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Ulcerative Colitis: A Stomach Disease

Gastrointestinal diseases always trouble people. Ulcerative colitis is also one of the stomach diseases which can have serious impact if treatment is not given in time. It is an inflammatory bowel disease that causes chronic inflammation of the digestive tract and patient complaints for abdominal pain and diarrhea. Ulcerative colitis can be unbearable and sometimes can lead to severe complications. It usually affects only the inmost lining of large intestine (colon) and rectum. It occurs only through continuous stretches of colon. It has episodes of remissions (periods of disappearance of the disease) and relapses, or it may infrequently be a permanent disease. Doctors still not found permanent cure for ulcerative colitis, but through effective therapies, symptoms can be reduced up to some extent. There is no age limit. People can grip under this disease at any age but most commonly first develops between the ages of 15 and 40. About 1 in 7 cases it first develops in people over the age of 60.

The root cause of this disease is unfamiliar but doctors categorize it as an auto-immune disorder, i.e. the patient's immune system reacts with the inner lining of the covering of the large intestine (colon). In that sense it is similar to many auto-immune joint diseases in which the immune system reacts with joints causing inflammation of the joints, pain and malformation. The disease may be linked with stress and certain skin rashes.

Symptoms

The main symptoms of Ulcerative colitis are bloody diarrhea associated with pain and cramps in the abdomen, fever and weight loss. Stools may be foul-smelling and defecation could be painful. In India, the disease is often diagnosed late. Doctors first confuse it for dysentery due to bacteria or amoebae.

Diagnosis

Diagnosis depends on the symptoms and physical examination by the medical practitioners. Certain tests are done such as sigmoidoscopy or colonoscopy, rectal biopsy and barium enema which are useful to diagnose the disease. Treatment: The main treatment is through drugs which repress immune reaction. In milder cases, drugs like 5-amino salicylic acid or sulphasalazine can be recommended to treat the disease. In more severe cases, drugs like corticosteroids, either oral, enemas are given. Severe cases of the disease may be treated by more powerful immunosuppressants or more effectively by surgery. Since surgery removes the colon against which the immune system reacts, it is the only best cure of the disease. The surgery involves total removal of the large intestine, followed by an operation called a permanent ileostomy. The ileum which is the lower part of the small intestine is brought through a cut in the abdominal wall and formed into an opening. This allows the stool to collect in a bag attached to the skin. In many cases the ileum can ultimately be joined with the anal canal thus restoring the normal passage of stools.

Ulcerative colitis can extend for many years. Complete and permanent cure with medication alone is not yet possible. Ulcerative colitis can generally be controlled with proper treatment, but surgery is often required for a cure. To control diarrhea, patient must drink only clear liquids such as water, juice and tea in sufficient amount. It is important to drink often to avoid dehydration. Sucking on ice cubes may help in cases of nausea. Patient must avoid solids as they can cause cramps. Chronic ulcerative colitis may lead to dreaded disease like cancer of the intestine. Therefore, regular checkups by the doctor are important when the disease is prolonged. The doctor may do a colonoscopy and a biopsy of the colon once in two years. This will keep out the possibility of pre-cancerous changes or early cancer so that early surgery and lasting cure can be done. Sometimes patient may feel feeble when having ulcerative colitis. But when he adopts good food habits taking recommended diet and changing lifestyle, it may help control symptoms and lengthen the time between flare-ups. There is no evidence that certain eatables cause inflammatory bowel disease. But certain foods and beverages can exacerbate your symptoms. It's always good to eliminate food from diet that seems to make signs and symptoms bad. There are some guidelines which may help to control disease. These are basically to limit dairy products. Like many people with inflammatory bowel disease, some people may find that problems, such as diarrhea, abdominal pain and gas, improve when they eliminate dairy products. Patient must try substituting yogurt or low-lactose cheeses, such as Swiss and cheddar, for milk. They can also use an enzyme product, such as Lactaid, to help break down lactose. In some cases, they may need to eliminate dairy foods completely. For most people, high-fiber foods, such as fresh fruits and vegetables and whole grains, are a part of a healthy diet. But if some one has inflammatory bowel disease, fiber may make diarrhea, pain and gas worse. If raw fruits and vegetables bother, they must try steaming, baking or stewing them.

It has been also observed that one can tolerate some fruits and vegetables, but not others. In general, person may have more problems with foods in the cabbage family, such as broccoli and cauliflower, and with very crispy foods such as raw apples and carrots. One must avoid problem foods. These food items may be beans, cabbage and broccoli, raw fruit juices and fruits, especially citrus fruits, spicy food, popcorn, alcohol, caffeine, and foods and drinks that contain caffeine, such as chocolate and soda. Patients are recommended to eat small meals. They may feel better if they eat five or six small meals rather than two or three larger ones. Drink plenty of liquids will relieve symptoms. Alcohol and beverages that contain caffeine stimulate intestines and can make diarrhea worse, while carbonated drinks frequently produce gas. Ulcerative colitis can interfere with ability to absorb nutrients and patient's diet may be limited, vitamin and mineral supplements are necessary in supplying missing nutrients. They don't provide essential protein and calories, however, and shouldn't be a substitute for meals. It will always be better to discuss with an experienced dietitian if a person notices that he is losing weight or his diet has become very limited.

There are some psychological effects of disease on patients suffering from ulcerative colitis. Although stress does not cause inflammatory bowel disease but it can make signs and symptoms much worse and may activate flare-ups. Stressful events can range from minor irritations to a move, job loss or the death of a loved one. It is a generally observed that when person is under stress, his normal digestive process changes. His stomach empties more slowly and secretes more acids. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself. Although it is not always possible to avoid stress but person can cope up with some ways to reduce it. Some of coping strategies include: mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to doctor about an exercise plan that's right for person. Bio stress-reduction technique helps person reduce muscle tension and slow heart rate with the help of a machine. The goal is to help person enter a relaxed state so that he can cope up more easily with stress. Bio is usually taught in hospitals and medical centers. Regular relaxation and breathing exercises is an effective way to cope with stress from ulcerative colitis. He can take classes in yoga and meditation or practice at home using books or tapes. He can also practice progressive relaxation exercises. These help to relax the muscles in body, one by one. Start by tightening the muscles in feet, then concentrate on slowly letting all the tension go. Next, tighten and relax calves. Continue until the muscles in body, including those in your eyes and scalp, are completely relaxed. Deep breathing also can help person relax. Most adults breathe from their chests. Deep breathing can also help relax abdominal muscles, which may lead to more normal bowel activity. Hypnosis may reduce abdominal pain and bloating. A trained expert can teach how to enter a relaxed state and then guide person as he imagine intestinal muscles becoming smooth and calm.

This disease requires immediate attention. If the disease is prolonged then the chance of developing cancer of the large intestine (colon) is higher than average in people. Therefore patients with ulcerative colitis are generally advised to have their large intestine regularly checked after having had ulcerative colitis for about 8-10 years. This involves a look into the large intestine by a flexible telescope (colonoscopy) every now and then. Doctor will advise exactly how often patient should have this test. Commonly, a colonoscopy is routinely done every three years in people who have had ulcerative colitis for 10-20 years, every two years in people who have had ulcerative colitis for 20-30 years, and every year in people who have had ulcerative colitis for 30 or more years. In most cases, any changes are noticed from biopsies taken during colonoscopy long before any cancer develops. This is a similar principle to cervical smear testing in women. If changes are found then doctor advises surgery to remove the large intestine to prevent development of cancer. Recent studies indicate that the risk of cancer is likely to be reduced in people who take regular long-term 5-aminosalicylate medication. People must be alert and take preventive measures to control disease like ulcerative colitis. They must immediately visit to doctor if symptoms are observed. At right time, if doctors apply proper treatment then patient's life can be better.

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