Ulcerative colitis

Causes, incidence, and risk factors The cause of ulcerative colitis is unknown. People with this condition have problems with the immune system, but it is not clear whether immune problems cause this illness. Although stress and certain foods can trigger symptoms, they do not cause ulcerative colitis. Ulcerative colitis may affect any age group, although there are peaks at ages 15 30 and then again at ages 50 70. The disease usually begins in the rectal area, and may involve the entire large intestine over time. Risk factors include a family history of ulcerative colitis, or Jewish ancestry.

Other tests that may be done to help diagnose this condition include:

Treatment
The goals of treatment are to: Control the acute attacks Prevent repeated attacks Help the colon heal Hospitalization is often needed for severe attacks.Your doctor may prescribe corticosteroids to reduce inflammation.You may be given nutrients through a vein (intravenous line).

DIET AND NUTRITION
Certain types of foods may worsen diarrhea and gas symptoms, especially during times of active disease.Diet suggestions include: Eat small amounts of food throughout the day.
Drink plenty of water (drink small amounts throughout the day).
Avoid fatty, greasy or fried foods and sauces (butter, margarine, and heavy cream).
Limit milk products if you are lactose intolerant.Dairy products are a good source of protein and calcium.

STRESS
You may feel worried, embarrassed, or even sad or depresed about having a bowel accident.Other stressful events in your life, such as moving, or losing a job or a loved one can cause digestive problems.
Ask your doctor or nurse for tips on your to manage your stress.

MEDICATIONS
Medications that may be used to decrease the number of attacks include: 5-aminosalicylates such as mesalamine or sulfazine, which can help control moderate symptoms Immunomodulators such as azathioprine and 6-mercaptopurine Corticosteroids (prednisone and methylprednisolone) taken by mouth during a flare-up or as a rectal suppository, foam, or enema Infliximab (Remicade) or other biological treatments, if you do not respond to other medications SURGERY Surgery to remove the colon will cure ulcerative colitis and removes the threat of colon cancer.Surgery is usually recommended for patients who have: Colitis that does not respond to complete medical therapy Changes in the lining of the colon that are thought to be precancerous Serious complications such as rupture (perforation) of the colon, severe bleeding (hemorrhage), or toxic megacolon Most of the time, the entire colon, including the rectum, is removed.Afterwards, patients may need a surgical opening in the abdominal wall (ileostomy), or a procedure that connects the small intestine to the anus to help the patient gain more normal bowel function.5/7/2012 10:01 AM Date visited 05/5/12 See also: Total proctocolectomy with ileostomy Total proctocolectomy and ileal -anal pouch Ulcerative colitis -when you go home from the hospital

Support Groups
Social support can often help with the stress of dealing with illness, and support group members may also have useful tips for finding the best treatment and coping with the condition.
For more information, visit the Crohn's and Colitis Foundation of America (CCFA) web site at www.ccfa.org.

Expectations (prognosis)
About half of patients with ulcerative colitis have mild symptoms.Patients with more severe ulcerative colitis tend to respond less well to medications.
Permanent and complete control of symptoms with medications is unusual.Cure is only possible through complete removal of the large intestine.
The risk of colon cancer increases in each decade after ulcerative colitis is diagnosed.

Complications
Repeated swelling (inflammation) leads to thickening of the intestinal wall and rectum with scar tissue.Death of colon tissue or severe infection (sepsis) may occur with severe disease.

Prevention
Because the cause is unknown, prevention is also unknown.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may make symptoms worse.
Due to the risk of colon cancer associated with ulcerative colitis, screening with colonoscopy is recommended.
) in the eye Tears or holes (perforation) in the colonCalling your health care providerCall your health care provider if: You develop persistent abdominal pain, new or increased bleeding, persistent fever, or other symptoms of ulcerative colitis You have ulcerative colitis and your symptoms worsen or do not improve with treatment, or new symptoms develop 4 basic tests for colon cancer: a stool test (to check for blood); sigmoidoscopy (inspection of the lower colon; colonoscopy (inspection of the entire colon); and double contrast barium enema.All 4 are effective in catching cancers in the early stages, when treatment is most beneficial.Review Date: 2/7/2012.Reviewed by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.