I have been experiencing frequent bouts of diarrhoea and abdominal pain. I also noticed mucus when I passed a motion. My GP suspects I have ulcerative colitis. I am female and in my early 20s. What is this condition, and how is it treated?
Conventional remedy:
In ulcerative colitis, the colon, or lower part of the digestive system, becomes inflamed. It is an autoimmune-type condition, which means the bowel tissue becomes allergic to itself. The inflammation stops water from being absorbed from the stool, so it remains very liquid. The lining of the colon becomes ulcerated, causing the mucus you have experienced. These factors contribute to the pain and diarrhoea.
Women are more often affected than men, and although it can occur at any age, colitis usually begins during young adulthood. There is an increased rate of ulcerative colitis in some families, but a hereditary rather than an environmental cause has not been conclusively established.
Your doctor has referred you for a colonoscopy, which is carried out by passing a narrow flexible telescope through the anus to inspect the lining of the colon. Sometimes, a barium enema is also used to aid diagnosis.
In cases where the ulceration is confined to the rectum (ulcerative proctitis), it can usually be brought under control with steroid enemas. Oral medication such as sulphasalazine may also be used. These work by dampening the inflammation.
Mild to moderate ulcerative colitis is usually treated with steroid tablets, such as prednisolone, steroid enemas and an anti-inflammatory drug (mesalazine). When the colitis is shown to have settled in a follow-up scope, the steroids will be stopped, although the anti-inflammatory drug may be continued for some time.
Severe colitis may require admission to hospital, where fluids and nutrition are provided by intravenous drips, to rest the bowel. In rare cases, surgical removal of the colon may be required.
Depending on the severity of your colitis, you should start to improve within six to eight weeks. Long-term treatment with steroid drugs may cause side effects such as fluid swelling or weight gain.
Dr Muiris Houston
Alternative remedy:
Ulcerative colitis is an inflammatory disease of the mucosa of the colon, which may ulcerate and become infected. It usually occurs in young adults. There are periods of remission, which can last for weeks, months or years.
In Western medicine, the exact cause is unknown, but in traditional Chinese medicine ulcerative colitis can be of external or internal origin.
External causes include improper diet, food intolerances and mental stress, all of which can lead to a dysfunction of the spleen and stomach.
Ulcerative colitis may be brought about by prolonged exposure to these external factors, producing an internal weakness. However, an internal weakness may have been there regardless, due to a genetic predisposition to the illness.
Although the symptoms of the disease lie in the large intestine, the internal cause is generally due to an imbalance in the spleen.
According to traditional Chinese medicine, the symptoms reported indicate a diagnosis of damp heat in the large intestine.
The function of the spleen is to transport, distribute and transform nutrients and to promote water metabolism. When there is a spleen dysfunction, dampness and heat are generated, and both descend into the large intestine. The function of the large intestine is to transport the residues of digested food for excretion.
The presence of heat causes irritation of the inner mucosa of the colon, which in turn causes frequent peristalsis and diarrhoea. Dampness causes mucus to be present in the stools.
The aim of acupuncture is to tone up the spleen, eliminate dampness and heat and strengthen the constitutional weakness.
Treatment is aimed at reducing bowel frequency and pain. The insertion of needles into acupuncture points stimulates the release of endorphins, which reduce pain and inflammation, strengthen the immune system and promote a feeling of well-being.
Emer O'Donnell
Emer O'Donnell is a qualified nurse and acupuncturist. The Acupuncture Foundation of Ireland can be contacted on 01-8574040
patientquery@irish-times.ie