Ulcerative colitis vs diverticulitis. Ulcerative Colitis vs. Diverticulitis: Understanding the Differences
What is the difference between ulcerative colitis and diverticulitis? How are their symptoms, causes, diagnosis, and treatments similar or different? Get the details.
Defining Ulcerative Colitis and Diverticulitis
Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) that causes inflammation and ulcers in the lining of the large intestine (colon). In contrast, diverticulitis is a condition where small, bulging pouches (diverticula) form in the colon wall and become inflamed or infected.
Shared Symptoms and Differences
Both UC and diverticulitis can cause similar symptoms like abdominal pain, cramping, diarrhea, and bleeding. However, UC is more likely to cause urgency to have a bowel movement, trouble passing stool despite the urge, weight loss, and fatigue. Diverticulitis, on the other hand, is more commonly associated with nausea, vomiting, bloating, and constipation.
Underlying Causes and Risk Factors
The causes of UC and diverticulitis differ. UC is thought to be an autoimmune condition where the body’s immune system mistakenly attacks the digestive tract. Diverticulitis, in contrast, is believed to be triggered by bacteria in the diverticula or increased pressure in the colon. Common risk factors for both include older age, race (white individuals are at higher risk), and certain dietary and lifestyle factors.
Diagnostic Approaches
Diagnosing UC and diverticulitis often involves a combination of medical history, physical exam, laboratory tests, and imaging studies like colonoscopy or CT scan. While the diagnostic approach may be similar, the specific findings can help differentiate between the two conditions.
Treatment Strategies
The treatment for UC and diverticulitis also has some similarities and differences. Both may involve medications to reduce inflammation and manage symptoms. However, UC often requires long-term treatment to control the disease, while diverticulitis may be treated more acutely during flare-ups.
Prognosis and Outlook
UC is a lifelong condition that can lead to serious complications, while diverticulitis is often a one-time or recurrent issue. The severity and course of each condition can vary greatly from person to person, emphasizing the importance of seeking proper medical care and following the recommended treatment plan.
Key Takeaways
While ulcerative colitis and diverticulitis share some common symptoms, they are distinct conditions with different underlying causes, diagnostic approaches, and treatment strategies. Understanding the differences between these two gastrointestinal disorders is crucial for ensuring accurate diagnosis and effective management.
What are the main differences between ulcerative colitis and diverticulitis in terms of their symptoms?
The main differences in symptoms are that ulcerative colitis is more likely to cause urgency to have a bowel movement, trouble passing stool despite the urge, weight loss, and fatigue, while diverticulitis is more commonly associated with nausea, vomiting, bloating, and constipation.
What are the key risk factors for developing ulcerative colitis versus diverticulitis?
Both conditions are more common in older individuals and white populations, but the underlying causes differ. Ulcerative colitis is thought to be an autoimmune condition, while diverticulitis is believed to be triggered by bacteria in the diverticula or increased pressure in the colon.
How do the diagnostic approaches for ulcerative colitis and diverticulitis differ?
The diagnostic approach for both conditions may involve a similar combination of medical history, physical exam, laboratory tests, and imaging studies like colonoscopy or CT scan. However, the specific findings from these tests can help differentiate between the two conditions.
What are the main differences in the treatment strategies for ulcerative colitis and diverticulitis?
Both conditions may involve medications to reduce inflammation and manage symptoms, but ulcerative colitis often requires long-term treatment to control the disease, while diverticulitis may be treated more acutely during flare-ups.
Ulcerative Colitis vs. Diverticulitis: What’s the Difference?
Written by Shishira Sreenivas
- Ulcerative Colitis and Diverticulitis: Similarities and Differences
- How Are Symptoms the Same and Different?
- How Are Causes and Risk Factors the Same and Different?
- How Is Diagnosis the Same and Different?
- How Is Treatment the Same and Different?
- Ulcerative Colitis and Diverticulitis: What’s the Outlook?
- More
If you’ve had stomach pain for a while and see blood when you poop, you might have ulcerative colitis (UC) or diverticulitis. The two conditions are different, but some of their symptoms can be the same because they’re both conditions in the large intestine or colon.
UC is a type of inflammatory bowel disease (IBD) that irritates the lining in your large intestine (also known as the colon). This causes tiny open sores, called ulcers, that produce pus and mucous.
Diverticulitis is a condition that you have when one or more tiny, bulging pouches (called diverticula) form over weak spots in the colon wall, and then tear and become infected or inflamed. Diverticula are usually pea-sized and can form anywhere throughout the colon. But they’re commonly found in the lower-left side of your large intestine called the sigmoid colon.
UC and diverticulitis both start out in the large intestine and share symptoms like belly pain and bloody poop. Both conditions are more likely the older you get, and both can range from mild to severe and vary for each person. But they differ in terms of what causes them and how your doctor might treat them.
UC is a lifelong condition that can lead to life-threatening problems. About a million Americans are affected by it. It can affect people at any age, including those in their 20s and 30s. If you have UC, you also might have weight loss or arthritis.
Diverticulitis, not a lifelong condition, is a complication of “diverticulosis.” It’s the term doctors use when one or more of the small bulging sacs grow on your colon wall. It usually starts in middle age and it’s common in older people. Diverticulitis can happen to you once and never happen again, or it might come and go. About 50% of those over the age of 60 have it, and almost everyone above 80 has it, too. Most are mild cases that don’t cause any symptoms and aren’t reasons to worry. Up to 30% of the people with diverticulosis go on to have diverticulitis. And among them, anywhere between 5%-15% will have symptoms like bloody poop.
UC and diverticulitis have some of the same symptoms, but they also have some that are different.
Shared ones include:
- Belly pain
- Cramping
- Diarrhea
- Bleeding
- Fever
If you have one or more of these symptoms, talk to your doctor. UC symptoms also include:
- Urgency to poop
- Trouble pooping despite the urgency
- Weight loss
- Fatigue
- Lack of growth in children
Diverticulitis symptoms also include:
- Nausea
- Vomiting
- Swelling or bloating
- Constipation
It’s important to note that if you have diverticulitis, you’re more likely to have constipation than diarrhea.
Doctors aren’t sure what causes you to get UC or diverticulitis, but the two conditions have some common risk factors:
- Age. Your odds for either condition go up as you get older.
- Race. White people are more likely than those of any other race to have UC or diverticulitis.
UC might be caused by an abnormal immune response in your body. This means that if your immune system is fighting off a virus or bacteria, it may mistakenly attack cells in your digestive tract, too.
Genes might also play a role. If a close relative like your parent or sibling has UC, you’re more likely to have it, too. If you’re of Ashkenazi Jewish descent (ancestors came from Eastern or Central Europe), your risk is even higher. Diet and stress don’t cause UC, but they may trigger your symptoms and cause flare-ups.
As for what causes diverticulitis, experts believe bacteria found in your poop might get pushed into the bulging sacs as it passes through the colon. This causes the sacs to become infected or inflamed. Another theory is that your poop, especially if you’re constipated, might put a lot of pressure against the colon walls as it passes through. This can cause tears in the sacs and increase your chances of an infection.
Other risk factors for diverticulitis include:
- Obesity
- Smoking
- Lack of exercise
- Diet low in fiber and high in animal fat
- Certain medications (like steroids, opioids, and nonsteroidal anti-inflammatory drugs like ibuprofen)
If you think you have either UC or diverticulitis, talk to your doctor about it. You might be referred to a gastroenterologist, a doctor who specializes in digestive issues, for a correct diagnosis.
Your doctor will first do a detailed medical exam. They’ll ask you about your medical history including things like your diet, your bowel movements, and medications you might be taking.
Common tests to diagnose UC and diverticulitis include:
- Blood tests. This is done to check for infections
- Stool sample test. This checks for bacteria or parasites that might cause your stomach pain, cramps, or diarrhea
- Colonoscopy. The doctor will use a thin, flexible tube with a camera on the tip to explore your entire colon. They may take small tissue samples to test.
- Flexible sigmoidoscopy. This is similar to a colonoscopy, except your doctor will only explore your rectum and s-shaped sigmoid colon – both of which are located at the lower end of your colon. This is usually done if you have severe inflammation.
- Barium enema. This test is also called lower gastrointestinal tract radiography. In this test, your doctor injects a liquid containing barium into your butt. The barium coats your entire colon and makes it easier to see clearly under an X-ray scan.
- CT scan. This test allows your doctor to scan your abdomen and pelvic area and spot inflamed areas in your colon. The scan can detect the irritated or inflamed pouches for diverticulitis and confirm the condition.
In both conditions, treatments usually involve medications or, sometimes, surgery. In severe cases, your doctor may recommend a combination of the two to bring your symptoms under control. Certain over-the-counter medications may ease some of your pain-related symptoms. These include:
- Anti-diarrheal medications
- Pain relievers
- Antispasmodics to ease cramps and bloating
- Iron supplements, especially if you’re bleeding
UC treatments may include:
Anti-inflammatory drugs. This is usually the first line of treatment. This can include drugs like 5-aminosalicylates and corticosteroids. Some newer drugs like sulfasalazine and 5-ASAs (like mesalamine), which are called “steroid-sparing,” can be safely taken long-term. Your doctor may not want you to take steroids long-term because of their side effects.
Immunosuppressant drugs. This helps to reduce inflammation in your colon and cut down the immune response that might attack your digestive cells.
Biologics. This targets the proteins made by your immune system.
Surgery. About 30% of people who have UC need surgery. It’s sometimes the only cure, especially if medications don’t ease your symptoms or they become too difficult to manage. Your doctor may consider a surgery called proctocolectomy.
In this procedure, your entire colon and rectum are removed. Most surgeries also involve a procedure in which your doctor will attach a pouch at the end of the small intestine or outside your body to pass poop directly into it.
Diverticulitis treatments may include:
Antibiotics. If your case is mild, your doctor may prescribe oral antibiotics to bring the symptoms under control. If you have multiple bouts of diverticulitis episodes, you’ll need to go to the hospital for intravenous (IV) antibiotics and fluids. At this point, your doctor may consider surgery as an option, too.
Surgery. Your doctor may recommend you have surgery for diverticulitis because of issues in your colon such as:
- Abscess (a type of walled-off infection)
- Obstruction
- Tears that cause pus or poop to leak into your stomach cavity
- Tunnel-like opening in the colon that connects with other organs (fistula)
- Continuous bleeding (if your diverticulitis is recurring)
In some cases, you may need a colostomy bag after surgery. It’s a pouch that’s attached outside of your body to pass poop into if your colon needs time to heal. Once your colon is healthy, your doctor might remove the colostomy bag.
UC is a lifelong condition, and your symptoms may come and go. About 30% of people with UC have severe symptoms, and flare-ups might happen more frequently. While medications often help, surgery may also be needed.
In contrast, most cases of diverticulitis, even though it’s also considered a lifelong condition, clear up with a 7- to 10-day course of antibiotics and plenty of rest. If you have severe symptoms, talk to your doctor about other treatment options.
Managing your diet and stress and making time for regular physical exercise are key to lowering your risks for both conditions. However, because some of the symptoms are specific, there are steps you can take to avoid your condition flaring up or getting worse.
To prevent diverticulitis, you should:
- Eat more fiber. This helps your poop move better in your digestive tract and reduces any pressure on the colon walls
- Drink lots of water, this prevents constipation.
If you’re not sure what to eat, talk to your doctor.
To lower your odds for UC or manage flare-ups, you should:
- Get plenty of sleep. This can ease emotional stress and keep your immune system in check.
- Avoid using too many nonsteroidal anti-inflammatory drugs (NSAIDs). For pain relief and fever, switch to alternatives like acetaminophen (Tylenol).
- Be careful when you take antibiotics. These drugs can trigger UC flare-ups. Let your doctor know if it does.
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Ulcerative Colitis vs. Diverticulitis: What’s the Difference?
Written by Shishira Sreenivas
- Ulcerative Colitis and Diverticulitis: Similarities and Differences
- How Are Symptoms the Same and Different?
- How Are Causes and Risk Factors the Same and Different?
- How Is Diagnosis the Same and Different?
- How Is Treatment the Same and Different?
- Ulcerative Colitis and Diverticulitis: What’s the Outlook?
- More
If you’ve had stomach pain for a while and see blood when you poop, you might have ulcerative colitis (UC) or diverticulitis. The two conditions are different, but some of their symptoms can be the same because they’re both conditions in the large intestine or colon.
UC is a type of inflammatory bowel disease (IBD) that irritates the lining in your large intestine (also known as the colon). This causes tiny open sores, called ulcers, that produce pus and mucous.
Diverticulitis is a condition that you have when one or more tiny, bulging pouches (called diverticula) form over weak spots in the colon wall, and then tear and become infected or inflamed. Diverticula are usually pea-sized and can form anywhere throughout the colon. But they’re commonly found in the lower-left side of your large intestine called the sigmoid colon.
UC and diverticulitis both start out in the large intestine and share symptoms like belly pain and bloody poop. Both conditions are more likely the older you get, and both can range from mild to severe and vary for each person. But they differ in terms of what causes them and how your doctor might treat them.
UC is a lifelong condition that can lead to life-threatening problems. About a million Americans are affected by it. It can affect people at any age, including those in their 20s and 30s. If you have UC, you also might have weight loss or arthritis.
Diverticulitis, not a lifelong condition, is a complication of “diverticulosis.” It’s the term doctors use when one or more of the small bulging sacs grow on your colon wall. It usually starts in middle age and it’s common in older people. Diverticulitis can happen to you once and never happen again, or it might come and go. About 50% of those over the age of 60 have it, and almost everyone above 80 has it, too. Most are mild cases that don’t cause any symptoms and aren’t reasons to worry. Up to 30% of the people with diverticulosis go on to have diverticulitis. And among them, anywhere between 5%-15% will have symptoms like bloody poop.
UC and diverticulitis have some of the same symptoms, but they also have some that are different.
Shared ones include:
- Belly pain
- Cramping
- Diarrhea
- Bleeding
- Fever
If you have one or more of these symptoms, talk to your doctor. UC symptoms also include:
- Urgency to poop
- Trouble pooping despite the urgency
- Weight loss
- Fatigue
- Lack of growth in children
Diverticulitis symptoms also include:
- Nausea
- Vomiting
- Swelling or bloating
- Constipation
It’s important to note that if you have diverticulitis, you’re more likely to have constipation than diarrhea.
Doctors aren’t sure what causes you to get UC or diverticulitis, but the two conditions have some common risk factors:
- Age. Your odds for either condition go up as you get older.
- Race. White people are more likely than those of any other race to have UC or diverticulitis.
UC might be caused by an abnormal immune response in your body. This means that if your immune system is fighting off a virus or bacteria, it may mistakenly attack cells in your digestive tract, too.
Genes might also play a role. If a close relative like your parent or sibling has UC, you’re more likely to have it, too. If you’re of Ashkenazi Jewish descent (ancestors came from Eastern or Central Europe), your risk is even higher. Diet and stress don’t cause UC, but they may trigger your symptoms and cause flare-ups.
As for what causes diverticulitis, experts believe bacteria found in your poop might get pushed into the bulging sacs as it passes through the colon. This causes the sacs to become infected or inflamed. Another theory is that your poop, especially if you’re constipated, might put a lot of pressure against the colon walls as it passes through. This can cause tears in the sacs and increase your chances of an infection.
Other risk factors for diverticulitis include:
- Obesity
- Smoking
- Lack of exercise
- Diet low in fiber and high in animal fat
- Certain medications (like steroids, opioids, and nonsteroidal anti-inflammatory drugs like ibuprofen)
If you think you have either UC or diverticulitis, talk to your doctor about it. You might be referred to a gastroenterologist, a doctor who specializes in digestive issues, for a correct diagnosis.
Your doctor will first do a detailed medical exam. They’ll ask you about your medical history including things like your diet, your bowel movements, and medications you might be taking.
Common tests to diagnose UC and diverticulitis include:
- Blood tests. This is done to check for infections
- Stool sample test. This checks for bacteria or parasites that might cause your stomach pain, cramps, or diarrhea
- Colonoscopy. The doctor will use a thin, flexible tube with a camera on the tip to explore your entire colon. They may take small tissue samples to test.
- Flexible sigmoidoscopy. This is similar to a colonoscopy, except your doctor will only explore your rectum and s-shaped sigmoid colon – both of which are located at the lower end of your colon. This is usually done if you have severe inflammation.
- Barium enema. This test is also called lower gastrointestinal tract radiography. In this test, your doctor injects a liquid containing barium into your butt. The barium coats your entire colon and makes it easier to see clearly under an X-ray scan.
- CT scan. This test allows your doctor to scan your abdomen and pelvic area and spot inflamed areas in your colon. The scan can detect the irritated or inflamed pouches for diverticulitis and confirm the condition.
In both conditions, treatments usually involve medications or, sometimes, surgery. In severe cases, your doctor may recommend a combination of the two to bring your symptoms under control. Certain over-the-counter medications may ease some of your pain-related symptoms. These include:
- Anti-diarrheal medications
- Pain relievers
- Antispasmodics to ease cramps and bloating
- Iron supplements, especially if you’re bleeding
UC treatments may include:
Anti-inflammatory drugs. This is usually the first line of treatment. This can include drugs like 5-aminosalicylates and corticosteroids. Some newer drugs like sulfasalazine and 5-ASAs (like mesalamine), which are called “steroid-sparing,” can be safely taken long-term. Your doctor may not want you to take steroids long-term because of their side effects.
Immunosuppressant drugs. This helps to reduce inflammation in your colon and cut down the immune response that might attack your digestive cells.
Biologics. This targets the proteins made by your immune system.
Surgery. About 30% of people who have UC need surgery. It’s sometimes the only cure, especially if medications don’t ease your symptoms or they become too difficult to manage. Your doctor may consider a surgery called proctocolectomy.
In this procedure, your entire colon and rectum are removed. Most surgeries also involve a procedure in which your doctor will attach a pouch at the end of the small intestine or outside your body to pass poop directly into it.
Diverticulitis treatments may include:
Antibiotics. If your case is mild, your doctor may prescribe oral antibiotics to bring the symptoms under control. If you have multiple bouts of diverticulitis episodes, you’ll need to go to the hospital for intravenous (IV) antibiotics and fluids. At this point, your doctor may consider surgery as an option, too.
Surgery. Your doctor may recommend you have surgery for diverticulitis because of issues in your colon such as:
- Abscess (a type of walled-off infection)
- Obstruction
- Tears that cause pus or poop to leak into your stomach cavity
- Tunnel-like opening in the colon that connects with other organs (fistula)
- Continuous bleeding (if your diverticulitis is recurring)
In some cases, you may need a colostomy bag after surgery. It’s a pouch that’s attached outside of your body to pass poop into if your colon needs time to heal. Once your colon is healthy, your doctor might remove the colostomy bag.
UC is a lifelong condition, and your symptoms may come and go. About 30% of people with UC have severe symptoms, and flare-ups might happen more frequently. While medications often help, surgery may also be needed.
In contrast, most cases of diverticulitis, even though it’s also considered a lifelong condition, clear up with a 7- to 10-day course of antibiotics and plenty of rest. If you have severe symptoms, talk to your doctor about other treatment options.
Managing your diet and stress and making time for regular physical exercise are key to lowering your risks for both conditions. However, because some of the symptoms are specific, there are steps you can take to avoid your condition flaring up or getting worse.
To prevent diverticulitis, you should:
- Eat more fiber. This helps your poop move better in your digestive tract and reduces any pressure on the colon walls
- Drink lots of water, this prevents constipation.
If you’re not sure what to eat, talk to your doctor.
To lower your odds for UC or manage flare-ups, you should:
- Get plenty of sleep. This can ease emotional stress and keep your immune system in check.
- Avoid using too many nonsteroidal anti-inflammatory drugs (NSAIDs). For pain relief and fever, switch to alternatives like acetaminophen (Tylenol).
- Be careful when you take antibiotics. These drugs can trigger UC flare-ups. Let your doctor know if it does.
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Diagnosis (page 7)
Page 7 of 10
Diagnosis
Before discussing the examination methods that allow correct diagnosis, I would like to note that inflammatory and ulcerative lesions of the colon mucosa are not always a manifestation of UC. The list diseases occurring with a similar clinical and endoscopic picture is large:
- infectious colitis (bacterial, viral, parasitic),
- Crohn’s disease,
- ischemic colitis (associated with insufficient blood supply to the intestinal wall),
- diverticulitis,
- drug-associated colitis,
- radiation colitis,
- colon cancer,
- solitary rectal ulcer
- endometriosis, etc.
The treatment of these diseases varies. Therefore, when the symptoms discussed above appear, the patient must definitely seek qualified medical help, and not self-medicate.
For a doctor to fully see the picture of the disease and choose the optimal treatment tactics, a comprehensive examination of the patient should be carried out. Necessary diagnostic procedures include laboratory and instrumental methods.
Blood tests are necessary to assess the activity of inflammation, the degree of blood loss, identify metabolic disorders (protein, water-salt), involvement in the pathological process of the liver, other organs (kidneys, pancreas, etc. ), determine the effectiveness of the ongoing treatment, tracking adverse reactions from medications taken.
Unfortunately, however, there are no “ulcerative colitis” blood tests sufficient to make a diagnosis. Modern immunological studies for specific indicators (perinuclear cytoplasmic antineutrophil antibodies (pANCA), antibodies to saccharomycetes (ASCA), etc.) serve only as an additional help in interpreting the results of all examinations and in the differential diagnosis of UC and Crohn’s disease.
Fecal tests, , which can be performed in any clinic and hospital (coprogram, Gregersen reaction – occult blood test) allow you to identify pathological impurities of blood, pus, mucus invisible to the naked eye. Bacteriological (crops) and molecular genetic (PCR) studies of stool are mandatory to exclude infectious pathology and select antibiotics. A relatively new promising study is considered to be the determination of indicators of intestinal inflammation in the feces (fecal calprotectin, lactoferrin, etc. ), which makes it possible to exclude functional disorders (irritable bowel syndrome).
Endoscopic procedures play a leading role in the diagnosis of inflammatory bowel disease. They can be performed both on an outpatient and inpatient basis. Before examining the intestines, it is very important to get the doctor’s recommendations for proper preparation for the procedure. Depending on the scope of the endoscopic examination, special laxatives, cleansing enemas, or a combination of both are usually used to fully cleanse the intestines. On the day of the study, only liquids are allowed. The essence of the procedure is the introduction through the anus into the intestines of an endoscopic apparatus – a tube with a light source and an attached video camera at the end. This allows the doctor not only to assess the condition of the intestinal mucosa, to identify the characteristic signs of UC, but also to painlessly take several biopsies (small pieces of intestinal tissue) using special forceps. Biopsy specimens are further used to carry out the histological examination necessary for the correct diagnosis.
Depending on the scope of the examination of the intestine, the following is performed:
- sigmoidoscopy (examination with a rigid sigmoidoscope of the rectum and part of the sigmoid colon),
- Fibrosigmoidoscopy (examination of the rectum and sigmoid colon with a flexible endoscope),
- fibrocolonoscopy (examination with a flexible endoscope of the colon),
- fibroileocolonoscopy (examination with a flexible endoscope of the entire large and part of the small (ileum) intestine).
Fibroileocolonoscopy is the preferred diagnostic test to distinguish UC from Crohn’s disease. To reduce the discomfort of the patient during the procedure, superficial anesthesia is often used. The duration of this study is from 20 minutes to 1.5 hours.
X-ray studies of the colon are performed when it is impossible to conduct a full endoscopic examination.
Barium enema can also be performed in a hospital or outpatient setting. On the eve of the study, the patient takes a laxative, he is given cleansing enemas. During the study, a contrast agent, a barium suspension, is injected into the patient’s intestine with an enema, then x-rays of the colon are taken. After emptying, air is introduced into the intestine, which inflates it, and x-rays are taken again. The resulting images can reveal areas of inflamed and ulcerated colonic mucosa, as well as its narrowing and expansion.
Plain radiography of the abdominal cavity in patients with UC allows to exclude the development of complications: toxic dilatation of the intestine and its perforation. Special preparation of the patient does not require.
Ultrasound examination (ultrasound) of the abdominal organs, hydrocolono-ultrasound, leukocyte scintigraphy, which reveal an inflammatory process in the colon, have low specificity in differentiating UC from colitis of other origin. The diagnostic value of MRI and CT colonography (virtual colonoscopy) continues to be refined.
Sometimes it is extremely difficult to distinguish UC from Crohn’s disease, this requires additional examinations: immunological, radiological (enterography, hydroMRI) and endoscopic (fibroduodenoscopy, enteroscopy, examination using an endoscopic video capsule) examination of the small intestine. Correct diagnosis is important because, despite the fact that immune mechanisms are involved in the development of both diseases, in some situations, treatment approaches can be fundamentally different. But even in developed countries, with a full examination, in at least 10-15% of cases it is not possible to distinguish these two pathologies from each other. Then the diagnosis of undifferentiated (unclassified) colitis is established, which has anamnestic, endoscopic, radiological and histological signs of both UC and Crohn’s disease.
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Forward
Ulcerative colitis: symptoms, treatment and clinical guidelines
Ulcerative colitis (formerly known as ulcerative colitis or UC) is a chronic inflammation of the lining of the large intestine with ulceration of the inner wall of the intestine. This is a severe chronic disease that can last for decades and significantly reduces the quality of human life. Approximately every 500th inhabitant of the Earth suffers from this pathology.
Most often, the first signs of ulcerative colitis appear in adolescence and early adulthood in the period of 15-30 years, but can be detected later.
What can cause ulcerative colitis?
Ulcerative colitis was previously thought to be caused by poor diet and frequent stress. However, further studies have shown that these factors may increase the severity of the symptoms of the disease, but are not its cause.
Currently, there is no single concept regarding the pathogenesis of ulcerative colitis. Probably, a significant contribution to the development of this disease is made by a violation of the mechanisms of the immune response in the body.
Hereditary causes can also play a role – most often, if there are relatives in the family who suffer from this pathology, other family members are also at increased risk. This is especially evident in the example of closed communities, for example, Ashkenazi Jews.
In addition, there is a theory that ulcerative colitis can be triggered by a high number of sulfate-reducing bacteria, the waste products of which trigger the development of this pathology.
Typology of ulcerative colitis
According to the localization of the affected area in the gastrointestinal tract, the following types of ulcerative colitis are distinguished:
- Proctitis – inflammation of the rectum.
- Proctsigmoiditis – affects the rectum and sigmoid colon.
- Distal colitis – pathological changes occur in the rectum, sigmoid and descending colon.
- Left-sided colitis – inflammation of the part of the large intestine located on the left side of the abdominal cavity (distal intestine plus transverse colon).
- Pancolitis – inflammation of the large intestine along its entire length.
Symptoms of ulcerative colitis
The most common symptoms of ulcerative colitis, depending on its location, are diarrhea with blood or pus, pain and cramps in the abdominal cavity. In addition, pathological fatigue, fever, nausea, sudden weight loss, anemia, joint pain and skin rashes are possible.
In different people, the symptoms of the disease may be stronger or weaker, all at once or separately. Spontaneous disappearance of symptoms (remission) is also possible, which can last for years.
Dangers, complications, risks of ulcerative colitis
- Colon cancer – patients are indicated for colonoscopy every 1-2 years;
- Thrombosis of arteries and veins;
- Inflammation of the eyes, mouth and skin;
- Bone demineralization and osteoporosis;
- Colonic edema;
- Inflammation and/or damage to the bile duct;
- Severe bleeding and associated infections;
- Dehydration due to constant blood loss.
Diagnosis of ulcerative colitis
Endoscopy is currently the leading diagnostic method. Also, for the diagnosis of ulcerative colitis, a histological analysis is performed to exclude Crohn’s disease from the diagnosis. To assess the severity of the course of the disease, laboratory tests are used (complete blood count, blood test for specific antibodies (pANCA) and inflammatory markers (C-reactive protein, CRP), fecal analysis). Ultrasound scanning and computed tomography can be used to assess the degree of edema of the large intestine and observe its possible perforation.
Treatment of ulcerative colitis
Treatment of ulcerative colitis, depending on the severity of the disease being tolerated, includes drug therapy, dietary changes and, in extreme cases, surgery. The course of therapy is aimed primarily at eliminating the symptoms of the disease and can be adjusted if unwanted side effects occur.
Clinical practice guidelines for the treatment of ulcerative colitis include the following types of drugs:
- Anti-inflammatory – to eliminate pathological inflammation;
- Antibiotics – for the treatment of associated infections;
- Corticosteroids – for short-term reduction of the immune response and inflammation;
- Immunosuppressants – to reduce the intensity of the immune response in the long term;
- Iron preparations – for the prevention of anemia and the restoration of hemoglobin levels;
- Specialized probiotics – to change the composition of the microflora of the gastrointestinal tract.
Is ulcerative colitis curable?
Unfortunately, even a well-chosen course of therapy is not able to guarantee a complete cure for ulcerative colitis. In some cases, patients continue to experience negative sensations even after surgery. However, following the doctor’s instructions, in combination with periodic diagnosis, allows you to achieve a stable remission in most cases.
Ulcerative Colitis Diet
Although diet is not a factor in causing ulcerative colitis, there are foods that increase the symptoms of the disease. These include milk, fiber-rich foods (vegetables, fruits, whole grains), spicy foods, alcohol, and caffeine. If the diagnosis is confirmed, these foods should be avoided. Following a diet for ulcerative colitis will help achieve sustainable remission.
Psychological care for ulcerative colitis
Since this pathological condition is associated with prolonged pain and chronic fatigue, the help of a qualified psychologist becomes important. The patient needs to reconsider his life attitudes, based on the reduced amount of resources; possibly change occupation and lifestyle. Psychological group therapy with patients suffering from this ailment may also be useful.
Traditional medicines in the treatment of ulcerative colitis
It is strictly not recommended to try to treat ulcerative colitis with “folk” remedies and alternative medicine.