Ulcerative Colitis Essay

How can the Disease Extent be divided?

Ulcerative colitis progresses from the rectum and moves proximally. Distal disease refers to inflammation that is limited to the rectum (proctitis) or rectum and sigmoid colon. Here it is referred to as proctosigmioditis. If the disease is more extensive it includes the left side of the colon and can cover the splenic flexure. This occurs in 40% of patients. Extensive colitis occurs up to the hepatic flexure. Pan colitis affects the whole of the colon and this can affect up to 20% of patients. Some patients with pan colitis have involvement of the terminal ileum, this is caused by an incompetent ileocaecal valve.

Fig 1: Image summarising the extent of Ulcerative Colitis15

Outline the Management of Ulcerative Colitis?

Patients with ulcerative colitis if usually referred to a gastroenterologist. This is a specialist who manages patients with gastrointestinal diseases. The physicians will need to assess the severity of the condition. The questions he or she is likely to ask include how many times are you passing stool? Is the stool bloody? Do you have nonspecific symptoms such as a high temperature, tachycardia and shortness of breath? The patient should be examined and investigated to rule out differential diseases.

If symptoms are mild then they may not require specific treatment as the symptoms can clear up by itself. Certain foods may trigger diarrhoea and bloating. They should be given lifestyle and dietary advice. They should be advised to drink plenty of fluids and eat small amounts of food throughout the day. Patients should avoid high fibre foods such as bran, beans and nuts. They may also limit their intake of milk products if they are lactose intolerant. Finally they should avoi...

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What is the Prognosis like for Patient’s with Ulcerative Colitis?

Ulcerative colitis is a chronic condition with significant relapses and remissions and an increased mortality. A Norwegian study has shown that after 10 year the colectomy rate was 9.8%.19 The IBSEN study showed that 83% of people initially had reoccurring disease. Although 50% were shown to be symptomless after five years.19 This study also demonstrated that 20% of people with proctitis or left-sided colitis progressed to extensive colitis.19

Conclusion

Ulcerative colitis is a fairly common disease with significant symptoms that affect the patient quality of life. With appropriate treatment it can be managed successfully. Surgery is curative.