Beware of Ulcerative Colitis, a Chronic Inflammatory Bowel Disease

Ulcerative colitis is a chronic inflammatory condition, not caused by infection; that affects the large intestine and leads to the formation of ulcers on the intestinal wall. This inflammation typically affects the rectum, gradually becoming less severe further into the intestine.

When the inflammation is limited to the rectum and sigmoid colon, it is known as rectosigmoiditis. In Asians, including those in Indonesia, the symptoms are usually mild to moderate, with only a small percentage of patients experiencing bloody stools or requiring surgery.

Ulcerative colitis primarily affects the innermost layer of the large intestine (colon) extending to the rectum. It involves inflammation, a defense mechanism of the body characterized by redness, pain, swelling, heat, and impaired movement. In most cases, the symptoms of ulcerative colitis develop gradually over time rather than suddenly. However, patients often overlook these symptoms, making it seem as though they appear abruptly.

Ulcerative Colitis Symptoms

The symptoms of ulcerative colitis can vary widely depending on the severity and location of the inflammation. In Indonesia, people with ulcerative colitis typically experience mild to moderate symptom. These symptoms are often so mild that they may be overlooked, leading to undiagnosed cases or inconsistent treatment.

These symptoms can significantly impact the quality of life for those affected. The most common symptoms include:

• Diarrhea with blood, mucus, or pus. One of the hallmark symptoms is diarrhea, often accompanied by blood, which comes from the inflamed inner lining of the intestine
• Abdominal pain or cramps. Patients frequently experience abdominal pain, ranging from mild to severe, usually localized in the lower abdomen but sometimes moving around. The pain may be felt only when the abdomen is pressed, though some patients may also need to move cautiously to avoid discomfort
• Bloating and frequent urge to defecate, without passing stool
• Loss of appetite. A common issue among ulcerative colitis patients is a decreased appetite
• Weight loss. Due to persistent diarrhea and reduced appetite, patients may experience significant weight loss
• In more severe cases, patients may develop a fever that is resistant to antibiotic treatment. With specialized tools, doctors can examine the inner lining of the digestive tract, revealing mucosal patterns that are characteristic of this disease

Causes of Ulcerative Colitis

The exact cause of ulcerative colitis is still unknown. However, several factors may contribute to the development of this disease, including:

• Autoimmune response, which is when the body's immune system malfunctions and mistakenly attacks the cells of the digestive system
• Family history. A person with a family history of ulcerative colitis has a higher risk of developing the disease. However, many people with ulcerative colitis do not have a family history
• Diet. A diet high in carbohydrates, fat, and gluten may increase the risk of ulcerative colitis
• Environmental factors. Certain environmental factors, such as infections and pollution, have also been identified as potential risk factors in the development of ulcerative colitis

Ulcerative Colitis Diagnosis

The process of diagnosing ulcerative colitis involves several stages. Doctors use various methods to ensure an accurate diagnosis. Some of these include:

Stool Test

A stool test is conducted to assess the risk of bleeding, inflammation, and digestive disorders, as well as to rule out infections in the digestive tract. This test includes a complete stool analysis, fecal calprotectin, and M2PK. Fecal calprotectin is commonly measured to determine the level of inflammation, both before and after treatment.

Endoscopy

Endoscopy is a procedure in which a flexible tube with a camera is inserted into the rectum and large intestine to directly visualize inflammation and ulcers in the intestinal walls, extending to the end of the small intestine. It also allows for the collection of tissue samples for laboratory analysis.

Biopsy

A microscopic examination or biopsy of tissue samples from the large intestine and the terminal part of the small intestine, taken during an endoscopy, offers a clearer understanding of the inflammation and damage in the intestines.

Blood Test

A blood test may be conducted to look for signs of inflammation (such as CRP, ESR, LDH, and TfR-F) or anemia, which are often associated with ulcerative colitis.

Sometimes, doctors may refer patients for additional tests, such as CT or MRI scans, to rule out other possible conditions. In some cases, diagnosing ulcerative colitis can be challenging because its symptoms may overlap with those of other medical conditions. Therefore, a thorough and comprehensive diagnostic process is essential to ensure accuracy.

Can Ulcerative Colitis Be Cured?

Currently, there is no cure for ulcerative colitis. However, effective treatment can control symptoms, extend periods of remission, and significantly improve the patient's quality of life. With appropriate medical care and, if necessary, surgical intervention, many patients can lead active and productive lives.

Colitis Ulcerative Treatment

Ulcerative colitis cannot be completely cured. People with this condition can enter a state known as remission, where they no longer experience symptoms. Treatment aims to reduce symptoms during flare-ups. Various treatment strategies are employed to manage ulcerative colitis, including controlling inflammation, adjusting dietary habits, and administering antibiotics to address infections if necessary.

Preventing ulcerative colitis may involve changes in diet and lifestyle. This includes avoiding foods that can increase inflammation, such as fried carbohydrates, soda, refined carbs or wheat flour and its derivatives, lards, organ meats, and processed meats.

Complications and a slow response to treatment often lead patients to switch doctors and change treatment methods frequently. Mild symptoms can sometimes decrease patient motivation to seek treatment, allowing the condition to worsen and lead to complications. Meanwhile, severe cases may require very expensive medications or even high-risk surgical procedures.

Effective monitoring of disease progression relies on cooperation between the patient and doctor. Patients with ulcerative colitis need to have regular follow-ups with their doctor to track the progression of the disease. This may include routine colonoscopies, monitoring of symptoms, as well as blood and stool tests.

Routine monitoring helps doctors assess how well the disease is controlled and whether any changes require adjustments in treatment. Understanding the progression of the disease over time is crucial for successful management.

Reference:

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