UC

Ulcerative Colitis ( UC ) Ulcerative colitis is an inflammatory bowel disease (IBD) that causes chronic inflammation of the digestive tract It is characterized by abdominal pain and diarrhea. Like Crohn's disease, another common IBD, ulcerative colitis can be debilitating and sometimes can lead to life-threatening complications.

Ulcerative colitis usually affects only the innermost lining of the large intestine (colon) and rectum. It occurs only through continuous stretches of the It occurs only through continuous stretches of the colon, unlike Crohn's disease, which occurs in patches anywhere in the digestive tract and often spreads deep into the layers of affected tissues

Etiology of UC: Unknown, unclear - Heredity - autoimmune reaction - Inflammatory reaction - Stress ( precipitates symptoms rather than causes UC )

Diagnosis of UC - Clinical manifestations Abdominal pain, diarrhea, bloody diarrhea Abdominal pain, diarrhea, bloody diarrhea - Endoscopy, biopsy Complications of UC - Toxic megacolon The most serious acute complication of ulcerative colitis that occurs when the colon becomes paralyzed, resulting in no bowel movement or passing gas

Signs and symptoms of toxic megacolon include fever, abdominal pain and swelling, weakness and disorientation If toxic megacolon isn't treated, the colon may rupture, causing peritonitis, a life-threatening condition requiring emergency surgery. Other complications to UC include: - Perforated colon, severe dehydration - Liver disease - Inflammation of the skin, joints and eyes - Colon cancer

Treatment of UC: There's no known cure for ulcerative colitis, but therapies are available that may dramatically reduce the signs and symptoms of ulcerative colitis and even bring about a long-term remission Ulcerative colitis treatment usually involves either drug therapy or surgery The goal of medical treatment is to reduce the inflammation that triggers the signs and symptoms

A. Anti-inflammatory drugs Anti-inflammatory drugs are often the first step in the treatment of IBD. They include: A. Anti-inflammatory drugs Anti-inflammatory drugs are often the first step in the treatment of IBD. They include: - Sulfasalazine It is a sulfa drug, in the gut is converted to sulfapyridine and 5-ASA ( 5-amino salicylates ) It is a sulfa drug, in the gut is converted to sulfapyridine and 5-ASA ( 5-amino salicylates ) Sulfapyridine has no antiinlammatory effect, absorbed to systemic circulation and responsible for most of the side effects to sulfasalazine including allergy Sulfapyridine has no antiinlammatory effect, absorbed to systemic circulation and responsible for most of the side effects to sulfasalazine including allergy 5-ASA remains in the colon and has good antiinflammatory effect 5-ASA remains in the colon and has good antiinflammatory effect-

- Mesalamine and olsalazine These medications tend to have fewer side effects than sulfasalazine has. These medications tend to have fewer side effects than sulfasalazine has. - Balsalazide This drug is similar to sulfasalazine, but produces fewer side effects This drug is similar to sulfasalazine, but produces fewer side effects

- Corticosteroids Corticosteroids can help reduce inflammation, but they have numerous side effects, including a puffy face, excessive facial hair, night sweats, insomnia and hyperactivity, high blood pressure, type II diabetes, osteoporosis, bone fractures, cataracts and an increased susceptibility to infections. Corticosteroids can help reduce inflammation, but they have numerous side effects, including a puffy face, excessive facial hair, night sweats, insomnia and hyperactivity, high blood pressure, type II diabetes, osteoporosis, bone fractures, cataracts and an increased susceptibility to infections. Long-term use of steroid drugs is not advised Long-term use of steroid drugs is not advised

Use corticosteroids only in cases of moderate to severe inflammatory bowel diseases that don't respond to other treatments Steroids may be used in conjunction with other medications as means to induce remission For example, steroids may be used with an immune system suppressor — the steroids can induce remission, while the immune system suppressors can help maintain remission

B. Immune system suppressors These drugs also reduce inflammation, but they target the immune system rather than treating inflammation itself. Immunosuppressant drugs include: - Azathioprine and Mercaptopurine These drugs have been recently approved to treat UC Because azathioprine and mercaptopurine act slowly, they are sometimes initially combined with a corticosteroids

- Cyclosporine It is a potent drug which is normally reserved for people who don't respond well to other medications - Infliximab This drug is a monoclonal antibody effective in patients with moderate to severe UC who don't respond to or can't tolerate other treatments It works by neutralizing a protein produced by your immune system known as tumor necrosis factor (TNF)

Nicotine skin patches These skin patches - the same kind smokers use - seem to provide short-term relief from flare-ups of ulcerative colitis for some people, especially people who formerly smoked

Other medications In addition to controlling inflammation, some medications may help relieve UC signs and symptoms. - Anti-diarrheals - Anti-diarrheals - Pain relievers. For mild pain e.g headache use acetaminophen. NSAIDs are contraindicated because they lead to diarrhea - Pain relievers. For mild pain e.g headache use acetaminophen. NSAIDs are contraindicated because they lead to diarrhea - Iron supplements. If patients have chronic intestinal bleeding, they may develop iron deficiency anemia - Iron supplements. If patients have chronic intestinal bleeding, they may develop iron deficiency anemia

Surgery If diet and lifestyle changes, drug therapy or other treatments don't relieve signs and symptoms of UC, surgery is recommend