ulcerative


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ulcerative

 [ul´sĕ-ra″tiv, ul´ser-ah-tiv]
pertaining to or characterized by ulceration.
ulcerative colitis a recurrent acute and chronic disorder characterized by extensive inflammatory ulceration in the colon, chiefly of the mucosa and submucosa. The etiology is unknown; hence, the term idiopathic is used in reference to ulcerative colitis. The disorder is not always limited to pathologic changes in the colon, but may become systemic, involving the joints and causing migratory arthritis, sacroileitis, and ankylosing spondylitis. Other organs that can become involved are the liver, skin, and eyes. Hypercoagulability may also be seen.



Ulcerative colitis shares many of the same characteristics with regional ileitis or crohn's disease; the two are often included in the broader diagnostic entity called inflammatory bowel disease. There are some who believe that both disorders are immunologic responses to the same as yet unknown etiologic agent.

Genetic predisposition to inflammatory bowel disease may exist; there is a higher incidence of ulcerative colitis and Crohn's disease among close relatives. Ulcerative colitis is slightly more prevalent in females than in males and most often appears between the ages of 15 and 20 years with a smaller peak at 55 to 60 years of age. Crohn's disease follows a similar pattern of incidence.
Clinical Manifestations and Complications. The patient with ulcerative colitis suffers from attacks of bloody, mucoid diarrhea that are usually precipitated by physical or emotional stress. These acute attacks can last for days, weeks, or even months and are followed by periods of remission that can extend from a few weeks to several decades. Some patients experience relatively few attacks throughout their lifetime, while others have frequent, prolonged, and potentially serious attacks that predispose the colon to malignant changes. Both acute and chronic diarrhea can upset the fluid and electrolyte balance, interfere with normal nutrition, and produce fever, abdominal cramps, and weight loss.



A sudden and severe attack of the disease can lead to cessation of bowel function and toxic megacolon or dilatation of the colon. This can occur spontaneously, or it may be preceded by barium enema, hyperkalemia, or anticholinergic narcotics, or there may be bacterial overgrowth with production of exotoxin. Other complications include severe blood loss and anemia, systemic toxicity, and metabolic disturbances. A serious sequela of long-term chronic and continuous ulcerative colitis is carcinoma of the colon, which occurs in approximately 5% of people with ulcerative colitis. The risk of it is lower for persons who have infrequent relapses than for those who are symptomatic for years. Guidelines on screening for colon cancer have been developed by an expert panel and endorsed by numerous organizations concerned with the care of patients with GI diseases. They advise colonoscopy every one to two years for people who have had inflammatory bowel disease throughout the colon for at least 8 years or who have had it in the left colon for at least 15 years.
Patient Care. During acute attacks, the patient will most likely present problems related to fluid volume deficit, alteration in nutrition, loss of electrolytes, potential for skin breakdown in the anal region, disturbance of sleep and rest, and discomfort from abdominal cramps. Long-term problems are likely to be related to anxiety, alterations in self-concept, social isolation, and fear of malignancy.



The plan of care should include observation of the number and character of stools, periodic auscultation of bowel sounds, measurement of intake and output, daily weight, checking for signs of bleeding and anemia, and monitoring of blood gases, electrolytes, and pH for evidence of acid-base imbalance or abnormal electrolyte values. It also is important to be alert for signs of inflammatory changes in the joints or lesions on the skin.

When diagnostic procedures such as sigmoidoscopy, barium enema, and stool analyses are necessary, patients should have a satisfactory explanation of the purpose of these tests and what is expected of them before, during, and after each procedure.

Long-term goals of care should help the patient comply with the prescribed medical regimen, which usually consists of antidiarrheic agents, anticholinergic drugs to relieve abdominal cramps, mild sedatives, and a diet of low-residue, bland foods that have high caloric and protein content. Antibiotics are sometimes needed to control infections of the bowel.

Surgical intervention may be the only alternative when more conservative treatments fail. The surgery usually involves creation of a permanent ileostomy, which brings on a new set of problems.

There is no cure for ulcerative colitis, and it is a debilitating disorder that can create many physiologic, psychological, and social problems for the patient. The frequent bouts of severe diarrhea and discomfort can be embarrassing and depressing. Emotional support, empathetic listening, and cooperative problem solving are essential components of patient care. Further information may be obtained by writing The Crohn's and Colitis Foundation of America Inc., 386 Park Avenue South, 17th floor, New York, NY 10016-8804, calling them at 1-800-932-2423 or 1-212-685-3440, or consulting their web site at http://www.ccfa.org.

ul·cer·a·tive

(ŭl'sĕr-ă-tiv),
Relating to, causing, or marked by an ulcer or ulcers.

ul·cer·a·tive

(ŭl'sĕr-ă-tiv)
Relating to, causing, or marked by an ulcer or ulcers.

Patient discussion about ulcerative

Q. Is it an ulcer? I am worried! Hi friend, I'm 35 year old male and recently I started to suffer from some strange symptoms I have never experienced. The first symptom was sharp pain in my upper abdomen that starts two of three hours after eating. In the beginning I thought it could be connected with some food intolerance but then I started to get this pain early in the morning, before any eating what so ever and all this was accompanied with nausea, frequent burping and weight loss. I have read some stuff about stomach ulcer and I could say that I poses almost every major symptom. Is there any way for me to be sure that I have developed disease of ulcer?

A. There is nothing you could do to check do you have ulcer or not by your self. Anyone who thinks he may have an ulcer needs to see a doctor because over time, untreated ulcers grow larger and deeper and can lead to other problems. So go now to the doctor.
http://www.youtube.com/watch?v=YrcrG-dcIXA

Q. What are the symptoms of Ulcerative Colitis? I am 40 years old and suffer from a lot of stomach aches and diarrhea. Do I have Ulcerative Colitis? What are its symptoms?

A. Here's a pretty good article that covers symptoms of UC:

http://www.wearecrohns.org/ucers/articles/319

Q. What is the difference between duodenal ulcer and stomach ulcer? I was diagnosed recently with duodenal ulcer. I heard the term stomach ulcer but not duodenal. What causes duodenal and what cause stomach ulcer? And how do they treat duodenal ulcer?

A. The duodenum is right after the stomach. They are both (as published a few years back) caused 90% of the time from a bacteria named helicobacter pylori. Hence the treatment for it is probably antibiotics. But I guess that should be your doctor’s call. Good luck!

More discussions about ulcerative
References in periodicals archive ?
The CONDUCT study is evaluating the first-in-class TLR9 agonist cobitolimod and includes 213 patients with left-sided moderate to severe active ulcerative colitis not responding to conventional therapy.
Ulcerative colitis only affects the colon (large intestine), however Crohn's disease can affect any part of the digestive system, from the mouth to the anus.
According to the company, cobitolimod is a Toll-like receptor 9 (TLR9) agonist, which can provide an anti-inflammatory effect locally in the large intestine, which may induce mucosal healing and relief of the clinical symptoms in ulcerative colitis.
After the investigators controlled for numerous demographic and clinical variables, being prescribed a strong opioid (morphine, oxycodone, fentanyl, buprenorphine, methadone, hydromorphone, or pethidine) more than three times per year significantly correlated with all-cause mortality in both Crohn's disease (hazard ratio, 2.2) and ulcerative colitis (HR, 3.
Worsening ulcerative colitis was the most common serious adverse event for patients who received both induction and maintenance therapy.
According to the study published in the Journal of Alimentary Pharmacology & Therapeutics, researchers diagnosed patients with ulcerative colitis and Crohn's disease before 18 years of age.
Theravance plans to initiate a Phase IIb/in adaptive design study in ulcerative colitis with TD-1473 and is planning to initiate a Phase n study in Crohn's disease this year.
Inflammatory damage from ulcerative colitis causes ulcers inside the lining of the large intestine (rectum and colon).
This study further investigated the effects of Breg cells and Th17 cells on ulcerative colitis by determining peripheral blood Breg cells, Th17 cells, and related molecules in patients with ulcerative colitis and provided theoretical basis for targeted therapy and prognosis of ulcerative colitis.
The product is a new type of drug that is claimed to help patients with moderate to severe ulcerative colitis back to a normal life.