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Gastrointestinal Diseases (cont.)

About Ulcerative Colitis

Ulcerative colitis is a chronic gastrointestinal disorder that is limited to the large bowel (the colon). Ulcerative colitis does not affect all layers of the bowel, but only affects the top layers of the colon in an even and continuous distribution. The first symptom of ulcerative colitis is a progressive loosening of the stool. The stool is generally bloody and may be associated with cramping abdominal pain and severe urgency to have a bowel movement. The diarrhea may begin slowly or quite suddenly. Loss of appetite and subsequent weight loss are common, as is fatigue. In cases of severe bleeding, anemia may also occur. In addition, there may be skin lesions, joint pain, eye inflammation, and liver disorders. Children with ulcerative colitis may fail to develop or grow properly.

Approximately half of all patients with ulcerative colitis have mild symptoms. However, others may suffer from severe abdominal cramping, bloody diarrhea, nausea, and fever. The symptoms of ulcerative colitis do tend to come and go, with fairly long periods in between flare-ups in which patients may experience no distress at all.

Complications of ulcerative colitis are less frequent than in Crohn's disease. Complications can include bleeding from deep ulcerations, rupture of the bowel or failure of the patient to respond to the usual medical treatments. Another complication is severe abdominal bloating. Patients with ulcerative colitis are at increased risk of colon cancer.

The four major classes of medication used today to treat ulcerative colitis are: aminosaliclylates (5-ASA), steroids, immune modifiers (azathioprine, 6-MP, and methotrexate) and antibiotics (metronidazole, ampicillin, ciprofloxin, others). In one-quarter to one-third of patients with ulcerative colitis, medical therapy is not completely successful or complications arise. Under these circumstances, surgery may be considered. This operation involves the removal of the colon (colectomy). Unlike Crohn's disease, which can recur after surgery, ulcerative colitis is "cured" once the colon is removed.



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