What you need to know about ulcerative colitis

Ulcerative colitis is a chronic disease that affects the large intestine. It becomes inflamed or ‘ulcerated’ (‘pitted or eroded’). Although life expectancy is normal, there might still be complications if you don't know what to expect. Find out if you have the disease by knowing its symptoms, diagnosis and treatment.

Diagnosis and symptoms

The disease can start at any age, but usually begins between 15 to 30 years. Some people have their first attack between 50 to 70 years.

  • Cause

The cause of ulcerative colitis is not known although it is established that heredity and an ‘overactive immune response’ are contributing factors.

  • Symptoms

Ulcerative colitis has the following symptoms:

* Intense diarrhoea

* High fever

* Abdominal pain or cramps

* Peritonitis (inflammation of the lining of the abdominal cavity)

During flare-ups, the affected person is severely ill. The symptoms are felt gradually beginning with an intense urge to defecate coupled with mild abdominal cramps. Blood and mucus are present in the stool. The episode can last from days to weeks. It can also come back or recur at any time.

Depending on the extent of the disease and the areas affected, stools may be normal or hard and dry. Where the disease is confined to the rectum and the ‘sigmoid colon’, fever may be mild or even absent. If ulcerative colitis is present farther up the large intestine, stools are looser and the person may have 10-20 bowel movements per day along with intense cramps and abdominal pain. Poor appetite and fever are also present.

  • Diagnosis

Stool examinations and blood tests help determine if the person has ulcerative colitis. In addition, x-ray of the abdomen and sigmodoiscopy (examination of the sigmoid colon using a viewing tube) allows the doctor to confirm the extent of the inflammation.

Prognosis and treatment

Ulcerative colitis is chronic. Therefore, repeated flare-ups and remissions are expected. The treatment is aimed at replacing fluids and nutrients lost during bowel movements and to reduce the impact of symptoms. The patient will be put on dietary restriction such as taking iron supplements for anaemia, avoiding raw fruits and vegetables, and consuming dairy products.

Anti-diarrhoeal drugs are given as well as anti-inflammatory drugs. Furthermore, 'immunodulating' drugs are also administered. In other patients, surgery may be necessary especially in cases where cancer or pre-cancer is detected or due to the narrowing of the large intestine. The bottom line is, surgery is rarely needed and life expectancy is normal.

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