What are the main symptoms of ulcerative colitis. How is ulcerative colitis diagnosed. When should a person with ulcerative colitis go to the hospital. What are the potential complications of untreated ulcerative colitis. How does ulcerative colitis differ from Crohn’s disease.

Understanding Ulcerative Colitis: An Overview

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that affects the lining of the large intestine (colon) and rectum. This condition is characterized by inflammation and ulcers in the digestive tract, leading to a variety of symptoms that can significantly impact a person’s quality of life. While the exact cause of ulcerative colitis remains unknown, researchers believe that a combination of genetic and environmental factors play a role in its development.

Ulcerative colitis is often confused with Crohn’s disease, another form of IBD. However, there are key differences between the two conditions. While Crohn’s disease can affect any part of the digestive tract from mouth to anus, ulcerative colitis is limited to the colon and rectum. Additionally, the inflammation in ulcerative colitis is continuous and affects only the innermost lining of the colon, whereas Crohn’s disease can cause patchy inflammation that extends through all layers of the bowel wall.

Recognizing the Symptoms of Ulcerative Colitis

The symptoms of ulcerative colitis can vary greatly from person to person and may range from mild to severe. Common symptoms include:

• Abdominal pain and cramping
• Diarrhea, often with blood or pus
• Rectal pain and bleeding
• Urgency to defecate
• Inability to defecate despite urgency
• Weight loss
• Fatigue
• Fever

In some cases, ulcerative colitis can also cause symptoms outside of the digestive system, such as:

• Joint pain and swelling
• Mouth sores
• Skin problems
• Eye inflammation

Can ulcerative colitis symptoms come and go. Yes, ulcerative colitis is characterized by periods of active disease (flares) and remission. During remission, a person may experience few or no symptoms, while flares can bring about severe symptoms that may last for days or weeks.

Causes and Risk Factors of Ulcerative Colitis

While the exact cause of ulcerative colitis remains unknown, researchers have identified several factors that may contribute to its development:

Immune System Dysfunction

One prevailing theory suggests that ulcerative colitis may be an autoimmune disorder. In this scenario, the immune system mistakenly attacks the cells in the digestive tract, leading to inflammation and ulceration.

Genetic Factors

There is evidence to suggest that ulcerative colitis may have a genetic component. People with a family history of IBD are at a higher risk of developing the condition. Several genes have been identified that may increase susceptibility to ulcerative colitis.

Environmental Triggers

Certain environmental factors may trigger the onset of ulcerative colitis or exacerbate symptoms in individuals who are genetically predisposed. These triggers may include:

• Stress
• Certain medications
• Diet
• Smoking (interestingly, smoking appears to have a protective effect against ulcerative colitis, although it is not recommended due to its numerous health risks)

Are there specific age groups more prone to developing ulcerative colitis. While ulcerative colitis can affect people of any age, it is most commonly diagnosed in young adults between the ages of 15 and 30. There is also a second peak in diagnosis among individuals aged 50 to 70.

Diagnostic Procedures for Ulcerative Colitis

Diagnosing ulcerative colitis typically involves a combination of medical history, physical examination, and various diagnostic tests. The most common procedures used to diagnose and assess the severity of ulcerative colitis include:

Colonoscopy

A colonoscopy is the gold standard for diagnosing ulcerative colitis. During this procedure, a flexible tube with a camera is inserted into the rectum and guided through the entire colon. This allows the doctor to visualize the lining of the colon and identify any areas of inflammation or ulceration. Biopsies (small tissue samples) may be taken during the colonoscopy for further analysis.

Flexible Sigmoidoscopy

Similar to a colonoscopy, a flexible sigmoidoscopy examines the rectum and lower part of the colon. This procedure may be used when symptoms suggest inflammation limited to the left side of the colon.

Blood Tests

Various blood tests can help diagnose ulcerative colitis and assess its severity:

• Complete Blood Count (CBC): Can reveal anemia or elevated white blood cell count, indicating inflammation or infection
• C-reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR): These markers can indicate the presence and severity of inflammation in the body
• Antibody tests: Certain antibodies may be present in people with ulcerative colitis

Stool Tests

Stool samples may be analyzed to rule out other conditions and assess inflammation levels:

• Fecal calprotectin: A protein that indicates intestinal inflammation
• Stool cultures: To rule out bacterial or parasitic infections

Imaging Studies

In some cases, imaging studies may be used to assess the extent of inflammation or identify complications:

• X-rays
• CT scans
• MRI

How long does it typically take to receive a diagnosis of ulcerative colitis. The diagnostic process can vary depending on the individual case and the severity of symptoms. In some cases, a diagnosis may be reached within a few weeks, while in others, it may take several months of testing and observation to confirm ulcerative colitis.

Treatment Options for Ulcerative Colitis

While there is no cure for ulcerative colitis, various treatment options are available to manage symptoms, induce and maintain remission, and improve quality of life. The choice of treatment depends on the severity of the disease, its location in the colon, and individual patient factors.

Medications

Several classes of medications are used to treat ulcerative colitis:

• Aminosalicylates: These anti-inflammatory drugs are often the first-line treatment for mild to moderate ulcerative colitis
• Corticosteroids: Used to reduce inflammation during severe flares, but not recommended for long-term use due to side effects
• Immunomodulators: These drugs suppress the immune system to reduce inflammation
• Biologics: Targeted therapies that block specific proteins involved in the inflammatory process
• Janus Kinase (JAK) inhibitors: A newer class of drugs that work by blocking certain enzymes involved in inflammation

Dietary Modifications

While diet doesn’t cause ulcerative colitis, certain foods may trigger or worsen symptoms in some individuals. Working with a dietitian to identify trigger foods and ensure proper nutrition is an important part of managing ulcerative colitis.

Probiotics

Some studies suggest that certain probiotics may help maintain remission in ulcerative colitis, although more research is needed in this area.

Surgery

In severe cases or when medical treatments are ineffective, surgery may be necessary. The most common surgical procedure for ulcerative colitis is a proctocolectomy with ileal pouch-anal anastomosis (IPAA), which involves removing the entire colon and rectum and creating an internal pouch from the small intestine.

Can ulcerative colitis be cured through surgery. While surgery can eliminate ulcerative colitis by removing the affected parts of the colon, it is generally considered a last resort when other treatments have failed or complications arise. It’s important to note that even after surgery, some individuals may experience complications or develop related conditions.

Complications of Ulcerative Colitis

Ulcerative colitis can lead to various complications, both within the digestive system and throughout the body. Some potential complications include:

• Severe bleeding
• Perforated colon
• Severe dehydration
• Liver disease
• Osteoporosis
• Increased risk of colon cancer
• Toxic megacolon (a rare but serious condition where the colon rapidly expands)
• Blood clots
• Growth delays in children

How often should individuals with ulcerative colitis undergo cancer screening. The risk of colon cancer increases with the duration and extent of ulcerative colitis. Generally, colonoscopy screenings should begin 8-10 years after the onset of symptoms and be repeated every 1-2 years. However, the exact screening schedule may vary based on individual risk factors and should be determined in consultation with a gastroenterologist.

Living with Ulcerative Colitis: Lifestyle Considerations

Managing ulcerative colitis extends beyond medical treatments. Lifestyle modifications can play a crucial role in managing symptoms and improving overall quality of life:

Stress Management

While stress doesn’t cause ulcerative colitis, it can exacerbate symptoms. Implementing stress-reduction techniques such as meditation, yoga, or regular exercise can be beneficial.

Dietary Considerations

While there’s no one-size-fits-all diet for ulcerative colitis, some general guidelines may help:

• Stay hydrated
• Eat smaller, more frequent meals
• Avoid trigger foods (which can vary from person to person)
• Consider keeping a food diary to identify problematic foods

Smoking Cessation

Although smoking may have a protective effect against ulcerative colitis, the health risks associated with smoking far outweigh any potential benefits. Quitting smoking is strongly recommended for overall health.

Regular Exercise

Regular physical activity can help reduce stress, improve overall health, and may have anti-inflammatory effects. However, it’s important to consult with a healthcare provider before starting any new exercise regimen.

Mental Health Support

Living with a chronic condition like ulcerative colitis can take a toll on mental health. Seeking support through therapy or support groups can be beneficial for managing the emotional aspects of the disease.

How can individuals with ulcerative colitis maintain a social life. Managing ulcerative colitis while maintaining an active social life can be challenging, but it’s not impossible. Open communication with friends and family about the condition, planning ahead for outings, and knowing the location of restrooms can help. Additionally, working with a healthcare team to effectively manage symptoms can improve confidence in social situations.

When to Seek Medical Attention for Ulcerative Colitis

While regular check-ups are essential for managing ulcerative colitis, certain symptoms warrant immediate medical attention. Individuals with ulcerative colitis should seek emergency care if they experience:

• Severe abdominal pain
• Heavy, persistent diarrhea
• Significant rectal bleeding
• High fever (above 101°F or 38.3°C)
• Signs of dehydration (extreme thirst, dry mouth, dark urine, dizziness)
• Severe fatigue

These symptoms could indicate a severe flare-up or complications that require prompt medical intervention. In some cases, hospitalization may be necessary to manage severe symptoms, prevent complications, and adjust treatment plans.

What should individuals with ulcerative colitis pack for a hospital visit. It’s advisable to have a pre-packed hospital bag containing essentials such as comfortable clothing, toiletries, a list of current medications and dosages, insurance information, and any medical devices or supplies specific to managing ulcerative colitis. Including items for comfort and entertainment, such as books or a tablet, can also be helpful during a hospital stay.

Ulcerative colitis Information | Mount Sinai

Inflammatory bowel disease – ulcerative colitis; IBD – ulcerative colitis; Colitis; Proctitis; Ulcerative proctitis

Ulcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel disease (IBD). Crohn disease is a related condition.

Why Choose Mount Sinai?

Mount Sinai has a unique and rich tradition of specialized and individualized treatment and scientific research and discovery in ulcerative colitis. The physicians/scientists in the Mount Sinai Health System are constantly conducting clinical trials and are developing new drug therapies to help patients manage their disease. Learn more about ulcerative colitis.

There are 3 basic tests for colon cancer; a stool test (to check for blood), sigmoidoscopy (inspection of the lower colon), and colonoscopy (inspection of the entire colon). All 3 are effective in catching cancers in the early stages, when treatment is most beneficial.

The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

Ulcerative colitis is categorized according to location. Proctitis involves only the rectum. Proctosigmoiditis affects the rectum and sigmoid colon. Left-sided colitis encompasses the entire left side of the large intestine. Pancolitis inflames the entire colon.

Causes

The cause of ulcerative colitis is unknown. People with this condition have problems with their immune system. However, it is not clear if immune problems cause this illness. Stress and certain foods can trigger symptoms, but they do not cause ulcerative colitis.

Ulcerative colitis may affect any age group. There are peaks at ages 15 to 30 and then again at ages 50 to 70.

The disease begins in the rectal area. It may stay in the rectum or spread to higher areas of the large intestine. However, the disease does not skip areas. It may involve the entire large intestine over time.

Risk factors include a family history of ulcerative colitis or other autoimmune diseases, or Jewish ancestry.

Symptoms

The symptoms can be more or less severe. They may start slowly or suddenly. Half of people only have mild symptoms. Others have more severe attacks that occur more often. Many factors can lead to attacks.

Symptoms may include:

• Pain in the abdomen (belly area) and cramping.
• A gurgling or splashing sound heard over the intestine.
• Blood and possibly pus in the stools.
• Diarrhea, from only a few episodes to very often.
• Fever.
• Feeling that you need to pass stools, even though your bowels are already empty. It may involve straining, pain, and cramping (tenesmus).
• Weight loss.

Children’s growth may slow.

Other symptoms that may occur with ulcerative colitis include the following:

• Joint pain and swelling
• Mouth sores (ulcers)
• Nausea and vomiting
• Skin lumps or ulcers

Exams and Tests

Colonoscopy with biopsy is most often used to diagnose ulcerative colitis. Colonoscopy is also used to screen people with ulcerative colitis for colon cancer.

Other tests that may be done to help diagnose this condition include:

• Barium enema
• Complete blood count (CBC)
• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)
• Stool calprotectin or lactoferrin
• Antibody tests by blood

Sometimes, tests of the small intestine are needed to differentiate between ulcerative colitis and Crohn disease, including:

• CT scan
• MRI
• Upper endoscopy or capsule study
• MR enterography 

Treatment

The goals of treatment are to:

• Control the acute attacks
• Prevent repeated attacks
• Help the colon heal

During a severe episode, you may need to be treated in the hospital. Your doctor may prescribe corticosteroids. You may be given nutrients through a vein (IV line).

DIET AND NUTRITION

Certain types of foods may worsen diarrhea and gas symptoms. This problem may be more severe during times of active disease. Diet suggestions include:

• Eat small amounts of food throughout the day.
• Drink plenty of water (drink small amounts throughout the day).
• Avoid high-fiber foods (bran, beans, nuts, seeds, and popcorn).
• Avoid fatty, greasy or fried foods and sauces (butter, margarine, and heavy cream).
• Limit milk products if you are lactose intolerant. Dairy products are a good source of protein and calcium.

STRESS

You may feel worried, embarrassed, or even sad or depressed about having a bowel accident. Other stressful events in your life, such as moving, or losing a job or a loved one can cause worsening of digestive problems.

Ask your health care provider for tips about how to manage your stress.

MEDICINES

Medicines that may be used to decrease the number of attacks include:

• 5-aminosalicylates such as mesalamine or sulfasalazine, which can help control moderate symptoms. Some forms of the drug are taken by mouth. Others must be inserted into the rectum.
• Medicines to quiet the immune system.
• Corticosteroids such as prednisone. They may be taken by mouth during a flare-up or inserted into the rectum.
• Immunomodulators, medicines taken by mouth that affect the immune system, such as azathioprine and 6-MP.
• Biologic therapy, if you do not respond to other drugs.
• Acetaminophen (Tylenol) may help relieve mild pain. Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). These can make your symptoms worse.

SURGERY

Surgery to remove the colon will cure ulcerative colitis and removes the threat of colon cancer. You may need surgery if you have:

• Colitis that does not respond to complete medical therapy
• Changes in the lining of the colon that suggests an increased risk for cancer
• Severe problems, such as rupture of the colon, severe bleeding, or toxic megacolon

Most of the time, the entire colon, including the rectum, is removed. After surgery, you may have:

• An opening in your belly called the stoma (ileostomy). Stool will drain out through this opening.
• A procedure that connects the small intestine to the anus to gain more normal bowel function.

Support Groups

Social support can often help with the stress of dealing with illness, and support group members may also have useful tips for finding the best treatment and coping with the condition.

The Crohn’s and Colitis Foundation of America (CCFA) has information and links to support groups.

Outlook (Prognosis)

Symptoms are mild in about one half of people with ulcerative colitis. More severe symptoms are less likely to respond well to medicines.

Cure is only possible through complete removal of the large intestine.

The risk for colon cancer increases in each decade after ulcerative colitis is diagnosed.

Possible Complications

You have a higher risk for small bowel and colon cancer if you have ulcerative colitis. At some point, your provider will recommend tests to screen for colon cancer.

More severe episodes that recur may cause the walls of the intestines to become thickened, leading to:

• Colon narrowing or blockage (more common in Crohn disease)
• Episodes of severe bleeding
• Severe infections
• Sudden widening (dilation) of the large intestine within one to a few days (toxic megacolon)
• Tears or holes (perforation) in the colon
• Anemia, low blood count

Problems absorbing nutrients may lead to:

• Thinning of the bones (osteoporosis)
• Problems maintaining a healthy weight
• Slow growth and development in children
• Anemia or low blood count

Less common problems that may occur include:

• Type of arthritis that affects the bones and joints at the base of the spine, where it connects with the pelvis (ankylosing spondylitis)
• Liver disease
• Tender, red bumps (nodules) under the skin, which may turn into skin ulcers
• Sores or swelling in the eye

When to Contact a Medical Professional

Contact your provider if:

• You develop ongoing abdominal pain, new or increased bleeding, fever that does not go away, or other symptoms of ulcerative colitis
• You have ulcerative colitis and your symptoms worsen or do not improve with treatment
• You develop new symptoms

Prevention

There is no known prevention for this condition.

Goldblum JR, Large bowel. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai and Ackerman’s Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018:chap 17.

Lichtenstein GR. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 132.

Mowat C, Cole A, Windsor A, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011;60(5):571-607. PMID: 21464096 pubmed.ncbi.nlm.nih.gov/21464096/.

Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD. ACG clinical guidelines: ulcerative colitis in adults. Am J Gastroenterol. 2019:114(3):384-413. PMID: 30840605 pubmed.ncbi.nlm.nih.gov/30840605/.

Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF. Ulcerative colitis. Lancet. 2017;389(10080):1756-1770. PMID: 27914657 pubmed.ncbi.nlm.nih.gov/27914657/.

Last reviewed on: 2/6/2022

Reviewed by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Ulcerative colitis and hopitalization: Risks and more

A person with ulcerative colitis (UC) who experiences frequent bowel movements or bloody diarrhea for more than 3 days may require hospitalization. People may also experience flare-ups or complications if it is left untreated.

This article will explain the symptoms, complications, and treatments of UC. It also looks at the outlook for those with the condition and when they should go to the hospital.

UC is a form of inflammatory bowel disease (IBD). A person should consult a doctor if they experience symptoms of UC and have never had it diagnosed. If symptoms persist or are severe, people should seek medical attention.

The symptoms of UC include:

• recurring diarrhea, which may contain mucus or blood
• frequent need to empty the bowels
• abdominal pain
• fatigue
• weight loss

A person may need admission to the hospital for further tests and treatment if symptoms are severe and doctors cannot help manage them as an outpatient.

A person with a previous UC diagnosis should contact their gastroenterologist if they suspect a flare-up.

Flare-ups

People with UC may experience episodes of mild symptoms, periods of few or no symptoms (known as remission), or flare-ups. A person can usually treat mild and moderate flare-ups at home.

However, the most severe flare-ups may require hospitalization to minimize the risk of dehydration or other potentially severe complications.

Signs of a flare-up include:

• frequent bowel movements, such as more than five times in 24 hours
• loose stool
• diarrhea with blood or mucus for more than 3 days
• fever
• waking up at night to have a bowel movement

A person may also experience nongastrointestinal symptoms, which could cause:

• arthritis
• eye swelling
• mouth ulcers
• rash
• mental health disorders

Doctors will assess a person’s symptoms, general health, and medical history.

Physical examinations will also check for signs such as abdominal tenderness and anemia. Other tests involve the examination of a stool sample and blood tests.

Further tests may include:

• Imaging tests: These tests may include an X-ray and CT scan to obtain a detailed visual of a person’s colon and rectum and rule out other serious complications.
• Sigmoidoscopy: This test evaluates the level and extent of bowel inflammation in the lower portion of the colon. During this test, the doctor will insert a flexible tube with a camera connected to it to collect a sample of bowel tissue, known as a biopsy.
• Colonoscopy: This test can help evaluate the entirety of the colon. The doctor will insert a tube with a camera inside the rectum during this test.

Treatments

The treatment depends on the severity of a person’s condition. The aim of treatment is usually to reduce symptoms and induce remission.

The treatment for the onset or flare-up of UC may include:

• 5-aminosalicylic acid drugs
• corticosteroids
• immunosuppressants such as cyclosporine and infliximab
• IV fluids and electrolytes administered directly into the veins
• biologic medications
• surgery, such as colectomy, if symptoms have not improved with other lines of treatment in 3–5 days after hospital admission

Adequate nutritional support is also an important part of managing UC symptoms.

Read more about UC types and treatments.

How long will a person stay in the hospital?

The time a person will stay in the hospital depends on the severity of their UC. Doctors usually discharge a person when symptoms respond to the treatment within a few days to a few weeks.

Medical professionals will take different samples to monitor the inflammation. They will also keep track of the consistency of the stool and the frequency of the bowel movements.

Doctors will allow a person with UC to leave the hospital when they are stable and can manage their symptoms at home.

Doctors do not know the exact cause of UC. However, research suggests potential causes of UC may include:

• A dysregulated autoimmune response: This response occurs when a person’s immune system, which usually defends their body against infections, mistakenly attacks the good bacteria. The bacteria usually help digestion and live inside the colon, but the immune system mistakes them for being an infection. This response leads to an inflammation of the colon and rectum. Learn more about UC as an autoimmune disease.
• Genetics: This occurs in people with certain types of genes. Among people with UC, 8–14% have a family history of IBD, and having a first-degree relative with the condition makes someone four times more likely to develop it. Read more about genetics and UC.
• Environmental factors: Certain environmental factors may increase the risk of developing UC, such as:
  • pollution
  • medication
  • certain types of diets

Find out about possible environmental factors linked to UC.

UC may lead to other potential complications that can result in hospitalization. If severe UC symptoms are left untreated, the following conditions may develop:

Perforated colon

Long-term colon inflammation may lead to perforation of the intestinal wall. This perforation can allow bacteria to leak into a person’s abdomen, causing peritonitis.

Peritonitis is a serious condition that can lead to blood poisoning and sepsis, a potentially fatal infection.

The symptoms of colon perforation may include:

• nausea and vomiting
• severe abdominal pain
• fever
• chills

A person with a perforated colon requires immediate medical attention. Doctors will conduct surgery to open the abdomen and immediately repair the hole in the intestines. This procedure is known as a laparotomy.

If a person experiences sepsis, they will require urgent medical treatment with IV fluids and antibiotics.

Read more about perforated colon causes and treatment.

Fulminant colitis

Fulminant colitis is uncommon but may occur in a small portion of people with severe UC who have:

• more than 10 stools per day
• continuous bleeding in their stool
• abdominal pain
• abdominal distention, or stomach swelling
• fever
• anorexia

Fulminant colitis is a medical emergency, and a person with its symptoms needs immediate hospitalization. Doctors usually treat fulminant colitis with IV medications or surgery.

Read more about colon surgery.

Toxic megacolon

Toxic megacolon is a serious and rare complication of UC. This condition may result in the enlargement of the colon. This can cause the rupture of the colon and septicemia as a consequence. Therefore, it requires immediate hospitalization.

The symptoms of toxic megacolon may include:

• severe bloody diarrhea
• low blood pressure
• abdominal tenderness
• rapid heart rate
• fever
• abdominal distension

Treatment options for toxic megacolon include:

• IV fluids
• IV steroids
• IV antibiotics
• bowel rest
• nasogastric compression to help release air from the bowel

Doctors will perform emergency surgery if people show signs of:

• hemorrhage
• peritonitis
• perforation

The usual surgical procedure for toxic megacolon involves subtotal or total colectomy (partial or total removal of the affected area) and ileostomy (creating an opening in the abdominal wall to release stool).

Learn more about colectomy versus ileostomy.

Rectal bleeding

Rectal bleeding occurs in most people with UC in varying amounts. This symptom usually results from ulcers in the lining of the large intestine. This symptom may lead to anal fissures or hemorrhoids.

Severe bleeding is uncommon, but a person must seek medical attention immediately.

Treatment for rectal bleeding depends on the specific cause, but doctors usually prescribe anti-inflammatory drugs to treat UC and bleeding.

Learn more about UC and rectal bleeding.

If hemorrhoids are causing rectal bleeding, medical professionals may treat them with the following:

• over-the-counter creams
• suppositories containing hydrocortisone
• outpatient surgical procedures such as rubber band ligation

People can treat most fissures with remedies such as:

• fiber supplements
• stool softeners
• warm baths
• topical creams

Primary sclerosing cholangitis

This condition is a possible complication of UC, consisting of the inflammation of a person’s bile ducts. Primary sclerosing cholangitis does not usually cause symptoms before it reaches an advanced stage.

The symptoms of primary sclerosing cholangitis may include:

• upper right abdominal pain
• itchy skin
• fatigue
• jaundice
• weight loss

Currently, there is no treatment for primary sclerosing cholangitis. The most severe cases of primary sclerosing cholangitis may require a liver transplant.

Bowel cancer

People with active UC have a higher risk of developing bowel cancer. Some of the symptoms of bowel cancer may overlap with those of UC, so a person should try to seek a prompt diagnosis to start a course of treatment.

Due to the risk, even without symptoms, doctors recommend that people with UC have a screening colonoscopy 8 years after first developing symptoms and then every 1–3 years, depending on the severity of the disease.

Bowel cancer treatment may include:

• surgery
• radiotherapy
• chemotherapy
• targeted therapies

Various methods help control symptoms and reduce the risk of developing complications that require hospitalization. These include:

• eating five or six smaller meals per day
• drinking plenty of fluids
• taking dietary supplements
• keeping a food diary to find out whether certain types of food make the symptoms of UC worse
• eating a low residue, or low fiber, diet
• exercising
• relieving stress, where possible, with relaxation techniques

Before changing their diet, a person with UC should consult a gastroenterologist or nutritionist.

UC may affect people differently. Some may remain in remission, while others may experience a flare-up of symptoms. Doctors usually prescribe medications to control the symptoms of UC.

A person with UC may develop serious complications if symptoms become severe or are left untreated. This may require immediate medical treatment in a hospital. If a person with severe symptoms does not respond to the usual line of treatment, doctors may need to perform surgery.

Lifestyle changes may help control and reduce the frequency of a person’s flare-ups. People can consult their gastroenterologist for management and treatment options.

What is Crohn’s disease and how much does it cost to treat

Ulcerative colitis usually starts abruptly: the patient notices blood in the stool or diarrhea occurs. In Crohn’s disease, manifestations can be intermittent for a long time. For example, sometimes the stomach hurts, sometimes loose stools, weight gradually drops. In both cases, you should immediately consult a doctor.

At the same time, it is impossible to make an accurate diagnosis only by symptoms, since similar manifestations can be with many intestinal diseases. Blood tests are usually ordered to look for inflammation, stool tests for occult blood, or Colon View Hb/Hp, and fecal calprotectin to make sure the inflammation is not caused by other causes.

A colonoscopy is also prescribed with a mandatory examination of the terminal ileum with multiple biopsy – an endoscopic examination of the large intestine and the distal part of the small intestine, during which pieces of tissue are taken to be studied in the laboratory. Colonoscopy is recommended to be performed under intravenous anesthesia, or sedation.

Gastroscopy may also be needed – an examination of the stomach and duodenum, if there is a suspicion that Crohn’s disease has affected the upper gastrointestinal tract.

At the age of 11, I developed severe diarrhea, the doctors decided that it was an infection and put me in the infectious disease department of a local hospital. They tried to treat me with antibiotics, but it didn’t help.

Seven days later, I lied to the doctor that everything was over so that they would let me go home, but at home the symptoms intensified – after a couple of days I ended up in the hospital again.

The doctors could not figure out what was wrong with me: diarrhea began to wake me up at night, my weight was dropping, and so was my appetite. I was prescribed a diet in the form of children’s cereals on the water, and then only kefir was allowed at all.

Most of the time I slept. Mom was allowed into my room, she began to lie with me, but I still didn’t get better. By that time, the chair was 20 times a day. Mom started calling hospitals in Moscow and asked to call the doctor on the phone, explaining the situation. As a result, one of the children’s hospitals agreed to take me on compulsory medical insurance.

In the new hospital, I had a colonoscopy with an intestinal biopsy. My entire large intestine was affected, and I was diagnosed with ulcerative colitis.

Mom was worried that I would become disabled and cried. I was prescribed a special anti-inflammatory treatment – I then took these pills for a year.

I was very happy. The pain went away, I didn’t wake up from the nighttime urge to go to the toilet, I played with other children all day, I began to eat normal food. I started to gain weight and a month later I was already at home.

For about a year, my mother followed my diet and adhered to diet table number four – it does not contain fatty meat, fish, legumes, whole milk, cheese and much more. However, with my pocket money, I secretly bought myself chips with cola.

A year later, I underwent a planned colonoscopy, which showed that my intestines had completely healed. They canceled my pills. Thus began my ten-year remission.

Diet for Crohn’s disease and ulcerative colitis

Nikolay Golovenko
gastroenterologist, GMS Clinic

In Russia, with inflammatory bowel diseases, special dietary tables are often prescribed or severe dietary restrictions are advised, excluding entire food groups from the menu. However, there is no evidence that this helps to improve well-being or somehow affects the course of the disease.

People with Crohn’s disease and ulcerative colitis can follow the usual dietary recommendations that apply to everyone: eat enough vegetables and fruits, less processed foods and sweets. In ulcerative colitis, it is also recommended to eat less red meat. And if, with Crohn’s disease, a narrowing has formed in the intestines, then it may be necessary to limit fiber in the diet so as not to provoke intestinal obstruction.

The second exacerbation, when I was again in the hospital

All these ten years I did not remember the diagnosis and did not check in any way. Already in adulthood, I once had a severe stomach ache and diarrhea appeared. I thought that the disease had returned, and went to the doctor in a private clinic. She prescribed me the same anti-inflammatory medicine for the intestines that I took in childhood – Salofalk. I drank the pills for a couple of weeks, and everything went away. Periodically, the symptoms returned for several years, but I did not attach any importance to this.

After university, I fell ill with depression, by which time the symptoms of bowel disease were pronounced. Diarrhea didn’t bother me because I rarely left the house. I didn’t have the strength to deal with the disease. So several more years passed.

With the onset of the COVID-19 pandemic, the symptoms increased dramatically. Nausea joined the pains in my stomach and diarrhea, I lost consciousness several times, the weight began to drop rapidly. I decided to go to the hospital for an examination, but on a CT scan, I was found to have bacterial pneumonia. Then any pneumonia was equated to covid, so I was refused hospitalization in the gastroenterology department, they offered me only a hospital for people with a coronavirus infection.

I refused and treated pneumonia at home with antibiotics, sometimes coming to the hospital for drips. I cured my pneumonia, but I didn’t get better. I wanted to get to a good gastroenterologist and found a private hospital.

There I had a colonoscopy for the first time since the age of 12 and the diagnosis of ulcerative colitis was confirmed. The doctor found a narrowing in the intestines and mistook it for cancer, which greatly frightened my mother. It didn’t matter to me what the diagnosis was: I just wanted not to wake up from pain every two hours and agreed to any treatment.

I again took a course of antibiotics, which the doctor prescribed for me for some reason, and the same anti-inflammatory drugs. I spent three days in the hospital, I could not stay any longer, because there was no more money. In three days I spent 300,000 R.

It seemed to me that I would return home, I would take pills – and everything would be fine.

However, after a couple of days, all the symptoms returned. After that, I went to the state clinic for compulsory medical insurance.

In the hospital, one of the types of Clostridium was found in my intestines – this bacterium causes severe inflammation of the intestines, often appears after antibiotic treatment. I was prescribed the necessary antibacterial treatment, and I quickly recovered. I was also prescribed hormonal drugs, I was very worried that I would get fat because of them. I spent a month in the hospital, then went home to recover.

After an exacerbation, I developed anemia, which often happens with inflammatory bowel diseases. I spent a total of 18,000 rubles on her treatment.

I spent 300,000 R for three days in a private clinic

Due to taking hormonal drugs, I really gained a lot, as I developed Cushing’s syndrome due to an excess of glucocorticoid hormones.

After stopping the pills, I returned to my normal weight in a year

My new diagnosis

The state clinic where I was treated was good, but not specialized – the doctors advised the next time to go to the State Scientific Center of Coloproctology. Ryzhykh, where they treat inflammatory bowel diseases, or find a gastroenterologist who works with them.

After I was discharged, I made an appointment with a private doctor, about whom I read good reviews in a chat for people with inflammatory bowel diseases. He was also recommended to me by a pediatric gastroenterologist who once treated me. One doctor’s appointment cost 7000 R.

The doctor at first suggested that I just had a clostridial infection, and not ulcerative colitis: each of my exacerbations began after taking antibiotics. We agreed that I would take my anti-inflammatory pills, and in a few months I would do a colonoscopy with a biopsy. Such a study costs 40,000 R. If the intestines heal, then there is no ulcerative colitis.

Unfortunately, three months later, the colonoscopy showed the same picture, and the doctor changed the diagnosis to Crohn’s disease. Inflammatory bowel disease is difficult to distinguish – it often happens that one diagnosis is changed to another.

I was very worried about the abrupt change in the diagnosis, I also felt despair and fatigue due to the prolonged exacerbation. I thought the new diagnosis was worse. So, with ulcerative colitis, if everything goes bad and no treatment works, you can remove the rectum and live on with the stoma. This is such a “hole” in the stomach, to which the intestines are led. Crohn’s disease can affect the entire gastrointestinal tract, and inflammation often returns after surgery. This means that operations can be repeated.

The gastroenterologist prescribed pills that suppress the immune system – the immunosuppressant Azathioprine. In autoimmune diseases, this is a way to block an unwanted reaction of the immune system.

Before treatment, it was necessary to vaccinate, taking into account age and previous vaccinations. Then the immunity will be weakened, it is easy to catch something, and it is better to protect yourself in advance at least from those diseases for which there are vaccines. I got vaccinated against pneumococcus, whooping cough, tetanus, diphtheria, coronavirus and hepatitis A.

You also need to get tested for tuberculosis. If there is a focus of the disease in the body, after the suppression of the immune system, the disease can become active or begin to progress rapidly.

I was glad that for the first time in my illness, the doctor told me that I didn’t need a diet, I could go in for sports, work out the press and even give birth to a child if I wanted to.

But it was still hard to come to terms with the new diagnosis. There was intense anxiety. I was afraid that I would spend the rest of my life in endless hospitalizations, communicating with burnt-out doctors, on drugs that increase the risk of developing tuberculosis or cancer.

At first, the doctor recommended therapy with a colonoscopy after two to three months

During the study, signs of Crohn’s disease were found

Treatment of Crohn’s disease and ulcerative colitis

Nikolay Golovenko
gastroenterologist, GMS Clinic

Inflammatory bowel disease cannot be completely cured. As a rule, you need to take therapy for life. Ulcerative colitis is often treated with anti-inflammatory drugs such as mesalazine and sulfasalazine. The first one is more expensive, but it is also better tolerated.

Crohn’s disease and severe forms of ulcerative colitis require drugs that suppress the immune system, such as methotrexate. Similar drugs are prescribed for other autoimmune diseases such as rheumatoid arthritis.

Biological therapy with monoclonal antibodies and some other drugs that selectively act on the immune system may also be prescribed.

During exacerbations, hormonal drugs – glucocorticoid hormones – can be used. They quickly relieve inflammation, but they have many side effects, so these drugs should not be taken constantly.

Sometimes surgery is indicated for ulcerative colitis or Crohn’s disease – if the disease is life-threatening or greatly reduces its quality. With ulcerative colitis, the entire large intestine is removed, with Crohn’s disease, the part of the intestine that is most affected by the disease. Patients with Crohn’s disease are operated on more often, as they often experience various complications: abscesses, intestinal narrowing, intestinal fistulas.

Is disability due to Crohn’s disease and why I did without it

In inflammatory bowel diseases, including Crohn’s disease, you can apply for disability if the disease affects your ability to work. The severity of the disease, complications, and whether the therapy is effective are taken into account.

Disability gives the right to social benefits and free receipt of a number of medicines. Some of which are expensive, and it is unprofitable to buy them yourself.

In particular, people with disabilities can undergo biotherapy for free – this is treatment with monoclonal antibodies, special medications in the form of injections or droppers. Such medicines are the most expensive: from 20,000 R to 200,000 R per pack.

If you receive biologics for disability, you need hospitalization for an examination in order to start treatment. Then at least once a year you have to go for preventive examinations.

If the drug is in the form of injections or tablets, it can be taken at home. Later, they can give an indefinite disability group, and it will not be necessary to go to examinations every year.

In addition to disability registration, there are two more ways to get biotherapy for free.

High-tech medical care. Need hospitalization in a specialized center for the treatment of inflammatory bowel diseases. In Moscow, this is the State Scientific Center for Coloproctology named after I. A. N. Ryzhikh and Moscow Clinical Research Center. In St. Petersburg – the Peter the Great Clinical Hospital and the VZK Center at the 31st city hospital.

You can’t choose the drug, they won’t give it to you either. For each injection, you need to come every two or eight weeks, depending on the drug. Before each injection, you need to take a lot of tests and get a referral from a therapist at a local clinic.

Clinical Trials. You need to undergo examinations and take tests, as well as keep a diary of self-observation. You can receive the drug only while the study is in progress. It usually lasts from one to seven years. Participation is free. You can find such studies through a special website.

The doctor immediately warned me that drugs that suppress the immune system might not help. Then biotherapy will be needed – for the sake of it, I began to apply for disability in advance. However, my attempt ended in failure.

I was denied disability three times with the following wording: “No persistent violations of body functions were found. ” After the third refusal, the decision of the commission can only be appealed in court.

The next day after the refusal of disability, I received a bad decisive analysis – after all, it was necessary to start treatment with biological preparations. I decided to buy them myself. Other options for free treatment did not suit me either: I realized that I did not want to depend on commissions and doctors in hospitals.

Now a doctor in a private clinic writes me a prescription, with which I go to the pharmacy and buy medicine. My drugs now are the biological drug Dalibra in injections and the immunosuppressant drug Azathioprine in tablets. I do injections on my own once every two weeks. It is not necessary to go to the hospital, as well as to take tests, without the need.

The responsibility for the treatment lies entirely with me, and only I am responsible for the process of obtaining the medicine. I spend about 30,000 R per month on them, half of them or more go to Dalibra. It seems to me that this is not a very big price for health. For medicines, you can apply for a tax deduction and return 13% of their cost if you work officially. I don’t have such an opportunity, so I didn’t return anything.

If biological therapy gives the desired effect, I will take it all my life. The doctor told me that you can cancel after four years of stable remission without symptoms, but then the likelihood of a new exacerbation increases.

Every three months I need to take a stool test for calprotectin to assess inflammation in the intestines, it costs 3000 R. I also need to do a computed tomography of the intestines once a year, since both my large and small intestines are affected, in addition, they have narrowings . It costs 11,000 R. Only the large intestine is visible on colonoscopy, I need to repeat this study every five years.

11,000 R I pay annually for computed tomography of the intestine

My biologic

A list of examinations that must be completed before each hospitalization in order to receive free biotherapy. It takes a huge amount of time

Computed tomography showing improvement

What tests and examinations are needed for inflammatory bowel diseases

Nikolay Golovenko
gastroenterologist, GMS Clinic

With ulcerative colitis and Crohn’s disease, you should regularly visit a doctor and be examined. It is worth checking the level of calprotectin protein in feces – on average every six months to a year. This is necessary to assess the strength of inflammation and the effectiveness of therapy.

It is also important to have a colonoscopy periodically – in some cases once a year, more often in a period of three to five years. With these diseases, the risk of developing colon cancer is higher, the examination helps not to miss it at the initial stage.

In case of malabsorption of nutrients, it may be necessary to control the level of vitamins B12 and D, and sometimes others.

Prognosis for Crohn’s disease and ulcerative colitis

Crohn’s disease can progress in different ways. In about 20% of people with this disease, it goes into stable remission, that is, the symptoms disappear and the person feels healthy. My remission has started again now – more than a year after the new diagnosis was made.

In some people, on the contrary, the condition worsens over time. Many of those diagnosed with Crohn’s disease need surgery sooner or later, either because of the disease itself or because of its complications.

Ulcerative colitis usually occurs with exacerbations and remissions between them. In about 20% of people with this disease, within five years, it spreads to neighboring parts of the colon. In 20-30% of cases, surgery will be required.

Against the background of biological therapy, the level of calprotectin in the analyzes decreased to normal. So the inflammation subsides.

Complications of Crohn’s disease

Nikolay Golovenko
gastroenterologist, GMS Clinic

The intestinal wall in Crohn’s disease can collapse due to the formation of deep ulcers – then a hole, or fistula, is formed in it. In place of healed ulcers, narrowings, or strictures, often form, due to which intestinal obstruction is possible.

If the small intestine is affected, there may be weight loss due to nutritional deficiencies. Anemia due to latent blood loss is also possible.

How to live with Crohn’s disease

My attitude towards illness. The disease taught me a very important skill: to take care of myself. People around me, especially my age, more often treat their body as if they rented it. But I know that the body does not forgive an irresponsible attitude towards itself.

I also go to a psychotherapist twice a month, he helped me a lot with accepting the diagnosis and fighting anxiety. The thought that my health can actually be bought scares me. There is a remission as long as there is a cure. Therefore, most of all I am afraid of being left without money.

At any moment, the aggravation can return, so I try to live life to the full here and now. My exacerbation lasted four years, but the worst is over, and recently I went into a long-awaited remission.

What are the limitations for Crohn’s disease. There are not so many of them because of the disease. For example, many people think that I follow a strict diet. In fact, Crohn’s disease is a disease of the immune system, not a digestive one. Everything is possible. I also use sunscreen and don’t tan because one of my drugs increases my risk of skin cancer.

With Crohn’s disease, it’s absolutely forbidden to smoke, but I didn’t smoke anyway. You can drink sometimes, you can play sports, flying is also not harmful. The introduction of drugs once every two weeks cannot be skipped, so if I go somewhere, I take a cooler bag with medicines with me.

Is it possible to be vaccinated against coronavirus and other diseases with Crohn’s disease. Crohn’s disease without severe exacerbation is not a contraindication to vaccination. And before starting immunosuppressive or biological therapy and during it, it is even recommended to be vaccinated against a number of infections so as not to catch anything dangerous when immunity is reduced by drugs.

Vaccination against COVID-19 is indicated almost without restrictions for people with inflammatory bowel disease during remission, with mild or moderate inflammation. If the inflammation is severe, then the decision to vaccinate or not is made by the doctor, taking into account the benefits and risks.

Immunosuppressive and biological therapy are also not contraindications to vaccination. The only caveat is that in this case, live vaccines and vaccines based on replicating, that is, “replicating”, viral vectors cannot be injected. The existing Russian coronavirus vaccines, in particular Sputnik V, are not among these.

I made several vaccinations before starting therapy: Prevenar 13 against pneumococcal infection, Adasel against diphtheria, tetanus and pertussis, and Havrix against hepatitis A. After the start of treatment, I was vaccinated with two components of Sputnik V against coronavirus infection.

I tolerated all the vaccines well, only Sputnik V gave me a little headache. There were no exacerbations of the disease or deterioration in well-being after that.

I spent 740,800 R for the treatment of Crohn’s disease in 4 years

Item of expenses	Price
Hospitalization in a private clinic	300 000 R
Biological product “Dalibra”, 9 packs	144 000 R
Salofalk, 11 packs	77 000 R
Colonoscopy, 2 times	60 000 R
Blood and stool tests in private laboratories	50 000 R
Appointment with a private doctor, 5 appointments for 7000 R	35 000 R
Psychotherapist, 5 appointments	22 500 R
Computed tomography of the intestine, 2 times	22 000 R
Anemia treatment	18 000 R
“Budenofalk”, 2 packs	8000 R
Azathioprine, 14 packs	4300 R

Remember

1. Inflammatory bowel disease is an autoimmune disease. It is impossible to cure them completely.
2. Distinguishing between Crohn’s disease and ulcerative colitis is difficult even for doctors, so the diagnosis often changes along the way.
3. Colonoscopy and stool tests are commonly used for diagnosis.
4. Crohn’s disease can be treated with immunosuppressive therapy that suppresses the immune system. And if it does not help, biological therapy is needed.
5. With Crohn’s disease, you can apply for disability if the severity of the disease prevents you from working. In this case, you can get the right to free treatment with certain drugs.
6. Biological therapy can be obtained free of charge not only when applying for a disability, but also as part of high-tech medical care or when participating in clinical trials.
7. With the right treatment, remission can be achieved, but this is not always possible.
8. Crohn’s disease and ulcerative colitis sometimes require surgery – it happens that no treatment helps, and the inflamed part of the intestine can only be removed.
9. Against the background of properly selected therapy, you can lead a normal life without following strict diets and other restrictions.

symptoms, diagnosis, signs, treatment, diet for UC, cost of therapy

This text was written by a reader in the Community. Carefully edited and formatted according to editorial standards.

Yuliya Tsvetkova

Author profile

In the spring of 2020, I began to be disturbed by mild but constant pain in the lower abdomen.

It seemed nothing serious. At first, I looked for the cause of the pain at the gynecologist, but the doctor found nothing. Later, in early June, blood appeared in the stool, then I turned to a proctologist, who, without additional examinations, diagnosed me with hemorrhoids and prescribed Detralex in tablets, suppositories and Posterisan ointment. It cost about 3000 R.

I was treated like this for at least two weeks, but the symptoms did not go away. After that, the proctologist sent me for the first colonoscopy, where I was finally given the correct diagnosis – non-specific ulcerative colitis. What is ulcerative colitis? Inflammation affects the mucous membrane of the rectum first, and then other parts of the large intestine.

Patients can vary greatly in symptoms: rectal pain and stool bleeding, diarrhoea, abdominal pain and cramps, desire to defecate but inability to do so, weight loss, fatigue and fever. Symptoms usually appear and progress over several weeks, may recede and then reappear.

Over time, complications may develop, including life-threatening ones, such as dehydration or heavy bleeding. Ulcerative colitis also increases the risk of osteoporosis and colon cancer.

It is still not known exactly why ulcerative colitis occurs. It is believed that the disease develops due to a malfunction in the immune system: it begins to attack the cells of the digestive tract. The risk of getting sick is higher in people under 30 years of age and people with a genetic predisposition if close relatives had such a diagnosis.

The only way to know for sure that a person has ulcerative colitis is to do a colonoscopy with a biopsy: the doctor pinches off a small piece of intestinal tissue for laboratory analysis. Additionally, they may prescribe blood and stool tests, make an X-ray or CT scan of the abdominal cavity.

There are two ways to treat ulcerative colitis: medication and surgery.

Medical method. May include anti-inflammatory drugs, immune suppressants, or biologics that neutralize immune system proteins. With the help of medications, symptoms can be alleviated and remission achieved.

Patients respond differently to drugs, so finding the right treatment can take time.

Surgical method. If medical treatment does not work and the disease greatly impairs the quality of life, the doctor may suggest removing the colon and rectum. After surgical treatment, the disease will not return, but the doctor must warn about the risks of such an operation.

How I got to the hospital

At first, the disease was found only in the rectum. Additionally, I was given an analysis that helps to determine the markers of intestinal inflammation – fecal calprotectin. According to the results, the proctologist prescribed “Salofalk” – an anti-inflammatory drug in the form of granules and rectal foam, and also recommended to adhere to the diet of table No. 4 according to Pevzner.

The doctor did not refer me to other specialists, but about five months after the start of treatment, already in December, I read on the Internet that not only proctologists deal with my disease, and I myself turned to a gastroenterologist.

I wanted to find a magic pill for everything, and there was no trust in doctors, so I changed several gastroenterologists: they slightly adjusted the treatment, but prescribed drugs with the same active ingredient – mesalazine.

At this time, the disease progressed: I had severe rectal bleeding, which could not be stopped with non-steroidal anti-inflammatory drugs. Because of this, in March 2021, one of the gastroenterologists referred me for a second colonoscopy: the study showed that the localization of the disease had changed and the UC had risen higher in the intestine. The general condition was also not very good: weakness and low blood pressure. Therefore, the doctor recommended that I go to the hospital.

/crohn-disease/

What is Crohn’s disease and how much does it cost to treat?

I agreed because it was already difficult mentally and I wanted to be taken care of. Then I still hoped for a magical treatment in the hospital.

About ten months have passed since the start of treatment in July and admission to the hospital in April. During this time, 120,000 rubles were spent on the purchase of medicines.

The expenses for diagnostics were mostly covered by the VHI policy. But the analysis for fecal calprotectin is not included in either the VHI program or the CHI. Colonoscopy was also paid for by insurance, but I did this procedure under sedation, for which I paid about 8000 RUR each time.

Before being admitted to the hospital, I spent about 159,000 R on diagnostics and treatment

Expenses

Expenses

Drugs

About 120,000 R

Two sedations 9000 3

16,000 Р

All consultations of proctologists and gastroenterologists

13,000 Р

Analysis for fecal calprotectin

10,000 R

See a doctor

We do not make recommendations in this article. Please consult with your doctor before deciding on treatment. The responsibility for your health rests solely with you.

How a suitable treatment regimen was selected for me

In the hospital I was treated with anti-inflammatory non-steroidal drugs and antibiotics, and they also prescribed Cortiment, a glucocorticosteroid for topical use: I bought only one pack for 11,700 R. Then I learned that the diet there is no need to comply: you can eat anything, taking into account individual tolerance, only a sparing diet can be recommended during exacerbations. But in general, it is important to eat healthy and balanced food, just like any other person.

Ten days later I was discharged with an open sick leave, minor improvements, and recommendations to continue hormone therapy. At the same time, the bleeding did not go anywhere.

Ten days later, I again went to see the doctor who had seen me in the hospital. There was no improvement, and on the same day I was again admitted to the hospital: therapy with systemic glucocorticosteroids intravenously and in the form of microclysters began.

/ibs/

What is irritable bowel syndrome and how to treat it

On the recommendation of the head of the department of gastroenterology, I also started a personal psychotherapy: I was very overwhelmed by my condition. Even during the examination, the manager noted that my stomach is always in tension: some doctors say that the matter is in the sensitivity of the nervous system and working with a psychotherapist makes it possible to experience this symptom less often.

So I spent another nine days in the hospital. During this time, the bleeding finally managed to stop, and I was discharged with a transfer to treatment with glucocorticosteroids Metipred and Prednisolone. At first glance, these two medicines are inexpensive, but it all depends on the dosage. Hormonal drugs are taken according to the scheme with a gradual decrease in dosage until complete cancellation.

“Metipred” and “Prednisolone” did not stop taking non-steroidal anti-inflammatory drugs: I continued therapy with “Mesalazine” and spent at least 15,000 R per month on it.

For three months of treatment I spent 62,200 R

Expenses

Expenses

Mesalazine

45,000 R

Cortiment 9 0003

11,700 R

Metipred and Prednisolone

5500 R

side effects I encountered

I was very glad that I no longer see blood where it should not be. But I had no idea what severe side effects I would have to face. It was very difficult almost three months – both physically and psychologically.

I developed joint pain and acne, my periods stopped, my face swelled, and intraocular pressure increased. I quickly got tired and felt weak.

This is how I looked before hormone therapy And this is how I looked during. I rarely took pictures: it was difficult to recognize myself This is how I look now

By August 2021, I finished hormone therapy, and in September there was blood in the stool again. Because of this, at the end of October 2021, I ended up in the hospital again: now I was offered treatment with drugs from the GIBT group – genetically engineered biological therapy. I get vedolizumab, or Entivio, under OMS: it prevents specific inflammatory cells from entering the gastrointestinal tract – this helps to reduce inflammation and the severity of symptoms.

From October 2021 to March 2022 I received five Entivio drips at different intervals. Now, for therapy, I need to go to the hospital every eight weeks. Thanks to this treatment, there have been no symptoms for four months. But it is still difficult for me to judge the persistence of remission.

I still continue to take non-steroidal anti-inflammatory drugs, I buy them at my own expense. Now these are Salofalk granules and rectal suppositories.

Now I spend 15,000 R per month on treatment

Expenditure item

Expenses

Salofalk

12,000 R

Rectal suppositories

3000 R

my life

Before my illness, I worked as an air traffic controller. Due to the specifics of the work, I was suspended for medical reasons, and for some time I worked in another position, but spent a lot of time on vacation: I simply didn’t have the strength to work and it was more profitable than sick leave.