Ulcerative Colitis
Definition: A chronic, episodic, inflammatory disease of the large intestine and rectum characterized by bloody diarrhea.
Causes, incidence, and risk factors: The cause is unknown, and it may affect any age group although there are peaks at ages 15 to 30 and then again at ages 50 to 70.
The disease usually begins in the rectal area and may eventually extend through the entire large bowel. Repeated episodes of inflammation lead to thickening of the wall of the intestine and rectum with scar tissue. Death of colon tissue or sepsis may occur with severe disease. The symptoms vary in severity and their onset may be gradual or sudden. Attacks may be provoked by many factors, including respiratory infections or stress.
Risk factors include a family history of ulcerative colitis or Jewish ancestry. The incidence is 5 out of 10,000 people.
Prevention: Because the cause is unknown, prevention is also unknown.
Symptoms: diarrhea of between 10 and 25 times a day, blood and pus may be present, abdominal pain and cramping that usually subsides after a bowel movement, abdominal sounds (borborygmus, a gurgling or splashing sound heard over the intestine), fever, weight loss, stools - foul smelling and tenesmus.
Additional symptoms that may be associated with this disease: nausea & vomiting, joint pain and gastrointestinal bleeding.
Treatment: The goals of treatment are to control the acute attacks, prevent recurrent attacks, and promote healing of the colon. Hospitalization is often required for severe attacks. Corticosteroids are prescribed to reduce inflammation. Sulfasalazine may decrease the frequency of attacks. Surgery may be indicated in refractory disease.
Expectations (prognosis): The course of the disease varies with remissions and exacerbations over a period of years, or the disorder can present as a fulminant disease. A permanent and complete cure is unusual. The risk of cancer increases in each decade after the diagnosis.
Complications: perforation of the colon, carcinoma, massive colonic hemorrhage, inflammation of the joints, ankylosing spondylitis, lesions in the eye, mouth ulcers, liver disease, impaired growth and sexual development in children and pyoderma gangrenosum.
Last updated May 25, 1999
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