Ulcerative colitis (UC) is a chronic inflammatory bowel disease. It primarily damages the mucosal layer in the colon area. Its severity varies with the extent of the damage to the mucosal layer and affected areas.
In its most limited form, Ulcerative colitis is found in the distal rectum. Whereas in its most extended form, it affects the entire colon.
Usually, chronic inflammatory bowel disease is categorized into two diseases as Crohn’s disease and ulcerative colitis. These two variations differ per the symptoms. However, there are epidemiological, clinical, and therapeutic similarities between the two.
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Difference between Ulcerative Colitis and Crohn’s Disease
- UC is generally associated with episodes of recurrent attacks and with complete remission of symptoms in the interim. Crohn’s disease occurs more often with abdominal pain and perianal disease.
- UC is recognized by gastrointestinal bleeding, but Crohn’s disease is characterized by Cobble stoning mucosa and aphthous or linear ulcers.
- According to the radiographic studies, patients with Crohn’s disease normally show fistulas, asymmetry, and ileal involvement, but UC shows incessant diseases without fistulizing or ileal disease.
- Crohn’s disease shows mucosal discontinuity, transmural involvement, and granulomas. But, ulcerative colitis does not show like this. Crypt abscesses and granulomas are found in Crohn’s disease.
Primary Risk Group
Ulcerative colitis (UC) is an idiopathic inflammatory bowel disease. Both men and women get equally affected by this health problem. It has been found to be more common in developed or industrialized economies.
The primary reason for UC being a fast-paced lifestyle that leads to mental stress and prevents one from healthy eating.
The severity of the disease may also range from nominal to florid ulceration and dysplasia (abnormal growth of tissues, a stage preceding cancer). It may give rise to carcinoma. Some of the high probability of health complications observed with unmanaged UC are listed below:
- Arthritis and more specifically peripheral arthritis that affects joints such as knees and ankles
- Stomatitis – Stomach infections
- Steatosis – Liver Disease
- Blurred Vision and Conjunctivitis – Eye infections
- Urinary Tract Infections
The usual histological (microscopic) lesion of ulcerative colitis is the crypt swelling. In this case, the epithelium of the crypt breaks down and the lumen fills with polymorphonuclear cells.
With the destruction of the crypts, normal mucosal architecture is lost and resulting scarring shortens and it can make the colon slender.
Symptoms of Ulcerative Colitis
Ulcerative colitis symptoms can be different as it is dependent on the site and severity of inflammation. Most common symptoms are provided here:
- Diarrhea, often with blood or pus
- Rectal pain
- Rectal bleeding — discharge of small amount of blood with stool
- Abdominal pain and cramping
- Urgency to defecate
- Inability to defecate in spite of the urgency
- Weight loss
- Very slow growth will be observed in children
Ulcerative Colitis Classification per Site of Occurrence
Usually, most people with ulcerative colitis have mild to moderate symptoms. The symptoms of ulcerative colitis may vary, with some people having long periods of remission.
UC is usually classified according to its place of occurrence. Here are they.
This type of Inflammation occurs in the area next to the anus (rectum), and rectal bleeding may be the single sign of the disease. This form of ulcerative colitis is somehow mildest.
This inflammation involves the rectum and sigmoid colon (lower end of the colon). Symptoms are bloody diarrhea, abdominal cramps and pain, fail to pass the bowels despite the urge to do so (tenesmus).
It is severe which always affects the whole colon and passes bouts of blood in stool in the form of diarrhea. It also causes abdominal cramps and pain, fatigue, and significant weight loss.
Inflammation spreads from the rectum up through the sigmoid and descending colon. People suffer from bloody diarrhea, abdominal cramping, and pain on the left side, and quick weight loss.
Acute severe UC
This is a very rare form of colitis. It affects the entire colon and causes severe pain, more diarrhea, bleeding, fever, and inability to eat.
Causes of Ulcerative Colitis
There is no specific reason behind ulcerative colitis disease. Earlier, diet and stress were considered, but today doctors say that these may worsen the condition, rather genetics, the body’s own immune system, and the environment can cause UC.
It has been seen that around one-fifth of people with ulcerative colitis have a family history of the same disease. Though it can be hereditary, it does not happen always.
Environmental, Lifestyle, and Diet
Poor diet, air pollution, cigarette smoke, and unhygienic conditions may cause UC.
Auto-Immune System Disease
When the immune system of our body fails to fight a viral or bacterial infection, inflammation related to ulcerative colitis occurs. After this, our immune system goes on countering the ongoing inflammation.
Excess consumption of linoleic acid
Linoleic acid is a fatty acid found in red meat, several cooking oils, and some types of margarine. Research says that its excessive consumption can trigger UC.
Ayurvedic Treatment of Ulcerative Colitis
Ayurvedic treatment of UC is based on increasing the digestive strength and flushing toxins out of the system. Ayurvedic herbs and foods that ignite the digestive fire, enhance the assimilation of the food and remove Ama – toxins from the body.
It is believed that when the digestive fire is low, Ama or toxins are produced in the body. This unwanted waste or toxins leads to inflammation and hence resulting in symptoms of UC.
Generally, progression in digestion and absorption (Agni) increases the strength (Bala), complexion (Varna), and the bodyweight of the patient. Here are some herbs that help improve the condition.
Ayurvedic herbs for Ulcerative Colitis
- Aloe vera gel
- Tormentil extract
- Wheatgrass juice
- Curcumin (the active ingredient in Turmeric)
Nagaramotha and Indrayava: These drugs help reduce the frequency of bowel and also help to enhance the appetite. The Stambhana (stops bleeding) property of Nagakesara herb in the herbal mix helps to end blood in the stools.
Madhuyashti and Amalaki: These help in relieving the symptoms of heat intolerance, headaches, and blood in the stools due to their Pitta Dosha alleviation properties.
Dadimashtaka Choorna: It improves Pachana (digestion) and reduces the frequency of bowels. Due to its Pachaka (digestive), Shoolahara (pain relieving), and Vatanulomana properties (Vata Dosha alleviation), Shankha Bhasma eases Udara Shoola (abdominal pain) and Pravahana (bloating).
Mustarista and Dhanyapanchaka Kvatha: Both of the herbal pastes improve digestion and push the toxins out of the body. They ignite the digestive fire and improve the metabolism and absorption of nutrients.
Ahara and Vihara – Diet and Lifestyle practices
- One should stop Vata Dosha promoting foods. These include heavy, gaseous, and hard to digest foods such as beans, cabbage, dairy products, spicy foods, alcohol, and caffeinated drinks.
- Management of stress through relaxation techniques such as meditation, music, and massage.
- Avoid the consumption of processed foods. Processed foods contain allergens that would trigger inflammation and immune response.
- Avoid untimely meals – One should eat at a fixed time and in a fixed quantity. Following a routine helps to bring the Vata Dosha in balance.
- Eat foods and drinks that can help to flush toxins out such as juices, unctuous and hydrating fruits, and vegetables.
- Consume soft and easy to digest foods such as khichari and porridge.
- Include daily work out regime, preferably in the form of brisk walks or swimming. Do not carry out strenuous physical activity, as it will aggravate Vata, instead follow calm, relaxing, and toning activities in nature.
- Sip warm/hot teas such as cumin tea, fennel tea, and ginger tea.
- Consume flax seed and psyllium husk in the night.
- Stop smoking.
- Hydrate with water and natural drinks such as coconut water.
- Reduce and manage stress. Avoid stressful situations and triggers. Additionally, practice mindfulness through exposure to open and natural spaces, reading books, listening to music, pursuing healthy habits, disconnecting from the internet and social media, and by spending time with loved ones.
- Avoid large meals and start with small 4-5 meals instead of 3 big ones. More often than not large meals cause cramps and burden the digestive system.
- Limit the intake of milk or other dairy products.
- Increase physical activity such as yoga to strengthen abdominal muscles. Stronger muscles are able to handle cramps and gas much better.
Foods to Avoid
- Red peppers, green onions, red wine, wheat, and cow’s milk are some examples of foods that trigger IBS. If you want to get the same food value that provides the triggers, you can eat spinach, broccoli, turnip greens, yogurt, tofu, sardines, salmon with bones, calcium-fortified orange juice and bread, etc.
- Fried and greasy foods lead to the production of cholecystokinin hormone that induces contractions in the colon and hence making the pain or symptoms of Colitis worse.
- Avoid irritants such as caffeinated drinks – coffee and tea, Soda, Alcohol, and Nicotine.
- Avoid chewing gums, mint, and tobacco products that introduce excess air into the body through the digestive tract.