from infection by producing certain proteins that bind to harmful microorganisms, in people with ulcerative colitis, the immune system mistakenly overreacts to food and harmless bacteria in the intestine, causing ulceration and chronic inflammation.
It is estimated that abound 700,000 Americans suffer from ulcerative colitis. Men and women are equally affected, with most people being diagnosed with the disease in their 30s.
It is not clear what causes ulcerative colitis, but the disease tends to run in families. Many patients have a close relative diagnosed with the disease. It is also more common among people of European and Jewish origins. Diet and environmental factors may also play a role in stimulating the body’s reaction in producing uncontrolled inflammation.
Signs and Symptoms
Many patients experience mild symptoms, but some experience more bothersome symptoms such as:
- Blood in the stool
- Chronic diarrhea with abdominal pain
- Crampy abdominal pain
- Delayed growth and development
- Feeling of low energy
- Loose bowel movements that become more urgent
- Loss of appetite
- Weight loss
These symptoms tend to come and go, with flare-ups and remissions in between, which can be months or years apart. It may run an unpredictable course, which can make diagnosis and treatment difficult.
A thorough evaluation of the patient’s medical history, physical examination, and laboratory tests is necessary to make a diagnosis. Initial tests may include blood and stool examinations. Since ulcerative colitis can be very similar to infectious diarrhea, a special procedure such as sigmoidoscopy or total colonoscopy may be required to confirm the diagnosis. These endoscopic exams involve the use of flexible instruments that are inserted into the rectum and colon to allow visualization of inflamed areas of the colon. A biopsy (sampling of intestinal tissue) may be done to confirm the diagnosis using microscopy.
The treatment for ulcerative colitis includes a combination of changes in diet, medications and surgical procedures (if necessary).
Medications for ulcerative colitis aim to suppress inflammation in the colon, reduce symptoms, and allow the tissues to heal. These medications are also used to decrease the frequency of flare ups and maintain remission. These may include:
- Aminosalicylates such as olsalazine, sulfasalazine, mesalamine, and balsalazide, which aim to decrease inflammation during mild-to-moderate episodes and to prevent relapses of the disease.
- Corticosteroids such as budesonide, prednisone, and methylprednisolone, which suppress the immune system and treat moderate to severe episodes.
- Immunomodulators, which modulate or suppress the immune system response and reduce inflammation when aminosalicylates and corticosteroids are not effective in maintaining remission.
- Antibiotics to treat infections.
- Biologic Therapies, for people with moderate-to-severe symptoms, these treatments aim to bind natural proteins that trigger inflammatory processes in the disease.
Up to one-third of patients with ulcerative colitis do not respond adequately to medical therapy and experience complications. Surgery may be considered to remove part of the colon and rectum that are affected.
At American Infusion Centers we use the following drugs for ulcerative colitis: