Ulcerative colitis (IBD)

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that primarily affects the colon and rectum. The mucous membranes of the intestine are red, swollen, bleed easily and may sometimes have ulcers. The infestation is usually continuous and often more pronounced in the rectum.

Cause

Ulcerative colitis is thought to arise from a combination of factors including hereditary predisposition, changes in intestinal flora, diet and environmental influences.

Ulcerative colitis is related to Crohn's disease, but there are distinct differences.

Symptoms

The disease often has a variable course in which periods with symptoms and disease activity alternate with periods without symptoms and little disease activity.

The symptoms listed below may occur:

  • Diarrhea (often with mucus and/or blood)
  • Abdominal pain
  • Weight loss

Additional symptoms may include:

  • Fever
  • False urge to sit down
  • Nausea and/or vomiting
  • Fatigue

Diagnosis

Diagnosis is made based on your pattern of symptoms and with additional tests. A blood draw and stool test is always required. Usually you will have a colonoscopy in which samples of the bowel (biopsies) are also taken. Sometimes a gastroscopy or a scan of the abdomen is needed.

Colonoscopy
Gastroscopy

Treatment

Which treatment is most appropriate depends from person to person. This includes your age and the severity of the inflammation. The presence of strictures and the involvement of other organs also affect treatment.

A possible treatment may consist of medication where one can choose medication to treat an attack in the short term and/or medication to keep the symptoms and inflammation away in the long term.

The surgery

Surgery is required if the intestinal inflammation is not sufficiently controllable with medication, or if colon cancer develops in the colon. Usually in this case, the entire colon is removed, regardless of how large the inflamed portion is. If only part of the colon is removed, the disease will almost always come back in the remaining part of the colon.

Surgical treatment usually consists of two procedures. First, the colon is removed from the abdomen. During this procedure, a temporary stoma will be made on the last part of the small intestine.

After twelve weeks, the second procedure takes place. Here the stoma is removed again and a kind of reservoir (pouch) is made of the last part of the small intestine. This reservoir should replace the function of the removed rectum. Thus, a stoma is no longer needed. The procedure can be done through laparoscopy (keyhole surgery) in many cases.

Laparoscopy (keyhole surgery)

Aftercare

To evaluate whether the treatment was successful, you will need to visit the doctor at regular intervals. Additional tests may be performed for monitoring.