Ulcerative Colitis Information - symptom, cause, picture, treatment of
Ulcerative Colitis Information
Ulcerative colitis is an idiopathic inflammatory condition that involves the mucosal surface of the colon, resulting in diffuse friability and erosions with bleeding. Approximately 50% of patients have disease confined to the rectosigmoid region (proctosigmoiditis); 30% extend to the splenic flexure (left-sided colitis); and less than 20% extend more proximally (extensive colitis). There is some correlation between disease extent and symptom severity. In the majority of patients, the extent of colonic involvement does not progress over time. In most patients, the disease is characterized by periods of symptomatic flare-ups and remissions. Ulcerative colitis is more common in nonsmokers and former smokers. Disease severity may be lower in active smokers and may worsen in patients who stop smoking. Appendectomy before the age of 20 years for acute appendicitis is associated with a reduced risk of developing ulcerative colitis.
Symptom of Ulcerative Colitis
The clinical profile in ulcerative colitis is highly variable. Bloody diarrhea is the hallmark. On the basis of several clinical and laboratory parameters, it is clinically useful to classify patients as having mild, moderate, or severe disease. Patients should be asked about stool frequency, the presence and amount of rectal bleeding, cramps, abdominal pain, fecal urgency, and tenesmus. Physical examination should focus upon the patient's volume status as determined by orthostatic blood pressure and pulse measurements and by nutritional status. On abdominal examination, the clinician should look for tenderness and evidence of peritoneal inflammation. Red blood may be present on digital rectal examination.
Treatment of Ulcerative Colitis
There are two main treatment objectives: (1) to terminate the acute, symptomatic attack and (2) to prevent recurrence of attacks . The treatment of acute ulcerative colitis is dependent upon the extent of colonic involvement and the severity of illness.
Patients with mild to moderate disease should eat a regular diet but limit their intake of caffeine and gas-producing vegetables. Fiber supplements decrease diarrhea and rectal symptoms (psyllium, 3.4 g twice daily; methylcellulose, 2 g twice daily; bran powder, 1 tbsp twice daily). Antidiarrheal agents should not be given in the acute phase of illness but are safe and helpful in patients with mild chronic symptoms. Loperamide (2 mg), diphenoxylate with atropine (one tablet), or tincture of opium (8–15 drops) may be given up to four times daily. Such remedies are particularly useful at nighttime and when taken prophylactically for occasions when patients may not have reliable access to toilet facilities.