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Ulcerative Colitis

Ulcerative Colitis: Frequently Asked Questions

Thursday, April 26, 2012 - 09:30

Contributing Author: Guy Slowik FRCS

Here are some frequently asked questions related to ulcerative colitis.

Q: Is ulcerative colitis an autoimmune disease?

A: There is certainly a malfunction in the immune system that takes place in ulcerative colitis. However, immunosuppressive medications used to keep individuals from rejecting transplanted organs have shown less effectiveness in treating ulcerative colitis than in treating Crohn's disease.

Q: Is ulcerative colitis life threatening?

A: Ulcerative colitis is very rarely life threatening. Cases of toxic megacolon or excessive bleeding due a very severe flare-up where the colon swells up massively can be life threatening, which is why surgery is undertaken quickly if these conditions develop. Normally, ulcerative colitis is a chronic, life-long illness, characterized by periods of few symptoms, known as remission, and periods of very active disease, known as flare-ups.

Q: If both parents have ulcerative colitis, what are the chances that their children will have ulcerative colitis?

A: Ulcerative colitis is not a strictly genetic disease. To date, scientists have found no specific gene that miscodes and causes ulcerative colitis. The chances of a child having ulcerative colitis if his or her parents do is only slightly greater than the chances of any child having ulcerative colitis.

Q: If I need surgery, will I have to wear an ostomy bag?

A: Not necessarily. There are three options for eliminating bowel waste after removal of the colon. One is the standard ostomy, and use of ostomy appliances. Another is a so-called continent ostomy, which is emptied through a rigid tube you insert through the valve-like ostomy opening. The third is the ileo-anal pull-through, where the ileum is attached to the rectal wall, and you eliminate through the anus.

Q: Should I be worried about steroid treatment?

A: Steroids have proved to be powerfully effective medications for literally thousands of people who live with ulcerative colitis. However, steroids are also toxic. Doctors today know that steroids are useful in bringing about remission, but not in maintaining remission. This knowledge, and better understanding of the drugs such as 6-MP that regulate the body's immune response, allow doctors to get people off steroids much more quickly than in the past. Today, far fewer people are steroid dependant than years ago.

Q: Are diagnostic tests to find out if I have ulcerative colitis painful?

A: sigmoidoscopy entails some discomfort, but little pain for most people. If you have active disease, however, this test can be very uncomfortable. Colonoscopy is a more painful procedure, and because of that, doctors use a combination of a sedative and a painkiller, known as "conscious anesthesia," when performing a colonoscopy. Abarium enema also is uncomfortable, but not usually painful, except when it is performed on a person with active disease.

Q: Should I be worried about colon cancer if I have ulcerative colitis?

A: Statistical evidence does show that people with ulcerative colitis do have a slightly higher incidence of colon cancer than the general population. For this reason, doctors begin regularly screening those with colitis eight years after diagnosis. Those with pancolitis (ulcerative colitis affecting the entire colon) have the highest incidence of colon cancer.

Q: My 11-year-old was just diagnosed with ulcerative colitis. I thought only adults could get the disease. Does my child face any special obstacles in having the disease treated?

A: In the last quarter century, it has become clear that ulcerative colitis affects large numbers of children and young teens. Nutritional deficiency is a major issue in treatment of children with ulcerative colitis. Children are growing machines, and although inflammatory bowel disease may not cause great weight loss for youngsters, a failure to grow and a backsliding on height and weight charts should be a sign that something is wrong and worth investigating. Children facing ulcerative colitis also have significant self-image issues to deal with.

Ulcerative Colitis