Fitango Education          Health Topics                    Ulcerative Colitishttp://www.fitango.com/categories.php?id=104
Overview   Ulcerative colitis is a chronic, or   long-lasting, disease that causes inflammation and   sores, called ulcers...
Overview   rectum—the end part of the colon.   UC is one of the two main forms of chronic   inflammatory disease of the ga...
Overview   Normally, the large intestine absorbs water   from stool and changes it from a liquid to a solid.   In UC, the ...
Causes   The cause of UC is unknown though theories   exist. People with UC have abnormalities of the   immune system, but...
Causes   immune system protects people from infection by   identifying and destroying   bacteria, viruses, and other poten...
Causes   digestive tract. UC sometimes runs in families and   research studies have shown   that certain gene abnormalitie...
Causes   addition, while sensitivity to certain foods or food   products does not cause   UC, it may trigger symptoms in s...
Symptoms   The most common symptoms of UC are   abdominal discomfort and blood or pus in   diarrhea. Other symptoms includ...
Symptoms   -- fever   -- nausea   -- weight loss   -- loss of appetite   -- rectal bleeding   -- loss of body fluids and n...
Symptoms   -- skin lesions   -- growth failure in children   Most people diagnosed with UC have mild to   moderate symptom...
Symptoms   fevers, bloody diarrhea, nausea, and severe   abdominal cramps.1 UC   can also cause problems such as joint pai...
Symptoms   occur, but they think these complications may be   the result of inflammation   triggered by the immune system....
Diagnosis   Ulcerative colitis can be difficult to   diagnose because its symptoms are similar to   those of other intesti...
Diagnosis   Crohn’s disease causes inflammation deeper within   the intestinal wall and can   occur in other parts of the ...
Diagnosis   a gastroenterologist, also called a   gastroenterological specialist, a doctor   who specializes in digestive ...
Diagnosis   -- Blood tests. A blood test involves   drawing blood at a health care provider’s office or   commercial facil...
Diagnosis   Blood tests can also detect anemia, which could be   caused by bleeding in the   colon or rectum.   -- Stool t...
Diagnosis   container for catching and storing the stool. The   sample is returned to the   health care provider or a comm...
Diagnosis   rectum caused by bacteria, a virus, or parasites.   -- Flexible sigmoidoscopy and colonoscopy. These   tests a...
Diagnosis   The tests are similar, but colonoscopy is used to   look inside the rectum and   entire colon, while flexible ...
Diagnosis   instructions to follow at home before the test. The   person may be asked to   follow a clear liquid diet for ...
Diagnosis   -- For both tests, the person lies on a table   while the doctor inserts a flexible tube into the   anus. A sm...
Diagnosis   can see inflammation, bleeding, or ulcers on the   colon wall. The doctor may   also perform a biopsy by snipp...
Diagnosis   microscope to confirm the diagnosis. These tests   are performed at a hospital or   outpatient center by a gas...
Diagnosis   rectum or lower colon that may be causing   symptoms.   -- Cramping or bloating may occur during the   first h...
Diagnosis   make plans for a ride home. Full recovery is   expected by the next day.   -- Computerized tomography (CT) sca...
Diagnosis   injection of a special dye, called contrast medium.   CT scans require the person   to lie on a table that sli...
Diagnosis   x-ray technician, and the images are interpreted by   a radiologist—a doctor who   specializes in medical imag...
Diagnosis   make the colon, rectum, and lower part of the   small intestine more visible in   x-ray images. The procedure ...
Diagnosis   anesthesia is not needed. These tests can show   physical abnormalities and are   sometimes used to diagnose U...
Treatment   Treatment for UC depends on the severity of   the disease and its symptoms. Each person   experiences UC diffe...
Treatment                **Medication Therapy**   While no medication cures UC, many can   reduce symptoms. The goals of m...
Treatment                **Medication Therapy**   improve quality of life. Many people with UC   require medication therap...
Treatment                **Medication Therapy**   Aminosalicylates, medications that   contain 5-aminosalicyclic acid (5-A...
Treatment                **Medication Therapy**   intestine. Sulfapyridine may lead to side effects   such as nausea, vomi...
Treatment                **Medication Therapy**   fewer side effects, and can be used by people who   cannot take sulfasal...
Treatment                **Medication Therapy**   inserted in the rectum; or through an enema—   liquid medication put int...
Treatment                **Medication Therapy**   Corticosteroids, such as prednisone,   methylprednisone, and hydrocortis...
Treatment                **Medication Therapy**   through an enema, a rectal foam, or a   suppository, depending on which ...
Treatment                **Medication Therapy**   increased risk of infection. Because of harsh side   effects, steroids a...
Treatment                **Medication Therapy**   medications are used for long-term symptom   management.   Immunomodulat...
Treatment                **Medication Therapy**   are prescribed for people who do not respond to   5-ASAs. Immunomodulato...
Treatment                **Medication Therapy**   including   nausea, vomiting, fatigue, pancreatitis, hepatitis, a   redu...
Treatment                **Medication Therapy**   Infliximab (Remicade) is an anti-tumor   necrosis factor (anti-TNF) agen...
Treatment                **Medication Therapy**   targets a protein called TNF that causes   inflammation in the intestina...
Treatment                **Medication Therapy**   and increased risk of infections, particularly   tuberculosis.   Other m...
Treatment                   **Hospitalization**   Sometimes UC symptoms are severe enough   that a person must be hospital...
Treatment                   **Hospitalization**   providers will use intravenous fluids to treat   diarrhea and loss of bl...
Treatment                       **Surgery**   About 10 to 40 percent of people with UC   eventually need a proctocolectomy...
Treatment                       **Surgery**   is sometimes recommended if medical treatment   fails or if the side effects...
Treatment                       **Surgery**   rupture, or cancer risk. Surgery is performed at a   hospital by a surgeon; ...
Treatment                       **Surgery**   following operations:   Ileoanal pouch anastomosis, also   called “pouch sur...
Treatment                       **Surgery**   surgeon preserves the outer muscles of the rectum   during the proctocolecto...
Treatment                       **Surgery**   the pouch and passes through the anus in the   usual manner. Bowel movements...
Treatment                       **Surgery**   such as increased diarrhea, rectal bleeding, and   loss of bowel control. Po...
Treatment                       **Surgery**   attaches the ileum to an opening made in the   abdomen, called a stoma. The ...
Treatment                       **Surgery**   and worn outside the body to collect stool. The   pouch needs to be emptied ...
Treatment                       **Surgery**   change the ostomy pouch and how to protect the   skin around the stoma.   Th...
Treatment                       **Surgery**   possible by talking with their doctors;   enterostomal therapists, nurses wh...
Ulcerative Colitis
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Ulcerative Colitis

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Ulcerative colitis is a chronic, or
long-lasting, disease that causes inflammation and sores, called ulcers, in the
inner lining of the large intestine, which includes the colon and the
rectum—the end part of the colon.

UC is one of the two main forms of chronic
inflammatory disease of the gastrointestinal tract, called inflammatory bowel
disease (IBD). The other form is called Crohn’s disease.

Normally, the large intestine absorbs water
from stool and changes it from a liquid to a solid. In UC, the inflammation
causes loss of the lining of the colon, leading to bleeding, production of pus,
diarrhea, and abdominal discomfort.

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Ulcerative Colitis

  1. 1. Fitango Education Health Topics Ulcerative Colitishttp://www.fitango.com/categories.php?id=104
  2. 2. Overview Ulcerative colitis is a chronic, or long-lasting, disease that causes inflammation and sores, called ulcers, in the inner lining of the large intestine, which includes the colon and thehttp://www.fitango.com/categories.php?id=104 1
  3. 3. Overview rectum—the end part of the colon. UC is one of the two main forms of chronic inflammatory disease of the gastrointestinal tract, called inflammatory bowel disease (IBD). The other form is called Crohn’s disease.http://www.fitango.com/categories.php?id=104 2
  4. 4. Overview Normally, the large intestine absorbs water from stool and changes it from a liquid to a solid. In UC, the inflammation causes loss of the lining of the colon, leading to bleeding, production of pus, diarrhea, and abdominal discomfort.http://www.fitango.com/categories.php?id=104 3
  5. 5. Causes The cause of UC is unknown though theories exist. People with UC have abnormalities of the immune system, but whether these problems are a cause or a result of the disease is still unclear. Thehttp://www.fitango.com/categories.php?id=104 4
  6. 6. Causes immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. With UC, the body’s immune system is believed to react abnormally to bacteria in thehttp://www.fitango.com/categories.php?id=104 5
  7. 7. Causes digestive tract. UC sometimes runs in families and research studies have shown that certain gene abnormalities are found more often in people with UC. UC is not caused by emotional distress, but the stress of living with UC may contribute to a worsening of symptoms. Inhttp://www.fitango.com/categories.php?id=104 6
  8. 8. Causes addition, while sensitivity to certain foods or food products does not cause UC, it may trigger symptoms in some people.http://www.fitango.com/categories.php?id=104 7
  9. 9. Symptoms The most common symptoms of UC are abdominal discomfort and blood or pus in diarrhea. Other symptoms include -- anemia -- fatiguehttp://www.fitango.com/categories.php?id=104 8
  10. 10. Symptoms -- fever -- nausea -- weight loss -- loss of appetite -- rectal bleeding -- loss of body fluids and nutrientshttp://www.fitango.com/categories.php?id=104 9
  11. 11. Symptoms -- skin lesions -- growth failure in children Most people diagnosed with UC have mild to moderate symptoms. About 10 percent have severe symptoms such as frequenthttp://www.fitango.com/categories.php?id=104 10
  12. 12. Symptoms fevers, bloody diarrhea, nausea, and severe abdominal cramps.1 UC can also cause problems such as joint pain, eye irritation, kidney stones, liver disease, and osteoporosis. Scientists do not know why these problemshttp://www.fitango.com/categories.php?id=104 11
  13. 13. Symptoms occur, but they think these complications may be the result of inflammation triggered by the immune system. Some of these problems go away when UC is treated. http://digestive.niddk.nih.gov/ddiseases/pubs/coli tis/http://www.fitango.com/categories.php?id=104 12
  14. 14. Diagnosis Ulcerative colitis can be difficult to diagnose because its symptoms are similar to those of other intestinal disorders and to Crohn’s disease. Crohn’s disease differs from UC in thathttp://www.fitango.com/categories.php?id=104 13
  15. 15. Diagnosis Crohn’s disease causes inflammation deeper within the intestinal wall and can occur in other parts of the digestive system, including the small intestine, mouth, esophagus, and stomach. People with suspected UC may be referred tohttp://www.fitango.com/categories.php?id=104 14
  16. 16. Diagnosis a gastroenterologist, also called a gastroenterological specialist, a doctor who specializes in digestive diseases. A physical exam and medical history are usually the first steps in diagnosing UC, followed by one or more tests and procedures:http://www.fitango.com/categories.php?id=104 15
  17. 17. Diagnosis -- Blood tests. A blood test involves drawing blood at a health care provider’s office or commercial facility and sending the sample to a lab for analysis. The blood test can show a high white blood cell (WBC) count, which is a sign of inflammation somewhere in the body.http://www.fitango.com/categories.php?id=104 16
  18. 18. Diagnosis Blood tests can also detect anemia, which could be caused by bleeding in the colon or rectum. -- Stool test. Stool tests can show WBCs, which indicate UC or another IBD. The doctor will give the person a pan and ahttp://www.fitango.com/categories.php?id=104 17
  19. 19. Diagnosis container for catching and storing the stool. The sample is returned to the health care provider or a commercial facility and sent to a lab for analysis. The sample also allows doctors to detect bleeding or infection in the colon orhttp://www.fitango.com/categories.php?id=104 18
  20. 20. Diagnosis rectum caused by bacteria, a virus, or parasites. -- Flexible sigmoidoscopy and colonoscopy. These tests are the most accurate methods for diagnosing UC and ruling out other possible conditions, such as Crohn’s disease, diverticular disease, or cancer.http://www.fitango.com/categories.php?id=104 19
  21. 21. Diagnosis The tests are similar, but colonoscopy is used to look inside the rectum and entire colon, while flexible sigmoidoscopy is used to look inside the rectum and lower colon. For both tests, the doctor will provide written bowel prephttp://www.fitango.com/categories.php?id=104 20
  22. 22. Diagnosis instructions to follow at home before the test. The person may be asked to follow a clear liquid diet for 1 to 3 days before the test. A laxative may be required the night before the test. One or more enemas may be required the night before and about 2 hours before the test.http://www.fitango.com/categories.php?id=104 21
  23. 23. Diagnosis -- For both tests, the person lies on a table while the doctor inserts a flexible tube into the anus. A small camera on the tube sends a video image of the intestinal lining to a computer screen. The doctorhttp://www.fitango.com/categories.php?id=104 22
  24. 24. Diagnosis can see inflammation, bleeding, or ulcers on the colon wall. The doctor may also perform a biopsy by snipping a bit of tissue from the intestinal lining. The person will not feel the biopsy. The doctor will look at the tissue with ahttp://www.fitango.com/categories.php?id=104 23
  25. 25. Diagnosis microscope to confirm the diagnosis. These tests are performed at a hospital or outpatient center by a gastroenterologist. In most cases, a light sedative, and possibly pain medication, helps people relax. The test can show problems in thehttp://www.fitango.com/categories.php?id=104 24
  26. 26. Diagnosis rectum or lower colon that may be causing symptoms. -- Cramping or bloating may occur during the first hour after the test. Driving is not permitted for 24 hours after the test to allow the sedative time to wear off. Before the appointment, a person shouldhttp://www.fitango.com/categories.php?id=104 25
  27. 27. Diagnosis make plans for a ride home. Full recovery is expected by the next day. -- Computerized tomography (CT) scan and barium enema x ray. A CT scan uses a combination of x rays and computer technology to create three-dimensional (3-D) images. A CT scan may include thehttp://www.fitango.com/categories.php?id=104 26
  28. 28. Diagnosis injection of a special dye, called contrast medium. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. The procedure is performed in an outpatient center or hospital by anhttp://www.fitango.com/categories.php?id=104 27
  29. 29. Diagnosis x-ray technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging; anesthesia is not needed. A barium enema x ray involves the injection of contrast medium, called barium, into the colon tohttp://www.fitango.com/categories.php?id=104 28
  30. 30. Diagnosis make the colon, rectum, and lower part of the small intestine more visible in x-ray images. The procedure is performed in a hospital or outpatient center by an x-ray technician, and the images are interpreted by a radiologist;http://www.fitango.com/categories.php?id=104 29
  31. 31. Diagnosis anesthesia is not needed. These tests can show physical abnormalities and are sometimes used to diagnose UC. http://digestive.niddk.nih.gov/ddiseases/pubs/coli tis/http://www.fitango.com/categories.php?id=104 30
  32. 32. Treatment Treatment for UC depends on the severity of the disease and its symptoms. Each person experiences UC differently, so treatment is adjusted for each individual.http://www.fitango.com/categories.php?id=104 31
  33. 33. Treatment **Medication Therapy** While no medication cures UC, many can reduce symptoms. The goals of medication therapy are to induce and maintain remission—periods when the symptoms go away for months or even years—and tohttp://www.fitango.com/categories.php?id=104 32
  34. 34. Treatment **Medication Therapy** improve quality of life. Many people with UC require medication therapy indefinitely, unless they have their colon and rectum surgically removed. The type of medication prescribed depends on the severity of the UC.http://www.fitango.com/categories.php?id=104 33
  35. 35. Treatment **Medication Therapy** Aminosalicylates, medications that contain 5-aminosalicyclic acid (5-ASA), help control inflammation. One medication, sulfasalazine (Azulfidine), is a combination of sulfapyridine and 5-ASA. The sulfapyridine component carries the anti-inflammatory 5-ASA to thehttp://www.fitango.com/categories.php?id=104 34
  36. 36. Treatment **Medication Therapy** intestine. Sulfapyridine may lead to side effects such as nausea, vomiting, heartburn, diarrhea, and headache. Other 5-ASA agents, such as olsalazine (Dipentum), mesalamine (Asacol, Canasa, Lialda, Rowasa), and balsalazide (Colazal), causehttp://www.fitango.com/categories.php?id=104 35
  37. 37. Treatment **Medication Therapy** fewer side effects, and can be used by people who cannot take sulfasalazine. Depending on which parts of the colon and rectum are affected by UC, 5-ASAs can be given orally; through a rectal suppository, a small plug of medicationhttp://www.fitango.com/categories.php?id=104 36
  38. 38. Treatment **Medication Therapy** inserted in the rectum; or through an enema— liquid medication put into the rectum. Unless the UC symptoms are severe, people are usually first treatedwith aminosalicylates. These medications are also used when symptoms return after a period of remission.http://www.fitango.com/categories.php?id=104 37
  39. 39. Treatment **Medication Therapy** Corticosteroids, such as prednisone, methylprednisone, and hydrocortisone, also reduce inflammation. They are used for people with more severe symptoms and people who do not respond to 5-ASAs. Corticosteroids, also known as steroids, can be given orally, intravenously, orhttp://www.fitango.com/categories.php?id=104 38
  40. 40. Treatment **Medication Therapy** through an enema, a rectal foam, or a suppository, depending on which parts of the colon and rectum are affected by UC. Side effects include weight gain, acne, facial hair, hypertension, diabetes, mood swings, bone mass loss, and anhttp://www.fitango.com/categories.php?id=104 39
  41. 41. Treatment **Medication Therapy** increased risk of infection. Because of harsh side effects, steroids are not recommended for long-term use. Steroids are usually prescribed for short-term use and then stopped once inflammation is under control. The other UChttp://www.fitango.com/categories.php?id=104 40
  42. 42. Treatment **Medication Therapy** medications are used for long-term symptom management. Immunomodulators, such as azathioprine (Imuran, Azasan), 6-mercaptopurine (6-MP) (Purinethol), and cyclosporine (Neoral, Sandimmun, Sandimmune), suppress the immune system. These medicationshttp://www.fitango.com/categories.php?id=104 41
  43. 43. Treatment **Medication Therapy** are prescribed for people who do not respond to 5-ASAs. Immunomodulators are given orally, but they are slow-acting and can take 3 to 6 months to take effect. People taking these medications are monitored for complicationshttp://www.fitango.com/categories.php?id=104 42
  44. 44. Treatment **Medication Therapy** including nausea, vomiting, fatigue, pancreatitis, hepatitis, a reduced WBC count, and an increased risk of infection. Cyclosporine is only used with severe UC, because one of its frequent side effects is toxicity, which means it can cause harmful effects to the body over time.http://www.fitango.com/categories.php?id=104 43
  45. 45. Treatment **Medication Therapy** Infliximab (Remicade) is an anti-tumor necrosis factor (anti-TNF) agent prescribed to treat people who do not respond to the other UC medications or who cannot take 5- ASAs. People taking Infliximab should also take immunomodulators to avoid allergic reactions. Infliximabhttp://www.fitango.com/categories.php?id=104 44
  46. 46. Treatment **Medication Therapy** targets a protein called TNF that causes inflammation in the intestinal tract. The medication is given through intravenous infusion—through a vein—every 6 to 8 weeks at a hospital or outpatient center. Side effects may include toxicityhttp://www.fitango.com/categories.php?id=104 45
  47. 47. Treatment **Medication Therapy** and increased risk of infections, particularly tuberculosis. Other medications may be prescribed to decrease emotional stress or to relieve pain, reduce diarrhea, or stop infection.http://www.fitango.com/categories.php?id=104 46
  48. 48. Treatment **Hospitalization** Sometimes UC symptoms are severe enough that a person must be hospitalized. For example, a person may have severe bleeding or diarrhea that causes dehydration. In such cases, health carehttp://www.fitango.com/categories.php?id=104 47
  49. 49. Treatment **Hospitalization** providers will use intravenous fluids to treat diarrhea and loss of blood, fluids, and mineral salts. People with severe symptoms may need a special diet, tube feeding, medications, or surgery.http://www.fitango.com/categories.php?id=104 48
  50. 50. Treatment **Surgery** About 10 to 40 percent of people with UC eventually need a proctocolectomy—surgery to remove the rectum and part or all of the colon.1 Surgeryhttp://www.fitango.com/categories.php?id=104 49
  51. 51. Treatment **Surgery** is sometimes recommended if medical treatment fails or if the side effects of corticosteroids or other medications threaten a person’s health. Other times surgery is performed because of massive bleeding, severe illness, colonhttp://www.fitango.com/categories.php?id=104 50
  52. 52. Treatment **Surgery** rupture, or cancer risk. Surgery is performed at a hospital by a surgeon; anesthesia will be used. Most people need to remain in the hospital for 1 to 2 weeks, and full recovery can take 4 to 6 weeks. A proctocolectomy is followed by one of thehttp://www.fitango.com/categories.php?id=104 51
  53. 53. Treatment **Surgery** following operations: Ileoanal pouch anastomosis, also called “pouch surgery,” makes it possible for people with UC to have normal bowel movements, because it preserves part of the anus. For this operation, thehttp://www.fitango.com/categories.php?id=104 52
  54. 54. Treatment **Surgery** surgeon preserves the outer muscles of the rectum during the proctocolectomy. The ileum—the lower end of the small intestine— is then pulled through the remaining rectum and joined to the anus, creating a pouch. Waste is stored inhttp://www.fitango.com/categories.php?id=104 53
  55. 55. Treatment **Surgery** the pouch and passes through the anus in the usual manner. Bowel movements may be more frequent and watery than before the procedure. Inflammation of the pouch, called pouchitis, is a possible complication and can lead to symptomshttp://www.fitango.com/categories.php?id=104 54
  56. 56. Treatment **Surgery** such as increased diarrhea, rectal bleeding, and loss of bowel control. Pouch surgery is the first type of surgery considered for UC because it avoids a long-term ileostomy. Ileostomy is an operation thathttp://www.fitango.com/categories.php?id=104 55
  57. 57. Treatment **Surgery** attaches the ileum to an opening made in the abdomen, called a stoma. The stoma is about the size of a quarter and is usually located in the lower right part of the abdomen near the beltline. An ostomy pouch is then attached to the stomahttp://www.fitango.com/categories.php?id=104 56
  58. 58. Treatment **Surgery** and worn outside the body to collect stool. The pouch needs to be emptied several times a day. An ileostomy performed for UC is usually permanent. A specially trained nurse will teach the person how to clean, care for, andhttp://www.fitango.com/categories.php?id=104 57
  59. 59. Treatment **Surgery** change the ostomy pouch and how to protect the skin around the stoma. The type of surgery recommended will be based on the severity of the disease and the person’s needs, expectations, and lifestyle. People faced with this decision should get as much information ashttp://www.fitango.com/categories.php?id=104 58
  60. 60. Treatment **Surgery** possible by talking with their doctors; enterostomal therapists, nurses who work with colon surgery patients; other health care professionals; and people who have had colon surgery. Patient advocacy organizations can provide information about support groups and other resources.http://www.fitango.com/categories.php?id=104 59

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