Ulcerative Colitis: The Complete Guide on Symptoms, Treatment, and Prevention

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This is an inflammatory bowel disease that affects the lining of the large intestine (colon) and rectum. It is a chronic condition that can cause significant discomfort and impact the quality of life of patients.

This comprehensive guide on ulcerative colitis will clarify common questions, as well as provide essential information about the symptoms, treatment, and prevention of this disease.

What is ulcerative colitis?

It is a chronic inflammatory disease that affects the large intestine, including the colon and rectum. The inflammation causes the development of ulcers in the intestinal mucosa, causing symptoms such as diarrhea, abdominal pain, and rectal bleeding.

It is an autoimmune condition, which means that the body’s immune system mistakenly attacks healthy tissue in the intestine.

Although the exact cause of the disease is not fully understood, it is believed that a combination of genetic, environmental, and immunological factors is involved.

This disease is part of a larger group of conditions called inflammatory bowel diseases (IBD), which also includes Crohn’s disease. Unlike Crohn’s disease, which can affect any part of the gastrointestinal tract, colitis is limited to the colon and rectum.

The inflammation usually begins in the rectum and spreads continuously through the colon. The disease can range from mild to severe and, in some cases, can be debilitating.

Symptoms of ulcerative colitis

Symptoms can range from mild to severe and may develop gradually or suddenly. The main symptoms are:

Chronic diarrhea: often accompanied by blood or pus.

Abdominal pain: usually in the lower abdomen.

Fecal urgency: intense sensation of the need to evacuate.

Weight loss: due to poor nutrient absorption and reduced appetite.

Fatigue: caused by chronic inflammation and blood loss.

Fever: in cases of severe inflammation.

Anemia: resulting from continuous blood loss in the stool.

Tenesmus: sensation of incomplete evacuation.

Nausea and vomiting: in more severe cases or when inflammation is intense.

Risk factors for ulcerative colitis

Various factors can increase the risk of developing the condition, and understanding these factors is essential for prevention and proper management of the disease. Genetics plays a significant role.

Having a close relative with the disease, such as a parent or sibling, substantially increases the risk of developing ulcerative colitis.

Studies show that genetic predisposition is one of the main determinants, although the disease is not directly inherited in a simple manner.

Age is also an important factor.

The condition is usually diagnosed in people under 30 years of age, although it can occur at any age. Adolescents and young adults are most often affected, indicating that youth is a critical period for the development of the disease.

However, it is not uncommon to see cases arising in older individuals, particularly those between 50 and 60 years old.

Ethnicity is another factor that influences risk. People of Ashkenazi Jewish descent have a higher likelihood of developing colitis.

The prevalence among this group is notably higher than in the general population, suggesting a particular genetic predisposition.

A history of intestinal infection can also trigger the disease in predisposed individuals.

Some bacterial and viral infections of the gastrointestinal tract are known to disrupt the microbial balance of the intestine, which can initiate or exacerbate the inflammatory response in genetically susceptible people.

The environment in which a person lives and lifestyle-associated factors have a significant impact.

Environmental factors, such as a Westernized diet rich in saturated fats, refined sugars, and processed foods, may contribute to increased risk.

Urbanization and exposure to environmental pollutants are also considered factors.

Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is another risk factor.

Medications such as ibuprofen and naproxen, when used frequently, can increase the likelihood of developing the condition.

These medications can irritate the lining of the intestine and trigger inflammation.

Although stress does not directly cause colitis, it can worsen symptoms in people who already have the disease.

Emotional and psychological stress can trigger flare-ups and exacerbate existing symptoms.

Therefore, it is important for individuals with this condition to practice effective stress management techniques, such as meditation, regular physical exercise, and psychological therapy.

In summary, this disease is influenced by a complex combination of genetic, environmental, and lifestyle factors.

Knowing these risk factors can help in early diagnosis and the development of effective prevention strategies.

Attention to these aspects can make a significant difference in the lives of those living with the condition, allowing for more effective management of the condition and a better quality of life.

Diagnosis of ulcerative colitis

The diagnosis is made through a combination of clinical, laboratory, and imaging tests.

Initially, the doctor performs an evaluation of symptoms, family history, and a complete physical examination. Blood tests are often requested to detect anemia or signs of inflammation, indicating the presence of the disease.

Stool tests are important to rule out other causes of diarrhea and identify the presence of blood or infection.

A colonoscopy is one of the main diagnostic methods, allowing to visualize the inside of the colon and obtain tissue samples for biopsy, essential to confirm the diagnosis and assess the extent of inflammation.

In some cases, a sigmoidoscopy, which is similar to a colonoscopy, but examines only the rectum and lower part of the colon, may be used, especially when inflammation is suspected to be limited to these areas.

Imaging tests, such as computed tomography (CT) or magnetic resonance imaging (MRI), are also used to assess the extent of inflammation and rule out other conditions.

Serological tests can help distinguish between colitis and other inflammatory bowel diseases.

During a colonoscopy, the doctor can collect small tissue samples (biopsies) for laboratory analysis, which helps to confirm the diagnosis and assess the extent of inflammation.

A sigmoidoscopy, being less invasive than a complete colonoscopy, may be preferred in cases where inflammation is suspected to be limited to the rectum and lower part of the colon.

Treatments for ulcerative colitis

The treatment aims to reduce inflammation, control symptoms, and prolong periods of remission.

Treatment options include anti-inflammatory medications, such as aminosalicylates (e.g., mesalamine) and corticosteroids (e.g., prednisone), which are often the first line of treatment and can help reduce inflammation and relieve symptoms.

Immunosuppressants, such as azathioprine and cyclosporine, are used to reduce the activity of the immune system and prevent attacks against the body.

Biologic medications, such as infliximab and adalimumab, target specific proteins involved in inflammation and are used in moderate to severe cases.

Antibiotics may be prescribed to treat or prevent secondary infections that can occur in people with the condition.

Adapting the diet to avoid foods that irritate the intestine, such as fatty, spicy, and high insoluble fiber foods, can help control symptoms.

Nutritional supplements are often necessary to correct nutrient deficiencies such as iron, calcium, and vitamin D.

Proctocolectomy, which involves the removal of the colon and rectum, can be curative but requires the creation of an ileal pouch or the use of a stoma.

Living with ulcerative colitis can be challenging, but with an effective treatment plan and a supportive medical team, it is possible to live a full and active life.

Being informed about the disease, adhering to the prescribed treatment, and making lifestyle adjustments are crucial steps for successful management of ulcerative colitis.

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