Treatment Ulcerative Colitis
Ulcerative colitis is frequently confused with haemorrhoids and Crohn's disease. Differences and correct methods of treatment
Ulcerative colitis or ulcerative colitis is an inflammatory bowel disease that causes inflammation and ulcers (sores) in the digestive tract. The consequences can be disturbed bowel movements, bleeding, weight loss and chronic fatigue.
The disease affects the inner lining of the large intestine (colon) and rectum. Symptoms usually develop over time rather than suddenly.
Ulcerative colitis can be debilitating and sometimes lead to life-threatening complications. Although it has no known cure, there are ways to significantly alleviate the symptoms of the disease, which do not appear for long.
Types of ulcerative colitis
Doctors often classify ulcerative colitis according to its location. Types of ulcerative colitis include, according to the Mayo Clinic:
Ulcerative proctitis: inflammation is confined to the area closest to the anus (rectum), and rectal bleeding may be the only sign of the disease;
proctosigmoiditis: inflammation involves the rectum and the sigmoid colon - the lower end of the colon. Signs and symptoms include bloody diarrhoea, abdominal cramps, pain and the need to go to the toilet even after complete evacuation of the bowel (tenesmus);
left-sided colitis: inflammation extends from the rectum up through the sigmoid and descending colon. Signs and symptoms include bloody diarrhoea, abdominal cramps, left-sided pain and urgent need to go to the toilet;
pancolitis: this type often affects the entire colon and causes bouts of bloody diarrhoea that can be severe, abdominal cramps and pain, fatigue and significant weight loss.
Ulcerative colitis is most common in Northern Europe and North America and is usually diagnosed in people aged between 15 and 30. However, there is a second, lower incidence peak between 50 and 70 years of age.
Anemia may be a sign of ulcerative colitis: symptoms
The doctor notes that initial symptoms of ulcerative colitis can be mild and usually include blood in the stool and loose stools. In addition, abdominal pain is common. Because of the blood present in the stool, it is frequently mistaken for hemorrhoids.
Read an extensive interview with vascular surgery specialist Toni Feodor about the manifestations and correct treatment of haemorrhoids here.
More severe symptoms include, according to the gastroenterologist, signs of systemic disease, including:
fever,
weight loss,
anemia due to lack of iron.
Smoking, a protective factor
In people genetically predisposed to ulcerative colitis, an excessive immune reaction to normal intestinal flora is the underlying pathological mechanism. This inflammatory process leads to mucosal damage and further to diarrhoea, pain and bleeding.
How it differs from hemorrhoids and irritable bowel
Endoscopic procedures plus biopsy are the only reliable methods of correctly diagnosing ulcerative colitis. For confirmation and to differentiate ulcerative colitis from haemorrhoids and Crohn's disease, you may still need:
blood tests (to identify possible anaemia);
faecal analysis (leukocytes or certain proteins present in the stool may confirm the diagnosis of ulcerative colitis. A stool culture may also rule out an infectious cause of the symptoms);
colonoscopy with biopsy;
X-ray (in case of severe symptoms, the doctor may request a conventional X-ray to rule out serious complications such as perforation of the colon);
computer tomography;
MRI.
Treatment for ulcerative colitis according to severity
The doctor notes that treatment depends largely on how extensive and active the disease is. Mild forms or disease confined to the rectum can be treated with mesalazine, an anti-inflammatory drug.
However, for extensive and very active disease, strong therapy should be used early. This is the so-called biologics such as infliximab, vedolizumab or ustekinumab, among others - antibodies against pro-inflammatory cytokines.
Higher risk of colon cancer
It is important to know that people with ulcerative colitis are at higher risk of developing colon cancer than people without the condition. However, patients with proctitis are not at the same high risk.
However, those with other forms of ulcerative colitis are recommended to be screened for colon cancer.
Possible complications of ulcerative colitis include:
massive bleeding;
perforation of the colon;
severe dehydration;
osteoporosis;
chronic fatigue;
inflammation of the skin, joints and eyes;
toxic megacolon (a rapidly inflaming colon);
increased risk of blood clots in the arteries and veins.
What diet is recommended in ulcerative colitis
According to the gastroenterology specialist, there are no dietary restrictions for patients with ulcerative colitis. A varied and healthy diet containing fruit, vegetables and protein is recommended.
Permitted and prohibited foods in ulcerative colitis
Here are some general dietary suggestions, recommended by the Mayo Clinic, that can help you keep the disease under control:
Limit dairy products. Many patients with inflammatory bowel disease find that problems such as diarrhoea, abdominal pain and gas improve after limiting or eliminating dairy products. You may be lactose intolerant - meaning your body cannot digest the sugar in dairy products (lactose);
Eat little and often. You may find that you feel better if you eat five or six small meals a day, rather than two or three larger meals;
Drink plenty of fluids. Try to consume plenty of fluids daily. Water is best. Alcohol and caffeinated drinks stimulate bowel motility and can worsen diarrhea, while carbonated drinks frequently produce gas.
Contact a nutritionist. If you're starting to lose weight or your diet has become very restricted, talk to a nutritionist about an appropriate eating plan.
Measures to limit stress
Although stress does not directly cause inflammatory bowel disease, it can aggravate signs and symptoms and trigger flare-ups.
To help control stress, you can try:
an exercise programme - even light workouts can help reduce stress, improve mood by releasing happy hormones and normalising bowel function. Talk to your doctor about an appropriate exercise plan;
regular relaxation and breathing exercises. You can go to yoga and meditation classes.
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