Ulcerative Colitis - Basics Lecture

Introduction

• Speaker: Dr. Bill Faubian, Gastroenterologist at Mayo Clinic
• Topics Covered: Basics of ulcerative colitis, including its definition, causes, symptoms, diagnosis, and treatment.

What is Ulcerative Colitis?

• A type of inflammatory bowel disease (IBD).
• Causes chronic inflammation and ulcers in the superficial lining of the large intestine (colon) including the rectum.
• Prevalence: ~1 million Americans.
• Impact: Painful, debilitating, emotionally stressful; can lead to severe complications.
• Treatment: No cure, but treatment can help patients live a more comfortable life.

Causes and Risk Factors

• Exact Cause: Unknown.
• Possible Triggers: Abnormal immune response, genetics.
• **Risk Factors: **
  • First-degree relatives with the disease.
  • Age: Most diagnosed before age 30.
  • Ethnicity: Higher risk for whites, especially those of Ashkenazi Jewish descent.
  • Diet and stress can exacerbate symptoms, but don't cause the disease.

Symptoms

• Vary based on severity and location in the colon.
• Common Symptoms:
  • Diarrhea with blood or pus
  • Fever and fatigue
  • Anemia
  • Loss of appetite and weight loss
  • Abdominal pain and cramping
  • Rectal pain and bleeding
  • Urgent need for bowel movements without ability to do so
  • In children: delayed growth and development
• Possible Complications:
  • Severe dehydration
  • Perforated colon
  • Bone loss
  • Inflammation of skin, joints, eyes
  • Increased risk of blood clots and colon cancer

Diagnosis

• Definitive Diagnosis: Biopsy via endoscopic procedure.
• Initial Steps:
  • Medical history review.
  • Blood tests (anemia, infection).
  • Stool study (white blood cells, specific proteins, rule out pathogens).
  • Endoscopic Procedures:
    • Colonoscopy (full large intestine view + biopsy).
    • Flexible sigmoidoscopy (rectum and lower colon view).
  • Imaging:
    • Abdominal X-ray (e.g., perforated colon).
    • MRI/CT scan (detailed bowel view, extent of inflammation).

Treatment

• **Types of Treatment: **
  • Medications:
    • Anti-inflammatory drugs (corticosteroids).
    • Immune system suppressants.
    • Biologics (targeted immune system therapies).
    • Anti-diarrheals, pain relievers, anti-spasmodics, iron supplements.
  • Surgery:
    • Removal of damaged tissue.
    • Extreme cases: full colon removal.
    • Consider risks and benefits with the doctor.
• Lifestyle and Dietary Recommendations:
  • Maintain a food diary to identify triggers.
  • Limit dairy, eat small meals, stay hydrated, avoid caffeine/alcohol/carbonation.
  • Consult a dietitian if diet becomes too limited.
• Mental Health:
  • Manage stress (exercise, relaxation techniques).
  • Seek therapy, especially for anxiety/depression.
  • Support groups for shared experiences.

Conclusion

• Management: Expert medical care and treatment strategy essential.
• Ongoing Research: Advances in understanding and treating the disease, aiming for cure/prevention.
• Additional Resources: More videos on the topic and visiting mayoclinic.org.
• Final Note: Aim to help patients regain a normal life.