Chances of cure for ulcerative colitis
The drugs used in the treatment of ulcerative colitis can only treat the symptoms of the disease and reduce the frequency and severity of acute attacks, but they cannot cure the disease. This disease can only be cured by a complete removal of the colon. However, this step should not be taken lightly, as the operation carries some risks of complications and in any case leads to temporary, in some cases even permanent, faecal incontinence, which places a great deal of psychological stress on many patients.
Complications
In the case of severe relapses with heavy blood loss, a life-threatening situation can sometimes arise that requires a blood transfusion or, in extreme cases, even an emergency operation. Another dreaded complication in ulcerative colitis is the toxic megacolon. If the inflammation spreads to the intestinal nervous system, it can lead to intestinal paralysis (intestinal paralysis; ileus) and thus to a stretching of the intestinal wall (intestinal dilatation).
As a result of the intestinal dilatation, the intestinal bacteria can quickly pass through the intestinal wall and thus develop a life-threatening peritonitis. Peritonitis is a severe inflammation that can quickly lead to life-threatening blood poisoning (sepsis) and shock with circulatory failure. In addition, this complication carries the risk of intestinal perforation, which must be treated surgically as soon as possible.
The onset of a toxic megacolon is characterised by severe abdominal pain (acute abdomen), tachycardia, fever and interruption of the initial diarrhoea (ileus). If the intensive medical care with antibiotics (bacteria-killing drugs) and glucocorticoids (cortisone; strong anti-inflammatory effect) remains unsuccessful, the affected intestinal section must be surgically removed (resected). After years of ulcerative colitis, changes (dysplasias) can occur in the mucous membrane, which can easily degenerate into colon cancer (colon cancer).
If the entire colon (pancolitis) is affected over a period of 20 years, the risk of degeneration into a malignant tumour is about 50%. Therefore, there is a proven prevention plan for cancer screening, which should be carried out consistently. For this purpose, a preventive examination by means of colonoscopy is performed once a year in the case of pancolitis after 8 years of age and after 15 years in the case of left-sided colitis.
Nutrition in ulcerative colitis
In ulcerative colitis, nutrition plays an important role in two aspects of the disease, both in the development and in the therapy of the disease. Why ulcerative colitis really occurs has not yet been conclusively clarified. However, it is now known that there are many factors that play a role in the development of ulcerative colitis, this is also known as multifactorial genesis.
These factors include a disturbed immune system, bacteria/viruses, the development of the natural intestinal flora, a hereditary predisposition and psychosomatic causes as well as nutrition. It is assumed, for example, that a very low-fibre diet can contribute to the development of ulcerative colitis. Some ingredients, especially proteins from cow’s milk, are also suspected of promoting this chronic inflammatory bowel disease.
To support this theory, there are studies that show that people who were not breastfed by their mothers in infancy have a higher risk of developing the disease than a control group. An important part of the therapy of ulcerative colitis is an individually designed nutritional plan, which may vary slightly from patient to patient. In principle, patients are allowed to eat what is good for them.
In general, a diet rich in vegetables, fruit, fibres and proteins and poor in fats, meat and alcohol has become established. For some patients it is also advisable to avoid dairy products or soft drinks. It is often also important to ensure that the food has a sufficiently high calorie content, because patients often lose a lot of weight due to frequent diarrhoea.
During a severe acute attack, normal food intake may become impossible for a patient with ulcerative colitis. In such a case it is necessary to change the diet to an artificial diet that does not have to pass through the intestine, i.e. so-called parenteral nutrition. This can, for example, enter the body through the vein.
