The urgency of the ulcerative colitis problem is high in the modern world since this particular colorectal pathology is quite common today. Moreover, despite years of research, ulcerative colitis still remains a disease with an unclear etiology and insufficiently studied pathogenesis. The common knowledge is that ulcerative colitis is a chronic recurrent colorectal disease, characterized by hemorrhagic-purulent inflammation of the colon with the development of local and systemic complications. In addition to yet cryptic etiology, the clinical course of the disease is also quite unpredictable. For example, in a number of patients, there is an alternation of periods of exacerbation and remission, while in others – a continuously recurrent course. I feel that the issue of ulcerative colitis does not get enough discussion in both the clinical and research field, and that is why I decided to summarize my own knowledge of the matter. By doing this, I hope that I will understand the disease better and will be able to communicate with my patients more clearly.
Upon completing my research, I have found out that there is a lot of theories regarding ulcerative colitis’ genesis. A copious number of studies inclined to the infectious and allergic mechanism of formation. Several others gave preference to genetic predisposition – but, as opposed to this opinion, there is research that hints at the influence of the environment. However, all of them es agree on the point that ulcerative colitis requires a complex diagnosis, as, due to the non-specificity of symptoms, it can be hard to set a difference between colitis and other colorectal diseases. A particular study on that matter caught my interest while I have been searching for the diagnostic tools that would be the most useful while dealing with colitis. Kuwada et al. (2021) identified “circulating autoantibodies against integrin αvβ6 in most patients with UC, which, due to their high specificity and sensitivity, may be effective and reliable markers for UC diagnosis” (p. 2392). Indeed, immunologic markers can be considered as one of the more effective ways to determine the presence of ulcerative colitis, as antimicrobial peptides play a major role in protecting the organism from infectious agents.
Patients with ulcerative colitis also experience a tremendous amount of pain. Moreover, they belong to a group with a high risk of colorectal cancer, and due to it, often experience malignant pain. According to Jarvis et al. (2020), “malignant pain often parallels the pathology created by the tumor cells” (p. 267). Thus, the therapy is mainly aimed at reducing inflammation in the intestines, as well as correcting the general condition: eliminating intoxication, and normalization of electrolyte balance. These measures generally lead to the mitigation of localized pain, which notably improves the patients’ quality of life.
Several modern research also suggests the use of synbiotic supplements to be helpful in treating ulcerative colitis. Roselli and Finamore (2020) claim that “experimentally, synbiotic supplementation might represent a valid strategy to improve intestinal inflammatory diseases by providing selected probiotic strains and prebiotic fibers” (p. 176). Synbiotics – a combination of probiotics and prebiotics – are considered to have a greater effect on ulcerative colitis biochemical markers than any biotics separately. Dietary restrictions have also proved to decrease the severity of the colitis symptoms, as they help regulate intestinal microbiota. Keshteli et al. (2019) found that “UC patients who were on a carrageenan-free diet plus placebo had a lower relapse rate in comparison to patients who consumed two oral capsules of carrageenan per day” (p. 1506). However, I have found it interesting that, according to this study, neither milk nor dairy products exclusion from a diet produced a significant impact on the patients’ condition.
Still, in my opinion, it might be safer to ask a patient to lower the intake of these products due to the possibility of lactose intolerance. Overall, the research I conducted provided me with useful insights into both the diagnostic means of ulcerative colitis and the treatment strategies. I look forward to using the information I gathered to use in my practice and educating my patients on the perspectives of colitis’ diagnostics and treatment.
References
Jarvis, C., Eckhardt, A., & Thomas, P. (2020). Physical examination & health assessment. Elsevier.
Keshteli, A. H., Madsen, K. L., & Dieleman, L. A. (2019). Diet in the Pathogenesis and Management of Ulcerative Colitis; A Review of Randomized Controlled Dietary Interventions.Nutrients, 11(7), 1498–1510. Web.
Kuwada, T., Shiokawa, M., Kodama, Y., Ota, S., Kakiuchi, N., Nannya, Y., Yamazaki, H., Yoshida, H., Nakamura, T., Matsumoto, S., Muramoto, Y., Yamamoto, S., Honzawa, Y., Kuriyama, K., Okamoto, K., Hirano, T., Okada, H., Marui, S., Sogabe, Y., … Seno, H. (2021). Identification of an Anti–Integrin αvβ6 Autoantibody in Patients With Ulcerative Colitis.Gastroenterology, 160(7), 2383–2394. Web.
Roselli, M., & Finamore, A. (2020). Use of Synbiotics for Ulcerative Colitis Treatment.Current Clinical Pharmacology, 15(3), 174–182. Web.