Ulcerative Colitis : Symptoms,risk factors And Prevention
Tuesday, December 13,2016
Hemorrhagic ulcer disease(ulcerative colitis) as well as Crohn’s disease is a chronic intestinal inflammatory disease (IBD) of the colon and rectum. If Crohn’s disease can occur anywhere in the digestive tract and reach the tissues at depth, colitis Ulcer is a superficial involvement of the mucosa, which begins at the rectum to ascend into the colon.
There are four forms of ulcerative colitis, depending on the extent of the disease:
Ulcerative proctitis, which is confined to the rectum;
Proctosigmoiditis, which affects the rectum and the sigmoid colon;
Distal colitis, which affects the part of the colon located on the left side of the body (from the rectum to the top of the descending colon);
Pancolitis, which affects the entire colon.
In Canada, it is estimated that almost 2 out of every 1,000 people (men, women and children) have ulcerative colitis.
In France, the incidence of UC has decreased to 3.5 / 100,000 while it increases for Crohn’s disease. In Europe it is 1.7 to 20.3 / 100 000 and is more frequent in northern Europe than in the south (Norway / Portugal gradient)
The disease is diagnosed especially in people aged 30 to 40 years, but it can occur at any age. Men and women are affected in almost the same proportions, but not at the same ages. This could be related to smoker or former smoker status. There is a female predominance for Crohn’s disease, a less pronounced masculine predominance for HCV.
There is a genetic predisposition to ulcerative colitis.
Hemorrhagic ulcerative colitis (HCV) is due to a dysregulation of the immune system that attacks the cells of its own organism.
Scientists believe that the inflammation of the colorectal mucosa is due to an excessive immune reaction of the body against viruses or bacteria present in the intestine. According to the most probable hypothesis, this autoimmune reaction would be directed against the “harmless” bacteria normally present in the digestive tract (intestinal flora).
EHR could also be related to environmental factors not yet elucidated.
Food stress and intolerance can trigger symptoms in some people, but these factors are not the cause of the disease.
Hemorrhagic ulcer may be associated with joint (axial or extremity) disorders, skin (erythema nodosum), inflammation of the eyes or liver problems (sclerosing cholangitis). These disorders are related to the autoimmune reaction involved in the disease.
The most serious acute complication of ulcerative colitis is called “toxic megacolon”. It occurs when inflammation of the colon is so severe that the colon dilates and is susceptible to perforation. This causes severe pain, fever, vomiting and swelling of the abdomen. A doctor should be consulted urgently in the presence of these symptoms in order to prevent the colon from perforating and peritonitis from occurring. Fortunately, this complication rarely occurs (in less than 2% of cases).
People with ulcerative colitis should be aware of the risk of anemia. Indeed, when the disease is severe, blood loss can be abundant to the point of causing anemia, which can be compensated by iron supplements.
Several complications related to the long-term use of certain drugs, such as corticosteroids or immunosuppressants, may occur. Thus, long-term use of corticosteroids increases the risk of osteoporosis, cataract, hypertension, type 2 diabetes … Corticosteroids and immunosuppressants may also increase the risk of infection.
The symptoms appear in seizures:
Painful abdominal cramps, especially in the lower abdomen;
Blood in the stool (even a hemorrhage in case of severe thrust);
Frequent stools, even during the night;
An urgent need to defecate, even if there is little or no stool to evacuate (rectal tenesmus);
Weight loss due to reduced appetite and poor absorption of nutrients into the intestine;
Tiredness, often caused by anemia;
Fever, especially in the case of a pancolitis with significant symptoms;
In children, severe ulcerative colitis can hinder development (delayed growth, delayed puberty, etc.).
People at Risk
Some populations are more at risk than others because of their genetic inheritance. Whites are 2 to 5 times more affected by ulcerative colitis than Blacks or Asians.
The Jewish community (of Ashkenazi origin) is 4 to 5 times more affected by this disease than other populations.
Up to 20% of people with ulcerative colitis have a close family with Crohn’s disease or only 6% with ulcerative colitis, suggesting a genetic predisposition. If two parents are affected; The risk of the occurrence of IBD during the course of life would be 36%
There are no known
Living in an urban environment or in an industrialized country increases the risk of ulcerative colitis;
Non-steroidal anti-inflammatory drugs (NSAIDs, anti-inflammatory drugs other than corticosteroids) and oral contraceptives may be incriminated but this remains to be confirmed. NSAIDs are not recommended for RCH;
Food factors are incriminated to the extent that this disease affects the countries of Europe and North America. (High consumption of sugar, red meat). The disease affects more and more the Maghreb which reinforces a role of the food. (Modification of the diet in young people, soda, coca);
Isotretinoin (Accutane), a drug used in the treatment of severe acne, may sometimes be involved in the onset of certain hemorrhagic rectocolitis.
Although the causal relationship has not been proven, studies have reported cases of ulcerative colitis following the use of isotretinoin.
Measures to prevent disease
Since the precise causes of ulcerative colitis are still relatively vague, we can not prevent its occurrence.
Measures to prevent complications
People with inflammatory bowel disease have been recommended for 5 years or more to make an appointment with their gastroenterologist each year. Various tests are available to quickly detect abnormalities in the digestive tract, including colorectal cancer. See also our factsheet Colorectal cancer
Daily Prevention Measures
In the event of outbreaks of the disease:
Dietary advice has no scientific validation. This disease is not food-borne, so it is unnecessary to impose restrictions.
Dietary advice is one of common sense
Do not take foods and drinks that aggravate your symptoms.
Avoid spicy foods, alcohol, some vegetables (cabbage, broccoli, beans) and drinks and foods that contain caffeine. These tend to cause bloating;
Pay particular attention to milk and certain dairy products, which trigger diarrhea, pain and flatulence in some people with lactose intolerance. There is, however, no demonstrated link between lactose intolerance or milk protein allergy and ulcerative colitis;
Limit intake of dietary fiber. Although dietary fiber is an important component of a healthy diet, they often aggravate the symptoms of ulcerative colitis. Preferably consume cooked rather than raw fruits and vegetables;
Eat several small meals during the day rather than 2 or 3 hearty;
Consume a good amount of liquid, preferably water, avoiding carbonated drinks, alcoholic beverages and those containing caffeine;
In the event of a serious crisis, doctors may also introduce a “no residue” regimen, excluding any source of plant fibers, animal residues and greasy residues, to restore the colon for a few days during the outbreak.
Between periods of symptoms:
Consume foods rich in dietary fiber to regulate intestinal transit. Dietary fiber would also have the advantage of facilitating the growth of bacteria normally present in the intestines.
Prefer protein from lean meats, poultry, fish and eggs. It is important to adopt a healthy diet that contains good fats;
Practice relaxation techniques and exercise to better manage your stress. If stress does not cause ulcerative colitis, it can aggravate its symptoms as it interferes with normal digestive functions. Exercise also helps to regulate intestinal transit. Relaxation methods can also help control pain in times of symptoms.
Tuesday, December 13,2016-13:40:13[London]
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