What is Ulcerative colitis?
Ulcerative colitis is a long term condition associated with inflammation of the colon ( large intestine or bowel ) and rectum ( end of the colon). Ulcerative colitis is abbreviated as UC and supposed to be the type of Inflammatory bowel disease ( Ibd) that comprises a set of diseases that affects the GI tract.
Ulcerative colitis is associated with inflammation of the colon and rectum that produces tiny sores like ulcers on the mucosal lining of the entire colon. This inflammation usually initiates in the rectum that gradually moves upwards and affects the colon. This inflammation results in the upward movement of bowel contents and empties frequently. This upward movement of bowel contents results in damages of the cell on the lining of the bowel resulting in the formation of sores or ulcers that are further associated with mucus, pus, and bleeding.
What is the pathophysiology of ulcerative colitis?
Pathophysiology of ulcerative colitis involves the elevated strength of colonic sulfate-reducing bacteria that leads to a higher concentration of hydrogen sulfide gas. This toxic gas results in the formation of sores and inflammation in the colon and rectum. Studies also reveal that hydrogen sulfide causes impairment in the beta-oxidation pathway that serves to provide nutrients to the colonic epithelial barrier. The colonic epithelial barrier helps to maintain the human colonic mucosa along with immune cells in lamina proportions. This Hydrogen sulfide disturbs the colonic epithelial barrier and leads towards UC.
Causes of ulcerative colitis:
Although the pathophysiology of ulcerative colitis reveals the pathological condition behind this disease but several other factors are also responsible for its occurrence. Overactivation of the immune system may contribute towards the existence of UC but researchers are still unable to explain why only the intestine and colon gets damaged by overstimulation of the immune system and not other body organs. So the following factors may become the cause of ulcerative colitis
- Genetic disorder
- Environmental factors
- Immune disorders
Symptoms of ulcerative colitis:
Sig and symptoms of ulcerative colitis collective involved the Gastrointestinal tack as well as the extent of environment and severity of the disease. People diagnosed with ulcerative colitis may show no symptoms at all or mild symptoms. This condition is called remission while the severe or troubling symptoms are known as flareup or relapses. The most common symptoms of ulcerative colitis are as follows
- Bloody stools
- Abdominal pain
- Mouth sores
- Joint pain
- Joint swelling
- Decreased appetite
Some additional symptoms include
- Shortness of breath
- Eye inflammation
- Skin problems
- More bowel movements
Diagnosis of ulcerative colitis:
Multiple diagnostic tests will be run by doctors to confirm this disease. As ulcerative colitis resembles Crohns disease therefore it is mandatory to confirm its occurrence. The following diagnostic procedures are used:
Tool test: Examination of the stool helps the doctor to determine blood, bacteria, parasites, and inflammatory markers.
Endoscopy: Endoscopy is performed by using a flexible tube to examine the stomach, esophagus, and small intestine.
Colonoscopy: This diagnostic procedure is performed by inserting a flexible tube in the rectum to examine the inside of the colon.
Biopsy: In a biopsy, a sample of tissue from the colon is being removed for analysis.
CT scan: It involves the specialized X rays ob abdomen and pelvis.
Treatment for ulcerative colitis:
It is mentioned previously that ulcerative colitis is associated with inflammation of the colon and rectum therefore the main objectives of the treatment plan are to reduce inflammation and relief the symptoms to prevent flare-ups and extend the duration of remission. Treatment of ulcerative colitis includes
- Ulcerative colitis medications,
- Ulcerative colitis diet
Ulcerative colitis medications:
The main objective of Ulcerative colitis medications is to relieve inflammation. However ulcerative colitis medications depend upon severity and symptoms. For mild symptoms, the doctor may prescribe the following types of ulcerative colitis medications
- Mesalamine (Asacol and lialda)
- Sulfasalazine (Azulfidine)
- Balsalazide (Colazal)
- Olsalazine (Dipentum)
- 5-aminosalicylates (5-ASA)
Sometimes corticosteroids are prescribed as a part of ulcerative colitis medications but due to severe adverse effects, its use is limited.
In the case of patients with moderate or symptoms, the doctor may prescribe another type of medication known as biologics that is antibodies to reduce inflammation. It includes
In the case, of hyperactivation of the immune system, Immune modulators are used as ulcerative colitis medications like methotrexate. These immunomodulators may suppress the activity of the immune system.
In case of severe conditions like chronic symptoms with heavy blood loss, perforation of the colon, or severe blockage. These problems may be detected by a CT scan or colonoscopy. Surgery for ulcerative colitis involves the complete removal of the colon with the formation of a new pathway for waste. After this surgery, a patient will be able to pass the stool through the rectum. Patients will have more frequent Bowel moments and watery than normal ones.
Ulcerative colitis diet:
Patients living with ulcerative colitis need some modification in their diet. While a patient with severe symptoms of ulcerative colitis must follow a strict diet plant or tips to smoothen the process of digestion and excretion without further damaging the colon. The title of ulcerative colitis is a set of diet recommendations and tips to avoid worsening situation due to food. The ulcerative colitis diet plan includes the following tips
- Minimize the use of fat and eat a low-fat diet
- Use vitamin C as it has a protective effect on the colon
- Increase fiber intake in your diet to ease the passage of stool
- Take your food in small episodes. Eat meal 5 to 6 times rather than 3 main meals in a day
- Drink plenty of water, healthy juices, and increase your overall fluid intake in the diet.
Colitis cancer that is also known as bowel cancer is one of the most serious complications of ulcerative colitis. Patients with ulcerative colitis have a high risk of developing colitis cancer and this risk increase more with a longer duration of disease. Initial symptoms of colitis cancer are too similar to UC like
- Abdominal pain
- Blood in stool
Colitis cancer is diagnosed with thtough colonoscopy. Aminosalicylates are prescribed by doctor or pharmacist to reduce the risk of colitis cancer however in order to decrease the risk of colitis cancer following tips should be considered
- Take a balanced diet
- Maintain a healthy weight
- Do exercise regularly
- Quit alcohol and smoking
Living with ulcerative colitis:
Offcourse ulcerative colitis is a disease with complications and troublesome for patients with pain and inflammation. Living with ulcerative colitis for the patients needs some modifications in overall lifestyle including diet, proper medications, and some preventive measures to reduce the risk of further complications. Patients living with ulcerative colitis are strictly told by their doctors to follow the mentioned below preventive measures
- Change the diet with a reduced amount of fat and increase the amount of fiber-rich diet
- Relief your stress to reduce the frequency of symptoms of UC
- A low residual diet with dietary supplements helps you to fight against it in a more better way.
- Ulcerative colitis may lead to depression therefore your doctor may suggest you some antidepressants.
- Besides it work on yourself to stay depression-free as much as possible.
- Pregnant women with flareup may have a chance of premature delivery therefore it should be discussed with your health care team
Before you leave:
This article is designed with the objective, to sum up, all the necessary information on one page. However dont try to use any medication without the suggestion of your health care provider, Ulcerative colitis can be managed with medications and its long term cure is still unknown. You can help yourself to reduce the risk of more complications by following preventive measures and tips as it helps to avoid the more troubling situation and also contribute to relief of the symptoms of UC.
A student of Pharm D from University of Karachi. She has keen interest in all the attributes towards pharmacy especially community pharmacy and hospital pharmacy with an objective to make medications sound and safe. She loves to provide information about Pharmaceutical Analysis and Pharmacology in a best way so people with no medical background can understand.