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Ulcerative Colitis

Ulcerative colitis is a Severe and potentially life-threatening inflammation and subsequent ulceration of the large intestine (colon). Repeated attacks cause thickening and scarring of the colon to the point where it cannot adequately undertake its task of absorbing excess fluid from the faeces. The cause is unknown, bur it is more common in whires than in blacks and orientals, and six times more common in Jews than other Caucasians. The overall incidence in developed countries is about one in every thousand people.

The symptoms are often quite mild at first, but subsequent attacks steadily worsen to cause bloody diarrhoea with severe abdominal cramps and pain. Large amounts of mucus may be present in the diarrhoea, and in severe cases the diarrhoea may occur twenty times a day, consist entirely of blood and mucus, and be severe enough to cause the patient to collapse. Occasionally, periods of apparent constipation can occur between attacks of diarrhoea. Further symptoms include fever, loss of appetite, weight loss and overwhelming tiredness.

Numerous serious complications include abscesses around the anus, a rupture of the colon (urgent surgery necessary), colon cancer, massive over dilation of the large intestine (megacolon), and false connections (fistula) from the gut to the bladder or vagina caused by ulcers breaking through to these adjacent organs. Inflammation in the colon may be associated with inflammation in other parts of the body, including the skin, joints, eye, mouth and liver.

The diagnosis is confirmed by a barium meal x-ray or colonoscopy (a tube is passed through the anus into the colon to allow it to be examined).

The disease passes through phases of active disease and remission) and treatment is aimed at treating the active disease when it occurs and preventing an attack from developing. Severe attacks require admission to hospital for drips into a vein, antibiotics, and steroids. Milder attacks may be treated by steroid tablets or suppositories (given through the anus). Prevention and the treatment of mild attacks require a specific diet that is high in protein but excludes dairy products, and the regular use of sulfasalazine, which reduces gut inflammation. Uncontrolled disease may require the surgical removal of the entire colon and an ileostomy (the small intestine is opened our Onto the skin of the abdomen and Wastes are collected in a bag).

Although there is no permanent cure, most cases can be adequately controlled by medication. Because of the long-term complications and related conditions in other organs, the average life expectancy of these patients is slightly less than normal.