Ulcerative colitis – causes, symptoms, diagnosis, treatment, pathology

Ulcerative colitis – causes, symptoms, diagnosis, treatment, pathology


Inflammatory bowel disease can cause inflammation
in the small and large intestine, in other words…inflammation of the bowel. Colitis refers specifically to inflammation
in the colon, or the large intestine. Ulcerative colitis is a type of inflammatory
bowel disease that tends to form ulcers along the inner-surface or lumen of the large intestine,
including both the colon and the rectum. These ulcers are spots in the mucosa where
the tissue has eroded away and left behind open sores or breaks in the membrane. Sometimes there is a flare which means that
new damage has occurred, and then there are periods of remission when the tissue starts
to heal up. Ulcerative colitis is actually the most common
type of inflammatory bowel disease, not that there are that many, but this one causes inflammation
and ulcers in the mucosa and submucosa of the large intestine only, which is an important
point that sets it apart from Crohn disease, another inflammatory bowel disease. Now although certain environmental factors
like diet and stress were once thought to be the culprit behind these ulcers forming
in the gut, now it’s thought that these are more secondary, meaning they seem to make
symptoms worse, but ulcerative colitis is now ultimately thought to be autoimmune in
origin. In fact, cytotoxic T cells from the immune
system are often found in the epithelium lining the colon, so the thought is that inflammation
and ulceration in the large intestine is caused by T cells destroying the cells lining the
walls of the large intestine, leaving behind these eroded areas or ulcers. It’s unclear what exactly these T cells
are meant to be targeting though. Some patients have p-ANCAs in their blood,
or perinuclear antineutrophilic cytoplasmic antibodies, which are a kind of antibodies
that target antigens in the body’s own neutrophils. Although not completely understood, some theories
suggest this may be partly due to an immune reaction to gut bacteria that have some structural
similarity to our own cells, allowing antibodies to those gut bacteria, or p-ANCAs, to “cross-react”
with neutrophils. Patients also seem to have a higher proportion
of gut bacteria that produce sulfides, and often high sulfide production is correlated
with periods of active inflammation as opposed to remission. Ultimately, though, these are mostly correlations
and theories, and we’ve yet to nail down the precise mechanism behind mucosal destruction;
the cause is ultimately some combination of environmental stimuli, perhaps the sulfide-producing
bacteria, mixed with a genetic predisposition, because patients with a family history of
ulcerative colitis are more likely to develop the disease themselves. It also seems to be more common in young women
from the teens to 30s, with more prevalence among caucasians and eastern european jews. With ulcerative colitis, the pattern for ulceration
seems to be circumferential and continuous, meaning that the inflammation goes around
the whole lumen and starts in the rectum and continues along the large intestine without
any apparent breaks of “normal” or unaffected tissue, like it’s working it’s way from
one end to the other. As more damage is done to the tissue, patients
experience pain in the left lower quadrant which corresponds to the rectum, and more
severe and frequent bouts of diarrhea, sometimes with blood in the stool as well. As the mucosa and epithelium are destroyed,
blood and serum may be released into the lumen, which contributes to the blood seen in the
stools, but also, what’s one of the main jobs of the large intestine? Absorbing water. As these cells are destroyed, the large intestine
can’t perform this function as efficiently and ends up letting too much water through,
contributing to diarrhea. Diagnosis of ulcerative colitis typically
requires colonoscopy, which is when a long tube with a camera at the end, is inserted
retrograde through the anus, and into the rectum and colon to see the ulcers, and take
a biopsy. In addition, radiological imaging maybe done
with the help of CT scan, MRI, a barium enema, which is where a liquid is injected into the
rectum through a small tube, and an X ray is taken to look for abnormalities in the
large intestines. Treatment for ulcerative colitis depends on
the severity of symptoms, often anti-inflammatory medications like sulfasalazine or mesalamine
are given; in more severe cases, drugs that suppress the immune system, like corticosteroids,
azathioprine, or cyclosporine might be prescribed. If those fail, biologic treatments, such as
infliximab, a TNF inhibitor, adalimumab and golimumab can be used. Finally, if these treatment options fail,
sometimes patients will have a colectomy which is a surgical removal of the colon. Since the disease only affects the large intestine,
removal of the colon generally cures the disease, but you have to weigh the benefits of curing
the disease against the total loss of of the large intestine! Alright, as a quick recap… ulcerative colitis
is the most common type of inflammatory bowel disease, where ulcers form along the inner-surface
or lumen of the large intestine, including both the colon and the rectum. Ulcerative colitis is diagnosed with the help
of colonoscopy, and barium enema, and treatment involves anti-inflammatory medications, immunosuppressant,
or colectomy to remove diseased parts of the colon in severe cases.

67 Replies to “Ulcerative colitis – causes, symptoms, diagnosis, treatment, pathology”

  1. You guys always have such fantastic content. And totally relevant for me today – I'm taking my SAGES FES skills exam tomorrow (skills test that all surgeons must pass in order to be credentialed for colonoscopy and upper endoscopy 😊). Rock on, Osmosis crew!

  2. Thank you for sharing this info. I was diagnosed with UC just last year of june and it's pretty hard to deal with.

  3. This was perfect. It's everything I've Been Told. But the way you showed it makes sense. Whereas before I did not understand it. I was diagnosed for Crohn's at first and that was an error. I am now on the Sulfasalazine. Best med! My rheumatologist said the colon probably cause my lupus. I now have fibromyalgia and RA.

  4. Indeed your videos are easy to understand things, but more details could be added to help us medical students too (not only patients)
    Thank you so much 🙂

  5. If patients show a higher percentage of sulfides which lead to inflammation… Why do they treat the illness with sulfer drugs like sulfasalazine?

  6. If you eat an inflammatory diet, you get these diseases. Autoimmune is also caused by inflammation. Inflammatory diets contain animal products of any kind. Plant based is an alkaline diet. Colonoscopy is not clinically efficacious. Get a sigmoidoscopy instead or just eat right and reverse the disease.

  7. Thank you for uploading this. I love learning stuff about the human body and the diseases. This one in particular because my boyfriend was diagnosed with it a few years ago so I always like learnng about it.

  8. Thank you for your work! This channel is great and should be more popular across students and non-students.
    I have a question: have you ever done a video on angioflogosis? I'm studying it right now but I can't really grasp it all.

  9. I find it interesting that people with ulcerative colitis often have a higher proportion of gut bacteria that produce sulfides. This opens up a lot of questions, which could help those of us with ulcerative colitis if we found the answers.

    Yes, ulcerative colitis affects the colon and rectum, while Crohn's can affect other parts of the digestive tract. However, it's also possible for those with ulcerative colitis to get manifestations elsewhere. I have gotten extra-intestinal inflammation associated with my ulcerative colitis in my muscles, tendons, joints, eyes, and kidneys.

    I'm Racing in Orange for the Crohn's and Colitis Foundation. Please support me and this foundation by donating through my Race in Orange page at http://online.ccfa.org/goto/JoyEllen . More than 80 cents of every dollar goes to help find treatments and cures for Crohn's disease and ulcerative colitis and to improve the quality of life for children and adults affected by these diseases.

  10. Thank you for this video this explained UC much better than my doctor did. I've been struggling to understand what UC is but this cleared most of up. By the way I'm Hispanic and Spaniard and no one in my entire family has had UC, which is strange because I don't fit any of the categories you said are likely to have UC. I got uc when I was 19 years old which I also think is strange. Still some questions to be answered but I really hope they find a cure for this disease.

  11. Hello, i am also a medical student and this channel helped me a lot during my studies and get a refrence during my exam. i am motivated with you guys and started my own channel regarding medicine which is subjective exam oriented 🙂 thankyou osmosis team.. just started my channel in 2018 so suggestions are highly appreciated to improve 🙂
    visit "MedgossipHD" on youtube and check out how i have made 🙂 thankyou

  12. Mai 8 year se ulcer ka pasent tha muje sirf desi medicine Mai iska parmanet ilaz mila ab mai bilkull thek hu thank God 9877344522

  13. removing the colon "cures" the disease? Only by our idiotic medical-care system standards. Actually curing the disease means adressing the cause and stopping the body attacking it's own tissue. Not just removing the part that's "not functioning". If my arm hurts, let's just remove it right? I'm not trying to diminish your work, your videos are EXCELLENT. But i do get annoyed when someone uses term "cured" for such stupid methods our doctors use trying to treat the disease they know nothing about and they do more harm then good. Actual cure for IBD's? Removing grains, beans and conventional dairy in lots of cases. Also strong probiotics (home made milk Kefir, water Kefir, Kombucha, VSL#3) help in lots of cases. What also helps rebuild gut lining is amino acid Glutamine and supplement called Collagen powder. Anyway, i wish all of people with this nasty disease good luck in their healing!

  14. Aloe Vera leaf,blend gel with water and use as a suppository and mix moringa powder with water and drink… and i guarantee within 24hrs your suffering will stop! Aloe Vera leaf is found in the produce section. Moringa powder can be purchased online. Worked better than any medicine I’ve taken

  15. Sir ek question tha I am suffering from ulcerative colitis in rectum .. I am getting blood in stool and mucus many times a day ..I am taking Vegas OD tablet for inflimation .. is there any other solution accordingly to you which can cure it ..I am getting this issue from last 2 years

  16. Should include more histopathological features, as it more diagnostic feature and used to distinguish between crohns

  17. UC care pack of Planet Ayurveda is the combination of natural and herbal ingredients which manages and treat ulcerative colitis without any side effects.

  18. Just recently got diagnosed with this. Worse pain of it is the rectum in my opinion. Thank you for helping me understand more

  19. I just read the book "How I overcame Ulcerative Colitis: My Journey" , short concise book on how this man is symptom free for the last 10 years and has no more colitis. Excellent read. Available on Amazon.

  20. My wife was suffering with ulcerative colitis from last 1 year. She took several allopathic medications but got no relief. Then she heard about planet ayurveda and started taking medication. Now she is alright.

  21. Wow my great grandfather died from this. My grandmother (his daughter) had severe gastrointestinal issues till her passing. And now there's ME 😢 😠 trying to find out what MY problem is gastrointestinal fml

  22. This video is awsome! I am actully a guy whit a inflammation and yes blood does come out your butt also NO CURE.

  23. I promise you that when i finish medical school, i'll make patron account just to donate for you.🥰😘😍🥰. Hope someone remind me after 2 years.

  24. If a person is in complete remission of the ulcerative colitis, can usg of whole abdomen detect the PANCOLITIS of that person??

  25. poor information based on antiquated propoganda from a Pharmaceutical driven medical model. I had U.C. for 8 years, and nothing in this video would have helped me heal, if you are interested in healing, contact me, and I can guide you through the process. thanks

  26. Plz try to include histological aspects too other wise its simply superc👌🏻👌🏻😍😍🥰🥰

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