Colitis, a general term, refers to inflammation of the mucosa lining the large intestine and signs of inflammation such as edema and swelling.
What is Colitis? What are the Symptoms of Colitis?
Typical complaints of colitis patients are abdominal pain, cramps in the abdomen, diarrhea and a feeling of bloating in the abdomen. Some patients may also experience bloody diarrhea. Other symptoms include fever, chills, weakness, fatigue, and dehydration.
Additionally in patients:
- Abdominal tenderness,
- Fast weight loss,
- Depression,
- Joints pain,
- Mucus and/or blood in the stool and rectal bleeding may also occur.
What are the Known Types of Colitis?
The most common type of colitis is Ulcerative Colitis (UC), but other types of colitis:
- Colitis in Chron's disease,
- Diversion colitis (in the dysfunctional bowel region after colostomy or ileostomy) colitis),
- Ischemic colitis (colitis developing due to intestinal blood supply disorder),
- Infectious colitis (Campylobacter, Salmonella, Shigella, Clostridium difficile, Escherichia coli, Yersinia, Chlamydia, Neisseria , Tuberculosis),
- Fulminant colitis (used for acute severe colitis),
- Chemical colitis (colitis caused by chemicals given to the large intestine in enemas or other procedures),
- Collagenous colitis (It is a subtype of microscopic colitis. A thick layer of collagen has developed inside the large intestine tissue),
- Microscopic colitis (diagnosed under the microscope although the large intestinal mucosa is normal in endoscopy. The patient clinically has pain, cramps, bloating, watery bloodless diarrhea),
- Lymphocytic colitis (A subtype of microscopic colitis. White blood cells (lymphocytes) increased in number in the large intestine tissue),
- Atypical colitis (In cases that do not meet the pathological diagnostic criteria of colitis but have a clinical picture suggestive of colitis).
Colitis How is the Treatment Done?
Treatment of colitis is planned according to the type of colitis.
In the presence of infection, if the causative microorganism is bacteria, appropriate antibiotics are used systemically. viral e The symptoms limit themselves after a while with adequate fluid support and rest. In very serious cases, removal of the large intestine and/or part of the small intestine may be required.
In ischemic colitis, it is essential to rest the intestines and replace the fluid. If the lost blood cannot be replaced in this way, then the part of the intestine that lost blood should be surgically removed. If symptoms do not improve after 24 hours, a physician should be consulted.
What is Ulcerative Colitis?
Ulcerative colitis (UC) is the most common inflammatory bowel disease in the world. In Western societies, one out of every thousand people is affected by this disease. Ulcerative colitis is a disease in which an inflammatory event of unknown cause occurs in the wall of the large intestine, causing wounds on the intestinal surface and usually accompanied by bleeding. The reason for the appearance of symptoms such as bleeding, electrolyte loss, wound formation and edema is completely the inflammation that occurs in the intestinal mucosa.
UC is usually limited to colon and rectum involvement. Unlike UC, in Crohn's disease, involvement can be seen throughout the entire digestive tract, starting from the mouth area.
Inflammatory bowel diseases are most commonly seen between the ages of 15-25. However, another common age group is between the ages of 50 and 70. Genetic predisposition contributes to the development of both Crohn's and ulcerative colitis, and an increased risk of colorectal cancer occurs during the course of these two diseases. A decrease may occur. The relationship between the risk of developing Crohn's disease and appendectomy is the opposite.
While the risk of Crohn's disease, one of the inflammatory bowel diseases, increases with smoking, there may be a relative decrease in the risk of ulcerative colitis with smoking.
How Does Ulcerative Colitis Develop?
The immune system in that area, which is responsible for the defense of the intestines, plays a key role in the occurrence of these diseases. In healthy people, the epithelial cell layer on the inner wall of the intestines prevents bacteria and antigens that may cause inflammation from passing into the space between the cells. In inflammatory bowel diseases, a problem with the barrier function develops and inflammation progresses more severely as a result of the involvement of microorganisms in the intestines during the course of the disease.
Inflammation occurs as a result of the immune response following a defect in the epithelial barrier, the collection of defense cells in that area, and the effect of intestinal bacteria that normally survive with humans. In ulcerative colitis, inflammation usually starts from the last parts of the large intestine (rectum) and tends to progress towards the beginning, and involvement occurs continuously. The symptoms of the disease may be exacerbated by the use of non-steroidal anti-inflammatory drugs in susceptible individuals.
What are the Symptoms of Ulcerative Colitis?
The main symptom in ulcerative colitis patients is bloody diarrhea. In addition to the main symptom, symptoms such as urgent toilet need, constant straining (tenesmus), abdominal pain, weight loss and fever can be added to the disease picture during the course of the disease.
Ulcerative colitis can cause some complaints in areas other than the intestine. The most common extra-intestinal symptom in these patients is joint inflammation (arthritis). Arthritis, eye involvement and red, raised, painful skin lesions called erythema nodosum usually coexist and show an activation related to the course of the disease. , does not correlate with the course of inflammatory bowel diseases. During the course of inflammatory bowel diseases, liver and bile-related problems may also manifest themselves. In particular, there is a strong relationship between ulcerative colitis and a gallbladder-liver disease called sclerosing cholangitis. available.
If these two diseases are together, there is an increased risk of developing colorectal cancer. The eye findings observed in inflammatory bowel diseases are uveitis (inflammation of the middle round part of the eye) and episcleritis (inflammation of the white part of the eye called the sclera).
Is There a Risk of Cancer in Ulcerative Colitis Disease?
It has been determined that the risk of colorectal cancer is increased in patients with ulcerative colitis who have had the disease for more than 10 years. This risk is more pronounced in people whose entire large intestine is affected. Colorectal cancer usually begins in the 60s in healthy individuals, but this age limit for ulcerative colitis patients can be reduced to the age of 50.
How to Diagnose Ulcerative Colitis?
The diagnosis is made in the presence of findings of imaging methods supporting clinical symptoms. At the same time, stool examination can be done in order to exclude the possibility that the underlying cause is an infection. Observing the changes related to the disease in the intestines during colonoscopy is important in the diagnosis. At the same time, it provides clarification of whether the disease continues in a single region or throughout the entire large intestine. It has diagnostic value during attacks.
What is Ulcerative Colitis Diet? What Should Ulcerative Colitis Patients Eat?
One of the points to be considered in ulcerative colitis nutrition is to pay attention to a low-fat diet, since fatty foods can exacerbate symptoms. High-carbohydrate diets are more suitable for UC patients because they lose weight. These patients may be lactose intolerant. For this reason, it is recommended that they prefer foods with low lactose content or lactose-free.
Foods with low fiber content are more suitable for these patients in order not to accelerate bowel movements. UC patients usually use corticosteroids in their treatment. Therefore, salt restrictions are necessary in their diet.
FODMAP (fermentable oligo- and di Saccharides and polyols) (these are found in some carbohydrates, sugars, and alcohol) should opt for a low-FODMAP diet. It is recommended that UC patients also pay attention to a gluten-free diet as they may also have gluten sensitivity. Patients with UC have to be very careful about their diet as it can trigger diarrhea and/or cause electrolyte imbalance and dehydration through blood loss. Since these patients lose their nutrients with diarrhea, they need to take nutritional supplements because they cannot have a balanced diet when symptoms (disease activity) occur.
UC patients prefer small and frequent meals rather than large-volume meals. In this way, both their bowel movements do not accelerate and they can digest the food they take sufficiently. Caffeine in chocolate, coffee and energy drinks is not recommended for these patients because it accelerates bowel movements.
How to Treat Ulcerative Colitis
The aim of medical treatment in ulcerative colitis is in a short time To provide control (remission) of symptoms, to improve quality of life, to reduce the need for long-term steroid use, to reduce the complications of the disease and the drugs used in the treatment.
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