Considered as one of the two major inflammatory bowel diseases, ulcerative colitis (UC) manifests itself in the large intestine. It is a multifactorial and polygenic disease, which can also include a genetic predisposition. UC is a lifelong illness and has a significant impact on an individual s emotional and social quotients. The inflammation starts at the rectum and spreads upwards with tiny ulcers forming in the lining of the colon. Contents of the bowel move and empty rapidly. There is a discharge of pus and mucus from the ulcers. The disease rarely affects the small intestine. UC can affect people of all ages but tend to develop between 15 years and 30 years of age.
Genetics: individuals with a family history of ulcerative colitis
Immune system reactions: the intestinal epithelial barrier is compromised leading to UC
Use of NSAIDs
Low levels of vitamin A and E
Signs and symptoms
Discharge of mucus from the rectum
Lower abdominal pain
Diarrhoea and cramps
Significant weight loss
Grading ulcerative colitis:
Severe: > 4 bowel motions per day; hypoalbuminemia < 30g/L, rectal bleeding
Moderate: > 4 bowel motions per day; rectal bleeding
Mild: < 4 bowel motions per day; rectal bleeding
Serologic markers: Antineutrophil cytoplasmic antibodies (ANCA); perinucelar ANCA (pANCA)
CBC for anaemia and thrombocytosis
Comprehensive metabolic panel for hypoalbuminaemia; hypokalaemia; hypomagnesaemia; alkaline phosphate
Inflammatory markers: to check for erythrocyte sedimentation rates
Stool assays: culture for bacterial pathogens
Endoscopy and biopsy
Plain abdominal radiographs
Cross-sectional imaging studies
Most of the ulcerative colitis patients can be treated with medications. Surgery is a definitive therapy for ulcerative colitis. Predominant indications for surgery are non-responsiveness to medical treatment, uncontrolled colonic bleeding, dysplasia, adenocarcinoma , complications of ulcerative colitis like toxic megacolon or perforation. Such complications require emergency surgery as these are life-threatening situations.
Dr. Deepak Varma prescribes long-term monitoring for individuals diagnosed with ulcerative colitis. He drafts a careful treatment plan, which has to be followed by the patient throughout their lives.