diseases

ULCERATIVE COLITIS


Introduction
It is an inflammatory disease of the bowel (intestines) .It represents a breakdown in the balanced immunological cycle that is there in the body. The damage is caused due to the autoimmune changes in the body.

The cause of ulcerative colitis is unknown but genetic factors involving the inflammatory modulatory genes on chromosome 12 probably predispose an individual to develop ulcerative colitis when he is exposed to emotional stress, environmental factors etc.


Symptoms:
. The onset is usually gradual
. Bloody diarrhea is an important hallmark of the disease
. There is abdominal discomfort before the stools
. Inflammation of the rectum along with rectal bleeding can also be present
. Constipation
. The frequency of the stools depends upon the severity of the disease

Signs:
. Anorexia loss of appetite
. Weight loss
. Anemia
. Fever
. Tachycardia
. Tenderness in the abdomen

The other manifestations besides the intestines are:
. Apthous ulcers in the mouth
. Episcleritis
. Arthritis (large joints)

The uncommon manifestations are:
. Pyoderma gangrenosum
. Thrombo embolism

Other conditions that can develop:
. Sacroilitis
. Arthalgia (small joints)

Uncommon conditions:
. Primary sclerosing cholangitis
. Ankylosing spondylitis
. Sweets syndrome

Investigations:
. Sigmoidoscopy and rectal biopsy
. Plain abdominal radiography
. Colonoscopy is the preferred investigation initially for bloody diarrhea because it provides better mucosal definition and biopsy can be done. Colonoscopy is dangerous in acute condition in such cases flexible Sigmoidoscopy after phosphate enema is the procedure of choice.

Other investigations:
. Stool examination
. Full blood count
. Erythrocyte sedimentation rate (ESR)
. C-reactive protein to evaluate the severity of the disease
. Liver function tests.

Management of active ulcerative colitis
The general measures that should be taken are
. Bed rest if there is dehydration and electrolyte imbalance it should be corrected with proper intravenous fluids.
. Blood transfusion has to be carried out so as to maintain a proper hemoglobin level if the person is suffering from anemia.
. Diet In the initial acute stage nothing but water should be given by mouth. Later high roughage diet has to be given. Exclusion of mil products is occasionally helpful.

Also see role of Homeopathy in the treatment of ulcerative colitis.

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