- Ulcerative colitis: A form of IBD characterised by continuous inflammation and ulcers in the colon’s lining, starting from the rectum and spreading upwards.
- Proctitis: Inflammation confined to the rectum, often considered an early or limited form of UC.
Both conditions result in symptoms such as diarrhoea, abdominal pain, and rectal bleeding.
Why Do Ulcerative Colitis and Proctitis Happen?
The exact cause is unknown, but several factors may contribute:
- Immune system dysfunction: An abnormal immune response triggers inflammation in the intestinal lining.
- Genetic predisposition: A family history of IBD increases the risk.
- Environmental triggers: Smoking, diet, infections, or stress may play a role.
- Gut microbiome imbalance: Changes in intestinal bacteria may contribute to inflammation.
When Do Ulcerative Colitis and Proctitis Occur?
UC and proctitis can develop at any age but are most common in individuals aged 15–30 or 50–70. Symptoms often occur in cycles, with periods of remission followed by flare-ups.
Common symptoms include:
- Persistent diarrhoea, often with blood or mucus
- Abdominal cramps or pain
- Urgency to defecate
- Fatigue and weight loss
- Rectal pain or bleeding (more common in proctitis)
How to Treat Ulcerative Colitis and Proctitis
Procedures or treatment focuses on reducing inflammation, relieving symptoms, and preventing complications. The approach varies based on the severity of the condition.
Medications:
- Aminosalicylates (5-ASA): Reduce inflammation in the colon and are often the first-line treatment.
- Corticosteroids: Used during flare-ups to control inflammation; not suitable for long-term use due to side effects.
- Immunosuppressants: Medications like azathioprine or methotrexate help reduce immune system activity.
- Biologic therapies: Drugs such as infliximab or adalimumab target specific pathways of inflammation.
- Rectal treatments: Suppositories, enemas, or foams containing 5-ASA or steroids are particularly effective for proctitis.
Lifestyle and Dietary Modifications:
- Eating smaller, low-fibre meals during flare-ups to ease symptoms
- Avoiding trigger foods such as spicy or fatty items
- Staying hydrated to counter diarrhoea-related dehydration
Surgical Options:
- Colectomy: Removal of the colon may be necessary in severe or unresponsive UC cases.
- Proctectomy: For persistent proctitis, surgery may involve removing the rectum.
Monitoring and Prevention:
- Regular colonoscopies are crucial for detecting complications, such as colorectal cancer, which UC patients are at higher risk of developing.
- Stress management, smoking cessation, and adherence to prescribed medication can reduce flare-ups.
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