What is ulcerative colitis?

Ulcerative colitis is an intestinal inflammatory disease that starts in the rectum and spreads out to all the sections of the colon (ascending, transverse and descending). It is a chronic disease that results in inflammation in the wall of the large intestine, known as mucosa, which works as a barrier against harmful substances and helps with secreting and carrying nutrients, water and minerals. At times, the inflammation of the mucosa extends to another layer of the colon which causes the wall to get thinner. That contributes to the likelihood of its perforation. Just like in Chron’s disease, ulcerative colitis (UC) presents periods of activity and others of remission.

UCcauses the excessive apparition of ulcers, mucus and blood on the inside surface of the intestine. Those ulcers usually happen to be little and superficial. However, if they spread, they generate an accumulation of inflammatory cells. When those wounds heal, they may cause the apparition of little masses of tissue.

Besides, UC may affect other parts of the body like eyes, skin, joints… what is known as extraintestinal manifestations. That makes the patient suffer from joint pain, skin spots, stones in the gallbladder, or eye inflammation.

Just as the cause of the disease is unknown, there is no cure for it either. Nevertheless, if the symptoms are too injurious and the treatments do not work effectively on the patient, surgery may be done. It consists of reconstructing the intestinal transit with a reservoir. Another option is to remove the colon. That is considered to be the cure for the UC. Notwithstanding, it only happens after the failure of every other treatment. It is individually studied in every patient, in cases of extreme necessity.

What is the cause of ulcerative colitis?

UC arises as a consequence of a poor immune response to the organism itself. The origin of this inappropriate response is still unknown, but the stronger theories point at the genetic predisposition, the bacterial flora and the environmental influences as the possible causes of the disease. 

There exist multiple harmful substances to our intestine, to which the immune system (under normal circumstances) responds properly protecting the organism from any damage that may affect it. Sometimes those intestinal immunologic responses fail and that is when the UC appears. This situation is usually prolonged and maintained in the long term, making the ulcerative colitis a chronic disease.

The reasons why those immune responses fail are still unknown, but the most powerful theories state that it could be due to genetic alterations of the intestinal immune system. Its cells have the ability to notice the presence of different pathogenic agents and they are able to stop them. Some people present genetic alterations in those agents’ receptors, which lead to wrong identifications and, consequently, to wrong inflammatory responses.

Is the ulcerative colitis hereditary?

Despite the implication of genetic factors in the apparition of the disease, it is not considered to be hereditary. That is because the external factors like tobacco, the previous gastrointestinal infections, some drugs, or even the stress have influence on it too. It does exist the hereditary influence in suffering from UC. However, it is not more than 15% of the risks for first-degree relatives.

How is ulcerative colitis diagnosed?

Diagnosing the disease is sometimes difficult, because the symptoms may be diverse and, in some occasions, they are attributed to other conditions. The blood and stool tests are the most reliable ones, they can help identify if there is inflammation or infection; the so-called image tests, where the inflamed zones may be seen, besides the extension and the seriousness of the disease. And lastly, the endoscopic tests with biopsies confirm the diagnosis of the UC. Those provide any type of necessary information in order to know if there exist ulcers, inflammation, bleeding or stenosis.

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