Ulcerative Colitis 101
Ulcerative colitis (UC) is a chronic inflammation of the large intestine (the colon) and there are several different types. Thirty-percent of all patients have “ulcerative proctitis,” which involves an inflammation of the rectum; the last six inches of the colon only. The prognosis for this type of colitis is good, since there are limited complications of this mild form, yet there will still be an increased risk of colon polyps and cancer. Another type, “proctosigmoiditis,” affects the rectum and the s-shaped sigmoid colon just above the rectum. “Left-sided colitis” sufferers have inflammation from the rectum to the spleen area. “Pan-ulcerative/total colitis” sufferers have their entire colon affected and may result in serious complications.
Loose and bloody stools are what send most patients running to the doctor’s office with UC. They may find themselves running to the restroom suddenly and doubling over with cramps and uncomfortable abdominal pain. As the inflammation worsens, patients report fatigue and unexplained weight loss. About half of all sufferers exhibit only mild symptoms. However, if left untreated, more serious complications arise, such as anemia, skin lesions, joint pain, liver disorders, improper development, colon wall holes and cancerous colon polyps. Often sufferers have periods of remission and recurrence, which makes the inflammation sometimes difficult to treat.
The cause of ulcerative colitis is not yet known, but studies indicate it may have something to do with the immune system, genes and one’s environment. Many scientists believe an outside agent, like a virus or bacteria, invades the body and “turns on” the body’s immune system, which then has trouble turning off again. It’s unclear whether this foreign agent damages the intestinal wall, which caused the body to overreact with layer after layer of white blood cells, or if the body’s immune system actually triggered the disease. However, many scientists have linked UC with the development of small bowel cancer, colon cancer and rectal cancer.
There are many drug treatments available for ulcerative colitis. Typically, doctors will first prescribe an anti-inflammatory drug like sulfasalazine (Azulfidine), mesalamine (Asacol, Rowasa), olsalazine (Dipentum) or balsalazide (Colazal). While these medications are effective at relieving symptoms, some patients report side effects like diarrhea, nausea, vomiting, headaches and heartburn. For patients who have moderate-to-severe inflammatory bowel disease that hasn’t responded to anti-inflammatories, corticosteroids may be prescribed for the short-term, although they have serious side effects like facial swelling, hyperactivity, insomnia, heightened blood pressure and osteoporosis. Lastly, collagenous colitis may be treated by immune system suppressors like: azathioprine (Imuran), mercaptopurine (Purinethol), cyclosporine (Neoral, Sandimmune), or infliximab (Remicade). However, these drugs may cause damage to other organs and Remicade can’t be taken by people with congestive heart failure, multiple sclerosis or a history of colorectal and small bowel cancer.
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