What is Ulcerative Colitis?
Ulcerative Colitis (UC) is a disease that causes persistent inflammation and sores in the large intestine. These sores usually contain mucus, and cause pain. Ulcerative Colitis is a defect of the immune system. The immune system mistakes food and safe bacteria for pathogens which ultimately increases inflammation.
Since the inflammation is chronic, patients often feel the need to go to the bathroom often, which is also associated with pain. Patients of ulcerative colitis often experience the following when going to the bathroom:
- Bloody stools
- Soft bowel movements
- Going to the bathroom often
- Cramps when going to the bathroom
These conditions, over time, cause patients to:
- Lose their appetites
- Lose weight
UC was thought to be caused by diet, but doctors are reconsidering this. Instead, they think the immune system may be more to blame. In order to best treat UC, an early diagnosis is preferred.
How is Ulcerative Colitis Diagnosed and Monitored?
To diagnose UC, a biopsy is taken. Biopsies include taking a small sample of intestinal tissue, and testing it to see if its cells are normal. Over 90% of abnormal tissue that forms with UC can be noticed during colonoscopy, without biopsy. Random biopsies can also be used to monitor patients with UC. However, a recent study shows that this may not be so useful.
The study aimed to assess how useful random biopsies were for patients with chronic UC. 1,010 biopsies taken between 1998 and 2008 were studied. Of those patients, 475 undergoing biopsy already had ulcerative colitis.
The results showed that:
- 88 of 1,010 colonoscopies were successful at showing abnormal cells
- Of those 88, only 8 were detected via random biopsies
- 75 biopsies detected abnormal cells because they were targeted at tissue thought to be abnormal
What does this mean for patients?
Random biopsies are not that useful. Ulcerative colitis is easy to see, so taking a random biopsy has a low chance of finding anything new. Secondly, the results show that only 8 out of 88 successful biopsies were conducted as random biopsies. It would be better to monitor UC patients and only take biopsies if the tissue appears abnormal.
Future studies should look into how to earlier detect abnormal cells in this disease.