CONDITIONS
ULCERATIVE COLITIS
It is an inflammatory disease that causes long-lasting inflammation and ulcers in the colon (large gut). It affects the innermost lining of the large intestine and the terminal part of the gut (rectum). Symptoms are usually gradual in onset.
Sign and Symptoms
Depending on where it occurs and the severity of inflammation, symptoms of ulcerative colitis can vary from person to person. Some common ones include;
- Abdominal pain and cramping
- Diarrhoea, often with pus or blood
- Rectal pain
- Urgency to defecate
- Rectal bleeding
- Inability to defecate properly despite the urgency
- Fatigue
- Fever
- Weight loss
Causes
The causes are not yet known. Experts think it might be due to the overreacting immune response to normal bacteria in the digestive tract. Some say that other microorganisms (bacteria and viruses) other than the normal flora of the GIT may cause it. There is a strong genetic predisposition as well.
Diagnosis
Ulcerative colitis can be diagnosed after ruling out other possible causes for same signs and symptoms. To help confirm a diagnosis, a doctor may recommend having one or more of the following tests or procedures:
- CBC (complete blood count)
- Colonoscopy
- Stool sample
- Flexible sigmoidoscopy
- X-ray
- Computerised tomography enterography (CTE)
- Magnetic resonance enterography (MRE)
Treatment
Its treatment usually involves either medication or surgery. Drug therapy includes
- Anti-inflammatory drugs
- Corticosteroids
- 5-aminosalicylates
- Immune system suppressors
- Cyclosporine (Gengraf, Neoral, Sandimmune)
- Vedolizumab (Entyvio)
- Azathioprine (Azasan, Imuran)
- Mercaptopurine (Purinethol, Purixan)
- Other medications
- Antibiotics
- Anti-diarrhoea medications
- Iron supplements
- Pain relievers
Surgery
Surgery can be the ultimate curative treatment. It involves removal of the entire colon and rectum (proctocolectomy). Ileal pouch-anal anastomosis is the procedure commonly done in most cases in which a surgeon constructs a pouch from the end of the small intestine. The pouch has a direct connection to the anus, allowing a patient to pass faeces relatively normally.
Making a pouch is not possible in all cases so a surgeon may create a permanent opening in the abdominal wall called ”ileal stoma”, through which stools can be passed and collected in an attached bag.