Diseases & Conditions Blog

Ulcerative colitis

What is this Condition?

Colitis is an inflammatory, often chronic disease that affects the lining of the lower intestine. It starts in the lowest section and often extends upward into the colon, producing swelling and open sores. The small intestine is rarely involved. Most cases are mild and localized; however, prompt medical attention is necessary because the disorder can progress rapidly and may cause a perforated colon and potentially fatal infection of the abdominal lining.

People with colitis run a higher than average risk of developing colon cancer, especially if the disease begins before age 15 or persists for longer than 10 years.

What Causes it?

The exact cause of colitis is not known. One theory links it to abnormal immune response in the stomach and intestine, possibly associated with food or bacteria. Stress, once suspected of causing colitis. has been shown merely to worsen it. It is most common in young adults, especially women, and symptoms seems to peak between ages 15 and 20, with another peak between ages 55 and 60.

What are its Symptoms?

The primary symptoms of colitis are repeated attacks of pain accompanied by bloody diarrhea, often containing pus. The intensity of the attacks varies with the extent of inflammation. Other symptoms include spastic rectum and anus, abdominal pain, weakness, irritability, loss of appetite, weight loss, nausea, and vomiting.

How is it Diagnosed?

The doctor can use a scope to see changes in the mucous lining of the lower intestine and detect thick pus. He or she may also obtain a specimen for study to confirm the condition and use a deeper scope to check how far the disease extends and what harm it’s done. A barium enema X-ray can show the extent of the disease and detect complications, such as narrowed passages and cancer. Lab tests and blood tests reveal the severity of the attack.

How is it Treated?

Severe colitis requires hospitalization. Drugs are used to treat inflammation, nutrition is monitored, and dehydration due to excessive diarrhea is corrected. Intravenous feeding helps the intestinal tract to rest, decreases stool volume, and restores positive nitrogen balance. Blood transfusions or iron supplements may be needed to correct anemia.

Surgery a last resort and is performed only if other measures fail or the symptoms become unbearable. The most common surgical procedure simply removes the diseased section of intestine. Another type of surgery creates a reservoir, known as a Kock pouch, from a loop of small intestine that empties through a tube opening just above the pubic hairline.

What is this Condition?

Peptic ulcers are sores that develop in the mucous lining of the lower esophagus, stomach, and sections of the intestine called pylorus, duodenum, and jejunum. They are most common in the following circumstances:

• About 80% of all peptic ulcers are duodenal ulcers, which affect part of the small intestine and most often strike men between ages 20 and 50.

• Gastric ulcers, which affect the stomach lining, are most common in middle-aged and elderly men, especially in chronic users of some anti-inflammatory drugs or alcohol.

• Duodenal ulcers usually follow a chronic course, with remissions and flare-ups, but 5% to 10% of sufferers develop complications that reqUire surgery.

>What Causes it?

Though the precise cause is not known, peptic ulcers are thought to develop when the mucous lining becomes weakened, gets inadequate blood flow, or is defective. Recent research findings include the following:

• Stress may stimulate long-term overproduction of gastric secretions that can erode the stomach, duodenum, or esophagus.

• Backup of stomach acid through a lining damaged by chronic gastritis or irritants, such as aspirin or alcohol, is a likely cause of gastric ulcers.

• In elderly people, the pylorus begins to malfunction, permitting bile to back up into the stomach - a common cause of gastric ulcers in this age-group. For unknown reasons, these ulcers often strike people with type A blood and become malignant more often than duodenal ulcers.

• Too much acid secretion, possibly caused by an overactive vagus nerve, contributes to the formation of duodenal ulcers. These ulcers tend to afflict people with type 0 blood, Duodenal ulcers may persist for life. If they do heal, they usually leave scars that can later break down and ulcerate again.

What are its Symptoms?

Heartburn and indigestion usually signal the start of a gastric ulcer attack. Eating a large meal can stretch the person’s stomach, causing pain and a feeling of fullness and bloating. Other typical effects include weight loss and repeated episodes of digestive tract bleeding.

Duodenal ulcers produce heartburn and pain in the middle of the stomach that is relieved by food. The person gains weight (eating to relieve discomfort) and feels a peculiar sensation of hot water bubbling in the back of the throat. Attacks usually occur about 2 hours after meals, whenever the stomach is empty, after taking aspirin, or after drinking orange juice, coffee, or alcohol. Attacks recur several times a year. Vomiting and other digestive disturbances are rare.

Other Symptoms and Complications

Any of these ulcers may be symptom-free or may penetrate the pancreas and cause severe back pain. Other complications of peptic ulcers include perforation, hemorrhage, and obstruction of the opening between the stomach and the small intestine.

How is it Diagnosed?

Upper digestive tract X-rays show abnormalities in the mucous lining. The doctor can analyze stomach secretions for evidence or use a scope to see the ulcers. Stools may test positive for traces of blood.

How is it Treated?

If you have a peptic ulcer, the doctor will probably treat you with an antibiotic at least once to wipe out a bacterium called Helicobacter pylori because it can infect ulcers even with other causes. He or she may prescribe a familiar drug such as Achromycin or Amoxil. People who take anti-inflammatory drugs may use a drug called Cytotec to reduce ulceration. A coating agent also may be administered to a person with duodenal ulcers. Mostly, the doctor treats your symptoms with drug therapy and rest, starting with antacids.

If you have a bleeding ulcer, the doctor begins emergency treatment with insertion of a nasal tube to bathe the ulcer with iced salt water, possibly containing norepinephrine. A scope can be used to see the bleeding site and a laser or cautery to control bleeding. If the ulcer perforates or persists, or if malignancy is suspected, surgery will be recommended.

What is this Condition?

Anorectal abscess is a localized accumulation of pus that results from inflamed tissues near the rectum or anus. Inflammation may produce a fistula - an abnormal tubelike passage in the skin - that opens into the rectum. This condition is far more common in men than in women, possibly because men wear coarser clothing, which may irritate the skin and interfere with air circulation.

What Causes it?

Inflammation and the resulting abscess typically begin with a scrape or tear in the lining of the anal canal, rectum, or skin that later be­comes infected. It may be caused by an injection for treatment of internal hemorrhoids; an enema tip; internal puncture wound from undigested sharp objects such as eggshells or fishbones; or by insertion of a foreign object. Muscle strains or an illness may start the abscess, but many abscesses develop without an obvious cause.

As pus develops, a fistula may form in the soft tissue beneath the muscle fibers of the sphincters (especially the external sphincter).

What are its Symptoms?

The person with an abscess feels a throbbing pain and tenderness at the infection site. A hard, painful lump develops on one side that makes sitting uncomfortable.

How is it Diagnosed?

The doctor can find the abscess with his or her fingers and by a visual exam. Usually it appears as a red, tender, oval swelling close to the anus. Sitting or coughing increases pain, and pus may drain from the abscess. Less often, the abscess covers a large area and the doctor can see a hard mass that bulges into the anal canal. An abscess higher in the canal may produce a dull, aching pain in the rectum, tenderness and, occasionally, a swelling and hardness the doctor can find with his or her finger.

An abscess high in the pelvis is rare, but it may be heralded by a fever and a tender mass. Sometimes the doctor will insert a scope to examine the area or order barium enema X-rays to rule out other problems.

How the Abscess Drains

If the abscess drains by forming a fistula, the pain usually goes away. The doctor sees the drainage and irritated skin where the fistula opens. If the infection is severe, the person may have chills, fever, nausea, vomiting, and feel generally uncomfortable.

How is it Treated?

Anorectal abscesses require surgery, with a local anesthetic, to drain the pus. If the abscess has formed a fistula, that must also be removed and then a drain inserted for 48 hours.

What can a Person with an Anorectal Abscess do?

after surgery, the person receives medication for pain relief and begins a recovery that takes 4 to 5 weeks for a common abscess and 12 to 16 weeks it it’s more involved. Cleaning the area regularly and gently will avoid another infection. The person also may need a stool­softening laxative, such as Hydrocil Instant or Metamucil, to avoic constipation, which might stress the incision.