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Living with Ulcerative Colitis: Understanding Causes, Symptoms, and Treatment Options

  Ulcerative colitis is a chronic inflammatory disease of the gastrointestinal tract, primarily affecting the colon and rectum. It causes inflammation and ulcers in the lining of the digestive tract, leading to a variety of uncomfortable and painful symptoms. As one of the best super speciality hospitals in Palakkad, Kerala, Thangam Hospital of PMRC provides comprehensive care for patients with ulcerative colitis, offering insights into its causes, symptoms, and treatment options.   Understanding Ulcerative Colitis What is Ulcerative Colitis? Ulcerative colitis (UC) is an autoimmune condition characterised by chronic inflammation of the colon’s inner lining. The exact cause of this condition remains unclear, but it is believed to be related to a combination of genetic predisposition, immune system dysfunction, and environmental factors. UC can be a debilitating disease, impacting all aspects of life, including diet, mental health, and daily activities.   Types of Ulcerative Colitis Ulcerative colitis can manifest in various forms, based on the extent of the inflammation:  
  • Ulcerative Proctitis: Inflammation is confined to the rectum.
  • Proctosigmoiditis: Involves the rectum and the lower part of the colon.
  • Left-Sided Colitis: Affects the left side of the colon.
  • Pancolitis: Involves the entire colon and is the most widespread form of the disease.
  • Acute Severe Ulcerative Colitis: A rare, severe form of UC that can present life-threatening complications.
  Causes of Ulcerative Colitis While the precise cause of ulcerative colitis remains unclear, several factors appear to contribute to its development:  
  1. Genetics
A family history of ulcerative colitis or other autoimmune diseases increases the likelihood of developing the condition. Genetic research has identified multiple genes that may play a role in the inflammatory response associated with UC.  
  1. Immune System Response
An abnormal immune response to intestinal bacteria may lead the immune system to mistakenly attack the cells of the colon, resulting in inflammation.  
  1. Environmental Factors
Several environmental factors may trigger ulcerative colitis in genetically predisposed individuals. These factors include:  
  • A high-fat diet or low-fiber diet.
  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs).
  • An imbalance in good and bad bacteria in the gut.
  • Stress, which, while it does not cause UC, might exacerbate symptoms.
 
  1. Microbiome
Emerging research has highlighted the role of gut microbiota in maintaining gut health. An imbalance in gut bacteria can potentially lead to increased inflammation and symptoms characteristic of UC.   Symptoms of Ulcerative Colitis Symptoms of ulcerative colitis can vary from mild to severe and may present differently depending on the extent of the disease. Common symptoms include:  
  1. Diarrhoea
Frequent, loose stools are often one of the first signs of ulcerative colitis. In severe cases, bowel movements may occur over ten times a day.  
  1. Abdominal Pain and Cramping
Individuals with UC often experience abdominal discomfort, cramps, and pain, particularly during bowel movements.  
  1. Rectal Bleeding
The presence of blood in the stool can be alarming. This occurs due to the ulcerations in the colon lining.  
  1. Urgency to Defecate
Patients often feel an urgent need to evacuate their bowels, which can lead to difficulties with daily activities.  
  1. Fatigue and Weight Loss
Chronic inflammation can lead to fatigue and unintended weight loss due to malabsorption of nutrients and changes in appetite.  
  1. Fever
In some cases, patients may experience low-grade fevers, indicating systemic inflammation.   Diagnosis of Ulcerative Colitis Diagnosing ulcerative colitis typically involves a combination of the following:  
  • Medical History: Discussing symptoms, personal history, and family history.
  • Physical Examination: A thorough exam to check for tenderness in the abdomen.
  • Blood Tests: To assess inflammation levels and check for anaemia or infection.
  • Stool Tests: To rule out infections and check for the presence of blood.
  • Endoscopy: A colonoscopy or flexible sigmoidoscopy, where a thin tube with a camera is inserted into the rectum to view the colon lining and take biopsy samples.
  • Imaging Studies: CT scans or MRIs may be used to assess the extent of the disease.
  Treatment Options for Ulcerative Colitis While ulcerative colitis currently has no cure, various treatment options can help manage symptoms and induce remission. These include:  
  1. Medications
Medications are the cornerstone of ulcerative colitis treatment and may include:  
  • Aminosalicylates: These anti-inflammatory drugs (e.g., mesalamine) are commonly used to induce remission and maintain long-term control.
  • Corticosteroids: These drugs (e.g., prednisone) help reduce inflammation but are generally used for short-term control due to potential side effects.
  • Immunomodulators: Medications that suppress the immune system responses (e.g., azathioprine, mercaptopurine) are often used when standard medications are ineffective.
  • Biologics: Targeted therapies (e.g., infliximab, vedolizumab) that address specific components of the immune system may be prescribed for moderate to severe cases.
 
  1. Nutritional Support
Nutritional management is crucial, especially during flare-ups. Dietitian consultation can help patients identify foods that worsen symptoms and create a balanced eating plan. A low-residue diet may be recommended during flare-ups to minimise bowel movements and ease discomfort.  
  1. Surgery
In severe cases that do not respond to medication, surgery may be necessary. Procedures may include:  
  • Colectomy: Surgical removal of the colon, which can result in a cure from UC but may require an ostomy or a pouch procedure.
  • Ileal Pouch-Anal Anastomosis (IPAA): This surgery creates a pouch from the small intestine, which is then connected to the anus, allowing for normal bowel function without an ostomy bag.
 
  1. Lifestyle Modifications
Certain lifestyle changes can help manage ulcerative colitis symptoms, such as:  
  • Stress Management: Yoga, meditation, and therapy can help reduce stress, which may impact symptoms.
  • Regular Exercise: Staying physically active may help improve overall well-being and reduce symptoms.
  Living with Ulcerative Colitis Living with ulcerative colitis can be challenging, but effective management strategies can greatly improve quality of life. Here are some tips for living well with UC:  
  • Stay Informed: Understand your condition, treatment options, and participate actively in your healthcare decisions.
  • Communicate Openly: Keep your healthcare provider informed about your symptoms and any changes in your condition.
  • Join Support Groups: Engaging with support groups can provide emotional support and valuable resources from others experiencing similar challenges.
  Consult Experts Ulcerative colitis is a chronic condition that requires ongoing management and care. Understanding its causes, symptoms, and available treatment options is vital for making informed decisions about your health.   At Thangam Hospital of PMRC, we are dedicated to providing world-class healthcare services tailored to meet the needs of our patients. With 24 years of unwavering excellence in medical care, we stand as a trusted institution in Palakkad, ready to assist you in effectively managing ulcerative colitis and other health concerns. Your health and well-being are our priorities. Contact us today to schedule an appointment and take the first step towards better health!

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