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Gastroenterology & Hepatology

Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) that occurs as a result of long-term inflammation of the rectum and colon. IBD is a collective term used to describe several digestive tracts (GI) disorders.

Symptoms of Ulcerative Colitis

People who have been diagnosed with UC may occasionally have minor symptoms or none at all. However, the symptoms could return. This is referred to as a flare-up.

Common symptoms of UC include:

  • Fever
  • Bloody stool
  • Abdominal pain
  • Diarrhea
  • Rectal pain
  • Weight loss
  • Mouth sores
  • Nausea
  • Joint pain
  • Joint swelling

Causes of Ulcerative Colitis

Ulcerative colitis can occur as a result of an overactive immune system. However, it is not known why certain immune systems attack the large intestine in response, while others do not.

The following are some of the factors that play a role in who develops ulcerative colitis:

  • Genetics: An individual may inherit a gene from a parent that increases the chances of developing ulcerative colitis.
  • Environmental factors: An individual’s immune system may be activated or triggered by bacteria, viruses, and antigens.
  • Other immune disorders: Chances of developing a second immune disorder are high if the patient already has one type.

When to See a Doctor

After being diagnosed with ulcerative colitis, one should see a doctor if he/she begins to experience symptoms such as:

  • Severe rectal bleeding
  • High fever
  • Swelling of areas around the skin or joints
  • Severe abdominal pain
  • Dehydration
  • Persistent diarrhea

Diagnosis of Ulcerative Colitis

The following are tests used in the diagnosis for UC:

  • Blood tests: During a full blood count, anemia is looked for (a low red cell count). Other tests, such as high levels of C-reactive protein and a high sedimentation rate, also point to inflammation.
  • Stool test: The doctor will examine the patient’s stool for certain inflammatory markers, blood, bacteria, and parasites.
  • CT scan: This is a specialized X-ray performed on the patient’s abdomen and pelvis.
  • Endoscopy: The doctor will use a flexible tube to examine the patient’s stomach, esophagus, and small intestine.
  • Biopsy: The procedure involves removing a sample tissue from the colon for analysis.
  • Colonoscopy: A colonoscopy is a procedure where a doctor looks into the colon by inserting a lighted scope called a colonoscope into the patient’s rectum.

Treatment of Ulcerative Colitis

The main objective for treating ulcerative colitis is to relieve symptoms during a flare-up and prevent symptoms from recurring (maintaining remission). In most individuals, this is achieved by taking medicines such as:

  • Corticosteroids (steroid medicines)
  • Aminosalicylates (ASAs)
  • Immunosuppressants

Usually, mild to severe flare-ups are manageable at home. However, more serious flare-ups require a visit to the hospital.

Surgery may be necessary if medicines are not effective at controlling one’s symptoms or if the quality of life is significantly affected by the condition. Surgery may involve the removal of some or all of the patient’s bowel (colon).

During surgery, the small intestine may be forced through an abdominal incision called a stoma. This type of surgical procedure is known as an ileostomy. The stoma can be temporary in some situations and can be closed after the gut has recovered.

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