How to distinguish ulcerative colitis from related conditions

Video: Crohn’s disease and ulcerative colitis: Differences

Content

Steps
Part 1 of 3: Identifying the Primary Symptoms of Ulcerative Colitis
Part 2 of 3: Distinguishing between Ulcerative Colitis and Related Conditions
Part 3 of 3: Making an accurate diagnosis
Tips
Additional articles

Ulcerative colitis is an inflammatory bowel disease (IBD) that causes chronic inflammation and painful ulcers on the lining of the colon and rectum. Although the cause of ulcerative colitis is still unknown, there is growing evidence that it is caused by a malfunctioning immune system. Other forms of IBD and various intestinal disorders and disorders can cause similar symptoms, but other treatments may be required. In view of this, it is important to be able to distinguish ulcerative colitis from other diseases of the gastrointestinal tract.

Steps

Part 1 of 3: Identifying the Primary Symptoms of Ulcerative Colitis

1 Pay attention to chronic diarrhea. One of the main symptoms of ulcerative colitis is chronic diarrhea, that is, persistent loose stools. At the same time, pus or blood is often present in the stool, which is associated with the formation of ulcers in the colon (rectum).
- Attacks of diarrhea can be interspersed with light spotting from the anus if the ulcers are located in the rectum, which is the extreme (peripheral) portion of the colon.
- The symptoms of ulcerative colitis in different patients vary within certain limits, from mild to severe, depending on the degree of inflammation and the site of ulceration.
2 Consider the likelihood of more frequent urge to defecate. In addition to diarrhea, ulcerative colitis leads to more frequent urge to defecate, and patients often cannot go for long periods of time without going to the bathroom. Ulcers in the walls of the colon affect the ability of the rectum to hold stool and excess moisture becomes saturated.
- As a result, ulcerative colitis leads to diarrhea with loose and watery stools, which, if symptoms are severe, can lead to dehydration. In this case, periodic intravenous fluid injections may be required.
- Ulcerative colitis is classified according to the degree of colon involvement. If the ulcers form only in the rectum, the symptoms can be quite mild, while with more extensive involvement of the colon, they are more severe.
3 Consider the likelihood of abdominal pain and cramps. Another common symptom of ulcerative colitis is abdominal pain and cramps. It is primarily caused by ulcers, as well as indigestion and intestinal microflora disorders due to diarrhea. Bloating and flatulence in the lower abdomen is also common, depending on the diet.
- Avoid spicy and fiber-rich foods, as well as dairy products. These foods can worsen the pain and cramps in the stomach associated with ulcerative colitis.
- Ulcerative colitis is usually more severe in children and adolescents than in adults.
4 Pay attention to gradual weight loss. In ulcerative colitis, even in a mild form, involuntary weight loss is common.This is due to several reasons: chronic diarrhea, unwillingness to eat and thereby provoke symptoms, insufficient absorption of nutrients due to disturbances in the functioning of the colon. These factors lead to gradual weight loss, especially in adolescents and young adults. Sometimes body weight is reduced to dangerous levels.
- Due to illness, the body is in "starvation mode". This leads to the fact that first fat stores are burned, and then muscles and connective tissues are processed for amino acids and energy.
- Talk to your doctor about vitamins and supplements, and foods that are high in calories that will not worsen your symptoms of ulcerative colitis.
- Try to eat not two or three, but 5-6 times a day in smaller portions to improve digestion.
5 Pay attention to chronic tiredness and fatigue. Chronic diarrhea, loss of appetite, weight loss and lack of nutrients contribute to another common symptom of ulcerative colitis - lack of energy and fatigue throughout the day. At the same time, chronic fatigue does not go away after a long night's sleep or a day's rest. In addition, muscle weakness is observed.
- Another cause of chronic fatigue is anemia - a lack of iron caused by loss of blood in sores. Iron is used in the blood (hemoglobin) to carry oxygen to the cells of the body, allowing them to generate energy.
- Due to a lack of energy and nutrients, ulcerative colitis can stunt the growth and development of young children.
6 Take a closer look at the less common, but nonetheless common symptoms. Ulcerative colitis can cause joint pain (especially large joints), a red skin rash all over the body, eye irritation, and chronic mild fever. Usually, these symptoms indicate that ulcerative colitis is caused by an overly active or malfunctioning immune system.
- If the disease is caused by an overly active or malfunctioning immune system, it is considered an autoimmune disease. In this case, the body attacks itself, leading to severe inflammation.
- Inflammatory arthritis of the joints (eg, knees, palms, or spine) often develops in middle age with prolonged ulcerative colitis.

Part 2 of 3: Distinguishing between Ulcerative Colitis and Related Conditions

1 Do not confuse ulcerative colitis with Crohn's disease. Although both of these diseases lead to intestinal inflammation, Crohn's disease can affect any area of the intestine (small and large intestine). At the same time, ulcerative colitis is limited to the intestinal mucosa and submucosa, that is, the surface layers of its walls. Crohn's disease, in addition to these two layers, can also affect deeper areas - the muscle and connective tissues of the intestine.
- Crohn's disease is generally more serious and has more severe symptoms than ulcerative colitis. Crohn's disease is accompanied by deeper and destructive ulcers and leads to more severe impairment of nutrient absorption.
- Crohn's disease most often develops at the border of the small intestine and the large intestine (in the ileocecal region), therefore the accompanying symptoms (pain and cramps) are usually observed higher in the abdomen, near the stomach.
- In addition, bloody diarrhea is associated with Crohn's disease, although in this case the blood is darker due to the fact that ulcers are usually located farther from the anus.
- Crohn's disease is also characterized by damage to various parts of the colon, significant damage to the small intestine, and detection of granulomas on biopsy. The main symptoms of the disease are diarrhea and abdominal pain (especially in the lower right quarter).
2 Don't confuse ulcerative colitis with irritable bowel syndrome (IBS). IBS is not an inflammatory disease and does not lead to ulcers in the intestines.This disease affects the muscle contractions in the intestines - they become more frequent and faster and resemble cramps. Because of this, IBS is also often accompanied by diarrhea, frequent urge to defecate, and cramps in the lower abdomen, but in this case there is no blood or pus in the stool.
- The diagnosis of IBS is often based on the following criteria: abdominal discomfort or pain that improves after a bowel movement, frequent changes in stool frequency and / or changes in stool consistency that last at least 12 weeks.
- As a rule, IBS is accompanied by less painful sensations due to the absence of ulcers on the intestinal walls. Painful spasms with IBS often subside with another bout of diarrhea.
- IBS is mainly caused by certain foods and stress. Unlike ulcerative colitis, IBS is not associated with a genetic predisposition.
- IBS is much more common in women, while the likelihood of inflammatory bowel disease does not depend on gender.
3 Do not confuse ulcerative colitis with lactose intolerant. If you are lactose intolerant, your body is unable to properly digest milk sugar (lactose) due to a lack of the enzyme lactase. As a result, gut bacteria absorb lactose, resulting in gas, bloating, and diarrhea. Typically, symptoms of lactose intolerance appear 30–120 minutes after consuming dairy products.
- Unlike lactose intolerance, ulcerative colitis develops gradually and in most cases develops into a chronic form. With ulcerative colitis, remission is possible, but it cannot be cured by avoiding certain foods.
- Lactose intolerance leads to more explosive diarrhea due to increased gas production, but in this case, the stool does not contain blood and pus.
- Lactose intolerance is often accompanied by nausea, but fatigue, fatigue, and weight loss are usually not observed.
4 Consider the difference between ulcerative colitis and intestinal infections. Intestinal infections (viral or bacterial) develop fairly quickly and cause pain, abdominal cramps and diarrhea, but they usually go away in about one week. In most cases, bacterial infections result from food poisoning (salmonella, E. coli, and other bacteria) and are accompanied by severe vomiting and high fever, which is uncommon for ulcerative colitis.
- In some cases, an intestinal infection can severely irritate the intestinal mucosa and lead to bloody diarrhea, but this usually clears up in about one week.
- Intestinal infections can affect any part of the intestine or stomach, while ulcerative colitis is limited to the large intestine.
- Most stomach ulcers are caused by bacteria Helicobacter pylorileading to upper abdominal pain, nausea and bleeding. However, stomach ulcers are not accompanied by diarrhea, and the blood in the stool resembles coffee grounds.
5 Be aware that ulcerative colitis sometimes increases your risk of colon cancer. The symptoms of acute ulcerative colitis and colon cancer are very similar. Both diseases are associated with severe pain, bloody diarrhea, high fever, weight loss, and constant fatigue. Ulcerative colitis increases the risk of colon cancer if it affects the entire colon, causes extensive inflammation, or persists for more than eight years.
- Acute ulcerative colitis increases the risk of cancer in men more than in women, especially with primary sclerosing cholangitis, a chronic liver disease.
- People with ulcerative colitis should have a colonoscopy every 1–3 years to make sure the disease has not developed into cancer.
- Surgery to remove the entire colon can help prevent colon cancer.

Part 3 of 3: Making an accurate diagnosis

1 See a gastroenterologist. Although a therapist can rule out some possible causes of abdominal pain and chronic diarrhea with blood and stool tests, it is best to see a gastrointestinal specialist, gastroenterologist. With the help of special diagnostic equipment, the gastroenterologist will be able to examine the walls of the colon and detect possible ulcers.
- A blood test can confirm anemia (low red blood cell count) caused by internal bleeding due to perforation of the intestinal wall with ulcers.
- A blood test will also help to identify an increased concentration of white blood cells, which, in turn, indicates a bacterial or viral infection.
- If a stool test reveals blood and pus (dead white blood cells), it may indicate inflammatory bowel disease, while the presence of bacteria or other parasites indicates infection.
2 Get a colonoscopy. Using a thin, flexible tube with a camera at the end, the gastroenterologist will examine your large intestine. In this case, the probe is inserted into the rectum, and it can be used to examine the entire large intestine and identify possible ulcers. During the procedure, your doctor may take a small piece of tissue for biopsy (examination under a microscope).
- A flexible sigmoidoscope is also sometimes used as a probe, which allows you to view the sigmoid colon (part of the colon). Sigmoidoscopy is preferable to colonoscopy in cases of severe inflammation of the colon.
- Examining your bowels with a tube may cause some discomfort, but it is usually fairly painless and does not require strong pain relievers or anesthesia. Lubricants and muscle relaxants are usually sufficient.
3 Take other visual examinations. For severe symptoms, a gastroenterologist may order an abdominal x-ray. Before doing this, you will be given a thick suspension of barium sulfate to drink, which will allow you to get a clearer image of the colon. The doctor may also order a computed tomography (CT) scan of the abdomen to see how badly and deeply the colon is damaged. With CT, you can easily distinguish between ulcerative colitis and Crohn's disease.
- Magnetic resonance enterography is a more sensitive technique that detects inflammation and ulcers in the colon without radiation.
- Chromoendoscopy is used to rule out colon and rectal cancer. At the same time, a special dye is injected into the rectum, which stains the cancerous tissue.

Tips

Although the exact cause of ulcerative colitis is not known, stress, poor diet and genetic predisposition are thought to be contributing to it.
Approximately 10–20% of patients with ulcerative colitis have relatives with the same disease.
Most often, ulcerative colitis occurs in immigrants from Eastern Europe of Jewish nationality (Ashkenazi).
Ulcerative colitis is most often diagnosed at the age of 15–35 years.
About 50% of patients with ulcerative colitis experience mild symptoms, while the second half of patients have more severe symptoms, and in 10% of cases, the disease causes serious damage to health.
Although ulcerative colitis does not completely heal, its symptoms can be alleviated with proper nutrition, stress reduction, medication (NSAIDs, corticosteroids, immune modulators, biologics), and surgery for serious cases.