INTRODUCTION:
People usually feel abdominal pain and acidity and take over-the-counter medications to suppress the symptoms. Do they do it right? The inflammatory disease that affects the rectum and colon can be called colitis. Colitis patients have mucosal inflammation that starts in the rectum and can extend to other areas of the gut, like the colon. The symptoms of this deadly disease are diarrhea, which can be diagnosed by colonoscopy. This disease affects those who have a family history of colitis, which means that genetics plays a role here, but along with this, some environmental factors can also cause it. Physiological factors include epithelial barrier defects and dysregulated immune systems. Patients with acute, severe ulcerative colitis should be hospitalized for intensive treatment due to the high morbidity and mortality rate.
Risk factors:
Environmental factors are the leading contributors after genetics, because if a person has the habits of drinking and smoking, he will be at a high risk of contracting colitis. Dietary habits also play an important role in it. Patients with colitis have epithelia barrier defects, dysregulated immune responses, and dysbiosis, which initiate the inflammation.
Hormone replacement therapy, non-steroidal anti-inflammatory medicines, and oral contraceptives have all been linked to an increased risk of ulcerative colitis.
Diagnose:
Colitis can be diagnosed using clinical signs, laboratory results, endoscopy, and biopsy. Endoscopy and biopsy should not be the initial investigations but may be scheduled following a critical assessment of the patient’s health and the findings from the preliminary tests.
Blood D-lactate concentrations may be a sensitive indicator of colonic ischemia, but this laboratory test is still in its experimental stages.
In individuals with ischemic colitis, an electrocardiogram, a transthoracic procedure, or even Holter monitoring may be required.
However, it may help in the identification of toxic megacolon, bowel obstruction, and intestinal perforation (pneumoperitoneum). Plain X-rays are of poor utility. Although it is not specific for ischemic colitis, thumbprinting is a classic finding for mucosal edoema.
CT Scans: This sections and multidetector CT can clearly show inflammatory alterations in the intestinal wall and aid in determining the severity of the disease. In terms of the site of involvement, the degree and appearance of thickening of the intestinal wall, and the kind of consequences, ulcerative colitis can be distinguished from granulomatous colitis (Crohn disease).
Colonoscopy: The ultimate diagnosis requires a colonoscopy or proctosigmoidoscopy; in microscopic colitis, it normally looks normal; however, edoema or erythema may be present. Although they can be present in patients using non-steroidal anti-inflammatory drugs, ulceration signals a different diagnosis.
TREATMENT:
Inducing and maintaining remission is the main goal of medical management, with the long-term objectives of avoiding disability, colectomy, and colorectal cancer as secondary objectives. Targets for remission include the end of rectal bleeding and an improvement in bowel habits, which are clinical signs.
The severity and scope of the condition influence the choice of drugs.
The optimum level of symptom control and mucosal healing that is needed to prevent long-term complications remains a priority for the health care profession.
Follow-up: It’s important for patients to comprehend their care and participate in it. During the active period, clinical parameters should be reevaluated every three months. Every 6 to 12 months after symptoms have subsided, clinical reviews should be done. Colonoscopies, particularly with dye-spray chromoendoscopy, should be conducted every one to five years to monitor for colorectal dysplasia and assess potential flares.
Complications:
- Intestinal perforation
- Bowel strictures, fistulas, abscess, and intestinal obstruction
- Fecal incontinence
- Pelvic abscess
- Enterocutaneous fistulas, particularly in Crohn disease
- Pouchitis
- Guillain-Barre syndrome (Campylobacter jejuni colitis, cytomegalovirus colitis, and reported in ulcerative colitis)
- Hemolytic uremic syndrome (enterohemorrhagic E coli, Shigella)
- Encephalopathy, seizures (Shigella)
Conclusion:
Depending on the underlying cause, colitis can be self-limiting, fatal, chronic, or recurrent. Patients with recurrent and chronic colitis require lifetime observation. General practitioners have important roles in early disease diagnosis, patient support, helping patients quit smoking, and disease management. Nursing staff should motivate patients to take charge of their health and provide information about their pathology and medication regimens. Patients who have chronic colitis may experience anxiety and sadness and require counselling. To achieve the best results for patients with colitis, all these varied specialties must collaborate as part of an interprofessional team.
