About 5 percent of people with ulcerative colitis develop colon cancer. The risk of cancer increases with the duration of the disease and how much the colon has been damaged. For example, if only the lower colon and rectum are involved, the risk of cancer is no higher than normal. However, if the entire colon is involved, the risk of cancer may be as much as 32 times the normal rate.
Sometimes precancerous changes occur in the cells lining the colon. These changes are called “dysplasia.” People who have dysplasia are more likely to develop cancer than those who do not. Doctors look for signs of dysplasia when doing a colonoscopy or sigmoidoscopy and when examining tissue removed during these tests.
According to the 2002 updated guidelines for colon cancer screening, people who have had IBD throughout their colon for at least 8 years and those who have had IBD in only the left colon for 12 to 15 years should have a colonoscopy with biopsies every 1 to 2 years to check for dysplasia. Such screening has not been proven to reduce the risk of colon cancer, but it may help identify cancer early. These guidelines were produced by an independent expert panel and endorsed by numerous organizations, including the American Cancer Society, the American College of Gastroenterology, the American Society of Colon and Rectal Surgeons, and the Crohn’s & Colitis Foundation of America.
More on Ulcerative Colitis (Overview)
Ulcerative colitis is a chronic long-term condition. As stated earlier, it is a form of inflammatory bowel disease which causes swelling, ulceration and loss of function of the colon (large intestine) and rectum. Inflammatory bowel disease (IBD) is a term used to describe two diseases, ulcerative colitis and Crohn’s disease, which cause inflammation of the bowel.
Colitis most commonly affects the rectum and the the sigmoid colon (lower part of the colon) but can involve all of the colon. When only the rectum is involved it is sometimes called ulcerative proctitis or just proctitis. When the entire colon is involved it is sometimes called pancolitis.
Ulcerative colitis can affect people at any age but most commonly occurs in young adults between the ages of 15 and 25 years. The condition also has an increased incidence between the ages of 50 and 70 years. Women are more commonly affected by the condition than men. Children are rarely affected.
Up to 20 percent of people suffering from ulcerative colitis have a relative or a family member with ulcerative colitis or Crohn’s disease. People of Jewish descent and whites have a higher incidence of ulcerative colitis.
Ulcerative Colitis Symptoms
About 50 percent of the people who have ulcerative colitis have mild symptoms. People with ulcerative colitis can develop pain in the abdomen, weight loss, diarrhea (blood and mucus) and tiredness. Some people may also experience nausea and vomiting, fever, mouth ulcers. The most common ulcerative colitis symptoms are episodes of bloody diarrhea and pain in the lower abdomen. There may also be a sensation of urgent need to pass a bowel motion. The bowel motions may be explosive and may contain mucous or pus. For others, ulcerative colitis symptoms vary in intensity and severity, and may come on suddenly or develop slowly.
Other symptoms that may be experienced include:
anemia
fatigue
weight loss
loss of appetite
rectal bleeding
loss of body fluids and nutrients
skin lesions
joint pain
growth failure (specifically in children)
Ulcerative Colitis Causes
The exact cause of ulcerative colitis is unknown. People with ulcerative colitis have abnormalities of the immune system, the body’s immune system is believed to react abnormally to the bacteria in the digestive tract. Some experts believe there may be a genetic cause.
Factors such as stress and eating certain foods do not cause ulcerative colitis but may worsen the symptoms.
Ulcerative Colitis Diagnosis
When a person has experienced symptoms of rectal bleeding, intermittent diarrhea and abdominal pain, ulcerative colitis may be suspected. In order to diagnose ulcerative colitis, your physician will help to perform one or more tests or procedures. These include blood tests, stool sample, flexible sigmoidoscopy, colonoscopy, barium enema, x-ray, and/or a CT scan. These tests will also help your physician rule out other conditions such as diverticulitis, Crohn’s disease, irritable bowel syndrome, and colon cancer.
If ulcerative colitis is suspected, endoscopy may be recommended. Endoscopy is the most important diagnostic test used to diagnose ulcerative colitis. During this test a small flexible tube (an endoscope) with a fiber-optic camera at its tip is passed into the rectum and colon. The doctor is able to see the lining of the rectum and colon on a television screen and can look for signs of inflammation and ulceration that may indicate ulcerative colitis. Small tissue samples (biopsies) from the lining of the colon and rectum can be taken for testing. Ulcerative colitis can be diagnosed by the characteristic abnormalities of this tissue.
X-ray tests using barium (a chalky liquid that is able to be seen on x-rays) can be helpful in determining how much of the colon is affected by ulcerative colitis. The barium is administered into the rectum and colon via a tube inserted through the anus. A series of x-rays is taken, showing the outline of the inside of the colon and highlighting any abnormalities.
Ulcerative Colitis Treatment
Dietary adjustments and lifestyle changes may be enough to curb symptoms of mild cases of ulcerative colitis. Avoiding stress, eliminating dairy products, drinking more liquids, taking probiotics (FKC Regenesis), eating smaller meals, and avoiding problem foods and beverages such as carbonated drinks, caffeine, and gassy foods may help to keep your symptoms in check.
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