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Ulcerative collitis.pptx
- 1. ULCERATIVE COLITIS SUBMITTED BY- ARPIT JAIN BAMS 2ND YEAR BATCH - 2017-18
- 2. INTRODUCTION Ulcerative colitisis a fairly common long term condition that causes inflammation in the colon. It is a form of inflammatory bowel disease (IBD) that is similar to Crohn's disease. The colon removes nutrients from undigested food and eliminates the waste products through the rectum and anus in the form of feces. In severe cases, ulcers form on the lining of the colon. These ulcers may bleed, which produces pus and mucus. According to the Genetics Home Reference library, an estimated 750,000 people in the United States have ulcerative colitis. This is equivalent to 40–240 in every 100,000 people.
- 3. SYMPTOMS Symptoms Shareon PinterestAbdominal pain is a common symptom of ulcerative colitis. The first symptom of ulcerative colitis is usually diarrhea. Feces becomes progressively looser, and there may be abdominal pain with cramps and a severe urge to pass stools. Diarrhea may begin slowly or suddenly. Symptoms depend on the extent and spread of inflammation. The most common symptoms of ulcerative colitis include: abdominal pain bloody diarrhea with mucus
- 4. The followingmight also occur: fatigue or tiredness weight loss loss of appetite anemia elevated temperature dehydration a constant urge to pass feces Symptoms are often worse early in the morning. Symptoms may be mild or absent for months or years at a time. However, they will usually return without treatment and vary depending on the affected part of the colon.
- 5. TYPES Ulcerative proctitis This type affects only the end of the colon, or the rectum. Symptoms tend to include: rectal bleeding, which may be the only symptom rectal pain an inability to move the bowels, despite frequent urges Ulcerative proctitis is usually the mildest type of ulcerative colitis.
- 6. Colon affected by ulcerativecolitis With massive pseudopolyps(Inflamm atory tissues).
- 7. Proctosigmoiditis Thisinvolves the rectum and the sigmoid colon, which is the lower end of the colon. Symptoms include: bloody diarrhea abdominal cramps abdominal pain a constant urge to pass stool
- 8. Left sided colitis This affects the rectum and the left side of the sigmoid and descending colon. Symptoms usually include: bloody diarrhea abdominal cramping on left side weight loss
- 9. Pancolitis Thisaffects the whole colon. Symptoms include: occasionally severe, bloody diarrhea abdominal pain and cramps fatigue considerable weight loss
- 10. Fulminant colitis This is a rare, potentially life threatening form of colitis that affects the whole colon. Symptoms tend to include severe pain and diarrhea, which can lead to dehydration and shock. Fulminant colitis can present a risk of colon rupture and toxic megacolon, which causes the colon to become severely distended
- 11. DIET Some dietarymeasures may help relieve symptoms, including: eating smaller, more regular meals, such as five or six small meals per day drinking plenty of fluids, especially water, to prevent dehydration avoiding caffeine and alcohol, which can both increase diarrhea avoiding sodas, which can increase gas keeping a food diary to identify which foods make symptoms worse
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- 13. A doctormay suggest temporarily following a specific diet depending on symptoms, such as: a low fiber diet a lactose free diet a low fat diet a low salt diet It may help to take supplements or eliminate particular foods from the diet. However, a person should discuss any complementary or alternative measures with a doctor before trying them.
- 14. Causes Theexact causes of ulcerative colitis are unclear. However, they may involve the following: Genetics About one-fifth of people with ulcerative colitis have a close relative who has the same condition, suggesting that it is heritable. Environmental The following environmental factors might affect the onset of ulcerative colitis: diet air pollution cigarette smoke poor hygiene
- 15. Immune system The body might respond to a viral or bacterial infection in a way that causes the inflammation associated with ulcerative colitis. Once the infection resolves, the immune system continues to respond, which leads to ongoing inflammation. Another theory suggests that ulcerative colitis may be an autoimmune condition. A fault in the immune system may cause it to fight nonexistent infections, leading to inflammation in the colon.
- 16. RISK FACTORS Some knownrisk factors for ulcerative colitis include: •Age: Ulcerative colitis can affect people at any age but is more common at 15–30 years of age. •Ethnicity: White people have a higher risk of developing the condition, as do those of Ashkenazi Jewish descent. •Genetics: Although recent studies have identified certain genes that may play a role in ulcerative colitis, the link is unclear due to the role of environmental factors.
- 17. DIAGNOSIS A doctorwill ask about a person's symptoms and medical history. They will also ask whether any close relatives have had ulcerative colitis, IBD, or Crohn's disease. They will also check for signs of anemia, or low levels of iron in the blood, and tenderness around the abdomen. Several tests can help rule out other possible conditions and diseases, including Crohn's disease, infection, and irritable bowel syndrome.
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- 19. These include: blood tests stool tests X-ray barium enema, during which a healthcare professional passes a fluid called barium through the colon to show any changes or anomalies in a scan sigmoidoscopy, in which a healthcare professional inserts a flexible tube with a camera at the end, called an endoscope, into the rectum colonoscopy, wherein a doctor examines the whole colon using an endoscope
- 20. TREATMENT A personwith ulcerative colitis will need to see a doctor who specializes in treating conditions of the digestive system, or a gastroenterologist. They will assess the type and severity of the condition and create a treatment plan. People with severe symptoms may require hospitalization, but a person with mild-to-moderate symptoms will most likely need outpatient treatment. Treatment will focus on: managing active symptoms until they go into remission maintaining remission to prevent further symptoms
- 21. Managing activeulcerative colitis Treatment will involve the use of several types of medication. We discuss these in the following sections: 5-aminosalicylic acid This is the standard treatment option for ulcerative colitis. Aminosalicylates tend to be effective in reducing inflammation. They often come in pill form, but doctors sometimes prescribe them as suppositories. For those who have an allergy to sulfa, there are also sulfa free forms available.
- 22. The mainforms include: mesalamine balsalazide sulfasalazine Side effects might include: nausea skin rash headaches diarrhea
- 24. If thesymptoms become severe or do not respond to aminosalicylates, a doctor may prescribe steroids. These can also reduce inflammation. Prolonged use of steroids, especially oral steroids, can have serious side effects. A doctor will usually recommend discontinuing steroid treatment as soon as the condition responds. Side effects include: acne and other skin problems low mood sleep problems swelling indigestion
- 25. Long termadverse effects include a higher risk of: bruising cataracts diabetes glaucoma high blood pressure muscle weakness osteoporosis thinning skin weight gain Immunosuppressants
- 26. If othertreatments have not been effective, or when the gastroenterologist needs to discontinue steroids, immunosuppressants may help relieve symptoms. These reduce immune activity and soothe inflammation in the colon and rectum. People tend to use an immunosuppressant called azathioprine to treat ulcerative colitis. Possible side effects include: nausea diarrhea liver damage anemia bruising infections
- 28. BIOLOGICS Biologics Doctorsmay prescribe antitumor necrosis factor agents to bring about remission. These include: infliximab (Remicade) adalimumab (Humira) golimumab (Simponi) Vedolizumab (Entyvio), a different biologic that targets the gut mucosal immune system
- 29. SURGERY Surgery Ifother treatments do not provide relief, surgery may be an option. Some surgical options include: Colectomy: A surgeon removes part or all of the colon. Ileostomy: A surgeon makes an incision in the stomach, extracts the end of the small intestine, and connects it to an external pouch, called a Kock pouch. The pouch then collects waste material from the intestine. Ileoanal pouch: A surgeon constructs a pouch from the small intestine and connects it to the muscles surrounding the anus. The ileoanal pouch is not an external pouch.
- 30. COMPLICATIONS Complications Thepossible complications of ulcerative colitis range from a lack of nutrients to potentially fatal bleeding from the rectum. We cover more possible complications in the sections below: Colorectal cancer Ulcerative colitis, especially if symptoms are severe or extensive, increases the risk of developing colon cancer. According to the National Institute of Diabetes and Digestive and Kidney Diseases, colon cancer risk is highest when ulcerative colitis affects the entire colon for longer than 8 years. Males with ulcerative colitis also have a higher risk of colon cancer than females with the condition.
- 31. Other possiblecomplications of ulcerative colitis include: inflammation of the skin, joints, and eyes liver disease osteoporosis perforated colon severe bleeding severe dehydration To prevent a loss of bone density, a doctor may prescribe vitamin D supplements, calcium, or other medications.
- 32. REFERENCES PATHOLOGY By Harshmohan ANATOMYBy BD Chaurasia INTERNET
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