DEAR DR. GOTT:
Can you give me some advice about ulcerative colitis? I have had this condition for 25 years. I have seen several doctors and taken lots of medication over the years and had to quit my job because of it. My doctor insists it is caused by bacteria but I was wondering if it could be caused by allergies?
DEAR READER:
Ulcerative colitis (UC) is a disease of the colon (large intestine) and rectum. It causes ulcers (sores) in the intestinal lining and inflammation (swelling). The ulcers forms where the swelling has killed the lining cells causing bleeding and pus. The inflammation can also cause diarrhea.
Ulcerative colitis affects men and women equally. It can occur at any age but generally starts between ages 15 and 30, appears to run in families and is more common in Caucasians and those of Jewish descent.
Symptoms include bloody diarrhea, abdominal pain, weight loss, skin lesions, anemia, rectal bleeding, fatigue, joint pain, loss of appetite, loss of body fluids and nutrients, and more. Children with ulcerative colitis often fail to grow properly.
The cause of UC is unknown. Sufferers have immune system abnormalities but it is not currently known whether this is caused by or the result of the disorder. It is currently believed that, because of this abnormality, the body adversely reacts to normal intestinal bacteria thus causing inflammation which in turn leads to ulcers. This is essentially an allergic reaction. However, in this case there are no foreign substances (such as pollen or animal dander) and the body is over-reacting to its own, normal tissues.
Diagnosis is based on symptoms, colonoscopy, imaging studies and medical history. It is important during diagnosis to find out the severity of the disease. This will dictate the treatment.
Treatment consists of medication (corticosteroids such as prednisone, high strength anti-inflammatories such as Dipentum and sulfasalazine and immunodulators such as mercaptopurine), hospitalization (for severe symptoms causing dehydration) and surgery. Surgery is a final, and often necessary, option for severe disease. Up to 40 percent of UC sufferers will have to have part or all of the colon removed because of massive bleeding, rupture and rarely because medications don’t work or endanger the patient’s life (because of side effects and allergic reactions). Surgery may also be necessary because of the risk of cancer. Nearly five percent of UC patients will develop colon cancer. Studies are currently being done on how the immune system works and to develop new and more specific therapies.
I urge you to follow the advice of a gastroenterologist. This type of doctor specializes in disorders of the esophagus, stomach and intestines. He or she will be up-to-date on the newest medications, procedures and treatment options.
To give you related information, I am sending you a copy of my Health Report “Diverticular Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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