Ulcerative colitis

Ulcerative colitis is a recurrent chronic inflammatory bowel disorder associated with immune dysregulation. The severity will depend on the degree of inflammation, as well as whether the extent affects only the rectum or also the colon. It is estimated to have a prevalence of up to 0.02%, making it the most common form of inflammatory bowel disease worldwide.

The specific cause of ulcerative colitis is unknown, although the following non-genetic factors seem to be involved to varying degrees in its development:

• Age and gender. Although it can occur at any age, it predominantly appears bimodally in women between 15-30 years and 50-70 years.
• There is a higher incidence described in Western Northern Europe and Jewish populations in America, but it can affect all age groups equally.
• There seems to be an autoimmune dysregulation in response to food or bacterial antigens, however, it is unknown if this influences the development of the disorder or the appearance of symptoms.
• The contribution of alterations in the composition of the intestinal microbiota has been postulated, as well as air pollution, medications, and certain diets.

Symptoms depend on the anatomical location and severity of the inflammation. Generally, it is characterized by:

• Ulcers in the mucosa of the colon and/or rectum.
• Rectal bleeding.
• Diarrhea and abdominal pain.

These symptoms may be accompanied by abdominal cramps, fatigue, nausea, weight loss, and anemia.

Over time and with the progression of the disease, other symptoms may also appear, including extraintestinal manifestations:

• Fever.
• Skin rashes and mouth sores.
• Joint pain and arthritis.
• Red and painful eyes.
• Liver disease.
• Loss of fluids and nutrients.

Additionally, there may be an increased risk of developing colon cancer.

Ulcerative colitis cannot be prevented, however, different measures can help in preventing flare-ups and limiting their severity.

• Reducing stress levels as it can delay gastric emptying and increase acids. It is recommended to sleep at least seven hours, exercise regularly, even lightly such as walking, yoga, or meditation.
• Diet can play a fundamental role in controlling symptoms and prolonging the time between flare-ups. Some foods can worsen symptoms and should be avoided, especially during crises. These vary between individuals but generally include fatty foods, high sugar content, carbonated drinks, high fiber content, coffee, chocolate, or alcoholic beverages. Sometimes salt and dairy products can be problematic. It is recommended to eat more frequently in smaller amounts. If the condition is severe, bland and soft foods may cause less discomfort. Patients should also ensure they drink plenty of fluids, especially water. A daily multivitamin supplement can be useful as colitis interferes with the proper absorption of nutrients. Patients should consult a nutritionist or dietitian if dietary restrictions become difficult to manage.
• It is recommended to avoid taking medications that have not been prescribed by their doctor and to follow any recommendations derived from treatments for both ulcerative colitis and other simultaneous conditions.