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Digestive Disorders

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Ulcerative Colitis

Symptoms

Recurrent episodes of bloody, pus- and mucus-filled diarrhea.

Pain on the left side of the abdomen that lessens after a bowel movement.

Painful bowel movements; feeling of incomplete evacuation; rectal urgency, pain, cramps.

Weight loss.

Symptoms in remote sites of the body, including arthritis and inflammation of the eyes.

Severe attack: nausea, vomiting, dehydration, profuse sweating, appetite loss, bloating, high fever (104° F), heart palpitations.

When To Call Your Doctor

Call a doctor if you experience diarrhea that contains blood or mucus or if abdominal pain becomes severe, especially with a high fever.


What Is It?

Ulcerative colitis is a persistent inflammation of the lining of the colon; small ulcers form and eventually develop into abscesses. Episodes of painful, bloody diarrhea and other symptoms may vary in intensity and alternate with symptomless periods of normal bowel function. The condition may develop gradually over a period of years or appear without warning in a sudden, severe attack. In very severe episodes, the patient is at risk for potentially life-threatening blood poisoning (due to toxins found in infected abscesses) and excessive blood loss (due to bloody diarrhea). Other serious complications include massive dilatation of the colon (toxic megacolon) and perforation of the colon wall, allowing intestinal contents to infect the abdominal cavity (peritonitis). Those who have had ulcerative colitis for 10 years or more are at increased risk of colorectal cancer. The disorder most often affects young adults.

What Causes It?

The precise cause of ulcerative colitis is unknown, though it appears to be an autoimmune disorder (the body’s immune system is overstimulated and attacks its own tissues, in this case, the colon).

Hereditary factors may play a role.

Stress, anxiety, or depression may result from suffering from this chronic, often debilitating illness. Though not a cause, emotional factors may intensify symptoms in those with ulcerative colitis.

Certain foods may exacerbate symptoms in people sensitive to them (such as milk in those with lactose intolerance).

Prevention

Ulcerative colitis cannot be prevented at present.

Diagnosis

Blood and stool samples are taken.

Sigmoidoscopy or colonoscopy (use of a lighted viewing tube) is used to inspect the large intestine.

A biopsy of the colon lining is usually taken during the sigmoidoscopy or colonoscopy.

A barium enema with x-ray may be performed.

Periodic screening for early colon cancer (with colonoscopy) is recommended for those who have had ulcerative colitis for more than 10 years.

How To Treat It

A hot water bottle or a heating pad may be applied to the abdomen to relieve cramps.

Guard against irritating the colon during a flare-up by avoiding milk and milk products if sensitive.

Bed rest may be necessary during severe attacks.

Anti-inflammatory drugs such as sulfasalazine are often prescribed for mild attacks and to prevent recurrence.

Corticosteroids are the most effective treatment for more severe attacks.

Enemas containing corticosteroids or aspirin-like drugs may be used to treat internal inflammation.

Nutritional supplements may be recommended if there is malnutrition or anemia.

When diarrhea is severe, patients may be hospitalized and fed intravenously.

Surgical removal of part or all of the colon may be required if the inflammation does not respond to medication. Results of such surgery are often very favorable. Some physicians recommend removal of the colon to prevent colon cancer in those who have had active ulcerative colitis for 10 to 20 years.

 

From Johns Hopkins Symptoms and Remedies, the complete home medical reference. You can order this book now on our secure server.

 

 


 


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2005
WHITE PAPERS
Digestive Disorders

The Digestive Disorders White Paper from The Johns Hopkins White Papers series is an annual, in-depth report written by Hopkins physicians.


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Johns Hopkins Symptoms and Remedies
An easy-to-use reference work that can help you pinpoint the cause of hundreds of symptoms, from abdominal pain to skin rash to swollen glands.

 

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