Male1: Sometimes we hear this term colitis, like ulcerative colitis and Crohn’s disease, first of all, what is ulcerative colitis, is it a common thing?
Male2: Well let us start with the term colitis. If it is in everything ending in –itis, it means an inflammation, so colitis is inflammation of the colon, which is the last part of the intestine, it is like the swish of the intestine, really where the fecal matter is formed, organized and stored. So there are different reasons that a patient may have inflammation of the colon. A patient may have an infection for example. In the majority of these cases, the infection is transitory and may last for days or weeks, and then obviously, the inflammation may produce diarrhea, sometimes passage of mucus or blood in the stools and crampy abdominal pain.
The other condition that you are mentioning is ulcerative colitis. That is a chronic condition that is going to last for years. It is a condition that makes part of a group of diseases called inflammatory bowel disease and ulcerative colitis is a condition that we do not know exactly what is the cause of that problem, but probably is due to the interaction of some genetic factors, some environmental problems, probably certain bacteria maybe involved in that, some particular enhanced immunological and inflammatory response from the part of the host and the consequence of that is that the patient is going to have persistent inflammation of the colon.
Male1: If we suspect it, how do we diagnose it?
Male2: Well, again, medical history is going to be very important. Patients presenting with ulcerative colitis may have a history of a variety of problems. The common problems include abdominal pain; some recurrent, chronic episodes of abdominal pain or variable intensity. The patient may also have bouts of diarrhea with the passage of blood in the stools or mucus sometimes.
The common manifestations of these problems particularly in children are the consequences upon the growth of these patients. So patients with chronic inflammation may present with delayed in growth or with decrease in the weight.
Male1: What age usually is it diagnosed by?
Male2: When this condition of ulcerative colitis and the other conditions that belongs to inflammatory bowel diseases called Crohn’s disease, typically have their peak in the second and third decade of life, but certainly, we have diagnoses by the gastroenterologists, deconditions very early in life, in the first, second or three years of life.
Male1: And if we do suspect it, we make a diagnosis, is it treatable?
Male2: Yes, certainly, the diagnosis is going to involve a series of tests, including the x-rays and endoscopies and taking biopsies, and yes, the condition can be treated with different products to decrease the inflammation. The first goal of the treatment is to subside the symptoms so that they are very acute and produce a tremendous discomfort of the patient like the diarrhea, the pain, and all of these types of complications and certainly, once that we improve the flare up of the colitis and commonly, we give the patients are medications in order to maintain the remission of the condition.
Male1: Do they end up with surgery sometimes?
Male2: Occasionally, the patient may need surgery. One of the complications of ulcerative colitis is massive unstoppable bleeding and when that occurs, the condition maybe severe that the patient is requiring blood transfusions and if the problem persists despite all of our efforts with the medical treatment, certainly the patient may need colectomy. In other words, resecting the colon of the patient.
Another interesting aspect of the surgical treatment for ulcerative colitis is that ulcerative colitis is a condition limited to the colon of the patient. Therefore, later on in life, we tend not to do that in the pediatric age group, but in the adult age, the patient may have removal of the colon and then being cured of the disease. It is important also to take into account the fact that one of the potential complications of ulcerative colitis are long term is the possibility of the presence of malignancies in the colon and therefore, the importance eventually of considering the surgical treatment with colectomy subsequently in life, but this is again, a decision that for the most part, we, the pediatric gastroenterologists in the age group of patients that we treat, we do not have to do.
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