Ulcerative Colitis
Ulcerative Colitis is an inflammatory bowel disease whose
cause is unknown. It tends to occur in teenagers and young
adults, but also affects those over age 55. The presenting
symptoms are usually bloody diarrhea, mucoid stools, abdominal
cramping and occasionally fever and weight loss.
Most cases are mild to moderate, and up to 30% of cases will
resolve completely for many years or forever. Others
however, will have symptoms that come and go, while 20-25% may
have chronic symptoms.
There are many medications that are used to treat this disease.
Mild to moderate disease may require suppositories or enemas to
treat the lower colon (i.e. Canasa, Rowasa, Cortenema).
Oral medications (i.e. Asacol, Azulfidine, Colazal, Pentasa) are
often helpful. Sometimes antibiotics like Flagyl or Cipro
are useful. For more severe or chronic disease, we may
employ immune modulators like Imuran, Azasan, 6-MP or
Prednisone. Remicade has been used in refractory cases.
If none of the above regimens can put the patient in remission,
and the quality of life is poor, then surgery is warranted.
Most of the time, a patient will be able to have the diseased
colon removed completely, and a connection made between the
small bowel and the anus, known as an ileo-anal anastomosis.
They may then live quite normally, as they did before they
contracted ulcerative colitis.
The most important part to remember about this disease is that
it is not the same for each person. The severity varies
greatly between people, as does their response to treatment.
One must be willing to try many regimens sometimes before the
right one is found for you.
Another important pearl that we learned through reviewing our experience over the past 15 years is that it is rare for ulcerative colitis to develop into cancer, even after 20-30 years or more of having the disease. Dysplasia is also quite rare, in our collective experience.
