Ulcerative Colitis

Ulcerative colitis is an inflammatory bowel disease (IBD) which causes ulcers (sores) and inflammation in the gastrointestinal tract. Ulcerative colitis occurs when the lining of the colon (large intestine), rectum, or both becomes inflamed. The inflammation results in the development of tiny sores called ulcers on the large intestine lining.

These ulcers normally begin to develop in the rectum and spread up the gastrointestinal tract. When the colon and rectum are inflamed, it causes the bowel to move its content rapidly and empty frequently. Ulcers develop due to the cells on the surface of the lining of the bowel dying. These ulcers can result in bleeding and discharge of mucus and pus. Ulcerative colitis can cause symptoms such as abdominal pain and cramping, bloody diarrhoea, and rectal pain. An urgency to defecate is common. Ulcerative colitis symptoms vary from mild to moderate, depending on the severity of the inflammation and where it occurs.

There are different types of ulcerative colitis, namely:

• Ulcerative proctitis:
  This is an inflammation which occurs near the rectum (anus), and may cause symptoms like rectal pain, urgency and bleeding.
• Proctosigmoiditis:
  This is a condition where the rectum and sigmoid colon (the lower end of the colon) becomes inflamed. Symptoms include bloody diarrhoea, abdominal cramps, urgency and pain.
• Left-sided colitis:
  This is when the inflammation extends from the rectum to the left side of the sigmoid and descending colon. Signs and symptoms usually include weight loss, bloody diarrhoea and abdominal cramping.
• Pancolitis:
  This is a condition where the entire colon is inflamed. It causes symptoms such as occasionally severe bloody diarrhoea, significant weight loss, fatigue and abdominal cramps and pain.

Endoscopic procedures like colonoscopy and flexible sigmoidoscopy, with a tissue biopsy, will be used to help diagnose ulcerative colitis. Imaging procedures including an x-ray, CT scan and CT and MR enterography may also be used to examine the colon as well to rule out serious complications. Ulcerative colitis treatment involves Dr John Wright prescribing drugs, including anti-inflammatory drugs, immune suppressors and modern biologics. These days most patients will be given biologic drugs to help reduce the body's immune response by targeting proteins that lead to inflammation. These new agents have made surgical removal of diseased bowel a very rare event.