Conditions & Investigations

Inflammatory bowel disease - ulcerative colitis

Inflammatory bowel disease - ulcerative colitis

Ulcerative colitis is a chronic disease of the large intestine, also known as the colon. In ulcerative colitis, the inner lining of the colon becomes inflamed and develops tiny open sores, or ulcers, that produce pus and mucous. The combination of inflammation and ulceration can cause abdominal pain and diarrhoea.

Ulcerative colitis is the result of an abnormal response by your body's immune system. Normally, the cells and proteins that make up the immune system protect you from infection. In people with IBD, however, the immune system mistakes food, bacteria, and other materials in the intestine for foreign or invading substances. When this happens, the body sends white blood cells into the lining of the intestines, where they produce chronic inflammation and ulcerations.

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It is important to understand the difference between ulcerative colitis and Crohn's disease. Crohn’s disease can affect any part of the Gastrointestinal (GI) Tract, but ulcerative colitis affects only the colon. Additionally, while Crohn’s disease can affect all layers of the bowel wall, ulcerative colitis only affects the lining of the colon.

While both ulcerative colitis and Crohn’s disease are types of Inflammatory Bowel Diseases (IBD), they should not be confused with Irritable Bowel Syndrome (IBS), a disorder that affects the muscle contractions of the colon. IBS is not characterized by intestinal inflammation.

What are the Signs and Symptoms?

  • bowel movements become looser and more urgent
  • persistent diarrhoea accompanied by abdominal pain and blood in the stool
  • stool is generally bloody
  • crampy abdominal pain

People suffering from ulcerative colitis often experience a loss of appetite and may lose weight as a result. A feeling of low energy and fatigue is also common.

The symptoms of ulcerative colitis can come and go, with fairly long periods in between flare-ups in which patients may experience symptoms at all. These periods of remission can span months or even years. The unpredictable course of ulcerative colitis may make it difficult for physicians to evaluate whether a particular course of treatment has been effective or not.

What are the Causes of Ulcerative Colitis? Who is Affected?

Although considerable progress has been made in IBD research, we do not yet know what causes this disease. Studies indicate that the inflammation in IBD involves a complex interaction of factors: the genes a person has inherited, the immune system, and something in the environment. Foreign substances (antigens) in the environment may be the direct cause of the inflammation, or they may stimulate the body's defenses to produce inflammation that continues without control. Researchers believe that once the IBD patient's immune system is "turned on," it does not know how to properly "turn off" at the right time. As a result, inflammation damages the intestine and causes the symptoms of IBD. That is why the main goal of medical therapy is to help patients regulate their immune system better.

Men and Women are equally likely to be affected, and most people are diagnosed between the ages of 20 to 40. However the disease can occur at any age and older men are more likely to be diagnosed than older women.

While ulcerative colitis tends to run in families, researchers have been unable to establish a clear pattern of inheritance. Studies show that up to 20 percent of people with ulcerative colitis will also have a close relative with the disease. The disease is more common among white people of European origin and among people of Jewish heritage.