Understanding Ulcerative Colitis: Symptoms, Risks, and Effective Management

Ulcerative colitis is a chronic inflammatory bowel disease that primarily affects the innermost lining of the large intestine (colon) and rectum. While it was once more prevalent in Western countries, its incidence has been rising steadily in China due to changing lifestyles and improved living standards. This condition is characterized by recurring episodes of inflammation, leading to significant discomfort and a reduced quality of life for sufferers. Understanding ulcerative colitis—its symptoms, risks, treatment options, and prevention strategies—is essential for managing the disease effectively.

What Exactly Is Ulcerative Colitis?
Ulcerative colitis is not simply a case of chronic colitis; it belongs to a group of conditions known as inflammatory bowel diseases (IBD), which also includes Crohn's disease. The inflammation mainly affects the mucosal and submucosal layers of the colon, often starting in the rectum and spreading upward into the sigmoid and descending colon. Unlike infections such as bacterial dysentery or amoebic colitis, ulcerative colitis has no single identifiable cause, making diagnosis complex and long-term management necessary.

Common Symptoms of Ulcerative Colitis
The most typical signs include:

- Abdominal pain, usually on the lower left side, which may ease after a bowel movement.
- Diarrhea with mucus or pus, sometimes occurring up to 30 times a day in severe cases.
- Blood in the stool, caused by damaged mucosal tissue.
- A persistent urge to defecate, even when the bowels are empty (tenesmus).
- Additional symptoms like fever, fatigue, weight loss, and nighttime bowel movements may also occur.

Can Ulcerative Colitis Lead to Cancer?
Long-standing and untreated ulcerative colitis increases the risk of developing colorectal cancer. This type of cancer differs from sporadic colon cancer, as it arises from chronic inflammation rather than genetic mutations. Studies show that the risk increases over time: approximately 1.6% after 10 years, 8.3% after 20 years, and 18.4% after 30 years of disease onset. Risk factors include early age at diagnosis, extensive colon involvement, family history of colon cancer, and coexisting conditions like primary sclerosing cholangitis.

Treatment Options for Ulcerative Colitis
Managing ulcerative colitis involves a combination of lifestyle adjustments, medication, and in some cases, surgery. Treatment goals include reducing inflammation, achieving remission, and preventing relapse.

- Lifestyle and Dietary Adjustments: During flare-ups, rest and a low-residue diet can help reduce symptoms. Nutritional supplements may be needed to address deficiencies.
- Medication Therapy: First-line drugs include 5-aminosalicylic acid (5-ASA) agents like mesalamine. For moderate to severe cases, corticosteroids, immunosuppressants (e.g., azathioprine), and biologics (e.g., infliximab) may be prescribed.
- Surgical Intervention: In cases of severe complications like toxic megacolon or uncontrolled bleeding, surgical removal of the colon may be necessary.

Preventing Relapse and Maintaining Remission
While there's no cure for ulcerative colitis, several strategies can help prevent flare-ups and maintain long-term remission:

- Consistent Medication Use: Even during symptom-free periods, continuing prescribed medications under medical supervision is crucial.
- Healthy Eating Habits: A nutrient-rich, low-spice, easily digestible diet tailored to individual needs can minimize irritation.
- Stress Management: Psychological support and mindfulness techniques can reduce emotional strain and improve outcomes.
- Gut Microbiota Balance: Probiotics such as bifidobacteria and Clostridium butyricum help restore gut flora balance and promote healing.
- Regular Colonoscopies: Monitoring through periodic colonoscopies allows for early detection of complications, especially in high-risk patients.

Conclusion
Ulcerative colitis is a lifelong condition that requires comprehensive and continuous care. With proper treatment, dietary management, and regular medical follow-ups, most patients can lead active, fulfilling lives. Early diagnosis and adherence to treatment plans are key to minimizing complications and improving long-term prognosis.