Understanding Ulcerative Colitis

Understanding Ulcerative Colitis
Ronaldo S. Lora

Abstract:

The incidence of ulcerative colitis in the Philippines is worth a second look. Although it is more prevalent in the west, there had been a noted steady rise in Asia especially among Filipinos. It must be understood that any form of awareness in order to make known of this particular disease will be helpful and important since we tend to dismiss any stomach ailment as something minimal and passing. Ulcerative colitis is an inflammatory bowel disease (IBD) that causes chronic inflammation of the digestive tract. Like Crohn's disease, another common IBD, ulcerative colitis can be painful and debilitating and sometimes can lead to life-threatening complications. Ulcerative colitis and Crohn's disease are similar – they are so similar that can be mistaken for one another. Both inflame the lining of the digestive tract, and both can cause severe bouts of watery or bloody diarrhea and abdominal pain. Ulcerative colitis usually affects only the innermost lining of the large intestine (colon) and the rectum. Crohn's disease, on the other hand, can occur anywhere in the digestive tract, often spreading deep into the layers of affected tissues. There are no known medical cure for ulcerative colitis, but therapies are available that may dramatically reduce its signs and symptoms which may even bring about a long-term remission.

I. Personal experience:
My bouts with ulcerative colitis began when I was 28-years-old. The disease was still vague and I really had no idea what I was going through during that time. The symptoms were varied: bloody diarrhea, high grade fever and constant abdominal pain. The diarrhea was so severe that I had to visit the bathroom at least six times a day or at the worst, even more. The changes that happened were so drastic that I gradually lost 25 kilos from my normal weight of 80. The blood I passed was bright red and so fresh that it took me aback for little did I know that I already had inflammatory bowel problems. This kind of situation brought me to frequent hospitalizations for intravenous hydration and blood transfusions.

II. Psychological Impact:
The doctors I first consulted were probably medically aware but not thoroughly competent and capable to treat the inflammation and severe bleeding of the digestive tract. It was unfortunate then that the easiest recourse for a stop-gap measure was the use of anti-motility tablets and nothing else. It was further aggravated when I had to take countless antibiotics that all the more complicated the situation. There were no warnings regarding what food to eat and what to avoid. I felt weaker after every hospitalization without concrete answers to my condition. After several trial and error, I met my present gastroenterologist at PGH (Philippine General Hospital) from whom I got to understand my sickness and hear ulcerative colitis for the first time. I was able to recuperate but exacerbations were very prominent.

I believe that in the Philippines, cases pertaining to inflammatory bowel disease have not yet received its proper forum and share of information although medical cases have been significant in cities particularly Manila, Davao and Batangas. Maybe, it is not that much discussed as compared to other sicknesses mainly because it has a lower incidence compared to western countries. I was so engrossed with what I was going through that I had to do research just to unburden my fears.

III. Nature of the Disease:
The term ulcerative colitis refers to the condition of an inflamed colon. It further complicates by perforating the linings of the intestines if not treated well. It most often manifests to cause symptoms between the ages of 15 and 40. The presence of fever and bloody diarrhea as I mentioned indicates colonic tissue damage. The ulcerations on the surface of the intestines can be compared when we scar and wound our outer skin and it starts to form scabs but does not completely heal because it constantly peels off due to continuous rubbing of the colon against other surfaces. Once food is taken in and peristalsis begins, the intestine becomes irritated as the food passes in a fast forward motion causing poor absorption. Also, this triggers gas, bloating and both a bloody and watery diarrhea. Sometimes, ulcerative colitis can be so detrimental that patients may develop inflammation in unrelated areas like the eyes, joints and the skin. Taking low fiber and low fat diet will lessen scratching of the colon. Other possible causes of ulcerative colitis can be attributed to an immune system dysfunction, uncooked foods that trigger bacterial infection and the pressure of stress.

IV. Medical Diagnosis and Treatment:
The best way to identify ulcerative colitis is through colonoscopy with biopsy. The doctor makes sure that the intestines are clear through laxative preparations and enema cleansing. With the aid of a monitor, a flexible fiber optic tube is inserted through the rectum to view the abnormalities inside the colon. If the pain can be tolerated, patients can watch the procedure from the screen unless otherwise they choose to be asleep.

As of the moment, oral medication called the “5-ASA” generic drugs helps in controlling down the inflammation. The familiar brands in the Philippines are Salofalk and Pentasa which are expensive given the fact that about 6 tablets of a 1 gram measurement is needed for daily maintenance. Along with these ASA drugs, is the need to take steroids in small amounts. These combinations are done to counteract constant inflammation. However, when worse comes to worse, the need for surgery cannot be disregarded as a last resort for combating ulcerative colitis. As it may seem a bleak recourse, to regain quality of life is only to go under the knife.

V. Conclusion:
Certain diseases concerning intestinal problems should no longer be overlooked nowadays. Precaution is a must especially in the food we take because there is no substitute for a healthy mind and body. As the famous tag line of the philosopher Fuerbach would say “you are what you eat” ought to keep us aware that we are mainly responsible for living a productive healthy life. There is an array of symptoms involving intestinal problems that should not be overlooked and disregarded. People in the country afflicted with ulcerative colitis or any IBD problems should be able to work with other support groups so that awareness of this disease or any sickness for that matter can be given the proper attention and advocacy.