What is Ulcerative Colitis?

Ulcerative colitis (UC) is a chronic mucosal disease that almost always involves the rectum and may extend proximally to all or part of the colon.

Ulcers form in the inner lining or mucosa of the colon or rectum, often resulting in diarrhea, blood, and pus.

The terminology used to describe the area affected is:
  • Proctitis: Disease only in the rectum (the lower part of the colon that connects with the anus)
  • Proctosigmoiditis or Left sided colitis: Disease in the left side of the colon (rectum and sigmoid colon)
  • Pancolitis: Disease in entire colon.

Ulcerative colitis most often begins gradually and can become worse over time. Most people have periods of remission—times when symptoms disappear—that can last for weeks or years. The goal of care is to keep people in remission long term.

Symptoms
Symptoms of ulcerative colitis may range from mild abdominal cramping with frequent small-volume bowel movements to profuse diarrhea. Mild disease, which afflicts two-thirds of patients, has been defined as fewer than four stools daily, with or without blood, with no systemic disturbance. With severe disease, the patient has more than six stools per day with blood, with evidence of systemic disturbance as shown by fever, tachycardia, anemia, or erythrocyte sedimentation rate greater than 30.

Causes
There are no direct known causes for ulcerative colitis, but many factors may contribute to the development of the illness, including genetics, impaired immune system response, and environmental triggers:
  • Ulcerative colitis tends to run in families, suggesting that genetics have a role in this disease
  • Environmental factors include intestinal infections, cigarette smoking, or Nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. An abnormal immune response causes the immune system to attack the cells in the inner lining of the large intestine, too.
Sometimes, other parts of the body are affected by the inflammation these include: joints (swollen, red and painful joints), skin (rashes), eyes (inflamed itchy and red eyes), bones (osteoporosis) and liver (inflamed liver).

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