Introduction

An inflammatory bowel disease (IBD) is known as Ulcerative Colitis, causing inflammation of the digestive system and ulcers (sores). The innermost lining of your large intestine (colon) and rectum is affected by ulcerative colitis.

Colitis ulcerative may cause life-threatening problems and can be weakening. Tackling can reduce indications and symptoms of the condition considerably and provide lasting remission, while it does not have a recognized cure.

Types

Depending upon the location where it is exactly located in the body, the ulcerative colitis has following types:

  • Ulcerative proctitis – it is the mildest form. It’s in the portion that is closest to your anus that is solely in the rectum. The only indication of the illness is rectal bleeding.
  • Proctosigmoiditis – The rectum and sigmoid colon – the bottom end of the colon – include inflammation. Symptoms and signs are bloody diarrhea, stomach cramps, discomfort and failure to bowel movements.
  • Left-sided colitis – Inflammation stretches across the sigmoid and descending colon from the rectum. Abdominal cramps and pain on the left side can be felt in this type of colitis.
  • Pancolitis –This kind typically affects the entire colon and can produce severe, abdominal pains, tiredness and substantial weight loss out siding diarrhea with blood

Diagnosis

The diagnosis typically is dependent on the results of the following tests taken by the medical specialist.

  • Blood tests to look for anemia or inflammation
  • Stool samples to look for parasites in your colon
  • Colonoscopy to examine the whole wide colon
  • Flexible sigmoidoscopy to examine the lower part of the colon. A bendable tube is inserted with a camera on its one end. A small tool is taken to hold the specimen which further is examined under the microscope. This is called as biopsy
  • X-ray
  • Stool tests
  • Magnetic Resonance Imaging (MRI)
  • Computed Tomography (CT) Scan

Causes

When your immune system makes a mistake, ulcerative colitis occurs. White blood cells that often defend your lining, instead, assault your colon. They induce swelling and ulceration

Doctors are not quite sure why the disease occurs. The illness sometimes takes place in families. Your genes may play a part. There may also be other things in the environment around you.

Risk factors may include:

  • Age – most likely between the age group of 15-30 or above 60 years
  • Ethnicity or race –usually white people are at a higher risk but it can affect people of any race
  • Family history –you are at 30% risk of developing the disease if you have any close family member with the same condition

Signs and Symptoms

Ulcerative colitis symptoms and signs can vary depending upon the severity of the disease. Some may include:

  • Persistent Diarrhea (bloody or filled with pus)
  • Cramping
  • Abdominal pain
  • Rectal bleeding –passing small amount of blood with stool
  • Fatigue
  • High grade fever
  • Urgency to defecate
  • Unable to defecate despite urgency
  • Rectal pain
  • Weight loss
  • Stunted growth in children
  • Strain in eyes (painful)
  • Anemia
  • Skin sores
  • Sleepless nights
  • Canker sores
  • Joint pain
  • Muscle soreness
  • Dehydration
  • Feeling of fullness in colon even after defecation
  • Loss of fluids and nutrients

Most people have mild to severe symptoms of ulcerative colitis (UC). The course of UC might vary; some individuals have extended remission periods. It is an unpredictable disease and it may not be possible for doctors to assess whether or not your medication is beneficial due to the duration of the remission between flares.

Treatment

Ulcerative colitis cannot be cured, however therapies can reduce inflammation, make you feel better and bring you back to your everyday activities. Therapy also relies on the individual’s severity, thus the therapy varies on the demands of each person. The aim of the drug is to induce and sustain remission and enhance the quality of life of ulcerative colitis sufferers. Health professionals employ a number of medicines in the large intestines to reduce inflammation. The tissue can be healed by decreasing swelling and inflammation. It can help ease your symptoms and reduce discomfort and diarrhea. Following medications are recommended:

Anti-inflammatory drugs

  • Aminosalicylates: Your physician may prescribe sulfasalazine (Azulfidine®) for mild to moderate ulcerative colitis. A non-sulfonated aminosalicylate such as mesalamine (Canasa®, Delzicol®, Asacol® etc.
  • Corticosteroids: You may require a corticosteroid such as dexamethasone, Deltasone® or budesonide, Entocort® EC, Uceris® if you have a severe type of ulcerative colitis.

Immunosuppressant drugs

  • Azathioprine and mercaptopurine

These immunosuppressants are the most commonly utilised for the treatment of inflammatory bowel conditions. If you take these, you must monitor your doctor constantly and get your blood examined periodically for adverse effects, including liver and pancreatic problems.

  • Cyclosphorin

Usually this medicine is reserved for patients who have not been adequately informed about other drugs. Cyclosporine is potentially dangerous and unsuitable for long-term usage.

  • Tophacitini

It is considered a “small molecule” and functions by halting the inflammatory process.

Biologics

This therapy class focuses on immune system proteins. Biological types of colitis treatment include:

  • Infliximab, golimumab These medications are called TNFs that are working to neutralise the protein that your immune system produces. These drugs, or biologics, are called TNFs. It is for patients with severe ulcerative colitis who cannot react to conventional therapies or tolerate them.
  • Vedolizumab – It acts by preventing inflammatory cells from reaching the location.
  • Stelara is a medication that works by blocking a different protein that causes inflammation.

 

Surgery

Operation can remove ulcerative colitis and remove the whole colon and rectum (proctocolectomy). In the majority of instances, this necessitates an operation termed ileoanal anastomosis (J-pouch).

Other medications may include anti-diarrheal medicines like loperamide. They may increase the risk of an enlarged colon so must be taken with care and supervision of the concerned doctor. Some pain relievers such as Tylenol but not ibuprofen or diclofenic sodium because they may worsen the situation and increase the disease severity

Iron supplements must be taken in case of anemia.

 

Reference

[i] https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/diagnosis-treatment/drc-20353331

[ii] https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/what-is-ulcerative-colitis