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Ulcerative Colitis

What is UC?
(UC) is an idiopathic chronic inflammatory condition affecting the large bowel and rectum. UC is one of the “Inflammatory Bowel Diseases” and results from the immune system attacking the bowel. The inflammation in Ulcerative colitis nearly always involves the rectum and “spreads” up the bowel. In severe cases the entire colon may be involved. UC is often lifelong.

Who gets UC?
Anyone can develop UC, although it is more common in White people and those of Jewish heritage. There is an increased risk in people who have a family history of Inflammatory Bowel Disease (either UC or Crohn’s disease). The incidence of ulcerative colitis peaks in people aged 15-25 years and in people aged 55-65 years, although it can occur in people of any age

What are the symptoms of UC?
UC can lead to recurrent episodes of diarrhea with or without rectal bleeding & mucous. Sufferers may experience urgency to go to toilet and a sensation of incomplete bowel emptying (tenesmus). Abdominal cramps are not uncommon.
UC may have symptoms outside of the bowel including; arthritis, eye irritation (episcleritis), skin rashes (erythema nodosum or pyoderma gangrenosum), or liver problems (primary sclerosing cholangitis).

How is UC diagnosed?
UC is diagnosed by excluding other diseases which may cause similar symptoms such as infection, using stool culture. However, colonoscopy and biopsy is essential to make the diagnosis. Patients usually have a history of recurrent episodes of diarrhea with or without blood.

How is UC treated?
Treatment for UC depends on the severity of inflammation and the location within the bowel. A combination of oral medications and either enemas or suppositories are often adequate to control symptoms and settle the inflammation. These include prednisolone, sulphasalazine, mesalazine, balsalazide &/or azathioprine. In severe cases intravenous medication – hydrocortisone &/or infliximab may be required. In rare cases surgery to remove the colon and rectum is required if the inflammation becomes life-threatening.

Is there a risk of cancer?
Yes. Because of the chronic inflammation which can occur there is a slightly increased risk of colon cancer above the background population. For this reason it is recommended that patients with UC undergo periodic surveillance of the bowel with colonoscopy.

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