Tuesday, June 7, 2011

Granulomatous Colitis - Ulcerative Colitis

Overview, Causes, & Risk Factors

Ulcerative colitis is a chronic disease of the colon, or large bowel. It causes inflammation and destruction of the tissue lining the colon.
What is going on in the body?
Ulcerative colitis occurs when the lining of the colon is attacked by the body's immune system. It involves an autoimmune response, which means that the person's body produces antibodies against its own tissues. The disease usually starts at the rectum and involves entire sections of the colon. The attack may cause abscesses, or pus pockets, in the lining.
What are the causes and risks of the disease?
The cause of ulcerative colitis is unknown. People with ulcerative colitis have an autoimmune response that destroys the colon lining. However, it is not known whether the response is the cause or the result of ulcerative colitis. Many scientists believe that the immune response is triggered by a virus or bacteria.
Stress and dietary factors do not cause ulcerative colitis. However, they may worsen the symptoms when someone has the disease. Spicy foods and dairy products may trigger symptoms, for example.

Symptoms & Signs

What are the signs and symptoms of the disease?
As the colon lining breaks down, the person experiences abdominal pain. The pain is usually on the left side of the abdomen. It may improve after the person has a bowel movement. Bloody diarrhea is another common symptom. The person may have 10 to 20 bowel movements a day. The person may also have pain and cramping around the rectum.
Other common symptoms of ulcerative colitis include:
  • fatigue

  • fever

  • loss of appetite

  • loss of fluid and nutrients

  • rectal bleeding

  • unintentional weight loss

    • Ulcerative colitis can also cause problems in other parts of the body. These effects may include:
  • anemia, or a low red blood cell count

  • arthritis, or joint pain and swelling

  • eye irritation

  • kidney stones

  • liver disease, including hepatitis and cirrhosis

  • osteoporosis, or bone thinning

  • rash

    • Diagnosis & Tests

    How is the disease diagnosed?
    Diagnosis of ulcerative colitis begins with a medical history and physical exam. The healthcare provider may order tests, including:
  • a barium enema, which is an X-ray of the colon

  • blood tests to check for anemia or signs of inflammation

  • a biopsy of tissue from the colon lining

  • a colonoscopy, which allows the provider to insert a lighted scope and see the colon lining

  • a lab test to check for blood in the stool

    • Prevention & Expectations

    What can be done to prevent the disease?
    There is no known way to prevent ulcerative colitis.
    What are the long-term effects of the disease?
    Ulcerative colitis can cause serious long-term effects, including:
  • a higher risk of colorectal cancer

  • life-threatening blood loss

  • malnutrition

  • peritonitis, or inflammation of the abdominal cavity lining

    • What are the risks to others?
    Ulcerative colitis is not contagious and poses no risk to others.

    Treatment & Monitoring

    What are the treatments for the disease?
    Treatment of ulcerative colitis varies, depending on the intensity and location of the inflammation. The healthcare provider will work with the individual to control the inflammation. Treatment may include:
  • ASA agents, such as sulfasalazine and mesalamine, to control inflammation

  • corticosteroids, such as prednisone, which are used when ASA agents aren't able to control the disease

  • dietary restrictions to allow the colon to rest

  • a diet that eliminates foods, such as milk, that trigger the person's symptoms

  • intravenous fluids to replace fluid and body salts

  • medicines to help the person relax

  • pain medicines as needed

    • If these measures aren't successful in controlling the disease, surgery may be recommended. The entire colon and rectum may be removed. An ileostomy is done to empty the contents of the small bowel into a pouch. A newer procedure known as an ileoanal anastomosis leaves part of the rectum intact. Bowel waste is then passed out through the rectum.
    What are the side effects of the treatments?
    Medicines used to treat ulcerative colitis may cause vomiting, lethargy, and allergic reactions. Surgery may cause bleeding, infection, and allergic reaction to anesthesia.
    What happens after treatment for the disease?
    People with ulcerative colitis will have periods where the symptoms go away. Usually, however, the symptoms do return.
    How is the disease monitored?
    People with ulcerative colitis will have regular visits with the healthcare provider. The provider will order regular colonoscopy exams to monitor the disease. Any new or worsening symptoms should be reported to the healthcare provider.

    Attribution

    Author:David J. Craner, MD
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:05/31/01
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:05/22/01

    Sources
    Professional Guide to Disease, Sixth Edition, Springhouse. Springhouse Publication, 1998.
    Griffith, H. Winter. Instructions for Patients, Fifth Edition. Philadelphi, W.B. Saunders Company, 1994.
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