Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Common symptoms of ulcerative colitis include rectal
bleeding and diarrhea, but there is a wide range of symptoms among patients with
this disease. Variability of symptoms reflects differences in the extent of
disease (the amount of the colon and rectum that are inflamed) and
the intensity of inflammation. Generally, patients with inflammation confined to
the rectum and a short segment of the colon adjacent to the rectum have milder
symptoms and a better prognosis than patients with more widespread inflammation
of the colon. The different types of ulcerative colitis are classified according
to the location and the extent of inflammation:
Ulcerative proctitis refers to inflammation
that is limited to the rectum. In many patients with ulcerative proctitis,
mild intermittent rectal bleeding may be the only symptom. Other patients
with more severe rectal inflammation may, in addition, experience rectal
pain, urgency (sudden feeling of having to defecate and a need to rush to
the bathroom for fear of soiling), and tenesmus (ineffective, painful urge to move one's bowels).
Proctosigmoiditis involves inflammation of the rectum and the sigmoid
colon (a short segment of the colon contiguous to the rectum). Symptoms of
proctosigmoiditis, like that of proctitis, include rectal bleeding, urgency,
and tenesmus. Some patients with proctosigmoiditis also develop bloody
diarrhea and cramps.
Left-sided colitis
involves inflammation that starts at the rectum and extends up the left colon
(sigmoid colon and the descending colon). Symptoms of left-sided colitis
include bloody diarrhea, abdominal cramps, weight loss, and left-sided
abdominal pain.
Pancolitis or universal colitis
refers to inflammation affecting the entire colon (right colon, left colon,
transverse colon and the rectum). Symptoms of pancolitis include bloody
diarrhea, abdominal pain and cramps, weight loss, fatigue, fever, and night
sweats. Some patients with pancolitis
have low-grade inflammation and mild symptoms that respond readily to
medications. Generally, however, patients with pancolitis suffer more severe
disease and are more difficult to treat than those with more limited forms of
ulcerative colitis.
Fulminant colitis
is a rare but severe form of pancolitis. Patients with fulminant colitis are
extremely ill with dehydration, severe abdominal pain, protracted diarrhea
with bleeding, and even shock. They are at risk of developing toxic megacolon
(marked dilatation of the colon due to severe inflammation) and colon rupture
(perforation). Patients with fulminant colitis and toxic megacolon are treated
in the hospital with potent intravenous
medications. Unless they respond to treatment promptly, surgical removal of
the diseased colon is necessary to prevent colon rupture.
While the intensity of
colon inflammation in ulcerative colitis waxes and wanes over time, the location
and the extent of disease in a patient generally stays constant. Therefore, when
a patient with ulcerative proctitis develops a relapse of his disease, the inflammation usually is confined to the rectum. Nevertheless, a small number
of patients (less than 10%) with ulcerative proctitis or proctosigmoiditis can
later develop more extensive colitis. Thus, patients who initially only have
ulcerative proctitis can later develop left-sided colitis or even pancolitis.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Pink eye, also called conjunctivitis, is redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Clostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found on bedpans, furniture, toilet seats, linens, telephones, stethoscopes, fingernails, rings, floors, infants' rooms, and diaper pails. They even can be carried by pets. Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. Treatment for C. difficile colitis hydration, replenishment of electrolyte deficiencies, discontinuing the antibiotic that caused the colitis, and using antibiotics to eradicate the C. difficile bacterium.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
Dyspepsia (indigestion) is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate infrequency and intensity. Symptoms of dyspepsia include upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). These symptoms are most often provoked by eating.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
The inflammatory bowel diseases (IBD) are Crohn's disease (CD) and ulcerative colitis (UC). The intestinal complications of Crohn's disease and ulcerative colitis differ because of the characteristically dissimilar behaviors of the intestinal inflammation in these two diseases.
Erythema nodosum is a skin inflammation that results in reddish, painful, tender lumps most commonly located in the front of the legs below the knees. Erythema nodosum can resolve on its own in 3 to 6 weeks, leaving a bruised area. Treatments include anti-inflammatory medications and cortisone by mouth or injection.
Corticosteroid drugs such as prednisone and prednisolone are commonly used to treat asthma, allergic reactions, RA, and IBD. Steroids such as these do have serious drawbacks such as steroid withdrawal symptoms such as: fatigue, weakness, decreased appetite, weight loss, nausea, vomiting, abdominal pain, and diarrhea. Speak with your healthcare provider prior to tapering off steroid medications.
Bronchiectasis is a condition in which the bronchial tubes of the lung become damaged. Inflammation from infection or other causes destroys the smooth muscles of the bronchial tubes. Bronchiectasis is a form of COPD (which includes emphysema and chronic bronchitis). There are three primary types of bronchiectasis: 1) cylindrical bronchiectasis; 2) saccular bronchiectasis; and 3) cystic bronchiectasis. Bronchiectasis may also be acquired or congenital. The most common symptoms of bronchiectasis are recurrent cough and sputum production. There is no cure for bronchiectasis. Treatment is often geared toward controlling the symptoms of bronchiectasis.
Primary sclerosing cholangitis (PSC) is a chronic, progressive disease of the bile ducts that channel bile from the liver into the intestines. There is an association between primary sclerosing cholangitis and ulcerative colitis and Crohn's disease. Symptoms of primary sclerosing cholangitis include abnormal liver blood tests, itching, fatigue, and jaundice. Primary sclerosing cholangitis is treated with medications and in some cases, liver transplant.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Biologic rhythms, or biorhythms, are how our bodies respond to the regular phases of the sun, moon, and seasons. A medical chronobiologist studies how the "body clock" or biorhythms affect diseases and how the body clock responds to treatment of diseases and conditions at different times of the day.
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