Ulcerative colitis is a chronic inflammatory disease of the colon, which usually runs in batch mode. It often begins in the rectum and can continuously from there spread throughout the large intestine. The exact cause is unknown. As with Crohn's disease but there is evidence that it is an autoimmune disease. This means the body's immune system is directed against its own for unknown reasons and causes intestinal inflammation. There are also some hereditary predisposition for ulcerative colitis. May also play a role in bacteria or viruses. In some patients will deteriorate over also to inflammation of other organs, particularly the joints, biliary tract and skin.
In Germany around 170,000 people suffering from ulcerative colitis, the disease usually begins between the 20th and 40 years of age. Both sexes are equally affected often. The disease is highly individual and can not be predicted. Patients with ulcerative colitis have an increased risk of colon cancer. This risk increases with duration of disease and the extent of the inflammation.
The following symptoms may occur in ulcerative colitis:
* Severe diarrhea, often with blood in
* Painful bowel movement (tenesmus)
* Weight loss
* Tiredness, fatigue, loss of appetite
* Fever
* Painful joints
* Dermatitis
When such symptoms occur, you should consult a doctor.
What complications are possible
* Hemorrhage: Is the loss of blood through the intestines too large may be needed blood transfusions. Also is a surgical procedure required
* Intestinal perforation (perforation): If the intestinal wall breaks through, the intestinal content reaches the abdominal cavity, where it can cause acute life-threatening infections.
* Toxic megacolon: The toxic megacolon is an acute, maximum expansion of the large intestine, which can by a severe attack of ulcerative colitis can be triggered. The toxic megacolon resulting in a life-threatening bowel obstruction and to threaten a breakdown of the intestinal wall. Symptoms include severe pain, fever and massive circulation problems.
How your doctor makes the diagnosis.
* Laboratory tests: are ulcerative colitis in the acute episode of increased inflammation in the blood values (e.g., increase in white blood cells). Often the same is anemia (anemia) before.
* Ultrasound: Some intestinal changes show up in ulcerative colitis as early as ultrasound, for example, a thickening of the bowel wall
* Colonoscopy: Here are the altered areas clearly visible. At the same time, samples can be taken for microscopic examination.
* X-ray / MRI: After administration of a contrast agent in the intestine can be considered X-ray or MRI. Thus, the inflamed areas are made visible.
Especially important is the differentiation of ulcerative colitis compared to the second major chronic inflammatory bowel disease, Crohn's disease. In spite of all diagnostic procedures, this distinction does not succeed in all patients. Here, only the future course of the disease shed.
What your doctor can do.
Basically, between the treatment of active ulcerative colitis and treatment differences in relapse-free interval.
* Cortisone-containing preparations: they dampen the acute inflammatory effective one. If only the rectum is affected, as can cortisone enema may be used. By the local effect the cortisone out there to fewer side effects throughout the body.
* Immunosuppressants: suppressing drugs such as cyclosporine, the immune system and may additionally be required in severe exacerbations.
* Diet: In addition to any drug therapy is recommended during an acute episode of low-fiber diet with liquid food, severe flares can also be an artificial diet is required.
Chronic active history:
In this course, despite a long-term drug therapy of ulcerative symptoms persist.
* Immunosuppressants: Here comes mainly azathioprine, the substance used, which also suppresses the immune system.
* Infliximab: In some cases, used this drug, which is among the biologics. It is an antibody that is directed against the body's own TNF-alpha (tumor necrosis factor). TNF-alpha plays an essential role in triggering inflammation. All immune-regulating drugs may be associated with serious side effects and are therefore used only with extreme caution and close monitoring. However, it is especially in severe cases with infliximab achieved today are often successful treatment, which seemed in earlier times hard to reach. The use of biologics in ulcerative colitis leads - this was demonstrated in studies - for sustainable healing of the intestinal mucosa. The focus is on this type of treatment, the intention of the aggressive disease activity crucial to counteract. The main goal is ultimately to avoid extensive surgery of the digestive tract, which almost always take an irretrievable loss of bowel segments for security.
Intermittent therapy
In ulcerative colitis and in relapse-free interval, a long-term therapy is recommended.
* Aminosalicylates (mesalazine, sulfasalazine,): they block is the impact of endogenous substances that are responsible for the inflammatory process reactors, on the other they also their production. They also reduce the risk of cancer. Depending on the location of the infestation, they are used as tablets, suppositories or enemas. Cancer screening should because of the increased risk of colon cancer from 8 Year of illness once a year, a colonoscopy with removal of samples are carried out.
Treatment of complications
In case of serious complications, an operation is unavoidable. The type of surgery depends on the present findings. In very severe cases, doctors will have to take even the entire removal of the colon into consideration. Since biologics can be used, can often prevent these situations.
What can you do.
Basically, your diet should mainly consist of light food. It includes whole-grain breads, rice, pasta, vegetables, fresh fruits and salads, low-fat dairy products and low-fat meats. Any form of dietary fiber promotes healthy digestion. Sugar-containing products and those should be avoided rather high in white flour.
By Tara Kaprowy
