Wednesday, September 3, 2014

Facts You Need to Know About Ulcerative Colitis

Facts You Need to Know About Ulcerative Colitis

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Facts You Need to Know About Ulcerative Colitis

Posted: 02 Sep 2014 08:00 AM PDT

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Belonging to the group of disorders related to irritable bowel disease (IBD), ulcerative colitis is a painful condition that primarily affects the colon and rectum. Early identification of ulcerative colitis limits the likelihood of complications and offers the best chance for successful management. While early diagnosis can be helpful, not taking care of the issue can prove fatal.

The next facts will provide the information necessary for identifying ulcerative colitis and recognizing its potential complications. These following facts will also help you understand the range of therapeutic approaches available and how to apply them effectively to the condition.

What Is Ulcerative Colitis?

Like many bowel diseases, ulcerative colitis is defined as a chronic inflammatory autoimmune disease and features open sores on the colon wall. The causes remain unknown. Risk factors associated with its development include family history, a recent Salmonella or Campylobacter infection, and living in modern, industrialized nations at higher latitudes. [1] It affects young adults in greater numbers than other age groups, although it can also develop in young children. For many, this disease is a life-long battle with less than 50% of patients achieving long-term remission. [2]

How It Works: A Current Understanding

No direct mechanism has been identified to trigger ulcerative colitis. While the immediate causes remain relatively unknown, research has identified immune cell penetration of the colon wall as a cause of inflammation. [3] Certain chemicals released by intestinal cells and gram-negative bacteria stimulate cell receptors that generate an immune response. [4] Continued inflammation of the colon wall reduces mucus production leading to tissue damage in the form of sores or ulcers. [5]

Causes

Diet, genetics, and stress top the list of causes believed to trigger ulcerative colitis. [6] Other factors may include:

Hydrogen Sulfide Buildup

Sulfate-reducing bacteria creates sulfide which takes on the form of the highly-toxic hydrogen sulfide in fecal matter. Patients with ulcerative colitis report fecal hydrogen sulfide levels four times than that of normal feces. [7] The presence of this toxic gas may play a role in the formation of ulcers, although researchers suggest the sulfate-reducing bacteria themselves may reflect a wider problem within the intestinal environment.

Dietary Triggers

One particular case of ulcerative colitis involved a man reporting intestinal pain and severe bloody diarrhea. Each instance occurred after the use of a weight loss supplement. [8] The case study could not identify whether the weight loss supplement caused the ulcers or exacerbated a pre-existing condition.

Parasites

A study from Mexico found intestinal infestation by protozoa in 24% of ulcerative colitis patients. Age, gender, and disease presence played a role in determining the incidence of infestation. These patients also experienced reduced effectiveness from conventional treatments. [9] A similar study looked at 31 patients with amoeba infestation. Researchers determined the presence of amoeba did not play a role in the severity of the disease, although increased ulcer localization in the colon did appear related. [10]

Symptoms

Typical symptoms include bloody diarrhea (which may include mucus) and abdominal pain. As the condition worsens, the amount of blood increases and bowel movements may become painful and include abdominal cramping. [11] Anemia, fever, and weight loss may occur, all symptoms which reflect those of Crohn's disease.

Intestinal Complications

Patients with IBD, like ulcerative colitis and Crohn's disease, often experience iron-deficiency anemia and osteoporosis. These symptoms often result from the disease itself or its subsequent treatment. [12] Inflammation extends to other organs in 40% of patients, while others experience swelling of the iris in the eye. [13] Some patients experience problems with deep vein thrombosis and pulmonary embolism. [14] In extreme cases, toxic megacolon (swelling of the colon tissue), colonic hemorrhage, and perforation can also result. [15] [16]

Advanced Risks

On top of the many serious complications of the disease, ulcerative colitis can develop into even more concerning issues. These include:

Stroke

With increased risk of blood clots, the risk for cerebral thrombosis – blood clots in the brain – also increases. One recently-reported case involved a patient who experienced an arterial stroke as a result of his ulcerative colitis. [17] Inflammation and internal bleeding can increase chances of developing blood clots. Genetic mutations, such as the Factor V Leiden mutation, can increase clotting tendencies that further exacerbate the condition.

Colon Cancer

The breakdown of the mucus layer along with chronic internal swelling can contribute to cancerous lesions. Researchers speculate the increased turnover of cells in affected areas may contribute to colorectal cancer formation. The intestinal bacterial environment may also affect cellular response which may trigger and stimulate cancer cell growth. [18] [19]

Are There Natural Approaches?

Science is continuing to find effective and safe options for individuals suffering from ulcerative colitis, and many researchers are turning to natural compounds for a solution. Probiotic therapy is just one of the many avenues that are currently being explored, and even acupuncture and herbal therapies have been suggested. Until then, it is always best to eat a healthy, easy-to-digest diet while working alongside your healthcare provider.

Do you have ulcerative colitis? Let us know your thoughts and experiences with this disease in the comments!

-Dr. Edward F. Group III, DC, ND, DACBN, DCBCN, DABFM

References:

  1. Adams SM, Bornemann PH. Ulcerative colitis. Am Fam Physician. 2013 May 15;87(10):699-705.
  2. Torres J, Danese S, Colombel JF. New therapeutic avenues in ulcerative colitis: thinking out of the box. Gut. 2013 Nov;62(11):1642-52. doi: 10.1136/gutjnl-2012-303959.
  3. Ko IK, Kim BG, Awadallah A, Mikulan J, Lin P, Letterio JJ, Dennis JE. Targeting improves MSC treatment of inflammatory bowel disease. Mol Ther. 2010 Jul;18(7):1365-72. doi: 10.1038/mt.2010.54.
  4. Szumilas D, Krysiak R, Okopie B. The role of TLR4 receptor in development of inflammation and carcinogenesis in ulcerative colitis and pharmacotherapy of this disorder. Wiad Lek. 2013;66(1):3-9.
  5. Andersen V, Olsen A, Carbonnel F, Tjønneland A, Vogel U. Diet and risk of inflammatory bowel disease. Dig Liver Dis. 2012 Mar;44(3):185-94. doi: 10.1016/j.dld.2011.10.001.
  6. Dorofeyev AE, Vasilenko IV, Rassokhina OA, Kondratiuk RB. Mucosal barrier in ulcerative colitis and Crohn’s disease. Gastroenterol Res Pract. 2013;2013:431231. doi: 10.1155/2013/431231.
  7. Levine J, Ellis CJ, Furne JK, Springfield J, Levitt MD. Fecal hydrogen sulfide production in ulcerative colitis. Am J Gastroenterol. 1998 Jan;93(1):83-7.
  8. Sivarajah V, Abdul Q, Pardoe H, Lunniss P. Ulcerative colitis associated with the herbal weight loss supplement Hydroxycut. BMJ Case Rep. 2013 Jan 3;2013. pii: bcr2012007509. doi: 10.1136/bcr-2012-007509.
  9. Yamamoto-Furusho JK, Torijano-Carrera E. Intestinal protozoa infections among patients with ulcerative colitis: prevalence and impact on clinical disease course. Digestion. 2010;82(1):18-23. doi: 10.1159/000273871.
  10. Vukobrat-Bijedic Z, Husic-Selimovic A, Bijedic N, Bjelogrlic I, Djuran A. Intestinal amebiasis in a group of patients with ulcerative colitis: influence on clinical course of the disease. Med Arh. 2013;67(1):10-2.
  11. Lee JK, Tang DH, Mollon L, Armstrong EP. Cost-effectiveness of biological agents used in ulcerative colitis. Best Pract Res Clin Gastroenterol. 2013 Dec;27(6):949-60. doi: 10.1016/j.bpg.2013.09.007.
  12. Pezerovi D, Zulj M, Klarin I, Majnari L, Vcev I, Vcev A. Clinical expression of inflammatory bowel diseases–a retrospective population-based cohort study; Vukovarsko-Srijemska County, Croatia, 2010. Coll Antropol. 2013 Sep;37(3):919-27.
  13. Ott C, Schölmerich J. Extraintestinal manifestations and complications in IBD. Nat Rev Gastroenterol Hepatol. 2013 Oct;10(10):585-95. doi: 10.1038/nrgastro.2013.117.
  14. Patil SA, Cross RK. Update in the management of extraintestinal manifestations of inflammatory bowel disease. Curr Gastroenterol Rep. 2013 Mar;15(3):314. doi: 10.1007/s11894-013-0314-8.
  15. Jaqua NT, Stratton A, Yaccobe L, Tahir U, Kenny P, Kerns T. A review of the literature on three extraintestinal complications of ulcerative colitis: an ulcerative colitis flare complicated by Budd-Chiari syndrome, cerebral venous thrombosis and idiopathic thrombocytopenia. Acta Gastroenterol Belg. 2013 Sep;76(3):311-6.
  16. Langan RC, Gotsch PB, Krafczyk MA, Skillinge DD. Ulcerative colitis: diagnosis and treatment. Am Fam Physician. 2007 Nov 1;76(9):1323-30.
  17. Russell RK, Protheroe A, Roughton M, Croft NM, Murphy MS, Spray C, Rodrigues AF, Wilson DC, Puntis J, Cosgrove M, Tamok A, Rao P, Down C, Arnott ID, Mitton SG. Contemporary outcomes for ulcerative colitis inpatients admitted to pediatric hospitals in the United Kingdom. Inflamm Bowel Dis. 2013 Jun;19(7):1434-40. doi: 10.1097/MIB.0b013e31828133d6.
  18. Valavanis A, Tegos T. A Case of Transient Ischemic Attack in a patient with Ulcerative Colitis. Hippokratia. 2013 Jan;17(1):79-80.
  19. Rogler G. Chronic ulcerative colitis and colorectal cancer. Cancer Lett. 2013 Aug 11. pii: S0304-3835(13)00552-1. doi: 10.1016/j.canlet.2013.07.032.

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