Ulcerative Colitis

What's this

Ulcerative colitis is a chronic inflammatory disease that affects the large intestine, first affecting the rectum, then eventually extending to the entire colon. Typical symptoms are abdominal pain and diarrhea, often mixed with blood and mucous discharge.

Unlike Crohn's disease (another "chronic inflammatory bowel disease"), ulcerative colitis affects only the most superficial layers of the intestinal lumen, without extending to the underlying ones; furthermore, the manifestations remain localized in the large intestine, while in Crohn's disease they can also affect other tracts of the digestive tract.

At present, ulcerative colitis has neither a certain origin nor a definitive cure, but the pharmacological therapies available are able to reduce the symptoms and prevent complications; in some cases the effectiveness is such as to even favor spontaneous remission. in the long period of time.

Causes

Doctors do not yet know the exact cause of origin, even if many hypotheses of the past have now fallen away. Today we know, for example, that stress can no longer be considered the main cause of the disease, even if it can still favor the exacerbation. as it happens for psoriasis.
The currently most reliable hypotheses take into consideration the binomial between immune theory and heredity. Some researchers think that ulcerative colitis is caused by a virus or a bacterium, capable of triggering an exaggerated inflammatory response in the body, in turn capable of altering the normal metabolism of the cells that make up the intestinal mucosa. Others believe that this "alteration of the immune response is triggered by food-borne, bacterial or autogenic allergens. This last theory, based on autoimmune etiology, is currently considered the most viable hypothesis.

An important role would also seem to be played by individual genetics, since some epidemiological studies have shown a higher incidence of the disease among the relatives of an affected person.
There are therefore numerous hypotheses on the origin of ulcerative colitis, even if for the moment none of them is able to provide concrete answers.

Risk factors

During the numerous studies that have followed one another to investigate the root causes of the disease, a series of risk factors have also emerged, which in some way seem to predispose the patient to the development of the disease. Such factors include age, with a higher risk under thirty "and a secondary peak around the sixth decade of life, ethnicity, the most susceptible being white, a diet high in fat but low in fiber and, as mentioned, the familiarity for the pathology; there is also a slight predominance in the female sex. Finally, an important risk factor could also be represented by a condition known as sclerosing cholangitis, in which there is an inflammation of the bile ducts that from the liver, organ producing bile, they pour into the initial tract of the small intestine. The two diseases are in fact often associated.

Symptoms

For further information: Symptoms of ulcerative colitis

Symptoms of ulcerative colitis vary according to the severity and location of the inflammatory process.

When this remains confined to the rectal site, the patient may experience modest bleeding and tenesmus, that is, a painful spasm of the anus with a sensation of urgent need to defecate. As the inflammation extends ascending to the other sections of the large intestine. , is accompanied by increasingly severe symptoms. The classic manifestation includes diarrheal discharge mixed with blood, abdominal pain, fatigue, weight loss, and night sweats. All these symptoms have a relapsing course; acute episodes therefore serve as a prelude to periods of total remission, in turn followed by temporary exacerbations; in general, however, the disease does not worsen over time, even if an "exacerbation of the disorders is still possible in cases of medium severity.

When observed at the endoscopic examination, the mucous membrane of the rectum and of more or less extended parts of the colon presents numerous point ulcerations, hence the term "ulcerative colitis". In an advanced stage, the small ulcers merge with each other, creating lesions of the mucosa more or less extensive. These small ulcerations, which cause bleeding and the discharge of mucus into the lumen of the intestine, are responsible for the classic symptoms associated with ulcerative colitis.