About colitis gravis
What is colitis gravis?
Ulcerative colitis is an inflammatory bowel disease (IBD) of unknown cause. It is characterized by chronic inflammation and ulceration of the lining of the major portion of the large intestine (colon). In most affected individuals, the lowest region of the large intestine, known as the rectum, is initially affected. As the disease progresses, some or all, of the colon may become involved. Although associated symptoms and findings usually become apparent during adolescence or young adulthood, some individuals may experience an initial episode between ages 50 to 70. In other cases, symptom onset may occur as early as the first year of life.
Ulcerative colitis is usually a chronic disease with repeated episodes of symptoms and remission (relapsing-remitting). However, some affected individuals may have few episodes, whereas others may have severe, continuous symptoms. During an episode, affected individuals may experience attacks of watery diarrhea that may contain pus, blood, and/or mucus; abdominal pain; fever and chills; weight loss; and/or other symptoms and findings. In severe cases, individuals may be at risk for certain serious complications.
For example, severe inflammation and ulceration may result in thinning of the wall of the colon, causing tearing (perforation) of the colon and potentially life-threatening complications. In addition, in some cases, individuals with the disorder may eventually develop more generalized (systemic) symptoms, such as certain inflammatory skin or eye conditions; inflammation, pain, and swelling of certain joints (arthritis); chronic inflammation of the liver (chronic active hepatitis); and/or other findings.
The specific underlying cause of ulcerative colitis is unknown. However, genetic, immunologic, infectious, and/or psychologic factors are thought to play some causative role.
What are the symptoms for colitis gravis?
Depending on your condition, you may experience one or more of the following symptoms:
- Abdominal pain or Cramping
- Bloating in your abdomen
- unexpected Weight loss
- Diarrhea with or without blood
- blood in your stool
- urgent need to move your bowels
- Chills or Fever
What are the causes for colitis gravis?
Ulcerative colitis (UC) is one of two conditions classified as inflammatory bowel disease. The other is Crohn’s disease.
UC is a lifelong disease that causes inflammation and bleeding ulcers within the inner lining of your large intestine. It generally begins in the rectum and spreads to the colon.
UC is the most commonly diagnosed type of colitis. It occurs when the immune system overreacts to bacteria and other substances in the digestive tract, but experts don’t know why this happens.
Common types of UC include:
- proctosigmoiditis, which affects the rectum and lower portion of the colon
- left-sided ulcerative colitis, which affects the left side of the colon beginning at the rectum
- pancolitis, which affects the entire large intestine
What are the treatments for colitis gravis?
Ulcerative colitis treatment usually involves either drug therapy or surgery.
Several categories of drugs may be effective in treating ulcerative colitis. The type you take will depend on the severity of your condition. The 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 are often the first step in the treatment of ulcerative colitis and are appropriate for the majority of people with this condition. These drugs include:
- 5-aminosalicylates. Examples of this type of medication include sulfasalazine (Azulfidine), mesalamine (Asacol HD, Delzicol, others), balsalazide (Colazal) and olsalazine (Dipentum). Which one you take, and whether it is taken by mouth or as an enema or suppository, depends on the area of your colon that's affected.
- Corticosteroids. These drugs, which include prednisone and budesonide, are generally reserved for moderate to severe ulcerative colitis that doesn't respond to other treatments. Due to the side effects, they are not usually given long term.
Immune system suppressors
These drugs also reduce inflammation, but they do so by suppressing the immune system response that starts the process of inflammation. For some people, a combination of these drugs works better than one drug alone.
Immunosuppressant drugs include:
- Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan). These are the most widely used immunosuppressants for the treatment of inflammatory bowel disease. Taking them requires that you follow up closely with your doctor and have your blood checked regularly to look for side effects, including effects on the liver and pancreas.
- Cyclosporine (Gengraf, Neoral, Sandimmune). This drug is normally reserved for people who haven't responded well to other medications. Cyclosporine has the potential for serious side effects and is not for long-term use.
Tofacitinib (Xeljanz). This is called a "small molecule" and works by stopping the process of inflammation. Tofacitinib is effective when other therapies don't work. Main side effects include the increased risk of shingles infection and blood clots.
The U.S. Food and Drug Administration (FDA) recently issued a warning about tofacitinib, stating that preliminary studies show an increased risk of serious heart-related problems and cancer from taking this drug. If you're taking tofacitinib for ulcerative colitis, don't stop taking the medication without first talking with your doctor.
This class of therapies targets proteins made by the immune system. Types of biologics used to treat ulcerative colitis include:
- Infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi). These drugs, called tumor necrosis factor (TNF) inhibitors, or biologics, work by neutralizing a protein produced by your immune system. They are for people with severe ulcerative colitis who don't respond to or can't tolerate other treatments.
- Vedolizumab (Entyvio). This medication is approved for treatment of ulcerative colitis for people who don't respond to or can't tolerate other treatments. It works by blocking inflammatory cells from getting to the site of inflammation.
- Ustekinumab (Stelara). This medication is approved for treatment of ulcerative colitis for people who don't respond to or can't tolerate other treatments. It works by blocking a different protein that causes inflammation.
You may need additional medications to manage specific symptoms of ulcerative colitis. Always talk with your doctor before using over-the-counter medications. He or she may recommend one or more of the following.
- Anti-diarrheal medications. For severe diarrhea, loperamide (Imodium A-D) may be effective. Use anti-diarrheal medications with great caution and after talking with your doctor, because they may increase the risk of an enlarged colon (toxic megacolon).
- Pain relievers. For mild pain, your doctor may recommend acetaminophen (Tylenol, others) — but not ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and diclofenac sodium, which can worsen symptoms and increase the severity of disease.
- Antispasmodics. Sometimes doctors will prescribe antispasmodic therapies to help with cramps.
- Iron supplements. If you have chronic intestinal bleeding, you may develop iron deficiency anemia and be given iron supplements.
Surgery can eliminate ulcerative colitis and involves removing your entire colon and rectum (proctocolectomy).
In most cases, this involves a procedure called ileoanal anastomosis (J-pouch) surgery. This procedure eliminates the need to wear a bag to collect stool. Your surgeon constructs a pouch from the end of your small intestine. The pouch is then attached directly to your anus, allowing you to expel waste relatively normally.
In some cases a pouch is not possible. Instead, surgeons create a permanent opening in your abdomen (ileal stoma) through which stool is passed for collection in an attached bag.
You will need more-frequent screening for colon cancer because of your increased risk. The recommended schedule will depend on the location of your disease and how long you have had it. People with proctitis are not at increased risk of colon cancer.
If your disease involves more than your rectum, you will require a surveillance colonoscopy every one to two years, beginning as soon as eight years after diagnosis if the majority of your colon is involved, or 15 years if only the left side of your colon is involved.
What are the risk factors for colitis gravis?
Ulcerative colitis affects about the same number of women and men. Risk factors may include:
- Age. Ulcerative colitis usually begins before the age of 30. But it can occur at any age, and some people may not develop the disease until after age 60.
- Race or ethnicity. Although whites have the highest risk of the disease, it can occur in any race. If you're of Ashkenazi Jewish descent, your risk is even higher.
- Family history. You're at higher risk if you have a close relative, such as a parent, sibling or child, with the disease.
Is there a cure/medications for colitis gravis?
Ulcers, diarrhea, cramping, persistent inflammation, and severe abdominal discomfort are all symptoms of colitis gravis, a chronic inflammatory illness of the intestine.
- Infection, inflammatory bowel disease (IBD), inadequate blood supply to the colon, and invasion of the colon wall by lymphocytic white blood cells are some of the potential reasons for an inflamed colon.
- An area of the colon, or the entire colon, may become affected as the condition worsens.
- Although the related signs and symptoms typically appear in youth or early adulthood, some people may have their first episode between the ages of 50 and 70.
- Other times, symptoms could start within the first year of life.
Cure or medication for colitis gravis
- There is no treatment, but it can be treated depending on the underlying cause of colitis.
- Patients occasionally need a little more than just symptomatic treatment, such as painkillers and bowel control drugs. Controlling inflammation, treating particular symptoms (such as diarrhoea, rectal bleeding, stomach discomfort, etc.), replenishing any lost fluids or minerals, and preventing recurring episodes are the main goals of treatment for people with colitis gravis.
- Initially, certain drugs could be suggested to assist reduce diarrhea.
- However, these medications must be taken with considerable caution since, in severe situations, they may promote colonic dilatation and toxic megacolon.
Ulcer,Diarrhoea,Cramping,Persistent inflammation,Severe abdominal discomfort
Loss of appetite,Intense pain,Rapid weight loss,Fatigue,Ulcers on the colon that may bleed,Tenderness in the abdomen,Changes in bowel movements,Swelling of colon tissue,Depression,Erythema (redness) of the colon surface,Fever,Diarrhea with or without blood,Rectal bleeding