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Ulcerative Colitis

What is Ulcerative Colitis?

Ulcerative Colitis(UC) is an idiopathic chronic inflammatory condition affecting the large bowel and rectum. It is often a lifelong problem and results from the immune system attacking the bowel. The inflammation in Ulcerative colitis nearly always involves the rectum and spreads up the bowel. In severe cases the entire colon may be involved.

Who gets Ulcerative Colitis?

Anyone can develop Ulcerative Colitis, although it is more common in people of caucasian heritage. The risk is increased in people who have a family history of Inflammatory Bowel Disease (either UC or Crohns disease). The incidence of ulcerative colitis peaks in people aged 15-25 years and ?55-65 years, although it can occur in people of any age.

What are the symptoms of Ulcerative Colitis?

Ulcerative Colitis can lead to recurrent episodes of diarrhoea with or without rectal bleeding & mucous. Sufferers may experience urgency to go to toilet and a sensation of incomplete bowel emptying. Abdominal cramps are not uncommon. Ulcerative Colitis may have symptoms outside of the bowel including; arthritis, eye irritation (episcleritis), skin rashes (erythema nodosum or pyoderma gangrenosum), or liver problems (primary sclerosing cholangitis).

How is Ulcerative Colitis diagnosed?

Ulcerative Colitis is diagnosed by excluding other diseases which may cause similar symptoms such as infection, using stool culture. However, colonoscopy and biopsy is essential to make the diagnosis. Patients usually have a history of recurrent episodes of diarrhoea with or without blood.

How is Ulcerative Colitis treated?

Treatment for Ulcerative Colitis depends on the severity of inflammation and the location within the bowel. A combination of oral medications and either enemas or suppositories are often adequate to settle the inflammation. These medications include prednisolone, sulphasalazine, mesalazine, balsalazide and azathioprine. In severe cases, intravenous hydrocortisone &/or infliximab may be required. In rare cases, surgery to remove the colon and rectum may be required if the inflammation becomes life-threatening.

Is there a risk of cancer?

Yes. Because of the chronic inflammation there is a slightly increased risk of colon cancer above the background population. For this reason it is recommended that patients with Ulcerative Colitis undergo periodic surveillance of the bowel with colonoscopy.