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Important things to know about ulcerative colitis
The one who matters the most to you just received a diagnosis of the disease that must sound very intimidating. While the silence in the doctor’s office is natural in the moment, you found the right place for help. The Ulcerative Colitis (UC) is a manageable disease regardless of how frightening it may sound. We will help you to understand everything.
Imagine the large intestine. It is the garden hose in your body. In a healthy person, the colon is smooth on the inside. In the UC, the colon has ulcers inside and inflammation. So, it is an autoimmune disease of the large intestine and rectum.
Ulcerative Colitis is the name of the disease. Do not confuse it with the Crohn’s disease. It is the relative, not twin-sister of UC as Crohn’s can occur anywhere in the gastrointestinal tract.
Bloody diarrhea is the primary symptom of the disease. In addition, the urgency to defecate and cramping is common for UC.
You may also hear the terms “flares” and “remission” from the doctor. Flares mean that the disease is active and causes inflammation and ulcers in the colon. Remission means that the inflammation is gone and there are no symptoms. Our goal is to stay in remission for as long as possible.
The colonoscopy is performed to diagnose UC. In addition, the doctor performs biopsy to confirm the presence of the disease. The blood tests to check the inflammation markers such as C-Reactive Protein are routine procedures.
Now, it is time to talk about the treatment as medication is your new best friend. First-line treatment of the UC is the 5-ASA drugs (mesalamine). It is used to reduce the inflammation in the colon. If the 5-ASA drugs are not effective enough, the corticosteroids may be prescribed.
The long-term use of the steroids (prednisone, for example) causes bone loss, weight gain and mood swings. So, the steroids are used for stopping flares and slowly reduced. In other words, the steroids are fast-acting drugs that should be used for a short time.
The moderate and severe cases of UC are treated with biologics. The drugs like Humira and Entyvio block certain parts of the immune system that cause inflammation in the colon. These drugs are delivered intravenously or via injections.
In general, the treatment of UC is based on the medications. As you may already understand, dieting is not the part of the treatment for UC. The thing is that there is no universal “diet for UC” and each patient has different triggers.
During the flares, the low-fiber foods are better for the patients. Such foods as white rice, toast and lean protein are recommended. Remember to avoid raw vegetables, nuts and seeds as they are difficult to digest in this condition.
The hydration is the crucial point for the patients with UC, especially in case of diarrhea. During the bad flare, the patient should drink the electrolyte drinks rather than water. Dehydration may occur quickly and cause the hospitalization. Ensure that they drink fluids constantly.
As we mentioned above, the brain and intestines are connected. So, the stress management is crucial as it may be the reason of flares. Yoga, meditation or silent time will be helpful.
Let us be frank about the social aspect of the disease as they may be the hardest in case of UC. Imagine that the patient needs the nearest toilet in this exact moment and he is in the traffic jam or a meeting. This leads to the anxiety also known as the “bathroom map effect”. It means that they have to plan their activities based on the location of the nearest toilet.
You may notice that the patient is withdrawn from the social events. But of course, it does not mean that they do not enjoy socializing. They are afraid of having accidents in the public places. You can give some time to think where the nearest toilet is or make plans near it.
When the disease is under control, the complications of UC are rare. The long-term inflammation increases the risk of the cancer development. That is why colonoscopy screening is the key to prevention. In general, we start screening one-two years after the diagnosis.
One more complication of UC is the toxic megacolon. In this case, the colon enlarges and can be ruptured. It is a medical emergency and the patient should go to the hospital. If they stopped passing gas and stool and have fever, call 911. Do not wait until morning.
The surgery is the option when all the methods of the treatment fail. The removal of the colon and rectum is the radical way to cure the disease. The patient can choose between the surgery to make the internal reservoir (J-pouch) or ostomy.
Many patients live an active life with ostomy. Of course, it takes adaptation and some effort. But many patients prefer to have an ostomy as it saves them from painful flares. Quality of life is the main thing.
You are responsible for the emotional state of your family member. Nearly 50% of patients suffer from depression and anxiety. Do not try to fix their problems immediately. Sometimes they just need someone to listen to them.
Educate yourself because they do not need to explain everything once again. You should know what flares are to help them. You can be their advocate if they cannot visit a doctor on their own due to their weakness. Prepare the list of questions for the doctor before the visit.
The support group is the source of the useful information and moral support. You can research local resources either via google or ask an AI assistant.