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Ulcerative colitis (UC) is a disease that causes very non-specific symptoms and is difficult to diagnose. Statistics show that in Poland there may already be tens of thousands of patients with ulcerative colitis. What are the symptoms of ulcerative colitis? How is this disease treated?
Ulcerative colitis (UC)is a disease in which diarrhea can last for many days, cause significant dehydration and blood loss, so it excludes you from normal life. The essence of the disease is chronic inflammation of the colon mucosa. The inflammatory process begins in the rectum, spreads to the sigmoid colon and, over time, may extend to the entire intestine. Most often, symptoms of the disease first appear before the age of 40.
Ulcerative colitis (UC): causes
The causes of ulcerative colitis, an autoimmune disease, are still unknown. We know, however, that the development of the disease is favored by genetic predisposition (it often runs in families), diet, intestinal infections, and an incorrect composition of their bacterial flora.
However, the greatest importance is assigned to disorders of the immune system. For unknown reasons, it reacts to factors that are indifferent to a he althy organism (e.g. non-pathogenic bacteria, food). This excessive immune response triggers an uncontrolled inflammatory process that leads to damage to the mucosa of the large intestine, the formation of bleeding erosions, ulcers, and so-called paving the mucosa, stiffening the walls with flattening folds, pseudopolyps (unlike glandular polyps, they are not precancerous).
Ulcerative colitis (UC): course
Ulcerative colitis is often mild, with long periods of remission. Sometimes symptoms come back only once, twice a year, or even once every few years. Sometimes, however, relapses are frequent, and exacerbations are so severe that hospitalization is necessary.
The dominant symptom is diarrhea with an admixture of blood and mucus, a feeling of urgency. They are particularly troublesome because patients may even have more than 20 bowel movements a day. This symptom is accompanied by:
- stomach pains,
- loss of appetite.
Other symptoms are less frequent:
- low-grade fever,
- fever,
- lose weight.
Malnutrition occurs sporadically because most of the nutrients are absorbed in the small intestine, which is not affected by the disease.
The consequences of the UCLA are:
- lose weight,
- weakness,
- anemia due to iron deficiency and blood loss,
- joint pain and swelling,
- urolithiasis,
- osteoporosis,
- sometimes skin changes (erythema nodosum, ulcerative dermatitis).
A serious complication of the disease is colon distension, accompanied by fever, impaired consciousness, and decreased blood pressure. It threatens with perforation of the intestine, and colon cancer can be a long-term consequence.
ImportantResearch will clarify doubts
Clinical symptoms are not specific, therefore, laboratory tests are performed on feces (for occult blood, bacteria and parasites) and blood (ESR, CRP, antibodies specific for autoimmune enteritis).
Ultrasound and radiological examinations may also be helpful, but colonoscopy with biopsy is of the greatest diagnostic importance. Detects disease-specific changes:
- inflammatory infiltrates,
- erosions,
- ulcers,
- smoothing the folds of the mucosa
- and non-precancerous pseudopolyps.
Ulcerative colitis (UC): treatment
The goal of ulcerative colitis treatment is to achieve remission, maintain it for as long as possible, and prevent the consequences of the disease. In therapy, preparations from three groups are used.
The first are aminosalicylates. They are administered not only in the period of the relapse, but also in remission, because they extend the period of asymptomatic course of UC. Chronic use of aminosalicylates in maintenance doses is a kind of chemoprevention - it protects against cancer formation, because after 20 years of disease, the possibility of neoplastic processes in the affected large intestine increases.
These drugs, however, are too weak in severe exacerbations of the disease. Then, glucocorticosteroids are used, which inhibit the inflammatory process more strongly. They are administered briefly during UCS relapses because they have numerous side effects.
On the other hand, immunosuppressive drugs are used for several years. They suppress the over-reactivity of the immune system, thus preventing disease relapses.
The therapy is supplemented with vitamins and minerals (the patient may have their deficiencies), omega-3 acids(have anti-inflammatory properties) as well as probiotics and prebiotics which normalize the intestinal flora. However, the recommendations recommend that when caring for the intestinal microbiota, use probiotics carefully and select strains tested for effectiveness and safety1 .
For those patients in whom standard therapy fails, biological therapy is often the last resort.
Research has shown that they quickly relieve symptoms and heal the mucosa of the large intestine. One of them is reimbursed by the National He alth Fund under the so-called drug programs (treatment is provided only by specialized centers). It is reserved for the heaviest forms of UZJG. It is a great opportunity for patients who are not helped by standard treatment.
May save them from colectomy, a mutilating operation to remove part or all of the large intestine. It is associated with numerous complications, necessitating repeated surgical procedures (abscesses, inflammation of the internal fecal reservoir, leaky anastomosis of this reservoir with the anus and, as a result, peritonitis, stoma emergence, fertility problems).