episodes of bloody, pus- and mucus-filled diarrhea.
on the left side of the abdomen that lessens after a bowel
bowel movements; feeling of incomplete evacuation; rectal
urgency, pain, cramps.
in remote sites of the body, including arthritis and inflammation
of the eyes.
attack: nausea, vomiting, dehydration, profuse sweating,
appetite loss, bloating, high fever (104° F), heart palpitations.
When To Call Your Doctor
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?
cause of ulcerative colitis is unknown, though it appears to
be an autoimmune disorder (the bodys immune system is overstimulated
and attacks its own tissues, in this case, the colon).
factors may play a role.
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.
may exacerbate symptoms in people sensitive to them (such as
milk in those with lactose intolerance).
colitis cannot be prevented at present.
Blood and stool
samples are taken.
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.
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
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
are the most effective treatment for more severe attacks.
corticosteroids or aspirin-like drugs may be used to treat internal
supplements may be recommended if there is malnutrition or anemia.
is severe, patients may be hospitalized and fed intravenously.
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.
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