Understanding Ulcerative Colitis

Ulcerative colitis is a disease that causes inflammation and sores, called ulcers, in the top layers of the lining of the large intestine. The inflammation usually occurs in the rectum and lower part of the colon, but it may affect the entire colon. Ulcerative colitis rarely affects the small intestine except for the lower section, called the ileum. Ulcerative colitis may also be called colitis, ileitis, or proctitis.

The inflammation makes the colon empty frequently, causing diarrhea. Ulcers form in places where the inflammation has killed colon lining cells; the ulcers bleed and produce pus and mucus.

Ulcerative colitis occurs most often in people ages 15 to 40, although children and older people sometimes develop the disease. Ulcerative colitis affects men and women equally and appears to run in some families.

Theories about what causes ulcerative colitis abound, but none have been proven. The most popular theory is that the body's immune system reacts to a virus or a bacterium by causing ongoing inflammation in the intestinal wall.

People with ulcerative colitis have abnormalities of the immune system, but doctors do not know whether these abnormalities are a cause or a result of the disease. Ulcerative colitis is not caused by emotional distress or sensitivity to certain foods or food products, but these factors may trigger symptoms in some people.

Treatment for ulcerative colitis depends on the seriousness of the disease. Most people are treated with medication. In severe cases, a patient may need surgery to remove the diseased colon. Surgery is the only cure for ulcerative colitis.

Some people whose symptoms are triggered by certain foods are able to control the symptoms by avoiding foods that upset their intestines, like highly seasoned foods or milk sugar (lactose). Each person may experience ulcerative colitis differently, so treatment is adjusted for each individual. Emotional and psychological support is important.

Most patients with mild or moderate disease are first treated with 5-ASA agents, a combination of the drugs sulfonamide, sulfapyridine, and salicylate that helps control inflammation. Sulfasalazine is the most commonly used of these drugs. People with severe disease and those who do not respond to mesalamine preparations may be treated with corticosteroids. Prednisone and hydrocortisone are two corticosteroids used to reduce inflammation.

About 5 percent of people with ulcerative colitis develop colon cancer. The risk of cancer increases with the duration and the extent of involvement of the colon. For example, if only the lower colon and rectum are involved, the risk of cancer is not higher than normal. However, if the entire colon is involved, the risk of cancer may be as great as 32 times the normal rate.

Because chronic diarrhea can strip your body of essential nutrients, it is very important to eat a balanced diet and maintain a high fluid intake, to avoid becoming dehydrated. Nutrient deficiencies commonly found are as follows: iron, zinc, potassium, magnesium, copper, vitamin B12, C, E, K, A, D, B1, B2 and folate.

A lack of these nutrient's are associated with growth retardation, anaemia, bone loss, lack of energy and proneness to infection and food sensitivities. Supplementation is essential in these conditions. If the drug sulfasalazine is used to control the bowel inflammation, vitamin B12 and folate injections must be considered on a regular basis.

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