What is it about ?
Ulcerative colitis is a chronic inflammatory colon disease in which the inflammation is confined to the mucous membrane. We do not know the cause. It seems that a family (hereditary) factor plays a role. A failing immune system could also contribute to its onset. Infections and stress seem to make the disease worse.
What is its frequency?
The disease mainly occurs in Western and Nordic countries. In western countries, the disease affects about 450 in 100,000 people. The presence of the disease in the family increases the risk of developing it.
How to recognize it?
Ulcerative colitis progresses with recurrent and persistent flare-ups, whether or not mixed with phlegm or blood, and sometimes with stomach pain. Eventually, the slight loss of blood can lead to anemia, which is characterized by pallor, unusual fatigue. Sometimes there is an involuntary loss of feces. The relapses are interspersed with periods that are asymptomatic, spontaneous or due to treatment. In 1 to 2 in 10 people affected, the symptoms are present all the time.
Problems can also develop outside the intestine, such as eye inflammation (uveitis or episcleritis), from joints (arthritis), skin (erythema nodosum) and bile ducts (primary sclerosing cholangitis).
Ulcerative colitis can sometimes be like Crohn’s disease, but there are some differences. Stomach pain is predominant in Crohn’s disease, while ulcerative colitis is more marked by bloody diarrhea. The anus is rarely inflamed in Crohn’s disease, while it can be in ulcerative colitis.
A distinction is made between benign, moderate and severe colitis. Mild colitis is characterized by at least 4 bowel movements per day, without anemia or signs of inflammation in the blood. We speak of moderate colitis, when there is between 4 and 6 bowel movements per day, a slight anemia and no signs of inflammation in the blood. Severe colitis, on the other hand, is characterized by more than 6 bowel movements per day, marked anemia and inflammatory factors in the blood.
How is the diagnosis made?
If ulcerative colitis is suspected, a blood test is taken and you are referred to a specialist in the gastrointestinal system (gastroenterologist) for an examination. colonoscopy. Small pieces of intestinal tissue are also taken (biopsy) for analysis. If the doctor suspects complications (such as an abscess), he will order a CT scan or an x-ray of the abdomen.
What can you do ?
There is no scientific evidence indicating that diet influences the course of colitis. Adapted diets therefore make little sense. However, it is useful to moderate your consumption of hot spices and alcohol.
What can your doctor do?
Treatment depends on the severity of the symptoms and the part of the colon affected. If the disease mainly affects the end of the colon, local treatments, such as enemas and suppositories, will usually be used.
Medicines that decrease inflammation of the intestine (mesalazine or sulfasalazine) and cortisone form the basis of treatment.
In the event of severe ulcerative colitis, treatment should preferably be monitored in a specialized center. If you have a bleeding intestines, a blood transfusion is sometimes necessary and you must be fed by infusion (parenterally).
The disease can also dilate the intestine. Part of the colon may therefore need to be removed by surgery. If the disease does not respond to drug therapy, sometimes it is suggested to completely remove the colon and connect the bowel directly to the anus.
Ulcerative colitis increases the risk of bowel cancer. The colon is checked every 1 to 5 years by colonoscopy.
Want to know more?
- Colonoscopy – Erasme Hospital
- The radiography, here, Where to find on this page of Cliniques St Luc UCL
- CT-scan – Erasme Hospital
- Mesalazine – CBIP – Belgian Center for Pharmacotherapeutic Information
- Sulfasalazine – CBIP – Belgian Center for Pharmacotherapeutic Information
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