A B C D E F G H I J K L M N O P R S T U V W

ULCERATIVE COLITIS

What is Ulcerative Colitis ?

The colon is the lower part of the digestive system. In the colon the stools become more solid because water is removed from them through the wall of the bowel. In ulcerative colitis the colon becomes inflamed. Diarrhoea, often with mucus and blood mixed with the stool is the main symptom. The diarrhoea may be frequent and occur day and night. There is often urgency to pass a stool and sometimes difficulty in controlling the motions and incontinence can occur. Once your stool is passed there may be a feeling of not having completely emptied the bowel. If the inflammation is in the rectum only, then urgency, incomplete emptying and blood occur without diarrhoea. Some abdominal pain relating to a bowel action is common, but severe pain is not. In more serious cases, fever, dehydration and abdominal pain are always present. If not properly treated, it can be a serious disorder.

How does Ulcerative Colitis occur ?

The cause is unknown but the bowel inflammation is not due to infection. The inflammation stops water from being absorbed out of the stools, so that they remain very liquid. The lining of the colon becomes ulcerated, causing the mucus and the blood. Irritation of the bowel by all these factors then causes the pain and diarrhoea.

Why does Ulcerative Colitis occur ?

Women are affected more often then men. It may occur at any age, but young adulthood is the most common age for the condition to start. There is an increased rate in some families. It is not known if this is truly heredity or something to do with the environment.

Treatment Involved for Ulcerative Colitis

Once the diagnosis is suggested, the doctor will arrange for you to have a test called a sigmoidoscopy. A narrow tube is passed through the anus to inspect the lining of the colon. Sometimes a small sample of tissue (biopsy) is taken to be examined under the microscope. Further teats such as colonoscopy in which a longer flexible telescope is used to examine the colon may then be required. Alternatively, a barium enema in which special dye is inserted into the colon and can be visualised on X-ray may be used.. Treatment depends on the site and the severity of the inflammation. If the inflammation is confined to the rectum or lower end of the colon then local treatments are preferred. Often cortisone in liquid or foam preparations is used to suppress the inflammation. Tablets are also given which help to maintain the benefits of the initial treatment. Mild to moderate ulcerative colitis does not usually require admission to hospital. More extensive or more severe attacks of colitis are treated with cortisone tablets. If the attack is severe or doesn’t respond to treatment then admission to hospital is required in order that additional treatment can be provided. If the disease progresses, an operation to remove the whole colon may occasionally be needed.

During Treatment for Ulcerative Colitis

Mild to moderate colitis improves after about 6 - 8 weeks of treatment. Severe colitis takes rather longer. Steroid (prednisolone) tablets can cause fluid swelling, weight gain, high blood pressure, and diabetes. There is also an increased risk of infection. After months of treatment, they cannot be suddenly stopped: the body's own cortisone supply may have been affected and needs time to recover. Mesalazine, which is also used and provides long term treatment to reduce the frequency of episodes of colitis may cause rashes, nausea and occasionally anaemia. Let the doctor know if these occur. During treatment there will be regular check-ups and possibly further examinations of the colon to ensure that the colitis is responding to treatment and that there are no side-effects. Sudden worsening of diarrhoea, fever, bloating of the abdomen, and vomiting are signs that you must notify the doctor immediately.

After Treatment for Ulcerative Colitis

Ulcerative colitis produces symptoms which come and go, even when treated. An operation to remove all or part of the colon may be needed for patients with uncontrollable symptoms which do not respond to treatment, and for children who fail to grow. Sometimes the bowel can be rejoined. If the entire colon is removed either an artificial opening of the bowel [ileostomy] or an artificial rectum can be made from the end of the small bowel [ileo-anal pouch]. Complications from colitis may occur in different parts of the body after months or years. These include skin rashes, arthritis, mouth ulcers, liver inflammation and eye disorders. They are not common. The most important long-term complication is cancer of the colon. This is more likely to occur if you have had total colitis for more than 10 years. For this reason, if your inflammation involves the entire colon, you will probably be offered a colonoscopy every year once you have the condition for 10 years or more.

If Ulcerative Colitis is left untreated

An untreated severe attack may cause death due to dehydration and bursting of the colon (peritonitis). Untreated mild attacks of colitis impair performance and the quality of life for the affected individual.

Effects on family of Ulcerative Colitis

The condition causes quite a lot of distress to relatives as well as to you. They will also need to be supportive during flare-ups of the disorder.