Ulcerative colitis

Ulcerative colitis is a chronic, mostly intermittent disease of the large intestine. It causes ulcers (lat. ulcera) in the inner mucosal layer of the colon, as the large intestine is also called (hence "colitis": inflammation of the colon). Typical symptoms are an increased urge to defecate, diarrhea with blood and mucus admixtures, and moderate to severe abdominal pain, often in the left upper abdomen.

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The inflammation of the intestinal mucosa, beginning in the rectum, spreads continuously to different extents in the large intestine. Thus, the degree of spread in the intestine is distinguished. Proctitis is referred to when the inflammation is limited to the rectum. If it also extends to the left-sided large intestine, left-sided colitis is present. If, on the other hand, the entire colon is inflamed, it is called pancolitis .

If a chronic inflammatory bowel disease is suspected, the gastroenterologist (i.e. a gastrointestinal specialist) carries out various examinations. Patients with ulcerative colitis often experience pressure pain in the lower left abdomen . Scanning the Bach region can thus provide the first indications of possible ulcerative colitis. Since the disease begins in the last part of the intestine, the rectum, the gastroenterologist examines the anus and feels it carefully. Blood and stool samples from the patient are analyzed to get indications of an inflammation in the body. Inflammation markers such as CRP (C-reactive protein) and calprotectin indicate the severity of the existing inflammation.

A study by the Barmer GEK assumes that between 420,000 and 470,000 people in Germany suffer from chronic intestinal inflammation. Women and men are about equally likely to develop ulcerative colitis, usually as young adults between the ages of 25 and 35. In principle, anyone can get sick, including small children and the elderly.

In order to rule out other causes of diarrhea, the patient's stool is examined for diarrhea pathogens (microbiological diagnostics). Infectious intestinal inflammation caused by bacteria (infectious colitis) often differs only slightly from ulcerative colitis, but usually subsides after a few days to a maximum of two weeks. The final diagnosis is usually made by means of a colonoscopy . The treating person inserts an endoscope into the colon to observe the condition of the intestinal mucosa. Ulcers, which are common in ulcerative colitis, can be identified and removed. Tissue samples taken are sent to the laboratory. This means that diseases with similar symptoms to Crohn's disease can usually be ruled out.

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Patients with total ulcerative colitis (pancolitis) should have an annual colonoscopy from the age of eight because the patient is at increased risk of colon and rectal cancer. In patients with left-sided ulcerative colitis, an annual colonoscopy should be performed after 15 years of disease.

The school medical treatment of ulcerative colitis is aimed at controlling the inflammation in the large intestine and alleviating the symptoms. As a rule, therapy includes drugs that are prescribed at different levels of escalation, depending on the severity of the disease.

Commonly used drugs include anti-inflammatory agents such as sulfasalazine and mesalazine, which reduce inflammation directly in the intestine. In more severe cases, the use of cortisone may be necessary to suppress the inflammation. In addition, immunosuppressants (drugs that suppress the immune system) such as azathioprine are also used. In the case of particularly severe courses, biologics can also be prescribed by the doctor. This class of drugs includes infliximab and adalimumab, better known by the trade names Humira and Remicade. Both drugs modulate the immune system and thus inhibit inflammation in the intestine.

Usually, therapy is carried out in close cooperation with a gastroenterologist, who individually coordinates the correct drugs and dosages to the patient in order to control the disease and prevent flare-ups. In some cases, it may be necessary to surgically remove part of the colon, especially if there are complications such as intestinal obstruction or ulcers. The classical treatment of ulcerative colitis is aimed at improving the quality of life of those affected and minimizing the risk of complications.

If you are convinced that ulcerative colitis is a condition that its origin or treatment has nothing to do with your diet, then you can stop reading at this point. The following paragraph is aimed at those of you who lead a self-determined life and do not want to be dependent on the lifelong use of medication.

If ulcerative colitis is indeed a digestive problem that is aggravated by the consumption of certain foods, then a carnivore diet is most likely to counteract chronic intestinal inflammation.

By avoiding all potentially problematic foods that make the intestinal barrier permeable (lectins such as gluten, or irritating an already inflamed intestinal mucosa (fiber). Contrary to the popular belief that fiber has a positive effect on intestinal health, the opposite is often the case with an inflamed intestine. Food components that are not digestible irritate the inflamed intestinal mucous wall and thus worsen the symptoms.