Ulcerative colitis is an unceroinflammatory disease limited to the colon and affecting only the mucosa and submucosa except in the most severe cases. In contrast to Crohn disease, ulcerative colitis extends in a continious fashion proximally from the rectum. Well-formed granulomas are absent. Similar to Crohn disease, ulcerative colitis is a systemic disorder associated in some patients with migratory polyarthritis, sacroiliitis, ankylosing spondylitis, uveitis hepatic involvement (pericholangitis and primary sclerosing cholangitis and skin lesions.
Epidemiology
Ulcerative colitis is global in distribution and varies in incidence relative to Crohn disease, supporting the concept that they are separate disease. In the United States, incidence is about 4 to 12 per 100,000 population slightly greater than Crohn disease. As with Crohn disease, the incidence of this condition has risen in recent decades. In the United States, it is more common among whites than among blacks and women are affected more often than men. The onset of disease peaks between the ages of 20 and 25 years but the conditionmay arise in both younger and considerably older individuals.
Clinical Features
Ulcerativecolitis typically presents as a relapsing disorder marked by attacks of bloody mucoid diarrhea that may persist for days , weeks, or months, then subside, only to recur after an asymptomatic interval of months to years or even decades. In the fortunate patient, the first attack is the last. At the other end of the spectrum, the explosive initial attack may lead to such serious bleeding and fluid and electrolyte imbalance as to constitute a medical emergency. In most patients, bloody diarrhea containing stringy mucus, accompanied by lower abdominal pain and cramps usually relieved by defecation, is the firsts manifestation of the disease. In a small number of patients, constipation may appear paradoxically, owing to disruption of normal peristalsis. Often the first attack is preceded by a stressful period in the patient's life. Spontaneously or more often after appropriate therapy these symptoms abate in the course of days to weeks. Flare-ups when they do occur may be precipitated by emotional or physical stress and rarely concurrent intraluminal growth exterotoxin forming C difficile. Sudden cessation of bowel function with toxic dilation (toxic megacolon)rarely develops with severe acute attacks; perforation is a potentially lethal event.
About 60% of patients have clinically mild disease. In these individuals, the bleeding and diarrhea are not severe and systemic signs and symptoms are absent. Almost all patients however, have at least one relapse during 10-year period about 30% of patients require colectomy with the first 3 years of onset because of uncontrollable disease.
The most feared long term complication of ulcerative colitis is cancer. There is a tendency for dysplasia to arise in multiple sites, and the underlying inflammatory disease may mask the symptoms and signs of carcinoma. Historically the risk of cancer is highest in patients with pancolitis of 10 or more years duration, in whom it exceeds by 20 fold to 30 that in a control population equivalent to an absolute risk of colorectal cancer 35 years after diagnosis of 30%. Screening programs of patients with ulceration of dysplasia and carcinoma is in fact quite low provided that initial examinations were negative for dysplasia.
Whilst suffering from abdominal pain and passing some mucus and even blood in the stools can be alarming, many people who find these symptoms suddenly appearing often think the worst and confuse them with another more serious condition. It is normally the case that the lesser symptom, inflammatory bowel syndrome will be diagnosed rather than inflammatory bowel disease, otherwise known as ulcerative colitis.
Sufferers of colitis will be faced with enduring symptoms that are much harsher and more serious than those related to inflammatory bowel syndrome. The ulcerative colitis symptoms will not suddenly appear and for the person to be immediately incapacitated. What happens is that a part of the large colon gradually becomes inflamed and the open wound that is created starts to excrete mucus and blood. This can vary in amounts depending on the extent of the colon's inflammation. The person will start to notice that their stools will start to contain such mucus and blood and the stools themselves will change their form to a more diarrhoea like consistency.
In addition, the sufferer will experience some abdominal pain and find that when passing a stool that this action will create sometimes acute pain as the waste passes over the inflamed part of the large colon. Tiredness and lack of hunger can also be felt as the body is trying to fight the disease though due to the general overall feeling of being unwell, the person may not desire much food.
Depending on the severity of the attack, the ulcerative colitis symptoms can last for anything between a few days to several weeks. Some people find themselves in remission for long periods of time whilst others may face periods of reoccurring symptoms.
Bearing this is mind, the sufferer should accept that their life will most likely have to be put on hold for the period of time that the symptoms are live. But there is a real dilemma that has to be addressed. Often, the person will not know how long the attack will last, how strong the symptoms will be, what affect it has on the body, what should and shouldn't they eat, and when they can realistically start to get back into their usual lifestyle again. And in addition, whether they will be able to pick up their life where they left it as if there had been no attack at all.
It is also common for the sufferer to be anxious about the future, whether the attack was a once of occurrence or if a pattern of relapses will develop and what severity will they take. There is a desire for practical information to try and address such dilemmas which, if left unanswered, can result in anxieties causing possible stress. And that is the precise thing a sufferer will want to avoid.
Michael Tasker has sinced written about articles on various topics from Massage, How to Sell on Ebay and Fitness. The author has lived with colitis, an ilesotomy and now a j pouch since 1994 and all the real experiences and knowledge which only a colitis survivor has are now available to you to. Here is the opportunity to find the answers to make your daily life easi. Michael Tasker's top article generates over 22200 views. to your Favourites.