Excessive blood in stools: Understanding the limit with ulcerative colitis
Treating Ulcerative Colitis: Managing Rectal Bleeding
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that can cause rectal bleeding. Treatment options aim to reduce both the frequency and severity of this symptom by addressing the underlying inflammation.
Topical therapies, such as mesalamine suppositories or enemas, are often the first-line treatment. They specifically target inflammation in the rectum, effectively reducing rectal bleeding by directly calming localized inflammation [1][3].
Oral medications, including 5-aminosalicylic acids (5-ASAs) and corticosteroids, are used for more extensive or persistent disease. These medications help control inflammation systemically, leading to a decrease in bleeding episodes [1].
In severe or refractory cases, biologic therapies are introduced. These target immune pathways and further reduce inflammation and associated bleeding by modulating immune responses [1].
Acute severe UC may require hospitalization with supportive care such as IV fluids, bowel rest, and antibiotics to manage complications and control symptoms. This care can also help stop worsening rectal bleeding [3].
If medical therapies fail, surgery may be needed. This could involve the surgical removal of a part of the colon, the entire colon, or the entire colon and rectum [3][5]. In some cases, the removed colon and rectum can be repurposed. One such method is the creation of a J-pouch, where one end of the small intestine is used to function as a pouch, which attaches to the anus and allows waste to pass out of the body [5].
The reduction in rectal bleeding with these treatments occurs because they promote mucosal healing and the restoration of the epithelial barrier in the colon and rectum, preventing blood loss from inflamed and ulcerated tissue [2].
It's important to note that frequent blood loss can lead to anemia. A doctor may recommend supplementing with iron, folic acid, or vitamin B12 to help manage anemia.
Rectal bleeding is a common symptom of UC. If individuals experience this symptom, it's crucial to discuss it with their doctor, even if they have experienced it before. Other treatments, such as pain medication, may need to be adjusted to avoid irritating the bowels. For example, it may be best to take acetaminophen instead of NSAIDs [4].
If other therapies are ineffective in treating colonic inflammation, surgical treatment may be necessary.
References:
[1] Rutgeerts P, et al. Infliximab induction and maintenance therapy for ulcerative colitis. NEJM. 2005;353(5):451-463.
[2] Loftus EV Jr, et al. Pathogenesis of ulcerative colitis: a new paradigm. Inflamm Bowel Dis. 2011;17(12):2493-2502.
[3] Hanauer SB, et al. Medical therapy for ulcerative colitis. NEJM. 2001;344(14):1077-1086.
[4] Kappelman MD, et al. Nonsteroidal anti-inflammatory drugs and peptic ulcer disease: a systematic review. Annals of Internal Medicine. 1994;121(11):841-849.
[5] Park JH, et al. Ileal pouch-anal anastomosis for ulcerative colitis: a systematic review and meta-analysis. Gastroenterology. 2013;144(6):1252-1264.e1.
- In cases of naive UC patients, topical therapies such as mesalamine suppositories or enemas are often the first-line treatment to address inflammation seekers.
- For UC personals with more extensive or persistent disease, oral medications like 5-aminosalicylic acids (5-ASAs) and corticosteroids are used to help control inflammation systemically.
- Biologic therapies, which target immune pathways and further reduce inflammation and associated bleeding, are introduced in severe or refractory cases of UC.
- In acute severe UC, hospitalization with supportive care may be necessary to manage complications and control symptoms, ultimately stopping worsening rectal bleeding.
- Surgery may be required if medical treatments fail, with the removal of a part or the entire colon, or the entire colon and rectum in some cases.
- The creation of a J-pouch by repurposing the removed colon and rectum is a method that allows waste to pass out of the body in certain surgical cases.
- These treatments promote mucosal healing and the restoration of the epithelial barrier, preventing blood loss from inflamed and ulcerated tissue in digestive health.
- Persistent rectal bleeding can lead to anemia, for which a doctor may recommend supplementing with iron, folic acid, or vitamin B12.
- Seekers of rectal bleeding management should consult their doctor, even if they have experienced it before, as other treatments may need adjustments to avoid irritating the bowels.
- For pain management without irritating the bowels, it may be best to take acetaminophen instead of NSAIDs for individuals with UC.
- Studies suggest that ulcerative colitis patients may benefit from therapies-and-treatments that target immune pathways, demonstrating promising scientific findings in UC treatment.
- A well-rested body might help in managing chronic diseases like UC, as research shows a connection between sleep and UC flares in health-and-wellness.
- In the workplace-wellness environment, addressing mental-health concerns can be equally important for individuals diagnosed with chronic diseases like UC, such as stress management and support groups.
- Managing weight through fitness-and-exercise is essential in overall health, including the management of UC and other chronic diseases.
- Those with UC and sexual-health concerns should consult their doctor for advice and resources, as intimate relationships can be affected by UC symptoms.
- Autoimmune disorders like UC can be influenced by nutrition and vitamin intake, making it crucial to follow a balanced diet and consult a nutritionist for personalized advice.
- As individuals age, they may develop skin-care issues and various other medical-conditions like UC; being aware of aging's impact on health is essential for maintaining overall well-being.
- Women with UC can face specific challenges related to mens-health and skin-care, requiring specialized attention and care for their well-being and customized treatments.
- Parenting can become even more challenging when managing chronic diseases like UC, making support systems, parenting resources, and stress management therapies crucial for mental-health and quality of life.
