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Ulcerative colitis is a type of Inflammatory Bowel Disease (IBD) that affects the colon or large intestine. We look at how the condition can be treated
The lining of these becomes inflamed and ulcers can develop. It can affect different lengths of the colon and it tends to present with bloody diarrhoea. There are a lot of treatment options, and whilst they will not cure ulcerative colitis, they can help to control it and prevent the symptoms from happening altogether.
In the less severe cases, the patients may either have the disease on the left side of the colon, which is the bottom third of the colon, or just in the back passage. They may have fewer symptoms or their symptoms will be slightly different in that they may not always have diarrhoea but they may have blood and urgency. Urgency is a big problem in inflammatory bowel disease.
Nobody knows what causes ulcerative colitis, but it is thought to be the result of a problem with the immune system.
Some research has suggested that the immune systems of people with the condition mistakes “friendly bacteria” in the colon, intended to help the digestion process, as a harmful infection leading to the colon and rectum becoming inflamed.
An alternative theory held by some doctors is that a viral or bacterial infection triggers the immune system, but for an unknown reason it doesn't “turn off" once the infection has passed and the inflammation continues.
Some health professionals subscribe yet to another theory which suggests no infection takes place and the immune system may simply malfunction by itself, or that there is a lack of balance between bad and good bacteria in the bowel.
Research has suggested that inherited genes may be a factor in developing ulcerative colitis, with studies finding that at least one in four people with the disease having a family history of the condition.
The patient may not need anything other than these treatments, or they may need oral gut-specific anti-inflammatories like mesalazine in order to bring it under control. If the condition has got rather more extensive but not yet total colitis, then the patient will definitely need drugs like mesalazine and may need a short course of steroids to bring it under control.
If it is total colitis and the patient is noticeably unwell, they may need to be admitted to hospital as an emergency to have intravenous steroids. That is rare but it can happen. If the patient is not as ill as needing urgent hospital treatment, then they may need prednisolone, and subsequently mesalazine and drugs like azathioprine in the long run.
Treatment can also reduce the patient’s cancer risk in the future because there is a slightly increased risk of cancer in both the inflammatory bowel diseases, so by managing the disease through treatment the risk of cancer is thereby reduced.
Steroids are only mainly used in the short-term in order to minimize the side effects, which can also include rarer consequences such as bone thinning, diabetes, and cataracts. Azathioprine is a well-recognized drug and the side effects include a reduction in the white blood cells, which is monitored through regular blood tests and an abnormal liver function test.
Of course, if none of these steroids work, there are newer forms of treatment called biologic therapy which are given to try and turn off the inflammation. However, there is still a minority of people who need emergency surgery if the steroids or biologic therapy does not go as planned.
While stress is not a cause of the condition, it can exacerbate symptoms. Regular exercise can be a good way to tackle stress.
Not only is exercise important for overall health, but it can help relieve some of the symptoms of ulcerative colitis, such as fatigue, and strengthen the bones and muscles. Patients should also avoid certain types of medications like ordinary anti-inflammatories, such as naproxen and indomethacin, which can worsen the condition.
Abdominal pain and bloating can happen in ulcerative colitis as well. There is also the difficulty about having a chronic disorder, in other words one that there is not a cure for.
atients are usually young and feel very aggrieved about having something that is going to significantly affect their life. They may find it useful to join a local IBD group for support. There are around 50 Crohn’s and Colitis UK Groups located across the UK.
This is a very big operation and is usually always kept for either people whose lives are in danger from their colitis, which rarely happens, or those who have symptoms that are interfering so much with their lives and conventional therapies are not going to help.