Clinical symptoms and physical examination usually already provide the physician with a tentative diagnosis of ulcerative colitis. The blood shows signs of inflammation in ulcerative colitis, but these are nonspecific and also do not always correlate with the severity of the disease.
The most important examination for more precise clarification is colonoscopy, in which a tissue sample is taken and examined in the laboratory and under the microscope. The diagnosis of ulcerative colitis can almost always be made in this way.
In addition, an ultrasound examination of the abdomen and a stool examination are performed. In this way, other causes such as an infection can be ruled out and other organ changes can be detected.
Ulcerative colitis: therapy
To date, ulcerative colitis can only be cured by surgery (OP). This surgery means the complete removal of the colon (colectomy). However, this is reserved only for certain complications and severe courses of ulcerative colitis in which symptoms do not improve with drug treatment.
The aim of the latter is, on the one hand, to prolong the time between relapses and, on the other hand, to attenuate the relapses. Anti-inflammatory drugs are used for this purpose, if possible only at the site of the disease (e.g. by suppositories), but in more severe cases they must also be administered through the bloodstream.
Important drugs are aminosalicylates in milder courses, otherwise cortisone preparations. If these do not help against ulcerative colitis, drugs that slow down the immune system (immunosuppressants) are prescribed. Still being tested are the additional administration of antibiotics, incense extracts, and so-called growth factors.
Treating ulcerative colitis
Probiotics, certain bacteria that improve intestinal flora (Escherichia coli Nissle), are also recommended to mitigate disease flare-ups in ulcerative colitis. A promising alternative could be the “cocktail” of pig whipworm eggs taken regularly 2 times a month. The parasites are supposed to hatch from these in the intestine, die after a short time and are excreted. The idea behind this is that it stimulates the immune system. The effectiveness has not yet been proven.
The exact treatment plan of this ulcerative colitis therapy depends on the individual course, the severity of the disease, the age of the patient and whether there is an acute attack (“acute therapy”) or this should only be prevented (“maintenance therapy”).
Ulcerative colitis: diet and bed rest.
It is important to see a doctor in a timely manner as soon as ulcerative colitis symptoms appear, as early drug intervention can shorten the duration and severity of the episode. During an inflammatory episode, it is advisable to maintain bed rest and possibly also to stop eating. In severe cases of ulcerative colitis, hospitalization and an IV may be required. A special diet for ulcerative colitis patients is not necessary, although a balanced, light, whole-foods diet is useful.
If bleeding occurs frequently, iron may need to be supplemented, and if cortisone is taken for prolonged periods, calcium and vitamin D are recommended to prevent bone damage. Psychological support and self-help groups make it easier for those affected to cope with the disease.
Ulcerative colitis: course and prognosis
If only the last sections of the intestine are affected by ulcerative colitis, the prognosis is good. However, if the entire colon is affected, life expectancy is limited. A severe first episode, advanced age at onset, and complications also worsen the prognosis for ulcerative colitis. To detect precancerous lesions early, regular colonoscopies are essential in ulcerative colitis from the eighth year of disease onward.
