Ulcerative colitis

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

The specific cause of ulcerative colitis is not known, although the following non-genetic factors appear to be involved to varying degrees in its development:

  • Age and gender. Although it can appear at any age, it occurs preferentially bimodally in women between the ages of 15-30 years and 50-70 years.
  • A higher incidence has been described in northern Western European and American Jewish populations, but it can affect all age groups equally.
  • There seems to be an autoimmune dysregulation to food or bacterial antigens, however, it is not known if this influences the development of the disorder or the appearance of the manifestations.
  • Alterations in the composition of the intestinal microbiota, as well as atmospheric pollution, medications and certain diets have been postulated to contribute.

Although the exact cause is unknown, research suggests an interaction of environmental factors, including an overactive immune response on the intestinal mucosa, together with the contribution of genetic factors with an estimated heritability of about 27%. Given its debilitating nature and the possibility of triggering life-threatening consequences, the FinnGen project has recently tackled through GWAS, the study of genetic predisposing factors on 4000 cases and 210,000 controls. As a result, 6 loci significantly related to the predisposition to develop this disorder have now been identified.

Symptoms

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

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

This symptomatology may be accompanied by abdominal cramps, fatigue, nausea, weight loss and anemia.

With time and 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

In addition, there may be an increased risk of colon cancer.

Prevention

Ulcerative colitis cannot be prevented, however, different measures can help in preventing the onset of flare-ups, as well as limiting the severity of the flare-ups.

  • Reduce stress levels as stress can delay gastric emptying and increase acid. To this end, it is recommended to sleep at least seven hours, do regular exercise, even light exercise such as walking, yoga or meditation.
  • Diet can play a key role in controlling symptoms and prolonging the time between flare-ups. Some foods can worsen symptoms and should be avoided, especially during flare-ups. These tend to vary between individuals, but are generally fatty foods, high sugar, carbonated beverages, high fiber, coffee, chocolate or alcoholic beverages. Sometimes salt and dairy products can be problematic. It is necessary to eat more frequently and in smaller quantities. If the ailment is severe, soft and bland foods may cause less discomfort. Patients should also be sure to drink plenty of fluids, especially water. A daily multivitamin supplement may be helpful, 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 your physician, and to follow possible recommendations derived from treatments for both ulcerative colitis and other concurrent conditions.

Number of observed variants

13.5 million variants

Number of risk loci analyzed in the study

5 loci

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