What is Colitis?
A health article about Colitis fromYour Health Online the A to Z directory of dealing with Health Problems & nutritional Self Care Strategies
Ulcerative-colitis, like Crohn's disease, is an inflammation of the digestive tract, specifically the lining of the large bowel.
Signs & Symptoms
Chronic ulcerative colitis usually begins in the lower part of the bowels and spreads upwards.
The first symptom of the trouble is an increased urgency to move the bowel, followed by cramping pains in the abdomen and bloody mucus in the stools.
As the disease spreads upwards, the stools become watery and more frequent and are characterized by rectal straining.
All this loss of blood and fluid from the bowels results in weakness, fever, nausea, vomiting, loss of appetite and anaemia.
The patient may develop a bloated feeling because the gas is not absorbed or expelled normally.
Some patients suffer from constipation alternating with period of loose bowel
Still others may suffer from a persistent diarrhoea for years together.
The patient is usually malnourished and may be severely underweight.
He may suffer from frequent insomnia.
Ulcerative colitis in its severe form may also lead to nutritional problems.
The improper assimilation of the ingested foods due to inflammatory conditions may cause deficiency diseases. This may gradually result in nervous irritability, exhaustion and depression.
In very severe cases, the patient may even develop suicidal tendencies.
Here are the signs and symptoms that may accompany ulcerative colitis, depending on its classification:
• Ulcerative proctitis. In this form of ulcerative colitis, inflammation is confined to the rectum and for some people, rectal bleeding may be the only sign of the disease. Others may have rectal pain, a feeling of urgency or an inability to move the bowels in spite of the urge to do so (tenesmus).
• Left-sided colitis. As the name suggests, inflammation extends from the rectum up the left side through the sigmoid and descending colon. Signs and symptoms include bloody diarrhea, abdominal cramping and pain, and weight loss.
• Pancolitis. Affecting the entire colon, pancolitis causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, weight loss and night sweats.
• Fulminant colitis. This rare, life-threatening form of colitis affects the entire colon and causes severe pain, profuse diarrhea and, sometimes, dehydration and shock. People with fulminant colitis are at risk of serious complications including colon rupture and toxic megacolon, which occurs when the colon becomes severely distended.
Types of Colitis
Both the rectum and colon can be affected. When the rectum is affected in isolation, the condition is called ulcerative proctitis. When the colon is affected the condition is called pan-colitis.
The course of ulcerative colitis varies, with periods of acute illness often alternating with periods of remission. But over time, the severity of the disease usually remains the same. Only a small percentage of people with a milder condition, such as ulcerative proctitis, go on to develop more severe signs and symptoms.
What Causes Colitis?
The main cause of colitis is chronic constipation and the use of purgatives.
Constipation causes an accumulation of the hard faecal matter which is never properly evacuated. Purgatives used as a ‘cure’ only increase irritation. Often, colitis is caused by a poorly digested roughage, especially of cereals and carbohydrates, which causes bowel irritation.
The disease may also result from an allergic sensitivity to certain foods especially milk, wheat and eggs.
Often, the intake of antibiotics may upset the bacterial flora in the intestines and interfere with proper digestion.
Severe stress may also produce ulcerative colitis. During any form of severe stress, outpouring of adrenal hormones causes such destruction of body protein that at times parts of the walls lining the intestines are literally eaten away.
Such stress also depletes the body of pantothenic acid. Experiments on animals have shown that they can develop ulcerative colitis when they are
kept on diets deficient in pantothenic acid.
Ulcerative colitis affects about the same number of women and men. Risk factors may include:
• Age. Ulcerative colitis can strike at any age, but you're most likely to develop the condition when you're young. Ulcerative colitis often strikes people in their 30s, although a small number of people may not develop the disease until their 50s or 60s.
• Ethnicity. Although whites have the highest risk of the disease, it can strike any ethnic group. If you're Jewish and of European descent, you're four to five times as likely to have ulcerative colitis.
• Family history. You're at higher risk if you have a close relative, such as a parent, sibling or child, with the disease.
• Where you live. If you live in an urban area or in an industrialized country, you're more likely to develop ulcerative colitis. People living in Northern climates also seem to have a greater risk of ulcerative colitis. Other environmental factors, such as a diet high in fat or refined foods, also may play a role.
• Inflamed bile ducts. This condition, called primary sclerosing cholangitis, causes inflammation of the bile ducts of the liver, and is associated with ulcerative colitis. If you have this condition, you doctor may look for ulcerative colitis even if you don't have signs or symptoms.
When to seek Medical Advice:
See your doctor if you experience a persistent change in your bowel habits or if you have any of the signs and symptoms of ulcerative colitis, such as:
• Abdominal pain
• Blood in your stool
• Ongoing bouts of diarrhea that don't respond to over-the-counter (OTC) medications
• An unexplained fever lasting more than a day or two
Although ulcerative colitis usually isn't fatal, it's a serious disease that, in some cases, may cause life-threatening complications.
The usual treatment of colitis with suppressive drugs is based on trying to reduce the inflammation that triggers your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission. Ulcerative colitis treatment usually involves either drug therapy or surgery.
In many other cases they suppress the symptoms temporarily, without removing the cause. In such cases, the symptoms will often recur until colitis becomes chronic.
Here is information from the Mayo Clinic (http://www.mayoclinic.com/health/ulcerative-colitis) on medical intervention options
Doctors use several categories of drugs that control inflammation in different ways. But drugs that work well for some people may not work for others, so it may take time to find a medication that helps you. In addition, because some drugs have serious side effects, you'll need to weigh the benefits and risks of any treatment.
• Anti-inflammatory drugs
Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease. They include:
• Sulfasalazine (Azulfidine). Sulfasalazine can be effective in reducing symptoms of ulcerative colitis, but it has a number of side effects, including nausea, vomiting, heartburn and headache. Don't take this medication if you're allergic to sulfa medications.
• Mesalamine (Asacol, Rowasa) and olsalazine (Dipentum). These medications tend to have fewer side effects than sulfasalazine has. You take them in tablet form or use them rectally in the form of enemas or suppositories, depending on the area of your colon affected by ulcerative colitis. Mesalamine enemas can relieve signs and symptoms in more than 80 percent of people with ulcerative colitis in the lower left side of their colon and rectum. Olsalazine may cause or worsen existing diarrhea in some
• Balsalazide (Colazal). This is another formulation of mesalamine. Colazal delivers anti-inflammatory medication directly to the colon. The drug is similar to sulfasalazine, but uses a less toxic carrier and may produce fewer side effects.
• Corticosteroids. Corticosteroids can help reduce inflammation, but they have numerous side effects, including a puffy face, excessive facial hair, night sweats, insomnia and hyperactivity. More serious side effects include high blood pressure, type 2 diabetes, osteoporosis, bone fractures, cataracts and an increased susceptibility to infections. Long-term use of these drugs in children can lead to stunted growth.
Also, corticosteroids don't work for everyone who has ulcerative colitis. Doctors generally use corticosteroids only if you have moderate to severe inflammatory bowel disease that doesn't respond to other treatments. Corticosteroids aren't for long-term use and are generally prescribed for a period of three to four months.
They may also be used in conjunction with other medications as a means to induce remission. For example, corticosteroids may be used with an immune system suppressor — the corticosteroids can induce remission, while the immune system suppressors can help maintain remission. Occasionally, your doctor may also prescribe steroid enemas to treat disease in your lower colon or rectum. These, too, are only for short-term use.
Immune system suppressors
These drugs also reduce inflammation, but they target your immune system rather than treating inflammation itself. Because immune suppressors can be effective in treating ulcerative colitis, scientists theorize that damage to digestive tissues is caused by your body's immune response to an invading virus or bacterium or even to your own tissue. By suppressing this response, inflammation is also reduced. Immunosuppressant drugs include:
• Azathioprine (Imuran) and mercaptopurine (Purinethol). These drugs have been used to treat Crohn's disease for years, but their role in ulcerative colitis is only now being studied. Because azathioprine and mercaptopurine act slowly, they're sometimes initially combined with a corticosteroid, but in time, they seem to produce benefits on their own, with less long-term toxicity.
Side effects can include allergic reactions, bone marrow suppression, infections, and inflammation of the liver and pancreas. If you're taking either of these medications, you'll need to follow up closely with your doctor and have your blood checked regularly to look for side effects.
• Cyclosporine (Neoral, Sandimmune). This potent drug is normally reserved for people who don't respond well to other medications or who face surgery because of severe ulcerative colitis. In some cases, cyclosporine may be used to delay surgery until you're strong enough to undergo the procedure; in others, it's used to control signs and symptoms until less toxic drugs start working. Cyclosporine begins working in one to two weeks, but because it has the potential for severe side effects, including kidney and liver damage, fatal infections and an increased risk of lymphoma, you and your doctor will want to talk about the risks and benefits of treatment.
• Infliximab (Remicade). This drug is specifically for adults and children with moderate to severe ulcerative colitis who don't respond to or can't tolerate other treatments. It works by neutralizing a protein produced by your immune system known as tumor necrosis factor (TNF). Infliximab finds TNF in your bloodstream and removes it before it causes inflammation in your intestinal tract and contributes to the formation of infected sores called fistulas.
Some people with heart failure, people with multiple sclerosis, and people with cancer or a history of cancer can't take Remicade. If you're currently taking Remicade, talk to your doctor about the potential risks. The drug has been linked to an increased risk of infection, especially tuberculosis, and may increase your risk of blood problems and cancer. You'll need to have a skin test for tuberculosis before taking infliximab and a chest X-ray if you lived or traveled extensively where tuberculosis has been found.
Also, because Remicade contains mouse protein, it can cause serious allergic reactions in some people — reactions that may be delayed for days to weeks after starting treatment. Once started, infliximab is often continued as long-term therapy, although its effectiveness may wear off over time.
These skin patches — the same kind smokers use — seem to provide short-term relief from flare-ups of ulcerative colitis for some people, especially people who formerly smoked. How nicotine patches work isn't exactly clear, and the evidence that they provide relief is contested among researchers. Talk to your doctor before trying this treatment.
Don't take up smoking as a treatment for ulcerative colitis. The risks from smoking far outweigh any potential benefit.
In addition to controlling inflammation, some medications may help relieve your signs and symptoms. Depending on the severity of your ulcerative colitis, your doctor may recommend one or more of the following:
Anti-diarrheals. A fiber supplement such as psyllium powder (Metamucil) or methylcellulose (Citrucel) can help relieve signs and symptoms of mild to moderate diarrhea by adding bulk to your stool. For more severe diarrhea, loperamide (Imodium) may be effective. Use anti-diarrheal medications with great caution, however, because they increase the risk of toxic megacolon.
Laxatives. In some cases, swelling may cause your intestines to narrow, leading to constipation. Talk to your doctor before taking any laxatives, because even those sold over-the-counter may be too harsh for your system.
Pain relievers. For mild pain, your doctor may recommend acetaminophen (Tylenol, others). Don't use nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen (Aleve). These are likely to make your symptoms worse.
Iron supplements. If you have chronic intestinal bleeding, you may develop iron deficiency anemia. Taking iron supplements may help restore your iron levels to normal and reduce this type of anemia once your bleeding has stopped or diminished.
If diet and lifestyle changes, drug therapy or other treatments don't relieve your signs and symptoms, your doctor may recommend surgery.
Surgery can often eliminate ulcerative colitis. But that usually means removing your entire colon and rectum (proctocolectomy). In the past, after this surgery you would wear a small bag over an opening in your abdomen (ileostomy) to collect stool. But a procedure called ileoanal anastomosis eliminates the need to wear a bag. Instead, your surgeon constructs a pouch from the end of your small intestine. The pouch is then attached directly to your anus. This allows you to expel waste more normally, although you may have as many as five to seven soft or watery bowel movements a day because you no longer have your colon to absorb water.
If you have surgery, your doctor may discuss whether an ileostomy or an ileoanal pouch is right for you. Between 25 percent and 40 percent of people with ulcerative colitis eventually need surgery.
Self Care strategies for Living with Colitis
Many people express quite aggressive opinions that medical intervention only deals with symptoms and leave the underlying problem to become worse until it is become unnecessarily agrivated and can be a serious threat to the patient’s health.
Plain warm water or warm water with a little olive oil used as a wash-out is considered by many to be the best method of softening and removing the accumulations of hardened matter sticking to the walls of the colon.
Diet plays an important part in the treatment of colitis. It is advisable to observe a juice fast for five days or so in most cases of ulcerative colitis. The juices may be diluted with a little boiled water. Papaya juice, raw cabbage and carrot juices will be especially beneficial.
Citrus juices should be avoided. The bowel should be cleansed daily with a warm water enema.
After the juice fast, the patient should gradually adopt a diet of small, frequent meals of soft cooked or steamed vegetables, rice, dalia (coarsely broken wheat), well ripened fruits like banana and papaya, yogurt and home-made cottage cheese. Sprouted seeds and grains, whole meal bread and raw vegetables may be added gradually to this diet after about 10 days. All food must be eaten slowly and chewed thoroughly.
Foods which should be excluded from the diet are white sugar, white bread and white flour products, highly seasoned foods, highly salted foods,strong tea, coffee and alcoholic beverages and foods cooked in aluminium pans.
Ripe bananas are highly beneficial in the treatment of ulcerative colitis, being bland, smooth, easily digested and slightly laxative. They relieve acute symptoms and promote the healing process.
An effective remedy for ulcerative colitis is the use of butter- milk. It is the residual milk left after the fat has been removed from yogurt by churning. Buttermilk enema twice a week is also soothing and helps in re-installing a healthy flora in the colon.
Another valuable remedy for colitis is tender coconut water, it is soothing to the soft mucosa of the colon. Cooked apple also aids the healing of ulcerative conditions because of its ample concentration of iron and phosphorous.
The patient should have a bowel movement at the same time each day and spend 10 to 15 minutes in the endeavour. Straining at stools should be avoided. Drinking two glasses of water the first thing in the morning will stimulate a normal bowel movement.
An enema may be used if no bowel movement occurs.
Complete bed rest and plenty of liquids are very important. The patient should eliminate all causes of tension, adjust to his disability and face his discomfort with patience.
Diet change strategies:
Vitamin & Nutrient Associations
If there is one supplement or alternative health product that will be most likely to help with IBS it is Aloe Vera Juice.
Aloe heals where it touches. If you cut or graze your hand and there is an aloe vera plant near buy you can cut the succulent leaf and rub the internal gel on the wound and the discomfort will reduce quickly and the rate of healing will normally be dramatically faster than without the use of the aloe products.
Internally it is a little more to difficult to apply aloe so you need to use a high quality Aloe Vera Juice.
A quality product will be clear to look at and pleasant smelling. If you find a cloud solution that smells and tastes poorly then you will have an extract of the full juice. This is very good for cleansing the lower bowel and is a much cheaper product but it will not deliver the same cleansing and healing properties as a juice that is extracted from just the heart of the plant.
In addition to the another product that will help to balance the irritable bowel problem is acidophilus.
These two products together will promote healing through the entire digeative tract and will, in many cases, assist in bringing irritable bowel syndrome back under control and aid in preventing “flare ups”.
One note, acidophilus tablets (if you take the product in that form) absord water from the bowel so if you have diarrohea problems taking one or two tablets with only a small water will help reduce the fluid in the gut.
Once you have a basic cleansing and healing process happening then you should look at adding in some nutrition products to heal your whole system.
If you are using even high quality products like these DO NOT go onto full product use on day one. Introduce things gradually over a few days or even a few weeks.
Initially if you are going to use a protein based meal replacement powder it would be best to take powder/shake just once a day.
After a few days add any supplement tablets starting with one of them taken only one time a day initially and adding the rest of the tablets progressively and then taking them twice a day and finally on to normal usage three times a day.
This whole process may take a few days, a few weeks or even a month to establish but if is removes the problems of irritable bowel syndrome from your life it is worth it.
A final note: often when people start on this program they feel very good after a short time and think they can go onto a normal diet immediately. DO NOT DO THAT. Introduce things gradually. If it takes six weeks to get onto a normal diet where you can eat anything it is a fantastic outcome. Be patient with the process.
Further reading through our articles on health issues will give you a body of information that will help you decide what options you have to deal with the underlying causes of your Colitis problem through giving your body the nutrition products that will assist you body to heal from the inside out.
We wish you well in your search for solutions to this problem and your movement towards better health in all areas.
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