ULCERATIVE COLITIS

Ulcerative colitis (colitis ulcerosa) is a diffuse non-specific inflammation of the colonic mucosa, which in more severe cases leads to ulcerations. It is a non-specific inflammatory bowel disease. The exact cause of the disease is not known. It is believed that a major contributor to the development of the disease is abnormal reaction of the immune system which leads to inflammatory infiltration of the bowel. Genetic and environmental factors also play a role. In most cases, symptoms of ulcerative colitis are mild. Remissions are interspersed with acute relapses. In 20% of patients, the disease is severe. First symptoms usually appear between 15 and 25 years of age, later onset is rare.

The main symptom is diarrhoea with blood, constipation is less frequent. Patients may also experience tenesmus (painful urge to pass stool). Frequent symptoms include abdominal pain (usually in the lower left abdomen or in the rectum), fever, fatigue, weight loss.

If you experience bleeding from your digestive tract, recurring diarrhoea, abdominal pain, fever or unexplained or unintended weight loss, see your general practitioner for diagnostic work-up. 

You should have basic laboratory tests and stool analysis done to rule out an infection, as well as colonoscopy – an examination that will help to evaluate the extent of the lesions in the large bowel and to collect biopsies for histopathology analysis.

Unfortunately, ulcerative colitis cannot be entirely cured. The goal of pharmacological therapy is to prolong remissions, prevent relapses and alleviate the symptoms.

The following therapies are used:

• 5-aminosalicylic acid (5-ASA) preparations (mesalazine, sulfasalazine) in tablets, suppositories and enemas
• steroids (hydrocortisone, prednisone, budesonide)
• immunosuppressants (azathioprine, mercaptopurine, cyclosporin)
• biologicals – which include antibodies affecting the immune system

In severe cases, when pharmacological treatment is not effective, a removal of the whole bowel and stoma surgery may be needed.

There are no special dietary recommendations for patients with ulcerative colitis. The diet should be varied and rich in nutrients, vitamins and minerals. The most important thing is to avoid foods which cause or aggravate the symptoms. Restrictive diet is recommended only in severe relapses. Patients in relapse should avoid eating high-fibre foods, such as wholemeal bread, pulses, vegetables (in particular cabbage), or fruits that can worsen diarrhoea.