7 March 2019 Although it has some similarities with Crohn's disease, ulcerative colitis is restricted to the final part of the digestive tube - the colon and rectum. As such, it only affects the innermost layer of the wall (mucous), with a diffuse and continuous inflammation of varying severity. Its severity can range from a mild process to the presence of abscesses and ulcerations associated with significant changes to the morphology of the affected regions . People with ulcerative colitis tend to alternate between periods when the disease is evident and periods when there are no symptoms at all. It is not possible to predict when one of these phases is going to occur or how long it will last, which can be months or years. What are the causes of ulcerative colitis? The cause of ulcerative colitis is not known . The following are considered as being among the possible causes: Immune system disorders; Changes in vascularisation; Infection; Diet; Interactions between the above causes. As with Crohn's disease, ulcerative colitis involves a disproportionate and exaggerated reaction to food compounds or other compounds present in the digestive tract which, while innocuous, are not recognised as such. Who can be affected by ulcerative colitis? Ulcerative colitis can affect individuals of any age. As a rule, it is usually diagnosed for the first time in young adults , although it can also be diagnosed at advanced ages. Its incidence is slightly higher among women and people living in urban areas, and it is likely that some genetic determinism is involved. What are the symptoms of ulcerative colitis? Symptoms of ulcerative colitis usually include: Frequent episodes of diarrhoea with blood, pus and/or mucous; Abdominal pain when defecating; Fever; Weight loss. These symptoms can be intense and may appear suddenly or they may develop progressively . There may also be extra-intestinal symptoms with ulcerative colitis, such as: Arthritis; Skin lesions; Eye problems; Hepatitis; Biliary disorders; Anaemia. In children, delayed growth may be observed. Unlike Crohn’ s disease, intestinal obstructions, fistulae and perianal problems are rare in ulcerative colitis. How is ulcerative colitis diagnosed? A diagnosis of ulcerative colitis is made on the basis of: Medical history; Symptoms; Patient examination; Any additional examinations considered necessary. The additional examinations may include the following: Blood tests : these may suggest the existence of inflammation; Stool tests : these may show blood loss; Contrast X-rays : to locate areas of inflammation and help to determine their severity; Proctosigmoidoscopy or colonoscopy : to visualise the inside of the colon, check the extent and severity of the disease, detect possible complications and, if necessary, obtain samples to confirm the diagnosis. Computerised tomography and magnetic resonance images may also be recommended for the diagnosis of ulcerative colitis. What is the treatment for ulcerative colitis? Initially, the treatment approach for ulcerative colitis involves the administration of drugs , usually long-term. These drugs are intended to treat the symptoms and maintain and prolong periods of remission , while controlling the possible side effects of the drugs. However, it is estimated that around 50% of patients with ulcerative colitis will require surgical treatment at some stage of the disease. The curative treatment of ulcerative colitis consists of surgical resection of the entire colon and rectum, for which there are several possible procedures. The choice depends on the specific nature of each case. The most common reasons for patients being submitted to surgical treatment include cases where: There is no response to pharmacological treatment; There are complications associated with the disease, such as severe bleeding, perforation of the intestinal wall and infections; There is a need to eliminate serious consequences on growth in non-adult subjects; There is a need to reduce the risk of cancer developing. Gastroenterologists and general surgeons can help treat this disease. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
